Objective To find the reasonable treatment strategy by analyzing the failure pattern and survival rates of radical resection of gastric cancer.Methods Data were collected from 110 patients with radical resection and adjuvant treatment of gastric cancer,counted up the number of cases that failure in different ways.The survival rate after operation was calculated by Kaplan-Meier.The chi-square test was used to find the differences in survival rates between different differentiation,location and gender.Results 1,3,5-year survival rates of 110 cases were 83.64％ (92/110),46.36％ (51/110),35.45％ (39/110),respectively.Malignant ascites was the main failure type for postoperative of gastric cancer,approximately accounting for 41.51％ (22/53),abdominal lymph node metastasis accounting for 30.19％ (16/53),anastomotic recurrence accounting for 13.21％ (7/53),abdominal implantation and mesenteric metastasis accounting for 9.43％ (5/53),organ metastasis accounting for 5.66％ (3/53).The 5-year local failure rate of concurrent chemoradiotherapy group was a little lower than that in adjuvant chemotherapy alone group (15.00％ ∶22.22％).The 1-year survival rates of adjuvant chemotherapy alone and concurrent chemoradiotherapy group were 84.44％ and 80.00％ respectively,with no significant difference (x2 =0.236,P =0.627).However,the 3,5-year survival rates of the two groups were 66.67％ vs 40.00％ and 53.33％ vs 20.00％ respectively,with statistically significant differences (x2 =4.930,P =0.026 ; x2 =7.294,P =0.007).Conclusion Peritoneal metastasis is the most common failure pattern for the patients with gastric cancer who received radical operation and adjuvant treatment.The relapse rate of concurrent chemoradiotherapy group is lower than that in adjuvant chemotherapy alone group,but the overall survival rate is similar.

Objective To investigate the relationship between the mechanism of gynecomastia and serum hormone levels ,as well as liver function in male patients with liver cirrhosis .Methods Forty‐six male patients with liver cirrhosis and gynecomastia were collected as gynecomastia group from March 2013 to March 2014 ,and at the same period seventy male patients with liver cirrhosis but without gynecomastia were studied as non‐gynecomastia group . The condition of mammogenesis and maximum of breast thickness were measured by bilateral breast ultrasound .Hormones including luteinizing hormone (LH) ,follicle‐stimulating hormone (FSH) , prolactin (PRL) ,estradiol (E2) ,progesterone (PRGE) ,and testosterone (T);liver function including alanine aminotransferase (ALT) ,aspartate aminotransferase (AST) ,total bilirubin (TBil) and serum albumin (Alb);blood coagulation function including prothrombin time (PT) ,platelet count (PLT) were examined and the Child‐Pugh scores were calculated .t‐test was performed for results comparison between gynecomastia group and non‐gynecomastia groups .Chi‐square test was used to compare the difference in drinking rate between two groups . The patients of gynecomastia group and non‐gynecomastia group were further divided into Child‐Pugh Grade A ,B and C subgroups according to Child‐Pugh scores and the patients of gynecomastia group were divided into subgroups according etiology such as posthepatitic cirrhosis ,alcoholic liver cirrhosis and posthepatitic cirrhosis combined with alcoholc cirrhosis .Single factor analysis of variance was applied to compare the laboratory findings between subgroups ,and least‐significant difference mothod was used to further compared the differences between two subgroups .Results Among forty‐six male patients with liver cirrhosis and gynecomastia ,the mean thickness of breast was (7 .56 ± 2 .84) mm .All the differences of TBil ,Alb ,PT and Child‐Pugh score of Child‐Pugh grade patient were statistically significant between gynecomastia group and no gynecomastia group ((96 .72 ± 75 .86)μmol /L vs (60 .57 ± 54 .00)μmol /L ,(29 .12 ± 4 .90) g/L vs (33 .86 ± 6 .86) g/L ,(19 .06 ± 4 .76) s vs (15 .54 ± 2 .57) s ,11 .54 ± 0 .91 vs 10 .33 ± 0 .57 ,respectively ,t=2 .79 ,-4 .33 ,4 .58 ,2 .22 ,all P<0 .05) . The alcoholic drinking rate of gynecomastia group (74% (34/46) vs 53% (37/70)) increased ,and the difference was statistically significant compared with that of non‐gynecomastia group (χ2 =5 .183 , P<0 .05) .There was no statistically significant difference in E2 levels between gynecomastia group and non‐gynecomastia group (P>0 .05) .PRL and E2/T ratio ((404 .49 ± 297 .26) mU/L and 68 .74 ± 46 .37) were higher than those of non‐gynecomastia group ((279 .77 ± 111 .57) mU/L and 13 .60 ± 11 .55) ,and T was lower than that of non‐gynecomastia group ((7 .15 ± 5 .74) nmol/L vs (15 .46 ± 8 .53) nmol/L) ,and the differences were statistically significant (t=2 .72 ,7 .90、-6 .27;all P<0 .05) .Among patients with gynecomastia ,breast of patients with alcoholic liver cirrhosis was significantly thicker than that of patients with posthepatitic liver cirrhosis ((9 .25 ± 3 .59) mm vs (6 .67 ± 2 .48) mm) ,while the level of PRGE was lower than that of patients with posthepatitic liver cirrhosis ((0 .61 ± 0 .51 ) nmol/L vs (1 .49 ± 1 .47 ) nmol/L ) , and the differences were statistically significant (F= 3 .634 and 2 .674 ,both P< 0 .05) .Along with the severity of liver injury ,E2 level of gynecomastia group gradually increased ,however there was non‐statistically significant difference compared with non‐gynecomastia group (P>0 .05) .T level of gynecomastia group gradually decreased ,and those of Child‐Pugh B ,C subgroup ((8 .20 ± 7 .58) nmol/L and (4 .18 ± 3 .76) nmol/L) were siginificantly lower than that of Child‐Pugh A subgroup of non‐gynecomastia group ((17 .64 ± 9 .04) nmol/L ,F=9 .37 ,P<0 .05) .The E2/T levels of gynecomastic group gradually increased .There was significant difference in E2/T level between Child‐Pugh C subgroup of gynecomastia group (105 .49 ± 94 .42) and Child‐Pugh A grade subgroup of non‐gynecomastia group (11 .38 ± 9 .60 ,F=12 .57 ,P<0 .05) .Conclusions There are different degrees of sex hormone disorder in the serum of male patients with liver cirrhosis and gynecomastia which is more significant in PRL ,T and E2/T .T and E2/T level are correlated with the degree of liver functional impairment .Gynecomastia in alcoholic liver cirrhosis is more severe than that of posthepatitic liver cirrhosis .

Objective To investigate clinical characteristics, diagnosis, treatment and prognosis of thyroid carcinoma in childhood. Methods Sixty patients under 14 years of age with thyroid carcinoma were retrospectively reviewed. Results Forty-nine suffered from papillary carcinoma, eight were with follicular carcinoma and three with medullary carcinoma. Cervical lymph node metastasis was found in 36 cases (60%). Operations included unilateral total thyroidectomy and isthmectomy in 20 cases (33.3%), unilateral total thyroidectomy and contralateral subtotal thyroidectomy in 36 cases (60%) and total thyroidectomy in 4 cases (6.7%). The follow-up period was 1 to 20 years (mean 10.5 years), and the survival rate of 5 and 10 years were 93% and 87.1% respectively. Conclusions Most thyroid carcinoma in children is well differentiated and the prognosis is good. A proper surgical procedure and postoperative comprehensive therapy are important for good outcome.

Objective To analyze the complexity of molecular structure in porcine T cell receptor gene and its similarity compared to humans.Method Based on the gene of porcine T cell receptor alpha chain ( TCRα) from the Gen-Bank database, 93 swine T cell receptor alpha chain genes ( STA) were cloned by reverse transcription-polymerase chain reaction (RT-PCR) from porcine peripheral blood lymphocytes, lymph nodes and spleen.Result Sequence analysis showed that STA genes all contain a domain of variable signal peptide and V, hypervariable J and conservative C.Howev-er, nucleotide sequence of STA was not completely identical with only 68.4%to 98.7%homology among genes, and had extremely sophisticated polymorphism and diversity.This was accord with the genetic structure of TCRαchain.Molecular structure, genetic evolution and classification of these genes were carried out according to the homology of TCRαgene, which all have several sites and zones of mutation on the domain of signal peptide, FR1 and CDR1, FR2 and CDR2, FR3 and CDR3.Analysis of similarity and classification of TCRαV domain(STAV)and J domain (STAJ) of Hezuo minipig u-sing IMGT/V-QUEST tools compared with those of humans found the genetic evolution relationship that was closer, and each of TRAV and TRAJ also found to have a corresponding fragment of humans, ever in 92% of similarity of TRAV be-tween swine and humans.Conclusion Our results indicate that inbred Hezuo minipig possesses genetic diversity against complicated environment of microbes in healthy status, and Hezuo minipig is suitable as an animal model for research on human immunology and diseases.

Objective To investigate the effect and underlying mechanism of apolipoprotein E (APOE) genetic polymorphism in treating blood brain barrier (BBB) breakdown after traumatic brain injury (TBI).Methods Human APOE knock-in mice (ε3,ε4),APOE knockout mice,and APOE wild-type mice with each numbering 80 were respectively divided into TBI group (n =50),sham-operation group (n =15) and normal control group (n =15) according to the random number table.TBI group was subdivided at 1 day (n=15),3 days (n=15),and7 days (n=20).TBI was induced with a pneumatically operated injury device.BBB permeability to large or small molecules was evaluated by measuring Evans blue (EB) and fluorescein sodium (NaFI) extravasation into the damage area at 1,3,and 7 days postinjury.Brain water content was determined using the dry-wet method.Western blotting and qRT-PCR for tight junction-associated proteins Occludin and Claudin-5 were performed at 7 days postinjury.Results With respect to normal control group,BBB permeability to EB and NaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice.There appeared significant increase in BBB permeability to EB and NaFI in TBI group,with insignificant differences among rats of each genotype at 1 and 3 days postinjury (P ＞ 0.05).Whereas at 7 days postinjury,BBB permeability to EB in APOE wild-type and e3 mice returned to the normal level (P ＞ 0.05),but it re mained at a high level in APOE knockout and ε4 mice (P ＜ 0.01).Meanwhile,BBB permeability toNaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice (P ＜ 0.01).Brain water content was equivalent among rats of each genotype at 1,3 and 7 days postinjury (P ＞0.05).Western blotting and qRT-PCR demonstrated Occludin and Claudin-5 in ε4 and APOE knockout mice were significantly lower than those in ε3 and APOE wide-type mice (P ＜ 0.05).Conclusion APOE plays an important role in restoration of BBB function after TBI,but ε4 may impede the recovery of BBB breakdown after TBI through its effect on tight junction.

OBJECTIVETo discuss the effect of surgical staging and using craft bone with vancomycin for the treatment of calcaneal fractures.

METHODSFrom January 2006 to December 2012,13 patients with open calcaneal fractures were treated including 9 males and 4 females with an average of 35.2 years old ranging from 23 to 66. All cases were emergency cases. According to Sanders classification of calcaneal fractures, 2 cases were type II, 7 cases were type III, 4 cases were type IV. According to Gustilo-Anderson soft tissue injury classification, 8 cases were type II, 2 cases were type III A, 2 cases were type III B, 1 case were type III C. Firstly a thorough debridement or VSD procedures were applied,secondly calcaneal fracture were treated with open reduction, plate fixation and bone graft complex with antibiotics. Based on clinical examination, radiographic evaluation, and American Foot and Ankle Surgery Society (AOFAS), ankle function were evaluated after operation.

RESULTSOpen wounds were headed after dressing and repairing,, lateral calcaneal wound were healed during the first period. All patients were followed up for 6 to 36 months (means 14.5 months). Fracture healing time was 14 to 20 weeks (means 16.2 weeks). Last follow-up AOFAS ankle-hindfoot score was (80.0 +/- 7.4) ranging from 55 to 95.

CONCLUSIONFor patients with open fractures, through reasonable clinical evaluation, staging operation, using bone graft with antibiotics can reduce the incidence of postoperative wound infection and promote fracture healing.

Adult ; Aged ; Anti-Bacterial Agents ; administration & dosage ; Bone Transplantation ; methods ; Calcaneus ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Fracture Healing ; Fractures, Open ; surgery ; Humans ; Male ; Middle Aged

To enhance the immunogenicity of DNA and adenoviral vector vaccines expressing HIV-1 subtype B gp160, human interleukin 15 (hIL15) DNA adjuvant (pVR-hIL15) was constructed. BALB/c mice received DNA prime/protein boost immunization with pVR-HIVgp160/Ad5-HIVgp160 alone or combined with pVR-hIL15. Cellular and humoral immune responses were evaluated by IFN-gamma enzyme-linked immunosorbent spot assay and enzyme-linked immunosorbent assay, respectively. Compared with those immunized with vaccines alone, the mice immunized with vaccines combined with pVR-hIL15 had significantly increased specific cellular response and antibody titer (P < 0.05). It suggests that the IL15 DNA adjuvant can enhance the immune responses induced by prime-boost regimen using DNA and adenoviral vector encoding HIV-1 subtype B gp160.
Adenoviridae ; genetics ; Adjuvants, Immunologic ; Animals ; Antibodies, Viral ; immunology ; Antibody Specificity ; Female ; Genetic Vectors ; genetics ; HIV Envelope Protein gp120 ; immunology ; HIV Envelope Protein gp160 ; genetics ; immunology ; HIV Envelope Protein gp41 ; immunology ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Interleukin-15 ; genetics ; Mice ; Mice, Inbred BALB C ; Vaccines, DNA ; genetics ; immunology

OBJECTIVETo study the relationship between thrombocytopenia in pregnancy associated with various causes and neonatal outcomes.

METHODSMedical records of 140 pregnant women with thrombocytopenia in pregnancy and the neonatal outcomes from January 2009 to December 2010 were reviewed retrospectively. The pregnant women were classified into four groups according to the causes of thrombocytopenia: gestational thrombocytopenia (GT; n=94), pregnancy with immune thrombocytopenic purpura (ITP; n=30), pregnancy with other hematological disease (aplastic anemia or myelodysplastic syndrome; n=12), and other causes (n=4): pregnancy induced hypertension syndrome, pregnancy with systemic lupus erythematosus, and pregnancy with alcoholic cirrhosis. The neonatal outcomes in the four groups were compared.

RESULTSThe premature birth rates in the GT and the ITP groups were 11.3% and 16.7%, respectively. There was no significant difference between the two groups. The premature birth rate in the other hematological disease group was 53.8%, which was significantly higher than that in the GT (P<0.01) and the ITP groups (P<0.05). Congenital passive immune thrombocytopenia was found in 2 neonates (2%) in the GT group and in 4 neonates (13%) in the ITP group (P<0.05). In addition, other diseases were also observed in neonates in the ITP group, including 1 case (3%) of ITP and 1 case (3%) of Evans syndrome. Intracranial hemorrhage occurred in one neonate (8%) in the other hematological disease group. Neonatal lupus syndrome was found in 1 case (25%) in the other causes group.

CONCLUSIONSThrombocytopenia in pregnancy associated with different causes may result in different neonatal outcomes.

Adult ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Hematologic ; Pregnancy Outcome ; Premature Birth ; epidemiology ; Prognosis ; Retrospective Studies ; Thrombocytopenia ; complications ; drug therapy

Objective To investigate the expression of TLR9 mRNA of peripheral blood mononuclear cells (PBMCs) in patients with acute pancreatitis .Methods Fifty two AP patients with the disease duration in 24 h were collected ,peripheral EDTAK2 coag‐ulation vein blood were collected on the first ,third and fifth day ,then plasma were cryop reserved to detect pancreatic elastase , proinflammatory cytokines and anti‐inflammatory cytokines .Then the peripheral EDTAK2 coagulation vein blood two to three months after treatment were collected in the same method to undertake these tests ,and act as the reference level value .Peripheral blood was collected from 36 acute pancreatitis patients .Three months later ,peripheral blood was collected again from these 36 peo‐ple as controls .PBMCs were isolated by Ficoll‐Hypaque gradient centrifugation .RT‐PCR was adopted to determine the relative con‐tent of the expression of TLR9 mRNA of the PBMCs .Results The relative content of expression of TLR9 mRNA were significant‐ly up‐regulated in the patients with acute pancreatitis ,compared with that of controls (P<0 .05) .The up‐regulated expression of TLR9 mRNA was related to expression of TNF‐a and IL‐1 .Conclusion The up‐regulated expression of TLR9 mRNA in acute pan‐creatitis patients indicates that infective factors might be mediated by TLR 9 .

Objective To study the expression of splice variant of progesterone-induced blocking factor (PIBF) of healthy adult and hepatocellular carcinoma (HCC) patients. Methods Western blot was used to find out the expression in 3 normal livers and tumor and para-tumor tissue of 8 HCC patients. Use T Test to compare the difference. Immunohistochemistry was used to detect the expression in tumor and para-tumor tissue of 48 HCC patients. The splice variant of PIBF serum concentrations of 103 healthy adult, pre-operation and part of 5 days post-operation of 109 HCC patients was tested with ELISA. Result The expression of HCC tissue is lower than para-tumor tissue. The serum concentrations of healthy adult and HCC patients is 73.04 ± 6.29 ng/mL and 49.10 ± 4.07 ng/mL, and the difference was statistically significant (P=0.010). The analysis of blood concentrations of pre-operation and part of 5 days post-operation of 15 HCC patients indicate that the expression of pre-operation is lower than post-operation, and the difference was statistically significant (P = 0.008). Conclusion The splice variant of PIBF is low expressed in HCC tissue and serum. PIBF is a potential protein plays important role in cancer.