腰椎横突副突乳状突的解剖学观测及临床意义

为寻求椎弓根螺丝钉较简捷的进钉点,作者观测20具成年干燥骨骼,T11-L5共140块椎骨的横突副突、乳状突,行穿针操作,椎骨X线拍片,用卡尺及角度测量仪测量结果证实:腰椎横突副突、乳状突及下关节突关节面外上缘连线所形成的三角形顶角角分线中点与椎弓根长轴线相重合或极其接近,故此三角形的顶角角分线中点可作为椎弓根螺丝钉的进钉点。通过12例胸腰椎骨折病人临床应用验证,是一种简捷确实可行的椎弓根螺丝钉进钉点的定位方法。

RELATIONSHIP BETWEEN CYCLIN G1 AND HUMAN PAPILLOMA VIRUS INFECTION IN CERVICAL INTRAEPITHELIAL NEOPLASIA AND CERVICAL CARCINOMA

Objective To evaluate the overexpression of cyclin G1 in cervical intraepithelial neoplasia （CIN） and cervical carcinoma, and the correlation between cyclin G1 and high-risk human papilloma virus （HPV） infection. Methods All of the specimens were obtained from the Department of Pathology of China-Japan Friendship Hospital from January 2000 to August 2004. We detected the expression of cyclin G1 with immunohistochemistry, HPV16/18 infection with in situ hybridization, and high-risk HPV infection with Hybrid capture system Ⅱ （HC-Ⅱ） in normal group （25 cases）, CIN Ⅰ （48 cases）, CIN Ⅱ （56 cases）, CIN Ⅲ（54 cases）, and invasive cervical squamous-cell carcinoma （SCC, 31 cases）. Results The positive rates of cyclin G1 expression in CIN（77.85% ）and SCC cervical tissues （87. 10% ） were significantly higher than normal （ 8.00%, P 〈 0. 01 ）, and the intensities of cyclin G1 expression in CIN（40. 60% ） and SCC cervical tissues （61.51%） were significantly higher than normal （2. 72%, P 〈0.05）. The positive rates and intensities of cyclin G1 expression increased gradually with the grade of cervical lesions. High-risk HPV infection rates were higher in CIN and SCC than normal groups （P 〈 0.05 ）. There was a positive correlation between cyclin G1 expression and high-risk HPV infection detected with HC-Ⅱ （Kendall＇s tau-b =0. 316, 0. 269, 0. 352, and 0. 474 in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ, and SCC, respectively, P 〈 0. 05 ）. Conclusions Cyclin G1 is overexpressed in CIN and SCC. Cyclin G1 may be a biomarker for detecting CIN and SCC. Cyclin G1 may play an important role in the oncogenesis of CIN and SCC by high-risk HPV infection.

Hypertrophied anal papillae and fibrous anal polyps,should they be removed during anal fissure surgery?

AIM:Hypertrophied anal papillae and fibrous anal polyps are not given due importance in the proctology practice. They are mostly ignored being considered as normal structures.The present study was aimed to demonstrate that hypertrophied anal papillae and fibrous anal polyps could cause symptoms to the patients and that they should be removed in treatment of patients with chronic fissure in anus. METHODS:Two groups of patients were studied.A hundred patients were studied in group A in which the associated fibrous polyp or papillae were removed by radio frequency surgical device after a lateral subcutaneous sphincterotomy for relieving the sphincter spasm.Another group of a hundred patients who also had papillae or fibrous polyps,were treated by lateral sphincterotomy alone.They were followed up for one year. RESULTS:Eighty-nine percent patients from group A expressed their satisfaction with the treatment in comparison to only 64% from group B who underwent sphincterotomy alone with the papillae or anal polyps left untreated.Group A patients showed a marked reduction with regard to pain and irritation during defecation (P=0.0011), pricking or foreign body sensation in the anus (P=0.0006) and pruritus or wetness around the anal verge (P=0.0008). CONCLUSION:Hypertrophied anal papillae and fibrous anal polyps should be removed during treatment of chronic anal fissure.This would add to effectiveness and completeness of the procedure.

Ultrasound features of extranodal extension in the metastatic cervical lymph nodes of papillary thyroid cancer:a case-control study

Objective：Extranodal extension in cervical lymph nodes is an important risk factor for the progression and prognosis of papillary thyroid cancer.The purpose of this study was to identify the common and characteristic preoperative ultrasonography features that are associated with the pathologic extranodal extension of metastatic papillary thyroid carcinoma.Methods：We retrospectively assessed and compared clinicopathologic and ultrasound features between 60 papillary thyroid cancer patients with extranodal extension and 120 control patients with papillary thyroid cancer without extranodal extension.Results：With respect to the pathological N stage and clinicopathologic features,N1b stage papillary thyroid carcinomas were more frequently found in patients who were extranodal extension-positive,in comparison with those who were extranodal extension-negative（78.3%vs.63.3%,P=0.043）.Extranodal extension was detected most frequently in level VI cervical lymph nodes（48.7%）.In our univariate analysis of patients with papillary thyroid carcinoma,cervical lymph nodes with extranodal extension showed higher incidences of node matting,microcalcification,cystic area,aspect ratio＆lt;2,and larger diameter than those without extranodal extension（all P〈0.05）.Our multivariate analysis demonstrated that node matting and cystic area were independent risk factors for the presence of extranodal extension[odds ratio（OR）：4.751,95%confidence interval（CI）：1.212~18.626,P=0.025;OR：2.707,95%CI：1.127~6.502,P=0.026].Conclusions：Common ultrasound features may indicate the presence of extranodal extension in patients with metastatic cervical lymph nodes of papillary thyroid carcinoma.

Pancreaticoduodenectomy for duodenal papilla carcinoma: A single-centre 9-year retrospective study of 112 patients with long-term follow-up

AIM To retrospectively evaluate the factors that influence long-term outcomes of duodenal papilla carcinoma (DPC) after standard pancreaticoduodenectomy (SPD). METHODS This is a single-centre, retrospective study including 112 DPC patients who had a SPD between 2006 and 2015. Associations between serum levels of CA19-9 and CEA and various clinical characteristics of 112 patients with DPC were evaluated by the. 2 test and Fisher's exact test. The patients were followed-up every 3 mo in the first two years and at least every 6 mo afterwards, with a median follow-up of 60 mo (ranging from 4 mo to 168 mo). Survival analysis was conducted using the Kaplan-Meier survival and Cox proportional hazards model analysis. The difference in survival curves was evaluated with a log-rank test. RESULTS In 112 patients undergoing SPD, serum levels of CA19-9 was associated with serum levels of CEA and drainage mode (the P values were 0.000 and 0.033, respectively); While serum levels of CEA was associated with serum levels of CA19-9 and differentiation of the tumour (the P values were 0.000 and 0.033, respectively). The serum levels of CA19-9 and CEA were closely correlated (chi(2) = 13.277, r = 0.344, P = 0.000). The overall 5-year survival was 50.00% for 112 patients undergoing SPD. The Kaplan-Meier survival analysis showed that increased serum levels of CA19-9, CEA, and total bilirubin were correlated with a poor prognosis, as well as a senior grade of infiltration depth, lymph node metastases, and TNM stage(the P values were 0.033, 0.018, 0.015, 0.000, 0.000 and 0.000, respectively). Only the senior grade of infiltration depth and TNM stage retained their significance when adjustments were made for other known prognostic factors in Cox multivariate analysis (RR = 2.211, P = 0.022 and RR = 2.109, P = 0.047). CONCLUSION For patients with DPC, the serum levels of CA19-9 and CEA were closely correlated, and play an important role in poor survival. Increased serum levels of total bilirubin and lymph node metastases were also correlated with a poor prognosis. The senior grade of infiltration depth and TNM stage can serve as independent prognosis indexes in the evaluation of patients with DPC after SPD.

Screening and analysis of differentially expressed genes of dermal papillae cells with aggregative behavior

Objective: To screen and clone differentially expressed genes of dermal papillae cells (DPC) with aggregative behavior, and to explore the molecular mechanism of their aggregation. Methods: Total RNAs were extracted from DPC with and without aggregative behavior and double strand cDNAs were synthesized by using SMART cDNA synthesis, respectively. The cDNA fragments of differentially expressed genes in DPCs with aggregative behavior were isolated by suppression subtractive hybridization. Positive clones were screened by PCR method and verified by cDNA dot blot, Northern blot and then analyzed through homologous retrieving. Results: A subtractive cDNA library of DPC with aggregative behavior has been successfully constructed. The result of screening and cloning of the library showed that, DPC with aggregative behavior could expresse genes related to homologous aggregation, proliferation and cycle control, including known genes (capping protein, paladin, vascular endothelial growth factor), hematopoietic stem/progenitor cells (HSPC) related clone (HSPC011 and HSPC016) and a new gene. Conclusion: The construction of subtracted library of DPC lays solid foundation for screening and cloning new and specific genes related to aggregative behavior of DPC. Several genes might be cooperatively involved in the homologous aggregation, proliferation and cycle control of DPC. Among these genes, capping protein and palladin might be closely related to the aggregative behavior of dermal papilla cells, and VEGF and HSPC related clone would be responsible for the status of higher proliferation of dermal papilla cells.

Coexistence of tuberculous peritonitis and primary papillary serous carcinoma of the peritoneum:A case report and review of the literature

A major diagnostic challenge to the evaluation of an incomplete intestinal obstruction is to distinguish between infectious and malignant etiologies.We present a case of an elderly woman complaining of abdominal pain accompanied with nausea and vomiting,and failure to pass gas or stools.Anti-tuberculosis drugs were used to relieve her abdominal pain,and a needle biopsy of the peritoneal cavity showed evidence of primary papillary serous carcinoma of the peritoneum(PSCP). This is a rare description of tuberculosis in the setting of PSCP.This report illustrates the potential complex nature of malignancies,and emphasizes the need to consider coexistence of malignancy and infection in patients, especially in those with risk factors for malignancy who fail with antibiotic therapy.

Differential c-erbB-1 and c-erbB-2 mRNA expression in cancer of the pancreas compared with cancer of the papilla of Vater

AIM： We examined quantitative mRNA expression of growth factor receptors （c-erbB-1, c-erbB-2） and the anti-apoptosis gene survivin known to be regulated in pancreatic adenocarcinomas and compared the expression pattern with that in carcinomas of the papilla of Vater. METHODS： Quantitative real-time reverse transcriptase- PCR （QRT-PCR, Taqman^TM） was performed to analyze mRNA expression levels of c-erbB-1, c-erbB-2 and survivin in normal and corresponding tumor samples of 31 pancreatic adenocarcinomas and 8 cancers of the papilla of Vater. RESULTS： The overall median mRNA expression of survivin was significantly increased in both adenocarcinoma of the pancreas （P〈0.01） and papilla of Vater （P〈0.008） compared with uninvolved normal control tissue. In pancreatic cancer, expression of c-erbB-1 was significantly decreased compared with the normal pancreatic tissue （P〈0.03）, whereas in the cancer of the papilla of Vater expression of c-erbB-2 was significantly downregulated （P〈0.05） compared with the paired normal samples. Gene expression was not associated with tumor stage, differentiation or prognosis. CONCLUSION： The common anti-apoptosis gene survivin is overexpressed both in the cancer of the papilla of Vater and pancreas. In contrast, the growth factor receptor genes c-erbB-1 and c-erbB-2 are differentially regulated in both tumor entities adding further evidence that pancreatic cancer is biologically different from the cancer of papilla of Vater.

Cloning and bioinformatic analysis of HSPC016 gene in dermal papilla cells

Objective： To clone the full-length cDNA sequence of HSPC016 gene, an aggregative growth related gene in dermal papilla cells （DPC）, and analyze its characteristics and predict its biological function. Methods： Rapid amplification of cDNA ends （RACE） technology was entailed to amplify the 5＇ and 3＇ sequences of HSPC016. The amplified fragments were TA-cloned, sequenced and spliced together to obtain the full-length cDNA. Its chromosome localization, domain and possible function were analyzed by bioinformatic methods. Results.. Two isoforms, 400 bp and 493 bp, were obtained. The gene was mapped on chromosome 3q21. 31, and was conservative on evolution. HSPC016, a 64aa protein, belongs to PD053992 protein family and its functional domain was homologous to T2FA gene. Conclusion： PISPC016 may be related to transcriptional regulation and its protein product may act as a subunit of a transcriptional complex and play a role on DPC growth and differentiation through facilitating or suppressing other genes＇ transcription within the nucleus.

小议临汾发现的元代银锭状铜范

小议临汾发现的元代银锭状铜范刘建民，邓爱记１９９０年临汾市在某工地地表３米以下，挖出一件银锭铜范。此范为青铜质，重约３５０克，束腰形，通长９５，上端宽７３，下端７５，腰狭４２毫米；范身平放高为１３，范腔长８１，两端宽均为６０，腰狭２４，深５毫米，范腔...