Search

肝样腺癌是一种发生于肝外的具有肝细胞癌样分化特点的高度侵袭性肿瘤，易转移，预后差。原发于胆管的肝样腺癌罕见，临床诊断中易被忽视。本文报道1例原发于胆总管并伴有肝转移的肝样腺癌，通过对其临床病理学特征及免疫组织化学特点进行分析并复习相关文献，总结其诊断及鉴别诊断要点。.

3例以心脏受累为突出表现的嗜酸粒细胞增多综合征患儿，均为女性，年龄2~15岁，心脏以右心室受累为主，表现为心腔内血栓形成、心尖闭塞样改变，合并或仅有心包积液，FIP1L1-PDGFRa融合基因均阴性；经糖皮质激素及对症治疗后，嗜酸粒细胞均恢复正常。例1随访1年遗留右心室心尖部闭塞样改变；例2随访2个月血栓消退；例3治疗2周后心包积液吸收。.

The thermophysical properties of liquid Zr–V alloys covering a whole composition range were systematically measured by an electrostatic levitation technique. A series of maximum undercoolings from 150 to 386 K (0.2 TL) was achieved for 11 different liquid alloys under containerless state and radiative cooling conditions, where Zr83.5V16.5 and Zr20V80 alloys displayed the strongest undercooling ability. The densities of liquid Zr–V alloys were measured over a wide temperature range from overheated to undercooled states, and the results exhibited a linear dependence on temperature for all 11 compositions. Two typical solidification pathways were observed for hypoeutectic alloys. Except for a slowing down of decreasing tendency near a eutectic Zr57V43 alloy, the liquid densities of Zr–V alloys almost decrease linearly with increasing V content. Accordingly, the thermal expansion coefficients of Zr–V alloys were also derived from containerless measurements, and they showed an increasing tendency with V content. Since thermal radiative dominated the heat transfer process, the ratio of isobaric specific heat to hemispherical emissivity was directly deduced from the thermal balance equation, leading to a quadratic relationship with temperature. It was found that the increase of V content enhanced the ability of radiative heat dissipation below 16.5 at. % V content.

Aims To investigate the incidence of and factors associated with anastomotic leakage (AL) following gastrectomy for gastric cancer. Methods We retrospectively analyzed 3632 patients who underwent a laparoscopic gastrectomy or open gastrectomy for gastric cancer. A logistic regression model was used to identify the determinant variables, and a nomogram for AL was developed. Results A total of 3632 patients were included in the study, 50 of whom (1.4%) developed AL. Postoperative deaths occurred in 6 (0.2%) patients with AL failure to rescue. Esophagojejunal AL (27/50) and Billroth I AL (20/50) were the most common types of AL. Gastrografin swallow was the main diagnostic method. The diagnosis was made a median of 9 days postoperatively. The median healing time for AL was 34.5 days. Of the 50 AL patients, 56% of patients could be managed nonsurgically, whereas 28% of patients required percutaneous radiologic drainage, 6% of patients were treated by endoscopy, and 10% of patients required a second surgery. A multivariate analysis showed the following adverse risk factors for AL: age ≥65 years, hemoglobin ≤8.0 g/dL and malnourishment. A multivariable model for AL showed a strong optimism-adjusted discrimination (concordance index, 0.675). The 5-year overall survival rates for patients without or with AL were 59.4% and 67.4%, respectively (p = 0.354). Conclusions AL was infrequent but was more prevalent in patients with age ≥65 years, hemoglobin ≤8.0 g/dL and malnourishment. We created a novel nomogram that can provide individualized prediction of AL in patients after a gastrectomy for gastric cancer, which may help clinicians in making treatment decisions.

Research on the clinicopathology and prognosis of gastric neuroendocrine carcinoma (GNEC) is rare, and a uniform standard for treatment has not been established. Therefore, we retrospectively analyzed the clinical data of 132 cases of GNEC to investigate the factors influencing prognosis.A total of 132 patients diagnosed with GNEC at Fujian Medical University Union Hospital from January 2006 to December 2013 were enrolled. This study was performed to analyze the factors related to patient prognosis.In total, 58 men and 74 women whose ages ranged from 38 to 83 years old (62 ± 10) were enrolled. The 1- and 3-year survival rates for these patients were 83.9% and 47.6%, respectively. Of these patients, 100 underwent radical resection, 22 underwent palliative resection, and 10 received chemotherapy alone. The median survival times following radical resection, palliative resection and chemotherapy alone were 48, 20 and 12 months, respectively (P 0.01). Univariate and multivariate survival analyses of patients who underwent radical resection showed that tumor size, N stage, Ki-67 labeling index, mitotic index and the application of postoperative adjuvant chemotherapy were independent factors affecting patient prognosis. The correlation analysis of the Ki-67 labeling index and mitotic index with prognosis showed that patient survival decreased significantly when the Ki-67 labeling index increased (P 0.05).Patients who underwent radical resection had the best prognosis among GNEC. For these patients, tumor size, N stage, Ki-67 labeling index, mitotic index and the application of postoperative adjuvant chemotherapy were the clinicopathological factors significantly associated with patient prognosis.

Tetra-needlelike ZnO (T-ZnO) whiskers were directly synthesized by thermal oxidation in the atmosphere. The issue of large variations in morphology, purity, and field-emission performance was found to be greatly relieved through the optimization of the growth temperature, to balance the effects of increasing saturated vapor pressure (Ps) of zinc and decreasing oxygen content (nO2) with increasing temperature. The T-ZnO whiskers grown at 1000 °C exhibited uniform morphology, a low turn-ON electric field of 3.2 V/ $\mu \text{m}$ , a large field enhancement factor of 7122, and better field-emission stability than whiskers grown at other temperatures, so as to be suitable for application as field emitters. Using the optimized growth process, we fabricated a seven-segment field-emission digital tube which dynamically displayed the numbers 0–9 under the control of a driving circuit.

Celiac disease is a multifactorial disorder caused by an unknown number of genetic factors interacting with an environmental factor. Hence, most patients are singletons and large families segregating with celiac disease are rare. We report on a three-generation family with six patients in which the inheritance pattern is consistent with an autosomal dominant model. To date, 27 loci explain up to 40% of the heritable disease risk. We hypothesized that part of the missing heritability is because of low frequency or rare variants. Such causal variants could be more prominent in multigeneration families where private mutations might co-segregate with the disease. They can be identified by linkage analysis combined with whole exome sequencing. We found three linkage regions on 4q32.3-4q33, 8q24.13-8q24.21 and 10q23.1-10q23.32 that segregate with celiac disease in this family. We performed exome sequencing on two affected individuals to investigate the positional candidate regions and the remaining exome for causal nonsense variants. We identified 12 nonsense mutations with a low frequency (minor allele frequency

A new cucurbitacin with an unusual ring A, isocucurbitacin D 25-O-acetate (1), was isolated from Bolbostemma paniculatum Franguent together with one known compound, cucurbitacin E (2). The structure of new compound was established by spectroscopic methods.

The aim of this study is to evaluate the long-term effect of negative lymph node (LN) counts on the prognosis after curative distal gastrectomy among gastric cancer patients.The study enrolled 634 patients with gastric cancer, who had undergone curative resection (R0) with distal gastrectomy from 1995 to 2004. Long-term surgical outcomes and relationships between the negative LN count and the 5-year survival rate were investigated.The 5-year survival rate of the entire cohort was 57.6%. The number of metastasis negative LN was positively associated with the retrieved node according to the Pearson's correlation test (P 0.001). Cox regression analysis showed the negative LN count was an independent predictor of survival (P 0.05). Based on the statistical assumption the best fitting linear, linear regression showed a significant survival improvement based on increasing negative LN count for patients with stages I (P = 0.014), II (P = 0.011) and III (P = 0.003). The greatest survival differences were observed at cutoff value 10 negative LN counts for stage I, and 15 for stages II, III and IV.Negative LN counts can reflect the extent of lymphadenectomy for gastric cancer after curative distal gastrectomy. The higher the negative LN count, the better the survival would be; the best long-term survival outcome was observed on the negative LN count more than 10 (stage I) or 15 (stages II, III, and IV).

Although epidural analgesia may provide adequate pain relief and minimize systemic side effects, long-term, even permanent placement of epidural catheter for chronic or cancer-related pain management carries a potential risk of both superficial and deep infection. The development of antibiotics microspheres that could be dwelled in epidural drug-delivery devices is likely to achieve a significant advance allowing antibiotics given by the intradiscal route to control catheter-related infections. In the present study, the composite microspheres composed of double-walled microcapsules and PLGA were constructed for encapsulating water-soluble antibiotics, cefazolin. The results show that these microspheres could efficiently control the initial release of drug, which was only 3.0% at 2 h. Cefazolin encapsulated in the composite microspheres released gradually nearly in a constant rate in the first 16 days, and still maintained a relative fast rate in the next 14 days, indicating that composite microspheres could improve the incomplete release of entrapped drugs.

A new cucurbitacin with an unusual ring A, isocucurbitacin D 25-O-acetate (1), was isolated from Bolbostemma paniculatum Franguent together with one known compound, cucurbitacin E (2). The structure of new compound was established by spectroscopic methods.

To investigate the controlled release effect of a thermo-sensitive gel, Pluronic F127 (PF127) on microspheres, poly[D,L-lactic-co-glycolic acid] (PLGA) microspheres were coated with Pluronic F127 gel and the in vitro release was evaluated. The results demonstrated that PF127, which gelled at 37 degrees C, inhibited the initial burst release of drug from microspheres effectively.