Objective To investigate the role of mitochondrial KATP channel in the mechanism of the protective effect of ischemic preconditioning (IP) against ischemia-reperfusion (I/R) injury.Methods Forty-eight Wistar rats of both sexs weighing 250-350 g were used in this study. Forty rats were randomly divided into 5 groups ( n = 8 each): group A I/R; group B IP+ I/R; group C diazoxide (DZ mito-KATP channel activator) + I/R; group D 5-HD (mito-KATP channel blocker) + IP + I/R and group E 5-HD + DZ + I/R. Another 8 animals were used for electron microscopic examination of normal mitochondria as control. The animals were anesthetized with intraperitoneal pentobarbital 30 mg?kg-1. The hearts were immediately excised and passively perfused in a Langendorff apparatus with K-H solution at 5.8 kPa perfusion pressure and 36.5-37.5℃ via aortic cannulation. A fluid-filled latex balloon was via left atrium in left ventricle for the measurement of left ventricular function. I/R was induced after 30 min stabilization by clamping aortic cannula for 40 min followed by 30 min reperfusion. In group B and D the isolated hearts underwent 2 episodes of 5 min ischemia followed by 5 min reperfusion before I/R. In group C and E DZ 50 ?mol?L-1 was infused for 10 min and in group D and E 5-HD 100 ?mol?L-1 was infused for 10 min before I/R. HR, LVSP, LVEDP and coronary flow (CF) were measured at the end of stabilization (T0 , baseline), immediately before I/R (T1 ) and at 10, 20 and 30 min of reperfusion (T2.3.4.), and left ventricular developed pressure (LVDP= LVSP- LVEDP) was calculated. Myocardial tissue was obtained at the end of 30 min reperfusion for electron microscopic examination of mitochondria. Mitochondrial ultrastructure was assessed by Flameng scoring system (0 = normal, 4 = severely damaged) .Results Ischemic and DZ preconditioning significantly increased LVDP and decreased LVEDP and Flameng score. 5-HD pretreatment partly antagonized the protective effect of IP and completely antagonized that of DZ against I/R injury. Conclusion Ischemic preconditioning protects the heart against I/R injury mainly by activating mitochondrial KATP channel.

Objective To explore the effect and safety of transcranial approach for spheno-orhital meningioma. Design Retro- spective case series. Participants Thirty-two patients being operated with transcranial approach. Twenty-four cases were meningothelial meningiomas, 3 cases were fibrous meningiomas, 1 case was psammomatous meningioma, 2 cases were atypital meningiomas, 2 case were malignant meningiomas. Methods All patients underwent frontal-temporal craniotomy, the involved sphenoid wing bone and peri- orbit were removed to prevent recurrence. The superior orbital fissure and optic canal were decompressed, the dural and periorbital de- feet were repaired by autogenous temporal fascia or artificial dura. Main Outcome Measures Preoperative and postoperative exoph- thalmus and eyeball movement, the extent of tumor resection, the ratio of recurrence. Results The extent of tumor resection: 8 cases were Simpson gradeⅡ, 20 cases Simpson gradeⅢ, 4 cases Simpson grade IV. After surgery, proptosis were improved in all patients, ophthalmoplegia was found in 6 eases. There was no operation-related death or other significant complication. Tumor recurred in 6 cas- es. Conclusions Adequate exposure of the tumor and bony decompression of the cranial nerves can result from transcranial approach, all the involved bone should be removed in order to prevent recurrence. This approach is relatively safe and the ptoptosis are improved significantly. Complete surgical resection is difficult because of the involvement of the orbital apex, superior orbital fissure and cav- ernous sinus.

Objective To observe the therapeutic effect of acupuncture combined with rehabilitation on dysphagia after stroke at differentstage. Methods According to the randomized trial principle, 155 cases were divided into two groups: control group (n=80) and observationgroup (n=75). The control group was treated with rehabilitation training, and the observation group was treated with acupuncture and rehabilitationtraining, 5 times every week for 4 weeks. The two groups were assessed by TCM swallowing assessment scores and Kubota testbefore and after treatment. Results According to Kubota test, the total rate was 66.67% in the control group and 89.33% in the observationgroup with a significant difference between the groups (P<0.001). In the observation group, the total rate was 90.48% at acute stage and88.89% at the convalescence stage with a significant difference (P<0.01). According to TCM swallowing assessment, the total rate was64.00% in the control group and 74.67% in the observation group with no significant difference between the groups (P<0.05). In the observationgroup, the total rate was 90.48% at acute stage and 68.52% at the convalescence stage with a significant difference (P<0.001). ConclusionAcupuncture combined with rehabilitation facilitates to improve the swallowing function in stroke patients following dysphagia especiallyat acute stage.

Objective To evaluate the palliative effect of 89 SrCl on multiple metastatic bone-pain of malignant turnouts.Methods The palliative effect and side effect of 126 patients with metastatic bone-pain of malignant turnouts after intravenous injeotion 89SrCl were observed.Results The bone-pain vanished or released in 109 patients after therapy.The total effective rate was 86.5%.Bone scan showed that metastatic focals in 38 patients grew down and vanished.The counts of leucocyte was decreased mildly in 19 patients.The damage of liver and kidney was not observed after therapy.Conclusion The 89 SrCl has obvious effect on treating patients with metastatic bone-pain and osteolytic of carcinoma,the aide-effect is mild and it can be used repeatedly.

Objective To explore the changes and the tendency of breast cancer radiotherapy in China within the past decade.Methods A survey on breast cancer radiotherapy in 1 999 and 2006 was conducted in 4 hospitals located within the southeast coastal region of China,including patients'clinical characteristics,the purpose of radiotherapy and its techniques.Results The percentage of breast conservative treatment(BCT)increased from 3%in 1999 to 13%in 2006.For radiotherapy techniques in 2006 compared with 1999,the growth trend was found in use of breast immobilization devices(80% vs.46%),treatment planning system(70% vs.23%),and CT simulation(14%vs.0).The frequency was increased in the chest wall irradiation after masteetomy(90%vs.67%),but decreased in internal mammary region(30%vs.76%)and axilla(37%vs.69%)treatment.There were no differences in total dose and fractionation prescription.Conclusions BCT was performed more frequently,but postmastectomy radiotherapy was still essential option in China at present.Although some advanced techniques were applied frequently in clinical practice.Simulation,treatment planning,and irradiation target design were urgent for improvement and standardization.

Objective To investigate proliferation and apoptosis of colonic epithelial cells from ulcerative colitis (UC)patients with active new-onset,remission and active recurrent stages,and to study the effects of 5-aminosalicylic acid (5-ASA)on proliferation and apoptosis of colonic epithelial cells during the treatment of inducing remission and maintanence remission. Methods From January 2002 to December 2012,twelve patients with mild-to-moderate UC who received treatment and long-term follow-up and achieved remission with 5-ASA and received long-term maintanence treatment with it were assigned to UC group.At the same period,10 healthy individuals with negative endoscopy results or solitary colonic polyp were assigned to control group.The biopsy tissues from colonoscopy for pathological examination of patients in UC group at new-onset active stage,remission stage and recurrence stage were obtained.Levels of proliferation marker Ki-67 and apoptosis of colonic epithelial cells were determined by immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL)assay,respectively.Data were expressed by median(lower quartile,upper quartile).Kruskal-Wallis test and Mann-Whitney test were performed to compare the differences between groups and Bonferroni method was used for correction.Results The median proliferation indexes (PI)of colonic epithelial cells of UC patients at new-onset active period,remission period and recurrent active period were 31 .65 % (19.14%,39.66%), 12.30% (11 .11 %,14.10%) and 44.15 % (33.65 %,52.45 %), respectively,which were all higher than those of control group (7.89% (6.54%,8.86%))there were statistically significant differentes among four groups (H =30.033,P <0.01 );those of new onset active period and recurrent active period were both higher than remission period,and the differences were statistically significant (all P <0.05/6).The median apoptosis indexes (AI)of colonic epithelial cells in UC patients at new-onset active period,remission period and recurrent active period were 24.18%(17.81 %,27.16%),44.19% (43.41 %,50.55 %),41 .24% (33.78%,46.24%),respectively,which were all higher than those of control group (2.65 %(2.48%,2.98%)),there were statistically significant differences among four groups (H =31 .563,P <0.01);and those of remission and recurrent active period were both higher than new-onset active period (all P <0.05/6).The median apoptosis/proliferation ratios of control group,new onset active period,remission period and recurrent active period were 0.320 0 (0.275 5 ,0.425 0),0.749 9 (0.634 9,1 .115 8 ),3.282 8 (3.133 1 ,4.406 8 )and 1 .008 2 (0.801 9, 1 .099 2),respectively,there were statically significant differences among four groups (H =29.441 ,P <0.01);those of new onset active period and recurrent active period were both lower than that of remission period and the differnces were statistically significant (both P <0.05/6 ).Conclusions Proliferation and apoptosis imbalance in colonic epithelial cells of UC patients is one of the important mechanisms for the pathgensis of UC.5-ASA does not promote the proliferation of epithelial cells during UC remission period.

Objective To investigate the eftect of radiation dose of dual-source computed tomography (CT) dual energy single-phase enhanced scan in patients with esophageal cancer.Methods The prospective study was conducted.The clinicopathological data of 56 patients with esophageal cancer who were admitted to the Lishui Hospital of Zhejiang University between January 2015 and December 2016 were collected.All the patients were divided into the experimental group (undergoing dual-source CT dual energy single-phase enhanced scan) and control group (undergoing dual-phase CT enhanced scan) bv randomised block method.TNM classification of esophageal cancer (Seventh Edition) published by American Joint Committee on Cancer (AJCC) was used as a standard TNM staging.Two observers independently read films.All the patients underwent radical resection of esophageal cancer or palliative surgery,and then received adjuvant radiochemotherapy.Follow-up using outpatient examination and telephone interview was performed to detect postoperative survival of patients up to March 2017.Observation indicators:(1) consistencies of T staging,N staging and M staging;(2) accuracies of T staging,N staging and M staging (pathological results as a gold standard);(3) radiation dose of CT scan;(4) treatment and follow-up situations.The Kappa test was used for evaluating the consistency,κ≥0.75 as a good consistency,0.40≤κ＜0.75 as a normal consistency and κ＜0.40 as a poor consistency.Comparisons of count data and ratio were done by the chi-square test.Comparisons of measurement data were analyzed by the t test.Results A total of 50 patients were enrolled in the study,including 25 in the experimental group and 25 in the control group.(1) Consistencies of T staging,N staging and M staging:all the 50 patients finished successfully CT scans.Two observers considered that consistencies of T staging,N staging and M staging in the 2 groups were normal (κ =0.452,0.618,0.729,P＜0.05).Consistencies of N staging and M staging were superior to T staging.(2) The pathological results were used as a gold standard.Accuracies of T staging,N staging and M staging in the experimental and control groups were 72％,76％ and 88％,84％ and 92％,88％,respectively,with no statistically significant difference between the 2 groups (x2 =0.10,0.37,0.50,P＞0.05).(3) Radiation dose of CT scan:volume CT dose index (CTDIvol),dose length production (DLP) and effective radiation dose (E) were (10.35±2.01) mGy,(400.63± 34.13) mGy · cm,(5.61 ± 0.47) mSv in the experimental group and (3.55 ± 0.60)mGy,(140.66± 10.89) mGy · cm,(1.98±0.17) mSv in the control group,respectively.There were statistically significant differences in CTDIvol and E between the 2 groups (t =16.23,36.30,P＜0.05).(4) Treatment and follow-up situations:of 50 patients,43 patients received treatments,including 32 undergoing radical resection (11 receiving postoperative adjuvant chemotherapy),6 undergoing palliative surgery,3 receiving single radiotherapy and 2 receiving single chemotherapy.Thirty-six of 43 patients were followed up for 3-18 months,with a median time of 6 months.During follow-up,1-year survival rate was 61.1％.Conclusion Dual-source CT dual energy single-phase enhanced scan in patients with esophageal cancer cannot reduce accuracy of TNM staging,but decreased effectively radiation dose.

Objective To evaluate cerebral parenchymal atrophy of patients with Alzheimer's disease(AD)through the compara-tive analysis of the volume and morphology of the brain ventricle between patients with AD and normal elderly.Methods 20 patients with AD and 20 normal elderly people were scanned at 3.0T MR,and lateral ventricle section images were achieved,and the lateral ventricle volume and the anterior horn,posterior horn and temporal horn of the lateral ventricle were calculated by analyzing the re-construction of section images with MIMICS software from Belgian.Results As compared with normal elderly group,the patients with AD exhibited significantly increased the volume of left ventricular volume(LV),right ventricular volume (RV)and total vol-ume (TV)(P<0.05).Angle of bilateral anterior horn and temporal horn but not posterior horn of the lateral ventricle in patients with AD were significantly higher than that in normal elderly (P<0.05).The volume of the left,right and total cerebral ventricle, the angle of the anterior horn of the left and right lateral ventricle and the angle of the temporal horn of the left and right lateral ven-tricle were negatively correlated with MMSE (P<0.05).Conclusion Patients with AD exhibites significantly greater volume and an-gle of the lateral ventricular than normal elderly people.These related data measured can predict brain parenchymal atrophy of pa-tients with AD more conveniently and accurately.

Objective To investigate the value of 99Tcm-methoxyisobutylisonitrile (MIBI) scintigraphy in assessing the preoperative chemotherapy response and multidrug resistance of osteosarcoma.Methods From January 2007 to October 2008, 12 patients (female:4, male:8; mean age:16.3 years,range:8-27 years) underwent early (10min) and delayed (120 min) 99Tcm-MIBI scintigraphy before and after preoperative chemotherapy.Seven cases had osteosarcoma at the distal femurs, 2 at the proximal tibias, 2 at the upper end of humerus and 1 at the fibula.The tumor-to-background ratio (T/B) and washout rate (WR) were calculated.Tumor necrosis was classified according to Huvos criterion after limb salvage surgery.Immunohistochemical staining for P-glycoprotein(gp) was examined.Spearman correlation analysis and t-test were performed.Results According to Huvos criterion, 7 patients were classified as good responders with more than 90% of tumor cell necrosis and 5 as poor responders with less than 90% of tumor cell necrosis.R value (ratio of early phase T/B after and before chemotherapy) was significantly lower in good responders than that in poor responders (0.473 ± 0.21 vs 0.998 ± 0.06, t= 5.342, P= 0.000 ).R value was significantly correlated with the degree of tumor cell necrosis ( rs=- 0.87, P= 0.000 ).WR was significantly higher in patients with positive P-gp expression than that in patients with negative P-gp expression ((38.36 ±18.64)% vs (6.40±5.87)%, t= -3.278, P=0.008).There was significant correlation between the WR and P-gp expression (rs = 0.91, P= 0.001 ).Conclusion 99Tcm-MIBI scintigraphy is a feasible non-invasive technique to assess the chemotherapy response and to detect P-gp expression of osteosarcoma.

BACKGROUND: Intravenous transplantation has been regarded as a most safe method in stem cell therapies. There is evidence showing the homing of bone marrow stem cells (BMSCs) into the injured sites, and thus these cells can be used in the treatment of acute myocardial infarction (MI). This study aimed to investigate the effect of intravenous and epicardial transplantion of BMSCs on myocardial infarction size in a rabbit model. METHODS: A total of 60 New Zealand rabbits were randomly divided into three groups: control group, epicardium group (group I) and ear vein group (group II). The BMSCs were collected from the tibial plateau in group I and group II, cultured and labeled. In the three groups, rabbits underwent thoracotomy and ligation of the middle left anterior descending artery. The elevation of ST segment>0.2 mV lasting for 30 minutes on the lead II and III of electrocardiogram suggested successful introduction of myocardial infarction. Two weeks after myocardial infarction, rabbits in group I were treated with autogenous BMSCs at the infarct region and those in group II received intravenous transplantation of BMSCs. In the control group, rabbits were treated with PBS following thoracotomy. Four weeks after myocardial infarction, the heart was collected from all rabbits and the infarct size was calculated. The heart was cut into sections followed by HE staining and calculation of infarct size with an image system. RESULTS: In groups I and II, the infarct size was significantly reduced after transplantation with BMSCs when compared with the control group (P<0.05). However, there was no significant difference in the infarct size between groups I and II (P>0.05). CONCLUSION: Transplantation of BMSCs has therapeutic effect on MI. Moreover, epicardial and intravenous transplantation of BMSCs has comparable therapeutic efficacy on myocardial infarction.