Abstract:Objective:To construct chimeric mouse-human Fab antibody from a mouse monoclonal antibody NP11-4 which is specific to membrane protein of Schistosoma japonicum by genetic engineering technique,and further identify the binding ability of chimeric antibody fragment. Methods:Light chain variable region(VL) and heavy chain variable region(VH) genes cloned from mouse monoclonal antibody NP11-4 were amplified by RT-PCR,and sequenced and analyzed after being ligated into pMD18-T vector. Then VH and VL were fused into CH1 domain of human IgG1 and CL domain of human kappa chain respectively to obtain fragments of Fd and light chain. Chimeric Fab(cFab) was amplified by overlap PCR from chimeric genes of Fd and light chain. After the cFab DNA was ligated into the phagmid vector pComb3XSS,the expression vector pComb3XSS-Fab was transformed into E. coli Top 10F’,and the of soluble protein induced by IPTG(isopropyl-β-D-thiogalactoside) was detected. The expressions of products were detected by ELISA and Western blot methods. Results:An expression vector pComb3XSS-Fab to express cFab against Schistosomiasis japonica was successfully constructed. The cFab protein was expressed in soluble form and secreted form,which was confirmed by Western blot. ELISA demonstrated that the cFab possessed the activity and specificity of interacting with SEA(soluble egg antigen). Conclusion:The cFab retained the high affinity and specificity similar with the original mouse mAb NP11-4. This cFab fragment can be further modified to generate immunotoxin for therapeutic uses.

Abstract:Objective:To construct and express a recombinant immunotoxin expression vector composed of a human anti-c-Met single-chain Fv fragment gene and a PE38KDEL gene,and to examine the binding ability of the purified product to human hepatic cellular cancer cell line SMMC 7721. Methods:The human anti-c-Met gene fragments were amplified through PCR then it was subcloned into a PE38KDEL gene inserted fusion protein expression plasmid,which was expressed by pBAD/GⅢA vector. The recombinant vector was identified by restriction endonucleases digestion,PCR and DNA sequencing. After transformed into E.coli Top10F′and induced by L-arabinos,the inclusion bodies were denatured,renatured and refolded,then resolvable protein was purified. The binding ability and effect on cell proliferation test of the purified protein was evaluated by FACS and MTT,respectively. Results:The expression vector pBAD/GⅢA/c-Met/PE38KDEL was constructed successfully and the expression product existed mainly in the form of inclusion body. The refolding product remained the binding ability of the single-chain antibody and had significant effect of cell toxicity. Conclusion:Results of our study on c-Met/PE38KDEL and its effects on SMMC7721 show that the fusion protein would be a promising candidate for tumor targeted immunotherapy.

Abstract:Objective:To investigate the effects of lipoxin A4(LXA4)on epithelial- myofibroblast transdifferentiation(EMT)induced by recombinant human connective tissue growth factor(CTGF)in human renal tubular epithelial cell line(HK2)in vitro. Methods:The cultured HK2 cells were stimulated with CTGF for 48 hours with or without pretreatment of LXA4. The morphological changes were observed under an inverted microscope. The expressions of E-cadherin,α-smooth muscle actin(α-SMA)were detected by RT-PCR and Western blot. Results:CTGF induced the morphological changes of HK2 cells from oval to fusiform and stellate appearance,down-regulated the E-cadherin expression and up-regulated α-SMA expression both on mRNA and protein level. The expressions of mRNA and protein of E-cadherin reduced by CTGF(0.067 ± 0.015 and 0.257 ± 0.221,respectively)were increased by LXA4(0.270 ± 0.082 and 0.827 ± 0.177 respectively,P < 0.05). The expressions of mRNA and protein of α-SMA stimulated by CTGF(0.653 ± 0.256 and 0.167 ± 0.050,respectively)were inhibited by LXA4(0.070 ± 0.046 and 0.023 ± 0.023,respectively,P < 0.05). Conclusion:LXA4 inhibited the EMT of HK2 cells induced by CTGF. It suggests that the inhibition of LXA4 on CTGF-induced EMT could be a therapeutic strategy against tubulointerstitial fibrosis.

Abstract:Objective:To investigate the effect of pretreatment with oleanolic acid(OA) on glycogen content during hepatic ischemic reperfusion(IR)in rats. Methods:128 Male Sprague-Dawley(SD)rats were randomly devided into sham(A),IR(B),0.5%sodium carboxymethycellulose(CMC-Na)(C),OA+0.5% CMC-Na(D)equally. Before operation,all rats got intragastric administration once a day for 7 days, group D with OA(100 mg/kg)+0.5% CMC-Na,group A,B with water,group C with 0.5% CMC-Na in same volume. At the 8th day,rats suffered from segmental(70%)hepatic ischemia for 60 min and were followed by different periods of reperfusion. Blood and liver tissues were collected and measured respectively at preoperation,0,3 and 6 h after reperfusion for ALT,glycongen and lactate. And changes of histological pathology were also observed by light microscope. Results:Before operation,glycongen content of group D increased compared with other groups(P < 0.05). After reperfusion glycogen content in grup A decreased at 0,3,6 h compared with group B,C and D(P < 0.05);glycongen content in group D increased compared with group B and C respectively(P < 0.05). At 0 h after reperfusion,lactate level of group D increased compared with other groups(P < 0.05);lactate level of group B and C increased compared with group A(P < 0.05). At 3,6 h after reperfusion,the activity of ALT of group B,C and D increased compared with group A(P < 0.05);the activity of ALT in group D decreased compared with group B and C respectively(P < 0.05);group D had relieved morphologic changes compared with group B and C. Conclusion:OA pretreatment could increase glycogen content,also provide the rat liver with significant tolerance to IR injury. The mechanism may be related to the increased level of energy during IR.

Abstract:Objective:To investigate the role and mechanism of G-protein-coupled receptor kinase interacting protein 1(GIT1)and extracellular signal-regulated kinases 1 and 2(ERK1/2)in osteoblasts induced by durative pressure. Methods:The osteoblasts were mechanically stimulated on coverslips. The phosphorylation of ERK1/2 and GIT1 of osteobasts treated with or without the Src kinase inhibitor PP2 was measured by Western blot. The interaction between GIT1 and pERK1/2 was detected by coimmunoprecipitation. Cell area of groups treated with or without the Src kinase inhibitor PP2 was caculated by image-pro plus 5.0. Results:The phosphorylation of ERK1/2 and GIT1 and the interaction between GIT1 and pERK1/2 of osteoblasts treated with durative pressure significantly increased. The cell size increased significantly after durative pressure. Conclusion:These data suggests that 300 kPa durative pressure stimuates Src,consequently pathway induces the phosphorylation of ERK1/2 and GIT1 in osteoblasts,further increases the combination of pERK1/2 and GIT1 to migrate osteoblasts. The Src-GIT1/ERK1/2 pathway may play a important role in osteoblast migration induced by durative pressure.

Abstract:Objective:To investigate the effect of active immunization against gastric inhibitory popeptide(GIP)on behavior of SD rats. Methods:Male rats were fed with high-fat diet and divided into control group and GIP immunized group. Animals of experimental group and control group were immunized subcutaneously with 400 -滋g of GIP-KLH and KLH at the indicated time points respectively. GIP-specific antibody titers were determined by ELISA according to standard protocols differences on GIP-induced the insulin secretion of MIN6 cells using GIP-specific antibodies and behavior between two groups were investigated. Results:After four weeks of single immunization,high GIP-specific antibody titers were induced. Antibody levels further increased with continue injections. Compared with the control group,GIP-KLH immunized rats’serum containing specific antibodies significantly inhibited GIP-induced the insulin secretion on MIN6 cells(P < 0.01).Compared with control rats,distance(P < 0.01),speed(P < 0.01),active times(P < 0.05),the number of activities(P < 0.01)in spontaneous activity test were different(P < 0.05)significantly in GIP immunised group. Both the two groups showed no significant differences in test section of Morris water maze test(P > 0.05). Conclusion:Active immunization against GIP resulted in high,GIP-specific antibody titers. GIP immunized rats had a decreasing spontaneous activity.

Abstract:Objective:To investigate the physiological and pathological function of HSP27 by construct and identify the recombinant adenoviruses containing green fluorescence protein(GFP)and mouse HSP27 gene with PAdEasy system. Methods:The coding region of HSP27 was subcloned into the shuttle vector pAdTrack-CMV to form pAdTrack-CMV-HSP27. The identification was performed by PCR,sequencing and restriction digest. Chemical transformation of the plasmid pAdEasy-1 into E. coli BJ5183 strain was performed to prepare BJ5183-pAdEasy-1 as the competent bacterium,in which pAdEasy-1 and pAdTrack-CMV-HSP27 were cotransformed. Finally,the recombinant adenovirus containing the coding region of HSP27 gene was constructed by transfecting 293 cells with linearized adenoviral genomes of Ad-CMV-HSP27,and produce was used to infect mice spermatocyte,the expression of HSP27 protein was detected by Western blot. Results:The recombinant plasmids identified by PCR and directly sequencing were positive. GFP was observed after construction,high concentration of spermatocytes infected by recombinant adenortrus was harvested,and HSP27 protein expressed correctly. Conclusion:The recombinant adenoviruses expressing HSP27 and GFP using AdEasy system,which will facilitate further functional studies of HSP27,are successfully performed in this study.

Abstract:Objective:To evaluate expression of Fgfs in hypopspadiac male rats induced by maternal exposure to DBP. Methods:Twenty pregnant rats were randomly divided into 2 groups and given DBP by gastric intubation at a dose of 0,750 mg/kg from gestation day(GD)14 to GD18. On postnatal day(PND)1,live pups were counted and hypospadias of male pubs were examined. The anogenital distance(AGD)and body weight of male pubs were measured. On PND7,real-time quantitative RT-PCR was used to quantify mRNA expression of Fgf8,Fgf10 and Fgfr2 in GT of hypospadiac male rats. Results:The number of live pubs in the DBP treated group significantly decreased. The body weight and the AGD of hypospadiac male rats significantly decreased. Moreover,significantly decreased expression of Fgf8,Fgf10 and Fgfr2 were observed. Conclusion:The down-regulation expression of Fgfs signaling molecules might lead to the occurrence of hypospadias induced by maternal exposure to DBP.

Abstract:Objective:To investigate the expressions of survivin,caspase-3 and NF-κB in hepatocellular carcinoma(HCC)and their relationship with clinical pathologic features of HCC. Methods:40 cases of HCC specimens were collected as study group and 10 cases of normal specimens as control. Immunohistochemcal method was used to detect the expressions of survivin,caspase-3 and NF-κB. Results:Positive expression rate of survivin was 67.5% in HCC study group,while negative in the control. There was significant difference between the study and normal control groups(-字2=12.082,P < 0.05). In the study group,the positive expression rate of survivin was higher in the group with oncogenic portal vein thrombosis than in the group without(-字2=5.405,P < 0.05). The positive rate of survivin was higher in the cases with extrahepatic metastasis than in coses without(-字2=4.596,P < 0.05). 35.0% of the study group expressed caspase-3,while 80.0% of the control group expressed caspase-3. Significant difference was found between these two groups(-字2=4.875,P < 0.05). 77.5% of the experimental group expressed NF-κB while negative in the control. There was significant difference between these two groups(-字2=17.238,P < 0.05). The positive expression rate of NF-κB was higher in the low differentiation group than those in the high differentiation group(-字2=4.198,P < 0.05). There was negative correlation between the expression of caspase-3 and survivin(r=-0.679,P < 0.05). However,the correlation between the expression of NF-κB and survivin was positive(r=0.519,P < 0.05). Conclusion:Since survivin,caspase-3 and NF-κB each has a different effect on the origin and development of HCCs,the combination of detection of these three factors will provide us a valuable clinical index for the degree of malignancy and capability of metastasis,it offers HCC a better treatment regimen and prognosis.

Abstract:Objective:To investigate the relationship between resistance to TRAIL and methylation status of DR4 and DR5 in bladder cancer cell lines. Methods:T24 and BIU87 bladder cancer cell lines were employed in the study of mRNA expression DR4 and DR5 inbladder cancer cells were detected using reverse transcription polymerase chain reaction(RT-PCR). DNA methylation status of wes examined by methylation specific polymerase chain reaction(MSP) in bladder cancer cells with low expression of DR4 and DR5 mRNA. Furthermore,bladder cancer cells were exposed to TRAIL and TRAIL combined 5-aza-2,-deoxycytidine(AzadC) to measure cancer cells growth and apoptosis by Flow Cytometry. Results:No DR4 and DR5 expression were detected in T24 cell line by RT-PCR. The methylation status was determined and correlated with the expression pattern. We observed DR4 and DR5 promoter hypermethylation. In contrast,DR4 and DR5 hypermethylation could not be found in BIU87 cell line which remained DR4 and DR5 expression. The apoptosis rates of T24, BIU87 bladder cancer cells treated with 100 ng/ml TRAIL singly were 7.6%, 30.4% respectively,which had significant difference compared with the groups without treatment(P < 0.05). However the apoptosis rates of T24 and BIU87 cell lines treated by 100 ng/ml TRAIL combined with 5 μmol/L AzadC reached 29.2%,31.7% respectively. Conclusion:Our findings showed a functional relevance of the DR4,DR5 expression in T24 cell line and suggested a substantial contribution of DR4,DR5 hypermethylation and consequent loss of DR4,DR5 expression in bladder cancer.

Abstract:Objective:To examin the single nucleotide polymorphism(SNP) in COX-2 promoter(-1195G>A) and the association between pathological parameters and COX-2 expression in colorectal cancer. Methods:Genotyping of the COX-2 promoter -1195G>A was carried out by single-tube SYBR GREEN PCR with Tm-shift primers. 118 samples of colorectal cancer patients were anaylzed by genotyping. Results:Stratified analysis indicated that an elevated risk of lymph node metastasis and advanced stage was observed in subjects who carried at least one A allete(AA or GA) compared with patients with GG genotype(P=0.007,0.010,respectively). High expression of COX-2 was found in subjects carrying AA or GA genotype compared with patients with GG genotype(OR= 3.01and 2.79 respectively). Conclusion:COX-2 SNP-1195G>A was associated with clinicobiological behaviors of tumor, such as lymph node metastasis,tumor stage, and expression of COX-2 protein. -1195A allele indicated high risk of lymph node metastasis,advanced stage and high rate of COX-2 staining positive in immunohistochemisty.

Abstract:Objective:To construct the eukaryotic expression vector of pCDNA3.1A-GATA4 and detect its expression in P19 cells. Methods:Because the GC level of the coding sequence of mouse GATA4 was too high, a two step PCR was adopted to clone the full-length coding regions of GATA4,and then the right PCR product was inserted into PMD19-T vector. After DNA sequence analysis,GATA4 was subcloned into pCDNA3.1A vector. Finally,a eukaryotic expression vector of pCDNA 3.1A-GATA4 was obtained. The pCDNA3.1A-GATA4 expression vector was transfected into P19 cells by liposome mediation and the expression was determined by Western blot. Results:The coding sequence of mouse GATA4 gene was successfully amplified and the analysis of DNA sequence approved that the recombinant eukaryotic expression vector contained GATA4 cDNA. Western blot showed that P19 cells transfected with pCDNA3.1A-GATA4 could overexpress the mouse GATA4. Conclusion:The pCDNA3.1A-GATA4 expression vector was constructed successfully and the transfected P19 cells could overexpress mouse GATA4 gene,which pave the way for further studies on the function of GATA4 in the differentiation myocardium and development of heart.

Abstract:Objective:To investigate the radiation damage on rabbit trachea by 125I brachytherapy seeds implantation using factorial design,and evaluate the security of clinical application. Methods:The 2×2 factorial design was applied to observe the effects of I-125 brachytherapy seeds and radiation time,and the interaction of the two factors.16 healthy male New Zealand rabbits weighing 2.5～3.0 kg were divided into 8 pairs by heterogeneous paired rules. Two groups(14 d,30 d)were made further randomly,each group had 4 pairs. Two rabbits in the each pair were distributed into two groups:test group(0.5 mCi×3)and control group(non-radioactive seeds×3). Three seeds implaned in the trachea wall had a linear distribution at intervals of 10 mm. On the 14th day and the 30th day after operation,the tracheas of the corresponding group were collected and examined by visual observation,histopathologic examination by HE stain,and transmission electron microscopy to understand the degree of inflammatory injury. All the statistical analysis were performed by STATA 7.0 software. Results:Perforation and thrombogenesis were not observed in both test group and control group on the 14th day and the 30th day. There was no statistical difference of the inflammation score in the test group, compared with the control group(P > 0.05). Injuries of radiosensitive cellular organelle were observed by transmission electron microscopy in the test group,but there was no significant difference of the electron microscopic examination between the 14th day and the 30th day. Conclusion:Implantation of three 0.5 mCi I-125 brachytherapy seeds at intervals of 10 mm has little radiation damage of the rabbit trachea and is safe for clinical application.

Abstract:Objective:To analyze the subtypes distribution of Human Immunodeficiency Virus-1(HIV-1)in Jiangsu province,and the relationship between subtypes and transmission route. Methods:83 blood samples with EDTA-K3 were collected from population with HIV-1 confirmed lately using western blot test. Viral RNA was extracted from plasma and used by a RT-nest PCR to amplify the env and gag gene of HIV-1. The PCR amplimers were partially sequenced on ABI 3730. After sequences alignmented by ClustalX,phylogenetic analysis was performed using MEGA 3.1 software. Results:7 subtypes including CRF01_AE,CRF07_BC,CRF08_BC,B,C,CRF02_AG,A1 were found circulating in Jiangsu. 3 predominated clades were CRF 01_AE,CRF07_BC,and B,which accounted for 31.6%,25%,and 19.7%,respectively. 5 subtypes consisting of CRF07_BC,B,CRF01_AE,C,CRF08_BC,circulated in population via heterosexual contact,and CRF 07_BC accounted for 32.6%,B was 23.3%,and CRF 01_AE was 20.9%. CRF 01_AE,CRF 07_BC,B,CRF 08_BC circulated among men who sex with men having HIV-1,and CRF 01_AE was dominative. The circulated HIV-1 subtypes among IDUs included CRF 07_BC-B-CRF 01_AE-A1-CRF 02_AG,CRF 01_AE was the dominated,which accounted for 58.4%. Conclusion:There were more kinds of subtypes circulating in Jiangsu than other province. Of 7 subtypes,5 except CRF02_AG and A1 were found in population with HIV-1 via heterosexual contact. The increasing complex characteristic of HIV-1 sequences may be associated with acquiring HIV via sexual intercourse.

Abstract:Objective:To analyze the factors for health among urban residents,especially the behavior factors,so as to put forward suggestions for the improvement of their lifestyle or behavior. Methods:The behavior factors (alcohol consumption,smoking) and health related factors (sex,age,income) were analyzed based on the data of household investigation among urban residents from 18 cities in 9 provinces of the eastern,middle and western regions in China. Results:There was obvious effect of alcohol consumption,smoking,obesity,age,education degree and income on health and there was interaction effect between alcohol consumption and smoking. Alcohol consumption,obesity and age had negative relationship with health,while income and education were the protective factors. There was no significant effect of sex,marriage status,insurance and smoking on health. Conclusion:The risk factors for health are alcohol consumption,obesity and age,while the protective factors are income and education.

Abstract:Objective:To implement the standardized diagnosis and treatment of breast cancer,in order to enhance the medical quality,improve the quality of life,save medical cost and reduce medical expenses of patients with breast cancer. Methods:The study chose home medical records,clinical diagnosis and treatment information and detailed expense data of 1 164 cases of breast cancer in-patient in Jiangsu Provincial Tumor Hospital from January 2003 to September 2007,and used the minimum cost to carry on retrospective statistical analysis. Results:The average days of hospitalization of breast cancer patients by non-standardized and standardized comprehensive diagnosis and treatment were 60.59 days and 39.84 days respectively,the average times of hospitalization were 3.77 and 2.52 respectively,the total hospitalization expenses per capita were 54 863.27 yuan and 33 426.71 yuan,and all differences were statistically significant. Conclusion:The expenses of comprehensive treatment of breast cancer were relatively higher. The days of hospitalization,the average number of hospitalization and the total hospitalization expenses were reduced and the clinical treatment effects were improved after implementation of the standardized diagnosis and treatment. The implementation of standardized diagnosis and treatment of breast cancer was more feasible in clinical economics than non-standardized method,and had a better promotional and application value.

Abstract:Objective:To analyze the risk factors of slow coronary flow and therapeutic effect of diltiazem. Methods:Fifty-seven coronary arteriongraphy imageology documents are analyzed retrospectively. Thirty-one patients with coronary slow flow but without coronary disease confirmed by coronary angiography were selected as slow coronary flow group,and 26 patients,without coronary slow coronary flow and coronary disease,confirmed by coronary angiography as well,were selected as control group. Clinical features,the efficacy of diltiazem on coronary slow flow and the MACE outcomes were investigated in the two groups by t test and chisquared test Results:There was no significantly difference between the two groups in gender,age,heart rate,blood pressure,fasting plasma glucose,blood lipid,and coagulation time. However,levels of RBC and uric acid were significantly higher in the slow coronary flow group compared with the control group. Moreover,significant higher uric acid was observed in subjects with slow coronary flow after adjustment of age,sex,hypertension,diabetes mellitus,dyslipidemia and smoking status. None cardiovascular event occurred on the patients in slow coronary flow group. However,patients treated with diltiazem felt chest complaint lighten than those in the control group. Conclusion:High uric acid palys an important role in the pathogenesis of slow coronary flow. Diltiazem as an adjunct may further lighten chest complaint in patients with slow coronary flow.

Abstract:Objective:To investigate the changes of serum anti-CRP autoantibodies(CRP-Ab) and their relationship in acute coronary syndrome (ACS) patients. Methods:Serum samples were taken from all patients with ACS(n=120),stable angina pain (SAP)(n=61) and subjects without coronary heart disease (NCAD) (n=120)subjects. The serum levels of CRP-Ab(IgG)were quantitatively measured by indirect ELISA assay. Absorbance(A) was measured at 405 nm. Positive cut-off values were calculated from the 95 th percentile of the A values in NCAD subjects. Results:The serum levels of CRP-Ab were greatly elevated in patients with ACS(1.75±1.09) compared with SAP(1.27±0.6.1) and NCAD(0.875±0.43) subjectes (P < 0.01,respectively). The positive tatio of CRP-Ab in ACS group(44.17%) are higher than SAP group(8.84%) (P < 0.001). There was no significant correlation between the serum level of CRP-Ab and the number of lesioned artery of coronary artery stenosis (P > 0.05). Conclusion:we found that autoantibodies to CRP are common in sera from patients with ACS. It is likely that this explains the relative of CRP response in patients with ACS.It can be excluded that anti-CRP autoantibodies have biological potentials of pathophysiological interest in ACS.

Abstract:Objective:To investigate the effects of ICSI(intracytoplasmic sperm injection)cycles with frozen sperm obtained by PESA(percutaneous epididymal sperm aspiration)by retrospective study performed in 54 patients. Methods:Sperm from the 54 infertile males by PESA were frozen with conventional freezing method. After frozen-thawed and ICSI process,the fertilized oocytes were cultured in vitro for 72 hours and high quality embryos were transfered to the wives. 282 cases of fresh epidielymal sperms were tested as control. Fertilization rate,implantation rate,clinical pregnancy rate were compared beween two groups,the cycle with frozen-thawed sperm and the cycles with fresh PESA sperm as control. Results:No significant differences were found in rate of fertilization,cleavage high-qualified embryo,clinical pregnancy between two groups(72.4% vs 74%,98.1% vs 96.3%,51.7% vs 46.8%,42.6% vs 39.0%,respectively,P > 0.05). Neither vital pregnant complications nor neonate malformations were found in both groups. Recovering rate of frozen sperm form PESA was 65.9%. Conclusion:The embryo development and pregnant outcome were not effected by using frozen-thawed sperm obtained by PESA.

Abstract:Objective:To investigate the clinicopathological characteristics of gastric carcinomas of less than 2 cm in diameter and situation of lymph node metastasis. Methods:The data from 453 patients surgically treated for gastric cancer less than 2 cm in diameter between 1998 and 2007 were reviewed retrospectively. The clinicopathological variables inculding age,gender,histological type,morpliologieal type,size,location,depth of invasion and tumor thrombus which were associated with lymph node metastasis,were evaluated. The results of retrospective analysis of clinicopathological data of 198 patients with advanced cancer were compared with those of 255 patients with early cancer. Univariate and multivariate analyses of the data were performed to evaluate the clinicopathological variables associated with lymph node metastasis. Results:A significant difference was observed on the tumor size(1.31 ± 0.57 cm vs 1.70 ± 0.47 cm,P < 0.0001),the incidence of lymph node metastasis(11.8% vs 46.0%,P=0.0001)and the presence of vascular or lymphatic invasion(3.5% vs 7.6%,P=0.0341)in the two groups. The histological classification,tumor size,depth of gastric carcinoma infiltration and presence of vascular or lymphatic invasion showed a positive correlation with the rate of lymph node metastasis by univariate analysis. Multivariate analyses revealed that histological classification,depth of gastric carcinoma infiltration and presence of vascular or lymphatic invasion to be significantly and independently related to lymph node metastasis. The depth of gastric carcinoma infiltration was the strongest predictive factor for lymph node metastasis. For early gastric cancer,tumor size,depth of gastric carcinoma infiltration and presence of vascular or lymphatic invasion were the risk factors for lymph node metastasis. For advanced cancer,the histological classification and depth of gastric carcinoma infiltration were the risk factors for lymph node metastasis. Conclusion:Histological classification,depth of gastric carcinoma infiltration and presence of vascular or lymphatic invasion are independent risk factors for lymph node metastasis in gastric cancer less than 2 cm in diameter. Minimal invasive treatment,such as laparoscopic gastrectomy,may be a possible treatment for highly selective patients.

Abstract:Objective:To establish a technique of marking the position of atlas pedicle screw entry point with the medial border of axis pedicle as an anatomical landmark. Methods:100 atlantoaxial CT films of normal adults(including 50 males and 50 females)were selected randomly to measure the horizontal distance from atlas pedicle screw entry point to medial border of axis pedicle by Tan’s method(method a)and Ma Xiangyang’s method(method b). The reliability of using the horizontal distance for marking the positioning of atlas pedicle screw entry point through clinical application was evaluated. Results:In method a,the horizontal distance was(6.0 ± 0.8) mm in male,and(5.5 ± 0.8) mm in female. In method b,it was(9.4 ± 1.1) mm in male,and(8.2 ± 1.3) mm in female. 8 atlas pedicle screws were placed exactly in 4 patients,and no neural or vascular injury was observed. The postoperative radiographs verified all of atlas screws with a good position. Conclusion:The medial border of axis pedicle could be as a convenient anatomic landmark to determine the position of atlas pedicle screw entry point,and the landmark is more invariant and clear comparing with the previous anatomical ones.

Abstract:Objective:To investigate the diagnostic value of magnetization transfer contrast gradient echo T2WI sequence in injury of knee joint. Methods:The MRI data of 56 cases with knee injury were analyzed retrospectively. All cases were performed with FSE sequence(Sagittal T1WI,T2WI)and Sagittal magnetization transfer contrast gradient echo T2WI sequence. The size,signal intensity,margin of bone contusion were analyzed,and the difference of sequence was compaired. Results:Among 56 cases,43 cases and 45 cases fuci were demonstrated on FSE T1W,T2W respectively. 50 cases fuci were depicted on magnetization transfer contrast gradient echo T2WI Sequence. The differences of the size,signal intensity homogeneity,border of bone contusions were statistically higher on MTC-GRE T2WI than that on FSE(P < 0. 05). Conclusion:MTC-GRE T2WI Sequence has great diagnostic value in contusion of knee joint,and it is superior to FSE sequence.

Abstract:Objective:To investigate diameters and location of inferior vena cava in 100 normal adults by CT,and evaluate its the values on clinical application. Methods:The maximum and minimum diameters of inferior vena cava of 100 normal adults were measured. The distance from the X-axis(in first liver hilar level,along foreside of vertebra drawing a horizontal) or Y-axis(along starboard of vertebra drawing a perpendicular) to inferior vena cava was measured. The angle between the maximum diameter of inferior vena cava and the X-axis was measured also. All datum were dealed with statistics. Results:At the level of right atrium,the minimum diameters of IVC was relative invariablenes according to age and gender(P > 0.05). The upper limits of 95% cases were less than 3.0 cm in different groups disparted on age and gender. The maximum diameters of IVC and the ratio of the maximum and minimum diameters were variable in different groups(P < 0.05). At the level of the first liver hilar,the minimum diameters of IVC didn’t change with age(P > 0.05),but changed with the genders(P < 0.05). But the upper limits of 95% were less than 22 mm. Moreover the maximum diameters of IVC and the ratio of the maximum and minimum diameters were variable in different groups disparted on age and gender(P < 0.05). The distances from the X-axis and Y-axis to inferior vena cava had no changes in the different groups on age or gender(P > 0.05). The upper limits of 95% were less than 2.5 cm and 1.0 cm,respectirely. The angle between the maximum diameter of inferior vena cava and the X-axis was 31°±5°,without diffences in groups divided by age(P > 0.05),but changed with gender(P < 0.05). But the upper limits of 95% were less than 60°. Conclusion:The minimum diameter of IVC can be taken as a sensitive indexe to evaluate the size of IVC. The range of the location of normal IVC and the angle conseructed with the X-axis were ascertainable in CT. It can offer reference for judgement of the change of IVC’s location induced by hepaorenal recess disease.

Abstract:Objective:To investigate the outsets and manifestation of sleep disorders in stable phase of COPD patients combind with SAHS (Sleep Apnea/Hypoventilation Syndrome),so as to improve the understanding of origin and clinical features of COPD from the aspect of sleep medicine. Methods:124 stable phase COPD patients were subjected to continuous blood oxygen saturation measurement during the sleep without any oxygenation. Multi-lead polygraph examination was performed to obtain ODI and AHI (ODI>5 incidents per hour or AHI≥10 incidents per hour as a diagnostic standard for SAHS). 64 COPD patients without any complications were selected as control. These controls were paired with the above COPD patients who were complicated with SAHS, according to their age, gender and WI (Weight Index). The features of sleep disorders were analyzed by comparing the individuals in the paired groups. Results:27.4% of the 124 patients with COPD (34/124) had overlapping syndrome (COPD + SAHS). Statistically significant differences were found between the two groups among AHI, pattern of sleep disorder, ODI/AHI % and SIT90%,SIT85%,SIT80% (the percentage of sleep time when SpO2<90%,85%,80% to the total sleep time). Conclusion:It was estimated that there were about 25%～30% of stable COPD patients with overlapping syndrome presently in our country. Comparing with the uncomplicated COPD patients, the OS had severe sleep disorder pattern, predominantly the hypoventilation types. The OS had more severe hypoxemia. SIT90%,SIT85% and LSpO2 were the most sensitive indexes for hypoxemia in OS patients during the sleep.