Lymph node metastasis is the main prognostic factor of endometrial cancer patients.As the metastasis of early endometrial cancer patients is very low,it remains a controversy whether these patients are necessary to undergo conventional lymphadenectomy and a challenge to confirm the scope of lymph node dissection.We intend to demonstrate the application of lymphadenectomy in patients with early endometrial cancer via the impact of lymphadenectomy on the prognosis of these patients.The risk factors for lymph node metastasis of endometrial cancers were analyzed to explore its value in the surgical option.Furthermore,the guidance of sentinel lymph node in surgical staging and prognostic prediction of early endometrial cancer was explored to clarify the applied condition and scope of lymphadenectomy in these patients.

Purpose It has been demonstrated that hepatocytes uptake of Gd-EOB-DTPA obviously decreased,which would result in decreased liver-to-lesion contrast.Therefore,this study was to evaluate the potential of increasing flip angle to improve the image quality of Gd-EOB-DTPA enhanced MR.Materials and Methods A total of 114 patients with focal liver lesions (FLLs),who underwent Gd-EOB-DTPA-enhanced MR of the liver,were enrolled in this retrospective study.39 patients were noncirrhotic group,36 patients were Child-Pugh A group,23 patients were Child-Pugh B group,and 16 patients were ChildPugh C group.Tl-weighted with fat suppression volume interpolated breath hold examination (VIBE) sequence was acquired before and 5 min,10 min,15 min,20 min after the administration of Gd-EOB-DTPA with both conventional low FA (9 °) and high FA (27 °) protocols separately.Signal to noise ratio (SNR),liver to lesion contrast (LLC),the liver to lesion SI ratio (LLSIR) were calculated and analyzed between low and high FA protocol images in each group and each scan time.Results The LLC and LLSIR on GdEOB-DTPA-enhanced MR images using a high FA (27 °) protocol were significantly higher in comparison with the conventional low FA (9°).In Child B group and Child C group,the LLC and the LLSIR with low FA significantly reduced during 15～20 min after contrast agent injection,however with high FA,the value of LLC and LLSIR tended to be horizontal.Conclusion A high FA protocol in comparison with the conventional 9° FA can obviously improve the image quality,which is reliable for liver lesion depiction on GdEOB-DTPA-enhanced MR images,especially to those with severe liver cirrhosis.

Aim To explore the role of progesterone re-ceptor B ( PRB ) in regulation of medroxyprogesterone acetate ( MPA) sensitivity in endometrial cancer cells, and to investigate the effect of MPA on the biological character in Ishikawa cells infected with shRNA targe-ting PRB gene. Methods Ishikawa cells were stably transfected with PRB shRNA using lentivirus to knock-down endogenous PRB expression. Real-time fluores-cent quantitative PCR was applied to confirm the knockdown effect. MTT assay, flow cytometry and cell invasion assay were applied to detect the influence of MPA on endometrial cancer cell proliferation, apopto-sis and invasion. We also used Western blot assay to detect the effect of MPA induced the activation of ERK/MAPK signal pathway. Results Recombinant lentiviral vector expressing shRNA targeting PRB gene was successfully established, results of real-time PCR and Western blot showed that compared with control group, PRB expression in Ishikawa cells infected with shRNA decreased obviously ( P <0.01 ); MPA could repress endometrial cancer cells proliferation and inva-sion, meanwhile promoted its apoptosis ( P <0.01 ) . However, the effect was almost reverse in Ishikawa cells infected with shRNA. Furthermore, MPA induced ERK/MAPK activation in Ishikawa cells infected with shRNA. Conclusions PRB plays a role in regulating therapeutic sensitivity of MPA in endometrial cancer cells;and for Ishikawa cells infected with shRNA tar-geting PRB gene, MPA has effects on the biological character via pERK1/2-MAPK signal pathway.

ObjectiveTo explore the biological features of colorectal adenoma with chicken-skin mucosa ( CSM ) and its clinical significance.MethodsExpression of cell proliferation markers ( Ki-67 and COX-2) and apoptosis-related factors ( survivin and caspase-3) in normal colorectal mucosa,colorectal adenoma without CSM,colorectal adenoma with CSM and colorectal adenocarcinoma were detected by immunohistochemistry SP method and enzyme-linked immunosorbent assay (ELISA).ResultsImmunohistochemical results revealed a decreased trend in expressions of Ki-67 and COX-2 from colorectal adenocarcinoma through colorectal adenoma with and without CSM to normal colorectal mucosa,while the expressions of survivin and caspase-3 showed an increased trend.By ELISA,the expressions of Ki-67,COX-2,surviving and caspase-3 showed no significant difference (P ＞ 0.05 ) between colorectal adenoma with CSM and coloreetal adenocarcima,while these variables were significantly different (P ＜ 0.05) between coloreetal adenoma with and without CSM,so as well between normal colorectal mucosa and other 3 groups.ConclusionThe biological characteristics of colorectal adenoma with CSM are different from those without,showing an activated cell proliferation and inhibited cell apoptosis with increased carcinogenesis risk.

Objective To explore the clinical effect of endoscope emergency operation in the treatment of gastric variceal bleeding.Methods According to the digital table,90 patients with acute bleeding gastric varices were randomly divided into the control group and the observation group,each group 45 cases.The control group only received drug treatment,and the observation group was given endoscopic therapy.The clinical effect of the two groups were compared.Results The immediate hemostatic rate,rebleeding rate,varicose veins subsided total efficiency of the observation group were 100.00％,17.78％,86.67％,respectively,which were better than those of the control group (84.44％,44.44％,28.89％) (x2 ＝ 5.72,P ＜ 0.05).Conclusion Endoscope emergency operation combined with oral drug in treatment of gastric variceal bleeding has good effect,can achieve rapid hemostasis,prevent recurrence,and it is worthy of clinical application.

ObjectiveTo investigate the selective mechanism of dehydroepiandrosterone (DHEA)for osteoblast via ERβ. Methods High expression of ERβ in hMG63-ERβ group ( infected with pWPTERβ), gene silencing of ERβ in hMG63-shERβ group (infected with pLVTHM-GFP/ERβ-shRNA) and hMG,63 group (control) were cultured and treated with 1 × 10-7 mol/L DHEA, with or without U0126 and etoposide. The proliferation and apoptosis of hMG63 were evaluated by flow cytometry. The mRNA level of estrogen receptor subtype was detected by reverse transcription-PCR. ResultsThe expression of ERβ in hMG63-ERβ group and hMG63-shERβ group were increased 7. 39 times and decreased 17％ compared with that in hMG63 group (control). DHEA could increase ERβ expression in hMG63 in each group, however, it did not influence the expression of ERα mRNA. When the level of ERβ was high, DHEA could accelerate the proliferation [proliferation index were ( 81.6 ± 7.6) ％ in hMG,63-ERβ, ( 75.0 ± 5.3 ) ％ in hMG63, P ＜ 0. 05]and inhibit the apoptosis [apoptosis rate were ( 12.2 ± 1.6) ％ in hMG63-ERβ, ( 14. 6 ± 1.5 ) ％in hMG63, P ＜0. 0 1], which was blocked by U0126 [proliferation index were (33. 2 ± 2. 0)％ in hMG63-ERβ, (41.2 ± 2. 4) ％ in hMG63, apoptosis rate were (40. 5 ± 4. 3 ) ％ in hMG63-ERβ, (43.3 ± 4. 1 ) ％in hMG63, all P ＜0. 05]. When the expression of ERβ was silenced, DHEA could not inhibit the apoptosis of hMG63 anymore. ConclusionDHEA selectively act on osteoblasts via the dominant expression of ERβ.

Objective To investigate the efficacy and safety of pramipexole versus fluoxetine in the treatment of depression in Parkinson's disease ( PD). Methods A randomized, clinical trial of pramipexole versus fluoxetine treatment for 12 weeks in 50 patients suffering from combined PD and depression was accomplished. The efficacy and safety assessments of the treatments were performed at different time points. Results For the intent-to-treat (ITT) population, the Hamilton Depression Rating Scale (HAMD) scores decreased progressively in both the pramipexole and the fluoxetine group, and a between-time statistical analysis was significant for both groups. The efficacy proportion of patients who responded to the treatment, as defined by at least a 50% reduction in HAMD score, was 56. 0% in the pramipexole group versus 48. 0% in the fluoxetine group (χ~2 =0. 321, P>0. 05). Similarly, the proportion of patients who recovered, as defined by a final HAMD score ≤8, was 52. 0% in the pramipexole group versus 32. 0% in the fluoxetine group (χ~2 =2. 053, P>0. 05) , but the difference between the two treatments showed no statistical significance. At the endpoint, both the Unified Parkinson's Disease Rating Scale (UPDRS) part Ⅱ and part Ⅲ subscores improved in the pramipexole group, by a mean of 2. 9±3. 7 (t= 2.366, P<0.05) and7.2±5.1 (t=2.654, P< 0.05), respectively, and the latter was significantly different from the change in this variable of the fluoxetine group (P<0. 05). Spearman analysis showed that no relationship between HAMD score and UPDRS Part II or Part III subscore. The findings for the per-protocol (PP) population were consistent with the above results, except that the proportion of patients who recovered in the pramipexole group was significantly larger than that in the fluoxetine group. The adverse events in both groups were mild dizziness, nausea and anorexia. No significant difference was found in the frequencies of the adverse events between the pramipexole and fluoxetine group. Conclusions Pramipexole is effective and safe in the treatment of Chinese PD patients combined with depression.

Objective To investigate the clinical efficacy of intraoperative methylprednisolone used in combination with perioperative enteral nutrition support in improving liver synthetic function after hepatectomy and postoperative recovery.Methods In this prospective controlled trial,79 patients treated with hepatectomy at Departement of Hepatobiliary Pancreatic Surgery in Drum Tower Hospital between June 2013 and May 2014 were included and divided into control group (n =39) and steroid group (n =40) according to the order of surgery.The control group underwent hepatectomy only,while the steroid group received intraoperative methylprednisolone (500 mg) at the start of liver excision.Both of the two groups were given the same perioperative enteral nutrition support.Liver function,prealbumin (PA),and C-reactive protein (CRP) levels were measured before and on days 1,3,and 5 after the operation.Human blood albumin infusion volume,postoperative gas passing,postoperative hospital stay,and incidence of complications were recorded.Results The serum level of PA on day 3 after hepatectomy was significantly higher in the steroid group than in the control group [(101.26 ±61.17) mg/L vs.(81.84 ±43.58) mg/L,t =-1.607,P =0.049].The serum level of cholinesterase on day 1 after hepatectomy was significantly higher in the steroid group than in the control group [(5.60±1.54) kU/Lvs.(4.68±1.01) kU/L,t=-3.136,P=0.004].On day1 and day 3 after hepatectomy,the serum levels of CRP were significantly lower in the steroid group than in the control group [(41.79 ±20.86) mg/L vs.(62.08 ±38.33) mg/L,t =2.933,P=0.027;(64.14 ±32.38) mg/L vs.(102.64 ± 49.05) mg/L,t =4.127,P =0.006].The postoperative hospital stay was significantly shorter in the steroid group than in the control group [(12.62 ±5.74) d vs.(15.41 ± 10.00)d,t =1.514,P =0.002].Conclusion Intraoperative use of methylprednisolone combined with perioperative enteral nutrition support may inhibit postoperative inflammatory response,promote early recovery of liver synthetic function,and help to promote rehabilitation after hepatectomy.

Objective To evaluate the effect of operation on breast duct fishtula. Methods 41 patients with breast duct fitula were subjected to fistulectomy or mastectomy. Results All patients had no re ccurrence after operation from 0.5 to 17 years. The clinical analysis showed that the causes of breast duct fistula were bacterial infection, retracted nipple, tissuration in the middle of nipple and breast duct dialation. Conclusions Fistulectomy or mastectomy is the most effective treatment of breast duct fistula.

Due to the low molecular weight and simple structure, the production of specific antibodies against acrylamide is unavailable. In this study, a novel hapten was synthesized through the derivatization of acrylamide and 4-mercaptophenylacetic acid. The hapten was then coupled to carrier protein and used to immunize New Zealand rabbits. Polyclonal antibody which showed specific binding to the acrylamide derivative ( hapten) was obtained. The antibody was labeled with horseradish peroxidase ( HRP) and used to develop a direct competitive enzyme-linked immunosorbent assay ( dc-ELISA) . The dc-ELISA was used to determine the content of acrylamide derivative, and then transferred to the content of acrylamide. The assay showed an IC50 value of 45. 49 μg/L, a limit of detection of 3. 0 μg/L and the linear range of 9. 2-195 μg/L for acrylamide. The recovery of acrylamide from spiked food sample was determined ranging from 83 . 6% to 112 . 7%. Good correlations between the results of dc-ELISA and standard HPLC-MS/MS were obtained. The proposed dc-ELISA is suitable for the determination of acrylamide in food samples.