Purpose:To investigate genetically a diagnostic method of occult metastasis of lymph node in patients with squamous cell carcinoma of the esophagus.Methods:Using assays of reverse transcriptase polymerase chain reaction technique (RT PCR), MUC1 gene mRNA in thirty negative and thirty positive control lymph nodes was detected to evaluate diagnostic sensitivity and specificity. Eighty seven negative regional lymph nodes by conventional histologic examination (pN 0 ) from thirty patients with esophageal carcinoma were studied to detect MUC1 gene mRNA to diagnose lymph node occult metastasis.Results:MUC1 mRNA was not identified in any specimen of negative control group (specificity =100%); MUC1 mRNA was identified in twenty five of positive control specimen (sensitivity =83%). MUC1mRNA was identified in nine lymph nodes (10.3%) from eight patients with pN 0 esophageal carcinoma. Conclusions: Nodal occult metastasis could be diagnosed by the detection of expression of MUC1mRNA of lymph node in patients with pN 0 esophageal carcinoma.

BACKGROUND:Aging, lack of estrogen and few activities may lead to the decrease of resting energy expenditure in menopause women so as to induce the body composition changes, which can result in disease, such as obesity and fracture. OBJECTIVE:To explore the change of body composition and resting metabolic rate among premenopausal, perimenopausal and postmenopausal women. METHODS:2 312 women who came to outpatient clinic were recruited, including 1 310 premenopausal women, 790 perimenopausal women and 212 postmenopausal women. Body composition and resting energy expenditure were measured in each woman. RESULTS AND CONCLUSION:(1) Body fat percentage of perimenopausal and postmenopausal women was significantly higher than that of pre-menopausal women. (2) There was no significant difference in resting metabolic rate among the three groups. When adjusted body weight, the resting energy expenditure per kilogram was significantly lower in perimenopausal women than in premenopausal women. (3) Bone mineral density, femoral neck strength, lower limb maximal strength, and leg muscle distribution coefficient were significantly lower in postmenopausal women than in perimenopausal and premenopausal women (P < 0.05). (4) Weight and leg muscle distribution coefficient were positively correlated with the resting energy expenditure per kilogram, and height, body mass index, body fat percentage were negatively correlated with the resting energy expenditure per kilogram. These findings indicate that the body composition can change in women after menopause, such as body fat increasing, muscle content decreasing, and bone mass loss. There is a certain relationship between the change in body composition and resting energy expenditure.

Purpose:To investigate the correlation between early postoperative metastasis with occult micrometastasis of mediastinal lymph nodes in patients with stageⅠa non small cell lung carcinoma (NSCLC).Methods:Using RT PCR assay, detection of the expression of MUC1 mRNA was used to diagnose occult micrometastasis in mediastinal lymph nodes. All the patients underwent checked up at least once a year to detect early metastatic lesions after surgery, by means of CT scan of chest and brain, ultrasound examination of liver and adrenal glands, and bone scanning. The patients with and without occult nodal micrometastasis were divided into two different groups. Difference in early metastatic rate between two groups of patients was compared by ? 2 test, and odds ratio (OR) was calculated.Results:Occult nodal micrometastasis was diagnosed in sixteen patients (32.0%). Early metastatic rate (31.25%) in the patients with occult nodal micrometastasis was higher than that (5.88%) in the patients without occult nodal micrometastasis ( P

Objective To investigate the expression of chemokine receptor CCR7 and its correlation with lymph node metastasis and prognosis in esophageal cancer after esophagectomy. Methods One hundred and eighty-four patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between June, 2003 and June, 2005. The expression of CCR7 was detected by immunohistochemistry. All statistic analyses were performed with SPSS 13.0 statistical software. According to the clinico-patho-logic factors, the difference of CCR7 expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The expression rate of CCR7 in stage Ⅰ , stage Ⅱ and stage Ⅲ patients was 25.0 % , 70.3% and 85.5% , respectively. The difference of CCR7 expression between stage Ⅱ and stageⅢ was statistically significant (x2 =5.0, P =0.02). The CCR7 expression rate in T1, T2 and T3 patients was 33.3% , 64.9% and 80.9% , respectively. The difference of CCR7 expression between T2and T3 was statistically significant (x2 =5.4, P =0.01). The level of expression of CCR7 in patients with lymph node metastasis was significantly higher than those without metastasis (x2 =10.8, P = 0.00). The 5-year survival rate instage Ⅰ , stage Ⅱand stage Ⅲ patients was 100.0% , 38. 3% and 22.4% , respectively. The 5-year survival rate in patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression (x2 = 23.7, P = 0.00). The 5-year survival rate in T2, T3, NO and N1 patients with CCR7 overexpression was significantly lower than those without CCR7 overexpression The result of Cox analysis demonstrated that T , N and CCR7 overexpression were independent prognostic factors. Conclusion CCR7 expression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage,N stage and lymph node metastasis. The patients with CCR7 expression was significantly lower the 5-year survival rate than without CCR7 expression. T stage, lymph node metastasis and CCR7 expression were independent prognostic factors.

Objective: To explore the effect of radiotherapy on preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lewis esophagectomy. Methods: Three hundred and sixty-six pa-tients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients un-derwent Ivor-Lewis esophagectomy with two-field lymph node dissection in our hospital between June 1999 and June 2004. All statistical analyses were performed with SPSS 13.0 statistical software. Kaplan-Meier method was performed to calculate the relapse rate. Log-rank test was performed to compare the relapse rate. Cox regression analysis was performed to identify independent prognostic factors for postoperative lymph node metastasis. Results: Of the 366 cases, lymph node metastasis was found in 105 patients (28.5%)within 3 years after surgery, occupying 52.2% (105/201) of total recurrence. Of the 181 patients treated with postoperative radiotherapy, lymph node metastasis was found in 37 patients. The rate of lymph node metasta-sis was 20.4%, significantly lower than that in patients treated with chemotherapy alone and those without sys-temic adjuvant therapy (P<0.05). Chemotherapy was administered in 103 cases and lymph node metastasis was found in 33 patients. The rate of lymph node metastasis was 32.0%, lower than that in patients without systemic adjuvant therapy, but without statistical significance (P=0.17). The results of Cox analysis demon-strated that T stage, lymph node metastasis and postoperative adjuvant radiotherapy were independent prog-nostic factors. Conclusion: Ivor-Lewis esophagectomy for the middle third thoracic esophageal cancer was a safe surgical procedure. Postoperative radiotherapy is helpful for the control of local recurrence. T stage,lymph node metastasis and postoperative adjuvant radiotherapy are independent prognostic factors. Radio-therapy is helpful for preventing the recurrence of lymph node metastasis of esophageal cancer after Ivor-Lew-is esophagectomy.

Objective To investigate the risk factors with lymph node metastatic recurrence in patients with N0 esophageal cancer after Ivor-Lewis Esophagectomy. Methods The subjects were 82 patients with pN0 esophageal cancer who underwent Ivor-Lewis esophagectomy from January 2001 to January 2005. By using RT-PCR, VEGF-C mRNA was detected in tumor issues, and Mucin l( MUC1 )mRNA was detected in lymph nodes. The Kaplan-Meier method was used to calculate the survival rate and lymph nodal metastatic rate. Log-rank test was performed to compare the recurrence rate, and Cox regression multivariate analysis was performed to determine independent prognostic factors. Results VEGF-C mRNA was identified in 42 patients (51.22%), and MUC1 mRNA was identified in 23 patients(28.05% )from at least 1 lymph node station . The diagnosis of lymph node micrometastasis (LNMM) was based on the detection of MUC1 mRNA. The first recurrence exhibiting lymph node metastasis was recognized in 37 patients (45.1%) at the first 3 years after operation and this was significantly associated with T status ( P ＜ 0. 05 ). Lymph node metastatic rate for patients with VEGF-C mRNA expression in tumor issues was significantly higher than that for patients without VEGF-C mRNA expression( P ＜0. 01 ). And lymph node metastatic rate for patients with LNMM was significantly higher than that for patients without LNMM ( P ＜0. 01 ). The results of multivariate analysis confirmed that T status, VEGF-C mRNA expression in tumor issues and LNMM were independent relevant factors. Conclusion Status,VEGF-C mRNA expression in tumor issues and LNMM in patients with N0 esophageal cancer were independent risk factors for 3-year lymph node metastatic recurrence after Ivor-Lewis Esophagectomy.

Objective To investigate the expression of MTA1 protein and its relationship to the prognosis in esophageal cancer after esophagectomy. Methods One hundred and sixty-five patients with middle third squamous cell carcinoma of the esophagus were enrolled in this study. All patients underwent operation in Provincial Hospital Affiliated to Shandong University between January 2002 and January 2004. The expression of MTA1 protein was detected by immunohistochemistry. All statistic analyses were performed with SPSS 10.0 statistical software. According to the clinicopathologic factors, the difference of MTA1 protein expression was compared by x2 test. Kaplan-meier method was performed to calculate the survival rate, Cox regression multivariate analysis was performed to determine independent prognostic factors. Results The 5-year survival rate in Ⅰ stage,Ⅱ stage and Ⅲstage was separately 100.0% 、38.3% and 22.4%, and the MTA1 protein expression rate in Ⅰ stage, Ⅱ stage and Ⅲ stage was separately 25.0% 、30.9% and 57.9%, the difference of MTA1 protein expression between Ⅱ stage and Ⅲ stage was statistically significant ( x2 = 11.6, P = 0. 00). The MTA1 protein expression rate in T1 stage, T2 stage and T3 stage was separately 42.9% 、13.3% and 50%. MTA1 protein expression rate in T2 stage patients and T3 stage patients was separately 13.3% and 50%, the difference of MTA1 protein expression between them was statistically significant (x2 = 13.2, P =0.00). The positive expression of MTA1 protein in patients with lymph node metastasis was significantly higher than those without metastasis ( x2 = 8.2, P = 0.04). The 5-year survival rate in patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P =0.00 ), and the 5-year survival rate in T3 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.01 ), and the 5-year survival rate in N0 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression (P = 0.03 ), and the 5-year survival rate in N1 stage patients with MTA1 protein positive expression was significantly lower than those without MTA1 protein positive expression ( P =0.04). However, the 5-year survival rate in T2 stage patients with MTA1 protein positive expression was not significantly lower than those without MTA1 protein positive expression (P =0.20). The result of Cox analysis demonstrated that N stage and MTA1 protein positive expression were independent prognostic factors. Conclusion MTA1 protein overexpression was detected in esophageal squamous cell carcinoma and was found to be significantly associated with T stage and lymph node metastasis. The patients with MTA1 protein overexpression was significantly lower the 5-year survival rate than without MTA1 protein expression. Lymph node metastasis and MTA1 protein overexpression were independent prognostic factors.

Objective To analyze the detection results and clinical significance of human papillomavirus (HPV) DNA genotypes in the patients with condyloma acuminate (CA)and high risk (HR)population of CA and normal population of physical examination (PE).Methods 527 cases of CA patients (CA group),208 cases of HR (HR group)and 197 cases of normal PE (PE group)in the outpatient were selected.The human HPV DNA genotypes in 932 samples of different population were examined with HybriMax;the positive detection rates,the preponderance types of HPV and the multiple genotype infection in three groups were analyzed.Results The HPV positive rate in CA group was 98.29% and the preponderance types were HPV 6,11,33,and 52 genotypes.The HPV positive rate in HR group was 26.44% and the preponderance types were HPV 6,11,33,and 66 genotypes.The HPV positive rate in PE group was 5.58% and the preponderance types were HPV 6 and 11 genotypes.The difference in the positive detection rates of HPV between HR and PE groups had statistical significance (P < 0.05 ). The positive rates of multiple genotype infection in CA group and HR group were 36.43% and 5.77%,respectively,and there was significant difference (P < 0.01 ); the positive rate of double infection was the highest (18.41%), followed by the positive rate of triple heavy infection (11.20%) and the positive rate of septuple heavy infection (0.38%).Conclusion The HPV 6 and HPV 11 of low-risk HPV genotypes are the most common genotypes in different population. The HR group and PE group are all asymptomatic but the positive detection rate of HPV in HR group is higher than that in PE group. The positive rate of HPV multiple genotypes infection in CA group is higher than that in HR group,and the double infection or triple heavy infection are the most common infection.

Objective To inverstigate the effect and safety of refractory intrahepatic and extrahepatic bile duct stones treated by choledochoscope holmium laser combined with electrohydraulic lithotripsy.Methods The cllnical data of 67 cases of postoperative intrahepatic and extrahepatic bile duct stones treated with combined endoscopic holmium laser and electrohydraulic lithotripsy were analysed retrospectively.Results After 1 to 7 times of biliary endoscopic holmium laser electrohydraulic lithotripsy treatment,65 patients had complete removal of all residual stones with the success rate of 97%,and without complications.Conclusions After holmium laser combined with electrohydraulic lithotripsy,the effect of choledochoscopic removal of intrahepatic and extrahepatic bile duct residual stones can be greatly improved It is a safe method for treatment of refractory intra-and extra-hepatic bile duct stones.

AIM: To clarify the possible mechanism of decrease in coronary flow (CF) after long-term hypothermic storage of the isolated rat hearts. METHODS: The isolated rat hearts preserved in different solutions (SDMC-1,2 S., Stanford S., Collin's S.) at 0℃ for 8 hours were reperfused with 5-hydroxytryptamine (5-HT)(10 -4 mmol/L) and adenosine(Ade)(5 mmol/L) respectively, and the coronary flow(CF), coronary vascular resistance(CVR) and the weight of heart were measured before and after reperfusion. RESULTS: CF decreased while CVR increased in all groups after storage-reperfusion. When endothelium-dependent vasodilator (5-HT) was used, CF in SDMC-2 group was highly increased and CVR decreased. Whereas CF was significantly decreased and CVR increased in Collin's group( P