Clinical pathology analysis of esophageal sarcomatoid carcinoma

Objective： The purpose of this study was to study the clinical, imaging characters and pathological characteristics of esophageal sarcomatoid carcinoma. Methods： We reviewed 23 cases of esophageal sarcomatoid carcinoma from Janu ary 2006 to December 2013 in four hospitals. The data of patients who were esophageal sarcomatoid carcinoma operated were retrospectively analyzed. All cases had completed upper gastrointestinal barium images materials and 14 of these cases had completed CT images materials. Upper gastrointestinal barium images and CT imaging features include tumor location, size, shape, and strengthen, etc. The biological parameters of lesions including the express of cytokeratin AE1/AE3, 34E12,, Vimentin, desmin, Actin, S100 and Ki67 detected by immunhistochemical UltraSensitiveTM SP method （n = 23）, and the patients＇ data of contrastographic picture （n = 23）, imaging characters of CT scan （n = 14）, and their relationship were studied. Results： Upper gastrointestinal barium images, CT imaging and gastrointestinal fiberscopy revealed Iobulated intraluminal filling defect 0.4 cm to 5.7 cm x 3.5 cmx 1.3 cm （mean = 3. 7 cm） in the mid （n = 14）, lower （n = 7） and upper （n = 2） intrathoracic esophagus. Among 23 cases of esophageal sarcomatoid carcinoma, 19 patients were of mushroom type, 2 patients was of ulcer type, and 2 patients were of medulla type; 19 patients were pedunculated, and 4 patients were no pedunculated （2 patients was of ulcer type）. The tumor surface was relatively smooth and esophageal compliance was maintained. The pathological changes of esophagus such as lightly locked, rigid wall nomanifest partly, esophageal lumens expand partly, major filling sublobe defect could be shown through contrast medium. Normal esophagus was no unpack obviously over pathological changes. Enhanced computed tomography showed tumors in the intrathoracic esophagus and 8 lymph nodes metastases in 3 cases. Histologically, carcinomatous and sarcomatous components coexist. Microscopically, the tumor comprised poorly differentiated squamous cell carcinoma and spindleshaped cells resembling leiomyosarcoma. Immu nohistochemically, spindleshaped sarcomatous cells displayed weekly positive reaction to cytokeratin AE1/AE3. Transitional zone was seen between sarcomatous and carcinomatous elements in 5 cases. The 17 lymph nodes metastases in 5 cases （53 lymph nodes） among 23 cases esophageal sarcomatoid carcinoma （187 lymph nodes） were observed. Conclusion： The clinical and radiologic features of esophageal sarcomatoid carcinoma overlap with those of other esophageal neoplasms. There are the radiologic imaging changes such as a large, intraluminal, polypoid mass, major filling sublobe defect and pedicle skin flap tumor in esophageal lumen, esophageal lumen extension partly, dissepiment rigidity wall no obviously, etc. Histologically, carcinomatous and sarcomatous components coexist and the biphasic pattern is the key diagnostic feature. However, esophageal sarcomatoid carcinoma has a more favorable prognosis than other malignant esophageal neoplasms. Immunohistochemical staining seems necessary to distinguish these lesions from other esophageal neoplasms.     

Clinical and pathological characteristics of intraductal proliferative lesions and coexist with invasive ductal carcinomas

Objective： The purpose of this study was to study the clinical and pathological characteristics of breast intraductal proliferative lesions （IDPLs） and associated with invasive breast cancer. Methods： We reviewed 327 cases of breast intra- ductal proliferative lesions including 53 cases of usual ductal hyperplasia, 57 cases of atypical ductal hyperplasia, 89 cases of ductal carcinoma in situ, and 128 cases coexist with invasive ductal carcinomas. Cases of pure invasive cancer without intraductal proliferative lesions were excluded. The mult IDPLs biological parameters including the express of ER, PR, HER2, HIF-lo and Ki-67 detected by immunohistochemistry S-P method （n = 327） and the levels of CA153, TSGF, CA125 and CEA both in nipple discharge and serum （n = 179） measured with Electrochemiluminescence method and their relationship were studied, and 30 cases of normal pregnant women were compared with. Results： A single histologic subtype was present in 49.85% （163/327） of the cases, two subtypes in 33.03% （108/327）, and three in 17.13% （56/327）. The most common subtypes present were cribriform （43.12%, 141/327） and solid （38.53%, 126/327）, while the comedo （16.35%, 54/327）, and micropapillary （12.84%, 42/327） subtypes were less common. Comedo and solid were frequently found together for coexpres- sion as were micropapillary and papillary subtypes. However, Comedo subtype was much less likely to be found with papillary, cribriform or micropapillary subtypes. Additionally, comedo subtypes tend to be hormone receptor negative, Her2 positive and high-grade while the cribriform and solid subtype tends to be hormone receptor positive, Her2 negative and low grade. Papil- lary subtype was least likely to be associated with an invasive cancer. Furthermore, the nipple discharge and serum levels of CA153, TSGF, CA125 and CEA in coexist with invasive ductal carcinomas patients were significantly higher than those in the benign breast disease （pure intraductal proliferative lesions） and normal pregnant women （P 〈 0.01）. Additionally, the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than in the serum （P 〈 0.01）, and had a positive correlation with the Ki-67, grade, clinical stage, lymph node metastasis and tumor recurrence （P 〈 0.05）, and negative correla- tion with the level of ER and PR （P 〈 0.05）. The sensitivity of the four serum tumor markers in combination was only 69.77%, in contrast, the combined detection both in discharge and serum was 97.67%, and the negative predictive value was 99.03%. The sensitivity of combined detection both in nipple discharge and serum were significantly higher than other detection （P 〈 0.05）. Conclusion： IDPLs often present more than one histologic subtype and the most common subtypes are cribriform and solid, while comedo and micropapillary subtypes are less common. Our results suggest that the levels of CA153, TSGF, CA125 and CEA in nipple discharge were significantly higher than those in the serum, and is associated with HIF-le. The aberration of HIF-la may play a key role during oncogenesis and promote breast cellular transformation into malignancy, a finding useful for further understanding of tumorigenesis. Nipple discharge can be the earliest presenting symptom of breast cancer. The dynamic combined detection of the four tumor markers both in nipple discharge and serum are helpful to the stratification of preoperative patients and benefit to better prewarning markers for monitoring their recurrence and metastasis and clinical staging of tumors in clinic, but cannot increase the sensitivity of judging the patients with early breast cancer.     

The effect of different inflation volumes of laryngeal mask airway on efficacy of closed circuit controlled ventilation in pediatric cancer patients

Objective： The laryngeal mask airway （LMA） is an established way for airway control during spontaneous ventila- tion. Its ability to deliver positive pressure ventilation without leakage especially in low flow states is still controversy. The aim of this study is to test the possibility of using LMA in pediatric closed circuit controlled ventilation, and to find out the optimum cuff volume to perform closed system ventilation. Methods： Twenty children scheduled for elective surgeries were enrolled in a crossover study. Laryngeal mask airway was used. In stage I, the cuff was inflated with the maximum volume of air as rec- ommended by the manufacturers. Adjustment of volume of air inflated into the LMA cuff to the minimum volume to obtain the effective seal was done at stage II. The leak pressure, intracuff pressure and the leak volume were measured in both stages. Results： The cuff filling volume was significantly lower compared to the maximum cuff inflation volume in stage I. Leakage values showed significantly less values in stage II of the study with smaller cuff inflation volumes. The airway leakage pressure was significantly lower in stage fl in comparison to stage I. Cuff inflation pressure in stage I showed marked elevation which dropped significantly after adjustment of cuff volume in stage I1. Conclusion： Laryngeal mask airway is an effective tool to provide closed circuit controlled ventilation in pediatrics. Inflation of the cuff by the minimum volume of air needed to reach the just sealing pressure is suggested to minimize the leakage volume.     

Application of non-small cell lung cancer pleural effusion cell blocks in molecular pathological detection

Objective： The tumor tissues used in molecular pathological detection were usually obtain,ed by surgery, which would cause trauma and may not be suitable for the terminal cancer patients. This paper evaluated the value of the non-small cell lung cancer （NSCLC） pleural effusion cell blocks as tumor tissues replacement materials in the application of molecular pathological detection. Methods： Tumor cells were made into cell blocks through stratified centrifugal from 30 NSCLC pa- tients with the pleural effusion. The immunohistochemistry, fluorescence in situ hybridization （FISH） and gene sequencing methods were employed in our experiments. Results： The tumor cells of cell block section were rich and could keep part of histological structure. Immunohistochemistry staining could assist diagnosis and tumor parting. Epidermal growth factor receptor （EGFR） FISH-positive was found in 33.33% of the group, high polysomy in 6 cases, amplification in 4 cases. EGFR gene mutations were found in 8 cases of 30 samples, with an incidence of 26.67%, 6 cases were detected in the exon 19, and 2 cases were detected in the exon 21. Conclusion： The NSCLC pleural effusion cell blocks are useful for the diagnosis and determining the primary source of tumor, instructed targeted therapy.     

The impact of Deta-elemene on Deta-tuDulJn of human hepatoma hepg2 cells

Objective： The aim of this study was to investigate the impact of beta-elemene injection on the growth and beta-tubulin of human hepatocarcinoma HepG2 cells. Methods： Cell proliferation was assessed by MTT assay. Cell cycle distribution was detected by flow cytometry （FCM）. The mRNA expression of beta-tubulin was measured by RT-PCR. West- ern blot analysis was used to determine protein expression of beta-tubulin and the polymerization of beta-tubulin. Results： Beta-elemene injection inhibited HepG2 cells proliferation in a dose- and time-dependent manner; FCM analysis indicated beta-elemene injection induced cell cycle arrested at S phase. RT-PCR and western-blot analysis showed that beta-elemene injection down-regulated beta-tubulin expression at both mRNA and protein levels, presenting a dose-dependent manner. Moreover, beta-elemene injection reduced the polymerization of microtubules in a dose-dependent manner. Conclusion： Beta-elemene injection can inhibit the proliferation of hepatoma HepG2 cells, the mechanism might be partly related to the down-regulation of beta -tubulin and inhibition of microtubular polymerization.     

Clinical observation of platinum-based combined with concurrent three-dimensional conformal radiotherapy in patients with locally advanced non-small cell lung cancer

Objective： The aim of our study was to explore the shortterm efficacy of platinumbased combined with concur rent chemoradiotherapy for locally advanced nonsmallcell lung cancer （NSCLC）. Methods： Between 2006 to 2010, 78 cases of locally advanced NSCLC were enrolled into this trial. All patients were given platinumbased chemotherapy combined with concurrent threedimensional conformal radiotherapy （3DCRT）. Chest CT scans were obtained during endexpiratory and endinspiratory pauses when performing positioning. Image fusion was done after the image data was transferred to treat ment plan system （TPS）. The target volume was delineated on the fusion images. The chemotherapy was given on the first day of radiotherapy. Comprehensive examinations were conducted 46 weeks after concurrent chemoradiotherapy to assess shortterm efficacy. Results： Complete remission （CR） was achieved in 8 cases and partial remission （PR） in 54 cases. The efficiency rate reached 79.5%. Grade IllIV radiation esophagitis occurred in 11.5%. No exit and death cases during treat ment. Conclusion： Concurrent chemoradiotherapy could significantly improve the shortterm efficacy and prolong survival of stage III NSCLC, meanwhile the adverse reactions could be tolerated.     

The observation of single-agent gemcitabine maintenance therapy in patients with metastatic breast cancer

Objective： The aim of the study was to evaluate the efficacy and tolerability of single-agent gemcitabine in the maintenance treatment of histologically confirmed metastatic breast cancer cases. Methods： The 45 patients carried ef- ficacious chemotherapy were divided into maintenance therapy group （n = 23） and control group （n = 22） according to the different treatment methods. Patients in the maintenance therapy group received gemcitabine therapy until 6 cycles, disease progression or adverse effect intolerance. Within the control group, the patients were given best supportive care. Follow-up was made until disease progression, death or 2 years. The short-term clinical efficacy and adverse effects, progression-free survival （PFS） and median survival of recurrence （MSR） of these two groups were compared and analyzed. Results： Com- pared with the control group, the experiment group had higher response rate （RR; 73.9% vs 31.8%; P 〈 0.05）, and significantly progress of median PFS （13.1 vs 9.6 months; P 〈 0.05）. However, the progression of MSR had no statistically difference with the control group （23.3 vs 21.1 months; P 〉 0.05）. Most of the treatment-related adverse events were mild, and the most common adverse event was hematologic toxicity. The 3 cases occurred grades 3-4 neutropenia and 3 cases occurred grades 3-4 thrombocytopenia. The 1 patient stopped treatment because of grade 3 allergic reaction, and 4 patients required dose reduction for grade 4 adverse events. Other adverse effects were grades 1-2, and all were recovered after symptomatic treat- ment. There was no significant side effect which threatened the life. Conclusion： In the extension maintenance treatment, gemcitabine can consolidate the therapeutic effect in advance and significantly prolong median PFS of metastatic breast cancer patients. In conclusion, gemcitabine monotherapy with a favorable safety profile is an effective maintenance treatment in metastatic breast cancer patients.     

The latest advances of experimental research on targeted gene therapy for prostate cancer

The absence of effective therapies for castration-resistant prostate cancer （CRPC） establishes the need to de- velop novel therapeutic modality, such as targeted gene therapy, which is ideal for the treatment of CRPC. But its application has been limited due to lack of favorable gene vector and the reduction of ＂bystander effect＂. Consequently, scientists all over the world focus their main experimental research on the following four aspects： targeted gene, vector, transfer means and comprehensive therapy. In this paper, we reviewed the latest advances of experimental research on targeted gene therapy for prostate cancer.     

Comparison of two methods for assessing leakage radiation dose around the head of the medical linear accelerators

Objective： The aim of this study was to measure the leakage by two methods with ion chamber and ready packs film, and to investigate the feasibility and the advantages of using two dosimetry methods for assessing leakage radiation around the head of the linear accelerators. Methods： Measurements were performed using a 30 cm^3 ion chamber; the gantry at 0°, the X-ray head at 0°, the field size at between the central axis and a plane surface at a FSD of 100 as a reference, a series of concentric circles having radii of 50, 75, and 100 cm with their common centre at the reference point. The absorbed dose was measured at the reference point, and this would be used as the reference dose. With the diaphragm closed, the measurements were taken along the circumference of the three circles and at 45~ intervals. Results： Leakage radiations while the treatment head was in the vertical position varied between 0.016%-0.04%. With the head lying horizontally, leak- age radiation was the same order magnitude and varied between 0.02%-0.07%. In the second method, the verification was accomplished by closing the collimator jaws and covering the head of the treatment unit with the ready pack films. The films were marked to permit the determination of their positions on the machine after exposed and processed. With the diaphragm closed, and the ready packs films around the linear accelerator the beam turned on for 2500 cGy （2500 MU）. The optical den- sity of these films was measured and compared with this of the reference dose. Leakage radiation varied according to the film positions and the magnitude of leakage was between 0.005%-0.075%. Conclusion： The differences between the values of the leakage radiation levels observed at different measurement points do not only reflect differences in the effective shielding thickness of the head wall, but are also related to differences in the distances between the target and the measurement points. The experimental errors involved in dosimetric measurement also contribute to such differences.     

Study of the Dextran-DTPA-Gd at rabbit popliteal fossa lymph node metastasis from thigh transplanted tumor with interstitial magnetic resonance lymDhoqraDhv

Objective： The aim of the study was to investigate the developing situation of the interstitial magnetic resonance （MR） lymphoid contrast agent Dextran-DTPA-Gd through the rabbit popliteal fossa lymph node metastasis from thigh VX2 transplanted tumor injection to show targeting enhanced metastatic lymph nodes and lymphatics. Methods： VX2 tumor was transplanted to the right hind limb quadriceps of 12 healthy New Zealand rabbits and the left side as a contrast. Eight rabbits had homonymy popliteal lymph node metastasis after 1 month through 3.0 GE MRI and they were later injected with lym phatic targeting contrast agent Dextran-DTPA-Gd 0.4 mL （3.96 x 10^-3 tool/L） through bilateral hindlimb toe web respectively. Enhanced MR images were obtained with interval 10 min, 15 min, 20 rain, 25 min, 30 rain, 35 min, 40 rain, 45 rain, 50 min, 55 min, 60 min, 2 h, 4 h, and 24 h. The signal intensities before and after enhancing were measured to calculate the enhanc- ing rates （E%） of popliteal lymph node and the popliteal lymph node signal intensity-time curves were drawn to observe the development of cancer metastasis lymph nodes and lymphatics and to compare the differences of interval sides. Results： Ten minutes after injected into the rabbit＇s bilateral hindlimb toe web, we could see hind lymphatic and popliteal lymph nodes were strengthened significantly and evenly without blood vessels developing. The signal reached a peak after 35 rain with E% to 315%, which decreased to 205% after 4 h and would be undifferentiated with the surrounding tissues after 24 h. Sta- tistical analysis was made to popliteal lymph node enhancement rate. It was considered statistically significant as long as P 〈 0.05. The tumor-side popliteal lymph node manifested as coarse and irregular shape, lymphatic vessels tortuous dilated and lymphatic chain incomplete as a result of tumor infection. Conclusion： Dextran-DTPA-Gd is specific to lymphoid tissue development. It can targeting display regional lymphatic drainage concretion and the morphology of normal and cancer cells metastasis lymph nodes rapidly.     

rdentification of label-retaining cells in human gastric ：ancer xenograft in nude mice

Objective： This study has investigated the existence of label-retaining cell and its distribution in gastric cancer, in the hope that this information will assist investigations on gastric cancer stem cells. Methods： The gastric carcinoma cell line BGC-823 was labeled with BrdU in vitro and then engrafted into the right axilla of nude mice, which developed tumors. Label-retaining cells were quantified by immunohistochemical methods. Results： BrdU positive cells constituted about 96% of the cells in xenograft tumors after 10 days. Subsequently, BrdU positive cells gradually decreased, at the 80th day, label- retaining cells steadily occupied about 0.5%. This set of population cell localized in the margin of cancer nests, which had no difference in cellular morpha. Conclusion： The study demonstrates the presence of label-retaining cells in human gastric cancer xenografts in nude mice and the label-retaining cells may be related with cancer stem cells, which are most likely the cause for spread, metastasis and recurrence.     

Reversal effect of recombinant human Endostatin on cisplatin resistance in A549/DDP human lung adenocarcinoma cells in vitro

Objective： Recombinant human Endostatin （rh-Endostatin, YH-16） can reverse cisplatin resistance in A549/DDP cells. However, the possible effect of rh-Endostatin in reversing DDP-resistance in A549/DDP cells and the mechanism are needed to be investigated. Methods： Lung adenocarcinoma cell line A549 and its DDP-resistant cell line A549/DDP were treated with DDP and/or recombinant human Endostatin. Difference in drug resistance was analyzed between different regi- mens and between different cell lines after a 72 h-treatment in vitro. And below the non-cytotoxic concentration of rh-End- ostatin, the possibility of rh-Endostatin in reversing DDP-resistance in A549/DDP was evaluated. The resistance protein which was detected in the study included P glycoprotein （P-gp） and topoisomerase II （Topo-II）. Results： Rh-Endostatin below 400 IJg/mL showed no cytotoxicity in either A549 or A549/DDP after 72 h-treatment with it. The inhibited concentration of 50% （IC50） observed for DDP was （0.79 _＋ 0.05） IJg/mL in A549 and （13.2 ＋ 1.1） in A549/DDP respectively. IC50 was reduced to 2.57 ＋ 0.05 #g/mL in A549/DDP treated by rh-Endostatin below the non-cytotoxic concentrations in combination with DDP, with a reversal fold （RF） of 5.14 and a relative reversal rate of 85.6%. Apoptotic rates were 2.01%, 13.47% and 29.26% re- spectively for cells treated with rh-Endostain, DDP, and the combination. The rate of the A549/DDP control group was 0.99%. The expression level of P-gp or Topo-II was higher in A549/DDP cells than in A549 cells. Rh-Endostatin may partially reverse DDP-resistance in A549/DDP cells in vitro, with a probable mechanism related to lowering expression of P-gp and Topo-II. Conclusien： Rh-Endostatin of non-cytotoxic dose partially reversed cisptatin resistance in cisplatin-resistant human lung adenocarcinoma cell line A549/DDP. Rh-Endostatin reversed the resistance of A549/DDP cells to DDP, which may be related to decreased protein expression of P-gp and Topo-II in A549/DDP cells.     

Comparison of vinorelbine plus cisplatin with vinorelbine plus capecitabine in patients with anthracyclines- and taxanes-refractory advanced breast cancer

Objective： The aim of our study was to compare the efficacy and toxicities of vinorelbine plus cisplatin （NP） regimen with that of vinorelbine plus capecitabine （NX） regimen in the treatment of anthracycline- and taxane-refractory advanced breast cancer. Methods： Forty-six patients with anthracycline- and taxane-refractory advanced breast cancer were equally randomized into a NP group （n = 23） and a NX group （n = 23）. Response rates and toxicities were evaluated after 2 cycles of chemotherapy. Results： The overall response rate were 48.0% in both groups. There were no significant differences in disease control rates （78.0% vs. 83%） or 1-year survival rates （54.6% vs. 55.9%）. The main adverse events were bone marrow depression and gastrointestinal reaction, and no significant difference was found in toxicities between the groups. Conclusion： For anthracycline- and taxane-refractory advanced breast cancer, NP and NX regimens exerted similar curative effects with acceptable toxicity.     

The efficacy of bevacizumab in Chinese patients with metastatic colorectal cancer and its effect in different line setting

Objective： We aimed to evaluate the effect of bevacizumab in the palliative treatment of Chinese metastatic colorectal cancer （mCRC） and its efficacy in different lines. Methods： Patients of mCRC treated with bevacizumab or not at Sun Yat-sen University Cancer Center from 2005 to 2013 were recruited as the study group and control group. The endpoints were objective response rate （ORR）, disease control rate （DCR）, overall survival （OS） and progression free survival （PFS）. The OS and PFS of first-, second- and third-line treatment groups were compared between study group and control group. Re- sults： The median PFS of the study and the control group were 8.2 months （7.0-9.4 months）, 5.7 months （4.7-6.6 months）, P = 0.001; OS were 26 months （5.4-130.5 months）, 18 months （16.6-19.4 months）, P 〈 0.001, respectively. The ORR and DCR of first-, second- and third-line were 30.3% （20/66）, 20% （6/30）, 17.6% （3/17） and 97% （64/66）, 86.7% （26/30）, 100% （17/17）. In the first-line chemotherapy group, the OS of the study group and the control group were 22.9 （5.4-96.7） months and 18 （16.6-19.4） months （P 〈 0.001）; PFS were 9.4 （8.4-10.4） months and 5.7 （4.7-6.6） months （P 〈 0.001）, respectively. While in the second- and third-line setting, only OS were statistically different, PFS had no significant difference. Conclusion： The combination of bevacizumab and chemotherapy had a promising short-term and long-term efficacy in Chinese mCRC patients than those without bevacizumab regimens, and the effect could be better reflected in the first-line treatment.     

Jinshuixian in combination with radiotherapy suppresses the proliferation of A549 cells by inhibiting the expression of VEGF

Objective： The aim of our study was to investigate whether Jinshuixian has the abilities of inhibiting tumor growth and radio-sensitivity effect. Methods： Cultured lung A549 ceils were randomly divided into 6 groups： normal control group （NC）, the Jinshuixian group （JSX）, radiotherapy （RT）, JSX for the first day and the next day followed by RT group （JSX~ RT）, RT for the first day and the next day followed by JSX group （RT→JSX） and RT ＋ JSX concomitantly group （JSX ＋ RT）. MTT was applied to measure the cell viability, RT-PCR and ELISA were used to test the expression of mRNA and protein of VEGF. Results： The proliferation of A549 cells were inhibited in JSX and combined groups and the inhibiting effects were time dependent. The expression of VEGF in RT group was increased, however, VEGF in JSX and combination groups were largely decreased over time when compared to NC group. Results in JSX→RT, RT→JSX and JSX ＋ RT groups did not achieve significantly differences. Conclusion： JSX has the ability of anti-tumor growth in vitro accompanied down-regulating of VEGF, especially when combined with radiotherapy, and its effect is time-dependent. However, more studies in vivo and in vitro are needed to further supporting these effects.     

Effects Of the anti-tumor composition of the acetoacetate extract of vitex negundo seed on the growth of human cervical carcinoma xenografts in nude mice

Objective： The aim of our study was to investigate the effects of the anti-tumor composition of the acetoacetate extract of Vitex Negundo Seed （EVn-50） on the growth of human cervical carcinoma HeLa cells xenografts in nude mica and its possible molecular mechanism. Methods： Models of human cervical cancer HeLa cells xenografts transplanted subcuta- neously in nude mice were established and randomly divided into 7 groups （each group including 5 nude mice）： saline group, Taxol group, EVn-50 group, comp-6 group, comp-7 group, comp-8 group and comp-10 group. The volume and weight of Xe- nograts were observed and compared. The alteration of the weight of nude mice, and the change of serum levels ofLDH, ALT, Cr and WBC counts were examined and compared. The apoptotic rate of human cervical carcinoma HeLa cells xenografts was analyzed by FCM. The expressions of P53 and Bcl-2 proteins of HeLa cells xenografts were determined by Western blot- ting. Results： EVn-50 and its fractionated extracts could significantly suppress the increasing volume and weight of human cervical carcinoma HeLa cells xenografts in nude mice models in time-dependent manner, yet had no significant effect on the weight of nude mice, the serum levels of LDH, ALT, Cr and WBC were counted. When the xenografts were treated with EVn-50 and its fractionated extracts for 16 days, the apoptotic rate of xenografts cells were significantly increased, and the expression of P53 protein was up-regulated and protein level of Bcl-2 was decreased. Conclusion： EVn-50 and its fractionated extracts could suppress the growth of human cervical carcinoma HeLa cells xenografts in nude mice, which may be related to its pro- motion on xenografts cells apoptosis through down-regulation of Bcl-2 expressionPand activation of P53 expression.     

Morphology and survival of cryopreserved-thawed ovarian tissues after heterotopic autotransplantation

Objective： The aim of our study was to observe the survival and morphological changes of thawed ovarian tis- sues after heterotopic transplantation. Methods： Twenty SPF-SD female rats （5-6 weeks old） were equally randomized into the control group and experimental group. In control group, the freshly isolated ovaries were fixed in formalin. In experimental group, the freshly isolated ovaries were vitrified immediately and cut into thin slices. After stored in liquid nitrogen for 21 days, the tissues of experimental group were rapidly thawed and transplanted into back muscles of rats for 2 or 4 weeks, respectively. After that, all rats in experimental group were sacrificed and the ovarian tissues were collected and fixed in 4% formaldehyde solution. Then the ovarian tissues were stained with HE and observed under the light confocal microscope. Re- suits： With the naked eyes, there was no specific alteration except the size reduction with color changing. Under microscopy, we found normal cortex and medulla in the ovary, and the primordial follicles and follicles in various stages were observed in the cortex. The normal oocytes in ovarian tissues of experimental group were significant decreased than in the control group. Conclusion： The ovarian tissues survive well in experimental group and there is no significant difference in the proportion of follicles between different times （2 and 4 weeks） after grafting. Our results suggest that thawed ovarian tissues could survive after heterotopic transplantation into back muscles of rat models and maintain their morphology and function.     

Clinical implications and prognostic value of five biomarkers in endometrial carcinoma

Objective： The aim was to identify the relationship between ER, PR, P53, Ki-67, PTEN, the association with clinicopathological parameters and the correlation with survival. Methods： We studied 190 cases of primary endornetrial carcinoma in which ER, PR, Ki-67, P53, PTEN antigens were investigated with the use of immunohistochemical methods. To evaluate the correlations among immunohistochemical staining and the age, menopause status, histological type, FIGO stage, grading, depth of invasion, lymph nodes involvement and serum tumor marker. Survival analysis was assessed within single and combined biomarkers types. Results： The percentage of Ki-67 and P53 positive endometrial tumors was signifi- cantly higher in ER negative vs ER positive tumors （both P = 0.000）. The same trend was evident in PR positive and nega- tive group. The percentage of PTEN positive tumors was significantly higher in PR positive versus PR negative tumors （P = 0.021） but was no difference in different ER status. ER and PR status were significant predictors with FIGO staging, grading and recurrence. There was no clear association between PTEN positivity and clinicopathological parameters except more relevance with endometrioid histotype （P = 0.013）. Positive Ki-67 or P53 was found to be strictly related to more aggressive features. There was statistically significant difference in different status of P53 and Ki-67 in survival time. Conclusion： ER and PR positive tumors showed a statistically significant association with better clinical outcome, PR has more significant influ- ence on prognosis. The percentage of positive Ki-67 or P53 was significantly higher in hormone-independent group versus in hormone-dependent group and combined Ki-67 and P53 may have more effect on prognosis in former group.     

Reconstruction of composite defects of the nose following tumor resection - a single author＇s experience and evaluation of the outcome

Objective： The aim of the study was to present our experience in reconstruction of complex defects of the nose. Methods： Fourteen patients presenting with large composite defects of the nose were anatomically reconstructed after full tumor clearance of a skin cancer. The aesthetic outcome was assessed subjectively and objectively while the functional outcome was only assessed subjectively in 13 patients. Results： Basal cell carcinoma （BCC）, represented the tumor excised in 10 patients while the remaining 4 patients suffered from squamous cell carcinoma （SCC）. One patient died of extensive local recurrence of SCC after 6 months. The commonest flap used for inner lining was the septal flap while the forehead paramedian flap provided the external coverage for the majority of patients. All flaps survived completely except in one patient who developed distal paramedian forehead flap necrosis. Two patients developed multiple abscesses and sinuses discharg- ing parts of cartilage grafts through the flaps＇ skin with one patient suffering from total extrusion of the costal cartilage grafts. Two other patients suffered from severe nostril stenosis. All patients had variable degree of difficulty in airway passage, while most patients were satisfied with the total nasal appearance. The objective assessment of the overall appearance of the nose scored less than the subjective satisfaction. Conclusion： Reconstruction of complex nasal defects has a high learning curve. Intranasal flaps are usually of limited size and nostril asymmetry is likely to occur. Local or regional skin flaps if available are still considered a good choice for inner as well as outer lining.     

The effect of Jinlong capsule on the immune function for intervened patients with primary liver cancer

Objective： The aim of this study was to evaluate the effect of Jinlong capsule on the immune function for inter- vened patients with primary liver cancer. Methods： Matched the inclusion criteria, 60 patients were selected and randomly divided into two groups. The treatment group had 30 cases treated with Jinlong capsule combined with the transcatheter arterial chemoembolization （TACE）; the control group had 30 cases treated with TACE. Each group was treated 30 days as a cycle, which had completed at least two cycles. Indicators of cellular immune function about the activity of CD3, CD4, CD8, CD4/CD8 and natural killer （NK） cell were detected before and after treatment, then to compare and analysis with each other. Results： Before treatment, the activity of peripheral blood CD3, CD4, CD8, CD4/CD8 and NK cell in the two groups was no significant difference （P 〉 0.05）; after treatment, the activity of CD3, CD4 and NK cell in the treatment group was significantly increased, the ratio of CD4/CD8 increased, and the value of CD8 decreased （P 〈 0.05）, the activity of CD3, CD4 and NK cell in the control group was significantly decreased, the ratio of CD4/CD8 decreased （P 〈 0.05）, and the value of CD8 slightly higher than before treatment （P 〉 0.05）, the difference between the two groups indicated the statistical significance （P 〈 0.05）. Incidence of gastrointestinal reactions, leucopenia, hemoglobin, platelet decline in the treatment group was lower than those in the control group, but without presenting the statistical significance （P 〉 0.05）. Conclusion： Jinlong capsule with hepatic arterial infusion chemotherapy can improve the patients＇ immune function, and reduce the adverse reactions of interventional chemotherapy. Hence, it deserves to be promoted in clinically.