Purpose:To investigate the expression of VEGF and its prognostic significance in ampullary carcinoma.Methods:22 resected tumor specimens from patients with ampullary carcinoma were immunohistochemically stained for VEGF and CD34 (surrogate for vessels) by streptavidin-peroxidase (S-P) method. Results:Expression of VEGF in tumor tissue was found in 50% cases of patients with ampullary carcinoma. The mean MVD for the entire group was 26.4?12.8. A significantly higher MVD(35.0?9.6) was observed in the tumors with positive VEGF expression compared with tumors with negative VEGF expression(17.7?9.3)( P

ObjectiveTo evaluate the result of direct parathyroid adenomectomy for the treatment of hyperparathyroidism caused by single parathyroid adenoma. MethodsClinical data of 13 cases were retrospectively analyzed from 1993 to 2000. Preoperative Bus, CT, 99mTc-MIBI localization was suggestive of a single adenoma and direct parathyroid adenomectomy through minimal incision was performed.ResultsHyperparathyroidism was cured in all cases. One case underwent second operation in which the pathology found malignancy, making the success rate of simple adenomectomy of 92.3%.Conclusions Simple parathyroid adenomectomy for primary hyper parathyroidism caused by single adenoma is effective?safe alternative to conventional neck exploration should preoperative diagnostic measures verify a single adenoma as the etiology of hyperparathyroidism.

Objective To evaluate the effect of chest backplate in treating multiple rib fractures in patients with focal abnormal breathing.Methods The clinical data of 36 patients with multiple rib fractures and focal abnormal breathing who were treated by Chrisofix chest backplate were analyzed.Results Thirtyfour patients were cured by chest backplate and other conservative treatments,and 2 patients underwent rib internal fixation surgery.The numeric rating scales scores before and after the application of the chest backplate were (8.1 ± 0.7) scores and (5.2 ± 0.5) scores respectively(P ＜ 0.01).Seven patients had skin blisters forming around the shield,which were cured by liquid extraction with a syringe and gauze covered with povidone iodine.No patients stopped treatment because of allergy.Conclusions Chest backplate is an effective,easy and inexpensive method for patient with multiple rib fractures and focal abnormal breathing who doesn't need exploratory thoracotomy.It is worthy to spread in clinical treatment.

OBJECTIVE: To investigate the changes of ultrastructure of biliary epithelia with ischemic-type biliary lesion (ITBL) and the protection effect of exogenous growth hormone (GH) in order to provide experimental information for prevention of biliary complication after liver transplantation. METHODS: Rats underwent liver transplantation were randomized into control group, ITBL group and recombinant human growth hormone (rhGH) group (n=6, respectively). Each group was given drugs at the same day postoperation. 7 days later, the specimen of bile ducts was collected. The epithelial changes of biliary tract were observed with TEM, and the injury degree of the epithelia was analyzed quantitatively in a specialized image analysis system. The epithelial plane measurement parameters of each group were measured, including the density of area and quantity of epithelia, and the density of area of epithelial microvilli. RESULTS: As compared with control group, in ITBL group the integrity of bile ducts was destroyed, epithelial microvilli became sparse, the epithelial plane measurement parameters were significantly decreased (P

Objective To investigate the effect of cyanidin-3-glucoside extracted from Chinese bayberry on the proliferation. migration and invasion ability of the gastric cancer cell lines MGC803 and SGC7901 in vitro, and explore the possible mechanism of the preventive effects of C3G on tumor metastasis.Methods After treatment by C3G, the growth inhibiting of C3G on MGC803 and SGC7901 was determined by MTF assay, cell migration and invasion ability was evaluated with transwell chamber. Expression of Matrix metalloproteinase 2( MMP-2 )mRNA and protion on cells were analyzed by RT-PCR and Western blot.Results C3G significantly inhibited the proliferation of MGC803 and SGC7901 cells in a concentration and time-dependent manner as measured by MTT method ( P ＜0. 01 ), and the IC50 were: MGC803:24 h IC50 =6. 27 μg/ml;SGC7901:24 h IC50 = 5.42 μg/ml. After the cells were treated with C3G, the migration and invasion ability of MGC803 and SGC7901 cells decreased significantly ( P ＜ 0. 01 ) the number of invasive cells in 24 hours of the negative control MGC803, SGC7901 group was ( 207 ± 9 ) and ( 115 ± 9 ),respectively, while in C3G 10 μg/ml group the number of invasive cells decreased to( 24 ± 5 ) , ( 14 ± 6). In addition, the expression of MMP-2 mRNA and protion decreased abviously ( P ＜ 0. 01 ), all that was in a concentration-dependent manner. Conclusions In vitro, C3G has a concentration- and time-dependent growth inhibiting effect on MGC803 and SGC7901 cells, and may prevent metastasis by affecting migration and invasion ability of tumor cells. This action may be mediated by down-regulation of MMP-2mRNA and protein.

Objective To investigate the value of ionic-contrast esophagogram in diagnosis of intrathoracic anastomotic leakage after oesophagectomy.Methods The data of 728 patients suffered esophagectomy were retrospectively collected.723 patients without clinical manifestations of anastomotic leakage were divided into group A(esophagogram before eating,n=465) and group B(non-esophagogram before eating,n=258).The incidence of anastomotic leakage was compared between the two groups.Results The discovery rates of anastomotic leakage in group A and B were 0.43%(2/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two group(P=0.55).The total incidence rates of anastomotic leakage in group A and B were 0.65%(3/465) and 0.78%(2/258),respectively,the difference was no statistically significant between the two groups(P=0.84).5 patients with clinically suspected anastomotic leakage,all had loculated pleural effusion,4 cases had fever,and 2 cases had abnormal chest drainage.Finally,4 cases(80%) were confirmed to be anastomotic leak by esophagogram.Conclusion Routine ionic-contrast esophagogram before eating do not improve intrathoracic anastomotic leakage detection rate after esophagectomy,but when patients have fever,loculated pleural effusion and abnormal chest drainage,esophagogram is necessary and can improve the detection rate of esophageal anastomotic leak.CT radiography may detect smaller anastomotic leakage than conventional esophagogram.

Objective To study the current management strategy for colorectal injuries. Methods The clinical data of 86 consecutively admitted patients with penetrating colorectal injuries were retrospectively reviewed. Results Most injuries were of closed type. Iatrogenic colon injury accounted for 14%. There were 61 patients (71%) associated with other abdominal organ injuries. Operations were performed in all patients. Seventy six patients were treated with primary repair or resection and anastomosis, and 10 with diverting colostomy. In recent 10 years mortality rate dwindled from 10% to 4%(2/46). Mortality was most often caused by hemorrhagic shock, associated organ injuries or severe secondary infection. Conclusions Most colorectal traumas are blunt closed type in China. Primary repair or resection and anastomosis at the time of initial exploration is most often used for colorectal injuries. Indications for diverting colostomy are severe shock, heavy intra abdominal contamination, poor condition, and rectal injury. Fecal peritonitis should be effectively prevented and treated.

Objective To investigate the effect of cyanidin-3-glucopyranoside extracted from Chinese bayberry on proliferation and apoptosis of human gastric cell line SGC7901.Methods After cocultured with C3G on different concentrations,cell proliferation was determined by MTT assay; morphology of apoptosis were observed by laser confocal microscopy; TUNEL assay was applied to measure the apoptoic rate; The expression of Bcl-2,Bax,Caspase-3,ICAD protein were observed by Western blot assay.Results C3G significantly inhibited the proliferation of SGC7901 cells in a concentration-and timedependent manner as measured by MTT method(P ＜ 0.01).After cells were treated with C3G,the presence of typical morphological changes of apoptosis was confirmed with laser confocal microscopy after Hoechst 33258 fluorescence staining.TUNEL assay indicated that the number of apoptotic cells in C3G-treated group was greater than that in the gastric cancer cells group(P ＜ 0.01).The expression level of Bcl-2 was down-regulated while the expression level of Bax was up-regulated by C3G,the ratio of Bcl-2 protein and Bax protein decreased.C3G may accelerate the activation of procaspase-3 and down-regulate the expression of ICAD(P ＜ 0.01).Conclusions C3G inhibits SGC7901 cell growth and induces apoptosis in a concentraion-and time-dependent manner.This action may be mediated by down-regulating Bcl-2/Bax,resulting in Caspase-3 activition and decreased ICAD protein expression.

Objective To investigate the clinical significance of WDHD1 protein expression in esophageal squamous cell carcinoma.Methods The expression of WDHD1 protein in esophageal squamous cell carcinoma,adenocarcinoma of esophagus and normal esophagus tissues by immunohistochemical MaxVision was detected.Results The expression of WDHD1 protein in the tissues of esophageal squamous cell carcinoma was significantly higher than that in the normal esophagus tissues and adenocarcinoma of esophagus (15.68 ± 3.01 vs.3.89 ± 2.98 and 4.66 ± 2.46)(P ＜ 0.05),there was no significant between normal esophagus tissues and adenocarcinoma of esophagus (P ＞ 0.05).The expression of WDHD 1 protein in the tissues of esophageal squamous cell carcinoma,high-middle differentiation tissues was higher than poorly differentiation,TNM stage Ⅲ + Ⅳ stage was higher than Ⅰ + Ⅱ stage,depth of invasion T3 + T4 was higher than T1 + T2,with lymph node metastasis tissue was higher than without,differences was statistically significant (P ＜0.05).Conclusions The higher expression of WDHD1 protein is the marker of high invasive and low histological grade of esophageal squamous cell carcinoma,and WDHD1 in esophageal squamous cell carcinomas may play an important role in development.

Tumor invasion and metastasis are regarded as main reasons for the failure of therpy and the reason of patients death.The mechnism of tumor metastasis is still uncertain.The pre-metastatic niche hypothesis provides us with new ideas to discover the mechnism.Numerous materials are involved in the formation of the pre-metastatic niche according to this hypothesis,including bone marrow-derived cells,microvesicles,exosomes,CD44,and so on.A further research on this hypothesis helps to deeply understand the nature of metastasis and leads clinical doctors to explore novel targets for clinical diagnoses and therapies.