Vasculogenic mimicry in non-small cell lung cancer and its relationship with tumor stage

Objective： The purpose of the study was to study the mechanism of vasculogenic mimicry （VM） and its relationship with tumor stage in non-small cell lung cancer （NSCLC）. Methods： Forty-two patients with NSCLC were collected, 19 belonged to the early stage （stages Ⅰ ＋Ⅱ） while 23 were late stage （stages Ⅲ ＋ Ⅳ）. Moreover, 20 patients got surgical treat ment and 22 got chemotherapy. We studied the relationship of VM with stage, chemotherapeutic effect, HIF-la, microves sel density （MVD） and clinicopathologic features. Results： VM in patients of early stages were significantly more than late stages （68.4% vs 26.1%, P = 0.006）, and the positive rate of VM was proportional to HIF-la （P = 0.034）. But no correlation was found between VM and chemotherapeutic effect （14.3% vs 26.7%, P = 1.00） or MVD （P 〉 0.05）. Furthermore, we found VM also showed a negative correlation with distant metastases and lymph nodes metastases （P 〈 0.05） while no correlation was found with other clinicopathologic. Conclusion： VM was generated during the early stage in NSCLC and correlated with lymph nodes metastases. As the disease progressed, VM may be replaced by vascular endothelial cells, so the late-stage patients especially people with distant metastases had fewer VM. As the main factor produced by hypoxia, HIF-la may make a difference in VM formation. Thus we inferred VM might be a new target for targeted therapy, and could provide help for clinical staging and treatment.     

急进高原健康人凝血-纤溶指标研究

目的：研究不同海拔高度健康人群凝血纤溶系统的变化及对机体的影响;方法北京组（海拔50m,n=34）、沱沱河组（海拔4700m,n=34）志愿者,应用美国Courter公司生产的ACL9000型全自动凝血分析仪,检测凝血酶原时间（PT）、凝血酶时间（TT）、活化部分凝血活酶时间（APTT）、纤维蛋白原（FBG）、纤溶酶原（PLG）、纤溶酶抑制物（PL—IN）、D-二聚体（DD）七项凝血-纤溶指标。结果：沱沱河组PT、TT、APTT、DD均高于平原组,FBG、PLG、PL—IN均低于平原组,（P〈0．05）。提示高原缺氧血液高凝,纤溶亢进。结论：健康人群进入高海拔地区凝血-纤溶系统指标较明显的变化,高原地区缺氧,机体血管内皮损伤、红细胞增生等可能是引起这种变化的主要原因。提示在高原地区疾病诊治,尤其是重危病人的抢救中应高度重视凝血-纤溶系统的变化。     

Genome-wide search for type 2 diabetes/impaired glucose homeostasis susceptibility genes in the Chinese: significant linkage to chromosome 6q21-q23 and chromosome 1q21-q24

This genome-wide search for susceptibility genes to type 2 diabetes/impaired glucose homeostasis (IGH) was performed on a relatively homogeneous Chinese sample with a total number of 257 pedigrees and 385 affected sibpairs. Two regions showed significant linkage to type 2 diabetes/IGH in the Chinese. The region showing linkage to type 2 diabetes/IGH from the entire sample group analysis was located on chromosome 6q21-q23 (128.93 cM, 1-LOD [logarithm of odds] support interval between 124 and 142 cM, according to the Marshfield genetic map), with a maximum likelihood score of 6.23, a nonparametric linkage (all) score of 4.48, and empirical P value <0.001. With a subanalysis based on 101 affected sibpairs with age at diagnosis of type 2 diabetes/IGH <40 years, we detected significant evidence for linkage to chromosome 1q21-q24 (192.1 cM, 1-LOD support interval between 182 and 197 cM), with a maximum likelihood score of 8.91, a nonparametric linkage (all) score of 5.70, and empirical P value <0.001. No interaction was observed between these two regions. Our independent replication of the region on chromosome 1q that has been shown to be linked significantly to type 2 diabetes/IGH in Chinese supports the notion that gene(s) in this region may be universally important in the development of human type 2 diabetes.     

胰岛素瘤：附21例报告

目的探讨胰岛素瘤的术前定位方法与术中决策。方法对１９８２～１９９８年外科治疗的２１例胰岛素瘤进行回顾性分析。结果全组２１例,女１９例（９０５％）,男２例。年龄中位数为３６岁。术前均明确诊断为胰岛素瘤。但曾误诊癫痫７例,精神病２例,误诊率４２８％。Ｂ超定位准确者７５％,ＣＴ定位准确者５０％。结论胰岛素瘤定位较困难;Ｂ超、ＣＴ是术前较为实用的定位检查方法;如经各种检查仍不能定位时,可根据临床表现施行剖腹探查。手术方式首选胰岛素瘤剜除术,必要时也可行胰十二指肠切除或胰体尾切除。对无法彻底切除的恶性胰岛细胞瘤,应尽量切除原发和转移病灶。     

不同磨抛方法对烤瓷表面粗糙度的影响

目的:观察不同的磨抛程序和自上釉的陶瓷表面的粗糙度,为临床陶瓷修复体抛光提供可参考的依据.方法:按照不同的抛光程序进行分组,以自上釉组作为对照组.在抛光过程中以粗糙度测试仪测试抛光过程中陶瓷表面粗糙度变化并进行统计学分析.结果:经由粗到细的磨抛工具进行抛光后,陶瓷表面粗糙度均稳步下降,各组在使用ceramaster抛光头后表面粗糙度值趋于稳定,与其后使用抛光膏抛光后已无显著性差异(P＞0.05),凡是经Ceramaster及抛光膏抛光后的实验组陶瓷表面粗糙度与对照(上釉)组无显著差异(P＞0.05).结论:陶瓷使用由粗到细的抛光工具逐步抛光,可以使陶瓷表面粗糙度稳步下降,选用合适的抛光工具和合理的抛光程序可以简化抛光过程并使陶瓷表面达到上釉陶瓷表面的粗糙度.     

A Phase I Trial of Oxaliplatin for Intraperitoneal Hyperthermic Chemoperfusion for the Treatment of Peritoneal Surface Dissemination from Colorectal and Appendiceal Cancers

Background  Cytoreductive surgery with intraperitoneal hyperthermic chemoperfusion (IPHC) has evolved into a promising approach for peritoneal surface malignancy. A large body of literature suggests that oxaliplatin has excellent cytotoxicity against colorectal cancer. Therefore, we undertook a phase I evaluation of IPHC with oxaliplatin for peritoneal dissemination from colorectal and appendiceal cancers to establish the dose-limiting toxicity (DLT) and the maximum tolerated dose (MTD). Methods  Cohorts of three patients underwent cytoreductive surgery followed by a 2-h IPHC with escalating doses of oxaliplatin at a target outflow temperature of 40°C. The initial peritoneal oxaliplatin dose was 200 mg/M² with increases planned in 50 mg/M² increments. Plasma and perfusate samples were collected during the IPHC and evaluated using emission spectrometry techniques. Normal tissue and tumor samples were collected before and after the IPHC for analysis. DLT was defined as a grade 3 toxicity lasting 5 days. Results  Fifteen patients were enrolled at two dose levels. Peritoneal fluid areas under the curve (AUCs) were above those of plasma. Additionally, intratumoral oxaliplatin was similar to that of surrounding normal tissue. Dose-limiting toxicities at 250 mg/M² were observed in two of three patients enrolled in this study. Conclusion  We found that IPHC with 200 mg/M² of oxaliplatin is well tolerated and is the MTD for a 2-h chemoperfusion. Higher doses are not feasible with this perfusion protocol given the significant toxicities associated with 250 mg/M² oxaliplatin. Based on the data from this phase I study, we propose to conduct further studies with oxaliplatin delivered at 200 mg/M².     

Glucagon-like peptide 2: a new treatment for chemotherapy-induced enteritis

BACKGROUND: Glucagon-like peptide 2 (GLP-2) is a recently identified intestinal epithelium-specific growth factor that has been shown to reduce the severity of inflammatory disorders of the intestine in rodent models. We hypothesized that GLP-2 administration would be beneficial in chemotherapy-induced enteritis either by preventing injury or by promoting recovery. MATERIAL AND METHODS: Rats received no drug (control), chemotherapy alone [5-fluorouracil (5-FU), 190 mg/kg, ip] (Chemo), 5-FU followed by 3 days of GLP-2 analog (ALX-0600, 0.1 microg, sc twice daily) (CH-G), or GLP-2 analog for 6 days prior to 5-FU and for 3 days afterward (G-CH-G). Animals were pair fed. Rats received 5-bromo-2-deoxyuridine (Br-dU, 50 mg/kg, 2.5 h prior to sacrifice on Day 3 postchemotherapy) for immunohistochemical assessment of cellular proliferation. RESULTS: Chemotherapy induced significant reductions in body weight, villus height, and crypt depth compared with controls. Intestinal wet weight, villus height, and crypt depth were significantly higher for the CH-G group compared with the Chemo group. The CH-G group also showed a significant improvement in villus height compared with the G-CH-G group. Crypt depth, but not jejunal wet weight or villus height, was significantly improved in the G-CH-G group compared with the Chemo group. The percentage of Br-dU-labeled cells in the intestinal crypts did not differ among the groups. CONCLUSIONS: These results suggest, for the first time, that GLP-2 treatment initiated after chemotherapy administration enhances intestinal recovery. In contrast, GLP-2 treatment initiated prior to chemotherapy administration to prevent injury has less beneficial effect. GLP-2 administration may be beneficial to patients suffering from chemotherapy-induced enteritis.     

Factors Associated with Recurrence Within 2 Years After Curative Surgery for Gastric Adenocarcinoma

Background

Despite curative surgery for gastric cancer, many patients die of recurrent cancer. Few studies have investigated the time to recurrence after curative resection for gastric cancer.

Methods

Data were collected prospectively between December 1987 and December 2006. A total of 1,549 patients underwent curative resection of adenocarcinoma of the stomach at Taipei Veterans General Hospital. Among them, 419 patients had recurrence; they were divided into early recurrence (<2?years) and late recurrence (??2?years). The clinicopathological characteristics, survival time after recurrence, and recurrence patterns were compared between the two groups.

Results

Multivariate analysis showed that stage III gastric cancer patients with early recurrence had larger tumors and more lymph node metastasis than patients with late recurrence, while no difference between early and late recurrence was observed in stage I and II patients. Early recurrence was associated with more distant metastasis than was late recurrence. Patients with advanced TNM stage tended to die within 2?years after recurrence.

Conclusions

Gastric cancer patients with larger tumors and more lymph node metastasis tended to have early recurrence, especially stage III patients. Advanced TNM stage was associated with early cancer death after recurrence.     

不同缝合方法在肝移植胆道重建中的应用比较

目的 比较不同的缝合方法在肝移植胆道重建中的应用。方法时上海交通大学医学院附属瑞金医院2002年6月至2005年9月完成的158例肝移植所采用的不同胆道缝合方法厦术后胆道并发症进行回顾性分析。结果158例中26例采用间断缝合法，3例发生胆道并发症，其中2例为吻合口狭窄；47例采用连续缝合法，5例发生胆道并发症，其中3例为吻合口狭窄；85例采用改良连续缝合法，6例发生胆道并发症，但无吻合口狭窄。结果显示吻合口狭窄的发生率在3组间的差异有显著性（P〈0．05），改良连续缝合法吻合口狭窄的发生率明显低于其他两组。结论改良连续缝合法是一种较理想的胆管缝合方法，可有效降低术后吻合口狭窄的发生率。