Objective To investigate the clinical characteristics and therapy of acute perforation of gastric carcinoma(APGC) to improve the diagnosis,treatment and prognosis of APGC. Methods Forty cases of APGC admitted to Gong liao hospital of Zhenping county.Of the forty patients,ten underwent repair of perforation,twenty-one cases underwent palliative gastrectomy (six of them underwent lymphadenectomy three weeks after previous gastrectomy );five subjected to radical gastrectomy. two underwent gastrostomy or jejunostomy for nutrition.One underwent drainage and peritoneal lavage only;1 received non-operative therapy.Results Four patients died in this series.The 1-,2-,3-years survival rate was 83.3%(30/36),52.8%(19/36),27.8%(10/36)respectively. Conclusions Early diagnosis and adopting resection of gastric cancer plus comperhensive treatment can improve the prognosis of patients with APGC.

Objective To investigate the expression of phospho-histone H3 (PHH3) protein in pancreatic neuroendocrine neoplasms (PNENs) and explore its potential value for pathological grading of PNENs.Methods Clinical and pathological data of 283 patients with PNENs treated in Changhai Hospital from December 2000 to May 2016 were retrospectively analyzed.PNENs tissue chip was prepared,and immunohistochemistry was used to examine the expression of PHH3 and Ki67.The receiver operating characteristic curve for PHH3 was drawn and the area under the curve(AUC) was calculated to determine the cutoff value for PNENs grading.Ki67 was used for PNENs grading according to domestic and intemational criteria for PNENs classification.The relationship of PHH3 and Ki67 classification with clinical pathological features and prognosis of PNENs as well as the correlation between the two classification methods were analyzed.Results Of 283 patients,132 were male and 151 were female,aged from 16 to 78 years old.The average age was (50 ± 1) years old.There were 44 cases with functional PNENs and 239 with non-functional PNENs.The diameter of tumors ranged from 1.1 cm to 17 cm and the average diameter was (4.1 ± 1.2)cm.According to the Ki67 standard,there were 127,116,33 and 7 cases of Grade G1,G2,pancreatic neuroendocrine tumor(PNET) G3 and pancreatic neuroendocrine cancer(PNEC) G3.According to the PHH3 standard,there were 118,119,3 8 and 8 cases of Grade G1,G2,PNET G3 and PNEC G3.There was a positive correlation between the two grading criteria (r =0.941,P ＜0.001).PHH3 expression and PNENs grading were not correlated with age,gender,tumor functional or not and tumor locations (all P ＞ 0.05),but were both positively correlated with tumor size,histological grade,lymph node metastasis,TNM stage and prognosis (all P ＜0.05).The average time of observing PHH3 and Ki67 staining per case in the immunohistochemistry of tissue chip was 9 min and 45 min,respectively.Conclusions Detection of PHH3 expression in PNENs can be used for the pathological diagnosis,grading and prognostic evaluation,which was more accurate and convenient than Ki67 criteria.

Thyroid cancer is one of the most common malignant tumors in the human endocrine system . It is one of the common diseases in head and neck ,thyroid and breast surgery .Its incidence rate is increasing year by year .With the development of ultrasonography and fine needle aspiration biopsy ,as well as the auxiliary exami-nation of gene detection technology ,the detective rate of early diagnosis of papillary thyroid microcarcinoma ( PT-MC) is getting higher and higher .Compared with conventional surgery , highlighting the advantages of minimally invasive surgery , endoscopic and ultrasound guided percutaneous ablation and other new surgical methods are gradually applied in clinical treatment .Combined with the new guideline ,the present paper reviews the progress in the diagnosis and treatment of papillary thyroid microcarcinoma .

Background The study on influences of gender,age and axial length (AL) on lens thickness (LT) and anterior chamber depth (ACD) in normal population is still lack in China.Objective This study was to measure LT and ACD in normal subjects and discuss their changes with age,gender and AL.Methods AL,ACD and LT were measured on 866 eyes of 433 normal population with Lenstar LS900 in Tianjin Eye Hospital from March through December in 2013,including 390 eyes in 195 males and 476 eyes of 238 females.ACD/AL,LT/AL and (ACD+LT)/AL were calculated after measurement.The subjects were grouped to the 10-20 years group,21-30 years group,31-40 years group,41-50 years group,51-60 years group and ≥61 years group based on age,or the 22 mm≤AL＜24 mm group,24 mm≤AL＜26 mm group and AL≥26 mm based on AL,and the measured parameters were compared and analyzed among the groups.Oral informed consent was obtained from each subject or child contutor prior to any medical examination.Results AL,ACD and LT values were (24.41±1.37),(2.89±0.42) and (4.05±0.52) mm in the males,and those in the females were (23.83±1.31),(2.72±0.40) and (4.20±0.44) mm,showing significant differences between them (t=6.278,6.102,-4.595,all at P=0.000).No significant differences were found in ACD,LT,ACD/AL,LT/AL and (ACD+LT)/AL values between the right eyes and the left eyes (t=-0.713,0.186,-0.754,0.296,-0.168,all at P＞0.05).As the increase of the AL,ACD was remarkable deepened but LT was declined,with the considerable difference among the 22 mm ≤ AL＜24 mm group,24 mm ≤ AL＜ 26 mm group and AL ≥ 26 mm group (F =176.640,94.569,both at P =0.000).ACD value was higher,but LT value was lower in the 24 mm≤AL＜26 mm group or AL≥26.00 mm group than that in the 22 mm≤AL＜24 mm group (all at P＜0.05).ACD value was gradually reduced,while LT value was elevated with aging,with significant differences among the different age groups (F =104.531,373.225,all at P =0.000).Significant correlations were found between age and ACD,LT or (ACD + LT)/AL,with the regression equations of ACD (mm) =-0.015 × age + 3.434 (F =-22.979,P =0.000);LT (mm) =0.024 × age + 3.122 (F =44.856,P =0.000),LT/AL =0.001 × age + 0.122 (F=37.982,P=0.000),(ACD+LT)/AL=0.001×age+0.259 (F=22.451,P=0.000).Conclusions Compared with normal females,males have thinner LT and deeper ACD.In the normal eyes,longer AL is,thinner LT is and the deeper ACD is.LT thickens and ACD deepens with aging.

Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcomas, this sarcoma occurs rarely in the larynx. Herein, we describe an unusual case of ASPS occurring in the larynx. The patient was a 46-year-old woman who presented with a more than 2-year history of right pyriform fossa mass and progressive hoarseness for three months. The endoscopic examination of the larynx revealed a mass in the right pyriform fossa with smooth surface and well-defined margin. Computed tomography demonstrated a heterogeneous tumor in the right pyriform fossa, and involving the paralaryngeal space, measuring approximately 2.1 cm x 1.7 cm x 2.6 cm, which was resected via lateral neck approach. Histopathology and immunohistochemistry revealed an ASPS. To ours knowledge, this is the first reported case of ASPS arising in pyriform fossa.
Female ; Hoarseness ; Humans ; Immunohistochemistry ; Larynx ; pathology ; Middle Aged ; Sarcoma, Alveolar Soft Part ; pathology ; Tomography, X-Ray Computed

Objective To explore the application of contrast-enhanced scoring system in the diagnosis of breast tumor.Methods 249 patients with 260 lesions were examined by elastography and contrastenhanced ultrasound before surgery.All the lesions were scored according to the two different methods.Pathological results were made the golden criteria.The diagnosis accuracy of the two methods were compared.Results There were 145 benign and 115 malignant tumors.The diagnosis accuracy,specificity and sensibility of elastography were 85.0％,88.3％,80.1 ％ respectively.The critical value of contrastenhanced ultrasound was between 3 and 4.The diagnosis accuracy,specificity and sensibility of contrastenhanced ultrasound were 88.9％,87.6％,90.4％ respectively.Area under ROC curve of the two methods were 0.901 and 0.910,the difference was not statistically significant.Conclusions Contrast-enhanced ultrasound 5-point scoring system was an initial quantitative criterion for breast tumor diagnosis.The diagnosis accuracy was parallel to that of elastography.

In the present study, the efficacy of Naoxintong capsule (NXT), a compound Chinese herbal medicine, combined with dual antiplatelet therapy (DA) in a rat model of coronary microembolization (CME) was evaluated.

Risk Factors ; Tars ; toxicity ; Tobacco Products ; standards ; toxicity ; Tobacco Use Disorder ; etiology ; prevention & control

BACKGROUND:In treatment of lumbar diseases, lumbar fusion therapy fails in 20%of cases and may lead to a series of complications such as pain, intervertebral space col apse, and delayed kyphosis deformity.
OBJECTIVE:To observe the effect of nucleus pulposus on interbody fusion after removing the anterior column disc of rabbit lumbar vertebra.
METHODS:A total of 36 healthy Japanese white rabbits were randomly and equal y divided into three groups, with 12 rabbits in each group. (1) Group of anterior longitudinal ligament+bone grafting:The L3 intercalated disc were wel exposed and anterior longitudinal ligament was stripped, obtaining a space to L3 intercalated disc, then the iliac bone was implanted. (2) Group of excising anterior 1/3 disc+bone grafting:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and sutured as Group of anterior longitudinal ligament+bone grafting. (3) Group of excising anterior 1/3 disc+fixation:After the anterior 1/3 disc tissue was excised, the iliac bone was implanted and the anterior column fixation was performed.
RESULTS AND CONCLUSION:Biomechanical testing showed that, at 12 weeks, the verticality tensile force in the group of anterior longitudinal ligament+bone grafting was obviously higher than other two groups, and have better fusion rate and could bear stronger force. Lateral position lumbar radiography showed that, the bone graft was absorbed and no new bone grew into the intervertebral space in the group of excising anterior 1/3 disc+bone grafting at 12 weeks;the formation of osseous bridge was found in the group of excising anterior 1/3 disc+fixation;complete bony fusion was found in the group of anterior longitudinal ligament+bone grafting. Histological examinations showed that, at 12 weeks, no bone tissue formed in the group of excising anterior 1/3 disc+bone grafting;a smal amount of bone trabecula and osteocytes were observed in the group of excising anterior 1/3 disc+fixation;a great quantity of newborn bone trabecula and osteocytes, remodeling lamel ar bone and canalis haversi structure were observed in the group of anterior longitudinal ligament+bone grafting. The stability of anterior column has notable effect on interbody fusion, after the anterior column disc is destroyed, the free nucleus pulposus may affect spinal fusion, so restoring the stability of the anterior column may promote interbody fusion, but stil cannot get solid spinal fusion.

ObjectiveTo generate a prokaryotic expression system of series predominant epitopes (UreB322 and UreB527) of Helicobacter pylori UreB protein,and to synthesize a multiple antigenic peptide (MAP) vaccine by linking both the two epitopes with a peptide carrier (Poly-Asp-Lys),and to determine the immunogenicity and immunoprotection of the MAP vaccine.MethodsLinking primer PCR was performed to generate an enterokinase(EK) site-containing series UreB322 and UreB527 epitope encoding gene for construction of its prokaryotic expression system.The expressed target recombinant fusion protein 8 ×[rEK-UreB322-EK-UreB527-EK] was hydrolyzed with EK and then rUreB322-EK and rUreB527-EK epitope peptides were extracted using a Sephadex G-25 column.rUreB322-EK,rUreB527-EK and Poly-Asp-Lys were linked using carbodiimide method to produce a MAP vaccine (MAP-rUreB322/B527).The antigenicity and immunoreactivity of each of the two epitope peptides and MAP-rUreB322/527 were determined by ELISA and Western blot assay.An animal H.pylori strain SS1-infected model in BALB/c mice was used to detect the immunoprotection of MAP-rUreB322/527.ResultsAn octuple-repeated series UreB322-UreB527 encoding gene and its prokaryotic expression system were obtained.The yield of target fusion protein 8×[rEKUreB322-EK-rUreB527-EK] was as high as 48％ of the total bacterial proteins.EK hydrolyzed the target fusion protein completely into rUreB322-EK and rUreB527-EK peptides.The linking ratio of rUreB322-EK,rUreB527-EK and Poly-Asp-Lys was as high as 92.5％.The antibody against whole cell of H.pylori and rUreB-IgG could recognize and combine with the rUreB322-EK,rUreB527-EK or MAP-rUreB322/527.The specific serum antibody level in MAP-rUreB322/527-immunized mice was significantly higher than that in rUreB-immunized mice (P＜0.05).The immunoprotective rates(83.3％ and 91.7％ ) by immunization with50 or 100 μg MAP-rUreB322/527 in the H.pyloristrain SSI-infected mice were significantly higher that those(d1.7％ and 50.0％ ) by immunization with equal rUreB(P＜0.05).ConclusionAn gene composed for encoding a repeated series predominant epitopes of H.pylori UreB protein and its prokaryotic expression system are successfully generated in this study.MAP-rUreB322/527,the multiple antigenic peptide vaccine based on the two predominant epitopes of UreB,can noticeably increase the immunoprotection in H.py/or/infected mice.