Objective To investigate the correlation between clinical features of breast cancer and microsatellite instability(MSI).Methods 60 samples of breast cancer were eollected and 5 microsatellite polymorphism loci were selected.MSI analysis Was made after DNA isolation,PCR amplification,electrophoresis and EB staining.Results The rate of MSI was 33.3%in breast cancer and 0%in normal breast tissues.MSI in breast cancer was associated with carcinoma differentiation degree.Conclusion MSI is an early event during breast carcinogenesis and it plays an important role in estimation of malignant degree.

Objective To study the effects of heart ischemia reperfusion on conductive function of atrioventricular node (AVN) in rabbits. Methods Animal models of ischemia reperfusion of AVN were established by ligating and reopening the right coronary artery of rabbits. A total of 60 adult rabbits were divided into control groups ( n =10), right coronary artery occlusion group ( n =10), and ischemia reperfusion groups with ligation of the right artery occlusion for 10, 30, 60 and 120 min respectively ( n =10 for every subgroup). The hemodynamics, His bundle electrography and epicardial electography were carried out and recorded. Results After occlusion of right coronary artery, 94.8% animals in experimental groups were found to have prolonged atrial His interval (AH) ( P

Objective To investigate the role of mismatch repair gene hMLH1 in pancreatic carcinoma and its clinicopathological significance.Methods hMLH1 was extracted from 60 cases of pancreatic carcinoma tissues and 60 cases of normol pancreatic tissues.hMLH1 expression in pancreatic carcinoma and normal tissues was detected by SP immunohistochemical staining.Results The strong,weak and loss expression of hMLH1 in pancreatic carcinoma tissues and normal pancreatic tissues was 0 vs 83.33％ (50/60),31.7％ (19/60)vs 16.67％ (10/60),and 68.3％ (41/60) vs 0 respectively.The protein expression of hMLH1 was not related to patient's age,tumor location,or pathological types (P ＞ 0.05),but it was related to lymph node metastasis (x2 =8.579,P =0.004),clinical stage (x2 =9.586,P =0.002) and pathological differentiation (x2 =20.372,P =0.001).Conclusion The loss expression of hMLH1 has a correlation with pancreatic carcinogenesis,differentiation degree,and disease progression.

Objective To compare the dosimetry of three different radiation therapy plans [threedimensional conformal radiation therapy (3DCRT),intensity modulated radiation therapy (IMRT),intensity modulated arc radiotherapy (IMAT)].Methods Selected 15 cases with middle thoracic esophageal cancer,Varian Eclipse 8.6 planning systems were designed with 3DCRT,IMRT,IMAT,3DCRT using 5-8 coplanar radiation fields,IMRT using 7 coplanar radiation fields,IMAT using 2 radians.Three planned dose difference were compared.Results Compared with 3DCRT,IMRT and IMAT were better with heterogeneity index (HI),conformality index (CI),VPTV 95 ％,V5,V20,V35 of total lung,and V30 of heart (t =2.531,P＜ 0.05).There was no statistically significant difference for the V10,V15,V25,V30 mean dose of total lung,the mean dose of heart,the maximum dose of spinal cord,and the minimum dose of PTV among the three plans (t =1.325,P ＞0.05).Conclusion IMAT and IMRT are similar in the middle thoracic esophageal cancer radiotherapy target volume dose coverage and organs at risk protection,they are better than 3DCRT.IMAT in the monitor units and delivery time are less than IMRT.

Objective To explore the effect of rituximab on serum hepcidin (Hepc), soluble CD40 ligands (sCD40L), platelet derived growth factor-BB (PDGF-BB) and lactate dehydrogenase (LDH) in patients with malignant lymphadenoma.Methods 52 patients with malignant lymphoma from the hospital were randomly divided into control group and experimental group.The control group were treated by cyclophosphamide, pirarubicin, vincristine and prednisone and the experiment group were treated on the basis of control group with rituximab.The serum hepcidin, sCD40L, PDGF-BB and LDH levels were compared after treatment.Results Compared with pre-treatment, the serum hepcidin, PDGF-BB and LDH levels were lower( P<0.05), the sCD40L level was higher(P<0.05) post-treatment.The serum hepcidin, PDGF-BB and LDH levels in experimental group post-treatment were lower, sCD40L level was higher than those in control group(P<0.05).Conclusions The rituximab could reduce serum hepcidin, PDGF-BB and LDH levels and elevate serum sCD40L level in patients with malignant lymphadenoma.

AIM: To study influence of ischemia-reperfusion(IR) on apoptosis and expression of apoptosis-related genes Fas-L, Bax and Bcl-2 of sinoatrial node(SAN) cells in rabbits in vivo. METHODS:Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I 10 min , I 30 min , I 60 min and I 120 min ) and IR groups (I 10 min R 4h , I 30 min R 4h , I 60 min R 4h and I 120 min R 4h ). IR injury model of SAN was established by occluding and loosening the start section of right coronary artery. The apoptosis of SAN cells was detected by TUNEL staining. The expression of Fas-L, Bax and Bcl-2 of SAN cells was detected by immunohistochemistry. RESULTS:①No obvious apoptosis of SAN cells was observed in control group, I 10 min and I 30 min groups. Apoptosis of different degrees in SAN cells were found in 68.3%(41/60) rabbits in I 60 min , I 120 min and 4 subgroups of IR. ②The highest expression of Fas-L and Bax was observed in I 120 min group and that of Bcl-2 was in I 60 min group. ③The highest expression of Fas-L and Bax was observed in I 60 min R 4h group. The peak level of Bcl-2 was observed in I 30 min R 4h group. ④The expression of Fas-L and Bax was significant higher in IR group than that in ischemic group at the same time point. CONCLUSION:Ischemia and IR induced apoptosis of SAN cells in rabbit in vivo . Fas-L、Bax、Bcl-2 may participate in the regulation of apoptosis and the injury during IR aggravates the apoptosis of SAN cells.

Objective To study the effect of ischemia reperfusion(IR) on electrophysiological function of sinoatrial node(SAN) in rabbits. Methods Ninety healthy adult rabbits were divided randomly into control group, ischemia groups (I) 10(I10 min), 30(I30 min), 60(I60 min) and 120 min(I120 min) and IR groups (10, 30, 60 and 120 min ischemia followed by 4 h reperfusion respectively)(I10 minR4 h, I30 minR4 h, I60 minR4 h and I120 minR4 h). There were 10 rabbits in the control group and each subgroup. IR injury model of SAN was established by occluding and loosening the start section of right coronary artery(RCA). The changes of AA interval and arrhythmia were recorded by electrocardiography and cardiac chamber electrography synchronously. Results ① There was no significant difference in AA interval between different time points in the control group. ② Sinus arrest(SA), sinus bradycardia with arrhythmia(SB), or atrial tachyarrhythmia(AT) were found in 51 rabbits (63.75%) out of 80 rabbits in I and IR groups in ischemic period. The incidence rate of arrhythmia increased in a time dependent manner. The AA intervals also increased by at least 40 ms in 54 rabbits (67.5%). ③ Sinus or atrial arrhythmia during ischemic period was found in 26 out of the 40 rabbits in IR group, but 15 returned normal after reperfusion. ④ Increased AA intervals were found in 27 out of the 40 rabbits in IR group during ischemic period. Most of them recovered to pre occlusion level within 10 min after reperfusion, but the AA intervals prolonged again in I60 minR4 h and I120 minR4 h groups as the reperfusion elongated. Conclusion ① These findings suggest that about 2/3 of the rabbit sinus node arteries may stem from right coronary artery. ② Electrophysiological changes due to ischemia of SAN resemble the electrocardiogram of sick sinoatrial node syndrome. ③ Reperfusion arrhythmia can be induced by reperfusion after a long time of ischemia.

To introduce the biological properties and functions of individual blood-brain barrier components,and summarize the most widely used in vitro blood-brain barrier models,compare their strengths and weaknesses,and provide suggestions on model selection in blood-brain barrier research and new-drug research and development.

Objective To assess the application value of pancreatic stent placement for endoscopic resection of duodenal major papilla adenoma.Methods A total of 67 cases of duodenal major papilla adenoma that were confirmed by biopsy and underwent endoscopic papillectomy from August 2007 to July 2016 in endoscopy center of Drum Tower Hospital of Nanjing were analyzed retrospectively.There were 50 patients treated with pancreatic stent placement and 17 patients without as the control group.The general information, efficacy and complications of two groups were collected at the same time.Results There were no significant differences in gender(P=0.070), age(P=0.151) or tumor size(P=0.136) between pancreatic stent placement group and the control group.There were no statistical differences in en bloc resection rates or complete resection rates between the two groups.And there were no significant differences in short-term complications of bleeding(P=0.428), pancreatitis(P=0.982), cholangitis(P=1.000), perforation(P=1.000)or long-term complications of distal common pancreatic duct stricture between the two groups.Conclusion Pancreatic stent should not be routinely placed in endoscopic papillectomy, and should be considered for specific cases.

Objective:To evaluate the application value of small IT knife pre-cut in assistance to duodenal papillary cannulation compared with conventional guidewire cannulation.Methods:A retrospective analysis was performed on the data of 90 patients with choledocholithiasis including 52 patients with small IT knife pre-cut assisted intubation (small IT knife group) and 38 patients with conventional guidewire intubation (conventional group) in endoscopic retrograde cholangiopancreatography (ERCP) from May 2016 to July 2019 in the digestive endoscopy center of Nanjing Drum Tower Hospital. The basic data, curative effect and complications of the two groups were collected and compared.Results:There was statistically significant difference in gender composition between the small IT knife group and the conventional group ( χ2=5.679, P=0.017), but no significant difference in other baseline data between the two groups (all P>0.05). The median intubation time of the small IT knife group was significantly shorter than that of the conventional group (141.5 s VS 270.0 s, Z=1 268.0, P=0.022). There were no significant differences in the success rate of intubation [98.1% (51/52) VS 94.7% (36/38), χ2=0.760, P=0.571], the incidence of intraoperative bleeding [15.4% (8/52) VS 7.9% (3/38), χ2=1.148, P=0.345], postoperative pancreatitis [5.8% (3/52) VS 7.9% (3/38), χ2=0.159, P=0.694], and postoperative cholangitis [1.9% (1/52) VS 5.3% (2/38), χ2=0.760, P=0.571] between the two groups. No perforation occurred in the two groups. After stratifying according to the operator′s proficiency, the median intubation time was significantly different between the small IT knife expert group and the conventional expert group (116.0 s VS 258.0 s, Z=276.0, P=0.038), while there was no significant difference in the intubation time among other groups (all P>0.05). Conclusion:The small IT knife is safe and effective to pre-cut and assist intubation in ERCP, and it may shorten the intubation time.