Purpose:To explore the relationship between the occurence of acute respiratory failure after subototal esophagectomy and three-field lymphadenectomy and the choice of anesthesia and management.Methods:From March 2000 to Janunary 2001,thirty-seven patients scheduled for subtotal esophagectomy and three-field lymphadenectomy with e- sophageal cancer,adopting the combination of epidural,cervical nerve block,and general anesthesia were studied.Re- sults:Seven cases out of thirty-seven had acute respiratory failure,accounting for 19% in whole group.They had complete recovery after antifectious therapy and respiratory support.Conclusions:To combine the epidural,cervical nerve block and general anesthesia can reduce intravenous anesthetics use and shorten the extubation time,decrease the incidence of postop- erative respiratory failure.

Objective To investigate the expression of Toll-like receptor 4 (TLR4) and CD80 in unexplained recurrent spontaneous abortion and their relationship,discuss its possible roles in guiding eugenics,and provide a new idea for clinical diagnosis and prevention.Methods The study group were 60 cases with unexplained recurrent spontaneous abortion patients.The control group included 30 cases of normal early pregnancy without previous history of adverse pregnancy.The expressions of TLR4 and CD80 were detected with immunohistochemistry in the peripheral blood,chorion,and decidua from each case.Results TLR4 had higher expression in the peripheral blood,the chorion and decidua from the recurrent spontaneous abortion women than that from normal pregnancy women (P ＜ 0.05).Levels of CD80 were significantly higher in recurrent spontaneous abortion group than in normal pregnancy group (P ＜ 0.05).There was a positive correlation between TLR4 and CD80 (r =0.982,0.986,and 0.776,P ＜0.01).Conclusions The study shows that TLR4 and CD80 were expressed in peripheral blood lymphocytes and villi and decidua of early pregnancy (normal pregnancy or abnormal pregnancy).Higher expressions of TLR4 and CD80 might play an important role in the occurrence of recurrent spontaneous abortion.

Background and purpose:Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Intrahepatic recurrence is the main factor affecting its medium-term survival rate. Therefore, the search for the markers of metastasis is essential. This study aimed to evaluate the relationship of expression of tyrosine kinase phosphorylation Tyr416 of sarcoma (SRC pY416) in HCC with clinical parameters and prognosis. Methods:Immunohistochemical method and Western blot were used to detect the expression of non-receptor tyrosine kinase (SRC pY416) in 112 cases of HCC tissues and 40 cases of corresponding cancer adjacent normal liver tissues. Hepatitis B virus (HBV) DNA and alpha fetoprotein (AFP) in patients were detected with chemiluminescence. In the 12 months Follow-up of the study,the association between SRC pY416 expression and clinical parameters was analyzed. Results:SRC pY416 expressions in HCC (65.40±15.69) were higher than those in cancer adjacent normal liver tissues (11.25±2.73,P<0.001). The expressions of SRC pY416 were all associated with the age, the liver cirrhosis, the complete capsule, the tumor differentiation, the HBV DNA and the AFP value of the patients (P<0.01). 12 months after operation, single factor analysis showed that the recurrence was associated with the tumor differentiation, the HBV DNA, the AFP value and the expression of SRC pY416 of the patient (P<0.01). Multivariate analysis showed that the expression of SRC pY416 was an independent prognostic factor for recurrence and metastasis in patients with HCC in 12 months. Conclusion:SRC pY416 may play an important role in the metastasis of HCC. The expression of SRC pY416 may be the marker for HCC liver metastasis.

AIM: To investigate the biological characterics of human second-trimester fetal cord blood mesenchymal stem cells (MSC) and its application prospects in utero gene transfer/therapy (IUGT). METHODS: Nuclear cells separated from cord blood were cultured in DMEM medium. Surface antigens of the MSC were analyzed by the FACScan flow cytometry. Adipogenic and osteogenic mediums were used to assess the differentiation ability of the cells. Adenovirus vector deliver green fluorescent protein gene (Ad-GFP) was used to transfected the MSC and the expressing of GFP was detected by fluorescent microscope. The MSC were injected into the liver of newborn rat. The immunofluorescence analysis was conducted to determine the presence of double-positive CD105+/CD166+ cells in different organs of rats. MSC were subcutaneous injected into the human-nonobese diabetes/severe combined immunodeficiency disease (NOD/SCID) mice and carcinogenesises of the MSC in vivo were detected by pathological diagnosis. RESULTS: MSC could be separated from fetal cord blood. These cells were uniformly positive for CD29, CD44, CD59, CD105, CD166 and negative for CD34, CD45, CD80, CD86, HLA-DR. The cells had the abilities to differentiate into adipogenic and osteogenic cells in vitro, expressed the GFP at high levels (56 32%?3 28%). The MSC were located at different organs after injected into the newborn rats and didn't have carcinogenicity in vivo. CONCLUSION: Human second-trimester fetal cord blood MSC is an promising target cells in fetal IUGT.

Objective To investigate the cognitive status of pregnant women on labor in liberal position and demand investigation, and analyze the reason and influencing factors of pregnant women choosing labor in liberal position. Methods Totally 177 pregnant women from the Third Affiliated Hospital of Guangzhou Medical University were chosen by convenience sampling method. They were investigate by self-designed questionnaire in order to get their information. Results The cognition of pregnant women on labor in liberal position was low, however, there was positive correlation between the degree of cognition and confidence in willingness to choose liberal position delivery mode ( r=0. 379, P<0. 05 ) . Relieving labor pain was the most attractive reason for pregnant women to try this delivery method. Conclusions Along with the two-child policy, enhancing the spreading and promotion of the concept of labor in liberal position, and well management the implementation of this mode of delivery method are the concerns of obstetrics health care in the future.

BACKGROUNDTo investigate the clinical possibility of detection of lung cancer cells in the peripheral blood with cytokeratin and 2F7/S5A monoclonal antibody by flow cytometry (FCM) in patients with lung cancer.

METHODSFive mililiter peripheral blood was collected. The mononuclear cells were isolated by Ficoll-Hypaquegradient centrifugation. Then the cells were labeled with lung specific antibody (2F7/S5A) and antibodies against CD45, cytokeratin (CK). The quantitation of CD45 -CK +2F7/S5A + cells were performed by FCM.

RESULTSA total of 151 people were studied, including 20 healthy controls, 116 patients with lung cancer and 15 patients with benign pulmonary diseases. The phenotype of monocytes of peripheral blood was CD45 +CK -2F7/S5A -, while the phenotype of lung cancer cells was CD45 -CK +2F7/S5A +. No cancer cell was found in peripheral blood of all the healthy controls. One out of 15 cases of benign pulmonary diseases was found to have CD45 +CK -2F7/S5A - cells in peripheral blood. And 39 out of 116 patients with lung cancer were found to have circulating lung cancer cells. The sensitivity, specificity, positive predictive value and negative predictive value of detection was 33.62% , 93.33%, 97.50% and 15.38%, respectively. The average quantitation of circulating cancer cell detected was 0.12×10⁶/L.

CONCLUSIONSThere is high specificity and positive predictive value of the examination of circulating cancer cells in patients with lung cancer by FCM, which could detect trace cancer cell in peripheral blood of lung cancer. It may be valuable in diagnosis and treatment of lung cancer.

OBJECTIVETo detect potential mutations in genes related with non-syndromic oculocutaneous albinism I-IV and ocular albinism type I in two couples who had given births to children with albinism.

METHODSAll exons of the non-syndromic albinism related genes TYR, OCA2, TYRP-1, MITF, SLC45A2 and GPR143 were subjected to deep sequencing. The results were verified with Sanger sequencing.

RESULTSFor the two female carriers, the coding region of the TYR gene was found to harbor a frameshift mutation c.925_926insC, which was also suspected to have been pathogenic. In one of the male partners, a nonsense mutations c.832C>T was found, which was also known to be pathogenic. Another male partner was found to harbor a TYR gene mutation c.346C>T, which was also known to be a pathogenic nonsense mutation.

CONCLUSIONThe coding region of the TYR gene c.925_926insC (p.Thr309ThrfsX9) probably underlies the OCA1 disease phenotype.

Adult ; Albinism, Oculocutaneous ; enzymology ; genetics ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; China ; Exons ; Female ; Frameshift Mutation ; Humans ; Male ; Membrane Glycoproteins ; genetics ; Molecular Sequence Data ; Mutation, Missense ; Oxidoreductases ; genetics ; Pedigree

Objective To achieve low-dose digital breast tomosynthsis (DBT) projection recovery using penalized weighted least square algorithm incorporating accurate modeling of the variance of the projection data and noise correlation in the flat panel detector. Methods Models were established for the quantal noise and electronic noise in the DBT system to construct the penalized weighted least squares algorithm based on noise correlation for projection data restoration. The filter back projection algorithm was then used for DBT image reconstruction. Results The reconstruction results of the ACR phantom data at different dose levels showed a good performance of the proposed method in noise suppression and detail preservation. CNRs and LSNRs of the reconstructed images from the restored projections were increased by about 3.6 times compared to those of reconstructed images from the original projections. Conclusion The proposed method can significantly reduce noise and improve the quality of DBT images.

Objective To analyze the clinical features of nonimmunocompromised patients with allergic bronchopulmonary aspergillosis (ABPA).Methods The clinical data of 11 nonimmunocompromised patients diagnosed as ABPA from June 2010 to December 2015 in Zhejiang Jinhua People's Hospital were retrospectively analyzed.SPSS 18.0 was used for analysis.Results Among 11 patients with ABPA, Five were males and 6 were females, with an average age of (49.3 ±11.0) years.All patients had cough, expectoration and wheezing;cough and tan sputum in 4 cases, bloody sputum in 3 cases, fever in 2 cases and chest pain in 2 cases.In auscultation dry rales were heard in all patients , and limited wet rales were heard in 3 cases.The peripheral blood leukocyte counts were elevated in 5 patients [11.7(10.3-13.5) × 109/L)] and the eosinophils counts were increased in 9 patients [1.79(0.09-7.63) ×109/L].The total IgE was elevated to 3640(1329-9430) IU/mL.Skin prick test was positive ( grade 3 to 5) in 10 cases, Aspergillus fumigatus specific IgE increased to 23.6(1.75-67.30) kU/L in 6 cases, Aspergillus fumigatus specific IgG raised to 83.3(51-126) mg/L in 5 cases.Chest CT showed patchy, punctate exudation in 8 cases, central bronchiectasis in 9 cases, bronchial mucosal plug formation in 4 cases, and atelectasis in 1 case.Mediastinal lymph nodes were found in 2 cases.All 11 patients were treated with glucocorticoid hormone, and 8 patients were also received itraconazole oral solution for treatment.After treatment, the clinical symptoms were improved rapidly.Conclusion Nonimmunocompromised patients with ABPA have no specific clinical manifestations , and often are misdiagnosed as asthma , which is worth the attention of clinicians.

Objective To achieve low-dose digital breast tomosynthsis (DBT) projection recovery using penalized weighted least square algorithm incorporating accurate modeling of the variance of the projection data and noise correlation in the flat panel detector. Methods Models were established for the quantal noise and electronic noise in the DBT system to construct the penalized weighted least squares algorithm based on noise correlation for projection data restoration. The filter back projection algorithm was then used for DBT image reconstruction. Results The reconstruction results of the ACR phantom data at different dose levels showed a good performance of the proposed method in noise suppression and detail preservation. CNRs and LSNRs of the reconstructed images from the restored projections were increased by about 3.6 times compared to those of reconstructed images from the original projections. Conclusion The proposed method can significantly reduce noise and improve the quality of DBT images.