OBJECTIVE: To investigate the rules of lymphatic metastasis of rectal carcinoma, and to help clinical diagnosis and treatment. METHODS: A retrospective analysis was performed in the 979 patients with rectal carcinoma who underwent surgical resection from 1995 to 2004. The associations between lymphatic metastasis and clinicopathologic variables were evaluated by Chi-squared test and logistic regression. RESULTS: The rate of lymph node metstasis was 71.4% for patients younger than 30 years old, 40.7% in the patients with tumor diameters over 6 centimeters, 82.5% in the patients with extraneous tumor invasion, 71.6% for patients of poor-differentiated adenocarcinoma, 70.4% for patients with mucoid adenocarcinoma, 100% for patients with signet-ring cell carcinoma and 46.4% for patients with more than half intestinal circumference invasion. Logistic regression analysis showed that the degree of lymphatic metastasis was related to the differentiating degrees, depths of tumor invasion and intestinal circumference invasion, and the differentiating degree was the major factor. CONCLUSION The lymphatic metastasis of rectal carcinoma is related to age, tumor size, intestinal circumference invasion, depth of tumor invasion and the differentiating degree of the tumor; the differentiating degree is the major factor.
Adenocarcinoma ; pathology ; Adult ; Age Factors ; Carcinoma, Signet Ring Cell ; pathology ; Female ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Rectal Neoplasms ; pathology ; Retrospective Studies

AIM:To observe the expression of Snail1 and insulin-like growth factor-1 (IGF-1) in NRK-52E cells induced by high glucose,and to investigate the relationship of Snail1 and IGF-1 in the mechanism of epithelial to mesenchymal transition (EMT) in diabetic kidney disease (DKD).METHODS:The NRK-52E cells were treated with Snail1 siRNA and IGF-1 siRNA after cultured with high glucose medium for 72 h,and divided into control group,high glucose group,non-targeting (NT) siRNA group,Snail1 RNAi group and IGF-1 RNAi group.The cells were harvested at 48 h and 72 h.Real-time PCR was used to detect the mRNA expression of Snail1,IGF-1,E-cadherin and fibronectin (FN),and the protein levels were determined by immunofluorescence staining.RESULTS:Compared with control group,the expression of E-cadherin at mRNA and protein levels declined after stimulation with high glucose (P ＜ 0.01),while that of FN was elevated (P ＜0.01).Meanwhile,the mRNA and protein levels of Snail1 and IGF-1 were markedly increased (P ＜0.01).The expression of E-cadherin at mRNA and protein levels was improved in Snail1 RNAi group as compared with high glucose group (P ＜ 0.01),while that of FN,IGF-l and Snail1 was significantly down-regulated (P ＜ 0.01).The same changes were observed in IGF-1 RNAi group (P ＜0.01).The protein expression of each factor in NT group had no significant change as compared with high glucose group (P ＞ 0.05).Pearson correlation analysis showed a close positive relationship between the expression of Snail1 and IGF-1 protein (r =0.852,P ＜ 0.01).CONCLUSION:Snail1 may facilitate DKD development by regulating IGF-1 in the process of EMT.

OBJECTIVETo investigate the clinical implications of reperfusion arrhythmias during primary percutaneous coronary intervention (PCI) for patients with acute myocardial infarction (AMI).

METHODSData from 228 AMI patients in whom the infarct-related artery (IRA) were successfully recanalized by primary PCI were retrospectively analyzed. The 228 patients were divided into 2 groups: myocardial ischemia-reperfusion injury (MIRI) group (n=119) in whom MIRI events occurred within minutes after successful recanalization of IRA, and non-MIRI group (n=109). The 119 patients in MIRI group were further divided into 3 subgroups: severe bradycardia with hypotension (brady-arrhythmia subgroup), lethal ventricular arrhythmias requiring electrical cardioversion (tachy-arrhythmia subgroup), and IRA antegrade flow less than or equal to TIMI 2 grade without angiographic evidence of abrupt closure (no-reflow subgroup).

RESULTS(1) Clinical and angiographic data: Compared with non-MIRI group, MIRI group was characterized by more inferior infarct location, shorter ischemic duration, more frequently right coronary artery as IRA, more diseased vessels, more often TIMI 0 grade of initial antegrade flow in IRA, less pre-infarction angina, more renal insufficiency, and higher in-hospital mortality (13.4% vs. 4.6%, P=0.021). (2) The peak CK level was remarkably lower in brady-arrhythmia subgroup than that in non-MIRI group (2010 IU/L vs. 2521 IU/L, P=0.039). The peak CK or CK-MB level was notably higher in no-reflow subgroup than in non-MIRI group (4573 IU/L, 338 IU/L, respectively, P=0.000). (3) Left ventricular ejection fraction in no-reflow subgroup was significantly lower than in non-MIRI group (38.7% +/- 8.3% vs. 51.2% +/- 8.1%, P=0.000), left ventricular end-diastolic volume in no-reflow subgroup was greater than that in tachy-arrhythmia subgroup [(135 +/- 32) ml vs. (105 +/- 19) ml, P=0.029].

CONCLUSIONReperfusion arrhythmias may imply the existence of much survived myocardium and do not enhance myocardial damage, while no-reflow increases myocardial injury and induces permanent impairment of cardiac function.

Arrhythmias, Cardiac ; complications ; Cell Survival ; Humans ; Myocardial Infarction ; therapy ; Myocardial Reperfusion ; Myocardial Reperfusion Injury ; etiology ; Myocardium ; enzymology ; Retrospective Studies

OBJECTIVETo explore the risk and protective factors for the occurrence of myocardial ischemia-reperfusion injury (MIRI) during primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI).

METHODSClinical and angiographic data of 228 AMI patients in whom the infarct-related arteries (IRA) were successfully revascularized by primary PCI were analyzed retrospectively. MIRI was defined if the following conditions existed after PCI: severe bradycardia with hypotension, or lethal ventricular arrhythmias requiring electrical cardioversion, or IRA antegrade flow < or = TIMI 2 grade flow without angiographic evidence of thrombus, emboli, dissection or spasm. Multivariate logistic regression was used to identify independent relative factors among 18 clinical and angiographic factors for occurrence of MIRI.

RESULTSMultivariate logistic regression analysis showed that independent risk factors for MIRI were the time intervals from AMI onset to IRA reflow < or = 6 h (P = 0.014), inferior infarction localization (P = 0.006), IRA antegrade flow prior to PCI < or = TIMI 1 grade (P = 0.028), multivessel lesions (P = 0.063) and renal insufficiency (P = 0.067). Pre-infarction angina was found to be an independent protective factor (P = 0.005).

CONCLUSIONSShort time intervals from AMI onset to IRA revascularization, inferior wall infarction location, low IRA antegrade flow prior to PCI, multivessel lesions and renal insufficiency may promote the occurrence of MIRI during primary PCI, whereas pre-infarction angina may be a cardioprotective factor attenuating MIRI.

Adult ; Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; adverse effects ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Myocardial Reperfusion Injury ; etiology ; Retrospective Studies

Objective To retrospectively analyze 40 cases of hanging and 33 cases of ligature strangulation in Kunming, to explore the neck injury characteristics and similarities and differences of related asphyxia signs of corpses in hanging and ligature strangulation cases, in order to provide reference for forensic identification. Methods Statistics of hanging and ligature strangulation cases accepted by Kunming Municipal Public Security Bureau from 2000 to 2017 were collected. Data including the gender, age, injury tool, neck injury and related asphyxia signs of the deceased in hanging and ligature strangulation cases were statistically tested by SPSS 23.0. Results There were more males in hanging cases than females. However, there were more females than males in ligature strangulation cases. In hanging cases, suicide was common, while homicide was rare. In ligature strangulation cases, homicide was common, while suicide or accidental death was rare. The average age of the deceased in hanging cases were older than those in ligature strangulation cases. The ligature mark in hanging was usually above the thyroid cartilage. The ligature mark in ligature strangulation was usually at the same level of the thyroid cartilage. The most common vital reactions were exfoliation and subcutaneous hemorrhage at the ligature mark, common among the deceased in hanging cases. Hyoid fracture rate of the deceased in ligature strangulation cases was more common than those in hanging cases. Conclusion The gender, age distribution, position of ligature mark, detection rate of vital reactions at the ligature mark and hyoid fracture rate of the deceased can help distinguish hanging from ligature strangulation.
Asphyxia ; Female ; Homicide ; Humans ; Male ; Neck Injuries ; Retrospective Studies ; Suicide ; Thyroid Cartilage

Objective To detect the diatom population diversity in Dianchi by constructing a 18S rDNA clone library. Methods DNA from diatoms in 6 water samples of Dianchi was amplified with diatom 18S rDNA specific primer.The 18S rDNA clone library was constructed, and clones were randomly selected for sequence. Sequence alignment was performed by BLAST. The diatom population distribution in Dianchi was analyzed and the phylogenetic tree of diatom 18S rDNA in Dianchi waters was established with the MEGA v7.0.14 software. Results Two hundred and forty clones were sequenced, with 167 diatom sequences obtained, including 11 diatom species such as Stephanodiscus, Diatoma, and Melosira. There were certain differences in diatom population distribution among the 6 samples. Conclusion The population distribution of diatom species in Dianchi shows unique features and the sequence analysis of diatom 18S rDNA has a certain reference value to the inference of forensic drowning sites.
China ; DNA, Ribosomal/genetics* ; Diatoms/classification* ; Drowning ; Forensic Sciences ; Humans ; Phylogeny ; RNA, Ribosomal, 18S/genetics*