Objective To investigate the surgical indicatin and outcome of recurrent gastric carcinoma.Methods Review the clinical data of 56 cases with recurrent gastric carcinoma underwent reoperation from 1990 to 2000.The operative indication, surgical method and complications were analized.Results In 25 cases the recurrent tumor were resected (44.6%),in 10 cases adjacent organs were resected.NO operative motality was observed.Conclusions More aggressive radical resection of the gastric cancer is the key to prevent recurrence.Laparotomy should be performed without delay once there is a suspicion of recurrence.

Animals ; Cochlea ; growth & development ; metabolism ; Female ; Guinea Pigs ; Male ; Nerve Growth Factor ; metabolism

Objective To study the rule of lower-cervical lymphatic metastasis in thoracic esophageal carcinoma,and make evaluation about the reasonable extent of lymphadenectomy. Methods One hundred and eight cases of thoracic esophageal carcinoma through chromatic ultrasound and CT before operation were divided into different groups selectively,while three fields lymphadenectomy (3-FL) was adopted in 31 cases,and two fields lymphadenctomy (2-FL) was adopted in 77 cases. Results The rate of lower-cervical lymphatic metastasis was 87.1%(27/31) through chromatic ultrasound and CT,and that was 25.0%(27/108) before the two up-mentioned examinations (P<0.05). In all cases, the rate of lower-cervical lymphatic metastasis in the upper pectoral esophageal carcinoma was 47.6% (10/21),that in the middle pectoral esophageal carcinoma was 21.3%(13161),and that in the middle and lower pectoral esophageal carcinoma was 19.5%(17187) ,P<0.05. Through 3-FL, the rate of lower--cervical lymphatic metastasis in the upper pectoral esophageal eareinoma was 57.1%(12/21), that in the middle pectoral esophageal carcinoma was 23.0%(14/61), and that in the middle and lower pectoral esophageal carcinoma was 21.8%(19/87), P<0.05. Conclusions The regionality metastasis is the main fashion in thoracic esophageal carcinoma with lower-cervical lymphatic metastasis. It is feasible to judge lower-cervical lymphatic metastasis through chromatic ultrasound and CT before operation.The 3-FL of the upper pectoral esophageal carcinoma is recommended. The 3-FL is selectable in the middle and lower pectoral esophageal carcinoma according to the result of chromatic ultrasound and CT.

Objective To investigate the value of elasticity score and elasticity strain ratio (SR) in predicting the central lymph nodes metastasis of papillary thyroid microcarcinoma (PTMC). Methods This study conducted a retrospective analysis of ultrasonography ifndings of 236 thyroid lesions from 208 patients. All of them underwent surgery in Ruijin Hospital of Shanghai Jiao Tong University from June 2012 to March 2013. Totally 82 PTMC from 82 patients were included in this study. Among them 12 patients with 12 PTMC had central lymph nodes metastasis. The elasticity score and SR were compared between metastasis and non-metastasis groups, and the receiver operating characteristic (ROC) curve of SR was calculated. Results The differences of PTMC elasticity score between two groups showed no statistical signiifcance (χ2=5.00, P=0.08). The average SR of the group with central lymph nodes metastasis is 2.44±0.61, which is higher than the group without lymph nodes metastasis whose average SR is 1.67±0.42. Differences are statistically signiifcant (t=5.5, P=0.00). The area under curve of SR-ROC curve was 0.847. Using 2.01 as cutoff of SR, the sensitivity, speciifcity, accuracy of predicting central lymph nodes metastasis was 83.3%, 81.4%, 78.6%respectively. Conclusion The SR but not elasticity score could be a meaningful indicator for predicting lymph nodes metastasis.

Objective To investigate the efficacy of small interfering RNA against Pseudomonos aeruginosa expressing MexA-MexB-OprM multidrug efflux pump in vivo.Methods Two short hairpin (sh)RNA expression vectors targeting the MexB gene,and negative controls,were designed,synthesized,and electrotransformed into the P.aeruginosa strain PAO1.The in vivo therapeutic efficacy of the MexB small interfering (si)RNAs was determined by infecting a murine model of chronic P.aeruginosa lung infection (1 × 107 CFU/ml).The mice were killed on day 3,5 and 7 after infection with the Pseudomonas aeruginosa strains.Results In the murine infection model,treatment with MexB-siRNAs led to significantly reduced bacteria burden of the bellows by day 5 and 7 post-infection,and reduced the P.aeruginosa-induced pathological changes.In addition,MexB-siRNA2 treatment enhanced neutrophil recruitment and production of inflammatory cytokines (IL-1β,IL-12) in the early infection stage (day 3) (P＜0.05),both of which decreased by day 7.Conclusion MexB-siRNA could inhibit both mRNA expression and the activity of P.aeruginosa in vitro.siRNA was effective in reducing the bacterial load in a murine model of chronic lung infection.Targeting of MexB with siRNA appears to be a novel strategy for treating P.aeruginosa infections.

Objective To investigate the clinicopathological difference and prognosis of colorectal adenocarcinomas including mutinous, Signet-ring cell, papillary and tubular carcinomas. Methods Two thousand and eighty-nine patients with colorectal cancer underwent colorectal operation between August 1994 and April 2007. The clinicopathological characteristics of mucinous adenocarcinoma (n=144), signet-ring cell carcinoma (n=25), papillary and tubular carcinomas (n= 1837) were compared expect of other types of cancer (n = 83). The single factor and Logistic regression methods were used to analyze the clinicopathological parameters that influence the prognosis of colorectal cancer such as age, location of the tumor, staging, peritoneum and pathological typing. The survival rates of patients with above three types of adenocareinomas were analyzed. Results The mean age of onset was lowest in patients with mutinous adenocarcinomas [(54. 20 ± 16.25) years] compared with that in patients with signet-ring cell cancer [(40.43 ± 12.88)years] or papillary and tubular carcinomas [(58. 73 ±13.62)]. There were significant differences in gender, size and location of the tumor, TNM staging, peritoneal metastasis, lymph node involvement and adjacent organ invasion among three groups (all P values <0.05). The single factor and Logistic regression analysis revealed that both mucinous adenocarcinoma and signet-ring cell carcinoma were risk factors ot prognosis. The patients with mucinous adenocarcinoma or signet-ring cell tumor were poor in long-term overall survival in comparison with patients with papillary and tubular carcinoma (P<0. 001). Conclusions The colorectal mucinous and signet-ring cell adenocarcinomas are risk factors for prognosis of colorectal cancer, which imply the poor outcome.

OBJECTIVE To evaluate the long-term toxicity of fully human anti-human tumor necrosis factor-α monoclonal antibody(anti-hTNF-α FHMA)for injection in cynomolgus monkeys. METHODS Forty cynomolgus monkeys were randomly divided into 5 groups (4 males and 4 females in each group):negative control group,adalimumab 10 mg·kg-1 group,anti-hTNF-αFHMA 2,10 and 50 mg·kg-1 groups. Cynomolgus monkeys in each group were injected sc once a week for 5 consecutive times, followed by 4 weeks of recovery. During the test,general clinical observation,body mass,body temperature,electrocardiogram(ECG),hematology,coagulation function,blood biochemistry,urine, ophthalmology,immune index,and pathological changes in organs and tissues were observed. At the same time,plasma drug concentrations were detected and the toxicokinetics parameters were analyzed. RESULTS No significant toxicological changes related to drugs were observed in general clinical observation,body mass,body temperature,ECG,ophthalmic examination,blood cell counts,coagu?lation function,blood biochemistry,urine analysis,lymphocyte subsets,cytokines,serum immuno?globulin,serum complement. Neutralizing anti-drug antibody(ADA)could be detected in adalimumab group and anti-hTNF-αFHMA groups. Anti-hTNF-αFHMA showed linear dynamic characteristics in cyno?molgus monkeys. At the same dose(10 mg·kg-1),anti-hTNF-αFHMA had similar immunogenicity and kinetics characteristics to adalimumab. CONCLUSION The level of anti-hTNF-α FHMA at which no adverse effect was observed was 50 mg · kg-1,which is equivalent to 75 times clinical dosage of quasi (0.67 mg·kg-1),which suggests that anti-hTNF-αFHMA be safe in clinical use.

Objective To investigate the value of modified pancreatoduodenectomy in the treatment of ampullary carcinoma by comparing the efficacy of pancreatoduodenectomy with preservation of ascending portion of duodenum and that of Whipple procedure. Methods The clinical data of 133 patients with ampullary carcinoma who had been admitted to the Qilu Hospital from 1990 to 2006 were retrospectively analyzed. Of the 133 patients, 88 received Whipple procedure (group A) and 45 received pancreatoduedenectomy with preservation of ascending portion of duodenum (group B). The preoperative condition of the patients and short- and long-term efficacy of the 2 procedures were compared by Fisher exact probability, t test, chi-square test, Kaplan-Meier survival curve and Log-rank test, and the differences between the efficacy of the 2 procedures were compared. Results The operation time, time of gastrointestinal function recovery, hospital stay and ratio of patients with blood transfusion were (366±111) minutes, (7.4±1.4) days, (24±9) days and 76% (67/88) in group A, and (325±32)minutes, (4.3±1.4)days, (31±14)days, 42% (19/45) in group B, with significant difference between the 2 groups (t = 2.34, 2.08, 1.98 ; χ2 = 14.99, P < 0.05). The medium survival time of patients in groups A and B were (19.0±1.5)months and (16.9±1.7) months, with no significant difference between the 2 groups (χ2 = 0.46, P > 0.05). There was no significant difference in the occurrence of postoperative complications between the 2 groups (P > 0.05). Conclusions Pancreateduodenectomy with preservation of ascending portion of duodenum can be applied for patients with ampullary carcinoma.

Objective To investigate the expression changes and clinical significance of microRNA-155(miR-155) and chemokine receptor 4(CXCR4) in placental tissue from the patients with preeclampsia(PE).Methods Thirty pregnant women with severe PE(sPE) in the Third Affiliated Hospital of Zhengzhou University from December 2015 to February 2016 served as the sPE group,and contemporaneous 30 healthy pregnant women undergoing cesarean section due to the social factors served as the healthy control group(N).The real-time fluorescent quantitative PCR(RT-PCR) was used to detect the expression of miR-155 and CXCR4 mRNA in placental tissue and the relationship between miR-155 and CXCR4 levels was analyzed.The immunohistochemistry SABC methods were used to detect the expression of CXCR4 protein in villous cytotrophoblast(VCT) tissue microarray(TMA,42 cases in the normal control group 1,56 cases in the PE group) and extravillous cytotrophoblast(EVCT) TMA(29 cases in the normal control group 2,47 cases in the PE group) constructed by the same research group.Results (1) There was no statistically significant difference in the age,gestational age and pre-pregnancy body mass index(BMI) between the two groups(P>0.05).The differences of blood pressure between the two groups were statistically significant(P<0.05).The neonatal birthweight in the sPE group was significantly lower than that in the control group with statistically significant differences(P<0.05).The urine protein in the sPE group was significantly higher than that in the control group with statistically significant differences(P<0.05).(2)In the placental VCTand EVCT TMA,the age had no statistical difference between the two groups(P>0.05).The gestational weeks of the PE group were earlier than those in the N group 1,the systolic/diastolic blood pressure and urine protein were higher than those in the N group,the differences all were statistically significant(P<0.05),the neonatal birthweight was significantly lower than that in the N group with statistically significant differences(P<0.05).(3)The expression level of miR-155 mRNA in placental tissue in the sPE group was 1.53±0.92,which was significantly higher than 0.87±0.73 in the control group,the difference between the two groups was statistically significant(P<0.05).(4) The expression level of CXCR4 mRNA in the N group was 1.51±1.85,which in the sPE group was 0.54±0.38,the difference between the two groups was statistically significant(P<0.05).(5) In the sPE group,the miR-155 level and CXCR4 level in placntal tissue had a significant correlation(r=-0.773,P<0.05).(6) CXCR4 protein was expressed in VCT and EVCT TMA;the CXCR4 positive expression rate of the PE group in VCT TMA was 48.21%(27/56),which in the sPE group was 47.92%(23/48) and which in the early onset PE group was 53.66%(22/41),which all were significantly lower than 83.33%(35/42)in the normal control group,the differences all were statistically significant(P<0.05).(7)The positive expression rate of CXCR4 in the PE group in placent EVCT TMA was 48.94%(23/47),which in the sPE group was 50.00%(22/44) and which in the early PE onset group was 52.63%(20/38),which all significantly lower than 79.31%(23/29) in the normal control group,the differences all were statistically significant(P<0.05).Conclusion The level of placental tissue miR-155 is increased in the patients with sPE,while the level of CXCR4 is decreases obviously,both have a negative correlation,which may be associated with the pathogenesis of PE.

Objective:To investigate the effect on the CXCR4/PI3K/AKT pathway after the transfection of miR-155 mimics and miR-155 inhibitor combined with the research on the ability of invasion and migration of human chorionic JEG-3 trophoblast cells. Methods:Chemically synthesized miR-155 mimics and miR-155 inhibitor were transfected into JEG-3 cells. The effect on the ability of invasion and migration were analyzed by Transwell migration assay and Wound healing assay. The expression of CXCR4 mRNA was detected by Real-time PCR. The expression of CXCR4 and p-AKT protein were detected by Western blot. Results: Transfection with miR-155 mimics significantly down-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 mimics had lower levels of migration and invasion capacity than cells in the control group(P<0. 05). However, transfection with miR-155 inhibitor significantly up-regulated the expression of CXCR4 as compared with the control group(P<0. 05);JEG-3 cells transfected miR-155 inhibitor had higher levels of migration and invasion capacity than cells in the control group ( P<0.05).Addition,the expression of p-AKT protein of JEG-3 cells was down-regulated after transfected miR-155 mimics,and the expression of p-AKT protein of JEG-3 cells was up-regulated after transfected miR-155 inhibitor. Conclusion:miR-155 may inhibits the invasion and migration of trophoblast cells by regulating CXCR4/PI3K/AKT pathway contributing to the development of preeclampsia.