New advances in the treatment of gallbladder cancer / 中华消化外科杂志

Surgery is still the first choice for the curation of early gallbladder cancer, and the surgical strategy is selected based on anatomic position of primary tumor, accurate preoperative stage, and strict indication assessment in order to achieve the optimal curative effect. However, most patients are in advanced stage or with distant metastasis at the first diagnosis, and the recurrence rate and 5-year survival rate are not satisfied even if they receive curative resection. Subsequently, it is urgent for the employment of more treatment strategies in the process management of gallbladder cancer patients, such as neoadjuvant therapy, postoperative therapy and first-line or second-line treatment of local advanced and metastatic patients. In recent years, application of molecular targeted agents and immunotherapy have brought greater hope and laid a vaster prospect for the treatment of gallbladder cancer. However, there is still lack of evidence-based medicine data on the prognostic results, and further researches are needed. By integrating the domestic and abroad new research achievements, the authors systematically summarize the current status and future trend on the management of gallbladder cancer, and hope to provide a macroscopic and systemic treatment chart, including necessary details.

Recent advances in colorectal cancer liver metastases / 中华肝胆外科杂志

Liver is the most common metastatic organ in patients with advanced colorectal cancer. Once colorectal cancer liver metastasis (CRLM) occurs, the prognosis will be poor. Therefore early detection of CRLM has a great clinical significance for improving the prognosis of CRLM patients. Surgical resection of primary and metastatic lesion is the only possible curable option for CRLM, translational therapy, interventional therapy and multidisciplinary team also provide more treatment ideas. Long non-coding RNA, cancer stem cells and phosphatidylinositide-3-kinases/protein kinase B signaling pathway reveal the main mechanism of CRLM from different aspects. This article reviews the recent advances in the early diagnosis, treatments and main mechanisms of CRLM.

A tracking study on sleep characteristics of submariners during a long-term voyage / 解放军医学杂志

Objective To explore the sleep characteristics of submariners during a long-term voyage, so as to provide scientific evidence for ensuring submariners with good sleep during long-term voyages. Methods The sleep status of submariners who participated in a long-term voyage was tested by Self-Rating Scale of Sleep (SRSS) before the voyage, and before and after each voyage section during the voyage. The sleep status variation of submariners who performed different types of tasks, from the beginning to the end of each voyage section and of each resting-on-the-sea section was analyzed respectively. Comparison of sleep scores was performed between submariners and surface ship crew in the second voyage section. Numbers of submariners with sleep problem were compared in each voyage section. Results Generally speaking, submariners' sleep status at the end of voyage section was significantly worse than that at the beginning of voyage section and that before the whole voyage (P0.05). After finishing a voyage section and taking a resting-on-the-sea, submariners' sleep status returned to the level of pre-voyage (P>0.05), and was significantly better than that before the resting-on-the-sea (P0.05). Compared with that of surface ship crew who accomplished the same voyage section, submariners had an obviously better sleep status after taking a resting-on-the-sea (P0.05), but the latter was significantly more than the former when the second voyage section was finished (P<0.05). During the resting-on-the-sea period, the numbers of submariners with sleep problems in both the second and the third voyage section were significantly more than those in the first voyage section (P<0.05, P<0.01). The numbers of submariners with sleep problems who implemented the third voyage section were significantly more than those who implemented the first and the second voyage section (P<0.01). Conclusions Generally, the sleep quality of submariners is significantly worse after accomplished a voyage section task, and the degree of sleep problems may be accumulated to worse and worse along with the increase of long-term voyage time. Whereas, submariners may have a significantly better sleep status after taking a resting-on-the-sea, implying that resting-on-the-sea is an effective way to ensure submariners a good sleep during a long-term voyage.

Effect of HIF-2α on regulating CDCP1 to promote hepatocellular carcinoma metastasis / 中华肿瘤杂志

Objective@#To investigate the effect of hypoxia inducible factor 2α (HIF-2α) on regulating CUB domain-containing protein 1 (CDCP1) and its role in hepatocellular carcinoma metastasis.@*Methods@#HIF-2α-knocked down and HIF-2α-stably overexpressing cells (MHCC97H) were prepared by small interfering RNA (siRNA) and lentivirus transfection, respectively. The expression of CDCP1 protein and mRNA in the above cells was detected by western blot and real-time PCR. The effect of HIF-2α on cell invasion ability was determined by Transwell assay. Furthermore, immunohistochemical staining was performed to detect the expression of CDCP1 in human HCC tissue samples.@*Results@#Both HIF-2α and CDCP1 were induced under hypoxic conditions. The activation of CDCP1 under hypoxic conditions was dependent on the expression of HIF-2α.When HIF-2α was overexpressed, the mRNA level of CDCP1 was greatly upregulated (5.92±0.28, P<0.05). When HIF-2α was knocked down by siRNA for 48 h and 72 h, the expression of CDCP1 was significantly downregulated (48 h: 0.25±0.04; 72 h: 0.18±0.02, all P<0.05). Moreover, analysis of human HCC samples showed that CDCP1 expression was correlated with tumor-free survival (P<0.05).@*Conclusions@#The results of this study indicate that the expression of CDCP1 is regulated by HIF-2α and is correlated with the progression of HCC. Inhibition of HIF-2α/CDCP1 may play certain inhibitory role in the metastasis of HCC.

Bolton analysis with malocclusions in Shanghai Fengxian district / 中国基层医药

Objective To measure Bolton index with malocclusions in Shanghai Fengxian district,and ana-lyze the distinction among different malocclusions patients in respect of gengder,age,and different Angle classifica-tion.Methods Measure Bolton index of plaster models of 348 eligible malocclusions patients who were selected ran-domly from Shanghai Fengxian District,and divided them into different groups by gender,age and Angle classification. Then,Bolton overall ratio and Bolton anterior ratio among these groups were analyzed and compared.Results The results showed that there were no significant differences of Bolton analysis in respect of gender or age(all P >0.05). It exsisted obvious differences in anterior ratios among the three Angle malocclusion class(P <0.05).Bolton anterior ratios were (79.88 ±3.15)%,(78.91 ±2.86)% and (80.59 ±1.55)%,mean of Class I and mean of ClassⅢwere bigger than that of Class Ⅱ.Bolton overall ratios of Angle class Ⅰ,classⅡ and class Ⅲ were (79.88 ± 3.15)%,(79.88 ±3.15)% and (79.88 ±3.15)%,and there were no obvious differences in overall ratios among them.Conclusion Bolton index with malocclusions for Shanghai Fengxian District accord with normol Bolton index of our country.Gender and age are not the influencing factors of Bolton index in Fengxian District.Bloton index anomalies are the important fator in malocclusions.We should pay more attention to the Bolton analysis of class Ⅱ malocclusions in clinical practice,and draw up a treatment plan combined with specific classification.

Application value of detection on stathmin, p16 and Ki-67 in the cervical intractable cases / 肿瘤研究与临床

Objective To investigate the clinical application value of stathmin, p16 and Ki-67 in the cervical intractable cases. Methods Immunohistochemical method was used to detect the expressions of stathmin, p16 and Ki-67 in surgical specimens of 288 cervical intractable cases, including 30 cases of cervical benign changes, 70 cases of cervical intraepithelial neoplasia (CIN)Ⅰ, 78 cases of CINⅡ, 85 cases of CINⅢand 25 cases of squamous cell carcinoma (SCC, as control group). The application value of stathmin, p16 and Ki-67 in the cervical cases were analyzed. Results The positive expression rates of Ki-67 of cervical benign changes and CINⅠwere 20.0 % (6/30) and 54.3 % (38/70) (χ2 = 3.29, P> 0.05). The expression rates of Ki-67 in CINⅡ, CINⅢ and SCC were all 100.0 %, and compared with the cervix benign changes, the differences were statistically significant (χ2= 112, P0.05), but the expression rates in CINⅢ and SCC were higher than those in cervical benign change, CINⅠand CIN Ⅱ(P< 0.01). The positive expressions of stathmin, p16 and Ki-67 in each group of CIN were positively correlated (r= 0.412, P< 0.05). Conclusions Combined detection of p16 and Ki-67 can assist in the differential diagnosis of cervical intractable cases, and provide objective indicators for the classification and accurate diagnosis of CIN. Combined detection of p16 and stathmin may help to identify high-grade, low-grade CIN and cervix benign changes for the reduction of over-treatment.

Influence of microvascular invasion on progression-free survival in patients with a solitary small hepatocellular carcinoma / 中华肝胆外科杂志

Objective To study the influence of microvascular invasion (MVI) on progression-free survival (PFS) in patients with a solitary small hepatocellular carcinoma,and to analyze the risk factors of MVI.Methods 126 patients with a solitary small hepatocellular carcinoma who underwent liver resection at Tianjin Medical University Cancer Hospital from January 2010 to December 2012 were retrospectively studied.Their demographic and clinicopathological characteristics including age,gender,HBV infection,HCV infection,alcohol consumption,comorbidity,liver cirrhosis,ascites,tumor size,tumor differentiation,MVI,satellite lesion,AFP,CA19-9,ALT and TBil were analyzed.Results The 1-,2-and 3-year PFS rates of patients with a solitary small hepatocellular carcinoma were 81.0％,60.3％ and 47.3％ after surgical resection,respectively.Univariate analysis revealed that MVI,comorbidity,non-well-differentiated tumor,tumor size ＞4 cm were risk factors of PFS.Multivariate analysis demonstrated that only MVI and comorbidity were independent factors of PFS.MVI occurred in 43.7％ of the patients.The median PFS of patients without MVI was 45 months,and the 1-,2-and 3-year PFS rates of these patients were 91.5％,67.6％ and 56.0％,respectively.The median PFS of patients with MVI was 30 months,and the 1-,2-and 3-year PFS rates were 67.3％,50.9％ and 35.4％,respectively.On univariate analysis,AFP ＞ 100 μg/L,non-well-differentiated tumor and satellite lesions were significantly associated with MVI.On multivariate analysis only non-well-differentiated tumor was independently associated with MVI.Conclusions MVI was an important factor affecting PFS in patients with a solitary small hepatocellular carcinoma.AFP ＞ 100 μg/L,non-well-differentiated tumor and satellite lesions were risk factors of MVI.

Diagnosis and treatment of autoimmune pancreatitis / 中华消化外科杂志

Objective To investigate the diagnosis and treatment of autoimmune pancreatitis (AIP).Methods The clinical data of 25 patients with AIP who were admitted to the Cancer Hospital of Tianjin Medical University between January 2009 and December 2013 were retrospectively analyzed.Patients received the test of serum γ-globulin and IgG4 and abdominal imaging examination.The revised HISORt or results of postoperative pathological examination were performed as diagnostic criteria.Patients who were unable to tolerate surgery were treated by oral prednisone.The focal masses were apparent in the pancreas by imaging examination,which cannot exclude the possibility of malignancy because of ambiguous pathologic characters of masses.Patients who received ineffective hormonal therapy and were able to tolerate surgery underwent surgery.All the patients were followed up by outpatient examination and telephone interview up to December 2014.Results Primary symptoms:jaundice was detected in 16 patients,obvious weight loss (weight loss ＞ 10％ standard body mass) in 4 patients,chronic diarrhea (duration of diarrhea ＞ 2 months or 2 weeks ＜ duration of intermittent diarrhea ＜ 4 weeks) in 3 patients and abdominal pain in 2 patients.Abnormal level of serum γ-globulin and increasing level of IgG4 were detected in 13 and 1 pateints.The results of imaging examinations showed that pancreatic masses,stenosis of bile duct and extrapancreactic organ involvement were detected in 19,6 and 11 patients.Of 25 patients with AIP,10 underwent conservative treatment without adverse reaction and 15 underwent surgical treatment,including 13 of 15 patients undergoing pancreaticoduodenectomy and 2 of 15 patients undergoing resection of the body and tail of the pancreas + splenectomy.The operation time,volume of intraoperative blood loss and postoperative recovery time of gastrointestinal function in 15 patients undergoing surgery were (271 ±59) minutes,(268 ± 109) mL and (3.8 ± 1.2)days.After operation,2 patients were complicated with abdominal infection and had remission of symptoms by symptomatic treatment,including 1 with pancreatic fistula and 1 with delayed gastric emptying.The duration of hospital stay of 15 patients undergoing surgery was (11.5 ± 2.9)days.The results of postoperative pathological examination showed that there were central acinar atrophy,extensive fibrosis,lymphoplasmacytic cell infiltration,nerve tissue surrounded by the plasma cell lymphoma and obstructive phlebitis.The absolute value of positive cells of IgG4 was more than 50 high power field and number of positive cells of IgG4 was more than positive cells of 40％ IgG.Twenty-five patients were followed up for a median time of 27 months (range,6-47months).Nineteen patients had remission of symptoms at month 6 after treatment with normal level of serum γ-globulin and IgG4 and without recurrence of pancreatic masses,including 7 receiving conservative treatment and 12 receiving surgical treatment.Conclusions The clinical signs of AIP are jaundice,abnormal serum γglobulin and pancreatic masses which are found by imaging examination.Surgery is safe and effective for the treatment of AIP,while surgical indications should be strictly followed because of the surgical trauma.

Effect of different pancreaticojejunal anastomoses on the occur-rence of pancreatic fistula after pancreaticoduodenectomy / 中国肿瘤临床

Objective:To investigate the effect of pancreaticojejunostomy on the occurrence of postoperative pancreatic fistula (POPF) after pancreaticoduodenectomy. Methods:Data from 145 patients with periampullary tumor who underwent pancreaticoduode-nectomy in Tianjin Medical University Cancer Institute and Hospital between October 2008 and August 2013 were reviewed. Factors potentially associated with POPF were analyzed by Pearson chi-square test and Logistic regression analysis. Results:Among the 145 patients, 27 were diagnosed with POPF, including 5 grade A, 17 grade B and 5 grade C. Neither duct to mucosa nor Blumgart pancreati-cojejunostomy was correlated with POPF in grade C. The univariate analysis showed that gender, pancreatic cancer, portal vein involve-ment, type of pancreaticojejunostomy, texture of pancreas, and diameter of the main pancreatic duct were closely correlated with POPF. The multivariate analysis using Logistic regression showed that different pancreaticojejunal anastomoses and genders were independent predictors of POPF. Conclusion:Different types of pancreatic anastomoses are a risk factor for POPF after pancreaticoduodenectomy.

Progress in research on animal models of liver cancer / 国际肿瘤学杂志

Asaresult,establishinganimalmodelsoflivercancerisofhighvalue.Therearetwoparts of the establishment of animal models-the selection of laboratory animals and the source of tumors.The animal models could be classified into different patterns due to difference sources of tumor,and these different patterns possess distinctive characters and limitations.The ideally animal models should satisfy the general requirements of biological habits,biochemical properties,and pathological features which are similar with human hepatocel-lular and easy to establish.

Analysis of treatment and prognosis of primary gallbladder cancer / 中华消化外科杂志

ObjectiveTo investigate the treatment strategies and factors influencing the prognosis of patients with primary gallbladder carcinoma.MethodsThe clinical data of 135 patients with primary gallbladder cancer who were admitted to the Cancer Hospital of Tianjin Medical University from January 2000 to December 2009 were retrospectively analyzed.The survival curve was drawn by the Kaplan-Meier method,and the survival rates were analyzed by using the Log-rank test.Factors which may have influences on the prognosis were analyzed by univariate analysis and COX multivariate analysis.ResultsThe overall 1-,3-,5-year survival rates of the 135 patients were 46.7％,10.4％ and 5.2％,respectively.The 1-,3-,5-year survival rates of 74 patients who received radical resection of gallbladder cancer were 68.9％,18.9％ and 9.5％,respectively.The 1-,3-,5-year survival rates of 50 patients who received palliative treatment were 24.0％,0 and 0,respectively.The 1-,3-,5-year survival rates of 11 patients who received conservative treatment were 0,0 and 0,respectively.There was no significant difference in the survival rates among patients who received different treatment methods (x2 =5.642,P ＜ 0.05 ). Of the 9 patients with gallbladder cancer who received reoperation after laparoscopic choledochotomy,the survival time of 1 patient in stage Ⅰ and 1 of the 3 patients in stage Ⅱ who received radical surgery exceeded 5 years,while the survival time of 5 patients in stage Ⅱ who received palliative treatment was shorter than 5 years.There was a significant difference in the survival time among the 3 groups of patients ( x2 =5.642,P＜0.05).Under the condition of same TNM stages ( Ⅱ,ⅢA,ⅢB,ⅣA,ⅣB),the survival rates of patients who received radical resection of gallbladder cancer were significantly higher than those who received palliative or conservative treatment ( x2 =8.971,21.250,44.153,6.696,21.722,P ＜ 0.05 ).The results of univariate analysis showed that age,CA19-9,TNM stages and treatment methods were risk factors influencing the median survival time ( x2 =8.466,3.977,9.837,5.642,P ＜ 0.05 ).The results of multivariate analysis showed that age,TNM stages and treatment methods were the independent risk factors influencing the median survival time ( Wald=5.779,14.724,11.640,P＜0.05).ConclusionThe prognosis of primary gallbladder cancer is poor.Age,TNM stages and treatment methods are the independent factors influencing the prognosis of patients with gallbladder cancer,and patients who receive radical resection have relatively good prognosis.

Metastatic solid pseudopapillary tumor of the pancreas / 中华普通外科杂志

Objective To analyze pathologic features, therapeutic strategies and prognosis of patients with metastatic solid pseudopapillary tumor of the pancreas (m-SPTP). Methods Twenty five patients with m-SPTP undergoing radical resection between June 1985 and Dec 2005 were retrospectively analyzed. Kaplan-Meier analysis was used to screen out risk factors of the prognosis of m-SPTP patients.Results Twenty-three postoperative patients were followed up until Dec 2007. The follow-up rate was 92% and the median follow up time was 78 months. The 5-year overall survival rate was 82%. Kaplan-Meier analysis showed that five variables including age, tumor size, pathologic features, number of metastatic lesions and lymphatic metastasis were related to overall survival. Conclusions Solid pseudopapillary tumor of the pancreas is low-grade malignant potential with a favorable prognosis, but not for the m-SPTP.Patients of ≥40 years old, tumor size (≥6 cm), pathologic features (including presence of areas with diffuse growth pattern and tumor necrosis), multiple metastatic lesions and lymphatic metastasis have poor prognosis.

Polymorphisms of four microsatellite markers tightly linked with polycystic kidney disease 2 gene in Chinese / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the polymorphisms of four microsatellites, D4S1534, D4S1563, D4S423 and D4S414, which are tightly linked to polycystic kidney disease 2 (PKD2) gene, and hence to provide a basis for studying the heterogeneity of adult polycystic kidney disease (APKD).</p><p><b>METHODS</b>An analysis on the DNA of some unrelated Chinese people was performed using polymerase chain reaction (PCR), polyacrylamide gel electrophoresis (PAGE) and silver staining.</p><p><b>RESULTS</b>In Chinese Hans, there are 11 alleles of D4S1534, and their sizes are 142-162 bp 14 alleles of D4S1563, 205-235 bp 17 alleles of D4S423, 103-135 bp; and 15 alleles of D4S414, 236-264 bp. The polymorphism information contents of the four microsatellites are 0.872, 0.844, 0.921 and 0.871 respectively.</p><p><b>CONCLUSION</b>In the Chinese Han people studied above, the four microsatellite markers that have many alleles are highly polymorphic genetic markers and may serve as the data of population genetics, suggesting that all four microsatellites could be used in studies on heterogeneity of APKD, linkage analysis of APKD and forensic personal identification.</p>

Expression of telomerase activity, telomerase RNA component and telomerase catalytic subunit gene in lung cancer / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate whether telomerase activity, human telomerase RNA (HTR) and human telomerase reverse transcriptase (HTERT) expression were associated with tumor development in lung cancer and whether telomerase is regulated at gene level or transcriptional level.</p><p><b>METHODS</b>Expression of HTR and HTERT was detected by reverse transcription-polymerase chain reaction (RT-PCR) in 68 human lung cancer and in 68 adjacent-neoplatic lung tissues. And telomerase activity was examined by a quantitative telomeric repeat amplification protocol (TRAP).</p><p><b>RESULTS</b>In 68 lung cancer tissues, telomerase activity, HTR and HTERT were expressed in 79%, 98.5% and 91.2% respectively, whereas all adjacent non-neoplastic lung tissues were telomerase negative. Most normal lung tissues expressed HTR (91.2%) and HTERT was detected in only 7 of 68 non-neoplastic tissues.</p><p><b>CONCLUSIONS</b>The relatively high frequency of telomerase activity in lung cancer whereas the detection of no telomerase activity in normal lung tissues suggested that telomerase may play an important role in tumorigenesis of lung cancer. Compared to HTR, HTERT expression was better associated with telomerase activity with a concordance of 88.9%. Telomerase activity may be regulated at transcription level or translation level.</p>

Study on the relationship between telomerase gene and telomerase activity in lung cancer tissue / 中国肺癌杂志

<p><b>BACKGROUND</b>To investigate the relationship between the telomerase activity and telomerase component expression in lung cancer, and to explore whether telomerase activity is regulated at the gene or transcriptional level.</p><p><b>METHODS</b>Expression of the hTR and hTERT were detected in 68 human lung cancer tissues and responsive adjacent non-neoplastic lung tissues by semi-quantitative reverse transcription-polymerase chain reaction. Telomerase activity was detected by telomeric repeat amplification protocol.</p><p><b>RESULTS</b>In 68 lung cancer tissues, the positive rate of the telomerase activity, hTR and hTERT expression were 79.4% (54/68), 98.5% (67/68) and 91.2% (62/68) respectively. Whereas most adjacent non-neoplastic lung tissues expressed hTR (62/68, 91.2%) also, hTERT was detected in only 7 (10.3%) normal lung tissues and no telomerase activity were detected in the 68 non-neoplastic lung cancer tissues. As compared with hTR, hTERT expression was closely related to telomerase activity. The concordance was 89.0% (121/136), whereas the concordance between telomerase and hTR was 43.4% (59/136).</p><p><b>CONCLUSIONS</b>The results suggest that telomerase may play an important role in tumorigenesis of lung cancer. Telomerase activity may be regulated in transcription level or translation level.</p>

Effects of nutrition intervention on psychological stress combining with sleep deprivation in rats / 解放军医学杂志

Objective To investigate the effect of nutrition intervention on psychological stress combining with sleep deprivation in rats. Methods Seventy-five male SD rats were randomly divided into five groups:control group,composite factor group,composite factor control group,nutrition group Ⅰ and nutrition group Ⅱ. The rat model of 14d psychological stress combining with 48h sleep deprivation was established by Communication Box and improved small platform methods. Rats in the 2 nutrition groups were gavaged with corresponding nutriment everyday; those in other groups were treated with gavage of physiological saline. Morris water maze place navigation test was employed to train rats and measure the ability of rats' spatial working memory. The antioxygenic potential of rats' blood serum and some nutrients were measured with corresponding kits. Results Compared with the composite factor group,the escape latency of all quadrants shortened significantly (P

Expression of TGF β1 in the Left Ventricular Tissue and its Relations to Left Ventricular Hypertrophy and Myocardial Interstitial Fibrosis in Renovasc ular Hypertensive Rats / 中华高血压杂志

Objective To investigate the roles of T GFβ1 and TGFβ1 typeⅠrecepter(TβRⅠ) in development of myocardial hypert rophy and myo cardial interstitium remodelling in renovascular hypertensive rat. 　Methods TGFβ1 and TβRⅠwere evaluated by qualitative and semi -qu antitative immunohistochemical staining to explore their distribution and ex peression in left ventricular tissue. Van Gieson staining were used in the stud y of total collagen in left ventricular interstitial tissue. 　Results Compared with sham-operated rat(SOR),the expression of T GFβ1 andTβRⅠ in left ventricular tissue were significantly increased in RHR(P <0.01 all). In RHR the antibody to TGFβ1 reacted primarily with cytoplasma a nd myo cardial interstitium while antibody to TβRⅠreacted mainly with myocyte membran es with weak labeling in myocardial interstitium. In SOR,very mild labeling for TGFβ1 and TβRⅠin myocardiun was found with no labeli ng in myocardial interstitium. Correlative analysis revealed that TGFβ1 or T βRⅠ was positively correlated with left ventricular mass index(LVMI),negativel y correlated with grey level of myocardial total collagen. Conclusions TGFβ1 and TβRⅠmay play important roles in develo pment of left ventricular hypertrophy and myocardial interstitial fibrosis.