Objective To determine the value of dynamic contrast enhanced (DCE?MRI) in predicting treatment response before preoperative chemoradiotherapy in locally advanced rectal cancer. Methods A cohort of consecutive patients with histologically confirmed rectal adenocarcinoma treated with preoperative chemoradiotherapy followed by total mesorectal excision (TME) surgery was enrolled in a prospective, pilot trial. All enrolled patients were examined using DCE?MRI at two time points: 2 to 5 days before neoadjuvant chemoradiation, 1 to 4 days before surgery. The following perfusion parameters (Ktrans, Kep, Ve) were measured for tumor. The patients were classified into pathological complete response (pCR) and non?pCR group according to the pathological results after operation. Those perfusion parameters were compared between the pCR and the non?pCR group and between before and after CRT in pCR and the non?pCR group with the t test. Receiver?operating curves (ROC) were constructed to further investigate the predictive value of Ktrans, Kep, Ve before neoadjuvant chemoradiation and were used to determine a threshold value at which patents with pCR could be distinguished from patients without complete response. Results The final study population consisted of 38 patients. There were 12 patients with a pCR and 26 patients with non?pCR. Before neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (1.25 ± 0.56)/min, (2.10 ± 1.61)/min and 0.73 ± 0.34, respectively, for non?pCR group they were (0.46 ± 0.39)/min, (1.15 ± 0.77)/min and 0.32±0.12, respectively. All perfusion parameters showed significant difference between those two groups(t values were 3.45,5.67 and 6.23 respectively, all P<0.05). After neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (0.28 ± 0.13)/min, (0.62 ± 0.27)/min and 0.21 ± 0.13 respectively, for non?pCR group, they were (0.32±0.12)/min, (0.83±0.42)/min and 0.17±0.10, respectively. All perfusion parameters showed no difference between those two groups(P>0.05), as well as the changes before and after neoadjuvant chemoradiation in those groups(P>0.05). ROC analysis for Ktrans pre?treatment revealed that Ktrans had an AUC of 0.837 in predicting pCR. A Ktrans of 0.66/min was emerged as the optimal cut?off for distinguishing pCR from non?pCR and for Ktrans>0.66/min, the sensitivity and specificity for predicting pCR were 75.0% (9/12) and 96.2% (25/26). Kep and Ve showed an AUC of 0.655 and 0.654 in predicting pCR. Conclusions In locally advanced rectal cancer, DCE?MRI can aid in predicting treatment response before preoperative chemoradiotherapy. Ktrans may become a better predictor to classify which patients will benefit from neoadjuvant chemoradiation.

Objective To explore the efficacy of high-resolution MRI in the prediction of tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.Methods The clinical data of 108 patients with T3 rectal cancer who were admitted to Shanghai Cancer Center of Fudan University from 2010 to 2012 were retrospectively analyzed.The TNM stage of tumor,extramural depth of tumor invasion (mrT3 stage),involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor were the main items of evaluation using the high-resolution MRI.A total of 108 patients underwent surgical resection of tumor after neoadjuvant chemoradiation therapy.The tumor complete response after neoadjuvant chemoradiation therapy was evaluated by tumor node metastasis (TNM) stage and tumor regression grade (TRG).The categorical data and multivariate analysis were done by the single factor analysis of variance (ANOVA) and Logistic regression analysis.Results The positive response rate of the T3a,T3b and T3c in the patients were 61.5％ (16/26),36.9％ (24/65) and 11.8％ (2/17) after neoadjuvant chemoradiation therapy,respectively.The mrT3,mrN and tumor diameter were the potential factors affecting response of neoadjuvant chemoradiation therapy by the univariate analysis of pathological restaging (x2 =50.474,30.985,8.318,P ＜ 0.05).The mrT3 was an independent risk factor affecting response of neoadjuvant chemoradiation therapy by the multivariate analysis of pathological restaging (OR =4.473,95 ％ confidence interval:2.003-9.991,P ＜ 0.05).There was no significant difference between the mrT3 stage,N stage,involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor before therapy and the response after neoadjuvant chemoradiation therapy based on the tumor regression grade(TRG) (x2 =6.264,6.159,2.949,2.189,6.335,P ＞ 0.05).Conclusion The mrT3 in patients undergoing high-resolution MRI before neoadjuvant chemoradiation therapy could predict the tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.

OBJECTIVEThe changes of pain threshold and expression of 5-hydroxytryptamine(5-HT) and c-Fos in spinal dorsal horn of rats were observed after targetedly damaged the cerebraspinal fluid-contacting nucleus (CSF-contacting nucleus) to provide experimental evidence for the mechanism of regulating pain CSF-contacting nucleus involved in.

METHODSMale adult SD rats were divided into control, sham, choleratoxin subunit B conjugated with horse-radish peroxidase (CB-HRP)and damage groups randomly. The pain threshold using mechanical withdrawal threshold (MWT) and thermal withdrawal latency (TWL) were recorded and analyzed. Immunofluorescence method was used to observe the expression of 5-HT and c-Fos in spinal dorsal horn.

RESULTSCompared with the control, sham and CB-HRP groups, the MWT and TWL of the damage group were significantly increased (P < 0.05). The results of immunofluorescence showed that 5-HT was detected in neurons of CSF-contacting nucleus. In the damage group, the number of neurons of CSF-contacting nucleus reduced gradually, and no survived neurons were observed at the 10th day. Meanwhile, both the expression of 5-HT and c-Fos in spinal dorsal horn increased gradually, and negatively correlated with the change of pain threshold.

CONCLUSIONThe method of targeted damaging CSF-contacting nucleus by cholera toxin subnit B conjugated with saporin(CB-SAP) is scientific and reliable, and it results in the changes of pain threshold and expression of 5-HT and c-Fos in spinal dorsal horn of rats. This study suggests that CSF-contacting nucleus participate in the regulation of pain, moreover, 5-HT and c-Fos play important roles in this regulation.

Animals ; Cerebrospinal Fluid ; Male ; Pain ; metabolism ; surgery ; Proto-Oncogene Proteins c-fos ; metabolism ; Rats ; Rats, Sprague-Dawley ; Serotonin ; metabolism ; Spinal Cord Dorsal Horn ; metabolism

Transcatheter electrical ablation was performed in 5 patients, none of them showed clinical effectiveness for treatment of antiarrhythmic drugs, with recurrent sustained ventricular tachycardia (VT). The localization of ventricular ectopic focus mainly depended upon the results of pace mapping. Energy used for each transcatheter electrical ablation (TEA) was usually 150-250J and the total energy was 550J to 800J respectively for each patient. No recurrence of VT was ob-served in 4 cases during 19 to 41 (mean 26. 8) months of follow-up period, two of them without adminstration of drug. Sustained VT relapsed during the 4th months after ablation in one case, however, heart rate during VT was much slower than before. Our experience suggests that long-term effectiveness of TEA for treatment of drug-resist VT is inspiring.

The resistin-like molecules(RELMs)are a novel protein family with tissue-specific distribution.Recent evidences suggest their important roles in type II diabetes mellitus,inflammation,immunological reactions and cell proliferation,which provoked many interests for the researchers.This overview summarizes the structure,tissue distribution,biological functions,regulatory pathways,and their relationship with diseases of these family members.

Hypertensive disorder complicating pregnancy is a special disease during pregnancy,and it is the key reason for rising death rate of maternal and perinatal infants.Its etiology and pathogenesis are not yet fully elucidated.It is generally accepted that placenta damage plays a central role in hypertensive disorders complicating pregnancy.In recent years,studies have shown that hypoxia inducing factor-1 (HIF-1),vascular endothelial growth factor (VEGF)and its receptor family are important regulatory factors associated with hypertensive disorders complicating pregnancy.In this article,we discussed the relationship between the two factors and hypertensive disorders complicating pregnancy.

Object To study the degree of deacetylation of chitosan and its residual amount left over in the clarified products when chitosan was used as a clarificant. Methods The free amino group in the deacetylated chitosan was determined by linear titration. Results The degree of deacetylation of chitosan was found to be about 80%. The residual amounts left over in the clarified products were lower than 10 -4 . Conclusion The results suggested that it is feasible to use chitosan as a clarificant for refining water extract of TCM.

[Objective] To evaluate the cellular biocompatibility of the nano poly(L-lactic acid)-block-poly(?-caprolactone)(Nano-PLLA-b-PCL)with canine articular cells and its feasibility as a scaffold for the cartilage tissue engineering.[Methods]Nano-PLLA-b-PCL was made by liquid-liquid phase separation.Canine articular cells were isolated and multiplied in vitro.The passage 3 cells were seeded onto the PLLA-b-PCL films and cultured in the 2-dimensional environment.The cytotoxicity was measured with MTT assay.Cellular Morphological changes were observed by phase-contrast microscopy and Hoechst33342 fluorometric method.Another passage 3 cells were seeded onto the Nano-PLLA-b-PCL scaffolds(experiment group),PLLA-b-PCL scaffolds(control group)and cultured in the 3-dimensional environment for 3 weeks.The ratio of cell adhesion was detected by cell counting method.The morphological changes of cells were observed by scanning electron microscopy.The protein content in seeded cells were determined by bioinchoninic acid assay(BCA).The content of DNA was quantified using Hoechst33258 assay.[Results]MTT assay showed the PLLA-b-PCL had no cytotoxicity.The seeded cells adhered and proliferated well into the Nano-PLLA-b-PCL scaffolds,and they maintained good cell phenotype.After 21-day cell culture within the Nano-PLLA-b-PCL scaffolds,the chondrocyte DNA and protein contents increased with time.Moreover,the content of DNA and protein was higher in the experiment group than that in the control group,respectively(P

Objective To serially observe carotid arteriosclerosis in rabbit model before and after CEA using high-resolution MRI. Methods Using New Zealand rabbits, lesions were created by air-drying an isolated segment of common carotid artery (120ml/min for 15min) and feeding the rabbits with a diet of 2% cholesterol, 6% peanut oil mixed with normal diet for 2 months. High-resolution MRI examinations were performed for 1 normal rabbit, 4 rabbits with replicated arteriosclerosis before CEA, and 2 rabbits with arteriosclerosis 10 days after CEA, and the results were compared with pathological findings. Results High-resolution MRI revealed the contour and shape of the type II to type IV lesions of rabbit carotid arteriosclerosis model. The MRI images of the lesions corresponded well with the pathological findings. The fibrous plaques were showed as low signals on TOF film, gray images on T 1, T 2, and PDW film, and were obviously enhanced by Gd-DTPA. The MRI images obtained 10 days after CEA also corresponded well with the neo-intima. Conclusion High-resolution MRI can be used as an effective non-invasive method to serially observe the arteriosclerosis lesion of rabbit carotid artery before and after CEA.

[Objective]To study the effects of Cable-Pin system used as a treatment alternative for patellar fractures.[Method]Thirty-five cases of patellar fracture were operated with the Cable-Pin system from October 2005 to May 2007.Their diagnosis were 19 transverse close ractures and 16 comminuted of patella.There were 21 males and 14 females.Their ages ranged from 21 to 75 years old.After open reduction,the author used a drill bit vertically through the patella in a superior direction,drilled the threaded portion of the pin across the fracture site,inserted a second Cable Pin through the second hole in a similar manner.A horizontally directed drill hole anterior to the pins was created in the superior pole of the patella.The two cables were crossed in a fighre eight over the an-terior surface of the patella.The Crimper Tensioning Handle was,the cable carefully,the handles of the crimper were squeezed until the crimp was fully crimped.[Result]The 35 patients were followed up for 12 to 18 months(mean 13.2 m).Fractures healed in all the cases without such complications as loosening of screw and cable loop,loss of reduction or irritation to soft tissue.Restoration of the knee joint motion was excellent in 32 cases and good in 3 cases according to Bostman score system.[Conclusion]Cable-Pin system as a new option for the treatment of patella fracture,can result in reliable fixation and low rate of complications.