Objective To investigate the possibility of using 5-aminolevulinic acid(5-ALA)induced protoporphyrin IX(PpIX)for photodynamic therapy(PDT)of nasopharyngeal carcinoma(NPC)cell line CNE2 cultured in vitro.Methods CNE2 cells cultured were incubated in a medium containing various concentrations of 5-ALA(0.01,0.05,0.1,0.25,0.5,1.0,2.0,4.0mmol/L)for 6 hours,then illuminated with different light doses(20,10,5,2J/cm2)using a semiconductor laser at 630nm.After 6,12,24 hours incubation with 5-ALA-PDT,the survival rates of CNE2 cells were analyzed by MTT assay.Results 5-ALA-PDT may effectively kill the CNE2 cells.The killing degree was positively correlated with the incubation time after irradiation,concentration of 5-ALA and the dosage of radiation(P

Objective To observe the levels of Livin and Caspase-3 in renal tissue of rats following acute paraquat (PQ) poisoning and the intervention effects of ulinastatin (UTI) . Methods Fifty-four Sprague-Dawley (SD) rats were randomly divided into three experimental groups: control group (group A),PQ poisoning group (group B) and UTI group (group C) (n = 18 in each group) . Rats in group B and group C were administered intragastrically with 80 mg/kg PQ, and rats in group C were treated with 100,000U/kg ulinastatin injected intra-psritoneally once a day; and rats in group A were administered intragastrically with the same volume of saline instead of PQ. At 24, 48, 72 hours after poisoning, the levels of Livin in renal tissue were detected by Westen blotting and the levels of Caspase-3 were detected by immunohistochemistry 24, 48, and 72 hours after poisoning, and the histopathological changes of renal tissue were observed at the same time. Results In the group A, the structure of renal tissue was distinct. In the group B, the distinctness of the structure of renal tissue declined significantly, and swelling, edema and vacuolar degeneration were observed 24 h after poisoning, and pathological changes became more and more obvious keeping pace with time elapsing, and sometimes karyopyknosis appeared and celluar structures disappeared with involvement of renal glomerulus and medulla. These pathological changes were significantly lessened in rats of group C. In the group A, there was little Caspase-3 in renal tissue of rats. Twenty-four hours after poisoning, the caspase-3 in renal tissue of rats of group B was found on the membrane and in the kytoplasm of renal tubular epithelial cells of cortical part. Compared with group B, the level of Caspase-3 in renal tissue of rats of group C decreased significantly to lower level (P ＜0. 01 ) . Compared with group A,the levels of Livin in renal tissue in rats of group B and group C increased significantly at all different intervals (P ＜0. 01 ), and as group B was compared with group C, the difference was statistically significant (P ＜0. 01 ) . Conclusions The main pathologyical changes of renal injury induced by PQ are epithelial swelling, vacuole degenerateion and necrosis. Caspase-3 is involved in the process of renal injury. UTI has a protective effect on the renal tissue of rats following paraquat poisoning through up-regulating the level of Livin and down-regulating the level of Caspase-3, however, the regulation mechanism as well as the pathway is still needed to further study.

Background and purpose:The evaluation of treatment response is one of the most important building blocks in determining the best strategy for the management of malignant tumors. In lymphoma and several solid cancer types, PET/CT-based response evaluation has been shown to be valuable, especially in visualizing the effect of the targeted treatment, which induces tumor activity changes not necessarily followed by tumor shrinkage. This study aimed to evaluate the role of18F-FDG PET/CT in the monitoring of response to sorafenib treatment in radioiodine-refractory differentiated thyroid cancer (RR-DTC) patients; and to compare the Response Evaluation Criteria in Solid Tumors (RECIST 1.1) with the European Organization for Research and Treatment of Cancer (EORTC) criteria.Methods:This was a single-center retrospective analysis of 14 patients with RR-DTC treated with sorafenib in the period from Dec. 2011 to Dec. 2014. A Wilcoxon signed-rank sum test was used to assess the differences in percentage changes between the sum of diameter and ∑SUVmax. These values of responses were statistically compared using the chi-square test (Fisher’s exact test). The differences in PFS between response categories according to either RECIST 1.1 or the EORTC criteria were evaluated using the Wilcoxon signed-rank sum test. The Spearman rank correlation coefficient was estimated between PFS and either morphologic (RECIST 1.1) or metabolic response (EORTC criteria) categories.Results:There was an agreement between the RECIST 1.1 and EORTC criteria in 10 of the 14 patients (χ2=2.345,P=0.424). The remaining 4 patients with SD in-cluded 2 patients with PMR and 2 patients with PMD. Differences in PFS among different response categories according to either RECIST 1.1 (χ2=8.571,P=0.003) or EORTC criteria (χ2=8.781,P=0.003) were statistically significant. Correlations were found between PFS and either morphologic (r=0.741,P=0.002) or metabolic (r=0.816,P=0.0004) response criteria. Conclusion:18F-FDG PET/CT imaging is of value in the monitoring of response to sorafenib in patients with RR-DTC. Although RECIST 1.1 and EORTC criteria agree in 71.4% patients, PET-based metabolic response criteria seems to be more accurate in predicting therapeutic outcome and may be more suitable than morphologic response criteria for the eval-uation of response to targeted therapy.

Objective To evaluate the feasibility and effects of endoscopic thyroidectomy(ETE) for papillary thyroid carcinoma(PTC).Methods A total of 137 patients with PTC were enrolled from January 2013 to January 2016.The patients were divided into two groups depended on different surgical approaches.The patients'' characteristics,such as age,gender,pain,intraoperative blood loss,hospitalization,central lymph node metastasis etc were retrospectively analyzed in the two groups.Results In the study,78 patients performed ETE,and 58 performed COT.There was one case converted to open surgery from ETE due to intraoperative bleeding.The clinicopathological characteristics and operative complications between the two groups had no significant differences,such as gender,time of drainage,postoperative hospitalized days,positive lymph node metastasis,injury of recurrent laryngeal nerve,permanent injury of parathyroid glands.The age of patients was younger in ETE(t=-4.299,P=0.000).The drainage content(t=9.539,P=0.000),intraoperative blood loss(t=2.862,P=0.005) and subcutaneous ecchymosis (χ2=13.482,P=0.000) were found more in the ETE.ETE required a longer operative time(t=8.162,P=0.000).However,ETE provided better cosmetic outcomes than COT [(9.4±0.5)points vs.(5.4±1.0)points,t=30.142,P=0.000].No clinical recurrence and metastasis occurred for at least one-year follow-up.Conclusion With excellent cosmetic results,ETE is a feasible and safe operation for patients with PTC without metastasis to lateral cervical lymph nodes.

OBJECTIVEThe aim of this study was to investigate the value of free anterolateral thigh myocutaneous flap (ALTMF) and computed tomography angiography (CTA) for the reconstruction of mouth-floor defects after the resection of middle-late stage carcinoma of the mouth floor.

METHODSSixteen cases of middle-late stage carcinomas of the mouth floor underwent radical resection, and mouth-floor and tongue defects were reconstructed with ALTMF. CTA was applied to plan the lateral circumflex femoral artery (LCFA) and its perforating vessel, which was verified during the operation.

RESULTSThe position of the perforating vessel in the operation was fully consistent with that designed by the preoperative CTA. All 16 flaps completely survived. The appearance and function of all cases were both satisfactory. All donor sites were primarily closed and healed without functional morbidity. During the follow-up period of 6-36 months, 15 cases survived with acceptable aesthetic and functional results in mouth floor and tongue reconstruction, except for 1 case (T4N2M0) that died of metastasis carcinoma 10 months after operation.

CONCLUSIONCTA can accurately locate the LCFA and artery perforator. Preoperative perforator planning using CTA in ALTMF transplantation is a reliable and useful method thatresults in safe operation with optimal outcome. The ALTMF is an ideal choice for the reconstruction of soft tissue defects after the resection of middle-late staie carcinoma of the mouth floor

Angiography ; Carcinoma ; Free Tissue Flaps ; Humans ; Mouth Floor ; Myocutaneous Flap ; Patient Care Planning ; Reconstructive Surgical Procedures ; Thigh ; Tomography ; Tongue

Objective To compare of the difference about ectopic activation between autogenous bone graft and allograft from large segment tibia of rabbits.Methods Eighty healthy adult Chinese rabbits (6 months of age),weighing (2.5 ±-0.5)kg,were randomly divided into experimental group (allogeneic bone group) and the control group (autograft group),40 rabbits in each group.Another 10 rabbits were allogeneic bone donor.In experimental group,when 1.5 cm long rabbit tibial allograft were finishied,they were implanted into spatium intermusculare between the musculus rectus femoris and medial vastus muscle of the rabbit around the saphenous artery and were fastened to the femur by 1.0 mm Kirschner-wire.In control group,autologous tibias were done,the same as experimental group including length and position and method.Four weeks and 8 weeks and 12 weeks postoperative,respectively,the postmortem specimens were examined gross and immunohistochemistry and the expression of BMP-2 and collagen type Ⅰ of transplanted bone tissue were detected.Results BMP-2 mainly exist in cytoplasm of osteoblasts and chondrocytes undifferentiated mesenchymal cells.Collagen type Ⅰ primarily exist in the bone matrix around the pit of bone.The expression level of BMP-2 of experimental group in postoperative 4,8,12 and 16 weeks were 85.25 ± 4.47,109.44 ± 14.69,141.85 ± 9.45,116.25 ± 14.18,respectively,and the expression level of BMP-2 of control group were 103.78 ±-6.59,124.95 ± 14.94,145.46 ± 8.10,112.48 ± 13.27,respectively.The expression level of collagen type Ⅰ of experimental group in postoperative 4,8,12 and 16 weeks were 78.74 ± 7.99,95.95 ± 6.99,139.91 ± 4.32,137.76 ± 3.48,respectively,and the expression level of BMP-2 of control group were 88.87 ± 11.26,102.45 ± 2.82,140.76 ± 4.62,139.05 ± 4.55.Compared with control group,there was a significant difference in the expression level of the BMP-2 and collagen type Ⅰ of experimental group in postoperative 4,8 weeks (P ＜ 0.05),but,there was no significant difference in the expression level of the BMP-2 and collagen type Ⅰ of experimental group in postoperative 12,16 weeks (P ＞ 0.05).The amount increased gradually during 4 weeks,8 weeks,12weeks,peaked at 12 weeks,BMP-2 displayed a downward trend at 16 weeks,and collagen type Ⅰ basiclly maintain the level of 12 weeks.Conclusion Allograft segment could complete activation while they are implanted into spatium intermusculare containing famous blood supply within 3 months,there is no significant difference between autologous bone and allograft,it shows the feasibility of ectopic activation about allograft segment.

Objective To investigate the application value of free plasma metanephrines metanephrine(MN) and normetanephrine (NM) measured with enzyme immunoassay (EIA), NM in diagnosis of pheochromocytoma. Methods Histologically confirmed pheochromocytomas (n=30) and control patients with hypertension (n=51) were enrolled in the study. Blood tests for free plasma metanephrines(MN and NM) were performed with a commercially available EIA kit and the results were compared with [3] I-metaiedobenzyl guanidine (MIBG) whole body scan findings. Results The whole body scan was positive in all pheochromocytoma patients and negative in 15 control patients with 100% accuracy. The median values in the 2 groups were 59.3 ng/L and 33.7 ng/L (Z=-2. 440, P<0.05) for MN, 652.0 ng/L and 36. 3 ng/L (Z=-6.699, P<0.001) for NM, with 96. 7% (29/30) sensitivity, 86. 3% (44/51)specificity and 90.1% (73/81) accuracy for their combination ( either or both positive). There was no significantly statistical difference when compared with 13I-MIBG whole body scan findings (100. 0% ,P >0. 05). Conclusion The results show that the EIA method may be eligible as an alternative to HPLC for plasma metanephrines determination in the identification of pheochromocytoma.

OBJECTIVE To investigate the in vitro effect of 4 kinds of implant materials on the biofilm formation of Staphylococcus epidermidis.METHODS S.epidermidis was cultured,purified and identified.Susceptibility test was done for S.epidermidis and the ability to produce biofilm was proven.The test samples were made into wafer shape for titanium alloy,Co-Cr-Mo alloy,ultrahigh molecular weight polyethylene(UHMWPE)and home-made polymethyl methacrylate(PMMA).S.epidermidis was cultured with 4 kinds of test samples for 5 days respectively.Bacteria adhering on surfaces of 4 kinds of test samples were dissolved with trypsin,and then diluted into bacterial suspensions.Each bacterial suspension was inoculated quantitatively and CFU were counted.Biofilm on surfaces of 4 kinds of test samples prepared by vacuum drying method was observed with SEM.RESULTS The strain proven to be S.epidermidis,was resistant to semisynthetic penicillins,and could produce biofilm.CFU count showed that CFU were the most on the UHMWPE surface and the number of CFU were(24.96?1.459)?105.CFU were(17.44?1.883)?105 on the PMMP surface.(0.424?0.065)?105 CFU were discovered on the surfaces of titanium alloy and(0.382?0.075)?105 CFU on Co-Cr-Mo alloy.When each group compared with UHMWPE and domestic PMMA respectively,all P value was

Objective To investigate the patterns of change in thyroid functional parameters ( serum TSH,FT3, and FT4 ) in patients with papillary thyroid cancer (PTC) before and after the initial 131I treatment for thyroidal remnant ablation. Methods Seventy-four PTC patients, treated with 3.7 GBq 131 I therapy, were divided into two groups, group A with serum TSH＜30 mIU/L and group B with serum TSH ≥30 mIU/L the day before 131I treatment. Five days after the treatment, the patients were re-examined for serum FT3, FT4, and TSH levels.Results In group A (22 cases), 5 days after the 131I ablation treatment, FT4significantly increased by 88% and FT3 by 87%, while TSH decreased by 87% (all P＜0. 05 ), and 45% (10/22)cases manifested the signs of transient thyrotoxicosis. In group B (52 cases)after treatment, individual variance of FT3 and FT4 was obvious,with FT4 decreased by 13% and FT3 decreased by 14% ( both P＜0. 05 ), while TSH slightly increased by an average of 6% ( P＞0.05 ). Conclusion After the initial 131 I ablation therapy for thyroidal remnant, the thyroid hormone levels in some PTC patients significantly increase while in others may slightly decrease in the early stage. The supplementary and suppressive therapy after 131I ablation for PTC patients might be individualized depending on the thyroid hormone determination.

Objective:To explore the clinical pathological characteristics and improve the recognition in the diagnosis and treatment of incidental (stage T1a -T1b)prostate cancer.Methods:Seven hundred and seventy-one patients who underwent TURP from May 2004 to September 2013 were analyzed retro-spectively.In our institution,TURP specimens should be totally submitted in an extensive sampling method.The tumor area was outlined by estimation of an experienced genitourinary pathologist and calcu-lated by the image analysis system software (Image J 1.47 h).The tumor area was then multiplied by the thickness of tissue.The total sum of all tumor volume was the estimated tumor volume.The clinical and pathological factors,follow-up results were obtained and we aimed to collect information about the period of watchful waiting (WW),PSA progression status,intervention status during the follow-up,the reason for intervention on WW and the type of intervention.Results:The average age of 771 patients was (71.3 ±5.9)years old,and the average BMI was (23.9 ±3.1)kg/m2 ,preoperative average tPSA was (4.4 ±2.8)μg/L.Eighty-six (11.2%)cases of incidental prostate cancer were detected.The patients in T1a group (77 cases,89.5%)had tumor volumes of (12.3 ±12.6)mm3 ,and the patients in T1b group had tumor volumes of (105.1 ±41.8)mm3 .The range of tumor volume was 0.4 -180.2 mm3 . The volume of all the 86 cases was less than 500 mm3 as the threshold of insignificant cancer.All the pa-tients were managed by WW.The mean follow-up time was 88.9 (27.9 -150.1)months.The Gleason score was <7 in 79 patients,and ≥7 in 7 patients.There was no significant difference in age,preopera-tive tPSA,preoperative PSAD,postoperative tPSA,prostate volume and TURP resection between T1a group and T1b group (P >0.05).Among 84 patients without follow-up losts,PSA progression occurred in 5 patients.One T1a patient underwent radical prostatectomy (RP)as an intervention,and 3 patients underwent hormone therapy.One patient in T1b group underwent radiotherapy for PSA progression and one was treated because of patient preference without evidence of disease progression.There were no pa-tients who died due to prostate cancer.Conclusion:Eighty-six (11.2%)cases of incidental prostate cancer were detected.The tumor volume of all the cases was insignificant cancer.The clinical outcomes of IPCa were satisfactory with the initial treatment of WW in the Chinese population.