Objective To explore the risk factors of ulcerative colitis-associated colorectal cancer (UC-CRC).Methods The retrospective case-control study was conducted.The clinicopathological data of 536 patients with ulcerative colitis (UC) who were admitted to the Henan Tumor Hospital from March 2004 to June 2015 were collected.Observation indicators:(1) follow-up results:cases with follow-up,follow-up time,cases of UC-CRC,age of onset,pathological type of UC-CRC;(2) risk factors analysis affecting occurrence of UC-CRC:gender,age of onset,course of disease,severity of disease,disease classification,extent of lesion,smoking history,family history of colorectal cancer,anemia,hypoproteinemia,body weight loss,extraintestinal manifestations,colonic polyps,backwash ileitis,atypical hyperplasia,anxiety or depression,treatment method and regular endoscopy reexamination.Follow-up using outpatient examination and telephone interview was performed to detect prognosis of patients up to April 2017.Patients underwent colonoscopy once every 6 months within 3 years after diagnosis and once every 1 year after 3 years.Measurement data with skewed distribution were described as M (range).The univariate analysis was done using the chi-square test and Fisher exact probability.The multivariate analysis was done using the Logistic regression model.Results (1) Follow-up results:of 536 patients,450 were followed up for 26.0-120.0 months,with a median time of 76.4 months.During the follow-up,16 patients were complicated with UC-CRC,including 9 males and 7 females.Age of onset of colorectal cancer was 14-78 years,with an average age of onset of 44 years.Pathological type:high-differentiated right colon adenocarcinoma was detected in 5 patients,high-and moderate-differentiated left colon adenocarcinoma in 3 patients,left colon signetring cell carcinoma in 2 patients,moderate-differentiated rectal tubular adenocarcinoma in 3 patients,highdifferentiated rectal papillary adenocarcinoma in 2 patients and malignant lymphoma in 1 patient.(2) Risk factors analysis affecting occurrence of UC-CRC:the results of univariate analysis showed that course of disease,extent of lesion,colonic polyps and atypical hyperplasia were risk factors affecting occurrence of UC-CRC (x2 =14.848,18.885,10.554,P＜0.05).The results of multivariate analysis showed that course of disease ＞ 10 years,lesion involving the whole colon,colonic polyps and atypical hyperplasia were independent risk factors affecting occurrence of UC-CRC (OR=12.893,17.847,7.326,19.742,95％ confidence interval:1.726-74.337,1.445-89.793,1.263-43.128,3.625-96.524,P＜0.05).Conclusion The course of disease ＞ 10 years,lesion involving the whole colon,atypical hyperplasia and colonic polyps are independent risk factors affecting occurrence of UC-CRC.

Objective To evaluate the result of early repair for urinary fistula caused by iatrogenic injury to ureter,bladder and urethra during resection of rectal cancer.Methods We retrospectively analyzed 26 cases of urinary fistula after resection of rectal cancer patients encountered in Department of General Surgery,Henan Tumor Hospital from October 2005 to May 2016.Urinary fistula was divided into four types according to the site of fistula.Results Surgery was performed ever after the diagnosis of the fistula was identified.In type Ⅰ fistula (6 cases of posterior urethral fistula) the treatment was stent placement and packing of the greater omentum.2 cases of bladder top fistula (type Ⅱ),were treated by fistula repair and cystostomy.Type Ⅲ involved 12 cases (bladder triangle fistula).The treatment was ureter stenting replantation,and cystostomy Type Ⅳ:ureteral fistula in 6 cases,the treatment was end-to-end anastomosis and stenting.After surgery 24 cases were cured and 2 cases (all of type Ⅲ fistula) ended up with permanent bilateral ureterocutaneostomy.Conclusion It is safe and effective to make early remedy repair for ureter,bladder and urethral fistula iatrogenically during rectal cancer resection.

Objective:This study aims to examine the clinicopathological features, diagnosis, and treatment of pulmonary margin-al zone B-cell lymphoma of mucosa-associated lymphoid tissue (PMZL-MALT). Methods:The clinicopathological features and immu-nohistochemical staining of CD20, CD79a, CD5, CD10, CD23, CyclinD1, and Ki-67 in seven patients with PMZL-MALT were ana-lyzed. Results:These patients, with a median age of 58 years, included three males and four females. Most of the patients suffered from cough, anhelation, and irregular fever. No specific imaging manifestation was observed. Tumor cells were positive for CD19 and CD20 but negative for CD5, CD10, and CyclinD1. The positive rate of Ki-67 was low. Conclusion:PMZL-MALT cases are easily misdiag-nosed because of the absence of specific clinical characteristics and X-ray features. Final diagnosis depends on pathological examina-tions.

Objective:To retrospectively analyze related factors of subtype transformation and to identify prognostic factors for pa-tients with retroperitoneal liposarcoma (RPLS). Methods:This study retrospectively analyzed the clinical data of 92 patients with RPLS, which were confirmed by postoperative pathology from July 1997 to October 2014 in Henan Provincial Tumor Hospital. Related studies were reviewed, and the prognoses were followed up. The factors may affect subtype transformation or prognoses were applied to the statistical analysis. Results:A total of 74 patients with RPLS were included according to the recruiting standard. The 5-year survival rate was 48.65%. Lobulated tumors (P=0.013) were the correlative factors that influenced subtype transformation. The Log-rank test showed that the age at diagnosis (P=0.045), multi-visceral resection (P=0.042), tumor necrosis (P<0.001), subtype transformation (P<0.001), and malignant level of pathological subtypes of the first operation (P<0.001) influenced overall survival. Multivariate Cox re-gression analysis showed that tumor necrosis and the malignant level of the initial histological grade were independent factors of over-all survival. Conclusion:Lobulated tumors are likely to transform the subtype. The prognosis of patients with RPLS is correlated with multi-visceral resection, tumors necrosis, subtype transformation, and the malignant level of pathological subtypes of the first opera-tion. Multi-visceral resection could not improve the 5-year survival rate of RPLS, and adjuvant therapy could not improve the prognosis.

This study was aimed to establish a quantitative method for the determination of agarotetrol in agarwood to control its quality. The HPLC analysis was performed on a Diamonsil C18 column (4.6 mm í 250 mm, 5 μm), eluted with a mobile phase of water with 0.1% formic acid and acetonitrile in gradient mode with the flow rate of 0.7 mL·min-1. The detection wavelength was set at 252 nm. The column temperature was 30oC. The results showed that the separation of agarotetrol and adjacent peaks were more than 1.5, which achieved a baseline separation. A good lin-earity (r = 0.999 8) was observed in the range of 2.0-125.0 μg·mL-1, with the average recovery of 102.75%. The a-garotetrol cannot be less than 0.15% based on the data of Agarwood samples. It was concluded that the method was accurate and reliable to determine the content of agarotetrol, which can be used for the quality control of agarwood.

Objective To prospectively investigate the optimal setting for sentinel lymph node biopsy (SLNB) in patients with breast cancer by comparing the effects of different preparation methods and injection sites of 99Tcm-SC in sentinel lymph node (SLN) mapping and detection.Methods Two batches of 99Tcm-SC were prepared by boiling for 3 min (radiotracer 1) and 5 min (radiotracer 2),respectively.Radioactive chemical purity (RCP) and size of colloid particles were measured at 10 min,1 h,2 h and 4 h after the preparation.One hundred and forty-seven patients with breast cancer were involved and randomly divided into 3 groups.Group A consisted of 40 patients with periareolar injection of radiotracer 1,group B of 40 patients with periareolar injection of radiotracer 2,and group C of 67 patients with peritumoral injection of radiotracer 2.Lymphatic mapping was performed for all patients using SPECT/CT preoperatively and blue dye was subdermally injected over the tumor.The detection rate of the axillary and internal mammary SLN was recorded.One-way analysis of variance,independent two-sample t and x2 tests were used to analyze the data.Results There was no significant difference of RCP between the two radiotracers at 10 min,1 h,2 h and 4 h after preparation (t =-0.267,-0.794,0.826 and-0.977,all P＞0.05).Compared with radiotracer 1,the percentage of particles smaller than 100 nm in radiotracer 2 reduced significantly ((73.72±2.36) ％ vs (65.25±3.56)％,t=6.436,P＜0.05) and the mean effective particle size was significantly larger ((45.27±6.42) nm vs (75.59t7.04) nm,t=7.315,P＜0.05).In groups A,B and C,the detection rate of the internal mammary SLN was 70.0％ (28/40),47.5％ (19/40) and 17.9％ (12/67),respectively,with significant difference (x2=29.525,P＜0.05).In groups A,B and C,the detection rate of the axillary SLN was 100％ (40/40),95.0％ (38/40) and 97.0％ (65/67),respectively,without significant difference (x2 =2.686,P＞ 0.05).Conclusion For SLNB of patients with breast cancer,the axillary and internal mammary SLN could be better detected by SPECT/CT lymphatic mapping using radiotracer prepared with a shorter boiling time,via periareolar injection,and combined with subdermal injection of blue dye.

Objective To evaluate a novel lymph node (LN) sorting method on surgical resected sample guided by nanometer carbon staining and principle following the supplying artery tributory in rightsided colon carcinoma.Methods From May 2015 to June 2016,51 patients were randomly divided into two groups adopting traditional LN sorting method and that of a combination of nanometer carbon and artery guided.The final LN status were compared between the 2 groups.Results The total LN number and the positive LN in novel method group were higher than control group (437 vs.349,70 vs.54).The dissection time used,the number of harvested positive LN that was ＜ 5 mm were significantly different [(13.1 ± 3.2) minvs.(17.8 ±3.8)min,t=4.75,P=0.000;1.0±l.0vs.0.2 ±0.6,t=3.51,P=0.000].The number of patients with harvested LN less than 12,the rate of positive lymph nodes,the rate of metastasis were not significantly different (all P ＞ 0.05) between the two groups.Conclusions Use of nanometer carbon development combined with artery approach facilitates LN sorting,yielding more positive LNs,and increating the accuracy of pathological staging in right-sided colon cancer.

This study was aimed to investigate the chemical constituents from the leaves of Vitex negundovar. cannabifolia. Column chromatography including silica gel, Sephadex LH-20, ODS, and semi-preparative HPLC were used to separate and purify the chemical constituents, and the structures were elucidated on the basis of physicochemical properties, MS and NMR spectroscopic data. As a result, 11 compounds were isolated from the ethyl acetate extract of V. negundo var. cannabifolia, and identified as apigenin (1), penduletin (2), chrysosplenol-D (3), quercetin (4), 1,4-dihydroxy-3R,5R-dicaffeoyloxy cyclohexane carboxylic acid (5), maeranthoin F (6), capsidiol (7), caryolandiol (8), β-sitosterol (9), p-hydroxybenzonic acid (10), and β-daucosterin (11). It was concluded that compounds 5 8were firstly isolated from the plants of Vitex genus, and compounds 1 and 4 were isolated from V. negundovar. cannabifolia for the first time.

Objective To investigate the clinical value of CT lymphangiography (CTL) combined with direct lymphangiography (DLG) in primary intestinal lymphangiectasia (PIL). Methods Sixteen patients diagnosed as PIL with intestinal enteroscopy were recruited in this retrospective study. All the patients were performed DLG and CTL one week before exploratory laparotomy. Subjective assessment in DLG included weak lymphatic fluid drainage, lymphangiectasia, lymphatic reflux, fistula and thoracic outlet reflux or obstruction. While for CTL combined with DLG, the intestinal and extra-intestinal lesions were evaluated, including lymph node, edema, lymphangiectasia and abnormal distribution, fistula, and lymphangiomatosis. All the diagnosis was compared with intestinal endoscopy results. Results For DLG, 16 weak lymphatic fluid drainages, 9 lymphangiectasia, 1 fistula with abdomen and 14 thoracic outlets weak lymphatic fluid drainage or obstruction were found. For DLG combined with CTL, 16 intestinal lumens dilatation and 14 circumferential intestinal thickening were found in intestinal lesions. While for extra-intestinal lesions, the imaging features included edematous findings (12 in mesentery, 7 ascites only, 2 hydrothorax and ascites, and 3 pericardial, thoracic and abdominal effusions), abdominal lymph nodes (6 cases), lymphangiectasia and abnormal distributions (14 cases), fistulas (lymph-intestinal luminal fistula in 4 cases, and lymph-abdominal fistula in 3 cases), lymphangiomatosis (3 cases), and thoracic duct outlet dysfunction and reflux (14 cases).The number of cases diagnosed as intestinal lymphangiectasia, intestinal luminal lymph exudation and lymph fistula were 16, 10 and 6 with intestinal endoscopy, while the number were 11, 0, and 4 with CTL combination with DLG. Conclusion Combination of CTL with DLG is valuable in the diagnosis of PIL.

Objective To investigate the distribution of TCR Vβ genealogy and clonal expansion in peripheral blood after infusing mesenchymal stem cells (MSC) in patients with chronic GVHD. Methods The complementarity determining region 3 (CDR3) of 24 TCR Vβ subfamily genes in peripheral blood mononuclear cell from 1 case with cGVHD after allogeneic hematopoietic stem cell transplantation (Allo-HSCT),who were treated with infusing MSC,were amplified using RT-PCR. The blood samples were taken at the first and the fifth day after 1st infusion; and the first day,the 10 th day and the 20 th day after the second infusion of MSC,as well as the MSC infused as control . The products were labelled by fluorescein and then analyzed the CDR3 size with gene scan technique to determine the clonality of T cells. Results There were no expression of TCR Vβ subfamily with the MSC infused and after the 1st day of the first infusion of MSC. Then 3,10,14,10 Vβ subfamilies clones are appeared at the other time points,of which were polyclone and oligoclone predominately. In the same time,the manifestations of cCVHD have been abated. Conclusion MSC played a certain role in reviving the immune function of the patients after Allo-HSCT and mitigating the disease of chronic GVHD. Lineage analysis of TCR Vβ subfamily showed some predominant expression.