This paper reports 32 patients with primary esophageal small cell undifferentiated carcinoma confirmed by histologic examination from April 1972 to January 1989 in our hospital. The 1-, and 3-, 5-year survival rates were 53.1%, 18.8% and 6.3%. 93.7% patients died of local un-control, recurrence or metastasis. The age, sex, tumor size, stenosis, position and the type in X-films did not influence the treatment results. Patients with primary esophageal small cell undifferentiated carcinoma should receive a multimodal treatment instead of surgery alone.

Adenomyomatosis of the gallbladder (GAM) is an acquired,benign proliferative lesion of the gallbladder which is characterized by mucosal proliferation with invaginations and diverticula penetrating into the thickened muscular layer (Rokitansky-Aschoff sinuses).GAM consists of 3 types:diffuse,segmental and fundus GAM.There is no specific presentation of GAM,and computed tomography is helpful for the diagnosis of this disease.From July 2010 to May 2013,16 patients with fundus GAM were admitted to the Second People's Hospital of Wuxi.Rokitansky-Aschoff sinuses and calotte sign at the thickened muscular layer of the fundus of the gallbladder are the typical presentation of the fundus GAM.Enhanced computed tomography examination is of great importance for the diagnosis of the fundus GAM.

Objective To investigate the expression and distribution of basic fibroblast growth factor (bFGF)and platelet-derived growth factor (PDGF)in the different phases of femoral neck fracture.Methods Immunohistochemical assays were used to determine the expression and distribution of bFGF and PDGF protein in 36 human specimen of femoral neck fracture.A was measured and analyzed by CMIAS color imaging analysis system for signals of bFGF protein were found high in the mesenchymal cells,monocyte and vascular endothelial cells at 1st week after fracture in 9 subjects,with A of (0.4076 ±0.0902).The weakly positive signals of PDGF protein were found in the mesenchymal cells,while strongly positive in the vascular endothelial cells with A of (0.2261 ±0.0636).At 2rd week,in 9 cases the expression of bFGF and PDGF was strongly expressed in fibroblasts,endothelial cells,cartilage cell and cartilage matrix,osteoblast,with A of[(0.6404±0.0920)and (0.7457±0.0756)]and significandy higher than that at 1st week (P＜0.05,P＜0.01).There was no significant difference between the 3rd and 3nd week with A of[(0.7168±0.1346)and (0.8033±0.0491),P＞0.05 ].The expression of bFGF and PDGF protein was reduced obviously at 4th week but was positive in young and cartilage tissue,with A of [(0.5374correlation between bFGF and PDGF protein in different phases (r1week=0.792,r2week=0.834,r3week=0.880,entiation of cartilage cell and osteoblast,and induce proliferation of vascular endothelial cells and new blood vessel.③ Both bFGF and PDGF are bone growth factors, cooperating in regulating proliferation and differentiation of cartilage cell and osteoblast for fracture healing.

Objective:To assess the role of EGFR mutations on pemetrexed response in patients with advanced lung adenocarcino-ma. Method: Forty pulmonary adenocarcinoma patients with evaluable lesions were retrospectively screened .They had been treated with pemetrexed-included chemotherapy and had EGFR gene test results. The evaluation endpoints were overall response rate,disease control rate and progression free survival. Result:No significant statistical difference was seen in overall response rate(ORR) (44.4%VS 31.8%, respectively) and disease control rate(DCR) (88.9%VS 81.8%, respectively ) between EGFR wild group and EGFR muta-tion group, but patients in EGFR wild group had longer progression free survival(PFS) ( 8.9 months VS 5.3 months;P=0.046). Conclu-sion:EGFR mutation status can influence the efficacy of pemetrexed.

Objective: To quantitatively study the incidental extra-cardiac ifndings (ECFs) by coronary computed tomography angiography (CCTA) in patients with suspected coronary artery disease (CAD) in order to better recognize those lesions in clinical practice.
Methods: A total of 1169 suspected CAD patients received CCTA in our hospital from 2011-06 to 2013-03 and 1030 patients were enrolled in this study. There were 589 in-patients, 441 out-patients and 549 patients≥60 years of age,481 patients < 60 years of age. 3 physicians evaluated the incidental ECFs in the full ifeld of view (FOV) in different window level and window width for lung, mediastinum, thorax and upper abdominal areas. Clinical relevance of ECFs were classiifed by corresponding scores. Score 1, the patients with severe lesion need immediate treatment, score 2, the lesion with clinical and prognostic signiifcance and score 3, the ifnding without clinical signiifcance.
Results: There were 197/1030 (19.1%) patients having 224 ECFs and 27 (2.6%) patients having 2 ECFs; 90/1030 (8.7%) patients having 106 signiifcant lesions including 3 (0.3%) of lung cancer and 8 (0.8%) of pulmonary embolism; 107 patients with 118 lesions without signiifcance. ECFs were found in 114/589 (19.4%) in-patients and in 83/441 (18.8%) out-patients, P>0.05; 76/481 (15.8%) of patients < 60 years of age and 121/549 (22.0%) of patients≥60 years,P<0.05.
Conclusion: Unexpected ECFs detection rate was 19.1% in patients undergoing CCTA without further radiation exposure by reconstruction with the full FOV setting, and 8.7% of ECFs had clinical signiifcance. Radiologists should routinely analyze the extra-cardiac organs in CCTA.

Objective To investigate whether MT1-MMP is involved in the inhibition effect of curcumin on the proliferation and invasion of breast cancer cell and the mechanism . Methods Firstly, MCF-7 cell lines transfected by MT1-MMP eukaryotic expression vector was established. We divided all cells into 3 groups,including null vector transfection group, non-transfected and transfected group with different concentrations of curcumin. The expression of MT1-MMP protein, the proliferation and invasion ability were respectively analyzed by western blot, transwell method, and cell counting kit-8 (CCK-8). Results The expression of MT1-MMP was inhibited by curcumin. Transwell and CCK-8 experiment indicated the proliferation and invasion abilities of MT1-MMP transfected MCF-7 cells were inhibited by curcumin in a concentration dependent manner. Conclusion The inhibition value of curcumin on proliferation and invasion is probably due to its ability to inhibit the expression of MT1-MMP.

Objective: To assess the renal cortical perfusion parameters by the imaging of computed tomography (CT) in patients of essential hypertension (EH) with target organ damage.
Methods: A total of 90 subjects with the entire information including 59 EH patients were studied. The EH patients were divided into 2 groups: EH + target organ damage group,n=30 and EH without target organ damage group,n=29. In addition, there was a Control group,n=31 healthy volunteers. All subjects received 128-slice dual-source CT renal perfusion scanning, the quantitative perfusion of renal cortex blood lfow (BF), blood volume (BV), time to peak (TTP) and the mean transit time (MTT) were examined and compared among different groups.
Results: There were 90/97 (92.8%) participants eligible for perfusion analysis. Compared to Control group, EH without target organ damage group had the similar parameters of BF, BV, MTT and TTP,P>0.05. While EH + target organ damage group had decreased BF (214.6 ± 36.1) ml/(min?100 ml ) than Control group (262.1 ± 26.6) ml/(min?100 ml ),P<0.01, and BV, TTP, MTT were similar to Control group,P>0.05. Compared to EH without target organ damage group, the EH + target organ damage group presented decreased BF (214.6 ±3 6.1) ml/(min?100 ml ) vs (268.9 ± 33.1) ml/(min?100 ml ), P<0.01 and prolonged MTT, TTP,P< 0.05.
Conclusion: CT imaging may evaluate the renal cortical perfusion changes, and especially BF which can relfect the renal perfusion more sensitively than other parameters in EH + target organ damage patients.

Aim To synthesize and identify artificial antigen of podophyllotoxin for the production of podophyllotoxin polyclonal antibody. Methods The hapten was synthesized by two different chemical approaches and characterized by TLC, IR, NMR, and MS. Mixed anhydride reaction (MAR) and active ester method (AEM) were used to couple the podophyllotoxin to carrier proteins (BSA and OVA). Characterization of artificial antigens was done by using spectroscopy and electrophoresis. The anti-podophyllotoxin polyclonal antibodies were obtained through immunizing rabbits. Results The results from IR, NMR and MS showed that 4-O-succinoyl podophyllotoxin (hapten) was successfully synthesized. The coupling molar ratios of the hapten and carrier proteins were 88.6 for Hapten-BSA1, 40.3 for Hapten-BSA2, 17.8 for Hapten-OVA1, and 54.2 for Hapten-OVA2. Hapten conjugates coupled with BSA yielded two sets of the specific and affinitive polyclonal antibodies. One set of antibodies showed an IC50 value of 2.21 μg·mL -1 with a detection limit of 0.12 μg·mL -1. Conclusion Antigenic conjugates were artificially synthesized, and based on these artificial antigens, polyclonal antibodies against podophyllotoxin were raised from rabbits immunized with two different immunogens and characterized with an indirect ELISA format.

Aim To investigate the effects and mecha-nism of nuclear factor-κ B inhibitor, PDTC, on global cerebral ischemia reperfusion ( GCIR ) rat hippocam-pus. Methods Forty-eight adult male Sprague-Daw-ley rats were randomly divided into one control group receiving sham operation and three experimental groups all receiving global cerebral ischemia for 20 min. In PDTC 100 mg·kg-1 group ( P100 ) and PDTC 200 mg ·kg-1 group ( P200 ) , PDTC 100 mg · kg-1 or PDTC 200 mg·kg-1 was injected ip one hour before ischemi-a respectively. Spatial learning and memory function of rats were tested using Morris water maze. HE staining was employed to observe pathological changes of hipp-ocampal neurons. Expression of COX2 was measured by Western blot, and the content of PGI2 and TXA2 in
rat hippocampus was detected by enzyme-linked immu-nosorbent assay. Results A significant increase of es-cape latency was observed in GCIR group compared to the sham operation group(P<0.05). PDTC 100 mg· kg-1 and PDTC 200 mg · kg-1 significantly reduced escape latency ( P <0.05 ) and histopathological injury in CA1 region of hippocampus. PDTC 100 mg · kg-1 and PDTC 200 mg · kg-1 also reduced COX2 expres-sion, PGI2 content, TXA2 content and PGI2/TXA2 . Conclusion Pretreatment with PDTC can protect hip-pocampus from GCIR injury through inhibition of COX2 expression and PGI2/TXA2 .

Objective To study the mortality and risk factors of death of critical patients treated in emergency department for initial stabilization and life support. Method The clinical data of 1240 critical patients from January 2005 to December 2006 were retrospectively analyzed. The patients were divided into death group and survival group. The differences of demographics, symptoms, physical signs and laboratory findings of patients between two groups were analyzed by using univariate and multivariate logistic regression analysis, sex, age, visiting time after attack, the history of chronic diseases, temperature, respiratory rate, heart rate, mean arterial pressure, respiratory dysfunction, circulatory dysfunction, hepatic dysfunction, gastrointestinal dysfunction, renal dysfunction, coagulation disorders, acid base and electrolyte disturbances, lencocyte count,platelet count, Glasgow coma scale (GCS) score and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ). Results There were higher mortality and morbidities of patients with diseases of respiratory, digestive, circulatory and nervous systems. The mortality of patients with the history of chronic diseases was higher (P < 0.01) ,and there were more patients with chronic obstructive pulmonary disease(COPD), chronic cardiac insufficiency, diabetes mellitus or cirrhosis of liver in death group (P < 0.05). The mortality of patients with 3 dysfunctional organs was 32.81%, and the mortality of lity of those with five dysfunctional organs was 76.67% . Logistic regression analysis indicated that male gender, age between 46 and 65, respiratory dysfunction, circulatory dysfunction, gastrointestinal dysfunction, hepatic dysfunction, low Glasgow coma scale (GCS) score and high APACHE II score were risk factors of the death of critical patients. Conclusions The mortality of patients with the history of critical diseases is higher. The more dysfunctional organs, the higher mortality is. Age between 46 and 65, male gender, and dysfunction of lung, circulation, gastrointestinal tract,and liver,and low CCS score and high APACHE II score are risk factors of the death of emergency and critical disease.