Gastric cancer is the leading cause of cancer mortality. The determination of early diagnosis and treatment of gastric cancer is an important issue for medical researchers.Although there are many methods to help clinicians detect gastric cancer, the early diagnosis rate is still unsatisfactory. As a newlydeveloped field, nanomedicine provides the potential for the diagnosis and treatment of gastric cancer. Nanomaterials have functional and structural properties that are not available from either discrete or bulk materials. Nanoparticles can be modified to target cancer cells, and when carrying fluorescent agents,they can delineate the focus clearly. Nanoparticles can also kill tumor cells without injuring normal cells when they serve as the drug loader. Fluorescent nanoparticles can also guide surgeons to resect lesions completely and clear the metastatic lymph nodes completely.

The role of nuclear factor kappaB in intestine injury induced by hepatic ischemia reperfusion was investigated. Eighteen male Wistar rats were divided into 3 groups randomly: sham operation group (group A), hepatic ischemia reperfusion group (group B) and hepatic ischemia reperfusion plus pyrrolidine dithiocarbamate (PDTC) group (group C). The rats in group A were only subjected to laparotomy, those in group B underwent partial hepatic ischemia reperfusion (ischemia for 1 h and reperfusion for 2 h) and those in group C underwent the same procedure as that of group B but received PDTC 200 mg/kg i.v. before and after ischemia. After reperfusion, tissues of jejunum and venous blood were obtained for measurement of TNF-alpha, MDA and MPO. The levels of TNF-alpha in jejunum and venous blood, the levels of MPO in jejunum in group B were significantly higher than those in group A and group C (P<0.05). There was no significant different in the levels of MDA between group B and group C. The severity of histological intestinal injury in group B and group C was similar. Hepatic ischemia reperfusion caused intestine injury, NF-kappaB may play an important role in this course and the targeting of upstream components of the inflammatory response, such as NF-kappaB, may have important therapeutic applications.
Intestines/*pathology ; Liver/*blood supply ; Liver/metabolism ; NF-kappa B/*biosynthesis ; Random Allocation ; Rats, Wistar ; Reperfusion Injury/*metabolism

The effects of the cyclin E expression levels on chemotherapeutic sensitivity of breast cancer cell line were explored. After the cyclin E expression was knockdown in MDA-MB-435 by RNA interference, FACS analysis and SA-beta-gal staining were used to evaluate the response sensitivity of breast cancer cells to DNA damage drugs (adriamycin, etc.). Adriamycin could induce G1 arrest in cyclin E knockdown MDA-MB-435 breast cell line and increase the percentage of cell senescence in cyclin E knockdown MDA-MB-435 cells. It was suggested that cyclin E knockdown could increase the chemotherapeutic sensitivity of breast cancer cells to DNA damage drugs.

Objective To examine the efficacy of applying clinical pathway (CP) teaching model in orthopedics clinical teaching.Methods Totally 64 medical undergraduates were randomized into 2 groups.The traditional teaching method and CP model were separately preformed on them.Their scores of theoretical,manipulation and case analysis exams at the end of internship were compared.Meanwhile the questionnaire of satisfaction degree also was conducted.Results Scores of exams and satisfaction degree were better in CP group than in classical group (P ＜ 0.05).Conclusions The novel CP model can promote the standardization and systematization of clinical teaching in orthopedics.It is conducive to evaluating teaching effect and performing teaching reform.Meanwhile,it is in accordance with the problem-based learning and can improve clinical teaching effect and satisfaction degree.

Objective To explore the clinical characteristics, diagnosis, treatment and prognosis of synchronous occurrence of gastrointestinal stromal tumor( CIST) and digestive tract cancer in 6 cases. Methods The clinical and pathologic data of 6 patients of synchronous occurrence of gastrointestinal stromal tumor and digestive tract cancer from January 2005 to September 2010 in Wuhan Union Hospital were analyzed retrospectively. Results In 4 cases both tumors were located in the same organ, in the other 2 cases tumors were located in the adjacent sites of digestive tract. Only 1 case was found both tumors by preoperative examination , and the others were found digestive tract cancer. Gastrointestinal stromal tumors were all in the very low risk group, the diameter of CISTs was less than 1 cm and the mitotic score was less than 2/50 HPF in all the cases. Digestive tract cancer showed no specical demonstrations both macroscopically and microscopically. Conclusions Clinical features of synchronous occurrence of CIST and digestive tract cancer are atypical. We should pay much attention to this entity in clinical practice. In this series, most CIST are in early stage and of low risk of malignance. The prognosis of patients with synchronous occurrence of GIST and digestive tract cancer mainly depends on digestive tract cancer.

Objective To investigate whether tumor necrosis factor-? (TNF-?) enhance the expression of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9(MMP-9) in hepatic cancer cell line HepG2 or not. Methods Cultured HepG2 cells were treated by TNF-? with various concentration and time. The morphological changes of HepG2 cells were studied microscopically and the proliferation of HepG2 were detected by methyl thiazolyl tetrazolium (MTT). The expression of VEGF and MMP-9 mRNA in cultured HepG2 were determined by relative quantitative reverse transcription polymerase chain reaction. The VEGF and MMP-9 protein level in supernatants and in cytoplasm were determined by enzyme-linked immunosorbent assay (ELISA) and by immunocytochemical staining, respectively.Results There was a little morphological changes in HepG2 with TNF-? treatment, but no change of cell proliferation in corresponding time. The expression of VEGF and MMP-9 mRNA was enhanced gradually with the TNF-? concentration increasing, the VEGF and MMP-9 protein level in supernatants and in cytoplasm was elevated gradually with the concentration increasing. There was a dependance on the concentration when the concentration of TNF-? was lower than or equal to 10~4 U/L. Furthermore, the effect of promotion was close to peak when the TNF-? concentration up to 10~4 U/L; but no time-effect pattern observed. Conclusion TNF-? can enhance the expression of VEGF and MMP-9 at the level of mRNA and protein in hepatic cancer cell line.

Objective To explore the methods, safety and efficacy of laparoscopic splenectomy (LS) and pericardial devascularization. Methods Five patients underwent LS and pericardial devascularization from January to June 2003. Results All the operations were completed under laparoscope and no hand-assisted procedure was required. The operating time was 3.0～4.0 hours (mean, 3.5 hours) and the intraoperative blood loss was 250～450 ml (mean, 350 ml). No surgical complications occurred. Conclusions Laparoscopic splenectomy with pericardial devascularization is a feasible, effective, safe and minimally invasive procedure for patients with normal-sized to medium-enlarged spleen.

Objective By observing the effectiveness of epidermal growth factor(EGF)combined with 5-flauouracil(5-FU)in the treatment of human colorectal cancer,to explore the anti-tumor effects of EGF.Methods MTT assay was used to evaluate the effects of EGF and 5-FU alone or combined use on the growth of tumor cells.The effects of EGF on PCNA expression were detected by Western blot,and flow cytometry was done to measure the changes in cell cycle.Results EGF could induce proliferation of tumor cells.With the increase in concentration of EGF,the number of cells in G0 phase was significantly reduced,and the expression of PCNA obviously increased.There was significant difference between 100 or 1 000 ng/mL EGF groups and control group(P＜0.05).The combined use of EGF and 5-FU could more significantly inhibited the growth of tumor cells than 5-FU alone(P＜0.05).Conclusion EGF can enhance the sensitivity of colorectal cancer cell Caco-2 to 5-FU,which might be related to the induction of proliferation of quiescent colorectal cancer cells.

Objective By investigating precision,linearity and accuracy of 9 commonly urine albumin assay systems (8 of immuno-turbidimetric assays and 1 of immuno-nephlometric assay),and comparing the concordance of measurement results,to elucidate the quality of the existing analytical systems.Methods Referring to Clinical and Laboratory Standards Institute (CLSI) EP15-A2,two mixed urines with U-Alb levels of 20 mg/L and 200 mg/L were made to validate precision; Referring to CLSI EP14-A2,fourty fresh urines were selected to evaluate matrix effect of saline diluted European Reference Materials (ERM) DA 470 and saline diluted urine,also to reflect the variation of measurement results among systems; Referring to EP6-A,saline diluted urines (10 levels) were made to validate linearity; Taking the theoretical concentration of precisely saline-diluted ERM-DA 470 as the target value,accuracy of each assay system was evaluated.Maximal allowable coefficient variation (CV) of ≤ 15％ was taken as the acceptable precision for each assay system,as rccommcnded by International Federation of Clinical Chemistry (IFCC)-and National Kidney Disease Education Program (NKDEP) ; maximum allowable bias of ≤25％ was taken as criteria for accuracy evaluation as used in Proficiency Test (PT) sponsored by College of American Pathologists (CAP).Results At level of micro-albuminuria(20-200 mg/L),all 9 systems total CVs were ≤ 15％ ; No matrix effect or interference were found in saline diluted ERM DA 470 and saline diluted urine.For A,B,E,F,G and I systems,validated linear regions were close to those stated in kit instruction;For C,D and H systems,the lower limits of validated linear region (18.7,3.6 and 12.0 mg/L,respectively) were higher than those stated in kits instruction (0,0.9 and 5.0 mg/L,respectively) ;For B and C systems,the lower limits of validated linear region were close to the upper limits of reference interval stated in kit instruction.When urine albumin was ≤ 12.6 mg/L,A,E,F,G and I systems showed good accuracy,absolute biases at all dilution were below 3 mg/L,D system showed higher positive bias (5.0-14.4 mg/L),B,C and H systems' biases were not evaluated because of high in-batch CV (the CV of B system≥ 18.1％,of C system ≥ 14.5％,of H system ≥ 39.1％); when U-Alb ranged in 25.2-201.0 mg/L,all 8 systems' relative biases were ≤25％,except D systems,which showed an un-acceptable positive bias (15.9％-44.3％).Good concordance among systems' results was present at level of microalbuminuria(20-200 mg/L),with CV among systems ＜ 15％ ;when urine albumin was ＜ 20 mg/L,CV among systems increased as allumin concentration decreased.The main contribution of variation came from B,C and H systems,which lower limits of linearity were relatively high.Conclusions At level of microalbuminuria(20-200 mg/L),except D system,the other 8 systems show good precision and accuracy;at low level of urine albumin(＜20 mg/L,especially ＜ 10 mg/L),precision and accuracy of some systems(B,C and H system) needs to be improved.

Urinary excretion of albumin indicates kidney damage and is recognized as a risk factor for progression of kidney disease and cardiovascular disease,resulting a widespread clinical utilization of urine albumin measurement.Considerable inter-method difference has been reported for urine albumin,there are no available reference materials and no reference measurement procedures for urine albumin.This review discusses the clinical utilization of urine albumin in recent years,the principles of existing measurement systems and difference of results among systems,and the current status of work about reference materials and reference measurement procedures.