Air Pollutants, Occupational ; analysis ; Chromatography, Gas ; methods ; Indenes ; analysis ; Workplace

Carbon Monoxide ; analysis ; Spectroscopy, Fourier Transform Infrared ; methods

OBJECTIVETo investigate the principle of management of colorectal high-grade intraepithelial neoplasia(HGIN) based on colonoscopic biopsy.

METHODSPatients diagnosed as colorectal HGIN based on colonoscopic biopsy in the Changhai Hospital from January 2002 to December 2009 were enrolled in the study. The clinical data of all the patients were collected and analyzed. According to the subsequent operation, cases were divided into local complete resection group and radical operation group. The discrepancy between the biopsy diagnosis and postoperative diagnosis was investigated.

RESULTSOf the 203 biopsy-based colorectal HGIN lesions, 156 underwent radical resection, while 47 received local complete resection. Univariate analyses indicated that tumors located in colon(P=0.02), tumors with sessile growth (P=0.00) and large tumors (P=0.00) were more likely to be treated with radical resection. Postoperative diagnosis revealed that 163 cases(80.3%) were invasive cancers, while the other 40 cases(19.7%) were HGIN lesions. Of the 156 cases resected radically, 140 cases were invasive cancers, 16 cases were diagnosed as HGIN. Of the 47 cases who underwent local complete resection, 24 cases were confirmed as HGIN but the other 23 cases were invasive cancers, in which 15 cases received subsequent radical operation.

CONCLUSIONSA large proportion of biopsy-proven colorectal HGIN lesions are invasive cancers. Therefore, local resection should be performed to confirm diagnosis. For highly suspected malignant tumors which can not be removed completely by local resection, if anus can be reserved, a radical transabdominal surgery is recommended even without biopsy-proven malignancy in order to avoid treatment delay.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Carcinoma in Situ ; diagnosis ; pathology ; surgery ; Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Endoscopy, Gastrointestinal ; Female ; Humans ; Male ; Middle Aged

BACKGROUNDNeoadjuvant chemoradiation is now considered the standard care for locally advanced rectal carcinoma (T3-4 or/and N1-2 lesions), but the accuracy of staging examinations including endorectal ultrasonography (ERUS) and MRI is far from excellent. In addition, the above staging equipment or professionals who perform the examinations may not be available in some hospitals, while preoperative colonoscopy and biopsy are usually obtainable in most hospitals. The objective of the present study was to investigate the clinical and pathological characteristics of locally advanced rectal carcinoma and identify candidates for neoadjuvant chemoradiation.

METHODSThis was a retrospective study. Patients who were treated for rectal cancer at Changhai Hospital from January 1999 to July 2008 were identified from our prospectively collected database. Statistical analysis was performed using SPSS Software System (version 15.0). The Mann-Whitney test, chi-square test and multivariate Logistic regression analysis were performed.

RESULTSA total of 1005 cases were included in this research, of which 761 cases were identified as locally advanced rectal carcinoma depending on postoperative TNM staging. The results of multivariate Logistic regression analysis indicated seven independent risk factors that could be used to predict a locally advanced rectal carcinoma independently: a high grade (including poor differentiation and undifferentiation) (OR: 3.856; 95% CI: 2.064 to 7.204; P = 0.000); large tumor size (OR: 2.455; 95% CI: 1.755 to 3.436; P = 0.000); elevated preoperative serum CEA level (OR: 1.823; 95% CI: 1.309 to 2.537; P = 0.000); non-polypoid tumor type (OR: 1.758; 95% CI: 1.273 to 2.427; P = 0.001); the absence of synchronous polyps (OR: 1.602; 95% CI: 1.103 to 2.327; P = 0.013); the absence of blood in stool (OR: 1.659; 95% CI: 1.049 to 2.624; P = 0.030); and a greater circumferential tumor extent (OR: 1.813; 95% CI: 1.055 to 3.113; P = 0.031). Based on these findings, a Logistic equation was established, the accuracy of which was 64% according to the information of the additional 50 cases.

CONCLUSIONSSome independent risk factors related with locally advanced rectal carcinoma were identified, based on which it is possible to establish a Logistic equation as a tool to predict candidates of neoadjuvant chemoradiation. Further research about optimization of the equation is warranted.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonoscopy ; methods ; Endosonography ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; diagnosis ; pathology ; Retrospective Studies

OBJECTIVETo identify a novel HLA-A allele in a Chinese Han individual.

METHODSOne mismatch was observed in HLA-A locus in HLA typing for CMDP donors using bi-allelic SBT kit. A confirmatory test for novel HLA allele was performed with mono-allelic SBT kit.

RESULTSThe DNA sequence was confirmed to be a novel HLA-A allele. There was 1 nucleotide differed from the closest matching HLA-A*11:01:01 at position 393(G→A), which resulting a change from GGG to GGA at codon 107, led to a silent mutation, conserving the amino acid Gly.

CONCLUSIONA novel HLA-A allele was confirmed and officially named HLA-A*11:01:37 (Genbank accession number, JN209962) by the WHO Nomenclature Committee for Factors of the HLA System in January 2012.

Alleles ; Base Sequence ; Blood Donors ; HLA-A11 Antigen ; genetics ; Humans ; Sequence Analysis, DNA

OBJECTIVETo investigate the association between the polymorphism of serotonin transporter gene-linked polymorphic region(5-HTTLPR) and slow transit constipation(STC).

METHODSPolymerase chain reaction was used to assess 5-HTTLPR polymorphism of SERT gene in 54 patients with STC and 100 healthy controls.

RESULTSThe frequencies of serotonin transporter short/short(S/S) and allele S genotypes were significantly higher in STC patients than those in controls(72.2% vs 50.0%; 83.3% vs 72.5%; both P< 0.05). There were no significant differences in 5-HTTLPR polymorphism respectively between the two groups according to gender and age(less than 45 and more than 45 years old). The frequency of S/S genotype was higher in the patients with less than 40% of the ingested markers evacuated within 72 h than those with more than 40% evacuated(71.7% vs 42.6%, P< 0.05).

CONCLUSIONThe presence of 5-HTTLPR allele S may contribute to the pathogenesis of STC.

Adolescent ; Adult ; Aged ; Alleles ; Chronic Disease ; Constipation ; genetics ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Polymorphism, Genetic ; Serotonin Plasma Membrane Transport Proteins ; genetics ; Young Adult

OBJECTIVETo investigate the reasonable proposal of prophylactic antibiotics use in selective colorectal operation.

METHODSOne hundred and sixty-five patients underwent colorectal surgery were randomized to Treatment 1 (55 cases), Treatment 2 (50 cases) and Control (60 cases) group. The Treatment 1 group was given oral MgSO4 solution at the night before operation, and Cefradine 2.0 g (I.V.) during the induction of anesthesia, continued with tow times of intravenous Cefradine 2.0 g and 0.5% Metronidazole 100 ml at an interval of 12 hours in 24 hours after the operation. The Treatment 2 group was given the same treatment as Treatment 1, but the antibiotics would not be withdrawn until 3-5 d after operation. On the basis of the treatment of Treatment 2 group, the Control group was given oral antibiotics 2-3 days before operation. Postoperative complications including surgical site infection, stoma leakage, dysbacteriosis, and WBC, body temperature, days of hospitalization and antibiotic expenses in the three groups were observed and compared.

RESULTSThere was no significant differences in surgical site infection, stoma leakage, WBC counting and its change, body temperature and hospital stay among the three groups (P > 0.05). The incidence rate of dysbacteriosis in Control group was significantly higher than that in Treatment 1 group (P < 0.05). The antibiotic expenses in the Treatment 1 group was significantly lower than those of the other two groups (P < 0.05).

CONCLUSIONSProphylactic antibiotic use during the induction of anesthesia and 24 hours after operation was reasonable in selective colorectal operation, it can prevent the surgical site infection effectively with good social-economic effects and fewer side effects.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; adverse effects ; Antibiotic Prophylaxis ; adverse effects ; methods ; Colorectal Surgery ; Female ; Humans ; Male ; Middle Aged ; Surgical Wound Infection ; prevention & control

OBJECTIVETo explore the angiogenesis and its maturation of hepatocellular carcinoma (HCC) and its correlation with deoxyhemoglobin parameters R2 * and T2 * values and the lesion/muscle R2*, T2 * ratio by using noninvasive magnetic resonance imaging (MRI).

METHODST2 *, R2 * values and the lesion/muscle R2 *, T2 * ratio in tumor periphery and center were calculated via series T2 * images in a total of 31 patients with surgically and pathologically confirmed HCC. After surgery, all sections were obtained from the specimen periphery in accordance with the MR analyzed areas. Continuous slices of each lesion were stained with hematoxylin-eosin (HE), and immunohistochemical staining was performed in vascular endothelial growth factor (VEGF), Flk-1, proliferating cell nuclear antigen (PCNA), CD34, and alpha smooth muscle actin (SMA). The expressions of VEGF, Flk-1, and PCNA index (PI) were evaluated. According to CD34 and SMA, some vascular parameters, including number, mean vessel area, total vessel area, circumference, diameter, distance between adjacent vessels, and variety index of microvessel and mature vessel, were calculated with a computed analysis system. The amounts of arterioles and veinlets, mature vessel index, and mean perfused fraction (mPF) were also recorded. All vessel parameters were compared with the calculated values of MRI.

RESULTSR2 * value or lesion/muscle R2 * ratio decreased and T2 * value or the lesion/muscle T2 * ratio increased in HCC when compared with hepatic parenchyma (P < 0.05); however, those values between lesion periphery and center and among different pathological grades were not significantly different (P > 0.05). T2 * value and the lesion/muscle T2 * ratio significantly decreased when the expression of VEGF was positive (P < 0.05). T2 * value was negatively correlated with microvessel amount (P = 0.047, r = - 0.639), while T2 * value and the lesion/muscle T2 * ratio were positively correlated with mPF (P = 0.040, r = 0.655; P = 0.048, r = 0.40, respectively). R2 * value was also positively correlated with mean area (P = 0.028, r = 0.688), total area (P = 0.021, r = 0.712) or circumference (P = 0.037, r = 0.663) of microvessel, and negatively correlated with mPF (P = 0.024, r = - 0.702). Meanwhile, the lesion/muscle R2 * ratio was positively correlated with mean area (P = 0.043, r = 0.647) and circumference (P = 0.026, r = 0.694) of microvessels.

CONCLUSIONR2 * or T2 * value may be influenced by the variation of deoxyhemoglobin caused by the heterogeneity of angiogenesis.

Adult ; Aged ; Carcinoma, Hepatocellular ; blood supply ; Female ; Hemoglobins ; Humans ; Liver ; pathology ; Liver Neoplasms ; blood supply ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Neovascularization, Pathologic

MicroRNAs are negative regulators of mRNA, and latest studies show that "mRNAs can also inhibit microRNAs". With these reciprocal interactions, different mRNAs with identical "microRNA binding site" cim regulate each other by competitively binding to the same microRNA pool. This is the novel competing endogenous RNA (ceRN A)regulating mechanism. The ceRN A mechanism, which is a totally new regulating mechanism , greatly expands the regulatory network across genes. It has been proved by experimental evidence that, in HCT116 colon cancer cells,KRAS and PTEN , ZEB2 and PTEN can regulate each other by ceRNA mechanism.
Colorectal Neoplasms ; genetics ; HCT116 Cells ; Humans ; MicroRNAs ; genetics ; PTEN Phosphohydrolase ; RNA, Messenger

OBJECTIVETo compare the accuracy of preoperative assessment in differentiation and grading of rectal adenocarcinoma.

METHODSOne hundred consecutive patients diagnosed as invasive rectal cancer by colonoscopy biopsy and undergone operation in the Changhai Hospital from March 2006 to May 2008 were studied retrospectively. Patient characteristics, examination records, operative and pathologic reports were reviewed. The slides of preoperative biopsy and postoperative pathologic specimen were reviewed to identify the differentiation by a single pathologist. The results of preoperative biopsy were compared to those of postoperative specimen which was considered as final diagnosis. The accuracy of preoperative assessment of differentiation was calculated. Patients were then divided into two groups based on the preoperative differentiation:the low-grade tumor including well and moderately differentiated tumors, and the high-grade tumor consisting of poorly differentiated and undifferentiated tumors. The accuracy of grading was also calculated.

RESULTSThe accuracy of preoperative assessment of differentiation was 72%, with 20% overgrading and 8% undergrading, while the accuracy of preoperative grading was 91%, with 4% overgrading and 5% undergrading. The accuracy of grading was significantly higher than that of specific differentiation(P<0.01).

CONCLUSIONThe grading of preoperative biopsy has high accuracy rate and should be considered in clinical practice.

Adenocarcinoma ; pathology ; surgery ; Adult ; Aged ; Aged, 80 and over ; Biopsy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Rectal Neoplasms ; pathology ; surgery ; Retrospective Studies