AIM: To observe platelet activation and fibrinolytic activity and evalute the effects of valsartan and amlodipine in elderly patients with essential hypertension. METHODS: Double antibody sandwich ELISA and spectrophotometric assay were used to examine the levels of platelet alpha granule membrane protein (GMP 140), tissue type plasminogen activator (t PA) and its inhibitor (PAI 1) in 57 elderly patients with essential hypertension and 30 normotensives. Valsartan was given in 29 cases (groupⅠ) and amlodipine in 28 cases (group Ⅱ) for 12 weeks. RESULTS: Elevated GMP 140, decreased t PA activity, and elevated PAI 1 activity were detected in the patients, but not in normotensives (P

Objective To investigate the clinical value of para-aortic lymphadenectomy in patients with cervical cancer in stage Ⅰ B2 and Ⅱ A2.Methods One hundred and six patients with cervical cancer in stage Ⅰ B2 and Ⅱ A2 were assigned into two groups:control group(55 patients,radical hysterectomy and pelvic lymphadenectomy) and study group (51 patients,radical hysterectomy,pelvic lymphadenectomy and para-aortic lymphadenectomy).Postoperative radiotherapy or chemotherapy was conducted appropriately.Intraoperative and postoperative characteristics,recurrence rate,survival rate were compared between two groups.Results In study group,the recurrence rate was 15.7 ％ (8/51),and in control group,the recurrence rate was 38.2％(21/55),there was significant difference (P ＜ 0.05).No significant difference were observed in the complication incidence [27.5％ (14/51) vs.30.9％ (17/55)],blood loss [(326.1 ± 59.1) ml vs.(316.1 ± 51.2) ml] and pelvic lymph node-positive rate [56.9％ (29/51) vs.58.2 ％ (32/55)](P ＞ 0.05).The incidence of para-aortic lymph node metastasis was 17.6 ％ (9/51).Positive correlation was observed between the number of the pelvic lymph node metastasis and para-aortic lymph node metastasis (P ＜ 0.01).Conclusions In cervical cancer,the number of the pelvic lymph node metastasis was associated with para-aortic lymph node metastasis,abdominal aortic lymphadenectomy in radical surgery for cervical cancer is safe and feasible and can improve the prognosis of the patients.

Objective To investigate effects of dendritic cells (DC) vaccine on immune function in postoperative gastric cancer patients Methods DCs were extracted and pulsed with self tumor antigens in vitro Fifty patients with gastric cancer were divided into 2 groups randomly Four times of DC vaccinations were administered at 7 days intervals to the postoperative patients in treatment group after they underwent chemotherapy The control group were treated with chemotherapy only The level of IL 12 、 IFN ? and IL 4 in peripheral blood were analysed Results In DCs group, the levels of IL 12 were 37?4、 68?6、 96?12 and 59?9 pg/ml, the levels of IFN ? were 61?12、 134?19、 145?20 and 111?15 pg/ml, and levels of IL 4 were 55?7、 49?6、 46?5 and 50?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively In control group, the levels of IL 12 were 39?7、 45?9、 44?10 and 44?6 pg/ml, the levels of IFN ? were 63?10、 61?13、 62?11、 61?7 pg/ml, and levels of IL 4 were 52?11、 55?9、 53?10、 55?8 pg/ml before and 2, 4 and 8 weeks after vaccination, respectively The levels of IL 12 and IFN ? increased significantly in DCs group No severe side effects were found during treatment Conclusion DC vaccine improves immune function of posroprative patients with gastric cancer

OBJECTIVEApplication of real-time shear wave elastography (SWE) measurement of patients with Chronic severe hepatitis B and liver cirrhosis of the liver stiffness, aimed to explore SWE can evaluate the existence of liver cirrhosis patients with esophageal varices (EV) and its severity.

METHODSAccording to the results of gastroscope, 256 cases of patients with chronic liver disease and cirrhosis of the liver can be divided into no EV group,mild EV group,moderate to severe EV group,analysis between groups in patients with liver stiffness, portal vein,spleen vein diameter, the correlation of liver fibrosis indexes and the degree of esophageal varices.Using receives operating characteristic curve (ROC) and area under curve of ROC to evaluate each index prediction ability.

RESULTSCompare the liver stiffiness, portal vein,spleen vein diameter had statistically significant difference in the no EV group, mild EV group,moderate to severe EV group, (F values are respectively 137.86,44.77,73.88, P < 0.05), Patients age, type IV collagen, larninin, hyaluronic acid had no statistically significant difference in the no EV group and mild EV group (P > 0.05) and had statistically significant difference in the other two groups (P < 0.05). Patients with gender, pro-collagen type III N-terminal peptide (PC III NP) had no statistically significant difference in the three groups (P > 0.05). Correlation analysis showed that portal vein, spleen vein diameter, type IV collagen, laminin, hyaluronic acid showed significant positive correlation (P < 0.05),highest correlation was liver stiffness and the degree of esophageal varices, correlation coefficient of 0.689 (P < 0.01). PC III NP and the degree of esophageal varices, liver stiffness showed no correlation (P > 0.05). Liver stiffness area under the ROC curve is 0.923, with a strong ability to predict than the portal vein and splenic vein diameter, LN, IV-C, HA, PCIII NP. Liver stiffness more than 7.55 kPa, diagnose mild EV sensitivity 90.5%, specificity 60%.Liver stiffness more than 18.85 kPa,the sensitivity of the diagnosis of severe EV 82.4%, specificity of 90.5%.

CONCLUSIONSSWE liver stiffness measurement was predicted the existence of the EV and the severity of liver disease patients and effective inspection method, can be used as evaluation of liver disease patients with esophageal varices non-invasive indicator of the initial screening.

Elasticity Imaging Techniques ; Esophageal and Gastric Varices ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis ; Portal Vein ; ROC Curve

OBJECTIVETo study the high risk factors of the third level of lymphatic metastasis in breast cancer patients to guide clinical practice.

METHODSThe clinical data of 746 breast cancer patients (all female, aged from 33 to 80 years with a median of 46 years) received radical or modified mastectomy between 2001 and 2011 was analyzed retrospectively. Eleven individual variables were selected to investigate high risk factors of the third level of lymphatic metastasis in different conditions.

RESULTSAxillary nodes metastasis status (OR = 4.541, 95%CI:3.569-5.776), tumor site (OR = 1.437, 95%CI:1.029-2.007), external nodes involved (OR = 3.809, 95%CI:1.683-8.618) and estrogen receptor (OR = 0.740, 95%CI:0.569-0.964) were high risk factors of the third level of lymphatic metastasis. Further analysis found that it is prone to happen a metastasis, especially when the tumor with a size over 5 cm and located at the lateral quadrant. Negative estrogen receptor was a risk factor of the third level lymphatic metastasis along with the tumor stage.

CONCLUSIONFor preoperative tumor biopsy shows Negative estrogen receptor of tumor stage T3 and over stage T3 when considering suspicious lymph node metastasis or external tissues metastasis intraoperatively should take in account into third level axillary lymph node dissection actively.

Adult ; Aged ; Aged, 80 and over ; Axilla ; pathology ; Breast Neoplasms ; pathology ; surgery ; Female ; Humans ; Lymph Node Excision ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Mastectomy ; methods ; Middle Aged ; Prognosis ; Retrospective Studies ; Risk Factors