With the development of tumor immunology research, it has been recognized that the anti-tumor immune system function is better to predict the prognosis. Relationship between the tumor-infiltrating lymphocytes (TIL) and colorectal cancer has become one of the hot topics in research. Here we summarize the latest studies about the relationship between the TIL and clinicopathological factors, prognosis and microsatellite instability (MSI).
Colorectal Neoplasms ; genetics ; immunology ; pathology ; Humans ; Lymphocytes, Tumor-Infiltrating ; immunology ; Microsatellite Instability ; Prognosis

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Middle Aged ; Multidetector Computed Tomography ; methods ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; Retrospective Studies ; Venous Thrombosis ; diagnosis ; diagnostic imaging ; Young Adult

OBJECTIVETo pool the data of studies about anticoagulation in non-massive pulmonary thromboembolism (PTE) and evaluate the efficacy and safety of low molecular weight heparin (LMWH) and unfractionated heparin (UFH) as the initial treatment.

METHODSMEDLINE CD-ROM from January 1966 to August 2003 and CBM CD-ROM from January 1978 to August 2003 were chosen for searching the randomized clinical trials (RCTs) that compared the efficacy or safety of LMWH and UFH in non-massive PTE. A meta-analysis was employed to evaluate the results of these two therapies.

RESULTSFive RCTs including 999 cases were analyzed. Compared with UFH, the combined odds ratio (OR) of LMWH in treating PTE was as follows: (1) The total OR of mortality of PTE patients treated with LMWH was 0.81 (95%CI 0.36-1.81, P > 0.05); (2) The total OR of recurrence of venous thromboembolism (VTE) in PTE patients treated with LMWH was 0.37 (95%CI 0.14-1.00, P=0.05); (3) The total OR of bleeding in LMWH was 0.47 (95%CI 0.16-1.39, P > 0.05);(4) The total OR of heparin-induced thrombocytopenia (HIT) in LMWH was 0.66 (95%CI 0.06-6.92, P > 0.05).

CONCLUSIONSLMWH and UFH can reduce the mortality and recurrence of VTE in patients with PTE in the same degree. The risk of major bleeding was similar in the two treatment groups. Initial subcutaneous therapy with the LMWH appeared to be as effective and safe as intravenous UFH in the initial treatment of PTE.

Adult ; Anticoagulants ; therapeutic use ; Female ; Heparin ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Odds Ratio ; Pulmonary Embolism ; drug therapy ; mortality ; Randomized Controlled Trials as Topic ; Recurrence ; Thrombolytic Therapy ; Treatment Outcome

Animals ; China ; epidemiology ; Disease Models, Animal ; Humans ; Polymorphism, Genetic ; Venous Thromboembolism ; diagnosis ; epidemiology ; genetics

To get the mature peptide of human-derived neurotrophin-6 (NT-6), NT-6 gene encoding mature peptide was amplified by PCR, using the NT-6 cDNA that had been cloned as templet. The gene encoding mature peptide of NT-6 gene was cloned into pGEX1-lambdaT plasmid to construct the fusion expression vector. Expression of fusion protein in Escherichia coli was defected after induction by isopropyl beta-D-thiogalactoside(IPTG). The mature peptide of NT-6 was collected with GST fusion protein purifying kit. It was shown that a fragment of 460bp was gained by PCR. With the techniques of double-cleave and electrophoresis, the recombinant vector was identified as pGEX1-NT-6. The recombinant vector pGEX1-NT-6 transformed Escherichia coli expressed fusion protein of 41KD after induction by IPTG. Cleaved by thrombin, the mature peptide of NT-6 was obtained; its molecular weight was about 15KD. The cloning and expression of human-derived NT-6 gene encoding mature protein has provided a basis for further studies on the function and clinical application of NT-6.
Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; genetics ; Humans ; Isopropyl Thiogalactoside ; pharmacology ; Nerve Growth Factors ; biosynthesis ; genetics ; Peptides ; genetics ; Recombinant Fusion Proteins ; biosynthesis ; genetics ; isolation & purification

OBJECTIVETo evaluate the method of palliative drainage by means of metallic indwelling stents or plastic tubes for patients with malignant biliary obstruction.

METHODSFrom January 1995 to February 2001, 243 consecutive patients (161 men and 82 women; aged 26 - 91 years, mean of 61.3 years) with malignant biliary obstruction were treated with transhepatic placement of metallic stents and/or plastic tubes. Among them, 47 patients had pancreatic carcinoma, 98 cholangiocarcinoma, 28 metastatic carcinoma and 60 hepatic carcinoma. 169 stents of nine types were used in this series. After stenting, 47 patients were treated for local tumors. Procedure- and device-related complications were recorded. Patient survival and stent patency rates were calculated with Kaplan-Meier survival analysis.

RESULTSOne hundred and three patients underwent successfully stent placement for the first time. Others had their stents installed 1 - 2 weeks after catheterization. Stents were used in 132 patients. Ninety-five patients were treated with a single stent. Seventeen patients had two stents installed for bilateral drainage, 20 patients had two stents installed from top to bottom to create stenting of adequate length, and 12 patients had stents placed across the ampulla. The 2-month mortality rate was 8.64% (21/243). Major complications occurred in two patients (0.8%, 2/243). Minor complications included self-limited bleeding into the drainage tubes and fever. The average patency of the initial stent was 7.5 months and average survival was 9 months. Thirteen patients received brachytherapy in their stents, 15 extra radiation therapy, and 19 intra-arterial infusion chemotherapy. The 47 patients treated for local tumors had an average survival of 11.3 months (log rank 32.8, P < 0.001) with an average patency of 9.7 months (log rank 4.7, P < 0.05).

CONCLUSIONPercutaneous transhepatic bile drainage as a palliative procedure is well tolerated by patients. After stenting, treatment for local tumor may prolong the duration of stent patency and the survival of patients.

Adult ; Aged ; Aged, 80 and over ; Bile Duct Neoplasms ; complications ; Cholangiocarcinoma ; complications ; Cholestasis ; diagnostic imaging ; therapy ; Drainage ; Female ; Humans ; Liver Neoplasms ; complications ; Male ; Middle Aged ; Palliative Care ; Pancreatic Neoplasms ; complications ; Radiography, Interventional ; Stents

Adult ; Chorea ; etiology ; Circulatory Arrest, Deep Hypothermia Induced ; Diffusion Magnetic Resonance Imaging ; Endarterectomy ; adverse effects ; methods ; Humans ; Male ; Pulmonary Embolism ; surgery

OBJECTIVETo clone human brain-derived neurotrophin-6(NT-6) gene and to observe its expression in the procaryotic cell.

METHODSTotal RNA was extracted from aborted antenatal cerebral cortex, and cDNA fragment of NT-6 was amplified through reverse transcript-polymerase chain reaction. After being incised and recovered, the NT-6 gene was cloned into pBK-CMV plasmid to construct a NT-6 gene expression vector. Expression of NT-6 gene in Escherichia coli was studied after being induced by isopropyl beta-D-thiogalactoside(IPTG).

RESULTSThe NT-6 gene expression vector was constructed and Escherichia coli with recombinant vector expressed specific protein after induction by IPTG.

CONCLUSIONThe cloning of human brain-derived NT-6 gene provides a basis for further studying the structure, function and clinical application of NT-6.

Amino Acid Sequence ; Brain ; metabolism ; Cloning, Molecular ; DNA, Complementary ; genetics ; Electrophoresis, Polyacrylamide Gel ; Escherichia coli ; genetics ; Gene Expression ; Molecular Sequence Data ; Nerve Growth Factors ; chemistry ; genetics ; metabolism ; Plasmids ; genetics ; Protein Structure, Tertiary ; RNA ; genetics ; isolation & purification ; Recombinant Proteins ; metabolism ; Reverse Transcriptase Polymerase Chain Reaction ; Sequence Homology, Amino Acid

BACKGROUNDPulmonary endarterectomy is safe and effective surgical treatment for chronic thromboembolic pulmonary hypertension. This study aimed to evaluate the efficacy of pulmonary endarterectomy in treatment of thromboembolic pulmonary hypertension.

METHODSA retrospective study of 15 patients who underwent pulmonary endarterectomy in Beijing Chaoyang Hospital was performed. Obvious pulmonary hypertension and hypoxemia were observed in all patients. Bilateral pulmonary endarterectomy was performed under cardiopulmonary bypass with profound hypothermic circulatory arrest.

RESULTSTwo patients (2/15) died of residual postoperative pulmonary hypertension and bleeding complication. The other 13 cases had significant decrease in systolic pulmonary artery pressure ((92.8 +/- 27.4) mmHg vs. (49.3 +/- 18.6) mmHg) and pulmonary vascular resistance ((938.7 +/- 464.1) dynesxsxcm(-5) vs. (316.8 +/- 153.3) dynesxsxcm(-5)), great improvement in cardiac index ((2.31 +/- 0.69) Lxmin(-1)xm(-2) vs. (3.85 +/- 1.21) Lxmin(-1)xm(-2)), arterial oxygen saturation (0.67 +/- 0.11 vs. 0.96 +/- 0.22) and mixed venous O(2) saturation (0.52 +/- 0.12 vs. 0.74 +/- 0.16) postoperatively compared to preoperative data. Mid-term follow-up showed that the cardiac function of all cases returned to NYHA class I or II, with great improvement in 6-minute walking distance ((138 +/- 36) m) and quality of life.

CONCLUSIONSBilateral pulmonary endarterectomy using cardiopulmonary bypass with the aid of deep hypothermia and circulatory arrest can effectively reduce pulmonary hypertension and provide good mid-term hemodynamic and symptomatic results with low surgical mortality rate and few complications.

Adolescent ; Adult ; Echocardiography ; Endarterectomy ; adverse effects ; methods ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thromboembolism ; surgery ; Young Adult

OBJECTIVE: To compare the safety and feasibility between modified circumferential purse-string closure and conventional primary linear closure of the wound following loop stoma reversal. METHODS: Clinical data of 88 consecutive patients who underwent loop colostomy or loop ileostomy closures at our hospital from July 2011 to June 2013 were retrospectively analyzed. Among them, 43 cases underwent modified purse-string technique (modified purse-string group), 45 cases underwent direct suture (direct suture group). The operation method of modified purse-string suture was as follows: (1) the circumferential subcutaneous adipose tissue was sutured with the absorbable suture, avoiding tightening at knotting and retaining a 1 cm pore;(2)absorbable suture was used to perform purse-string suture of the dermis, retaining a 0.5 cm central pore when knotting; (3) a rubber drain was placed through the pore. The clinical parameters, surgical results and postoperative complication of two groups were recorded and compared. RESULTS: There were 56 males and 32 females with age of (65.0±11.5) years old. Seventy-nine cases were malignant tumors, 6 were benign tumors and 3 were traumatic. There was no significant difference in the baseline data between two groups (all P>0.05). Compared with the direct suture group, the modified purse-string group had significantly lower wound infection rate [7.0%(3/43) vs. 24.4%(11/45), χ²=5.015, P=0.025]; significantly shorter postoperative hospital stay (mean 7.1 days vs. 8.6 days, t=-2.656, P=0.010); significantly lower total hospitalization costs (mean 25 668.4 yuan vs. 27 718.1 yuan, t=-2.488, P=0.015); however, the wound healing time of the modified purse-string group was significantly longer (mean 22.0 days vs. 13.0 days, t=5.701, P<0.001). The average healing time of the wounds in the direct suture group was 29.8 days, which was significantly longer than that of the first-stage healing cases (7.5 days, t=-15.446,P<0.001). The average wound healing time of the infected cases in the modified purse-string suture group was 22.0 days, compared with 22.1 days in the first-stage healing cases, the difference was not statistically significant(t=0.077,P=0.943). CONCLUSIONS Modified purse-string closure after loop stoma reversal is an appropriate technique with lower stoma site infection rate, shorter postoperative hospital stay and lower hospitalization cost than conventional primary closure, although wounds may take longer to heal in this approach.
Aged ; Bacterial Infections ; prevention & control ; Colostomy ; Female ; Humans ; Ileostomy ; Intestines ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Surgical Stomas ; Suture Techniques ; standards ; Sutures ; Wound Healing