Objective To assess the evolution of gastric epithelial dysplasia (GED). Methods We reviewed the history of 239 of patients with gastric dysplasia diagnosed by endoscopic biopsy, and 195 were followed up for 61. 37 months. Results Among 239 cases of dysplasia (261 lesions) , there were 119, with mild dysplasia, 77 with moderate dysplasia, and 43 with severe dysplasia. The gastric dysplasia lesions are mainly in lesser curvature, and its endoscopic appearance mostly is localized erosion. In the follow - up group, regression of dysplasia was demonstrated in 86. 36% , 81. 25% , and 47. 62% of mild, moderate and severe dysplasia respectively. Progression to gastric cancer was detected in 8. 18% , 15. 63% , and 72. 09% of mild, moderate, and severe dysplasia, respectively. The relative risk (RR) of mild, moderate, severe dysplasia was 1. 96, 3. 74, and 17. 25 respectively. Conclusion Carcinomatous evolution of GED increases proportionally with its histological grade. Gastroscopy biopsy follow-up should be held up for all grades of GED, especially, in high grade GED, gastroscopy and biopsy should be taken as soon as possible.

To study the significance of detection of K ras mutation in stool samples in the diagnosis of large intestinal cancer, stool and local tissue samples were collected from consecutively diagnosed patients, among them 23 cases suffered from large intestinal cancer, 20 cases from colorectal adenomatoid polyps and 20 healthy subjects. DNA was extracted from both the stool and the tissue, K ras gene mutations at the first and second base of codon 12 were studied by allele specific mismatch method in both of them. The results showed that K ras mutation rate in large intestinal cancer was 56 52%(13/23), which was much higher than 5%(1/20)in healthy subjects( P 0 05). There was a 92 31%(12/13)incidence of K ras mutation at the second base of codon 12 in large intestinal cancer. The results of detecting the K ras mutation were highly identical in both the stool and the tissue ( P

Objective To evaluate the clinicopathological characteristics of early gastric carcinoma for prognosis and the long term consequences of gastrectomy for quality of life in the aged. Methods The clinicopathological features and late postoperative complications by follow up study for 71 patients during 1973 1999 with early gastric cancer were reviewed by using hospital records. Results Forty six cases(64.8%) were diagnosed by routine gastroscopic checkup. 56 cases out of 71 (74.6%) were mucosal cancer without lymph node metastasis, 18 cases were submucosal cancer with lymph node metastasis in 2 cases. By histological study, we found that 32 lesions (45.1%) were located at the antrum, differentiated tubular adenocarcinoma was found in 43 cases, and multiple primary carcinoma in 5 cases and gastric stump cancer in 3 cases. The disorders of gastric stump included anastomotic gastritis, empting disturbance, erosion, ulcer, reflux esophagitis were found in 31, 7, 6, 4 and 3 cases, respectively. Fourteen patients showed weight loss and 9 showed anemia. Patients with proximal gastrectomy suffered more from disoders than the patients with distal gastrectomy. Conclusions Our results suggest that special attention should be given to the patients with chronic atrophic gastritis diagnosed by routine gastroscopy. Lymph node metastasis, multiple primary cancer and gastric stump cancer might affect the prognosis. Our results support the fact that the incidence of disorders of gastric stump are high; and the surgical treatment with gastroscopic procedure is recommended for the mucosal cancer in order to improve the patients' quality of life.

Objective To evaluate the importance of clinical screening and follow up by direct colonoscopy for colorectal cancer at an early and curable stage. Methods There were 2 196 elderly people aged between 60 to 89 years. The clinical screening by direct colonoscopy was performed according to the protocol. 1 740 of 2 196(79.2%) patients were followed up every year. Results Fifty two elderly persons were found to be colorectal cancer patients by colonoscopy, with the detectable rate being 2.4%. Nineteen were diagnosed early stage colorectal cancer, accounting for 36.5% of the detected colorectal cancer. Nine among the followed up cases were detected early colorectal cancer, accounting for 45 0% of the detected colorectal cancer. The resectable rate and the 5 year survival rate was 97 7% and 80 9% for colorectal cancer, respectively. 98 9% of the cecum intubation cases was successful. The incidence of complication for colonoscopy was 0 05%. Conclusions By clincal colonscopy screening and follow up study for colorectal cancer and precancerous changes in the elderly, the patients with adenomatoid polyps were early diagnosed and treated, so it raised the detectable rate of early colorectal cancer and the level of grade prevention of colorectal cancer.

BACKGROUND:Adipose-derived stem cels are regarded as the potential seed cels for tissue engineering. Colagenase digestion is used to isolate adipose-derived stem cels from fat pads currently. However, there are some problems, such as cumbersome operation and high cost.
OBJECTIVE: To study the basic biological characteristics of adipose-derived stem cels by tissue explants culture and to explore the differentiation potential into osteoblasts, adipocytes and endothelial progenitor cels in vitro.
METHODS:Adipose-derived stem cels were isolated by tissue explants technique from the bilateral groin fat pads of rats under aseptic conditions, and cultured in vitro. Cel counting kit-8 was used to detect the proliferative activity, and flow cytometry was employed to analyze the expression of cel surface markers. Passage 4 adipose-derived stem cels were cultured in osteogenic medium, adipogenic medium and endothelial progenitor cel medium for 2-3 weeks, and then the cels were identified.
RESULTS AND CONCLUSION:Adipose-derived stem cels that were isolated by tissue explants culture were easily cultured, and after subculture, cels were mainly spindle-shaped and grew in clone-like manner with swirling arrangement. Cels that experienced repeated subcultures stil kept stronger proliferative ability and the cel growth curve was shaped as a parabola. Immunochemical staining analysis revealed that adipose-derived stem cels were positive for CD44, CD90 and CD29, but negative for CD31, CD45. After adipogenic/osteogenic induction, the cels were respectively positive for oil red O staining and alizarin red staining. Induced endothelial progenitor cels were identified with CD34 and the ability to uptake Dil-ac-LDL and FITC-UEA. These findings indicate using the using tissue explants culture, high-purity adipose-derived stem cels easy to proliferate can be harvested, highly express stem cels-related antigens, and have the ability to differentiate into osteoblasts, adipocytes and endothelial progenitor cels, which meet the needs of seed cels in tissue engineering research.

OBJECTIVETo evaluate the safety and effectiveness of direct gastroscopy for detecting gastric cancer.

METHODSClinical screening by direct gastroscopy was performed for gastric cancer (GC) from September 1985 to July 1998. 3048 elderly people were screened. Their age ranged from 60 to 93 years, and 2034 of the 3084 were followed up.

RESULTSNinety-two patients with gastric cancer were discovered by gastroscopy, representing 3.02% of the screened population. The rate of early gastric cancer (EGC) was 63.04% (58/92) of all gastric cancers detected. The rate was up to 79.59% (39/49) on follow-up, and was 74.14% (43/51) in asymptomatic patients with gastric cancer. The excision rate was 88.89% for patients with gastric cancer, and 100% for patients with early gastric cancer. The 5-year survival rate was 91.89% for patients with gastric cancer, and 96.30% for patients with early gastric cancer.

CONCLUSIONClinical screening and follow-up by direct gastroscopy in persons over 60 years of age are a safe and effective method for raising the 5-year survival and detection rate of gastric cancer, especially early gastric cancer.

Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Gastroscopy ; Humans ; Male ; Middle Aged ; Prognosis ; Stomach Neoplasms ; diagnosis ; mortality ; Survival Rate

Objective To compare the impacts of percutaneous coronary intervention (PCI) and medical therapy on mortality in patients with stable coronary artery disease.Methods We searched PubMed,Embase,Cochrane central register of controlled trials,Wanfang data and CNKI to find relevant randomized controlled trials on PCI versus medical therapy for treating patients with stable coronary artery disease,which were reported before December 2013.Publications were selected according to inclusion and exclusion standard.Meta-analyses was performed with the software of STATA 12.0.Results Five randomized controlled trials and 5 567 patients were enrolled for this analysis.Compared with medical therapy,PCI could not significantly decrease the long-term all-cause mortality (RR =0.96,95％ CI 0.80-1.15),the cardiac death rate (RR =1.02,95％ CI 0.77-1.36),the myocardial infarction rate (RR =1.05,95％ CI 0.89-1.23),the acute coronary syndrome (RR =0.70,95％ CI 0.27-1.82),the rate of freedom from angina (RR =1.09,95％ CI0.98-1.21),and the rate of stroke (RR =1.27,95％ CI 0.75-2.15).However,the revascularization rate was significantly lower for patients in PCI group (RR =0.60,95％ CI 0.42-0.86).Conclusions Long-term mortality is similar for patients with stable coronary artery disease underwent PCI or medical therapy.

Objective To investigate the overall and subgroup efficacy,subgroup differences,predictors of efficacy and safety of roxadustat in the treatment of refractory non-severe aplastic anemia(NSAA)and low-risk myelodysplastic syndromes(LR-MDS).Methods Patients with refractory NSAA and LR-MDS who were admitted to the Department of Hematology,Peking Union Medical College Hospital from August 2020 to December 2022 were enrolled.All patients received first-line standard treatment,including recombinant human erythropoietin(rhEPO)for at least 3 months before roxadustat treatment.All patients received roxadustat 2.5 mg/kg every other day for at least 3 months,and were followed up for at least 8 months.The clinical characteristics of patients,roxadustat efficacy,predictors of efficacy,adverse effects,relapse and disease clonal evolution were analyzed.Results A total of 40 patients including 24 refractory NSAA and 16 LR-MDS were included.median age was 56(18～81)years and 40%were males.65%of the patients were transfusion dependent.Median follow-up was 21(9～34)months.22.5%,25.0%,47.5%,55.0%,57.5%,60.0%and 50.0%of the patients achieved haemato-logical improvement-erythroid(HI-E)at months 1,2,3,4,5,6,and end of the follow-up period,respectively,and no factors affecting HI-E were identified.The hemoglobin change from baseline was statistically different between the two groups at the end of the follow-up period.50%of patients were relieved from transfusion dependence.Adverse reactions were reported in 22.5%of patients.28.5%of patients relapsed after achieving HI-E,with a median time to relapse of 7(4～12)months.No clonal evolution was observed at the end of the follow-up period.Conclusions Our preliminary findings suggested that Roxadustat may be effective for patients with NSAA or LR-MDS refractory to conventional therapies and rhEPO,with mild adverse effects and low relapse rate.The degree of hemoglobin improvement may be better in the refractory NSAA patients.

Humans ; Cyclosporine/therapeutic use* ; Anemia, Aplastic/drug therapy* ; Neoplasms/drug therapy* ; Immunosuppressive Agents/therapeutic use* ; Benzoates/therapeutic use*