Objective To investigate the value of FDG PET-CT in the outcome assessment and prognostic evaluation for recurrent nasopharyngeal carcinoma (rNPC).Methods From January 2008 to December 2013,92 rNPC patients were treated in our center,who were histologically or radiologically diagnosed and re-staged according to the 2008 clinical staging system for nasopharyngeal carcinoma in China.The numbers of patients in stage Ⅰ,stage Ⅱ,stage Ⅲ,and stage Ⅳ were 8,11,39,and 34,respectively.According to the recurrent T stage (rT),the numbers of patients in rT1,rT2,rT3,and rT4 were 10,11,38,and 33,respectively.Twenty-eight patients had recurrence in the neck lymph nodes.All patients underwent pretreatment FDG PET-CT for the whole body or head/neck,and treated by radiotherapy with or without chemotherapy.The relationship of maximum standard uptake value (SUVmax) and clinical factors with clinical outcomes was analyzed.The Kaplan-Meier method was used to calculate overall survival (OS),disease-free survival (DFS),local recurrence-free survival (LRFS),regional recurrence-free survival (RRFS),and distant metastasis-free survival (DMFS).The log-rank test was used for survival difference analysis and univariate prognostic analysis.The Cox model was used for multivariate prognostic analysis.Results The 3-year OS,DFS,LRFS,RRFS,and DMFS were 33.6％,32.1％,32.8％,31.8％,and 33.7％,respectively.The median SUVmax was 8.35 (2.7-21.5).The SUVmax of 7.0 was taken as the optimal cut-off value for all patients.Patients with SUVmax ≤7.0 had a significantly higher 3-year OS rate than those with SUVm ax ＞7.0 (42.0％ vs.28.3％,P=0.019).The univariate analysis revealed that patient age,SUV and rN were significantly associated with OS (P=0.023,0.019,and 0.002).The multivariate analysis showed that SUVmax and rN were significant influencing factors for OS,DFS,and DMFS (HR=1.68,P=0.045 and HR=2.23,P=0.003;HR=1.67,P=0.042 and HR=2.39,P=0.001;HR=1.77,P=0.025 and HR=2.40,P=0.001).Conclusions SUVmax may be one of the useful prognostic factors for OS,DFS,and DMFS in rNPC patients.

18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is the integration of functional imaging and anatomic information,which is found to be particularly valuable in TNM staging,tumor volume delineating,post-treatment assessment,identification of recurrent and residual nasopharyngeal carcinoma (NPC).The combination of 18F-FDG PET-CT with other image technologies,different tracer agents,and specific molecular biomarkers can improve the application value of 18F-FDG PET-CT in NPC.

Objective To describe the distribution of positive lymph nodes of muscle invasive bladder cancer, and explore the relationship between positive nodes and pathological characters. Methods Pathological data from 208 consecutive cases of muscle invasive bladder cancer were collect-ed and reviewed. The correlation of tumor grade, tumor stage and lymph nodes status was analyzed. The locations and numbers of positive nodes were recorded and compared according to the specific grade or stage. Results There were 153 cases (73.6%)of G_3 tumor and 55 cases(26.4%) of G_2 tumor and none G_1 (0%)in this cohort. The case number from pT1 to pT4 was 59(28. 4%)、58 (27.8%)、48(23.0%)and 43(20.6%), respectively. The tumor grade was positively correlated with tumor stage in this cohort (r=0. 392, P=0. 000). 153 cases had been taken lymph node dissection. There was more node positive cases in pT_3 and pT_4 than that in T_1 (P=0. 001 ,P=0. 000), as well as pT_4 compared with pT_2 (P= 0. 012). The data showed that most of the positive nodes were located within the pelvic region. There was only 1 case and 1 node positive for G_1/G_2 tumor with 24.84% of node positive cases for G_3. The positive nodes involved from pelvic to proximal artery while the stage increased. Conclusions There is less chance for low grade (G_1/G_2) bladder cancer to be node posi-tive compared with G_3 ones. It is necessary to take a extensive lymphadenectomy for the patients with stage more than T_2.

Intensity-modulated radiotherapy(IMRT)is the first-line treatment for nasopharyngeal carcinoma currently. Previous studies have shown that regression of primary tumor and metastatic lymph nodes or a decrease in body weight causes the contour of normal organs and head-and-neck to shrink during the course of radiotherapy, which may lead to underdose in primary tumor and overdose in organs at risk (OARs)and then adversely affect treatment outcomes. Replanning during the course of radiotherapy can maintain the dose to target volume and reduce the exposure of OARs, which improves outcomes in some patients. For replanning during the course of IMRT, however, the advantages have not been widely recognized and there is still a long way to go before widely accepted timing and frequency of replanning are set up. Further studies are needed to figure out how to identify patients appropriate for plan modification.

Adult ; Aged ; Carcinoma, Hepatocellular ; metabolism ; Female ; Humans ; Liver Neoplasms ; metabolism ; Male ; Middle Aged ; RNA, Messenger ; biosynthesis ; Receptors, Somatostatin ; biosynthesis ; classification ; genetics ; Tumor Cells, Cultured

BACKGROUNDMono-(2-ethylhexyl) phthalate (MEHP), the metabolite of di-(2-ethylhexyl) phthalate (DEHP), was suspected to be toxic to human embryos. This study contributes to investigating its toxic effects by an embryonic stem cell test (EST) based on two human embryonic stem cell (hESCs) lines.

METHODSCH1 established in our own lab and H1, a federally registered cell line were two human embryonic stem cell lines used in this test. Four endpoint measurements were performed consisting of cell viability, proliferation ability, apoptosis as well as changes of gene expression patterns after spontaneous differentiation were determined. For measuring effects on the first three endpoints, the cells were treated with various concentrations of MEHP dissolved in dimethyl sulfoxide (DMSO) and only with DMSO which served as control and harvested after 5 days. For measuring effects during spontaneous differentiation, the RNA of embryoid bodies (EBs) formed after 8 days' MEHP exposure was collected and changes in differentiation specific gene expression patterns were analyzed by quantitative real time RT-PCR.

RESULTSAs a result the viability and proliferation ability of both cell lines decreased significantly at 1000 µmol/L MEHP, while there was no effect on apoptosis or cell morphology. In addition MEHP also changed the gene expression pattern in the EBs of both cell lines.

CONCLUSIONMEHP in a high dose was cytotoxic and affected the development of hESCs, which indicates its embryo toxicity in human embryos.

Apoptosis ; drug effects ; Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cell Survival ; drug effects ; Cells, Cultured ; Diethylhexyl Phthalate ; analogs & derivatives ; toxicity ; Dose-Response Relationship, Drug ; Embryonic Stem Cells ; drug effects ; pathology ; Humans

OBJECTIVETo explore the safety and feasibility of cervical triangulating stapled anastomosis(TSA) for esophagogastric anastomosis(EGA) after minimally invasive esophagectomy (MIE).

METHODSClinical data of 137 patients undergoing MIE for esophageal cancer(EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared.

RESULTSCervical anastomotic leakage occurred in 3 patients(3.9%) of TSA group, but in six(10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively(P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications.

CONCLUSIONSTSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.

Anastomosis, Surgical ; methods ; Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Neck ; surgery ; Postoperative Complications ; Retrospective Studies ; Treatment Outcome

Objective To explore the safety and feasibility of cervical triangulating stapled anastomosis (TSA) for esophagogastric anastomosis (EGA) after minimally invasive esophagectomy (MIE). Methods Clinical data of 137 patients undergoing MIE for esophageal cancer (EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared. Results Cervical anastomotic leakage occurred in 3 patients (3.9%) of TSA group, but in six (10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively (P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications. Conclusions TSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.

Objective To explore the safety and feasibility of cervical triangulating stapled anastomosis (TSA) for esophagogastric anastomosis (EGA) after minimally invasive esophagectomy (MIE). Methods Clinical data of 137 patients undergoing MIE for esophageal cancer (EC) in our department from January 2013 to March 2014 using end to side circular stapled anastomosis (CSA, 60 cases) or end-to-end triangulating stapled anastomosis (TSA, 77 cases) in the neck were retrospectively analyzed. The short-term outcomes between the two groups were evaluated and compared. Results Cervical anastomotic leakage occurred in 3 patients (3.9%) of TSA group, but in six (10.0%) of CSA group (P=0.152). The incidence of anastomotic stenosis was 1.3%(1/77) and 15.0%(9/60) in TSA and CSA group respectively (P=0.002). The median hospital stay and perioperative mortality were not significantly different between the two groups as well as postoperative respiratory and cardiovascular complications. Conclusions TSA is a safely and effectively alternative method for EGA with lower incidence of postoperative gastrointestinal complications, especially in anastomotic stricture.

Objective To study the effect of preemptive analgesia with celecoxib and parecoxib on the postoperative pain and stress responses of patients with leg fracture.Methods Eighty-two patients with leg fracture were randomly divided into experiment group( n =41 ) which received preemptive analgesia,and control group( n =41 ) which received routine analgesia.The visual analogue scale (VAS) was used to measured patients'pain at 4,8,12,24,48 h after operation.Levels of blood angiotensin-Ⅱ,cortisol and glucagon were assayed at various times as follows:pre-operation,end of surgery,postoperative 0,4,12,24 h,and adverse effects rate was observed in two groups.Results The postoperative 4,8,12,24 h score of experiment group were ( 3.54 ± 0.68),(4.08 ±0.97),(3.41 ± 0.59),respectively,lower than that of control group that were (4.63 ± 0.92),(5.38 ± 1.17),(4.48 ± 0.76 ),and the differences were statistically significant ( t =4.274 5,4.875 4,4.453 7,respectively ; P ＜0.05 ).While there was no significant difference detected in the VAS score of 24,48h between two groups (P ＞0.05).Levels of blood angiotensin- Ⅱ,cortisol and glucagon of patients' in 0,4,12 h of experiment group were significantly lower than that of the control group ( P ＜ 0.05 ),while no significant difference was found in the preoperation and post-operation 24 h between two groups( P ＞ 0.05 ).Adverse effects rate of experiment group was 7.3％ significantly lower than 31.7％ that of control group,the difference was statistically significant (x2 =7.77,P ＜0.01 ).There were 13 cases received the medicine of tramadol in experiment group and 32 cases in control group,and the difference was statistically significant (x2 =10.05,P ＜0.0 1 ).Conclusions Preemptive analgesia with celecoxib and parecoxib could decrease the postoperative pain of patients with leg fracture and reduce the adverse effects rate significantly and the stress reaction in postoperative period.