OBJECTIVE: To investigate the growth inhibition and apoptosis of BGC-823 gastric cancer cells induced by Oridonin and its mechanism. METHODS: The Oridonin-treated BGC-823 cells were detected using MTT, transmission electron microscopy (TEM), TUNEL and flow cytometry (FCM) etc. RESULTS: Oridonin(16, 32, and 64 ?g?mL-1) significantly inhibited the proliferation of BGC-823 cells in dose and time dependent manner, with the inhibition rates at 68.5%, 90.8%, and 94.7%, respectively within 24, 48, and 72 h after treatment with 64 ?g?mL-1 Oridnin. When treated with 32 ?g?mL-1 Oridonin for 2 h,mitochondria and endoplasmic reticulum were proliferated and swelled under TEM; At 8 h,vacuolization of mitochondria and endoplasmic reticulum were noted, the internal structure disappeared, and the nuclear chromatin margination vacuolization were in typical apoptosis change; At 24 h, BGC-823 cells were arrested at G2/M phase, and the apoptosis rate was 37.8% under FCM. CONCLUSION: Oridonin inhibiting proliferation and apoptosis of BGC-823 cells maybe related to G2/M phase arresting, and Oridonin induce apoptosis of BGC-823 cells may through mitochondria or endoplasmic reticulum apoptosis pathway.

OBJECTIVE: To analyze the clinical feature of cervical metastatic carcinoma of unknown primary site (CCUP) for guiding clinical diagnosis and treatment. METHOD: Twenty-seven cases of CCUP during May 2007 to September 2013 in department were analyzed retrospectively. Kaplan-Meier method and Log-rank test were used for survival analysis, multivariate analysis using the Cox regression model. RESULT: There is no significant influence among gender, age and the mass position on the median survival time. Median survival time of patients with different pathological types was statistically significant (P < 0.05). Treatment affected the median surial significantly (P < 0.05) and also was the independent prognostic factors (P < 0.05). CONCLUSION The early establishment of pathological type and primary focal position can improve the prognosis. Taking treatment according to pathological types can increase the patient's survival rate. Combined treatment can prolong the patient's survival time.
Carcinoma ; diagnosis ; secondary ; Combined Modality Therapy ; Head and Neck Neoplasms ; diagnosis ; secondary ; Humans ; Multivariate Analysis ; Neoplasms, Unknown Primary ; pathology ; Prognosis ; Retrospective Studies ; Survival Analysis ; Survival Rate

Objective To evaluate and analyze the diagnostic accuracy of 256-slice computed topographic angiog-raphy (CTA) and coronary angiography (CAG) in patients with coronary artery disease (CAD). Methods One hundred and one patients (suspected CAD and confirmed CAD with re-examination) underwent the 256-slice CTA and CAG were includ-ed in this study. The coronary artery imaging data of 101 patients were retrospectively collected and analyzed. Calculations for accuracy were conducted on a segmental basis. A total of 1 313 comparable segments were evaluated. The accuracy of 256-slice CTA was evaluated in the diagnosis of moderate and severe stenosis of coronary artery(stenosis in segments of cor-onary artery≥50%). The values for diagnostic accuracy of 256-slice CTA were analyzed, including mild stenosis: ＜50%, moderate stenosis:50%~75%, severe stenosis:76%~100%and complete occlusion. Results The sensitivity of 256-slice CTA for diagnostic accuracy to coronary heart disease was 94.87%, and the specificity was 52.17%. The positive predictive value was 87.06%and the negative predictive value was 75.00%. The accuracy rates of 256-slice CTA for evaluating the cor-onary artery stenosis were:mild stenosis (44.23%), moderate stenosis (44.23%), severe stenosis (40.00%) and total occlusion of coronary artery (51.77%), respectively. Conclusion The diagnostic value of 256-slice CTA for the degree of coronary ar-tery stenosis is insufficient, which can be used as a potential alternative screening examination to detect coronary artery ste-nosis in suspected patients and a method of re-examination in low risk patients with CAD.

ObjectiveTo evaluate the value of National Institute of Health Stroke Scale (NIHSS) combined with CT angiography(CTA) to predict the clinical outcome of acute ischemic stroke patients at ultra-early stage.Methods70 patients with acute ischemic stroke underwent brain CTA within 6 hours from symptom onset and were divided into two groups according to NNIHSS score, and clinical outcome was compared between two groups.ResultsThere were 38 patients with arterial occlusion on CTA and 32 patients with normal CTA. The percentage of occlusion on CTA for patients presenting with more severe neurological deficits was higher than those patients with slight to moderate deficits. The patients with occlusion on CTA and presenting with more severe deficits had a poor clinical outcome (P<0.01). 78% of patients with normal angiograms had good outcome, only 44.7% patients with arterial occlusion had a good clinical outcome(P<0.05). Both CTA evidence of vessel occlusion and admission NIHSS score correlated with clinical outcome measured by discharge NIHSS score(r=0.25, P=0.04 and r=0.73, P=0.000 respectively). The sensitivity and specificity for predicting clinical outcome by using the NIHSS score alone was 56.65% and 85.29%, and positive predictive value (PPV+) was 80.00%. There was a sensitivity of 63.89%, a specificity of 73.53%, a PPV+ of 71.88% if CTA showed vessel obstruction. If NIHSS scores combined with CTA to predict clinical outcome, the result showed a sensitivity of 70.11%, a specificity of 91.18%, a PPV+ of 88.00%.ConclusionThose patients with vessel occlusion on CTA appear to have a worse clinical outcome. NIHSS combining with CTA may increase specificity for judging prognosis and guide treatment.

Objective To determine the length of warm ischemic (WI) tolerance in bronchial graft from non-heart-beating donors. Methods Forty-eight rats were randomly divided into 4 groups (each group having 12 rats) according to different WI durations including WI-0 min (group A), WI-30 min (group B), WI-45 min (group C) and WI-60 min (group D). In each group, the tracheae from 6 rats were respectively imbedded in greater omentum of other 6 rats, and 14 days later, the transplanted tracheae were taken from recipients to evaluate epithelial thickness and regeneration. Results Epithelial thickness and the degree of epithelial regeneration had no significant difference (P >0. 05) between the syngeneic control group and the WI-30 minutes group. All of the grafts with WI duration of 45 min were viable, but the epithelium was significantly thinner than that in the syngeneic control group (P<0. 05). However all of the grafts with WI duration of 60 min showed lower viability rate. Conclusion The time limits of tolerance to WI of tracheal grafts from NHBDs may be 45 min.

Objective Using Mental Practice as a training method to train students grasping skills of minimally invasive surgery(MIS),and analyze the change of mental practice in training grasping skills of MIS.Methods 36 students were randomly divided into mental practice training group (MPTG) ( n =12 ),conventional training group (CTG) ( n=12),control group (CG) ( n=11 ).Under the uniform appraisal standards and conditions,using different training methods to teach the grasping skills of MIS,and analyze the results statistically.Results MPTG' s pre-training test results ( 16.18 ± 5.73 ) and post-training test results (79.47 ± 22.05 ) were significantly different(P ＜ 0.001 ),post-training and two weeks later test results ( 89.32 ± 31.56) displayed no significant difference(P=0.283) ; CTG' s pre-training test results ( 17.47 ±8.33) and post-training test results (57.18± 21.83 ) were significantly different (P ＜ 0.001 ),post-training and two weeks later test results (42.27 ± 24.64)had significant difference(P=0.048) ; CG's pre-training test results ( 18.19 ± 4.74) and post-training test results (38.04 ± 19.13 ) were significantly different(P =0.003 ),post-training and two weeks later test results (23.71 ±15.71 ) had significant difference (P=0.034).Compared with MPTG in pre-training test,CTG (P=0.632) and CG (P =0.464) neither had significant difference,but in the post-training test,CTG (P =0.014) and CG (P ＜0.001 ) both had significant difference compared with MPTG.In the two weeks later test,CTG and CG both (P＜0.001 ) had significant difference compared with MPTG.Conclusion Mental practice training method can improve the pedormance of gasping skills of MIS significantly and better durability,improve the learning curve,easy to implement in teaching,easy to master students,it will be a new method of MIS skills training in the future.

Objective: To explore the necessity of multi-slice CT (MSCT) and echocardiogram in diagnosing multiple cardiac myxoma or myxoma originated from special site of heart via analyzing medical imaging features. Methods: A total of 14 patients with multiple cardiac myxoma or myxoma not originated from left atrium fossa ovale were studied; the patients had operation conifrmed diagnosis in our hospital from 2003-02 to 2015-12, the imaging features of MSCT and echocardiography were analyzed and compared. Results: There were 12/14 patients diagnose by echocardiography with the accuracy of 85.7% and 11 patients diagnosed by MSCT with the accuracy of 84.6%. MSCT and echocardiography had similar pre-operative accuracy and complimentary advantages for diagnosing multiple cardiac myxoma or myxoma not originated from regular site of heart. Echocardiography was superior for examining the motion, pedicle position, shape and attachment point of cardiac myxoma; MSCT may exclude pulmonary embolism and coronary artery disease at meanwhile. Conclusion: Unconventional cardiac myxoma not only has similar image signs to typical single myxoma from left atrium, but also has the speciifc features; MSCT combining echocardiogram examinations could make more accurate diagnosis and provide a better condition for surgical treatment.

Objective: To investigate the multi-imaging diagnostic values, especially MSCT technology in patients with congenital aortic diverticulum with its clinical application. Methods: The MSCT ifndings in 12 patients with congenital aortic diverticulum were retrospectively analyzed. Results: There were 9 patients with right aortic arch and 1 with left aortic arch, all of them having coexisted aberrant subclavian artery which initially dilated like aneurysm by diverticulum changing (Kommerell diverticulum), and there was 1 patient with incomplete double aortic arch with atresia of left arch combining retro-esophageal aortic diverticulum (RAD) and 1 patient with ducts diverticulum. Echocardiogram only made the suggestive diagnosis of speeding up blood lfow or right aortic arch in 4 patients. While MSCT accurately displayed the diverticulum for the location, morphology and with or without other complications. The post-eroanterior chest radiograph indicated “double aortic node” as the special sign in 8 patients. The echocardiogram, X-ray and MSCT for correctly diagnosing the aortic diverticulum were as 0, 72.7% and 100% respectively. Conclusion: MSCT is a rather ideal non-invasive diagnosing method for aortic diverticulum, meanwhile X-ray could also make suggestive diagnosis; if MSCT and X-ray joint with echocardiogram examination may provide the effective supplement for valve structure and hemodynamics condition in relevant patients.

Objective To analyze the reason of hemoptysis after the bidirectional Glenn shunt procedure on complex congenital heart disease.Methods The feature of imaging data of 24 patients (1 6 males,8 females;age ranges:3-27 years;14 cases of single ventricle,3 cases of tricuspid Atresia,4 cases of pulmonary Atresia,3 cases of double Outlet Right Ventricle)after the bi-directional Glenn shunt procedure were retrospectively studied.Results Six patients had various degrees of hemoptysis (50 - 300 mL)after surgery,except for one case which has bronchiectasis on the left inferior lobe.The common feature of the other 5 cases present as plaque ground glass opacity and pulmonary arteriovenous fistula located at the corresponding subpleural field.After different therapy (three cases were performed endovascular management,2 cases were under expectant treatment),the lesion disappeared or obviously smaller which was clear evidence for the existence and bleeding of fistula.The occurrence of this disease in the present study was nearly 20.8%,which were accord with references.Conclusion Pulmonary arteriovenous fistula should be considered when crypto-genic hemoptysis happened after bi-directional Glenn shunt with complex congenital heart disease which exclude tuberculosis,bron-chiectasis or rupture and bleeding of MAPCAs.Multiple sliced CT angiography can be used to as the first line examination and sup-ply acute evidence for clinic therapy in time.

Objective Evaluating the imaging value of dual source computer tomography angiography (DSCTA) in diagnosis of anomalous origin of one pulmonary artery.Methods Clinical data of 13 patients with anomalous pulmonary artery diagnosed with DSCTA were retrospectively analyzed,and compared with data of echocardiography examination.Results The anomalous pulmonary was clearly diagnosed with DSCTA,which all originated from ascending aorta (AAO).Thirteen cases presented with anomalous right pulmonary artery.Of the total,11 cases originated from the proximal AAO,and 2 cases originated from the distal AAO.One patient was only with anomalous origin of right pulmonary.11 were complicated with PDA,7 were complicated with aortopulmonary septal defect and interruption of aortic arch(A type),1 case was complicated with dysplasia of aortic arch,1 case was complicated with aberrant right subclavian arteries,1 case was complicated with tetralogy of fallot(TOF),and 5 were complicated with right-sided aortic arch and right-sided descending aorta.Eight cases with anomalous pulmonary were diagnosed with echocardiography,3 cases were suspected,and 2 cases were missed.One case was complicated with TOF,5 cases were complicated with aortopulmonary septal defect,interruption of aortic arch (A type) and patent ductus artery (PDA),and 10 cases were complicated with moderate-severe regurgitation of tricuspid.In the 7 operative patients,there were consistent with DSCTA,the anomalous pulmonary and the complicated deformities were rectified.Conclusion DSCTA owns a high value in diagnosis of anomalous origin of pulmonary artery and complicated abnormities by clearly developing the pathologic anatomic features and cardiovascular malformations.