Surgical therapy should be the main method in treatment of rectal cancer.Along with the increase rate of undergoing anterior resection for rectal cancer,it is getting be paid more and more attention on postoperative anastomotic fistula as the main complications of rectal carcinoma.In recent research,anastomotic fistula occurred caused by various factors had also been put forward gradually,while the risk factors for postoperative anastomotic fistula were still remain unclear.Therefore,it is very important to understanding the risk factors in order to prevent the happening of the anastomotic fistula,and provide clinical basis for their necessary preventive colostomy.

Objective:To explore a method for isolation and culture of human epidermal stem cells. Methods:The Epidermal stem cell were isolated by adhering to collagen typeⅣafter obtained by digesting human foreskin with DispaseⅡand Tryp and culture in vitro in K-SFM. The expressions of?1-integrin and keratin 19 (K19) in epidermal stem cell were detected with immunocytochemical methods,and the colony forming efficiency was also studied. Keratinocytes were served also detected. Results:It was revealed by histologieal observation that colonieswere formed 24 hours after inoculation. The isolated and cultured cell cloning efficiency was higher than that of the control group. Positive expression of?1-integrin and K19 of cultured cells was detected by immunocytochemistry. Conclusion:Adult epidermal stem cells could be successfully isolated and cultured by adhension with typeⅣcollagen and culture with K-SFM

Objective:To study the clinicopathologic features、diagnosis and differential diagnosis of epithelioid sarcoma.Methods:Two cases of epithelioid sarcoma were collected according to the classification of soft tissue and bone tumors(WHO,2002) and were studied by hematoxylin-eosin and immunohistochemical staining.Results:One case was proximal type epithelioid sarcoma,and the other distal type epithelioid sarcoma.The case of distal type epithelioid sarcoma was female,twenty eight years old,and the site was the left leg;histological structure was the typical pseudo-granuloma formation,the tumor cells resembled epithelioid cells,with necrosis in the center.The case of proximal type epithelioid sarcoma was female,thirty six years old,and the site was the cervix;nodal formation can be observed,the tumor cells resembled spindle cells,abd the extent of necrosis was bigger.For the immunohistochemical staining,expressions of Vimentin、EMA and CK antigen were observed in the 2 cases,while expressions of Desmin、NSE and S-100 antigen were negative.Moreover,expressions of low CK and CD34 antigen were also observed in the case of distal type epithelioid sarcoma.On the other hand,expressions of Actin、SMA and HMB-45 antigen were not observed in the case of proximal type epithelioid sarcoma.Conclusions:Epithelioid sarcoma is a rare maliglant tumor of soft tissue,It's the key for diagnosis and differential diagnosis to combine clinic、histological structure、immunophenotype and prognosis together.

Objective:To investigate the clinicopathologic features,immunohistochemical foundings and prognosis ofprimarybreast diffuse large B cell lymphoma(DLBCL).Methods:Twelve cases of primary breast DLBCL,diagnosed according to the 2008 World Health Organization staging standards for haematopoietic and lymphoid tumors,were retrospectively studied.Immunochemical study was perfomed and follow-up information analyzed.The histopathologic and immunophenotypic features of all cases were summarized.Subclassification was carried out when CD10 and/or Bcl 6 positivity and negativity for MUM1 were considered indicative of germinal center B cell like type DLBCL(GCB DLBCL)and the opposite expression as non germinal center B cell like subtype(non GCB DLBCL).Results:Female 10 patients,male 2 patients.Median age of patients was 49 years.7 patients in right breast,5 patients in left.12(100%)patients in stageⅠE.The International Prognostic Index(IPI)of 1 patients was 2,which of 2 patients was 1,and which of 9 patients was 0.Follow-up information was available in 6 patients(50%),four of which were still alive and two died(survived 7 and 19 months respectively).The patients usually presented with unilateral painless enlargement of breast.Morphologically,the lymphoma cells of 7 DLBCL cases showed a centroblastic variant,5 a immunoblastic variant.5 patients with lymphoepithelial lesions(LEL).Expression of Bcl6 and MUM1 protein was observed in 8 and 12 cases,respectively,and without expression of CD10 in 12 cases.All of 12 patients with DLBCL belong to the non GCB DLBCL.Most cases demonstrated high proliferation index,the median of Ki-67 index was 40%and more than 40%was found in 7 cases(58.3%).Conclusion:Primarybreast diffuse large B cell lymphoma is a rare entity,and shows a non germinal center B cell phenotype,accurate pathologic diagnosis relies on detailed histologic examination and immunochemical study,and treated mainly by chemotherapy combining with other therapies.

Objective:To study the clinical and pathological features of primary NK/T cell lymphoma of testis and to investigate the effective diagnosis and treatment of this disease.Methods:The surgical specimens of two patients with primary NK/T cell lymphoma of the testis were observed by light microscopy,immunohistochemistry and examined by in situ hybridization for Epstein-Barr virus(EBV) RNA and the literature were reviewed.Results:The two patients respectively presented with bilateral and right-side painless testicular enlargement.The neoplastic cells were positive for CD45,CD2,CD56,cytoplasmic CD3(CD3?),CD45RO and Granzyme B,while the expressions of CD57,CD20,CD79a,CD30,CK,MPO,TdT,BCL-2 and PLAP were negative.In addition,the EBV RNA was detected in the lymphoma by in situ hybridization.Conclusion:Primary NK/T cell lymphoma of the testis is a rare entity and progressed rapidly.The expression of CD56,CD3?,cytotoxic granule associated ptoteins and EBV examination by in situ hybridization play an important role in diagnosis and differential diagnosis.

Interferon-inducible protein-10 (IP-10) is a member of the ELR-CXC-chemokine family,a molecule which is paid close attention to current studies.IP-10 can inhibit neovascularization and exert its function on anti-fibrosis as it binds with CXCR3,the only specific receptor to IP-10.Accumulating evidences revealed that IP-10 also involved in the pathologic process of ocular neovascular diseases.It shows that IP-10 was closely associated with subclinical chronic inflammation and involved in the development of age-related macnlar degeneration (AMD),which would be used as a clinical biomaker to make a definite diagnosis of AMD.The IP-10/CXCR3 signal,expressed on the choroidal endothelial cells,had the ability of suppressing choroidal neovascularization.Moreover,the over expression of IP-10 in the lesions of AMD may be attributed to the induction efficacy of promoting anti-angiogenic factor expression,such as IP-10 by vascular endothelial growth factor.IP-10 had an important role in the pathogenic process of diabetic retinopathy (DR) and might be used as a new indicator to evaluate the severity and prognosis of DR.And IP-10 may have the ability to suppress proliferative DR by interrupting formation of new vessels and promoting fibrosis of new vessels.Experimental study showed that IP-10 can reduce corneal neovascularization by down-regulating the expression of proangiogenic cytokines indirectly and suppressing the migration of vascular endothelial cells and tubegenesis directly.IP-10 is involved in the development of retinopathy of prematurity and polypoidal choroidal vasculopathy.Given its unique biological characteristics,IP-10 is expected to be a molecular target to inhibit neovascularization in treatment for ocular neovascular diseases.This article reviews the recent progress in the studies on relationship between IP-10 and several common neovascular eye diseases.

Objective To evaluate the significance of serum interleukin-17(IL-17)and matrix metalloproteinase-7(MMP-7)in the diagnosis of hepatocellular carcinoma(HCC). Methods A total of 52 patients with HCC(HCC group),32 patients with liver cirrhosis(LC group)and 36 healthy controls(control group)were enrolled for the study,and all samples were collected from The First Hospital of China Medical University. Serum levels of IL-17 and MMP-7 were determined using ELISA method. The diagnostic performance and their correlation was evaluated. Re-sults Serum levels of IL-17 and MMP-7 in HCC group were significantly higher than those in LC group(all P<0.001)and control group(all P<0.001). Both of them in LC group were higher than control group(all P<0.05). The area under ROC of serum IL-17 and MMP-7 were 0.901 (95%CI:0.847-0.954)and 0.845(95%CI:0.772-0.918). The sensitivity of serum IL-17 and MMP-7 in the diagnosis of HCC was 90.4%and 86.5%,respectively,and the specificity of the same markers was 77.9%and 76.5%,respectively. Combined detection of the two markers improved sensitivity to 98.7%and specificity to 94.8%. Serum IL-17 was positively correlated to MMP-7(r=0.513,P<0.01). Conclusion IL-17 and MMP-7 are involved in the progress of HCC,and serum IL-17 and MMP-7 may be useful markers in the diagnosis of HCC.

Objective To explore the effects of attributional styles, coping styles, irrational beliefs on the severity of depression. Mehtods A cohort of 74 major depressed patients was collected on admission and at discharge. The assessment included Beck Depression Inventory ( BDI) , Irrational Beliefs Scale (IBS) , Coping Styles Questionnaire (CSQ) , Attributional Style Questionnaire ( ASQ) was applied to depressed patients and 55 normal controls. For the results of statistical analysis, cognitive model of depression was framed. Results The results of statistical analysis showed that low frustration tolerance global evaluation, problem-solving, stable for the negative e-vents play a significant role, problem-solving and stable for the negative events had a direct effects on depression( β= 0.30, P < 0.01; β = - 0.68, P < 0.01 ). low frustration tolerance has a indirect effects. Conclusion problem-solving and stable for the negative events have a direct effects on depression, low frustration tolerance has a indirect effects.

BACKGROUND:Mesenchymal stem cels can differentiate into lung parenchymal cels involved in lung injury repair, providing a new approach for the application of mesenchymal stem cels in patients with chronic obstructive pulmonary disease. OBJECTIVE:To observe the effect of bone marrow mesenchymal stem cel transplantation on the repair of airway injury in rats with chronic obstructive pulmonary disease. METHODS:Twenty-four female rats were randomized into four groups: bone marrow mesenchymal stem cel transplantation group (cel transplantation group,n=12); bone marrow mesenchymal stem cels group (cel control group,n=4); model group (n=4); healthy control group (n=4). Rat models of chronic obstructive pulmonary disease were established in the cel transplantation group and model group using fumigation+lipopolysaccharide method; and at 1 day after modeling, model rats were given 1 mL CM-Dil-labeled bone marrow mesenchymal stem cels and 1 mL PBSvia the tail vein in these two groups, respectively. In addition to tracheal injection of normal saline (300 μL) at 1 and 14 days, rats in the cel control and healthy control groups were given 1 mL CM-Dil-labeled bone marrow mesenchymal stem cels and 1 mL PBSvia the tail vein, respectively. At 1, 7, 15 and 30 days after cel transplantation, lung tissue and serum markers of al rats were detected. RESULTS AND CONCLUSION:(1) Hematoxylin-eosin staining showed that emphysema and airway injury was milder in the cel transplantation group than the model group, but severer than the cel control and healthy control groups. (2) The total number of leukocytes and neutrophils in the peripheral blood was higher in the cel transplantation group than the cel control and healthy control groups (P < 0.05); with time, the total number of leukocytes and neutrophils was decreased gradualy. (3) Compared with the cel control and healthy control groups, the interleukin-10 level in the peripheral blood was lower and the levels of tumor necrosis factor-α and granulocyte colony-stimulating factor were higher at 1 day after cel transplantation (P < 0.05). With time, in the cel transplantation group, the interleukin-10 level was increased gradualy, the level of tumor necrosis factor-α was decreased gradualy, and the level of granulocyte colony-stimulating factor was increased first and then decreased, which was highest at 7 days after cel transplantation. (4) Partial CM-Dil-positive cels were positive for CC16. Taken together, bone marrow mesenchymal stem cel transplantationvia the tail vein can improve lung injury of rats with chronic obstructive pulmonary disease, and it is involved in the repair of airway injury through differentiation into epithelial cels and immune regulation.