Churg-Strauss Syndrome ; complications ; Coronary Artery Disease ; complications ; Humans ; Male ; Middle Aged

Animals ; Animals, Newborn ; Brain Edema ; prevention & control ; Hypoxia-Ischemia, Brain ; prevention & control ; Progesterone ; therapeutic use ; Rats ; Rats, Wistar

Objective To investigate the clinical characteristics and prognosis of patients with different molecular subtypes of breast cancer.Methods A cohort of 716 breast cancer patients which had clear immunohistochemical detection were investiged.Their molecular subtypes were categorized as Luminal A,Luminal B,HER-2 over-expressing and basal-like subtypes,based on detection of ER,PR,HER-2 expression,and the clinical data including characteristics,relapse,prognosis and prognostic factors of the patients with different subtypes of breast cancer were analyzed retrospectively.Results There were no significant differences among different molecular subtypes at the age,menopausal status,production times,clinical stage,and radiation therapy(P ＞0.05).There were significant differences among different molecular subtypes at axillary lymph node starus (x2 =17.208,P =0.001),turner size (x2 =20.528,P =0.000) and operation method (x2 =24.242,P =0.000) and chemotherapy regimens (x2 =10.711,P =0.013).Univariate and multivariate analyses showed that clinical stage (x2 =17.005,P =0.002),axillary lymph node status (x2 =11.267,P =0.000) and molecular typing(x2 =125.634,P =0.000) were independent prognostic factors affecting long-term survisal rate.Conclusion Breast cancer patients in different subtypes have different long-term survival rate.The patients in basal-like subtype have the worst long-term survival rate.Molecular subtypes may provide important information to predict the prognosis of breast cancer.

Objective To study the changes of endothelin-1(ET-1) and calcitonin gene-related peptide(CGRP) in plasma of cerebral vasospasm(CVS) after resection of skull base tumors and the effect of the two factors on cerebral vasospasm. Methods Totally 34 cases were divided into symptomatic cerebral vasospasm group,asymptomatic cerebral vasospasm group and nonvasospasm group after resection of skull base tumors.The blood specimens were obtained from the 34 patients on days 1,3,5,7 and 14 after the resection.The concentration of ET-1 and CGRP was detected by radioimmunoassay;meanwhile,transcranial doppler was recorded.Another 10 normal adult served as control group. Results ① Concentration of ET-1 in plasma elevated from the 1st day after resection of skull base tumors,reaching peak levels on day 5 to day 7,then decreased gradually and nearly recoverd on day 14.Concentration of CGRP in plasma decreased from day 3 after resection of skull base tumors,with the lowest concentration on day 7,then increased gradually and recoverd on day 14.② Concentration of ET-1 in plasma of the three groups was higher than that of normal adult group,while concentration of CGRP of the three groups was lower than that of normal adult group.③ Concentration of ET-1 in plasma in vasospasm groups was higher than that in nonvasospasm group(P

Objective To investigate the relation between polymorphism of NOS3 G894T and susceptibility of cancer .Methods Literatures under the inclusion and exclusion criteria about relation between polymorphism of NOS 3 G894T and susceptibility of cancer were collected by computer -based retrieval and manual retrieval .The pools ORs with 95% CI were calculated to assess the association strength between polymorphism of NOS 3 G894T and cancer risk by Meta methods .Sensitivity and publication bias were evaluated .Results 19 literatures with 7679 cases of cancer and 8180 cases as control group were included .The pooled result indica-ted that no significant association between its polymorphism and cancer (ORT versus G=1 .030 ,95% CI=0 .964 -1 .101 ;ORTT versus GG=1 .056 ,95% CI=0 .895-1 .245 ;ORTG versus GG=1 .045 ,95% CI=0 .977-1 .119 ;ORTT/TG versus GG=1 .047 , 95% CI=0 .981-1 .117 ;ORTT versus TG/GG=1 .005 ,95% CI=0 .900-1 .123) .No significant association was observed in sub-group analysis based on ethnicity ,cancer type ,and source of control group .Conclusion There was no relationship between NOS3 G894T polymorphism and cancer susceptibility .

Objective To observe the protective effect of progesterone on brain edema in newborn rats with hypoxic-ischemic encephalopathy(HIE).Methods Fifty-two 7-day-old neonatal rats were randomly divided into 5 groups:normol control group(group A),hypoxic-ischemic group (group B) and pretreatment groups(group C,D and E).Rats were subjected to left common carotid artery ligation,then were exposed to 8% oxygen and 92% nitrogen for 2.5 hours to establish HIE model.Progesterone was injected intraperitoneally into the groups C,D and E rats respectively at 30 minutes before hypoxia.All rats were killed at the 24 hours after operations,then the contents of water,sodium,potassium were mensurated. Results The contentation of water in group B was higher than that in group A,the contentation of water,sodium in groups C,D and E were significantly lower compared with group B, but the contents potassium were no difference between group C,E and B. Conclusion Progesterone exerts a prominent preventive and protetive effects on the hypoxic ischemic brain edema in newborn rats.

Objective To investigate the complications and the risk factors of pancreatic fistula after pancreaticoduodenectomy.Methods The clinical data of 339 patients who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Sun Yat-Sen University from January 2000 to Decembcr 2009 were retrospectively analyzed.The risk factors of pancreatic fistula were analyzed.The incidences of complications accured from 2000 to 2004 and from 2005 to 2009 were compared.All data were analyzed by the t test,chi-square test,Fisher exact probability or Logistic regression model.Results The incidence of complications of all patients was 33.0％ ( 112/339),and the incidence of pancreatic fistula was 8.6％ (29/339).Of the 29 patients complicated with pancreatic fistula,6 patients were in grade A,8 in grade B and 15 in grade C.Soft texture of remnant pancreas and the diameter of pancreatic duct smaller than 3 mm were the independent risk factors of pancreatic fistula( OR =1.75,3.75,P ＜ 0.05 ).The number of hospital death was 12,including 1 patient died during the first period (2000-2004) and 11 patients died during the second period (2005-2009).Three patients died of pancreatic fistula and abdominal hemorrhage,3 died of postoperative upper gastrointesitnal bleeding,2 died of cardiac insufficiency,1 died of respiratory failure,1 died of pancreatic fistula,abdominal infection and necrotic pancreatitis,1 died of abdominal hemorrhage and hepatic and renal failure,1 died of bililary fistula,abdominal infection and multiple organ dysfunction syndrome.Conclusions Soft texture of remnant pancreas and the diameter of the pancreatic duct smaller than 3 mm are important risk factors of postoperative pancreatic fistula.Pancreatic fistula is the main factor causing death after pancreaticoduodenectomy.

Objective To investigate the expression of DNA methyltransferases ( DNMTs) in hilar cholangiocarcinoma and its clinical significance.Methods A total of 150 samples of cholangetic tissues were collected from 111 patients with hilar cholangiocarcinoma ( cholangiocarcinoma group) and 39 patients with choledochocele ( control group) at the First Affiliated Hospital of Sun Yat-Sen University from April 1997 to March 2007.A tissue chip containing the samples of hilar cholangiocarcinoma and choledochocele was prepared.Expressions of DNMT1,DNMT3a and DNMT3b were detected by the immunohistochemical staining. Differences in the protein expressions of DNMTs in the cholangiocarcinoma group and the control group were compared,and the correlation between DNMTs protein expressions and clinicopathological features was analyzed.All data were analyzed by using the chi-square test or Fisher exact probability.The survival curve was drawn by using the Kaplan-Meier method and the survival rate was compared by using the Log-rank test.Results The rates of high protein expressions of DNMT1 and DNMT3b were 54.1％ (60/111) and 47.7％ (53/111) in the cholangiocarcinoma group, which were significantly higher than 28.2％ ( 11/39) and 23.1％ ( 9/39) in the control group　( x2 =7.740,7.240,P ＜0.05). The high protein expression of DNMT1 was correlated with-the Bismuth-Corlette classification and T staging of the tumor ( x2 =12.200, 17.800,P ＜0.05) ; there was no significant difference in the high protein expressions of DNMT3a in the cholangiocarcinoma group and the control group ( x2 =3.370.P ＞0.05 ) ; while the high protein expressions of DNMT3b was correlated with the Bismuth-Corlette classification (x2 =8.300,P ＜ 0.05 ),but not with the T staging. Sixty-six patients received hilar cholangiocarcinoma resection,and 42 of them were followed up.The median postoperative survival time of patients with low protein expression of DNMT1 was 23.9 months,which was significantly longer than 11.8 months of patients with high protein expression of DNMT1 (x2 =3.980,P ＜ 0.05).Conclusions DNMT1 and DNMT3b with high protein expression might play important roles in the carcinogenesis and development of hilar cholangiocarcinoma.There is an obvious relationship between the expression of DNMT1 and postoperative survival time of patients with hilar cholangiocarcinoma,and DNMT1 might be a valuable prognostic factor for hilar cholangiocarcinoma.

ObjectiveTo evaluate the effects of double plates in the treatment of humeral intercondylar fractures.MethodsFrom January 2004 to March 2011,31 patients with humeral intercondylarfractures were reviewed.According to AO/Müller classification,there were three patients with type C1 fractures,16 with type C2 and 12 with type C3.Trans-olecranon osteotomy or trans-triceps-side approach and internal fixation by standard method of AO double plates were performed in all patients.ResultsAll 31patients were followed up for 12 -18 months,which showed fracture healing 6-12 months after surgery.According to the Cassebaum scoring system,the effects were evaluated as excellent in seven patients,good in 19,fair in four and poor in one,with excellence rate of 87％. ConclusionDouble plates is proved to be a good choice for humeral intercondylar fractures,since it can obtain satisfactory outcome with solid fixation,stable mechanical properties,few complications and facilitation for early rehabilitation.

Objective To investigate the complications and the risk factors for pancreatic leakage after pancreaticoduodenectomy.Methods One hundred and sixty-nine patients who received pancreaticoduodenectomy in our hospital between January 2000 and December 2009 were reviewed.Chisquare and logistic statistic analysis were performed to determine the risk factors for pancreatic leakage.The difference in complication rates between different periods were analyzed.Results The mortality was 2.4％.The morbidity was 34.9％,and the pancreatic leakage rate was 7.7％.Logistic analysis revealed significant risk factors for pancreatic leakage included intraoperative bleeding of more than 400 ml(OR=2.87; 95％ confidence interval:1.17-8.19; P=0.048),soft texture of remnant pancreas(OR =1.95 ; 95 ％ confidence interval:0.87-6.19 ； P =0.032)and pancreatic duct diameter smaller than 3 mm(OR=3.78 ; 95 ％ confidence interval:1.01-10.63 ； P =0.019).There was no significant difference in mortality,morbidity,pancreatic leakage,and upper gastric bleeding between the periods 2000-2004 and 2005-2009.However,re-operation rate and postoperative hospital stay were significantly higher in the period of 2005-2009.Conclusions Intraoperative bleeding,soft texture of remnant pancreas and pancreatic duct diameter smaller than 3mm were significant risk factors for postoperative pancreatic leakage.A pancreaticojejunostomy anastomotic technique familiar to the surgeon might reduce postoperative pancreatic leakage.