Objective To study the expresion and significance of CXCR4 in gastric cancer(GC) and intra-abdominal metastasis.Methods Immunohistochemistry and PT-PCR were used to detecte the expresion of CXCR4 protein and CXCR4 mRNA in GC,lynph node metastasis(LNM),peritoneal metastasis(PM) and normal stomach(NM) tissues.Results There was no CXCR4 expression in normal gastric mucosa cell.The expression rate of CXCR4 in GC and PM was 59.4%,100% respectively(P

Objective To investigate the clinical efficacy of surgical treatment for stage Ⅳ gastric cancer after conversion therapy.Methods The retrospective cohort study was conducted.The clinicopathological data of 50 stage Ⅳ gastric cancer patients who were admitted to the First Affiliated Hospital of Dalian Medical University between January 2012 and June 2016 were collected.All the 50 patients who were diagnosed with single distal metastasis underwent chemotherapy.After chemotherapy,21 patients with operation indication receiving gastrectomy (R0 or R1 resection) were allocated into the conversion surgery group and 29 without operation indication continuing to chemotherapy were allocated into the chenotherapy group.Patients received S-1 + oxaliplatin or S-1 + docetaxel regimen.Patients underwent open distal or total gastrectomy.Observation indicators:(1) response assessment of chemotherapy (complete remission,partial remission,stable disease and progressive disease),grading of of adverse reactions;(2) intra-and post-operative situations of conversion surgery group:operation procedures,intraoperative situations (operation time,volume of blood loss,number of lymph node dissected and surgical margin) and postoperative situations (complications and duration of hospital stay);(3)comparison of follow-up and survival between the 2 groups;(4) prognostic factors analysis affecting stage Ⅳ gastric cancer patients.Follow-up using outpatient examination,correspondence and telephone interview was performed to detect postoperative survival of patients up to September 2016.Survival time was from operation to the last follow-up or death.Measurement data with normal distribution were represented as x±s.Comparison of count data and univariate analysis were done using the chi-square test.Ordinal data were analyzed by the nonparametric test.The survival rate was calculated by the Kaplan-Meier method,and the Log-rank test was used for survival analysis.Multivariate analysis was done using the COX regression model.Results (1) Response assessment of chemotherapy:of 50 patients,24 received S-1 + oxaliplatin regimen and 26 received S-1 + docetaxel regimen.Twenty-one patients in the conversion surgery group underwent chemotherapy,with negative peritoneal metastasis,N2 and below of lymph node metastasis (No.16 lymph node disappeared or reduced),invasive depth ＜T4b and narrowing or disappeared hepatic metastasis.A median preoperative chemotherapy cycle was 4.2 cycles (range,2.0-9.0 cycles).Chemotherapy reaction of 21 patients:15 had partial remission and 6 had stable disease.Twenty-nine patients without operation indication in the chemotherapy group didn't receive surgery.The median cycle of first-line chemotherapy was 5.5 cycles (range,2.0-10.0 cycles).Chemotherapy reaction of 29 patients:13 had partial remission,11 had stable disease and 5 patient had progressive disease.Chemotherapy adverse reactions of 50 patients:26 had reduced white blood cells (WBCs),including 6 with grade Ⅲ-Ⅳ of adverse reactions;29 had reduced neutrophils,including 12 with grade Ⅲ-Ⅳ of adverse reactions;18 had anemia,including 6 with grade Ⅲ-Ⅳ of adverse reactions;12 had reduced platelets,including 2 with grade Ⅲ-Ⅳ of adverse reactions;27 had apositia,including 5 with grade Ⅲ-Ⅳ of adverse reactions;7 had stomatitis;9 had diarrhea;3 had elevated serum creatinin;4 had hand-foot syndrome;3 had abnormal sensory nerve.There was no chemotherapy-related death.(2) Intra-and post-operative situations of conversion surgery group:of 21 patients in the conversion surgery group,8 underwent radical total gastrectomy + D3 lymph node dissection,6 underwent radical distal gastrectomy + D3 lymph node dissection and 7 underwent radical distal gastrectomy + D2 lymph node dissection (including 4 combined with resection of hepatic metastatic tumors and 1 combined with radiofrequency ablation of hepatic metastatic tumor).Operation time,volume of blood loss,number of lymph node dissected and recovery time of gastrointestinal function of 21 patients were (216±31)minutes,(128±52)mL,31±8 and (3.0± 0.7)days,respectively.There were 17 patients receiving R0 resection and 4 receiving R1 resection (3 with positive gastric margin and 1 with positive hepatic margin).There was no death.Seven of 21 patients with complications were cured by conservative treatment,including 2 with pancreatic fistula,1 with intra-abdominal hemorrhage,1 with intestinal obstruction,1 with pneumonia,1 with intra-abdominal infection and 1 with wound infection.Duration of hospital stay of 21 patients was (13.0±3.0) days.(3) Comparison of follow-up and survival between the 2 groups:50 patients were followed up for 6-46 months,with a median time of 24 months.The 3-year cumulative survival rates in the conversion surgery and chemotherapy groups were respectively 33.3％ and 6.9％,with a statistically significant difference between the 2 groups (x2 =7.678,P＜0.05).Results of further analysis showed that R0 resection of 17 patients and R1 resection of 4 patients in the conversion surgery group were respecgtively (25.3±2.8)months and (8.3±0.9)months,with a statistically significant difference between the 2 groups (X2=16.242,P＜0.05).(4) Prognostic factors analysis affecting stage Ⅳ gastric cancer patients:results of univariate analysis showed that T stage,N stage,response assessment of chemotherapy,surgery after chemotherapy and degree of tumor radical resection were related factors affecting prognosis of stage Ⅳ gastric cancer patients (X2 =5.288,12.645,25.581,8.372,12.001,P＜0.05).Results of multivariate analysis showed that R1 resection after conversion therapy was an independent risk factor affecting prognosis of stage Ⅳ gastric cancer patients (HR=14.021,95％ confidence interval:1.928-10.938,P＜0.05).Conclusion Radical resection after conversion therapy can increase survival rate of stage Ⅳ gastric cancer patients,and R1 resection after conversion therapy is an independent risk factor affecting poor prognosis of stage Ⅳ gastric cancer patients.

Objective To explore the migration of transplanted neural stem cells labeled with SPIO with 4.7T MR system and study cell differentiation by immunohistochemistry in ischemic rats. Methods Rat neural stem cells(NSCs)co-labeled with SPIO mediated by poly-L-lysine and bromode- oxyuridine(BrdU)were transplanted into the middle cerebral artery occlusion(MCAO)rats after 14 days when MCAO model was made successfully.4.7T MR scanner was used to monitor the migration of transplanted cells after 1.2,3,4,5 and 6 weeks post-transplantation.After MRI examination at 6th week,the rats were killed and Prussian blue staining and immunohistochemistric staining were per- formed to study migration and functional differentiation of NSCs.Results Three weeks after trans- plantation,linear hypointensity area derived from migration of labeled NSCs was observed in the corpus callosum adjacent to the injection site.Six weeks after transplantation,linear hypointensity area was moved toward the midline along the corpus callosurn.MRI findings were confirmed by Prussian blue staining and immunohistochemical straining.Co-labeled immunohistochemical methods demonstrated transplanted NSCs could differentiated into astrocytes and neurons.Conclusion MRI is very useful in demonstrating the migration path of labeled NSCs.Transplanted NSCs into ischemic rats can differen- tiated into astrocytes and neurons during the process of migration.

Objective To analyze the clinicopathologic features,effect of surgical treatment and prognosis of elderly patients with gastric cancer.Methods The records of 84 elderly patients(aged 80 years or above) with gastric cancer who underwent operation in our hospital from 2000-2008 were analyzed retrospectively.Results Ten patients had early gastric cancer(1a,8 cases,1b,2cases),stage II 12 cases,stage III 45 cases(53.6%) and stage IV 17 cases.Among them,81% patients had one or more co-morbidities.Cardiovascular disease was present in 43 cases(51.2%).Resection rate was 85.7%(72/84).Radical resection rate was 60.7%(51/84).Limited nodal dissection(

ObjectiveTo evaluate the application of chest-abdomen longitudinal diameter ratio,total lung area and lung longitudinal diameter in different gestational ages by two-dimensional ultrasonography.MethodsFive hundred and ninty-two fetus of normal singleton pregnancy between 18 and 40 weeks were ultrasonic scanned by standard 4-chamber view and fetus torso coronal section.The heart area,thoracic area,bilateral lungs pointed to the corresponding diaphragmatic dome gallery on the top of the vertical distance,diaphragmatic dome iterated top to the bottom of the fetal bladder distance were measured respectively.Related regression analysis was done on fitting total lung area and longitudinal diameter with pregnant increasing.ResultsA normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.The best-fit regression equations of total lung area was:Y =0.83 X +13.894,R2 =0.914;Lung longitudinal diameter was:Y =0.669 X + 3.124,R2 =0.892.Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation was in constant range:0.44 - 0.59.Conclusions Chest-abdomen longitudinal diameter ratio from 18 to 40 weeks gestation is in constant range.The normal pregnancy fetal total lung area and lung longitudinal diameter were increased as long as the gestational age.These parameters may be useful for the prenatal assessment of lung development.

Objective To investigate the approach and safety of minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi. Methods Clinical data of 21 cases with symptomatic caliceal diverticular calculi were retrospectively reviewed. Twelve females and 9 males aged 22 to 57 years old. The average diameter of caliceal diverticulum was 3.7 cm (2.5-7.0 cm) and average diameter of calculi was 2.3 cm (0.8-3.5 cm). The patients underwent flexible ureteroscopic lithotripsy, PCNL or mPCNL, laparoscopic techniques and laparoscopy-assisted transperitoneal PCNL, respectively. Four cases underwent flexible ureteroscopic lithotripsy. PCNL (2 cases) or mPCNL(5 cases)were performed in 7 cases. Nine cases underwent laparoscopic techniques. Laparoscopyassisted transperitoneal PCNL was performed in 1 case. Results The operations were performed successfully in 21 cases. No case need to transfer to open surgery during the operation and no major complications like perforation or organic injury were noted. One case with iatrogenic arteriovenous fistula of the kidney after 1 week postoperative was cured by delayed hemorrhage 2 days later, while clinical symptoms of 2 cases with residue calculi relieved. 19 cases without residue calculi were followed up for 6 to 12 month without recurrence. Conclusions After handling indication of treatment efficiently and creating advisable therapeutic decision-making, minimally invasive surgical procedures treating symptomatic caliceal diverticular calculi appears to be effective and safe.

We observed the effect of vibration parameters on lumbar spine under different vibration conditions using finite element analysis method in our laboratory. In this study, the CT-images of L1-L5 segments were obtained. All images were used to develop 3D geometrical model using the Mimics10. 01 (Materialise, Belgium). Then it was modified using Geomagic Studio12. 0 (Raindrop Geomagic Inc. USA). Finite element (FE) mesh model was generated by Hypermesh11. 0 (Altair Engineering, Inc. USA) and Abaqus. Abaqus was used to calculate the stress distribution of L1-L5 under different vibration conditions. It was found that in a vibration cycle, tensile stress was occurred on lumbar vertebra mainly. Stress distributed evenly and stress concentration occurred on the left rear side of the upper endplate. The stress had no obvious changes under different frequencies, but the stress was higher when amplitude was greater. In conclusion, frequency and amplitude parameters have little effect on the stress distribution in vertebra. The stress magnitude is positively correlated with the amplitude.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; physiology ; Vibration

Objective To investigate the diagnostic accuracy of 13C urea breath test (13C-UBT)in the diagnosis of Helicobacter pylori (Hp) infection in patients with gastric remnant.Methods A total of 94 gastric remnant patients (gastric remnant group) and 100 non-gastric remnant patients (control group) received 13C-UBT.According to the course of the disease,the gastric remnant group were divided into group 1 (29 cases,≤5 years),group 2 (33 cases,6 to 10 years) and group 3 (32cases,＞10 years).Before surgery,the diagnosis of Hp infection was according to 13C-UBT and gastric mucosa tissue staining.After surgery,the diagnosis was according to gastric mucosa tissue staining.The applying value of 13C-UBT in gastric remnant patients was evaluated.The consistency of results between 13C-UBT and gastric mucosa tissue staining were evaluated by the Kappa test.Results In gastric remnant group,the Hp infection rate after surgery (37.2％) was obviously lower than that before operation (79.8％;x2 =35.058,P＜0.01) and that of control group (77.0％).After surgery,the Hp infection rate of patients with Billroth Ⅱ gastrectomy (24.4％) was lower than that of patients with Billroth Ⅰ gastrectomy (47.2％ ; x2 =5.133,P=0.023).Before surgery,the Hp infection rate of gastric remnant subgroups were similar (P＞0.05).With the extension of the postoperative course,the Hp infection rate gradually decreased in gastric remnant subgroups (group 1:58.6％,group 2:36.4％,group 3:18.8％; x2=7.839,P=0.021).Setting the cut-off point at 2.0‰ in the gastric remnant group and 3.5‰ in the control group,the accuracy rate of diagnosis was the highest (92.6％ and 96.0％).There was good consistency between the results of 13C-UBT and gastric mucosa tissue staining (Kappa =0.84,P＜0.01).Conclusion With suitable operation and standard,13C-UBT may be a easy,safe and effective assay applied in the gastric remnant patients.

Objective To observe the efficacy and safety of liver decanoic sulfonic sodium in the treatment of elderly patients with acute coronary syndrome (ACS).Methods84 ACS patients over 70 years were randomly divided into the treatment and control groups.Two groups were treated on the basis of general,treatment 40 cases of liver of dibutyl sebacate with sodium sulfonated added 2.5 mg subcutaneous injection parumbilical,day 1,course 8 d ; control group 44 cases combined with low molecular weight heparin calcium 0.4 ml,2 times/day 1 time every 12 hours,according to body weight adjusted dose,Parumbilical shot in course of 8 days,observing the clinical effect of two groups during the treatment,as well as 4 weeks and bleeding during the treatment the incidence of cardiovascular events.Results The clinical effects of treatment and control groups was no significant difference (95％ and 91％,P ＞0.05) ; None of the two sets of death,myocardial infarction and recurrent malignant ventricular arrhythmia; none of the two sets of bleeding occurs,treatment of minor bleeding rates were significantly lower than those of control groups (7.5％ and 25％,P ＜ 0.05).Conclusion The study of dibutyl sebacate with sodium heparin and low molecular weight heparin calcium in the treatment of ACS are valid,but the former which significantly reduce the incidence of minor bleeding.Liver decanoic sulfonic sodium for acute coronary syndrome ACS)anticoagulation can not only effectively reduce cardiovascular events,but also significantly reduce bleeding risk,regardless of the patient's age,gender,renal function and risk stratification,especially for bleeding in high risk elderly patients with safe and clinical promotion.

0.05)in the frequency of alleles and genotypes between controls and coronary heart disease.In additional,at the 325 position,the TAFI antigen of the Thr325Thr was higher[(114.89?2.53)%]than that of the other genotype(Thr325Ile and Ile325Ile),there was significant difference between the TAFI antigen of the Thr325Thr and the others(P 0.05).But the TAFI activity of the Ile325Ile was lower(3.08?3.63 ?g/ml)than that of the other genotypes(Thr325Ile and Thr325Thr),there was significantly difference between the TAFI activity of the Thr325Thr and the other(P