Recently,with the development of the medical technique includes surgery,radiotherapy,chemotherapy and molecular targeted therapy,multi-subject combined modality therapy for esophageal carei noma has been become a tendency instead of surgery alone.Any single treatment is hard to improve the curative effect of treatment for esophageal carcinoma.Systemic individual comprehensive therapy for the different patients with esophageal carcinoma is likely to reduce recurrence rate,improve survival rates as well as to improve the quality of life.

Objective To investigate the value of DNA image cytometry in thediagnose of benign and malignant pleuroperitoneal fluids by comparing with the liquid-based cytological results. Methods There were 417 cases in-volved in this study. Pap stain for cytology analysis and feulgen stain for DNA image cytometry were used to identify benign and malignant pleuroperitoneal fluids respectively,then compared the results of the two methods. Results Clinically or pathologically,213 were classified as malignant and the other 204 as benign. The sensitivity, specifici-ty,accuracy, positive predictive value and negative predictivevalue of DNA image cytometry were 89. 7%,100%, 94. 7%,100%,and 90. 3%,respectively. However,the sensitivity,specificity,accuracy, positive predictive value and negative predictive value of liquid-based cytology were 63. 4%, 81. 9%, 72. 4%, 78. 5%, and 68. 2%, re-spectively. There were significant differences in thesensitivity, specificity,accuracy, positive predictive value and negative predictivevalue. Conclusion DNA image cytometry has great application value in the diagnosis of benign and malignant pleuroperitoneal fluids, and can increase the positive rate, reduce misdiagnosed rate with liquid-based cytology.

SUMMARY Lymphoma is a systemic disease. It is not uncommon to be found involved in digestive or central nervous system. However, lymphoma involved in these two systems at the same time is rare. The clinical feature of a case of lymphoma with gastrointestinal bleeding and limbs weakness was investigated and the literature was reviewed. The patient came to our hospital with melena and hematemesis. She was diagnosed as gastric ulcer by gastroscopy and biopsy showed lymphoma. Two days after she came to hospital, the patient presented with progressing limbs weakness. Magnetic resonance imaging (MRI) showed irregular abnormal signals in T2-T4 vertebra, which was enhanced obviously. A strip abnormal signal could be seen in spinal cord and involved in neighboring centrum and ribbing. The lesion extended to paravertebral tissue. The final diagnosis was lymphoma involved in stomach and spinal cord. Diseases presented with both upper digestive tract bleeding and symptoms of central nervous system were rare, including malignancies, virus infection and some therapy. Lymphoma was one of the causes. On the other hand, spinal cord ischemia might occur after gastrointestinal bleeding. Thus, doctors should examine the patients carefully to diagnose these diseases.

Objective To investigate the expression of hypoxia-inducible factor 1α (HIF-1α)gene in rat cerebral cortex neurons under hypoxia conditions,and provide more experimental basis for clinical treatment of hypoxic brain disease.Methods The rat cerebral cortical neurons in primary culture and hypoxia model were prepared and identified by immunocytochemistry analysis.The expression of HIF-1α in normal and hypoxic neurons was detected at 4 time points (12 h,24 h,48 h and 72 h) by immunohistochemical analysis.Results The expression of HIF-1α positive cells in normal control (NC) group was less at each time point,and it showed no statistically significant within groups.The weak expression of HIF-1α was found at 12 h in hypoxic group,and the expression augmented along with the time extended,it increased obviously at 24 h,reached the peak at 48 h(IOD＝0.27±0.02,F＝35.703,t＝11.795,P＜0.01),and declined until 72 h,it showed statistical significance between two groups at each time point.Conclusions The expression of HIF-1α is increased after hypoxia.HIF-1α has a protective effect on neurons after hypoxia.

Objective To explore the expressions of lectin-like oxidized low-density lipoprotein receptor-1(LOX-1)and apoptosis related genes caspase-3,Bax and bcl-2 in placenta,and their associations with the pathogenesis of preeclampsia.Methods Thirty preeclampsia patients(preeclampsia group),hospitalized in Department of Obstetrics,Shengiing Hospital of China Medical University from June 2005 to December 2006,were selected as the subject group,and 40 normal pregnant women as control group.The expressions of LOX-1 and apoptosis related genes caspase-3.Bax and bel-2 in different gestational weeks'placenta tissues were examined using immunohistochemistry.RT-PCR and western-blot.Results (1)Immunohistochemical detection in preeclampsia group:at 20 w+1-24 w,24 w+1-28 w,28 w+1-32 w.32w+1-36 w+1-36 w+1-40 w,respectively,the results of LOX-1 were 20.1±1.8,25.6±1.3,32.8±1.6,34.3 ±1.5,39.9±1.2;in the control group they respectively were 11.2±0.6,18.5±1.6,26.1±1.8,28.3 4-1.6,32.3±1.6;the difierence was significant(P<0.05).In preeclampsia group,the results of easpase-3 were 12.3±0.9,16.3±0.9,24.4 4-0.8,28.3±0.5,36.3±1.1.and in the control group they respectively were 8.5±1.0,12.3±1.1,17.4±1.2,20.4±stronger than those in normal pregnant women at different gestational weeks(P<0.05).However,the expression tendency of bcl-2 mRNA and proten was converse to the expression tendency of Bax.Conclusion The expressions of LOX-1,caspase-3,and Bax are upregulated in placentas of preeclampsia patients,while bcl-2 iS downregulated,both of which are associated with the pathogenesis of preeclampsia.

Female ; Humans ; Infant ; Mastocytosis, Systemic ; diagnosis ; pathology ; therapy

BACKGROUND: In recent years, foreign scholars have found that apolipoprotein E gene was associated with osteoporosis and its complicated hip fracture. National scholars adopted polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to primarily study the correlation of apolipoprotein E gene polymorphism with bone mineral density (BMD) and osteoporosis.OBJECTIVE: To observe the polymorphism of apolipoprotein E gene, and analyze its correlation with primary osteoporosis and osteoporotic fracture.SETTING: Department of Orthopaedics, Nanchang First Hospital.DESIGN: A clinical controlled observation.PARTICIPANTS: Sixty patients with primary osteoporosis (31 males and 29 females), were enrolled, including 30 cases of hip fracture, who were newly fractured and diagnosed according to radiogram, and 30 cases of simple osteoporosis; Thirty healthy subjects (16 males and 14 females)were also involved.METHODS: Sixty outpatients and inpatients with primary osteoporosis were selected from the Department of Orthopaedics, Nanchang First Hospital from January to December 2002, and they were divided into hip fracture group (n=30) and simple osteoporosis (n=30); Another 30 healthy physical examinees were taken as the healthy control group. All the subjects were fasted for more than 12 hours, and the samples of venous blood were collected on the next morning. DNA was extracted from the separated leucocytes. Gene site DNA amplification was analyzed with polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP). The individual DNA templates (provided by Daan Gene Diagnosis Center of Sun Yat-sen University) of identified apolipoprotein E2/2, E3/3 and E4/4 homozygotes were analyzed with PCR-SSCP, and the band showed that E3 was in the front, E2 in the middle, followed by E4. They were in electrophoresis with DNA templates of the samples at the same time, and the apolipoprotein E genotype of the template could be identified by the migration rate of the band.MAIN OUTCOME MEASURES: Apolipoprotein E genotypes were observed.RESULTS: All the enrolled subjects were involved in the analysis of results. ① Six genotypes were detected with PCR-SSCP in the 60 patients with primary osteoporosis and 30 healthy controls, including apolipoprotein E2/2, E3/2, 3/3, E4/2, 4/3, 4/4. ② There were very significant differences in the allele frequency of apolipoprotein E4 among the three groups (χ2=17.520, P ＜ 0.01). The allele frequencies of apolipoprotein E4 in the simple osteoporosis group and osteoporotic fracture group were obviously higher that that in the normal control group (χ2=4.904, 16.681, P ＜ 0.01),it was also markedly higher in the osteoporotic fracture group than in the simple osteoporosis group (χ2=4.658, P ＜ 0.01).CONCLUSION: Apolipoprotein E4 is closely associated with primary osteoporosis and osteoporotic fracture. Apolipoprotein E is a useful marker for primary osteoporosis, especially for osteoporotic fracture.

Objective To investigate the effects of cardiopulmonary bypass (CPB) with mild hypothermia on the pharmacodynamics of rocuronium in infants undergoing cardiac surgery.Methods Fifty ASA Ⅰ or Ⅱ and NYHA class Ⅰ or Ⅱ infants,aged 6 months-3 yr,weighing6-15 kg,undergoing repair ofventricular septal defect or atrial septal defect under CPB,were randomly divided into 2 groups ( n =25 each):profound hypothermia group and mild hypothermia group.The target temperature was controlled at 28-30 ℃ during CPB in profound hypothermia group,and at 32-34 ℃ during CPB in mild hypothermia group.Neuromuscular block was assessed by TOF-stimulation of ulnar nerve using with TOF-Watch accelerometer.Anesthesia was induced with midazolam O.1 mg/kg,propofol 2 mg/kg,fentanyl 6-8 μg/kg and rocuronium 600 μg/kg,and maintained with intermittent iv boluses of fentanyl and midazolam.The patients was tracheal intubated and mechanically venti1ated when the maximal depression of T1 was achieved.PETCO2 was maintained at 30-40 mm Hg.When T1 returned to 75％ of the control twitch,rocuronium 200 μg/kg was injected intravenously.The onset time,maximal N-M block time,clinical muscle relaxation time,and recovery index were recorded before CPB,during CPB and after CPB.Results Compared with profound hypothermia group,the onset time,maximal N-M block time and clinical muscle relaxation time were significantly shortened during CBP in mild hypothermia group ( P ＜ 0.05).Conclusion Compared with profound hypothermic CBP,mild hypothermic CBP can shorten the onset time and muscle relaxation time of rocuronium in infants undergoing cardiac surgery.

Objective To evaluate the long-term efficacy and safety of thermal balloon endometrial ablation (TBEA) for patients with menorrhagia. Methods From February 2004 to January 2008,105 women with menorrhagia was admitted to our hospital and treated by TBEA. The clinical data,including menstrual cycle and blood volume,as well as TBEA complications such as abdominal pain,infection,bleeding and conglutination,were followed up for a long period in the patients. Results Among the 105 patients,two were lost for follow-up,and one died of malignant tumor of the urinary system in 56 days after the TBEA,the other 102 (97.1%) patients achieved an follow-up for 3 (102 patients),6 (101 patients),12 (99 patients),24 (66 patients),or 36 months (51 patients) succesively. At each of the time point,the success/amenorrhea rates were 93.1% (95/102)/38.2% (39/102),93.1% (94/101)/33.7% (34/101),91.9% (91/99)/32.3% (32/99),93.9% (62/66)/34.8% (23/66),and 92.2% (47/51)/31.4% (16/51),respectively. No severe perioperative complications such as perforation of the uterus and adjacent organs,massive bleeding or infection due to mechanical or thermal injuries occurred. After the operation,11 (10.5%) patients had uterus contraction-like pain,which was relieved by analgesic drugs within 6 hours;8 (7.9%) patients had adhesion of the tissues around the cervix uteri and/or uterine cavity,4 of them were cured by dilation of the uterus,3 received surgical separation,and 1 underwent resection of the uterus. No significant difference in the effective rate and rate of amenorrhea was found between the 36-and 12-month follow-up results (?2=0.000,P=1.000 and ?2=0.014,P=0.906,respectively),or between 24-and 12-month follow-up results (?2=0.034,P=0.854;?2=0.114,P=0.736). Conclusion TBEA shows good long-term efficacy and safety,as an applicable alternative in the treatment of menorrhagia.

Objective To investigate the roles of cell apoptosis and the gene expressions of Fas, FasL, bcl-2 and bax in acute rejection of pancreaticoduodenal transplantation and to evaluate the function of duodenum biopsy for early detection of rejection in rats. Methods Wistar and SD rats were divided into two groups: ①Wistar rats that underwent allogenic pancreaticoduodenal transplantation from the organs of SD rats; ②Wistar rats that received homogenic transplantation. The grafts were then harvested on day 3, 5 and 7 after the transplantation, and all graft samples were observed with HE staining and TUNEL was also used to detect apoptotic cells. The expressions of Fas, FasL, bcl-2 and bax were measured by immunochemical method. According to Nakhleh’s score, pathologic features of transplanted pancreas and duodenum were ranged from one to three scores in order. Results The percentage of same or different scores between the pathological scores of pancreas and duodenum in allogenic pancreaticoduodenal transplantation group were 61.1% (11/18) and 38.9% (7/18) respectively, and there were 6 specimens of pancreatic tissue got higher scores with only one higher score for duodenum. There were significant differences of histopathologic rejection scores and apoptotic indices between the two groups, respectively (P