The purpose of the current study was to detect the potential therapeutic role of a survival benefit for women with advanced and recurrent endometrial carcinoma for their poor prognosis.A number of published studies for women with advanced and recurrent endometrial cancers were reviewed.We found that surgery had been the primary treatment of choice for an endometrial carcinoma.Where disease has spread to the uterine cervix,extended or radical surgery may be curative.The systematic lymph node resection improves the survival of women with intermediate/high-risk endometrioid uterine cancer,especially non-endometrioid carcinoma.The omentectomy may be beneficial for non-endometrioid cancer.A number of studies report a survival benefit from surgical cytoreduction in women with advanced and recurrent disease,although the degree of surgical effort is required in order to achieve an optimal result varies.Laparoscopic and robotic surgical staging for uterine cancer might be considered as a standard of care for endometrial cancer without extra-uterine metastasis.Laparotomy should be the first choice for extra-uterine metastasis and recurrent disease.Adjuvant radiotherapy and chemotherapy have a potential role in the management of high-risk,advanced,and recurrent disease.Efficacy of targeted and endocrinal treatment in women with advanced and recurrent endometrial cancer has been proved.

Objective To study the expression-mode and dynamic transmutation of high mobility group box-1 (HMGB1) in hepatocytes of the mouse model with acute hepatic failure and to study the interaction beween HMGB1 and tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β). Methods The mouse model of acute hepatic failure was established by injecting D-galactosamine (D-GalN) and lipopolysaccharide(LPS). Immunohistochemistry SABC method was used to detect the HMGB1 expression at 6 time points. The enzyme linked immunosorbent assay (ELISA) was used to determine serum TNF-α. IL-1β levels. Paired t test was used for statistical analysis. Results The HMGB1 expression was detectable at 2 hours after injection, which dramatically increased over time and peaked at 24 hours after injection. The serum TNF-a level and IL-1β level increased right after injection. The TNF-a level peaked at 8 hours after injection with a maximum value of (473.42±22. 99) pg/mL. The IL-1β level peaked at 2 hours after injection with a maximum value of (724. 49±34. 24) pg/mL. Both cytokine levels slowly decreased after peaking. IL-1β level returned normal with (51. 49±36. 87) pg/mL. Conclusions HMGB1 is one of the most important factors during the development of acute hepatic failure, which can promote the secretion of TNF-α and IL-1β at early stage and be abundantly expressed under the effect of these cytokines at middle and late stages with the result of liver damage. This process is directly correlated with the development and severity of hepatic failure.

Objective:To analyze the association of type 2 diabetes mellitus(DM) with the clinical and coronary angiographic features of coronary heart disease(CHD) in patients aged over 70 years old.Methods: A total of 310 elderly patients with coronary angiograph-confirmed coronary diseases,who were treated in Changhai Hospital during Apr.2006 to Jul.2008,were retrospectively analyzed.The patients were further divided into 2 subgroups according to the presence of DM: DM-CHD group(n=155) and non-DM-CHD group(n=155).The age,gender,blood pressure,blood lipid,ejection fraction(EF),the angiographic outcomes,etc.were analyzed and compared between the two groups.Results: The incidence of hypertension was significantly higher in the DM-CHD group than in the non-DM-CHD group(P

Objective: To study the influence of HMGB1-Abox on the expression of HMGB-1 in RAW264.7 cells stimulated by lipopolysaccharide(LPS)and its inhibition on the secretion of inflammatory factor.Methods: Use cloning vector to make up prokaryotic plasmid PET28a-HMGB1-Abox, which included the gene fragment of the A box of HMGB1, and recombinant vector was further transformed into Escherichia coil strain BL21(DE3),the recombinant plasmid was induced by isopropylthiogalactoside(IPTG)to express target protein.The protein was purified by Ni-column.We tested the effect of the different concentration of rHMGB1-Abox on the viabihty of RAW264.7 cells stimulated by LPS using CCK-8.Experimental group(EG)was treated with rHMGB41-Abox and control group(CG)was deh with PBS.TNF-α and IL-1β levels were detected by the enzyme linked immunosorbent assay(ELISA).Western blot and immunofluorescence staining method were used to compare the expression of HMGB1 in RAW264.7 cells with the experiment group and control group.Reverse transcription polymerase chain reaction(RT-PCR)was used to detect the variation tendency of HMGB1-mRNA.All procedures were manipulated at 2 \ 6 \ 12 \ 24 \ 48 h after treatment.Results: The recombinant prokaryotic expression vector PET28a-HMGB1-Abox was successfully constructed and mouse HMGB1-Abox protein about 14 kD was successfully expressed.There was a positive correlation between the viability of RAW264.7 cells and the concentration of protein and acting time.Compared to CG, TNF-α and IL-1β levels in EG declined significantly.In EG, Western blot and Immunofluorescence staining showed that the expression of HMGB1 protein was decreased and the expression of HMGB1-mRNA was reduced markedly and delayed.Conclusion: The rHMGB1-Abox could reduce expression and secretion of HMGB1 in RAW264.7 cells stimulated by LPS significantly,thereby to prevented the promotion of HMGB1 on pro-inflammatory mediator and inhibit the expression and secretion of inflammatory factors,which has some anti-inflammatory action.

Along with the advances in interventional therapy, compression methods for arterial closure require prolonged compression or long arterial sheath dwelling period, which in turn would increase the procedural time, complication rates, and patients' discomfort. Under this circumstance, a variety of percutaneous arterial closure devices was invented offering rapid and reliable hemostasis but there are still some controversies concerning, whether it can reduce the incidence of postoperative complications or not. This paper reviewed and comprehended many researches and literatures to assess the efficacy and complication rates of device-mediated closure versus the gold standard of manual compression. (J Intervent Radiol, 2006, 15: 564-567)

Objective To investigate the effects of total alkaloids in Buxus microphylla leaves (ABML) on isolated rats thoracic aorta rings,and then to explore the possible mechanisms underlying the effects.MethodsThoracic aortas of Wistar rats were isolated,removed,and mounted onto an organ bath.The effects of ABML at different concentration on the contraction of isolated thoracic aorta rings (with and without endothelium) precontracted with KC1 or PE were observed with organ bath technique.Dose-effect curves of CaCl2 were recorded by organ bath technique.The concentration of intracellular Ca2+ ([Ca2+]i) increased by PE,KCI,and caffeine in the presence of ABML was determined using Ca2+ sensitive fluorescence indicator Fura-2/AM loaded thoracic aorta vascular smooth muscle (VSM) cells of rats.ResultsIn aorta rings precontracted with PE and KCI,ABML produced concentrationdependent relaxation in both intact and denuded endothelium ring groups.There was no difference in the inhibition of contraction between the intact and denuded endothelium ring groups at the same concentration.Exposure of isolated thoracic aorta rings to ABML led to a significant reduction in the contracting response induced by CaCI2,and shifted the cumulative concentration-response curves to right.ABML could significantly inhibit the extracellular Ca2+ influx induced by PE and KCI under [Ca2+]0 of 1.5 mmol/L,with inhibitory ratios of 40.2％ and 49.9％,respectively.In the case of Ca2+-free,ABML could significantly inhibit the intracellular Ca2+ release induced by PE,with inhibitory ratio of 72.4％.ConclusionABML relaxes thoracic aorta VSM cells by suppressing influx of extracellular Ca2+ via voltage-dependent Ca2+ channel and receptor-operated Ca2+ channel.

0 05), respectively The overall rates of post-operative complications in the two groups were 11 5% and 24 7%(P

Objective To evaluate the role of postmastectomy radiotherapy in four subgroups of high-risk breast cancer patients, who were grouped by the status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (Her-2). Methods A total of 437 invasive breast cancer patients with T3-4N1 or N2-3 and available immunohistochemistry results of ER, PR and Her-2 were retrospectively analyzed. Patients were classified into 4 subgroups according to hormone receptors (ER or PR, Rec) and Her-2 status:Rec-/Her-2-(triple negative), Rec-/Her-2 +, Rec +/Her-2 + and Rec +/Her-2-. Rec-was defined as ER-and PR-. Rec + was defined as ER + and/or PR +. Her-2 positive was defined as Her-2 + + or Her-2 + + +. End points were isolated locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS) and overall survival (OS). Results The median follow up time was 48 months. Sixty-nine (15. 8%) patients were Rec-/Her-2-, 62 (14. 2%) Rec-/Her-2 +, 89 (20.4%) Rec +/Her-2 + and 217 (49.7%) Rec +/Her-2-. 480(93.4%) patients received chemotherapy and 352(80. 5%) received radiotherapy. Radiotherapy significantly reduced the 5-year LRR rates of all the four subgroups (Rec-/Her-2-: 13.1% vs. 33. 3%, Rec-/Her-2 + :9. 3% vs. 21.2%, Rec + /Her-2 + :9. 7% vs. 47.0%, Rec +/Her-2-:3. 2% vs. 15.4%). Radiotherapy significantly lowered the 5-year DM rates (26. 7% vs. 49.4%, 27.6% vs. 67. 5%, 18.4% vs. 100%) and improved the 5-year DFS rate (66. 7% vs. 33. 3% , 67.7% vs. 33. 3% , 72. 6% vs. 0%) as well as OS (73.9% vs. 25.2% ,69. 8% vs.41.5%, 91.0% vs. 32. 8%) of patients with Rec-/Her-2-, Rec-/Her-2 + and Rec +/Her-2 +. Conclusions In high-risk breast cancer patients, all subgroups of patients grouped by ER, PR and Her-2 status can benefit from postmastectomy radiotherapy.

Objective To identify high-risk group among gastric cancer patients treated with curative resection and more than D1 dissection, and investigate the indications for proper adjuvant therapy.Methods 297 patients who met the following enrolled criteria were retrospectively analyzed:treated between January 2002 and December 2004, primary gastric or gastroesophageal cancer, underwent curative gastrectomy and more than D1 lymphadenectomy, pathologically staged as T3-4N0-1M0,or TxN2-3M0.The overall survival (OS), disease-free survival (DFS), local-regional recurrence-free survival (LRFS) and distant metastasis-free survival (DMFS) were calculated, and possible prognostic factors were analyzed.Results The median follow-up time was 61 months.The follow-up rate was 92.3%.The 5-year OS, DFS, LRFS and DMFS were 57.9%, 52.2%, 70.6% and 71.7%, respectively.Four independent prognostic variables identified for OS, DFS, LRFS and DMFS using multivariate analysis were Borrmann type (Ⅰ+Ⅱ/Ⅲ+Ⅳ), total number of dissected lymph nodes (>18/≤18), number of positive lymph nodes (0-3/≥4), and 6th AJCC TNM stage (Ⅱ+Ⅲ a/Ⅲ b+ⅣM0)(χ2=3.94-16.34,P<0.05).If one unfavorable prognostic factor was scored as 1, according to the total scores of the four prognostic factors, four risk groups were generated as low (score:0), low-intermediate (score:1), high-intermediate (score:2) and high risk group (score:3 or 4).The 5-year OS, DFS, LRFS and DMFS were 85.7%, 61.0%, 58.6% and 38.6%(χ2=31.20,P<0.01) in low risk group, 85.2%, 61.3%, 48.1% and 31.8%(χ2=31.88,P<0.01) in low-intermediate risk group, 94.4%, 77.8%, 64.4% and 57.2%(χ2=18.36,P<0.01) in high-intermediate risk group and 87.9%, 75.0%, 74.2% and 55.5%(χ2=19.30,P<0.01) in high risk group.Conclusions Even with R0 resection and more than D1 lymphadenectomy, the outcome was poor for gastric cancer patients with two or more unfavorable prognostic factors.Prospective study is warranted to evaluate the efficacy of adjuvant concurrent chemoradiotherapy for this group of patients.

Objective:To observe the activity of urokinase-type plasminogen activator (uPA) in human tongue squamous cell carcinoma cell line Tca8113 under hypoxia in vitro. Methods:According to the different time of hypoxia, the test was divided into four groups as following: (1) 0 h; (2) 6 h;(3)12 h;(4)24 h. The expression of uPA was examined using immunochemistry. The expression of uPA mRNA was examined using in situ hybridization (ISH). The results of ISH staining of uPA mRNA were analysed using Spot and IPP image analysis system.Results:The uPA expression was found in cytoplasm and cytomembrane of Tca8113 cells.uPA mRNA expression was found in cytoplasm of the cells.The staining intensity of uPA mRNA in the groups of (1),(2),(3) and (4) was 0.175 251?(0.013) 863,0.263 191?(0.000 680),0.406 745?0.014 016 and 0.478 919?0.018 998 respectively(P