Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer.Methods A retrospective study was performed in 51 patients (average age (59± 12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015.Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging.With SUVmax as the statistical variable,comparison was made between the pathologically confirmed benign and malignant groups,and in case of the latter,the extent of infiltration,histologic grade and subtype of primary tumor,lymph node and distant metastases were also analyzed.Two-sample t test was used to analyze the data,and diagnostic efficacy of PET/CT for metastasis was calculated.Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor.SUVmax was found to significantly correlate with histopathology classification (benign:3.4 ± 1.2,malignant:12.8 ± 6.5) and depth of myometrial invasion (≥1/2:17.7±5.4,＜1/2:10.9±5.9;t=-8.7 and 3.2,both P＜0.05),but not with cervical stromal invasion,histologic grade or histologic subtype(t =1.8,-1.9,1.5,all P＞0.05).The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7％ (18/21),98.2％ (271/276),97.3％ (289/ 297),78.3％(18/23),98.9％ (271/274),respectively,and on a patient basis were 6/6,97.3％ (36/ 37),97.7％ (42/43),6/7,100％ (36/36),respectively.The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12.Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion,lymph node metastases and other metastases in patients with endometrial cancer,particularly in specificity and NPV.

Objective To compare the pros and cons of endoscopic papillary balloon dilation (EPBD) with those of endoscopic sphincterotomy (EST) in the treatment of common bile duct stones.Methods We searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared EPBD with EST for the removal of common bile duct stones were included from January 1983 to September 2012 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 software.Results A total of 18 randomized trials with 2385 participants met our inclusion criteria.EPBD compared with EST resulted in similar outcomes with regards to stone removal on 1 st attempt,overall stone removal,perforation,total short-term complication,long-term cholangitis or mortality.EPBD carries a higher risk of pancreatitis (RR =1.99,95％ CI:1.41-2.81) and severe pancreatitis (RR =4.68,95 ％ CI:1.36-16.11),and requires higher rates of mechanical lithotripsy (RR =1.31,95％ CI:1.14-1.50).Conversely,EPBD not only has statistically significant lower rates of bleeding (RR =0.14,95％ CI:0.06-0.34),but also leads to significantly less long-term cholecystitis (RR =0.38,95％ CI:0.19-0.76),long-term stone recurrence (RR =0.67,95％ CI:0.47-0.96) and total longterm complications (RR =0.52,95 ％ CI:0.40-0.67).Conclusion On the basis of lower rates of bleeding or long-term complications,EPBD should be the preferred strategy over EST for endoscopic management of common bile duct stones,however,the rate of pancreatitis,especially the severe pancreatitis is higher with EPBD.

Animals ; Brain ; cytology ; Cerebrospinal Fluid ; physiology ; Formaldehyde ; administration & dosage ; toxicity ; Inflammation ; chemically induced ; physiopathology ; Male ; Neurons ; metabolism ; physiology ; Pain ; chemically induced ; physiopathology ; Pain Measurement ; methods ; Rats ; Rats, Sprague-Dawley ; gamma-Aminobutyric Acid ; metabolism

Animals ; Cell Adhesion ; Cell Movement ; Colorectal Neoplasms ; metabolism ; pathology ; Drug Delivery Systems ; Epithelial-Mesenchymal Transition ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Neoplasm Invasiveness ; Neoplasms ; metabolism ; pathology ; Neural Cell Adhesion Molecule L1 ; chemistry ; metabolism ; Pancreatic Neoplasms ; metabolism ; pathology

Objective To compare clinical effects of appendicectomy and conservative treatment of uncomplicated acute appendicitis.Methods Searched The Cochrane library,Medline,Pubmed,Embase,CBM,CNKI,VIP and Wan Fang database in any language.RCTs that compared conservative treatment with appendicectomy in patients with uncomplicated acute appendicitis were included from January 1983 to May 2013 and qualities of the trials were evaluated.Statistic analyses were carried out using RevMan 5.1 soft-ware.Results Four randomized trials met our inclusion criteria (821partiCI:pants).Antibiotics compared with appendicectomy resulted in similar outcomes with regards to the incidence of complicated appendicitis (RR:0.89,95％ CI:0.29-2.68) and intra-abdominal infection(RR:0.54,95％ CI:0.13-2.35).Antibiotics carries a lower risk of complications (RR 0.46,95％ CI:0.32-0.67),but requires more length of hospital stay (Mean Difference 0.52,95％ CI:0.16-0.88).Conclusions The effect of conservative treatment is safe and effective.But the recurrent uncomplicated appendicitis recommends operation.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion for vascular dementia and explore its mechanism. Methods: A total of 70 patients with vascular dementia were randomized into an observation group and a control group, with 35 cases in each group. The control group was treated with piracetam, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment of the control group. The treatment lasted for 8 weeks. Before and after the treatment, the mini-mental state examination (MMSE), activity of daily living (ADL) and traditional Chinese medicine (TCM) symptom scores were assessed, and the levels of acetyl choline (Ach) and homocysteine (Hcy) were measured. The efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the MMSE and ADL scores in the observation group decreased significantly, and were lower than those in the control group (all P<0.05); the TCM symptom score of the observation group decreased significantly (P<0.05), while that of the control group had no significant change (P>0.05); the plasma Ach level in the observation group increased significantly (P<0.05), and the Hcy level decreased significantly (P<0.05), which were statistically different from those in the control group (both P<0.05). Conclusion: Heat-sensitive moxibustion plus piracetam is effective in treating vascular dementia. It can significantly improve dementia symptoms and ADL, which may be related to the correction of plasma Ach and Hcy levels.

Objective: To observe the clinical efficacy of heat-sensitive moxibustion in intervening acute ischemic stroke. Methods: A total of 112 patients were divided into a control group and an observation group by the random number table method, with 56 cases in each group. The control group was treated with conventional treatment, and the observation group was treated with heat-sensitive moxibustion on the basis of the treatment in the control group. The National Institute of Health stroke scale (NIHSS) and modified Barthel index (MBI) were evaluated, and the intracranial hemodynamic indicators including mean velocity (Vm), pulsatility index (PI) and resistance index (RI) were recorded, and the serum levels of superoxide dismutase (SOD) and homocysteine (HCY) were measured before and after treatment. Clinical efficacy was evaluated after treatment. Results: The total effective rate of the observation group was significantly higher than that of the control group (P<0.05). After treatment, the NIHSS scores in both groups decreased significantly (both P<0.05), and the MBI scores increased significantly (both P<0.05). The improvements of NIHSS and MBI scores in the observation group were superior to those in the control group (both P<0.05). Vm in both groups increased significantly (both P<0.05), PI and RI decreased (all P<0.05), and Vm, PI and RI in the observation group were superior to those in the control group (all P<0.05). The serum levels of SOD and HCY in the observation group were significantly improved, and were statistically different from those in the control group (both P<0.05). Conclusion: Conventional treatment plus heat-sensitive moxibustion is effective in intervening acute ischemic stroke. It can promote the recovery of neurological function, improve daily activities, and improve intracranial blood flow, which may be related to the regulation of serum SOD and HCY levels.

Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.

Objective: To study the quality and transdermal properties of matrine microemulsion-based hydrogel (MBH) to provide basis for the development of the preparation.Methods: The stability of MBH was observed at 4 ℃ for 3 months and the changes of particle appearance, viscosity, pH and matrine content were observed.The transdermal permeation of MBH was investigated by a dual chamber permeation and diffusion device with excised mouse skin as the barrier.Taking rabbits as the experimental subjects, the irritation of MBH to the normal skin and damaged skin was investigated.Results: The appearance, viscosity, pH and matrine content of MBH at 4 ℃ in 3 months did not change significantly.In vitro transdermal test showed that MBH had a good penetration rate on mouse skin, and no skin irritation occurred after single or multiple administrations.Conclusion: MBH has good stability and high rate of transdermal penetration without skin irritation, which is a promising drug delivery system of matrine with good application prospects.

BACKGROUND:Mild hypothermia can effectively ease secondary brain and spinal cord injuries, which has a definite protective effect on the central nervous system. Meanwhile, mild hypothermia is conducive to the proliferation, activation and growth of transplanted cells by improving the microenvironment of the injured spinal cord.OBJECTIVE:To investigate whether mild hypothermia intervention can regulate the proliferation and apoptosis of neural stem cells through the RhoA/ROCK pathway.METHODS:The neural stem cell injury model was prepared and randomly divided into two groups:normothermia group and mild hypothermia group. The mild hypothermia group was treated with mild hypothermia [(32.0±0.5) ℃] for 4 hours. Expression of RhoA, RHOCK, Nogo-A and NgR in neural stem cells was detected by RT-PCR and western blot assay. RhoA/RHOCK positive cells were observed by fluorescence microscope. The intracellular Ca2+ concentration in neurons was measured by laser scanning confocal microscopy.RESULTS AND CONCLUSION:The expression of RhoA, RHOCK, Nogo-A and NgR in neural stem cells at mRNA and protein levels was significantly lower in mild hypothermia group than in the normothermia group (P < 0.05). The intracellular Ca2+ concentration in the neural stem cells was lower in the mild hypothermia group than in the normothermia group (P < 0.05). The number of RhoA/RHOCK positive cells in the brain tissue of rats was significantly lower in the mild hypothermia group than in the in the mild hypothermia group (P < 0.05). To conclude, mild hypothermia regulates the proliferation and apoptosis of neural stem cells by inhibiting the RhoA/ROCK pathway.