Objective To analyze and explore the clinical features,pathological characters,treatment and prognosis of rectum carcinoid.Methods From January 1997 to January 2010,69 pathologically diagnosed rectum carcinoid cases were collected from Union Hospital of Tongji Medical College,Huazhong University of Science and Technology and other 7 hospitals.The clinical features,pathological characters,treatment and prognosis were analyzed. Results Of 69 rectum carconid cases,there were 36 males and 33 females.The average age was (49.3±12.9) years.The common symptom were hemotochezia,abdominal pain,constipation,diarrhoea and abdominal distension.There were 55 cases with lesions from the anus less than 8 cm and in other patients,lesions from the anus were all more than 8 cm.66 cases were typical carcinoid,3 cases were atypical carcinoid.40 cases underwent the immunohistochemical staining.The common markers for immunohistochemical staining were Syn,CgA and NSE,the positive percentage were 90％ (36/40),75％ (30/40) and 82.5％(33/40) respectively.A total of 24 patients received endoscopic therapy,44 patients had surgery,1 patient who refused surgery received only life support and symptomatic treatment.Conclusion No specific clinical symptoms of rectum carcinoid,and most were typical carcinoid.Lesions confined to mucosa and submucosa could be considered the endoscopic therapy.

Background:Gastrointestinal carcinoids are prone to be neglected in clinical practice because of the poor specific symptoms in early stage. Aims:To analyze the clinicopathological characteristics,treatment modalities and prognosis of a series of cases of gastrointestinal carcinoids for strengthening the understanding of the disease. Methods:A total of 116 patients diagnosed as gastrointestinal carcinoids by pathology from Jan. 1997 to Jan. 2010 in 8 hospitals at Wuhan were enrolled in this retrospective study. Data on sex,age,major symptoms,diagnostic approaches,treatment modalities, pathological features and prognosis, etc. were collected and analyzed. Results:The most common sites of the gastrointestinal carcinoids were rectum(59. 5%)and stomach(19. 8%);the most common symptoms were abdominal pain,abdominal distention and hematochezia. The positivity rates of immunohistochemical marker NSE,Syn and CgA were 92. 7%,87. 5% and 62. 5%,respectively. The proportion of stomach carcinoids with diameter larger than 2 cm was 73. 9%, and that of rectal carcinoids was only 13. 0%(P <0. 001). Most of the gastric carcinoids(81. 8%)infiltrated into or breakthrough the serosa;the rate of lymph node involvement in gastric carcinoids was significantly higher than that in rectal carcinoids(72. 7% vs. 17. 1%,P<0. 001),while typical carcinoids were less common in stomach than in rectum(60. 9%vs. 95. 7%,P<0. 001). Only one(4. 3%)gastric carcinoid patient underwent endoscopic therapy,while that for rectal carcinoids was 24 cases(34. 8%,P=0. 003). Surgical operation was the main therapeutic method for both gastric and rectal carcinoids. The 3-and 5-year survival rates for rectal carcinoids were 92. 8% and 62. 3%,respectively,and those for gastric carcinoids were 62. 6% and 49. 2%,respectively;there were no significant differences between the two groups(P>0. 05). Conclusions:Gastrointestinal carcinoids enrolled in this study distributed mainly in rectum and stomach. As compared with rectal carcinoids,gastric carcinoids were more advanced in disease stage with poorer prognosis. Regular health checks, strengthening the understanding of the disease,and grasping the specificities of carcinoids distributed at different sites might be helpful for the early diagnosis and treatment of gastrointestinal carcinoids,thus improving the survival rate.

Objective To test different expression protein markers of the serum from B-cell non-Hodgkin lymphoma(B-cell NHL) between diffuse large B-cell lymphoma(DLBCL) and follicular lymphoma(FL)patients using sudace enhanced laser desorption/ionization-time of flight-mass spectrometry(SELDI-TOF-MS)protein chip technology. Further, to test different expression of the protein markers of B-eell NHL patients after chemical therapy in order to discuss clinical significance. Methods Different expression of protein markers were analysed in serum between 54 B-cell NHL patients and 27 healthy volunteers by using SELDI-TOF-MS WCX-2 pertein chip. Meanwhile different expression of protein markers relative to pathology classification between 23 DLBCL patients and 12 FL patients were screened; and protein markers which affected prognosis of 23 DLBCL patients were screened. Results There were five specific marker proteins in 54 B-cell NHL patients and 27 healthy volunteers. Their relative molecular weights were 7974, 15 938, 3398,8564, and 8692. The protein markers of 7974 and 15 938 were at high level in patients and the protein markers of 3398, 8564 and 8692 were at low level in patients. There were two protein markers which affected the prognosis, with better outcome when the expression of 4795 and 4998 were increased. Conclusion SELDI-TOF-MS protein chip technology is a quick, easy and convenient method, with high-throughput analyzer which can screen several relatively specific protein markers from the serum of patients to diagnose B-cell NHL The relatively specific protein markers can be used to make pathology classification and to judge the prognosis of B-cell NHL, and have better clinical value.

OBJECTIVETo study the mechanism of integrin in hypertrophic scar.

METHODSFibroblasts from 10 samples of human hypertrophic scars was cultured, FQ-PCR assay was applied to detect mRNA expression of alpha-SMA in hypertrophic scar fibroblasts after integrin and FAK antibody blocking.

RESULTSmRNA of alpha-SMA in fibroblasts expressed obviously lower after integrin and FAK antibody blocking than that of control groups ( P < 0.05).

CONCLUSIONThrough accelerating the synthesis of alpha-SMA, integrin and FAK play an important role in contracture of hypertrophic scar.

Actins ; biosynthesis ; Adult ; Cells, Cultured ; Cicatrix, Hypertrophic ; metabolism ; pathology ; Contracture ; metabolism ; pathology ; Fibroblasts ; metabolism ; Focal Adhesion Kinase 1 ; biosynthesis ; Humans ; Integrins ; biosynthesis ; RNA, Messenger ; metabolism ; Young Adult

BACKGROUNDThere are few effective methods for treating injuries to the lower trunk of brachial plexus, and the curative effect is usually poor. The purpose of this study was to provide anatomic references for transferring the brachialis muscle branch of musculocutaneous nerve (BMBMCN) for selective neurotization of finger flexion in brachial plexus lower trunk injury, and to evaluate its clinical curative effects.

METHODSMicroanatomy and measurement were done on 50 limbs from 25 adult human cadavers to observe the origin, branch, type of the BMBMCN and median nerve, as well as their adjacent structures. Internal topographic features of the fascicular groups of the median nerve at the level of the BMBMCN were observed. In addition, the technique of BMBMCN transfer for selective neurotization of finger flexion of the median nerve was designed and tested in 6 fresh adult human cadavers. Acetylcholinesterase (AchE) staining of the BMBMCN and median nerve was done to observe the features of the nerve fibers. This technique was clinically tried to restore digital flexion in 6 cases of adult brachial plexus lower trunk injury. These cases were followed up for 3, 6, 9 and 12 months postoperatively. Recovery of function, grip strength, nerve electrophysiology and muscle power of the affected limbs were observed and measured.

RESULTSThe brachialis muscle was totally innervated by the musculocutaneous nerve (MCN). Based on the Hunter's line, the level of the origin of the BMBMCN was (13.18 +/- 2.77) cm. AchE histochemical staining indicated that the BMBMCN were totally made up of medullated nerve fibers. At the level of the BMBMCN, the median nerve consistently collected into three fascicular groups as shown by microanatomy in combination with AchE stain. The posterior fascicular group was mainly composed of anterior interosseous nerves and branches to the palmaris longus. The technique was tested in six fresh cadavers successfully, except that stoma split occurred in one case. Five of the six cases recovered digital flexion 12 months after operation, and at the same time grip strength, muscle power, and nerve electrophysiology also recovered markedly.

CONCLUSIONSThe technique of transferring the BMBMCN for selective neurotization of finger flexion is anatomically safe and effective, with satisfactory clinical outcomes.

Acetylcholinesterase ; analysis ; Adult ; Brachial Plexus ; anatomy & histology ; injuries ; Brachial Plexus Neuropathies ; surgery ; Clinical Trials as Topic ; Female ; Humans ; Male ; Middle Aged ; Musculocutaneous Nerve ; transplantation ; Nerve Transfer ; methods ; Retrospective Studies

Objective To investigate the association of HLA-A and -B alleles with syphilis in Shandong Han population. Methods The allele frequencies of HLA-A and -B were detected in 205 patients with syphilis and 5844 normal human controls by PCR-sequence specific oligonucleotide probe (PCR-SSOP)method. Results The patients with syphilis showed a higher frequency of HLA-A*02, B*15, B*40 alleles(all P＜0.01, Pc＜0.05) and a lower frequency of HLA-A*26 allele (P= 0.003, Pc = 0.039) than the normal human controls did. There was an increased frequency of HLA-B*15 and B*40 alleles in patients with symptomatic syphilis (both P＜0.01, Pc＜0.05), as well as an elevated frequency of HLA-A*02, 11, 29, B*15 and 40 alleles (all P＜0.01, Pc＜0.05) and a decreased frequency of HLA-A*30 and 33 in patients with asymptomatic syphilis(P=0.002, 0.026, Pc=0.001, 0.013 respectively), compared with the normal human controls. The frequency of HLA-A*30 allele was significantly higher in patients with symptomatic syphilis than in those with asymptomatic syphilis (P = 0.001, Pc = 0.013). Conclusions There seems to be an association between HLA-A*02, B* 15 and B*40 alleles and syphilis, between HLA-A*30 allele and symptomic syphilis, and between HLA-A*02, 11 and 29 alleles and asymptom1atic syphilis, in Shandong Han population.

OBJECTIVETo study the effects of DNA vaccine transdermal delivery with microneedle array.

METHODSThe pcDNA3.1-HPV16E7 recombinant vector acting as gene vaccine was established. The infiltration quantity of pcDNA3.1-HPV16E7 getting across the microchannels generated by microneedle arrays in vitro was observed. 30 BALB/c mice were divided into 3 groups (experimental group, in vain plasmid group, negative control). Each group had 10 mice. Then immunized BALB/c mice with a dose of 200 microg with microneedle array every two weeks. The control groups did the same as that as the study groups. Two weeks after the third immunization, the serum and lymphocytes were separated to detect the functions of humoral immunity with indirect immunofluorescence test, while, the functions of cellular immunity with lymphocyte transformation test was also detected.

RESULTSThe DNA vaccine could easily get across the microchannels generated by microneedle arrays in vitro. Moreover, the course was permanent and the whole infiltration quantity was comparatively high, reaching 0.73819 mg/cm2 at the 30th hour. And among immunized BALB/c mouse, DNA vaccine transdermal delivery with microneedle array could induce specific antibodies. Lymphocyte transformation test showed that there was significant difference for the lymphocyte transformation rate between experiment (the average of lymphocyte transformation rate was 47.25%) and control group (the average of lymphocyte transformation rate was 30.00%) (chi2 = 12.903, P < 0.001). Also, the difference was found between in vain plasmid group (the average of lymphocyte transformation rate was 43.00%) and negative control(chi2 = 7.292, P = 0.007). While, no difference was observed in the experimental group and in vain plasmid group (chi2 = 0.817, P = 0.366).

CONCLUSIONThe DNA vaccine combined administering with microneedle array might get across the microchannels generated by microneedle arrays in vitro and induce humoral and cellular immune response in vivo.

Administration, Cutaneous ; Animals ; Human papillomavirus 16 ; genetics ; immunology ; Injections ; Mice ; Mice, Inbred BALB C ; Skin Absorption ; Vaccines, DNA ; administration & dosage ; immunology

OBJECTIVETo investigate the feasibility and effectiveness of transverse rectus abdominis musculocutaneous (TRAM) flap with partial preservation of abdominal rectus muscle based on the anatomic study in cadavers.

METHODS5 adult female cadavers which provided by department of anatomy of Fujian Medical University were dissected after injection with medical red latex from the starting point of the inferior epigastric artery and superior epigastric artery. The TRAM flap with partial preservation of lateral abdominal rectus muscle were dissected for breast reconstruction. The location, route, branches and anastomosis of inferior and superior epigastric arteries were observed. Based on the anatomic study, breast reconstruction were performed in 8 cases with muscle-sparing TRAM flaps.

RESULTSThe inferior epigastric artery arises from external iliac artery (9/10, 90%) or femoral artery (1/10, 10%) at the joint point between the internal third and lateral two third. There are extensive anastomoses between superior and inferior epigastric arteries above the umbilicus, mostly between the 2cm below the first tendinous intersection and umbilical level. From Sept. 2009 to Sept. 2010, 8 cases received breast reconstruction with muscle-sparing TRAM flap. The patients were followed up for 3 months to one year. Fibrosis happened in subcutaneous fat at flap IV zone in 2 cases, borderline necrosis and subcutaneous fat liquefaction occurred in some areas of flap IV zone in 2 cases, which healed after debridement. The other 4 cases healed with no complication. Except for unsatisfied shape in one case, good result achieved in 7 cases. There was no abdominal weakness, hemia or other complication.

CONCLUSIONSIt is an effective and safe method in breast reconstruction with muscle-sparing TRAM flap. It is practical with comparatively short operation time and less morbidity in donor site.

Adult ; Female ; Humans ; Mammaplasty ; methods ; Middle Aged ; Rectus Abdominis ; surgery ; Surgical Flaps

OBJECTIVETo investigate the method of auricular reconstruction for concha-type microtia.

METHODSTwo-staged auricular reconstruction was applied in 13 cases (14 ears) with concha-type microtia. The cartilage auricular framework was fabricated and implanted in the first stage, followed by ear elevation and cranio-auricle angle formation at the second stage.

RESULTSThe patients were followed up for 2 months to 2 years with satisfactory aesthetic result. The reconstructed ears had a good appearance and position, and were symmetric to the healthy ears.

CONCLUSIONSThe two-staged auricular reconstruction with autologous cartilage framework is ideal for concha-type microtia.

Adolescent ; Adult ; Cartilage ; transplantation ; Child ; Ear Auricle ; surgery ; Ear, External ; abnormalities ; Female ; Humans ; Male ; Reconstructive Surgical Procedures ; Ribs ; Tissue Scaffolds ; Transplantation, Autologous ; Young Adult

OBJECTIVETo study the expression of neutral endopeptidase (CD10) and motility-related protein-1 (CD9) in malignant melanoma and their clinical significance.

METHODSImmunohistochemical study for CD10 and CD9 using Streptavidin-biotin complex technique was carried out in 48 cases of primary cutaneous malignant melanoma (CMM), 23 cases of metastatic melanoma and 23 cases of benign nevus.

RESULTSThe positivity rate of CD10 was highest in metastatic melanoma and lowest in benign nevus (P < 0.01). In contrast, the positivity rate of CD9 in metastatic melanoma was lower than that in CMM (P < 0.05). The expression of CD9 was inversely correlated with that of CD10 in malignant melanoma (CMM: r = -0.40, P = 0.005; metastatic MM: r = -0.44, P = 0.034). The expression of CD10 and CD9 in CMM also correlated with tumor histology, Clark's level of invasion and presence of nodal metastasis. A similar relationship was also observed for CD10 and CD9 expression in stromal fibroblasts of CMM (r = -0.43, P = 0.007).

CONCLUSIONSCD10 and CD9 expression correlates with the invasiveness and metastatic potential of malignant melanoma; both factors may demonstrate a counteracting effect. These two markers have potential implications in prognostic assessment of CMM. Stromal fibroblasts may also play an important role in the progression of CMM.

Antigens, CD ; metabolism ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphatic Metastasis ; Melanoma ; metabolism ; pathology ; secondary ; Membrane Glycoproteins ; metabolism ; Neoplasm Invasiveness ; Neoplasm Staging ; Neprilysin ; metabolism ; Skin Neoplasms ; metabolism ; pathology ; secondary ; Tetraspanin-29