Objective To investigate feasibility and validity of endovascular aortic repair (EVAR) of traumatic thoracic aortic injuries (TTAI).Methods A retrospective analysis was conducted on data of 13 patients with TTAI.Pathological changes were evaluated by spinal CT angiography (CTA) preoperatively and re-evaluated by digital subtraction angiography (DSA) in EVAR.CTA was performed again to confirm therapeutic effects at postoperative 3,6,12 months and annually thereafter.Results All patients had successful EVAR.Complete or partial cover of left subclavian artery was observed in four patients.Endoleak in angiography shortly after stent delivery was noticed in three patients.However,endoleak disappeared in one patient after short stent placement for twice; endoleak was evidently decreased in one patient after balloon dilation.Follow-up was performed for another patient with slight endoleak.A total of 12 patients were followed up,which showed no complications,such as endoleak,ischemia of left upper extremity,paralysis or stent-graft migration.Conclusion EVR is safe and effective in treatment of TTAI.

Objective To evaluate the value of cough test in the tension-free vaginal tape (TVT)procedure.Methods A cohort of 85 women with stress urinary incontinence underwent the TVT procedure with cough test (n =41) or without cough test (n =44).Patients in cough test group were performed according to the Ulmsten’s method strictly,with the stress of tape adjusted in light of cough test; whereas in other 44 operations,the tape was placed on the urethral tract without stress,and no cough test was performed.The urine catheter was removed after 48 hours postoperatively and follow-up evaluation was carried out at 12 month postoperatively.Results TVT procedure was carried out successfully in all patients by a single experienced surgeon.Four cases of urinary retention and 5 cases of voiding difficulty were observed in the cough test group.However,urinary retention or voiding difficulty was not detected in the nun-cough test group.Based on the twelve-month follow-up results,the cure rate was 92.6％ (38/41) in the cough test group and 93.1％ (41/44) in the non-cough test group.Flow-pressure study indicated that 11 cases in cough test group were in the obstruction zone,while only 3 cases in the obstruction zone were detected in the non-cough test group.Conclusions TVT is a safe as well as effective minimally invasive surgical procedure to treat female stress urinary incontinence.However,Adjusting stress of tape in accordance with cough test during the TVT may potentially increase the incidence of urinary dysfunction postoperatively.Therefore,no convincing evidence was gained to support the efficacy of cough test during TVT in terms of preventing postoperative voiding dysfunction.

AIM: To evaluate the effects of over-expression of cellular repressor of E1A-stimulated genes(CREG) mediated by retrovirus on neointima formation in injured rat carotid.METHODS: The pluronic F127 containing pLNCX/CREG or pLNCX/GFP retroviral vectors was placed around the injured rat carotid.The neointima,media areas and the intima to media ratio were calculated.Expressions of CREG,SM ?-actin and Ki-67 were detected.RESULTS: The GFP expression was observed at day 2 in pLNCX/GFP groups.The expression of exogenous CREG was also significantly increased in arteries at day 2 after pLNCX-CREG infection.Over-expression of CREG significantly suppressed neointima formation,attenuated the expression of Ki-67 and up-regulated SM ?-actin expression.CONCLUSION: Over-expression of CREG inhibits VSMCs proliferation and promotes VSMCs differentiation after vascular injury.It suggests that modulation of CREG expression or activity may be a viable approach to treat neointimal restenosis after percutaneous coronary intervention.

ObjectiveTo analyze the characterstics of phenotype and genotype of multidrug resistant tuberculosis (MDR-TB) and extensively drug resistant tuberculosis (XDR-TB) by molecular line probe assay and liquid culture with MGIT960.MethodsGenoType MTBDR Kits were used for identifying the types of the first-line and second-line antituberculosis drug resistant genes partly and BD MGIT960 was used for detecting the chug susceptibility.Results( 1 ) Out of 94 MDR-TB strains,the rate of drug resistant to EMB,AMK,OFX and MFX by BD MGIT960 assay were 36.2%,17.0%,54.3% and 55.3%,respectively.Among these isolates,13 were extensively drug resistant tuberculosis (XDR-TB).(2) Compared with MGIT960,the concordance rate of GenoType MTBDRplus was 86.2% and 95.7% respectively.Taking MGIT960 results as reference,the sensitivity of GenoType MTBDRsl detecting the susceptibility of EMB,AMK,OFX and MFX to 94 isolates were 47.1%,81.3%,94.1%,94.2%,respectively.The specificity were 75.0%,98.7%,90.7%,92.9%,respectively.(3) Among the rpoB mutation categories,S531L accounts for most.MTB resistant to IFN caused by the mutation of katG chiefly and the S315T1 was in the majority.The gyrA mutation sites located at the ninety-fourth codon most.Out of 94 strains,23 were mixed with 2 kindsof Mycobacterium tuberculosis at least and 7 were undetectable mutations.Conclusion Among the M/XDR-TB,the strains resistant to INH,RFP,AMK,OFX and MFX were caused most by the mutation of katG,rpoB,rrs and gyrA,respectively.The relationship between EMB and embB was not so clear relatively.As a fast detecting drug susceptibility test kit,GenoType MTBDR possess good sensitivity and specificity.So,it could be as an assistant method to guide the therapy on clinic.

OBJECTIVETo investigate the lymph nodes distribution and metastatic pattern of the ultra-low rectal cancer after neoadjuvant therapy.

METHODSA total of 21 rectal cancer gross specimen after neoadjuvant therapy and 23 rectal cancer gross specimen without neoadjuvant therapy were investigated by whole mount section and tissue microarray techniques with CK20. All the patients were treated by abdominoperineal resection.

RESULTSThere were 138 lymph nodes retrieved from the mesorectum in the neoadjuvant group including 39 metastatic lymph nodes and 12 micro-metastatic lymph nodes. Among these nodes, there were 7 rectal cancer cases with lymph nodes and 2 cases with micro-metastatic lymph nodes, and 6 cases had pathological complete remission. There were 415 lymph nodes retrieved from the mesorectum in the group without neoadjuvant therapy including 169 metastatic lymph nodes and 59 micro-metastatic lymph nodes. Among these nodes, there were 12 rectal cancer cases with lymph nodes and 4 cases with micro-metastatic lymph nodes. The proportions of metastatic lymph nodes in outer zone between the two groups were 21.5% and 29.0%, and those in pre-zone were 17.6% and 17.2% respectively. The ratio of metastatic lymph nodes in ischiorectal fossa between the two groups were 25.0% vs. 22.2% respectively. The rate of metastatic or micro-metastatic lymph nodes cases between the two groups were 4.8% vs. 13.0% respectively.

CONCLUSIONSThe lymph nodes distribution and metastatic pattern of the ultra-low rectal cancer are affected by neoadjuvant therapy. The proportions of the anal sphincter invasion and metastatic or micro-metastatic lymph nodes in ischiorectal fossa are lower after neoadjuvant therapy. Abdominoperineal resection as the standard treatment of the ultra-low rectal cancer after neoadjuvant therapy should be re-evaluated.

Biopsy ; Digestive System Surgical Procedures ; Humans ; Lymph Nodes ; pathology ; Lymphatic Metastasis ; Neoadjuvant Therapy ; Rectal Neoplasms ; pathology ; therapy

Adult ; Arthroscopes ; Bone Cysts ; surgery ; Bone Neoplasms ; surgery ; Female ; Humans ; Talus ; surgery

Insulin-like growth factor binding-protein-7 (IGFBP7) was obtained from our previous colonic adenocarcinoma (CRC) and normal mucosa suppression subtraction hybridization (SSH) cDNA libraries. By RT-PCR and immunohistochemistry, we found that IGFBP7 was overexpressed in CRC tissue compared to normal tissue. However, our in vitro experiments performed in 10 CRC cell lines showed that IGFBP7 expressed only in SW480 and Caco2 cell lines, which implied an underlying reversible regulatory mechanism. Using methylation-specific PCR (MSP) and bisulfite sodium PCR (BSP), we found that its expression was associated with DNA hypomethylation of exon1. This was further supported by the in vitro study which showed restored IGFBP7 expression after demethylation agent 5-aza-2'-deoxycytidine treatment. Correlation analysis between IGFBP7 expression and prognosis indicated that overexpression of IGFBP7 in CRC tissue correlated with favourable survival. Investigation of the functional role of IGFBP7 through transfection studies showed that IGFBP7 protein could inhibit growth rate, decrease colony formation activity, and induce apoptosis in RKO and SW620 cells, suggesting it a potential tumor suppressor protein in colorectal carcinogenesis. In conclusion, our study clearly demonstrated that IGFBP7 plays a potential tumor suppressor role against colorectal carcinogenesis and its expression is associated with DNA hypomethylation of exon 1.
Adenocarcinoma ; genetics ; metabolism ; Apoptosis ; genetics ; Cell Line, Tumor ; Colorectal Neoplasms ; genetics ; metabolism ; DNA Methylation ; Exons ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Insulin-Like Growth Factor Binding Proteins ; genetics ; metabolism ; Transfection ; Tumor Suppressor Proteins ; genetics ; metabolism

Insulin-like growth factor binding-protein-7 (IGFBP7) was obtained from our previous colonic adenocarcinoma (CRC)and normal mucosa suppression subtraction hybridization (SSH) cDNA libraries. By RT-PCR and immunohistochemistry, we found that IGFBP7 was overexpressed in CRC tissue compared to normal tissue. However, our in vitro experiments performed in 10 CRC cell lines showed that IGFBP7 expressed only in SW480 and Caco2 cell lines, which implied an underlying reversible regulatory mechanism. Using methylation-specific PCR (MSP) and bisulfite sodium PCR (BSP), we found that its expression was associated with DNA hypomethylation of exon 1. This was further supported by the in vitro study which showed restored IGFBP7expression after demethylation agent 5-aza-2'-deoxycytidine treatment. Correlation analysis between IGFBP7 expression and prognosis indicated that overexpression of IGFBP7 in CRC tissue correlated with favourable survival. Investigation of the functional role of IGFBP7 through transfecfion studies showed that IGFBP7 protein could inhibit growth rate, decrease colony formation activity, and induce apoptosis in RKO and SW620 cells, suggesting it a potential tumor suppressor protein in colorectal carcinogenesis. In conclusion, our study clearly demonstrated that IGFBP7 plays a potential tumor suppressor role against colorectal carcinogenesis and its expression is associated with DNA hypomethylation of exon 1.

OBJECTIVETo evaluate the erectile function of male patients treated by neoadjuvant radiochemotherapy and neoadjuvant chemotherapy alone for mid-low rectal cancer.

METHODSThe clinical data of 66 patients with rectal cancer from March 2011 to March 2013 were prospectively analyzed. Of all the patients, 56 cases were finally included in the study and were randomly allocated to two groups. Thirty patients were treated by neoadjuvant radiochemotherapy followed by surgery (RCS group), and 26 were treated by neoadjuvant chemotherapy followed by surgery (NCS group). The five-item version of the international index of erectile function (IIEF-5) questionnaire were used to determine erectile function before therapy and at least 12 months after surgery. The impacts of age, location, size of tumor, and body mass index on erectile function were analyzed.

RESULTSTotal score was decreased significantly at follow-up compared to initial assessment in both RCS and NCS groups (23.4 ± 1.30 vs. 11.7 ± 5.8, t = 10.748, P < 0.01; 23.1 ± 1.3 vs. 15.2 ± 6.7, t = 5.910, P < 0.01, respectively). Score difference was statistically higher in RCS group compared with NCS group (11.7 ± 5.6 vs. 8.0 ± 6.0, t = 2.394, P = 0.020). In terms of tumor location for RCS group, difference was statistically higher in the patients with low rectal cancer compared with those with middle rectal cancer (14.5 ± 3.5 vs. 9.5 ± 6.0, t = 2.894, P = 0.008).

CONCLUSIONSThe erectile functions of patients treated by neoadjuvant radiochemotherapy followed by surgery are more affected than that of patients treated by neoadjuvant chemotherapy followed by surgery in mid-low rectal cancer. Also low rectal cancer are significantly associated with erectile dysfunction in the patients treated by neoadjuvant radiochemotherapy followed by surgery.

Chemoradiotherapy ; Follow-Up Studies ; Humans ; Male ; Neoadjuvant Therapy ; Penile Erection ; physiology ; Prospective Studies ; Rectal Neoplasms ; surgery ; therapy ; Treatment Outcome