OBJECTIVETo explore the prognostic factors for rectal cancer patients with synchronous liver metastases.

METHODSData from a total of 77 cases of rectal cancer with synchronous liver metastases treated in our center from January 2002 to December 2008 were collected and reviewed. The total survival rate was analyzed by Kaplan-Meier method. Log-rank test and Cox regression model with SPSS 17.0 software were used to analyze 13 factors including clinicopathological factors and treatment choices.

RESULTSThe median survival time of the 77 cases was 12 months. The 1-, 2-, 3- and 5-year survival rates were 47.7%, 28.0%, 13.1%, and 1.5%, respectively. Univariate analysis with Kaplan-Meier method revealed that the differentiation of the primary tumor, T-stage, N status, the distribution, number and size of liver metastases, extrahepatic disease, serum CEA level at diagnosis and treatment modality were prognostic factors (P < 0.05). Multivariate analysis showed that the differentiation of the primary tumor (P = 0.007), T-stage (P = 0.027), the size of liver metastases (P = 0.003), serum CEA value at diagnosis (P = 0.000) were independent prognostic factors for rectal cancer patients with synchronous liver metastases.

CONCLUSIONThe factors affecting the prognosis for rectal cancer patients with synchronous liver metastases are the differentiation of the primary tumor, T-stage, N status, the distribution, number and size of liver metastases, extrahepatic disease, serum CEA level at diagnosis and treatment modality. The differentiation of the primary tumor, T-stage, the size of liver metastases, and serum CEA value at diagnosis are independent prognostic factors.

Adult ; Aged ; Aged, 80 and over ; Carcinoembryonic Antigen ; blood ; Female ; Follow-Up Studies ; Humans ; Liver Neoplasms ; pathology ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Proportional Hazards Models ; Rectal Neoplasms ; blood ; drug therapy ; pathology ; surgery ; Retrospective Studies ; Survival Rate

Hepatitis B, Chronic ; physiopathology ; psychology ; Humans ; Liver ; physiopathology ; Stress, Psychological ; physiopathology

OBJECTIVETo investigate the expression profiles of serum Golgi protein-73 (GP73) in liver cirrhosis and primary hepatic carcinoma (PHC) and determine its clinical value for differential diagnosis.

METHODSSerum protein expressions of GP73 and alpha-fetoprotein (AFP) were detected by enzyme-linked immunosorbent assay and chemiluminescence assay, respectively, in patients with PHC (n=80), liver cirrhosis (n=65), and healthy controls (n=50). Inter-group changes were assessed by Kruskal-Wallis test, and significance of these differences was assessed by Mann-Whitney test. A receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic efficiency and determine the cut-off values for GP73 and AFP. Sensitivity and specificity were compared by the Chi-squared test. Correlation between serum GP73 expression and clinical parameters was determined by Spearman's rank correlation analysis.

RESULTSThe PHC group showed significantly higher serum GP73 (282.0 mug/L) than the liver cirrhosis group (211.8 mug/L) and control group (58.3 mug/L) (H = 93.30, P less than 0.01). For differential diagnosis of PHC and liver cirrhosis, the cut-off value was 318.1 mug/L for GP73 and 13.4 mug/L for AFP. Sensitivity of GP73 was lower than AFP (45% (36/80) vs. 65% (52/80); X2 = 8.02, P less than 0.05). Specificity of GP73 was lower than AFP but no significance was found (83.1% (54/65) vs. 87.7% (57/65); X2=0.27, P more than 0.05). The areas under the ROC curves were not significantly different between GP73 and AFP (0.65 (95% confidence interval (CI): 0.54~0.72) vs. 0.75 (95% CI: 0.67~0.83); Z = 1.88, P more than 0.05). The area under the ROC curves increased but not significantly (0.80 (95% CI: 0.73~0.88) vs. 0.75 (95% CI: 0.67~0.83); Z=2.61, P more than 0.05). Serum GP73 was correlated with liver cirrhosis (r=0.27), vascular invasion (r=0.29), and TNM staging (r=0.27) (all P less than 0.05), but not with sex (r=0.13), age (r=0.10), enhanced AFP (> 13.4 mug/L; r=0.03), tumor size (r=0.18), or distant metastasis (r=0.04), all P less than 0.05.

CONCLUSIONSerum GP73 and AFP have comparable diagnostic efficiency, but the sensitivity of AFP is superior for differential diagnosis of liver cirrhosis and primary hepatic carcinoma. Elevated serum GP73 may be correlated with liver tumor load and aggressiveness.

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; Case-Control Studies ; Diagnosis, Differential ; Female ; Humans ; Liver Cirrhosis ; diagnosis ; Liver Neoplasms ; diagnosis ; Male ; Membrane Proteins ; blood ; Middle Aged ; Sensitivity and Specificity ; Transcriptome ; alpha-Fetoproteins ; metabolism

OBJECTIVETo investigate the clinical epidemiological characteristics and the major causes of primary liver cancer (PLC) in Xinjiang region.

METHODSThe clinical epidemiological information on the first page of case history of 3602 PLC patients, which were diagnosed in our hospital from January 2002 to December 2010, were retrospectively reviewed and analyzed.

RESULTSAmong the 3602 cases, the men/women gender ratio was 3.72:1; The proportion of Han, Uighur, Kazakh, and other nationality (Hui, Mongolian, Manchu, Xibo nationality) was 81.95%, 9.30%, 4.14%, 2.89%, and 1.72%, respectively. The comparative difference between Uighur and Han nationalities was significant (P < 0.05). The hepatitis virus detection results showed that HBs-Ag was positive in 1680 cases (59.57%), HCV-Ab was positive in 229 cases (9.41%). Virus detection was negative in 888 patients (24.65%). The hepatitis B virus positive rate in Uygur patients was 36.13% and in Kazakh patients was 40.37%, both significantly lower than that in patients of Han nationality (63.18%, P < 0.05).

CONCLUSIONSIn Xinjiang region, the infection rate of hepatitis B virus in Uygur and Kazak people is significantly lower than that in Han people. The distribution of gender and age does not differ significantly among different nationalities, compared with those in other regions. The prevalence of primary liver cancer in Xinjiang region has certain regional characteristics and features.

Adult ; Aged ; Asian Continental Ancestry Group ; ethnology ; China ; epidemiology ; ethnology ; Ethnic Groups ; Female ; Hepatitis B ; epidemiology ; ethnology ; Hepatitis B Surface Antigens ; analysis ; Hepatitis C ; epidemiology ; ethnology ; Hepatitis C Antibodies ; analysis ; Humans ; Liver Neoplasms ; epidemiology ; ethnology ; virology ; Male ; Middle Aged ; Retrospective Studies

OBJECTIVETachycardia induced cardiomyopathy (TIC), secondary to various tachyarrhythmias, is a reversible condition which can lead to cardiac enlargement and heart failure. The impairment of both structure and function of heart can be reverted completely or partially if tachyarrhythmias are ceased without delay. This study aimed to explore the clinical characteristics, therapeutic regimen and outcome of TIC in children.

METHODSClinical data of 12 children with TIC, who came from Peking University First Hospital from Feb. 2003 to Jun. 2009, were retrospectively analyzed and followed up. The echocardiogram data on admission were compared with those from 12 homochronous cases with idiopathic dilated cardiomyopathy matched with 12 TIC cases in age and gender.

RESULTSAtrial tachycardia is the commonest arrhythmia in 12 TIC cases (75%). Four cases underwent catheterization for radiofrequency ablation and all succeeded. The cardiac rhythm of 6 out of 8 cases treated with drugs became sinus rhythm after 3 days to 2 weeks antiarrhythmic drugs treatment. The remaining 2 cases still retained atrial rhythm, but the ventricular heart rates declined to normal. The left ventricular end-diastolic dimensions of the 12 cases were decreased compared with those of pretherapy [(37.5 ± 5.3) mm vs. (43.0 ± 5.7) mm, P < 0.01], and the left ventricular ejection fractions were increased [(60.5% ± 5.6%) vs. (33.7% ± 10.3%), P < 0.01], after (3.4 ± 2.3) months. In our (4.3 ± 2.4) year-follow-up, all cases were fine, except in one case the tachyarrhythmia relapsed because of discontinuation of the drug treatment by her parents. The left ventricular end-diastolic dimensions in 12 TIC cases were smaller than those of the 12 age- and gender-matched idiopathic dilated cardiomyopathy [(43.0 ± 5.7) mm vs. (54.8 ± 7.5) mm, t = 7.9, P < 0.01], and the ejection fractions were higher [(33.7% ± 10.3%) vs. (21.8% ± 7.5%), t = 3.7, P < 0.01].

CONCLUSIONThe diagnosis of TIC should be considered for the children with tachycardia, cardiac enlargement and cardiac insufficiency. The degree of cardiac enlargement and cardiac insufficiency might be of value for the differential diagnosis between TIC and idiopathic dilated cardiomyopathy. The rhythm control and ventricular rates control could all result in a favorite therapeutic efficacy.

Cardiomyopathies ; diagnosis ; Cardiomyopathy, Dilated ; diagnosis ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Retrospective Studies ; Tachycardia ; diagnosis

Objective To explore the establishment of a rat model of acute radiation-induced liver injury and sig-nificance of the dynamic changes of TGF-β1 expression.Methods Forty healthy 6-week old male SD rats were randomly divided into model group (n=30) and control group (n=10).The right liver of rats in the model group was given a single dose of 25 Gy 6 MV X-ray irradiation.Histopathological examination using HE staining and transmission electron microsco-py were conducted to observe the liver pathological changes in rats at 3, 5, and 10 days after irradiation, serum TGF-β1 was detected, and relevant indicators of liver function ( ALT, AST, ALP) were determined.Statistical analysis was per-formed using SPSS 17.0 software.Results At 3, 5 and 10 days after irradiation, early pathological changes in the liver cells were observed by electron microscopy, the expression of TGF-β1 was gradually increased with the time prolongation, and significant differences were found between the model group and the control group at different time points (P<0.05). The light microscopic observation of liver tissues did not show significant differences between the control group and model group.The liver ALT, AST, ALP at different time points did not show significant differences between the two groups ( P>0.05).Conclusion Electron microscopy can be used to evaluate the early changes of radiation-induced liver injury, pri-or to the alterations visible by routine light microscopy.TGF-β1 can be used to predict the degree of radiation-induced liver injury, and may be used as a sensitive serum cytokine in predicting the degree of radiation-induced acute liver injury.

OBJECTIVETo investigate the effects of damage-regulated autophagy modulator (DRAM) on radiosensitivity and the related mechanisms of implanted tumors of SGC7901 human gastric carcinoma cells in nude mice.

METHODSNude mice were randomly divided into model control group, radiotherapy group, and DRAM treatment group and radiotherapy combined with DRAM treatment group. When volume of transplantation tumor were 1.0 cm(3), radiotherapy, DRAM treatment was given. On days 3, 6 and 9 after treatment, the inhibition rate of tumor growth, pathological changes in tumor specimens, expression levels of P53, proliferating cell nuclear antigen(PCNA), C-myc, Fas-L, as well as apoptosis indexes in tumor samples were observed.

RESULTSInhibition rates of tumor in DRAM combined with radiotherapy were 9.3%, 14.1%, 16.7% on day 3, 6 and 9, respectively, all significantly higher than those in the radiotherapy group(5.0%, 8.8%, 6.5%, P<0.05). The expressions of PCNA and C-myc protein were down-regulated, while the expressions of P53 and Fas-L were upregulated.

CONCLUSIONDamage-regulated autophagy modulator gene may promote cell apoptosis and inhibit cell growth to enhance the radiosensitivity of transplanted gastric tumor in vivo in nude mice.

Animals ; Autophagy ; genetics ; Cell Proliferation ; Gene Expression Regulation, Neoplastic ; Humans ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Neoplasm Transplantation ; Radiation Tolerance ; Stomach Neoplasms ; genetics ; metabolism ; pathology ; radiotherapy ; Tumor Cells, Cultured

AIMTo evaluate the Rap1A mRNA expression and its significance in the testes of normal and azoospermic subjects.

METHODSA cDNA microarray that contained Rap1A and some other genes such as RBM, EIF1AY was used to identify the differential gene expression profiles between the normal and azoospermic testes. cDNA probes were prepared by labeling mRNA from azoospermic and normal testicular tissues through reverse transcription with Cy5-dUTP and Cy3-dUTP, respectively. The mixed cDNA probes were then hybridized with cDNA microarray (each containing 4096 unique human cDNA sequences). The fluorescent signals were scanned and the values of Cy5-dUTP and Cy3-dUTP on each spot were analyzed and calculated. In situ hybridization was employed to detect the expression of Rap1A in the testes of 10 fertile and 39 azoospermic subjects.

RESULTSOne hundred and twenty-eight differentially expressed genes were found to be possibly related to azoospermia, of which 56 were up-regulated and 72, down-regulated genes. The mRNA expression of Rap1A in the spermatogenic cells of azoospermic was stronger than that in those of the fertile testes.

CONCLUSIONRap1A may play certain roles in the development of azoospermia.

Adult ; Gene Expression ; Humans ; In Situ Hybridization ; Male ; Oligospermia ; metabolism ; RNA, Messenger ; analysis ; Spermatozoa ; chemistry ; Testis ; chemistry ; rap1 GTP-Binding Proteins ; genetics ; physiology

OBJECTIVETo screen for factor VIII inhibitor in patients with hemophilia A (HA) and explore the environmental risk factors for inhibitor development.

METHODSTotally 265 patients with HA were enrolled, including 107 consecutive inpatients and outpatients in Peking Union Medical College Hospital from April 2003 to April 2007 and 158 patients newly recruited from other hospitals. FVIII: C activity was measured by one-stage coagulation assay. FVIII inhibitor was determined using Bethesda method.

RESULTSIn 265 HA patients, FVIII inhibitor was detected in 22 patients (8.3%). Nine of them (86.4%) were low responders (inhibitor titers < or = 5 000 BU/L), 3 (13.6%) were high responders (the titers > 5 000 BU/L). The frequency of FVIII inhibitor was 50% in the patients aged over 50 years, which was significantly higher than those in other age groups (P = 0. 000). Among 158 newly recruited patients with full clinical data, the frequency of FVIII inhibitor was 12.8% in patients who had received infusion of FVIII products for more than 12 doses on average each year, while it was 5.8% in whom the infusion doses were less than 12 (P = 0.156). The frequency of FVIII inhibitor was 28.5% in patients with a history of continuous infusion of FVIII products whereas it was only 1.6% in patients without such history (P = 0.000). In patients who exposed to multiple-branded or single-branded FVIII products, the frequencies of FVIII inhibitor were 9.3% and 3.9%, respectively (P = 0.229).

CONCLUSIONThe development of factor VIII inhibitor in patients with hemophilia A may be related to the age and the history of continuous infusion of FVIII products.

Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; Environment ; Factor VIII ; antagonists & inhibitors ; Hemophilia A ; blood ; Humans ; Infant ; Male ; Middle Aged ; Risk Factors ; Young Adult

BACKGROUNDAlveolar echinococcosis (AE) is a disease in human and animals, and the cure rate is unsatisfactory. This study aimed to investigate the curative efficacy of different doses of locally applied radiotherapy on alveolar echinococcosis in rats.

METHODSRats infected with Echinococcus multilocularis were randomly divided into 4 groups of 15 rats each: low-, middle-, and high-irradiation groups and a control group. Rats in the control group underwent no treatment, while rats in the irradiation groups received 6-MeV radiotherapy at 20 Gy/8 f, 40 Gy/8 f, and 60 Gy/8 f respectively, once every 3 days for a total of 8 times. One month after radiotherapy, wet weight and AE vesicle inhibitory rate were detected in rats of each group. Histopathologic and ultrastructural observations of tissues with AE lesions were performed.

RESULTSIn the treatment groups, an obvious inhibitory effect was found in AE rats; the inhibitory rates were 50%, 72%, and 82%, respectively. There were also statistical differences in pathological changes and average wet weight of the lesions compared with the control group (P < 0.05). In the treatment groups, injuries of various degrees were found in the ultrastructure of the laminated and germinal layers in the capsular wall of AE, and injury was most severe in the high-dose group.

CONCLUSIONRadiotherapy has a dose-dependent inhibitory effect on the growth of AE.

Animals ; Dose-Response Relationship, Radiation ; Echinococcosis, Hepatic ; pathology ; radiotherapy ; Female ; Rats