Objective To find a method to improve the range accuracy of moving target such as peripheral lung tumors, since a single CT snapshot may not be accurate during the treatment process.Methods A simple harmonic motion phantom, embedded with a cube and a circular ball, was used to simulate the tumor motion. Individualized moving targets were scanned 24 times with different amplitudes and frequencies. Then the images were fused from every 1, 2 or 3 sets of CT scans. The GTV volume variation of circular target and the length variation of the cube target along the z axis were contoured and analyzed. Results As motion amplitude increased, the maximum of both circular target volume and cube target length was increased, while the minimum of the factors was decreased. Motion frequency affected the target volume less than amplitude. For a cube target with the length of 3.3 cm at stationary phase, when motion frequencies was 20 and motion amplitude was 2 cm, the maximal length was 2. 4 times of the minimal length (5. 1 cm vs. 2. 1 cm). When it came to the cube target groups fused from every 1,2 and 3 sets of CT scans, the average length and standard deviation were (3.77 ± 1.20) cm, (4.18 ±0. 91)cm and (4.52 ±0. 59) cm, respectively. With the increase of fused scan number, targets became bigger, the standard deviation decreased, and the change of center positions was decreased. Conclusions The motion amplitude, frequency and the number of CT scans are the main factors affecting target definition, though, the optimized scanning phase is not certained. When 4DCT and respiration gating technique are not available,the efficient and practical method to solve this problem is to scan the target three or more times and fuse them in planning system, which will generate a larger, more reproducible GTV volume for moving targets.

Increasing evidence has proved that inflammation plays an extremely important role in tumorigenesis.As the most representative biomarker for inflammation,C-reactive protein (CRP) has been considered to be critically associated with the prognosis of a variety of malignant tumors,like renal cancer.Numerous studies have shown that CRP is a significant prognostic factor for renal cancer patients treated with surgery,cytokine therapy or molecular-targeted therapy,and CRP has been incorporated into some prognostic algorithms for renal cancer.

Owing to their unique mechanism of action, marine antineoplastic compounds have been got more and more attention and the study of marine antineoplastic drugs is becoming a focus now. The development in the study of marine antineoplastic drugs was summarized in this paper.

Objective To investigate the role of deferoxamine pretreatment for hepatic ischemia reperfusion injury in liver auto-transplantation in rats. Method Murine liver auto-transplantation model was established. Ninety six male Sprague-Dawley rats were randomly divided into three groups: 32 rats in deferoxamine pretreatment group (D), 32 rats in control group with aqua pro injection pretreatment(C) and 32 rats in sham-operation group (S). The animals were killed at 30 min, 2 h, 6 h, 24 h after operation respectively. ALT and AST level, superoxide dismutase (SOD) and malondialdehyde (MDA), liver histological change(HE), the protein expression of HIF-1α、TNF-α and IL-1 were measured. Results At 30 min, 2 h, 6 h, 24 h after operation, the levels of ALT,AST,MDA and the expression of IL-1 protein and TNF-α protein were higher in group C than group D significantly,while the expression of HIF-1α and SOD were higher in group D [SOD(411±70; 384±53; 379±46)、H1F-1α(0.0413±0.0040; 0.0684± 0.0032; 0.0583±0.0032; 0.0491±0.0026)] than group C significantly (P<0.01) [SOD(341±21; 323±25; 303±25)、HIF-1α (0.0254±0.0024; 0.0312±0.0022; 0.0381±0.0022; 0.0257± 0.0015)] (F>59.881;P<0.01). Conclusion The up-regulated expression of HIF-1α, decreased liver lipid peroxidation injury and TNF-α and IL-1 levels, may be involved in the mechanism hy which deferoxamine pretreatment protects liver from ischemia reperfusion injury in rats' liver auto-transplantation.

Objective To observe the ultrastructure and absorption function of colon mucosa in rat with ultra-short bowel syndrome. Methods Totally 30 SD rats were randomly divided into three groups: ultra-short bowel group (90%-95% of the intestine was surgically resected, n = 10), sham group (n = 10), and normal control group (n = 10). All animals were given with enteral nutrition. Scanning electron microscopy was performed 21 days later to observe the morphology of mucosal surface, and transmission electron microscopy was performed to observe the ultrastructural changes of intestinal epithelial cells. The absorption of colon to water, carbohydrates, and amino acid determined after 3 hours of closed perfusion of the colon with D-xylose solution and 15N-glycine on the continuous cycle of colon. Results As shown by the transmission electron microscopy, compared with the normal control group, rats in the ultra-short bowel group showed significantly decreased goblet cells on colonic mucosl surface, increased epithelial cells, longer and denser microvillus, increased area of membrane surface, increased number of cell-cell junctions, increased number of desmosome, tight junction, and gap junctions, higher development of endoplasmic reticulum and dictyosome, and increased number of mitochondria. As shown in the screening electron microscopy, compared with the normal rats, rats in the ultra-short bowl group had significantly deeper colon folds, thicker mucous membrane, increased number of bay openings, and longer and denser microvillus-like structures inside bays. The capability of water absorption was signicatnly higher in the ultra-short bowl group than in the sham group and normal control group (P = 0. 000) . The absorption rates of xylose and 15 N-glycine were also significantly higher in the ultra-short bowl group than in the control group (P ＜ 0. 01). Conclusions The absorption capability can be compensatively increased in rats with ultra-short bowel syndrome. Decreased apoptosis of colon mucosa cells, increased absorption cells, hyperplasia of microvilli, increased area of the membrane surface,and increased number of mitochondria may constitute its material and energy bases.

Objective To study the treatment of abdominal compartment syndrome(ACS) secondary to fulminant acute pancreatitis (FAP).Method A retrospective study was conducted from Jan.2009 to Dec.2011 to analyze the therapeutic results of 18 patients with ACS secondary to FAP.Results Three out of 7 patients who received non-operative therapy died (mortality rate 42.9％).Three out of 11 patients treated with early surgery died (mortality rate 27.3％),which was significantly better than those patients treated conservatively.Conclusion A reduction in intra-abdominal pressure improved the function of the viscera in the treatment of ACS secondary to FAP.The decompressive effects of early surgery was efficacious,and it reduced the mortality rate.

Objective To evaluate the procedure and the therapeutic efficacy of duodenumpreserving pancreatic head resection (DPPHR) in treating benign lesions in the head of the pancreas.Methods From February 2003 to August 2011,DPPHR was performed in 21 patients with benign lesions in the head of the pancreas.Thirteen patients were male and eight were female.Age ranged from 30 to 48 years,and the lesions ranged from 2.0 cm to 5.6 cm in diameter.Posterior superior pancreaticoduodenal artery was conserved in all patients.Results There was no hospital death.Pancreatic fistula was the main and the most often morbidity,occurring in 33.3％.After operation all patients with preoperative abdominal pain were completely pain free.Preoperative hypoglycemia in 2 patients turned to eugycemia.There was no recurrences report during following up.Concl~ions DPPHR was safe and effective in treating benign lesion in the head of pancreas.It was important in preserving blood supply to the duodenum by posterior superior pancreaticoduodenal artery.

Objective To discuss the diagnosis and surgical treatment of solid pseudopapillary tumor (SPTP) of the pancreatic head.Methods From January 2008 to August 2013,the clinicopathological data of 12 patients who were diagnosed and surgically treated in our hospital for this condition were analyzed retrospectively.Results There were 11 women and 1 man,the mean age was 28.7 years,with a range from 11 to 43.The mean diameter of the tumor was 7.5 cm(2 ～ 15 cm),6 of 12 of these tumors were more than 10 cm.Seven patients underwent pancreaticoduodenectomy,2 duodenum-preserving pancreatic head resection,2 local resection of tumor,1 palliative resection,1 pancreaticoduodenectomy combined with resection of part of the portal vein.All the diagnoses were confirmed by postoperative histopathology.In a follow-up which ranged from 3 to 65 months,all the patients were alive with no evidence of disease recurrence.Conclusions Most of the SPTPs of the pancreatic head were huge.The diagnosis was difficult.Complete tumor resection is the best treatment.

Objective To explore the outcome of laparoscopic visual reality training in participants with different clinical experiences. Methods Clinical training doctors,advanced study doctors,intern doctors practiced peg transfer,cutting and making saturation and instrumental tie by using laparoscopic visual reality training,then made statistical analysis. The participants were trained for 2 weeks,90 min per day. The scores before and after the training in the 3 groups were recorded and compared. Results Before the training,the level of intern doctors on peg transfer、cutting and making saturation and instrumental tie was lower than the level of clinical training doctors and advanced study doctors(P0.05). The level of three different operators after training was obviously higher than that of themselves before training(P

BACKGROUND: How to determine the proximal section of electricity-injury nerve which is available for nerve grafting, is key point to the functional recovery. The method used before is to observe if there is normal axonal structure under operating microscope. But the clinical result proves unsatisfactory.OBJECTIVE: To evaluate the appliance value of somatosensory evoked potential (SEP) technique in the detection of nerve injury after electrical injury.DESIGN: Retrospective analysis based on the cases.SETTING: Department of Plastic Surgery, Ninth People's Hospital Affiliated to Shanghai Jiaotong University PARTICIPANTS: Totally 12 patients with severe electrical injury who received treatment in the Department of Plastic Surgery, Shanghai Ninth People's Hospital were included in this study. Among them, there were 9male and 3 female, aged from 6 to 54 years.METHODS: SEP of injured nerve was measured progressively and pathological section observation was given correspondingly. The function recovery of patients receiving nerve transplantation by using SEP was evaluated and compared with that before treatment through a follow-up.MAIN OUTCOME MEASURES: Amplitude, latency and corresponding pathological section of SEP of injured nerve as well as the functional recovery of the SEP plane of the cases with patients receiving nerve transplantation by using SEP to choose transplanted plane.plitude and latency of SEP was positively correlative with the quality of were repaired with SEP technique to select the anastomosis site for nerve transplantation and 8 cases were followed up after operation. The average follow-up time was 22.7 months ranging from 17 to 26 months. And 2-point resolution sense reaches grade Ⅱ or Ⅲ in 5 cases. (America hand surgery association criterion: 2-point resolution distance ＜ 6 mm was grade Ⅰ ,6-10 mm was grade Ⅱ ,11-15 mm was grade Ⅲ ,＞ 15 mm was grade Ⅳ).CONCLUSION: Electricity-injured nerve owns complicated pathology.SEP technique is a valuable method for function evaluating or selecting of the anastomsis site for nerve grafting in those cases.