Objective To explore the relation between clinical-pathological features,Siewert classification and prognosis of esophagogastric junction (EGJ) carcinoma,and to assess the applicability of the new edition of American Joint Committee of Cancer (AJCC) staging guideline on EGJ adenocarcinoma in China.Methods From 2002 to 2012,the clinical data,pathological features,treatment and prognosis of 218 patients with EGJ malignant tumor were retrospectively analyzed.The patients were typed according to Siewert classification criteria and each case was staged according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma and gastric cancer.Kaplan-Meier method and Log-rank test were performed for survival analysis.Results According to the Siewert classification,type Ⅰ was rare (nine cases,4.1％),type Ⅱ was the most common type (150 cases,68.8％) and followed by type Ⅲ (59 cases,27.1％).There was no significant difference in survival curve among the three types (P＞0.05).The survival curve was drawn according to 7th edition of AJCC TNM staging criteria for esophagus adenocarcinoma.In T staging,the prognosis of patients at T4b was better than that of patients at T4a,the prognosis of patients at ⅡB was better than that of patients at ⅡA.The survival curve of patients at Ⅲ C obviously crossed with that of patients at Ⅳ,which was not in conformity with clinical results.The survival curve was drawn according to 7th edition of AJCC staging criteria for gastric cancer.In T staging,the survival curve of patients at Tis was overlapped with that of patients at T1a.The survival rate of patients at ⅡB could not be accurately predicted by the overall staging.In general,the survival of patients with EGJ carcinoma was better predicted according to 7th edition of AJCC staging criteria for gastric cancer than 7th edition for esophagus adenocarcinoma.Conclusions Neither 7th edition of AJCC staging criteria for esophagus adenocarcinoma nor for gastric cancer could accurately predict its prognosis.In our country,EGJ malignant tumor was similar to gastric cancer and had specific clinical-pathological features.It is necessary to research and establish EGJ carcinoma staging criteria instead of applying the current staging criteria for esophagus adenocarcinoma or gastric cancer.

Objective To explore the histopathological features of 850 patients with esophageal malignant tumor in 10 years.Methods From January 2002 to January 2012, 850 patients diagnosed with esophageal malignant tumor were enrolled.Tumor location, general type, pathological type and TNM stage were retrospectively analyzed.All the data were described as case number and percentage.Results Among the 850 cases of esophageal malignant tumor, 33 lesions (3.9％) located in the neck segment of esophagus, 119 lesions (14.0％) located in the upper segment, 44 lesions (5.2 ％) located in the upper-middle segment, 409 lesions (48.1％) located in the middle segment, 123 lesions (14.5 ％) located in the middle-lower segment, 122 lesions (14.4％) located in the lower segment.Among the 724 eases clearly diagnosed as esophageal malignant tumor by general type, the most cases were ulcer type (305 cases, 42.1％), followed by medulla type (260 cases, 35.9％), fungating type (80 cases, 11.0％) and constrictive type (70 cases, 9.7％), and the least cases were intraluminal type (nine cases, 1.2％).Among the 850 cases of esophageal malignant tumor, squamous cell carcinoma (794 cases, 93.4 ％) was the most common cytological type, followed by small cell carcinoma (19 eases, 2.2％), and the least common cytological type was adenocarcinoma (seven cases, 0.8 ％).Among the 724 cases with clear TNM staging, case number of Tis, T1, T2, T3 and T4 stage was eight (1.1％), six (0.8％), 271 (37.4％), 278 (38.4％) and 161 (22.2％), respectively.Among the 122 cases of distal esophageal carcinomas (104 cases with clear TNM staging), most cases were squamous cell carcinoma (112 cases, 91.8 ％), the others cases were adenocarcinoma (three cases, 2.5 ％), small cell carcinoma (three cases, 2.5 ％), basaloid squamous cell, adenosquamous, neuroendocrine carcinomas and carcinosarcoma (one case in each type, 0.8％).Conclusions Esophageal carcinoma was mostly located in the middle segment of in which squamous cell carcinoma was predominant while adenocarcinoma was less common.Esophageal cancer located at lower segment of esophagus is with a wide range of pathological spectrum, squamous cell carcinoma was still dominant, however, esophageal adenocarcinoma is rare.

Objective To study effects and other related problems of surgery for patients with cervical spine fracture and ankylosing spondylitis.Methods Twelve patients with cervical spine fracture and ankylosing spondylitis were treated with surgery from April 1986 to April 2004.All eases were studied retrospectively.They were followed up for an average of 67.5 months and their complete clinical data were kept.The neurological function was evaluated by ASIA (American Spinal Injury Association) impairment scale,and the image analyzing software (Image-Pro Plus 5.1) was used to measure the angles of superior and inferior vertebral bodies of the fusion segment at flexion and extension positions.The difference between flexion and extension angles,?,served as the parameter of interspinal movement.According to the definition of spinal fusion by FDA (Food and Drug Administration),the?≥4?was considered as nonfusion.Other related problems were discussed by descriptive study.Results The average improvement in the nine patients with neurological injury was 1.3 ASIA grades.The injured segments in 10 cases were treated with fusion,of whom nine were fused by internal fixation.The fusion rate was 100%.Three cases were scheduled to have laminoplasty,but two had to receive laminectomy instead because of intraoperative complete fracture at the hinged side.Ten patients were complicated by insufficient function of major organs preop- eratively,and endotracheal intubation was difficult to perform in eight cases.Postoperative complications occurred in three cases,but fortunately healed completely.There were no deaths or fatal complications.Conclusions The neurological function can be improved by surgery for patients with cervical spine fracture and ankylosing spondylitis. Although the cervical spine is instable for most of the patients,fusion with internal fixation is indicated and can be successful.Those who had preoperative systemic diseases are likely to suffer from postoperative complications.The difficult endotracheal intubation is a common intraoperative problem.

Objective To evaluate the value of helical CT scan in the diagnosis of small renal cell carcinoma.Methods The helical CT features of small renal cell carcinoma proved by operation and pathology in 14 cases were studied retrospectively.Results CT showedisodense mass in 7 cases,slightly low density mass in 5 cases,slightly hyperdense mass in 1 case,cystic and solid mass in 1 case,and among them 2 cases showed punctural calcification.The lesions showed marked enhancement in cortical phase in 12 cases,slight to moderateenhancement in 2 cases,in parenchymal phase,the tumor density dropped promptly,and in the pelvic phase the tumor density droppedfurther. Conclusion Small renal cell carcinoma is of certain characteristic on multi-phasic spiral CT contrast-enhanced scan,it is a very valuable method in diangosis of small renal cell carcinoma.

AIM: To investigate the level of ET-1 produced by cultured human bronchial epithelial cells (HBECs) under injury and the effects of injured HBECs on ET-1 production in sub-epithelial fibroblasts. The interaction between ET-1 and matrix metalloproteinase-9(MMP-9) was detected in HBECs under damage. The purpose of the study is to evaluate the effect of injured HBECs related to ET-1 release on airway remodeling in asthma. METHODS: ET-1 level was detected in supernatants from cultured HBECs 12 h after being treated with either mechanical scraping or LPS stimulation or mechanical scraping plus LPS, as well as from subepithelial fibroblasts cocultured with mechanical damaged HBECs. It was also measured in the supernatant from HBECs transfected with MMP-9 expression plasmid. MMP-9 activity was assessed in supernatants from HBECs stably transfected with pEGFPc1 -antisense-ET-1 converting enzyme(ECE) RNA. RESULTS: It was found that there was an increase in ET-1 level in supernatants from HBECs either treated with mechanical scraping plus LPS or transiently transfected with MMP-9 plasmid, as well as from sub-epithelial fibroblasts cocultured with mechanical scraping HBECs compared with that in controls. Gelatin zymography showed a obviously attenuated gelatinolytic activity of MMP-9 in conditioned media of HBECs expressing antisense ECE RNA after mechanical damage. CONCLUSIONS: Airway epithelial cells under injury are able to overproduce ET-1 as well as initiate ET-1 release from sub-epithelial fibroblasts, MMP-9 produced by injured bronchial epithelial cells may also increase ET-1 processing leading to ET-1 production further. The interaction between ET-1 and MMP-9, both of which enhanced in damaged HBECs, may play an important role in airway inflammation related to airway remodeling in asthma.

Objective To explore the curative effects of uterine arterial embolization(UAE) in treating adenomyosis.Methods Bilateral UAE was performed by Seldinger’s technique in 39 patients with adenomysis (11 cases coexisted with uterine leiomyoma).The catamenia,menorrhalgia,anemia,the size of uterus and lesions were observed after procedure.Results 6 months after treatment,mean catamenia was reduces 56.2%(?

Acute Disease ; Adult ; Humans ; Male ; Occupational Diseases ; diagnosis ; therapy ; Phosphines ; poisoning ; Poisoning ; diagnosis ; therapy

Objective:To evaluate the perioperative effects of glutamine-supplemented total parenteral nutrition support on immune function of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer randomized into three groups.The groups of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric 104.6 kJ/(kg?d) and isonitrogenous 0.20 g/(kg?d)total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.All variables were measured before and after operaition.Immune function and inflammatory responses were investigated.Results:No serious complication occurred in any group during the trial.The percentages of CD3~(+)cell and CD8~(+) cell decreased in three groups after operation.The percentage of CD4~(+)cell and NK cell and the ratio of CD4~(+)/CD8~(+) of group B was the highest in the three group on the sixth day after operation.Total lymphocyte count was higher in group B than that in group A and the levels of C reactive protein and prostaglandin E_(2) in group B were lower than those in group A.Conclusions:Glutamine-supplemented TPN is beneficial in raising total lymphocyte count and decreasing the level of C reactive protein and prostaglandin E_(2).And it can also modulate immunosuppressive status and inflammatory response of postoperative patients.

Objective:To evaluate the effects of perioperative glutamine-supplemented total parenteral nutrition support on nutritional status of patients with gastrointestinal cancer.Methods:60 patients with gastrointestinal cancer were randomized into three groups.The group of A(standard TPN group)and B(glutamine-supplemented TPN group) were given an isocaloric(104.6 kJ/(kg?d) and isonitrogenous(0.20 g/kg?d~(-1)) total parenteral nutrition for 10 days(5 days before operation and 5 days after operation) together with a course of chemotherapy before operation lasting for 5 days.The 25%～35% of nitrogenous source of group B was supplied by glutamine dipeptiven.The group of C(control group) was treated by routine program.Nutritional status was determined by body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of albumin,prealbumin transferin,glutamine,muscle concentration of glutamine and nitrogen balance.Results:No serious complications occurred in any groups during the trial.Body weight,triceps skinfold thickness,arm muscle circumference,plasma concentrations of prealbumin,transferin and nitrogen balance were not significantly different among groups.On postoperative day 6,the concentration of glutamine in blood and muscle in Gln-TPN group was higher than that in other two groups.Conclusions:Glutamine-supplemented TPN is beneficial to alleviating the state of catabolism caused by chemotherapy and operation.It can raise the concentrations of glutamine in blood and muscle,decrease the loss of muscle and fat tissue and promote synthesis of protein.

Objective To screen 18 endophytes from Pseudolarix kaempferi Gord for molluscicidal effect and identify them by morphology. Methods Molluscicidal tests were performed according to the immersion test suggested by WHO and the strain screened was identified by the slide culture. Results The mortality rates of snails immersed by JJ18 broth salified (pH=7) were 26.7%, 76.7% and 100.0% for 24,48 h and 72 h, respectively, and 53.3% and 86.7% in 5% and 10% concentrations of JJ18 broth, respectively. The active components were extracellular moiety of the broth which had no acute toxicity to fish, and JJ18 strain belonged to Aspergillus. Conclusion Extracellular moiety of endophyte JJ18 from Pseudolarix kaempferi Gord is a new resource of molluscicide.