Ear, Middle ; pathology ; Female ; Granuloma, Plasma Cell ; pathology ; Humans ; Mastoiditis ; pathology ; Middle Aged

Objective To detect the mutation frequency and mutation type of tumor suppressor PTEN in sporadic breast carcinoma tissues, and to investigate the association of PTEN gene mutation and sporadic breast cancer. Methods Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to amplify 9 exons of PTEN and to analyze the conformation polymorphism, then DNA sequencing methods was used to detect point mutation of PTEN gene nine exons of abnormal single strand conformation in breast carcinoma. Results One of 45 cases showed 24th condon A→C missense mutation in the exon2 of PTEN gene, and this mutation made Met to change to Ala in PTEN protein structure. Conclusion These data indicated the existence of PTEN mutation in sporadic breast cancer, but PTEN gene mutation rate is very low.

ObjectiveTo evaluate the role of nitric oxide (NO) in ischemia reperfusion injury (IRI) and acute rejection (AR) of intestinal transplantation in rats.MethodsThe rat orthotopic intestinal transplantation was performed. Animals were assigned to the following 4 groups with random methods:transplant control group,L-arginine (L-Arg) group,NG-Nitro-L-arginine methyl ester (L-NAME) Ⅰ group (group Ⅰ ) and L-NAME Ⅱ group (group Ⅱ ).The rats in different group were given saline,L-Arg (150 mg· kg-1 · d-1 ),L-NAME (4 and 8 mg· kg-1 · d-1 ) injection respectively from the operative day.The recipient survival time was observed.The pathologic changes were observed by HE staining.The activity of nitric oxide synthases (NOS) was measured by using immunohistochemistry.The abilities of glucose absorption and serum NO levels were tested.Results The recipient survival timein transplant control group,L-Arg group,group Ⅰ and group Ⅱ were (11.7 ± 1.2),(10.2 ± 1.0),( 12.3 ± 1.5) and ( 17.3 ± 1.9) days respectively,and the survival in group Ⅱ was prolonged significantly (P＜0.01).As compared with control group,the Park scores in L-Arg group and group Ⅰ were reduced,and IRI were attenuated; the Park score in group Ⅱ was increased (P＜0.01),the IRI was aggravated,but the AR was attenuated.As compared with control group,during the IRI period,the iNOS staining in group Ⅰ was decreased,and both iNOS and nNOS staining in group Ⅱ was decreased; during the AR period,the iNOS staining in group Ⅱ was decreased obviously.The serum NO levels were increased gradually in all groups.As compared with control group,the increase of serum NO level in group Ⅱ was delayed.As compared with control group,the glucose absorption levels in L-Arg group were increased significantly from 30 min after reperfusion to POD-3 (P＜0.01),and the postoperative glucose absorption levels in groups Ⅰ and Ⅱ maintained the low levels.ConclusionNO may play a dual role as both cytotoxic and cytoprotective effects in IRI,and aggravate mucosal damage in AR in rats intestinal transplantation.The glucose absorptive capacity of graft is promoted by supplementation of LArg at early postoperative period.

Objective To investigate the clinical and pathological features of urothelial carcinoma with clear cell variant.Methods The pathological and clinical data of 7 cases pathological diagnosed urothelial carcinoma with clear cell variant between March 2005 and May 2014 were retrospectively reviewed.There were 6 males and 1 female,aged 46-75 years (mean,61 years).Clinical manifestations included gross hematuria in 5 cases,hematuria and backache in another 2 cases.The mean tumor size was 3.5 cm (ranged 2.0-6.0 cm).One case was multiple tumor and 6 cases were single tumor.Five cases were positive in urine cytology.All the 7 cases accepted surgical treatment,including radical nephroureterectomy in 2 cases,transurethral resection of bladder tumor plus pharmorubicin regular intravesicalinstillationin 1 case,and radical cystectomy in 4 patients.Results Pathological findings revealed that all the tumors were high-grade urothelial carcinoma with clear cell variant in different proportion.Among them,clear cell tumor was predominant in 1 case and focal in other 6 cases.Meanwhile,tumorsaccompanied by glandular differentiation were found in 2 cases,squamous differentiation was found in 1 case,and micropapillary variant was found in 1 case.Vascular tumor embolus was found in 4 cases.Pathological stage was pT2a (n =1),pT2b (n =3),and pT3a (n =3).Immunohistochemicalstaining revealed cytokeratin 7 (+),cytokeratin 20 (+),epithelial membrane antigen (+)and prostate specific antigen (-).Six cases were followed up.The bladder preservation case was followed up for 8 months without recurrence.In 3 radical cystectomy cases,1 died of cancer 25 months after surgery and another 2 case were followed up for 10 and 12 months after surgery without recurrence and metastasis.In 2 nephroureterectomy cases,1 died of tumor metastasis 18 months after surgery and the other case was followed up for 6 months without recurrence or metastasis.Conclusions Urothelialcarcinoma with clear cell variant is a malignancy often with advanced stage and poor prognosis.Radical surgery is recommended for the treatment.

Diabetic vascular complications are the key cause of the poor life quality and high mortality in diabetic patient. Advanced glycation end products (AGEs) and its cross-links play important roles in the diabetic vascular complications. Endothelial cells damage induced by AGEs may account for the initial agent for diabetic vascular complications. Recent studies have shown that AGEs inhibitors and breakers can prevent and reverse these complications. This article reviewed the research progress of AGEs and endothelium dysfunction. The potential therapeutic method was also stated.

Objective To investigate the patients' radiation dose received in digital radiography (DR) and provide basic data for developing diagnostic reference levels.Methods The patient' s ESD was estimated using the TLDs and DAP was measured by the dose-area product meter.The E values were then calculated by the DAP using Monte Carlo data and RefDose software.Measurements were made for twelve types of examination:skull PA,skull LAT,chest PA,chest LAT,abdomen AP,pelvis AP,cervix spine PA,cervix spine LAT,thoracic spine PA,thoracic spine LAT,lumber spine PA and lumber spine LAT.Results Both kV and mAs varied in the same type of examination for ESD,DAP and E(F =33.47,24.68,43.19,P ＜ 0.05).The dose each time for lumber spine LAT was the highest,reached 4.62 mGy in ESD and 2.26 Gy·cm2 in DAP,respectively.The E of abdomen AP averaged as 0.59 mSv,higher than that of lumber spine LAT.Even for the same type of examination,the dose from each equipment was different.Conclusions DR has the potential to reduce the patients' radiation doses.The guidance levels suitable for Chinese population should be established as soon as possible.

Objective To investigate the effects of total flavonoids of Herba Epimedii(HEF)on the metabolism of typeⅠcollagen and the expression of cathepsin K in the bone of ovariectomized(OVX)rats. Methods Fifty-four female SD rats were allocated into 6 groups;OVX group,sham operation group,OVX rats followed by three doses of HEF(40,80 and 160 mg?kg~(-1)?d~(-1))and nilestriol(0.1 mg?kg~(-1)?d~(-1))for 12 weeks respectively.Bone mineral density(BMD)of whole body was determined by dual-energy X-ray absoptiometry.The level of cross-linked N-telopeptide of typeⅠcollagen(NTx)in the urine were determined by ELISA.The amounts of typeⅠcollagen protein and cathepsin K protein in bone tissue were detected by immunohistochemical method and Western blotting.Results Compared with OVX group,the total BMD values in the HEF treated groups were increased(all P＜0.05),and the expression levels of typeⅠcollagen in three HEF treated groups rose significantly in a dose-dependent manner after 12 week,and simultaneously,both the expression of cathepsin K in bone and the level of NTx/Cr were reduced markedly(P＜0.05),being most significant(P＜0.01)in the group treated with the highest dose of HEF(160 mg?kg~(-1)?d~(-1)).Conclusion HEF seems to be able to elevate BMD and improve bone quality of rats via promoting synthesis and inhibiting proteolysis and absorption of typeⅠcollagen in the bone.

Objective:To observe the effects of genistein on proliferation and apoptosis of human non -small cell lung cancer cell line A549/DDP.Methods:①MTT assay was applied to evaluate the resistance index of A 549/DDP cell line to cisplatin and half in-hibitory concentration ( IC50 ) .②Inhibition rate of A549/DDP cell proliferation and IC 50 value were evaluated by MTT assay after treat-ment with 0, 1.25, 2.5, 5.0, 10, 20, 40, 60, 80 μg/ml genistein for 48 hour respectively.③A549/DDP cell cycle and apoptosis were evaluated by flow cytometry after treatment with 6.25, 12.5, 25 μg/ml genistein for 24 hours respectively.Results:①In expo-sing to cisplatin, the IC50 of A549 and A549/DDP was 33.6 μmol/L and 76.9 μmol/L respectively.The resistance index was 2.3. Cell growth inhibition rate increased following the cisplatin concentration increasing gradually .②A549/DDP growth inhibition rate in-creased at first and later decreased gradually following treatment with the genistein dose increased .The IC50 of A549 and A549/DDP was about 85.1 μg/ml and 80.2μg/ml respectively.③After treatment with 6.25, 12.5, 25μg/ml genistein for 24 hours, there were more A549/DDP cells arresting and showing apoptosis along with the genistein dose increased .Conclusion: Genistein can inhibit A549/DDP proliferation, cause A549/DDP arresting in G2/M phase and induce A549/DDP cell apoptosis with dose dependently .

Objective To explore the influence of modified Lawrence's reconstuction procedures following total gastrectomy for gastric cancer to alimentation of patients. Methods Retrospective analysis of nutritional status and symptoms of digestive tract in 76 patiens of total gastrectomy for gastric cancer while 3 and 6 month after modified Lawrence's reconstuction procedure. Results Examination was given in 48 patients 3 month after operation. Emptying time of barium was 60-100 min, barium meal backflowing to esophagus was not observed in all patients when they were in erect or decubitus position, no sign of narrow of anastomotic stoma. The hemoglobin, total protein, body weight and food-intake of patients 3 or 6 months after operation was as same as them before operation. Conclusion The patients undergoing this reconstuction procedure will recover normal food habits soon after operation, Lawrence's reconstuction procedures is a satisfactory choice in patients of total gastrectomy for gastric cancer because of its safety and convenient.

Objective To improve the prognosis and radical resection of the extended pancreaticoduodenectomy for patients with pancreatic cancer in the ucinate process involving mesentery mot. Methods From Jan. 2004 to Dec. 2007, a total of 23 ( 14 male and 9 female, aged between 30 and 72 years old) patients with pancreatic cancer in the ucinate process involving mesentery root were treated in our department. Curative resection was performed for all patients by the extended pancreaticoduodenectomy with superior mesenteric artery (SMA) isolation and mesentery root resection. The surgical procedure, the safety and prognosis were analyzed retrospectively. Results 12 patients underwent the procedure, among them 11 also underwent combined SMV partial resection and reconstruction. The operation time was (4.2 ± 1.1 ) hours, and the blood loss was ( 1 635 ± 1 362) ml with the blood transfusion of ( 1 609 ± 1 462 ) ml. There was no operation related death in this case series, and mild to severe diarrhea occurred in 6 cases. The post-operative stay ranged 9 to 30 days. The pathological examination showed that the tumor size was (5.3 ± 1.4) cm. 13 patients (57%) had one or more lymph nodes metastasis. 20 patients (87%) had nerve involvement. Among 11 patients with SMV partial resection and reconstruction, 10 patients had endangium involvement. 22 patients had negative surgical margins for all specimens. Rapid intra-operative frozen pathological examination showed negative surgical margins in one patient, however, post-operative paraffin section pathological examination revealed nerve involvement between SMA and celiac trunk. After a follow-up of 5 to 42 months, liver metastasis occurred in 4 patients, and local recurrence occurred in 3 patients. The 1-year and 2-year accumulated survival rates were 77.2% and 42.5%, respectively. Conclusions Isolation SMA and the mesentery resection in extended pancreaticodudenectomy were safe and useful. Using this modified technique, Radical operation resection could be achieved in the treatment of pancreatic cancer in uncinate process.