Objective To assess the association between serum levels of carbohydrate antigen 125 (CA125) and the heart function in the elderly with congestive heart failure (CHF). Methods CA125, carcinoembryonic antigen (CEA) ,alpha-fetoprotein ( AFP), CA199, CA15-3, CA724, liver and kidney function and NT-proBNP were measured in 178 patients with heart failure. Ve, Va, Ve/Va, left ventricular end-diastolic diamete ( LVEDD), left ventricular end-systolic diamete ( LVESD ), left ventricular ejection fraction ( LVEF ) and time were measured using echocardiograph. All patients were classified as Ⅰ + Ⅱ , Ⅲ and Ⅳ level according to the criteria of New York Heart Assocation ( NYHA), and the incidence of pleural effusion, peripheral edema,atrial fibrillation were observed. Results Among the 178 patients,serum CA125 were ≤35 U/ml in 91 patients with median of 9.9( 3.4 - 33.7 ) U/ml, ＞ 35 U/ml in 87 patients with median of 64. 4 ( 20. 2 - 462. 1 ) U/ml.Among those patients with CA125 ＞ 35 U/ml ,heart function was classified as level Ⅲ + Ⅳ in 82 patients,and level Ⅰ + Ⅱ in 5 patients. Among the patients with CA125 ≤35 U/ml,heart function was classified as level Ⅲ + Ⅳin 7 patients,and level Ⅰ + Ⅱ in 84 patients. Heart function was significantly different between the two CA125 groups( x2= 133. 3 ,P ＜0. 001 ). The incidence of pleural effusion,atrial fibrillation ,peripheral edema in the higher CA125 group were 32. 2%, 51.7% and 78. 2%, respectively, which were significantly higher than those in the normal CA 125 group ( 5.5 %, 9. 9% and 19. 8 %, repactively ) ( P ＜ 0. 01 ). NT-proBNP, LVESD,LVEF and time in the higher CA125 group were 2524. 0( 104.0 - 19 308. 0) ng/L,35 (27 -55) mm,49% (23%-66% ) and 268 (210 -312)ms, which were significantly differenct from those in the normal CA125 group [356.0 ( 32.0 - 5201.0) ng/L, 32 ( 26 - 53 ) mm, 59% ( 42% - 69% ) and 290 ( 260 - 340 ) ms, respectively](Ps ＜0. 05). The linear regression showed that serum CA125 was positively correlated with NT-ProBNP and urea nitrogen ( BUN ) ( r= 0. 3326 and 0. 3430, Ps= 0. 002 ) , as well as negtively correlated with LVEF and time (r= -0. 3016,P =0. 006;r = -0. 336,P =0. 004). Conclusion Serum CA125 in the elderly with congestive heart failure increased with the worsing of heart function, and correlated with the level of NT-proBNP, LVEF and time,as well as pleural effusion, atrial fibrillation, peripheral edema.

Objective The aim of this study is to verify the feasibility of transumbilical endoscopic cholecystectomy by using the tri-channel trocar technique.Methods Eight domestic pigs were submitted to transumbilical endoscopic cholecystectomy using the tri-channel trocar technique.After establishment of pneumoperitoneum,a tri-channel trocar was placed through an infra-umbilical incision.A fine grasper of 2 mm in diameter was inserted through a small skin incision on the right upper abdomen into abdominal cavity to grasp the fundus of the gallbladder.Then the cystic duct was dissected with a flexible hook.Once the cystic duct and artery were free,they were clipped by a clip fixing device,and the gallbladder was separated from the liver bed using flexible hook dissection.The specimen was then extracted through the umbilical trocar.Results All the gallbladders were removed successfully in the eight pigs without severe bleeding during dissection,or intraoperative and postoperative complications.The operation time was from 1.5 to 2.5 hours and decreased with experience.Postmortem examination revealed that the gallbladder fossa was clean,and the clips on the cystic duct and artery were secure.Neither bile leakage nor hemorrhage was found at the operative field.Conclusions Transumbilical endoscopic cholecystectomy is feasible and safe without leaving obvious abdominal scars.

Objective To investigate the distribution of ligustrazine hydrochloride in guinea pig blood, cerebrospinal fluid and perilymph fluid afte intramuscular injection. Methods The HPLC was used for determination of ligustrazine hydrochloride in guinea pig blood, cerebrospinal fluid and perilymph fluid afte intramuscular injection by internal and external standard method.Results Ligustrazine hydrochloride could be absorbed into blood rapidly after intramuscular administration in guinea pig. The concentration reach its high level in 20 min.It was 357.76 ?g/ml. It decreased to low level 2 h after injection.It could be found in cerebrospinal fluid 10 min after injection. The concentration reached its high level in 20 min.It was 120.50 ?g/ml.It decreased to low level 70 min after injection. The ligustrazine hydrochloride could be found in perilymph fluid 5 min later.Its high level in 20 min was 215.79 ug/ml.It decreased to low level 70 min after injection.The results indicated that ligustrazine hydrochloride was rapidly absorbed and eliminated after intramuscular administration in guinea pig.Conclusion Ligustrazine hydrochloride can be absorbed into blood, enter cerebrospinal fluid and perilymph fluid. It can pass through blood-brain barrier and blood-labyrinth barrier. The results indicates that ligustrazine hydrochloride is rapidly absorbed and eliminated after intramuscular administration in guinea pig.

Objective To investigate the variations of tendency of drug-resistance from Jan 2006 to Dec 2008. the origin and the distributing of Acinetobacter baumannii and provide basis for selection of clinical drugs.Methods The characteriztion and sensitivity to antibiotics of Acinetobacter baumannii were analysed using VTTEK-32 system.Results 107 strains of Acinetobacter baumannii were separated and characterized during the three years.The rates of resistance to antibiotics were Imipenem 0.9%,Amikacin 5.6%,Ampicillin/Sulbactam 6.5%,Ampicillin 74.8% Ceftriaone 63.6%,Cefotaxime 38.3%,Aztreonam 25.2%.The resistance rate of Acinetobacter baumanii increased from 2006 to 2008,showed increasing tendency.Conclusion Acinetobacter baumannii showed good sensitivity to Carbapenems,Aminoglycosides,β-lactam antibiotics,Acinetobacter baumanii are widely distributing in hospital and are widely resistant to many kinds of antibiotics,The results suggested that the resistance of Acinetobacter baumannii to antibiotics should be continuously monitored,it will be beneficial for infection-control to collect antibiotics basing on the results of drug-sensitive test.

Objective · To investigate antiemetic effect of aprepitant for moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Methods · From 2014 July to 2015 August, 130 cases of gastrointestinal cancer patients were collected in Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, who received moderate emetogenic risk of chemotherapy for at least four courses. One hundred and nine patients were treated with aprepitant, palonosetron and dexamethasone on day 1, and aprepitant and dexamethasone on day 2 and 3. Twenty-one patients only received aprepitant and dexamethasone on day 1 and dexamethasone on day 2 and 3 in the first course of chemotherapy. During subsequent courses of chemotherapy they received aprepitant and treated in the same way as 109 patients. MASCC antiemetic tool (MAT) was used to evaluate the intensity of nausea. The primary endpoint was complete response (CR, no emesis and use of no rescue antiemetics) during the overall study phase (0-120 h after chemotherapy) at the second course. The secondary endpoint was complete protection (CP, CR plus no significant nausea) during the overall, acute (0-24 h), and delayed (24-120 h) phases at the second course. Results · The CR rates were 90.0%, 94.6% and 90.8% of patients in the overall, acute and delayed phases, respectively. The corresponding CP rates were 83.8%, 87.8% and 84.6 %, respectively. The CR rate increased from 42.9% to 57.1% during acute phase and increased from 9.5% to 90.5% during delayed phase for 21 patients after treatment with aprepitant. The main adverse reactions include constipation, anorexia and hiccups. Conclusion · Aprepitant combined with palonosetron and dexamethasone can effectively prevent moderately chemotherapy-induced nausea and vomiting in patients with gastrointestinal cancer. Aprepitant therapy can effectively maintain antiemetic effect in patients with many chemotherapy courses.

Objective:To establish a simplified heterotopic whole small bowel transplantation model in rat.Methods:Ninety pairs of inbred male Wistar rats were used as donors and recipients.The whole small intestine with a vascular pedicle composed of superior mesenteric artery and portal vein was harvested as the graft.After left nephrectomy of recipient,revascularzation of graft was accomplished by end-to-side anastomosis between donor superior mesenteric artery and recipient infra-renal aorta using a 9-0 continuous suture and an end-to-end anastomosis between the donor portal vein and left renal vein of the recipient with the cuff technique.The proximal end of the graft was ligated and the distal end was exteriorized to form an enterostoma.Results:Average time of an operation was 130 min and the mean warm ischemia time of grafts was 30 min.The successful rate of this model was 100% and 86(95.6%) recipients survived longer than 7 days after operation.Conclusion:The simplified techniques we used was effective and parcticable in improving successful rate of rat heterotopic small bowel transplantation.

OBJECTIVETo investigate the clinical pathological features, diagnosis and differential diagnosis of pigmented dermatofibrosarcoma protuberance (PDFSP).

METHODSThe clinical history, histopathological features, immunohistochemical characteristics, treatment and prognosis were analyzed in seven cases of PDFSP. Fluorescence in situ hybridization (FISH) was used to detect the expression of COL1A1/PDGFB fusion gene, and related literature was reviewed.

RESULTSThe median age of the seven patients (4 females, 3 males) was 47 years with the tumors involving mostly the trunk (four cases). Histologically, PDFSP showed a cellular lesion composed of spindle cells arranged in short fascicles that form a distinct storiform pattern, and the pigmented bipolar or multipolar dendritic cells were present with tentacle like processes emanating from a nucleus containing zone. One case showed fibrosarcomatous change. The pigment was tinctorially similar to melanin. The spindle cells were positive for CD34 and vimentin, but negative for HMB45, Melan A, S-100, desmin, CD68 or α-SMA. HMB45, Melan A, S-100 and vimentin were expressed in the melanin containing cells in 4, 4, 5 and 7 cases, respectively. The labeling index of Ki-67 was 1%-8%. Among the 4 cases successfully examined by FISH, 3 showed t(17;22)(q21;q13) which suggested COL1A1/PDGFB fusion gene. Three patients were treated by wide local excision and four were treated by simple surgical excision. Two patients developed recurrences during the follow-up period of 12 to 123 months. Of those treated by wide local excision, none developed recurrence. No patient died in the follow-up period.

CONCLUSIONSPDFSP is a rare pigmented variant of DFSP and an intermediate grade malignant tumor. The orgin of the tumor cells is still controversial. Surgical pathologists and dermatopathologists need to be aware of the prototypical histological appearance of PDFSP as there is a risk of misdiagonsing it as either pigmented tumors associated with neurocutaneous syndromes or a highly malignant melanocytic neoplasm.

Adult ; Aged ; Antigens, CD34 ; metabolism ; Child, Preschool ; Dermatofibrosarcoma ; diagnosis ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; MART-1 Antigen ; metabolism ; Male ; Melanoma ; metabolism ; pathology ; Melanoma-Specific Antigens ; metabolism ; Middle Aged ; Neoplasm Recurrence, Local ; Neurilemmoma ; metabolism ; pathology ; Neurofibroma ; metabolism ; pathology ; Oncogene Proteins, Fusion ; metabolism ; Prognosis ; Retrospective Studies ; S100 Proteins ; metabolism ; Skin Neoplasms ; diagnosis ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To observe the effects of 2 Gy γ-ray irradiation on regulatory T cells (Tregs) and Th17 cells and immune balance of mice.Methods A total of fifty C57BL/6 male mice were randomly divided into two groups,the irradiated group exposed to 2 Gy of whole body γ-ray irradiation,and the control group sham-irradiated.At 1,3,7,14 and 28 d after radiation,changes of peripheral haemogram were detected respectively and Tregs in peripheral blood,thymus and spleen and Th17 cells in spleen were analyzed by flow cytometry.Results Compared with control group,the number of peripheral blood white cells (WBC) and lymphocyte in irradiated group reduced significantly post-irradiation (t =8.89-33.54,P ＜ 0.05),while the cell number of peripheral CD4 + CD25 + Tregs post-irradiation rose but not significantly.Thymic Treg cells increased 1 and 3 d post-irradiation(t =-6.45,-10.59,P ＜0.05),but reduced 28 d post-irradiation (t =5.34,P ＜ 0.05).Splenic Treg cells ascended obviously from 1 to 14 d post-irradiation (t =-6.82-3.89,P ＜ 0.05).After irradiation splenic Th17 cells increased at 1 d,and reached the maximal level at 3 d (t =-2.42,P ＜ 0.05),more obviously than splenic Treg cells.The reduction of Treg/Th17 ratio from 1 to 14 d post-irradiation disturbed Treg/Th17 balance and made it drift to the direction of Th17 (t =4.02-8.04,P ＜ 0.05).Conclusions Treg/Th17 imbalance plays an important role in immune injury induced by irradiation.

Objective To explore the correlation between lower urinary tract symptoms (LUTS) with prostate volume and peak flow rate in aging staff men with benign prostatic hyperplasia (BPH). Methods A total of 180 elderly patients were randomly enrolled. They were diagnosed with BPH by rectal touch and transected ultrasound from April 2008 to December 2008. The international prostate symptom score (IPSS), prostate volume (PV) as well as peak flow rate (QMAX)were analyzed respectively. Results IPSS were ( 9. 1 ± 0. 7 ) scores, ( 12. 1 ± 0. 7 ) scores and (14.0±1.3) scores in 60-69 years old group, 70-79 years old group and more than 80 years old group. PV were (40. 6±1.9) ml, (42. 4±1.9) ml and (48. 7±2.8) ml in corresponding groups, and PV was elevated along with aging (F= 5. 705, 2. 983, P＜0. 05). QMAX were ( 14.7 ± 0. 6) ml/s,(14.0±0. 5) ml/s and (12.6±0.9) ml/s, and QMAX was decreased along with aging (F=2. 131, P＞0. 05). Along with aggravation of LUTS, PV (ml) increased (39. 2±18. 1 vs. 45.7±16.9 vs. 47. 9± 16. 5) and QMAX (ml/s) decreased ( 15.0 ± 4.8 vs. 13. 5 ± 5.06 vs. 11.5 ± 4. 7, F= 3. 427, 4. 742, P ＜0.05). Conclusions The LUTS of patients with BPH is aggravated with aging, at the same time, the degree of LUTS increases with PV and decreases with QMAX. If get active treatment of drugs if available, they may improve their quality of life.

ObjectiveTo observe ultrasound images of normal full-term intracranial venous system,in order to provide reference images and guidelines for clinical practice.Methods Courser shape and spectrum characters by anterior fontanel acoustic window of 65 normal newborn infants had been observed.Results①The demonstration of subendymal vein,cerebral vein,Galen vein longitudinal sinus,straight sinus,lateral sinus confluence was 100％,that of basal vein and falcial sinus was 21％ (14/65) and 29％ (19/65),respectively.②The flow rate of a cranial vein decreased.③ In the overall 65 cases,9 ependymal veins,intracranial veins,Galen veins,62 sinus rectus,63 lateral sinuses,65 longitudinal sinuses and confluence sinuums had impulsive blood spectrum.A basal vein had impulsivity in 14 cases.4 of 19 falcial sinuses had impulsivity.Conclusions Color Doppler ultrasound can identify intracranial veins effectively,but some limitations must be taken into account.Blood flow rate of Galen vein sinus confluence is immeasurable.