Objective To evaluate the safety of surgical procedures for patients after heart valve prosthesis implantation.Methods Clinical data of 12 cases with heart valve prosthesis implantation undergone other surgical treatment from November 1996 to December 2005 were retrospectively analyzed.All the cases had routine oral warfarin with prothrombin time (PT) of 20.0—28.3 s averaged 23.5 s, international normalized ratio (INR) for prothrombin of 1.79—2.23 averaged 1.95 and heart functional class Ⅰ—Ⅲ.Among them,appendectomy was performed in three cases with acute appendicitis,reposition and repair in one with inguinal hernia,radical gastrectomy in two with gastric carcinoma,left hemicolectomy in one,cholecystectomy in three,left femoral head replacement in one,and bilateral high ligation and ablation of great saphenous vein in one.Elective surgical operation was performed in seven cases,and emergency operation in five.In those with elective surgery,warfarin was stopped 2—3 days before operation,while 5—10 mg vitamin K_1 was injected intramuscularly 6—8 hours before emergency surgery with preoperative median PT of 15.1 and 15.3 s and median INR of 1.24 and 1.30,respectively.In operation,5—10 mg vitamin K_1 were injected intravenously into the patients by drip depending on their bleeding on the surface of wound.ECG,blood pressure,hemoglobin and oxygen saturation were routinely monitored for all the cases intraoperatively and postoperatively.For the cases with heart function above class Ⅱ,fluid infusion was adjusted based on intubated central venous pressure,and for those with general anesthesia,analyses of blood gases and electrolyte were monitored routinely in operation.Results OPeration time averaged 20—160 rain in all the 12 patients,with blood loss 5—280 ml in average and without complications of massive hemorrhage,thrombosis and heart failure.Conclusions Surgical operation was safe for patients with heart valve prosthesis implantation,if preoperative PT and INR were adjusted to about 15 s and 1.30,respectively by cessation of warfarin or application of vitamin K_1,combined with careful manipulation and strengthened perioperative management.

Objective To evaluate the clinical application of CT-guided localization with combination of methylene blue and a Hookwire system for small pulmonary nodules (SPNs) before video-assisted thoracoscopic resection.Methods CTguided localization the SPNs before resection in 56 patients and 60 nodules,then underwent video-assisted thoracic surgery (VATS) resection.Among 56 patients,19 males and 37 females,aged from 35 to 81 years,mean age was (61.1 ±8.9)years.Results SPNs diameter (6.80 ±4.12) mm,distance from the parietal pleura (15.38 ±4.63) mm.CT-guided localization success rate was 100％,positioning time (10.76 ± 8.17) min,8.9％ (5/56) had micro pneumothorax aftet positioning,7.1％ (4/56) occurrence of needle tract bleeding,no conservative treatment.VATS resection rate was 100％.The pathology of 60 lesions were shown:Bronchiolo-alveolar carcinoma(BAC) were 33 lesions(55.0％),BAC and adenocarcinoma were 11 lesions(18.3％),Atypicaladenomatous hyperplasia (AAH) were 7 lesions (11.8％),Inflammation were 4 lesions (6.7％),Harmatoma were 3 lesions(5.0％),Tuberculoses were 2 lesions(3.3％).Conclusion CT-guided localization with combination of methylene blue and a Hookwire system before video-assisted thoracoscopic resection is a promising technique for small solitary pulmonary nodules.It could play an important role in accurate localization of small pulmonary nodules,and it is a safe technique with clinical application.

Purpose To explore the accuracy of ALK fused gene expression by immunohistochemistry ( IHC) in non-small cell lung cancer ( NSCLC) patients, and to investigate the clinical and pathological features of ALK-positive NSCLC patients. Methods By u-sing rabbit monoclonal D5F3 antibody, ALK IHC was performed on 234 NSCLC patients. ALK positive cases were confirmed by reverse transcription-polymerase chain reaction ( RT-PCR) . Results The positive incidence of ALK by IHC in 234 NSCLC specimens was 8. 97% (21/234), the positive rate of ALK fused gene verificated by RT-PCR was 5. 98% (14/234). There was significant difference with histological type, age, stage (P<0. 05), but no significant difference with gender, smoking history, tumor differentiation. Of 21 cases of ALK-positive NSCLC patients, the consistency of IHC and RT-PCR was 0 when IHC was ( +) , however, when IHC was or immunohistochemical score was >120, the consistency rate was 100%. Conclusion Although immunohistochemical expres-sion of ALK fused gene may have a certain false positive, IHC or immunohistochemical score> 120 show very high value for ALK fused gene RT-PCR followed by ALK immunohistochemistry in lung cancer is a economical and feasible method for the valuation of ALK fused gene.

OBJECTIVETo study the biologic process of energy metabolism in brain during acupuncture using positron emission tomography (PET) with 18F-2-desoxyglucose (18FDG) for further elucidation of the relationship between acupunctural signal and nerve system.

METHODSElectroacupuncture (EA) was applied on right lateral of a healthy volunteer and paralytic limbs of 4 patients with cerebral infarction at acupoints L14, LI11, ST36 and SP6 using Hans acupoint-nerve stimulator. PET imaging was conducted on the healthy subject or patients with the same posture before and during EA with GE Advance II PET system.

RESULTSPET showed that in the healthy subject, before EA, the glucose metabolism (GM) in bilateral cerebral cortex, bilateral thalamus, basal nuclei and cerebellum was almost symmetrical, but during EA, the GM in contralateral thalamus, contralateral frontal lobe and parietal lobe (motor and sensory area) increased obviously. While in the patients before EA, the GM in the infarcted area was significantly lower than that in the non-infarcted area, as compared with that observed with CT and MRI, it showed a similar figure but with bigger abnormal area. During EA, GM in the infarcted area increased with apparent reduction of size. Increased GM of focal area, widened cerebral cortex and decreased edematous area were shown in patients with larger infarction area. Quantitative analysis revealed evident change in local/total ratio of glucose and increase of GM change rate.

CONCLUSION(1) EA on limb acupoints of healthy subject could induce obvious increase of regional GM in brain and contralateral thalamus, contralateral frontal lobe and parietal lobe (motor and sensory area). (2) EA on acupoints of paralytic limbs could cause increase of GM in contralateral thalamus, contralateral frontal lobe and parietal lobe. Besides, GM also increased in the area with lowered GM before EA, accompanied with shrinkage or disappearance of lesion. (3) Acupuncture could evoke the function of brain cells and raise the GM in them.

Aged ; Brain ; diagnostic imaging ; metabolism ; Cerebral Infarction ; diagnostic imaging ; metabolism ; Electroacupuncture ; Energy Metabolism ; Female ; Fluorodeoxyglucose F18 ; Glucose ; metabolism ; Humans ; Male ; Middle Aged ; Radiopharmaceuticals ; Random Allocation ; Tomography, Emission-Computed

OBJECTIVETo investigate the feasibility of dynamic magnetic resonance diffusion tensor imaging (DTI) in rabbit models with implanted VX2 hepatic tumor grafts.

METHODSMRI and DTI images were obtained from 16 rabbit models with implanted VX2 hepatic tumor grafts (14, 18, 22, and 26 days after tumor implantation, respectively) and 4 normal rabbits. The average diffusion coefficient (ADC) and exponential ADC (eADC) were estimated and compared against pathological findings.

RESULTSThe ADC values increased after tumor implantation but then decreased in the rabbit models, whereas eADC exhibited a pattern of reverse changes. These changes significantly differed from those in the control group. Coagulation necrosis and fibrous hyperplasia showed obvious increase as found by pathological examination.

CONCLUSIONDynamic MR DTI quantitative analysis of rabbit models of implanted VX2 hepatic tumor can partially describe the growth behaviors of implanted liver cancer.

Animals ; Carcinoma, Hepatocellular ; pathology ; Diffusion Magnetic Resonance Imaging ; Female ; Image Enhancement ; methods ; Liver Neoplasms ; pathology ; Male ; Neoplasm Transplantation ; Rabbits ; Random Allocation

OBJECTIVETo investigate the association of SOX9 expression and clinicopathologic factors and prognosis of gastric cancer.

METHODSA retrospective cohort study including 112 gastric cancer patients admitted to the Zhejiang Provincial People's Hospital from 2004 to 2006 was performed. Immunohistochemical analysis was used to evaluate the expression of SOX9 in the 112 specimens of gastric cancer tissues and 70 non-cancerous tissues adjacent to the tumor.

RESULTSLow expression of SOX9 was seen in 5(7.1%) tissues out of 70 non-cancerous tissues adjacent to the tumor. A total of 94(83.9%) patients had varying expression of SOX9, of whom 51(45.4%) had overexpression. Univariate analysis demonstrated that the expression of SOX9 was significantly associated with Lauren classification (P<0.05), tumor invasion(P<0.01), lymph node metastasis(P<0.05), distant metastasis(P<0.05) and tumor stage(P<0.05), however there was no significant association between SOX9 expression and sex, age, histological type, histology differentiation or tumor size. Kaplan-Meier analysis showed that the 5-year survival rate of patients with SOX9 over-expression was significantly lower than that of patients with low expression(29.4% vs. 49.2%, P=0.031). Multivariate Cox regression analysis showed that histology differentiation(P=0.046), tumor invasion(P=0.001), and distant metastasis(P<0.01) were independent prognostic factors for gastric cancer, however the over-expression of SOX9 was not significant(P=0.948).

CONCLUSIONSThe expression SOX9 is associated with the growth, invasion, and metastasis of gastric cancer, as well as the prognosis. However, SOX9 expression is not an independent factor for the prognosis in patients with gastric cancer.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; SOX9 Transcription Factor ; metabolism ; Stomach Neoplasms ; metabolism ; pathology

The purpose of this study was to determine the changes of pathogens in hematological ward and susceptibility of patients received chemotherapy to antibiotics. The pathogens were taken from blood, urine and sputum of patients who accepted chemotherapy from years 2001 to 2005, then were isolated and identified. The susceptibility test was performed by disk diffusion method. The results showed that the total of 418 strains were detected. Gram-negative bacteria were the most common of nosocomial infection. Pseudomonas aeruginosa, Enterobacter cloacae, E. coli account for the most of Gram negative- bacteria infection and most resistant to broad-spectrum penicillin, Acinetobacter baumannii showed a trend of increase. The ratios of gram positive bacteria and fungi were increased slowly, mainly as Enterococcus and Candida. Enterococcus is the most common cause of Gram-positive bacterial infection. Vancomycin resistance did not occur. It is concluded that Gram-negative bacteria are main cause of nosocomial infection in patients with hematological malignancies. Gram positive bacteria and fungi had been more frequent. Strains resistant to antimicrobial agents increase.
Cross Infection ; epidemiology ; microbiology ; Drug Resistance, Bacterial ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Gram-Negative Bacterial Infections ; epidemiology ; microbiology ; Hematologic Diseases ; microbiology ; Hematologic Neoplasms ; microbiology ; Humans ; Microbial Sensitivity Tests

OBJECTIVETo study the metabolic chemistry and pharmaco-dynamics characters of ligan from seeds of Arctium lappa.

METHODHPLC method was used in the study. The analysis was carried out on C18 column. The mobile phase was CH3CN-0.05% H3PO4 (36:64) with flow-rate at 0.6 mL x min(-1) and wave-length of 210 nm. The column temperature was kept at 25 degrees C.

RESULTThe results indicated that the ligan was detected in plasma and the main organs 5 min after po. The main metabolic production in plasma was arctigenin. In addition, arctigenin and an unknown product were found in metabolic production in the organs.

CONCLUSIONThe method was stable,simple and reproducible. It can be used to determine the metabolic product of the ligan. The metabolic chemistry of ligan in plasma was obviously different from that in the main organs.

Animals ; Arctium ; chemistry ; Chromatography, High Pressure Liquid ; methods ; Furans ; blood ; metabolism ; Glucosides ; blood ; metabolism ; Lignans ; blood ; isolation & purification ; metabolism ; pharmacokinetics ; Liver ; metabolism ; Male ; Mice ; Plants, Medicinal ; chemistry ; Reproducibility of Results ; Seeds ; chemistry ; Tissue Distribution

OBJECTIVETo investigate the expression of GLUT1, p63 and DNA-Pkcs in serous ovarian tumors and their significance.

METHODSGTUL1, p63 and DNA-Pkcs expression at protein level was detected by immunohistochemistry in patients with serous ovarian tumors. Chi-square analysis was used to assess if their expression is associated with clinicopathologic characteristics of the tumors.

RESULTSCells in the normal ovarian tissues were not stained with GTUL1 and p63 antiserum, but DNA-Pkcs was positively stained. The intensity of GTUT1 and p63 expression was stronger in malignant ovarian serous tumors compared with other subtypes (P < 0.01). There were significant differences of DNA-PKcs among normal ovaries (100.0%), benign (95.0%), borderline (90.0%) and malignant (60.0%) serious ovarian neoplasms (P < 0.01). The level of GLUT-1 expression was correlated with FIGO staging, intraperitoneal implantation, ascites and lymph node metastasis (P < 0.05). p63 expression was associated with clinicopathologic characteristics except ascites (P < 0.05). DNA-PKcs was only correlated with FIGO staging and lymph node metastasis (P < 0.05).

CONCLUSIONThe results suggest that the abnormal expression of GTUT1, p63 and DNA-Pkcs may perhaps participate in serous ovarian tumor occurrence and development and may be considered as a marker reflecting tumor malignant behavior.

Adolescent ; Adult ; Aged ; Cystadenocarcinoma, Serous ; metabolism ; pathology ; Cystadenoma, Serous ; metabolism ; pathology ; DNA-Activated Protein Kinase ; metabolism ; Epithelium ; metabolism ; Female ; Gene Expression Regulation, Neoplastic ; Glucose Transporter Type 1 ; metabolism ; Humans ; Immunohistochemistry ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Nuclear Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Ovary ; cytology ; Trans-Activators ; metabolism ; Transcription Factors ; Tumor Suppressor Proteins ; metabolism ; Young Adult

OBJECTIVETo explore polarization of T lymphocyte and its relationship with apoptosis of marrow cells in patients with myelodysplastic syndromes (MDS).

METHODSMeasurements of Th1, Th2, Tc1, Tc2 subsets in bone marrows from 34 patients with MDS and 13 normal controls were performed by flow cytometry. INF-gamma and TNF-alpha in marrow serum were determined by ELISA (Enzyme-linked immunosorbent assay). Apoptosis index of marrow cells was detected by TUNEL (TdT-mediated dUTP nick end labeling). Correlations between Th1, Th2, Tc1, Tc2 subsets and INF-gamma, TNF-alpha levels as well as apoptosis index were analyzed, and relationship between TNF-alpha, INF-gamma levels and apoptosis index was also investigated.

RESULTS(1) The percentage of Th1 cells [(10.1 +/- 1.6)%], Tc1 cells [(24.0 +/- 3.6)%] and Tc1/Tc2 ratio (50.0 +/- 11.1) was significantly increased in patients with MDS than in normal controls [(4.0 +/- 0.5)%, (5.8 +/- 0.6)% and 13.4 +/- 2.7, respectively]. Levels of INF-gamma [(58.6 +/- 21.7) microg/L] and TNF-alpha [(15.7 +/- 3.8) microg/L] in marrow serum of MDS patients was markedly elevated compared to normal controls [0 and (0.3 +/- 0.2) microg/L, respectively]. An increased apoptosis index of nucleated cells was observed in MDS patients [(7.8 +/- 1.5)%] as compared to controls [(2.1 +/- 0.3)%, P < 0.05]. The Th1 cell percentage showed a positive correlation with the levels of INF-gamma and TNF-alpha (r = 0.38, P < 0.05 and r = 0.39, P < 0.05, respectively), and with apoptotic index of nucleated marrow cells in MDS patients (r = 0.33, P < 0.05). Furthermore, a positive correlation was observed between INF-gamma, TNF-alpha levels and apoptotic index of marrow cells (r = 0.74, P < 0.01 and r = 0.73, P < 0.01, respectively). (2) Th1, Tc1 cells and Tc1/Tc2 ratio in MDS-RCMD patients was markedly elevated (P < 0.01) but did not in RCMD-RS, RAEB-1 and RAEB-2 patients as compared to normal controls. (3) An elevation in the percentages of Th1, Tcl and Tc1/ Tc2 ratio was detected in patients with IPSS lower-risk but did not in higher-risk group as compared to controls. (4) Increased Th1 and Tc1 percentages and Th1/Th2 and Tc1/Tc2 ratios were observed in RCMD patients with normal karyotype, but did not in those with abnormal karyotype. Conclusions Th1/Th2 and Tc1/Tc2 in bone marrow of MDS patients were unbalanced, polarizing to type I reaction especially in patients with RCMD subtype, IPSS lower-risk and normal karyotype. The increased Th1 cells in bone marrow may account for the increased apoptosis of nucleated marrow cells in MDS, through proapoptotic cytokines such as INF-gamma and TNF-alpha.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Apoptosis ; immunology ; Bone Marrow ; immunology ; metabolism ; pathology ; Female ; Hematopoietic System ; immunology ; Humans ; Interferon-gamma ; metabolism ; Male ; Middle Aged ; Myelodysplastic Syndromes ; immunology ; T-Lymphocytes ; immunology ; Tumor Necrosis Factor-alpha ; metabolism