Objective To explore the value of diffusion-weighted imaging (DWI) on evaluation and prediction of therapeutic outcome in concurrent chemoradiotherapy for cervical squamous carcinoma.Methods 26 cases of cervical squamous carcinoma were examined by MRI before and one month after concurrent chemoradiotherapy.The patients were divided according to tumor response evaluated by Response Evaluation Criteria in Solid Tumors (RECIST).Apparent diffusion coefficient (ADC) values and the receiver operating characteristic (ROC) curve analysis were carried out before and one month after treatment.Results 26 cases had higher mean ADC one month after the concurrent chemoradiotherapy than that before treatment[(1.542±0.189) × 10-3 mm2/s vs (0.898±0.096) × 10-3 mm2/s,P ＜ 0.05].After the treatment,there were 17cases of complete remission (CR) and 9 cases of partial remission (PR).ADC value in PR group was higher than that in CR group [(0.960±0.115) × 10-3 mm2/s vs (0.864±0.067) × 10-3 mm2/s,P ＜ 0.05].ROC curve showed that with 0.927 × 10-3 mm2/s of ADC as threshold to determine the tumor remission,the sensitivity and specificity were 66.7 ％ and 76.5 ％,respectively,and the area under the ROC curve was 0.752 (P ＜ 0.05).At one month after treatment,the tumor volume was decreased in different degrees in CR group and PR group,and the differences of ADC had statistical significance between the two groups [(1.603±0.183) × 10-3 mm2/s vs(1.427±0.146) × 10-3 mm2/s,P＜ 0.05].ROC curve showed that with 1.444 × 10-3 mm2/s of ADC as a threshold for diagnosing tumor residual,the sensitivity and specificity were 76.5 ％ and 55.6 ％ respectively,and the area under the ROC curve was 0.765 (P ＜ 0.05).Conclusions DWI as a useful supplement,can help to precisely evaluate the tumor response after the concurrent chemoradiotherapy and monitor the effects of the treatment.Besides,the ADC before chemoradiotherapy has the predictive value on short-term prognosis in cervical squamous cell carcinoma.

Objective To evaluate the role of MR imaging (MRI) and MR cholangiography (MRC) for the diagnosis of hepatic hilar cholangiocarcinoma (HHC) and assessment of tumor resectability. [WT5”HZ]Methods [WT5”BZ] MRI and MRC were performed in 280 patients with obstructive jaundice from Mar.1997 to May.1999. The diagnosis of HHC was proved in 38 cases (13 6%, 38/280) by laparotomy and pathology. Imaging features and classification as related to surgical therapy of the tumor were analyzed. [WT5”HZ]Results [WT5”BZ] Tumor was identified in 24 out of 38 HHC cases. The contrast enhancement scanning further found tumors in 8 out of 14 HHC cases,with a total rate of tumor finding of 84% (32/38). MRI also suggested hepatic metastasis in 4 cases, portal vein invasion in 7 cases. MRC found hilar obstruction and dilatation of the intrahepatic biliary tree in all HHC cases. The surgical resection rate was 24%(9/38) including 4 cases of typeⅠ,3 cases of typeⅡ,1 of type Ⅲa and 1 of typeⅢb. Resection was impossible or not worthwhile in cases with hepatic metastasis, invasion of portal vein and/or hepatic artery. Conclusion [WT5”BZ]MRI and MRC plays an important role in the diagnosis of hepatic hilar cholangiocarcinoma and assessment of tumor resectability.

Objective To research and analyze about the quality of life of patients after liver or kid-ney transplantation and return to work aiming at understanding the influence of return to work on their quality of life. Methods The general condition questionnaire and the generic quality of life inventory- 74 (GQOLI-74) were used to survey the quality of life of 30 patients who returned to work after liver or kidney transplantation (the experimental group), the results were compared with 30 cases of the same kinds who did not return to work (the control group). The influence of return to work after liver or kidney transplanta-tion on quality of life was analyzed. Results The total score of quality of life,the score of every dimension and factor were higher in the experimental group than those in the control group. Conclusions Return to work contributes to improvement of quality of life for patients after liver or kidney transplantation.

Objective To evaluate the effects of inhalation sevoflurane in the early ischemia and reperfusion on pulmonary inflammatory response in patients undergoing cardiac surgery with extracorporeal circulation (ECC). Methods Forty patients with rheumatic heart disease scheduled for elective valve replacement were randomly assigned into 2 groups (20 patients in each group): control group and sevoflurane group. In sevoflurane group, 2% sevoflurane was inhaled for 15 min before and after the ascending aorta was blocked, and also before and after the ascending aorta was opened. Paitents in control group didn′t inhale sevoflurane. Time was defined as the followings: after anesthesia and before skin incision (T0), immediately before ECC (T1), immediately after ECC (T2), 2 h after ECC (T3), 6 h after ECC (T4) and 24 h after ECC (T5). At T0, T2, T3, T5, the radial artery blood was obtained to detect the levels of plasma tumor necrosis factor-α(TNF-α), interleukin-8(IL-8) and soluble intercellular adhesion molecule-1(sICAM-1). At T1, T2, the pulmonary artery and pulmonary vein blood was obtained to detect the neutrophil count and calculate the differences between the vein and artery. At T0, T2, T3, T4, T5, the arterial blood gas was detected and differences of alveoli-arterial oxygen pres [P(A- a)O2], oxygenation index (OI), static compliance (Cst) were calculated. Results The levels of plasma TNF-α, IL-8 and sICAM-1 were higher at T2, T3, T5 than those at T0 in two groups (P<0.05). The levels of plasma TNF-α, IL-8 and sICAM-1 were decreased in sevoflurane group at T2 and T3, compared with those in control group (P<0.05). The neutrophil counts of pulmonary artery, pulmonary vein and the differences between the vein and artery were higher at T2 than those at T0 in two groups (P<0.05). The neutrophil counts of pulmonary artery, pulmonary vein and the differences between the vein and artery were decreased in sevoflurane group at T2 compared with those of control group (P<0.05). The level of P(A- a)O2 was higher at T2, T3, T4 and T5 than that at T0 in two groups (P<0.05). The level of OI was decreased at T2, T3, T4 and T5 compared with that at T0 in two groups (P<0.05). The level of Cst was decreased at T2, T3 and T4 compared with that at T0 in two groups (P<0.05). The level of P(A-a)O2 was decreased in sevoflurane group at T2, T3 and T4 compared with that in control group (P<0.05). The levels of OI and Cst were higher in sevoflurane group at T2, T3 and T4 compared with those in control group (P<0.05). Conclusions Severe pulmonary inflammation often occurs during cardiac surgery with ECC, and it can be relieved by inhalation of sevoflurane in the early ischemia and reperfusion.

Objective To investigate the neuropathic pain (NP) accompanying spinal cord injury (SCI),and to analyze the related factors to provide references for its prevention and treatment.Methods Seventy SCI patients with NP were selected using the DN4 scale.Their age,gender,occupation,education level,monthly income,injury position,marital status and other data were surveyed using a general questionnaire.Their NP situation was surveyed using a simplified McGill pain questionnaire (SF-MPQ).Results The patients' average visual analogous scale (VAS) score was 4.37.Their average pain rating index (PRI) according to the SF-MPQ was 8.23,with the PRI-sensory and PRI-emotional components 5.23 and 3.00 respectively.The average degree of present pain intensity was 1.86,between mild pain and discomfort,and discomfort was the description most commonly used.The most common pain descriptor was prickling pain,followed by burning pain and bulge pain.85.7％ of the patients felt that their pain had an adverse effect on their affective state,and exhaustion occurred more often than any other descriptive words.Univariant analysis showed that the degree of injury,education level,marital status,monthly income,family support and medication history were all factors correlated with NP perceptions.Multi-variate logistic regression analysis showed that being unmarried and severity of injury were independent protective factors against NP.No family support,no medication and low income were independent risk factors for NP.Conclusion The type of neuropathic pain varies in patients with spinal cord injury.The intensity of the pain is mostly at a medium level.The emotional state of most patients was affected.Neuropathic pain involves many factors.Being unmarried and severely injured are independent protective factors,while lack of family support,no medication,and having low income were independent risk factors.

Objective:To get a rapid and stable method of induction of rapid cultivation and maturation of Dendritic Cells(DC) from human peripheral blood in vitro.Methods:Cultured plastic-adherent monocytes were isolated from tumor patient peripheral blood mononuclear cells and GM-CSF(1 000 u/ml),IL-4(500 u/ml) were added in the cells at 0 h,which were separated into four groups.Poly(I ∶ C)(Polyriboinosinic Polyribocytidylic Acid) were added in the first group cells at 24 h and the DC cells were collected at 48 h;TNF-? in the second group cells were added at 24 h and the cells were collected at 48 h;Poly(I ∶ C) were added in the third group cells at 36 h and the cells were collected at 72 h;TNF-? were added in the last group cells at 36 and the cells were collected at 72 h.Results:The results of flow cytometer showed that the third group got the most mature DC.The dendritic cells from the third group have significant stimulatory activity in allogeneic lymphocyte proliferation.Conclusion:The method of rapid cultivating and maturating of Dendritic Cells from human peripheral blood in vitro induced by Poly(I ∶ C) is rapid,stable,economical and simple.It may facilitate future studies of DC and its clinical application.

Objective:The aim of this study was to investigate the association of mRNA expressions of ERCC1 (excision repair cross-complementing group 1) and BRCA1 (breast cancer 1) with chemosensitivity to cisplatin in malignant pleural and peritoneal effusions.Methods:Malignant pleural and peritoneal effusions were collected from 46 patients diagnosed with stage Ⅳ malignant tumor, prospectively. The tumor cells were isolated and the sensitivity of tumor cells to cisplatin was detected by adenosine triphosphate-bioluminescence assay (ATP-TCA). Real-time quantitative PCR was used to determine the mRNA expressions of ERCC1 and BRCA1. Results:The expression level of ERCC1 mRNA was negatively correlated with sensitivity of non-small cell lung cancer (NSCLC) to cisplatin (P= 0.001, r=0.685). BRCA1 mRNA expression level had negative correlation with sensitivity to cisplatin in both NSCLC (P=0.014, r=0.541) and gastric cancer (P=0.002, r=0.625). A significant interaction was found between the effects of ERCC1 and BRCA1 mRNA expressions on sensitivity to cisplatin (P=0.010 for all patients;P=0.027 for gastric cancer patients).Conclusion:ERCC1 and BRCA1 mRNA expression levels correlated with ex vivo chemosensitivity of tumor cells to cisplatin in malignant pleural and peritoneal effusions. Detection of both ERCC1 and BRCA1 may have a higher reliability in predicting the sensitivity of tumor cells to cisplatin than detection of single ERCC1 or BRCA1 expression.

Objective To evaluate the significance of COLD-PCR in detecting KRAS mutation of pancreatic cancer and colorectal cancer patients. Methods First, set up COLD-PCR and compared the sensitivities of COLD-PCR/Sanger sequencing with PCR/Sanger sequencing using mixed cell lines ( KRAS wild-type cell line SW116 and KRAS mutant cell line SW480).Then, detected KRAS mutation of 20 formalin-fixed paraffin-embedded samples of pancreatic cancer and 39 formalin-fixed paraffin-embedded samples of colorectal cancer using PCR/Sanger sequencing and COLD-PCR/Sanger sequencing, respectively and compared the coincidence rate and consistency. Results The low detection limits of PCR/Sanger respectively. KRAS frequency detected by COLD-PCR/Sanger sequencing [75% (15/20)] in 20 cases of pancreatic cancer was higher than that detected by regular PCR/Sanger sequencing [40% ( 8/20 ) ,x2 =5.013, P < 0.05]. KRAS frequency detected by COLD-PCR/Sanger sequencing [44% (17/39)] in 39 cases of colorectal cancer was higher than that detected by regular PCR/Sanger sequencing [31% (12/39) ,x2 =1. 372, P = 0. 174]. The coincidence rate of these two methods was 0. 730 and the difference had no statistical significance. The coincidence rate of detecting KRAS mutation was 65% in pancreatic cancer and the results showed a good correlation between two methods and the two methods had bad agreement in diagnosis (Kappa = 0. 364, P < 0. 05 ). COLD-PCR/Sanger sequencing could detect more cases of KRAS mutations from pancreatic caner than regular PCR/Sanger sequencing. This was because there were many non-tumor cells in pancreatic tumor tissue and COLD-PCR/Sanger sequencing was more sensitive than regular PCR/Sanger sequencing. The coincidence rate of detecting KRAS mutations was 87% in colorectal cancer and the results were showed a good correlation between two methods and the two methods had substantical agreement in diagonsis ( Kappa = 0. 730, P < 0. 05 ) . Conclusion COLD-PCR/Sanger sequencing is highly sensitive to screen KRAS mutation in pancreatic cancer and colorectal cancer patients.

Background and purpose: It has been reported that some low dose chemotherapy drugs have antiangiogenetic effects. The purpose of this study was to investigate the effect of inhibiting angiogenesis by low dose hydroxycamptothecin on H22 hepatoma transplantation tumor mouse models. Methods: H22 transplantation tumor mouse models were established, CTX was administrated in abdominal cavities as positive control group. 0.9%NaC1 solution was administrated as negative control group. Intra abdominal cyclophosphamide and hydroxycamptothecin (0.2 and 0.4 mg/kg) were injected for 10 days continuously. The growth of tumor were observed and measured. The tumor inhibitory rates were tested in animal tumor model with experimental treatment. The expression of VEGF and CD34 were measured by means of immunohistochemistry. Results: Hydroxycamptothecin had effect on tumor growth. Tumor weight inhibitory rates of hydroxycamptothecin with 0.2 and 0.4 mg/kg were 23.53% and 43.25% respectively. The difference was significant when compared with the negative control group (P<0.05). The expression of VEGF and MVD can be suppressed significantly than negative control group in vivo (P<0.05). Conclusion:Hydroxycamptothecin have inhibitory effect on tumor growth and the expression of VEGF and MVD with H22 hepatoma transplantation tumor mouse models in low dose. The mechanism possibly involved inhibiting the angiogenesis.

Objective To explore the relationship of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with gastrointestinal bleeding in adult patients with Henoch-Sch(o)nlein purpura (HSP).Methods Laboratory data including routine blood test results,C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) were collected from 115 adult patients with HSP and 100 healthy controls,and retrospectively analyzed.NLR and PLR were calculated and compared.Logistic regression analysis was used to determine variables associated with gastrointestinal bleeding in adult patients with HSP,and the receiver operating characteristic (ROC) curve was drawn to estimate the predictive efficacy of these variables.Results NLR and PLR were both significantly higher in adult patients with HSP than in healthy controls (both P ＜ 0.05),and NLR,PLR and CRP levels were all significantly higher in adult HSP patients with gastrointestinal bleeding than in those without (all P ＜ 0.05).Logistic regression analysis showed that NLR was an independent risk factor for gastrointestinal bleeding in adult HSP patients (P ＜ 0.05).The ROC curve revealed that the optimal cut-off point of NLR for predicting gastrointestinal bleeding was 3.24 in adult patients with HSP,with the sensitivity and specificity being 85.1％ and 71.3％ respectively.Conclusions Both NLR and PLR evidently increase in adult patients with HSP,especially in those with gastrointestinal bleeding.NLR is a potential predictor for gastrointestinal bleeding in adult patients with HSP.