Objective To study the effect of radiotherapy and prognostic factors for patients with post-operative loco-regional recurrence of esophageal carcinoma. Methods From 2000 to 2005,91 patients with esophageal carcinoma who developed post-operative loco-regional recurrence were analyzed retrospectively. The interval between surgery and recurrence was 1 -35 months, with a median interval of 11.1 months. There were 4 patients with anastomosis relapse, 6 with anastomosis and mediastinal lymph nodes relapse,4 with abdominal lymph node relapse, 20 with supra-clavicular lymph node relapse, 34 with mediastinal lymph node relapse, and 23 with mediastinal and supra-clavicular lynph node relapse. There were 56 and 35 patients who received conventional and three-dimensional conformal radiation therapy respectively, with a total radiation dose of 50 -70 Gy. Sixty-eight patients received adjuvant chemotherapy.Results The follow-up rate was 95%. The 1-,2-and 3-year overall survival rates were 52%, 20% and 14%, respectively. In univariate analysis, the recurrence time (P = 0. 001), postoperative stage (P =0. 000), radiation dose (P =0. 001) ,overall response rate (P =0. 000) ,T stage (P =0. 028), and N stage (P = 0. 003) were related with prognosis. Multivariate analysis showed that the recurrence time (P =0. 014), postoperative stage (P = 0. 006), radiation dose (P = 0. 009), overall response rate (P = 0. 000)were independent prognostic factors for survival. Conclusions Radiotherapy may improve the survival of esophageal carcinoma patients with postoperative recurrence. Patients with long recurrence-free time, early stage, high response rates, and radiation dose of higher than 60 Gy have better prognosis.

This study aims to detect early changes of kidney in patients with primary hypertension by 3.0 T functional magnetic resonance imaging (fMRI). 26 patients with primary hypertension (hypertension group) and 33 healthy volunteers (control group) underwent conventional and functional magnetic resonance scans, which included blood oxygen level-dependent (BOLD) MRI, diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI). We measured renal cortical thickness (CT), parenchymal thickness (PT), and functional values of renal cortex and medulla including R2* value, apparent diffusion coefficient (ADC) value and fractional anisotropy (FA) value in each group, and then calculated the cortical/parenchymal thickness ratio (CPR). Compared with those in the control group, CT and CPR in hypertension group were larger (P < 0.01), cortical and medullar R2* values increased (P < 0.01) whereas medullar FA values decreased (P < 0.05). It could be well concluded that noninvasive 3.0 T functional MRI would have important clinical significance in identifying early abnormalities of kidney in hypertension patients.
Anisotropy ; Diffusion Magnetic Resonance Imaging ; Diffusion Tensor Imaging ; Essential Hypertension ; Humans ; Hypertension ; Kidney ; pathology ; Magnetic Resonance Imaging

Objective To investigate the effect of external fixator on repairing the vascular injuries in the knee and calf.Methods From May 2004 to October 2010,208 patients (234 sides) with vascular injuries in knee and calf,treated with external fixation,were retrospectively analyzed,including 192 males (217 sides) and 16 females (17 sides) with an average age of 39.6 years (range,14-67).Blood vessel damage:the popliteal artery injury in 84 patients (86 sides),the anterior tibial artery injury in 36 (46),the posterior tibial artery injury in 41(49),the anterior tibial artery and the posterior tibial artery injury in 47 (53).Complete ischemic of the injured distal limb existed in 129 patients(141 sides),incomplete ischemia in 79 patiets (93 sides).All patients underwent emergency surgery.The AO external fixators were used in 164 patients,the chuangsheng inlaid external fixators in 37,and the hybrid external fixators in 7.The injured vessels were anastomosed directly,or indirectly with great saphenous vein.The wounds were treated with phase Ⅰ bandage,skin grafts,flap transplantation or VSD suction.Results One hundred and ninty four patients obtained successful limb salvage; but 14 patients underwent amputation owing to serious damage of limb and poor general condition.One hundred and twenty seven patients underwent the second stage debridement combined with skin graft or flap transplantation; 24 patients underwent the first stage free skin graft or flap transplantation;wound cicatrized by oneself in 43 patients.One hundred and forty eight patients were followed up for 8 months to 3 years.External fixators were removed after an average of 7.2 months (range,1-18).The average healing time of fracture in 102 patients was 5.6 months (range,3-13).Forty patients suffered bone nonunion or bone defect; after treated by fracture fixation,bone graft or bone transport,all of them got bone union.Conclusion The external fixation can shorten operation time as well as the time of limb ischemia,which is an effective option on repairing vascular injuries in knee and calf.

Objective To investigate the effect and mechanism of DADS in inhibiting the proliferation and inducing apoptosis of gastro-esophageal cancer cells in vitro.Methods The gastro-esophageal adenocarcinoma cells OE1 9 were treated by DADS of different concentrations in vitro.Morphologic changes were observed by the microscope and MTT assay was performed to test the growth-inhibitory effect of DADS on OE1 9 cells.Apoptosis rate of OE1 9 treated with different concentrations of DADS was measured by flow cytometry.Real-time PCR was used to detect DADS-induced effects on mRNA expressions of Caspase-3 ,Caspase-9 ,Bcl-2 ,Bax and NF-κB in OE1 9 cells.Results DADS inhibited the proliferation of OE19 cells in a dose-dependent manner.The apoptosis rate of OE19 cells was 14.0%,25.4% and 19.0% and 27.2%,respectively,when treated with 40 and 80μg/mL DADS for 24 h and 48 h.Real-time PCR assay showed that DADS could enhance mRNA expression levels of Caspase-3 and Caspase-9 and significantly decrease the mRNA expression levels of NF-κB and Bcl-2 and the ratio of Bcl-2/Bax. Conclusion DADS can significantly inhibit the proliferation and induce the apoptosis of gastro-esophageal adenocarcinoma cells via mitochondria-dependent pathways,which may be related to NF-κB and Bcl-2 families.

This study investigated the abnormal expression of ATP synthase β-subunit (ATPsyn-β) in pancreas islets of rat model of polycystic ovary syndrome (PCOS) with type 2 diabetes mellitus (T2DM),and the secretion function changes after up-regulation of ATP5b.Sixty female SD rats were divided into three groups randomly and equally.The rat model of PCOS with T2DM was established by free access to the high-carbohydrate/high-fat diet,subcutaneous injections of DHEA,and a single injection of streptozotocin.The pancreas was removed for the detection of the ATPsyn-β expression by immunohistochemical staining,Western blotting and reverse transcription-PCR (RT-PCR).The pancreas islets of the rats were cultured,isolated with collagenase Ⅴ and purified by gradient centrifugation,and the insulin secretion after treatment with different glucose concentrations was tested.Lentivirus ATP5b was successfully constructed with the vector of GV208 and transfected into the pancreas islets for the over-expression of ATPsyn-β.The insulin secretion and intracellular ATP content were determined after transfection of the PCOS-T2DM pancreas islets with Lenti-ATP5b.The results showed that the expression of ATPsyn-β protein and mRNA was significantly decreased in the pancreas of PCOS-T2DM rats.The ATP content in the pancreas islets was greatly increased and the insulin secretion was improved after the up-regulation of ATPsyn-β in the pancreas islets transfected with lenti-ATP5b.These results indicated that for PCOS,the ATPsyn-β might be one of the key factors for the attack of T2DM.

Through exploring the role of placental endocrine,the relationship between placental endocrine changes and certain disease states,and the relationship between placental endocrine and rational use of drugs commonly used in pregnancy were summarized.Placental hormones play an important role during pregnancy.Placental endocrine abnormality can cause some diseases that may need drug treatment.Besides,some drugs also can affect the placenta endocrine,resulting in adverse pregnancy outcomes.Drug safety during pregnancy requires the consideration of the interaction between medicine and placenta endocrine.

Objective To characterize the whole-sequence of plasmid pB557-NDM isolate from Enterbacter cloacae and elaborate its antibiotic-resistant mechanisms .Methods Antibiotic resistance genes were determined by PCR , followed by amplicon sequencing .The activity of class A/B/D carbapenemases was determined by modified Carba NP test .Conjugation experiments were performed to verify the transferability of plasmid pB 557-NDM.The minimum inhibitory concentration (MIC) values of bacterial strains were tested using VITEK 2.The genetic structure, mobile elements and antibiotic-resistant mechanisms of transferable plasmid pB 557-NDM were determined by a whole genome sequencing method .Results The modified CarbaNP test showed that B557 and B557-EC600 had class B carbapenemase activity , and that the blaNDM was carried by plasmid pB557-NDM.This plasmid could be transferred into E.coli through conjugation experiments and therefore could confer corresponding antibiotic resistances to the transconjugant B 557-EC600.Plasmid pB557-NDM was an IncA/C2 plasmid, whose total length was 141.65 kb, and the GenBank accession number was KX786648.It had two inserted regions.One was the blaCMY-6 region where the blaCMY gene was carried by a transposition unit IS Ecp1-blaCMY , the other was the blaNDM-1 region which consisted of a ΔTn1696-In46-rmtC-ISKpn14-ΔTn125 complex structure.Conclusion The production of plasmid pB557-NDM in strain B557 contributes most to its high resistance to many antibiotics .The blaNDM-1 gene is carried in a trancated transposition ΔTn125.

Background Following the accelerated speed of population aging in China,the incidence of cataract is rising gradually.Researches indicated that senescenee marker protein-30 ( SMP-30 ) is closely associated with the occurring and developing of cataract. Objective This study was to investigate the expression of SMP-30 in human lens epithelial cells(LECs) of age-related cataract and study the relationship between SMP-30 and apoptosis.Methods Capsulotomy was performed on 80 eyes of 59 patients with simple cortex age-related cataract and 70 eyes of 53 age-matched patients with nucleus age-related cataract.The anterior capsular specimens were obtained by circularly capsulorhexis during the operation.Expressions of the SMP-30 protein and mRNA in the LECs of two types of cataract were detected using immunochemistry and real-time PCR respectively.Apoptosis of the LECs was assayed by TUNEL.The differences of expression of SMP-30 and apoptosis were compared between the two types of cataract.Results Immunochemistry showed that SMP-30 was expressed in cytoplasm of LECs.The expression intensity of SMP-30 was higher in the center zone compared with periphery zone.The apoptosis rate of LECs was significantly higher in the center of the anterior capsule than the periphery in both two types of cataract ( nucleus cataract:19.34％±0.11％ vs 8.32 ％ ± 0.57 ％,P =0.025 ; cortex cataract:42.07 ％ ± 0.86 ％ vs 13.55 ％ ± 0.64 ％,P =0.010 ).The expression amount of SMP-30 mRNA was lower at the periphery than the center of lens in both two types of cataract (nucleus cataract:45.21±2.79 vs 76.42±11.21,P=0.042 ;cortex cataract:108.32±4.32 vs 206.34±15.67,P=0.037 ),and that of nucleus cataract was significantly lower than cortex cataract (60.02±9.08 vs 157.33 ± 13.01,P =0.034),and the apoptosis rate of LECs was declined in the nucleus cataract group compared with the cortex cataract group ( 14.05％ ±0.22％ vs 27.70％ ±0.81％,P =0.007 ). Conclusions LECs apoptosis exists in age-related cataract.SMP-30 probably plays an important role in the formation of cataract.

E2A is involved in promoting forkhead box P3 (FOXP3) and retinoid-related orphan receptor gamma t (RORγt) gene transcription,which are pivotal transcription factors of T regulatory cells and Thl7 cells,respectively.Little is known about the involvement of E2A in pregnancy process.This study aimed to investigate the expression of E2A,cytotoxic T-lymphocyte-associated protein 4 (CTLA-4),and Foxp3 in luteal phase endometrium of women suffering recurrent miscarriage (RM) (n=21) and control group (n=11) by immunohistochemistry,with the Vectra(R) automated quantitative pathology imaging system for analysis.The percentage of E2A+ cells and CTLA-4+ cells was significantly higher in the endometrium of women with RM than in the controls.There was positive correlation between E2A and CTLA-4 (r=0.523,P=0.002),E2A and FOXP3 (r=0.380,P=0.032),and FOXP3 and CTLA-4 (r=0.625,P=0.000) in the mid-secretory phase of endometrium for all subjects.It was concluded that the abnormal expression of endometrial E2A existed in mid-secretory endometrium of women with RM,and there was a positive correlation between E2A and FOXP3,and E2A and CTLA-4,suggesting the possible regulation role of E2A involved in regulating endometrium receptivity.

Adult ; Female ; Follow-Up Studies ; Hepatitis B Surface Antigens ; blood ; Humans ; Liver Transplantation ; Male ; Middle Aged ; Tissue Donors