Objective The aim of this study was to investigate the feasibility and clinical value of detecting sentinel lymph node (SLN) with combined radioisotope and blue dye method in early stage cervical cancer. Methods Between March 2005 and April 2006, 50 patients with cervical cancer, who were staged Ⅰ b and Ⅱ a by International Federation of Gynecology and Obstetrics (FIGO), underwent SLN detection with preoperative lymphoscintigraphy. A dose of 148 MBq (4×10-4L) 99Tcm-sulfur colloid (SC) was injected into the uterine cervix at 3 and 9 o'clock position with lymphoscintigraphy taken at 15-60 min after injection. Intraoperative detection of "hot spot" lymph nodes was performed with a handheld gamma probe (γ-detection). During operation, 2-4 ml metend blue dye (BD-detection) was injected into the uterine cervix at the same positions. All patients underwent hysterectomy and pelvic lymphadenectomy. The spatial and pathological relationships of the SLN samples were compared between the two methods. SPSS 13.0 was used for statistical analysis. Results The detection rate of SLN with combined radioisotope and blue dye was 96.0% (48/50). γ-detection alone was 92.0% (46/50) and BD-detection alone was 70.0% (35/50, x2=4.92, P<0.05). In 37 patients lymphoseintigraphy showed the same SLN as γ-detection did, with a coincidence rate of 74.0% (37/50). The SLN with metastases were confirmed by histopathology in 11/48 (22.9%) patients. In the remaining 37 patients with SLN negative for metastasis, there was 1 case with non-SLN showing metastasis. In the 2 patients negative for SLN, 1 was positive for non-SLN metastasis. The SLN accuracy rate was therefore 97.9% (47/48), and the negative predictive value was 97.3% (36/37) with one patient false negative. About 72.3 % (115/159) of SLN were found in obturator region, 5.0% (8/ 159) in iuteriliac region, 12.0% (19/159) in external iliac chain, 6.9% (11/159) in common iliac region and 3.8% (6/159) in parametrium. The number of left-sided SLN detected was more than that of the right (x2=5.06, P=0.021 ). Conclusion Combined radioisotope and blue dye technique is a feasible and valuable tool to detect pelvic SLN in patients with early uterine cervical malignancy.

UNLABELLEDTo investigate the clinical and pathological characteristics, treatment, and The data of 12 patients prognosis of synchronous primary cancer of the endometrium and ovary. Methods with synchronous primary cancer of the endometrium and ovary were retrospectively reviewed . Results Eight patients had the same histological type of endometrioid carcinoma in both uterus and ovary, 4 patients had different histological types in uterus and ovary. Synchronous primary cancer of the endometrium and ovary was difficult to be dignosed preoperatively. All ovarian tumors were small with an average diameter of 7 cm. Infertility was common among these patients(40.7%). Most of them had early stage I lesion (66.7%). endometrioid carcinomas was the main pathologic type (66.7%). All patients were treated surgically followed by chemotherapy with a 3-year survival rate of 66.7% (8/12).

CONCLUSIONSynchronous primary endometrium and ovary cancer is a specific kind of tumor different from either the primary endometrium carcinoma or ovary carcinoma, and usually can be detected in early stage with a good prognosis.

Adenocarcinoma ; pathology ; therapy ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Carcinoma, Endometrioid ; pathology ; therapy ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Cystadenocarcinoma, Papillary ; pathology ; therapy ; Endometrial Neoplasms ; pathology ; therapy ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; Middle Aged ; Neoplasms, Multiple Primary ; pathology ; therapy ; Ovarian Neoplasms ; pathology ; therapy ; Retrospective Studies ; Survival Analysis

OBJECTIVETo investigate the clinical significance of micrometastasis detection in sentinel lymph nodes (SLN) from patients with early cervical carcinoma.

METHODSThirty patients with early cervical carcinoma were studied to identify SLN intraoperatively using methylene blue. One lymph node was removed randomly from palpable SLN and other pelvic lymph nodes (nSLN) in each patient, so 268 lymph nodes were collected and cut into two halves, one half of the lymph node was used to analyze the expression of cytokeratin 19 (CK19) mRNA by real-time fluorescence quantitative polymerase chain reaction to determine the presence of micrometastasis, the other half was examined by routine histology with HE staining.

RESULTS67 SLNs were detected in 28 cases (93.3%). Pelvic lymph nodes of 6 cases were confirmed pathological metastasis. The sensitivity of SLN detection was 66.7%, the accuracy rate was 96.4%, and the false negative rate was 16.7%. Among 268 lymph nodes (including 9 lymph nodes with pathological metastasis) detected by real-time fluorescence quantitative polymerase chain reaction, 68 lymph nodes were pathological negative but had micrometastasis, accounting for 26.3% (68/259) in pathologically negative lymph nodes. Among 24 patients with pathological negative lymph nodes, 16 cases had micrometastasis, accounting for 66.7% in those patients. Among 16 patients with micrometastasis, SLN of 3 cases were negative, but nSLN were micrometastasis, so the SLN false-negative rate rose to 18.2%. There were no significant relationships between pelvic lymph nodes micrometastasis and perivascular space involvement, deep stromal invasion and tumor grade (all P > 0.05). The micrometastasis rate of nSLN in patients with SLN micrometastasis was 100%, significantly higher than that in the patients with SLN non-micrometastasis (27.3%, P < 0.01).

CONCLUSIONSReal-time fluorescence quantitative polymerase chain reaction is a sensitive method to detect SLN micrometastasis. SLN micrometastasis may be an effective complement to SLN pathology to predict nSLN metastasis. Pelvic lymph nodes micrometastases have no significant relationship with pathological risk factors in cervical cancer and prognosis of patients.

Early Detection of Cancer ; methods ; Female ; Humans ; Lymphatic Metastasis ; diagnosis ; Neoplasm Micrometastasis ; diagnosis ; Neoplasm Staging ; Prognosis ; Sentinel Lymph Node Biopsy ; Uterine Cervical Neoplasms ; diagnosis

OBJECTIVETo study the clinical feature and more reasonable diagnostic typing criteria for patients with liver failure.

METHODS13/21 cases of ALF, SALF with no past liver disease, 49/72 cases of with chronic hepatitis, and 23/73 cases ALF, SALF with liver cirrhosis, were analyzed respectively.

RESULTS1 ALF patients (1). There exist significant statistic differences in ALB, ALT, CHE in three ALF groups.(2). It had statistic differences in those patients with hepatic encephalopathy.(3). The prognosis of the patients with chronic hepatitis group (42.85 percent) was best than that of chronic cirrhosis (26.09 percent) and no past liver disease (15.38 percent). (2) In SALF patients (1). There exist significant statistic differences in ALB, GLO, ALT, AST, BDIL, GLU and CHE in three SALF groups.(2). It had statistic differences in those patients with hepatic encephalopathy in three SALF groups.(3). The prognosis of the patients with chronic hepatitis group (51.39 percent) was best than that of chronic cirrhosis (36.85 percent) and no past liver disease (33.33 percent).

CONCLUSIONThere are different clinic feature and prognosis in three ALF or SALF groups, so we suggest that it were clinic practicability and science in classify of liver failure at present.

Humans ; Liver Failure ; classification ; Liver Failure, Acute ; classification ; Prognosis

OBJECTIVETo explore the implication of karyotype analysis in diagnosis and prognosis of myelodysplastic syndrome (MDS).

METHODSThe chromosomes were prepared with direct method, brief culture of cells and R-banding techniques, and then the karyotypic analysis was performed.

RESULTSeventy-seven out of 283 patients (27.21%) had karyotypic abnormalities, including the numeral abnormalities of chromosomes and structural alterations. The most common chromosomal aberrations were +8, -20/20q-, -Y, translocation, -7/7q-, +9, -5/5q-. The rate of abnormal karyotype in refractory anemia with erythroblasts (RAEB) and refractory anemia erythroblasts-transformation (RAEB-t) was much higher than in refractory anemia (RA). Patients with abnormal karyotype or higher IPSS scores had a higher risk of transformation into acute leukemia than patients with normal karyotype or lower IPSS scores (P<0.05).

CONCLUSIONMDS is a highly heterogenous disorder and karyotype analysis is helpful for its diagnosis and prognosis estimation.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Chromosome Aberrations ; Chromosome Deletion ; Chromosomes, Human, Pair 8 ; genetics ; Female ; Humans ; Karyotyping ; Male ; Middle Aged ; Myelodysplastic Syndromes ; genetics ; Prognosis ; Translocation, Genetic ; genetics

OBJECTIVETo compare the safety of intravenous thrombolytic therapy with recombinant tissue plasminogen activator (rtPA) in ischemic patients under the guidance of CT and multi-mode MRI.

METHODSThe clinical, laboratory, and radiologic data from 113 consecutive hyperacute ischemic patients who received intravenous rtPA therapy from June 2009 to October 2011 was retrospectively reviewed. The rate of hemorrhagic transformation (HT) and the clinical outcome between CT and multi-mode MRI was compared. Etiological subgroups were classified according to Chinese ischemic stroke subclassification (CISS).

RESULTSAmong 113 patients treated with intravenous rtPA, the mean age was 66 ±12 years, 74(65.5%) were man, the pretreatment National Institutes of Health Stroke Scale score (NIHSS) was 12.4 ±6.5, and time from symptom onset to therapy was 259.7 ±131.7 min. Postlytic radiological HT was found in 34 patients (30.1%). Symptomatic ICH occurred in 9 patients (8%). Logistic regression analysis suggested that multi-mode MRI was an independent predictor of reduced risk of HT.

CONCLUSIONThe risk of hemorrhagic complications is lower in patients receiving intravenous thrombolytic therapy with rtPA guided by multi-mode MRI than those guided by CT scan.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Brain Infarction ; drug therapy ; Cerebral Hemorrhage ; chemically induced ; prevention & control ; Female ; Humans ; Logistic Models ; Magnetic Resonance Imaging ; methods ; Male ; Middle Aged ; Recombinant Proteins ; administration & dosage ; adverse effects ; therapeutic use ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; adverse effects ; Tissue Plasminogen Activator ; administration & dosage ; adverse effects ; therapeutic use ; Tomography, X-Ray Computed ; Young Adult

Objective This study was conducted to determine the prognostic factors of cervical adenocarcinoma.Methods Between July 2008 and June 2013, 211 consecutive patients were treated because of International Federation of Gynecology and Obstetrics(FIGO) stage IA-IVB cervical adenocarcinoma.Overall survival was analyzed by the Kaplan-Meier method.Results One-year OS rate was 96.2%,and 3-year OS rate was 88.6%,and 5-year OS rate was 74.7%.Patients'age,FIGO stage,postoperative clinicopathological factors such as depth of stromal invasion,number of pelvic lymph node metastasis and para-aortic lymph node metastasis,were analyzed to discriminate their prognostic role.In the univariate analysis, age,FIGO stge,deep stromal invasion, lymph-vascular space invasion, number of pelvic lymph node metastasis,para-aortic lymph node metastasis were associated with poorer survival(P< 0.05).In the cox analysis, age (RR=4.940,95%CI:1.925-12.678),pelvic lymph node metastasis(RR=2.391,95%CI:1.311-4.360),para-aortic lymph node metastasis (RR=6.344,95%CI:1.007-39.990)and FIGO stage(Ⅲ vs I,RR=5.315,95%CI:2.760-12.203;Ⅳ vs I,RR=9.932,95%CI:2.905-18.846)were independent prognostic factors of invasive cervical adenocarcinoma.Conclusion Early detection and early treatment is very important for cervical adenocarcinoma patients.Give the patient suitable and maybe more aggressive adjuvant therapy according to surgical pathology is helpful for imporving adenocarcinoma treatment.

Objective To probe the technical processes of the suboccipital retrosigmoidal craniotomy with replacement of bone flap and deep muscles incision and suture and its clinical application. Methods The data of 40 patients undergoing suboccipital craniotomy to the cerehello-pontine angle lesions, deep muscles incision and suture in our hospital from May, 2003 to May, 2005 were analyzed retrospectively. Results All the procedures of craniotomy including removal of the bone flap, deep muscles incision and suture were accomplished safely with an average operation time of 40-60 min. Two patients appeared post-operative subcutaneous hydrops without CSF leakage and the majority can move their head freely sixth day after the operation. Conclusion Suboccipital retrosigmoidal craniotomy with replacement of bone flap, and deep muscles incision and suture, being a safe and feasible method, may decrease the happening of postoperative CSF leakage and encephalocele, and accelerate the recover of head movement.

OBJECTIVETo investigate the effects of chronic lead exposure on expression of autophagy-associated proteins in rat hippocampus.

METHODSSD rats were randomly divided into three groups: control group was given distilled water, lead-exposed groups were given 0.5 g/L (low-dose) or 2.0 g/L(high-dose) lead acetate solution in drinking water. The rat pups started to drink the lead content water until 60 d maturity. The lead contents in blood and brain samples were analyzed by graphite furnace atomic absorption spectrophotometry. The expressions of Beclin 1, LC3, LAMP2 and cathepsin B proteins were detected by Western blot and immunohistochemistry.

RESULTSCompared with control group, the contents of lead were significantly higher in blood and hippocampus samples in chronic lead-exposed rats (P<0.01). Western blot showed that the expression of Beclin 1 and LC3-II/LC3-I increased significantly in high dose lead-exposed group compared with control group (P<0.05 or P<0.001). The confocal laser immunostaining results demonstrated that increased immunofluorescence staining of cathepsin B in hippocampal neurons compared with control animals.

CONCLUSIONThe disturbance of autophagy-lysosome signaling molecules might be partially contribute to neurotoxicity of chronic lead exposure.

Animals ; Apoptosis Regulatory Proteins ; metabolism ; Autophagy ; drug effects ; physiology ; Beclin-1 ; Cathepsin B ; metabolism ; Chronic Disease ; Disease Models, Animal ; Female ; Hippocampus ; drug effects ; metabolism ; pathology ; Lead Poisoning ; metabolism ; pathology ; Lysosomal-Associated Membrane Protein 2 ; metabolism ; Male ; Microtubule-Associated Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; drug effects

AIM:To investigate the protective effect of mucin 2(MUC2)on intestinal mucosa of colitis model mice,and to explore the correlation between the expression of anti-CBir1 flagellin antibody and MUC2.METHODS:The mice were randomly divided into normal control group,2,4,6-trinitrobenzenesulfonic acid(TNBS)group,lipopolysaccha-ride(LPS)+ovalalbumin(OVA)+TNBS group and ketotifen+TNBS group.The expression of MUC2 in colon tissue was determined by PAS staining and immunohistochemistry, and the anti-CBir1 antibody level in the serum of mice in each group was measured by ELISA.RESULTS:The scores of disease activity index and histological index in TNBS group were higher than those in normal control group(P<0.05).The scores in LPS +OVA+TNBS group were much higher than those in TNBS group(P<0.05).However, the values in ketotifen +TNBS group were lower than those in TNBS group (P<0.05).PAS staining showed a decrease in goblet cells in TNBS group.Compared with TNBS group,the colonic mu-cosa integrity in LPS+OVA+TNBS group was destroyed, and the number of goblet cells in ketotifen +TNBS group in-creased significantly.Immunohistochemical staining showed that the expression of MUC 2 in the intestinal tract of each mo-del group was basically consistent with the results of PAS staining.The serum anti-CBir1 antibody level in TNBS group was higher than that in normal control group(P<0.05), and that in LPS+OVA+TNBS group was significantly higher than that in TNBS group(P<0.05),whereas that in ketotifen +TNBS group was decreased slightly(P<0.05).CONCLU-SION:MUC2 plays a protective role in the pathogenesis of colitis in mice,and there is a negative correlation between the expression of MUC2 and the bacterial flagellin in the intestinal mucosa of mice with colitis.