Objective To explore endoscopic findings and histopathological characteristics of duodenal protuberant lesions in order to improve diagnosis of duodenal protuberant lesions.Methods A total of 869 cases of duodenal protuberant lesions were detected and collected in endoscopy center of Drum Tower Hospital from 2005 to 2010,of which endoscopy findings and pathological characteristics were studied retrospectively.Results Of the 869 case with duodenal protuberance,50 cases were misdiagnosed as real protuberant lesions.Of the 819 real protuberant lesions,781 cases (95.4％)were benign lesions and 38 cases (4.6％) were malignant lesions.Pathological results indicated that most were chronic inflammation benign lesions (338 cases),accounted for 41.3％.Secondary were Brunner gland hyperplasia (155 cases),accounted for 18.9％.Of malignant lesions,most were adenocarcinoma (25 cases,accounting for 3％ ),others were six cases of carcinoid tumor,six cases of malignant lymphoma and one case of embryonal rhabdomyosarcoma.Endoscopic findings of duodenal protuberant lesions were diverse,such as round,hemispheric,finger-like,lobulated,streak and so on.The diameter of duodenal protuberant lesions varied,the largest was 5 centimeter and most were sessile lesions (726 cases,88.6％).Endoscopic ultrasonic findings indicated that internal echo of benign lesions were even and each layer of structure was clear,while malignant lesions presented uneven internal echo,unclear layer structure and adjacent tissue or lymphoma nodes invasion.Conclusions Duodenal protuberant lesions cannot be confirmed by conventional endoscopic findings.Endoscopic ultrasonography may help to improve the diagnosis.Diagnosis should be confirmed by pathology.

Objective To investigate the growth inhibition and apoptosis induction effect of vitamin E succinate on MCF-7 human breast cancer cells and to analyze the modulation of Fas expression in this process. (Methods) Estrogen receptor positive MCF-7 human breast cancer cells were treated with VES for 12h, 24h and 48h. The concentrations of VES were 5?g/mL, 10?g/mL and 20?g/mL. The inhibitory effect was measured with MTT method and the cell cycle and cell surface Fas expression were analyzed with flow (cytometry). Fas protein level was detected by Western blotting assay. Results VES had significant inhibitory effect on the growth of MCF-7 human breast cancer cells and the effect was dependently related to time and dosage. The apoptotic rate rose from 1.2% to 11.2%,16.4%, 41.2%,after treated with VES for 48h at the concentrations of 5?g/mL,10?g/mL,20?g/mL respectively. Fas protein level and cell (surface) Fas expression in cancer cells increased after the administration of VES. Conclusions VES had (significant) growth inhibition and apoptosis induction effect on MCF-7 estrogen receptor positive breast cancer cells. The mechanism was related to Fas upregulation on the surface of cancer cells.

Objective To explore the correlation between the expression of hypoxia-inducihle factor-1α (HIF-1α) in the tissue of gastric cancer and the recurrence of gastric cancer after surgery.Methods A total of sixty patients with gastric cancer who received curative gastrectomy with complete follow-up data and recurrence after the surgery were taken as recurrence group.At same period,48 patients with gastric cancer treated and followed up for five years without recurrence were set as control group.The expressions of HIF-1α,CD34 and vascular endothelial growth factor (VEGF) in the gastric tissue section of recurrence group and control group were detected by immunohistochemistry streptavidin-peroxidase (S-P) staining.Chi-square test and Spearman correlation analysis were performed for the correlation analysis between the positive rates of HIF-1α and clinical pathological features.Kaplan-Meier method and Log-rank test were used for the analysis of survival condition in recurrence group.The independent prognostic factors of gastric cancer were analyzed by univariate analysis and Cox regression model.Results In recurrence group,the positive rate of HIF-1α expression was higher in cases with higher degree of gastric cancer differentiation,deeper invasion,lymph node metastasis,ascites,vascular invasion,lower TNM-stage and positive expression of VEGF.The differences were statistically significant (x2 =4.781,6.591,6.567,5.138,5.320,5.881 and 7.365,all P＜0.05).The positive rate of HIF-1α expression of recurrence group was correlated with the positive expression of VEGF and microvascular density (MVD) (r=0.350 and 0.317,both P＜0.05).The positive rate of HIF-1α expression of recurrence group (78.3％,47/60) was higher than that of control group (58.3 ％,28/48) and the difference was statistically significant (x2 =5.027,P＜0.05).The overall survival period of recurrence was nine months and one-year survival rate was 30.0％.Of which,the overall survival period and one-year survival rate of cases with negative HIF-1α expression were 18 months and 53.8％ and with positive expression were eight months and 21.3％.HIF-1α expression was independent prognostic factor of gastric cancer (OR =2.166,95％CI:1.183 to 3.965).Conclusions The expression of HIF-1α plays an important role in the angiogenesis of gastric cancer and is closely related with gastric cancer recurrence.Its expression can be considered as an indicator of gastric cancer recurrence and prognosis.

Objective: To investigate the growth inhibition and apoptosis induction effect of vitamin E succinate (VES) on human colon cancer cells and to analyze the modulation of apoptosis-mediator Fas expression in this process. Methods: Human colon cancer cell line LS174T was treated with VES for 12 h, 24 h and 48 h at the concentrations of 5 mg/L, 10 mg/L and 20mg/L. 1-(4,5-dimethylthiazo-2-yl)-3,5-diphenylformazan (MTT) assay was employed to detect the inhibitory effect of VES on the growth of colon cancer cells. Flow cytometry was then used to analyze the cell cycle of the colon cancer cells after being treated with VES and the apoptotic rate was calculated at the same time. To find out whether the Fas protein expression was modulated in this process, Western blotting assay and flow cytometry were used to detect the Fas protein level in whole cell lystates and on cell surface. Results: VES exhibited a significant inhibitory effect on the growth of human colon cancer cells in a doseand time-dependent manner. After being treated with VES at 5 mg/L, 10 mg/L and 20 mg/L for 48 h, the apoptotic rate of LS174T cells rose from 0.90% to 15.9%, 46.7% and 64.5%, respectively. Fas neutralizing antibody can significantly block VES-induced apoptosis. After the administration of VES, total Fas protein in whole-cell extracts increased in a dose-dependent manner. The flow cytometry showed that the mean fluorescence intensity rose from 5.43 to 9.88, 13.21 and 18.0 after being treated with VES. Conclusion: VES can induce significant growth inhibition and apoptosis in human colon cancer cells. The modulation of Fas expression is one of the mechanisms involved in this process and may be related to the upregulation of Fas molecule on the cancer cell surface.

Objective To investigate the incidence of Mycobacterium tuberculosis (TB) infection among human immunodeficiency virus (HIV)-infected individuals in Shanghai and Yunnan Province and to analyze the risk factors of TB infection.Methods Seventy HIV-infected individuals from Yunnan Province and 67 from Shanghai were enrolled.T-SPOT.TB was employed to detect TB-specific T cells in the peripheral blood mononuclear cells (PBMC).CD4+ and CD8+ T cells in PBMC from the enrolled subjects were detected by flow cytometry.Data were analyzed using Mann-Whitney test,Fisher's exact test and Logistic regression.Results The incidence of latent tuberculosis (LTB) infection among HIV-infected individuals in Yunnan Province was 64.3 ％ (45/70),which was much higher than Shanghai (20.8％ [14/ 67]).The median CD4+ T cell count of HIV-infected individuals with LTB infection in Yunnan Province was 509/μL,while that in Shanghai was 324/μL,which was significant different (U=148,P=0.003).The median CD4+ T cell count in HIV single infected individuals from Yunnan Province was 418/μL,which was not significantly different from that of H IV + LTB individuals from that area (U =378,P =0.120).Moreover,the median CD8+ T cell counts of HIV-infected individuals with latent tuberculosis infection in Yunnan Province and Shanghai were 409/μL and 781/μL,respectively (U=109,P＜0.01).Conclusions The incidence of LTB infection among HIV-infected individuals in Yunnan Province is significantly higher than Shanghai.CD4+ and CD8+ T cell counts are correlated with TB infection among HIV-infected individuals.

ObjectiveTo evaluate the advantages and disadvantages of endoscopic thyroidectomy by the breast approach. MethodsFrom August 2002 to April 2003, sixty single thyroid nodule patients were divided into 2 groups randomly. Group 1 (30 patients) received endoscopic thyroidectomy(ET) by the breast approach. The other 30 patients underwent conventional thyroidectomy(CT). Preoperative diagnosis,operative time,operative cost,postoperative pain,complications,and cosmetic result between the 2 groups were compared. ResultsOperative time was 118.0?34.3 minutes for ET group and 80.0?23.5 minutes for CT group( P

Objective To investigate the inhibitory effect of vitamin E succinate(VES) combined with ~chemotherapeutic drugs on the proliferation of human breast cancer cells. Methods Bcap-37 human breast cancer cells were treated with VES combined with chemotherapeutic drugs for 24h and 36h. The ~concentrations of VES were 10?g/mL and 20?g/mL and those of 5-florouracil, mitomycin and ~cyclophosphamide were 16.9?g/mL and 33.8?g/mL, 1?g/mL and 3.3?g/mL and 100?g/mL and 300?g/mL respectively. The inhibitory effect was measured with MTT method and the cell cycle and cell ~surface Fas expression were analyzed with flow cytometry assay. Results The combination of VES with ~chemotherapeutic drugs had a significant inhibitory effect on the growth of Bcap-37 human breast cancer cells. Flow cytometry assay of cell cycle showed that the natural apoptptic rate of Bcap-37 cells was 0.7%;after treatment with VES 20?g/mL,the apoptotic rate was 19.2%;after treatment with 5-Fu,mitomycin and ~cyclophosphamide the apoptotic rates were 16.2%,16.7% and 12.3%,respectively;after the combined use of VES and the 3 chemotherapeutic drugs,the apoptotic rates were 40.3%,44.8%,39.6%,~respectively .Fas expression in cancer cells increased after the co-administration of VES and chemotherapy drugs. Conclusions VES combined with chemotherapeutic drugs had significant inhibitory effect on the growth of Bcap-37 human breast cancer cells. The mechanism may be related to Fas upregulation on the surface of cancer cells.

Objective To investigate the inhibitory effect of vitamin E succinate(VES) on experimental breast cancer in nude mice.Methods MCF-7 human breast cancer cells were inoculated subcutaneously in nude mice.VES was administrated at a dosage of 150mg/kg body weight for 5 weeks.Then,the size of the tumor was measured and cell cycle and cell surface Fas/FasL were detected by flow cytometry.Fas/FasL expression in tumor tissue was detected with immunohistochemistry,and apoptosis index was detected by TUNEL method.Results VES showed obviously inhibitory effect on the growth of graft breast cancer tumor in vivo.VES treatment blocked tumor cells in G_0/G_1 phase.Fas/FasL expression was up-regulated accompanied with a rise of apoptotic index in tumor tissue.Conclusions VES had potent inhibitory effect on MCF-7 breast cancer graft in nude mice.The mechanism involved may be related to the up-regulation of Fas/FasL expression and promotion of apoptosis of tumor cells.

OBJECTIVETo explore the correlation between methylation of insulin-like growth factor 1 (IGF-1) gene promoter and its placenta-specific expression and fetal macrosoma.

METHODSOne hundred twenty nine healthy pregnant women were recruited between April 2011 and March 2012. Baseline data were collected with self-report questionnaires. Real-time quantitative PCR was used to determine the expression of IGF-1 mRNA in the placenta. Methylation level of the IGF 1 gene was determined with matrix-assisted laser desorption/ionization-time of flight mass spectrometry.

RESULTSThe expression of IGF-1 in placenta and its methylation level showed no significant difference between macrosomic fetuses and controls. No linear correlation was found between IGF-1 mRNA expression and methylation level of IGF-1 promoter (r=0.128, P=0.295). IGF-1 promoter region in placenta showed a hypomethylation status. However, a positive correlation was found between IGF-1 expression and birth weight below 4260 g (r=0.264, P=0.022). The expression of IGF-1 mRNA was significantly higher in those with a birth weight below 4260 g, which suggested that placental IGF-1 expression may contribute to increased birth weight. In regard to fetal overgrowth, however, there seemed to be a negative correlation in which placental IGF-1 expression was downregulated to limit fetal overgrowth.

CONCLUSIONNo linear correlation was found between placental IGF-1 expression and methylation level of IGF-1 promoter with a hypomethylation status. The contribution of placental IGF-1 expression to birth weight is bidirectional. Increased expression seems to promote fetal growth, while decreased expressions may curb overgrowth, therefore control fetal growth in a relatively normal range.

Birth Weight ; DNA Methylation ; Female ; Fetal Macrosomia ; genetics ; Humans ; Infant, Newborn ; Insulin-Like Growth Factor I ; genetics ; Placenta ; metabolism ; Pregnancy ; Promoter Regions, Genetic ; RNA, Messenger ; analysis

Furthering healthcare reform calls for public hospitals to curb unreasonable growth of medical expenses,reduce drug proportion,and lower the costs of medical materials consumed per 100 RMB medical income.In view of the hospital,the authors established a data-based monitoring system for key indicators of medical consumables,formulated an evaluation scheme of rational use,and implemented the corresponding control measures,which provide a reference for scientific control of clinical rational use of the medical consumables.