Objective To study the rules of circumferential margin invasion(CMI)in middle and(or)lower rectal cancers by pathological large slices stained with HE and labeled with CK20,and provide a pathological basis for clinical therapy of rectal cancer.Methods Forty-one patients with middle or low rectal cancer were randomly selected in 8 months.The surgically resected specimens were detected after they were made into the pathological large slices stained with HE and labeled with CK20.Results The mesentery CMI positive rate in the pathological slices with HE staining and CK20 labeling was 21.95%,and 29.27% respectively.The mesentery CMI positive rate in moderately-and well-differentiated group was lower than in poorly-differentiated group(P＜0.05).Moreover,the mesentery CMI rate was higher in the specimens with lower edge less than 5 cm away from the dentate line than that in those with lower edge more than 5 cm away from the dentate line(P＜0.05).There was no significant correlation between CMI with the factors such as gender,age,pathological general types,tumor infiltration depth,lymph node metastasis,and surgical procedures(all P＞0.05).Conclusion There were risk factors for the CMI such as low location,poor differentiation and so on.The CMI patients should be treated with standardized adjunctive therapy after operation.

Objective To study the prognostic factors in patients of HCC after hepatectomy by Cox proportional hazard.Methods 145 patients operated on for HCC from 1986 to 1996 were followed up to the end of 1999. Seventeen possible factors associated with long survival were analyzed by Kaplain Meier Log rank estimation. A multivariative survival analysis of these individual variables was undertaken using the cumulative survival rate by the computer′s Cox proportional hazard. Results The overall cumulative survival rate at 1?3?5?7?10?12 years was 75 0%?44 4%?29 5%?23 5%?21 2%? and 16 9%, respectively. Results showed that the way by which a tumor was found?tumor size?portal thrombi?satellite nodule?UICC TNM stage?cutting margin?radical resection were the prognostic factors by individual variable analysis;A multivariative analysis showed that tumor finding mode?UICC stage?cutting margin?recurrence?radical resection were associated with prognosis.Conclusion The prognostic factors of HCC focused on two aspects: early diagnosis and treatment method. UICC TNM stage is most predictive for prognosis. Cutting margin of more than 1 cm is needed for long term survival.

Objective:To explore the mechanism of promotion effect of juglone combined with cisplatin on the apoptosis of human cervical cancer HeLa cells,and to clarify the effects of its associated signal transduction pathways.Methods:The HeLa cells at logarithmic growth phase were divided into control group,juglone group, cisplatin group and juglone combined with cisplatin group (combined treatment group).The inhibitory rates of proliferation of HeLa cells were detected by MTT assay.The apoptosis was detected by Hoechst 33258 staining. The expressions of Bcl-2, Bax and caspase-3, AKt, and pAKt were detected by Western blotting method. Results:The MTT results showed that the HeLa cell proliferation at 24,48 72 h in each drug group was inhibited;compared with control group,the profileration of HeLa cells in juglone group and cisplatin group was significantly inhibited,especially in combined group. Compared with single drug group,the inhibitory effect in combined treatment group was more significantly.After treatment for 12 h,the typical morphological changes of apoptosis were found in juglone group and cisplatin group by Hoechst 33258 staining,especially in combined treatment group. The Western blotting results showed that the expression levels of Bcl-2 and pAKt in HeLa cells in juglone group and cisplatin group 12 h after treatment were decreased obviously,whereas the expression levels of Bax,Caspase-3,and AKt were increased significantly, especially in combined treatment group compared with control group. Conclusion:Juglone combined with cisplatin could inhibit the PI3K/AKt pathway,thereby promoting the apoptpsis of HeLa cells.

OBJECTIVE To explore the pro-apoptotic mechanism of juglone in SiHa cells and to in?vestigate its associated signal transduction pathways. METHODS SiHa cells were treated with juglone 20μmol·L-1 for 24,48 and 72 h. Cellular morphology was detected by inverted microscopy.The cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay. After 24 h treatment with juglone 20μmol·L-1,the cell apoptosis was detected by flow cytometry while the expressions of apopto?sis-related protein BCL-2,BAX and cleave-caspase-3,PI3K/AKt pathway-related protein PTEN,AKT and pAKT were detected by Western blotting. RESULTS After treatment with juglone for 24, 48 and 72 h,the growth of SiHa cells was significantly inhibited. Compared with cell control group,cells in juglone treated gruop were sparse,slipped off the wall,became round and the cell proliferation inhibitory rate was 43.3%,63.0%and 73.1%(P<0.05,P<0.01),respectively. Twenty-four hours post treatment, the early apoptosis rate of juglone treated gruop cells was increased by(6.47±1.79)%(P<0.01)compared with cell control group. Western blotting results showed that the expression of BCL-2 decreased by 53.0%while the expression of BAX and caspase-3 increased by 85.5%and 183.3%,respectively. The expression of PTEN was increased by 75.0% but the pAKt was decreased by 45.8%(P<0.01). CONCLUSION Juglone can upregulate the expression of PTEN, thus inhibiting PI3K/AKt pathway and promoting apoptosis of SiHa cells.

Objective To evaluate the prognostic value of China Classification System and TNM staging in patients with liver cancer undergoing resection. Methods From Jan 1986 to Dec 2000, 246 patients underwent resection of liver cancer. At least three years of follow-up was made in these 246 cases. Results The 1, 3, 5, 7, and 10-year disease-free survival rates were 55%, 30%, 25%, 20% and 18%, respectively. The 1,3,5,7,and 10-year disease-free survival rates predicted by China Classification System and TNM staging were statistically different and positively correlated with each other. Differences of survival rate between stageⅠa、Ⅰb、Ⅱa 、Ⅱb and Ⅲ by China Classification System were all statistically significant. Conclusions Based both on tumor extension and liver function, China Classification System was more accurate in than TNM stage predicting the prognosis of liver cancer patients undergoing resection.

Objective To investigate the clinicopathologic features and treatment of thyroid microcarcinoma (TMC). Methods From January 1997 to December 2006,311 patients who underwent surgery and defined as TMC(tumor size≤1 cm)were enrolled. Results TMC was identified incidentally by frozen pathologic examination on thyroidectomy specimens in tentative benign goiters in 181 patients; another 130 patients with clinically detectable primary tumors or suspected nodal metastases were grouped to as clinically overt TMC. The clinically overt TMC had a higher incidence of bilateral multifocal tumors (18.5%vs.9.4%,P=0.03),and cervical lymph node metastases(27.7%vs.10.5%,P=0.000)than that in clinically occult TMC group. Conclusion TMC may vary considerably in clinical and biologic behaviors between these two subtypes: clinically overt and occult. Lobectomy for single lesion, total or near total thyroidectomy for multifocal with central compartment nodal dissection should be performed, lateral nodal dissection was not carried out unless US or physical examination detected nodal metastases. Lobetomy, subtotal or more limited thyroidectomy for occult TMC, diagnosed incidentally following thyroid surgery for initially tentative benign thyroid disease, could all be treatment of choice depending on the preference of surgeons.

OBJECTIVETo evaluate the prognostic value of CLIP score system for patients with resection of HCC.

METHODSA retrospective survey was carried out in 174 patients undergoing resection of HCC from January 1986 to June 1998. 153 of 174 patients with curative resection were followed up for at least three years. Disease-free survival rate was defined as the time relapsed from the date of image diagnosis and either the date of death or the date of the latest follow-up visit, with final evaluation at June 30, 2001. Recurrences were classified into early ( 3 year) recurrence. Risk factors for recurrences and prognostic factors for survival in each group were analyzed by the chi-square test, the Kalain-Meier estimation and the COX proportional hazards model respectively.

RESULTSThe 1-, 3-, 5-, 7-, and 10-year cumulative disease free survival rates were 57.2%, 28.3%, 23.5%, 18.8% and 17.8%, respectively. The associated factors with early recurrence were as fellows: tumor size > 5 cm, microsatellite, venous invasion, tumor morphology, tumor extension, advanced TNM stages, CLIP scores, radical resection, and resection margin, respectively. But both CLIP scores and Child stage were associated with late recurrence. Univariate survival curves analysis expressed that Child grades, radical resection, resection margin, tumor size, microsatellite, venous invasion, tumor morphology, tumor extension, TNM stages, and CLIP scores were associated with prognosis. The multivariate analysis by COX proportional hazards model, the independent prognostic factors for survival were radical resection, resection margin, and TNM stages.

CONCLUSIONSCLIP score, which takes into account both liver function and tumor extension, has displayed a unique superiority in predicting the tumor early and late recurrence and prognosis. It could be an useful tool in predicting the patient recurrence and prognosis with resection of HCC. Meanwhile, it may help physicians to decide the more appropriate management in advance for patients with HCC.

Adolescent ; Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; mortality ; surgery ; Child ; Data Collection ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; diagnosis ; mortality ; surgery ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Prognosis ; Recurrence ; Retrospective Studies ; Survival Rate

This paper reported a rare case of hypercalcemic crisis caused by a parathyroid adenoma with hemorrhage and cystic degeneration. Preoperative imaging examination of the patient was unable to determine the histological origin of the cervical cystic lesion. Despite aggressive medical treatment and hemodialysis, hypercalcemic crisis could not be relieved. Therefore, surgical exploration and excision of the cervical lesion were performed, and final diagnosis of parathyroid adenoma with hemorrhage and cystic degeneration was confirmed by pathology. Blood calcium level and renal function returned to normal after the surgery.

Objective To investigate the development and application of blood purification in PICU. Methods The demographic data,diagnosis,length of stay,prognosis,patterns and frequency of blood purifi-cation and complications of PICU patients treated with blood purification in our hospital from 2010 to 2017 were retrospectively analyzed. Results The patients with blood purification accounted for 3. 1％ of hospital-ized children in the same period. From 2010 to 2017,the patients and times with blood purification increased by 370. 6％ and 398. 3％ respectively. The times of continuous veno-venous hemodiafiltration(CVVHDF), plasma exchange and hemoperfusion increased by 135. 2％,6300％ and 1600％ respectively. The frequency of CVVHDF,plasma exchange and hemoperfusion accounted for 42. 8％(492/1151),33. 5％(386/1151), and 23. 7％ (273/1151) respectively. Drug and toxic poision accounted for the highest proportion of 28. 6％(81/284),neurological diseases accounted for 20. 8％(59/284),sepsis with multiple organ dysfunction syn-drome accounted for 18. 0％( 51/284 ) , digestive system diseases, autoimmune diseases, renal diseases and metabolic diseases accounted for 14. 4％( 41/284 ) ,4. 9％( 14/284 ) ,4. 9％ ( 14/284 ) and 4. 2％( 12/284 ) respectively. The cure rate was 63. 8％. Complication included thrombus. Conclusion Blood purification has become the preferred modality for the management of critically ill children. Pediatric blood purification tech-niques have developed rapidly in our PICU and domestic pediatric. Further specification is required,so that it may represent the adequate choice for critical ill children.

Objective To evaluate the change of clinicopathological features and prognosis of papillary thyroid cancer over a 15-year period.Methods The clinicopathological features and outcomes of papillary thyroid cancer patients were analyzed in three groups according to the time of diagnosis:group Ⅰ (1997-2001),group Ⅱ (2002-2006),and group Ⅲ (2007-2011).Results As time advanced,the average age of papillary thyroid cancer patients increased,tumor stage,like size,extrathyroid invasion and lymph node metastasis decreased dramatically (P ＜ 0.01).The percentage of multifocality and bilaterality increased.The long-term follow up data (median follow up time was 6.6 years),indicated that the 15-year over all survival was 97.8％ and the 15-year disease-free survival was 90.2％.Tumor ≥3 cm,bilaterality,extrathyroid invasion,lymph node metastasis and AJCC stage were correlated with tumor recurrence.By multivariate COX-regression analysis only lymph node metastasis and bilaterality were independent risk factors.Conclusion The clinicopathological features of papillary thyroid cancer changed over 15 years,with the percentage of early-staged patients increased.Lymph node metastasis and bilaterality are two risk factors for tumor recurrence.