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

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

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

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

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

OBJECTIVETo establish the processing method of Cistanche tubulosa decoction pieces.

METHODThe orthogonal test of four factors and three levels was used to optimize the main factors in the process of fresh C. tubulosa decoction pieces processing, including the thickness, temperature, and the time for inactivation of the enzyme in the plant. The result showed that the optimized condition was that fresh C. tubulosa was cut into 4 mm thickness, and heated at 70 degrees C for inactivation the enzyme in the plant for 6 min. Moreover, the optimized method was compared with the method of insolation and traditional dried method.

RESULTThe content of echinacoside in the C. tubulosa decoction piece by the optimized method was 7.3 times of that dried by insolation, and 12.8 times of that by traditional dry method; the content of verbascoside was 6. 5 and 14. 9 times of that dried by insolation and by traditional dry method, respectively; the content of galactitol was 7.1 and 13.2 times of that dried by insolation and by traditional dry method, respectively.

CONCLUSIONThe quality of C. tubulosa decoction pieces could be improved by this method, and its crud drug could be saved, which would protect the source of the mild Herba Cistanche, and produced the better economic and ecological benefits.

Cistanche ; chemistry ; Desiccation ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; standards ; Galactitol ; analysis ; Glucosides ; analysis ; Glycosides ; analysis ; Hot Temperature ; Phenols ; analysis ; Plants, Medicinal ; chemistry ; Quality Control ; Technology, Pharmaceutical ; methods

Objective To investigate the prevalence of anti-hepatitis E virus (HEV) and genotypes of hepatitis E virus in 8 species of animals including swine, cattle, sheep, horse, donkey, dog, chicken and duck in the suburb of Beijing. Methods Serum samples were collected from the 8 species of animals, and fecal samples of younger swine were collected from 2 stock farms. Anti-HEV was detected by Double Antigen Sandwich Assay. HEV RNA from fecal samples was detected by a reverse transcription nested polymerase chain reaction (RT-nPCR). Parts of the PCR products were cloned and sequenced. The swine HEV sequences were analyzed genetically. Results The positive rates of anti-HEV in serum specimens of swine, cattle, horse, donkey, sheep, dog, duck and chicken were 80.43%(481/598), 15.02%(52/346), 14.29%(40/280) ,0(0/26) ,9.88%(33/334), 0(0/ 21) ,3.03% (7/231) and 2.53%(8/316), respectively. The anti-HEV prevalence of adult swine(≥6 months)and younger swine(≤3 months)were 87.86%(369/420)and 62.92%(112/178)respectively. 74 of 111 (66.67% ) pig faces were positive for HEV RNA. Sequence analysis on these positive samples showed that there were 6 groups of HEV designated as bjsw1, bjsw2, bjsw3, bjsw4, bjsw5 and bjsw6. The 6 strains of HEV shared 94.5%-99.6% sequence identity of partial HEV ORF2 nucleotide with each other. The identities of HEV ORF2 nucleotide sequences between the 6 strains and genotype 1, 2, 3 and 4 were 75.6%-78.6% , 75.6%-76.2%, 77.1%-80.7% and 83.7%-94.5%, respectively. The sequence identity between the 6 strains and human HEV genotype 4d was 90.0%-94.5% . Conclusion HEV infection was seen in swine, cattle, horse, sheep, duck and chicken in the suburbs of Beijing. The anti-HEV positive rate appeared the highest in swine and the lowest in dog and donkey. The six strains of HEV isolated from younger swine belonged to genotype 4d.

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7％ versus 77.1％ in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.