Randomized trials have demonstrated a benefit from neoadjuvant chemotherapy in gastric cancer.However the optimal approach in individual patients is not clear.There are differences in the chemical drug sensitivities of individual patients.This scenario demands the development of methods to predict response to neoadjuvant therapy.This paper reviews the relevant research progress.Published results are as follows:histological characteristics and histopathological response corelate with survival,traditional imaging needs improvement and integration to increase the accuracy,while PET holds advantage in early selection of patients without response,and existing candidate biomarkers need to bc properly qualified.

Although the development of diagnosis and treatment about degenerative scoliosis has improved significantly,it still remains controversial about how to select appropriate surgical methods.The goal of this review is to raise awareness and stimulate attention on the correlation between clinical manifestation and spinal deformity,which is one of the key factors to affect the surgical outcomes on the opinion of more and more researchers in the past 20 years.When an adult spinal deformity is not the source of symptoms and the clinical symptom is outside of curve,symptomatic relief may be provided through limited decompression.If thoroughly decompression,it will be enough to combine with short segment fixation.However,while an adult deformity is the source of symptoms and the clinical symptoms is within the curve,the options are typically limited decompression on the basis of good stability,otherwise,it will be the only consideration of decompression combined with long segment fixation.

Background and purpose:RASSF10 acts as a kind of tumor suppressor in various tumor tissues, but researches in cardiac adenocarcinoma has not been reported. This study aimed to detect the methylation status and expression ofRas-association domain family 10 (RASSF10) in gastric cardia adenocarcinoma (GCA), and explore its role in occurrence and development of GCA.Methods:Methylation speciifc polymerase chain reaction (MSP), reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry method were respectively used to detect methylation status, mRNA expression and protein expression ofRASSF10 in 81 GCA tissues and corresponding normal tissues.Results:The promoter methylation frequency ofRASSF10 in GCA tissues (64.20%, 52/81) was signiifcantly higher than that in corresponding normal tissues (20.99%, 17/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). RASSF10 mRNA expression in GCA tissues (0.57±0.05) was significantly lower than that in corresponding normal tissues (0.78±0.02,P<0.05), and was closely correlated with TNM stages and lymph node metastasis (P<0.05). Protein expression of RASSF10 in GCA tissues (31.10%, 26/81) was signiifcantly lower than that in corresponding normal tissues (71.60%, 58/81,P<0.05), and was closely correlated with TNM stages, differential degree and lymph node metastasis (P<0.05). The promoter methylation frequency ofRASSF10 in GCA tissues was inversely related to its protein expression.Conclusion:Inactivation of RASSF10 caused by aberrantmethylation in the promoter region may be closely correlated with the GCA tumorgenesis.

Objective To investigate the aberrant methylation and expression of growth arrest and DNA-damage-in-ducible 45 gamma (GADD45G) gene in gastric cardia adenocarcinoma (GCA). Methods Bisulfite conversion-methylation specific polymerase chain reaction method (BS-MSP) and immunohistochemistry method were used respectively to detect the methylation status and protein expression of GADD45G in 138 GCA tumor tissues and corresponding normal tissues. Re-sults The methylation status of GADD45G distal promoter (region 1) was not detected in GCA tumor tissues and corre-sponding normal tissues. For GADD45G region 2 and region 3, the BS-MSP results of region 3 were identical to that of re-gion 2. The methylation frequency of proximal promoter and exon 1 in GADD45G island 2 (region 2 and region 3) in GCA tu-mor tissues (49.3%, 68/138) was significantly increased compared to that in corresponding normal tissues (0, P＜0.01). The methylation status of this two sites in tumor tissues was associated with TNM stage of tumors (P＜0.05). The protein expres-sion of GADD45G in tumor tissues was significantly decreased than that in corresponding normal tissues (P ＜ 0.05),and threre was a significant negative correlation with methylation status of GADD45G proximal promoter and exon 1 (rs=-0.398). Conclusion The decreased expression of GADD45G by hypermethylation of proximal promoter exon 1 of the gene may play an important role in gastric cardia adenocarcinoma.

Objective To investigate the expression of MnSOD and E-cadhefin in nasopharyngeal carcinoma(NPC) tissue and its relationship with clinicopathological features and prognosis. Methods The expression of MnSOD and E-cadherin were detected by immunohistochemistry method in 60 NPC patients. Results Of the whole group,lymph node positive group and lymph node negative group,the strong positive rate of MnSOD protein was 47% (28/60) ,49% (25/51 patients) and 33% (3/9) (x2 =0.76,P =0.382), respectively.The corresponding strong positive rate of E-cadherin protein was 47% (28/60) ,43% (22/51) and 78% (7/9) (x2 =3.69,P =0.047) ,respectively.The expression of MnSOD increased with T stage and N stage.The higher expression of MnSOD was significantly associated with the larger size of metastatic lymph node(r =0.46 ,P =0.002) ,more radioresistance and poorer prognosis,but not with the region of lymph node metastasis(r =0.223,P = 0.116).The lower expression of E-cadherin was closely relevant with higher N stage and the smaller region of lymph node metastasis(r =-0.33,P = 0.020),but not with T stage,lymph node size or radiosensitivity(r =-2.19,P=0.093;r=-0.07,P=0.623;r=-0.18,P=0.170).Multi variate analysis showed that MnSOD and E-canherin were independent prognostic factors (x2= 4.45,P = 0.035;x2 =5.12,P=0.024). Conclusions High expression of MnSOD may stimulate tumor growth and reduce radiosensitivity.High expression of E-cadherin may inhibit lymphatic metastasis,while has no rela tionship with tumor growth and invasion.MnSOD and E-cadherin could affect the prognosis of NPC patients.

Objective To evaluate peak rotation in the endocardium(endo)and epicardium(epi)and peak mural torsion in patients with anterior wall acute myocardial infarction(AMI)before and after revascularization by speckle tracking imaging(STI).Methods The study comprised 20 normal controls and 21 consecutive xpatients with a first-episode anterior wall AMI with stenosis of the left anterior descending artery.All patients underwent Successful percutaneous coronary intervention within 12h onset of AMI.During one month, two patients were ruled OUt because one died of heart failure and the other suffered from persistent atrial fibrillation.Conventional echocardiography and STI were performed in normal controls and AMI patients before and one month after revascularization.Results In the left ventricle(LV)apical and basal level,peak endo-and epi-rotation and peak mural torsion in AMI patients were significantly reduced relative to those of normal control group(all P<0.01).One month after revascularization,there were significant changes in these three variables,especially in peak endorotation(P<0.01).Peak apical endo-rotation positively correlated with LV ejection fraction(LVEF)(r=0.717,P<0.01)and inversely correlated with LV end-diastolic volume(EDV)(r=-0.694,P<0.05).However,tight relations were not found among other variables at the two planes.Conclusions Peak endo-and epi-rotation and peak mural torsion can make the sensitive assessment of abnormal myocardial contractile performancein AMI patients using STI.

Objective To explore the relationship of plasma level of B-type natriuretic peptide (BNP) with cardiovascular risk,the severity of coronary heart disease(CHD),and the short-term prognosis in patients with type 2 diabetes. Methods 154 patients with type 2 diabetes,of them 95 cases complicated with CHD and 65 with hyper-tension were selected in this study. The CHD patients were diveded into 3 groups: AMI(n=32), UAP(n=33) and SAP(n=30). The relationship of the plasma BNP levels with cardiovascular risks, with each coronary heart disea-ses,were observed. The patients were followed up for 6 months to study the predicting role of BNP on the death in pa-tients accompanied with CHD. Results The plasma BNP level was (397.34±217.79) ng/L, which was correlated with age, CRP, hypertension and CHD (r=0.631,0.672, 0.762,0.857, P<0.05 for each);the plasma BNP levels increased with age(r=0.896,P<0.01):(57.6±12.3) ng/L in patients <50 years old,(146.2±53.4)ng/L in patients 50≤and < 59 years old, (388.4±67.5) ng/in patients 60≤and < 69 years old, and (423.8±132.6) ng/L in patients≥70 years old (P<0.01 or P<0.05). The plasma BNP levels, was higher in patients with hyper-tension than that in patients without hypertension [(314.7±125.3) ng/L vs (136.8±98.7) ng/L, P<0.01];Higher in patients with CHD than that in patients without CHD [(425.03±200.80)ng/L vs (37.64±21.57) ng/L,P<0.01)]. The short-term prognosis of patients with CHD was correlated with the levels of BNP, and BNP levels≥485 ng/L may be an independent predicting factor for cardiac death within one month. Conclusions Plas-ma levels of BNP were associated with some cardiovascular risks,which may be one of biomarkers for cardiovascular risks in patient complicated with CHD.

Objective To compare the adherence condition of mycobacterium tuberculosis on 2 kinds of artificial joint interface. Methods The Chromium-Cobalt-Alloy with hydroxyapatite ceramic coating and porous coating were cocultured with the bacterial liquid of mycobacterium tuberculosis. The optical density of mycobacterium tuberculosis in different interfaces were detected by turbidimetry. Adherence conditions were observed by electron microscope scanning. Results There was no significant difference between two groups in the optical density value (P>0.05). The electron microscope scanning showed that more mycobacterium tuberculosis adhered to the porous coating than hydroxyapatite ceramic coating (P<0.05). Conclusion The hydroxyapatite ceramic coating has more advantages to the porous coating in prosthetic replacement for patients with joint tuberculosis.

Objective To assess the feasibility,safety and advantages of robotic-assisted precise hepatectomy.Methods Between April and July 2009,13 consecutive patients underwent robotic-assisted hepatectomy for hepatic diseases.The clinical data were analyzed retrospectively.Results All 13 Da Vinci surgical systemassisted precise hepatectomies were successfully performed without conversion to laparotomy.Major hepatectomies were performed in 9 patients,left lateral segmentectomies in 4 patients.All the Da Vinci surgical system-assisted hepatectomies were performed anatomically with hilum dissection.Prior to the parenchymal transaction,vascular control of the portal vessels was carried out whenever possible.The mean operative time was 338 minutes(range,150-720 minutes).The mean blood loss was 208 ml(range,50-800 ml).No patient required blood transfusion,and no mortality,transient bile leakage was observed in patients with hilar cholangiocarcinoma.The mean postoperative stay was 7 days(range,2-13 days).Conclusions These preliminary results show that Da Vinci surgical system-assisted precise hepatectomy is safe and feasible with potential benefits of a minimally invasive approach.Da Vinci surgical system may broaden the indications for laparoscopic hepatactomy,and it enables surgeons to perform precise laparoscopic hepatectomy which required hilum dissection,hepatocaval dissection,endoscopic suturing and microanastamosis.

Objective To investigate the promoter methylation status of SFRP1 and SFRP2 gene in gastric cardia adenocarcinoma (GCA). Methods Methylation specific PCR (MSP) method was used to examine the methylation status of the 5' CpG island of SFRP1 and SFRP2 gene in tumors and corresponding normal tissues. Results Methylation frequencies of SFRP1 and SFRP2 gene in tumor specimens were 87.2 % (82/94) and 83 %(78/94), which was significantly higher than that in corresponding normal tissues (14.9 % and 55.3 %, respectively) (P <0.001). Methylation frequencies of SFRP1 in lymph node metastasis group (96.4 %) was significantly higher than that in no lymph node metastasis group (73.7 %). Methylation frequencies of SFRP1 and SFRP2 gene in poor differentiation group were all higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference(P >0.05). 63 cases of GCA showed both of SFRP1 and SFRP2 gene simultaneous methylation, which including 36 cases of lymph node metastasis group, 27 cases of no lymph node metastasis group. Simultaneous methylation frequencies of SFRP1 and SFRP2 gene in lymph node metastasis group was higher than that in no lymph node metastasis group, poor differentiation group was higher than that in moderate and poor-moderate differentiation groups, but both of them did not show significant difference (P >0.05). Conclusion Promoter methylation of SFRP1 and SFRP2 might be related with oncogenesis of GCA and hypermethylation of SFRP1 gene might be related with the malignant behavior of GCA.