OBJECTIVETo study the expression of carbonic anhydrase (CA) IX and its significance in molecular subtyping of breast carcinomas. METHODL MaxVision immunohistochemical staining was used to examine the expression of ER, PR, HER2, CK5/6, EGFR, and CA IX in 117 cases of breast invasive ductal carcinomas.

RESULTSThe patients' age ranged from 25 to 71 years (mean 49.6 years). All the 117 cases were subclassified into five subtypes, with 66 (56.4%) luminal A, 6(5.1%) luminal B, 10 (8.6%) HER2 positive, 20 (17.1%) basal-like, and 15 (12.8%) unclassified tumors. The expression of CA IX in luminal A and basal-like breast cancers was 13.6% (9/66) and 8/20, respectively, with a significant difference (P < 0.05). Among the luminal A cancers, the expression of CA IX in tumors > 2 cm (7/27, 25.9%) was significantly (P < 0.05) higher than that of tumors ≤ 2 cm (2/39, 5.1%). The expression of CA IX in grade 3 invasive ductal carcinoma (18/50, 36.0%) was significantly higher than that in grade 1 (2/21, 9.5%) and 2 (7/46, 15.2%) tumors (both P = 0.006). In CA IX-negative of invasive ductal carcinoma, the expression of ER and PR was 61.1% (55/90) and 55.6% (50/90), respectively; whereas in CA IX-positive cancers, the expression of ER and PR was 37.0% (10/27) and 29.6% (8/27), respectively. The expression of hormone receptors in CA IX-negative tumors was significantly higher than that in CA IX-positive tumors (for both ER and PR, P < 0.05).

CONCLUSIONSThe expression of CA IX correlates not only with molecular subtypes of breast cancer, but also with the grading, hormone receptors and diameter of mammary invasive ductal carcinoma. CA IX is a relative independent marker of poor prognosis in breast cancer.

Adult ; Aged ; Antigens, Neoplasm ; metabolism ; Biomarkers, Tumor ; metabolism ; Breast Neoplasms ; classification ; metabolism ; pathology ; Carbonic Anhydrase IX ; Carbonic Anhydrases ; metabolism ; Carcinoma, Ductal, Breast ; classification ; metabolism ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Grading ; Receptor, ErbB-2 ; metabolism ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Tumor Burden

Objective To evaluate the schistosomiasis control effect of the measures of replacing cattle with machine for cul?tivation and forbidding depasturage of livestock on marshlands in marshland and lake regions. Methods The retrospective re?view and field survey were implemented in the Jiangling and Gongan counties of Hubei Province where were implemented with the measure of replacing cattle with machine for cultivation,and Yuanjiang and Huarong counties of Hunan Province where were implemented with the measure of forbidding the depasturage of livestock on marshlands. The schistosome infection status of hu?man,cattle,and Oncomelania hupensis snails,and schistosome?infested field excreta were surveyed from 2007 to 2013. The ef?fects of the interventions were compared before and after their implementations. Results The 6 villages of Hubei Province were implemented with the measure of replacing cattle with machine for cultivation,and 7 villages of Hunan Province were imple? mented with the measure of forbidding the depasturage of livestock on marshlands. From 2007 to 2013,the schistosome infection rates of residents declined from 3.95%to 0.70%(χ2 =128.376,P<0.05),with the descend range of 82.53%. The descend ranges of the measures of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands were 83.081%and 81.62%respectively,and there was no significant difference between the two measures(χ2 =0.132,P>0.05). The infection rate of cattle decreased from 3.66%in 2007 to 0.65%in 2013,and the descend range was 82.24%(χ2=13.692,P<0.05). The field excreta was surveyed in the snail breeding place in 2013. The investigated area was 157.435 hm2, and 625 samples of field feces of cattle were collected with the density of field excreta of 3.97/hm2,and the positive rate was 1.12%(7/625). The schistosome infection rate of snails and the density of infected snails decreased successively from 2007, and no infected snails were detected from 2011 to 2013. Conclusions The schistosomiasis endemic situation are decreased sig?nificantly after the interventions of replacing cattle with machine for cultivation and forbidding the depasturage of livestock on marshlands. Therefore,schistosomiasis control effect of these measures is notable in the marshland and lake regions.

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; surgery ; Alkaline Phosphatase ; metabolism ; Carcinoma, Endometrioid ; metabolism ; pathology ; Diagnosis, Differential ; Endodermal Sinus Tumor ; metabolism ; pathology ; surgery ; Female ; GPI-Linked Proteins ; metabolism ; Glypicans ; metabolism ; Humans ; Isoenzymes ; metabolism ; Keratin-7 ; metabolism ; Liver Neoplasms ; metabolism ; pathology ; secondary ; Middle Aged ; Mucin-1 ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; surgery ; alpha-Fetoproteins ; metabolism

Objective we assessed our institutional outcomes of hybrid treatment for aortic arch disease with supra-aortic debranching and endovascular stent graft repair.Methods From March 2016 to November 2016,6 patients underwent Hybrid total aortic arch repair:1 had aortic arch pseudoaneurysm;1 had type Ⅲ aortic dissection;4 had aortic arch aneurysm because of hypotension,of whom 1 with aneurysm prerupture and 1 with Aortic intramural hematoma.Supra-aortic vessels were involved and high-risk for traditional operations in all patients.Bifurcated artificial vessels were used,main vessel was end-to-side anastomosed with ascending aorta.Branching vessel were end-to-end anastomosed with right innominate artery and left subclavian artery,end-to-side anastomosed with left common carotid artery.Then,stent graft was implanted into ascending aorta and aortic arch.All patients were followed postoperatively,with regularly contrast computed tomography angiogram (CTA) and echocardiography(discharge,three months,six months,and yearly).Results Hybrid procedure with supra-aortic debranching and endovascular stent graft repair were completed in all patients,technical success rate was 100％.There were no perioperative obvious morbidity and mortality,follow-up period were 2-9 months.1 patients had stroke during follow-up period,condition improved after treatment.Supra-aortic vessels were patency and there were no endoleak in all patients.There were no recurrent aortic disease during follow-up period.Conclusion Hybrid aortic arch replacement can be performed with good postoperative and early results in high-risk patients for traditional open repair.

Objective: To elucidate the possible mechanism responsible for the improved protection of terminal warm blood cardioplegia (TWBC) after hypothermic cardiopulmonary bypass (CPB) through analysis of tubulin (TB) components changes in myocardial cells exposed to TWBC. Methods: Stable animal models of CPB were established in cats, which were then randomly divided into 2 groups. Group Ⅰ was subjected to intermittent cold blood cardioplegia (ICBC) whereas group Ⅱ to ICBC followed by TWBC before uncross-clamping. Left ventricular performance was then monitored and evaluated by LVSP, LVEDP, ±dp/dtmax and t-dp/dtmax in both groups and semi-quantitive analysis was conducted with Western blot method as to the content and constitution of TB in myocardial cells at 15 min, 120 min after aortic crossclamping (ACC) and 5 min,15 min, 60 min,120 min after reperfusion. Results: Within 120 min after reperfusion, systolic and diastolic functions decreased significantly in group Ⅰ as compared with group Ⅱ(P<0.05). At 115 min after ACC and 15 min after reperfusion, the content of free and polymerized TB in both groups had no difference (P>0.05). At 120 min after ACC and 5 minutes after reperfusion, there was a significant difference between groupⅠ andⅡ (P<0.01). Conclusion: TWBC accelerates the repolymerization of myocardial TB during hypothermic CPB, which may mediate the improved cardiac performance in the early stage of myocardial reperfusion.

OBJECTIVETo investigate the effect of farnesoid-X-receptor (FXR) antagonist Z-guggulsterone in an in vivo high-fat fed apolipoprotein E knockout (ApoE(-/-)) mice model of myocardial ischemia/reperfusion (I/R).

METHODSMale ApoE(-/-) mice were randomly divided into three groups: standard ApoE(-/-) group (fed with standard mouse diet for 12 weeks before myocardial I/R procedure, n = 18), high-fat ApoE(-/-) group (fed with high-fat mouse diet for 12 weeks before myocardial I/R procedure, n = 22), and high-fat ApoE(-/-) + FXR antagonist group(fed with high-fat mouse diet for 12 weeks and received FXR antagonist Z-Guggulsterone 30 minutes before myocardial I/R procedure, n = 17). The expression of FXR was detected by real-time quantitative-PCR. Myocardial infarct size was determined by Evans blue/TTC double staining methods. Myocardial apoptosis was determined by in situ TUNEL technique. Markers of the mitochondrial-mediated apoptotic pathway (cytochrome c release, caspase-9 activity, and BAX and BCL-2 levels), endoplasmic reticulum stress apoptotic pathway (caspase-12 activity and CHOP level), and death receptor apoptotic pathway (caspase-8 activity, and Fas and FasL levels) were also measured.

RESULTFXR expression (3.7-fold higher, P < 0.01), myocardial infarct size [(62.1 ± 7.0)% vs. (33.8 ± 5.8)%, P < 0.01] and myocardial apoptosis index[ (36.8 ± 5.7)% vs. (17.2 ± 3.8)%, P < 0.01]were all significantly higher in high-fat ApoE(-/-) group than those in standard ApoE(-/-) group. Compared with high-fat ApoE(-/-) group, myocardial infarct size [(24.4 ± 4.7)% vs. (62.1 ± 7.0)%, P < 0.01] and myocardial apoptosis index [(13.8 ± 2.7)% vs. (36.8 ± 5.7)%, P < 0.01] were significantly reduced in high-fat ApoE(-/-) + FXR antagonist group. Moreover, levels of mitochondrial-mediated apoptotic pathway markers (cytochrome c release, caspase-9 activity, and BAX/BCL-2 levels) and endoplasmic reticulum stress apoptotic pathway markers (caspase-12 activity and CHOP level) were significantly lower in high-fat ApoE(-/-) + FXR antagonist group than those in high-fat ApoE(-/-) group (all P < 0.01). Levels of death receptor apoptotic pathway markers (caspase-8 activity, and Fas and FasL levels) were similar between high-fat ApoE(-/-) group and high-fat ApoE(-/-) + FXR antagonist group.

CONCLUSIONFXR antagonist alleviates myocardial reperfusion injury in cholesterol-fed ApoE(-/-) mice via inhibition of the mitochondrial-mediated and endoplasmic-reticulum stress pathway.

Animals ; Apolipoproteins E ; genetics ; Apoptosis ; drug effects ; Caspase 9 ; metabolism ; Cholesterol, Dietary ; administration & dosage ; Cytochromes c ; metabolism ; Disease Models, Animal ; Endoplasmic Reticulum Stress ; Male ; Mice ; Mice, Knockout ; Myocardial Reperfusion Injury ; metabolism ; pathology ; prevention & control ; Pregnenediones ; pharmacology ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Receptors, Cytoplasmic and Nuclear ; antagonists & inhibitors ; metabolism ; bcl-2-Associated X Protein ; metabolism

OBJECTIVETo analyze the early and long-term results after mitral-aortic valve replacement for rheumatic valvular disease and the determinant factors involved and subsequent therapies.

METHODS1 154 patients receiving combined mitral-aortic valve replacement for rheumatic valvular disease from May 1981 to May 2001 were reviewed. The mean age of the patients was 41.48 +/- 10.00 years. Concomitant valve plasty was performed for associated tricuspid organic or significant functional lesions. Lateral tilting disc or bileaflet valve prostheses were used for replacement. New York Heart Association functional status showed Class III or IV in 91.77% of the patients. Moderate to severe pulmonary hypertension occurred in 29.38% of the patients. The duration of follow-up varied from 8 months to 20 years.

RESULTSThe hospital mortality was decreased from 6.50% to 4.45%. The 5-, 10- and l5-year survival rates were 89.46% +/- 1.35%, 86.50% +/- l.91% and 67.86% +/- 6.16%, respectively. The 5-, 10- and l5-year thromboembolic event free rates were 97.80% +/- 0.74%, 88.31% +/- 2.20% and 94.08% +/- 2.29%, respectively. the 5-, 10- and l5-year anticoagulant related bleeding free rates were 94.80% +/- 1.09%, 89.32% +/- 2.10% and 83.12% +/- 3.57% respectively. Cardiac functional status returned to Class II in 98% patients and to Class III in 2% during follow-up.

CONCLUSIONSBoth left and right ventricular functions may be impaired as a result of rheumatic valvular disease. Tricuspid valve should be explored during surgery and any significant tricuspid annular enlargement and regurgitation showed be corrected in concomitance. Long-acting penicillin regimen is needed for 3 - 5 years for the prevention of rheumatic fever relapse. A low intensity anticoagulant regimen after valve replacement with prothrombin time targeting at 1.5 - 2.0 times is advisable in lessening anticoagulant related bleeding yet optimizing sufficient prevention against thromboembolic complications.

Adolescent ; Adult ; Aged ; Aortic Valve ; surgery ; Female ; Follow-Up Studies ; Heart Valve Diseases ; etiology ; surgery ; Heart Valve Prosthesis Implantation ; methods ; mortality ; Humans ; Male ; Middle Aged ; Mitral Valve ; surgery ; Postoperative Complications ; prevention & control ; Recurrence ; Retrospective Studies ; Rheumatic Heart Disease ; complications ; prevention & control ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Tricuspid Valve ; surgery ; Young Adult

OBJECTIVETo investigate and re-evaluate the relationship between burn wound sepsis and tissue bacterial quantity.

METHODSThirty-two patients admitted during past 5 years were enrolled in the study. Bacterial isolation and quantity in burn wound tissue were carried out. Meanwhile clinical signs were evaluated for the staging of burn wound sepsis.

RESULTS1) Bacterial invasion could be identified in 123 pieces of tissue samples from 32 patients. Samples with tissue bacterial quantity > or = 10(5)/g were found in 82 subeschar tissue samples, and 41 samples with bacteria <10(5)/g. Subeschar tissue samples with bacterial quantity > or = 10(5)/g could be determined in 68 samples from 18 patients, and < 10(5)/g in 20 samples from 5 cases. In addition, samples of subeschar tissue with bacterial quantity > or = 10(5)/g could only be found in some of the samples form 9 cases. 2) Burn wound sepsis could be classified into I-IV stages according to tissue bacterial quantification and clinical signs.

CONCLUSIONBurn wound sepsis could be established by identification of bacterial invasion into living tissue with clinical symptoms of toxemia.

Adolescent ; Adult ; Burns ; complications ; diagnosis ; microbiology ; Colony Count, Microbial ; Female ; Humans ; Male ; Middle Aged ; Sepsis ; diagnosis ; etiology ; microbiology ; Young Adult

OBJECTIVETo investigate the effect of lipid peroxidation on testosterone (T) in the serum and bcl-2 expression in the Leydig cells of aging male rats.

METHODSThe D-galactose-induced subacute aging male rat model was established and 20 SD rats were randomly divided into two groups of equal number: a D-galactose (D) group and a control (C) group. The activity of superoxide dismutase(SOD) and the level of malondialdehyde (MDA) were examined by spectro-absorptiometer, the expression of bcl-2 by immunohistochemical method, and the concentration of serum T by radio-immunity technique.

RESULTS(1) The activity of SOD in the testis of the D group was (116 +/- 18.09) U/ mg x prot, significantly lower than in the C group [(156 +/- 31.02) U/mg x prot (P < 0.01)]. (2) The level of MDA in the testis of the D group was (1.77 +/- 0.41) nmol/mg x prot, significantly higher than in the C group [(1.19 +/- 0.15) nmol/mg x prot (P < 0.05)]. (3) Serum T in the D group was (2.39 +/- 0.90) nmol/L, significantly lower than in the C group [(8.95 +/- 2.53) nmol/L (P < 0.01)]. (4) The expressions of bcl-2 in the leydig cells of the D and C groups were (35.1 +/- 3.6)% and (49.6 +/- 7.4)% respectively, with statistical difference between them (P < 0.01).

CONCLUSIONLipid peroxidation affects the concentration of serum T and the expression of bcl-2 in the Leydig cells of aging male rats.

Aging ; metabolism ; Animals ; Gene Expression ; Leydig Cells ; metabolism ; Lipid Peroxidation ; Male ; Proto-Oncogene Proteins c-bcl-2 ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley ; Testosterone ; blood

OBJECTIVETo evaluate the surgical technique and indication on descending aortic aneurysms.

METHODSFrom January 1996 to June 2006, 41 patients with descending aortic aneurysm underwent operation, including DeBakey type III dissection in 26, false aneurysm in 6, true aneurysm in 4, and residual or newly complicated type III dissection after the surgery of Marfan syndrome in 5. Operations were performed by left heart bypass in 9, femoral-femoral bypass in 7, pulmonary-femoral bypass in 2, and deep hypothermic circulatory arrest in 23. The whole thoracic descending aorta was replaced in 15, and intercostal arteries were reimplanted in 12.

RESULTSOne patient died of acute renal failure with the hospital mortality 2.4%. Main complications: respiratory dysfunction in 6, renal dysfunction in 6, recurrent nerve injuries in 4, chylothorax in 2, and no paraplegia.

CONCLUSIONSSurgical intervention of descending aortic aneurysm still has its unique advantages and indications; surgical safety is markedly improved by the use of deep hypothermic circulatory arrest.

Adolescent ; Adult ; Aged ; Aortic Aneurysm, Thoracic ; surgery ; Extracorporeal Circulation ; methods ; Female ; Follow-Up Studies ; Humans ; Hypothermia, Induced ; Male ; Middle Aged ; Retrospective Studies