Objective To analyze the incidence and risk factors for regional nodal failure(RNF) and chest wall recurrence(CWR) in T1 or T2 breast cancer patients(median age 44 year-range 26-72) with 1-3 positive axillary nodes treated with postmastectomy radiotherapy limited to the regional nodes.Methods From 1990 to 1999,320 patients were treated with postmastectomy(radical or modified radical) radiother- apy confined to the supraclavicular and internal mammary nodes with a median dose of 50 Gy in 25 fractions over 5 weeks.The median number of nodes examined was 8 (range 1-24).The median lymph nods rate (LNR) was 25% (range 5%-100%).Results The 5-year overall survival rate and disease free survival rate was 89.7% and 83.4%,respectively.The 5-year RNF and CWR was 7.9% and 5.7%,respectively. The 5-year RNF in patients with LNR＜30% and≥30% was 4.4% and 14.0% (P=0.002).The 5-year CWR in the subgroups with LNR＜30% and≥30% was 3.5% and 9.6% (P=0.018).In age≤35 year eld patients with LNR≥30%,the 5-year RNF and CWR was 40.0% and 20.0%.In T2 patients with LNR≥30%,the 5-year RNF and CWR was 15.8% and 12.2%.Age and LNR were independent prognostic factors for RNF+CWR,LNR was the only independent prognostic factor for CWR by multivariate analysis. Conclusions In T1 or T2 breast cancer patients with 1-3 positive axiliary nodes treated with radical or modified radical mastectomy,a relatively high incidence of chest wall recurrence is observed in the subgroup of patients with lymph nods rate of 30% or greater accompanied by a T2 primary tumor or age≤35 years old. Lymph nodes rate is the only significant prognostic factor of chest wall recurrence.For these patients,post- operative lymphatic drainage area and chest wall irradiation should be considered.

Objective To construct an hybrid bioartificial liver supporting system,and observe its effectiveness and safety on patients with acute on chronic liver failure.Methods Hybrid bioartificial liver supporting system (HBALSS) was constructed using bioreactor with HepG2 cells transfected with human augmenter of liver regeneration (hALR) gene.12 acute on chronic liver failure patients were divided into 2 groups randomly.The treatment group was treated with the hybrid bioartificial liver support system.The group underwent plasma exchange was used as control.Results In the treatment group,four patients recovered,one patient died of hepatic encephalopathy,one patient died of hepatorenal syndrome,one patient recovered,but died of gastrointestnal bleeding after 1 year.In control group,two patients recovered,one patient underwent orthotropic liver transplantation,and three patients died of liver failure.Conclusion The hybrid bioartificial liver supporting system with HepG2 cell line was established successfully and have certain safety and effectiveness on acute on chronic liver failure patients.

Objective To study the clinical characteristics of hepatitis B virus-related acute-on-chronic liver failure patients with familial aggregation.Methods 275 patients with hepatitis B virus - related acute-on-chronic liver failure were investigated.The patients were divided into familial aggregation and nonfamilial aggregation group basis on their epidemiological features.Clinical data and biochemical indicators between the two groups were analyzed statistically.Results 93 of 275 patients( 33.82％ ) case were family aggregation.There was no significant difference compared with chronic hepatitis B patients( 38.3％ ).The mean age of the two groups was 45.98 and 43.61 years old,respectively (P ＞ 0.05 ).The rates of liver cirrhosis in family aggregation group were significant higher than non - familial aggregation group( 73.91％ vs 58.24％,p ＜ 0.05 ).Serum total (TBil) and prothrombin activities ( PTA ) were no significant difference between the two groups,but ALT level in familial aggregation group was much higher (407.80U/L vs 256.45 U/L,P0.05 ).Conclusion Familial aggregation were not related to acute-on-chronic liver failure in chronic HBV hepatitis patients. But the rate of liver cirrhosis were higher in patients with familial aggregation.

OBJECTIVETo explore the preventive and treatment effects of smectite powder on enteral bacterial translocation in scalded rats.

METHODSFifty-four Sprague-Dawley (SD) rats were randomly divided into three groups, i.e. normal control (A, n = 6), burn control (B, n = 24), and burn treatment (T, n = 24) groups. The rats in B and T groups were fed with tracing bacteria JM109, which was transfected with PUC19 plasmid in advance. The rats were subjected to 30% TBSA scald injury after the plasmid was shown to have colonized in the intestine. Smectite powder (0.6 g/day/kg) was fed to rats of T group immediately after the scalding, while those in B group received no smectite powder. Bacterial translocation in blood and mesenteric lymph nodes in all groups was observed and identified by enzyme digestion at 12 post scald hour (PSH) and on 1, 3 and 5 post-scald days (PSD). The contents of malondialdehyde (MDA) and superoxide dismutase (SOD) were determined in rat intestinal tissue. And the degree of injury to the entire small intestine was observed pathologically. The villus height of intestinal mucosa was measured, and the rate of epithelial nuclear splitting of mucosal crypts was calculated.

RESULTSThe number of rats with positive blood bacterial culture in B group was obviously higher than that in A and T groups (P < 0.05) on 1 and 5 PSD. The bacterial quantity in mesenteric lymph nodes (MLN) in T group on 1 PSD (38 +/- 16 CFU/g) and 5 PSD (68 +/- 20 CFU/g) were obviously lower than those in B group (228 +/- 67 vs 183 +/- 29 CFU/g, P < 0.05). There was significant difference in the intestinal contents of MDA and SOD between B and T groups at each time point (P < 0.05). The rat jejunum villus height and the epithelial nuclear splitting in the small intestine mucosa in T group were evidently higher than those in B group (P < 0.05 or 0.01).

CONCLUSIONSmectite powder is beneficial to the protection of the intestinal mucosa in scalded rats, and can effectively prevent postburn intestinal bacterial translocation in rats.

Animals ; Bacterial Translocation ; Burns ; drug therapy ; microbiology ; Intestinal Mucosa ; microbiology ; pathology ; Rats ; Rats, Sprague-Dawley ; Silicates ; therapeutic use

Hepatocytes act as a reservoir for the human immunodeficiency viruses (HIV) and are responsible for its continual dissemination in the peripheral circulation. For this reason, galactosylated liposomes (GalLs) containing home-made [(2-lactoylamido) ethylamino] formic acid cholesterol ester (CH-ED-LA ) as a homing device were prepared to study the biodistribution of the liposomal azidothymidine palmitate (AZTP) in mice. Four liposomes of the present study, soybean phosphatidylcholine (SPC)/cholesterol(CH)/CH-ED-LA (80 : 10: 10, 10% GalLs), SPC/CH/CH-ED-LA (80 : 15:5, 5% GalLs), SPC/CH/CH-ED-LA (80 : 17 : 3, 3% GallLs) and SPC/CH (80 : 20, CL) incorporated AZTP were prepared by ethanol-injection method followed by ultrasonic-dispersion and characterized by entrapped efficiency which was more than 95% and their mean diameter was less than 100 nm, respectively. The effects of the addition upon the liposomal membrane potential and AZTP content were also unseen. The distributions of AZT in various organs were determinated by reversed phase HPLC after intravenous administration via tail vein in mice, at a dose of 15.85 mg x kg(-1) AZT solution and 30 mg x kg(-1) AZTP (at equimolar doses) in CL or GalLs, respectively. Compared to AZT control solution, the half-life of AZT in each group of AZTP liposomes increased significantly (P < 0.05). In addition, the concentration-averaged overall drug targeting efficiency (r(e)) of the liver presented by AZTP CL and GalLs containing 3% , 5% , 10% (mol/mol) CH-ED-LA increased 1.32 and 1.48, 2.13, 1.50 times as that of AZT solution, respectively. These results indicate that liposomes containing such novel galactosylated lipid, CH-ED-LA, had remarkably improved the targetability of AZTP to liver, and are anticipated to be a potential candidate for liver targeting delivery carriers.
Animals ; Anti-HIV Agents ; administration & dosage ; pharmacokinetics ; Cholesterol ; analogs & derivatives ; chemistry ; Drug Carriers ; Drug Compounding ; Drug Delivery Systems ; Female ; Injections, Intravenous ; Liposomes ; chemistry ; Liver ; metabolism ; Male ; Mice ; Palmitates ; administration & dosage ; pharmacokinetics ; Particle Size ; Random Allocation ; Tissue Distribution ; Zidovudine ; administration & dosage ; pharmacokinetics

OBJECTIVETo observe the effect of acupuncture on proliferation and differentiation of neural stem cells in brain tissues of rats with traumatic brain injuny.

METHODSThirty SD rats were randomly and equally allocated to the sham-operated, the model and the acupuncture groups. The traumatic brain injury model was established by the free drop method. For the rats in the acupuncture group, acupuncture was applied once a day for 7 days. Brain histotomy was carried out when treatments were completed. Immunohistochemical techniques were adopted to detect the cells that express nestin, neurofilament proteins (NF)-200 and glial fibrillary acidic proteins (GFAP), the markers of neural stem cells, neurons, astrocytes respectively.

RESULTSCompared to the sham-operated group, the number of nestin-positive cells and NF-200-positive cells in brain tissues was decreased significantly in the model group (P < 0.01), whereas the number of GFAP-positive cells was significantly increased P<0.01). Compared to the model group, the positive cells of nestin, NF-200, GFAP in brain tissues in the acupuncture group were increased obviously (P<0.01).

CONCLUSIONSAcupuncture can significantly increase the number of nestin-positive cells, NF-200-positive cells and GFAP-positive cells, indicating the significant increase of neural stem cells, neurons and astrocytes in number. Acupuncture can improve neuranagenesis by promoting the proliferation and differentiation of neural stem cells in brain tissues. This might be one of the mechanisms for acupuncture to treat traumatic brain injury and to promote the repair of nervous function.

Acupuncture Therapy ; Animals ; Brain ; pathology ; Brain Injuries ; pathology ; therapy ; Cell Differentiation ; Cell Proliferation ; Cerebral Cortex ; pathology ; Glial Fibrillary Acidic Protein ; metabolism ; Intermediate Filament Proteins ; metabolism ; Male ; Nerve Tissue Proteins ; metabolism ; Nestin ; Neural Stem Cells ; metabolism ; pathology ; Neurofilament Proteins ; metabolism ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo investigate the correlation between vascular remodeling index (RI) and serum adiponectin, plasma monocyte chemoattractant protein-1 (MCP-1), endothelial function and evaluate the mechanism of coronary in-stent restenosis.

METHODSRI 6 months after percutaneous coronary intervention (PCI), serum adiponectin, plasma MCP-1 and flow-mediated dilation (FMD) before and 3 days,6 months after PCI were measured in 30 patients with and 30 without coronary in-stent restenosis.

RESULTSCompared with patients without restenosis and those with restenosis before PCI, the patients with coronary in-stent restenosis showed significantly increased plasma MCP-1 3 days and 6 months after PCI (P<0.05) and reduced RI 6 months after PCI, serum adiponectin and FMD 3 days and 6 months after PCI (P<0.05). RI was positively correlated to serum adiponectin and FMD and inversely to MCP-1.

CONCLUSIONThe occurrence of coronary in-stent restenosis is the result of the interrelations between multiple factors.

Adiponectin ; blood ; Adult ; Aged ; Angioplasty, Balloon, Coronary ; Chemokine CCL2 ; blood ; Coronary Disease ; blood ; physiopathology ; therapy ; Coronary Restenosis ; blood ; etiology ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Stents ; adverse effects

Objective：This study was designed to establish a salivary EBV-EA IgA and DNase IgA test technique, and seek a fast and specific diagnostic technique for nasopharyngeal carcinoma (NPC). Methods：Polypeptides of EBV-DNase(ED) and EA-D was synthesized as catching antigens. With ELISA technique, IgA/ED and IgA/EA-D were evaluated respectively in saliva and serum from NPC patients and healthy volunteers. Results：After statistic analysis of the optical density(OD) values of samples, the diagnostic criteria of NPC in the examination of either IgA/ED or IgA/EA-D was defined as following：OD≥ 0.3 for serum and OD≥ 0.45 for saliva. Significantly statistical difference existed between the values of either IgA/ED or IgA/EA-D titer in patients with NPC and the values in healthy volunteers,P<0.0001. The coincidence rates between the diagnosis of above IgA/ED or IgA/EA-D titer testes and corresponding histological diagnosis were 72.6％ － 77.3％ . Conclusion： The Elisa test to detect salivary IgA/ED and IgA/EA-D with synthesized polypeptides is a simple, repeatable, and cheap technique with stability and sensitivity. However its coincidence rate with histology should be improved.?

OBJECTIVETo assess the spermatogenic function of the infertile patients with Y-chromosomal microdeletion.

METHODSThirty-five 23-44 years old patients with microdeletions of Y chromosome were included in this study. Three semen analyses confirmed that 26 cases were non-obstructive azoospermia and 9 oligospermia with sperm count < 1 x 10(6)/ml. They were divided into 3 groups by the locus of deletion, 5 cases of AZFa + b + c deletion in group 1, 4 cases of AZFb + c and 3 cases of AZFb deletion in group 2, and 23 cases of AZFc deletion in group 3. Semen was collected and centrifuged, the supernatant removed and the centrifugate applied on the clean slides after dilution. Following Wright's-Giemsa staining, the slides were viewed under the microscope. Testis histopathological biopsy was performed for 6 of the cases.

RESULTSIn group 1, no spermatogenic cells were observed but only Sertoli cells in 1 case, with a consistency between the result of spermatogenic cell test and that of testis biopsy. In group 2, spermatogenic cell tests revealed spermatocytes in 6 cases, 2 were proved by testis biopsy with sperm maturation arrest in the primary spermatocyte stage, and spermatogenic cells of all developmental stages were seen in 1 AZFb deletion patient with the same sperm maturation arrest as the above two. In group 3, only primary spermatocytes were detected by spermatogenic cell test in 5 oligospermia patients but no spermatogenic cells in the 15 azoospermia cases, and biopsy revealed 2 cases of Sertoli cell-only syndrome.

CONCLUSIONThe spermatogenic cell test can effectively assess the spermatogenic function of AZF deletion patients. Non-invasive and easily accepted by patients, it is highly recommendable for the evaluation of spermatogenesis of patients with Y-chromosomal microdeletion.

Adult ; Chromosome Deletion ; Chromosomes, Human, Y ; Humans ; Infertility, Male ; etiology ; genetics ; pathology ; Male ; Semen ; cytology ; Semen Analysis ; Testis ; pathology

OBJECTIVETo investigate the etiology, pathology, and clinical characteristics of cryptogenic liver diseases in order to develop a pathogenic profile for clinical diagnosis and therapeutic design.

METHODSThe data of the 566 patients diagnosed with abnormal liver function and who had undergone liver biopsy at our institute between January 2006 to March 2010 were retrospectively analyzed. The Chi-squared (x²) test was used to assess disease correlation with sex and the rank sum test was used to assess disease correlation with continuous data since all data had asymmetric distribution.

RESULTSAmong the 566 patients, abnormal liver function was attributed to alcoholic liver disease (n=175; 30.92%), drug-induced or environmentally-induced liver disease (n=101; 17.84%), hereditary and metabolic disease (n=93; 16.43%), infectious hepatitis disease (n=84; 14.84%), fatty liver disease (n=53; 9.36%), and autoimmune liver disease (n=30; 53.00%). Thirty patients had unknown etiology, despite liver biopsy analysis. Among these disease subgroups, there were distinct correlations with sex, age, and levels of alanine transaminase (ALT) and gamma-glutamyltransferase (GGT). The autoimmune liver disease group was correlated with sex (q=9.14, 7.435, 5.071, 9.529, and 12.5, respectively; P less than or equal to 0.01). The alcoholic liver disease group and autoimmune liver disease group were correlated with age (vs. genetic metabolic disease group: q=17.254 and 10.302; infectious hepatitis group: q=17.523 and 10.697); drug/environmentally-induced liver damage group: q=9.170 and 5.266); fatty liver group: q=7.118 and 4.661) (P less than or equal to 0.01). In addition, the alcoholic and autoimmune liver disease groups were correlated with GGT levels (vs. genetic metabolic disease group: q=8.003; infectious hepatitis group: q=4.793; drug/environmentally-induced liver damage group: q=4.404) (P less than or equal to 0.01).

CONCLUSIONLiver pathology is important for the diagnosis of cryptogenic liver diseases. Patient age, sex, and biochemistry index may facilitate diagnosis and treatment in the absence of pathology.

Adolescent ; Adult ; Biopsy ; Child ; Child, Preschool ; Female ; Humans ; Liver ; pathology ; Liver Diseases ; classification ; diagnosis ; pathology ; Male ; Middle Aged ; Young Adult