Autophagy is an adaptive response of cells to physiological and pathological conditions.The down-regulation of autophagic activity in some types of tumor cells is believed to play a critical role of tumorogenesis.Many anticancer drugs can activate autophagy in cancer cells and participate in the molecular regulation of autophagy.These drugs also induce apoptosis of cancer cells.The actual role of autophagy in antitumor effects of these drugs,however,depends on concentrations of drugs and the types of tumor cells.The induction of autophagy by anticancer drugs produces dual effects on viability of tumos cells. Autophagy as a therapeutic target of tumor chemotherapy has a promising application in the future.

According to the inclusion and exclusion criteria, we searched for relevant original articles in some big Chinese and English databases. The qualities of the studies were evaluated with QUADAS quality assessment tool. A software program, Meta-disc, was used to obtain the pooled estimates and heterogeneity test for sensitivity, specificity, SROC curve, and so on. Finally the 17 article were included. On a per-patient basis, the pooled sensitivity (SEN), specificity (SPE), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), Q*, SROC area under curve for 99mTc-MDP bone scan and computed tomography (CT) were 0. 87 and 0.99, 0.81 and 0.98, 3.88 and 13.86, 0.2 and 0.03, 27.73 and 612.17, 0.8418 and 0.9732, 0.9097 and 0.9952, respectively. On a per-focus basis, the pooled SEN, SPE, LR+, LR-, DOR, Q*, SROC area under curve for 99mTc-MDP bone scan was 0.86, 0.97, 13.32, 0.16, 102.4, 0.8944, 0.9528, respectively. For CT, only 1 article were included. This paper demonstrate: whether 99mTc-MDP or CT both have high diagnostic efficiency for bone metastase of breast cancer.
Bone Neoplasms ; diagnosis ; secondary ; Breast Neoplasms ; pathology ; Female ; Humans ; Sensitivity and Specificity ; Technetium Tc 99m Medronate ; Tomography, X-Ray Computed

Objective To identify the possible risk factors for esophageal delayed bleeding after endoscopic submucosal dissection ( ESD ) of early esophageal carcinoma and precancerous lesions. Methods Data of 281 patients with early esophageal carcinoma and precancerous lesions treated by ESD were reviewed. Risk factors for esophageal delayed bleeding were investigated by univariate analysis and logistic multivariable regression analysis. Results Esophageal delayed bleeding occurred in 22 patients ( 7. 83%) . Univariate analysis showed there was significant difference between delayed bleeding group and non?delayed bleeding group in regard of age ( P=0. 046 ) , lesion size ( P=0. 013 ) , and lesion infiltration depth( P<0. 001 ) . Together with three factors above, the intraoperative bleeding ( P=0. 068 ) was also analyzed by Logistic multivariable regression analysis which showed only infiltration depth was the independent risk factor of early esophageal carcinoma and precancerous lesions treated by ESD( P=0. 002, OR=6. 88,95%CI:1. 07?39. 28) . Conclusion Patients older than 60 years and diameters more than 3 cm might be prone to delayed bleeding, but the direct factor is infiltration depth. The deeper lesions infiltrate, the delayed bleeding is more likely to occur.

Objective To investigate the short and long term effect of mifepristone on hysteromyoma.Methods The treatment group ( n=60 ) was given mifepristone and the control group ( n=60 ) vitamin C.The volume of hysteromyoma was measured using B-mode ultrasound prior to and at the end of treatment.L H,FSH,E2 progesterone ( P) ,liver function and blood creatinine were monitored each month.At the second year,3 0 cases from treatmentgroup were given mifepristone again for 3 months in the same way as the first course and with the same indexes monitored. Results Mifepristone had1 0 0 % effective rate with one-course curative rate of6.67% ,the hysteromyoma volume decreased by an average of at least 3 5.1 0 % ,while the volume gradually increased over 6months after discontinuing mifepristone with the recurrence rate of3 0 .0 0 % .At the second course of treatment hysteromyoma was further reduced by50 .2 0 % ,with the scope of reduction larger than thatatthe firstcourse( P

OBJECTIVE:To discuss drug quality management practice in medical institutions.METHODS:The status quo of pharmaceutical administration and its trend of development were analyzed based on national laws and regulations for the drug control,the contents on drug quality management practice in medical institutions were presented.RESULTS:The management system,operation criteria,record system should be formulated respectively in drug quality management of medical institutions aimed directly at drug supply and drug use.CONSLUSION:The formulation of drug quality management practice in medical institutions is essential in the efforts to ensure safety,effectiveness and economy of drug use.

The importance and necessity of undergraduates participating in the training plan of the medical research was clarified.Based on the actual ability of students and the characteristic of experimental teaching plan,we think that combination of experimental teaching of small group with research training is a strategy for enhancing the ability of the medical undergraduates to do research.This proposal will speed up the medical educational goal by the activation of novel idea,the cultivation of innovatory thought and the enhancement of creative ability.

Objective To study the pathological,ultrastructural and immunohistochemical features of kidney oncocytoma (RO). Methods The clinical and histological features of 13 patients (5 men and 8 women;mean age,58 years,age 44 -78 years) with RO were observed.Immunohistochemical staining was performed on paraffin-embedded tissues with a panel of antibodies including vimentin,EMA,ckpan,CK7,CK18,E-cadherin,CD10,RCC,CD117,34βE12,HMB45,s-100 and Ki-67.Of the 13 cases,10were found incidentally during a health examination while the other three cases presented with lumbago and discomfort of the lumber.Four cases were analyzed by electron microscopy.Eleven were treated with radical nephrectomy and 2 with partial nephrectomy. Results Histologically,the tumor cells were mainly arranged in closely packed nests,aciniform or tubule with an occasional microcystic pattern in loose edematous hypocellular fibrous stroma.Tumor cells had moderate to abundant granular eosinophilic cytoplasm with a small,round and uniform nucleus containing finely and evenly dispersed chromati.However,focal nuclear atypia were observed with no mitotic activity.Immunohistochemically,all cases were diffusely positive for CK18 and showed variable immunoreactivity for E-cadherin,CD117,CD10 and CK7.Twelve cases were positive for EMA. All cases were negative for vimentin,34βE12,HMB45 and s-100.The proliferative index (Ki-67) was very low in all cases,with less than 1％ of the nuclei labeled.Electronic microscopy showed the cytoplasm had abundant mitochondria with lamellar cristae.Follow-up on 10 patients ( range from 2 to 67months) showed no recurrence or metastasis. Conclusions Tumor cells arranged in nests with loose hypocellu]ar and edematous stroma is the most important histological feature of RO.The immunohistochemical features could be helpful for both diagnosis and differential diagnosis.

Objective To investigate the vessel structure changes of carotid artery with age in normal adults with a newly-developed 3-dimensional ultrasound imaging modality.Methods One hundred and twenty-five normal adult volunteers were divided into five groups:group A,20-29 years old,25 cases;group B,30-39 years old,27 cases;group C,40-49 years old,28 cases;group D,50-59 years old,23 cases;group E,older than 60 years old,22 cases.The straight sections of common carotid arteries were scanned by full-volume three-dimensional ultrasound probe.With a vessel plaque quantification software (VPQ),the following parameters were obtained:intima-media thickness (IMT),vessel total area (VTA),vessel lumen area (VLA),vessel wall area (VWA),and normalized wall index (NWI).Results IMT,VTA,VWA,VLA and NWI were all positively correlated with age (r =0.79,0.48,0.77,0.27 and 0.67 respectively,P =0.00),and there was significant difference among age groups (P ＜0.01).IMT,VTA,VWA increased with age gradually whereas VLA increased only in group E and NWI showed no significant difference between group E and D.VWA and VTA of males were significantly greater than those of females in group A,B and C,and VLA of males was significantly greater than females in group A and B.There was no significant difference in IMT and NWI between gender groups.Conclusions Age is an important factor to carotid remodeling,and IMT,VTA and VWA increase with age,but VLA keeps constant in people under 60-year-old while NWI becomes stable in people over 50-year-old.It is essential to consider the physiological changes of carotid with age when pathophysiological process of atherosclerosis is involved.

Objective To evaluate the flexible spectral imaging color enhancement (FICE) system in the diagnosis of early esophageal carcinoma and precancerous lesions.Methods A total of 257 patients with suspicious esophageal lesions were examined successively by FICE,magnifying FICE,iodine dyeing endoscopy and magnifying iodine dyeing endoscopy.Findings were compared with the pathologic diagnosis.Results The positive rates of early esophageal carcinoma by FICE (92.6％,25/27) and iodine dyeing endoscopy (88.9％,24/27) were not significantly different (P =0.642),nor were those of magnifying FICE (96.3％,26/27) and magnifying iodine dyeing endoscopy (92.6％,25/27),(P =0.556).The magnifying FICE could reveal the IPCL of early esophageal carcinoma clearly.Early esophageal carcinoma and advanced neoplasia were mainly type Ⅳ + Ⅴ,low-level neoplasia and esophagitis were type Ⅱ + Ⅲ,and normal esophagus was type Ⅰ.However,the magnifying iodine dyeing endoscopy was not able to reveal IPCL.There was no adverse reaction in FICE,but the adverse reaction rate was 12.8％ (33/257) in iodine dyeing endoscopy.Conclusion Magnifying FICE can accurately determine the pathological types of early esophageal carcinoma,which is an effective complement to iodine dyeing endoscopy.

Objective To investigate the expression and clinicopathological features of matrix metalloproteinase 17 (MMP17) in gastric cancer.Methods The expressions of MMP17 at protein and mRNA level in 42 gastric carcinoma surgical specimens,42 endoscopic biopsy specimens of normal gastric tissue and 40 endoscopic biopsy specimens of atrophic gastritis were detected by immunohistoehemistry and reverse transcriptase-polymerase chain reaction (RT-PCR) respectively.Their relations with gastric clinicopathological features were analyzed.Chi square test,t-test and one-way ANOVA analysis were performed for comparing the differences between groups.Results There was no statistically significant difference(P＞0.05) in the expression rate of MMP17 between 42 specimens of normal gastric tissue(7.1％,3/42) and 40 specimens of atrophic gastritis (10.0％,4/40),however both were significantly lower than that of gastric carcinoma (73.8％,31/42,x2 =38.74,34.10,both P＜0.05).The expression quantity of MMP17 at mRNA level of 42 specimens of normal gastric tissue and 40 specimens of atrophic gastritis was 0.226 ± 0.032 and 0.254 ± 0.074 respectively,there was no significant difference(P＞0.05),however both were lower than that of gastric carcinoma (0.476±0.043,t=8.079 and 4.493,both P＜0.05).The expressions of MMP17 at protein and mRNA level were related to depths of invasion,lymph node metastasis and serous membrane involvement in gastric carcinoma patients (x2 =5.300,5.054,4.438,t =2.437,2.372,2.203,all P＜0.05),but not correlated with age,gender,lesion length,lesion site and histological grade (all P＞0.05).The positive rate of MMP17 expression in patients with survival time less than 2 years was significantly higher than that in patients with survival time over two years (x2 =12.71,P＜0.05).Conclusions In gastric carcinoma tissues,the expression of MMP17 increased along with the progression of gastric carcinoma.The detection of MMP17 may have some clinical reference value in determining the prognosis of gastric cancer patients.