Liver three-dimensional simulation technology is a cross-field study of hepatic surgery,anatomy,computer image technology and virtual three-dimensional technology.Compared to the two-dimensional images,the three-dimensional technology applied to the planning of liver surgery has obvious advantages and unique features.This technology not only can three-dimensional clarity of presentation and precise positioning of the important structures of the liver inside and outside,but also allow the surgeon independent dividing a interest region of liver inside and outside.Visualization of the liver and liver volume measurement preoperative planning,can effectively reduce the risk of postoperative liver failure,the remnant liver necrosis and postoperative bile leakage.

Objective To investigate the better radiation modalities for single and multiple brain metastases.Methods Between July 2005 and July 2008,50 patients with single or multiple brain metastases were retrospectively analyzed.The primary cancer of all patients were controlled.Thirty patients with whole brain radiotherapy and stereotactic radiosurgery were included in the combination group,and 20 patients with stereotactic radiosurgery were included in another group.Stereotactic radiosurgery prescription doses of 45％-75％ isodose line were used to wrap around the planning target,which was 15-20 Gy in edge and 30-45 Gy in center.Stereotactic radiosurgery was performed once.Whole brain radiotherapy total dose was 40 Gy,which was given to patients by 2 Gy in 1 fraction,1 fraction every day,5 times every week.Results The efficient rate of combination group was 90％ (27/30),and single group was 60％ (12/20).It was obviously higher in combination group (x2 =6.294,P =0.012).For combination group,the 1-year survival rate was 50％ (15/30) and the 2-year survival rate was 30％ (9/30).However,for another group,the 1-year survival rate was 35％ (7/20) and the 2-year survival rate was 15％ (3/20).The survival rates of two groups were no difference (x2 =1.096,P =0.295 ; x2 =1.480,P =0.224).There were no patients survived more than 3 years in both groups.Stratified analyses showed that the l-year survival rates of the patients with single brain metastasis were no difference in two groups (100.0％ vs 66.7％,x2 =1.556,P =0.212).Whereas the 1-year survival rate in combination group of the patients with multiple brain metastases was higher than that in single group (42.3％ vs 29.4％,x2 =11.023,P =0.001).There were no statistically significant differences in 2-year survival rates in both groups with single and multiple brain metastases (75.0％ vs 66.7％,x2 =1.200,P =0.273 ; 23.1％ vs 5.9％,x2 =3.782,P =0.052).Conclusion Whole brain radiotherapy and stereotactic radiosurgery are important treatment modalities for single or multiple brain metastases.The optimal treatment modality for single brain metastasis is stereotactic radiosurgery,while it is a good choice to make whole brain radiotherapy and stereotactic radiosurgery for multiple brain metastases.

Objective To investigate the effects of angiotensin Ⅱ (Ang Ⅱ) on the expression of C-terminal Src kinase (Csk) in Ang Ⅱ-infused rat model and cultured podocytes,and to explore the role of Csk in Ang Ⅱ-induced cytoskeletal rearrangement of podocytes.Methods Twenty-four Wista rats were randomly subjected to normal saline infusion,or Ang Ⅱ infusion at 400 ng · kg1 · min-1 (via subcutaneous osmotic minipumps) for 2 or 4 weeks.Renal histomorphology was evaluated through electron microscopy.The expression of glomerular Csk was analyzed by immunofluorescence and Western blotting.In vitro,conditionally immortalized mouse podocytes were cultured and treated with Ang Ⅱ doses ranging from 10-9 mol/L to 10-5 mol/L and for different hours.The expression of podocytes Csk was assessed by Western blotting.After transfection to podocytes with Csk siRNA,FITC-conjugated phalloidin was used to stain F-actin,to investigate the role of Csk in Ang Ⅱ-induced or cytochalasin D-induced cytoskeletal rearrangement.Results (1) Examination of Ang Ⅱ infusion rats glomerular and podocyte ultrastructure by electron microscopy revealed foot process effacement and fusion; (2) In Ang Ⅱ infusion rats,the expression of glomerular Csk was increased (P ＜ 0.05); (3) In vitro,Ang Ⅱ-stimuli up-regulated the expression of Csk (P ＜ 0.05),and the effects of Ang Ⅱ were on dose-dependent and time-dependent manner; (4) Ang Ⅱ-induced disruption of F-actin was alleviated by Csk siRNA transfection in cultured podocytes; furthermore,cytochalasin D depolymerized the F-actin cytoskeleton,while Csk siRNA stabilized the actin filaments.Conclusion The enhanced expression of Csk may be involved in Ang II-induced podocytes cytoskeletal rearrangement and foot process fusion.

Objective To evaluate the effect of aldosterone (Ald) on glomerular mesangial cells apoptosis and to explore the possible mechanisms.Methods Twenty-four Sprngue-Dawley rats were subcutaneously embedded with osmotic mini-pumps and randomly divided into 3 groups.Aldosterone (1.5 μg/h) was administrated subcutaneouly by osmotic mini-pumps in Ald group,eplerenone (Epl,100 mg·kg-1·d-1) and Ald (1.5 μg/h) was given to Epl group.And normal saline was used in control group (Con group).Systolic blood pressure and urinary albumin excretion rate (UAER) were detected on day 0,7,14,21,28.Blood and kidney samples were harvested on day 28.Plasma creatinine,potassium and aldosterone were measured.Renal paraffin sections were stained by PAS and the morphological changes were evaluated by light microscopy.Apoptosis index of mesangial cells were detected by TUNEL assay.The glomerular mesangial cells (MCs) were cultured in a DMEM-F12 media.MCs apoptosis was evaluated by staining cells with Annexin V and propidium iodide (PI) using flow cytometer.Expression of Bcl-2 and Bax mRNA was examined by RT-PCR.The protein level of Bad or phospho-Bad was measured by Western blotting.Results Ald-infused rats developed hyperaldosteronemia and hypokalemia.Rats in Ald group exhibited significant hypertension and marked albuminuria.Ald group rats showed increased number of TUNEL-positive mesangial cells when compared with control rats (P＜0.05).Aldosterone induced mesangial cells apoptosis in a time-dependent manner.Expression of Bcl-2 mRNA was decreased but Bax mRNA was increased in aldosterone treated MCs compared to that in Con group (P＜0.05).Aldosterone promoted dephosphorylation of cytosolic phospho-Bad compared with vehicle treated cells (P＜ 0.05).However,eplerenone attenuated these effects of aldosterone.Conclusion Aldosterone directly promotes mesangial cells apoptosis,and eplerenone can attenuate this effect of aldosterone.Dephosphorylation of cytosolic phospho-Bad may be the key role in the progression of mesangial cells apoptosis induced by aldosterone.

More than 85% of all cancers express telomeras e activity. Human telome rase has been proposed as a novel and potentially highly selective target for ca ncer therapy. Inducers of differentiation are involved in regulation of telomera se activity. In the present review, the effects of retinoids, vitamin D3 compo unds, tea catechins and matrine on telomerase activity in malignant cells were r eviewed.

Objective To observe the clinical efficacy and adverse reactions of intensity modulated radiotherapy (IMRT) combined with cisplatin for patients with carcinoma of cervix.Methods One hundred patients with carcinoma of cervix were randomly divided into 2 equal groups to undergo IMRT only (IMRT group)and IMRT combined group (IMRT with cisplatin chemotherapy group),with 50 cases in each.Both groups were treated with external intensity modulated radiotherapy,with the total dose of 50 Gy,2 Gy/fraetion,25 fractions in total,and 5 times/week.Two weeks later,internal radiotherapy followed,with the total dose of 42-48 Gy,1 time/week with 6-8 times and 6-7 Gy/fraction.When the internal radiotherapy began,the external radiotherapy stopped immediately.The combination group was treated concurrently with cisplatin given by intravenous drip once a week,at the dose of 30-40 mg/m2 body surface area for 4-5 weeks,and with total cisplatin dosage of 50-65 mg.Follow-up was conducted for 18 months(3-60 months).The 1-,3-,and 5-year survival rates,local control rate,distant metastasis rate,and disease-free survival rate,blood test,rectum,and bladder were observed.Results The 1-year survival rate,local control rate,distant metastasis rate,and disease-free survival rate did not differ significantly between these 2 groups,however,the 3-and 5-year survival rates,local control rates,distant metastasis rates and disease-free survival rates of the combination group were all significantly better than those of the IMRT group (x2 =3.843,4.336,4.336,4.960,P ＜ 0.05 ; x2 =3.934,4.454,4.000,4.244,P ＜0.05).The incidence rates of radiation proctitis and leukopenia of the combination group were significantly higher than those of the IMRT only group (x2 =4.110,4.320,P ＜ 0.05),whereas the incidence rates of cystitis,anemia,and thrombocytopenia were not significantly different between these 2 groups.No serious grade 3-4 proctitis and cystitis were observed in these 2 groups.Conclusions The IMRT combined with cisplatin chemotherapy shows higher 3-year and 5-year long-term efficacy in the patients with carcinoma of cervix than IMRT only group.

More than 85% of all cancers express telomerase activity. Human telomerase has been proposed as a novel and potentially highly selective target for canon therapy. Inducers of differentiation are involved in regulation of telomerase activity. In the present review, the effects of retinoids, vitamin D3 compounds, tea catechins and matrine on telomerase activity in malignant cells were reviewed.

Objective To assess the efficiency and reliability of clinical genetic diagnosis of methylmalonic acidemia(MMA) using new generation sequencing platform (HiSeq2000).Methods 1.Nine patients diagnosed with clinical signs of MMA were recruited.DNA library from the patients were mixed with designed gene capture probe.The whole exons region of 48 genes related to organic acid metabolism were screened using the gene capture combined with high-throughput sequencing.2.The joints were removed and the low quality data were filtered,the data were analyzed by means of SNP and InDel.To avoid the false positive,the abnormal sites were verified using the Sanger sequencing method.3.The detection of the organic acid in the urine was performed through gas chromatography-mass spectrometry and other auxiliary examinations.Results 1.Gene mutation:7 gene mutations of MMACHC were identified in 7 patients.Seven mutations:c.482G ＞ A,c.567_568insT,c.609G ＞ A,c.440_441del,c.80A ＞ G,c.315C ＞ G,c.90G ＞ Awere screened.The mutation c.440_441del had not been reported before,and others were all related to the disease.Two gene mutations of mutase apoenzyme(MUT) were identified in 1 case,all of which were introns:.c.754-1G ＞ C,c.1677-1G ＞ A.The novel mutation was c.754-1G ＞ C.No gene mutation was identified in 1 patient.2.Clinical manifestation:all of the patients were development delay,but the degrees were different;3 patients with convulsion; 1 patient with headache and central facial paralysis;1 patient with repeated intractable metabolic acidosis;1 patient with repeated hemolysis.Electroencephalogram of the all patients were abnormal;the result of cranial MRI of the 8 patients were abnormal;In all patients,urine level of methylmalonic acid significantly increased (273.4-146 022.8 times).Blood homo cysteine of 8 patients were significantly increased(27.13-396.84 μmol/L,normal ＜ 20 μmol/L).3.Sanger sequencing:there were no false positive exists.Conclusions 1.There were not a correlation between the clinical manifestation and gene mutation of the patients with MMA.The c.609G ＞ A was the hotspot mutation of MMACHC gene in Chinese patients with MMA and homocysteinemia.2.The mutations c.440_441del and c.754-1G ＞ C were presumed to be novel mutations.3.Gene capture technology combined with next-generation sequencing technology could be used to interrogate the wealth of data available in the human genome and lay the foundations for counseling of gene.This platform can be readily and timely adopted by clinical molecular diagnosis of MMA and represents a high throughput,high sensitivity,high efficiency and other characteristics approach for screening common genetic diseases.

Objective To explore the value of static and dynamic MRI before and after operation of pelvic organ prolapse (POP). Methods 29 patients with POP (POP group)and 12 normal women (control group)underwent static and dynamic MRI.The morphologic changes of pelvic floor were observed on MR images.The measurements of bladder,uterus,Douglas pouch to pubococcygeal line (B-PCL,U-PCL,D-PCL),the puborectal hiatus line (H-line),muscular pelvic floor descent (M-line),the levator hiatus size (LHS),the levator plate angle (LPA),the iliococcygeus angle (ICA)and the urethral inclination angle (UA)were recorded on dynamic MR images.Results 19 cystoceles,28 uterine prolapses,4 rectoceles and 14 hernias of Douglas pouch were detected with MRI.29 cases of pelvic floor relaxation,27 cases of levator ani muscle defect and 24 cases of pubocervical fascial defect were found.The values of B-PCL,U-PCL, D-PCL,H-line,M-line,LHS,LPA,ICA and UA of POP group were larger than control group (P<0.01).The positions of pelvic organ returned to normal in 9 cases of 21 postoperative cases,while 12 cases remained prolapses.There was no displacement of mesh in 8 cases of mesh implant.The values of B-PCL,U-PCL,D-PCL,UA after operation were smaller than those before operation (P<0.05).Conclusion Static and dynamic MRI can evaluate morphological and functional changes of pelvic floor before and after operation of POP comprehensively,and may reveal those invisible pelvic floor dysfunction and postoperative remnant defects.