Objective To investigate and evaluate serum level of heparanase in diabetic patients with acute coronary syndrome.Methods Forty-six diabetic patients with acute coronary syndrome(ACS) were enrolled as DM+ACS group,as well as,52 patients with ACS were studied as ACS group,27 diabetic patients as DM group,and 28 health volunteers served as normal control group.CRP,MMP-9 and heparanase in serum were measured with ELISA.The receiver operating characteristic curves of CRP,MMP-9 and heparanase were produced and the cutoff values were determined.Results The serum level of heparanase was significantly higher in DM+ACS group than in the ACS group,DM group and normal control group.The areas under the curve(AUC) of ROC were 0.941,0.813 and 0.967 respectively.Significant difference of AUC were observed between groups.The serum level of heparanase was significantly higher in DM+AMI subgroup than in DM+UAP subgroup.Conclusion Serum heparanase is related with the development of acute coronary syndrome in diabetic patients.Serum heparanase can be used as a more effective serological indicator for the plaque destabilization and rypture in diabetic patients than CRP and MMP-9.

Objective:To used the internationally accepted methods of CT quality assurance for testing their quality, to maintain the normal operation of CT scanner and guarantee the quality of photographic image.Methods: Toshiba Activion 16 row CT, set the scanning conditions: tube voltage 120 kv, 310 mas exposure, scan time is 0.33 s, scanning layer thickness: 10 mm, 5 mm, 1.5 mm, view(FOV) 150 mm×150 mm, 512 x 512 reconstruction matrix. We measured the following performance parameters for CT spatial resolution, low contrast resolution,uniformity and noise with Catphan500 phantom made by the phantom laboratory of U.S.A.Results: The spatial resolution, low contrast resolution, uniformity and noise of the CT are all in line with the requirements. Obtained by detecting the X-ray dose, pixel, the thickness of the above parameters are affected, but also the interaction between the above parameters simultaneously.Conclusion: By detecting the spatial resolution, low contrast resolution of medical image, we can effectively guarantee system performance, maintaining optimal image quality.

Obesity has rapidly become a pandemic and is associated with increased carcinogenesis, especially esophageal adeno-carcinoma (EA). Adipose tissue is considered an endocrine organ because of its capacity to secrete a variety of adipokines, such as leptin, adiponectin, and resistin. Adipokines have recently been found to be associated with different types of chronic esophageal diseas-es, including gastro-esophageal reflux diseases, Barrett esophagus, and carcinogenesis. First-hand evidence supporting the inhibitory and/or active function of adipokines has been collected on human EA. This review aims to provide important insights into the potential mechanisms of adipokines in EA progression.

Objective To investigate the best models of esophageal cancer surgical approaches,lymphadenectomy ranges and postoperative comprehensive treatment.Methods From January 1998 to December 2007 in 10 years,1 162 cases of different parts with esophageal cancer were analysized which were treated with surgically adopting sequential abdomen,chest,neck three-incision approaches.Taking three-step screening way of preoperative imaging,preoperative ultrasound localigation fineneedle aspiration biopsy cytology and intraoperative rapid fieezing pathological examination were applied to make the selectivity of the first-times cervico-thoraco-abdominal three-field lymph node dissection (3FLND),first-times standard thoracoabdominal two-field lymph node dissection (2FLND) and second-times third-field cervical lymphadenectomy.Meanwhile,we implemented actively postoperative comprehensive treatment and observed the overall clinical efficacy and long-term survival.Results In the group of 1 162 cases with esophageal cancer surgery.The operating resection rate was 100 ％,Radical resection of 97.6 ％ (1 134/1 162).Perioperative overall complication rate was 16.4 ％ (191/1 162).Anastigmatic fistula was 0.6 ％ (7/1 162).Five cases dead in 30 days after surgery.The whole group of lymph node metastasis rate was 52.6 ％ (611/1 162),lymph node metastasis degree in 12.1％ (3 092/25 564).Full group of the first-times 3FLND was 348 cases.The positive rate was 94.8 ％ (330/348),Implementing the first-times 2FLND was in 814 cases and the second-times thirdfield cervical lymph node dissection was performed in 89 cases.The postoperative complications of the 3FLND was significantly higher than that of 2FLND (23.6 ％ vs 13.4 ％).The difference was statistically significant (x2 =18.37,P ＜ 0.001).However,The difference was not statistically significant between 3FLND and 2FLND (P ＞ 0.05).There is no significant difference between the first-times 3FLND with the second-times 3FLND accumulating survival (P ＞ 0.05).But different degree of lymph node metastasis determined prognosis.The difference was significant (x2 =35.57,P ＜ 0.001).In our group the postoperative comprehensive treatment application rate was 87.2 ％.Surgery combined with comprehensive treatment overall 1,3,5 years survival rates were 92.1％,69.2 ％,49.6 ％ respectively.Conclusions The sequential three-incision approaches and selectivity of lymph node dissection have the radical nature thoroughly,fewer complications,high quality of life and the long-term survival advantages.It should be a widely used method in the clinical surgery of the esophageal cancer.Implementing the three-step screening way to selecting the first-times 3FLND,the firsttimes 2FLND and the second-times third-field cervical lymphadenectomy that have targeted strongly and high accuracy,a definite object in view and avoiding patient excessive trauma.Applying the comprehensive treatment after surgery and the re-treated of patients with recurrence that can further more improve the longterm survival of patients.The comprehensive treatment should be the target direction of the future development of esophageal cancer.

The expression of DNA methyltranferase 1 (DNMT1 )mRNA and protein in 20 controls of normal oral mucosa tissue and 43 cases of oral squamous cell carcinoma(OSCC)was detected by Real-Time PCR and immunohistochemical staining and Western blot respectively. DNMTl mRNA CT values in OSCC and the controls were 0.958 6 ±0.986 6 and 0.459 5 ±0.525 8 respectively(Z =-2.028,P <0.05), The positive expression of DNMT1 protein in OSCC and the controls was 87% and 25% respectively(P <0.05).DNMT1 may play a role in the development of OSCC.

Obesity is rapidly becoming a pandemic and is associated with increased carcinogenesis,especially hepatocellular carcinoma (HCC).Adipose tissue has been considered as an endocrine organ because of its capacity to secrete a wide variety of adipokines,such as leptin,adiponectin and resistin.Recently,adipokines have been demonstrated to be associated with many kinds of chronic liver diseases,liver fibrosis and cirrhosis,and carcinogenesis.Direct evidence supporting the inhibitory and/or activating role of adipokines in the process of carcinogenesis and progression of human HCC has been rapidly accumulating. This review aims to provide important insights into the potential mechanisms of adipokines in the development of HCC.Further investigations will shed light on a new therapeutic target in HCC.

Objective:To investigate the expression of insulin-like growth factor binding protein 3 (IGFBP-3) in salivary pleomorphic adenoma(SPA).Methods:The expression of IGFBP-3 protein in 40 cases of SPA(group SPA),40 of normal glandular tissue(group N) and 10 of salivary gland malignant tumor(group CA) was detected by Western blot.The expression of IGFBP-3 mRNA in 50 cases of SPA,50 of salivary gland normal tissue and 10 of CA was detected by qRT-PCR.Results:The expression(A value) of IGFBP-3 protein in group N,SPA and CA was 8.54 ± 3.95,4.78 ± 2.07,3.63 ± 2.27 respectively.The expression ration of IGFBP-3 mRNA of group N vs SPA or CA,P ＜ 0.05;SPA vs CA,P ＞ 0.05 (SPA/N was 0.654 ± 0.387,CA/N:0.452 ± 0.229) respectively,but showed no significance difference between SPA and the CA groups(P ＞ 0.05).Difference of IGFBP-3 mRNA expression was observed with different envelope infiltration of SPA (P ＜ 0.05),no significant difference was observed in different age,gender or relapse groups.Conclusion:IGFBP-3 Low expression of IGFBP-3 in pleomorphic adenomas may reduce the antagonism of IGF-1R,causing the proliferation of tumor cells and promote tumor formation.

ObjectiveTo evaluate the surgical outcomes and prognosis of patients after liver resection for noncolorectal liver metastases.Methods72 patients with liver metastases who underwent liver resection at Tianjin Medical University Cancer Hospital were retrospectively studied.There were 32 males and 42 females,aged between 35～78 years.After liver resection,68 patients had a R0 resection (negative histological margin),and 4 patients had a R1 resection (positive histological margin).The primary tumours were breast,(n =16,22.2 ％),lung (n =14,19.4 ％),gastrointestinal (n=12,16.7％),gynecological (n =8,11.1％),pancreatobiliary (n =8,11.1％),melanoma (n=4,5.6％),sarcoma (n=4,5.6％),and genitourinary (n=2,2.8％).The mean diameter of the main tumour was 4.8 cm (range,1.5- 11.0 cm).The mean number of liver metastases was 1.2 (range,1-5).Liver metastases were synchronous in 6 patients (8.3％) and metachronous in the remaining 66 patients (91.7％).ResultsThe operative mortality was 0％.The mean hospital stay was 14.4 days (range 6-67 days).The median overall survival was 31 months (range,6-127 months).The 1-,3- and 5-year survival rates were 81.9％,37.5％ and 23.6％,respectively.Univariate analysis revealed primary tumour sites (breast vs.others),histological type (adenocarcinoma vs.others),postoperative chemotherapy,number of liver metastases (solitary vs.multiple) and time to liver metastases from diagnosis of primary tumours (≤ 12 months vs.＞ 12 months) were associated with overall survival (all,P＜0.05).In multivariate analysis,factors independently associated with poor survival were nonbreast origin (P =0.012),time to liver metastases from diagnosis of primary tumours ＜12 months (P=0.027) and multiple liver metastases (P=0.008).ConclusionsIn selected patients,liver resection is an effective and safe treatment for noncolorectal liver metastases.The time to liver metastases from diagnosis of primary tumours was independently associated with overall survival.For solitary or liver metastasis of breast origin,surgical resection significantly improved survival.

Objective To explore possible associations between osteopontin(OPN) and intact parathyroid hormone(iPTH),to investigate effects of them on the progression of carotid artery calcification in patients receiving long-term hemodialysis.Methods Forty-eight maintenance hemodialysis (MHD) patients and 28 age-and sex-matched healthy volunteers were recruited.The concentration of OPN in peripheral blood was determined by enzyme linked immunosorbent assay (ELISA).Levels of iPTH and presence of plaques in the common carotid arteries were also measured.The demographics were recorded.Results Compared with controls,levels of OPN[(137.4±80.8) ng/L vs (31.6±6.7) ng/L,P ＜ 0.01] and iPTH[(456.4±326.4) ng/L vs (66.9±19.3) ng/L,P ＜ 0.01] were higher in MHD patients before hemodialysis,the numbers of calcific plaques in the common carotid arteries were increased in MHD patients (P ＜ 0.01).There was a positive correlation between pre-dialysis OPN levels and iPTH levels (r =0.620,P ＜ 0.01) in MHD patients.Higher levels of OPN and iPTH correlated with greater numbers of calcific plaques in the common carotid arteries after division into three subgroups of MHD patients based on calcific plaques.In multiple linear regression analysis,the correlation between the pre-dialysis OPN and iPTH levels remained the same even if adjusting for confounding effects[β =0.468,95％C1 (0.036,0.195),t =2.936,P =0.005].Conclusion OPN level is positively correlated with iPTH level in hemodialysis patients,which suggesting that both of them play important roles in the progression of carotid artery calcification.

Objective To evaluate the possibility and safety of balloon kyphoplasty for the aged osteoporotic thoracolumbar burst fractures. Methods From October 2007 to December 2012, 78 patients with aged osteoporotic thoracolumbar burst fractures were treated by balloon kyphoplasty. The inflatable balloon was inserted through pedicle of vertebal arch to make fracture reduction, then the centrum was stuffed with bone cement. The whole procedure was pinpointed and detected by C-arm x-ray machine. Results All operations were completed successfully. The lumbar and back pain of the patients relieved obviously. The quality of patients' life was significantly improved. Imaging examinations revealed that the vertebrae altitude was recovered and the kyphosis was corrected obviously. Conclusion Balloon kyphoplasty is effective to treat the aged osteoporotic thoracolumbar burst fractures. But the operation had certain risk, we must do a good job in preoperative preparation, strictly handle surgical indication and accurately operate.