After receiving radical resection of primary rectal cancer,about 4％ to 30％ patients would occur local recurrence.Diagnosis of local recurrence relies on postoperative follow-up,physical examination,tumor markers and imageological examination.For the local recurrent patients,conservative therapeutic regimen had been popular in the past days with poor prognosis and quality of life.Nowadays multimodality treatment with radical resurgery combined with chemoradiotherapy and IORT has been taking the main part in the management of local recurrence.The choice of surgery depends on the site of recurrence and invasion situation inside the pelvic cavity.The aim of the radical reoperation is R0 resection because it leads to an optimistic prognosis.Previously irradiated patients are relatively safe after receiving median-dose reirradiation.For the cases whose recurrence are unavailable for radical resection,palliative operation and chemoradiotherapy may be the wise choice to relieve their symptoms and improve the quality of life.

Objective: To observe the effect of extracorporeal shock wave therapy (ESWT) on proliferation, cell cycle and intercellular adhesion molecule-1 (ICAM-1) expression in human umbilical vein endothelial cells (HUVECs). Methods: HUVECs were culturedin vitro at the concentration of (1×105/ml) and the cells were divided into 2 sets of groups:CSWT group, the cells were treated by different energy of (0.03, 0.09, 0.18, 0.24) mJ/mm2 respectively and corresponding Control group, in which the cells had no CSWT. HUVEC proliferation was detected by CCK colorimetric method, cell cycle was measured by lfow cytometry, mRNA and protein expressions of ICAM-1 were examined by RT-PCR and Western blot analysis respectively. Results: Compared with Control group, (0.09 mJ/mm2) CSWT group had promoted HUVECs proliferation,P<0.05 and the other CSWT groups were similar to corresponding Control groups,P>0.05; (0.09 mJ/mm2) CSWT group showed decreased proportion of G0/G1 stage and increased S and G2/M stages, allP<0.05; while (0.03 mJ/mm2) CSWT group only increased the proportion of G2/M stage,P<0.05 and the other CSWT groups were similar to corresponding Control group,P>0.05. Compared with Control group, (0.09 mJ/mm2 ) and (0.03mJ/mm2) CSWT groups showed increased mRNA expression of ICAM-1 (9.27±0.95) vs (1.02±0.27),P<0.001 and (7.08±0.60) vs (1.02±0.27),P<0.01; (0.09 mJ /mm2) CSWT group had elevated protein expression of ICAM-1,P<0.05. Conclusion: ESWT especially at (0.09 mJ/mm2) may accelerate cell cycle transition from G0/G1 stage to S and G2/M stages, promote HUVECs proliferation and increase ICAM-1 expression which may play important roles in ESWT facilitated angiogenesis in vitro.

BACKGROUND:There is few mesenchymal stem cells(MSCs) in the bone marrow,about one BMSC in 1?104-1?105 monocytes.Following in vitro isolation,purification and amplification,it is satisfactory for in vivo requirement.OBJECTIVE:To observe biological characteristics and potentiality of multi-directional differentiation of BMSCs in vitro.DESIGN,TIME AND SETTING:The cytological in vitro study was performed at the Institute of Urinary Surgery,Union Hospital Affiliated to Fujian Medical University from October 2007 to December 2008.MATERIALS:A total of 30 clean male Sprague Dawley rats of inbreeding line were supplied by Silaike,Shanghai,China.METHODS:BMSCs from rats were isolated and cultured in vitro by using the whole bone marrow adherence method.When 80%-90% confluency,BMSCs were digested by trypsin.At the third passage,BMSCs were induced to differentiate into osteoblasts and adipocytes.MAIN OUTCOME MEASURES:Cell morphology was observed under the inverted phase contrast microscope.BMSCs surface markers were detected using flow cytometry.Osteogenic ability was examined by alizarin red staining.Adipogenic ability was measured by Oil red O staining.RESULTS:The primary cells and the passage cells were mostly fusiform in shape,to be similar to fibroblasts.Cell still kept a high potential of growth and amplification following over 10 subcultures.At the third passage,BMSCs were positive for CD44,CD90,CD106,but negative for CD34,CD45,CD11b.Following 21 days of osteogenic induction,cell alizarin red staining showed that alizarin red was positive in osteoblasts.Following 2 weeks of adipogenic induction,oil red O staining showed that red lipid droplet existed in adipocytes.CONCLUSION:Whole bone marrow adherence method can isolate,purify and amplify BMSCs in vitro.The obtained cells have general biological characteristics of MSCs,and also have potentiality of multi-directional differentiation.

BACKGROUND:Studies have shown that extracorporeal shock wave therapy is an effective, safe, and non-invasive treatment for ischemic heart disease, which can improve angiogenesis in the ischemic myocardium. OBJECTIVE:To summarize the research advances in promotion of angiogenesis for ischemic myocardium by extracorporeal shock wave therapy. METHODS:A computer-based online search of PubMed database and CNKI database was performed for relevant articles published between 1998 and 2014 with key words of “shock wave, ischemic heart disease, angiogenesis, cytokine, stem cel” in English and Chinese, respectively. Articles related to the promotion of angiogenesis for ischemic cardiovascular disease by extracorporeal shock wave were selected. Repetitive articles were excluded. According to inclusion criteria, 51 literatures were selected in result analysis. RESULTS AND CONCLUSION: Extracorporeal shock wave therapy can improve angiogenesis in the ischemic myocardium by mobilizing proliferation and differentiation of stem cels into vascular endothelial cels, and by enhancing the expression of growth factors such as vascular endothelial growth factor and basic fibroblast growth factor. Moreover, the extracorporeal shock wave therapy can create a local favorable microenvironment for angiogenesis by inhibiting inflammation, oxidative stress and apoptosis and by regulating components of the extracelular matrix. Extracorporeal shock wave therapy plays an important role in the angiogenesis of ischemic myocardium and displays a good clinical prospect in the treatment of ischemic heart disease. However, the specific mechanism requires further studies.

Objective The extracorporeal cardiac shock wave therapy ( CSWT ) can promote angiogenesis in ischemic myo-cardium and improve myocardial perfusion , but its mechanisms remain to be clarified .This study aimed to explore the effects of CSWT on the endothelial progenitor cells (EPCs), vascular endothe-lial growth factor ( VEGF) and Interleukin-8 ( IL-8) as well as its re-lieving effect on angina pectoris in patients with coronary heart dis-ease. Methods After Dobutamine stress echocardiography ( DSE) and 99 mTc-MIBI myocardial perfusion imaging (MPI) at rest and un-der stress, 25 patients with coronary heart disease underwent 9 three-month cycles of CSWT .Before and after the treatment , we obtained the results of 6-min walk test, NYHA cardiac function grades , CCS angina pectoris classes, Seattle Angina Questionnaire (SAQ) scores, doses of nitroglycerin administered , left ventricular diastolic di-ameter ( LVDD) , and left ventricular ejection fraction ( LVEF) .We evaluated myocardial perfusion and myocardial contractile function using MPI and the peak systolic strain rate (PSSR) at rest and under stress, respectively. Results After CSWT, the numbers of EPCs and EPC-CFUs cultured in vitro were significantly increased as compared with the baseline (34.52±6.58 vs 19.56±4.28, P<0.01;12.44±2.66 vs 5.04±1.90, P<0.01), and so was that of the circulating EPCs in the peripheral blood ([904.73±94.77] vs [815.68±101.08] /mL, P<0.05), the levels of VEGF and IL-8 (155.29±23.6 vs 122.26±18.85, P<0.01;149.37±46.51 vs 21.86± 5.96, P<0.01), the distance of 6-min walk (P<0.01), NYHA cardiac function grades (P<0.01), CCS angina pectoris classes (P<0.01), SAQ scores (P<0.01), doses of nitroglycerin administered (P<0.01), and MPI scores at rest and under stress (2.16±0.16 vs 1.04±0.19, P<0.01;1.40±0.16 vs 0.80±0.16, P<0.01), but no statistically significant differences were observed in LVDD and LVEF before and after treatment (P>0.05).The PSSR showed no significant changes at rest (1.21±0.62 vs 1.04±0.43, P>0.05) but remark-ably increased under stress after CSWT (2.02±1.00 vs 1.35±0.66, P<0.01). Conclusion CSWT can up-regulate the expressions of VEGF and IL-8 and improve the function of EPCs in the peripheral blood , and thus plays an important role in relieving the symptoms of angina pectoris , promoting cardiac function and enhancing exercise tolerance in patients with coronary heart disease .

Objective Extracorporeal shock wave therapy ( ESWT ) can promote angiogenesis and collateral circulation es-tablishment by introducing shock waves to ischemia myocardium , however , the specific mechanisms remain unclearly .The study aimed to explore the effects of 0.09mJ/mm2 shock wave treatment on human umbilical vein endothelial cell (HUVEC) proliferation, vascular endothelial growth factor (VEGF) and Interleukin-8 (IL-8) expressions. Methods There were an experimental group and a control group in the experiment .The tubes of the experiment group were set in shock wave devices without the treatment of shock waves .As for the experiment group, 0, 0.03, 0.09, 0.18, 0.24 mJ/mm2 shock waves were introduced , followed by the addition of CCK8 solution and the measurement of A value at the wavelength of 450nm by microplate reader .The HUVEC cell lines were performed 0.09 mJ/mm2 ultrasonic shock energy , CCK8 colorimetric method were utilized to detect the HUVEC proliferation , real time PCR and flow cytometry were applied to detect the expressions of VEGF and IL-8 mRNA respectively . Results ① CCK8 colorimetric method revealed that 0.09 mJ/mm2 shock energy markedly promoted the HU-VEC proliferation compared with the control group , with A450 value comparison (0.70 ±0.04 vs 0.54 ±0.09, P<0.05 ), while no sta-tistical significance was found in 0.03, 0.18, 0.24 mJ/mm2 shock energy compared with the control group ( P >0.05 ).②RT-PCR showed that the 0.09 mJ/mm2 energy significantly enhanced the expressions of VEGF and IL-8 mRNA compared with the control group (7.93 ±0.90 vs 1.07 ±0.40, 7.34 ±1.67 vs 1.00 ±0.09, P<0.001).③Flow Cytometry showed that the expressions of VEGF and IL-8 mRNA significantly increased after 0.09 mJ/mm2 ESWT compared with the control group (39.89 ±4.79 vs 20.98 ±3.30, 31.33 ± 5.61 vs 22.60 ±3.76, P<0.05). Conclusion Low-energy ESWs can surely promote HUVEC proliferation and increase the expres-sions of VEGF and IL-8, and the up-regulation of VEGF and IL-8 may play an important role in the promotion of angiogenesis by ESWT .

Objective: The study examines the effectiveness of a CBT treatment programme over and above that of Treatment As Usual (TAU), with children who were referred to an outpatient child psychiatric clinic for disruptive behaviour disorders in Singapore. Methods: One hundred and three children aged 8 to 12 (mean±SD=10.22±1.31) who participated in the study were assigned to either the CBT+TAU (n= 51) or TAU group (n=52). Children in both the CBT+TAU and TAU groups received a standard and typical service offered to children at the outpatient child psychiatric clinic. In addition, children in the CBT+TAU group attended the CBT treatment programme that consisted of nine 1.5 hour weekly sessions. Results: Findings from ANCOVA indicated that children in the CBT+TAU treatment group showed significantly lower levels of aggression and significantly lower levels of parental stress at posttreatment and at 3-month follow-up in comparison to the TAU group. Conclusions: Findings from the present study provided some evidence of the effects of CBT in reducing aggressive behaviour and parental stress among children with disruptive behaviour disorders. Interpretation of the findings, recommendations for future research, and implications of the present study were presented.

A total of 55 cases of advanced schistosomiasis patients combined with Ⅲ-grade hepatic fibrosis and ascites were randomized into a splenectomy group and non-splenectomy group. The peripheral vein blood phlebotomized from these patients were detected for leucocytes, hematids, thrombocytes, acidophils, glutamic-pyruvic transaminase,alkaline phosphatase,albumin, total bilirubin,three-type precollagen, fore-type collagen, hyaluronic acid, IgG, IgA, C_3, C_4 and the sub-group of lymphocytes such as CD3、CD4、 CD8 、CD56 + 16. There were no significant difference on hepatic function and the level of hepatic fibrosis between the groups above metioned. It could be found that leucocytes, thrombocytes, IgG, IgA, CD56 + 16 increased while CD3, CD4, and albumin decreased in the splenectomy group. In conclusion, leucocytes and thrombocytes increase after splenectomy, cytoimmunity declines and humoral immunity enhances.

Objective To investigate the expression and the significance of toll-like receptor 3 (TLR-3)in placenta,tumor necrosis factor-α(TNF-α)in maternal and cord blood of idiopathic fetal growth restriction(IFGR),and their correlation with the pathogenesis of symmetric and asymmetric IFGR.Methods From April 2008 to April 2009,42 primiparae of singleton pregnancy and their IFGR babies,who delivered at term through cesarean section, in the Third Affiliated Hospital of Zhengzhou University were enrolled. All subjectects were divided into symmetric IFGR group (n=20) and asymmetric IFGR group (n =22). Another 42 non-IFGR pairs were randomly selected as the control group. The polink-2 plus polymerized horseradish peroxidase (HRP) immunohistochemical method and the enzyme linked immunosorbent assay (ELISA) were applied to detect TLR-3 and TNF-α levels. Results (1) The expression of TLR-3 protein were observed in all maternal placenta of the three groups. TLR-3 essentially expressed in syncytiotrophoblasts and hofbouer cells in the symmetric IFGR and control group, but expressed mostly in hofbouer cells and less in syneytiotrophoblasts in the asymmetric IFGR group. (2) The expression of TLR-3 in the syncytiotrophoblasts of the symmetric and asymmetric IFGR group was significantly lower than in the control group (111±14 and 118±11 vs. 156 ± 9, P<0. 01). The number of TLR-3 positive in Hofbourer cell in the symmetric IFGR group was lower than the control group (8. 9±2. 8 vs 17.5±2. 8, P <0. 01 ), but the number in the asymmetric IFGR group was higher (23.8±3.7) compared with the control group (P <0. 01). (3) The TNF-α levels in the maternal and cord blood of the symmetric and the asymmetric group were higher than that of the control group [maternal : (90±10) μg/L and ( 86±11 ) μg/L vs. (73±9) μg/L;cord blood: (92±12) μg/L and (96±8) μg/L vs. (79±9) μg/L;P<0.01]. (4) Neither symmetric nor the asymmetric IFGR group showed any correlations between the maternal and cord blood levels of TNF-α (P>0. 05). (5) Significant correlation was found between the TNF-α level of the cord blood and TLR-3 expression in the placenta in both the symmetric and asymmetric IFGR group(P<0. 05),but no relationship was found between the maternal blood TNF-α level and TLR-3 expression in the placenta (P>0. 05). Conclusions The variantions of TLR-3 expression in placenta and the increased expression of TNF-α in cord blood are associated with the genesis IFGR. The reduced expression of TLR-3 may related to symmetric IFGR, while the increased TLR-3 level in hofbouer cells may lead to asymmetric IFGR.

Objective To confirm that rat bone marrow mesenchymal stem cells (MSC) transfected with nerve growth factor (NGF) gene in the bladder tissue of diabetic rats bladder tissues can survive and stably express NGF. Methods A diabetic rat model was constructed. The BrdU-labelled MSC transfected with NGF gene were transplanted into the diabetic rats bladder tissues. BrdUlabelled immunohistochemistry was used to observe the growth of MSC transfected with NGF gene in the diabetic rats bladder tissues. The expression of NGF mRNA and protein were checked by RT-PCR and ELISA. Results A diabetic rat model was successfully built by a single intraperitoneal injectionof STZ. The blood glucose was still high after 8 weeks. NGF gene modified MSC could be detected in the bladder of diabetic rats by BrdU-labelled immunohistochemistry. The concentration of NGF in the control group, disease group and treatment group were ( 114 ± 3), ( 70 ± 2), ( 110 ± 2) pg/ml by ELISA and mRNA quantity by RT-PCR were 0. 183±0. 004, 0. 032±0. 139, 0. 130±0. 165, respectively. Compared with the control group, the expression of NGF gene was decreased (P＜0. 05) in the incidence group. The expression of NGF gene was increased (P＜0. 05) in the treatment group compared with the disease group. Conclusions The NGF gene-modified MSC could survive in diabetic rats bladder tissues. The NGF gene in MSC could stably express in diabetic rats bladder tissues.