Cyclooxygenase-2 (COX-2),the rate-limited enzyme that converts arachidonic acid into prostaglandin,has been found overexpression in many malignant tumors.The overexpression of COX-2 plays an important role in tumor genesis and progression and is closely associated with tumor prognosis,so this enzyme has become one of the potential therapeutic targets.Experimental studies reveal that selective COX-2 inhibitors can enhance the tumor radiosensitivity through a variety of molecular pathways and have a protective effect for normal tissues.Selective COX-2 inhibitors are promising radiotherapy modifiers and the underlying molecular mechanisms still need to be further studied.

Objective To establish the carotid fusiform aneurysm model in rabbits carrying similar characteristics of human intracranial aneurysms by using induction method with porcine pancreatic elastase. Methods Twenty-five New Zealand white rabbits were randomly divided into normal control group (n=5), saline control group (n = 5) and study group (n = 15). The rabbits of the study group were randomly and equally subdivided into 7-day subgroup, 14-day subgroup and 21-day subgroup. By using induction method with porcine pancreatic elastase to digest right common carotid the fusiform aneurysm model was established in all the rabbits of the study group. DSA examination , HE staining and elastic fiber staining pathologic examination were carried out at 7, 14 and 21 days after the procedure to observe the imaging and pathologic changes of the fusiform aneurysm models. Results DSA angiography showed that the mean vascular diameters of the normal control group and the saline control group were (1.64 ± 0.17) mm and (1.66 ± 0.24) mm respectively. The mean length and width of the fusiform aneurysm of the 7-day subgroup, 14-day subgroup and 21-day subgroup were (19.33 ± 1.65) mm and (2.86 ± 0.21) mm, (19.66 ± 1.18) mm and (3.95 ± 0.54) mm, and (19.84 ± 0.82) mm and (4.03 ± 0.95) mm, respectively. Pathologically, rupture of internal elastic membrane, disordered structure of tunica media smooth muscle and distortion of cell shape were observed in the rabbits of 7-day subgroup. Gradually stabilized aneurysmal lumen intimal hyperplasia was seen in the rabbits of 14-day subgroup. Remarkable structure changes at the aneurysmal neck-cavity junction were found in the rabbits of 21-day subgroup. Elastic fiber staining demonstrated that strikingly thinned elastic layer was observed in the rabbits of 7-day subgroup, gradually thinning elastic layer at the aneurysmal neck-cavity junction was seen in the rabbits of 14-day subgroup, and the thinned elastic layer became stable in the rabbits of 21-day subgroup. Conclusion Using simple surgical method combined with porcine pancreatic elastase to digest vascular wall, carotid fusiform aneurysm models can be reliably established in New Zealand white rabbits which carry similar morphologic and pathologic characteristics of human intracranial aneurysms.

Objective:To investigate the onset mechanism of cervical vertigo from the proprioceptive sensation and provide clinical basis for its treatment.Methods:Among the 121 cases that conformed to the diagnostic criteria of cervical vertigo,70 cases who presented with negative neck-rotation test and cervical vertigo without obvious vascular factors by transcranial Doppler(TCD)were assigned to the observation group,while 51 cases who presented with positive neck-rotation test and cervical vertigo due to spasm of vertebral basal artery or insufficient blood supply by TCD were assigned to the control group.The cases in the two groups were treated once every day,5 days make up one treatment course and the resuIts were statistically analyrzed after one treatment course.Results:The skull triaxial spatial offset of the cases in the two groups were significantly reduced after the treatment (P<＜0.01).However, there was no statistically significant difference between the skull triaxial spatial offset between the two groups (p＞0.05).It is not conclusive that the therapeutic effect in the two groups was significantly different after one treatment course.Conclusion:Tuina manipulation therapy can improve the skull spatial ofrset repositioning ability of the Patients.

Surgical resection is the primary treatment for locally advanced rectal cancer,but the local recurrence rate of surgical resection is still at a high level. Preoperative and postoperative chemoradiotherapy not only decreases the local recurrence rate of surgical resection,but also elevates the survival rate and life quality. Recently,adjuvant chemoradiotherapy has been applied as the standard therapy for locally advanced rectal cancer. The application of targeted drugs,new chemotherapy drugs and rapid changing radiotherapy technology provide more approaches to the treatment of locally advanced rectal cancer.

OBJECTIVE To make the patients using the central venous catheter safely when given chemotherapy and intravenous nutritional therapy,and to decrease the catheter infection by establishing effective infection-preventing systems. METHODS Many infection-preventing actions were carried out,including a three-level management,improving the workers′ training in catheter operation and maintenance,and health education. RESULTS Comparing with the matched group,the infection rate of the experimental group was much lower after the actions.The actions prevented the increase of infection effectively. CONCLUSIONS Building and carrying out the systems are proved to be important measures to decrease the catheter infection and ensure the quality of life among patients during the therapy in hospital.

ObjectiveTo observe the effect of succus entericus reinfusion with continuous enteral nutrition on the barrier function of intestinal mucosa and nutritional status in patients with stomal type fistulas. Methods Sixteen patients with stomal type fistula from July 1995 to May 2008 were enrolled in the study. A]l patients met the following conditions: gut function returned normal; abdominal infection was controlled; total enteral nutrition was provided ; and the length of small intestine for succus entericus reinfusion was more than 50 cm. Intestinal mucosa was taken at 25 to 30 cm away from stoma of fistula by endoscope 0, 7, and 14 days after reinfusior. Hematoxylineosin staining was performed to count the number of intestinal intraepithelial lymphocytes (IIELS). In addition,proliferating cell nuclear antigen (PCNA) was measured with immunohistochemical staining. Serum protein levels were determined by immunonephelometry. ResultsThe percentage of IIELS in intestinal mucosa ( 19.06％ ±4.81％ vs. 12.81％ ±2.95％, P=0.000) and the percentage of PCNA positive cells ( 12.13％ ±4.33％ vs.6.44％ ± 2.34％, P =0.000) 14 days after succus entericus reinfusion were significantly higher than those on the day of reinfusion. Serum fibronectin level increased from ( 152.80 ± 16.50 ) to ( 227.05 ± 45.36 ) mg/L ( P =0.000), and transferring protein level increased from ( 2.16 ± 0.52 ) to ( 2.62 ± 0.41 ) g/L ( P =0.017 ) 14days after succus entericus reinfusion. ConclusionSuccus entericus reinfusion is effective in protecting the intestinal mucosa in patients with stomal type fistulas.

Clinical data of 14 patients with iatrogenic duodenal injuries treated in hospital from January 2000 and January 2010 were retrospectively reviewed.Iatrogenic duodenal injuries were found intraoperatively in 9 cases,in whom repair or additional jejunostomy was performed and all were cured and discharged.In 2 patients the duodenal injuries were found within 24 hours postoperatively,1 was cured,another had low flow duodenal fistula and cured with conservative treatment.Duodenal bypass and extraoral drainage were performed in 2 patients whose duodenal injuries was found 72 hours after surgery and died from severe infection of retroperitoneal space and multiple organ failure respectively.One patient whose duodenal injury was found 7 d postoperatively suffered from septic shock and died in 4 h after admission.The results suggest that early detection and early management would result in satisfied outcome for patients with iatrogenic duodenal injuries,the first 24 hours are crucial.

Objective To investigate the feasibility and effectiveness of inducing rabbit common carotid fusiform aneurysms via the common carotid extravascular digestion method. Methods Sixteen New Zealand white rabbits were randomly assigned into either an experiment group ( n=12 ) or a control group (n=4). Porcine pancreatic elastase 80-400 U were used to incubate and digest 2 to 4 cm segment of artery distal to the origin of right common carotid artery. One week after modeling,intravenous angiography was performed and the length and width of fusiform dilatation of common carotid artery were measured. The fusiform dilated artery was examined with hematoxylin and eosin staining and the vascular morphological changes were observed with scanning electron microscope. Isotonic saline solution was used to incubate common carotid arteries of the 4 New Zealand white rabbits in the control group. After one week,the same method was used to observe the lumen of common carotid artery and intimal changes. Results After the digestion of common carotid artery adventitia,the angiography of 12 New Zealand white rabbits of the experimental group revealed fusiform dilatation of common carotid artery of the 10 model rabbits. The widest diameter of the fusiform artery was 3. 70 ± 0. 32 mm;two rabbits had common carotid artery occlusion. Compared with the control group,the right common carotid artery diameter enlarged significantly in the experimental group (1. 80 ± 0. 16 mm,P<0. 01). The HE staining showed that the lumen widened, adventitia and media reduced. Scanning electron microscope showed intimal inflammatory injury and thrombus attachment. Conclusion Using porcine pancreatic elastase to digest the adventitia of common carotid artery can make fusiform dilatation of common carotid artery in rabbits. Using this method may effectively induce a model of fusiform aneurysm,and it has certain feasibility.

Objective To study the effects of two different methods of high-pressure injections on imaging quality of synchronous left axillary artery and vein by using volume CT.Methods Forty seven patients who underwent left axillary vein and artery CTA examination study were analyzed retrospectively according to the contrast agent injection scheme and was divided into two groups A and B.Group A of 25 patients used protocol A,adopted clinical routine delay scanning method,via right elbow vein inject contrast medium.Group B of 22 patients used protocol B,adopted artery delayed imaging combined with vein direct imaging method,via right elbow vein,left radial vein inject contrast agent,respectively.Both values of CT and contrast to noise ratio (CNR) of two groups were compared,objective image quality was compared by two blinded readers.Mann Whiteny U test was used.Results The median of CT values for left axillary artery in group A was 151.9 HU.The median of CNR values for left axillary artery in group A was 7.4.The median of CT values for left axillary vein in group A was 116.0 HU.The median of CNR values for left axillary vein in group A was 3.83.The median of CT values for left axillary artery in group B was 348.8 HU.The median of CNR values for left axillary artery in group B was 25.3.The median of CT values for left axillary vein in group B was 497.0 HU.The median of CNR values for left axillary vein in group B was 35.4.Both values of CT and CNR in two groups showed significant difference (Z=-5.735,-5.799,-5.863 and-5.863,P＜0.01).All of the median scores in group B were greater than in group A(P＜0.01).Conclusion The enhancement effect of protocol B in the left axillary arteriovenous synchronous imaging is significantly higher than those of protocol A,and demonstrates clear image quality and clearer anatomic relationship.