Objective To study the preoperative nursing care in excision of adrenal tumor by using laparoscope. Methods 72 patients with adrenal tumor have undergone the excision of adrenal tumor by using laparoscope in our hospital. Preoperative nursing included mental care, cardiac and pulmonary function assessement, pharmacotherapy, gastrointestinal and skin preparation. Postoperative monitoring the condition of all the patients, and given oxygen uptake to prevent hypercarbonemia. All the patients were encouraged to do functional recovery early and were guided to diet properly. Results All patients were successful obtained the excision of adrenal tumor by using laparoscope except two were reversed to open surgery. The patients could take food and leave bed in the first post-operative day. The mean post-operative stay was 6 days. Hydrothorax occurred in 2 cases and fat liquidation and wound infection occurred in 2 cases. There were no major complications such as hemorrhage and hypercarbonemia occurred. Conclusion The excision of adrenal tumor by using laparoscope is safe and reliable. Sufficient preoperative preparation, careful post-operative monitoring and timely using counter-measure are the key points in nursing care.

Objective To investigate epigenetic silencing of the proapoptotic gene MAPK10 by methylation in B-cell lymphoma. Methods We examined MAPK10 expression and methylation in seven cell lines derived from B-cell lymphoma by semi-quantitative RT-PCR and methylation-specific PCR (MSP), respectively. Methylation status was further examined in 24 diffuse large B-cell lymphoma (DLBCL), 15 follicular lymphoma (FL) and 12 reactive hyperplasia lymph nodes (LRH) both by MSP and bisulfite genomic sequencing (BGS). Results MAPK10 is silenced or downregulated in all seven B-cell lymphoma cell lines mostly due to promoter methylation. MAPK10 methylation was frequently detected in DLBCL (17 of 24, 71%) and FL (15 of 15, 100 %), but not in 12 LRH tissues. Conclusion MAPK10 is frequently inactivated by tumor-specific methylation, and thus, is a potential biomarker.

Humans ; Proto-Oncogene Proteins c-met ; genetics ; metabolism ; Stomach Neoplasms ; genetics ; metabolism

Objective To establish a method for the determination of berberine hydrochloride in Huanglian Jiangtang Pill. Methods The sample was extracted with hydrochloric acid-methanol(1 ∶ 100). The chromatographic conditions were as follows:Diamonsil C18 chromatographic column(250 mm? 4.6 mm,5 ? m)with a mobile phase of acetonitrile-0.05 mol/L potassium dihydrogen phosphate(28 ∶ 72),the detection wavelength at 350 nm and the flow rate being 1.0 mL? min-1. Results A good linearity was obtained from 0.244 ? g to 2.928 ? g of berberine hydrochloride in Huanglian Jiangtang Pill(r=0.999 9,n=7).The average recovery was 99.07 % and RSD=1.30 %(n=6). Conclusion This method is simple,sensitive,specific and accurate for determination of berberine hydrochloride in Huanglian Jiangtang Pill.

Objective To compare oligoneucleotide arrays with sequence specific primer polymerase chain reaction (PCR-SSP) for HLA-DR genotyping in order to develop a new technique of genotyping for donors and recipients in kidney transplantation. Methods Sixty DNA samples of donors and recipients were subjected to HLA-DR typing by oligoneucleotide arrays and PCR-SSP simultaneously. The results of the two typing techniques were analyzed.Results Of 60 samples using the two above-mentioned typing techniques, the results in 56 samples were identical with the accordance rate being 93 %, and in the remaining 4 unidentified samples verified by the other laboratory, oligoneucleotide arrays made 1 allele miss typing for 2 samples , 1 allele mistaking for 1 and PCR-SSP made 1 allele miss typing for 1 sample. Among the total, 20 samples retyping was made and its reproduction rate was 96 %. Conclusion The oligoneucleotide arrays technique for HLA genotyping has advantage of high sensitivity, high efficiency, high level standard and it is incomparable.

The pathological subtypes of breast cancer can be further divided into different molecular subtypes based on their immunohistochemical staining, such as estrogen receptor (ER) , progesterone receptor (PR) , human epidermal growth factor receptor2 (HER2) and Ki67 expression, including luminal subtype, HER2 overexpression subtype and triple negative subtype. The luminal subtype is defined as ER and/or PR positive. In molecular mechanism, the expression activity of ER can regulate the expression of PR, so the expression of ER and PR is usually consistent. However, in the process of detection, some breast cancers with inconsistent ER/PR expression often appear, especially those with ER (-) /PR (+) . There is still controversy about whether such cases are true. Patients with this type of breast cancer should be subjected to ER and PR immunohistochemical staining again, and then reclassified according to HER2 status. The expression of ER/PR is closely related to the efficacy of endocrine therapy for breast cancer, so its test results will directly affect the treatment options of clinician. This article will review and discuss the research progress of the causes and mechanisms of ER (-) /PR (+) breast cancer.

According to the target-model of the health care system and characteristics of the health financing system,it is proposed in the paper that the charges of medical services should be the main revenue of public hospital compensation.Efforts should be made to adjust health care service prices and strengthen pharmaceutical management simultaneously so as to rebuild the structure of medical service charge.Medical insurance should make the majority in the compensation to cover most the medical expenses,with government subsidies supporting development.Both government financial investment and medical insurance should join their efforts for planning-guidance and performance-guidance.The authors also suggested to improve a graded and normative diagnoses and treatment system,regulate medical behaviors of public hospitals and their cost standards,justifying the total compensation and standard verification of such hospitals.

Purpose To explore the relationship between the mutations of epidermal growth factor receptor ( EGFR) and KRAS genes and clinicopathological characteristics in patients with non-small cell lung cancers (NSCLC). Methods Clinical samples from 431 NSCLC patients were obtained for EGFR and KRAS gene analysis. PCR based direct DNA sequencing was used to investigate mutations in exon 18-21 of EGFR gene and codon 12 and 13 of exon 2 of KRAS gene. Results The overall EGFR mutation rate of primary NSCLC was 53. 6% (231/431) in this study cohort and eight cases showed double EGFR mutations. Mutation rates in female and male were 65. 2% (122/187) and 46. 9% (98/209), respectively. The mutation rate was higher in patients with non-smokers and adeno-carcinoma and adenosquamous carcinoma subtypes than in their counterparts (P<0. 05), with the percentage of 57. 2% (124/216), 60. 3% (199/330), 42. 9% (6/14), respectively. In squamous cell carcinomas and other subtypes, EGFR mutation rates were 11. 6% (5/43) and 11. 1% (1/9), respectively. The EGFR mutation types included exon 18 point mutations (4. 0%, 9/227), exon 19 deletion mutations (4. 5%, 101/227), exon 20 insert or point mutations (9. 7%, 22/227) and exon 21 point mutations (41. 4%, 94/227). Activating mutations of KRAS gene were detected in 7. 8%(31/396) of NSCLC. Twenty-eight patients showed codon 12 mutations ( G>T, G>A, G>C) , and three patients had codon 13 mutations ( G>A, G>T) . Most of these mutations were G to T transversion (64. 5%, 20/31). Conclusion Polymerase chain reaction-direct sequencing is a reliable and effective method for the detection of the EGFR and KRAS gene mutation in NSCLC patients. The mutation rate of EGFR is higher in Chinese patients, especial-ly in non-smoking female patients with adenocarcinoma.

Objective To investigate the clinical significance of cross reactive groups (CREG) matching in highly sensitized recipients of kidney recipients by testing their serum PRA levels and specificity.Methods The dynamic PRA levels and the specificity were determined. CREG matching was used to select the best donors. Results The preoperative PRA levels in 60 kidney recipients heightened simply or mixedly. Acccording to CREG matching with 0 to 1 MM, 2 MM and 3 to 4 MM, the average recovery time of postoperative creatinine was 6.5 , 7.0 and 12.7 days respectively and the number of the patients with delayed graft function was 0, 7 and 3 respectively.Conclusion There was a great applied value to raise survival rate of patients or allografts for highly sensitized recipients of kidney recipients by CREG matching, to select donors with compatible HLA phenotype or more compatible, to shun the specific antigen of pre existing HLA antibody in recipients and to strictly prohibit HLA repeat mismatches for those retransplantation recipients.

Objective To study the clinical, histopathological and immunohistochemistric features of different types of primary cutaneous lymphomas.Methods 17 cases of primary cutaneous lymphomas were ret-rospectively reviewed.All cases were classified according to the WHO-EORTC(World Health Organization-Eu-ropean Organization for Research and Treatment of Cancer) classification system combined with morphology and immunobistochemistry.The clinicopathological features of each type were observed and summarized.Results Among the 17 cases, male were 10, female were 7.The average age was 51 years old (from 16 to 78).All pa-tients visited the doctor for skin diseases 14 cases were T-cell lymphoma including 5 cases of primary cutaneous anaplastic large cell lymphuma, 2 cases of mycosis fungoides, 4 cases of subcutaneous panniculitis-like T-cell lymphoma, and 3 cases of primary cutaneous peripheral T- cell lymphomas (including 1 primary cutaneous ag-gressive epidermotropic CD8+ cytotoxic T-cell lymphoma).3 cases were B-cell lymphoma including 2 diffuse large B-cell lymphoma, leg-type and 1 primary cutaneous follicle center lymphoma.Conclusion The clinical behaviors and pathological characteristics of primary cutaneous lymphomas were complicated and variant.Nei-ther of them could be neglected in the diagnosis.