Objective To study the effect of applicaton of the implanted artificial defecation control device (IADCD) in patients with lower rectal cancer. Methods The "radical resection aiming at achieving automatically controlled defecation" was performed in 32 patients with lower rectal cancer, On the basis of Mile's operation, the IADCD was implanted in those patients. Postoperatively, the defection control, psychological effect of the defecation mode on the patients, complications and adverse effects were observed. Results In treatment group (32 cases), satisfactory defecation control was achieved in 31 cases 1 month after the operation, and in another case 2 month after operation, and no obvious complications and untoward effects. In control group(16 cases), 8 cases had 1～2 times formed stool 3 months after operation, 4 cases achieved 6 months after the operation. Conclusions For patients with lower rectal cancer, the "radical resection aiming at achieving automatically-controlled defecation" could achieve the complete resection of lower rectal tumor and near to normal defecation without obvious untoward effects.

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Endothelial leukocyte adhesion molecule -1 ( ELAM -1 ) is a member of the cell adhesion molecules,which plays a great role in the distant metastasis of tumor in ligand interactions between sLe (x)and sLe(a).Recently,it becomes a new research hotspot on applying ELAM -1 in targeted cancer therapy.Many studies results show that by regulation of ELAM -1 in biological effects ,such as ELAM-1 and ligand inhibitors , monoclonal antibody ,targeting gene ,and other mediates of the path of blocking therapy ,thereby inhibiting or bloc-king tumor distant metastasis ,so as to achieve the purpose of tumor therapy and improve the prognosis .Therefore , ELAM-1 is expected to exert a critical role in the tumor targeted therapy .In this paper ,the application value of ELAM-1 in tumor related targeted therapy is reviewed .

Objective To evaluate the diagnostic value of high frequency ultrasound in sebaceous gland carcinoma of eyelid (SC).Methods The ultrasonic characteristic for 11 cases with eyelid SC were respectively analyzed by using 13 MHz high frequency ultrasound and 22 MHz ultra-high frequency ultrasound.Results Through 13 MHz high frequency ultrasound,in 7 patients who exhibited Pagetoid invasion the lid shin thickness of tumor side displays no significant alteration in a comparison with normal side.Furthermore,the color Doppler flow imaging (CDFI) evealed a branch-like blood flow surrounding the masses in all cases,but the blood flow of seven patients with Pagetoid invasion had no difference compared with the healthy side.On 22 MHz ultra-high frequency ultrasound examination,slit-like low echo was found in 9 ;transition zone of tumor infiltration can be identified in 9 ; the echo of tumors with Pagetoid invasion was lower than the healthy side and the skin thickness of tumors with Pagetoid invasion was thicker (0.6 ±0.1) mm than the healthy side.CDFI revealed that mesh-basket like blood flow was rich in all patients,the small branch blood vessels arrived at subcutaneous,and vasa vasorum were found in some patients.The region with Pagetoid invasion was rich in blood flow.The sonography findings on 13 MHz and 22 MHz high frequency ultrasound examination were compared with chisquare test.There were significant differences on homogeneous echo,slit-like low echo,transition zone of tumor infiltration,infiltration skin thickness,blood distribution,central blood vessels,vasa vasorum,blood flow in the region with Pagetoid invasion (x2 =12.571,15.231,15.231,4.701,22.000,15.231,4.899,10.267,P＜0.05).Conclusions Slit-like low echo in the mass is a main finding of eyelid sebaceous gland cercinoma on the 22 MHz ultra-high frequency ultrasound.The ultra-high frequency ultrasound can accurately reveal the skin depth infiltrated by the eyelid sebaceous gland cercinoma and this method can provide solid guidance for clinical treatment strategies.

Objective To compare the clinical curative effect and the pros and cons of microwave intracavitary minimally invasive treatment and traditional operation for varicose veins in lower extremities.Methods(Treatment) group:The varicosities of greater saphenous vein were treated by microwave coagulation intracavitary treatment together with injection coagulation treatment of its tributaries. Control group:The varicosities of(greater) saphenous vein were treated by traditional operation.Results Treatment group was better than control group in improvement of symptoms,cosmetic effect of diseased limb,operation time,amount of blood loss,length of hospital stay,and complications of operation.Conclusions Microwave coagulation intracavitary treatment of varicose veins in lower extremities has more advantages,such as minimally invasive,little pain,quick recovery,good cosmetic effect,better result,fewer complications,and simplicity of operation.

Plasma nesfatin-1 levels were assayed by ELISA in patients with impaired glucose regulation (IGR),type 2 diabetes mellitus( T2DM ),and healthy subjects with normal glucose tolerance( control group).The results showed that plasma nesfatin-1 levels in IGR and T2DM groups were significantly higher than that in control group [ ( 1.91 ±0.79 and 1.80±0.80 vs 1.41 ±0.58) μg/L,P＜0.01 ].Plasma nesfatin-1 levels were positively correlated with body mass index(BMI),HbA1c,waist hip ratio,fasting plasma glucose,fasting insulin,and homoestasis model assessment insulin resistant index( HOMA-IR,P＜0.05 or P＜0.01 ).Multiple regression analysis showed that BMI and HOMA-IR were independent related factors in influencing plasma nesfatin-1 levels (both P＜0.01 ).These results suggest that nesfatin-1 may partially contribute to the pathogenesis of insulin resistance and T2DM.

Objective:To investigate whether pORF5 plasmid protein of Chlamydia trachomatis(Ct) induces 1L-1βand 1L-18 production in THP-1 cells,and its potential molecular mechanism.Methods:pORF5 plasmid protein was used to stimulate THP-1 cells at different concentrations(0,3,6,12,24,36 μg/ml),then the inflammatory cytokines IL-18 and IL-1βwere detected by ELISA at the time of 0,8,16,24,36 h;The mRNA expression of NALP3 inflammasome were detected by Realtime-PCR,and Caspase-1 activity was determined by Western blot analysis.THP-1 cells were transfected with siRNA targeting NALP3 and ASC gene for 24 h or pretreated with Caspase-1 inhibitor(Z-YVAD-FMK) for 30 min,and subsequently stimulated with pORF5(24 μg/ml) for 24 h,then secretion of IL-1βand IL-18 were analyzed by ELISA.Results: The pORF5 plasmid protein induced THP-1 cells to secrete IL-1βand IL-18 by dose-and time-dependent manners,production of IL-1βand IL-18 reached their peaks(491 pg/ml and 186 pg/ml) at concentration of 24 μg/ml,and the peak amount of IL-1βand IL-18 occurred at 24 h and 16 h post-stimulation respectively.pORF5 plasmid protein in-creased mRNA expression of NALP3 inflammasome and activated Caspase-1 in THP-1 cells.NALP3 siRNA,ASC siRNA and Z-YVAD-FMK reduced pORF5-induced IL-1βand IL-18 production when compared with control groups(P<0.05).Conclusion:pORF5 plasmid protein could induce THP-1 cells to produce IL-1βand IL-18 through NALP3 inflammasome activation,which may play an important role in the pathogenesis in Ct infection.

OBJECTIVETo study the chemical constituents of aerial parts of Ammopiptanthus mongolicus.

METHODIsolation and purification were carried out on silica gel, Sephadex LH-20 and HPLC column chromatography. The structures of the compounds were identified by physico-chemical properties and spectral analysis.

RESULTNine compounds were isolated and identified as (+)-maackiain (1), brevifolin (2), 7-hydroxy-4'-methoxy isoflavanone (3), daidzein 4',7-diglucoside (4), genistein 4', 7-di-O-beta-D-glucoside (5), isolupalbigenin (6), ononin (7), beta-sitosterol (8), beta-daucosterol (9).

CONCLUSIONCompounds 2, 4 - 6 were obtained from the genus Ammopiptanthus for the first time.

Chromatography, Agarose ; methods ; Chromatography, High Pressure Liquid ; methods ; Fabaceae ; chemistry ; Glucosides ; chemistry ; isolation & purification ; Isoflavones ; chemistry ; isolation & purification ; Plant Extracts ; chemistry ; isolation & purification ; Plant Leaves ; chemistry ; Pterocarpans ; chemistry ; isolation & purification ; Silica Gel ; Sitosterols ; chemistry ; isolation & purification ; Taxoids ; chemistry ; isolation & purification

OBJECTIVETo study the clinicopathological features and prognosis of renal cell carcinoma with sarcomatoid differentiation (RCCS).

METHODSThe clinical data and pathological materials of 18 RCCS cases were retrospectively reviewed.The follow up data were available in 13 RCCS cases, and were compared with the follow up data of 20 cases of clear cell renal cell carcinoma (RCC).

RESULTSThe 18 RCCS patients included 14 males and 4 females, and were 49-79 years old (mean age: 62 years old). On gross examination, the tumor size was 3-19 cm in diameter (mean diameter: 9.8 cm). Histologically, all tumors were composed of a mixture of typical RCC with sarcomatoid component, including 9 clear cell RCC, 3 chromophobe RCC and one papillary RCC. The sarcomatoid components included 9 cases of fibrosarcoma, 3 cases of leiomyosarcoma, 5 cases of malignant fibrous histocytoma and one case of undifferentiated sarcoma. Immunohistochemistry showed that the sarcomatoid components were strongly vimentin-positive in 18 cases, and one or more epithelial markers (EMA, AE1/AE3, CK7, CK18) were expressed to varying degrees in 14 cases, but the high-molecular weight keratin 34βE12 was scarcely expressed. The sarcomatoid components presented positive expressions of CAIX in 88.9% (16/18) and CD10 in 72.2% (13/18) cases. Among the 18 RCCS patients, 13 patients were followed-up: 9 patients died in 1-25 months after the surgery, of which 5 cases died of lung or bone metastasis, and 4 patients died of systemic failure. The twenty RCC cases without sarcomatoid differentiation were followed up for 3-65 months after the surgery, and the majority of them was alive uneventfully except for 2 cases who died of lung or bone metastasis of the tumor. The Kaplan-Meier survival analysis showed that the median survival time of the 18 RCCS patients was 8 months, while that of the 20 RCC cases without sarcomatoid differentiation was 62 months (P<0.001).

CONCLUSIONSThe presence of sarcomatoid differentiation in renal cell carcinoma indicates highly aggressive behavior and poor prognosis. The positive expressions of the immune markers CAIX and CD10 may play important roles in the transformation from renal cell carcinoma to sarcomatoid component.

Aged ; Biomarkers, Tumor ; metabolism ; Carcinoma, Renal Cell ; metabolism ; mortality ; pathology ; Female ; Humans ; Immunohistochemistry ; Kaplan-Meier Estimate ; Kidney Neoplasms ; metabolism ; mortality ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Sarcoma ; metabolism ; mortality ; pathology ; Tumor Burden

Objective To determine the expression of cathepsin L2 (CTSL2)and evaluate its activity in skin lesions of seborrheic keratosis (SK),to observe the ultrastructural changes of melanosomes in the skin lesions of SK,and to estimate the effect of CTSL2 on the degradation of melanosomes.Methods Twenty patients with SK were enrolled from the Department of Dermatology,Renmin Hospital of Wuhan University.The lesional tissue and the perilesional normal skin were biopsied from each patient.Among 15 of the 20 patients,hematoxylin and eosin (HE)staining and Fontana-Masson silver staining were performed to observe the distribution of melanin granules,transmission electron microscopy (TEM)was conducted to observe the ultrastructural changes of melanosomes,and immunohistochemical staining was performed to estimate the cellular proliferative activity.RT-PCR and fluorogenic substrate cleavage assay were performed in the other 5 patients to determine the mRNA expression of CTSL2 and evaluate its activity,respectively.Sucrose density gradient ultracentrifugation was performed to isolate and purify melanosomes from the retinal pigment epithelium (RPE) harvested from a discarded eyeball of a 35-year old male patient with informed consent.The purified melanosomes were incubated with epidermal lysates of SK lesions,and TEM was used to observe the changes in the membrane structure of melanosomes.Statistical analysis was carried out by paired t test,and a P value ＜ 0.05 was considered statistically significant.Results A large number of melanin granules were deposited in SK lesions,while the linear deposition of melanin granules was only seen in the basal layer of the normal skin.TEM showed that the percentage of damaged melanosomes was much higher in the normal skin (49.00％ ± 4.00％) than in the SK lesions (24.33％ ± 3.06％)(t =8.49,P ＜ 0.05).RT-PCR revealed that the mRNA expression and activity of CTSL2 were both significantly lower in the SK lesions than in the normal skin (mRNA:0.35 ± 0.09 vs.0.43 ± 0.08,t =3.17,P ＜ 0.05;activity:17.46 ± 0.45 vs.28.78 ± 0.58,t =34.29,P ＜ 0.05).Moreover,TEM also showed that the percentage of damaged melanosome was lower in the SK lesion lysate-treated group (32.33％ ± 4.93％) than in the normal skin lysate-treated group (43.00％ ± 2.65％,t =3.30,P ＜ 0.05).Conclusion Decreased expression of CTSL2 in the SK lesions can affect the degradation of melanosomes by keratinocytes.However,whether CTSL2 directly takes part in the pathogenesis of SK or not is still needed to be further confirmed.