Objective To examine the expression of transforming growth factor β(TGF-β) activated kinase 1 (TAK1) in esophageal organization and the impact of TAK1 expression on clinicopathologic data. Methods Specimens from 80 patients with esophageal adenocarcinoma managed in our hospital were included in this study. Immunohistochemical staining was used to detect the expression of TAK1 in 80 cases of esophageal squamous cell carcinoma tissues and 80 cases of normal esophageal mucosal tissues. All the specimens were confirmed by pathology for esophageal squamous cell carcinoma or esophageal normal tissues. Results The positive expression rate of TAK1 in esophageal cancer organizations and normal esophageal mucosal tissues were 80% and 11.25%, respectively. The positive expression rate of TAK1 in esophageal cancer were significantly higher than those in normal esophageal mucosal tissue (P < 0.05). The positive expression rate of TAK1 in esophageal cancer organizations has nothing to do with the age, sex, tumor differentiation degree and size (P>0.05), but with lymph node metastasis and clinical stage (P<0.05). Patients with positive TAK1 expression had significantly lower five-year survival rate than those with tumors having positive TAK1 expression Conclusion TAK1 played an important role in the pathology and development of squamous cell carcinoma , and could be an important therapeutic target in the treatment of esophageal cancer.

Animals ; Dental Implantation, Endosseous ; adverse effects ; Dental Implants ; adverse effects ; Dental Prosthesis, Implant-Supported ; adverse effects ; Dentition ; Humans ; Malocclusion ; etiology ; Maxillofacial Development

Objective To evaluate the value of mini-thoracotomy for open heart surgery.Methods From December 1995 to January 2008,810 patients including 660 cases of congenital heart diseases,129 cases of valvular heart diseases and 21 cases of heart myxoma,underwent open heart surgery by mini-thoracotomy through cardiopulmonary bypass in our hospital.Among the cases,superior median sternotomy was performed on 36 patients,inferior median sternotomy was made on 59,right parasternal mini-thoracotomy was carried out in 3,right anterolateral thoracotomy was done on 658,and right axillary mini-thoracotomy was used in 54.A total of 382 patients received beating-heart surgery.Results The postoperative mortality in our patients was 1.5%(12 cases).In this series,the mean postoperative mechanical ventilation time,drainage volume,and hospital stay were(6.7?4.2) hours,(210?165) ml,and(7.4?4.9) days respectively.421 of the patients received no blood transfusion.None of the patients developed sternal dehiscence or mediastinal infection.Follow-up was available in 690(85%) of the patients up to a mean of(48.2?25.3) months,none of them died during the period.The cardiac function of the patients was significantly improved after the operation(preparation vs postoperation: 310 cases vs 478 cases for grade Ⅰ,438 vs 212 for grades Ⅱ-Ⅲ,and 62 vs 0 for grade Ⅳ,Z=-13.21,P=0.000).The mean cardiothoracic ratio was decreased significantly after the operation(0.51?0.11 vs 0.53?0.08,t=4.065,P=0.000),while the left ventricular ejection fraction was increased markedly(0.63?0.11 vs 0.57?0.11,t=-10.529,P=0.000).Conclusions The mini-thoracotomy is superior in cosmetic results and the postoperative morbidity rates of sternal malformation and infection.Proper selection of patients,good exposure of the surgical field,and skillful surgical procedures are crucial for the outcomes of the operation.

OBJECTIVE To study the epidemiology and the sensitivity to antibiotics of bacteremia in intensive care unit,and provide the reference for the clinical antimicrobial agents usage. METHODS 465 cases of bacteremia from Jan 2005 to Dec 2007 in the First Affiliated Hospital,Medical College of Zhejiang University were retrospectively analyzed. RESULTS Totally 1465 strains of pathogens were isolated in three years,and the positive rates were 22.6%.From them 155 strains were fungi(10.6%),611 strains were Gram-positive bacteria(57.9%) and 392 strains were Gram-negative bacteria(37.1%).G + strains mainly included coagulase-negative Staphylococcus(CNS,43.0%) and Staphylococcus aureus(2.1%);the sensitive antibiotics were vancomycin and teicoplanin.G-strains mainly included Acinetobacter baumannii(8.6%);Stenotrophomonas maltophilia(6.6%);Pseudomonas(5.1%) and Klebsiella pneumoniae(5.3%),the sensitive antibiotics were cefoperazone/sulbactam. CONCLUSIONS The positive rates of blood culture are higher in intensive care unit than in others.We should pay more attention to CNS for its high infection rate.The sensitive antibiotics of G + are vancomycin and teicoplanin.The sensitive antibiotics of G-are cefoperazone/sulbactum.Antimicrobial therapy should be conducted according to susceptibility test.The candidemia caused by non-Candida albicans(NCA) is increaseing in recent 3 year.

OBJECTIVETo sum up the experience in diagnosis and treatment of Fournier's gangrene and find an optimal evaluation tool for its prognosis by comparing currently used prognostic scoring systems.

METHODSWe retrospectively analyzed 16 cases of Fournier's gangrene diagnosed and surgically treated in our hospital between 2004 and 2012. Using Fournier's Gangrene Severity Index (FGSI), Uludag Fournier's Gangrene Severity Index (UFGSI), Age-Adjusted Charlson Comorbidity Index (ACCI), and Surgical Apgar Score (sAPGAR) , we obtained the prognostic scores of the patients and made comparisons among different scoring systems.

RESULTSFGSI, UFGSI, ACCI, and sAPGAR were all clinically used scoring systems. Statistically significant differences were found in the scores of ACCI and UFGSI but not in those of FGSI and sAPGAR between the death and survival groups, with the maximum area under the ROC curve and minimum standard error for the ACCI score.

CONCLUSIONBoth ACCI and UFGSI are useful for evaluating the prognosis of Fournier's gangrene. However, ACCI is even better for its higher sensitivity and specificity and easier clinical collection.

Age Factors ; Aged ; Fournier Gangrene ; diagnosis ; mortality ; surgery ; Humans ; Prognosis ; Retrospective Studies ; Sensitivity and Specificity ; Severity of Illness Index

Adult ; Facial Nerve Diseases ; complications ; Female ; Humans ; Mastoiditis ; complications ; Neurofibroma ; complications

Objective To investigate the effect of partial sleep deprivation (PSD) on cardiac electric activity and function of vascular endothelium. Methods Eighteen Sprague-Dawley rats were randomly divided into two groups (9 each):PSD group and control group. PSD lasted 10 days,20 hours each day. Body weight and surface electrocardiogram (S-ECG) were examined and recorded 1d before PSD,and 1d,4d,7d and 10d after PSD. Serum concentrations of glucose,total cholesterol (TC),triglyceride (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),creatin kinase (CK),creatin kinase-MB (CK-MB),high-sensitivity C-reactive protein (hs-CRP),nitric oxide (NO),von Willebrand factor (vWf),endothelin-1 (ET-1) and E-selectin were determined the next day after 10d of PSD. Results Compared to that 1d before PSD,body weight in PSD groups decreased significantly,while increased obviously in control group. Compared to that in control group,the body weight of rats decreased significantly (P

Objective:To construct the recombinant eukaryotic expression vector plasmids with mutant C-kit cDNA and to study the effect of the mutant C-kit gene on cell proliferation and cell cycle in gastrointestinal stromal tumor (GIST). Methods: Wild-type C-kit cDNA was cloned from human embryonic brain tissue by RT-PCR technique.Site-directed mutagenesis of the wild type C-kit cDNA was performed according to the C-kit mutations we cloned. Recombinant plasmids were stably transfected into human embryonic kidney cell line and the cells expressing mutant C-kit were selected by special cell culture medium containing G418.Expressions of C-kit protein of the transfectants were detected by Western blot.Cell proliferation and cell cycle of the transfectants were detected by MTT clolorimetic assay and flow cytometry,respectively.Whether HEK cell with mutated C-kit cDNA could grow autonomously in nude mice or not was also detected. pcDNA3 vector transfected and recombinant plasmids with wild-type C-kit cDNA transfected HEK cell were used as the control groups. Results: The mutant C-kit cDNA was obtained by site-directed mutagenesis of the wild type C-kit cDNA. Compared with the 2 control groups ,the growth rate and proliferative activity of the HEK cells with mutant C-kit cDNA were increased significantly.The analysis of cell cycle showed that more HEK cells with mutanted C-kit cDNA remained in proliferation phase (S+G 2-M)than the groups without mutated C-kit cDNA.HEK cells with the mutated C-kit also grew autonomously in nude mice.Conclusion: Mutation of C-kit gene can increase proliferation of human cells,causing malignant transformation of human normal cells,which may play an important role in the malignant transformation of GIST.

Objective To establish a normal lumbar spine 3-dimensional(3D) finite element model(FEM) and discuss the biomechanics of the lumbar motions. Methods A geometrical model was constructed on the basis of a healthy adult male's lumbar CT image.The lumbar spine FEM was established by finite element analysis software.After setting the boundary and loading the burden,the lumbar spine's range of motion and stress distribution in different institutions such as anterior flexion,posterior extension,left or right bending and axial rotating were recorded. Results The lumbar spine FEM included 114 953 tetrahedron units.The results of the FEM matched the results of the in vitro experiment of biomechanics. Conclusion The lumbar spine FEM can imitate the motions of the lumbar spine.

Stress urinary incontinence is one of the most common diseases in urinary system.At present,the major methods for treating stress urinary incontinence include medication,physico-behavior therapy and operation.However,for various reasons,the current methods do not yield satisfactory results.As a newly emerging technique,tissue engineering provides a new concept and method to treat stress urinary incontinence.The application of tissue engineering in the treatment of stress urinary incontinence is reviewed in this article.