Volume 93  ·   Issue 32  ·  2013

To explore the expression of metastasis-associated colon cancer 1 (MACC1) proteins in esophageal carcinoma and neighboring tissues.

The expressions of MACC1 were detected in 60 specimens of esophageal carcinoma and neighboring tissues with immunohistochemistry and Western blotting.All the specimens were selected from 2010—2012 of Guangfu Hospital of Jinhua, 38 males and 22 females, aged (50±12) years.And the correlations of the expressions of MACC1 proteins with the clinicopathologic features of esophageal carcinoma were also analyzed.

Expression of MACC1 protein was predominantly located in cytoplasm and membrane.The positivity rates of MACC1 protein were 68.3% (41/60) in esophageal carcinoma tissue and there were significant differences from those in neighboring tissue (25.0 (15/60), P<0.01).Western blotting analysis showed that the expression level of MACC1 protein in esophageal carcinoma was greater than that in corresponding adjacent tissues (0.64±0.05 vs 0.21±0.10, P<0.05).Moreover, the positivity rates and relative expressions of MACC1 showed significant correlations with TNM stage and pathology grade (all P<0.05).

The abnormal expression of MACC1 may be associated with malignant progression of esophageal carcinoma.

To evaluate the sonographic features of different pathological types of breast granulomatous diseases and analyze the feasibility of ultrasonic diagnosis.

A total of 32 patients with different pathological types of breast granulomatous diseases were recruited.Their clinical and sonographic findings were retrospectively reviewed.There were granulomatous mastitis (n=12), breast xanthogranuloma (n=5), lipogranuloma (n=2), foreign body granuloma (n=1) and nonspecific granulation hyperplasia (n=12).

Based on major sonographic appearances, they were divided into 4 patterns of tubular, mass, diffuse and cystic mass.In 12 patients with granulomatous mastitis and 12 patients with nonspecific granulation hyperplasia, the major sonographic appearance was of tubular pattern (n=6, 5), followed by mass pattern (n=4, 5) and diffuse pattern (n=2,2).Five patients with breast xanthogranuloma and 1 patient with foreign body granuloma all showed mass pattern.In 2 patients with lipogranuloma, one was of mass pattern and abother cystic pattern.In patients with granulomatous mastitis and patients with nonspecific granulation hyperplasia, it showed a high diagnostic reliability of ultrasound.The ratio of inflammatory lesion as the first sonographic diagnosis was 10/12 and 8/12 respectively and ultrasonic BI-RADS 4b or above both only 1/12.However, the ratio of sonographic imaging in patients with xanthogranuloma and Lipogranuloma mimic breast cancer, in which ultrasonic score as breast imaging-reporting and data system (BI-RADS) 4b or above was 4/5 and 1/1 respectively.

Ultrasound is valuable in evaluating the lesions in patients with granulomatous mastitis and nonspecific granulation hyperplasia.However a definite diagnosis is still dependent on histopathology.

To compare the efficacies of non-surgical treatment for pediatric and adult sagittal fractures of mandibular condyle.

From January 1985 to December 2010, our department treated 67 cases (82 sides) sagittal fractures of mandibular condyle with occlusal splint at a height of 1-2 mm in molar region for six months or other non-surgical treatment.Their clinical and radiological remodeling of affected condyles after treatment were reviewed at six mouths, one year and each year after treatment.They were divided into 2 groups according to age.There were 28 patients (34 sides) aged over 12 years and 39 patients (48 sides) under 12 years.During a follow-up period of 2-25 years, mandibular activity, mouth opening and parallel CT scan of condylar morphological alterations were examined.

Under 12-year-old group: good mandibular function was observed in 39 patients.Maximal mouth opening over 35 mm was achieved at 6 months.Only 11 of 39 patients had deviation on mouth opening at 6 months.Radiological studies showed that 32 condyles were complete remodeling and 16 condyles were partial remodeling.Poor remodeling was not observed.Over 12-year old group: Ankylosis occurred in 4 joints.And 15 of 28 patients had deviation on mouth opening at 6 months.Radiological studies showed the remodeling of condyles was complete (n=6), partial (n=16) and poor (n=12) respectively.

Mandibular functional recovery and condylar remodeling are better in children with more powerful healing and reconstructing capacities.

To explore the efficacies of extended pelvic lymph node dissection (e-PLND) before or after radical cystectomy (RC).

From January 2003 to January 2013,a total of 107 patients underwent e-PLND plus RC.And their relevant clinical data were reviewed.Their median age was (62±10) years.The e-PLND were divided into 10 regions and 6 groups according to the anatomic sites.Forty-seven (43.9%) underwent RC after e-PLND (group A) and 60 (56.1%) had RC before e-PLND (group B).Two groups were compared for operative duration, numbers of lymph nodes removed, metastatic rates of lymph node, dissected lymph node positive rates and operative complications.The results were analyzed with Chi-square or Student′s test.

Clinicopathological characteristics were comparable for two groups (P>0.05).The mean operative durations of e-PLND were similar in both groups ((83±27) vs (78±24) min,P>0.05).The mean operative durations of RC were significantly shorter in group A than those in group B ((79±41) vs (113±44) min,P<0.01).The mean number of lymph nodes removed (25.5±9.7 vs 29.0±8.4) and the mean number of lymph nodes removed at internal iliac (5.7±2.9 vs 7.2±3.5) and presacral (1.3±1.1 vs 2.5±1.6) regions were significantly fewer in group A than those in group B (all P<0.05).The metastatic rates of lymph node (34.0% (16/47) vs 31.7% (19/60)), dissected lymph node positive rates (9.0% (108/1197) vs 7.5% (130/1743)) and operative complications (23.4% (11/47) vs 20.0% (12/60)) were similar in both groups (all P>0.05).

RC is performed preferably after e-PLND, and internal iliac and presacral area should be dissected for additional lymph nodes after RC.

To evaluate the reliability of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) expression in breast cancer by immunohistochemistry and discuss their influencing factors.

The pretreatment biopsy specimens were collected from 148 patients (from Beijing Cancer Hospital between 2004 to 2010) with invasive breast cancer.After reslicing and staining (ER:SP1, PR:1E2, HER-2:4B5), the status of ER, PR and HER-2 was analyzed by a pathological expert with automated imaging system Ariol MB-8.And their results were compared with the original reports.

The concordance rates between original reports and automated image system were ER:76.35%, PR:49.32%, HER-2:63.51% while Kappa values 0.12 (P=0.020), 0.18 (P=0.002) and 0.08 (P=0.200) respectively.And the concordance rates between expert reports and automated image system were ER:93.92%, PR: 81.08% and HER-2:76.35% while Kappa values 0.77 (P<0.001), 0.67 (P<0.001) and 0.32 (P<0.001) respectively.

For the expressions of ER, PR and HER-2, the disaccording results of original reports and automated image system may be mainly due to the differences of antibodies, staining methods and interpretations.

To retrospectively analyze the bacteriological spectrum and drug susceptibility of pus flora from abdominal traumatic patients with severe intra-abdominal infection.

A total of 41 severe intra-abdominal infected patients with abdominal trauma were recruited to collect 123 abdominal pus specimens.And the results of laboratory microbiology and drug sensitivity were analyzed with the WHONET 5.4 software.

A total of 297 strains of bacteria were isolated at (7.2±2.3) strains for each patient.Gram-positive bacteria accounted for 44.1% (131/297), Gram-negative bacteria 55.2% (164/297) and fungi 0.7% (2/297).The top five isolates were Escherichia coli, Staphylococcus aureus, Klebsiella pneumonia, Enterococcus faecalis and Pseudomonas aeruginosa.Those antibiotics highly sensitive (>90%) to Escherichia coli included cefoperzone (91%), imipenem (98%) | highly sensitive to Gram-positive cocci included teicoplanin (100%) and linezolid (100%).Staphylococcus aureus was 100% sensitive to vancomycin.The agents with a high susceptibility to Klebsiella pneumonia included imipenem (100%) and amikacin (79%).Ciprofloxacin (90%) had the highest sensitivity to Pseudomonas aeruginosa.

The predominant bacteria of causing severe intra-abdominal infection of traumatic patients is Gramnegative bacteria, but the infection of Gram-positive bacteria, especially the ratio of Staphylococcus aureus infection is also comparatively high.Cefoperazone,ciprofloxacin, imipenem, vancomycin, teicoplanin and linezolid have higherly antibacterial activity.

To design a blood ordering schedule and explore the influencing factors of blood utilizing and ordering for tumor surgical patients.

For a total of 58 306 tumor surgical patients,22 643 applications of blood ordering and 7430 person-times of blood utilization from October 2002 to May 2012 were retrospectively analyzed at Cancer Hospital of Chinese Academy of Medical Sciences.Their clinical profiles and test results were analyzed.

The operative transfusion rate was 32.81%.According to the operation position and the blood transfusion and preparation data, the surgical blood ordering schedule of tumor patients was established.Patient gender, hemoglobin, hematocrit, platelet, total protein and albumin level test results had significant effect on the transfusion of red blood cells (OR=0.797,9.614,1.949,0.437,0.444,2.038,all P<0.05).Patient gender, hemoglobin, hematocrit, activated partial thromboplastin time,prothrombin time,albumin and total protein level test results had significant effect on the transfusion of plasma (OR=0.851, 1.367,1.801,1.652,2.922,2.224,1.362,all P<0.05).

For surgical tumor patients, blood ordering should be based upon the test results of routine blood, blood coagulation and protein level test results to ensure that blood transfusion is both rational and safe.

To analyze the related factors of complications and treatment efficacy with flexible endoscopy for esophageal foreign body (FB).

In a retrospective study with consecutive data, 101 adults including 52 males and 49 females with esophageal FB impaction between January 2005 and December 2012 admitted into Department of Gastroenterology′s Endoscopic Unit at Peking University Third Hospital were included, aged (49±21) years.

(1) FB impaction in upper and middle esophagus accounted for 87.1% (n=88) of all esophageal FBs.No significant difference existed in interval time from impaction to removal of FB impacted between upper, middle and lower esophagus (P>0.05). (2) Patients with esophageal FB seeking hospital treatment accounted for 82.2% (n=83) within 24 h and 99.0% (n=100) within 48 h.Food lump, fish bone, chicken bone and fruit seeds accounted for 76.2% (n=77). (3) Positive rates were 91.3% (21/23) and 24.1% (7/29) with upper gastrointestinal barium contrast and chest or abdominal plain film.The success rate was 94.1% (n=95) with flexible endoscopy for removal of FB. (4) Denture was the most difficult FB for removal.Four patients in all 11 patients with denture impacted were not removed successfully with flexible endoscopy. (5) The complication (except for mild scratch) rate was 48.5% (n=49) and the perforation rate 3.0% (n=3).Whether complications took place or not was independent of age, location of impaction, time from impaction to removal and size of FB (all P>0.05), but dependent on piercing into esophageal wall, concomitant with esophageal stricture and types of FB (all P<0.01).Whether perforation or not was independent of any above factor.

Esophageal FB should be removed as soon as possible within 24 h especially for those with sharp edges and piercing into esophageal wall.

To assess the application value of a new radiofrequency device Habib 4X in liver resection.

A restrospective study was performed during March 2010 to July 2011.Forty-four patients underwent liver resection with radiofrequency device Habib 4X and another 54 patients traditional liver resection.Intraoperative blood loss, blood transfusion, Pringle′s maneuver requirement, liver parenchyma transaction time, liver function recovery, complications, mortality and recurrence were recorded.

The mean resection time was (67±22) min for Habib 4X group versus (93±23) min for traditional group (P=0.000).Pringle′s maneuver was required in 10 patients (22.7%) for Habib 4X group and 31 (57.4%) for traditional group (P=0.001).The mean blocking time was (7±2) vs (18±6) min (P=0.001), mean blood loss volume (243±132) vs (500±421) ml (P=0.002).Postoperative recovery of liver function was better in Habib 4X group than traditional group.None developed mortality in Habib 4X group.And no resection margin recurred during a 18-month follow-up.

Bipolar radiofrequency device Habib 4X is recommended for precoagulation in hepatectomy.And the advantages of minimized blood loss and reduced resection time result in its lower rates of morbidity and mortality.

To evaluate the expression of early growth response gene-3 (EGR3) in human oral squamous carcinoma tissue, non-adjacent tissue and oral carcinoma cell lines and detect the effects of EGR3 expression on the biological behaviors of oral squamous carcinoma cell lines.

From October 2008 to December 2009, the expression of EGR3 was detected in 20 human oral squamous carcinoma tissue, non-tumor adjacent tissue and 2 oral carcinoma cell lines.The total-length plasmid of EGR3 was constructed and transfected into oral squamous carcinoma line Tca-8113 to observe the proliferation and apoptosis.

There was a high-level expression of EGR3 mRNA in normal oral squamous epithelial and non-tumor adjacent tissues (2.108±0.996 and 1.721±1.196).And a low-level expression or a loss of EGR3 mRNA in human oral squamous carcinoma tissue and oral carcinoma cell lines (0.007±0.005 and 0.007±0.001)(both P<0.05).Tca-8113 transfected by EGR3 plasmid had a high-level expression of EGR3 m RNA capable of inhibiting the proliferation of Tca-8113 and promoting its apoptosis dramatically.The stimulating index in overexpression of EGR3 was lower than control group (0.35±0.11 vs 0.82±0.21, P<0.05).After overexpression of EGR3 in Tca-8113, the frequency of middle-Late stage of apoptosis (Annexin-V/PI double positive) was higher than the frequency of vector group (23.12%±6.65% vs 5.96%±0.98%, P<0.05).

A low-level expression or a loss of EGR3 in human oral squamous carcinoma and an over-expression of EGR3 in human oral squamous carcinoma may inhibit the proliferation and promote apoptosis of oral squamous carcinoma.

To explore the most appropriate method for the isolation of human umbilical cord mesenchyamal stem cells (MSCs) through a comparison of different methods.

Fifteen umbilical cord specimens from full-term healthy fetus with caesarean birth were completely rinsed with phosphate buffer saline (PBS) and sliced into 1 mm³ tissue blocks after removal of umbilical vessels and external membrane.These tissue blocks were averagely divided into 4 groups after washing and centrifuge.Then four methods for the isolation of human umbilical cord MSCs were compared: an explant culture and three enzymatic methods of collagenaseⅡ, collagenaseⅡ/trypsin and collagenaseⅡ/hyaluronidase.The count of living cells was evaluated by trypan blue dye exclusion test.Cell morphology was observed under inverted microscope.The expressions of cell surface markers CD105, CD90, CD73, CD31, CD44, CD45, human leukocyte antigen-Ⅰ (HLA-Ⅰ) and human leukocyte antigen classⅡ molecules (HLA-DR) were detected by immunofluorescent staining.Cell proliferation was assayed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT).

The human umbilical cord MSCs were successfully isolated by four isolated methods.However the isolation method used profoundly altered the cell number and proliferation capacity of isolated cells.Isolated cells using four methods were counted at (5.44±0.21)×10⁵, (4.03±0.24)×10⁵, (4.91±0.33)×10⁵and (5.94±0.40)×10⁵respectively.More cells were obtained with collagenaseⅡ/hyaluronidase than other three methods (all P<0.05).Cells out of tissue blocks were observed at Day 9-11 and cells were observed at Day 2 with three types of enzyme digestion.The fusion time of cells were (18.5±3.5), (8.0±1.0), (7.5±1.5) and (3.5±0.5) days respectively.The fusion time of cells obtained with collagenaseⅡ/hyaluronidase was lower than other methods (all P<0.05).Cell morphology: polygonal, irregular and of large volume for explant culture; relatively short and small for collagenaseⅡ and collagenaseⅡ/trypsin methods; thin spindle for collagenaseⅡ/hyaluronidase method.Immunofluorescent staining revealed that CD105, CD73, CD90 and CD44 were expressed in all groups while there was no expression of CD31, CD45 or HLADR.And the cells obtained with collagenaseⅡ/hyaluronidase method were in a higher cell proliferation rate and activity compared to other methods.

The collagenaseⅡ/hyaluronidase method is optimal for the isolation of human umbilical cord MSCs than other methods.

To explore the main mediated molecules of mucin (MUC) 5AC extracellular secretion stimulated by airway shear stress (SS).

The 16 human bronchial epithelial (HBE) cells were cultured and randomized divided by Stata software into 5 groups: A.control group; B.SS stimulated group; C.SS stimulated& NSC23766 (a specific inhibitor of Rac-1) incubated group; D.SS stimulated& Cytochalasin D incubated group; E.Cortactin-siRNA (a small interfering RNA of Cortactin) transfected& SS stimulated group.Each group consisted of 6 parallel wells.Triplicate experiments were performed for statistical analysis.Rhythmic rotating device was used to simulate the breathing air flow mediated shear stress.The function of Cortactin was inhibited by Cortactin-siRNA.The relative content of MUC5 AC in supernatant was measured by enzyme linked immunosorbent assay (ELISA).The p-Cortactin (phosphorylation Cortactin) relative level, Cortactin relative level and the effect of transfection were measured with Western blotting.And laser confocal microscope was used to observe the polymerization of F-actin.

The transfection of CortactinsiRNA successfully inhibited the function of Cortactin.The relative content of MUC5AC was (0.210±0.013), (0.631±0.025), (0.473±0.112), (0.330±0.067), (0.272±0.019) in groups A, B, C, D and E, the group B was significantly higher than any other group (P=0.000, 0.043, 0.000, 0.000).The Cortactin relative level in group B (0.670±0.048) was significantly higher than that in group E (0.132±0.014)(P<0.01).But as compared with groups A, C, D (0.641±0.016, 0.622±0.012, 0.653±0.027), there was no significance (all P>0.05).The p-Cortactin relative level in group B (0.582±0.067) was significantly higher than that in groups A, C, E (0.131±0.011,0.393±0.045, 0.170±0.016)(P=0.000, 0.021, 0.000).But as compared with group D (0.511±0.029), there was no significance (P=0.246).

Rac-1, Cortactin and F-actin are the main mediated molecules of airway shear stress-stimulated MUC5AC extracellular secretion.