Objective To investigate the feasibility, short-term efficacy and adverse effects of 125 I seed implantation guided by ultrasonography or CT in the treatment of recurrent rectal cancers. Methods A total of 15 patients (4 women and 11 men) with recurrent rectal cancer entered the study. Uneer epidural anesthesia, the patients were treated with 125 I seed implantation under the guidance of either transvaginal ultrasonography or CT scans. The prescribed matched peripheral dose (MPD) was 90~110 Gy, with an activity per seed of 0.50~0.70 mCi and the total number of sources implanted of 33~70. Chest and pelvic X-ray examinations were performed within 24~48 hours after implantation to determine whether or not seed misplacement or migration existed. An additional three-dimensional conformal radiation therapy with a 4~6 fields technique was required in 6 patients 4 weeks postoperatively, with 200~300 cGy/fx, 5 fx/week, up to a total dose of 4500~5 000 cGy. Additional chemotherapy with oxaliplatin, 5-fluorouracil and tetrahydrofolic acid for one treatment course was given in 2 patients. The patients were followed for 3~15 months and the tumors were evaluated by CT findings. Results Relief from pain was achieved at a mean of 7 days after procedure, offering a complete relief in 12 patients, a partial relief in 2, and no change in 1, the effective rate being 93%(14/15). Nine patients showed a complete remission, 2 showed a partial remission, 4 showed a progressive disease, the local control rate being 73%(11/15). Two patients died of the dissemination to lungs. In 1 patient 1 seed had migrated to the pelvic side-wall and did not cause any clinical morbidity in a follow-up of 12 months. Conclusion 125 I implantation in recurrence of rectum cancer guided by ultrasonography or CT was safety, minimally invasion, low morbidity and high efficacy, it was worth of development and promotion.

2 months) was 93%(14/15); both 1- and 2-year local control rates were 83%; and 1- and 2-year survival rates were 72.9% and 62.5%, respectively. The median survival time was 32 months. Three patients had distant metastasis. Five patients died of lung metastasis (1 case) or multiple organ failure (4 cases). No complication or side-effect was observed in the patients, except skin ulceration in one patient. Conclusions Interstitial implantation of ~(125)I seed combined with or without external beam radiation therapy is convenient, effective, safe, and minimally invasive for soft tissue tumor, especially for metastatic or recurrent tumors.

Objective To construct short hairpin RNA (shRNA) recombinant expression vector for herpes simplex virus typeⅡ(HSV-2) UL29 gene and observe its inhibitory effect on HSV-2. Methods Four interference target sites of HSV-2UL29 gene were selected to construct 4 groups of small hairpin RNA respectively,named shRNA recombinant expression vector. The expression vectors were transfected into HEK293 cells with liposome. HEK293 cells were infected with HSV-2 after expression vector being transfected. The viral titer was estimated by end-point titration assay. The level of transcription was estimated by Real-Time PCR method. The expressing effect of protein was detected by Western-blot. Results Recombinant expression vector pGPU6/GFP/Neo-shRNA was constructed successfully. The result of end-point titration assay showed that the viral titer was reduced comparing with blank control (P<0.05). The result of RT-PCR showed that inhibition rates were respectively 28.80%, 59.95%, 66.08%and 36.27% comparing with blank control, and there were significant differences (P < 0.05). The effect of UL29shRNA1461 group was the best one. The result of Western-blot showed that the expressing quantity of ICP8 was reduced. Conclusion Recombinant expression vector pGPU6/GFP/Neo-shRNA can interfere HSV-2 UL29 gene expression from different cell level in vitro, which can inhibit the replication of HSV-2 genome in HEK293 cells. Thus, RNA interference (RNAi) is conducive to the further exploration of viral therapy.

BACKGROUND:To achieve the stability of the fracture reduction and try to keep the integrity of the cervical vertebra activity, domestic and foreign scholars have carried out the clinical and experimental research on the limited internal fixation of single segment, and achieved good clinical curative effect. There was no obvious discomfort symptoms caused by the instability of the atlantoaxial joint. OBJECTIVE:To perform biomechanical analysis of fixed atlas fractures by single phase with three-dimensional motion experiment. METHODS:Six fresh upper cervical spine specimens (C0-C5) were used, and made into models of double fracture of the anterior arch of the atlas. Single segment fixation was conducted with metacarpal bone reconstruction plate system simulation. Data of each specimen in intact state, fracture state and internal fixation state were measured. The neutral zones in fracture state, internal fixation state and intact state were compared, and the difference of three-dimensional motion range and intact state were compared. RESULTS AND CONCLUSION:(1) There was statistical y significant difference between the neutral zones and range of motion with those of fracture status and intact status (al P<0.05). No significant difference was found between the result of fixation status and intact status (al P>0.05). (2) Results verify that simulation of single-segment fixation of unstable atlas fractures with metacarpal bone reconstruction plate system can obtain good stability, restore the stability of the upper cervical spine, and simultaneously ful y avoid adverse effects of fusion.

BACKGROUND:Anterior cervical discectomy and fusion surgery is a good choice for repair of degenerative cervical disc herniation, but it is reported that fusion can affect the exercise of cervical neighboring stages. Artificial disc replacement can not only play a role in mitigation of cervical disease neurological symptoms and signs, but also maintain stability and semental activity of cervical spine, and reduce secondary adjacent segmental degeneration.
These two methods which applied in cervical degenerative intervertebral disc herniation stil remain controversial. OBJECTIVE:To investigate the short-term effect of artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single segmental cervical disc herniation. METHODS:Total y 48 patients with single segment radiculopathy or myelopathy cervical diseases induced by cervical disc herniation that required surgery and received a three-month fol ow-up were included and retrospectively analyzed. These patients were divided into replacement group (n=21) and fusion group (n=27) according to the different repair programs. Patients in the replacement group were subjected to Prestige LP cervical artificial disc replacement, and patients in the fusion group were subjected to disc fusion using interbody fusion cage of Johnson or al ogeneic fibularing. They were fol owed up at 1 week, 3, 6, 12, 24, 36 months after treatment. Complications were recorded during the fol ow-up. The pain of patients was evaluated using neck and upper limb pain visual analogue scale scores. The therapeutic effect was evaluated using Japanese Orthopaedic Association (JOA) score. The clinical symptoms improvement and daily functional status of patients after treatment were evaluated using cervical disability index. RESULTS AND CONCLUSION:During the final fol ow-up, the fusion rate in fusion group was 93%(25/27). Comparisons between groups:at the 1 week and final fol ow-up after treatment, the visual analog scale scores of neck and upper limbs and cervical dysfunction indexes were al lower than those before treatment;the Japanese Orthopaedic Association scores were higher than those before treatment (P<0.05). In the final fol ow-up, the visual analog scale scores of neck and upper limbs and cervical dysfunction index were al lower than those after one week of treatment, and the Japanese Orthopaedic Association scores were higher than those after one week of treatment (P<0.05). There were no significant differences in the above indicators at each time point between these two groups (P>0.05). The cervical activity and surgical segmental motion after cervical disc replacement were significantly higher than those in the fusion group;the difference was statistical y significant (P<0.05). There were no serious complications in these two groups. There was no significant difference in the incidence of complications between these two groups (P>0.05). These results suggest that the artificial cervical disc replacement and anterior cervical decompression and fusion for the treatment of single cervical disc herniation have the same effect in terms of patients’ symptoms mitigation. With respect to fusion technique, artificial disc replacement surgery has the advantage of maintaining cervical stability and activities of replacement segments.

BACKGROUND:In recent years, with the continuously improving of the fixation systems and technology, conducting anterior cervical decompression bone graft accompanying with anterior plate fixation have been accepted by most scholars, however, the complications related to this also appeared constantly. In view of this, the zero notch interbody fusion plate (Zero-P) has been approved for the clinical treatment of cervical degenerative disease. OBJECTIVE:To discuss the early application effect of Zero-p on anterior cervical decompression and fusion. METHODS:The study enrol ed 22 patients who underwent anterior cervical decompression and fusion with Zero-P between February and December 2014. The number of Zero-P implanted in the C3-4, C4-5, C5-6 was 1, 3 and 18 respectively. Pain and neurological improvement were evaluated using Visual Analog Scales score and Japanese Orthopaedic Association (JOA) score for al the patients after operation. The X-ray plain of lateral and flexion-extension lateral of cervical vertebra were shot. The degradation degree was judged based on the measurement results from the cervical lateral X-ray films about the ratio of cephalad and caudal adjacent intervertebral space to vertebral body height, and adjacent segments osteoarthritis situation. The abnormal activity at the surgical spaces was observed by the extension and flexion lateral X-ray plain. RESULTS AND CONCLUSION:Twenty-two patients obtained fol ow up for 10-28 months. 2 patients had dysphagia on the fourth day and the fifth day after operation (extremely mild). The symptom disappeared within 2 weeks after treatment. The Visual Analog Scales score was significantly lower compared with preoperation (P<0.05), the JOA score was significantly higher than that before operation (P<0.05) , the cervical Cobb angle was significantly higher than that before operation (P<0.05). There were no significant differences statistical y in comparison of the Visual Analog Scales score, JOA score and cervical Cobb angle at different time points after operation (P>0.05). In cephalad adjacent intervertebral space, 3 cases had developed hyperosteogeny (first level). In caudal adjacent intervertebral space, 1 had developed hyperosteogeny (first level). There was no significant difference in the hyperosteogeny between cephalad adjacent intervertebral space and caudal adjacent intervertebral space (P>0.05). There was no significant difference in the R value in cephalad adjacent intervertebral space and caudal adjacent intervertebral space between preoperation and postoperation (P>0.05). During the fol ow-up, no abnormal activity at the surgical spaces and implant displacement was observed. These results suggest that using Zero-p in the treatment of monosegmental disc disease has significant effect, can effectively improve the cervical curvature and establish good cervical stability. The incidence of postoperative dysphagia is low. The degeneration of adjacent segments after treatment was not increased in early stage.

Objective:To investigate the effects of two SNP sites of delta-like ligand protein-1 (DLL1) gene rs2738822 (C>T) and rs9459988 (T>G) and gene expression on bone marrow suppression after neoadjuvant chemotherapy for breast cancer.Methods:Breast cancer patients who received neoadjuvant chemotherapy were selected as study subjects, including 90 patients with severe bone marrow suppression and 72 patients with mild bone marrow suppression. Patient’s demographic characteristics and laboratory test indicators were collected. Two SNP sites of DLL1, rs2738822 and rs9459988, were genotyped by capillary electrophoresis and section analysis (SNaPshot) . The relative mRNA expression of DLL1 gene was detected by quantitative reverse polymerase chain reaction (QRT-PCR) method.Results:For The rs2738822 of DLL1 gene, the genotype distribution difference between severe and mild bone marrow suppression groups was statistically significant ( χ2=8.622, P=0.013) . Compared with CC genotype, CT and TT genotype carriers had a higher risk of severe bone marrow suppression, with an OR value of 2.746 (1.335-6.882) and 3.054 (1.282-8.143) , respectively. The dominant model results showed that TT OR CT carriers had a significantly higher risk of severe bone marrow suppression than THOSE with CC genotype [ OR=2.976 (1.231-4.963) ]. For rs9459988, there was no significant difference in genotype distribution between severe bone marrow suppression group and mild bone marrow suppression group ( χ2=2.149, P=0.342) . Results of the dominant model showed that TG or GG carriers had a significantly higher risk of severe bone marrow suppression than TT carriers, with an OR value of 2.046 (1.053-5.611) . The relative mRNA expression level of DLL1 gene was 1.15±0.23 in patients with severe bone marrow suppression, which was significantly lower than that in patients with mild bone marrow suppression (2.64±0.51) ( t=6.381, P<0.001) . For rs2738822, with the increase of T allele, the relative mRNA expression level of DLL1 gene decreased gradually ( P<0.05) . For rs9459988, the relative mRNA expression level of DLL1 gene in patients with mutant allele G was also significantly lower than that in wild-type CC carriers ( P<0.05) . Conclusion:Mutations of DLL1 genes rs2738822 and rs9459988 are related to the occurrence of severe bone marrow suppression after neoadjuvant chemotherapy for breast cancer, and can be used as a genetic marker to predict the degree of bone marrow suppression after neoadjuvant chemotherapy for breast cancer patients.

ObjectiveTo illustrate the biocompatibility of rapamycin-batroxobin eluting stent(RBES). MethodsStent made with rapamycin-batroxobin and polymer were implanted in the coronary artery of experimental group and the rapamycin with the polymer in the control group, which including 8 miniature pigs in each group. Coronary arteriographies were taken before, exactly after implanting the stent and before sacrificed the pigs. The whole blood cell counts, biochemical indexes, blood pressures, heart rates, body weights before implantation and sacrifice, together with the behavior states during the observation were analyzed. The coronary arteries of the implantation segment were observed under the scanning electron microscope and histologically. Lungs, stomachs, intestines, bowels, livers, kidneys and the ventricular walls which infused by the stents supported arteries were also observed histologically. ResultsBone marrow suppression, hemolysis, liver and kidney disfunction had not been found in the 2 groups. There was no significant difference in heart rate, blood pressure and body weight between 2 groups. Behavior was not influenced. All stents were implanted successfully. And there was no stenosis in coronary artery in both group during the 28-day period. There were no significant differences in endothelium square and the ratio of endothelium square to tunica media square. No definite inflammatory cell was found. There were no pathological damages related to RBES in lungs, stomachs, intestines, bowels, livers, kidneys and the ventricular walls infused by the stent supported arteries.ConclusionThe blood compatibility and histocompatibility were good after RBES were implanted in coronary arteries of miniature pigs.

Objective To investigate the changes and significances of peripheral blood CD34,KDR/CD34,CD133/CD34,and CD117/CD34 positive cell levels in patients with hemorrhagic stroke at the acute phase. Methods Thirty patients with acute hemorrhagic stroke admitted to the Department of Neurosurgery, Jiangsu Haimen People’s Hospital from September 2013 to April 2014 were enrolled retrospectively. At the same time,20 healthy subjects were selected as a control group. CD34 +,KDR+ /CD34 +,CD133 + /CD34 +, and CD117 + /CD34 +cell levels in peripheral blood were detected in patients with hemorrhagic stroke at day 1 to day 7 after cerebral hemorrhage and the day of physical examination of the control group using FACSCalibur flow cytometry. The data were obtained and analyzed using CELLQuest software. Results Peripheral blood CD34 + cells and KDR+ /CD34 +, CD133 + /CD34 +, CD117 + /CD34 + cells at day 1 to day 7 after ischemic stroke were all lower than control group (all P<0. 05). CD34 + and CD117 + /CD34 + cells decreased firstly at day 1 and 2, then increased gradually;KDR+ /CD34 + and CD133 + /CD34 + cells increased gradually at day 1 to day 5,they were all reached the peak at day 5,which were (14. 8±3. 5) í105 and (16. 7±3. 3) í105 respectively. Compared with that at day 1,CD34 + cells at day 5 and 6 were (27. 4 ±6. 3) í105 and (25. 4 ±5. 7) í105 respectively;KDR+ /CD34 + and CD133 + /CD34 + cells at day 4,5,and 6 were (10. 2±3. 1) í105,(14. 8±3. 5) í105,(12. 1±3. 4) í105 and (14. 3±3. 6) í105,(16. 7±3. 3) í105,and (13. 1±4. 0) í105,respectively;CD117 + /CD34 + cells at day 5 was (21. 3 ±4. 2) í105,which were all higher than the first day after cerebral hemorrhage (P<0.05). In the CD34 + cells,the proportion of KDR+ /CD34 + cells at day 1 to day 7 all decreased compared with the control group (all P<0. 05);the proportion of CD133 + /CD34 + cells at day 4 was (65±4)%,it was higher than the control group (P<0. 05);the proportion of KDR+ /CD34 + cells at day 5 was (55±6)% compared with day 1;the proportion of CD133 + /CD34 + at day 4 was (65 ±4)%;the proportions of CD117 + /CD34 + cells at day 4 and day 5 were (69 ±6)% and (72 ±6)% respectively,and they all increased (all P <0. 05). Conclusion Peripheral blood CD34 + cells and their cell subsets are change in patients with hemorrhagic stroke in acute phase. Speculating the different cell subsets may have different functions and potential. KDR+ /CD34 + and CD133 + /CD34 + may be the early sensitive indicators of acute hemorrhagic stroke,and CD117 + /CD34 + is largely mobilized in early stage.

Pulmonary vein isolation (PVI) is a new ,effective and radical method to cure atrial fibrillation .Within a period after radiofrequency ablation (RFA) ,coagulation system is activated in patients ,then thrombus incident such as cerebral embolism may happen .The present article made a review on its mechanism .