Objective To develop a system achieving automated real-time tracking and localizing of tumor center in radiotherapy. Methods High-accuracy infrared tracking cameras' coordinate system was calibrated with the treatment machine. A kind of passive marker was introduced, which can be imaged by computed tomography and can be localized by the infrared cameras during radiotherapy. Several markers on the surface of the thermal-shaped film were fixed, and then the real-time co-ordinates of the markers was compared with those obtained from the computed tomography. With subsequent space registration, the position biases could be shown finally, which could help achieving the real-time tracking and localizing of the tumor center. Results With infrared tracking cameras and appropriate software, the system can achieve automated and real-time localization in radiotherapy. Conclusion The system is more automated, accurate and speedy than the traditional localization method.

Objective To investigate the clinicopathologic characteristics of and HPV subtypes in vulvar condyloma acuminatum(CA)and subclinical HPV infection.Methods Eighty patients with a positive acetowhite test and suspected subclinical HPV infection were selected from 272 patients with typical CA lesions in perianal and external genital region.Tissue specimens were obtained from typical CA and suspected subclinical HPV-infected lesions followed by pathological examination and HPV-DNA detection.Finally,71 patients were confirmed to suffer from both CA and subclinical HPV infection.A comparative analysis was performed to assess the differences in histopathological manifestation and HPV genotypes between CA and subclinical infection lesions.Results Pathological examination revealed typical histological changes of CA in 71(88.75％)typical CA specimens and 4(5％)suspected subclinical infection specimens,as well as squamous dysplasia in 9(11.25％)CA specimens and 71(88.75％)suspected subclinical infection specimens.HPV-DNA was positive in all(80)of the CA specimens and 93.75％(75)of the suspected subclinical infection specimens,negative in 5(6.25％)suspected subclinical infection specimens.Obvious differences were observed in pathological manifestation,koilocyte number(P ＜ 0.05),but not in the distribution of HPV subtypes(P ＞ 0.05),between typical CA and concurrent subclinical HPV infection lesions in patients.Conclusion The diagnosis of subclinical HPV infection should be based on the result of acetowhite test,with the results of pathological examination and HPV DNA detection as an adjuvant.

Rotating wall vessels (RWVS), an ingenious apparatus for three-dimensional suspension culture, is widely used to build a simulated microgravity-effect on cell. Independent researchers have proposed hypotheses to illustrate why RWVS can simulate certain aspects of microgravity. Many of the hypotheses stated that the culture condition in RWVS is determined by the cellular mechanical environment which is a result of low fluid shear and microcarrier's motion. The microcarrier's motions consist of primary and secondary motions. In the light of the analysis of forces loaded by the microcarriers, some conclusions are drawn from the data on microcarriers' primary and secondary motions about which many simulations and observations have already been conducted.
Cell Culture Techniques ; instrumentation ; methods ; Gravitation ; Models, Theoretical ; Motion ; Rotation ; Stress, Mechanical ; Weightlessness Simulation

BACKGROUNDTo investigate the expression of COX-2 and its relation to clinical pathophysiological features and prognosis in non-small cell lung cancer (NSCLC).

METHODSThe expression of COX-2 protein was detected in 52 NSCLC tissues by immunohistochemical (S-P) method.

RESULTSThe positive COX-2 expression was observed in 25 (48.1%) cases of NSCLC tissues. The positive rate of COX-2 expression was 76.5% and 34.3% in adenocarcinoma and squamous cell carcinoma respectively (P < 0.01). The positive rate of COX-2 expression in T3+T4 disease (92.3%) was remarkably higher than that in stage T1+T2 (33.3%) (P < 0.01). There was a remarkable difference in COX-2 expression rate between clinical stage I+II (28.1%) and clinical stage III+IV (80.0%) groups (P < 0.01). The positive rate of COX-2 expression was 83.3% in those with lymph node metastasis, but only 17.9% in those without lymph node metastasis (P < 0.01). In addition, there were significant differences in positive rate of COX-2 expression among patients with ≤2, > 2 but < 5, ≥5 years of survival span respectively (P < 0.01).

CONCLUSIONSOverexpression of COX-2 in NSCLC, especially in adenocarcinoma, is closely related to invasion, lymph node metastasis and clinical stage of lung cancer. It may play a role in development of NSCLC, and also may be a prognostic marker.

Objective To analyze the clinicopathologic factors affecting the formation of lymphovascular invasion (LⅥ) in patients with gastric cancer.Methods The retrospective case-control study was conduted.The clinicopathologic data of 1 260 patients with gastric cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University between January 2014 and December 2015 were collected.All the surgical specimens of patients were detected by hematoxylin-eosin (HE) stain and diagnosed by pathological experts.Stages of patients were evaluated by the seventh TNM staging system for gastric cancer of American Joint Committee on Cancer (AJCC) and Union for International Cancer Control (UICC).Observation indicators:(1) pathologica features:histological differentiation,invasive depth,lymph node metastasis and TNM staging;(2) follow-up situations;(3) influenced factors of the positive LⅥ:sex,age,histological differentiation,invasive depth,number of lymph node metastasis and TNM staging affecting positive LⅥ were analyzed.Follow-up using outpatient examination and telephone interview were performed to detect survival of patients up to June 2016.Univariate analysis was done using the chi-square test,and multivariate analysis was done using the trend chi-square test,and binary Logistic regression model.Results (1) Pathological features:1 260 patients with gastric cancer were diagnosed by postoperative pathological examinations,including 355 with positive LⅥ and 905 with negative LⅥ.Histological differentiation:high-differentiated tumor was detected in 13 patients,moderate-differentiated tumor in 232 patients and low-differentiated tumor in 775 patients.There were 95 patients with mucinous adenocarcinoma and 145 with signet-ring cell carcinoma.Invasive depth:tumor invasion into mucosal layer or submucosal layer (T1 stage) was detected in 242 patients,muscular layer (T2 stage) in 160 patients,gastric wall layer and no invasion into serosal layer (T3 stage) in 37 patients and subserosal layer (T4 stage) in 821 patients.Lymph node metastasis:no regional lymph node metastasis (N0 stage) was detected in 461 patients,1-2 lymph nodes metastases (N1 stage)in 164 patients,3-6 lymph nodes metastases (N2 stage) in 245 patients and more than 7 lymph nodes metastases (N3 stage) in 390 patients.TNM staging:there were respectively 191 patients in Ⅰ A stage,114 in Ⅰ B stage,62 in ⅡA stage,202 in ⅡB stage,132 in ⅢA stage,80 in ⅢB stage,476 in ⅢC stage and 3 in Ⅳ stage.(2)Follow-up situations:1 142 patients (320 with positive LⅥ and 822 with negative LⅥ) were followed up for 4.0-24.0 months,with a meidan time of 11.0 months and a follow-up rate of 90.635％ (1 142/1 260).During the follow-up,154 patients died,including 41 with positive LⅥ and 113 with negative LⅥ.(3) Influenced factors of the positive LⅥ:① results of univariate analysis showed that histological differentiation,invasive depth,number of lymph node metastasis and TNM staging were factors affecting positive LⅥ of patients with gastric cancer (X2=16.930,29.190,64.463,46.539,P＜0.05).② Results of the trend chi-square test showed that histological differentiation,invasive depth,number of lymph node metastasis and TNM staging were factors affecting positive LⅥ of patients with gastric cancer,with a linear correlation (X2 =54.883,69.130,164.618,119.594,r=0.211,0.243,0.365,0.316,P＜0.05).There was a greater correlation between number of lymph node metastasis and formation of lymphovascular invasion.③ Results of the binary Logistic regression model showed that moderate-and low-differentiated tumor and N1-N3 stage of lymph node metastasis were independent risk factors affecting positive LⅥ of patients with gastric cancer (OR=2.572,1.782,95％ confidence interval:0.495-1.494,0.386-0.781,P＜0.05).Conclusion Patients with lower tumor differentiation and / or greater number of lymph node metastasis may have a higher risk of forming LⅥ.

Objective To observe imaging characteristics of carotid body tumor and schwannoma in carotid space. Methods CT, MRI and digital subtraction angiography (DSA) appearances of 16 patients with carotid body tumors and schwannomas in carotid space confirmed pathologically were retrospectively analyzed. There were 8 patients with carotid body tumors and 8 patients with schwannomas. Six patients with carotid body tumors and 5 patients with schwannomas underwent CT plain scan. All the patients underwent MR plain and contrast-enhanced scan. Four patients with carotid body tumors and 2 patients with schwannomas underwent DSA examination. Results CT: Six carotid body tumors were lobulated soft tissue masses. The density of the tumors was similar to neck muscles. Two carotid body tumors involving jugular foramen expanded jugular foramen, and the margin was irregular and erosion-destructive. Five schwannomas were ovoid or fusiform soft tissue masses. The density of the tumors was mixed. Two schwannomas involved jugular foramen expanded jugular foramen, and the margin was smooth. MRI: Eight carotid body tumors were lobulated, well-defined, longitudinal growth masses with characteristic high-velocity flow voids. The tumor splayed and surrounded internal carotid artery and external carotid artery. The diameters of the arteries were normal. The tumors intensely enhanced on contrast-enhanced MRI. Eight schwannomas were ovoid or fusiform, well-defined, longitudinal growth masses with heterogeneous signal, splaying carotid artery and jugular vein. The diameters of the vessels were narrow. The tumors nonuniformly enhanced on contrast-enhanced MRI. DSA: Four carotid body tumors showed intense tumor blush, while 2 schwannomas showed slight tumor blush. Conclusion According to the imaging characteristic of the tumors, carotid body tumor and schwannoma in carotid space can be accurately differentiated.

Objective:To investigate the short-term efficacy of totally laparoscopic distal gastrectomy (TLDG) after endoscopic submucosal dissection (ESD) versus direct TLDG for early gastric cancer.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 623 patients with early gastric cancer who were admitted to the First Affiliated Hospital of Nanjing Medical University from March 2014 to December 2019 were collected. There were 405 males and 218 females, aged from 26 to 86 years, with a median age of 62 years. Of 623 patients, 25 cases undergoing TLDG after ESD were divided into ESD+TLDG group and 598 cases undergoing TLDG directly were divided into TLDG group. Observation indicators: (1) the propensity score matching conditions and comparison of general data between the two groups after propensity score matching; (2) intraoperative and postoperative situations of TLDG; (3) stratification analysis of the ESD+TLDG group. The propensity score matching was conducted by 1∶2 matching using the nearest neighbor method. Measurement data with normal distribution were represented as Mean±SD, and comparison between groups was done using the t test. Measurement data with skewed distribution were represented as M (range) and comparison between groups was done using the Mann-Whitney U test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ordinal data between groups was analyzed using the Mann-Whitney U test. Results:(1) The propensity score matching conditions and comparison of general data between the two groups after propensity score matching: 75 of 623 patients had successful matching, including 25 in the ESD+TLDG group and 50 in the TLDG group. Before propensity score matching, the body mass index (BMI), cases with tumor diameter ≤20 mm, 21 to 30 mm or>30 mm, cases with tumor classified as stage Ⅰ, stage Ⅱ or stage Ⅲ of clinical staging were (22.3±3.6)kg/m 2, 16, 6, 3, 24, 1, 0 of the ESD+TLDG group, respectively, versus (24.3±2.7)kg/m 2, 238, 125, 235, 312, 126, 160 of the TLDG group, showing significant differences in the above indicators between the two groups ( t=2.744, Z=?2.834, ?4.209, P<0.05). After propensity score matching, the BMI, cases with tumor diameter ≤20 mm, 21 to 30 mm or >30 mm, cases with tumor classified as stage Ⅰ or stage Ⅱ of clinical staging were (22.3±3.6)kg/m 2, 16, 6, 3, 24, 1 of the ESD+TLDG group, versus (23.6±2.9)kg/m 2, 29, 12, 9, 48, 2 of the TLDG group, showing no significant difference between the two groups ( t=1.542, Z=?0.597, 0.000, P>0.05). (2) Intraoperative and postoperative situations of TLDG: after propensity score matching, the operation time and time to postoperative drainage tube removal were 180 minutes(range, 124 to 289 minutes) and 6 days(range, 4 to 13 days) of the ESD+TLDG group,respectively,versus 170 minutes(range, 106 to 250 minutes) and 6 days (range, 4 to 9 days) of the TLDG group, showing significant differences between the two groups ( Z=-2.396, -3.039, P<0.05). Cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL, the number of lymph node dissected, duration of postoperative hospital stay, cases with perioperative complications as incision fat liquefaction, delayed gastric emptying, anastomotic bleeding or pulmonary infection were 7, 9, 9,34(range, 16 to 58), 8 days(range, 6 to 31 days), 1, 1, 0, 0 of the ESD+TLDG group,respectively,versus 18, 26, 6, 39 (range, 22 to 68), 8 days (range, 6 to 29 days), 0, 0, 1, 1 of the TLDG group, showing no significant difference between the two groups ( Z=-1.703, -1.958, -1.139, χ2=0.033, P>0.05). Cases with anastomotic bleeding were recovered after hemostasis under endoscopy and cases with other perioperative complications were recovered after conservative treatment. (3) Stratification analysis of the ESD+TLDG group. ① For 5 cases undergoing TLDG ≤14 days after ESD and 20 cases undergoing TLDG >14 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 200 minutes(range, 170 to 289 minutes), 0, 3, 2, 36(range, 9 to 57), 7 days(range, 5 to 9 days), 8 days(range, 7 to 9 days), 1 and 180 minutes (range, 124 to 253 minutes), 8, 6, 6, 34(range, 8 to 78), 6 days(range, 4 to 13 days), 8 days(range, 6 to 31 days), 1, respectively, showing no significant difference in the operation time of TLDG, volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative tube removal and duration of postoperative hospital stay between the two groups ( Z=?1.536, ?1.993, ?0.238, ?0.932, ?0.589, P>0.05), and no significant difference in cases with perioperative complications between the two groups ( P>0.05). ② For 13 cases undergoing TLDG ≤21 days after ESD and cases undergoing TLDG >21 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss as <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 200 minutes(range, 145 to 289 minutes), 2, 6, 5, 34(range, 8 to 57), 6 days(range, 4 to 11 days), 8 days(range, 6 to 11 days), 1 and 179 minutes(range, 124 to 240 minutes), 6, 3, 3, 34(range, 16 to 78), 6 days(range, 5 to 13 days), 8 days(range, 6 to 31 days), 1, respectively, showing a significant difference in the operation time of TLDG between the two groups ( Z=?2.241, P<0.05), while showing no significant difference in the volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay between the two groups ( Z=?1.471, ?0.163, ?0.084, ?0.194, P>0.05) and no significant difference in cases with perioperative complications between the two groups ( P>0.05). ③ For 15 cases undergoing TLDG ≤28 days after ESD and 10 cases undergoing TLDG >28 days after ESD, the operation time of TLDG, cases with the volume of intraoperative blood loss <50 mL, 50 to 100 mL or >100 mL during TLDG, the number of lymph node dissected, time to postoperative drainage tube removal, duration of postoperative hospital stay, cases with perioperative complications were 190 minutes (range, 145 to 289 minutes), 2, 7, 6, 33(range, 8 to 57), 6 days(range, 4 to 11 days), 8 days(range, 6 to 31 days), 1 and 179 minutes(range, 124 to 240 minutes), 6, 2, 2, 37(range, 16 to 78), 6 days (range, 5 to 13 days), 8 days(range, 6 to 14 days), 1, respectively, showing no significant difference in the operation time of TLDG, volume of intraoperative blood loss during TLDG, the number of lymph node dissected, time to postoperative tube removal and duration of postoperative hospital stay between the two groups ( Z=?1.619, ?2.000, ?0.667, ?0.370, ?0.057, P>0.05), and no significant difference in cases with perioperative complications between the two groups ( P>0.05). Conclusions:Compared with cases undergoing TLDG directly, the operation time to TLDG and time to drainage tube removal after TLDG for cases undergoing ESD+TLDG are prolonged, but there is no difference in the short-term efficacy. For cases undergoing TLDG ≤21 days after ESD and cases undergoing TLDG >21 days after ESD, there is a significant difference in the operation time of TLDG.

CHO cells expressing human GPIb/IX and rabbit red blood cells coated with human von Willebrand factor (VWF) were adapted to our study on the binding probability and the detachment force of GPIb/IX and VWF. With the micropipette system, the two cells were impinged under a constant force for controlled time. When the cells were pulled apart, the deformation of RBC was recorded, and the binding score and detachment force of the proteins were determined. After the two cells were impinged into 0.5 microm for 30 s, the binding probability of the two cells carrying GPIb/IX and VWF was 15.0%. Via analyzing the deformation of red blood cells, we found out the distribution of rupture forces of cells with GPIb/IX and VWF. Therefore, we infer that the continuous distribution of the detachment force is due to the stochastic effect. The most probable value of the detachment force was 10 pN.
Animals ; Binding Sites ; Blood Platelets ; metabolism ; CHO Cells ; Cell Adhesion ; Cricetinae ; Cricetulus ; Humans ; Platelet Activation ; physiology ; Platelet Glycoprotein GPIb-IX Complex ; chemistry ; metabolism ; Rabbits ; von Willebrand Factor ; chemistry ; metabolism

The molecular mechanism underlying muscular atrophy and gravisensing during spaceflight is still unknown. The major effects of spaceflight on body-wall muscles of Caenorhabditis elegans (C. elegans) in the structures and functions wore examined, and five important muscle-related genes and three proteins were studied after nearly 15-day spaceflight. The changes for the wall-muscles were observed in situ. Decreased muscle fiber size was observed with myosin immunofluorescence and duller dense-body staining in flight samples, which suggested that muscular atrophy had happened during spaceflight. However, F-actin staining showed no differences between the spaceflight group and ground control group. Otherwise, after returning to the earth the C eleganu displayed reduced rate of movement with a lower ratio (height/width) in crawl trace wave, which indicated a functional defect. These results demonstrated that C. elegans muscular development was changed in response to microgravity, and changes also occurred at the level of gene transcription and protein translation. Expression of dys-I increased significantly in body-wall muscles, while hlh-1, myo-3, uric-54 and eg1-19 RNA levels decreased after spaceflight. Dystrophin (encoded by dys-1) is one of important components in dystrophin-glycoprotein complex (DGC). Increased dys-I expression after flight implied that the muscular cell would accept more gravity signals by DGC in mierogravity in order to keep mechanical balance within the cells. It is concluded that DGC was involved into the mechanical transduction in body-wall muscles of C. elegans when gravity varied, which potentially played a vital role in gravisensing. The changes ofhlh-l, myo-3, tmc-54 and egl-19 suggested that they had the effects of promoting microgravity-induced muscular atrophy in strcture and function aspects. Result of Western blotting showed that the level of myosin A in spaceflight group decreased, further confirmed that atrophy happened during flight.

Objective　 To investigate the relationship between clinicopathologic features and immunophenotypes in non-Hodgkin's lymphoma (NHL) of the spleen. Methods　 Clinicopathologic analysis and follow up; immunohistologic staining by SP method and EBER in situ hybridization. Results　 (1) Splenomegaly was found in al l 19 cases of spleen NHL, 10 of the 19 (52.6%) cases had masses or a mass in the ir enlarged spleen; (2) 14 of the 19 (73.7%) cases were of B-cell type (includi n g 5 cases of follicular type and 9 cases of diffuse type) ,in which 8 cases were centroblastic, 3 of centroblast/centrocyte and 4 cases of s mall lymphocyte types; all 10 cases of primary splenic lymphomas (PSL) were B-c ell type ; (3) 5 of the 19 cases (26.3%) had peripheral T-cell origin, including 4 cases of large cell type and 1 case of small cell type; of the 3 TIA-1 positive cases , 2 we re also positive for EBER 1/2 (one CD 8+ and another CD56+), the remaining case was CD8-, CD56-, EBER1/2-; all 5 cases were secondary NHL of the spleen; (4) Fol lo w up data were obtained for 14/19 cases (73.7%). 8 of 9 surviving cases were pri m ary NHL. The range of survival period varied from 8 to 10 years. All 5 deceased cases had secondary NHL and their survival period was 2 to 6 months. Conclusions　 Some relationship exists between the clinicopathology and origin of the tumor c ells in splenic NHL, the prognosis of primary NHL is better than that of the sec ondary NHL and the diagnosis of primary NHL should be made with discretion.