Objective To investigate the clinical pathological factors related to recurrence and metastasis of colorectal cancer patients treated with resection ,expect to improve the treatment effects .Methods The clinicopathologic and follow-up data of 212 patients with stage Ⅰ - Ⅲ colorectal cancer patients treated with resection from January 2009 to December 2013 were retrospec-tively analyzed by univariate and multivariate Logistic regression methods .Results Univariate analysis showed that T staging sys-tems ,gross type ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to recurrence of colorectal cancer after operation(P< 0 .05) ;age ,tumor size ,lymph node involvement ,T staging systems ,histological differentiation ,intestinal obstruction or perforation ,lymphatic and vascular invasion were correlated to metastasis of colorectal cancer after operation(P <0 .05) .Multivariate Logistic regression analysis showed that age ,tumor size and histological differentiation were independent factors for metastasis rate of colorectal cancer after operation(P< 0 .05) .There were no significant differences in Logistic regression analy-sis for recurrence(P> 0 .05) .Conclusion Age ,tumor size and histological differentiation are independent factors for metastasis rate of colorectal cancer after operation .

Objective To investigate the effect of IVIG on pre-existing anti-HLA-A2 Ab levels and graft skin survival.Methods C57BL/6 wild type mice were sensitized to HLA-A2 by intraperitoneal injec-tion (IP) of HLA-A2 TgN mouse spleen cells (C57BL/6-TgN [HLA-2.1]1Enge SC) expressing human HLA-A2 at day 0, week 3 and 4.Sensitized mice were respectively treated with human IVIG , albumin, gly-cine, or PBS for 5 days during week 7.Skin transplantation from TgN mice to C57BL/6 wild type mice was performed at week 10 .Efficacy of IVIG DES was assessed by measuring anti-HLA Ab levels by ELISA pre-/post-Rx and graft skin survival was monitored daily post-Tx.Results Changes of HLA-A2-IgG levels:IgG HLA-A2 class I Ab levels in all groups predictably increased from baseline following spleen cell IP and peaked at week 4 ( P <0.01 ) , indicating sensitization .IVIG-treated mice showed significantly lower IgG Ab levels vs.albumin, glycine and PBS-treated at week 9 post-desensitization ( P <0.01).IgG quickly increased to extremely high levels in all groups following skin transplantation ( P <0.01 ) .Graft skin sur-vival between Rx-groups were similar with all rejecting at about 7 days post-transplantation ( P >0.05 ) . Conclusion However, IVIG alone does not inhibit anti-HLA class I Ab production after skin transplanta-tion or prolong SG survival , indicating combination of IVIG with other immunosuppressant or more optimal protocol for desensitization might show more efficacy and should be under explored .

Objective To investigate the recheck rule by investigating the coincidence rate of the results detected by the LabU‐Mat urine dry chemistry analyzer and the Urised tangible composition analyzer with the results detected by the microscope examina‐tion .Methods 1 040 urine specimens from children outpatients and children inpatients were collected .Firstly ,the specimens were analyzed by the LabUMat urine dry chemistry analyzer and the Urised tangible composition analyzer ,and then detected by using the microscopic examination for investigating the recheck rule of the routine analysis by the urine automatic analyzer ;the regulation was evaluated by the missed detection rate ,and then the recheck rule avoiding the missed diagnosis of abnormal renal function was also evaluated .Finally ,clinically verify the rules adopting 200 specimens to perform the clinical verification on this recheck rule .Results Among the specimens used for researching the recheck rule ,the specimens of positive microscope examination results accounted for 58 .65% ,the specimens of negative results accounted for 41 .35% .In the positive detection specimens ,the specimens of RBC positive were the majority ,accounting for 50% ,the specimens of WBC positive accounted for 23 .08% and the specimens of CAST positive accounted for 7 .69% .The coincidence rate of the set rule was 87 .5% and the missed detection rate was 2 .9% .In conduc‐ting the verification on the recheck rule by 200 urine specimens ,the coincidence rate was 89 .52% and the missed detection rate was 2 .4% .Conclusion When the detection results of occult blood(BLD) ,WBC(LEU) and protein(PRO) by the dry chemistry analyzer and the detection results of RBC ,WBC ,CAST by the tangible composition analyzer are inconsistent or the differences among them are beyond 2 grades of differential ,the recheck by the microscopic examination should be performed .

Objective To study the expressions of Cx43,CD105 and VEGF in HBV related HCC tissues and the relationships between Cx43 expression and recurrence and prognosis after cancer radical resection in HCC patients stratified by serum AFP levels. Methods The expressions of Cx43,CD105,VEGF in 234 HBV related HCC tissues were examined by tissue microarray and two-step methods of PV-6000 of immunohistochemistry and the expressions of Cx43 in 20 frozen HCC specimens were examined by RT-PCR. Results Cx43 in HCC tissues was positive as examined by both immunohistochemistry and RTPCR methods.Positive Cx43 expression is correlated with lower early recurrence ( Log Rank P =0.001 ),longer disease free survival (Log Rank P =0.026 ) and overall survival( Log Rank P =0.000 ) as showed by the Kaplan-Meier analysis in patients with AFP ＜ 400 μg/L. The expression of Cx43 is an independent prognostic factor.The positive expression of Cx43 related with lower positive expression of CD105 and VEGF (P =0.018,0.023 ),and correlated with histological differentiation (P =0.002),the number of focus (P =0.033 ),blood vessel tumor embolism ( P =0.029 ). Conclusions The expression of Cx43 is correlative with the expression of CD105 and VEGF,and is predictive of HCC early recurrence and poor prognosis after radical hepatectomy in HBV related HCC patients with serum AFP ＜ 400 μg/L.

Objective To inspect the efficacy and mucosa healing condition of infliximab with azathioprine combination therapy in Crohn's disease (CD) and its correlation with prognosis.Methods A total of 20 active CD patients who received infliximab and azathioprine combination therapy at The First Affiliated Hospital of Sun Yat-sen University were objects of this study.The clinical efficacy was evaluated at 10 weeks,30 weeks,54 weeks and 2 years respectively according to CD activity index.The efficacy was evaluated under endoscopy at 10 weeks,30 weeks,54 weeks and 2 years respectively according to mucosal response situation under endoscopy.The data were analyzed by analysis of variance or Fisher's exact test between two groups.The factor affecred mucosal healing was analyzed by Logistic regression analysis.Results The clinical remission rate of patients without steroid at week 10,30,54 and 2 year were 12/20,16/20,15/20 and 15/20 respectively.Mucosal healing rate at week 10,30 and 54 weeks were 8/20,12/20 and 10/20 respectively.Logistic regression analysis indicated that age was the only factor affected mucosal healing at 30 weeks (OR =0.774,95％ CI:0.630 to 0.950).There was significant differences in clinical remission between mucosa response patients and invalid under endoscopy at 30 weeks and 2 years without steroid (at 30 weeks:14/14 vs 2/6; at 2 years:14/14 vs 1/6; all P＜0.01).Infliximab were withdrawn in 4 of 16 patients who was in non-steroid clinical remission at 30 weeks,and the other 12 patients were continued with infliximab therapy.There was no significant difference in non-steroid clinical remission rate (4/4 vs 11/12) and mucosa healing rate (2/4 vs 7/12) between withdrawal and continue of infliximab therapy (all P＞0.05).Conclusions Infliximab with azathioprine combination therapy can effectively promote and maintain mucosa healing in CD.The mucosa response patients can maintain long time non-steroid clinical remission.

Objective To investigate the evaluation standard and proper time point of anti-tuberculosis trial for differential diagnosis between intestinal tuberculosis (ITB) and Crohn's disease (CD). Methods Clinical data and endoscopic changes of 28 patients with confirmed ITB and 11 with confirmed CD,who underwent anti-tuberculosis trail, were retrospectively analyzed. Results No significant difference could be found in clinical characteristics of ITB and CD patients on baseline, such as active pulmonary tuberculosis, strong positive skin test and anal fistula/perianal abscess. Clinical symptoms were relieved in both groups right after anti-tuberculosis treatment. After 3 months of treatment, the no-improvement rate in ITB group was 0, whereas that of CD group was 27.3% (P =0. 004). The disappearance rate plus improvement rate of ulcer in ITB group was 90. 9% (20/22) plus 9. 1% (2/22) and 100% ( 28/28 ) plus 0 at 3 and 6 months of treatment, respectively. The disappearance rate plus improvement rate of nodular lesion was 58. 8% (10/17) plus 41.2% (7/17) and 76. 5% (13/17) plus 23.5% (4/17), respectively. There was no obvious improvement of active ulcer or nodular transformation in CD group at any time point ( P ＜ 0. 01 ).Conclusion With deficiency of special index for differential diagnosis of ITB and CD, some cases hard to differentiate still have to accept anti-tuberculosis treatment. Three months of anti-tuberculosis treatment is a proper time point to evaluate the efficacy. Disappearance of active ulcer and nodular transformation, together with cure or obvious improvement in clinic are taken as effective for treatment trail.

Objective: To discuss the effects of acupuncture plus Tuina (Chinese therapeutic massage) in intervening the mental development, motor function, cerebral hemodynamics, and muscle tone in kids with spastic cerebral palsy (CP). Methods: A retrospective analysis was conducted on 87 kids with spastic CP. They were divided into a control group and an observation group based on their original treatment plan. Kids in the control group received symptomatic treatment, motor development therapy, and Tuina treatment. The observation group was additionally given acupuncture treatment. One month was taken as a treatment course. After six courses, the efficacy, change in muscle tone, mental development, gross motor function, fine motor function, and the systolic velocity (Vs), mean velocity (Vm), and pulsatility index (PI) of the anterior cerebral artery (ACA), middle cerebral artery (MCA), and posterior cerebral artery (PCA) were compared between the two groups. Results: After treatment, the muscle tone score dropped in both groups (P<0.05) and was significantly lower in the observation group than in the control group (P<0.05). The observation group achieved more significant efficacy than the control group (P<0.05). After the intervention, the mental development index (MDI), psychomotor development index (PDI), gross motor function measure (GMFM) score, and fine motor function measure (FMFM) score all increased in both groups (P<0.05) and were notably higher in the observation group than in the control group (P<0.05). After treatment, the Vs and Vm of the ACA, MCA, and PCA were markedly higher in the observation group than in the control group (P<0.05), and the observation group was significantly lower than the control group comparing the PI of the ACA, MCA, and PCA (P<0.05). Conclusion: Based on the symptomatic treatment and motor development therapy, Tuina and acupuncture treatment can effectively treat spastic CP children, manifesting as reducing muscle tone, boosting mental development, and improving motor function and cerebral hemodynamics.

ObjectiveTo unify the definitions of colonoscopic characteristics of Crohn disease (CD) and intestinal tuberculosis ( ITB),and to evaluate colonoscopic and clinical features in the differential diagnosis of CD and ITB.MethodsA collaborative group composed of 10 experts from 5 hospitals voted to identify and confirm the colonoscopic characteristics.Clinical and colonoscopic characteristics were analyzed,thereafter,characteristics were scored based on different diagnostic specificity.ROC curve was used for determining the cutoff point to differentiate CD from ITB.ResultsFirstly,standard endoscopic images and descriptions were determined.Secondly,colonoscopic parameters which were significantly different between the CD and ITB patients included the follows:involvement of more than four intestinal segments,anorectal involvement,longitudinal ulcers,cobblestone appearance and transverse ulcers.Clinical findings which were significantly different between the CD and ITB patients included active pulmonary tuberculosis,PPD-test strong positive,anal fistula/perianal abscess and extra-intestinal manifestations in CD.4.4％(6/136) patients were confirmed by histological evidence of caseating granulomas.By using our scoring system,39.7％ (54/136) confirmed diagnoses and 18.4％ (25/136) suspected diagnoses were made in patients without histological evidence.ConclusionIdentification of colonoscopic characteristics and unification of the colonscopic diagnostic criteria were helpful in the differential diagnosis between CD and ITB.The differential diagnosis rate could he improved by using the scoring system.Half cases could not be confirmed even with combined pathology and the scoring system,so a more comprhensive scoring system would be warranted.

[Abstract] Objective: To investigate the effect of long non-coding RNA (lncRNA)-CCAT2 on the proliferation and cell cycle of cervical cancer cells. Methods: The expression of CCAT2 in 3 cervical cancer cell lines (HeLa, C-33A, and CaSki) was detected by qPCR and the cell line with the highest expression level was selected for subsequent experiments. CCAT2 overexpression and interference vectors were designed and synthesized. After transfection, qPCR was performed to detect the transfection efficiency. The cells were divided into 5 groups: control, sh-EV (empty vector), overExp-EV , sh-CCAT2, and overExp-CCAT2. MTT assay was performed to evaluate cell viability. Flow cytometry was performed to measure cell cycle. WB was performed to detect the expressions of Ki67, cyclin D1, and cyclin dependent kinase 4 (CDK4). Results: Among HeLa, C-33A, and CaSki cells, the highest expression of CCAT2 was found in CaSki cells. CCAT2 overexpression and interference vectors were successfully transfected into the CaSki cells. Compared with the control group, the cells viability and proliferation in the sh-CCAT2 group was significantly decreased (all P<0.01), the proportion of cells in the G1 phase was significantly increased (P<0.01), and the expression levels of Ki67, cyclin D1, and CDK4 were significantly decreased (all P<0.01). However, in the overExp-CCAT2 group, the cell proliferation was enhanced and the expression levels of Ki67, cyclin D1, and CDK4 were significantly increased (all P<0.01). Conclusion: CCAT2 affects proliferation and cell cycle of cervical cancer cells by regulating the expressions of their associated proteins.

OBJECTIVETo explore the role of silent information regulator 1 (SIRT1) signaling pathway in mediating the effect of dexmedetomidine (DEX) to alleviate postoperative cognitive dysfunction (POCD) in aged rats.

METHODSSeventy-two healthy male Sprague-Dawley rats aged 18-20 months (weighing 500-700 g) were randomized equally into normal control group, POCD model group, DEX pretreatment group, and DEX and SIRT1 inhibitor (EX527) pretreatment group. In the latter 2 groups, DEX (25 μg/kg) was injected intraperitoneally in the rats 30 min before the operation, and normal saline was injected instead in the other 2 groups; in EX527 group, EX527 (1 μg/kg) was injected intravenously 5 min before the operation. In all but the control group, the rats were subjected to laparotomy lasting 30 min, and on days 1, 3, and 5 following the operation, 6 rats were randomly selected from each group for Morris water maze test to evaluate their cognitive functions. Immediately after the test, the rats were sacrificed and the hippocampus was collected for determination of the levels of tumor necrosis factor- (TNF-) and interleukin-6 (IL-6) using ELISA; Western blotting was used to detect the expression of SIRT1 and nuclear factor- κB (NF-κB) in the hippocampal neurons.

RESULTSCompared with the control rats, the rats in POCD group and EX527 group showed significantly prolonged escape latency, decreased frequency of crossing the original platform, increased TNF- and IL-6 levels, lowered SIRT1 expression in the hippocampal neurons, and increased NF-κB expression ( < 0.05), and these parameters were comparable between POCD group and EX527 group ( > 0.05). DEX pretreatment significantly alleviated cognitive dysfunction and attenuated the changes in TNF-, IL-6, SIRT1, and NF-κB expressions induced by the operation ( < 0.05), and EX527 pretreatment of the rats obviously blocked the effects of DEX ( < 0.05).

CONCLUSIONSDEX alleviates POCD in aged rats probably via SIRT1 signaling pathway.