0.05).The ultramicrostructure of cells detected by electron microscope showed that GJIC function in transfected group was higher than that in the other two groups.While in migration assay,the numbers of cells in lower chamber passing through the membrane in transfected group,blank control group and negative control group were 112?23,306?49 and 322?91, respectively;with significant differences among 3 groups(P

OBJECTIVETo observe the effects of angiostatin gene combined with chemotherapy on implanted human ovarian carcinoma of nude mouse.

METHODSThe mice were randomly divided into four groups after 7 days of the intraperitoneal injection of tumor cells (4 x 10(6)), and injected respectively with empty plasmid pcDNA3.0, angiostatin plasmid, cisplatin, and angiostatin plasmid + cisplatin. For combinational treatment, reagents were delivered in a timed fashion, where angiostatin plasmid was injected first, followed by cisplatin 24h later. The tumor samples were prepared to be used in the examinations of the expression of angiostatin with immunohistochemistry, of MVD in the tumor with immunohistochemistry, and of cell apoptosis with TUNEL staining.

RESULTSTumor growth and ascites formation were inhibited in all 3 groups except for the control group. The therapeutic effectiveness in the combined group was more significant than in the other two groups. In this group, MVD (32.5 +/- 4.3) was the lowest and apoptosis index (5.12 +/- 0.63) was the highest (P < 0.01).

CONCLUSIONSAngiostatin gene therapy combined with chemotherapy has a synergistic effect on the inhibition of ovarian cancer angiogenesis and ascites formation. Combining multiple therapies to treat ovarian cancer is an effective strategy.

Angiostatins ; biosynthesis ; genetics ; Animals ; Antineoplastic Agents ; therapeutic use ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Female ; Humans ; Injections, Intraperitoneal ; Mice ; Mice, Nude ; Neoplasm Transplantation ; Ovarian Neoplasms ; blood supply ; pathology ; therapy ; Peritoneum ; Random Allocation ; Transplantation, Heterologous

Objective To investigate the possible origin of ovarian epithelial inclusions and its relationship with the low-grade ovarian serous carcinoma.Methods By comparatively evaluating the morphologic (secretory and ciliated cell distribution ) and immunophenotypic [using paired box gene 8 (PAX8),tubulin,calretinin,and Ki-67 as first antibodies] attributes of ovarian epithelial inclusions,the normal tubal epithelium,and the ovarian tumors,all adnexal tissues from a total of 198 patients were studied,including 116 adnexae removed for non-neoplastic indications,53 serous cystadenomas,44 serous borderline tumors,and 41 low-grade serous carcinomas,which were collected from Qilu Hospital of Shandong University and University of Arizona in USA.Immunohistochemical single staining was used to detect the expressions of PAX8,tubulin,calretinin,and Ki-67 in the two groups,while immunohistochemical double staining of PAX8/calretinin was used to figure out the immunophenotype of various ovarian epithelial inclusions in a more intuitive way.Results With immunohistochemical single staining of PAX8 and calretinin,the vast majority (90％,54/60) of ovarian surface epithelia displayed a mesothelial phenotype [calretinin(+),PAX8 (-)],whereas 10％ (6/60)of the cases displayed foci with tubal phenotype [calretinin(-),PAX8 (+)].In contrast,most (79％,728/921 ) of the ovarian epithelial inclusions displayed a tubal phenotype,though 21％ (193/921) of the ovarian epithelial inclusions showed a mesothelial phenotype.It was further proved by immunohistochemical double staining of PAX8/ calretinin.Secretory and ciliated cells were found in the ovarian epithelial inclusions with tubal phenotype.There was a progressive increase in the secretory/ciliated cells ratio and proliferative index,from ovarian epithelial inclusions/cystadenomas to borderline tumors to low-grade serous carcinoma,according to the expression of tubulin and Ki-67.Conclusions The findings make a strong argument that the ovarian epithelial inclusions displaying a tubal phenotype with PAX8 (+),calretinin (-) is likely derived from fallopian tube rather than through Mullerian metaplasia from ovarian surface epithelium.The increasing trend of secretory/ciliated cells ratio and proliferative index from ovarian epithelial inclusions/cystadenomas to borderline tumors to low-grade serous carcinoma indicates that the latter is a clonal expansion of secretory cells.Genetic and molecular studies are needed to further confirm these findings.

Objective To evaluate the feasibility and effectiveness of combination chemotherapy with etoposide and cisplatin(EP)regimen on the patients with high-risk,chemorefractory and recurrent gestational trophoblastic neoplasia(GTN).Methods Thirty-nine patients with gestational trophoblastic tumors were analyzed retrospectively,25 of 39 patients were of high-risk,9 patients were chemorefractory and 5 patients were recurrent.All 39 patients were administrated with EP regimen,and 10 patients were assisted with surgery.All the patients were followed up.Clinical response,toxicity,the occurrence of secondary tumors of all patients,and the fertility of 30 patients whose fertility function was preserved were investigated. Results Thirty-nine GTN patients underwent a total of 221 cycles of the EP regimen.The average number of courses for each patient was 5.7.The total complete remission rate of the regimen was 74%(29/39). Twenty-five patients with high-risk GTN received a total of 139 cycles and the average number of courses was 5.6.Nineteen patients achieved complete remission and 6 patients showed drug-resistant.The complete remission rate of the high-risk group was 76%(19/25).Nine patients with chemorefractory GTN obtained a total of 55 cycles and the average number of courses was 6.1.Six patients achieved complete remission and 3 patients showed drug-resistant again.The complete remission rate of the chemorefractory group was 6/9. Five patients with recurrent GTN received 27 cycles and the average number of courses was 5.4.Four patients achieved complete remission,1 patient showed drug-resistance and died.Bone marrow toxicity, gastrointestinal reaction and alopecia were the main side effects of the EP regimen,but the bone marrow toxicity was slight and no grade Ⅳ side effect occurred.No fatal effect was found.Eight of 30 patients whose fertility faction was preserved had become pregnant after recovery,with a total of 8 pregnancies.Among them,2 were terminated by induced abortion,and 6 underwent normal term delivery and gained 6 infants who had no congenital malformation.All the 6 children had normal growth and development after childbirth. None of the women developed secondary tumors.Conclusion The EP regimen is effective and safe for the treatment of high-risk,chemorefractory and recurrent GTN.

Objective To study the function of early persistent vacuum suction drainage in patients with high risk of pancreatic fistula after pancreaticoduodenectomy (PD).Methods From Jul.2010 to Jun.2013,the clinical data of 286 patients undergoing PD were retrospectively evaluated.87 patients with high risk of pancreatic fistula were screened and then divided into early persistent vacuum suction drainage group (the observation group) and conventional drainage group (the control group) according to postoperative drainage manners.We statistically analyzed the two groups in terms of general information,blood loss,operative time,medical expenses,hospital stay,mortality and morbidity of complications such as pancreatic fistula.Results There were 40 patients screened into the observation group and 47 patients into the control group.No difference was found between the observation group and the control group in basic clinical data or surgical data.There was no statistical difference between the two groups in delayed gastric emptying,bile leakage,bleeding or the incidence of pancreatic fistula and intra-abdominal infection.The incidence of pancreatic fistula with grade B and C in the observation group was statistically lower than that of the control group(12.5％ vs 34.0％,P＜0.05).The incidence of intraabdominal infection in observation group was statistically lower than those in the control group (20.0％ vs 40.4％,P＜0.05).The incidence of total complications in observation group was statistically lower than that in the control group (60.0％ vs 83.0％,P＜0.05),but no difference was found between the observation group and control group in morality.Early persistent vacuum suction drainage could reduce hospital stay((21.93±7.14) days vs (28.70±12.45) days,P＜0.05) and clinical expense ((64.8±12.0) thousands vs (75.2± 14.6) thousands,P＜0.05) in patients with high risk of pancreatic fistula after PD.Conclusions Early persistent vacuum suction drainage can reduce the rate of grade B and C pancreatic fistula in patients with high risk of pancreatic fistula undergoing PD.The manner can also reduce the incidence of intra-abdominal infection,total complications and cost of hospital stay.This manner can accelerate postoperative recovery of patients undergoing PD and is worth of widely used.

0.05).(4) Toxicity:Grade Ⅲ-Ⅳ myelosuppression was 60%(18/30)in Tp group,26%(8/31)in TC group and 30%(10/33)in PC group.The TP regimen had the greatest hematologic toxicity(P0.05). Conclusions As first line chemotherapy in epithelial ovarian cancer,TP regimen comparable to the standard chemotherapy regimen.

AIM: To investigate the expression of NKG2A,NKG2D and their ligands in pregnancy uterine micro-environment and to probe the function of NKG2A and NKG2D imbalance expression during the immunotolerance at the fetal-maternal boundary.METHODS: Decidual lymphocytes and peripheral lymphocytes were obtained from 30 women during 6-9 weeks of pregnancy who were undergoing selective termination.FACS technology was used to detect NK cells number and NKG2A,NKG2D expression.RT-PCR was used to investigate HLA-E and MICA mRNA in trophoblast tissue.RESULTS: Natural killer cells predominate,accounting for 70% of pregnancy endometrial lymphocytes.FACS results indicated that NKG2A was significantly increased in decidual NK cells as compared with that in peripheral NK cells,accounting for 97.86%?1.75% and 33.35%?10.92%.The difference between them in NKG2A expression was significant(P

Objective: To investigate the safety and efficiency of small incision minimally invasive approach pancreatic necrosectomy in the treatment of infected pancreatic necrosis. Methods: The data of 164 patients who underwent small incision minimally invasive approach pancreatic necrosectomy for infected pancreatic necrosis at Department of Pancreatic and Biliary Surgery, the First Affiliated Hospital of Harbin Medical University from January 2012 to December 2016 were analyzed retrospectively.Among 164 patients, there were 102 male and 62 female patients.The median age was 46 years(ranging from 19 to 79 years). One hundred and one patients(61.6%) suffered from severe acute pancreatitis and 63 patients(38.4%) suffered from moderately severe acute pancreatitis.Following step-up approach principle, the surgical procedures were performed for 131 patients(79.9%) who suffered from sepsis which could not be alleviated via percutaneous catheter drainage(PCD). The other 33 patients(20.1%) who did not undergo PCD directly took small incision minimally invasive approach pancreatic necrosectomy.Preoperative CT images were used to determine the location of the lesion.The PCD puncture points or the points where the abscess was closest to the skin were chosen as the incision.Gradually, the small incision minimally invasive approach pancreatic necrosectomy were performed via cutting all layers into the abscess. Results: The median time from the onset of symptom to first operation was 32 days(ranging from 23 to 45 days). The average hospital stay was 46 days(ranging from 29 to 103 days). The average number of drainage tubes placed was 4 pieces(ranging from 2 to 8 pieces). Ninety-two patients(56.0%) underwent minimal access retroperitoneal pancreatic necrosectomy. Thirty-six patients(22.0%) underwent minimal invasive approach lesser omentum sac pancreatic necrosectomy.Thirty-six patients(22.0%) underwent minimal invasive approach lesser omentum sac pancreatic necrosectomy combined with minimal access retroperitoneal pancreatic necrosectomy.A total of 148 cases(90.2%) were cured via minimally invasive approach pancreatic necrosectomy, 8 cases(4.9%) were cured after transfering to open pancreatic necrosectomy.The cure rate was 95.1%(156/164). The mainly postoperative complications included pancreatic fistula(25 cases), intra-abdominal hemorrhage(10 cases), gastric fistula (2 cases), duodenal fistula(4 cases) and colonic fistula(3 cases). The overall incidence rate of complications was 26.8%(44/164). Eight cases were dead after surgery and the in-hospital mortality was 4.9%(8/164). Conclusion In summary, small incision minimally invasive approach pancreatic necrosectomy is an effective way to clean up necrotic tissue, improve the drainage, reduce complications in dealing with infected pancreatic necrosis.

OBJECTIVETo investigate the in vitro effect of HSV-tk/GCV using a hTERT promoter-driven vector system on Skov3 ovarian cancer cells.

METHODSAn expression vector (pBTdel-279-tk) containing tk gene under the hTERT promoter was constructed by molecular biological methods, and then was transfected into Skov3 ovarian cancer cells, normal ovarian epithelial cells (NOEC) and human embryonic lung fibroblast by cationic liposome. Following the transfection with tk, GCV was added, and MTT and flow cytometry methods were applied to investigate its antitumor effect. RT-PCR was used to detect the tk gene in ovarian cancer cells and normal cells after the transfection of pcDNA3-tk or pBTdel-279-tk.

RESULTSpBTdel-279-tk/GCV system induced apoptosis in hTERT-positive ovarian cancer cells, but not in hTERT-negative normal ovarian epithelial cells and fibroblasts. The hTERT promoter system was almost as efficient in inducing cancer cell death as the CMV promoter. tk gene was expressed in Skov3 cells and NOEC after pcDNA3-tk transfection, while positive was only in ovarian cancer cells after pBTdel-279-tk transfection.

CONCLUSIONThe telomerasespecific transfer of the tk gene under the hTERT promoter is a novel targeting approach for the treatment of ovarian cancer and may lead to an effective and specific gene therapy.

Apoptosis ; genetics ; Cystadenocarcinoma, Serous ; genetics ; pathology ; DNA-Binding Proteins ; Female ; Ganciclovir ; pharmacology ; Genetic Therapy ; Humans ; Ovarian Neoplasms ; genetics ; pathology ; Promoter Regions, Genetic ; genetics ; Simplexvirus ; genetics ; Telomerase ; genetics ; Thymidine Kinase ; genetics ; Transfection ; Tumor Cells, Cultured

Objective To study the impact of blood transfusion on postoperative complications of pancreaticoduodenectomy.Methods The medical data of 356 patients who underwent pancreaticoduodenectomy from January 2005 to December 2011 were retrospectively analyzed.242 patients in the transfusion group received blood transfusion while the remaining patients in the non transfusion group received no blood transfusion.Results The rates of pancreatic fistula and pulmonary infection,mean operative time,intraoperative blood loss,and hospital stay were 17.8％,16.5％,6.4 h,920.0 ml and 29.1 d in the transfusion group compared with 8.8％,6.1％,5.4 h,150.0 ml and 25.9 d in the non-transfusion group,respectively (P＜0.05).However,there were no significant differences between the two groups in the rates of biliary fistula,gastrointestinal and intraabdominal bleeding,delayed gastric emptying and death.Conclusions Patients undergoing pancreaticoduodenectomy in the non-transfusion group had significantly lower rates of pancreatic fistula and pulmonary infection,shorter operative time and hospital stay,and less intraoperative blood loss.This study suggested that a reduction in intraoperative blood loss by advanced instruments and techniques,with operations carried out by experienced pancreatic surgeons in specialized pancreatic center,could result in a significantly lower postoperative complication rate.