Objective To investigate and evaluate serum level of heparanase in diabetic patients with acute coronary syndrome.Methods Forty-six diabetic patients with acute coronary syndrome(ACS) were enrolled as DM+ACS group,as well as,52 patients with ACS were studied as ACS group,27 diabetic patients as DM group,and 28 health volunteers served as normal control group.CRP,MMP-9 and heparanase in serum were measured with ELISA.The receiver operating characteristic curves of CRP,MMP-9 and heparanase were produced and the cutoff values were determined.Results The serum level of heparanase was significantly higher in DM+ACS group than in the ACS group,DM group and normal control group.The areas under the curve(AUC) of ROC were 0.941,0.813 and 0.967 respectively.Significant difference of AUC were observed between groups.The serum level of heparanase was significantly higher in DM+AMI subgroup than in DM+UAP subgroup.Conclusion Serum heparanase is related with the development of acute coronary syndrome in diabetic patients.Serum heparanase can be used as a more effective serological indicator for the plaque destabilization and rypture in diabetic patients than CRP and MMP-9.

Objective:To used the internationally accepted methods of CT quality assurance for testing their quality, to maintain the normal operation of CT scanner and guarantee the quality of photographic image.Methods: Toshiba Activion 16 row CT, set the scanning conditions: tube voltage 120 kv, 310 mas exposure, scan time is 0.33 s, scanning layer thickness: 10 mm, 5 mm, 1.5 mm, view(FOV) 150 mm×150 mm, 512 x 512 reconstruction matrix. We measured the following performance parameters for CT spatial resolution, low contrast resolution,uniformity and noise with Catphan500 phantom made by the phantom laboratory of U.S.A.Results: The spatial resolution, low contrast resolution, uniformity and noise of the CT are all in line with the requirements. Obtained by detecting the X-ray dose, pixel, the thickness of the above parameters are affected, but also the interaction between the above parameters simultaneously.Conclusion: By detecting the spatial resolution, low contrast resolution of medical image, we can effectively guarantee system performance, maintaining optimal image quality.

Obesity is rapidly becoming a pandemic and is associated with increased carcinogenesis,especially hepatocellular carcinoma (HCC).Adipose tissue has been considered as an endocrine organ because of its capacity to secrete a wide variety of adipokines,such as leptin,adiponectin and resistin.Recently,adipokines have been demonstrated to be associated with many kinds of chronic liver diseases,liver fibrosis and cirrhosis,and carcinogenesis.Direct evidence supporting the inhibitory and/or activating role of adipokines in the process of carcinogenesis and progression of human HCC has been rapidly accumulating. This review aims to provide important insights into the potential mechanisms of adipokines in the development of HCC.Further investigations will shed light on a new therapeutic target in HCC.

Obesity has rapidly become a pandemic and is associated with increased carcinogenesis, especially esophageal adeno-carcinoma (EA). Adipose tissue is considered an endocrine organ because of its capacity to secrete a variety of adipokines, such as leptin, adiponectin, and resistin. Adipokines have recently been found to be associated with different types of chronic esophageal diseas-es, including gastro-esophageal reflux diseases, Barrett esophagus, and carcinogenesis. First-hand evidence supporting the inhibitory and/or active function of adipokines has been collected on human EA. This review aims to provide important insights into the potential mechanisms of adipokines in EA progression.

Objective To investigate the best models of esophageal cancer surgical approaches,lymphadenectomy ranges and postoperative comprehensive treatment.Methods From January 1998 to December 2007 in 10 years,1 162 cases of different parts with esophageal cancer were analysized which were treated with surgically adopting sequential abdomen,chest,neck three-incision approaches.Taking three-step screening way of preoperative imaging,preoperative ultrasound localigation fineneedle aspiration biopsy cytology and intraoperative rapid fieezing pathological examination were applied to make the selectivity of the first-times cervico-thoraco-abdominal three-field lymph node dissection (3FLND),first-times standard thoracoabdominal two-field lymph node dissection (2FLND) and second-times third-field cervical lymphadenectomy.Meanwhile,we implemented actively postoperative comprehensive treatment and observed the overall clinical efficacy and long-term survival.Results In the group of 1 162 cases with esophageal cancer surgery.The operating resection rate was 100 ％,Radical resection of 97.6 ％ (1 134/1 162).Perioperative overall complication rate was 16.4 ％ (191/1 162).Anastigmatic fistula was 0.6 ％ (7/1 162).Five cases dead in 30 days after surgery.The whole group of lymph node metastasis rate was 52.6 ％ (611/1 162),lymph node metastasis degree in 12.1％ (3 092/25 564).Full group of the first-times 3FLND was 348 cases.The positive rate was 94.8 ％ (330/348),Implementing the first-times 2FLND was in 814 cases and the second-times thirdfield cervical lymph node dissection was performed in 89 cases.The postoperative complications of the 3FLND was significantly higher than that of 2FLND (23.6 ％ vs 13.4 ％).The difference was statistically significant (x2 =18.37,P ＜ 0.001).However,The difference was not statistically significant between 3FLND and 2FLND (P ＞ 0.05).There is no significant difference between the first-times 3FLND with the second-times 3FLND accumulating survival (P ＞ 0.05).But different degree of lymph node metastasis determined prognosis.The difference was significant (x2 =35.57,P ＜ 0.001).In our group the postoperative comprehensive treatment application rate was 87.2 ％.Surgery combined with comprehensive treatment overall 1,3,5 years survival rates were 92.1％,69.2 ％,49.6 ％ respectively.Conclusions The sequential three-incision approaches and selectivity of lymph node dissection have the radical nature thoroughly,fewer complications,high quality of life and the long-term survival advantages.It should be a widely used method in the clinical surgery of the esophageal cancer.Implementing the three-step screening way to selecting the first-times 3FLND,the firsttimes 2FLND and the second-times third-field cervical lymphadenectomy that have targeted strongly and high accuracy,a definite object in view and avoiding patient excessive trauma.Applying the comprehensive treatment after surgery and the re-treated of patients with recurrence that can further more improve the longterm survival of patients.The comprehensive treatment should be the target direction of the future development of esophageal cancer.

The expression of DNA methyltranferase 1 (DNMT1 )mRNA and protein in 20 controls of normal oral mucosa tissue and 43 cases of oral squamous cell carcinoma(OSCC)was detected by Real-Time PCR and immunohistochemical staining and Western blot respectively. DNMTl mRNA CT values in OSCC and the controls were 0.958 6 ±0.986 6 and 0.459 5 ±0.525 8 respectively(Z =-2.028,P <0.05), The positive expression of DNMT1 protein in OSCC and the controls was 87% and 25% respectively(P <0.05).DNMT1 may play a role in the development of OSCC.

Objective:To investigate the expression of insulin-like growth factor binding protein 3 (IGFBP-3) in salivary pleomorphic adenoma(SPA).Methods:The expression of IGFBP-3 protein in 40 cases of SPA(group SPA),40 of normal glandular tissue(group N) and 10 of salivary gland malignant tumor(group CA) was detected by Western blot.The expression of IGFBP-3 mRNA in 50 cases of SPA,50 of salivary gland normal tissue and 10 of CA was detected by qRT-PCR.Results:The expression(A value) of IGFBP-3 protein in group N,SPA and CA was 8.54 ± 3.95,4.78 ± 2.07,3.63 ± 2.27 respectively.The expression ration of IGFBP-3 mRNA of group N vs SPA or CA,P ＜ 0.05;SPA vs CA,P ＞ 0.05 (SPA/N was 0.654 ± 0.387,CA/N:0.452 ± 0.229) respectively,but showed no significance difference between SPA and the CA groups(P ＞ 0.05).Difference of IGFBP-3 mRNA expression was observed with different envelope infiltration of SPA (P ＜ 0.05),no significant difference was observed in different age,gender or relapse groups.Conclusion:IGFBP-3 Low expression of IGFBP-3 in pleomorphic adenomas may reduce the antagonism of IGF-1R,causing the proliferation of tumor cells and promote tumor formation.

Objective To explore the association between circulating endothelial cells (CECs)and atherosclerosis in maintenance hemodialysis(MHD)patients. Methods A crosssectional study was performed to investigate the association between CECs and carotid atherosclerotic change in 65 MHD patients,25 non-hemodialysis patients with chronic kidney disease(CKD)of stage 4 or 5(CKD-non-HD)and 24 age-and Sex-matched healthy controls. CECs in peripheral blood were determined by multiparametrie flow cytometry(FCM).CECs were labeled with CD3-PerCP and CD146-PE before FCM and identified as CD3dim,CD146bright.Atherosclerosis in both groups Was assessed by the measurement of common carotid arery intimamedia thickness (CCA-IMT)and plaque of the common carotid arteries with ultrasound scanner. Results CECs were significantly higher in pre-dialysis patients[(151.52±98.24) cell/ml]and CKD-non-HD patients[(183.00±81.38)cell/ml ] compared with control group[(106.50± 24.14)cell/ml](P<0.05 and P<0.01,respectively).But the number of CECs was not significantly different between MHD and CKD-non-HD patients.CCA-IMT was also significantly higher in MHD patients[(0.94±0.36)mm]and CKD-non-HD patients [(1.02±0.37)mml compared with control group[(0.75±0.15)mm](P<0.05 and P<0.01,respectively).The number of pre-dialysis CECs was positively correlated with CCA-IMT in MHD patients(r=0.328,P<0.01).Multivariate analysis showed that CEC level was a strong independent risk factor of CCA-IMT. Conclusion InMHD patients, CEC level is associated with carotid atherosclerosis and may be used as a marker to evaluate the endothelial damage.

ObjectiveTo investigate and analyze the clinical and pathological features of surgical treatment for primary bronchogenic carcinoma in adolescent patients.MethodsA retrospective review is presented of patients less than 30 years with surgical treatment of bronchogenic carcinoma between 1969 and 2008.There were59 patients (36 male and 23 female).Mean age was 23 years ( range 8-29 ) .The ratio of men to women patients was 1.7∶1.Forty-nine cases ( 83.0% ) were symptomatic at presentation and 18 cases(30.5% )were misdiagnosed as other diseases.Surgical procedures included radical resection in 46 cases,palliative resection in 3 cases,thoracotomy only for unresectable disease in 7 cases and VATS biopsy in 3 cases.The histological types were 18 adenocarcinomas,13 carcinoids,9 mucoepidermoid carcinoma,5 squamous cell carcimomas,4 small cell lung cancer,3 adenosquamous carcinoma and 4 others.On TNM staging,8 cases in stage Ⅰa,3 cases in stage Ⅰb,9 cases in stage Ⅱ a,12 cases in stage Ⅱb,15 cases in stage Ⅲa,8 cases in stage Ⅲb,4 cases in stageⅣ.ResultsThere were no operative death in radical group.Post-operative atelectasis in 3 cases.One case died from postoperative respiratory failure in explosive group,the postoperative five year survival rate was 27.0%.radical resection group 5-year survival was 35%.Univariate analysis identified TNM stage and surgical procedures as predictors of survival( P <0.05).factors that had no significant effect on overall survival included gender,histologic sbutype and postoperative chemotherapy (P > 0.05).The 5 year survival in stage Ⅰ,Ⅱ,Ⅲa,Ⅲb + Ⅳ were 75.0%,33.3%,14.3% and 0,respectively.The 5 year survival in lobectomy,pneumonectomy and exporsive were 43.0%,18.2% and O,respectively.On multivariate analysis,TNM stage of disease was the only independent predictor of survival ( P =0.000) .ConclusionWe should pay attention to adolescent lung cancer and improve the diagnosis rate avoiding of delaying surgical treatment.The five year survival rate of radical resection for adolescent lung cancer was good.They should be treated with aggressive multimodality therapy and surgical resection is the first-line treatment for them.

ObjectiveTo evaluate the surgical outcomes and prognosis of patients after liver resection for noncolorectal liver metastases.Methods72 patients with liver metastases who underwent liver resection at Tianjin Medical University Cancer Hospital were retrospectively studied.There were 32 males and 42 females,aged between 35～78 years.After liver resection,68 patients had a R0 resection (negative histological margin),and 4 patients had a R1 resection (positive histological margin).The primary tumours were breast,(n =16,22.2 ％),lung (n =14,19.4 ％),gastrointestinal (n=12,16.7％),gynecological (n =8,11.1％),pancreatobiliary (n =8,11.1％),melanoma (n=4,5.6％),sarcoma (n=4,5.6％),and genitourinary (n=2,2.8％).The mean diameter of the main tumour was 4.8 cm (range,1.5- 11.0 cm).The mean number of liver metastases was 1.2 (range,1-5).Liver metastases were synchronous in 6 patients (8.3％) and metachronous in the remaining 66 patients (91.7％).ResultsThe operative mortality was 0％.The mean hospital stay was 14.4 days (range 6-67 days).The median overall survival was 31 months (range,6-127 months).The 1-,3- and 5-year survival rates were 81.9％,37.5％ and 23.6％,respectively.Univariate analysis revealed primary tumour sites (breast vs.others),histological type (adenocarcinoma vs.others),postoperative chemotherapy,number of liver metastases (solitary vs.multiple) and time to liver metastases from diagnosis of primary tumours (≤ 12 months vs.＞ 12 months) were associated with overall survival (all,P＜0.05).In multivariate analysis,factors independently associated with poor survival were nonbreast origin (P =0.012),time to liver metastases from diagnosis of primary tumours ＜12 months (P=0.027) and multiple liver metastases (P=0.008).ConclusionsIn selected patients,liver resection is an effective and safe treatment for noncolorectal liver metastases.The time to liver metastases from diagnosis of primary tumours was independently associated with overall survival.For solitary or liver metastasis of breast origin,surgical resection significantly improved survival.