Objective To summarize the features of multi-slice spiral computed tomography (MSCT) examination of acute primary epiploic appendagitis,and investigate the clinical value of MSCT.Methods The clinical data of 19 patients with acute primary epiploic appendagitis who were admitted to the Yangzhou No.1 Hospital from December 2009 to March 2014 were retrospectively analyzed.All the patients received MSCT examination,and the data were transported to the work station for multiplanar reconstruction.The location,shape,size,density,peripheral performance and peritoneal thickening were observed.Results The foci of the 19 patients were located adjacent to the colon.One focus was adjacent to the cecum,4 were adjacent to the ascending colon,1 was adjacent to the hepatic flexure of the colon,6 were adjacent to the descending colon,and 7 were adjacent to the sigmoid colon.The shapes of the foci were similar to the oval or ring in 14 cases and similar to the flame in 5 cases.The diameters of the foci were 0.8-3.7 cm.The results of CT plain scan showed that the density of the foci was similar to that of the fat,and the CT value was-101--34 HU.The central density of the foci was lower,while the limbic density was higher.The results of CT enhanced scan showed a ring-like enhancement region in the foci,and the lesion was surrounded by slightly high-density inflammation.Point or linear slightly high-density shadows were detected at the center of the foci in 9 patients.The peritoneum was locally thickened in 14 patients.The colonic wall was locally thickened in 1 patient,and the pelvic effusion was detected in 5 patients.The results of CT reexamination of 4 patients showed that the inflammatory regions were reduced or disappeared,the mass shrank,nodulized or calcified.Conclusions MSCT examination can provide a specific features of primary epiploic appendagitis.It could accurately diagnose acute primary epiploic appendagitis when combined with multiplanar reconstruction.

BACKGROUND:Percutaneous vertebroplasty technique has become an effective means for clinical treatment of spinal osteoporotic fractures, but there is the risk of bone cement leakage.
OBJECTIVE:To explore the clinical effect of percutaneous vertebroplasty with low-dose bone cement for acute osteoporotic vertebral compression fractures.
METHODS:From September 2008 to February 2011, 32 patients with osteoporotic compression fractures were treated by percutaneous vertebroplasty. According to the dose of bone cement, the patients were divided into low dose group (2-4 mL) and routine dose group (4-6 mL). In addition, another patients who were hospitalized over the same period for acute osteoporotic compression and could not receive vertebroplasty due to urgical contraindication served as control group.
RESULTS AND CONCLUSION:The pain relief and vertebral height restoration rate of the low dose group and routine dose group were significantly better than the control group (P<0.05). The bone cement leakage rate and last fol ow-up incidence of adjacent segment vertebral fractures of the low dose group were also significantly lower than those in the routine dose group (P<0.05). Vertebroplasty with modified low dose bone cement can achieve satisfactory clinical effects, and effectively reduce the leakage of bone cement and incidence of adjacent segment secondary fractures.

Objective To explore the role and mechanism of Toll-like receptor 4(TLR4)and chemokine receptor 7(CXCR7)in the pathogenesis and development of Helicobacter pylori(HP)positive gastric cancer.Methods Tissues of 147 cases with gastric carcinoma and 60 normal control were collected.The protein expression of TLR4,CXCR7 was detected by immunohistochemical staining.HP infection in these samples were detected by immunohistochemistry and Gram staining.Results The positive rates of TLR4 and CXCR7 in gastric cancer tissues were 63.9% and 62.6%,respectively,which were significantly higher than those in normal control group(15.0% and 5.0%,respectively;X2=40.832,56.901,all P<0.01).The positive rates of TLR4 and CXCR7 in patients with lymph node metastasis were significantly higher than those without lymph node metastasis(X2=9.809,11.444,all P<0.01).The positive rates of TLR4 and CXCR7 in patients with stage Ⅲ and Ⅳ were significantly higher than those of stageⅠand Ⅱ(X2=24.927,27.642,all P<0.01).The expression of TLR4 and CXCR7 in gastric carcinoma was significantly related to HP infection.Kaplan-Meier survival analysis showed that the survival rates in TLR4 and CXCR7 positive group were significantly lower than those in TLR4 and CXCR7 negative groups(F=4.053,4.091,all P<0.05).COX regression analysis indicated that the TNM stage,the expression of TLR4 and CXCR7 were independent prognosis factors of gastric carcinoma.Conclusion TLR4 and CXCR7 are closely related to the occurrence and development of gastric cancer,and may play an important role in HP carcinogenesis.It may be involved in the invasion and metastasis of gastric cancer cells via LPS/TLR4 signaling pathway.

Purpose:To investigate the survival and prognostic factors in patients with stage Ib～IIb node-negative cervical carcinoma.Methods:From Nov.1993 to Dec. 1997,236 patients who had radical hysterectomy and pelvic lymphadenectomy and pelvic lymph node found negative were reviewed retrospectively. Survival rates were calculated by Kaplan-Meier method with differences in survival estimated by Log-rank test. Independent prognostic factors were identified by the Cox's proportional-hazards regression model. Results:The overall 5-year survival of the patients was 82.0% and the median survival time was 100.0 months. The recurrence and/or metastatic rate was 19.5%. Of these patients the 5-year survival rate was 16.9% and median survival time was 15.0 months. Among the variables,clinical stage(Ⅱb),tumor size(≥4 cm),histological type (non-squamous carcinoma),poor differentiation,deep stromal invasion,parametrial extension,vaginal margin involved,and lymphvascular permeation were the poor prognostic factors in univariate survival analysis ( P

Purpose:To detect the expression of cytokeratin 19 (CK19) mRNA and human papillomavirus type 16 (HPV16) mRNA in peripheral blood of cervical cancer patients. Methods:We used reverse transcription polymerase chain reaction (RT-PCR) to determine the expression of CK19 and HPV16 mRNA of 30 cervical cancer patients,8 patients with known distant metastases,16 patients with benign gynecological tumors and 9 healthy persons as control. Results:The presence of CK19 mRNA was observed in 3 peripheral blood samples among 30 cervical cancer patients (10%). The positive ratios for cervical patients with metastases,benign tumors and healthy control were 8/8,0/16 and 0/9. Only 10 cervical samples were proved to be HPV 16 positive by immunohistochemistry and/or hybridization in situ,whose expression of HPV16 mRNA in the peripheral blood were all negative (0/10). The positive ratios for cervical patients with metastasis,benign tumors and healthy control were 1/8,0/16 and 0/9,respectively. Conclusions:CK19 mRNA may be considered a powerful biomarker in the detection of peripheral blood of cervical cancer patients due to its high sensitivity and specificity. The detection of HPV16 mRNA was low and its clinical significance needs further evaluation.

Objective To explore the clinical effect of low-dose bone cement injection in percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures .Methods 41 cases of osteoporotic vertebral compression fractures from February 2009 to February 2012 were treated with percutaneous vertebroplasty .The patients were divided into the low-dose group and the conventional dose group according to the amount of bone cement injection .The postoperative VAS score ,cement leakage rate ,verte-bral height restoration degree and incidence rate of adjacent segment fracture were observed ,evaluated and compared .Results The follow-up period ranged from 3 months to 15 months(average 11 .2 months) .The postoperative pain relief effect in the conventional dose group and the low dose group was similar .The vertebral height restoration rate of the conventional dose group was superior to that of the low-dose group .In the aspects of the bone cement leakage rate and adjacent segment vertebral secondary fracture ,the low-dose group was superior to the conventional dose group .Conclusion In the procedure of percutaneous vertebroplasty ,applying the low-dose bone cement injection can reach the satisfactory clinical effect ,at same time can effectively reduce the complication oc-currence rate of bone cement leakage and adjacent segments secondary fractures .

Objective To evaluate the diagnostic accuracy of ultrasound miniature probe(UMP)examination in tumor invasion(T staging) and local lymphatic node metastasis(N staging) for colorectal carcinoma. Methods Preoperative UMP examinations(12 MHz) were performed on 53 patients with colorectal carcinoma undergoing surgeries.The diagnosis accuracy of UMP examination in T and N staging was determined by comparison of the results of operation exploration and histopathologic findings. Results The accuracy in T staging for colorectal carcinoma was 86% with UMP examination,and that for early stage colorectal carcinoma was 100%.The accuracy,sensitivity and specificity in N staging for colorectal carcinoma were 81%,77%,and 84%,respectively with UMP examination. Conclusion UMP examination works well in determining T stage of colorectal carcinoma,especially for early stage colorectal carcinoma and those with tumor stenosis.

AIM:To observe the effect of captopril on the genesis and development of gastric cancer , and to explore its clinical treatment feasibility for gastric cancer .METHODS:The human gastric cancer cell line AGS was used to establish a tumor model in nude mice , and the model mice were randomly divided into 3 groups: positive control ( 5-fluorouracil) group, normal control (saline) group and experimental (captopril) group.After intraperitoneal injection or intragastric administration of the drugs , the tumor growth curve was determined , and the tumor tissues were also sampled to detect the expression of Ki-67, STAT3, Bax and Bcl-2 by real-time quantitative PCR and immunohistochemistry .The apop-tosis was detected by TUNEL +DAPI staining .RESULTS: The tumor growth curve showed that the tumor model in the nude mice was successfully established .The tumor volumes among groups showed significantly different after 14 d growth. The increase in the tumor volume in normal control group was significantly faster than that in the other two groups , and that in positive control group was the slowest .The expression of Bax in captopril group increased , and the expression of STAT3, Ki-67 and Bcl-2 was reduced as compared with normal control group and positive control group .Compared with normal con-trol group, the apoptotic rate increased significantly , and the protein expression of p-STAT3 and STAT3 decreased obviously in positive control group and captopril group .CONCLUSION:With better feasibility , angiotensin-converting enzyme in-hibitor captopril has a significant effect on treating gastric cancer in the AGS nude mouse model by regulating the expression of STAT3, Bax, Bcl-2 and Ki-67 to accelerate the apoptosis of cancer cells , thus inhibiting tumor growth .

Objective To evaluate the feasibility and safety of laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion.Methods In performing this procedure,first dissect the right hepatic portal,and under selective hemihepatic inflow occlusion,laparoscopie Peng's multifunctional operative dissector (LPMOD) was used to transect the hepatic parenchyma by stepwise curettage and aspiration.Results Procedures were successful in all six patients of benign liver diseases,though a small subcostal auxiliary incision was needed in one case to control the middle hepatic vein branch hemorrhage.Operation time was 300-540 min[mean,( 399 ± 75 ) min].The time of hepatic portal dissect was 30-75 min[mean,(51 ± 16) min].The time of liver parenchyma transection was 60-160 min[mean,( 116 ± 32) min].Intraoperative blood loss was 600-3000 ml[mean,( 1486 ± 809 ) ml].The level of ALT increased to (302-557) U/L[mean,(386 ± 85 ) U/L]after the operation,and back to normal level in 5-11 d[mean,( 7.1 ± 2.0) d].The postoperative hospital stay was 10-18 d[mean,( 12.4 ± 2.6 ) d].No severe complication occurred after the operation.Conclusions Laparoscopic right hemihepatectomy under selective hemihepatic inflow occlusion is safe and feasible.

Objective To assess the diagnostic value of Logistic model in differentiating between malignant and benign ovarian lesions. Methods Thirty-five indexes of clinical and ultrasound data were recorded in 601 ovarian lesions confirmed by surgical pathology. The Logistic model was developed on a training set( n - 400) and tested on a test set( n = 201). Results Variable selection resulted in a set of 10 variables for the models: personal history of ovarian cancer, maximal diameter of the lesion, maximal diameter of the solid component, multilocular-solid tumor, solid tumor, ascites, flow within papillation, irregular walls, very strong intratumoral blood flow (i. e. color score 4) and acoustic shadows. Test set area under the receiver-operating characteristics curve was 0.963 with a sensitivity 93.9% and a specificity 93. 1 %. Conclusions Logistic model can accurately separate malignant from benign ovarian masses.