Preliminary study of stereotactic cardiac radioablation in radiotherapy of ventricular arrhythmia / 中华放射肿瘤学杂志

Objective:To introduce the stereotactic cardiac radioablation (SCRA) based on the stereotactic body radiotherapy (SBRT), and comprehensively evaluate the new approach by short-term effectiveness and safety.Methods:Patients with ventricular arrhythmia (VA) were evaluated and included in this clinical trial, who were immobilized by vacuum bag and performed simulation with 4-dimensional computed tomography (4DCT). In this study, the planning target volume (PTV) was set as the target to design a SBRT plan using volumetric modulated arc therapy (VMAT), which was evaluated by dose parameters such as R 50%, homogeneity index and conformity index, etc. The results of Holter and echocardiography were monitored during the follow-up and compared with the data before treatment. Results:Three subjects with ventricular tachycardia (VT) and one with premature ventricular contraction (PVC) received the same prescription of 25 Gy in a single fraction. The average volume of PTV was 71.4 cm 3(60.3-89.4 cm 3). The average time of beam delivery was 12.0 min (4.5-21.0 min). And the short-term follow-up lasted for an average of 18 weeks (14-25 weeks), which showed significant decrease in both VT and PVC load without complications. Conclusion:This study reports the implementation method of SCRA and proves its short-term effectiveness and safety, but the effects and standards of the key radiotherapy techniques still need to be explored.

Based on Delphi method to build an assessment index system for standardized residency training of pulmonary and critical care medicine / 中华医学教育探索杂志

Objective:To establish a scientific and systematic department rotation examination and evaluation system adapted to the development of Pulmonary and Critical Care Medicine according to the clinical needs and the actual situation of the hospital.Methods:The literature analysis method and Delphi method were adopted to determine the index system after two rounds of consultation. The weight of the index was determined by the method of optimal sequence diagram.Results:The positive coefficients of the two rounds of consulting experts were 100% and 95.65%. The average value of the authoritative coefficients of the two consulting groups was 0.85. And the coordination coefficients of the two rounds of expert consultations were 0.513 and 0.516 respectively. Finally, five first-level indicators and 14 second-level indicators were established.Conclusion:The enthusiasm and coordination coefficient of experts are good, and the results are credible. The established index system can be used for standardized residency training assessment of residents in Department of Pulmonary and Critical Care Medicine.

Emergency surgical strategies for patients with acute abdomen during the COVID-19 outbreak / 中华消化外科杂志

Objective:To investigate the emergency surgical strategies for patients with acute abdomen during the Corona Virus Disease 2019 (COVID-19) outbreak.Methods:The retrospective and descriptive study was conducted. The clinical data of 20 patients with acute abdomen who were admitted to the Union Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology between January 18, 2020 and February 10, 2020 were collected. There were 13 males and 7 females, aged from 25 to 82 years, with an average age of 57 years. All the patients with emergency surgeries received pulmonary computed tomography (CT) examination before surgery, and completed nucleic acid detection in throat swab if necessary. Patients excluded from COVID-19 underwent regular anesthesia, suspected and confirmed cases were selected a proper anesthesia based on their medical condition and surgical procedure. Patients excluded from COVID-19 underwent emergency surgeries following the regular procedure, suspected and confirmed cases underwent emergency surgeries following the three-grade protection.Observation indicators: (1) surgical situations; (2) postoperative situations. Measurement data with normal distribution were represented as average (range). Count data were described as absolute numbers.Results:(1) Surgical situations: of the 20 patients with acute abdomen, 16 patients were excluded from COVID-19, and 4 were not excluded. All the 20 patients underwent emergency abdominal surgeries successfully, of whom 2 received surgeries under epidural anesthesia (including 1 with open appendectomy, 1 with open repair of duodenal bulbar perforation), 18 received surgeries under general anesthesia (including 9 with laparoscopic repair of duodenal bulbar perforation, 3 with open partial enterectomy, 3 with laparoscopic appendectomy, 1 with laparoscopic left hemicolectomy, 1 with laparoscopic right hemicolectomy, 1 with cholecystostomy). The operation time of patients was 32-194 minutes, with an average time of 85 minutes. The volume of intraoperative blood loss was 50-400 mL, with an average volume of 68 mL. (2) Postoperative situations: 16 patients excluded from COVID-19 preopratively were treated in the private general ward postoperatively. One of the 16 patients had fever at the postoperative 5th day and was highly suspected of COVID-19 after an emergency follow-up of pulmonary CT showing multiple ground-glass changes in the lungs. The patient was promptly transferred to the isolation ward for treatment, and results of nucleic acid detection in throat swab showed double positive. Medical history described by the patient showed that the patient and family members were residents of Wuhan who were not isolated at home during the epidemic. There was no way to confirm whether they had a history of exposure to patients with COVID-19. Medical staffs involved in this case did not show COVID-19 related symptoms during 14 days of medical observation. The other 15 patients recovered well postoperatively. The 4 patients who were not excluded from COVID-19 preoperatively based on medical history and results of pulmonary CT examination were directly transferred to the isolation ward for treatment postoperatively. They were excluded from COVID-19 for two consecutive negative results of nucleic acid detection in the throat swab and recovered well. Two of the 20 patients with acute abdomen had postoperative complications. One had surgical incision infection and recovered after secondary closure following opening incision, sterilizing and dressing, the other one had intestinal leakage and was improved after conservative treatment by abdominal drainage. There was no death in the 20 patients with acute abdomen.Conclusions:Patients with acute abdomen need to be screened through emergency forward. Patients excluded from COVID-19 undergo emergency surgeries following the regular procedure, and patients not excluded from COVID-19 undergo emergency surgeries following the three-grade protection. The temperature, blood routine test and other laboratory examinations are performed to monitor patients after operation, and the pulmonary CT and throat nucleic acid tests should be conducted if necessary. Patients excluded from COVID-19 preopratively are treated in the private general ward postoperatively, and they should be promptly transferred to the isolation ward for treatment after being confirmed. Patients who are not excluded from COVID-19 preoperatively based on medical history should be directly transferred to the isolation ward for treatment postoperatively.

Safety and feasibility of the combined medial and caudal approach in laparoscopic D3 lymphadenectomy plus complete mesocolic excision for right hemicolectomy in the treatment of right hemicolon cancer complicated with incomplete ileus / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the safety and feasibility of the combined medial and caudal approach in laparoscopic D3 lymphadenectomy plus complete mesocolic excision(CME) for right hemicolectomy in the treatment of right hemicolon cancer complicated with incomplete ileus.</p><p><b>METHODS</b>Clinical data of 65 patients with incomplete obstructive right-sided colon cancer (T1 to 4M0) diagnosed by abdominal CT enhanced scan or MRI and/or electric colonscope undergoing laparoscopic right hemicolectomy (D3 lymphadenectomy + CME) at Department of Emergency Medicine and Department of Gastrointestinal Surgery from June 2014 to June 2017 were retrospectively analyzed. Among them, 33 patients received the combined medial and caudal approach (combined medial and caudal approach group) and the other 32 patients received the cephalo medial-to-lateral approach (cephalo medial-to-lateral approach group). The operation highlights of the combined medial and caudal approach group were as follows: (1) The superior mesenteric vein (SMV) was first identified and exposed using the combined medial and caudal approach, and lymph node dissection along the anterior and right of SMV was performed. (2) With horizontal part of duodenum as landmarks, the dorsal mesenteric membrane of terminal ileum was opened by caudal-to-cranial approach, and right retroperitoneal space along the Toldt's space was separated. The anterior of pancreatic head and the right Toldt's space were then exposed. (3) Finally using medial-to-lateral approach, the roots of ileocolic vessels, middle colic vessel and right colic vessel were disconnected and ligated along the left border of SMV. The right branch of gastrocolic trunk of Henle was ligated and lymph node dissection along SMV was performed again. Patients in cephalo medial-to-lateral approach group underwent conventional operation. Baseline information, intraoperative blood loss, operation time, number of harvested lymph nodes, proportion of no less than 12 harvested lymph nodes per case, postoperative hospital stay and postoperative morbidity in both groups were analyzed and compared.</p><p><b>RESULTS</b>Thirty-eight males and 27 females with age of 31 to 72 (56.8±11.7) years were enrolled in this study. There was no significant difference in baseline information between combined medial and caudal approach group and cephalo medial-to-lateral approach group(all P>0.05). Intraoperative blood loss [(106.5±24.5) ml vs. (308.4±27.1) ml, t=-31.501, P=0.000] was significantly less, and operative time [(176.3 ± 18.0) minutes vs. (208.4 ± 47.3) minutes, t=-3.602, P=0.001] was significantly shorter in the combined medial and caudal approach group. The proportion of no less than 2 harvested lymph nodes per case [87.9%(29/33) vs. 84.4%(27/32)], the number of harvested lymph nodes (22.5±8.9 vs. 21.5± 7.6), postoperative morbidity of complication [6.1%(2/33) vs. 12.5%(4/32)] and postoperative hospital stay [(11.9±1.5) days vs. (13.4±4.4) days] were not significantly different between the two groups(all P>0.05).</p><p><b>CONCLUSION</b>The combined medial and caudal approach in laparoscopic right hemicolectomy (D3+CME) in the treatment of incomplete obstructive right-sided colon cancer is safe and feasible, and has advantages of less intraoperative blood loss and shorter operation time compared to the cephalo medial-to-lateral approach.</p>

Anterior approach for right hepatectomy using liver hanging maneuver in severe blunt liver trauma / 中华普通外科杂志

Objective To evaluate the application value of anterior approach right hepatectomy using the liver hanging maneuver for severe blunt liver trauma.Methods Clinical data of 63 patients with severe blunt liver trauma undergoing right hepatectomy in our hospital from January 2011 to January 2017 were retrospectively analyzed.Among them,31 patients received anterior approach right hepatectomy (anterior approach group,31 cases) while the others did conventional right hepatectomy (conventional approach group,32 cases).Clinical data,intraoperative blood loss,postoperative alanine transaminase (ALT) at POD3,postoperative morbidity and mortality in both groups were analyzed and compared.Results There were eight surgical deaths,one in the anterior approach group and seven in the conventional approach group.All the 31 cases underwent anterior approach right hepatectomy successfully using the liver hanging maneuver.The mean intraoperative blood loss (768 ± 231) ml vs.(1 264 ± 1 248) ml (P ＜ 0.05),postoperative hepatic function ALT value at POD3 (155 ± 89) U/L vs.(689 ± 67) U/L (P ＜ 0.05),postoperative morbidity and mortality of the anterior approach group were markedly superior to conventional approach group (12.9％ vs.34.4％,3.2％ vs.21.9％,all P ＜ 0.05).Conclusions Anterior approach right hepateetomy using the liver hanging maneuver has advantages of decreased intraoperative blood loss,less hepatic function compromise,reduced postoperative morbidity and mortality compared to conventional approach right hepatectomy in cases of severe right liver blunt trauma.

Curcumin inhibits migration and invasion of lung cancer PC-9 cells via down-regulation of nectin-4 expression / 中国病理生理杂志

AIM:To investigate the effects of curcumin on the abilities of migration and invasion in the lung cancer PC-9 cells, and to observe the relationship between curcumin and nectin-4 expression.METHODS:The viability, migration and invasion of lung cancer PC-9 cells treated with curcumin or transfected with siNectin-4 were measured by MTT assay, wound healing test and Transwell assay , respectively.The protein levels of nectin-4, p-AKT and AKT in the PC-9 cells treated with curcumin or transfected with siNectin-4 were detected by Western blot .RESULTS:Curcumin in-hibited the viability of PC-9 cells.The wound healing rates and the numbers of the transmembrane cells in curcumin 10μmol/L and 20 μmol/L groups were decreased compared with control group without curcumin treatment .The expression level of nectin-4 was reduced after curcumin treatment for 24 h.The viability of the PC-9 cells was significantly inhibited after transfected with siNectin-4 for 48 h or 72 h (P<0.01), and the wound healing rates was decreased in siNectin-4 group compared with NC group (P<0.01).The numbers of the transmembrane cells in siNectin-4 group was significantly reduced (P<0.01).Curcumin and knockdown of nectin-4 suppressed the activation of AKT pathway in PC-9 cells.In si-Nectin-4+curcumin group , the cell viability reduced compared with curcumin group , and wound healing rates , cell inva-sive ability and AKT phosphorylation levels were decreased .CONCLUSION:Curcumin inhibits migration and invasion of the lung cancer PC-9 cells via down-regulation of nectin-4 expression and inhibition of AKT pathway .

Curcumin reverses hepatocyte growth factor-induced resistance to gefitinib in PC9 lung cancer cells / 中国病理生理杂志

AIM:To explore the molecular mechanism through which curcumin reverses hepatocyte growth factor (HGF)-induced resistance to gefitinib in lung cancer cells.METHODS:The methods of MTT assay, wound healing assay and Western blot were used to observe the effects of HGF, curcumin and gefitinib on the migration, drug susceptibility, epithelial-mesenchymal transition, and related signaling pathways in the PC9 lung cancer cells.RESULTS:HGF reduced susceptibility of the PC9 cells to gefitinib, and curcumin significantly reversed HGF-induced resistance to gefitinib.HGF induced migration and epihelial-mesenchymal transition, and promoted c-Met/AKT/mTOR pathway activation in the PC9 cells.Gefitinib alone did not prevent the above activities.However, combined with curcumin, gefitinib prevented the above activities.CONCLUSION:Curcumin reverses HGF-induced resistance of the PC9 cells to gefitinib by preventing epithelial-mesenchymal transition and inhibiting c-Met/AKT/mTOR activation.

Pantoprazole sodium inhibits epithelial-mesenchymal transition and cisplatin resistance in lung cancer cells and underlying mechanism / 中国病理生理杂志

[ ABSTRACT] AIM:To explore the inhibitory effects of pantoprazole sodium on epithelial-mesenchymal transition and cisplatin resistance in lung cancer cells and the underlying mechanism .METHODS: Using MTT method, wound healing assay , Transwell experiment , Western blot , the differences of morphology , invasion ability , migration ability , drug sensitivity and protein expression between A 549/DDP cells and A549 cells were determined .The effect of pantoprazole so-dium on morphology , invasion ability , migration ability , drug sensitivity and protein expression in A 549/DDP cells were al-so observed.RESULTS: Compared with A549 cells, A549/DDP cells had higher invasion and migration abilities , and lower drug sensitivity , exhibited mesenchymal phenotype and activated c-Met/AKT/mTOR pathway .Pantoprazole sodium inhibited the abilities of invasion and migration , and reversed the mesenchymal phenotype , drug resistance and the c-Met/AKT/mTOR pathway activation in A549/DDP cells.Treatment with c-Met inhibitor SU11274, PI3K inhibitor LY294002 and mTOR inhibitor rapamycin had the same effects on A 549/DDP cells as that of pantoprazole sodium .CONCLUSION:Pantoprazole sodium inhibits invasion , migration, epithelial-mesenchymal transition and cisplatin resistance in lung cancer cells by down-regulating c-Met/AKT/mTOR pathways .

miRNA-126 inhibits proliferation, migration and invasion of human lung cancer A549 cells via EGFR/AKT/mTOR pathway / 中国病理生理杂志

AIM:To investigate the effects of microRNA ( miRNA)-126 on the proliferation , migration and in-vasion of human lung cancer cell lines , and to explore its mechanism .METHODS:The A549 cells were transfected with miRNA-126 agomir by Lipofectamine 2000.The expression of miRNA-126 was detected by real-time PCR.The cell activity was detected by MTT assay .The number of viable A549 cells was counted by the method of Trypan blue exclusion .The cell colony-forming capability was determined by cell colony formation test .The cell migration and invasion abilities were assayed by wound healing and Transwell methods , respectively.The protein levels of p-EGFR, EGFR, p-AKT, AKT, p-mTOR and mTOR were determined by Western blot .RESULTS:The expression level of miRNA-126 was significantly in-creased in the A549 cells compared with negative control ( NC) group and control group ( P<0.01 ) .The proliferation of A549 cells was decreased extremely after transfected with the miRNA-126 agomir (P<0.01), so did the result of the cell colony-formation test.The migration and invasion abilities of the lung cancer cells were also significantly inhibited .The protein levels of p-EGFR, p-AKT and p-mTOR were significantly down-regulated compared with NC group and control group ( P<0.01) .CONCLUSION:Over-expression of miRNA-126 significantly inhibits the proliferation , migration and invasion ability of human lung cancer A 549 cells by down-regulation of EGFR/AKT/mTOR pathway .

Early rapid diagnosis and rational choice of the first-line agents for acute aortic dissection in the emergency department: ses / 中华急诊医学杂志

Objective To explore the rapid diagnosis and the rational chice of the first-line agents for acute aortic dissection (AAD) in the emergency department.Methods The clinical data of 360 patients with AAD treated at our hospital from March 2007 to March 2013 were retrospectively analyzed.Of them,338 patients with suspected AAD were examined by chest radiography,trans-thoracic echocardiography (TTE),and computed tomography angiography (CTA) successively.The reliabilities of results from each diagnostic method were verified by the gold standard of intra-operative findings and the comparisons of their diagnostic potential were carried out.Results The preoperative diagnostic sensitivity of chest radiography,TTE and CTA in the assessment of AAD were 64％,77％ and 100％,respectively;the specificity is 86％,90％ and 100％,respectively;the accuracy rats were 70％,78％ and 100％,respectively;the positive predictive values were 93％,99％ and 100％,respectively;the negative predictive values were 46％,27％ and 100％,respectively.In the work-up of any patient with suspected AAD,the emergency bedside non-invasive TTE or computed tomography was the first-line initial diagnostic screening,and the best method for the accurate diagnosis of AAD was CTA.Medical management included pain control and deliberate hypotension therapy by using rapidly short-acting vasodilator and beta blockers to lower heart rate,and the hibernation therapy in small dose of specific agents might serve as a useful adjuvant method,and the early combination of vasodilatation medicines was better than the single one.Of them,242 patients fortunately survived on treatment,and 42 died of hypovolemic shock after rupture of AAD and multiorgan failure.Conclusions Acute aortic dissection is the most potentially life-threatening cardiovascular disease,though it is extremely rare in the hypertensive patients,attending doctors should pay more attention.Early rapid diagnosis is the key to AAD treatment.The best method for correctly diagnosing AAD is complementary use of TTE,CTA and magnetic resonance angiography (MRA).Correct and timely diagnosis and strictly deliberate hypotension treatment are the essential determinant of decreasing mortality and improving prognosis of AAD.

Emergency one-stage intestinal resection and tension-free hernioplasty for acutely strangulated inguinal hernia complicating intestinal necrosis in 58 cases / 中华普通外科杂志

Objective To evaluate the validity and surgical outcome of emergency one-stage intestinal resection and tension-free hernioplasty for acutely strangulated inguinal hernia complicated with intestinal necrosis.Methods Clinical data of 58 patients diagnosed strangulated inguinal hernia and intestinal necrosis in our hospital from July 2011 to April 2014 were retrospectively analyzed.Of the 58 patients,33 were males and 25 were females,mean age of (64 ± 18) years (range 52-86).There were 28 strangulated inguinal and 30 femoral hernias undergoing emergency small bowel resection and tension-free mesh hernioplasty.Patients with intestinal perforations,preoperative peritonitis,inflammatory hernia and those who required colon resections were excluded from the study.Results The mean operative time was (92 ± 22) min (range,80-120 min).Average length of hospital stay was (8.6 ± 2.5) d (range,6-21 d).There were three postoperative c omplications (5.2％):one of subcutaneous hematoma,one of superficial surgical site infection and one of scrotal fluid collection,which were all cured by wound dressing,removal of infected prosthetic mesh,vacuum sealing drainage (VSD) and continuous irrigation,intravenous antibiotics and scrotal puncture.During a follow-up period of 6 to 32 months (mean 12 ± 6 months),there was no hernia recurrence.Conclusions Emergency one-stage intestinal resection and tension-free mesh hernioplasty for strangulated inguinal hernia complicated by intestinal necrosis is safe,feasible with a favourable outcome and low rate of postoperative complications.

Non-small cell lung cancer 95D cells co-cultured with 3D-bioprinted scaffold to construct a lung cancer model in vitro / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To fabricate an innovative scaffold for lung cancer cell culture and establish a three-dimensional lung cancer model in vitro, and to reveal the differences in biological functions of lung cancer cells under the two-dimensional and three-dimensional culture conditions.</p><p><b>METHODS</b>We chose agarose and alginate as the scaffold materials, and 3D printing technique was applied to construct cell culture scaffold. 95D cells were co-cultured with this scaffold. The differences of cell morphology, proliferation ability, protein expression, etc. in the cells cultured under 2D and 3D cultural conditions were evaluated by light microscopy using HE staining, MTT assay, scanning electron microscopy, and Western blot analysis.</p><p><b>RESULTS</b>Cells cultured in 2D wells displayed a spindle and polygonal morphology, whereas those grown in the 3D culture aggregated into spheroids, which invaded, migrated and disseminated into the surrounding scaffold. MTT assay showed that the proliferation rates of the 3D-cultured cells for 2-6 days were significantly lower than, but those cultured for 8-9 days were significantly higher than that of the 2D-cultured cells, indicating that proliferative activity of the cells grown in 2D cultures for 8-9 days was inhibited. In contrast, cells grown on 3D scaffolds still maintained a higher proliferation. The Western blot assay showed that the expression of Cdc42, p53, mTOR were significantly down-regulated in 3D scaffold-cultured group (0.529±0.103, 0.820±0.038 vs. 1.967±0.066), compared with that of the 2D-cultured group (3.063±0.139, 1.738±0.122 vs. 2.472±0.151) (P<0.05 for all), while the expression of MMP-2 was up-regulated in the 3D-cultured cells (1.110±0.029), significantly higher than that of the 2D-cultured cells (0.017±0.001) (P<0.05).</p><p><b>CONCLUSIONS</b>The cell morphology, proliferation and associated protein expression of lung cancer cells in 3D-culture systems are distinctively different as compared to those of the 2D-cultural cells. 3D-bioprinted agarose-alginate scaffold can better mimic the growth microenvironment of lung cancer in vivo and may provide a promising model for lung cancer research in vitro.</p>

Relationship between rs1057141 and rs1135216 polymorphisms of TAP1 gene and allergic rhinitis in Xinjiang Han people / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the association between transporter associated with antigen processing 1 (TAP1) rs1057141 and rs1135216 gene polymorphisms and predisposition to allergic rhinitis (AR) in Xinjiang Han people.@*METHOD@#A case control study was conducted. The region of the TAP1 * rs1057141 and rs1135216 was studied in 150 Xinjiang Han people with allergic rhinitis and 150 normal controls by using SNaPshot system, and these data were compared with other ethics groups in the world according to the NCBI gene bank.@*RESULT@#The genotypes distribution of the group were in the Hardy-Weinberg equilibrium(P>0.05). The frequencies of three genotypes(G/G, G/A, A/A) of TAP1 * rs1057141 were 4.00%, 30.00%, 66.00% in controls and 2.70%, 33.30%, 64.00% in AR groups , which showed no difference (P>0.05). The frequencies of three genotypes (G/G,G/A,A/A) of TAP1 * rs1135216 were 2.0%, 28.7%, 69.3% in controls and 1.30%, 27.30%, 71.40% in AR groups, which showed no difference either (P>0.05). According to the NCBI database, there was difference between Xinjiang Han people and other ethnics in the world.@*CONCLUSION@#Lacking association was found between the mutation of TAP1 * rs1057141, rs1135216 gene G allele and allergic rhinitis in the Xinjiang Han people. Maybe TAP1 * rs1057141, rs1135216 were not susceptibility genes to AR. And apparent differences existed in TAP1 gene polymorphisms between Xinjiang Han people and other ethnic groups in the world.

Multidisciplinary approach to acute massive gastrointestinal bleeding caused by Dieulafoy's lesion / 中华普通外科杂志

Objective To explore the multidisciplinary treatment for acute massive gastrointestinal (GI) bleeding caused by Dieulafoy's lesion.Methods The clinical data of 48 patients with Dieulafoy's lesions treated at our hospital from April 2007 to April 2012 were retrospectively analyzed.Of the 48 patients,40 were males and 8 were females,with a mean age of 46.7 years (range 21 -52 years).Accurate diagnosis was established by emergency upper gastrointestinal endoscopy, angiography and emergency laparotomy.Results The most common location of the bleeding Dieulafoy's lesion was at the body of stomach (40 cases),followed by the cardia (4 cases),the duodenum (2 cases) and the jejunum (2 cases ),with most lesions being located in the upper part of the stomach within 6 cm of the gastroesophageal junction.Correct diagnosis was made by endoscopy in 46 patients and by emergency laparotomy in 2 cases.Of the 18 patients initially treated endoscopically epinephrine injection and endoscopic hemoclips,2 cases needed angiography to identify the source of bleeding and were cured by transcatheter arterial embolization.23 patients underwent surgical therapy.In this series,47 cases were cured,1 patient died of hypovolaemic shock and multi-organ failure during the hospital stay.Average length hospital stay was (10.8 ± 2.5 ) d.Conclusions Dieulafoy' s lesion is less common cause of gastrointestinal bleeding.Endoscopy plays a key role in the diagnosis and treatment.Topical epinephrine injection and haemoclipping may cure the patients,if it fails angiography and embolization provides a therapy.Most patients may need a laparotomy and surgery as a decisive measure.

Exogenous PTEN Gene Induces Apoptosis in Breast Carcinoma Cell Line MDA468 / 华中科技大学学报（医学）（英德文版）

The effects and mechanisms of exogenous phosphatase and tensin homolog deleted from chromosome ten (PTEN) gene on phosphatase activity-dependent apoptosis of breast cancer cell line MDA468 were investigated. PTEN gene packaged with lipofectin was transferred into breast cancer cell line MDA468 and parental MDA468 cells served as controls. RT-PCR and Western blot were done to detect the expression of target genes. The expression of phosphospecific protein kinase B (PKB/Akt) and focal adhesion kinase (FAK) protein stimulated by epidermal growth factor (EGF) was also detected. Apoptosis was determined by flow cytometry with a double-staining method using FITC-conjugated annexin V and PI. MDA468 cells transfected with PTEN gene could express PTEN mRNA and protein. PTEN decreased the phosphorylation level of AKT protein and down-regulated FAK protein expression in MDA468 stimulated by EGF. The apoptosis rate was 21.68%. PTEN induced breast cancer apoptosis phosphatase activity-dependently. The mechanism is possibly relatedwith phosphoinositide 3-kinase (PI3K)/protein kinase B (PKB)/AKT signaling pathway. Those results may provide new clues on the gene therapy in breast cancer.

Exogenous PTEN gene induces apoptosis in breast carcinoma cell line MDA468 / 华中科技大学学报（医学）（英德文版）

The effects and mechanisms of exogenous phosphatase and tensin homolog deleted from chromosome ten (PTEN) gene on phosphatase activity-dependent apoptosis of breast cancer cell line MDA468 were investigated. PTEN gene packaged with lipofectin was transferred into breast cancer cell line MDA468 and parental MDA468 cells served as controls. RT-PCR and Western blot were done to detect the expression of target genes. The expression of phosphospecific protein kinase B (PKB/Akt) and focal adhesion kinase (FAK) protein stimulated by epidermal growth factor (EGF) was also detected. Apoptosis was determined by flow cytometry with a double-staining method using FITC-conjugated annexin V and PI. MDA468 cells transfected with PTEN gene could express PTEN mRNA and protein. PTEN decreased the phosphorylation level of AKT protein and down-regulated FAK protein expression in MDA468 stimulated by EGF. The apoptosis rate was 21.68%. PTEN induced breast cancer apoptosis phosphatase activity-dependently. The mechanism is possibly related with phosphoinositide 3-kinase (PI3K)/protein kinase B (PKB)/AKT signaling pathway. Those results may provide new clues on the gene therapy in breast cancer.

Role of smear examination of wound secretion in early diagnosis and treatment of gaseous gangrene after trauma / 中华急诊医学杂志

Objective To investigate the role of smear examination of wound secretion in early diagnosis and treatment of gaseous gangrene after trauma.Methods The data of 10 881 patients,who were carried to our hospital more than one hour after injuries from April 2003 to April 2006,were collected.Smear examination of wound secretion had been performed in these patients.Results Among the 10 881 wounded patients,11 patients developed gaseous gangrene,taking up 0.10%.Among the 11 gaseous gangrene patients,5 were caused by vehicle crash,3 by machine,2 by stone,1 by gun-shot injury.As for the wounded locations,7(63.6%)patients were in lower extremity,and 3(27.3%)patients in upper extremity,and 1 patient in mandible with head and neck wounds.The onset time of gaseous gangrene was(3.3?2.2)d.The 11 patients were completely cured.Seven patients with open comminuted fracture and lost limb function were performed with wound limb amputation,3 patients with injuries without fractures and 1 patient with mandible combined head and neck wounds were immediately treated with surgical debridement,cephalosporins,and hyperbaric oxygen(HBO). Conclusion Gas gangrene was extremely rare in injury patients but it was life-threatening,so doctors should pay more attention.Cleaning-up the wounds and debridement were critical for prevention of infection,and HBO might serve as an useful assistant method.Smear examination of wound secretion was helpful in early diagnosis and treatment of gaseous gangrene after trauma.

Construction and expression of human PTEN tumor suppressor gene recombinant adenovirus vector / 华中科技大学学报（医学）（英德文版）

The recombinant defective adenovirus vector carrying human PTEN tumor suppressor gene was constructed by using AdEasy-1 system and its expression was detected in human breast cancer cell line MDA-MB-468. Human PTEN cDNA was cloned into adenovirus shuttle plasmid pAdTrack-CMV to generate a recombinant plasmid pAdTrack-CMV-PTEN, then homologeous recombination was carried out in the E. coli BJ5183 by contransforming linearized shuttle vector with adenovirus backbone plasmid pAdEasy-1. The newly recombined defective adenovirus vector Ad-PTEN containing green fluorescent protein (GFP) was packaged and propagated in 293 cells. After being purified by cesium chloride gradient centrifugation, the adenovirus was transfected into human breast cancer cell line MDA-MB-468 in vitro. The expression of PTEN mRNA and protein in infected human breast cancer cell line MDA-MB-468 was detected by RT-PCR and Western blot respectively. The recombinant defective adenovirus vector carrying PTEN gene was constructed successfully. The viral titer of purified adenovirus was 2. 5 X 10(10) pfu/mL, and about 70% breast cancer cells were infected with Ad-PTEN when multiplicity of infection (MOI) reached 50. The exogenous PTEN mRNA and protein were expressed in MDA-MB-468 cells infected with Ad-PTEN by RT-PCR and Western blot. The recombinant defective adenovirus vector of PTEN gene was constructed successfully using AdEasy-1 system rapidly, which paved a sound foundation for gene study of breast cancer.

Construction and Expression of Human PTEN Tumor Suppressor Gene Recombinant Adenovirus Vector / 华中科技大学学报（医学）（英德文版）

The recombinant defective adenovirus vector carrying human PTEN tumor suppres sor gene was constructed by using AdEasy-1 system and its expression was detected in human breast cancer cell line MDA-MB-468. Human PTEN cDNA was cloned into adenovirus shuttle plasmid pAdTrack-CMV to generate a recombinant plasmid pAdTrack-CMV-PTEN, then homologeous recombination was carried out in the E. coli BJ5183 by contransforming linearized shuttle vector with adenovirus backbone plasmid pAdEasy-1. The newly recombined defective adenovirus vector AdPTEN containing green fluorescent protein (GFP) was packaged and propagated in 293 cells. After being purified by cesium chloride gradient centrifugation, the adenovirus was transfected into human breast cancer cell line MDA-MB-468 in vitro. The expression of PTEN mRNA and protein in infected human breast cancer cell line MDA-MB-468 was detected by RT-PCR and Western blot respectively. The recombinant defective adenovirus vector carrying PTEN gene was constructed successfully. The viral titer of purified adenovirus was 2.5×1010 pfu/mL, and about 70 % breast cancer cells were infected with Ad PTEN when multiplicity of infection (MOI) reached 50. The exogenous PTEN mRNA and protein were expressed in MDA-MB-468 cells infected with Ad-PTEN by RT-PCR and Western blot. The recombinant defective adenovirus vector of PTEN gene was constructed successfully using AdEasy-1 system rapidly, which paved a sound foundation for gene study of breast cancer.

Clinical study on the expression of lymphocyte activation antigen in peripheral blood of aged patients with non-small cell lung cancer / 中华老年医学杂志

Objective To analyze the expression of T lymphocyte activation antigen in peripheral blood of aged patients with non-small cell lung cancer . Methods The lymphocytes from peripheral blood in 45 aged patients with non-small cell lung cancer were immunologically labeled in double fluorescence and CD3-FITC, CD25/HLA-DR and CD69-PE and determined by flow cytometry. Normal aged donors, young patiens with lung cancer and aged benign lesion group were used as controls. Results Peripheral blood CD3 +/CD25 +, CD3 +/HLA -DR + and CD3 +/CD69 + in T lymphocyte with 45 aged lung cancer(7.24?1.85,28.46?5.39 and 7.78?2.63, respectively) were significantly lower than those in normal aged controls(10.35?2.54,37.16?5.51,11.02?2.18, respectively)and aged benign lesion (9.53?3.02, 35.33?5.23, 10.67?2.45, respectively)( P 0.05). Significant differences were found among them in stages Ⅲ, Ⅳ(7.15?1.13, 25.32?5.23, 7.14?2.81, respectively) and stagesⅠ,Ⅱ(8.06?1.21, 30.27?6.05, 8.43?2.67, respectively)( P 0.05). Conclusions Detection of CD3 +/CD25 +, CD3 +/HLA -DR + and CD3 +/CD69 + levels by flow cytometry might be helpful for reflecting the human immune function and the prognosis evaluation in patients with aged non-small cell lung cancer.