Objective To examine the ability of cancer metastasis to lymph nodes by study of the h(?)o,(?)thology of early gastric cancers. Methods Eighty-one cases of early gastric cancers with lymph node(?)etastasis were used as metastatic group. Another randomly selected 81 cases of early gastric cancer without lymph node metastasis were used as control group. Both groups consisted of 11 cases of intramucosal cancer and 70 cases of submucosal cancer. The location of cancers in tissue was further classified as two categories; the superficial lesions and invasive fronts. In addition, the gastric cancers were hislopathologically divided into three subtypes: differentiated, undifferentiated and the mixed type. The histopathological classification and location of cancers in tissue were similar between the two groups. Results In metastatic group, 40. 7% of the cancer revealed lower differentiation in invasive fronts, much higher than 11.9% in control group (P

221 subjects at risk for MS were enrolled and evaluated.The discovered mean number of MS components was little greater by IDF definition than by CDS one(2.33 vs 2.09,P>0.05).The concordance rate of both definitions was 80% in diagnosing MS.The female MS prevalence was higher by IDF (18/83) than by CDS (2/83)(P<0.05).But male MS prevalence was higher by CDS (18/138) than by IDF (7/138) (P<0.05).In those with normal glycaemia, more individuals were diagnosed to have MS by IDF definition (21/94,22.3%) than by CDS one (10/97,10.3%)(P<0.05).Of people with MS diagnosed on CDS definition, 11 (12%) were non-obese.Finally, 6% MS people was missed by IDF definition due to neglecting postprandial-challenge glycemia.In conclusions, the two definitions are comparable in identifying MS and its components, while from CDS to IDF definition some MS people drift in the way as follows: from men to women, from dysglycemia to abnormal fat metabolism, and from non-obesity to obesity.

Objective To investigate the relationship of glycaemia level and the artery stiffness by means of ultrasonography. Methods Among the individuals selected for screening for impaired glucose tolerance, the systolic and diastolic diameters of both common carotid arteries in a single cardiac cycle, and the intima-media thickness were measured. Based on these measured parameters the artery compliance (AC), stiffness index and Yang's elastic Model (YEM) were calculated. Both fasting blood sugar level and that of 2 hours after 75g glucose challenge were quintiled so as to compare the arteriosclerosis surrogates. Linear correlation and partial linear regression were used to analyze the relationship of both fasting and post-challenge blood sugar levels with the three surrogates. Finally, those surrogates were also compared among different glucose tolerance categories. Normal glucose tolerance (NGT, n=97), impaired glucose tolerance (IGT, n=51) and type 2 diabetes mellitus (T2DM, n=73) were classified by the previous results of 75g oral glucose tolerance test. Results The AC decreased, and SI and YEM elevated significantly after the third quintile of fasting glycaemia, while the similar changes were found after the fourth quintile of 2 hour glycaemia. Both fasting and post-challenge glycaemia correlated inversely with AC and positively with SI and YEM. Partial correlation analysis showed that the significance of the correlation of fasting glucose with the arteriosclerosis surrogates disappeared but that of post-challenge glucose with those surrogates remained. In different categories of glucose tolerance, AC decreased but YEM rose significantly in IGT and T2DM when compared with NGT. The SI of T2DM was higher than of NGT. However the three surrogates remained similar between IGT and T2DM. Conclusions Artery stiffness was enhanced with the increase in fasting or post-challenge glycaemic levels. Post-challenge glycaemia was a better determinant than fasting glycaemia. The degree of arteriosclerosis in IGT was higher than that in NGT, but was similar to that of T2DM.

objective To investigate the clinicopathological features of mini-cancer of the stomach. Method In this study,out of 296 early gastric cancer cases there were 34 cases of early gastric cancer in which tumor diameter was≤10 mm,among those there were 5 cases with tumor size≤2 mm and 29 cases of the size 2～10 mm. Result Mini-cancer accunted for 2% of all early gastric cancers in this series:All these mini-cancers were of intramucosal cancer(100%),while that took up to 45%in control group in which tumors were between≥2 mm and≤10 mm:Tumors were high or moderately differentiated pathologically in 100%of mini-cancers and 55%in control group.None of mini-cancer patients had lymph node metastasis,however,1 of 29 patients in control group had lymph node metastasis.Both groups had no blood vessel and lymphatic vessel invasion:The differentiation concordance rate between superficial lesions and invasive fronts in mini-cancer was 100%,higher than 86%in control group. Conclusion Gastric mini-cancer is usually of high differentiation,low tumor invasion and low rate of lympy node metastasis than control group.Endoscopic therapy is applicable for most gastric mini-cancers.

Objective To study the clinical features of the ectopic ACTH syndrome in order to increase the early diagnostic rate. Methods Clinical features and imaging diagnosis of 8 consecutive patients with ectopic ACTH syndrome were described and laboratory data were compared with those of 16 consecutive patients with ACTH-dependent Cushing′s syndrome accompanied with hypokalemia. Results The ectopic ACTH syndrome occurred in 11.3% of all patients with Cushing′s syndrome and the common causes were lung cancer and bronchial carcinoid. The clinical features of the ectopic ACTH syndrome differ from those of ACTH-dependent Cushing′s syndrome. Ectopic ACTH syndrome occured predominently in men and showed the duration of symptoms less than 5 months and a more rapid clinical course. There were apparent muscle weakness, edema of lower extremities, higher plasma ACTH and free cortisol (F), severe metabolic alkalosis and more negative responses to the high dose of dexamethasone suppression test. Chest X-rays and CT were helpful for tumor localization. The prognosis depended on whether the tumor was malignant or benign, and complete surgical resection of tumor was the key treatment. Conclusion Ectopic ACTH syndrome could be distinguished from the ACTH-dependent Cushing′s syndrome with hypokalemia according to the clinical features, laboratory data, plasm ACTH and F levels, as well as chest X-rays and CT.

Objective To understand the distribution of pathogenic genes in uropathogenic Esche-richia coli (UPEC) from urinary specimen and to analyze the pathogenicity of UPEC and their mechanism of apoptosis to HeLa cells. Methods We have analyzed 6 pathogenic genes among the 28 strains of the clini-cally isolated E. coli from urinary tract infected patients. The 6 pathogenic genes were surveyed by using the PCR amplification of the target genes. The adhesion experiments and tryphan-blue staining was used to screen the phenotype of the pathogenic strains, while Annexin V/PI method was applied to study the strains to cause apoptosis of the HeLa cells, which was further confirmed with electronic microscopy. Results We have detected 6 strains that carried the usp gene. Phenotype screening identified two high virulent isolates (strain 6N and 27N) from the 6 strains. Strain 27N and 6N contained very similar virulence gene profile ex-cept that strain 27N did not contain usp gene. Both strains can destroy HeLa cell within 3 hours causing cell death. Results of apoptosis detected by flow cytometry revealed that strain 6N induced 20.75% of HeLa cells to an early stage apoptosis within 1.5 hours. On the other hand, strain 27N induced only 1.55% of HeLa cells to apeptosis. Conclusion High virulent UPEC strain carrying usp gene can induce HeLa cell rapid early apoptosis.

Objective To investigate the clinical effect of modified storage type of autologous blood transfu-sion combined with shed blooding retransformation technique after OrthoPAT for artificial total knee arthroplasty. Methods 70 patients with total knee replacement were randomly divided into observation group and control group, 35 cases in each group.The observation group was treated with the modified storage autotransfusion combined shed blooding retransformation technique after OrthoPAT,while the control group was given conventional allogeneic blood transfusion.The hemoglobin values and blood coagulation function of the two groups at immediately before anesthesia and surgery,10min before autologous blood transfusion and after reinfusion of 15min,after 6h and 24h of surgery were recorded,and the drainage blood total value,allogeneic blood transfusion measurement issues and transfusion rate after 24h were recorded.Results The hemodynamics of the two groups were stable at each time,there were no difference at urine volume (all P >0.05).The coagulation conditions were normal of the two groups at each time,there were no statistically significant differences between the two groups (all P >0.05).The average volume and homologous blood transfusion rate in the observation group were (126.3 ±6.5)mL,1 /35,which were significantly lower than those in the control group [(476.4 ±10.6)mL,2 /35],the differences were statistically significant (t =10.73,χ2 =6.31,all P <0.05).The incidence rate of postoperative complication of the observation group was 5.7%,which was signifi-cantly lower than 22.9% of the control group,the difference between the two groups was statistically significant (χ2 =4.93,P <0.05).Conclusion The improved storage type of autologous blood transfusion combined with shed bloo-ding retransformation technique after OrthoPAT has exact effect for artificial total knee arthroplasty,the incidence of adverse reactions is low,as well as the low blood transfusion rate.

Objective To study the effect of total knee arthroplasty after limb position on postoperative hemorrhage,to provide basis for clinical diagnosis and treatment.Methods 270 cases of total knee arthroplasty were selected.The patients were divided into groupⅠ,group Ⅱand group Ⅲ according to the random number table method, 90 cases in each group.Patients of group Ⅰ with limb hip and knee were straight,group Ⅱ hip joint elevation of 45 degrees,70 degrees of knee flexion,group Ⅲ hip joint elevation of 45 degrees,the knee extension.All the patients were intervened for 12h after operation,were placed drainage bag 24 hours.The lead flow,preoperative,postoperative hemoglobin and 5 days after the knee joint activity were compared in the three groups.Results Induced flow after surgery in group Ⅰ was (433.4 ±25.3)mL,which was significantly higher than (402.6 ±19.6)mL and (403.5 ± 21.5)mL in group Ⅱand group Ⅲ,and the differences were statistically significant (t =5.253,5.301,all P <0.05),there was no significant difference of induced flow between groupⅡ and group Ⅲ(P >0.05).The hemoglobin levels of the three groups were (92.3 ±4.2)g/L,(114.9 ±6.4)g/L and (113.2 ±7.5)g/L,which were significantly decreased after operation,the differences were statistically significant compared with before operation (t =5.083, 6.034,7.893,all P <0.05),the hemoglobin after surgery of group Ⅰ was significantly lower than group Ⅱ and groupⅢ,the differences were statistically significant (t =6.423,7.043,all P <0.05),there was no significant difference between group Ⅱ and group Ⅲ (P >0.05).There was no significant difference of range of motion in the three groups after 5 days of operation (P >0.05).Conclusion Hip flexion can effectively reduce bleeding after total knee arthro-plasty,the flexion and extension of knee joint had no significant effect on postoperative hemorrhage.

Objective To explore the risk factors in post-polypectomy hemorrhage in rectum and to discuss the appropriate interventions.Methods A total of 313 patients with 373 polypi were included in this study. The clinical data were analyzed by SPSS 16 software. Results There were 313 patients with colorectal polypus curatively resected and 373 polypi in total.There were 11 (3.5％) patients subjected to post-polypectomy hemorrhage in rectum.Regression analysis showed that the independent risk factor of postpolypectomy hemorrhage in rectum was the hypertension of patients (P ＜ 0.01 ) and this hemorrhage had no significant correlations with patientg'ender,age,size of polypus,pathological characteristics and the methods of polypectomy.Conclusions Hypertension of patients is an independent risk factor in post-polypectomy hemorrhage.

Objective To study the differences of clinical and histopathologic features between ischemic colitis (IC) and ulcerative colitis (UC), which can make for the differential diagnosis and treatments. Methods Comparative analysis were focused on the clinical and histopathologic data of IC patients (20 cases) and UC patients (30 eases). Results The onset duration of IC [(5±7) d] was significantly shorter than that of UC [(953±1354) d]. IC patients tended to have history of cadiovascular diseases or abdominal surgery (65%). The typical clinical manifestations of IC were sudden onset of abdominal pain (85%), hematochezia (60%)and diarrhea (50%), but UC usually presented with abdominal pain (83%), diarrhea (63%), bloody mucopurulent stool (57%) and tenesmus (20%). Colonoscopy showed longitudinal ulceration (60%)on the mesenteric side, the segmental lesions usually involved only 1/4-1/2 of the perimeter of the lumen (80%), and the boundary of lesions was clear (75%) in IC patients. On the contrary, the ulcer of UC was usually map-like (43%), the lesions usually involved the entire lumen (90%), and the pseudopolyp (37%) was another colonoscopic feature of UC. The histopathologic study revealed that dilation and hyperaemia of vessels (90%) were common in IC. Severe edema of mucosa (95%) was usually presented in IC, and the thickened vascular wall (50%) was the histopathologic characteristic of IC.Crypt abscesses (47%) usually appeared in UC. Conclusions The histopathologic characteristics and differences of colonoscopic findings and clinical features provide strong bases for the differentialdiagnosis between IC and UC.