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Wuxi, China

Xu G.,Nanjing Medical University | Zhang W.,Nanjing Medical University | Lv Y.,Nanjing Medical University | Zhang B.,Nanjing Medical University | And 8 more authors.
Surgical Endoscopy and Other Interventional Techniques | Year: 2016

Differences in pathologic diagnosis between endoscopic forceps biopsy (EFB) and endoscopic submucosal dissection (ESD) for gastric intraepithelial neoplasia (GIN) and early gastric carcinoma (EGC) in Chinese patients remain unknown. The aim of the study was to investigate risk factors for under-diagnosed pathology in initial EFB, compared to final ESD. We reviewed endoscopic and histopathologic findings for tumor location, size, macroscopic pattern, nodularity, erythema, erosion, GIN (low and high grade), and EGC diagnosed with the WHO criteria. Differences in those features between EFB and ESD were compared and risk factors for under-diagnosis by EFB were analyzed. Although concordant in most (74.9 %) cases between EFBs and ESDs, pathological diagnoses in 57 (25.1 %) cases were upgraded in ESDs. Compared to the concordant group, the lesion size ≥2 cm, and depressed and excavated patterns were significantly more frequent in the upgraded group. Further multivariate regression analysis demonstrated the depressed pattern and lesion size ≥2 cm as independent risk factors for upgraded pathology with the odds ratio of 5.778 (95 % confidence interval 2.893–11.542) and 2.535 (95 % confidence interval 1.257–5.111), respectively. Lesion size ≥2.0 cm and the depressed pattern at initial EFB were independent risk factors for pathologic upgrade to advanced diseases in ESD. Therefore, these endoscopic characteristics should be considered together with the initial EFB diagnosis to guide the optimal clinical management of patients with GIN and EGC. © 2015, Springer Science+Business Media New York.

Zhou Z.H.,101 Hospital of PLA
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery | Year: 2013

To investigate the sensitivity of gastric cancer stem cells (GCSCs) to 5-fluorouracil (5-FU), and to explore the cytological mechanism of drug-resistance of gastric cancer. Immunohistochemical staining was employed to examine expression of stem cell marker CD44 and drug-resistance protein thymidylate synthase (TS) in 71 cases with gastric cancer. Based on morphology of cell colonies derived from AGS gastric cell line, colonies consisting of GCSCs were isolated, and expression of CD44 and TS, as well as self-renewal capacity of GCSCs were detected. Sensitivity of GCSCs to 5-FU was examined through CCK-8 assay. The positive rates of CD44 and TS were 59.2% (42/71) and 56.3% (40/71) in gastric cancer, and expression of CD44 was associated with that of TS (χ(2)=12.76, P<0.01; Kappa=0.41). Serial sections indicated that CD44+ cancer cells simultaneously expressed TS. AGS developed morphologically diverse colonies, and the GCSCs colonies exhibited a tight and regular shape, which were called holoclone. Holoclones expressed CD44 and TS strongly, possessing capacity of robust self-renewal and forming a lot of second passage clones after incubation. Subclones expressed CD44 and TS weakly, forming less second passage clones. Paraclones almost did not express CD44 and TS, forming no second passage clone after incubation. Affected by 5-Fu, three holoclones showed less growth inhibition compared with another colony type and wild-type AGS cells. Furthermore, IC50 of 5-FU for three holoclones was (113.43±5.81), (272.68±25.75) and (118.14±17.75) μmol/L respectively, which were significantly higher than that of one subcolony type [(16.97±1.01) μmol/L] and AGS cells [(27.52±0.59) μmol/L] (all P<0.05). GCSCs possess lower sensitivity to 5-FU, and may play a critical role in drug-resistance of gastric cancer.

Zong G.-J.,101 Hospital of PLA | Bai Y.,Shanghai University | Gu M.-B.,Shanghai University | Jiang H.-B.,Shanghai University | And 3 more authors.
Journal of Thoracic and Cardiovascular Surgery | Year: 2011

Objective: The purpose of this study was to investigate the feasibility and safety of pulmonary valve implantation via direct right ventricle puncture. Methods: A standard thoracotomy and direct right ventricle puncture were performed in 8 healthy sheep to implant the pulmonary valve stents. Animals were followed up for 18 months. Results: Three sheep died within the first 4 months after stent placement. The remaining 5 animals survived. After 18 months, examinations by color echocardiography, 64-slice computed tomography scan, and cardiac catheter showed an ideal position of each stent. The function of the pulmonary valves and hearts was not different compared with the preoperative conditions of the sheep. Anatomic examination revealed that the stent was covered by a layer of endothelial tissue with no stent fracture or valvular calcification. The histologic evaluation of the stent and surrounding tissue showed that the surface of the stent was smooth and covered by a complete layer of endothelial cells without obvious infiltration of inflammatory cells. The vascular wall was integrative without tear phenomenon in each layer of tissue. Conclusions: These results show that pulmonary valve stents can be implanted via direct right ventricle puncture. Further studies evaluating xenograft valve material and the effect of implantation in vivo are needed. Copyright © 2011 by The American Association for Thoracic Surgery.

He J.-Q.,101 Hospital of PLA | Chen J.-H.,Anhui Medical University | Zhu J.,101 Hospital of PLA | Chen L.,101 Hospital of PLA | And 5 more authors.
International Journal of Clinical and Experimental Medicine | Year: 2015

Objective: To explore the clinical effects of ultra-early microsurgery (< 24 hours) combined with extra­ventricular drainage for the treatment of poor-grade aneurysms. Methods: A total of 60 patients with poor-grade aneurysms were randomly divided into a microsurgery combined with extraventricular drainage (MED) group and conventional microsurgery (M) group. The prognosis was comparatively studied for these 2 groups. Results: All pa­tients underwent a Glasgow Outcome Scale (GOS) assessment during a 6-month to 2-year follow-up. The excellent recovery (GOS, 4-5 points) rate for the MED group was 30% higher than that of the M group, while the poor recovery (GOS, 1-2 points) rate was 26.7% lower than that of the M group (P = 0.016). The incidence of acute brain swelling (26.7% vs 53.3%; P = 0.035), cerebral infarction (20% vs 46.7%; P = 0.025), and vasospasm (16.7% vs 40%; P = 0.045) for the MED group was significantly lower than that of the M group. Conclusions: For microsurgery combined with extraventricular drainage, the risk of cerebral infarction and vasospasm were significantly reduced for patients with poor-grade aneurysms, and the prognosis was better. © 2015, E-Century Publishing Corporation. All rights reserved.

Mo X.,101 Hospital of PLA | Wang L.,Nanjing Southeast University | Zheng Q.,Nanjing Southeast University | Wu G.,101 Hospital of PLA
Journal of Nanoscience and Nanotechnology | Year: 2016

Circulating tumor cells (CTCs) have become established indicators for cancer therapy and prognosis. To effectively and specifically sort CTCs, numerous techniques have been developed in the last few decades. Recently, aptamer grafted nanostructured substrates have shown ultrasensitivity and considerable specificity in isolation of CTCs. However, due to the limitation of existing nanofabrication methods, large-scale fabrication of homogeneous nanostructured substrates is non-trivial and impose high fabrication costs. On the other hand, the heterogeneity of CTCs in biomarker expression also makes their isolation quite challenging. In this research, homogenous nanostructured surface on borosilicate glass substrates with more than 80 cm2 surface areas are successfully prepared at one time. Such area can process approximately 8 mL of blood. Bi-specific aptamers targeting epithelial cell adhesion molecule and prostate specific membrane antigen, respectively, are also tested. However, due to formation of hetero-dimers between two different aptamers originating from inherent annealing property of nucleic acids, bi-specific aptamers fail to efficiently capture cancer cells. This limitation reveals that multi-specific aptamers, when applied to cell isolation, must be analyzed to exclude any potential formation of hetero-dimers due to complementary sequence matching. Copyright © 2016 American Scientific Publishers All rights reserved.

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