[Observational study on perioperative outcomes of pelvic exenteration].

Objective: To investigate the surgical indications and perioperative clinical outcomes of pelvic exenteration (PE) for locally advanced, recurrent pelvic malignancies and complex pelvic fistulas. Methods: This was a descriptive study.The indications for performing PE were: (1) locally advanced, recurrent pelvic malignancy or complex pelvic fistula diagnosed preoperatively by imaging and pathological examination of a biopsy; (2)preoperative agreement by a multi-disciplinary team that non-surgical and conventional surgical treatment had failed and PE was required; and (3) findings on intraoperative exploration confirming this conclusion.Contraindications to this surgical procedure comprised cardiac and respiratory dysfunction, poor nutritional status,and mental state too poor to tolerate the procedure.Clinical data of 141 patients who met the above criteria, had undergone PE in the Sixth Affiliated Hospital of Sun Yat-sen University from January 2018 to September 2022, had complete perioperative clinical data, and had given written informed consent to the procedure were collected,and the operation,relevant perioperative variables, postoperative pathological findings (curative resection), and early postoperative complications were analyzed. Results: Of the 141 included patients, 43 (30.5%) had primary malignancies, 61 (43.3%) recurrent malignancies, 28 (19.9%) complex fistulas after radical resection of malignancies,and nine (6.4%)complex fistulas caused by benign disease. There were 79 cases (56.0%) of gastrointestinal tumors, 30 cases (21.3%) of reproductive tumors, 16 cases (11.3%) of urinary tumors, and 7 cases (5.0%) of other tumors such mesenchymal tissue tumors. Among the 104 patients with primary and recurrent malignancies, 15 patients with severe complications of pelvic perineum of advanced tumors were planned to undergo palliative PE surgery for symptom relief after preoperative assessment of multidisciplinary team; the other 89 patients were evaluated for radical PE surgery. All surgeries were successfully completed. Total PE was performed on 73 patients (51.8%),anterior PE on 22 (15.6%),and posterior PE in 46 (32.6%). The median operative time was 576 (453,679) minutes, median intraoperative blood loss 500 (200, 1 200) ml, and median hospital stay 17 (13.0,30.5)days.There were no intraoperative deaths. Of the 89 patients evaluated for radical PE surgery, the radical R0 resection was achieved in 64 (71.9%) of them, R1 resection in 23 (25.8%), and R2 resection in two (2.2%). One or more postoperative complications occurred in 85 cases (60.3%), 32 (22.7%)of which were Clavien-Dindo grade III and above.One patient (0.7%)died during the perioperative period. Conclusion: PE is a valid option for treating locally advanced or recurrent pelvic malignancies and complex pelvic fistulas.

[Characteristics of CD8+ T cell infiltration in colorectal cancer and their correlation with prognosis].

Objective: As cytotoxic T cells, CD8+ T lymphocytes can kill tumor cells by releasing perforin and other effector molecules, but the correlation between their infiltration level and the prognosis of colorectal cancer varies in previous studies. This study aims to explore the distribution of CD8+T cells in tumor center and invasive margin of colorectal cancer, and to analyze their correlation with the prognosis of patients. Methods: A retrospective cohort study was used to analyze the clinicopathological features of 221 patients with colorectal cancer from the colorectal cancer pathological database of the Sixth Affiliated Hospital of Sun Yat-sen University between 2009 and 2012. Case inclusion criteria: (1) colorectal cancers confirmed by postoperative pathology; (2) patients with follow-up data. Exclusion criteria: (1) multiple primary cancers; (2) inflammatory bowel disease, Lynch syndrome or familial adenomatous polyposis; (3) no available paraffin slides; (4) patients receiving preoperative radiotherapy or chemotherapy. A total of 221 patients met the criteria. Immunohistochemical staining was used to count the CD8+ T cells in tumor center and invasive margin in the paraffin slides. Meanwhile the relative expression of CD8B gene in 22 fresh freeze samples of colorectal cancer was detected. Then the correlation of the expression with CD8+T cell density was examined. The patients were divided into high and low infiltration groups according to the level of CD8+T cells. Log-rank test was applied to compare the overall survival of the two groups of patients, and Cox regression analysis was used to adjust the prognostic significance of CD8+T cell infiltration. Results: There were 118 males and 103 females. In 221 slides, CD8+T cells infiltrating in invasive margin were more than those in tumor center [median (range): 37(0-141) / field vs. 14(0-106) / field, Z=-11.985, P<0.001], and the number of CD8+T cell in the tumor center was positively correlated with those in invasive margin (r=0.610, P<0.001). The number of CD8+ T cell in tumor center was positively correlated with the relative expression of CD8B gene (r=0.524, P=0.012). Survival analysis showed that the overall survival of the high infiltration group was better than that of the low infiltration group both in tumor center and invasive margin (median survival: 84.1 months vs. 73.5 months, P<0.001; 84.2 months vs. 75.9 months, P=0.002). Cox regression analysis revealed that high CD8+T cell infiltration in tumor center was an independent protective factor of overall survival (HR=0.369, 95% CI: 0.168-0.812, P=0.013). Conclusions: The infiltration level of CD8+T cells in tumor center is lower than that in invasive margin, and they are positively correlated. The level of CD8+ T cell infiltration in tumor center is related to overall survival and can be used as a potential pronostic marker.

[Analysis on clinical efficacy, safety and economy of Shaobei injection and elastic band ligation in the treatment of grade II or III hemorrhoids].

Objective: Currently, various treatments such as hemorrhoidectomy, ligation and sclerotherapy injection can be applied in grade II or III hemorrhoids. This study aims to compare the clinical efficacy, safety and economy between Shaobei injection and elastic band ligation in treating patients with grade II or grade III hemorrhoids. Methods: A retrospective cohort study was used. Clinical data of 60 patients with grade II or grade III hemorrhoids at Department of Anorectal Surgery of the Sixth Affiliated Hospital, Sun Yat-sen University between January 2019 and October 2019 were collected. Patients were divided into two groups according to surgical methods. Patients in the Shaobei group received Shaobei injection (n=28), and those in the ligation group received elastic band ligation (n=32). Inclusion criteria: (1) diagnosis of grade II or III hemorrhoid; (2) application of Shaobei injection or elastic band ligation; (3) age between 18-75 years old. Exclusion criteria: (1) comorbidity with anal fissure, anal fistula, anal sinusitis or other perianal diseases; (2) patients with mental disorder or poor compliance; (3) incomplete clinical or follow-up data. Recurrent rate, postoperative pain, anal edema, anal distension, total cost of hospitalization, length of hospitalization, and postoperative life quality EQ-5D-3L score were compared between the two groups at postoperative 6-month. Results: No significant difference was observed in the baseline data (including Nystrom hemorrhoid symptom score) between the two groups (all P>0.05), except gender ratio [male proportion: Shaobei 75% (21/28) vs. ligation 37.5%(12/32), χ(2)=8.485, P=0.004]. No significant difference in recurrent rate was found between the two groups [14.3% (4/28) vs. 9.4% (3/32), χ(2)=0.035, P=0.851]. Compared to the ligation group, Shaobei group showed less pain at postoperative day 1 [VAS median (range): 2 (1-6) vs. 3 (1-7), Z=2.814, P=0.005] and postoperative day 7 [VAS median (range): 0 (0-2) vs. 1 (0-4), Z=3.149, P=0.002]; lower anal edema ratio at postoperative day 1 [10.7% (3/28) vs. 34.4% (11/32), Z=4.673, P=0.037]; lower anal distension ratio at postoperative day 1 [7.1% (2/28) vs. 28.1% (9/32), Z=4.391, P=0.048]; less hospitalization cost [(6343.5±1444.1) yuan vs. (10 587.1± 1719.0) yuan, t=12.515, P<0.001] and shorter postoperative hospital stay [median (range): 1 (1-5) days vs. 3 (1-6) days, Z=5.879, P<0.001]. The EQ-5D-3L scores of two groups were significantly improved six months after treatment [Shaobei group: (0.90±0.16) vs. (0.73±0.14); ligation group: (0.91±0.13) vs. (0.74±0.10); both P<0.001], while there was no statistically significant difference between the two groups (t=0.130, P=0.897). No complications such as massive hemorrhage, infection, iatrogenic anal fistula, rectal stricture and local induration occurred after the injection. Conclusions: Shaobei injection is effective and safe in treating grade II or III hemorrhoids. Compared with elastic band ligation, it can reduce morbidity of complications and hospitalization expenses.

Long noncoding RNA ILF3-AS1 regulates myocardial infarction via the miR-212-3p/SIRT1 axis and PI3K/Akt signaling pathway.

OBJECTIVE: Myocardial infarction (MI) is a serious cardiac disease due to its high incidence and mortality worldwide. Long noncoding RNAs (lncRNAs) have been found to play an essential role in the pathological progress of various cardiovascular diseases. ILF3-AS1 is a newly identified lncRNA, and many studies have demonstrated that ILF3-AS1 affects the development of various malignancies. However, the biological function of ILF3-AS1 and its underlying mechanism in MI are still unknown. In the present study, the function of ILF3-AS1 and the possible mechanisms against hypoxia-induced apoptosis in H9c2 cells were investigated. MATERIALS AND METHODS: H9c2 cells were exposed to hypoxia (1% O2) to mimic the in vitro model of MI. The levels of lncRNA ILF3-AS1 and microRNA miR-212-3p were measured by real-time PCR (RT-PCR). Transfection was performed to upregulate the levels of ILF3-AS1 and miR-212-3p. Western blot assays were carried out to measure protein expression. The relationship between ILF3-AS1 and miR-212-3p was verified by Dual-Luciferase reporter assay. RESULTS: We found that ILF3-AS1 was downregulated by hypoxia. Overexpression of ILF3-AS1 resulted in the relief of hypoxia-induced damage to H9c2 cells by rescuing cell viability, migration, and invasion and suppressing apoptosis, while downregulation of ILF3-AS1 had the opposite effects. Moreover, ILF3-AS1 could negatively regulate miR-212-3p expression, and upregulation of ILF3-AS1 could alleviate hypoxic injury via downregulation of miR-212-3p. Moreover, miR-212-3p negatively regulated SIRT1 expression. Further investigations revealed that ILF3-AS1 activated PI3K/Akt signaling and that application of the PI3K inhibitor LY294002 could abrogate the protective effects of ILF3-AS1 against hypoxia. CONCLUSIONS: In summary, we concluded that ILF3-AS1 provides protection against hypoxia-induced injury via the PI3K/Akt pathway, which may provide clues for the treatment of patients with MI.

Transcriptomic changes in the nasal epithelium associated with diesel engine exhaust exposure.

BACKGROUND: Diesel engine exhaust (DEE) exposure causes lung cancer, but the molecular mechanisms by which this occurs are not well understood. OBJECTIVES: To assess transcriptomic alterations in nasal epithelium of DEE-exposed factory workers to better understand the cellular and molecular effects of DEE. METHODS: Nasal epithelial brushings were obtained from 41 diesel engine factory workers exposed to relatively high levels of DEE (17.2-105.4 µg/m3), and 38 unexposed workers from factories without DEE exposure. mRNA was profiled for gene expression using Affymetrix microarrays. Linear modeling was used to identify differentially expressed genes associated with DEE exposure and interaction effects with current smoking status. Pathway enrichment among differentially expressed genes was assessed using EnrichR. Gene Set Enrichment Analysis (GSEA) was used to compare gene expression patterns between datasets. RESULTS: 225 genes had expression associated with DEE exposure after adjusting for smoking status (FDR q < 0.25) and were enriched for genes in pathways related to oxidative stress response, cell cycle pathways such as MAPK/ERK, protein modification, and transmembrane transport. Genes up-regulated in DEE-exposed individuals were enriched among the genes most up-regulated by cigarette smoking in a previously reported bronchial airway smoking dataset. We also found that the DEE signature was enriched among the genes most altered in two previous studies of the effects of acute DEE on PBMC gene expression. An exposure-response relationship was demonstrated between air levels of elemental carbon and the first principal component of the DEE signature. CONCLUSIONS: A gene expression signature was identified for workers occupationally exposed to DEE that was altered in an exposure-dependent manner and had some overlap with the effects of smoking and the effects of acute DEE exposure. This is the first study of gene expression in nasal epithelial cells of workers heavily exposed to DEE and provides new insights into the molecular alterations that occur with DEE exposure.

Microarray analyses of the dorsal root ganglia support a role for innate neuro-immune pathways in persistent pain in experimental osteoarthritis.

OBJECTIVE: Following destabilization of the medial meniscus (DMM), mice develop experimental osteoarthritis (OA) and associated pain behaviors that are dependent on the stage of disease. We aimed to describe changes in gene expression in knee-innervating dorsal root ganglia (DRG) after surgery, in order to identify molecular pathways associated with three pre-defined pain phenotypes: "post-surgical pain", "early-stage OA pain", and "persistent OA pain". DESIGN: We performed DMM or sham surgery in 10-week old male C57BL/6 mice and harvested L3-L5 DRG 4, 8, and 16 weeks after surgery or from age-matched naïve mice (n = 3/group). RNA was extracted and an Affymetrix Mouse Transcriptome Array 1.0 was performed. Three pain phenotypes were defined: "post-surgical pain" (sham and DMM 4-week vs 14-week old naïve), "early OA pain" (DMM 4-week vs sham 4-week), and "persistent OA pain" (DMM 8- and 16-week vs naïve and sham 8- and 16-week). 'Top hit' genes were defined as P < 0.001. Pathway analysis (Ingenuity Pathway Analysis) was conducted using differentially expressed genes defined as P < 0.05. In addition, we performed qPCR for Ngf and immunohistochemistry for F4/80+ macrophages in the DRG. RESULTS: For each phenotype, top hit genes identified a small number of differentially expressed genes, some of which have been previously associated with pain (7/67 for "post-surgical pain"; 2/14 for "early OA pain"; 8/37 for "persistent OA pain"). Overlap between groups was limited, with 8 genes differentially regulated (P < 0.05) in all three phenotypes. Pathway analysis showed that in the persistent OA pain phase many of the functions of differentially regulated genes are related to immune cell recruitment and activation. Genes previously linked to OA pain (CX3CL1, CCL2, TLR1, and NGF) were upregulated in this phenotype and contributed to activation of the neuroinflammation canonical pathway. In separate sets of mice, we confirmed that Ngf was elevated in the DRG 8 weeks after DMM (P = 0.03), and numbers of F4/80+ macrophages were increased 16 weeks after DMM (P = 0.002 vs Sham). CONCLUSION: These transcriptomics findings support the idea that distinct molecular pathways discriminate early from persistent OA pain. Pathway analysis suggests neuroimmune interactions in the DRG contribute to initiation and maintenance of pain in OA.

[Efficacy analysis of Altemeier and Delorme procedures for the rectal prolapse].

Objective: To evaluate the quality of life after Altemeier and Delorme procedures for rectal prolapse patients. Methods: A retrospective cohort study was performed. Clinical data of patients with full-thickness rectal prolapse undergoing surgical treatment in the Sixth Affiliated Hospital, Sun Yat-sen University from February 2013 to January 2018 were retrospectively analyzed. Patients who had no preoperative imaging data, who suffered from internal rectal intussusception, or who did not undergo Altemeier and Delorme operations were excluded. Sixty-seven patients were enrolled, including 32 males with median age of 20.5 (13, 34) years and 35 females with median age of 65.0 (50, 77) years. According to different procedures, patients were divided into the Altemeier group (48 cases) and the Delorme group (19 cases), who received standard Altemeier and Delorme operations respectively. The maximal prolapse length of preoperative squat position, the Longo constipation score, Wexner incontinence score, EQ-5D-5L score, postoperative complications and recurrence rate were analyzed and compared between two groups. Results: The maximal prolapse length of preoperative squat position in Altemeier group and Delorme group was (7.3±3.3) cm and (4.9±2.1) cm respectively with significant difference (t=2.907, P=0.005). The operations in both groups were successfully completed. The operation time and postoperative hospital stay of Altemeier group were longer than those of Delorme group [(112.3±47.0) minutes vs. (80.7±35.4) minutes, t=2.637, P=0.010; (11.3±5.0) days vs. (8.6±3.0) days, t=2.177, P=0.033]. The median follow-up period was 26 (13, 45) months. In the last follow-up, compared to pre-operation, the Longo constipation score [9.0 (6.0, 14.0) vs 4.0 (1.0, 6.5), Z=-4.989, P<0.001], Wexner incontinence score [0 (0, 5.5) vs. 0 (0, 2.0), Z=-3.325, P<0.001] and EQ-5D-5L score [45.0 (40.0, 57.5) vs. 80.0 (70.0, 87.5), Z=-5.587, P<0.001] were all improved obviously in the Altemeier group, meanwhile Longo constipation score [6.0 (5.0, 14.0) vs. 3.0 (1.0, 7.0), Z=-2.186, P=0.029], Wexner incontinence score [0 (0, 12.0) vs. 0 (0, 4.0), Z=-2.325, P=0.020] and EQ-5D-5L score [50.0 (35.0, 60.0) vs. 75.0 (65.0, 90.0), Z=-3.360, P=0.001] in the Delorme group were all improved obviously as well. The postoperative morbidity of complication between the two groups was not significantly different [10/48 (20.8%) vs. 4/19 (21.1%), χ(2)=0.049, P=0.826]. Sixteen patients (28.0%) relapsed after operation, including 10 patients in the Altemeier group and 6 patients in the Delorme group, without statistically significant difference (P=0.134). Conclusions: Both the Altemeier and Delorme procedures are effective treatments for rectal prolapse, which can improve the postoperative quality of life. Delorme procedure has the advantages of shorter operation time and faster postoperative recovery in patients with mild prolapse.

Gas Phase Ion Chemistry to Determine Isoaspartate in a Peptide Backbone.

Proof of concept evidence is presented for a new method for the determination of isoaspartate, an important post-translational modification. Chemical derivatization is performed using common reagents for the modification of carboxylic acids and shown to yield suitable diagnostic information with regard to isomerization at the aspartate residue. The diagnostic gas phase chemistry is probed by collision-induced dissociation mass spectrometry, on the timescale of the MS experiment and semi-quantitative calibration of the percentage of isoaspartate in a peptide sample is demonstrated. Graphical Abstract ᅟ.

Sirt1 mediates improvement in cognitive defects induced by focal cerebral ischemia following hyperbaric oxygen preconditioning in rats.

Hyperbaric oxygen preconditioning (HBO-PC) has been proposed as a safe and practical approach for neuroprotection in ischemic stroke. However, it is not known whether HPO-PC can improve cognitive deficits induced by cerebral ischemia, and the mechanistic basis for any beneficial effects remains unclear. We addressed this in the present study using rats subjected to middle cerebral artery occlusion (MCAO) as an ischemic stroke model following HBO-PC. Cognitive function and expression of phosphorylated neurofilament heavy polypeptide (pNF-H) and doublecortin (DCX) in the hippocampus were evaluated 14 days after reperfusion and after short interfering RNA-mediated knockdown of sirtuin1 (Sirt1). HBO-PC increased pNF-H and DCX expression and mitigated cognitive deficits in MCAO rats. However, these effects were abolished by Sirt1 knockdown. Our results suggest that HBO-PC can protect the brain from injury caused by ischemia-reperfusion and that Sirt1 is a potential molecular target for therapeutic approaches designed to minimize cognitive deficits caused by cerebral ischemia.

[Effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand].

Objective: To investigate the effects of vacuum sealing drainage technique in acute and chronic suppurative tenosynovitis of hand. Methods: A total of 9 cases acute and chronic suppurative tenosynovitis patients from January 2013 to April 2015 in Puai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology were retrospectively reviewed. There were 6 males and 3 females, aging from 27 to 65 years, the average age was 55 years. There were 3 cases of index finger, 3 cases of middle finger, 2 cases of ring finger, 1 case include three fingers. The infection causes included stabbing with fishbone in 3 cases, stabbing with animal bone fragments in 3 cases, wound by sawdust in 3 cases, meat grinder injury in 1 case, multiple fingers crush injury postoperative infection of garbage truck in 1 case. Bacterial infection included 2 cases with Staphylococcus aureus, 2 cases with Staphylococcus epidermidis, 1 case with normal Escherichia coli, 1 case with mixed infection of Enterobacter aerogenes, Klebsiella oxytoca and Staphylococcus, 1 case with Bauman Acinetobacter bacillus, 1 case with Proteus mirabilis and 1 case of no growth of pathogenic bacteria culture. After thorough debridement, vacuum sealing drainage was used to observe the characteristics of irrigation fluid, the formation of cavity inflammation, the prognosis of infection and the recovery of finger function. Results: Seven patients with suppurative tenosynovitis were treated for 7 to 14 days, replaced the vacuum sealing drainage dressing once; 1 patient was an illustration of the finger tip defect flap infected patients after 21 days of treatment, replaced the vacuum sealing drainage dressing twice, 1 patient was an illustration of the central refers to trauma, postoperative infection patients 28 d, replaced three times in the VSD. The follow-up time was 3 to 12 months (mean 8.2 months), 7 patients without tendon necrosis, secondary suture with no infection, 2 cases of traumatic surgery of patients with infection, tendon necrosis was removed, the infection has been effectively controlled, secondary suture with no infection. There were 6 cases were good and 3 cases were poor in the evaluation of postoperative finger function. Conclusion: Thoroughly debridement after vacuum sealing drainage in the treatment of suppurative tenosynovitis of hand has satisfactory curative effect.

Effect of OPCML gene on the biological behavior of gastric cancer cell line AGS.

The objective of this investigation was to explore the association of OPCML with gastric cancer and its clinical significance. The expression of OPCML was detected by immunohistochemistry in 118 cases of gastric carcinoma. The OPCML expression in the normal tissues and 7 kinds of gastric cells was assessed by RT-PCR. The recombinant plasmid pcDNA3.1-OPCML was constructed and transfected into AGS cells. CCK8 and colony formation assay were employed to analyze the effect of OPCML on AGS. Immunohistochemistry results showed that the expression of OPCML in gastric cancer was 68.6% and the expression of OPCML was negatively correlated with the depth of tumor invasion and tumor differentiation degree (P < 005); OPCML expression, depth of tumor invasion, lymph node metastasis and distant metastasis were important factors affecting the prognosis of the survival of the patients (P <0.05). OPCML m-RNA expression in the gastric cancer cells was significantly lower than that in the normal gastric mucosa. RT-PCR showed that the expression of OPCML was aberrantly increased in the cells transfected with pcDNA3.1-OPCML. CCK8 and colony formation assay showed that OPCML significantly inhibited the growth, proliferation, and colony formation of the AGS cells. OPCML plays an important role in gastric cancer, and may be a new prognostic indicator of gastric cancer.

Single-nucleotide polymorphisms of peroxisome proliferator-activated receptor-γ are associated with systemic lupus erythematosus in a Chinese Han population.

BACKGROUND: Evidence has indicated that peroxisome-proliferator activated receptor-γ (PPAR-γ) agonists could be used in the prevention and treatment of murine systemic lupus erythematosus (SLE). However, to our knowledge, just one previous study has focused on the association between PPAR-γ polymorphisms and SLE in humans. AIM: To investigate the association between PPAR-γ polymorphisms and SLE in a Chinese population and on additional gene-gene interaction between multiple single nucleotide polymorphisms (SNPs) in PPAR-γ. METHODS: Three SNPs of PPAR-γ were selected for genotyping in this case-control study: rs1805192, rs10865710 and rs709158. Logistic regression was used to examine the association between the three SNPs and SLE, and the odds ratio (OR) and 95% CI were calculated. Generalized multifactor dimensionality reduction (GMDR) was used to investigate additional interaction. RESULTS: All genotypes were distributed according to Hardy-Weinberg equilibrium. Logistic regression analysis showed a significant association between genotypes of rs1805192 variants and decreased SLE risk, after adjustment for sex, age, smoking, high-fat diet, low-fibre diet, alcohol status, body mass index and waist circumference. Participants with Ala allesles had a lower SLE risk than those homozygous for the wild-type allele (OR = 0.78; 95% CI 0.69-0.92). GMDR analysis indicated that there was a significant two-locus model (P = 0.001) involving rs1805192 and rs10865710, indicating a potential gene-gene interaction between them. Overall, the two-locus models had a cross-validation consistency of 10 out of 10 and a testing accuracy of 60.72%. CONCLUSIONS: There was a significant association between PPAR-γ rs1805192 genotypes and decreased SLE risk, and a potential gene-gene interaction between rs1805192 and rs10865710.

Analysis of KIT mutations and c-KIT expression in Chinese Uyghur and Han patients with melanoma.

BACKGROUND: The KIT gene plays an important role in the pathogenesis of malignant melanoma (MM). In recent years, activating mutations in KIT have been recognized as oncogenic. A number of therapies have been established, which provide significant clinical benefits for patients with MM with KIT mutations. Thus, detection of KIT mutations can have profound therapeutic implications. AIM: To investigate KIT gene expression in MMs in Chinese Uyghur and Han patients with mutations in KIT, and to identify the clinical features associated with KIT mutations and c-KIT expression. METHODS: In total, 105 MMs (56 from Uyghur and 49 from Han patients) were selected from patients in the Uyghur Autonomous region. Formalin-fixed, paraffin wax-embedded tumour sections were analysed for c-KIT expression using immunohistochemistry. Exons 11 and 13 of KIT were analysed for the presence of mutations using PCR amplification and DNA sequencing. RESULTS: Of the 105 MMs, 13 (10 Han and 3 Uyghur) were found to have mutations in KIT. Thus, the frequency of KIT mutations in Han patients was significantly higher than that in Uyghur patients (P = 0.02). We detected c-KIT expression in 71.4% and 42.9% of the tumour tissue samples collected from the Uyghur and Han patients, respectively. CONCLUSION: In the Xinjiang Uyghur Autonomous Region in China, chronic sun-induced damage MM is the most prevalent MM among Chinese Uyghur patients, whereas acral and mucosal MMs are the most prevalent in Uyghur patients. Mutations in the KIT gene do not correlate with c-KIT expression.

Association between genetic polymorphisms of PTGS2 and glioma in a Chinese population.

Several previous studies indicated that genetic polymorphisms in inflammatory factor genes were associated with glioma risk. However, the relationship between the prostaglandin-endoperoxide synthase 2 (PTGS2) genetic polymorphism and glioma remains unclear in the Chinese population. We selected 199 histologically confirmed adult glioma patients and 199 cancer-free controls for the present study and analyzed the distribution of the PTGS2 genotypes and haplotypes. We found that the CC+CT genotype of rs5275 was common in the control group but not in the glioma group (P = 0.033). In addition, we found that the frequency of the C allele was higher in the control group than in the glioma group (P = 0.014). For rs6681231, although we found no significant difference between the 2 groups in genotype distribution, we found that the frequency of the C allele was lower in glioma patients than in control subjects (P = 0.044). We found no significant difference between these 2 groups in the rs689466 genotype and allele distributions. Haplotype analysis suggested that the frequency of the C-A-C haplotype was significantly lower in glioma patients than in control subjects [P = 0.028, odds ratio (OR) = 0.628, 95% confidence interval (CI) = 0.413-0.955]. However, the frequency of the T-A-G haplotype was higher in glioma patients than in control subjects (P = 0.036, OR = 1.418, 95%CI = 1.022-1.967). Therefore, polymorphisms in the PTGS2 gene may be associated with glioma susceptibility in the Chinese population.

Anatomical information for intercostobrachial nerve preservation in axillary lymph node dissection for breast cancer.

This study aimed to provide additional anatomical information for axillary lymph node dissection (ALND) through in vivo anatomy studies of intercostobrachial nerve (ICBN) preservation in order to provide theoretical and practical experience for clinicians. A total of 156 patients with breast cancer underwent ALND at the Department of Gynecology of Baotou Tumor Hospital between June 2009 and March 2010. The origin, destination, main source, length, branch type, and direction of ICBN in axilla were observed, as well as its relationship with adjacent major blood vessels and nerves within the axilla. There were 120 cases of single trunk, 23 cases of double trunks, 9 cases of multiple trunks, and 4 cases without trunks in 156 patients with ICBN preservation. The transverse diameter at the origin of the ICBN was 1.89 ± 0.44 mm with a length of 94.45 ± 12.08 mm; the distances were 77.19 ± 21.04 mm, 29.34 ± 6.73 mm, 90.04 ± 13.13 mm, and 28.63 ± 13.01 mm from origin to the inferior margin at the midpoint of the clavicle, inferior margin of the axillary vein, the bottom of axilla, and branch point, respectively. The identification, dissection, and preservation of ICBN was simple and easy in a modified radical mastectomy for breast cancer and breast-conserving surgery, which only took 10-20 min, but effectively reduced the incidence of post-mastectomy pain syndrome and significantly improved the quality of life for patients after surgery.

Partial stapled hemorrhoidopexy versus circular stapled hemorrhoidopexy for grade III-IV prolapsing hemorrhoids: a two-year prospective controlled study.

BACKGROUND: Circular stapled hemorrhoidopexy (CSH) is an effective technique for treating prolapsing hemorrhoids; but urgency and anal stenosis are common postoperative complications. The aim of this study was to assess the efficacy and postoperative outcomes of partial stapled hemorrhoidopexy (PSH), compared with CSH. METHODS: Seventy-two consecutive patients with grade III and IV hemorrhoids who met the inclusion/exclusion criteria were divided in a non-randomized manner to undergo either PSH (n = 34) or CSH (n = 38). Intraoperative and postoperative parameters in both groups were collected and compared. RESULTS: The postoperative visual analog score for pain at first defecation was significantly lower in the PSH group than that in the CSH group (P = 0.001). Fewer patients in the PSH group experienced postoperative urgency, compared with those in the CSH group at 12 h, 1 day, and 7 days after surgery (P = 0.025, P = 0.019, and P = 0.043, respectively). Gas incontinence occurred in 3 patients (7.9%) in the CSH group, but in none of patients in the PSH group (P = 0.242). Postoperative anal stenosis developed in one patient (2.6%) in the CSH group, but in none of the patients in the PSH group (P = 1.0). The 2-year recurrence rate was 2.9 and 5.3%, respectively, in the PSH and CSH groups (P = 1.0). CONCLUSIONS: The 2-year recurrence rate is similar in patients with grade III-IV hemorrhoids treated with PSH or CSH. However, PSH is associated with less postoperative pain, fewer episodes of urgency, and no anal incontinence or anal stenosis.