Objective To evaluate the clinical value of preoperative mark with methylene blue for the submucosal tumor originating from the muscluaris propria around the cardia in submucosal tunnel.Meth-ods A total of 27 patients with cardiac tumors originating from muscularis propria diagnosed by endoscopy and endoscopic ultrasonography underwent endoscopic submucosal tunnel dissection from June 2011 to May 2014.Eighteen cases were marked by methylene blue,and 9 others were not.The operation time and the in-cidence of complications were compared between the two groups.Results All lesions were resected success-fully.The time of lesion location of non-mark group was 14.7 minutes(9-32 min),and that of mark group was 8.1 minutes(7-10 min).The incidence of subcutaneous emphysema of thorax and cervix of non-mark group was 2 /9(2 cases),and that of the mark group was 1 /18(1 case).The incidence of pneumoperitone-um of non-mark group was 1 /9(1 case),while that of the mark group was 2 /18(2 cases).There was no pneumothorax or mediastinal emphesema in all cases.Conclusion Marking with methylene blue before op-eration can shorten operation time effectively and lower incidence of complications.

OBJECTIVETo examine the feasibility and safety of gastric submucosal tunnel dissection of gastric submucosal tumors (SMTs) by double tunnel and double flex endoscope.

METHODSFifty patients with gastric SMTs detected by gastric endoscopy and endoscopic ultrasonography between January, 2012 and August, 2013 were enrolled in this study. Using carbon dioxide throughout the procedure, the mucous in the arc was incised along the margins of the lesion to separate the submucosa and create a tunnel. The exposed SMTs were resected completely and the mucosa was covered by endoscopic forceps followed by clipping of the incision. The complication, clinical outcomes, hospital stays and operation time were evaluated.

RESULTSOf the 50 lesions, 50 were located in the gastric fundus, 17 in the gastric antrum and 5 in the gastric body. The lesions were completely resected in all the patients. The diameter of the resected lesions ranged from 0.5 to 2.5 cm (mean 1.1 ± 0.6 cm), and the operation lasted for 35.3 ± 16.2 min (range 23-76 min). In 5 cases (10%), perforation occurred during the operation and was closed by clipping the incision with endoclips after the lesion resection; these patients were discharged after conservative management. Intraoperative bleeding occurred in 16 cases and was successfully managed through endoscopic methods. No delayed postoperative bleeding or perforation occurred in these patients. None of the 48 patients followed up showed tumor recurrence at one year after the operation, and 2 patients were lost for follow up.

CONCLUSIONEndoscopic submucosal dissection of gastric SMTs is effective and safe using double tunnel and double flex endoscope.

Dissection ; Endoscopes ; Endoscopy ; Endosonography ; Gastric Mucosa ; pathology ; surgery ; Humans ; Neoplasm Recurrence, Local ; Stomach Neoplasms ; surgery

Objective To investigate the expression of sialic acid-binding immunoglobulin-like lectin-one (Siglec-1, also called CD169) in lymphocytes, monocytes and neutrophils in peripheral blood in patients with coronary heart disease(CHD), and explore the relationship between Siglec-1 expression and atheresclerosis. Methods CD145 CD169 positive cell proportion and CD169 mRNA levels were respectively measured by flow cytometry and real-time quantitative reverse transcription-polymerase chain reaction (FQ-RT-PCR) in 57 CHD patients and 38 healthy controls. And the levels of serum hpids were determined by automatic biochemistry analyzer. Results The flow cytometry analysis showed that CD169 protein was not found in lymphocytes and neutrophils in both CHD patients and healthy controls. The rate of CD14 CD169 double positive ceils in monocytes in CHD group was significandy higher than that in healthy controls [(12.7±2.4)% vs (1.0±0.3)% ,t =23.2,P<0.01]. And FQ-RT-PCR analysis showed that the mean CD± mRNA copy number in PBMCs in CHD group was significantly higher(3.2 fold) than that in healthy controls [t = 6. 59, P < 0.01]. However, neither differences of CD169 protein positivities [[(12. 2 ± 2. 3) %vs (13.4±2.5)% ,t = 1.87,P >0.05] nor mRNA levels [3.64 fold vs 2.79 fold when compared with healthy controls,t =0. 98, P > 0. 05] were found between CHD patients with normal and abnormal levels of serum Lipids. Conclusions CD169 is mainly expressed in human tissue-resident macrophages but not expressed in peripheral blood monecytes. And when the monocytes is stimulated by inflammation, the expression of CD169 is increased. In patients with CHD, the increased expression of CD169 protein and mRNA level has demonstrated the activation of monocytes in peripheral blood. CD169 and CD169-mediated monocytes activation may play an important role in the development and progression of atherosclerosis.

Objective To investigate the presentationand significance of circulating autoantibodies to erythropoietin receptor (EPOR) in sera from patients with systemic lupus erythematosus (SLE). Methods One hundred and twenty-four consecutive patients with SLE, seven with autoimmune hemolytic anemia (AIHA), 19 patients with iron deficiency anemia (IDA) and 45 normal individuals were involved in this study. In all patients with SLE, the disease activity was evaluated using the European consensus Lupus Activity Measurement scale. Antibodies to EPOR were detected by enzyme-linked immunosorbent assay (ELISA). All data were tested with Chi-squared or Student's t tests by SPSS software. Results A higher frequency of antibodies to EPOR were detected in SLE patients than healthy controls (20.2% vs 2.2%, P=0.004), however, they could not be detected in AIHA and IDA patients. Moreover, anti-EPOR antibodies were detected in 17 (33.3%) of 51 SLE patients with anemia, compared with that in 8 (11.0%, P=0.002) of 73 patients without anemia. Furthermore, patients with antibodies to EPOR had more severe anemia and often presented as microcytic anemia (P =0.005) than those without anti-EPOR antibodies. Finally, anti-EPOR antibodies seemed to be more likely to occur in patients with skin rash (P=0.014), low levels of C3 component of complement (P=0.01), positive anti-dsDNA antibodies (P=0.000) and higher disease activity scores (P= 0.024). Conclusion The higher incidence of antibodies to EPOR in SLE patients with anemia suggest that anti-EPOR antibodies might play a vital role in the development of anemia in SLE patients. Thus, detecting anti-EPOR antibodies in SLE patients with anemia may be helpful.

OBJECTIVETo investigate the relationship between methylation of the CDH1 gene promoter on the expression of E-cadherin and β-catenin, and to evaluate the correlation with clinicopathological characteristics of the colonic carcinoma.

METHODSMethylation specific PCR (MSP) was used to detect CDH1 gene promoter methylation in the cancer tissue, adjacent tissues and normal tissues in 68 patients. The expression of E-cadherin and β-catenin was determined by immunohistochemistry staining.

RESULTSThe positive rate of CDH1 gene promoter methylation was 32.4% in adjacent tissues and 57.4% in cancer tissue, while no detectable methylation was found in all the normal tissues. The difference was statistically significant. The positive rate of E-cadherin was 92.6% in the normal tissues, 66.2% in the adjacent tissues and 44.1% in the cancer tissues. In all normal tissues, β-catenin was expressed only at the cellular membrane but not in the cytosol or nucleus, while the expression of β-catenin was present in the cytosol or nucleus in 29.4% of the adjacent tissues and 50.0% of the cancer tissues. The positive rate of CDH1 gene promoter methylation was negatively correlated with E-cadherin expression(r=-0.312, P=0.01) and positively correlated with β-catenin cytosolic/nucleus expression(r=0.309, P=0.018). The differentiation and metastasis of colonic carcinoma were associated with the aberrant expression of E-cadherin, β-catenin, and methylation of CDH1 promoter (P<0.05).

CONCLUSIONCDH1 gene promoter methylation may lead to aberrant expression of E-cadherin and β-catenin in colonic carcinoma, and may play an important role in promoting the invasion of tumor.

Adult ; Aged ; Aged, 80 and over ; Cadherins ; genetics ; metabolism ; Colonic Neoplasms ; genetics ; metabolism ; DNA Methylation ; Female ; Humans ; Male ; Middle Aged ; Promoter Regions, Genetic ; beta Catenin ; genetics ; metabolism

OBJECTIVETo investigate the effect of organic gallium and gallium chloride on bone metabolism and their therapeutic effect against tretinoin-induced osteoporosis in rats.

METHODSRat models of osteoporosis was established with intragastric administration of tretinoin at the daily dose of 85 mg/kg for 15 days and randomized into control, organic gallium and gallium chloride groups. After administration of the corresponding treatments (none for the control group) for 4 weeks, the changes of the indices for osteoporosis were evaluated through biochemical and pathological approaches.

RESULTSTretinoin induced obvious changes in bone structure and contents of bone calcium and other elements, causing also significantly increased tartrate-resistant acid phosphatase (TRAP) and alkaline phosphatase (AKP), which suggested the development of osteoporosis. Administration of organic gallium and gallium chloride treatments increased the bone density, bone cortex thickness and the percentage of bone trabecula, and Ga, Ca, P contents in the femur and teeth, but lowered the activity of TRAP and AKP, suggesting decreased bone conversion rate. Compared with gallium chloride, organic gallium required smaller dose with better safety to produce better therapeutic effect.

CONCLUSIONOrganic gallium can be safe and effective for treatment of tretinoin-induced osteoporosis in rats.

Animals ; Cell Line, Tumor ; Female ; Femur ; drug effects ; metabolism ; pathology ; Gallium ; chemistry ; pharmacology ; therapeutic use ; Hemodynamics ; drug effects ; Organometallic Compounds ; chemistry ; pharmacology ; therapeutic use ; Osteoporosis ; chemically induced ; drug therapy ; metabolism ; physiopathology ; Rats ; Rats, Sprague-Dawley ; Tooth ; drug effects ; metabolism ; Trace Elements ; metabolism ; Tretinoin ; pharmacology

OBJECTIVE: To investigate the changes of phospho-JNK (p-JNK) during the incised wound healing of the skin in mice and to explore the rule of the time-dependent change of p-JNK in wound age determination. METHODS: The changes of p-JNK expression in incised skin wound were detected by immunohistochemistry and Western blot. RESULTS: There was a minimal baseline staining of p-JNK in control mouse skin. Changes of p-JNK expression were mainly detectable in neutrophils in the wound specimens from 3 hours to 12 hours after injury. Afterwards, the p-JNK positive cells were mostly mononuclear cells and fibroblasts between post-injury day 1 and day 5, whereas the p-JNK positive cells were mostly fibroblasts between post-injury day 7 and day 14. Morphometrically, the ratio of the p-JNK positive cells to the total increased gradually in the wound specimens from 3 hours to day 1, and maximized at day 1 with a slight decrease from post-injury day 3 to day 5. The ratio showed a second peak in the specimens of day 7, and then decreased gradually from post-injury day 10 to day 14. The changes of p-JNK expression were observed throughout the wound healing stages by Western blot as well, with a peak expression occurring between 12 hour and day 3 after injury. CONCLUSION p-JNK may play a pivotal role in inducing apoptosis of neutrophils, mononuclear cells, and fibroblasts during skin wound healing and meanwhile, p-JNK may be a potentially useful marker for wound age determination.
Animals ; Biomarkers ; Female ; Forensic Medicine ; JNK Mitogen-Activated Protein Kinases/metabolism* ; Male ; Mice ; Phosphorylation ; Random Allocation ; Skin/injuries* ; Time Factors ; Wound Healing ; Wounds, Penetrating/enzymology*

This study was purposed to investigate the mechanism of thrombocytopenia in patients with systemic lupus erythematosus (SLE) through detecting anti-megakaryocyte antibodies in SLE patients. The serum anti-megakaryocyte antibodies in 36 SLE cases with thrombocytopenia were detected by using indirect immunofluorescence, the detected results were compared with detected results of 30 SLE cases without thrombocytopenia and 30 healthy persons. The results showed that the positive incidences of anti-megakaryocyte antibody in serum of 36 SLE cases with thrombocytopenia, 30 SLE cases without thrombocytopenia and 30 healthy persons were 19.4% (7/36), 6.7% (2/30) and 3.3% (1/30) respectively. As compared with SLE patients without thrombocytopenia and healthy persons, SLE patients with thrombocytopenia had higher incidence of anti-megakaryocyte antibodies, moreover there was significant difference between SLE patients with thrombocytopenia and healthy persons (p < 0.05), while there was no significant difference between SLE patients with or without thrombocytopenia (p > 0.05). It is concluded that autoantibodies against megakaryocytes exist in SLE patients and may partially contribute to the incidence of thrombocytopenia in SLE patients. The detection of anti-megakaryocyte antibodies with a enough case number is needed to make a final conclusion on thrombocytopenia pathogenesis in SLE.
Adult ; Autoantibodies ; blood ; Female ; Fluorescent Antibody Technique, Indirect ; Humans ; Lupus Erythematosus, Systemic ; blood ; immunology ; Male ; Megakaryocytes ; immunology ; Middle Aged

OBJECTIVE: To identify the effect of preoperative anemia on the prognosis of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy. METHODS: Clinicopathological and prognosis data on 686 patients with UTUC who underwent RNU at Peking University First Hospital between January 2000 and December 2013 were retrospectively analyzed. Preoperative anemia was defined as hemoglobin <130 g/L in men and <120 g/L in women based on the World Health Organization classification. The Kaplan-Meier method with log-rank test was applied to estimate the effect of anemia on survival. The associations of clinicopathologic features with overall survival and cancer-specific survival were evaluated using univariate and multivariate Cox regression models. RESULTS: There were 303(44.2%, 303/686) male and 383(55.8%, 383/686) female patients, and the median age was 68 years (interquartile range: 60-74 years). In all, 320 (46.6%, 320/686) patients were anemic before surgery. The median follow-up duration was 47 months. In all, 160 (23.3%) patients died, 141 (20.6%) died of cancer and 19 (2.7%) died of other disease or accidents. Preoperative anemia was associated with gender (P=0.002), age (P<0.001), lymph node positive (P=0.026), increased tumor grade (P=0.018), concomitant carcinoma in situ (P=0.038), tumor necrosis (P=0.007) and poor renal function (P<0.001). In univariate analysis, overall mortality was correlated with pre-operative anemia (P<0.001), gender (P=0.009), hydronephrosis (P=0.024), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture(P<0.001), sarcomatoid differentiation (P=0.013), history of ureteroscope (P=0.033) and tumor hemorrhage (P<0.001); cancer-specific mortality was correlated with preoperative anemia (P=0.001), gender (P=0.001), hydronephrosis (P=0.043), tumor stage (P<0.001), lymph node positive (P<0.001), tumor grade (P<0.001), tumor architecture (P<0.001), sarcomatoid differentiation (P=0.016), history of ureteroscope (P=0.028) and tumor hemorrhage (P=0.003). A multivariate Cox proportional hazards model indicated that preoperative anemia was an independent prognositic predictor for overall mortality (P<0.001, HR=1.861) and cancer-specific mortality (P=0.003, HR=1.688). CONCLUSION The preoperative anemia is an independent risk factor for cancer-specific survival and overall survival. Hemoglobin levels should be considered during patient counseling and in decision-making for further therapy.
Aged ; Anemia ; Carcinoma, Transitional Cell/surgery* ; Female ; Humans ; Male ; Middle Aged ; Nephrectomy ; Nephroureterectomy ; Prognosis ; Retrospective Studies ; Urologic Neoplasms/surgery*