Purpose To evaluate the clinical and pathological features of extramammary Paget’ s disease ( EMPD) and to investigate the related prognostic factors. Methods The clinical and pathological data of 30 patients with EMPD were reviewed retrospectively. The HE slides in the file were rechecked. Immunohistochemical stains were performed on archival paraffin-embedded sections with En-Vision method in 20 cases. Follow-up data were recorded. The relationship between the clinicopathological parameters and prognosis was statistically analyzed. Results Among the 30 patients, there were 26 males and 4 females, aged from 53 to 88 years with median age 70. Macroscopically, typical presentations of EMPD were eczematoid lesions. Microscopically, Paget’s cells were distributed sin-gly or in groups ( as glandular or nests patterns) within the epidermis. Immunohistochemical stains showed that Paget’ s cells were pos-itive for CK7, and negative for CK5/6 and p63. Follow-up data were available in 23 cases, 8 cases recurred resection, among them, 6 patients had positive resected margin and 4 died. The recurrent rate and mortality between the groups of dermal invasion and no der-mal invasion (P<0. 01 and P<0. 05), the groups of lymphatic metastasis and no lymphatic metastasis (P<0. 01), and the groups of positive and negative resected margin (P<0. 01 and P<0. 05) were statistically different. There were no statistically different with age and extent of lesion (P>0. 05). Conclusions CK7 is a sensitive and specific marker of Paget’s cells. Dermal invasion, lymphatic metastasis and positive resected margin are poor prognostic factors in EMPD.

Adult ; Facial Hemiatrophy ; Humans ; Male

Objective To study the effectiveness and safety of intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis therapy for acute ischemic stroke in patients with atrial fibrillation (AF).Methods A total of 94 patients treated with intravenous rt-PA thrombolysis within 4.5 hours after cerebral stroke onset were analyzed and divided into two groups:a non-AF group (n =64) and an AF group (n =30).Another 30 acute ischemic stroke patients with AF without thrombolytic therapy were selected as a control group.The prognosis of the three groups was compared.The National Institute of Health Stroke Scale (NIHSS) was used for comparison among the three groups before therapy and 7 days after therapy.The incidences of intracerebral hemorrhage (ICH) and symptomatic ICH (SICH) were recorded.The patients were followed up for 90 days and their clinical outcomes were assessed by using the modified Rankin scale (mRS).Results There were no significant differences in the NIHSS scores among three groups before treatment (P ＞ 0.05).The NIHSS scores were significantly lower in the AF and non-AF groups 7 days after thrombolysis therapy than those before thrombolysis therapy (P ＜0.05 and P ＜0.01),and no significant difference in the NIHSS scores was found in the control group before and after therapy (P ＞ 0.05).The incidence of ICH was significantly higher in the AF group than in the non-AF group (26.7％ vs.9.4％,P ＜ 0.05).No significant difference in the incidence of SICH was found between the AF and non-AF groups (13.3％ vs.6.3％,P ＞ 0.05).The favorable prognosis rate was higher in the AF and nonAFgroups than in control group (40.0％ vs.16.7％,P＜0.05; 45.3％ vs.16.7％,P＜0.01).No significant difference in very unfavorable prognosis rate was found between the AF and non-AF groups (20.0％ vs.18.8％,P ＞0.05).Conclusions It is effective and safe of rt-PA thrombolysis therapy for acute ischemic stroke patients with AF.

Objective To investigate the expression of Ezrin in gastric cancer tissues and its clinical significance.Methods Gastric cancer tissues and adjacent normal gastric tissues from 60 patients with gastric cancer were collected from June 2008 to May 2009 at the Southwest Hospital.The mRNA and protein expressions of Ezrin were detected by using the reverse transcription polymerase chain reaction and western blot.The relationship between Ezrin and the gender and age of patients,and tumor differentiation,pathological staging,depth of invasion and lymph node metastasis was analyzed.All data were analyzed using the t test,chi-square test and Spearman rank correlation.Results The Ezrin mRNA expression level was increased in 33 (55％) cases of adjacent normal gastric tissues and 21 (35％) cases of gastric cancer tissues; the Ezrin protein expression level was increased in 45 (75％) cases of adjacent normal gastric tissues and 22 (37％) cases of gastric cancer tissues.The mRNA and protein expressions of Ezrin in the normal adjacent gastric tissues were 1.30 ± 0.04 and 3.57 ± 0.45,respectively,which were significantly higher than 0.53 ± 0.36 and 0.96 ± 0.18 in the gastric cancer tissues ( t =5.309,22.617,P ＜ 0.05 ).The mRNA expression of Ezrin was positively correlated with the protein expression of Ezrin (r =0.602,P ＜ 0.05 ).The mRNA and protein expressions of Ezrin were related to the pathological stages,depth of invasion and state of lymph node metastasis (x2 =6.41,6.49,4.62; 5.40,8.87,4.12,P ＜ 0.05),but not to the gender,age and tumor differentiation (x2 =0.50,0.07,1.07 ; 0.01,1.16,1.96,P ＞ 0.05).Conclusion The mRNA and protein expressions of Ezrin are significantly decreased in the gastric cancer tissue,which might be responsible for genesis,development and metastasis of gastric cancer.

Adult ; Breast ; pathology ; Breast Neoplasms ; diagnostic imaging ; pathology ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnostic imaging ; pathology ; Ultrasonography

Objective To study the methods and skill of vena cava filter placement via the antecubital access. Methods Six patients with DVT (4 males and 2 females, mean age of 62) underwent vena cava filter placement via the antecubital access in Huashan Hospital from Oct. 2004 to May. 2006. The right basilic vein was punctured with the use of micropuncture technique. SNF (Simon nitinol filter, Bard)was inserted through its carrier into the 90-cm-long sheath. The filter was then deployed with a standard fashion in the IVC, 5 cm inferior to the renal vein. Results The filter was once placed successfully in all six patients within average time of 25 min without complications, but with good healing, exclusion of bleeding and no phlebitis. The position of filter was accurate without deviation and no occurrence of pulmonary embolism. Conclusions vena cava filter placement via antecubital access is easy, minimal invasive, no need of lying in bed postoperatively. It is beneficial for DVT patients as an alternative for the contra-indication to femoral venous access.

Objective To investigate the relationship between the expression of eonnexin 43 (Cx43) and clinicopathologieal characteristics of gastric cancer, and to study the role of Cx43 in peritoneal metastasis of gastric cancer. Methods Thirty-two patients who had gastric cancer and with peritoneal metastasis had been admitted to Southwest Hospital from January 2000 to December 2008. Gastric cancer tissues, adjacent tissues and metastatic peritoneal tissues were obtained postoperatively, and the expression of Cx43 was detected by immunohistochemistry. The relationship between Cx43 expression and clinicopathological characteristics of gastric cancer was analyzed. All data were analyzed via Spearman rank correlation coefficient, Fisher exact probability and chi-square test. Results The expression of Cx43 was mainly detected in the cell membrane and cytoplasm. The positive expres-sion rates of Cx43 in gastric cancer tissues, adjacent tissues and metastatic peritoneal tissues were 34% (11/32), 100% (32/32) and 94% (30/32), respectively. There were significant differences in the Cx43 expression between gastric cancer tissues and adjacent tissues (X~2=28.350, P < 0.01), and between gastric cancer tissues and metastatic peritoneal tissues (X~2 = 21.989, P < 0.01). The expression of Cx43 did not correlate with age and sex of patients (r = -0.030, - 0.169, P > 0.05), but with tumor differentiation, histological type and lymph node metastasis (r = 0.750, 0.642, - 0.357, P < 0.05). Conclusions There is a decreased expression of Cx43 in gastric cancer tissues and a up-regulated expression of Cx43 in metastatic peritoneal tissues. Cx43 may play a positive role in the peritoneal metastasis.

Hypoxic-ischemic brain damage (HIBD) is referred to a common type of cerebral damage, which is caused by injury, leading to shallow bleeding in the cortex with intact cerebral pia mater. In recent years, studies show that a various kinds of immune cells and immune cellular factors are involved in the occurrence of HIBD. CC chemokine receptor 2 (CCR2) is a representative of CC chemokine receptor, and is widely distributed in cerebral neuron, astrocyte, and microglial cells, and is the main chemo-tactic factor receptor in brain tissue. CC chemokine ligand 2 (CCL2) is a kind of basophilic protein and the ligand of CCR2, and plays an important role in inflammation. In order to provide evidence for correlational studies in HIBD, this review will introduce the biological characteristics of CCR2 and CCL2, and illustrate the relationship between the immunoreactivity and HIBD.
Animals ; Brain Injuries/pathology* ; Cerebral Cortex/physiopathology* ; Chemokine CCL2/metabolism* ; Chemokines, CC/metabolism* ; Hypoxia-Ischemia, Brain/metabolism* ; Macrophage Inflammatory Proteins/metabolism* ; RNA, Messenger/metabolism* ; Rats ; Rats, Sprague-Dawley ; Receptors, CCR2/metabolism*

Objective To compare the effects and significance of laparoscopic and open D2 gastrectomy on the expression of interleukin (IL)-6 and IL-10.Methods The clinical data of 146 patients with gastric cancer who were admitted to the Southwest Hospital from November 2010 to October 2011 were prospectively analyzed.All the patients were randomly divided into the laparoscopic group (75 patients) and open group (71 patients)according to the sealed envelope method.Laparoscopic or open D2 gastrectomy were performed according to the 14th edition of gastric cancer treatment guidelines of Japan Gastric Cancer Association.Peritoneal lavage fluid was collected at the beginning and the end of operation,and the concentrations of IL-6 and IL-10 in the peritoneal lavage fluid were detected by enzyme linked immunosorbent assay.The measurement data were analyzed using the t test,and the count data were analyzed using the chi-square test.Results The preoperative concentrations of IL-6 in the laparoscopic group and the open group were (34 ± 13)μg/L and (35 ± 12)μg/L,respectively,with no significant difference between the 2 groups (t =-5.110,P ＞ 0.05).The postoperative concentrations of IL-6 in the laparoscopic group and the open group were (4015 ± 1592)μg/L and (6724 ± 2112)μg/L,respectively.The postoperative concentration of IL-6 in the laparoscopic group was significantly lower than that of the open group (t =-8.367,P ＜ 0.05),and the postoperative concentrations of IL-6 were significantly higher than those before operation in the laparoscopic group and open group (t =-59.065,-87.123,P ＜0.05).The preoperative concentrations of IL-10 in the laparoscopic group and the open group were (43 ±9) μg/L and (42 ± 10) μL,respectively,with no significant difference between the 2 groups (t =1.190,P ＞0.05).The postoperative concentrations of IL-10 in the laparoscopic group and the open group were (92 ± 32)μg/L and (62 ± 23)μg/L,respectively.The postoperative concentration of IL-10 was significantly higher than that of the open group (t =6.408,P ＜ 0.05),and the postoperative concentrations of IL-10 were significantly higher than those before operation in the laparoscopic group and the open group (t =-12.680,-6.802,P ＜ 0.05).Conclusion Peritoneal inflammatory reaction is relatively lighter after laparoscopic D2 gastrectomy when compared with open D2 gastrectomy,which might prevent the peritoneal metastasis of gastric cancer mediated by IL-6.

Objective To estimate the security and effectiveness of double access technique to treat chronic total occlusion in lower extremity artery. Method Fifty four patients,who had lower limb arteriosclerosis and accepted failed endovascular treatment because of unable to reenter true lumen through antegrade access,were treated immediately in double access style to recanalize occluded artery (including 27 patients of dorsalis pedis artery puncture,17 patients of posterior tibial artery punctrue,5 patients of proximal anterior tibial artery puncture and 5 patients of distal superficial femoral artery puncture). Evaluate the revascularization rate,complication rate and 6-month limb salvage rate of double access technique,t test was used to compare the ABI.Results Revascularization rate was 98.2％ (53/54),average puncture frequency of every case was 6 ( the first access was 2 in every patient,the second access was 4 in every patient ),average treatment time was 167 minutes,complication rate was 5.6％ (3/54),2 patients were occlusion in puncture segment of the second access,1 patient was hematoma in the second access point. 6-month ABI after intervention increased from 0.44 ±0.13 to 0.69 ±0.15,6-month limb salvage rate was 100％. Conclusion For chronic total occlusion,double access is a feasible technique to deal with unable to reenter true lumen throughantegrade access,the complication rate is low,the primary limb salvage rate is relatively high.