Objective To explore the clinical features and risk factors influencing the prognosis of childhood non-hodgkin's lymphoma (NHL).Methods Pathologically diagnosed 81 pediatric patients with NHL and treated in our hospital from March 2006 to October 2012 were collected and analyzed.The 5-years overall survival rate and replace-free survival rate were calculated and analyzed by Kaplan-Meier method.The relationship between survival rates and differentfactors were analyzed using chi-square test.Logistic analysis were used to analyze risk factors of prognosis.Results Totally 81 pediatric patients with NHL included 23 cases of lymphoblastic lymphoma,11 cases of mature T/NK-cell tumor,and 47 cases of mature B-cell tumor,Burkitt lymphoma was the most common (35.80％).Swelling of periphery lymph node (43.78％),mediastinal involvement (45.45％) were observed as initial symptom in lymphoblastic lymphoma and mature T/NK-cell tumor,respectively.Among mature B-cell tumor,the main clinical feature of abdominal cavity (41.40％) was observed in 29 cases of Burkitt lymphoma,and abdominal mass (60.00％) was observed as initial symptom in diffuse large cell lymphoma.77 pediatric patients with NHL (4 cases withdrawing treatment) received treatments were found that 90.5％ attained complete remission (CR),5.19％ attained partial remission (PR),2.60％ rapidly relapsed after treatment,and 1.30％ appeared the central nervous system infiltration.76 pediatric patients with NHL were finished the follow up.The 5-years overall survival rate was 67.11％.The 5-years replace-free survival rate was 63.16％.B symptoms,the level of lactate dehydrogenase (LDH),and clinical stages were the influence factors of 5-years overall survival rate and replace-free survival rate (P ＜ 0.05).LDH ≥500 U/L (OR:3.294) and late stage (Ⅳ) were the independent risk factors of prognosis (P ＜ 0.05).Conclusion Clinical features of pediatric patients with NHL were variable.The level of LDH and late stage (Ⅳ) are independent risk factors of prognosis,which can provide some reference in early treatment.

Objective To explore the characteristic performance and value of ultrasonic testing for benign and malignant thyroid tumors of children with thyroid neoplasms.Methods Selected 64 cases of children with thyroid tumors in our hospital from July 2013 to August 2016.The patients were divided into benign group and malignant group depended on pathological results.Color Doppler ultrasonography was used to examine the thyroid gland in all children.Results The diagnostic accuracy of ultrasonography in the diagnosis of benign and malignant thyroid tumors was 95.45％ and 95％,respectively.The color blood flow was the main type of thyroid tumor in the benign group.The color blood flow was the main type of malignant tumor in the malignant group.The peak systolic blood flow velocity (Vmax) and resistance index (IR) in malignant group were significantly higher than those in benign group (P ＜0.05).The malignant group mainly has the characteristics of small calcified lesions,irregular shape,fuzzy edge,and inhomogeneous internal echo.Meanwhile,in the benign group,the thyroid tumors were mainly characterized by non calcified lesions,morphological rules,non blurred edges,and even internal echoes.The highest sensitivity was highest in the diagnosis of malignant thyroid tumors,and the highest specificity was highest in the diagnosis of malignant thyroid tumors.Conclusion Color Doppler ultrasound examination of thyroid tumors in children have a high accurate rate.Benign and malignant thyroid tumor ultrasound image characteristics are significantly different,and have practical value for clinical use.

Objective To investigate the clinical value of contrast-enhanced ultrasonography to the differential diagnosis of benign and malignant cystic solid lesions of the pancreas.Methods Sixty-three patients with cystic solid lesions of the pancreas received conventional and contrast-enhanced ultrasonography to observe the imaging features.The diagnostic coincidence rates of conventional ultrasound and contrast-enhanced ultrasonography for benign and malignant tumors of pancreas were compared with the histopathological results.Results In 63 patients,there were 32 patients with malignant tumors including 20 patients with ductal adenocarcinoma and 12 patients with solid pseudopapillary tumor,and 31 patients with benign tumors including 18 patients with serous cystadenoma and 13 patients with mucinous cystadenoma.The conventional ultrasound showed that there were light lesion edge,regular shape,inhomogeneous low-echo shadow in solid area,with or without blood flow signal and calcification in ductal adenocarcinoma and solid pseudopapillary tumor,while there were clear boundary,regular shape,no calcification and no blood flow signal in serous cystadenoma and mucinous cystadenoma.The contrast-enhanced ultrasonography showed low-echo shadow during enhancement phase and decline phase in ductal adenocarcinoma,high low-echo shadow during enhancement phase with low-echo shadow during decline phase in solid pseudopapillary tumor,and equal-echo or high-low echo shadow during enhancement phase with equal-echo or low-echo shadow during decline phase in serous cystadenoma and mucinous cystadenoma.Compared with the histopathological results,the diagnostic coincidence rates of contrast-enhanced ultrasonography for benign and malignant tumors of the pancreas were significantly higher (83.87％,84.37％) than those of conventional ultrasound (61.29％,46.87％) (P＜0.05).Conclusion Contrast-enhanced ultrasonography is valuable in the differential diagnosis of benign and malignant cystic lesions of the pancreas.

Objective To evaluation the application and safety of ultrasonography (US)-guided core needle biopsy (CNB) of supraclavicular lymph node for diagnosis and the molecular genetic testing of advanced lung cancer.Methods The clinical data of 178 lung cancer patients who underwent US-guided CNB of supraclavicular lymph node from March 2013 to May 2015 were retrospectively analyzed.Results The accuracy of US-guided CNB of supraclavicular lymph node diagnosing was 96.1%(171/178).The cutoff value of the short-axis dimension of supraclavicular lymph node on US was 9.75 mm, the sensitivity was 88.8%, and the specificity was 88.9%.There were significant differences between positive metastasis group and negative metastasis group in losing or deviating of a central hilar structure, lower echogenicity of cortex and RI (P<0.05).The rate of EGFR mutation positive and ALK positive in lung adenocarcinoma was 36.5% and 2.9% respectively.There was no operation-related complication of US-guided CNB of supraclavicular lymph node.Conclusions US-guided CNB of supraclavicular lymph node is a reliable method for diagnosing metastasis, histologic subtyping, and molecular genetic testing in lung cancer.It may gradually replace invasive lung biopsy.

目的 探讨颈部不同区域肿大淋巴结穿刺活检病理结果特点.方法 对767例颈部肿大淋巴结行超声引导下穿刺活检,结合颈部超声分区,对不同区域肿大淋巴结的病理结果分析.结果 转移性淋巴结多见于Ⅳ、Ⅴ区,淋巴瘤多见于Ⅱ、Ⅲ、Ⅳ区,反应增生淋巴结多见于Ⅰ、Ⅱ、Ⅲ区.结论 颈部不同区域肿大淋巴结性质不同,对颈部淋巴结进行精确的分区可为临床医生诊断、治疗疾病提供有价值的信息.

Objective To study the diagnosis value of contrast-enhanced ultrasonography in hepatic focal lesions disease.Methods Total 62cases of hepatic focal disease were diagnosed with contrast-enhanced and conventional ultrasound.The final diagnosis was confirmed by operation pathology results,contrast-enhanced CT or MRI,to evaluate the clinical application value of contrast-enhanced ultrasonography in hepatic focal lesions disease.Results Sensitivity,specificity,positive predictive value,negative predictive value and nicety value in diagnosis hepatic focal lesions disease by using contrast-enhanced ultrasonography were as follows:hepatocellular carcinoma,96.00%(24/25)、94.59%(35/37)、92.31%(24/26)、97.22%(35/36)、95.16%(59/62),respectively;liver metastasis 94.44%(17/18)、93.18%(41/44)、85.00%(17/20)、97.62%(41/42)、93.55%(58/62),respectively;hepatic hemangioma 93.33%(14/15)、97.87%(46/47)、93.33%(14/15)、97.87%(46/47)、96.77%(60/62),respectively;asymmetric fatty infiltration 100.00%(7/7)、98.18%(54/55)、87.50 %(7/8)、100.00%(54/54)、98.39%(61/62),respectively.Conclusion Contrast-enhanced ultrasonography is very useful in hepatic focal lesions.

Objective:To analyze the expression of C-erbB-2 in esophageal cancer tissues and adjacent cancer tissues,and approach the molecular mechanism in the process of esophageal carceration.Methods:To detect the variation of expression of C-erbB-2 by immunohistochemistry(ABC) in 66 cases of primarily esophageal cancer and matched adjacent cancer samples by exairesis,all samples were reel-like embedded,and record the number of isolated normal epithelial tissue and various kinds of lesions,i.e.,basal cell hyperplasia(BCH),dysplasia(DYS) and squamous cell carcinoma(SCC).Results:The positive rates of C-erbB-2 in normal esophageal epithelium,BCH,DYS,SCC were 14%,60%,37% and 89%,respectively,meanwhile,From normal esophageal epithelium to BCH,DYS,SCC,the positive rates of C-erbB-2 in the focal pattern and in the diffuse pattern of all tissues above were 50%,67%,48%,35% and 50%,33%,52%,65%,respectively.The positive rates of the C-erbB-2 in well differentiated,moderately differentiated,poorly differentiated SCC were 94%,100% and 75%,respectively.Conclusion:The alterations of C-erbB-2 protein expression occurred in early stage of esophageal carcinogenesis and the positive rates obviously increased with the lesions progressed,suggested that C-erbB-2 may be one of important molecular events involved in esophageal carcinogenesis.From normal esophageal epithelium to BCH,DYS,and SCC,the positive rate of C-erbB-2 in focal pattern of all tissues above decreased and that in diffuse pattern increased,suggested the expression of C-erbB-2 increased accompany with esophageal carcinogenesis.

Ojbective:To study the effects of erythromycin treatment to endotoxin-induced ALI(acute lung injury) in rat model.Methods: The rat model of ALI was made by injecting lipopolysaccharide(LPS) with a dose of 4mg/kg into vena caudalis.54 male SD rats were randomly divided into three groups: control group(NC),experiment group(LPS) and treatment group(EY),18 rats every group.In control group physiologic saline was injected,in experiment group LPS was injected,in treatment group LPS was injected as time as erythromycin injectable powder intraperitoneal injection(50 mg/kg).Measured the levels of IL-1β,IL-6,TNF-α,IL-8,IL-10 in serum and alveolar wash liquid of 54 rats by enzyme-linked immunosorbent assay(ELISA).Results:Compare treatment group with experiment group,PaO2 and pH stepped up,PaCO2 stepped down,lung coefficient was(0.62±0.07 vs 0.96±0.13,P0.05),lung water content(85.76±0.56 vs 82.88±0.47,P0.05),lung permeability index(7.41±0.61 vs 12.26±0.58,P0.05),all decreased significantly,IL-1β,IL-6,IL-8 and TNF-α in serum and alveolar wash liquid stepped down,however,IL-10 stepped up significantly.The lesion of lung tissue in treatment group was lighter than that in experiment group through pathology observing.Conclusion: Erythromycin can

Objective:To observe the therapeutic effect and side reaction of interventional therapy for advanced gastric cancer.Methods:Fifty eight cases of advanced gastric cancer were treated by interventional therapy,and infusing 5FU,CF,PDD,MMC,ADM into the artery of tumor.After added 10ml-20ml of super liquid lipiodol,and then made target arterial embolism by adding gelatin sponge,every other 4-6 weeks,and evaluated overall therapeutic effect.Results:After interventional therapy,the average remission rate of clinanical symptom was 90.20%.In 58 cases 3 cases(50.17%)were complete response;47 cases(81.03%)were partial response;50 cases were effective,and total effective rate was 86.21%.41 cases had fever(70.69),and the highest temperature was 39.80℃,35 cases(60.3%)had the upper abdomen pain,the symptoms above were all caused by partial necrosis tumors after chemotherapy,and these symptoms were all released one week after treatment.Among 58 cases,40 cases(68.97%)had Ⅰdegree gastrointestinal reaction,12 cases(20.69%)had Ⅱdegree,5 cases(8.62%)had Ⅲ degree;38cases(65.51%)had Ⅰdegree myelosuppression,10 cases(7.24%)had Ⅱdegree,no cases was Ⅲ or Ⅳdegree.Conclusion:Interventional therapy for advanced gastric cancer has good therapeutic effects,side reaction is light,and has some application value for clinical therapy.

目的:研究前列腺素 E 1 （PGE 1 ）预处理对急性心肌梗死大鼠心脏功能及病理改变的影响。方法:将大鼠分为6组:正常对照组（C 组）、急性心肌梗死模型对照组（M 组）、小剂量 PGE 1 (25μg·kg -1 )预处理早期保护作用组（LE 组）及延迟保护作用组（LD 组）、大剂量 PGE 1 (150μg·kg -1 )预处理早期保护作用组（HE 组）及延迟保护作用组（HD 组）。各组均经静脉分别给与等容积生理盐水及不同剂量的 PGE 1 对大鼠进行预处理。除 C 组外其余各组分别于预处理后20min 和24h 腹腔注射（ip）异丙肾上腺素（Isop）造成急性心肌梗死。Ip 以及 Isop 24h 后测定左室内压及其微分,测定并计算心电图Ⅱ导联,并对心肌进行病理学检查。结果:模型对照组左室内压的最大上升速率（+dp/dt max）、最大下降速率（-dp/dt max）和左室发展压（LVDP）均降至正常对照组的30%左右（P＜0.01）,而 PGE 1 预处理各组此三项指标均较模型组显著改善（P＜0.01）;模型对照组 J/R比值剧烈上升,（与正常对照组比 P＜0.01）,PGE 1 预处理各组该比值均显著下降（P＜0.01）;模型对照组出现较严重的心肌梗死病理改变,PGE 1 预处理各组心肌坏死程度均有不同程度的减轻。结论:PGE 1 预处理具有保护急性心肌梗死后的心脏功能,减轻心肌损伤及坏死病理改变的作用。

OBJECTIVE: To investigate the effect and mechanism of the esophageal nerve transmitters on esophageal cancer cells differentiation and to provide clues for esophageal cancer prevention and treatment. METHODS: EC109-line cells were divided into 6 groups: acetylcholine (Ach) group,Ach + Atropine group, norepinephrine (NE) group, NE + tolazoline group, Ach + NE group, and control group. The cells were cultured for 14 d in vitro, then fixed and stained with HE and peroxiredoxin-1 (PRX1) immunohistochemically staining. The data were analyzed with SPSS 10.0 statistical software. RESULTS: With the comparison of the cell growth and differentiation among the treatment groups and the control group, the chief findings included that: 1)the cells grew its processes in 3 days, the processes grew longer in 7 days, and some of them linked up together and became the networks in 14 days;2) the color stained with PRX1 immunohistochemically increased obviously; 3)the nuclear-cytoplasmic ratio between the cell nuclei and cytoplasm reduced. Three indexes of Ach and NE groups had a significant difference compared with the control group, P0.05. CONCLUSIONS: Ach and NE can induce the esophageal cancer cell differentiation, which may be related to the increase of PRX1 expression. These findings provide the basic data for a new research area in esophageal carcinogenesis and prevention.

患者女,21岁,因脐周持续性疼痛伴腹泻6个月,发现腹腔占位病变10 d入院.患者既往无肝炎,黄疸及发热病史,6个月前,脐周持续性疼痛,伴有黄色稀水样便,每天4～5次.实验室检查:甲胎蛋白(AFP)、C11～9,乙肝6项,丙肝检查均无异常.查体发现右上腹可触及一大小约20 mm×15 mm×15 mm包块,质硬,有触痛,表面光滑,不活动.

Objective:To investigate the expression of p53 protein and thrombospondin-1 (TSP-1) in esophageal squamous carcinoma and their clinical significance. Methods: Using immunohistochemical technique, to examine p53, TSP-1 and MVD expression in 68 cases of esophagus squamous carcinoma. Results: The positive rates of p53 protein and TSP-1 in esophageal squamous carcinoma tissue were 72.06% and 66.18% respectively. The expression of p53 protein had a negative correlation with TSP-1(P0.01). MVD in TSP-1 positive group (29.80±6.35), MVD in TSP-1 negative group (29.80±6.35) (P0. 01), TSP-1 had a negative correlation with MVD(P0.01). The expression of p53 had a significantly correlation with pathological grading, lymph node metastasis and clinical staging. Conclusion: TSP-1 may inhibit the angiogenesis, and prevent from the vessels development and metastasis of esophagus squamous carcinoma. Both p53 and TSP-1 expression may be helpful to the understanding of mechanism of angiogenesis in tumor.p53 and TSP-1 can be considered as biological indicators of malignant potential and prognosis of esophageal carcinoma.

Objective To investigate the changes of arterial Base Deficits(BD) in sepsis patients and analyze clinical significance of arterial base deficit in patients with sepsis resuscitation.Methods By performing a retrospectivereview of 56 cases of sepsis,whose data of BD changes were observed for 48-hours real-time monitoring,contrasting the BD data of the survivor group and death group and analyzing the relationship of BD and prognosis in the two groups.Results The dada of BD was increasing gradually in the patients of early stage of sepsis,which was significantly higher in survivor group than that of death group between 4 hours and 8 hours after developing sepsis(P<0.05).There was statistical difference between survivor group and death group(P<0.05).The arising of organs failure rate of death group was significantly higher than that of survivor group(P<0.05).Conclusion BD can be one of the chief monitoring marks when the fluid resuscitation adopt in the early stage after sepsis developing.Currently,the method of fluid resuscitation is still one of the efficient methods of improving low perfusion state.During the cure process if the BD is still in lower level in the early stage of sepsis maybe indicate worse prognosis.

Aim: To detect the promoter methylation of RASSF1A gene in esophageal cancer and adjacent normal tissue.Methods:Methylation special PCR was applied to detect RASSF1A methylation on 79 cases of esophageal squamous cell carcinoma (SCC) and 20 cases of adjacent normal tissue.Results: The detection rate of RASSF1A methylation in SCC (67%, 53/79) was much higher than that in adjacent normal tissue (15%, 3/20). The methylation of RASSF1A gene had significant difference among different age groups and differentiation degree, P0.05. However, the RASSF1A methylation was not associated with lymph node metastasis or tumor staging. The methylation rate in SCC was apparently higher than that in adjacent normal tissue from the same patient (50%(10/20) vs 15%(3/20)), P0.05. Conclusion: RASSF1A methylation is a common event in SCC; methylation in SCC is much higher than that in adjacent normal tissue and correlated with the age and differentiation of the patients.

2004年5月至2006年3月,南阳市中心医院肿瘤科分别采用利血生加升血小板胶囊、国产重组人白细胞介素-11(rhIL-11)治疗恶性肿瘤放化疗后血小板减少症患者52例,并比较2者的疗效,现报道如下.

Objective To characterize the expression and significance of SCCA1 with esophageal squamous cell carcinoma(SCC) in high-incidence area of esophageal cancer in Henan province.Methods SCCA1 protein of 30 patients with esophageal squamous cell carcinoma was detected by immunohistochemical staining(ABC).Results SCCA1 positive immunoreactivity was detected in 17/30(57%) distributed mainly in cytoplasm and scarcely in nucleus and there was no expression in 13/30(43%) cases.The positive expression of SCCA1 in patients with lymph node metastasis(13/22,59%) was higher than that in those without lymph node metastasis(4/8,50%),but the difference was not significant(P>0.05).The positive SCCA1 expression in advanced SCC(6/9,66%) was obviously higher than that in moderately differentiated(11/17,65%) and poorly differentiated(0/4,0%),the difference was significant(P<0.05).The positive expression of SCCA1 showed no correlation with TNM staging(P>0.05).None of SCCA1 protein expression was detected in normal tissues(0/30,0%) and the difference was significant between tumor and normal tissues(P<0.05).Conclusions SCCA1 protein expression in SCC tissues was correlated well with well differentiated SCC(P<0.05),This suggested that SCCA1 may be one of prognostic indicators for SCC.

目的探讨多发性骨髓瘤(MM)患者血清中脑源性神经营养因子(BDNF)、血管内皮细胞生长因子(VEGF)的表达及意义。方法采用酶联免疫吸附试验(ELISA)测定MM患者与健康体检者的血清BDNF和VEGF的浓度。结果患者血浆BDNF浓度为(4.19±0.36)ng/ml,与健康体检者(1.58±0.27)ng/ml相比,差异有统计学意义(P=0.007);患者血浆VEGF浓度为(78.24±11.25)pg/ml,与健康体检者(29.36±1.34)pg/ml相比,差异有统计学意义(P=0.004)。BDNF与VEGF水平间存在着相关性(r=0.367,P=0.018)。结论MM患者血清BDNF和VEGF显著增高,BDNF在体内可能具有明显的促血管新生效应,是继VEGF后又一促进血管增殖活性的细胞因子。

Aim:To detect the expression of RASSF1A protein in young patients with esophageal squamous cell carcinoma (SCC) and gastric cardia adenocarcinoma (GCA).Methods:Immunohistochemistry (ABC) method was applied to detect the expression of RASSF1A protein in SCC, GCA and the corresponding normal tissue in young patients from Linzhou, Henan.Results: The positive immunostaining rate for RASSF1A in SCC and GCA tissue was 83% (10/12), 89% (8/9), respectively, which was similar to that in corresponding normal tissue (P0.05). However, the immunostaining patterns were different. In SCC, there were scattered (4 cases) , focal (4 cases) and diffused (2 cases) immunostaining patterns; in normal esophageal tissue the papillary (3 cases) and focal (3 cases) immunostaining patterns were common; in GCA the focal (6 cases) pattern was predominant, and scattered (2 cases) pattern was present; there were diffused (5 cases) and focal (4 cases) patterns in the normal gastric cardia tissue. No significant relationship was observed among the rate of RASSF1A protein positive expression and differentiation, metastasis, or invasion depth both in SCC and GCA. Conclusion: The results demonstrate that RASSF1A protein expression is a frequent molecular event in SCC and GCA, suggesting that RASSF1A may play an important role in esophageal and gastric cardia carcinogenesis.

AIM: To observe the alterations of all kinds of pathophysiological and biochemical markers in rat model with endotoxin-induced acute lung injury (ALI) after pentoxifylline (PTX)treatment so as to approach the intervention effect of PTX treatment on ALI. METHODS: The rat model of ALI was made by injecting lipopolysacharide (LPS) at a dose of 4 mg/kg into vena caudalis. Seventy-two male SD rats with matched month age and weight were randomly divided into 3 groups: control group (NS), experimental group (LPS) and PTX treatment group, 24 rats each group. In control group physiologic saline was injected into vena caudalis; in experimental group 4 mg/kg LPS was injected into vena caudalis; in treatment group 0.036 mol/L PTX (10 mg/kg) was intraperitoneally (ip) injected 1 h before LPS injection into vena caudalis. Instantly after ALI rat modes were established successfully in erperimental group, 10 mg/kg PTX was injected ip, totally for 5 times, at an interval of 1 h; in the other 2 groups, same-volume physiologic saline was given in the same way. We determined PaO2, pH, PaCO2, lung coefficient, lung water content, lung permeability index, and detected the percentages of neutrocyte and macrophage in bronchoalveolar lavage fluid, the levels of malondialdehyde(MDA), superoxide dismutase(SOD), nitric oxide(NO) and inducible nitric oxide synthase(iNOS), and observed the pathomorphology of lung tissue. RESULTS: In treatment group compared with experimental group, PaO2 and pH stepped up, PaCO2 stepped down, lung coefficient (0.59±0.17 vs 0.92±0.11, P<0.05), lung water content(84.46±0.39 vs 80.22±0.37, P<0.05), lung permeability index(7.28±0.54 vs 12.32±0.28, P<0.05) were all decreased significantly, the percentage of neutrocyte in bronchoalveolar lavage fluid was reduced, NO and iNOS were depressed significantly, and SOD was improved significantly(P<0.05). The lesion of lung tissue in treatment group was lighter than that in experiment group through pathological observation. CONCLUSION: PTX can improve energy metabolism and reduce the cytotoxicity in LPS-induced ALI rats. PTX plays a role in intervening and preventing the development of ALI.