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Objective:To study the effectiveness and safety of intra-amniotic ethacridine injection in pregnancy induction at ≥28 gestational weeks due to fetal demise.Methods:This retrospective study recruited 77 singleton pregnant women who were admitted to Peking University First Hospital at ≥28 gestational weeks, from January 1, 2011 to December 31, 2021, because of fetal demise diagnosed by ultrasound. Four groups were classified according to different methods of induction, including ethacridine success group ( n=63), ethacridine failure group ( n=4), mifepristone plus misoprostol group ( n=5), and spontaneous delivery group ( n=5). Those in the ethacridine success group were further divided into scarred and non-scarred uterus group. The differences in general conditions and delivery outcomes among these women were analyzed using t-test, one-way analysis of variance, Chi-square test, and Mann-Whitney U test or Kruskal-Wallis H test. Results:(1) Among the 67 patients induced by ethacridine, the success rate was 94.0% (63/67). (2) Compared the ethacridine success group with the mifepristone plus misoprostol group or spontaneous delivery group, respectively, there was no significant difference in total labor duration, intrapartum hemorrhage volume, weight of the dead fetus, and the incidence of postpartum hemorrhage, perineal laceration, and intrauterine residue (all P>0.05). No serious complications such as placental abruption, disseminated intravascular coagulation, intrauterine infection, uterine rupture, conversion to cesarean section, or puerperal infection occurred in the three groups. (3) The duration between ethacridine injection and labor onset was shorter in the ethacridine success group than in the mifepristone plus misoprostol group [(28.5±12.0) h vs (54.2±17.6) h, t=－4.45, P<0.001]. (4) Among the 63 cases of ethacridine success group, the outcomes after induction were similar between scarred and non-scarred uterus group (all P>0.05). (5) The median duration between ethacridine injection and labor onset in the ethacridine success group was 26.8 h (2.3-66.0 h), which meant 95% of the patients went into labor within 51.7 h and 100% within 66 h after the injection. Conclusion:Intra-amniotic injection of ethacridine is safe and effective in termination for singleton pregnancy due to fetal demise at the third trimester and the duration from drug administration to labor onset was significantly shorter than that of mifepristone plus misoprostol, without increasing the risk of any complications.
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Objective To research the expression of Neuritin in gastric cancer .and the relationship between the expression of Neuritin with the occurrence and development of gastric cancer .Methods Collected 58 surgical specimens of gastric cancer from 2010 to 2013 in the first affiliated hospital of Shihezi University ,immunohistochemistry was used to examine the expression of Neu-ritin in gastric cancer and normal tissues near the cancer of the stomach .Results Immunohistochemical staining showed that Neu-ritin was moderately or highly expressed in 96 .55% (56/58) of gastric cancer ,and Neuritin was moderately or highly expressed in 94 .83% (55/58) of normal tissues near the cancer .There was no statistically significantly difference between two groups (P>0 .05);Neuritin was highly expressed in 82 .76% (48/58) of gastric cancer ,and Neuritin was highly expressed in 15 .52% (9/58) of normal tissues near the cancer ,differences between the two groups had statistically significantly (P 0 .05) .Conclusion The Neuritin expression level between gastric cancer and normal tissues near the cancer exist differences .There is overexpression of neuritin in gastric cancer .
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Cdx2 plays an important role in the proliferation and differentiation of normal intestinal cells. It has been suggested that Cdx2 is a master regulator of the intestinal differentiation program and is therefore not usually expressed outside the intestinal organs. Loss of Cdx2 expression leads to focal gastric differentiation in the colon, whereas aberrant expression of Cdx2 in the upper digestive tract may induce the initial trans-differentiation to intestinal metaplasia. The detection of a strong nuclear immunoreactivity for Cdx2 in metaplastic cells suggests that the protein is a major transcription factor in the development of intestinal metaplasia.Abnormal expression of Cdx2 is also correlated with early stage of adenocarcinoma in different organs, indicating that the protein may play an anti-oncogenic role in cancer development. The Inflammation-metaplasia-cancer'sequence is a frequent event in the lower esophagus, stomach, uterine cervix and the bladder. In all these specific anatomical sites, the noxious stimuli leading to metaplasia may have direct and/or indirect carcinogenic effects on chronically injured cells and Cdx2 plays a key role in the cascade process. Detection of Cdx2 expression in adenocarcinoma may be useful in the evaluation of malignancy and prognosis.
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Objective To compare the number of lymph node dissected by intraoperative lymphatic mapping guided D2 gastrectomy and that by standard D2 gastrectomy plus lymphadenectomy in patients of advanced gastric cancer. Methods In this study 20 advanced gastric cancer cases received intraoperative peritumor injection of carbon nanoparticles suspension ( group 1 ) and D2 lymphadenectomy was guided by the black-stained lymph nodes. 21 cases undergoing standard D2 lymphadenectomy served as controls (group 2). The number of lymph nodes removed and the condition of lymphatic metastasis in two groups, blackstained lymph nodes in group 1, and postoperative complications were compared. Results The average lymph nodes dissected in group 1 (35. 1 ± 13.4) were higher than in control group (26.2 ±7.8). The differences were statistically significant (t =2. 126, P =0. 034). The number of removed N2 and N3 lymph nodes in group 1 were more than that in control group. The total black-stained ration of lymph nodes was 52. 7% in group 1. The positive rate of lymph nodes was higher in black-stained lymph nodes (27.6%) than in unstained lymph nodes ( 10. 8% ) in group 1 and in control group ( 16. 9% ). The differences were also statistically significant ( x2 = 6. 034, P = 0. 016; x2 = 5. 142, P = 0. 023 ). Postoperative afferent loop obstruction developed in one case in group 1. Conclusions Lymphatic mapping guided D2 radical gastrectomy plus lymphadenectomy increases the number of lymph nodes dessected and improves the efficiency of positive lymph nodes excision for patients of advanced gastric cancer.
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Caudal-related homeobox transcription factor CDX2 is a specific nuclear transcription factor. It seems to play a key role in intestinal development and differentiation in normal and cancer tissues, and it is important for the maintenance of intestinal epithelium cells, liver-intestine cadherin(CDHIT) as one protein has intimate correlation with invasion and metastasis of tumor, has as well as highly expresses in intestinal-mucosa. Recent studies indicate that CDX2 and CDHI7 is closely associated with tumorigenesis,differentia-tion and metastasis. They might act as a new biomarker of gastric cancer diagnosis and a new target of tumor gene therapy.
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Objective To study the expression of LI-cadherin in gastric cancer, gastric stromal tumor, chronic gastritis and intestinal metaplasia. Methods Two hundred and forty four specimens were collected, including normal epithelia (n=28), chronic superficial gastritis (n=30), chronic atrophic gastritis(n=42), intestinal metaplasia (n=58), gastric adenocarcinoma (n=46), paracancerous gastric tissues (n=30), gastric stromal tumor (n=10). The expression of LI-cadherin was detected by S-P immunohischemistry with purified goat polyclonal antibody. Results The expression of LI-cadherin in normal epithelia and chronic gastritis are all negative, the positive rates of LI-cadherin expression in intestinal metaplasia and gastric adenocarcinoma is 83% (48/58) and 65% (30/46) respectively. By Laurien classification, the positive rate of LI-cadherin expression in intestinal type was higher(78% ) than those in the diffuse type (35%) (P<0.05). LI-cadherin was in positive correlation with lymph node metastasis and staging. Paracancerous tissues and gastric stromal tumor did not express LI-cadherin. Conclusions The abnormal expression of LI-cadherin was correlated with intestinal metaplasia and gastric adenocarcinoma. GCs with high LI-cadherin index have more lymph node metastasis. High expression rate of LI-cadherin in gastric cancer tissues may predict poor prognosis.
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Objective To explore the feasibility of laparoscopic surgery for esophageal hiatus hernia and reflux esophagitis complicated with cholecystolithiasis.Methods Five trocars were used for the patients to perform laparoscopic hiatal hernia repair,followed by fundoplication(Nissen fundoplication in 21 cases and Toupet fundoplication in 6),and then LC.Results The procedures were completed in all of the 27 cases.The postoperative mean esophageal pressure of the patients was significantly higher than that before the operations [(19.32?4.11) mm Hg vs(7.30?1.36) mm Hg,t=-16.407,P=0.000],while the 24-hour pH value were decreased markedly(9.20?2.15 vs 160.16?50.30,t=16.387,P=0.000).No hemorrhage,intra-abdominal infection,biliary leakage occurred in this series.The patients were followed up for 1 to 24 months(1-6 months in 7 cases,and 7-24 months in 20 cases),during which no esophageal stenosis or incisional hernia were detected.Conclusions It is feasible to perform primary laparoscopic surgery for patients suffering from esophageal hiatus hernia and reflux esophagitis complicated with simultaneous cholecystolithiasis,if no contraindications.
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Objective This study was to evaluate a new radical resection of hepatic hydatidosis. MethodSince 1999, total subadventitial cystectomy through the intraadventitial space of the hepatic hydatid cyst was performed on thirty patients with 45 liver hydatid cysts. Results The procedure was successful in all cases with no intraoperative rupture of the cysts. The average blood loss per cyst was 20?ml. There was no operative mortality, nor postoperative complications. Twenty one cases were followed up for an average period of 11 months with no recurrence. Conclusions The results indicate that the new procedure is a safe and radical alternative for the treatment of hepatic hydatidosis.
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AIM:To establish the gastric cancerous multidrug resistance cell stain BGC823/5-FU and investigate the relationship between the resistance and the expression of apoptosis related protein Survivin, Bcl-2, Bax and caspase-3. METHODS: Human gastric cancer cell line BGC823 was induced into MDR cell line by intermittent administration of high dose of 5-FU. MTT assay was used to detect the sensitivity of these MDR cells to some chemotherapeutic agents. Flow cytometry was used to detect the expression of P-glucoprotein and the accumulative value of intracellular daunorubicin (DNR) in these MDR cells. Western blotting was used to detect the expression of Survivin, Bcl-2, Bax and caspase-3. RESULTS: The resistance cell stain BGC823/5-FU was established, which possessed the ability of 10.82 fold resistance to 5-FU and cross-resistance to adriamycin, mitomycin C and cisplatin. The expression of P-glucoprotein was higher in BGC823/5-FU cells than that in BGC823 cells, while the accumulative value of intracellular DNR was decreased in BGC823/5-FU cells. Compared with its parent cells, expressions of Bax and caspase-3 in BGC823/5-FU cells were significantly down-regulated, surviving and Bcl-2 were upregulated in BGC823/5-FU cells. CONCLUSION: Gastric cancer cell line BGC823 has been induced into MDR cell line BGC823/5-FU. P-glucoprotein, Survivin, Bcl-2/Bax ratio and caspase-3 may play an important role in MDR of BGC823/5-FU cells.