Background and purpose:Colorectal cancer is one of the most common malignant tumors.Radical operation remains the primary treatment for the disease.Postoperative recurrence and metastases are the main cause for the patient' death.Reoperation for recurrent colorectal cancer is one of the methods to improve survival rate and quality of life for those patients.This study aimed to explore the cause,diagnosis and surgical treatment of recurrent colorectal cancer after operation.Methods:Thirty-five cases of postoperatively recurrent colorectal carcinoma who were treated from 2003 to 2006 at the Department of Surgical Oncology,2th Hospital of Jiaxing were retrospectively analyzed.Results:35 cases of colorectal cancers were re-operated and the overall rate of resection was 63 %,12 of them received radical resection with 4 recurrent rectal cancers and 8 recurrent colon cancers while others were palliatively treated.We followed up these patients from 6 to 36 months and there were 9 cases in 12 cases of radical respected group who were disease free,1 of them had lung metastases,1 liver metastases.While 23 cases in the palliative group,5 were dead,4 had liver metastases and 12 cases were alive.Of the 35 cases,26 cases(70%)tumor recurred within 3 years after first operations while others were recurrent at 1 year.Conclusions:For the patients with recurrent colorectal cancer,surgery remains one of the choices for the treatment.Multimodality treatment should be recommended for the patients at diagnosis.Completed resection of intestine with primary lesion,standard lymphadenectomy and eradicating peritoneal exfoliated cancer cells are the major steps to prevent recurrence of colorectal cancer.

AIM:To investigate the effects of microRNA-193 (miR-193) on the proliferation and apoptosis of rat bone marrow mesenchymal stem cells (MSCs).METHODS:Cultured rat MSCs were transfected with pre-miR-193 or anti-miR-193 to regulate the expression of miR-193.The proliferation of the MSCs after transfection was evaluated by MTS assay, colorimetric BrdU cell proliferation assay and Ki-67 immunostaining.Cell apoptosis was analyzed by flow cytometry with Annexin V/PI staining.The effect of miR-193 on the expression of cell cycle-related proteins was evaluated by qRT-PCR.RESULTS:Transfection of pre-miR-193 or anti-miR-193 regulated the expression of miR-193 in MSCs effectively . Over-expression of miR-193 significantly promoted the proliferation of MSCs ( P<0.05 ) , and inhibition of miR-193 re-duced the proliferation of MSCs (P<0.05).miR-193 had no significant effect on the apoptosis of MSCs (P>0.05).The result of qRT-PCR indicated miR-193 promoted the expression of cyclin-dependent kinase 2 ( CDK2 ) significantly ( P<0.01).CONCLUSION:miR-193 promotes the proliferation of MSCs possibly through the CDK 2 pathway.

Taking the diet problem of diabetic patients as an example,the paper puts forward the problems classification system based on functions in the view of users,classifies the problems put forward by patients through the Support Vector Machine (SVM) algorithm,and provides important support for the construction of the deep automatic Question Answering (QA) system.

Through the retrieval of literatures about the research and application of ontology in the diabetes field in PubMed,IEEE/ IET Electronic Library,ACM,WANFANG,CNKI,VIP and other Chinese and English databases,as well as the search engines Google Scholar and Baidu Scholar,the paper shows the current situations and summarizes the main study contents.The result shows that the study achievements of ontology in the field of diabetes increase rapidly and there are obvious advantages in semantic comprehension in recent decade.

The paper analyzes the documents related to the foreign medical automatic Question Answering (QA) system,and compares the differences between automatic QA and traditional network information retrieval,describes the automatic QA system in the aspects of application researches,common tools and relevant technologies.Combining foreign related researches,it also discusses the current key problems of medical automatic QA system and the implications for China in order to offer reference for further research.

Objective To examine the effect of modified electroconvulsive therapy (MECT) on the plasma oxida-tive stress level in bipolar depression. Methods Forty-two patients with bipolar depression were randomly divided into two groups. The intervention group (n=18) received antidepressants and 12 times MECT for 6 weeks and the control group (n=24) received antidepressants and Li2CO3 for 6 weeks. The Chinese versions of the 17 items Hamilton Depression Rating Scale (HAMD-17), Young Mania Rating Scale (YMRS), Clinical Global Impression Scale (CGI-S) and Treatment Emergent Symptom Scale (TESS) were used to assess participants at baseline and after 6 weeks of treatment. The plasma levels of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA)were detected at baseline and after 6 weeks to assess the level of oxidative stress. Results Repeated measures analysis of variance showed that the plasma level of SOD was higher in MECT group than in Li2CO3 group (F=15.26, P<0.01), and the level of MDA was higher in Li2CO3 group (F=18.18, P<0.01). The interactive effect of group and time was significant in GSH-Px level (F=6.39, P=0.02). The level of GSH-Px was lower in MECT group than in Li2CO3 group after 6 weeks (P<0.05). The CAT level was higher in the response patients than in non-response patients after 6 weeks (P<0.05). Con-clusions Both MECT treatment and Li2CO3 treatment can alter oxidative stress levels in patients with bipolar depression. The mechanisms underlying its therapeutic regimen may correct the imbalance of the plasma CAT level.

Detection of epileptic waves in EEG is particularly helpful in the interpretation of the underlying process in seizures. This study is aimed at providing a new method for automatic detection of epileptic waves through the wavelet analysis of EEGs. It mainly deals with the detection of spikes or spike-waves based on wavelet transform. Since spikes and spike-waves contain high frequency energy, they will be represented in a particular scale localized in a small time window. According to these feature waveforms of epileptic waves, a continuous processing system for epileptic waveforms detection is constructed. We apply discrete wavelet transform on EEGs. Because of the time-frequency domain localization of wavelet transforms, we can get the local maximal positions across several successive dyadic scales of wavelet transform. And these positions indicate the points of sharp transitions in EEGs. Then we calculate the distance between every two successive maximal positions in each scale. This distance stands for the period of subwave. Furthermore, the distribution of subwave periods of each scale can be worked out. Then, comparing the distribution of normal EEG's and epileptic EEG's. The difference between these two waveforms provides us the criteria for automatic detection and classification. In order to reduce the detection workload, we also compare the detection efficiency of each scale. The scale that provides highest accuracy is selected for our automatic detection system. The results presented in this study show that scale 3 provides the best detection accuracy. So, scale 3 is deemed to be the proper scale for automatic detection. This system has the following advantages: (1) Reduced the workload significantly by selecting proper scale(s) for automatic selection; (2) Enhanced the detection accuracy by selecting proper criteria and threshold; (3) Capable of continuous detection; (4) It is also fit for the detection of other biomedical signals. This system showed good performance, and the initial clinical results obtained are also encouraging.
Electroencephalography ; Epilepsy ; diagnosis ; Humans ; Wavelet Analysis

Predicting the termination of paroxysmal atrial fibrillation (AF) may provide a signal to decide whether there is a need to intervene the AF timely. We proposed a novel RdR RR intervals scatter plot in our study. The abscissa of the RdR scatter plot was set to RR intervals and the ordinate was set as the difference between successive RR intervals. The RdR scatter plot includes information of RR intervals and difference between successive RR intervals, which captures more heart rate variability (HRV) information. By RdR scatter plot analysis of one minute RR intervals for 50 segments with non-terminating AF and immediately terminating AF, it was found that the points in RdR scatter plot of non-terminating AF were more decentralized than the ones of immediately terminating AF. By dividing the RdR scatter plot into uniform grids and counting the number of non-empty grids, non-terminating AF and immediately terminating AF segments were differentiated. By utilizing 49 RR intervals, for 20 segments of learning set, 17 segments were correctly detected, and for 30 segments of test set, 20 segments were detected. While utilizing 66 RR intervals, for 18 segments of learning set, 16 segments were correctly detected, and for 28 segments of test set, 20 segments were detected. The results demonstrated that during the last one minute before the termination of paroxysmal AF, the variance of the RR intervals and the difference of the neighboring two RR intervals became smaller. The termination of paroxysmal AF could be successfully predicted by utilizing the RdR scatter plot, while the predicting accuracy should be further improved.
Atrial Fibrillation ; diagnosis ; Computer Systems ; Heart Rate ; Humans ; Machine Learning

The receptor of the heart transplantation was a patient with terminal dilated cardiomyopathy, the donor was a patient with congenital ventricular septal defect, in situ double-chamber heart transplantation was performed, and the result of the four-year follow-up was satisfactory. At present, donor is deficient,and those donors with congenital defect can also obtain satisfactory clinical application effects after appropriate handling.

Objective To study the locations, types and causes of different pseudoaneurysms in order to find out the optimal individualized treatment for different pseudoaneurysms. Methods Different methods were applied in treating 21 patients with pseudoaneurysm, which were located at limb (n = 11 ), spleen (n =3), kidney (n = 2) , common lilac artery (n = 1), internal iliac artery (n = 1), gallbladder (n = 1) and penis (n = 1 ). Different managements were employed in treating these pseudoaneurysms. Temporary obstruction of blood circulation with balloon together with arterial anastomosis or direct incision neoplasty was performed in 9 cases with pseudoaneurysms at limb arteries close to the larger joints. Endovascular stent graft was used to isolate the trunk type of pseudoaneurysm in 4 cases, in 2 of them branch arterial embolism and stent graft endovascular exclusion were applied as they had common iliae artery trunk type of pseudoaneurysm at the opening of internal iliac artery. Gelfoam together with metallic coils embolization was employed in 6 cases with terminal type of pseudoaneurysms. Results After different treatments, tumor cavities disappeared in the 21 cases with pseudoaneurysms. Distal arterial pulse returned to normal and no nerve damage occurred in 11 cases with limb pseudoaneurysms. No internal hemorrhage was observed and distal blood circulation returned to normal after graft endovascular exclusion in 2 eases with pseudoaneurysms at spleen artery trunk and in 2 cases with pseudoaneurysms at iliac artery trunk. In 6 cases with terminal type of pseudoaneurysms,the tumor cavity disappeared, hemorrhage stopped and no ischemic necrosis of organ occurred. But one of them with multiple traumatic pseudoaneurysms located at the second grade branch died one week after embolism due to a serious pelvic trauma accompanied with serious infection. Conclusion Based on the locations, types and causes of pseudoaneurysms, different individualized treatment should be adopted in order to obtain optimal results with least damages.