BackgroundOcular melanoma is a malignant tumor with a poor prognosis.To study its mode of pathogenesis and development is helpful for early diagnosis and treatment and improving prognosis. Objective This study was to analyze the location and pathological types of ocular melanoma,and explore the relationship of pathological types with prognosis of ocular malignant melanoma. Methods 110 clinical data and specimens of ocular melanoma were collected at West China Hospital,China.The specimens were examined by hematoxylin & eosin staining,immunochemistry and studying their ultrastructure.The growth location,histological classification,and their relationship with prognosis were analyzed and discussed.The clinicopathological records of the 1 l0 cases with ocular region malignant melanoma treated from January 1980 to December 2007 were analyzed.Results The primary locations of the tumors with respect to the tissue type were:66 cases in the uvea (60.00％ ),27 cases in the ocular surface tissue (24.55％),8 cases in the secondary lesion of orbit cavity (7.27％),7 cases on the eyelid skin (6.36％),and 2 cases in the lacrimal sac ( 1.82％ ).The neoplasm was classified according to pathological types:spindle-cell A type in 31 cases (28.18％ ),spindle-cell B type in 31 cases (28.18％),mixed-cell type in 25 cases (22.73％),epithelioid-cell type in 17 cases ( 15.46％ ) and other type in 6 cases (5.45％).The notability of diffusion or recurrence rate of the 5 pathological types showed statistical significance (x2 =14.463,P =0.006 ),and the rank in decending order was:other type,epithelioid-cell type,mixed-cell type,spindle-cell B type and spindle-cell A type.The clinical manifestations of ocular melanoma were dependent upon the lesion position without specificity.ConclusionsThe majority of the ocular malignant melanoma appears in the uvea and ocular surface tissue,and its common pathological types were spindle-cell type followed by mixed-cell type,epithelioid-cell type and other type.The highest recurrence rate is in other type of ocular malignant melanoma.Ophthalmologist should be aware of the clinical manifestation of ocular malignant melanoma.

Objective To investigate the potential role of MCP-1/CCL2 in experimental acute necrotizing pancreatitis (ANP) and complications. Methods 60 SD male rats were randomly divided into 3 groups: sham operation group ( n = 20 ), ANP group ( n = 20 ) and MCP-1 group ( n = 20 ). ANP model was induced by retrograde infusion of 3.5% sodium taurocholate, MCP-1 group received subcutaneous injection of MCP-1 antibody 0 h and 6 h after ANP induction. The serum levels of amylase, MCP-1, D-lactic acid,histological changes and the expression of MCP-1 mRNA of lung, small intestine and pancreas, the expression of MCP-1 protein in pancreas, MPO levels of small intestine MPO were determined. Results The serum levels of amylase, MCP-1, D-lactic acid in MCP-1 group at 12 h were (4666 ±412)U/L, (39.53 ±8.25)pg/ml and (6.3 ±2.2)mg/L, which were significantly lower than those in ANP group [ (9611 ±363)U/L, (63.42 ±9.32) pg/ml, (9.3 ± 2. 1 ) mg/L, P< 0.05 ) ]; the expression of MCP-1 mRNA in pancreas, small intestine and lung were 0.431 ± 0.009, 0. 211 ± 0.018 and 0.442 ± 0.017, which were significantly lower than those in ANP group [ (0.624 ±0. 010, 0. 523 ±0. 019 and 0. 569 ±0. 024, P <0.05) ]; the expression of MCP-1 protein in pancreas was 2.0 ± 0. 1, which was significantly lower than that in ANP group (4. 0 ± 0. 2, P <0.05). Lung and small intestine MPO were (11.1 ±3.0)U/g and ( 19.2 ±2.0)U/g, which were significantly lower than those in ANP group[(39.2±3.1)U/g and(13.1±2.1)U/g, P<0.05]. Conclusions Early blockade of MCP-1 not only attenuates the severity of ANP, but also decreases the degree of acute lung injury and intestine barrier dysfunction.

OBJECTIVE To investigate the effects of recombinant human epidermal growth factor (rhEGF) on wound healing of chronic sinusitis patients after functional endoscopic sinus surgery. METHODS A total of 110 patients with chronic sinusitis underwent functional endoscopic sinus surgery with both sides of their nose. The right side of their nasal cavity (control group) treated by nasal irrigation and steroid nasal spray, the left side of their nasal cavity (study group) treated by nasal irrigation and the nasal spray of steroid hormones and rhEGF. Surgical effect was evaluated under nasal endoscope at 2, 4, 12 and 24 weeks after surgery, while subjective symptom was evaluated depending on visual analogue scale (VAS). Both the score of endoscopic examination and VAS, also the rates of epithelization of the two groups were compared. RESULTS The score of endoscopic examination of the study group at 2 weeks after surgery was better than that of the control group, which had statistical significance, while the score of VAS had no statistical difference. The score of endoscopic examination and VAS, the rate of epithelization in study group at 4 and 12 weeks after surgery were better than those in control group, and the difference was statistically significant, but they were no statistical difference at 24 weeks after surgery. CONCLUSION The using of rhEGF nasal spray on chronic sinusitis patients with functional endoscopic sinus surgery can shorten the time of epithelization, improve the situation of nasal mucosa and patients' subjective symptoms, it is worthy of clinical application.

Objective To observe the clinical effect of transforaminal endoscopic surgical system (TESSYS) technique for atypical lumbar disc herniation. Methods Eighteen patients with atypical lumbar disc herniation underwent TESSYS technique under local anesthesia. Numerical rating scale (NRS) was used to evaluate the sciatica and/or back pain. The outcomes were evaluated by Oswestry disability index (ODI) and the Macnab score. Results The postoperative NRS scales were significantly lower than preoperative one (P<0.01). The postoperative ODI was lower than preoperative one (P < 0.05). Good rate of modified Macnab criteria was 88.89%. One patient occurred right hip pain and disappeared after partial closure. one patient turned to open surgery at 1 week. Conclusion The TESSYS technique was an effective method for atypical lumbar disc herniation. It has satisfactory clinical effect which is worthy of spreading for clinical application.

Objective To investigate the blood-saving effect of controlled low central venous pressure (CLCVP) in different types of hepatectomy.Methods Ninety ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 37-76 yr,weighing 40-75 kg,undergoing elective hepatectomy,were divided into 6 groups according to the surgical approach and whether CLCVP was used during surgery (n =15 each):CLCVP1-3 groups and nonCLCVP1-3 groups (NCLCVP1-3 groups).The standard hepatectomy,half liver resection and irregular hepatectomy were performed in CLCVP1-3 groups,respectively,with CLCVP.The standard hepatectomy,half liver resection and irregular hepatectomy were performed in NCLCVP1-3 groups,respectively,without CLCVP.In CLCVP1-3 groups,from skin incision to the end of liver resection,CVP was maintained ≤ 5 cm H2 O through adjustment of the position,fluid restriction and iv infusion of nitroglycerin,and norepinephrine was infused simultaneously to maintain mean arterial pressure ≥ 60 mm Hg.In NCLCVP1-3 groups CVP was maintained at 6-12 cm H2O.Intraoperative blood loss and blood transfusion were recorded.Results Compared with NCLCVP1-3 groups,intraoperative blood loss was significantly decreased in CLCVP1-3 groups (P ＜ 0.05).Compared with NCLCVP3 group,the amount of blood transfusion was significantly decreased,the constituent ratio of intraoperative blood loss ＜ 200 ml was increased,and the constituent ratio of intraoperative blood loss ＞ 1000 ml was decreased in group CLCVP3 (P ＜ 0.05).Conclusion CLCVP can decrease the intraoperative blood loss and blood transfusion in patients undergoing irregular hepatectomy.

Objective According to the characteristics of skin defects in ankle and foot select the posterior lateral leg pedide skin flaps supplyed by different blood to repair,providing advice and reference.Methods Between January,2001 and December,2015,163 cases of soft tissue defects at the foot and ankle were treated in our department.①The sural neurovascular flap was used in 93 cases in ankle and foot defect.②The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery in 36 cases in ankle and foot defect.③The sural nerve nutritional vessel flap pediele with the perforating branch of the peroneal artery including sensory reconstruction in 16 cases in heel rejion defect.④Peroneal artery perforator flap in 10 cases in anterior ankle,lateral malleolus and posterior malleolus defect.⑤The use of the sural fasciocutaneous flap alonged with peroneal artery and perforators in 8 cases in dorsal foot defect.The donor site with skin graft.Results Of the 93 sural neurovascular flaps,8 had partial loss,which were cured after dressing.All the sural nerve nutritional vessel flaps pediele with the perforating branch of the peroneal artery survived.Sensory grading standard by UK Medical Research Council was used to evaluate the recovery of sensory function on the last follow-up.The sensory function recovery of heel region flaps with reconstruction of the sensory was between S0 and S1.All peroneal artery perforator flaps survived.One of the sural fasciocutaneous flap alonged with peroneal artery and perforators occurred distal epidermis,which were cured after dressing.All patients were followed up 6-50 months (mean 20 months).All patients had recoveryed walking function,and infection wound had no recurrence after surgery.Conclusion According to the location,size,severity and the injury of peripheral vascular,select the most simple,safe,minimal damage flap for the soft tissue defects at the foot and ankle.The right choice and the exact design can improve flap survival rate,and recieve good clinical results.

AIM: To investigate the effects of tranfection of IL-2R antisense RNA expression plasmids on mouse spleen cells' proliferation in vitro and its possible mechanism. METHODS: Spleen cells were transfected with IL-2R antisense RNA eukaryotic expression plasmids using adhesion-assisted lipofection method, and then the spleen cells were stimulated by mitogen. Cells' proliferation was tested by tetrazolium salt (MTT) method. IL-2R mRNA and protein expression level were measured by slot-blot hybridization assay and flow cytometry method respectively. RESULTS: The proliferation of spleen cells was inhibited obviously after transfecting with recombinant plasmids. The inhibitory rate of pcAnti-mlL-2Rαβ- and pciAnti-mIL-2Rαβ-transfected group was higher than that of pcAnti-mIL-2Rα-and pcAnti-mIL-2Rβ-transfected group; the inhibitory rate of pcAnti-mIL-2Rα-tranfected group was higher than that of pcAnti-mlL-2Rβ-tranfected group. No inhibitory effect on the growth of NIH3T3 cells was observed when they were transfected with recombinant plasmids. IL-2R mRNA and protein expression level were decreased in spleen cells after transfection of recombinant plasmids. CONCLUSION: IL-2R antisense RNA can efficiently inhibit the proliferation of mouse spleen cells in vitro. IL-2Rαβ chimeric antisense RNA showed higher inhibitory rate than a or antisense RNA. IL-2Rα antisense RNA was more effective than β antisense RNA. It can be concluded preliminarily that the inhibitory effect of IL-2R antisense RNA was exclusively on the growth of cells functionally expressing IL-2R. The inhibitory effect on the spleen cells' proliferation was likely due to the blocking of IL-2R expression by antisense RNA.

Objective To explore the pattern of lymph node metastasis in patitsen with squamous cell carcinoma of the thoracic esophagus and its significance in lymphadenectomy.Methods The clinical data of 230 patients who received radical esophagectomy with three-field lymphadenectomy was analyzed.The metastatic sites of lymph nodes were correlated with tumor location by chi-square test.Logistic regression was used to analyze the relationship between clinic pathoingical factors and lymph node metastasis.Results Lymph node metastases were found in 133 of the 230 patients(57.8%).The average number of resected lymph nodes was 25.3? 11.4 per patient(range 11～71).The rates of lymph node metastasis were 41.6%,19.44%and 8.3%in the neck,thoracic medi- astinum and abdominal cavity for patients with upper thoracic esophageal carcinoma,33.3%,34.7%and 14%for patients with mid- die thoracic esophageal carcinoma and 36.4 %,34.1%and 43.2 %for patients with lower thoracic esophageal carcinoma.No signifi- cant difference in cervical or thoracic metastatic rate was observed among upper,middle and lower thoracic carcinoma.The difference in lymph node metastatic rate for nodes in the abdominal cavity was significant among upper,middle and lower thoracic carcinoma. The lower thoracic esophageal cancers were more likely to metastasize to the abdominal cavity.Logistic-regression showed depth of tu- mor invasion and angiolymphatic invasion were factors influencing lymph node metastasis.Conclusion Cervical and mediastinal node dissection should be performed independently from tumor location.Abdominal node dissection should be conducted more vigorously for lower thoracic esophageal cancer than of other locations.Patients with greater tumor grade,depth of tumor invasion and angiolymphatic invasion were more prone to develop lymph node metastasis.

Objective To evaluate treatment effects and to determine the prognostic factors of primary orbital lymphoma. Methods From March 1984 to October 2000, 44 primary orbital lymphoma patients were admitted into our hospital, with 27 males and 17 females. Twenty-seven patients had eyelid or conjunctiva primary, and 17 patients orbit primary. Patient's age ranged from 14 to 86 years (median, 50.5years). According to the Ann Arbor Staging System, there were 40 ⅠEA, 4 ⅡEA lesions. Cobolt-60 ?ray was given first to the whole orbit to 30-35?Gy followed by 180 kv X-rays or 9 Mev ?-beam to the focus to a total dose of 41.0-51.5?Gy (median, 46.5?Gy). Kaplan-Meier method was used to analyze the survival. Log-rank test was used to detect the difference between groups.Results Only 1 patient failed from primary site and 5 patients from distant metastasis after radiotherapy. The 5-year and 10-year cause-specific survival rate were 90.9% and 84.5%, respectively. On univariate and multivariate analyses, eyelid or conjunctiva localization and Ann Arbor stage ⅠEA were independent favorable prognostic factors for survival. The 5-year survival was much higher in eyelid or conjunctiva patients than in orbital ones (96.3% vs 70.6%, P=0.013). The survival time was longer in stage Ⅰ than in stage Ⅱ (P=0.000). Neither the RT dose nor the age or sex influenced the outcome.Conclusions Localized orbital lymphoma can be well controlled with low-dose RT alone. Patients with eyelid or conjunctival localization and stage Ⅰ have better cause-specific survival.

Objective: To construct and identify a lentiviral vector harboring RNAi sequence targeting the human high mobility group A1(HMGA1) gene.Methods: The effective sequence of siRNA targeting the HMGA1 gene confirmed in our previous study,the complementary DNA containing both sense and antisense Oligo DNA of the targeting sequence was designed,synthesized and cloned into the pGCL-GFP vector diced by the restriction enzyme of HpaⅠ and XhoⅠ,which contained the U6 promoter and green fluorescent protein(GFP).The resulting lentiviral vector containing HMGA1 shRNA was named LV-sh HMGA1 and confirmed by PCR and DNA sequencing.A total of 293T cells were cotransfected with LV-sh HMGA1,pHelper 1.0 and pHelper 2.0.All the virus stocks were produced by Lipofectamine2000-mediated transfection.The titer of the virus was tested according to the expression level of GFP.Results: PCR analysis and DNA sequencing demonstrated that the RNAi sequence targeting the human HMGA1 gene was successfully inserted into the lentiviral vector.The titer of the recombinant lentiviral vector was 5?107 TU/ml.Conclusion: The successful construction of the lentiviral vector of HMGA1 has prepared the ground for further studies on the functions of the HMGA1 gene with the RNAi technique.