Objective To assess the combined management of lower limb chronic venous diseases according to the CEAP classification. Methods One hundred and twenty patients were classified according to the CEAP classification. Based on clinical presentation and image study, all patients were treated with combined management plan including oppression, medication and surgery. Results All 120 patients (135 limbs) were followed up in clinic, the local recurrence rate was 18.52%(25/135). Conclusion CEAP classification expounds the developing process of lower limb chronic venous diseases. With CEAP, we can avoid the blind spot in the treatment and expand the extent of combined therapy. Accordingly, CEAP classification is useful in the treatment and diagnosis of chronic venous diseases.
【Abstract】Objective To investigate the diagnosis and treatment of primary small intestinal tumor (PSIT). MethodsEighty-eight cases of PSIT were analyzed in our hospital retrospectively. Results Thirty-six cases were diagnosed before operation, 52 cases were misdiagnosed and the percentage amounted to 59.1%. The major clinical manifestations of PSIT were abdominal pain (66 cases, 75.0%), obstruction (56 cases, 63.6%), abdominal mass (51 cases, 58.0%) and stool with blood (48 cases, 54.5%).The major pathological types of PSIT were adenocarcinoma (55.7%), sarcoma of smooth muscle (25.0%), lymphoma (13.6%), fatty sarcoma (5.7%). The tumors of 36 cases located in jejunum (40.9%), 34 cases in ileum (38.6%) and 18 cases in duodenum (20.5%).Conclusion It is difficult to diagnose PSIT before operation. The following advice could help to get a correct diagnosis: ① Surgeons should be alert when meeting a patient with the above symptoms, and then collect and analyze the clinical data comprehensively. ②Patients over 40 years with complaints of inexplicable abdominal pain, weight loss, anemia, dyspepsia and abdominal mass should be examined appropriately by gastrointestinal X-ray, gastrointestinal endoscopy, ultrasonography, CT and angiography of superior mesenteric artery. ③When the diagnosis can’t be confirmed, an exploratory operation should be performed immediately to avoid the delay of treatment. ④The treatment of PSIT includes radical resection of small intestine and chemotherapy according to the pathological results of tumor.
Objective To obtain the polypeptides specifically binding to gastric cancer BGC823 cell from a Ph.D-12 TM phage display peptide library (PDPL), to search the markers of gastric cancer for early diagnosis and treatment. Methods The gastric cancer BGC823 cell was used as the antigen and the immortalized gastric epithelial GES cell was used as control for 3 rounds subtraction biopanning from PDPL at room temperature. The positive and specific binding clones were identified by cell enzyme-linked immunosorbent assay (ELISA) and immunochemistry staining. Those DNA sequences of identified clones were sequenced, polypeptides were marked by fluorescein FITC peptide tag, and polypeptides affinity and specificity of gastric cancer cells and tissues were identified. Results After 3 rounds of panning, 20 phage clones were identified by ELISA, one of which （GC-11） was specially binding to the BGC823. Cell and tissue immunofluorescence assay further presented a high affinity of fluorescein-labeled peptide FITC-GC-11 with BGC823 and gastric cancer tissue.Conclusion A peptide GC-11 which is specific binding to gastric cancer BGC823 cell and gastric cancer tissue has been selected from PDPL.
目的 评价3DMax补片在腹腔镜下全腹膜外修补术(totally extraperitoneal,TEP)中修补腹股沟疝的价值。方法 回顾性分析我院2009年2～6月期间腹腔镜下应用3DMax补片对18例腹股沟疝患者行TEP的临床资料，分析其手术时间、住院时间、复发和并发症发生情况。结果 18 例患者中Ⅰ型疝3例，Ⅱ型疝4例，Ⅲ型疝9例，Ⅳ型疝2例； 斜疝11例，直疝6例，股疝1例。成功完成腹腔镜下TEP 17例。1例因疝内容物为末端回肠，与疝囊粘连并局部狭窄梗阻，中转开放手术切除部分回肠。手术时间40～95 min，平均65.4 min。术后均未使用镇痛剂，术后住院时间2～7 d，平均住院5.5 d。术后发生阴囊血清肿1例，经穿刺排液后愈合良好。随访1～6个月，无复发病例。结论 腹腔镜下TEP具有创伤小、恢复快、复发率低等优点，采用预先成型的3DMax 补片使手术操作更加简便。
Objective To design and construct the eukaryotic expressed vector of suicide genes, which contained 5 copies of hypoxia-responsive element (5HRE), promoter of alpha-fetoprotein gene (AFPp） and nitroreductase from Escherichia coli. Methods The constructing processes were as follows: ①The design of primer: Suicide genes of NTR in the Escherichia coli, which contained 6his-tag gene (6his-tag), were cloned by overlapping PCR. ②The construction of 5HRE: The single strand of synthetized HRE oligonucleotide was annealed, and 5HRE was constructed by multiple recombinant clone. ③The recombination of NTR gene, 5HRE, AFPp and pIRES2-EGFP: pIRES2-EGFP, which had removed the instant early promoter of cytomegalovirus, was recombined with NTR gene, 5HRE, AFPp. In this way, the eukaryotic expressed vector of pIRES2-EGFP-5HRE-AFPp-NTR, which carried NTR gene, 5HRE, AFPp was finally constructed. Results NTR gene, which contained the fusion of 684-base pair and 6his-tag gene, was cloned successfully, and its sequence was coincident with the result published by Genbank. A 221-base pair of 5HRE was also constructed, which was in accordance with the expected sequences. The integrity of the eukaryotic expressed vector was verified by restriction enzyme digestion and DNA sequence analysis, respectively. Conclusion The eukaryotic expressed vector of pIRES2-EGFP-5HRE-AFPp-NTR is successfully constructed, which may be used for its further investigation in vitro.
Objective To investigate the expressions of hypoxia-inducible factor-1α (HIF-1α) and caudal homeobox gene 2 (CDX2) in colorectal adenocarcinoma, and the relationships between them and the clinicopathologic factor of colorectal adenocarcinoma. Methods The expressions of HIF-1α and CDX2 were detected by immunohistochemistry in 62 specimens of colorectal adenocarcinoma and 20 specimens of normal colorectal mucosa tissue. The correlation between the expressions of HIF-1α and CDX2 was analyzed by Spearman rank correlation analysis. Results The positive rates of HIF-1α expression in normal colorectal mucosa tissue and colorectal adenocarcinoma were 5.0% （1/20） and 62.9% （39/62）, CDX2 were 95.0% （19/20） and 69.4% （43/62）, the differences of positive rate between different tissues were significant （Plt;0.05）. In colorectal adenocarcinoma, the expression of HIF-1α or CDX2 was related to tumor differentiation, lymph node metastasis, and Dukes staging (Plt;0.05). There was a negative correlation between HIF-1α and CDX2 expressions in colorectal adenocarcinoma （r=－0.293 2，Plt;0.05）. Conclusions The up-regulation of HIF-1α and down-regulation of CDX2 may be involved in the genesis of colorectal adenocarcinoma， and there is a negative correlation between the two kinds of protein. HIF-1α may participate in modulation of CDX2 expression and lead to accelerate the progression of colorectal carcinoma.
Objective To investigate the expressions of monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in gastric cancer tissues and normal gastirc mucosa tissues and the situation of helicobacter pylori (HP) infection, and detect their relationships and clinicopathologic significances. Methods Expressions of MCP-1 and VEGF were detected by immunohistochemistry in gastric cancer tissues and normal gastric mucosa tissues (5-10 cm from the mass), and HP was detected in specimen from gastric antrum by Giemsa dyeing method. Results MCP-1 and VEGF expressions in gastric cancer tissues were significantly higher than those in normal gastric mucosa tissues (P＜0.05), but there was no difference in HP positive and negative tissues included the cancer and the normal tissues （P＞0.05）. The expressions of MCP-1 and VEGF in carcinoma with tumordiameter ＞5 cm, poorly differentiated， lymph node metastasis， distant metastasis and Ⅲ+Ⅳ stage of TNM were significantly higher than those with tumor diameter ≤5 cm, well and moderately differentiated， non-lymph node metastasis， non-distant metastasis and Ⅰ+Ⅱ stage of TNM (P＜0.05). Conclusion The high expressions of MCP-1 and VEGF in gastric cancer may relate to tumor angiogenesis and metastasis, but HP infection may be irrelevant.