Objective To study the clinical efficacy and toxicity of combination of the radiotherapy and IP regimen for patients with local advanced esophageal cancer.Methods 68 cases of local advanced esophageal cancer were randomized into two groups, simple irradiation group(control group, n=33)receiving conventional radiotherapy to a total of 60Gy, combined group(research group, n=35)which received the same radiotherapy as simple irradiation group plus chemotherapy with IP regimen, patients in research group were treated with infusion of Irinotecan 65mg/m² and DDP 30mg/m² on day 1, 8.21 days was a cycle and 4 cycles were given.Results The remission rate, one and two year disease-free survival rate in research group were significant higher than that in control group.But the incidence of nausea, vomiting, myelosuppression and diarrhea was higher in research group.Conclusion The efficacy of concomitant radiotherapy and IP regimen for local advanced esophageal cancer is obvious and it can improve the survival rate of patients, which is worthy of clinical application.

Objective To study the expression and significance of CK19, Galectin-3 and TPO in the differential diagnosis between benign and malignant papillary thyroid hyperplasia.Methods The expression of CK19, galectin-3 and TPO in 53 cases of papillary thyroid lesions, including 32 with papillary thyroid carcinoma and 21 with papillary thyroid hyperplasia, were detected by immunohistochemical SP method.Results The positive rates of CK19 and galectin-3 in the papillary thyroid carcinoma were 97% and 94% respectively, and those were 19% and 14%respectively in the papillary thyroid hyperplasia.There was significant different between papillary thyroid carcinoma and papillary thyroid hyperplasia in CK19 and galectin-3 expression(P＜0.05).The positive rates of TPO in the papillary thyroid carcinoma and papillary thyroid hyperplasia were 6% and 95% respectively(P＜0.05).Conclusion CK19, galectin-3 and TPO are useful markers for the differential diagnosis between benign and malignant papillary thyroid hyperplasia.It is better for CK19 using together with galectin-3 and TPO.

Objective To investigate the clinical characteristics and prognosis of breast cancer patients in the rural old women above 65 years old.Methods 110 breast cancer cases over 65 years of age were collected and analyzed.Results The progress of study group was 3months to7years,averaging out to 12.3months.Major pathological type was invasiveductalcarcinoma(85.5%).Lymphatic metastasis rate were 46.4%.Estrogen or prog-esterone receptor was found to be positive in 71.7% by immunohistochemical staining.59 patients(53.6%)had comorbidity such as coronary heart disease,hypertention,diabetes,etc.The 5-year survival rate and 10-year survival rate were 59.1%and 38.2% respectively.Conclusion Breast cancer of elderly counywomen had long progress,the invasive ductal canaer dominated in pathologic histology.Estrogen or progesterone receptor were high.Surgery and endocrine therapy are important to achieve good clinical outcome.

Objectives To study the expression of protein BRCA1, p53 and Ki67 in epithelial ovarian cancer;To analyze the relationship between their expressions and prognosis.Methods An immunohistochemistry was performed on samples from 50 epithelial ovarian cancer.Results The expression of protein BRCA1 in ovarian cancer is much higher than that in the normal tissues(expression rate 88.0%, P＜0.05);The expression of protein BRCA1, p53 and Ki67 are not correlated with each other(P＞0.05);The expression of protein BRCA1, p53 and Ki67 are not associated with ages(P＞0.05);The Kaplan Meier survival analysis shows that the survivals among the three proteins have no significance(P＞0.05).Conclusion Overexpression of BRCA1 is much more significant for than ovarian cancer that of normal ovarian tissues.BRCA1, p53 and Ki67 might be used to predict the prognosis of ovarian cancer.

Objective We researched the injury of rats spinal cord made by gemcitabine and cisplatin combined chemotherapy in order to provide important academic guidance for synchronous chemoradiotherapy.Methods The dose of GEM and DDP is one-off 30mg/kg and 5mg/kg respectively.We observed spinal cord morphological change by light microscope and transmission electron microscope;detected the protein expression of apoptosis associated genes:bax and caspase-3 by immunohistochemistry.Results Gemcitabine or gemcitabine+cisplatin all caused spinal cord injury, and the injury caused by gemcitabine+cisplatin was more severe than gemcitabine alone.The spinal cord showed partial demyelination, denaturation of the white matter close to central canal, infiltration of flammatory cell, rarefaction of cinerea structure, and increase of veins by H-E staining;and demyelination of partial nerve fiber within the white matter, incrassation, twisting, and shrinkage of neural plate of spinal cord by transmission electron microscope.The apoptosis associated gene-bax and caspase-3 all had high-expression in all groups, moreover the expression of combined treatment group was obviously higher than gemcitabinealone(P＜0.05).Conclusion Not only gemcitabine alone can cause spinal cord injury, but also gemcitabine+cisplatin can cause it.The injury mechanism is associated with the high-expression of Bax and caspase-3.

Objective To study the expression of estrogen receptor(ER),progestogen receptor(PR)and Her-2 in breast cancer and its clinical significance.Method Expression of ER,PR,Her-2 of 76 breast cancer patients were determined by immunohistochemical staining.Result The expression of ER was negatively correlated with TNM stage and lymph nodes metastasis,The expression of PR was not correlated with TNM stage and lymph nodes metastasis,The expression of Her-2 was positively correlated with TNM stage and lymph nodes metastasis.Conclusion To detect the expression level of ER,PR,Her-2 may help to estimate the prognosis.

Objective To investigate the T cell subsets changes of patients with malignant tumors treated by Cryosurgery.Methods 109 tumors were collected from 105 patients who have been diagnosed as pathological stage Ⅲ or Ⅳ period advanced cancer and the expected survival time of patients were more than three months since June 2005 to December 2006.Samples were collected one week before and after 1-2 weeks treatment with Cryosurgery.T-cell subsets of peripheral blood CD3⁺, CD4⁺, CD8⁺, CD4⁺/CD8⁺were analyzed using flow cytometry without other treatment.Results After 3-12 months of Cryosurgery treatments the tumor was getting reduced significantly on CT and tumor was found disappered in some patients's.It was also found that the peripheral blood CD3⁺, CD4⁺, CD4⁺/CD8⁺from malignant tumors patients treated with Cryosurgery were significant increased(P＜0.05)compared to that of before treatment.Conclusion Treatment of Cryosurgery can enhance the cellular immune functions and improve the anti-tumor capacity of patients with malignant tumors.

Objective To assess factors influencing the development of DGE after pancreaticoduodenectomy.Methods Cochrane Library,Medline,Ovid and EMBASE databases were searched to identify studies that evaluated the influencing factors in DGE patients and control subjects after pancreaticoduodenectomy.Odds ratios and 95% confidence intervals(CIs)were then calculated by a meta-analysis.Results Six RCTs,twenty case-control and cohort studies met the inclusion criteria.Compared with control subjects,the risk of DGE was 2.35 for preservation of pylorus(95% CI,0.72-7.61),0.93 for postoperative enteral nutrition(95% CI,0.64-1.35),6.14 for postoperative intro-abdominal complications(95% CI,3.47-10.85),4.30 for Billroth I type gastrointestinal reconstruction(95% CI,1.00-18.43),and 0.12 for antecolic gastrointestinal reconstruction(95% CI,0.05-0.27).Conclusions Postoperative intro-abdominal complications were the most important factors associated with DGE.There was no significant association between the DGE and the preservation of pylorus.Postoperative enteral feeding did not show advantages in preventing DGE.Antecolic and Billroth II type gastrointestinal reconstruction seem to suggest an improvement in decreasing the incidence of DGE.

Objective To explore the change and significance of FOXP3⁺Treg within peripheral blood mononudear cells(PBMC),which stimulated by CD28 monoclonal antibody in tumor patients.Methods Ascites induced immune and pro-law chromatography for purification and preparation of the monoclonal antibody,Ficoll density gradient centrifugation to obtain peripheral blood PBMC,and/or stimulated by CD28 monoclonal antibody 10μg/mL after co-culture by immunofluorescence and flow cytometry analysis of FOXP3⁺ Treg,as well as the expression of FOXP3⁺Fas⁺Treg and FOXP3⁺ FasL⁺Treg.Results Immunofluorescence and flow cytometry showed that the peripheral blood of tumor patients with FOXP3⁺Treg expression ratio(6.208±2.754)%,while the control group(2.653±0.638)%.FOXP3+FasL+Treg cells activated by CD28 monoclonal antibody for the FasL expression(7.252± 2.23)%,and healthy control group(7.96± 2.938)% Before and after activation the ratio of FOXP3⁺Fas⁺Treg(1.467± 0.590)%,(3.692± 1.822)%.Conclusion The ratio of FOXP3⁺Treg within PBMC in tumor patients decreased(P＜0.01)after stimulating by CD28 monoclonal antibody which suggested the patients immune function recover and improve.

Objective To explore the significance of the expression of E-cad and CD44V6 in the metastasis of bone and brain of NSCLC.Methods The expression of E-cad and CD44V6 in 65 specimens of NSCLC and 30 specimens of adjacent normal tissues were detected by Envision immunohistochemistry.Result the high expression rate of CD44V6 was 44.6% in NSCLC,and 0 in adjacent normal tissues.CD44V6 staining in NSCLC tissues was correlated to classification,bone and brain metastasis and TNM stage(P＜0.05).The high expression rate of E-cad was significantly lower in NSCLC than that in adjacent normal tissues(53.8%vs.80.0%,P＜0.05).E-cad staining in NSCLC tissues was correlated to differentiation,bone and brain metastasis and TNM stage(P＜0.05).Conclusion Determination of CD44V6 and E-cad by immunohistchemistry might be useful in assessing tumor progression and distant metastasis and in predicting prognosis of lung cancer.

Objective To investigate the mechanism of acquired resistance of pancreatic cancer cell Puta8988 to pemetrexed and to analyze its correlation with the expression of TS,FPGS and RFC.Methods After more than two months inducing of pemetrexed,the cytotoxicity of drugs to the parental and resistant lines was assessed by MTT assay.When the IC5 of the resistant lines raise to a level which our experiment need,it is considered acquiring the character to resistance pemetrexed.Then the mRNA expression levels of TS,FPGS and RFC were detected using RT-PCR.Results Pancreatic cancer cells acquired drug-resistance to pemetrexed.After recurrent treatment with pemetrexed,the IC₅₀ values in Puta8988 cells were increased by 2.2 fold as compared to their parental cells.(P ＜ 0.05).RT-PCR showed a correlation between TS,FPGS and RFC mRNA expression levels and the sensitivity to pemetrexed after pemetrexed treatment.Conclusion These findings reveal that the levels of TS,FPGS and RFC following recurrent exposure to pemetrexed are associated with resistance to these drugs.These findings suggest that the activation of TS,FPGS and RFC genes after recurrent drug exposure contributes to the chemoresistance of pancreatic cancer cells and that their intervention might enhance chemosensitivity in pancreatic cancer.

Objective To study the clinical characteristics,and the prognostic factors of triple negative breast cancer.Methods 130 triple negative breast cancer patients were reviewed on clinical characteristics and prognosis.All cases were lack of expression of estrogen receptor,progesterone receptor,and Her-2/neu determined by immunohistochemistry.Results 17.1% of all breast cancer patients(774 cases)were triple negative breast cancer,and 68.9% of triple negative breast cancer patients(91 cases)were premenopausal.53.8% of patients(71cases)had the tumors with T2 size,and 39.4% of them(52 patients)had lymph node metastasis.The rate of relapse in patients with lymph node metastasis was obviously higher than that in patients without lymph node metastasis(P=0.001).The median time of follow-up was 63 months.33 cases relapsed and 20 patients had died.23 patients had at least two organs metastasis.The 5-year disease-free and overall survival rates were 73.8% and 85.7%,respectively.Conclusion Triple negative breast cancer patients commonly have high rate of multiple distant metastasis in 2-3 years after treatment.The status of lymph node is the most important prognostic factor.The triple negative breast caner patients with lymph node metastasis have poor prognosis.