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| 1 | Pathological evidence for residual SARS-CoV-2 in pulmonary tissues of a ready-for-discharge patient显示文摘Dear Editor,SARS-CoV-2,a novel coronavirus and causing COVID-19,has given rise to a worldwide pandemic.1,2 So far,tens of thousands of COVID-19 patients have been clinically cured and discharged,but multiple COVID-19 cases showed SARS-CoV-2 positive again in discharged patients,3 which raises an attention for the discharged patients.Also,there is an urgent need to understand the pathogenesis of SARS-CoV-2 infection.Here,we conducted postmortem pathologic study in a ready-fordischarge COVID-19 patient who succumbed to sudden cardiovascular accident.Pathological examination revealed SARSCoV-2-viruses remaining in pneumocytes and virus-caused pathological changes in the lungs.Our study provided new insights into SARS-CoV-2 pathogenesis and might facilitate the improvement of clinical guideline for virus containment and disease management. | Xiao-Hong Yao Zhi-Cheng He Ting-Yuan Li Hua-Rong Zhang Yan Wang Huaming Mou Qiaonan Guo Shi-Cang Yu Yanqing Ding Xindong Liu Yi-Fang Ping Xiu-Wu Bian | 2020 | Cell Research2020，30，6： | 35 |
| 2 | Pathological changes at early stage of multiple organ injury in a rat model of severe acute pancreatitis显示文摘BACKGROUND:Severe acute pancreatitis (SAP) is a commonly seen acute abdominal syndrome characterized by sudden onset,rapid progression and high mortality rate.The damage in peripheral organs may be more severe than that in the pancreas,and can even lead to multiple organ dysfunction.It is critical to recognize early pathological changes in multiple organs.This study aimed to assess the early pathological features of damaged organs in a rat model of SAP.METHODS:Thirty clean grade healthy male Sprague-Dawley rats weighing 250-300 g were randomly divided into a model control group (n=15) and a sham-operated group (n=15).The SAP rat model was induced by sodium taurocholate.Samples of blood and from multiple organs were collected 3 hours after operation.We assessed the levels of IL-6,TNF-α,PLA2,NO,ET-1,MDA,amylases and endotoxin in blood and observed the early pathological changes in multiple damaged organs.RESULTS:Levels of IL-6,TNF-α,PLA2,NO,ET-1 and MDA in serum and of amylase and endotoxin in plasma of the model control group rats were significantly higher than those of the sham-operated group (P<0.01).Different degrees of pathological change were observed in multiple damaged organs.CONCLUSION:Multiple organ injury may occur at the early stage of SAP in rats. | Zhang, Xi-Ping Zhang, Jie Ma, Mei-Li Cai, Yang Xu, Ru-Jun Xie, Qi Jiang, Xin-Ge Ye, Qian | 2010 | Hepatobiliary & Pancreatic Diseases International2010，9，1： | 33 |
| 3 | Intravoxel incoherent motion diffusion-weighted magnetic resonance imaging for predicting histological grade of hepatocellular carcinoma:Comparison with conventional diffusion-weighted imaging显示文摘AIM To compare intravoxel incoherent motion(IVIM)-derived parameters with conventional diffusion-weighted imaging(DWI) parameters in predicting the histological grade of hepatocellular carcinoma(h CC) and to evaluate the correlation between the parameters and the histological grades.METHODS A retrospective study was performed. Sixty-two patients with surgically confirmed h CCs underwent diffusion-weighted magnetic resonance imaging with twelve b values(10-1200 s/mm^2). The apparent diffusion coefficient(ADC), pure diffusion coefficient(D), pseudo-diffusion coefficient(D*), and perfusion fraction(f) were calculated by two radiologists. The IVIM and conventional DWI parameters were compared among the different grades by using analysis of variance(ANOVA) and the Kruskal-Wallis test. Receiver operating characteristic(ROC) analysis was performed to evaluate the diagnostic efficiency of distinguishing between low-grade(grade 1, G1) and high-grade(grades 2 and 3, G2 and G3) hC C. The correlation between the parameters and the histological grades was assessed by using the Spearman correlation test. Bland-Altman analysis was used to evaluate the reproducibility of the two radiologists' measurements.RESULTS The differences in the ADC and D values among the groups with G1, G2, and G3 histological grades of HCCs were statistically significant(P < 0.001). The D* and f values had no significant differences among the different histological grades of h CC(P > 0.05). The ROC analyses demonstrated that the D and ADC values had better diagnostic performance in differentiating the low-grade h CC from the high-grade h CC, with areas under the curve(AUCs) of 0.909 and 0.843, respectively, measured by radiologist 1 and of 0.911 and 0.852, respectively, measured by radiologist 2. The following significant correlations were obtained between the ADC, D, and D~* values and the histological grades: r =-0.619(P < 0.001), r =-0.628(P < 0.001), and r =-0.299(P = 0.018), respectively, as measured by radiologist 1; r =-0.622(P < 0.001), r =-0.633(P < 0.001), and r =-0.303(P = 0.017), respectively, as measured by radiologist 2. The intra-class correlation coefficient(ICC) values between the two observers were 0.996 for ADC, 0.997 for D, 0.996 for D*, and 0.992 for f values, which indicated excellent interobserver agreement in the measurements between the two observers.CONCLUSION The IVIM-derived D and ADC values show better diagnostic performance in differentiating high-grade hC C from low-grade hC C, and there is a moderate to good correlation between the ADC and D values and the histological grades. | Shao-Cheng Zhu Yue-Hua Liu Yi Wei Lin-Lin Li She-Wei Dou Ting-Yi Sun Da-Peng Shi | 2018 | World Journal of Gastroenterology2018，24，8： | 33 |
| 4 | Value of α-fetoprotein in association with clinicopathological features of hepatocellular carcinoma显示文摘AIM:To explore the relationship between α-fetoprotein(AFP) and various clinicopathological variables and different staging system of hepatocellular carcinoma(HCC) thoroughly.METHODS:A retrospective cohort study of consecutive patients diagnosed with HCC between January 2008 and December 2009 in West China Hospital was enrolled in our study.The association of serum AFP values with the HCC clinicopathological features was analysed by univariate and multivariate analysis,such as status of hepatitis B virus(HBV) infection,tumor size,tumor number,vascular invasion and degree of tumor differentiation.Also,patients were divided into four groups at the time of enrollment according to different cutoff values for serum value of AFP(≤ 20 μg/L,21-400 μg/L,401-800 μg/L,and ≥ 801 μg/L),to compare the positive rate of patient among four groups stratified by various clinicopathological variables.And the correlation of different kinds of tumor staging systems,such as TNM,Barcelona Clinic Liver Cancer(BCLC) staging classification and China staging,were compared with the serum concentration of AFP.RESULTS:A total of 2304 HCC patients were enrolled in this study totally;the mean serum level of AFP was 555.3 ± 546.6 μg/L.AFP levels were within the normal range(< 20 μg/L) in 27.4%(n = 631) of all the cases.81.4%(n = 1875) patients were infected with HBV,and those patients had much higher serum AFP level compared with non-HBV infection ones(573.9 ± 547.7 μg/L vs 398.4 ± 522.3 μg/L,P < 0.001).The AFP level in tumors ≥ 10 cm(808.4 ± 529.2 μg/L) was significantly higher(P < 0.001) than those with tumor size 5-10 cm(499.5 ± 536.4 μg/L) and with tumor size ≤ 5 cm(444.9 ± 514.2 μg/L).AFP levels increased significantly in patients with vascular invasion(694.1 ± 546.9 μg/L vs 502.1 ± 543.1 μg/L,P < 0.001).Patients with low tumor cell differentiation(559.2 ± 545.7 μg/L) had the significantly(P = 0.007) highest AFP level compared with high differentiation(207.3 ± 420.8 μg/L) and intermediate differentiation(527.9 ± 538.4 μg/L).In the multiple variables analysis,low tumor cell differentiation [OR 6.362,95%CI:2.891-15.382,P = 0.006] and tumor size(≥ 10 cm)(OR 5.215,95%CI:1.426-13.151,P = 0.012) were independent predictors of elevated AFP concentrations(AFP > 400 μg/L).Serum AFP levels differed significantly(P < 0.001) in the D stage of BCLC(625.7 ± 529.8 μg/L) compared with stage A(506.2 ± 537.4 μg/L) and B(590.1 ± 551.1 μg/L).CONCLUSION:HCC differentiation,size and vascular invasion have strong relationships with AFP,poor differentiation and HCC size ≥ 10 cm are independent predictors of elevated AFP.BCLC shows better relationship with | Chang Liu Guang-Qin Xiao Lu-Nan Yan Bo Li Li Jiang Tian-Fu Wen Wen-Tao Wang Ming-Qing Xu Jia-Yin Yang | 2013 | World Journal of Gastroenterology2013，19，11： | 22 |
| 5 | Infantile hepatic hemangioendothelioma:A clinicopathologic study in a Chinese population显示文摘AIM:To investigate whether the clinicopathologic features of infantile hemangioendothelioma(IHE) of the liver in a Chinese population are similar to the features observed in other races.METHODS:The clinical data,radiological findings,histopathological changes and outcome of 12 cases of IHE diagnosed by the Department of Pathology,West China Hospital over the last 10 years were analyzed retrospectively.Immunohistochemical studies were carried out using antibodies against CD31,CD34,Factor Ⅷ,cytokeratin 8 and cytokeratin 18.RESULTS:The 12 patients were aged from fetal to 5 years(three males and nine females).The tumor was presented with different clinical manifestations,mainly as an asymptomatic,palpable,upper abdominal mass,except for the two fetuses who were detected antena-tally by ultrasound.In one patient,this presentation was accompanied by an initial severe pneumothorax.No symptoms of congestive heart failure were present and neither congenital abnormalities nor vascular tumors in the skin or other organs were found.Laboratory abnormalities included leukocytosis(40%),anemia(60%),thrombocytosis(60%),hyperbilirubinemia(16.7%),abnormal liver function(50%) and increased α-fetoprotein(80%).Based on radiological findings and gross specimens,the tumor presented as a solitary lesion or a multifocal space-occupying lesion.The tumor size ranged from 5.0 cm × 3.5 cm × 2.0 cm to 13.8 cm × 9.0 cm × 7.7 cm,and the 0.2-1.1 cm nodules were diffusely distributed within the multifocal tumor.Seven cases were surgically resected,three cases underwent biopsy and the two fetuses were aborted.Histologically,nine cases were classified as typeⅠ and three as type Ⅱ,presenting aggressive morphologic features,immature vessels,active mitosis and necrosis.An inflammatory component,predominantly eosinophilic granulocytes,sometimes obscured the nature of the tumor.Ten patients are alive after a follow-up of 1-9 years.Based on immunohistochemistry,the endothelial cells in all cases were positive for CD31,CD34 and polyclonal factor Ⅷ antigen,whereas the scattered hyperplasia bile ducts were positive for cytokeratin 8 and cytokeratin 18.CONCLUSION:The clinical manifestations of IHE are non-specific.There is no significant correlation between histological type and prognosis.The clinicopathologic features of IHE in Chinese patients may provide a clue to further evidence-based studies. | Zhang Zhang,Hui-Jiao Chen,Wen-Juan Yang,Hong Bu,Bing Wei,Xiao-Yu Long,Jing Fu,Rui Zhang,Yun-Bi Ni,Hong-Ying Zhang,Department of Pathology,West China Hospital,Sichuan University,Guoxuexiang 37,Chengdu 610041,Sichuan Province,China | 2010 | World Journal of Gastroenterology2010，16，36： | 16 |
| 6 | How reliable is current imaging in restaging rectal cancer after neoadjuvant therapy?显示文摘In patients with advanced rectal cancer,neoadjuvant chemo radiotherapy provides tumor downstaging and downsizing and complete pathological response in up to 30%of cases.After proctectomy complete pathological response is associated with low rates of local recurrence and excellent long term survival.Several authors claim a less invasive surgery or a non operative policy in patients with partial or clinical complete response respectively,however to identify patients with true complete pathological response before surgical resection remains a challenge.Current imaging techniques have been reported to be highly accurate in the primary staging of rectal cancer,however neoadjuvant therapy course produces deep modifications on cancer tissue and on surrounding structures such as overgrowth fibrosis,deep stroma alteration,wall thickness,muscle disarrangement,tumor necrosis,calcification,and inflammatory infiltration.As a result,the same imaging techniques,when used for restaging,are far less accurate.Local tumor extent may be overestimated or underestimated.The diagnostic accuracy of clinical examination,rectal ultrasound,computed tomography,magnetic resonance imaging,and positron emission tomography using 18F-fluoro-2’-deoxy-Dglucose ranges between 25%and 75%being less than 60%in most studies,both for rectal wall invasion and for lymph nodes involvement.In particular the ability to predict complete pathological response,in order to tailor the surgical approach,remains low.Due to the radio-induced tissue modifications,combined with imaging technical aspects,low rate accuracy is achieved,making modern imaging techniques still unreliable in restaging rectal cancer after chemo-radiotherapy. | Paola De Nardi Michele Carvello | 2013 | World Journal of Gastroenterology2013，19，36： | 13 |
| 7 | Clinical characteristics of drug-induced liver injury and primary biliary cirrhosis显示文摘AIM To summarize and compare the clinical characteristics of drug-induced liver injury(DILI) and primary biliary cirrhosis(PBC).METHODS A total of 124 patients with DILI and 116 patients with PBC treated at Shengjing Hospital Affiliated to China Medical University from 2005 to 2013 were included. Demographic data(sex and age),biochemical indexes(total protein,albumin,alanine aminotransferase,aspartate aminotransferase,total bilirubin,direct bilirubin,indirect bilirubin,alkaline phosphatase,and gamma glutamyltransferase),immunological indexes [immunoglobulin(Ig) A,Ig G,Ig M,antinuclear antibody,anti-smooth muscle antibody,anti-mitochondrial antibody,and anti-mitochondrial antibodies] and pathological findings were compared in PBC patients,untyped DILI patients and patients with different types of DILI(hepatocellular type,cholestatic type and mixed type). RESULTS There were significant differences in age and gender distribution between DILI patients and PBC patients. Biochemical indexes(except ALB),immunological indexes,positive rates of autoantibodies(except SMA),and number of cases of patients with different ANA titers(except the group at a titer of 1:10000)significantly differed between DILI patients and PBC patients. Biochemical indexes,immunological indexes,and positive rate of autoantibodies were not quite similar in different types of DILI. PBC was histologically characterized mainly by edematous degeneration of hepatocytes(n = 30),inflammatory cell infiltration around bile ducts(n = 29),and atypical hyperplasia of small bile ducts(n = 28). DILI manifested mainly as fatty degeneration of hepatocytes(n = 15) and spotty necrosis or loss of hepatocytes(n = 14).CONCLUSION Although DILI and PBC share some similar laboratory tests(biochemical and immunological indexes) and pathological findings,they also show some distinct characteristics,which are helpful to the differential diagnosis of the two diseases. | Jun Yang Ya-Li Yu Yu Jin Ying Zhang Chang-Qing Zheng | 2016 | World Journal of Gastroenterology2016，22，33： | 8 |
| 8 | Nomograms for predicting pathological response to neoadjuvant treatments in patients with rectal cancer显示文摘BACKGROUND In recent decades, neoadjuvant therapy(NT) has been the standardized treatment for locally advanced rectal cancer(LARC). Approximately 8%-35% of patients with LARC who received NT were reported to have achieved a complete pathological response(pCR). If the pathological response(PR) can be accurately predicted, these patients may not need surgery. In addition, no response after NT implies that the tumor is destructive, resistant to both chemotherapy and radiotherapy, and prone to having a high metastatic potential. Therefore,developing accurate models to predict PR has great clinical significance and can help achieve individualized treatment in LARC patients.AIM To establish nomograms for predicting PR to different NT regimens based on pretreatment parameters for patients with LARC.METHODS Rectal cancer patients were identified from the database of The Sixth Affiliated Hospital, Sun Yat-sen University from January 2012 to December 2016. Logistic regression and nomograms were developed to predict the probability of pCR and good downstaging to ypT0-2N0M0(ypTNM 0-I), respectively, based on pretreatment parameters for all LARC patients. Nomograms were also developed for three NT regimens(capecitabine/deGramont-RT, mFOLFOX6, and m FOLFOX6-RT) to predict pCR probability.RESULTS Four hundred and three patients were included in this study; 72(17.9%) had pCR at the final pathology report, and 177(43.9%) achieved good downstaging to ypT0-2N0M0(ypTNM 0-I). The nomogram for predicting pCR probability showed that NT regimens, tumor differentiation, mesorectal fascia(MRF) status,and tumor length significantly influenced pCR probability. When predicting the probability of good downstaging, tumor differentiation, MRF status, and clinical T stage were the significant factors. Nomograms were developed based on NT regimens. For the capecitabine/de Gramont-RT group, the multivariate analysis showed that the neutrophil-lymphocyte ratio(NLR) was the only significant factor, thus we could not develop a nomogram for this regimen. For the m FOLFOX6-RT group, the analysis showed that the significant factors were tumor length and MRF status; and for the mFOLFOX6 group, the significant factors were tumor length and tumor differentiation.CONCLUSION We established accurate nomograms for predicting the PR to preoperative NT regimens based on pretreatment parameters for LARC patients. | Dong-Lin Ren Juan Li Hui-Chuan Yu Shao-Yong Peng Wei-Da Lin Xiao-Lin Wang Roshan Ara Ghoorun Yan-Xin Luo | 2019 | World Journal of Gastroenterology2019，25，1： | 6 |
| 9 | Correlation between intracoronary thrombus components and coronary blood flow after percutaneous coronary intervention for acute myocardial infarction at different onset time显示文摘BACKGROUND Acute myocardial infarction(AMI)is a leading cause of mortality.Early reperfusion to restore blood flow is crucial to successful treatment.In the current reperfusion regimen,an increasing number of patients have benefited from direct percutaneous coronary intervention(PCI).In order to understand whether there is a correlation between the components of coronary thrombosis and the absence of reflow or slow blood flow after coronary stent implantation in direct PCI,we collected data on direct PCI cases in our hospital between January 2016 and November 2018.AIM To investigate the correlation between intracoronary thrombus components and coronary blood flow after stent implantation in direct PCI in AMI.METHODS We enrolled 154 patients(85 male and 69 female,aged 36–81 years)with direct PCI who underwent thrombus catheter aspiration within<3,3–6 or 6–12 h of onset of AMI between January 2016 and November 2018.The thrombus was removed for pathological examination under a microscope.The patients of the three groups according to the onset time of AMI were further divided into those with a white or red thrombus.The thrombolysis in myocardial infarction(TIMI)blood flow after stent implantation was recorded based on digital subtraction angiography during PCI.The number of patients with no-reflow and slow blood flow in each group was counted.Statistical analysis was performed based on data such as onset time,TIMI blood flow.RESULTS There were significant differences in thrombus components between the patients with acute ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction(P<0.01).In the group with PCI<3 h after onset of AMI,there was no significant difference in the incidence of no-reflow and slow-flow between the white and red thrombus groups.In the groups with PCI 3-6 and 6-12 h after onset of AMI,there was a significant difference in the incidence of no-reflow and slow-flow between the white and red thrombus groups(P<0.01).There was a significant correlation between the onset time of AMI and the occurrences of no-reflow and slow blood flow during PCI(P<0.01).CONCLUSION In direct PCI,the onset time of AMI and color of coronary thrombus are often used to predict whether there will be no reflow or slow blood flow after stent implantation. | Ming-Ji Zhang Xin Liu Li-Hong Liu Ning Li Ning Zhang Yong-Qing Wang Xue-Jun Sun Ping-He Huang Hong-Mei Yin Yong-Hui Liu Hong Zheng | 2019 | World Journal of Clinical Cases2019，7，15： | 6 |
| 10 | Long-term outcomes after radical gastrectomy in gastric cancer patients with overt bleeding显示文摘AIM: To investigate the difference in long-term outcomes between gastric cancer patients with and without a primary symptom of overt bleeding(OB).METHODS: Consecutive patients between January 1, 2007 and March 1, 2012 were identified retrospectively by reviewing a gastric cancer database at Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine. A follow-up examination was performed on patients who underwent a radical gastrectomy. OB due to gastric cancer included hematemesis, melena or hematochezia, and gastric cancer was confirmed as the source of bleeding by endoscopy. Patients without OB were defined as cases with occult bleeding and those with other initial presentations, including epigastric pain, weakness, weight loss and obstruction. The 3-year overall survival(OS) rate, age, gender, AJCC T stage, AJCC N stage, overall AJCC stage, tumor size, histological type, macroscopic(Borrmann) type, lymphovascular invasion and R status were compared between patients with and without OB. Moreover, we carried out a subgroup analysis based on tumor location(upper, middle and lower).RESULTS: We identified 939 patients. Of these, 695(74.0%) were hospitalized for potential radical gastrectomy and another 244 received palliative resection, rerouting of the gastrointestinal tract, chemotherapy, radiotherapy or no treatment due to the presence of unresectable tumors. Notably, there was no significant difference in the percentage of OB patients between resectable cases and unresectable cases(20.3 % vs 22.1 %, P = 0.541). Fo l l o w- u p examination was performed on 653 patients(94%) who underwent radical gastrectomy. We found no significant difference in 3-year OS rate(68.2% vs 61.2%, P = 0.143) or clinicopathological characteristics(P > 0.05) between these patients with and without OB. Subgroup analysis based on tumor location showed that the 3-year OS rate of upper gastric cancer was significantly higher in patients with OB(84.6%) than in those without OB(48.1%, P < 0.01) and that AJCC stagesⅠ-Ⅱ(56.4% vs 35.1%, P = 0.017) and T1-T2 category tumors(30.8% vs 13%, P = 0.010) were more frequent in patients with OB than in those without OB. There was no significant difference in 3-year OS rate or clinicopathological characteristics between patients with and without OB(P > 0.05) for middle or lower gastric cancer.CONCLUSION: Upper gastric cancer patients with OB exhibited tumors at less advanced pathological stages and had a better prognosis than upper gastric cancer patients without OB. | Lei Wang Xu-An Wang Jia-Qi Hao Li-Na Zhang Mao-Lan Li Xiang-Song Wu Hao Weng Wen-Jie Lv Wen-Jie Zhang Lei Chen Hong-Gang Xiang Jian-Hua Lu Ying-Bin Liu Ping Dong | 2015 | World Journal of Gastroenterology2015，21，47： | 5 |
| 11 | Relevance of EGFR gene mutation with pathological features and prognosis in patients with non-small-cell lung carcinoma显示文摘Objective:To study the relevance of EGFR gene mutation with pathological features and prognosis in patients with non-small-cell lung carcinoma.Methods:A total of 297 patients from July 2009 to May 2013 were chosen as objects.EGFR gene mutation were detected with fluorescence quantitative PCR.Relevance of EGFR gene mutation with clinical and pathological features was analyzed,and the prognosis of EGFR- mutant-patients and that of EGFR- wide type-patients was compared.Results:In 297 patients.136(45.79%) showed EGFR gene mutation.EGFR gene mutation had no significant relevance with age.gender,smoking history,family history of cancer and clinical stage(P>0.05);there was significant relevance between EGFR gene mutation and blood type,pathologic types,differentiation and diameter of cancer(P<0.05).The difference between prognosis of EGFR- mutant-patients and that of EGFR- wide type-patients was statistical significance(P<0.05).Conclusions:EGFR gene mutation has significant relevance with pathological features,the prognosis of EGFRmutant-paticnts is better than that of EGFR- wide type-patients. | Cheng-De Wang Xin-Rong Wang Chao-Yang Wang Yi-Jun Tang Ming-Wen Hao | 2015 | Asian Pacific Journal of Tropical Medicine2015，8，3： | 5 |
| 12 | Radical resection of pathological membrane for Budd-Chiari syndrome显示文摘BACKGROUND: Budd-Chiari syndrome (BCS) refers to posthepatic portal vein hypertension and/or inferior vena cava hypertension syndrome caused by obstruction of the blood flow at the portal cardinal hepatic vein and/or posterior hepatic inferior vena cava. The main surgical treatments of BCS include operations on pathological lesioned membrane, shunt, and combined operations. There are more than ten treatments available and reports on their therapeutic effects vary. As to operations on lesioned membrane, there are Kimura’s finger rupture, balloon dilatation and membrane removal. With reference to our experience, the clinical value of membrane resection at normal temperature and under direct vision is discussed. METHODS: A total of 292 patients with BCS undergoing membrane resection at normal temperature and under direct vision from June 1996 to June 2005 were retrospectively analyzed. RESULTS: The short-term therapeutic effect in 256 patients was satisfactory and the effective rate was 87.7% (256/292). Within a week, ascitic fluid disappeared, the liver shrank and edema of the lower extremities was greatly relieved or even disappeared. Perioperative death occurred in 14 patients (4.8%). Of these, 3 had acute heart failure (one during the operation, one after 6 hours and one 7 days later). Six patients had thoracic cavity bleeding within 12 hours after the operation, 3 had acute respiratory distress syndrome (ARDS), 2 had disseminated intravascular coagulation (DIC), and 1 had pulmonary embolism. 158 patients were followed up for 6 months to 12 years, and 12 (7.6%) had recurrences. CONCLUSIONS: After membrane resection at normal temperature and under direct vision, hemodynamicswas found to be close to normal, damage was slight, effectiveness was evident and the recurrence rate low. So this method is effective in treating BCS. | Dang, Xiao-Wei Xu, Pei-Qin Ma, Xiu-Xian | 2007 | Hepatobiliary & Pancreatic Diseases International2007，6，2： | 5 |
| 13 | Effect of L-cysteine on remote organ injury in rats with severe acute pancreatitis induced by bile-pancreatic duct obstruction显示文摘BACKGROUND: Remote organ failure occurs in cases of acute pancreatitis (AP); however, the reports on AP induced by pancreatic duct obstruction are rare. In this study we determined the effect of L-cysteine on pancreaticobiliary inflammation and remote organ damage in rats after pancreaticobiliary duct ligation (PBDL). METHODS: AP was induced by PBDL in rats with 5/0 silk Sixty rats were randomly divided into 4 groups. Groups A and B were sham-operated groups that received injections of saline or L-cysteine (10 mg/kg) intraperitoneally (15 rats in each group). Groups C and D were PBDL groups that received injections of saline or L-cysteine (10 mg/kg) intraperitoneally (15 rats in each group). The tissue samples of the pancreas and remote organs such as the lung, liver, intestine and kidney were subsequently examined for pathological changes under a light microscope. The samples were also stored for the determination of malondialdehyde and glutathione levels. Blood urea nitrogen (BUN), plasma amylase, ALT and AST levels were determined spectrophotometrically using an automated analyzer. Also, we evaluated the effect of L-cysteine on remote organ injury in rats with AP induced by retrograde infusion of 3.5% sodium taurocholate (NaTc) into the bile-pancreatic duct. RESULTS: Varying degrees of injury in the pancreas, lung, liver intestine and kidney were observed in the rats 24 hours after PBDL. The severity of injury to the lung, liver and intestine was attenuated, while injury status was not changed significantly in the pancreas and kidney after L-cysteine treatment. Oxidativestress was also affected by L-cysteine in PBDL-treated rats. The concentration of tissue malondialdehyde decreased in the pancreas and remote organs of PBDL and L-cysteine administrated rats, and the concentration of glutathione increased more significantly than that of the model control group. However, L-cysteine administration reduced the severity of injury in remote organs but not in the pancreas in rats with NaTc-induced AP. CONCLUSION: L-cysteine treatment attenuated multiple organ damage at an early stage of AP in rats and modulated the oxidant/antioxidant imbalance. | Li-Juan Yang Rong Wan Jia-Qing Shen Jie Shen Xing-Peng Wang | 2013 | Hepatobiliary & Pancreatic Diseases International2013，12，4： | 5 |
| 14 | Diagnostic ability of multi-detector spiral computed tomography for pathological lymph node metastasis of advanced gastric cancer显示文摘BACKGROUND The reliability of preoperative nodal diagnosis of advanced gastric cancer by multi-detector spiral computed tomography(MDCT)is still unclear.AIM To examine the diagnostic ability of MDCT more precisely by using data on intranodal pathological metastatic patterns.METHODS A total of 108 patients with advanced gastric cancer who underwent MDCT and curative gastrectomy at Kanazawa Medical University Hospital were enrolled in this study.The nodal sizes measured on computed tomography(CT)images were compared with the pathology results.A receiver-operating characteristic curve was constructed,from which the critical value(CV)was calculated by using the data of the first 69 patients retrospectively.By using the CV,sensitivity and specificity were calculated with prospectively collected data from 39 consecutive patients.This enabled a more precise one-to-one correspondence of lymph nodes between CT and pathological examination by using the size data of lymph node mapping.The intranodal pathological metastatic patterns were classified into the following four types:Small nodular,peripheral,large nodular,and diffuse.RESULTS Although all the cases were clinically suspected as having metastasis,81 had lymph node metastasis and 27 had no metastasis.The number of dissected,detected on CT,and metastatic nodes were,4241,897,and 801,respectively.The CV obtained from the receiver-operating characteristic was 7.6 mm for the long axis.The sensitivity was 91.4%and the specificity was 47.3%in the prospective phase.The large nodular and diffuse metastases were easy to diagnose becausemetastatic nodes with a large axis often exhibit these forms.CONCLUSION The ability of MDCT to contribute to a nodal diagnosis of advanced gastric cancer was examined prospectively with precise size data from node mapping,using a CV of 7.6 mm for the long axis that was calculated from the retrospectively collected data.The sensitivity was as high as 91%,and would be improved when referring to the enhanced patterns.However,its specificity was as low as 47%,because most of metastatic nodes in gastric cancer being small in size.The small nodular or peripheral type metastatic nodes were often small and considered difficult to diagnose. | Zhi-Yong Jiang Shinichi Kinami Naohiko Nakamura Takashi Miyata Hideto Fujita Hiroyuki Takamura Nobuhiko Ueda Takeo Kosaka | 2020 | World Journal of Gastrointestinal Oncology2020，12，4： | 5 |
| 15 | Alterations of tumor-related genes do not exactly match the histopathological grade in gastric adenocarcinomas显示文摘AIM:To investigate the diverse characteristics of different pathological gradings of gastric adenocarcinoma (GA) using tumor-related genes.METHODS:GA tissues in different pathological gradings and normal tissues were subjected to tissue arrays.Expressions of 15 major tumor-related genes were detected by RNA in situ hybridization along with 3' terminal digoxin-labeled anti-sense single strandedoligonucleotide and locked nucleic acid modifying probe within the tissue array.The data obtained were processed by support vector machines by four different feature selection methods to discover the respective critical gene/gene subsets contributing to the GA activities of different pathological gradings.RESULTS:In comparison of poorly differentiated GA with normal tissues,tumor-related gene TP53 plays a key role,although other six tumor-related genes could also achieve the Area Under Curve (AUC) of the receiver operating characteristic independently by more than 80%.Comparing the well differentiated GA with normal tissues,we found that 11 tumor-related genes could independently obtain the AUC by more than 80%,but only the gene subsets,TP53,RB and PTEN,play a key role.Only the gene subsets,Bcl10,UVRAG,APC,Beclin1,NM23,PTEN and RB could distinguish between the poorly differentiated and well differentiated GA.None of a single gene could obtain a valid distinction.CONCLUSION:Different from the traditional point of view,the well differentiated cancer tissues have more alterations of important tumor-related genes than the poorly differentiated cancer tissues. | Guo-Yan Liu,Xiao-Hong Wu,Yi-Zhuo Lu,Chao Pan,Ping Yin,Hong-Feng Liao,Ji-Qin Su,Qing Ge,Qi Luo,Department of General Surgery,The Affiliated Zhongshan Hospital of Xiamen University,The Digestive Disease Research Institute of Xiamen University,Xiamen 361004,Fujian Province,China Guo-Yan Liu,Bin Xiong,Department of Oncology,The Affiliated Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei Province,China Kun-Hong Liu,Department of Data Mining,Software School of Xiamen University,Xiamen 361005,Fujian Province,China Yong Zhang,Yu-Zhi Wang,The Academy of Military Medical Sciences,Beijing 100850,China | 2010 | World Journal of Gastroenterology2010，16，9： | 4 |
| 16 | Diagnosis and treatment of benign multicystic peritoneal mesothelioma显示文摘Benign multicystic peritoneal mesothelioma(BMPM)is a rare cystic mesothelial lesion that occurs predominantly in reproductive aged women.A 56-year-old Caucasian male was admitted to our surgical department with a chief complaint of a painful mass in his right lower abdomen for almost 2 years.The physical examination revealed a palpable painful mass.Computed tomography demonstrated an irregular,cystic tumor in his right lower abdomen.There was no obvious capsule or internal septations.No enhancement after intravenous administration of contrast was noted.An exploratory laparotomy was performed,and a multicystic tumor and adherent to the caecum was noted.The walls of the cysts were thin and smooth,filled with clear fluid,and very friable.An en bloc resection of the tumor,including appendix and caecum,was performed.Histological examination revealed multiple cysts lined with flattened simple epithelial cells,and the capsule walls of the cysts were composed of fibrous tissue.Immunohistochemical analysis documented positive expression of mesothelial cells and calretinin.The final diagnosis was BMPM.The patient was well at 6-mo follow-up.BMPM is exceedingly rare lesion.A complete resection of the tumor is required.The diagnosis of BMPM is based on pathological analysis. | Tian-Bao Wang Wei-Gang Dai Da-Wei Liu Han-Ping Shi Wen-Guang Dong | 2013 | World Journal of Gastroenterology2013，19，39： | 4 |
| 17 | Clinicopathological predictors of long-term benefit in breast cancer treated with neoadjuvant chemotherapy显示文摘AIM To investigate the survival impact of clinicopathological factors, including pathological complete response(p CR) and tumor-infiltrating lymphocytes(s TIL) levels according to subtypes, in breast cancer(BC) patients who received neo-adjuvant chemotherapy(NAC).METHODS We evaluated 435 BC patients who presented and received NAC at the Instituto Nacional de Enfermedades Neoplasicas from 2003 to 2014. s TIL was analyzed as the proportion of tumor stroma occupied by lymphocytes, and was prospectively evaluated on hematoxylin and eosin-stained sections of the preN AC core biopsy. p CR was considered in the absence of infiltrating cancer cells in primary tumor and axillary lymph nodes. Analysis of statistical association between clinical pathological features, s TIL, p CR and survival were carried out using SPSSvs19.RESULTS Median age was 49 years(range 24-84 years) and the most frequent clinical stage was ⅢB(58.3%). Luminal A, Luminal B, HER2-enriched and(triple-negative) TN phenotype was found in 24.6%, 37.9%, 17.7% and 19.8%, respectively. p CR was observed in 11% and median percentage of s TIL was 40%(2%-95%) in the whole population. p CR was associated to Ct1-2(P = 0.045) and to high s TIL(P = 0.029) in the whole population. There was a slight trend towards significance for s TIL(P = 0.054) in Luminal A. s TIL was associated with grade Ⅲ(P < 0.001), no-Luminal A subtype(P < 0.001), RE-negative(P < 0.001), PgR-negative(P < 0.001), HER2-positive(P = 0.002) and p CR(P = 0.029) in the whole population. Longer disease-free survival was associated with grade Ⅰ-Ⅱ(P = 0.006), cN 0(P < 0.001), clinical stage Ⅱ(P = 0.004), ER-positive(P < 0.001), Pg R-positive(P < 0.001), luminal A(P < 0.001) and p CR(P = 0.002). Longer disease-free survival was associated with grade Ⅰ-Ⅱ in Luminal A(P < 0.001), N0-1 in Luminal A(P = 0.045) and TNBC(P = 0.01), clinical stage Ⅱ in Luminal A(P = 0.003) and TNBC(P = 0.038), and pC R in TNBC(P < 0.001). Longer overall survival was associated with grade Ⅰ-Ⅱ(P < 0.001), ER-positive(P < 0.001), PgR-positive(P < 0.001), Luminal A(P < 0.001), cN 0(P = 0.002) and p CR(P = 0.002) in the whole population. Overall survival was associated with clinical stage Ⅱ(P = 0.017) in Luminal A, older age(P = 0.042) in Luminal B, and pC R in TNBC(P = 0.005).CONCLUSION Predictive and prognostic values of clinicopathological features, like p CR and s TIL, differ depending on the evaluated molecular subtype. | Marco Galvez Carlos A Castaneda Joselyn Sanchez Miluska Castillo Lia Pamela Rebaza Gabriela Calderon Miguel De La Cruz Jose Manuel Cotrina Julio Abugattas Jorge Dunstan Henry Guerra Omar Mejia Henry L Gomez | 2018 | World Journal of Clinical Oncology2018，9，2： | 4 |
| 18 | Temporal and spatial cellular and molecular pathological alterations with single-cell resolution in the adult spinal cord after injury显示文摘Spinal cord injury(SCI)involves diverse injury responses in different cell types in a temporally and spatially specific manner.Here,using single-cell transcriptomic analyses combined with classic anatomical,behavioral,electrophysiological analyses,we report,with single-cell resolution,temporal molecular and cellular changes in crush-injured adult mouse spinal cord.Data revealed pathological changes of 12 different major cell types,three of which infiltrated into the spinal cord at distinct times post-injury.We discovered novel microglia and astrocyte subtypes in the uninjured spinal cord,and their dynamic conversions into additional stage-specific subtypes/states.Most dynamic changes occur at 3-days post-injury and by day-14 the second wave of microglial activation emerged,accompanied with changes in various cell types including neurons,indicative of the second round of attacks.By day-38,major cell types are still substantially deviated from uninjured states,demonstrating prolonged alterations.This study provides a comprehensive mapping of cellular/molecular pathological changes along the temporal axis after SCI,which may facilitate the development of novel therapeutic strategies,including those targeting microglia. | Chen Li Zhourui Wu Liqiang Zhou Jingliang Shao Xiao Hu Wei Xu Yilong Ren Xingfei Zhu Weihong Ge Kunshan Zhang Jiping Liu Runzhi Huang Jing Yu Dandan Luo Xuejiao Yang Wenmin Zhu Rongrong Zhu Changhong Zheng Yi Eve Sun Liming Cheng | 2022 | Signal Transduction and Targeted Therapy2022，7，4： | 4 |
| 19 | Ethnic variations in ulcerative colitis: Experience of an international hospital in Thailand显示文摘AIM: To investigate the clinical characteristics, treatment, medication use, and treatment response in patients with ulcerative colitis(UC) across ethnic groups.METHODS: This study retrospectively analyzed medical records of all 268465 patients who visited the Bumrungrad International Digestive Disease Center during 2005-2010. The demographics, clinical characteristics, medication use, results of investigations, and medical and surgical management for patients with UC were evaluated. Evaluation included sigmoidoscopy and colonoscopy performed in compliance with the American Society of Gastrointestinal Endoscopy practice guidelines. Patient ethnicities were categorized into seven groups: Thai, Oriental, South Asian(SA), Middle Eastern(ME), Caucasian, African, and Hispanic. UC pathological severity was classified into inactive, mild, moderate, and severe. Associations between categorical variables were analyzed using the χ2 or Fischer's exact test. Associations between categorical and interval variables were analyzed usingStudent's t-test and/or analysis of covariance.RESULTS: UC was diagnosed in 371 of the 268465 patients: male 56.33%; ME 42%, Caucasian 23%, and Thai 19%. Annual incidence of UC was 82 cases per 100000 with wide ethnic variation, ranging from 29 to 206 cases per 100000 in Oriental and ME patients, respectively. Of the patients with UC, 16.71% had severe UC with highest incidence among the patients from ME(20.39%) and lowest among the Caucasian population(11.90%). ME had highest proportion of pancolitis(52.90%), followed by Caucasian(45.35%) and Asian(34.40%). Only 20.93% of Caucasian patients received steroid, compared with 26.40% and 27.10% of Asian and Middle Eastern, respectively(P = 0.732). Overall, 13.72% of UC patients did not respond to steroid therapy, with non-significantly higher proportions of non-responders among Asian and Middle Eastern patients(15.22% and 15.04%, respectively)(P = 0.781). On average, 5.93% underwent surgical management with ethnic variation, ranging from 0% in African to 18% in SA. Cancer was found in three(Thai, ME, and African) cases(0.82 institution-specific incidence).CONCLUSION: Incidence, symptom duration, pathological severity, clinical manifestations, medication use, treatment response, need for surgical consultation, and cancer incidence of patients with UC potentially vary by ethnicity. | Vibhakorn Permpoon Krit Pongpirul Sinn Anuras | 2016 | World Journal of Gastrointestinal Pharmacology and Therapeutics2016，7，3： | 4 |
| 20 | Pathological changes in multiple organs of rats with severe acute pancreatitis treated by baicalin and octreotide显示文摘BACKGROUND:Severe acute pancreatitis(SAP)features fatal pathogenetic conditions and high mortality rate.The study of SAP complicated with multiple organ injuries is of important significance.In this study,we explored the protective effect of baicalin on multiple organs of SAP rats and compared it with that of octreotide through light and electron microscopic observations of the pathological changes. METHODS:The improved Aho method was used to prepare SAP rat models.These rats were then randomly divided into a sham-operated group(n=45),a model control group(n=45), baicalin-treated group(n=45)and octreotide-treated group (n=45).Based on the difference in time points after operation, these groups were subdivided into 3,6 and 12 hour subgroups (n=15).At the corresponding time point after operation,the mortality rate of rats was recorded,and then the rats were humanely killed to take samples of multiple organs that were subsequently examined for pathological changes under light and electron microscopy. RESULTS:At 12 hours after operation,the mortality rate of rats in the baicalin-and octreotide-treated groups was lower than that in the model control group(P<0.05).Compared to the model control group,the pathological changes and pathological scores in the baicalin-and octreotide-treated groups were mitigated and relieved to varying degrees.The pathological changes under electron microscopy were also improved.CONCLUSIONS:Both baicalin and octreotide show good protective effects on multiple organs of SAP rats.Baicalin as a new drug has good prospects in the treatment of SAP. | Zhang, Xi-Ping Tian, Hua Wu, Di-Jiong Feng, Guang-Hua Chen, Li Zhang, Jie Xu, Ru-Jun Cai, Yang Ju, Tong-Fa Xie, Qi | 2009 | Hepatobiliary & Pancreatic Diseases International2009，8，1： | 4 |
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