AIM: To establish the quality standard for Qingdai Powder (Indigo Naturalis, Radix Glycyrrhizae, Borax, Boreolum Syntheticum, Herba Menthae, Rhizoma Coptidis, Catechu, etc.) METHODS: Indigo Naturalis, Borneolum Syntheticum, Rhizoma Coptis, Radix Glycyrrhizae were indentified by TLC, and the content of indigo was determined by HPLC. RESULTS: Indigo Naturalis, Borneolum Syntheticum, Rhizoma Coptis, Radix Glycyrrhizae could be indentified by TLC. Indigo showed a good linear relationship at a rang of 27.35～ 410.25ng, r=0.9997. The average recovery of indigo was 99.03%( n =6) and RSD was 2.14%. CONCLUSION: The method is simple, accurate and high specificity with good repeatability. The method can be used for quality control of Qingdai Powder.

Objective To analyze the different spreading patterns and the prognostic factors of nasopharyngeal adenocarcinoma (NPAC).Methods The clinical and radiological data of 39 pathologically confirmed consecutive cases of NPAC were retrospectively reviewed.Results In the 1 1 patients with CT/MRI-detected cranial nerve (CN)involvement,there were ACC (n=7),CAC (n=2)and MEC (n=2)(P <0.05).Lymph node metastasis occurred in 40% of CAC,7.7% of ACC and 1 6.7% of MEC (P =0.035). Significant differences were observed in 5 year OS and DFS rates between patients with and without CT/MRI-detected CN involve-ment (P <0.001;P =0.001).In 1 9 patients with early stage disease (stageⅠ-Ⅱ),significant difference was observed in 5 year OS rate between the surgical treatment group and non-surgical treatment group (P =0.038),and the difference was not significant in DFS (P =0.056).Conclusion CT and MRI are valuable tools not only for discovering the different spreading patterns of NPAC, but also for its prognosis.

ObjectiveTo compare the levels of sFas in the sera among Kawasaki disease (KD),incomplete Kawasaki disease (IKD),and normal control groups,and to analyze the relationship of sFas with IKD children.MethodsA total of 32 cases of acute KD and acute IKD children,and 20 cases of the control children were selected,respectively.The levels of serum sFas among three groups were measured using ELISA kits.Each child among the three groups was examined by echocardiography.Results(1)The levels of serum sFas among the three groups were[ (0.54±0.20)ng/L in KD,(0.55±0.16)ng/L in IKD,and (0.24 ± 0.04) ng/L] in control group,respectively.The overall means of sFas in the KD and IKD groups were higher than the control group,and the differences were statistically significant( F=29.276,P＜0.05 ).(2)The levels of serum sFas among echocardiography abnormal and normal groups were[ (0.65±0.19) ng/L and (0.49±0.10)ng/L],respectively; and the difference between two groups were statistically significant ( t=3.139,P ＜ 0.05 ).ConclusionsThe expression levels of sFas in the peripheral serum of IKD children were increased,and there was a close association of overexpression of sFas with the cardiovascular damage in IKD children.

Objective To evaluate the role of necroptosis in intestinal ischemia-reperfusion (I/R) injury in rats.Methods Thirty-two healthy male Sprague-Dawley rats,weighing 200-220 g,were randomly assigned into 4 groups (n =.8 each) using a random number table:sham operation group (Sham group),I/R group,necroptosis inhibitor necrostatin-1 group (Nec-1 group) and solvent dimethyl sulfoxide (DMSO) group (group DMSO).Intestinal I/R injury was produced by clamping the superior mesenteric artery for 1 h followed by 24 h reperfusion in rats anesthetized with chloral hydrate.Necrostatin-1 1.0 mg/kg was administered intraperitoneally at 30 min before occlusion in Nec-1 group,while the equal volume of DMSO was given instead in group DMSO.The rats were sacrificed at 24 h of reperfusion and the intestinal tissues were removed for microscopic examination.Intestinal damage was assessed and scored according to Chiu.Blood samples were taken for determination of serum diamine oxidase (DAO) activity.The expression of activitied caspase-3 and receptor-interacting protein 1 (RIP1) in intestinal tissues was detected using Western blot.Results Compared with Sham group,Chiu's score,serum DAO activity,and the expression of activitied caspase-3 and RIP1 was up-regulated in I/R,DMSO and Nec-1 groups.Compared with I/R and DMSO groups,Chiu's score and DAO activity were significantly decreased,the expression of RIP1 was down-regulated,and no significant change was found in the expression of activitied caspase3 in group Nec-1.Conclusion Necroptosis is involved in intestinal I/R injury in rats.

OBJECTIVETo explore the risk factors associated with the prognosis in poorly differentiated(G3) advanced gastric cancer (AGC) and the effect of number of harvested lymph nodes on the prognosis.

METHODSClinical data of 484 patients with G3 advanced gastric cancer undergoing gastrectomy combined with lymphadenectomy in Zhongshan Hospital from December 2002 to October 2007 were retrospectively analyzed. The χ(2) test or Fisher's exact probability method was used to test measurement data. Survival was calculated using Kaplan-Meier method. Clinicopathological factors such as age, invasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node, lymphatic vessels involvement were analyzed using the Cox regression model.

RESULTSNumber of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly affected by groups of 15 lymph node dissected in G3 AGC patients (P<0.05). Invasion depth, number of lymph node dissected, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement were significantly independent predictors of survival in G3 AGC patients (all P<0.05). Patients with at least 20 lymph nodes had a better survival rate than those with less than 20(P<0.01).

CONCLUSIONSInvasion depth, number of harvested lymph nodes, lymph node metastasis, ratio of metastatic lymph node and lymphatic vessels involvement are important factors influencing the prognosis of G3 AGC. At least 20 lymph nodes should be recommended to ensure the quality of lymphadenectomy for gastric cancer.

Gastrectomy ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Prognosis ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; pathology ; surgery ; Survival Rate

OBJECTIVETo investigate the clinicopathological features of small gastrointestinal stromal tumors(GISTs) and to evaluate the efficacy of endoscopic therapy for GISTs.

METHODSClinicopathological and follow-up data of 418 patients with GISTs undergoing endoscopic therapy in the Zhongshan Hospital between January 2009 and July 2014 were analyzed retrospectively. All the cases were evaluated by the NIH risk classification and AIFP classification, and were grouped according to the tumor size and location. Nuclear atypia and mitotic count were used to evaluate the biological behavior of small GIST. Efficacy of endoscopic therapy was analyzed with follow-up data.

RESULTSOut of 418 patients, GISTs located in the esophagus was 14(3.3%), in the stomach 389(93.1%), in the duodenum 5(1.2%), in the rectum 10(2.4%). A total of 412(98.6%) patients were mainly spindle cells, and mitosis was not found in 320(76.5%) patients. In 389 small stomach GIST, 245(58.6%) were in fundic region. Cases were divided into four groups according to the size and the result revealed the bigger the size, the more the mitotic count. Nuclear atypia in the 1.5-1.9 cm group was significantly higher compared to other groups. Cases were divided into four groups according to the location and the result revealed the mitotic count was not associated to the location. While the nuclear atypia of stomach GIST was significantly higher than that of esophageal GIST and the nuclear atypia of rectum GIST was significantly higher than that of other positions. The median follow-up was 32(4-69) months. One case(gastric fundus GIST, >1.5 cm) presented local recurrence 23 months after operation and underwent endoscopic resection again. No recurrence or metastasis was found in other patients.

CONCLUSIONSEndoscopic resection technique is effective for small GISTs patients. The small GISTs with 0.4 cm diameter or less are often benign and should be followed up for long time. The small GISTs with 0.5 cm diameter or more possess the risk of malignancy, then surgical resection should be performed. Rectum small GISTs (except for 0.4 cm diameter or less) have worse biological behavior and should be removed.

Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors ; Humans ; Neoplasm Recurrence, Local ; Retrospective Studies

OBJECTIVETo explore the clinicopathological characteristics, efficacy, and prognostic factors for patients with duodenum gastrointestinal stromal tumor(GIST).

METHODSClinicopathological and follow-up data of 80 patients with duodenum GIST in the Zhongshan Hospital from January 2000 to December 2013 were analyzed retrospectively.

RESULTSThere were 38 male and 42 female patients with a median age of 54 years. The major symptoms were upper alimentary tract hemorrhage and abdominal pain. Thirty-nine patients received local tumor excision, 18 patients underwent segmental duodenectomy, 23 patients were subjected to pancreaticoduodenectomy, all these operations were R0 resection. Thirty patients received imatinib treatment after operation, and 11 among them had metastasis relapse. Recurrence-free survival rates of 1-, 3-, and 5-years were 96.2%, 90.6%and 78.6% retrospectively. Overall survival rates of 1-, 3-, and 5-years were 100%, 98.3% and 96.1%. Multivariate Cox analysis showed tumor size >5 cm, mitotic count >5 mitosis/50 HPF and intermediate/high NIH risk classification were associated with an increased risk of recurrence. The significant difference was not detected between the limited resection group and pancreaticoduodenectomy group in OS and RFS.

CONCLUSIONSSurgery is still the main treatment for duodenum GIST. The surgical program is mainly determined by the location and size of tumor. Imatinib therapy should be used if necessary.

Abdominal Pain ; Benzamides ; Duodenal Neoplasms ; Female ; Gastrointestinal Hemorrhage ; Gastrointestinal Stromal Tumors ; Humans ; Imatinib Mesylate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Pancreaticoduodenectomy ; Piperazines ; Prognosis ; Pyrimidines ; Retrospective Studies ; Survival Rate

Objective:To investigate the correlation between Lauren classification and pathological response after preoperative chemoradiotherapy in patients with locally advanced gastric cancer.Methods:From 2013 to 2019, 98 patients with definite Lauren classification who were enrolled in Sun Yat-sen University Cancer Center 5010 Phase Ⅲ clinical trials. Among them, 46 patients received preoperative chemoradiotherapy (CRT), and the remaining 52 cases received preoperative chemotherapy (ChT) and radical surgery. After preoperative therapy, the correlation between pathological response including the tumor regression grade (NCCN-TRG 0-3) and the lymph node stage (ypN 0-3) and Lauren classification was analyzed. A favorable pathological response (FPR) was defined as TRG 0-2 and ypN 0. Results:In the CRT group, patients with intestinal type (IT) tumors had a higher rate of ypN 0( OR=6.8, 95% CI: 1.8-25.0, P=0.004) and FPR ( OR=8.0, 95% CI: 2.2-29.9, P=0.002) than their counterparts with diffuse or mixed type tumors. However, Lauren classification was not significantly correlated with pathological response in the ChT group ( P>0.05). For patients with IT tumors, those receiving CRT had a higher likelihood of achieving a TRG 0-2 response ( P=0.033), an ypN 0 nodal regression ( P<0.001), and a FPR ( P<0.001) than their counterparts receiving ChT, whereas pathological response was not significantly associated with preoperative therapeutic method in patients with diffuse or mixed tumors ( P>0.05). Conclusion:Lauren classification may be a reliable predictor of the clinical efficacy of preoperative chemoradiotherapy for locally advanced gastric cancer, which can be utilized to select and optimize preoperative treatment.

OBJECTIVETo assess the clinical value of the diagnostic laparoscopy in choosing treatment strategies for patients with gastric cancer.

METHODSRetrospective analysis was performed on clinical and pathological data collected from 2 023 patients undergoing gastric cancer surgery in the Zhongshan Hospital of Fudan University from 2009 to 2014. All the patients were diagnosed as gastric cancer by endoscopic biopsy and staged by imaging examination before surgery. During the diagnostic laparoscopy procedure, a small periumbilical incision was made and a pneumoperitoneum with COunder 10-15 mmHg was established through a port. A 10 mm trocar was put in, and the camera was inserted. Two 5 mm trocars were put in two ports which located in midclavicular line two fingers under the left and right costal margin and then the instruments were inserted. A thorough inspection included ascites, the abdominal cavity, liver, diaphragm, spleen, greater omentum, colon, small intestine, mesentery, adnexa (female) and pelvic floor. If the tumor located at the posterior part of the stomach, the gastrocolic ligament was opened in order to look for carcinomatosis in the omental bursa. The accuracy rate of diagnostic laparoscopy in diagnosing adjacent organ invasion and intra-abdominal metastasis was calculated, and the rate of adjusting treatment plans after diagnostic laparoscopy was also calculated.

RESULTSThere were 52.7%(1 067/2 023) of patients underwent diagnostic laparoscopy. The accuracy rate of diagnostic laparoscopy in evaluating adjacent organ invasion and intra-abdominal metastasis were 98.3%(1 049/1 067) and 98.1%(1 047/1 067) respectively. Besides, 14 patients with stage T4b and 32 with intra-abdominal metastasis, which were missed by imaging examination, were diagnosed by diagnostic laparoscopy. The treatment plans of 9.3% (99/1 067) of patients were changed after diagnostic laparoscopy, and 65 (6.1%) cases of non-therapeutic laparotomy were avoided. However, 18 cases of adjacent organ invasion and 20 cases of intra-abdominal metastasis were still missed by diagnostic laparoscopy, and 12 cases received non-therapeutic laparotomy.

CONCLUSIONDiagnostic laparoscopy has considerable value in assessing adjacent organ invasion and intra-abdominal metastasis and has great clinical significance in making precise treatment plans.

Abdominal Neoplasms ; diagnostic imaging ; secondary ; Digestive System ; pathology ; Digestive System Surgical Procedures ; methods ; Female ; Humans ; Laparoscopes ; Laparoscopy ; instrumentation ; methods ; statistics & numerical data ; Laparotomy ; statistics & numerical data ; Male ; Neoplasm Invasiveness ; diagnostic imaging ; Patient Care Planning ; statistics & numerical data ; Retrospective Studies ; Stomach Neoplasms ; diagnostic imaging ; surgery ; Surgical Instruments ; Unnecessary Procedures ; statistics & numerical data

OBJECTIVETo investigate the frequency of different types of mature T- and NK-cell lymphomas diagnosed in a 4-year period at Sun Yat-sen University Cancer Center, and to study baseline CD30 for potential anti-CD30 targeted therapy in mature T- and NK-cell lymphoma.

METHODSAll cases of mature T- and NK-cell lymphoma diagnosed at Sun Yat-sen University Cancer Center from September 1, 2009 to August 31, 2013, were reviewed. Paraffin-blocks of available 164 consecutive cases were stained for CD30 immunohistochemistry using EnVision protocol.

RESULTSA total of 625 cases of mature T- and NK-cell lymphomas were diagnosed and the most common type was extranodal NK/T cell lymphoma (ENKTL), nasal type 319 (51.0%) cases, followed by angioimmunoblastic T-cell lymphoma (AITL) (119 cases, 19.0%), peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS) (81 cases, 13.0%), and anaplastic large-cell lymphoma (ALCL), including 48 cases (7.7%) of systematic ALCL and 11 cases (1.8%) of primary cutaneous ALCL. Besides ALCL, ENKTL had the highest expression rate of CD30 among the 164 cases, with positivity observed in 41 cases (62.1%, 41/66). Only 1 case of PTCL-NOS was CD30 positive. CD30 was not expressed in all 28 cases of AITL and other rare types of mature T- and NK-cell lymphoma.

CONCLUSIONSThe frequency of different types of mature T- and NK-cell lymphoma encountered at Sun Yat-sen University Cancer Center was similar to that seen in other areas of China and other Asia countries. CD30 expression is different among several types of mature T- and NK-cell lymphoma. In addition to ALCL, ENKTL has the highest expression rate of CD30, which may be a candidate disease for anti-CD30 targeted therapy.

China ; epidemiology ; Humans ; Immunohistochemistry ; Killer Cells, Natural ; Lymphoma, Extranodal NK-T-Cell ; epidemiology ; pathology ; Lymphoma, Large-Cell, Anaplastic ; epidemiology ; pathology ; Lymphoma, Primary Cutaneous Anaplastic Large Cell ; epidemiology ; pathology ; Lymphoma, T-Cell, Peripheral ; epidemiology ; pathology ; T-Lymphocytes