ObjectiveTo explore the correlation between cortactin differential expression and metastasis of colorectal cancer by testing the expression of cortactin in cell sublines with different metastatic ability.MethodHuman colon cancer cell line SW1116, and sublines of fifth subcutaneous ( SW1116_5), first, fifth generation (CRCLM1 、CRCLM3 ) characteristic of different liver metastasis were implanted subcutaneously in BALB/c mouse.Tumors were transplanted into the colon, and liver metastasis was observed, Western blotting and real time-PCR was used to detect the varience of cortactin. Transwell assay was applied to evaluate four cell lines migration and invasion ability. Immunohistochemistry was used to analyze the relationship of cortactin and clinicopathological characterizing in 86 cases of colorectal cancer.ResultCRCLM3( 100％ )has higher ability of metastasis than that of CRCLM1 ( 89％ ), SW1116(40％ )and SW1116_5 (44％) respectively. Expression of cortactin in the SW1116, SW1116_5, CRCLM1,CRCLM3 was gradually increased. There were significant differences between four cell lines by comparison between each others ( P ＜ 0.05 ). Immunohistochemical expression of cortactin in 86 cases was positive in 57 cases(66％ ), and negative in 29 cases (34％).ConclusionsDifferent expression of cortactin with colorectal cancer metastasis and clinical stage was positively correlated. Cortactin is a potential indicator for clinical staging and tumor metastasis of colorectal cancer.

Objective To study more effective treatment and care measures to release postpartum refractory urinary retention.Methods From January 2011 to December 2012,312 cases hospitalized single head delivery of perineum after episiotomy with maternal urinary retention were selected and divided into Group A,B and C stochastically,each group contained 104 cases.Group A was given phentolamine warm uterus paste on Qihai acupuncture point,Group B was given phentolamine treatment,Group C as control group was given warm uterus paste on Qihai acupuncture point.The treatment effects and treatment time were observed in three groups.The clinical outcomes and related indexes of medical resources consumption among 3 groups were compared.Results After intervention treatment on urinary retention of the 3 groups,the treatment time and effects on Group A was significantly better than Group B and C to relieve maternal urinary retention.The comparison among 3 groups had significant differences.While the postpartum hemorrhage,urinary tract infection caused by retention of urine and length of hospital stay and hospital costs were lower than Group B and C,the differences had statistical significance.Conclusions Phentolamine warm uterus paste on Qihai acupuncture point in treatment of postpartum refractory urinary retention is quick to work,simple,economic and safe,it has significant effects,and can significantly reduce complications,hospitalization time and cost of hospitalization.

Purpose To clarify the morphologic changes and significance of interstitial cells of Cajal-like cells in the bladder of diabetic guinea pig.Methods The experimental guinea pigs were induced by a single intraperitoneal injection of streptozotocin(STZ).The diabetic guinea pig model, who were made succesful for 4 weeks, were detected through the urodynamic evaluation.The distribution of ICCs-like cells in the detrusor, which were taken from these guinea pigs,were quantitatively analyzed after frozen section and indirect immunofluorescence methods and observed by electron microscopy.Results In the diabetic group, the maximum detrusor pressure was signifently lower than controls (P＜0.01), maximum bladder capacity, compliance, residual volume and leak point pressures was significently higer than controls (P＜0.05 or P＜0.01);In detrusor, compared with control, the ICCs-like cells of diabetes group showed significently decreased in quantity. In diabetic bladder, the quantity of gap junctions between ICCs-like cells and cells around,such as smoth muscle cells,terminal nerves and other ICCs-like cells,decreased significently.And more cavities and less organoids occurred in cytoplasm of diabetic ICCs-like cells. Mitochondria became swollen or even disapeared, accompanied with swollen endocytoplasmic reticulum.Conclusion The decrease and injures of ICCs-like cells in bladder may be one of the mechanisms resulting in urodynamic changes of diabetic cystopathy.

Objective To measure the value of orthopedic physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and Portsmouth modified POSSUM (P-POSSUM) scoring systems in predicting operative risks in aged hip fracture patients.Methods Orthopedic POSSUM and P-POSSUM were performed to predict complication incidence and mortality for 164 aged patients operated for hip fracture.Validation of the scoring systems was tested by assessing observed to expected ratio,discrimination,and calibration.Discriminative ability and calibration of both scores were estimated using receiver operation characteristic curve (ROC) and Hosmer-Lemeshow test respectively.Results Orthopedic POSSUM score performed in predicting incidence of postoperative complications showed overall observed to expected ratio of 0.86,area under the curve of 0.82,and good calibration (H2 =3.66,df=8,P ＞ 0.05).P-POSSUM performed in predicting mortality showed overall observed to expected ratio of 0.80,area under the curve of 0.93 and good calibration (H2 =3.21,df =4,P ＞ 0.05).While orthopedic POSSUM overestimated postoperative mortality (overall observed to expected ratio =0.27).Conclusion Orthopedic POSSUM and P-POSSUM scores are respectively accurate in predicting postoperative complication incidence and mortality in aged hip fracture patients,but orthopedic POSSUM score overestimates the mortality.

Objective In the previous study completed in Korea, early three-dimensional conformal radiotherapy concurrent with chemotherapy in rectal cancer after radical surgery demonstrated a better prognosis compared with late radiotherapy. However, with the report of MOSAIC trial, the adjuvant chemotherapy regimen had transferred from 5-Fu alone to combined 5-Fu and Oxaliplatin. We need more evidence to clarify the best radiotherapy timing during the whole period of adjuvant therapy . Methods Patients who met the following criteria were accrued in this study: 18-70 years old, lower anterior resection,pathologically proven rectal adenocarcinoma, stage T3-4 and/or N+, no evidence of distant metastases and KPS≥70. Three dimensional conformal Radiotherapy was started at the fourth week after surgery, which included 45 Gy whole pelvic radiation following by 6-10 Gy tumor bed boost. Oxaliplatin of 50 mg/m2 weekly and Xeloda 625 mg/m2 twice a day, every week from d1-5 were used concurrent with radiotherapy.Toxicity was evaluated and graded by common toxicity critera version 3. 0. The study was designed as Simon two-phase design, in the first phase, a total of 15 patients were accrued, and if more than or equal to 9 patients had grade 3 toxicity, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Otherwise, another 15 patients of the second phase were accrued, we would have 85% power to confirm the high toxicity of more than 50% if 18 out of 30 patients had grade 3 toxicity. Results From July 2008 to December 2008, 15 patients were treated with early radiotherapy concurrent with combined chemotherapy, Grade 3 gastrointestinal toxicity occurred in 12 patients and Grade 3 hematologic toxicity occurred in 2 patients. According to Simon design, we had 85% power to confirm the toxicity caused by early radiotherapy more than 50%. Conclusions For locally advanced rectal cancer patients, whole pelvic radiotherapy concurrent with oxaliplatin and xeloda had severe toxicities. Further studies are needed to decrease toxieities.

Objective　To explore the role of acute infection of Chlamydia pneumoniae (Cpn) in respiratory diseases. Methods　Microimmunofluorescence test was used to detect IgG antibodies for Cpn in serum obtained from 93 inpatients and PCR was used to test Cpn in detection of Cpn DNA in throat specimens from 55 of the 99 patients. Results　Acute Cpn infection was diagnosed in 35.5% of the respiratory diseases. Antibodies for Cpn (titer of ≥512) were present in 47.6% of the pneumonia group, which may suggest that during 1998 to 1999, Cpn caused an epidemic in Beijing. They were also present in 50% of asthma group, 50.0% of pulmonary heart disease group and 26.3% of lung cancer group. Only five patients (9.1%) were positive by PCR. There exists discrepancy between serological and PCR results. Conclusion　Detection of IgG antibodies for Cpn conduces to diagnosis of acute Cpn infection and give advice for appropriate therapy.

Objective To establish an ultraviolet-irradiation damage model in cultured fibroblasts derived from human skin and to explore the potential protective effects and mechanisms of amyloid precursor protein 17-met peptide (APP17-mer peptide) on the oxidative damage and collagen metabolism in cultured fibroblasts after ultraviolet irradiation. Methods Human dermal fibroblast cultures were established by outgrowth from foreskin biopsies of a healthy donor and were irradiated by a single exposure to ultraviolet rays and cultured in a series of concentrations of APP17-mer peptide (0, 20, 40, 80 μmol/L).The activity of fibroblasts was detected by the assay of MTT. The intracellular ROS level was measured with a confocal microscope. The expression of MMP-1 mRNA was analyzed real-time quantitatively following RT-PCR. Results Primary cultures of human skin fibroblasts were established from human foreskin in DMEM supplemented with 10 % fetal bovine serum. UV irradiation depressed cellular activity and increased intracellular level of ROS (P<0.05). 40μmol/L and 80μmol/L APP17-mer peptide increased the cellular activity in both UV irradiated fibroblasts and unirradiated fibroblasts (P<0.05), however,20 μmol/L did not show such protective effects (P>0. 05). 40μmol/L APP17-mer peptide could depress the level of ROS in irradiated libroblasts. A single exposure of fibroblasts to UV irradiation resulted in 1.78 foldup-regulation of MMP-1 mRNA compared with unirradiated sample, 40μmol/L and 80μmol/L APP17-mer peptide decreased the expression of MMP-1 mRNA (P<0.05 and P<0.01, respectively).Conclusion APP17-mer peptide can enhance cellular activity under UV-induced oxidative stress and in-hibit collagen degradation in fibroblasts irradiated with ultraviolet rays. Inhibition of ROS production may be involved in the protective mechanism of APP17 peptide.

Objective To assess the impact of respiratory motion on the displacement of target area and to analyze the discrimination between free breathing and active breathing control (ABC) in patients with gastric cancer treated with post-operative radiotherapy. Methods From January 2005 to November 2006, 22 patients with post-operatively confirmed gastric cancer were enrolled in this study. All diseases were T_3/ N +, staging Ⅱ - Ⅳ. Patients were CT scanned and treated by radiation with the use of ABC. Image J software was used in image processing, motion measurement and data analysis. Surgical clips were implanted as fiducial marks in the tumor bed and lymphatic drainage area. The motion range of each clip was measured in the resultant-projection image. Motions of the clips in superior-inferior (S-I), right-left (R-L) and anterior-posterior (A-P) directions were determined from fluoroscopy movies obtained in the treatment position. Results The motion ranges in S-I, R-L and A-P directions were 11.1 mam, 1.9 mm and 2.5 mm (F = 85.15, P = 0. 000) under free breathing, with 2.2 mm, 1.1 mm and 1.7 nun under ABC (F = 17.64, P = 0. 000), and the reduction of motion ranges was significant in both S-I and A-P directions (t = 4.36, P = 0. 000;t = 3.73,P = 0.000). When compared with under free-breathing, the motion ranges under ABC were kept unchanged in the same breathing phase of the same treatment fraction, while significant increased in different breathing phase in all three directions (t = - 4.36, P = 0. 000; t = - 3.52, P = 0.000; t =-3.79, P = 0. 000), with a numerical value of 3.7 mm, 1.6 mm and 2.8 mm, respectively (F = 19.46, P = 0. 000) . With ABC between different treatment fractions , the maximum displacements were 2.7 mm, 1.7 mm and 2.5 mm for the centre of the clip cluster (F =4.07,P =0. 019), and were 4.6 mm, 3.1 mm and 4.2 mm for the clips (F =5.17 ,P =0.007). The motion ranges were significant increased in all the three directions (t = - 4.09, P=0.000 ; t =-4.46, P = 0.000 ; t = - 3.45, P =0.000). Conclusions In the irradiation of post-operative gastric cancer, the maximum displacement of organ motions induced by respiration is in S-1 direction and the minimum in R-L direction under free breathing. The use of ABC can reduce the motions significantly in S-I and A-P directions, and the same changes exist in both inter-and intra-fraction treatment.

Objective To compare the dose distribution of the target and normal tissues in gastric cancers between three-dimension conformal radiation therapy (3DCRT) and intensity modulated radiation therapy (IMRT) plan when respiratory motion factors integrated in the plan. Methods From January 2005to November 2006, 10 patients with post-operatively radiation of gastric cancer were enrolled in this study.Planning CT were acquired conventionally with free-breath mode and the static treatment plans of the 3DCRT and IMRT were designed respectively. Probability distribution functions (PDF) were generated and convoluted with the static dose distributions from 3DCRT and IMRT plans to obtain the integrated plans. The dose distributions of the target and normal tissues were compared between 3DCRT and IMRT integration treatment plans, such as V45 of clinical target volume, V4o of liver and V15, V18 of left and right kidney.Results In the respiratory integrated treatment planning, the target volume coverage and homogeneity with IMRT are superior to those with 3DCRT ( ( V45 98%∶ 87% (t = -3. 35 ,P =0. 010) ,mean dose 46. 81 Gy ±0. 75 Gy∶45.99 Gy ± 1.12 Gy (t = -0. 31 ,P=0. 020) ). The V40 of teh liver in IMRT are smaller than those in 3DCRT ( 12%∶ 16% ;t=3.75,P=0.010). For the left kidney, the V15 and V18 in IMRT are smaller than those in 3DCRT ( (34%∶ 50% (t = 2. 17 ,P = 0. 050) and 27%∶46% (t = 3. 11 ,P = 0. 020) ),but for the right kidney, V15 and V18 in 3DCRT are smaller than those in IMRT ( ( 15%∶ 21% (t = - 2. 42,P=0.040) and 11%∶15% (t= -2.71,P=0.030)). Conclusions When respiratory motion factor integrated in the treatment plan, IMRT showed advantage both in target coverage and normal tissue sparing in the high dose region of liver and left kidney.

Objective To investigate the distribution of pelvic recurrence in rectal cancer after radical resection and analyze the outcome and prognostic factors of pelvic recurrent rectal cancer treated with radiotherapy. Methods Ninety-three patients with pelvic recurrent rectal cancer who received radiotherapy from August 2000 to August 2006 were retrospectively analyzed. Of them, 21 patients received pelvic radiation alone;56 received pelvic radiation plus chemotherapy and 16 received pelvic radiation plus surgery and/or chemotherapy. Radiotherapy was delivered with 60Coγor 6/15 MV X ray to a median dose of 59. 4Gy (range,20-74 Gy). Conventional fractionation was used in 90 patients. Chemotherapy was given to 68patients with a median number of 3 cycles ( range, 1 - 8 cycles). Concurrent chemo-radiation with 5-FU based regimen was given to 42 patients. After radiotherapy, 16 patients underwent surgical resection, with 7R0 resection and 9 palliative resection. Results The entire cohort included 132 recurrent sites. The most common recurrent sites were peri-rectal region ( 31.8% ), pre-sacral region ( 30. 3% ) and internal iliac nodal region (20. 2% ). The follow-up rate was 92% for the entire cohort, 39 and 4 patients had minimum follow-up time of 2 and 5 years respectively. Overall clinical response ( complete and partial symptomatic relief) was achieved in 83% of the patients after radiation therapy. The 2-and 5-year local progression-free survival rates were 49% and 22% respectively, and the 2-and 5-year overall survival rates were 46% and 14% respectively. Multivariate analysis showed that treatment modality was the independent prognostic factor for local progression-free survival. Patients treated with radiation plus surgery and/or chemotherapy had better local progression-free survival than those treated with radiation plus chemotherapy or radiation alone.Recurrent tumors larger than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were independent unfavorable prognostic factors for overall survival. Conclusions Perirectal region, pre-sacral region and internal iliac nodal region were the most common pelvic recurrent sites in rectal cancer. Radiotherapy is an effective palliative approach for patients with pelvic recurrent rectal cancer.Radiotherapy plus surgery and/or chemotherapy was associated with better local progression-free survival,and recurrent tumors lager than 5 cm in diameter, disease-free interval less than 2 years and distant metastasis after radiotherapy were unfavorable prognostic factors for overall survival of pelvic recurrent rectal caner.