Carcinoma, Hepatocellular ; enzymology ; pathology ; Glutathione Peroxidase ; Humans ; Liver Neoplasms ; enzymology ; pathology ; Thioredoxin-Disulfide Reductase

Following with the naissance and the development of the DICOM(the Digital Image Communication in Medicine) protocol,and numerous medical image equipments factory's support to the DICOM protocol,PACS(picture archiving and communication systems)are popularized quickly in hospital image section room,which pushes the progress of PACS industry.Hospitals have always been certain blindness in ushering and arguing PACS systems,uncertain how to control those providing company exactly on the technique.In this paper,some key problems are introduced in order to make everyone understand the relevant technique.

Objective To investigate whether curcumin could inhibit the metastasis of pancreatic cancer in vitro and in vivo and its mechanism.Methods Pancreatic cancer AsPC-1 cells were treated with different concentrations of curcumin.After 72 hours,cell survival rate were detected by MTT and the appropriate concentration of curcumin was selected.After treated with 6 μmol/L curcumin,early apoptosis of AsPC-1 cells were detected by Annexin V-FITC/PI double staining flow cytometry,and the effects of curcumin on the migration and invasion of AsPC-1 cells were observed.After establishment of the orthotopic nude mouse model of pancreatic cancer,the mice were orally treated with low dose (20 mg/kg body weight) and high dose (40 mg/kg body weight) of curcumin respectively.Eight weeks later mice were sacrificed to observe the tumor metastasis,immunohistochemical methods were used to detect the positive expressions of CD34,NF-κB and MMP-9 in the tumor tissue.Results Curcumin of different concentrations could inhibit the proliferation of AsPC-1 cells and induce its apoptosis in a dose dependent manner,and 6.μmol/L was the best dose of curcumin.After 6 μmol/L curcumin treatment,the migration coverage of AsPC-1 decreased from 70％ to 10％,the number of penetrating cells decreased from 136/200x magnification to 17/200x magnification,and the difference between the two groups was statistically significant (P ＜0.05).In the nude mouse model of pancreatic cancer,the size of the tumor decreased from (97.8 ± 15.3) mm3 to (44.3 ± 9.7) mm3 in high dose group and (28.1 ±7.1)mm3 in low dose group,the number of distant metastasis decreased from 108.3 ±6.7 to 29.5 ±4.5 and 8.9 ± 2.4,the expression of CD34 decreased from 20.5 ± 2.3 to 10.3 ± 1.2 and 7.9 ± 3.2,and the expression of MMP-9 decreased from 85.2 ± 2.3 to 53.2 ± 1.2 and 34.2 ± 3.1,and the difference was statistically significant (P ＜ 0.05).Conclusions Curcumin can inhibit the metastasis of pancreatic cancer both in vitro and in vivo,and its effect may be related to the inhibition of expressions of CD34 and MMP-9.

Cancer pain can seriously disturb patients′quality of life.Intractable cancer pain not ame-nable to standard analgesics is a horrifying truth in parts of the patients.Interventional pain management tech-niques can be an effective alternative for those patients.Based on the evidence of evidence-based medicine, celiac plexus block or splanchnic nerve block are recommended for the management of upper abdominal cancer pain,pelvic cancer pain can be managed with superior hypogastric plexus block,and back pain due to vertebral compression fractures with tumor invasion can be managed with percutaneous vertebroplasty or kyphoplasty. Intercostal nerve block for chest wall cancer pain,ganglion impar block and saddle block for perineal pain due to pelvic tumors should be used only in the context of an experimental study or in cases of compassionate use with no other available forms of effective pain relief.

Objective To observe the effects of two rehabilitation programs to staff in office with cervical spondylosis,and to explore the appropriate rehabilitation program for this group of people.Methods There were 37 office personnel with cervical spondylosis were selected by the inclusion criteria.They were randomly divided into treatment group A(once a week,n=17) and treatment group B (once a week,n=20) according to the random number table method.The treatment group A took middle frequency electrotherapy and infrared therapy,while the treatment group B took tuina manipulation.The changes of visual analogue scale (VAS) and cervical range of movement (ROM) were observed after 10 weeks of treatment.Results Compared with before treatment,the VAS scores of the two treatment groups decreased with statistically significant difference after 10 weeks of treatment(tA=12.91,tB=13.88,all P<0.05).There was no significant difference in VAS score between the two treatment groups after treatment(t=0.22,P>0.05).Compared with before treatment,the cervical ROM of the two groups increased significantly after treatment(tA anteflexion=-4.59,tA posterior extension=-5.13,tA left flexion=-4.24,tA right flexion=-3.25,tA left circumflexion=-7.13,tA right circumflexion=-7.47,tB anteflexion=-5.85,tB posterior extension=-7.28,tB left flexion=-8.64,tB right flexion=-8.38,tB left circumflexion=-11.72,tB right circumflexion=-11.95,all P<0.05).There were significant differences in the increase range of flexion,left flexion and left circumflexion between the two treatment groups after treatment(tflexion=-2.29,tleft flexion=-2.77,tleft circumflexion=-2.32,all P<0.05),but posterior extension,right flexion and right circumflexion had no statistically significant diffferences(tposterior extension=-1.97,tright flexion=-1.97,tright circumflexion=-1.97,all P>0.05).Conclusion The two kinds of rehabilitation programs can relieve the neck pain of the office personnel,but treatment group B is better than treatment group A in increasing cervical ROM.

Objective To compare the two cell adhesion assay techniques based on 51 Cr release and 3H-TdR incorporation.Methods Firstly,the cells to be tested were cultured to confluence in the 96 well plate for 24 hours. After with 51 Cr or 3H-TdR label, the isotope labeled cells were add into plate wells and incubated for another 4 hours. Then the un-adhered cells were removed by gently washing. The cpm of two assay system were counted, the sensitivity and stability of two methods were compared.Results Assay methods based on 51 Cr release and 3H-TdR incorporation could both reflect the cell adhesion level correctly. In assaying sensitivity and stability showed that the 3H-TdR incorporation assay was better than in 51 Cr release assay.Conclusions Adhesion method based on isotope label could provide good sensitivity and stability. The sensitivity and stability of 3H-TdR incorporation is better than that of 51 Cr release assay.

Objective To investigate the feasibility and technique of laparoscopic subtotal cholecystectomy(LSC).Methods Totally 168 patients were converted to LSC because of failure in laparoscopic cholecystectomy(LC).During the LSC,the Calot's triangle was separated and then the Hartmann's pouch was incised to decreased the intracystic pressure for the removal of the stones.Results Among the cases,5 patients were converted to open surgery for subtotal resection of the gallbladder.LSC was completed after clipping the cystic duct and artery in 122 patients;in the other 41 cases,the gallbladder was cut at the Hartmann's pouch to clip the bile duct and artery or suture the neck of the gallbladder,and then LSC was performed.The median operation time was(65.5?15.2)min,and the intraoperative blood loss was(71.5?15.5)ml.The time to resume the diet was(20.4?6.3)h postoperation.After the operation,7 patients developed local complications(4.2%),and the mean postoperative hospital stay was(4.2?2.6)d.Of the patients,105 were followed up for(25.5?6.5)months,during this period,5 patients had dyspepsia,3 had right shoulder pain,and 9 had right hypochondrium pain.Conclusions LSC is feasible for patients with complicated cholecystitis.It is important to control the perioperative hemorrhage and bile leakage.

OBJECTIVETo explore the methods and outcomes of a minimally posteromedial transverse incision in the hip knee flexion for the treatment of tibial avulsion fracture at the insertion of posterior cruciate ligament (PCL).

METHODSTwenty-one patients with tibial avulsion fracture at the insertion of PCL treated with a minimally posteromedial transverse incision in the hip knee flexion by cannulated screw fixation from March 2010 to March 2013 were retrospectively analyzed. There were 13 males and 8 females with an average age of 35.1 years old (ranged, 20 to 56 years). Eleven cases caused by traffic accident, 3 caused by falling, 4 caused by sport, 3 caused by heavy pounds. The injury duration ranged from 3 hours to 9 days with a mean of 3.5 days. The results of posterior drawer test were positive in all patients. Lysholm score was used to evaluated knee joint function.

RESULTSAll operations were successful without infection, vessel and nerve injuries and all incisions healed by first intention with the mean length of 5.8 cm (ranged, 5 to 6 cm). All patients were followed up from 7 to 23 months with an average of 12.7 months. The results of posterior drawer test were negative in all patients. X-ray films showed that all fractures healed. The Lysholm score was improved from preoperative 40.76±9.55 to 95.86±2.33 final follow-up (t=30.07, P=0.000).

CONCLUSIONTreatment of tibial avulsion fracture at the insertion of the posterior cruciate ligament through a minimally posteromedial transverse incision in the hip knee flexion with cannulated screw fixation is a better surgical procedure with the advantages of minimal incision, sufficient exposure, effective fixation, small scar and satisfactory effects.

Adult ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Hip Joint ; surgery ; Humans ; Knee Joint ; surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures ; Posterior Cruciate Ligament ; surgery ; Tibial Fractures ; surgery

Objective To quantify the incidental irradiation dose (ⅡD) to lymph node stations of esophagus when treating patients with T1-4N0 M0 thoracic esophageal squamous cell carcinoma (ESCC) with a dose of 60 Gy/30f.Methods Twenty-nine patients with medically inoperable T1-4N0M0 thoracic ESCC were treated with three-dimensional radiotherapy on involved-field.The conformal CTV was re-created using a 3 cm margin in the proximal and distal direction (following the course of the esophagus) beyond the barium esophagogram,endoscopic examination and CT defined GTV and a 0.5 cm margin in the lateral and anteroposterior directions of the CT defined GTV.The PTV encompassed 1 cm proximal and distal margins,0.5 cm radiaI margin on the basis of CTV.Cervical,mediastinal and abdominal lymph nodes were delineated respectively.Equivalent uniform dose (EUD) and other dosimetric paraneters were calculated for each nodal station.Nodal region whose metastasis rate is greater than 5％ was considered a high risk lymph node subgroups.Results Under a 60 Gy dose prescription,the median Dmean and EUD,V40 and V50 were ≥40 Gy,≥85％ and ≥75％ in most of the high risk nodal regions.For the subgroups whose EUD were less than 40 Gy,most of the ⅡD of these regions was significantly associated with the length and location of esophageal tumor (r =0.892,P =0.000).Conclusions Lymph node stations nearby of ESCC received considerable ⅡD with involved-field irradiation which could control subclinical lesions.But more clinical studies should be needed.

Objective To evaluate the clinical efficacy and toxicities of radical intensity-modulated radiotherapy (IMRT) combined with reduction in dose of prophylactic irradiation in the treatment of stage Ⅲ small cell lung cancer (SCLC).Methods A retrospective analysis was performed on the clinical data of 40 patients with stage Ⅲ SCLC who were admitted from January 2010 to August 2012.The prescribed dose was 60 Gy in 30 fractions to the primary gross tumor volume and was 54 Gy in 30 fractions to the planning target volume.All patients received induction chemotherapy,31 patients received adjuvant chemotherapy,and 22 patients received concurrent chemoradiotherapy;the platinum-based chemotherapy combined with etoposide or teniposide was adopted.Prophylactic cranial irradiation (25 Gy in 10 fractions) was administered to 17 patients.The short-term tumor response was evaluated by RECIST 1.0,and radiation-related toxicities were assessed by CTCAE 4.0.Overall survival (OS),local recurrence-free survival (LRFS),and progression-free survival (PFS) were calculated by Kaplan-Meier method.Results The short-term tumor response rate was 98％.The follow-up rate was 100％.Twenty-two patients were followed up for at least 2 years.The 1-and 2-year OS rates were 84％ and 48％,respectively; the LRFS rates were 89％ and 85％,respectively; the PFS rates were 61％ and 41％,respectively.Grade 0-1 radiation-related pneumonia was observed in 65％(26/40) of all patients,grade 2 in 25％ (10/40),grade 3 in 5％ (2/40),and grade 5 in 5％ (2/40).Grade 0-1 radiation-related esophagitis was observed in 53％ (21/40) of all patients,grade 2 in 43％ (17/40),and grade 3 in 5 ％ (2/40).Conclusions Preliminary results from this study suggested that IMRT combined with reduction in dose of prophylactic irradiation is safe and effective in patients with stage Ⅲ SCLC and is worth further evaluation in a large,prospective,randomized study.