Objective Although the correlation between high risk human papilloma virus (hrHPV) infection and cervical cancer ( CC ) or cervical intraepithelial neoplasia ( CIN ) is well known , vaginal cancer ( VC ) or vaginal intraepithelial neoplasia ( VAIN) also caused by hrHPV has not received enough attention .This article aims to explore the clinical characteristics of VC or VAIN after operations of CC or CIN in order to provide evidence for the treatment of these diseases . Methods The clinical charac-teristics and treatment of 15 cases with VC or VAIN after operations of CC or CIN were reviewed from Jan 2010 to May 2013 in our hos-pital. Results The mean age was (53.6 ±10.82) years, ranged from 39 to 73 years.The duration from the first operation to devel-oped VAIN or VC was (25.07 ±18.31) months, ranged from 1 to 60 months.There are 4 cases developed VC, 4 cases VAINⅢand 2 cases VINⅡfrom 10 CC patients;and 3 cases developed VC , 2 cases VAINⅢfrom 5 CINⅢpatients.hrHPV test were positive in all 15 patients.Treatment in these series were performed including total vaginectomy in 8 patients (3 VC, 4 VAINⅢ and 1 VAINⅡpatients), pelvic lymphonectomy in 1;upper vaginectomy in 2 patients (1 VC, 1 VAINⅢ), radiation or chemo-radiation therapy in 3 (3 VC), interferon muscle injection combined with topical application of estrogen and acyclovir gel in 2 (1 VC, 1 VAINⅡ). Conclusion Careful follow-up after CC or CIN operations are very important because continued hrHPV infection may result VC and VAIN lesions.Vaginectomy may be the best therapy .Interferon muscle injection combined with topical application of estrogen and acyclovir gel are also alternatively therapy , especially for hard to operate patients . Radiation therapy seems to be not very adaptable for VAIN patients .

Background: According to the 7th edition of the American Joint Committee on Cancer (AJCC) staging system, over 50% of patients with nasopharyngeal carcinoma (NPC) have N1 disease at initial diagnosis. However, patients with N1 NPC are relatively under-researched, and the metastasis risk of this group is not well-stratified. This study aimed to evaluate the prognostic values of gross tumor volume of metastatic regional lymph node (GTVnd) and pretreatment serum copy number of Epstein–Barr virus (EBV) DNA in predicting distant metastasis of patients with N1 NPC, and to develop an integrated prognostic model that incorporates GTVnd and EBV DNA copy number for this group of patients. Methods: The medical records of 787 newly diagnosed patients with nonmetastatic, histologically proven N1 NPC who were treated at Sun Yat-sen University Cancer Center between November 2009 and February 2012 were ana-lyzed. Computed tomography-derived GTVnd was measured using the summation-of-area technique. Blood sam-ples were collected before treatment to quantify plasma EBV DNA. The receiver operating characteristic (ROC) curve analysis was used to evaluate the cut-off point for GTVnd, and the area under the ROC curve was used to assess the predicted validity of GTVnd. The survival rates were assessed by Kaplan–Meier analysis, and the survival curves were compared using a log-rank test. Multivariate analysis was conducted using the Cox proportional hazard regression model. Results: The 5-year distant metastasis-free survival (DMFS) rates for patients with GTVnd > 18.9 vs. ≤ 18.9 mL were 82.2% vs. 93.2% (P < 0.001), and for patients with EBV DNA copy number > 4000 vs. ≤ 4000 copies/mL were 83.5% vs. 93.9% (P < 0.001). After adjusting for GTVnd, EBV DNA copy number, and T category in the Cox regression model, both GTVnd > 18.9 mL and EBV DNA copy number > 4000 copies/mL were significantly associated with poor prognosis(both P < 0.05). According to combination of GTVnd and EBV DNA copy number, all patients were divided into low-, moderate-, and high-risk groups, with the 5-year DMFS rates of 96.1, 87.4, and 73.8%, respectively (P < 0.001). Multi-variate analysis confirmed the prognostic value of this model for distant metastatic risk stratification (hazard ratio [HR], 4.17; 95% confidence interval [CI] 2.34–7.59; P < 0.001). Conclusions: GTVnd and serum EBV DNA copy number are independent prognostic factors for predicting distant metastasis in NPC patients with N1 disease. The prognostic model incorporating GTVnd and EBV DNA copy number may improve metastatic risk stratification for this group of patients.

Animals ; Ginsenosides ; pharmacology ; Hypertension, Pulmonary ; etiology ; metabolism ; Hypoxia ; complications ; metabolism ; Lung ; drug effects ; metabolism ; MAP Kinase Signaling System ; Male ; Panax ; Rats ; Rats, Sprague-Dawley

V-erb-a erythroblastic leukemia viral oncogene homolog 4 (ERBB4) has been reported to be somatically mutated in 19% of melanoma cases. To investigate the prevalence of ERBB4 mutations in melanoma patients from southern China, we analyzed 117 formalin-fixed, paraffin-embedded melanoma samples archived in the Sun Yat-sen University Cancer Center. A matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) platform was used to screen for mutations. No ERBB4 hotspot mutations were detected. Our results indicate that ERBB4 mutations may play a limited role in melanomas in China; therefore, targeting the ERBB4 mutation in melanoma patients from southern China may not be a promising strategy.
Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; genetics ; DNA, Neoplasm ; genetics ; Extremities ; Female ; Humans ; Male ; Melanoma ; genetics ; metabolism ; Middle Aged ; Mucous Membrane ; Mutation ; Paraffin Embedding ; Receptor, Epidermal Growth Factor ; genetics ; metabolism ; Receptor, ErbB-4 ; Skin Neoplasms ; genetics ; metabolism ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization

Objective·To investigate the influence of blocking receptor for advanced glycation end products (RAGE) on macrophages infiltration in diabetic wound healing. Methods·Ninety-six male C57BL/6J mice (8-week-old) were divided into diabetic group (n=72) and normal group (n=24) randomly. Diabetic mice were induced by streptozocin multiple intraperitoneal injection. One full-thickness excisional wound (diameter of 9 mm) was created by a sterilized punch. Diabetic mice were divided into 3 groups in which different topical treatments were applied to the wounds. Anti-RAGE antibody were applied in group R, rabbit IgG applied in group I, normal saline applied in group C. Normal mice were applied with saline topically (group N). All treatments were repeated on day 3 and day 7 after wounded. The wound healing conditions were observed. The wound and surrounding tissues from animals in each group were excised on day 1, 3, and 7 after wounded. Immunohistochemistry was utilized to investigate the changes of macrophages infiltration in quantity. Macrophages were also analyzed with respect to morphology by transmission electron microscopy (TEM). Results·① The wound closure ratio of group R was higher than those of group C and group I on day 14 after being wounded (P=0.000). ② On day 1, the numbers of macrophages in group R and group N were both bigger than those of group C and group I, but smaller on day 14 (P=0.000). ③ The morphological characters of macrophages also existed great differences under TEM. Conclusion·Number and morphology of macrophages are both abnormal in diabetic wound in a RAGE pathway depending manner. Based on macrophages, it suggests that impaired healing of diabetic wound is closely related to RAGE pathway.

Repeated acute intermittent hypoxia promotes the expression of growth factors and neurotrophic factors, as well as the key molecules for neural protection and plasticity. Hypoxic preconditioning may improve the survival rate of transplant-ed stem cells and protect the neural function. Meanwhile, acute intermittent hypoxia can be an approach to improve re-spiratory function after spinal cord injury. Hyperbaric oxygen may improve the neural tolerance to hypoxia and isch-emia, to protect the structure of cells and tissues, and promote the neuranagenesis. It is important to study the role of hy-poxic and hyperoxic preconditioning in spinal cord injury.

With aging of Chinese population,prevalence of vascular cognitive impairment(VCI)is increasing year by year.At present,drugs for VCI treatment at home and abroad still lack large samples of evidence-based medicine evidence.Compared with western medicine,Chinese medicine has characteristics of multi-component and multi-target.The present article makes a review on research progress of traditional Chinese medicine in treatment of VCI,aiming at providing new thinking for VCI treatment.

Objective To analysis the effects on the growth of rats by repeated restraint in dermal exposure test. Methods SD rats in the restraint group was bound for 6 hours per day for 91 days according the way by dermal exposure, while SD rats in the control group didn't receive the treatment. Clinical signs, body weight and food consumption changes were observed for 91 days. When the study was terminated, hematology, clinical biochemistry, urinalyses, gross necropsy, and histopathology were carried out. Statistical methods such as the generalized estimating equation were used to compare the differences between two groups. Results The statistical results of generalized estimating equation showed that there was an interaction between the group and test time for male and female rats in body weight changes (P<0.05), and the body weight of male rats in the restraint group was lower than the control group (P<0.05) . Further analysis showed that for male rats there was significant difference between groups since the forth week (P<0.05), and the interaction was found between groups and test time (P<0.05) . For female rats, the interaction was found since the eighth week between the group and test time (P <0.05) .There was no significant differences in other parameters between two groups (P>0.05) . Conclusion Repeated restraint during dermal exposure affected the body weight gain of rats, and the sensitivity of male rats was higher than that of female rats.

Objective To analyze the status of prediction and prevention for pressure ulcers in comprehensive hospitals in order to get suggestions for pressure ulcers.Methods Using consensus investigating times,tools,ways and procedure flows and judgment criteria,and organizing 457 nurses who trained and passed examination to do a cross-sectional investigation for condition of prediction and prevention for pressure ulcers in 12 comprehensive acute care hospitals.Data were calculated by SPSS 16.0 statistic software.Results Totals of 39 952 cases run into the database,the prevalence of pressure ulcers was 1.579％ and the incidence of hospital-acquired pressure ulcers was 0.628 ％ (251/39 952).Out of patients with Braden scale ≤ 16 points totally 4 710 cases,the first assessment rate was 50.235％ and reassessment rate was 56.645％.The first assessment rate of 380 patients found out pressure ulcers on admission was 87.38％ and reassessment rate was 90.842％.The reassessment rate of 251 patients with hospital-acquired pressure ulcers was 95.219％.The first assessment rate of 1 094 critical care patients on admission was 94％ and reassessment rate was 69.104％.The application rate of support surfaces or devices on beds and chairs for 4 710 patients with risk of pressure ulcers was 61.805％and 3.652％,respectively.The regular changing position rate on beds and chairs for 4 710 patients with risk of pressure ulcers was 75.138％ and 7.834％ respectively.The difference of Braden scores by clinical nurses and trained wound care team nurses was significant [(14.01 ± 3.54) vs (3.29 ± 3.54) ;t =3.221,P ＜ 0.01].Pressure ulcer risk patients use decompression pad status and timing change positions comparative differences were statistically significant (P ＜ 0.01).Conclusions The results of prediction and prevention for pressure ulcers in twelve comprehensive hospitals did not meet the guidelines' aim.It is important to set up the organized frame and train different professional nurses for preventing pressure ulcers,and enhance clinical nurses' recognition to prevent pressure ulcers,check and guide them regularly.

OBJECTIVETo investigate and compare the clinical implications of p16 deletion in childhood and adult B-lineage acute lymphoblastic leukemia (B-ALL).

METHODSA total of 129 cases of de novo childhood (73 cases) and adult (56 cases) B-ALL were examined genetically and immunologically using G-banding techniqhe, interphase fluorescence in situ hybridization (I-FISH) and immunophenotyping by flow cytometry, and their clinical data were retrospectively analyzed.

RESULTSOf 73 childhood cases, the prevalences of homozygous deletion, hemizygous deletion and no deletion of p16 were 24.7% (18 cases), 6.8% (5 cases) and 68.5% (50 cases) respectively, and of 56 adult cases, the incidences as of 14.3% (8 cases), 8.9% (5 cases) and 76.8% (43 cases) respectively. The incidence of p16 deletion between the two groups had no significant difference (P = 0.338). In both groups, patients with or without p16 deletion had no significant difference in terms of white blood cells (WBC) count at diagnosis, BM blast percentage, chromosome karyotype, extra-infiltration and CR1 rate. Of note, there were 2 cases, each in childhood and adult, showed no deletion at the time of diagnosis, their p16 deletions occurred at relapse. The deletion of p16 was associated with poor overall survival and event-free survival (EFS) in both childhood and adults. According to the standard of NCI risk stratification, we divided patients of two groups into standard and high risk category respectively, and performed further analysis. The significance of different risk category in children and adults was disparity. The overall survival (OS) rates of deletion and no deletion of p16 were 45.3% and 79.8% (P = 0.006) in children, and 7.7% and 22.6% (P = 0.002) in adults, respectively. EFS rates of deletion and no deletion of p16 were 33.5% and 58.1% (P = 0.008) in children, and 0 and 10.9% (P < 0.01) in adults, respectively. Of the standard risk category in children, OS rates of deletion and no deletion of p16 were 46.8% and 89.3% (P = 0.015) respectively, and EFS rates of deletion and no deletion of p16 as of 40.9% and 82.1% (P = 0.007) respectively. Of the high risk category in children, OS rates of deletion and no deletion of p16 were 41.7% and 67.4% (P = 0.193) respectively, and EFS rates of deletion and no deletion of p16 were 25.0% and 25.6% (P = 0.305) respectively. Of the standard risk category in adults, OS rates of deletion and no deletion of p16 were 20.0% and 46.9% (P = 0.092) respectively, and EFS rates of deletion and no deletion of p16 were 0 and 25.0% (P = 0.062) respectively. Of the high risk category in adults, OS rates of deletion and no deletion of p16 were 0 and 12.4% (P < 0.001) respectively, and EFS rate of deletion and no deletion of p16 was 0 and 4.8%(P < 0.001), respectively.

CONCLUSIONThis study indicated that deletion of p16 was associated with poor prognosis in both childhood and adult B-ALL, which highlighted an important significance to define the status of p16 in both childhood and adult B-ALL for predicting prognosis and guiding clinical intervention.

Adult ; Child ; Female ; Gene Deletion ; Genes, p16 ; Humans ; Male ; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Prognosis ; Retrospective Studies