AIM: To analyze the correlation between cytokineinduced killer (CIK) cells adoptive immunotherapy and cancer-related death in gastric cancer patients. METHODS: One hundred and fifty-six gastric cancer patients after o...AIM: To analyze the correlation between cytokineinduced killer (CIK) cells adoptive immunotherapy and cancer-related death in gastric cancer patients. METHODS: One hundred and fifty-six gastric cancer patients after operation at the Third Affiliated Hospital of Soochow University were enrolled in this study. Their clinical data including demographic characteristics, operation time, tumor size, pathological type and staging, tumor metastasis, outcome of chemotherapy or CIK cells adoptive immunotherapy, survival time or time of death were collected with a standard structured questionnaire. Kaplan-Meier method was used to estimate the median survival time, and the 2- and 5- year survival rates. Hazard risk (HR) and 95% confidence interval (95% CI) of CIK cells adoptive immunotherapy for gastric cancer were calculated using the two-stage time-dependent covariates Cox model. RESULTS: The survival time of gastric cancer patients was longer after CIK cells adoptive immunotherapy than after chemotherapy (χ 2 = 10.907, P = 0.001). The median survival time of gastric cancer patients was also longer after CIK cells adoptive immunotherapy than after chemotherapy (49 mo vs 27 mo, P < 0.05). The 2- and 5-year survival rates of gastric cancer patients were significantly higher after CIK cells adoptive immunotherapy than after chemotherapy (73.5% vs 52.6%, 40.4% vs 23.9%, P < 0.05). A significant difference was observed in the survival curve for patients who received CIK cells adoptive immunotherapy (0, 1-10, 11-25, and over 25 frequencies) (χ 2 = 14.534, P = 0.002). The frequencies of CIK cells adoptive immunotherapy were significantly related with the decreasing risk of death in gastric cancer patients after adjustment for sex and age of the patients, tumor stage and relapse (HR = 0.54, 95% CI: 0.36-0.80) when the first stage Cox model was used to define the subjects who remained alive beyond 36 mo as survivors. However, no correlation was observed between the frequencies of death in CIK cells adoptive immunotherapy and the 展开更多
Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Jap...Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Japan. SFTSV undergoes rapid changes owing to evolution, gene mutations, and reassortment between different strains of SFTSV. In this review, we summarize the recent cases and general properties of SFTS, focusing on the epidemiology, genetic diversity, clinical features, and diagnostics of SFTSV in China. From 2010 to October 2016, SFTS cases were reported in 23 provinces of China, with increased numbers yearly. Infection and death cases are mainly found in central China, where the Haemaphysalis Iongicornis ticks are spread. The national average mortality rate of SFTS infection was 5.3%, with higher risk to elder people. The main epidemic period was from May to July, with a peak in May. Thus, SFTS reminds a significant public health problem, and development of prophylactic vaccines and effective antiviral drugs will be highly needed.展开更多
Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and m...Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and management of NPC,the Chinese Society of Clinical Oncology(CSCO)arranged a multi-disciplinary team comprising of experts from all sub-specialties of NPC to write,discuss,and revise the guidelines.Based on the findings of evidencebased medicine in China and abroad,domestic experts have iteratively developed these guidelines to provide proper management of NPC.Overall,the guidelines describe the screening,clinical and pathological diagnosis,staging and risk assessment,therapies,and follow-up of NPC,which aim to improve the management of NPC.展开更多
加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表...加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表明,ERAS理念的实施可以缩短患者的住院时间,降低并发症发生率和再入院率,减少医疗费用。目前,在"白求恩公益基金会创伤骨科专业委员会"的组织下,已有一系列ERAS理念下创伤骨科常见骨折诊疗方案优化的专家共识发表,为指导和规范ERAS理念下骨折的治疗发挥了重要作用。该专家共识为此系列共识之一。胫骨平台骨折是创伤骨科比较常见且治疗困难的骨折之一,通过长期临床实践和研究,国内外医生、学者对于胫骨平台骨折的诊治取得了很多的成果和方法。ERAS理念的引入,可以为胫骨平台骨折的诊治提供更全面的平台,也为诊疗方法的选择和优化提供了更为明确的导向和标准。因此,经全国创伤骨科专家代表讨论,在循证医学基础上,以ERAS理念为指导,特制定本共识。该共识适用于成年人新鲜闭合性胫骨平台骨折(手术距伤后3周内)患者。展开更多
Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and...Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.展开更多
Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitabl...Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitable by the first NGH production test conducted in the South China Sea in 2017.Based on the understanding of the first production test,the China Geological Survey determined the optimal target NGH reservoirs for production test and conducted a detailed assessment,numerical and experimental simulation,and onshore testing of the reservoirs.After that,it conducted the second offshore NGH production test in 1225 m deep Shenhu Area,South China Sea(also referred to as the second production test)from October 2019 to April 2020.During the second production test,a series of technical challenges of drilling horizontal wells in shallow soft strata in deep sea were met,including wellhead stability,directional drilling of a horizontal well,reservoir stimulation and sand control,and accurate depressurization.As a result,30 days of continuous gas production was achieved,with a cumulative gas production of 86.14×104 m3.Thus,the average daily gas production is 2.87×10^4 m^3,which is 5.57 times as much as that obtained in the first production test.Therefore,both the cumulative gas production and the daily gas production were highly improved compared to the first production test.As indicated by the monitoring results of the second production test,there was no anomaly in methane content in the seafloor,seawater,and atmosphere throughout the whole production test.This successful production test further indicates that safe and effective NGH exploitation is feasible in clayey silt NGH reservoirs.The industrialization of hydrates consists of five stages in general,namely theoretical research and simulation experiments,exploratory production test,experimental production test,productive production test,and commercial production.The second production test serves as an important step from the exploratory production test to exper展开更多
Understanding the process of the changing phytoplankton patterns can be particularly useful in water quality improvement and management decisions. However, it is generally not easy to illustrate the interactions betwe...Understanding the process of the changing phytoplankton patterns can be particularly useful in water quality improvement and management decisions. However, it is generally not easy to illustrate the interactions between phytoplankton biomass and related environmental variables given their high spatial and temporal heterogeneity. To elucidate relationships between them, in a eutrophic shallow lake, Taihu Lake, relative long-term data set of biotic and abiotic parameters of water quality in the lake were conducted using multivariate statistical analysis within seasonal periodicity. The results indicate that water temperature and total phosphorus （TP） played governing roles in phytoplankton dynamics in most seasons （i.e. temperature in winter, spring and summer; TP in spring, summer and autumn）; COD （chemical oxygen demand） and BOD （biological oxygen demand） presented significant positive relationships with phytoplankton biomass in spring, summer and autumn. However, a complex interplay was found between phytoplankton biomass and nitrogen considering significant positive relationships occurring between them in spring and autumn, and conversely negative ones in summer. As the predatory factor, zooplankton presented significant grazing-pressure on phytoplankton biomass during summer in view of negative relationship between them in the season. Significant feedback effects of phytoplankton development were identified in summer and autumn in view that significant relationships were obser,qed between phytoplankton biomass and pH, Trans （transparency of water） and DO. The results indicate that interactions between phyto：plankton biomass and related environmental variables are highly sensitive to seasonal periodicity, which improves understanding of different roles of biotic and abiotic variables upon phytoplankton variability, and hence, advances management methods for eutrophic lakes.展开更多
AIM: To investigate the relationship between Helicobacterpylori (H. pylori) infection and the expressions of the p53,Rb, c-myc, bcl-2 and hTERT mRNA in a series of diseasesfrom chronic gastritis (CG), intestinal metap...AIM: To investigate the relationship between Helicobacterpylori (H. pylori) infection and the expressions of the p53,Rb, c-myc, bcl-2 and hTERT mRNA in a series of diseasesfrom chronic gastritis (CG), intestinal metaplasia type Ⅰ or Ⅱ(IMⅠ-Ⅱ), intestinal metaplasia type Ⅲ (IMⅢ), mild or modestdysplasia (DysⅠ-Ⅱ), severe dysplasia (DysⅢ) to gastric cancer(GC) and to elucidate the mechanism of gastriccarcinogenesis relating to H.pyloriinfection.METHODS: 272 cases between 1998 and 2001 wereavailable for the study including 42 cases of CG, 46 cases ofIMⅠ-Ⅱ, 25 cases of IMⅢ, 48 cases of DysⅠ-Ⅱ, 27 cases ofDysⅢ, 84 cases of GC.-H. pyloriinfection and the expressionsof p53, Rb, c-myc, bcl-2 were detected by means ofstreptavidin-peroxidase (SP) immunohistochemical method.HTERT mRNA was detected byin situ hybridization(ISH).RESULTS: The expressions of p53, Rb, c-myc, hTERT mRNAand bcl-2 were higher in the GC than in CG, IN, Dys. Theexpression of c-myc was higher in IMⅢ with-H.pyloriinfection(10/16) than that without infection (1/9) and the positive ratein DysⅠ-Ⅱ and DysⅢ with-H.pyloriinfection was 18/30 and 13/17, respectively, higher than that without infection (4/18 and3/10, respectively). In our experiment mutated p53 had noassociation with H.pyloriinfection, theexpression of Rb wasassociated with-H. pyloriinfection in GC, but the p53-Rb tumor-suppressor system abnormal in DysⅠ-Ⅱ cases, DysⅢⅡ and GCcases with H. pyloriinfection was 21/30, 15/17 and 48/48respecively, higher than non-infection groups (4/18, 3/10, 28/36). Furthermore the level of hTERT mRNA in GC with H. pyloriinfection (47/48) was higher than that without infection (30/36), however the relationship between bcl-2 and H. pyloriwasonly in IMⅢ. C-myc had a close association with hTERT mRNAin DysⅢ and GC (P＝0.0 253,0.0 305 respectively).CONCLUSION: In the gastric carcinogenesis, H. pylorimightcause the severe imbalance of proliferation and apoptosisin the precancerous lesions (IMⅢ and GysⅢ) first, leadingt展开更多
基金Supported by The National Natural Science Foundation of China, No. 30872176, 30950022 and 30972703grants of Jiangsu Province and Soochow University Medical Development Foundation, No. EE126765
文摘AIM: To analyze the correlation between cytokineinduced killer (CIK) cells adoptive immunotherapy and cancer-related death in gastric cancer patients. METHODS: One hundred and fifty-six gastric cancer patients after operation at the Third Affiliated Hospital of Soochow University were enrolled in this study. Their clinical data including demographic characteristics, operation time, tumor size, pathological type and staging, tumor metastasis, outcome of chemotherapy or CIK cells adoptive immunotherapy, survival time or time of death were collected with a standard structured questionnaire. Kaplan-Meier method was used to estimate the median survival time, and the 2- and 5- year survival rates. Hazard risk (HR) and 95% confidence interval (95% CI) of CIK cells adoptive immunotherapy for gastric cancer were calculated using the two-stage time-dependent covariates Cox model. RESULTS: The survival time of gastric cancer patients was longer after CIK cells adoptive immunotherapy than after chemotherapy (χ 2 = 10.907, P = 0.001). The median survival time of gastric cancer patients was also longer after CIK cells adoptive immunotherapy than after chemotherapy (49 mo vs 27 mo, P < 0.05). The 2- and 5-year survival rates of gastric cancer patients were significantly higher after CIK cells adoptive immunotherapy than after chemotherapy (73.5% vs 52.6%, 40.4% vs 23.9%, P < 0.05). A significant difference was observed in the survival curve for patients who received CIK cells adoptive immunotherapy (0, 1-10, 11-25, and over 25 frequencies) (χ 2 = 14.534, P = 0.002). The frequencies of CIK cells adoptive immunotherapy were significantly related with the decreasing risk of death in gastric cancer patients after adjustment for sex and age of the patients, tumor stage and relapse (HR = 0.54, 95% CI: 0.36-0.80) when the first stage Cox model was used to define the subjects who remained alive beyond 36 mo as survivors. However, no correlation was observed between the frequencies of death in CIK cells adoptive immunotherapy and the
基金supported by grants from the China Mega-Project for Infectious Diseases (2012ZX10004207)the China-US Collaborative Program on Emerging and Re-emerging Infectious Diseases (S2012Y03)+1 种基金the key project of the Health Ministry of Hubei Province (JX5A06)the Hubei Provincial Outstanding Medical Academic Leader program
文摘Severe fever with thrombocytopenia syndrome （SFTS） is an emerging infectious disease caused by SFTS virus （SFTSV）. SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Japan. SFTSV undergoes rapid changes owing to evolution, gene mutations, and reassortment between different strains of SFTSV. In this review, we summarize the recent cases and general properties of SFTS, focusing on the epidemiology, genetic diversity, clinical features, and diagnostics of SFTSV in China. From 2010 to October 2016, SFTS cases were reported in 23 provinces of China, with increased numbers yearly. Infection and death cases are mainly found in central China, where the Haemaphysalis Iongicornis ticks are spread. The national average mortality rate of SFTS infection was 5.3%, with higher risk to elder people. The main epidemic period was from May to July, with a peak in May. Thus, SFTS reminds a significant public health problem, and development of prophylactic vaccines and effective antiviral drugs will be highly needed.
文摘Nasopharyngeal carcinoma(NPC)is a malignant epithelial tumor originating in the nasopharynx and has a high incidence in Southeast Asia and North Africa.To develop these comprehensive guidelines for the diagnosis and management of NPC,the Chinese Society of Clinical Oncology(CSCO)arranged a multi-disciplinary team comprising of experts from all sub-specialties of NPC to write,discuss,and revise the guidelines.Based on the findings of evidencebased medicine in China and abroad,domestic experts have iteratively developed these guidelines to provide proper management of NPC.Overall,the guidelines describe the screening,clinical and pathological diagnosis,staging and risk assessment,therapies,and follow-up of NPC,which aim to improve the management of NPC.
文摘加速康复外科(enhanced recovery after surgery,ERAS)旨在通过采用一系列有循证医学证据的围手术期优化处理措施,减少手术患者生理和心理的应激,从而使患者从疾患和手术应激状态快速恢复。近年来,ERAS理念在国内外发展迅速,多项研究表明,ERAS理念的实施可以缩短患者的住院时间,降低并发症发生率和再入院率,减少医疗费用。目前,在"白求恩公益基金会创伤骨科专业委员会"的组织下,已有一系列ERAS理念下创伤骨科常见骨折诊疗方案优化的专家共识发表,为指导和规范ERAS理念下骨折的治疗发挥了重要作用。该专家共识为此系列共识之一。胫骨平台骨折是创伤骨科比较常见且治疗困难的骨折之一,通过长期临床实践和研究,国内外医生、学者对于胫骨平台骨折的诊治取得了很多的成果和方法。ERAS理念的引入,可以为胫骨平台骨折的诊治提供更全面的平台,也为诊疗方法的选择和优化提供了更为明确的导向和标准。因此,经全国创伤骨科专家代表讨论,在循证医学基础上,以ERAS理念为指导,特制定本共识。该共识适用于成年人新鲜闭合性胫骨平台骨折(手术距伤后3周内)患者。
文摘Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.
基金This study is supported by the offshore NGH production test projects under the Marine Geological Survey Program initiated by the China Geological Survey(DD20190226,DD20190218)the Major Program of National Natural Science Foundation of China(41730528,51991365)。
文摘Clayey silt reservoirs bearing natural gas hydrates(NGH)are considered to be the hydrate-bearing reservoirs that boast the highest reserves but tend to be the most difficult to exploit.They are proved to be exploitable by the first NGH production test conducted in the South China Sea in 2017.Based on the understanding of the first production test,the China Geological Survey determined the optimal target NGH reservoirs for production test and conducted a detailed assessment,numerical and experimental simulation,and onshore testing of the reservoirs.After that,it conducted the second offshore NGH production test in 1225 m deep Shenhu Area,South China Sea(also referred to as the second production test)from October 2019 to April 2020.During the second production test,a series of technical challenges of drilling horizontal wells in shallow soft strata in deep sea were met,including wellhead stability,directional drilling of a horizontal well,reservoir stimulation and sand control,and accurate depressurization.As a result,30 days of continuous gas production was achieved,with a cumulative gas production of 86.14×104 m3.Thus,the average daily gas production is 2.87×10^4 m^3,which is 5.57 times as much as that obtained in the first production test.Therefore,both the cumulative gas production and the daily gas production were highly improved compared to the first production test.As indicated by the monitoring results of the second production test,there was no anomaly in methane content in the seafloor,seawater,and atmosphere throughout the whole production test.This successful production test further indicates that safe and effective NGH exploitation is feasible in clayey silt NGH reservoirs.The industrialization of hydrates consists of five stages in general,namely theoretical research and simulation experiments,exploratory production test,experimental production test,productive production test,and commercial production.The second production test serves as an important step from the exploratory production test to exper
基金Project supported by the Chinese Academy of Sciences and the Chinese National Audit Office(No.KSH1-01)the Dutch Royal Academy of Arts and Sciences and Chinese Academy of Sciences(No.04CDP014).
文摘Understanding the process of the changing phytoplankton patterns can be particularly useful in water quality improvement and management decisions. However, it is generally not easy to illustrate the interactions between phytoplankton biomass and related environmental variables given their high spatial and temporal heterogeneity. To elucidate relationships between them, in a eutrophic shallow lake, Taihu Lake, relative long-term data set of biotic and abiotic parameters of water quality in the lake were conducted using multivariate statistical analysis within seasonal periodicity. The results indicate that water temperature and total phosphorus （TP） played governing roles in phytoplankton dynamics in most seasons （i.e. temperature in winter, spring and summer; TP in spring, summer and autumn）; COD （chemical oxygen demand） and BOD （biological oxygen demand） presented significant positive relationships with phytoplankton biomass in spring, summer and autumn. However, a complex interplay was found between phytoplankton biomass and nitrogen considering significant positive relationships occurring between them in spring and autumn, and conversely negative ones in summer. As the predatory factor, zooplankton presented significant grazing-pressure on phytoplankton biomass during summer in view of negative relationship between them in the season. Significant feedback effects of phytoplankton development were identified in summer and autumn in view that significant relationships were obser,qed between phytoplankton biomass and pH, Trans （transparency of water） and DO. The results indicate that interactions between phyto：plankton biomass and related environmental variables are highly sensitive to seasonal periodicity, which improves understanding of different roles of biotic and abiotic variables upon phytoplankton variability, and hence, advances management methods for eutrophic lakes.
基金the National Science Fund of Hubei Province,No. 98J087the Department of Health of Hubei Province,No.WJ01572
文摘AIM: To investigate the relationship between Helicobacterpylori (H. pylori) infection and the expressions of the p53,Rb, c-myc, bcl-2 and hTERT mRNA in a series of diseasesfrom chronic gastritis (CG), intestinal metaplasia type Ⅰ or Ⅱ(IMⅠ-Ⅱ), intestinal metaplasia type Ⅲ (IMⅢ), mild or modestdysplasia (DysⅠ-Ⅱ), severe dysplasia (DysⅢ) to gastric cancer(GC) and to elucidate the mechanism of gastriccarcinogenesis relating to H.pyloriinfection.METHODS: 272 cases between 1998 and 2001 wereavailable for the study including 42 cases of CG, 46 cases ofIMⅠ-Ⅱ, 25 cases of IMⅢ, 48 cases of DysⅠ-Ⅱ, 27 cases ofDysⅢ, 84 cases of GC.-H. pyloriinfection and the expressionsof p53, Rb, c-myc, bcl-2 were detected by means ofstreptavidin-peroxidase (SP) immunohistochemical method.HTERT mRNA was detected byin situ hybridization(ISH).RESULTS: The expressions of p53, Rb, c-myc, hTERT mRNAand bcl-2 were higher in the GC than in CG, IN, Dys. Theexpression of c-myc was higher in IMⅢ with-H.pyloriinfection(10/16) than that without infection (1/9) and the positive ratein DysⅠ-Ⅱ and DysⅢ with-H.pyloriinfection was 18/30 and 13/17, respectively, higher than that without infection (4/18 and3/10, respectively). In our experiment mutated p53 had noassociation with H.pyloriinfection, theexpression of Rb wasassociated with-H. pyloriinfection in GC, but the p53-Rb tumor-suppressor system abnormal in DysⅠ-Ⅱ cases, DysⅢⅡ and GCcases with H. pyloriinfection was 21/30, 15/17 and 48/48respecively, higher than non-infection groups (4/18, 3/10, 28/36). Furthermore the level of hTERT mRNA in GC with H. pyloriinfection (47/48) was higher than that without infection (30/36), however the relationship between bcl-2 and H. pyloriwasonly in IMⅢ. C-myc had a close association with hTERT mRNAin DysⅢ and GC (P＝0.0 253,0.0 305 respectively).CONCLUSION: In the gastric carcinogenesis, H. pylorimightcause the severe imbalance of proliferation and apoptosisin the precancerous lesions (IMⅢ and GysⅢ) first, leadingt
