Purpose To investigate the presence of perineural invasion (PNI) and the expression of human epidermal growth factor receptor 2 (HER-2) in patients with advanced gastric cancer.To discuss the correlation between PNI and the expression of HER-2 and their prognostic significance.Methods Paraffin sections of surgical specimens from 100 patients who underwent gastric resection were selected,and then PNI were detected by HE staining and the expression of HER-2 were detected by immunohistochemical (IHC).The correlation of perineural invasion with the clinicopathological features and HER-2 expression were performed.Results PNI was positive in 42 cases of 100 patients (PNI positive rate was 42％),the occurrence of PNI has significantly related with lymph node metastases,infiltrating depth,tumor emboli,TNM stage and expression of HER2.The difference was statistically significant (P ＜ 0.05).Univariate analysis showed that total survival rate of advanced gastric cancer was associated with T stage,tumor emboli,N stage,TNM stage,PNI and HER-2 expression (P ＜ 0.05).The overall survival of the PNI-negative patients was 45.3 months on average,much better than the PNI positive patients who was 15.4months in average (P ＜ 0.05).The overall survival of the HER2-negative patients was 43.2 months on average,much better than the HER-2-positive patients who was 22.7 months in average (P ＜ 0.05).By muhivariable Cox proportional hazards model of overall smvival,the positivity of PNI and HER-2 appeared to be new independent prognostic factors (P ＜ 0.05).Conclusion The detection of PNI and HER-2 expression maybe helpful for the prognosis of patients with advanced gastric cancer.In addition,HER-2 may be responsible for the presence of perineural invasion.

Objective:To establish a quantitative method for the determination of lysine hydrochloride in pediatric compound lysine granules. Methods:The quantitative determination was performed on an amino acids analyzer. The cationic resin column(150 mm × 4. 6 mm,7 μm)was used. The mobile phase was citrate buffer solution (pH 3. 45) and citrate buffer solution (pH 10. 85) with gradient elution at a flow rate of 0. 45 ml·min-1 . The detection wavelengths were set at 570 nm and 440 nm. Results:The linear range of lysine hydrochloride was 2. 692-21. 536 μg·ml-1(r=0. 999 5), and the average sample recovery was 98. 85% with RSD of 0. 63% (n=9). Conclusion:The method is sensitive, simple and reproducible. It can be used for the quality control of pediatric compound lysine gran-ules.

Objectives To investigate the effect and mechanism of terbutaline sulfate on pulmonary fluid transport in pre-mature rats. Methods Pregnant rats were randomly divided into 5 groups (control group, premature group, low-dose terbutaline group, high-dose terbutaline group and dexamethasone group). Drugs were administered by gavage after rats were fertilized for 16 days and continued for 3 days. Premature rats were taken out from the 19 days pregnant rats, and mature rats were delivered on the due day. Lungs were collected, and the ratio of pulmonary wet weight to dry weight (W/D), Na+, K+-ATP ase activity and concentration of cyclic adenosine monophosphate (cAMP) were measured in lungs. Results The W/D rate, Na+,K+-ATPase acti-vity and cAMP concentration in lungs had significant difference among different groups (P<0.01). The W/D rate was highest in premature group and lowest in the control group. It was lower in the high-dose terbutaline group than in the low-dose terbutaline group and the dexamethasone group (P<0.05). The Na+,K+-ATPase activity was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, and high-dose terbutaline group than in premature group, and it was higher in high-dsoe terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). The cAMP levle was lowest in premature group and highest in high-dose terbutaline group. It was higher in dexamethasone group, low-dose terbutaline group, high-dose terbutaline group than in premature group, and it was higher in high-dose terbutaline group than in low-dose terbutaline group and dexamethasone group (P<0.05). Conclusions Terbutaline sulfate facilitates lung fluid transport in premature rats, leading to reduce the W/D rate in terbutaline-treated group. We speculate that this effect is related to the increased cAMP level and Na+, K+-ATPase activity in lung tissue.

Objective To investigate the efficacy of treatment on malignant intracranial gliomas with the chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with radiotherapy of interstitial implantation of 125Ⅰ after microsurgery resection. Methods Sixty-five patients with malignant intracranial gliomas who had underwent craniotomy microsurgical resection were intraoperatively implanted in the tumor bed around with 5-Fu biodegradable polymers and 125Ⅰ seeds. After first implantation (3 months to 1 year), stereotactic guided implantation was carried out 1 or 2 times again. The patients were followed up for 6-36 months to observe the efficacy, edema and adverse reactions, compared with follow-up of 40 patients with malignant intracranial gliomas treated by conventional radiotherapy and chemotherapy after microsurgical total resection. Results Within 1 week after the implantation the patients had headache significantly, WBC of cerebrospinal fluid was increased to some degrees, and edema was obvious compared with surgery alone. All patients were treated and discharged. Forty-four patients were completely followed-up and the survival period was significantly longer. Within 6 months, 1 year, 2 years and 3 years, there were 4 cases (9.1 %) of recurrence and no case of death, 14 cases (31.8 %) of recurrence and no case of death, 20 cases (45.5 %) of recurrence and 12 cases (27.6 %) of death and 29 cases (65.9 %) of recurrence and 20 cases(45.5 %) of death, respectively. No obviously adverse reactions were found and the quality of life was significantly improved. Conclusion Microsurgical total resection is the key of the treatment. It is an alternative treatment of human malignant gliomas in the safe and effective way that the local chemotherapy of intracerebral implantation of 5-Fu biodegradable polymers combined with local sensitivity radiotherapy of interstitial implantation of 125Ⅰ after microsurgical resection.

Objective To investigate the neuroprotective effect of cattle encephalon glycoside and ignotin injection on the rat model of traumatic brain injury (TBI).Methods Three hundred and six SD rats were randomly divided into sham group,TBI group,high dose group,middle dose group and low dose group according to the random number table.Rats received 1.8,0.6 and 0.2 ml/kg of cattle encephalon glycoside and ignotin injection for 28 days in high,middle and low dose groups,respectively.TBI was induced by the modified Feeney' s weight-drop method.Rat mortality,neurological function score and learning and memory ability were recorded.Brain morphological changes were evaluated with 7.0 T small animal nuclear magnetic resonance and HE staining.Evans blue was applied to assess blood brain barrier (BBB) permeability and hydrocephalus was evaluated by the brain water content.Results Mortality in high dose group decreased significantly compared to that in TBI group (22.40％ vs.28.14％,P ＜ 0.05).Defects in neurological function and learning and memory induced by TBI were significantly mitigated in middle and high dose groups (P ＜ 0.05).Pathological damage and contralateral hippocampal atrophy in middle and high dose groups were reduced significantly compared to TBI group (P ＜ 0.05).Hippocampus neuroapoptosis in middle and high dose groups was significantly improved compared to TBI group (P ＜ 0.05).BBB damage was less severe in middle and high dose groups than in TBI group (P ＜ 0.05).The treatment was preventive against secondary hydrocephalus.Conclusion Middle or high dose cattle encephalon glycoside and ignotin injection over a 28-day period has significant neuroprotective effect on the TBI rats.

Objective To explore the risk factors of pulmonary infection in patients with basal ganglia hemorrhage . Methods A total of 152 patients with basal ganglia hemorrhage who received conservative treatment from March 2013 to Septem‐ber 2014 were enroled in the study ,while the incidence of pulmonary infections and and risk factors were retrospectively analyzed , and recorded the distribution of pathogenic bacteria .Results The pulmonary infections occured in 106 of 152 patients with the in‐fection rate of 69 .7% .The way of treatment ,history of smoke and consciousness were the independent risk factors for pulmonary infection(P<0 .05) .A total of 153 strains of pathogens were isolated from the patients of infection group ,in which there were 132 strains of gram negative bacteria ,10 strains of gram positive bacteria and 12 strains of fungi .Conclusion Basal ganglia hemorrhage associated with a greater incidence of pulmonary infection ,it should be noted the risk factors of pulmonary infection in basal ganglia hemorrhage patients to reduce the incidence of pulmonary infection .

Objective To detect the serum 25- OH-D levels in patients with systemic lupus erythematosus (SLE) and investigate the function of vitamin D in the pathogenesis of SLE. Methods Eighty SLE patients including 40 healthy donors and 40 RA (rheumatoid arthritis) patients were enrolled in this study. Serum 25-OH-D levels were detected with ECL method. Results (1)Serum 25-OH-D levels in patients with active SLE were lower than those with inactive SLE patients and healthy controls. (2)Serum 25-OH-D levels were negatively correlated with SLEDAI (Systemic Lupus Erythematosus Disease Activity Index) scores (r = -0.45,P < 0.01) and 24-hours urinary protein excretion (r = -0.32,P < 0.05). Conclusion Serum 25-OH-D levels in SLE patients decrease and have close relationship with disease activity and renal lesions.

Clinicopathological data of 15 patients with pyloric early cancer and precancerous lesions, who received endoscopic submucosal dissection (ESD) in Zhejiang Cancer Hospital from March 2011 to January 2020 were retrospectively analyzed. Postoperative pathology showed 7 cases of low-grade intraepithelial neoplasia, 3 cases of high-grade intraepithelial neoplasia, and 5 cases of early gastric cancer. R0 complete resection was achieved in all patients. The mean operation time was 55.2 min (35-78 min). One patient had delayed postoperative bleeding, and no other complications such as bleeding, perforation or abdominal pain occurred in other 14 patients. No recurrence, metastasis or pyloric stenosis was found during the follow-up of 31.3 months (1-106 months). ESD is safe and effective for early cancer and precancerous lesions in the pylorus.

Objective:To establish a method for the determination of aflatoxin( AF) B1,B2,G1and G2by HPLC in Xiao'er Fupi granule,and help manufacturers select safe raw materials for production through the analysis of test results of 31 batches of samples and the safety investigation of Xiao'er Fupi granule in terms of aflatoxin pollution. Methods: A post-column photochemical derivation HPLC method was used to detect the content of aflatoxin in Xiao'er Fupi granule. An Ecosil C18column(250 mm×4.6 mm,5 μm) was adopted with the mobile phase of acetonitrile-methanol-water (30: 10: 60)at the flow rate of 0.8 ml·min-1. The column tem-perature was maintained at 30 ℃. The sample size was 20 μl,The excitation wavelength was 360 nm and the emission wavelength was 450 nm in the fluorescence detection. Results:The linear range of aflatoxin B1,B2, G1and G2was 9.65-48.25 pg (r=0.999 1), 2.45-12.25 pg(r=0.999 8), 10.5-52.5 pg(r =0.995 6) and 2.55-12.75 pg (r =0.996 6), respectively. The recovery was 83.3%-95.6%. Totally 14 batches of samples contained aflatoxin,and the total content was 0.21 × 10 -3-0.54 ×10 -3μg·g-1. Conclusion:The method is convenient and accurate,which can be used for the quality control of Xiao'er Fupi granule.

Objective:To explore the safety and efficiency of a novel bipolar electric knife for endoscopic submucosal dissection.Methods:The thermal damage on tissue caused by the new bipolar knife and traditional monopolar knife were compared by finite element analysis. The vertical thermal damage to the porcine gastric wall caused by the two types of electric knife were analyzed in vitro animal experiments. In vivo animal experiments were used to compare operation related indexes of two types of electric knife, including en bloc resection rate and cutting efficiency in porcine digestive tract submucosal dissection. Results:Through overcoming deviation of experimental individuals and operator experience, the finite element model showed that the length, width and depth of thermal damage on tissue caused by the monopolar knife was 1.08 times, 1.12 times, and 1.23 times of that of the bipolar knife, respectively. Additionally, the bipolar knife caused less vertical thermal damage to the porcine gastric wall than the monopolar knife (433.25±42.58 μm VS 898.03±111.59 μm, t=6.740, P=0.003) in vitro animal experiments when charged for 1 s at the same power. Finally, in vivo animal experiments showed that the en bloc resection rates of the two kinds of electric knife systems were both 100.0%. In addition, the cutting area and cutting time of the bipolar knife was 229.58±185.29 mm 2 and 164.37±96.27 s, respectively. The corresponding indicators of the monopolar knife was 209.70±167.35 mm 2 and 162.65±69.97 s, respectively, and there was no significant difference (all P>0.05). Conclusion:The novel bipolar knife not only ensures the cutting efficiency but also reduces the thermal damage during endoscopic submucosal dissection in simulating experiment and animal experiment, which needs further verification in clinical trial.