Objective To explore the relationship between levels of plasma homocysteine (Hcy) and adrenomedullin (ADM) and sudden sensorineural hearing loss (SSHL) in elderly patients. Methods The 80 patients with SSHL but without any treatment were selected as SSHL group, while 80 age-and sex-matched subjects without SSHL were collected as the control group. The levels of plasma Hcy and ADM were measured by fluorescence method and radioimmunoassay, respectively. And the levels of plasma Hey, ADM, total cholesterol (TC) and triglyceride (TG) were compared between the two groups. Results The levels of plasma Hcy, ADM, TC and TG were significantly higher in SSHL group than in control group [(13. 81±2.88) μmol/L vs. (11. 58±2. 80)/xmol/L, (26. 40±3. 20)ng/L vs. (22. 45±2. 80)ng/L, (5.22±0. 87)mmol/L vs. (4. 52±0. 81)mmol/L, (1.80 ±0. 12)mmol/L vs. (1.52±0. 13)mmol/L;t=5. 03, 8. 22, 7.48, 3. 85, all P<0. 01). When the two groups with hypertension were compared, the levels of plasma Hey, ADM, TC and TG were (15.30±2. 77)μmol/L, (29.40±2. 80) ng/L, (5. 48±0. 98) mmol/L and (1.92±0. 18) mmol/L in SSHL group, which were higher than those in control group[(12. 80±2. 62) μmol/L, (25.20± 2. 60) ng/L, (5.01±1.03) retool/L, (1.62±0. 15) mmol/L3 (t=4.03, 7.01, 3.25, 7. 80, all P< 0. 01). There were no differences in systolic and diastolic blood pressure between the two groups(t= 0. 87, 0. 64;P=0. 38, 0. 55).Conclusions The changes of plasma levels of Hey and ADM in the elderly suggest that they could involve in the pathogenic process of SSHL, which may provide referential value for understanding the state of the disease and judging the prognosis

Objective To investigate rare etiological causes of giant gastric ulcers. Methods A retrospective investigation was made on 4986 endoscopically proved giant gastric ulcer in our hospital, from January 1976 to December 2000. The morphological features under endoscopy, pathology, diagnosis, treatment and prognosis were analyzed in 59 giant gastric ulcers with special causes. Results Thirty two cases of gastric eosinophilic granuloma,8 gastric carcinoid tumor,8 gastric schistosomiasis, 5 gastric Crohn's disease,4 gastric lymphoma and 2 gastric Behcet's disease were identified. Ten gastric eosinophilic granuloma,3 gastric carcinoid tumor,3 gastric schistosomiasis, 5 gastric Crohn's disease,3 gastric lymphoma , 1 gastric Behcet's disease were misdiagnosed at initial endoscopy.Conclusions Rare etiological causes of giant gastric ulcers could be divided into 3 categories: non-epithelium gastric tumor, gastric granulomatous disease and gastric vascular disease. Careful observation ulcer endoscopy, history inquiry, physical examination, comprehensive analysis and laboratory examination may provide useful information for the diagnosis. Biopsy may be falsely negative in some cases.

Basing on the market multi-target antitumor agent sorafenib, a series of sixteen 4-[4-(2-methyl-aminoacyl-pyridyl)]oxylphenyl aryl thiourea derivatives were designed and synthesized. Their structures were identified by the spectra of 1H NMR, MS and elemental analysis. The evaluation of antitumor bioactivities in vitro was done by MTT method. It was shown that the synthesized compounds had antitumor activities and compounds 1a, 1d, 1i and 1j showed better or equal antitumor activity on sorafenib.

Objective To compare the clinical results of two different anterior cervical surgical treatment for multi-segmental cervical spondylotic myelopathy (≥3 segments).Methods Twenty-three patients with segmental cervical spondylotic myelopathy,10 cases were treated with anterior cervical discectomy and fusion (ACDF) as ACDF group,13 cases were treated with anterior cervical corpectomy and fusion (ACCF) as ACCF group.The operation time,operative blood loss,JOA scores,neurological improvement rate and the variable of the D value were compared.Results The operation time and operative blood loss in ACDF group was significantly lower than that in ACCF group [(130.0 ±31.5) min vs.(150.0 ±42.5) min,(150.0 ± 120.8) ml vs.(310.0 ± 320.8) ml,P ＜ 0.05].The variable of the D value in ACDF group was significantly higher than that in ACCF group [(3.1 ± 1.4) mm vs.(2.3 ± 0.9) mm,P ＜ 0.05].There was no statistically significant difference in JOA scores,neurological improvement rate between ACDF group and ACCF group.Two cases of cerebrospinal fluid leakage in ACDF group,the oppression and drainage recovery after treatment.One case of 14 d after fistula complications in ACCF group,after patching were cured; 2 cases of titanium mesh shift,follow the fusion.Conclusions Both methods attain good clinical results.ACDF combined with ACCF treatment of multi-segmental cervical spondylotic myelopathy,with shorter operation time,relatively less blood loss,and better restoration of cervical sagittal alignment.

Objective Autologous hematopoietic stem cell transplantation (Auto-HSCT) has been widely used in hematological malignancies.To mobilize and harvest sufficient number of peripheral CD_(34)~+ cells is one of key issues for auto-HSCT. Peripheral CD_(34)~+ cell numeration has been used as an indicator for apheresis while we mostly rely on the peripheral WBC or MNC count. In this study, we try to evaluate the association of peripheral CD_(34)~+ count to the CD_(34)~+ cells number in the apheresis product and to find out a potential threshold. Methods From Jan 2007 to Dec 2009, a total of 57 apherosis for auto-HSCT were analysed. All patients were mobilized by cyclophophamide (CTX) plus G-CSF(5-10μg/kg) regimen. The apheresis were performed with COBE SPECTRA VERSION 6 and CD_(34)~+ count of both peripheral and apheresis products were analysed by flow cytometry. Results The median number of MNC in apheresis products was 4.6(0.3-10.5)×10~8/kg with median CD_(34)~+ cells at 2.4(0.16-34.9)×10~6/kg. The peripheral CD_(34)~+ count was the only parameter associated with the MNC and CD_(34)~+ cell numbers in the apheresis products while the WBC number was irrelevant to the results of apheresis. Our data showed that when the peripheral CD_(34)~+ count reach 15/μl, the efficacy of a single apheresis significantly improved with 81 % and 60 % reached 1 and 2×10~6 CD_(34)~+ cells/kg respectively and the total number of MNC and CD_(34)~+ cells were significantly superior to apheresis with peripheral CD_(34)~+ cells <15/μl, thus indicated that CD_(34)~+ ≥15 /μl can be used as the threshold for apheresis. Furthermore, the ROC analysis demonstrated that CD_(34)~+ cells ≥25(26.5-28.6) /μl is the best indicator level for a successful single apheresis. Conclusion Our study clearly showed that peripheral CD_(34)~+ cell count is a key indicator of apherosis. CD_(34)~+ cells at 15/μl can be used as the threshold to start apheresis in the clinical setting.

Objective To investigate the clinical significance of MTAP, CDKN2A and CDKN2B gene expression in diffuse large B-cell lymphoma (DLBCL). Methods MTAP, CDKN2A and CDKN2B gene expression were assessed by Real-time quantitative PCR in 40 cases of DLBCL and 19 cases of reactive hyperplasia. The clinical and follow-up data were also collected. Results Comparing with reactive hyperplasia, MTAP, CDKN2A and CDKN2B gene expression were decreased in DLBCL group (P = 0.024,0.044 and 0.047, respectively). Low-expression of all the three genes were associated with advanced Ann Arbor stage (P=0.004, 0.001 and 0.027, respectively). No obvious difference were observed according to gender, age, the number of the extra-nodal infiltration, ECOG score, bone marrow involvement and serum LDH level (P ＞0.05). MTAP and CDKN2A gene expression were associated with B symptoms (P =0.003 and 0.028, respectively) and IPI scores (P =0.001 and 0.011, respectively). With regard to survival rates,MTAP, CDKN2A and CDKN2B gene expression were significantly associated with OS (P =0.022, 0.019 and 0.042, respectively). Conclusion MTAP, CDKN2A and CDKN2B gene expression in DLBCL were decreased and related to disease progression and prognosis. They could be considered as biomarkers to evaluate biological behavior and clinical outcome of DLBCL patients.

Objective To explore clinieopathologieal features and prognosis in a high grade malignancy group of colorectal mueinous carcinoma, signet-ring cell carcinoma and low-differentiated carcinoma. Methods Retrospective analysis and follow-up were made on 148 patients with colorectal mucinous carcinoma, 55 patients with signet-ring cell carcinoma and 281 low- differentiated carcinoma treated in our hospital from 1988 to 2006. Obtained data were analyzed by SPSS13.0. Related factors underwent x2 analysis, survival analysis were estimated using Kaplan-Meier method and compared using the Log-rank test. Results Coloreetal signet-ring cell carcinoma were significantly different from mucinous carcinoma and low- differentiated carcinoma in gender, age, tumor location, bowel obstruction, operative modus, tumor embolism, tumor infiltration and lymph node metastasis(x2 = 7, 67,38.4,86.0,14.5,93.7,17.3,62. 1,24. 4,56.17 ,P <0.05). Median survival time was 24 months in signet-ring cell carcinoma, 47 months in mueinous carcinoma and 49 months in low- differentiated carcinoma. The difference is of significance(x2 = 21.3, P < 0.05). Conclusions Clinicopathological characteristics and prognosis of colorectal signet-ring cell carcinoma, mueinous carcinoma and low- differentiated carcinoma is of significant difference(P < 0.05). Malignancy of signet-ring cell carcinoma is higher with worse prognosis.

Objective To investigate the surgical treatment and indications for primary lesion in patients with stage Ⅳ rectal cancer.nethods Clinical data of 118 patients with stage Ⅳ rectal cancer undergoing surgical treatment from January 1988 to December 2005 in Cancer Hospital of Chinese Academy of Medical Sciences were analyzed retrospectively using Statistical Package for the Social Sciences(Release 13.0,SPSS,Inc).Survival was estimated using the Kaplan-Meier method and compared using the log-rank test.Cox regression was used in multivariate analysis.Results One hundred and five of 118 patients received rectal primary lesion resection,including 16 cases with simultaneously metastatic tumor resection.13 of 118 patients received ostomy.The overall 5-year survival rate of the primary lesion resection group was 8.57%,the 5-year survival rate of the metastatic tumor resection group was 31.2%.The median survival in the primary lesion resection group and the ostomy group was 15 months and 13 months respectively(X2=0.736.P=0.778).Multivariate analysis showed that degree of differentiation of primary tumor,maximal diameter of liver metastasis and chemotherapy were the most important prognostic factor of the primary tumor resection group.Conclusion Simultaneous resection of primary and metastatic tumor can prolong suivival time of patients with resectable stage Ⅳ rectal cancer.

Objective To investigate the surgical treatment for patients with isolated recurrence and metastasis of colon cancer after primary curative-intent resection. Methods In this stuay,58 cases suffering from postoperative recurrence of colon cancer between the year of 1996-2005 were analyzed retrospectively.Data were analyzed using statistical package for the social sciences(Release 11.5,SPSS,Inc).x2 analysis was used to determine the related factors,survival analysis was estimated using the Kaplan-Meier method and compared using tlle log-rank test. Results In this reoperative group radical resection was achieved in 81%(47/58)cases,and palliative operation in 11 cases,with median survival time of 48 months and 12 months respectively(x2=12.30,P=0.0005). Conclusion Postoperative isolated recurrence and metastasis of colon cancer usually allows radical resection in most cases with favorable long-time survival.

Objective To evaluate adjuvant chemoradiotherapy on gallbladder carcinoma after RO resection.Methods A total of 54 patients undergoing curative resection (R0) for gallbladder carcinoma between January 1991 and December 2006 were recruited for evaluation on the effect of postoperative adjuvant chemoradiotherapy,with the exception of 5 TINOM0 patients.Among the remaining 49 patients,11 patients received radiotherapy,and 21 cases had undergone adjuvant chemotherapy.Results The overall 1,3 and 5-year survival rates of these 54 patients were 81.1％,54.4％ and 48.4％,respectively.The overall 5-year survival rates of T1,T2,T3 and T4 were 100％,92.3％,27.8％ and 12.5％ ( x2 =25.307,P ＜0.001 ),respectively.The median survival for those patients receiving adjuvant radiotherapy was 12.8 months compared to 28 months of median survival for those treated without adjuvant radiation therapy (x2 =3.942,P =0.047 ).Adjuvant radiotherapy significantly prolonged overall median survival from 16 months to 95 months ( x2 =5.387,P =0.02 ) in the subgroup of patients with T3/T4 stage.Adjuvant radiotherapy for patients with positive lymph nodes improved overall median survival from 12 to 19 months (x2 =3.959,P =0.047 ).In addition,radiotherapy prolonged overall median survival from 12 moths to 128 months in patients with G3/G4 disease ( x2 =7.401,P =0.007).The median survival was not significantly different among patients with or without adjuvant chemotherapy (x2=0.086,P=0.770 ).Conclusions Adjuvant radiotherapy is recommended for lymph node positive,T3/T4,or G3/G4 gallbladder carcinoma patients following R0 resection.