ObjectiveTo evaluate the feasibility of a three-dimensional (3 D) operation planning system for precise hepatectomy in patients with giant hcpatocellular carcinoma (HCC).MethodsThe clinical data of 34 patients with giant HCC who received precise hepatectomy at the First Affiliated Hospital of Sun Yat-sen University from May 2009 to May 2011 were retrospectively analyzed.Preoperative evaluation was done based on the computed tomography data,and the resection margin and the volume of resectcd liver were calculated using simulation.The predicted resected liver volume and resection margins were compared with the results of the actual operations.All data were analyzed using the t test,and the correlation between predicted and the actual values was analyzed by calculating Pearson correlation coefficients.Results Hepatic and tumor tissues and the hepatic vessels were reconstructed three-dimensionally using the 3D preoperative simulation software.The volume of simulated resected liver and the length of resection margin were ( 2112 ± 1550 ) ml and ( 12 ± 6) mm,respectively,while the volume of actual resected liver and the length of resection margin were (2031 ± 1411 )ml and ( 12 ± 6)mm,respectively.The predicted and the actual values were statistically correlated ( r =0.961,0.923,P ＜ 0.05 ).There was no significant difference between the predicted and the actual values ( t =1.549,1.143,P ＞ 0.05 ).All patients received precise hepatectomy,and no hepatic failure or death was observed. Conclusion The 3D operation planning system can accurately evaluate the condition of the liver and simulate hepatectomy,and could contribute to safer and more curative precise hepatectomy in patients with giant HCC.

Objective To investigate the value of magnetic resonance (MR)diffusion kurtosis imaging (DKI)in diagnostic classi-fication of astrocytic tumors.Methods 31 patients with astrocytic tumors confirmed by operation and pathology were collected,in-cluding low-grade tumors (WHO gradeⅠ and Ⅱ)in 14 and high-grade ones (WHO grade Ⅲ and Ⅳ)in 1 7.Routine MRI and DKI scan were preoperatively conducted using Siemens 3.0T MR scanner.Mean kurtosis (MK),radial kurtosis (RK)and axial kurtosis (AK)values were calculated in the solid portion of the tumors and the contralateral normal white matter.Results The MK,RK and AK values in tumors were lower than those in contralateral normal white matter,and were significantly higher in high-grade tumors than those in low-grade ones (P <0.05).Conclusion The MK,RK and AK values obtained by DKI reflect the histological structure changes of the astrocytic tumors.DKI is helpful for the diagnostic classification of astrocytic tumors,exhibiting more value in optimi-zing the treatment.

Objective To evaluate the clinical value of susceptibility weighted imaging (SWI)in full-term neonatal hypoxic ische-mic encephalopathy (HIE).Methods Sixty-three neonates with HIE were collected and scanned by Siemens 3.0T superconducting MR scanner.Routine axial conventional MRI scan and axial SWI scan were conducted.Results In 63 neonates,a total of 29 cases with different degree of intracranial hemorrhage were scanned with SWI sequence.A total of 1 5 1 intracranial hemorrhages were found.Conventional MRI sequences were performed in 1 5 cases with different degree of intracranial hemorrhage.Only 78,43 and 88 hemorrhages were found by T1 WI,T2 WI and T2 Flair sequences,respectively.SWI were significantly superior to conventional MRI sequences in displaying the scope and boundary definition of hemorrhage.Conclusion SWI sequence is obviously better than the con-ventional MRI sequences in bleeding detection and displaying hemorrhage stove,and it provides a powerful imaging method for the clinical diagnosis and treatment.

Objective:To introduce a novel ridge preservation technique with micro-titanium plate avoiding the use of bone grafting materials,and evaluate the potential horizontal bone preservation effect of this new technique,applied on single maxillary central incisors after tooth extraction for future implant restoration.Methods:Nine patients (six women and three men),mean age (26.0 ±5.7)years(from 1 8 to 34 years)referred to the Department of Oral Implantology,Peking University School and Hospital of Stomotology,were selected and diagnosed with unsalvageable single middle incisor with fine general con-ditions,no signs of acute local inflammation,no ongoing or previous periodontitis,healthy neighboring teeth and intact buccal bone walls.Tooth extraction,delayed implant placement and implant-supported single crown restoration were selected as treatment plan.The teeth were extracted atraumatically with lo-cal anesthesia,followed by a reflection of a minor flap to exposed 2-3 mm of the buccal bone plate.Af-ter that,a micro-titanium plate was trimmed and bended to fit the convexity of the labial bone and fixed by two mini pins with intent to support the labial soft tissue.The flap was then repositioned over the micro titanium plate and secured with two single sutures.No bone grafting materials or releasing incisions were needed.The sockets were left to heal without any intention of primary wound closure.Cone-beam compu-ted tomographic (CBCT)scans were obtained before and four months after tooth extraction.Horizontal ridge widths were measured with CBCT software,and the preservation effects were calculated and recor-ded by the percentage of horizontal ridge alteration.Results:The nine extraction sockets were healed un-eventfully.The average socket width before extraction was (7.51 ±0.48)mm (6.92-7.82 mm).The average alveolar ridge labial-palatal width at the control point of the edentulous area was (6.81 ±0.44) mm (6.04-7.38 mm)4 months after tooth extraction,the mean percentage of ridge width preserved was 90.87%±2.91%(87.28%-95.60%).Conclusion:This novel ridge preservation method by the usage of a micro-titanium plate did not interfere with the natural socket healing process,and at the same time,largely preserved the width of alveolar ridge without any bone grafting procedures.Long term results remain to be seen.

Homology of three WSSV isolates, which were sampled from r epresentative maritime space of China: Tanghai isolate (Bo Bay of China), Ningbo isolate (East China Sea), Shenzhen isolate (South China Sea) was compared. Both of the genome RFLP patterns and the characteristic structural proteins SDS-PAG E electrophero grams showed that they were quite same. It suggested that they were the same ki nd of WSSV virus that caused explosive epidemic diseases of shrimps (EEDS) throu ghout southern and northern China. The same large PCR products achieved when usi ng the PCR primers from RV－PJ＝PRDV (P. japonicus, Japan) and WSBV＝PmNOBII I(P.monodon Taiwan, China) respectively to amplify the genome from P.chine nsis (Tanghai, China) with high fidelity Taq Polymerase. The sequence identiti es of WSSV from P. chinensis with those from RV－PJ＝PRDV (P.japonicus, Japan) and WSBV＝PmNOBIII (P.monodon Taiwan, China) are 97% and 100% respect ively, the results provided additional evidence that WSSV reported in different parts of the Asian and Pacific regions maybe quite the same or just different va riants of the same virus.

Loss of transforming growth factor (TGF)-beta signaling has been implicated in malignant transformation of various tissues. Smad4 plays a central role in the signal transduction of TGF-beta. Deletion or mutation of Smad4 has been described in a number of cancers. This study was aimed to investigate a potential role of Smad4 in leukemia including its expression and location in blast cells. The mononuclear cells were separated from bone marrow of leukemia patients. The samples, blast cells of which were more than 90% in mononuclear cells, were selected. The expression and location of Smad4 protein were analyzed by immunohistochemistry methods. The results showed that the Smad4 protein located mainly in nucleus, part of this protein located in cytoplasma, the expressions of Smad4 were not detected in 6 out of 9 ALL patients, in 7 out of 24 AML patients and in 1 out of 2 CML patients; these leukemia patients, in whose cells the expression of Smad4 was not detected, included one L1 and one L3, four L2, one M0, one M1, two M2a, one M3a, one M4b, one M6 and one CML. In conclusion, the Smad4 protein was mainly in nucleus, the deletion or functional change of Smad4 may related with the pathogenesis of human AML.
Humans ; Leukemia, Myeloid, Acute ; genetics ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; Signal Transduction ; Smad4 Protein ; biosynthesis ; genetics ; Transforming Growth Factor beta ; biosynthesis ; genetics

OBJECTIVETo study the effect of Gardenia-Aweto compound (GAC) and two component on preventing acute respiratory distress syndrome (ARDS) by the rabbit model of ARDS induced by intravenous injection of oleic acid. To detect the efficiency component of GAC in preventing ARDS.

METHODGAC was divided into two compounts, ethanol-soluble components (ESC) and ethanol-deposition components (EDC), based on polarity. Forty-three new zealand rabbits were randomly divided into five groups, the blank control group, the model group, the GAC groups, the ESC group, and the EDC group. The ARDS model was induced by intravenous injection of oleic acid. Dynamic changes of arterial blood gas, lung index, albumin in bronchoalveolar lavage fluid (BALF) in different groups and lung histological changes were observed and compared.

RESULTAs compared with the blank group, in the model group, GAC group, ESC group, EDC group the arterial PO2 and oxygen saturation deprived continuously. While SO2 in GAC group at time points 30, 60, 90, 120 min (P < 0.05 or 0.01) and SO2 in ESC group at time points 30, 60, 90 min were higher than those in ARDS group. PO2 in ESC group at time points 30, 60 min (P < 0.05) were higher than those in ARDS group. The value of LI and W/D were higher in ARDS group than in sham group (P < 0.01), they were much lower in HD group than in ARDS group (P < 0.01). Concentration of BALF-albumin increased markedly in ARDS group and pre-treatment groups compared with sham group, but it was much lower in GAC group and ESC group, there was a significant difference between GAC group (P < 0.01), ESC group (P < 0.05) and ARDS group. The lung histological changes had been improved in GAC group and ESC group. But no significantly difference between above-mentioned parameters was found in comparison in the model group and in the EDC group.

CONCLUSIONPreventive administration of GAC or ESC an protect the damaged lung function in ARDS rabbits induced by oleic acid. The efficiency component of GAC in preventing ARDS is ESC. GAC antagonizing ARDS may relate to its anti-inflammatory, immuno-modulatory, anti-oxidant and antithrombotic effects.

Animals ; Cordyceps ; chemistry ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Gardenia ; chemistry ; Lepidoptera ; Male ; Materia Medica ; isolation & purification ; therapeutic use ; Oleic Acid ; Phytotherapy ; Pulmonary Gas Exchange ; Rabbits ; Random Allocation ; Respiratory Distress Syndrome, Adult ; chemically induced ; pathology ; prevention & control

OBJECTIVETo explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury.

METHODSThe multi-central randomized controlled trial was adopted. The qualified subjects were randomized into an acupuncture + rehabilitation group (38 cases) and a rehabilitation group (35 cases). In the acupuncture + rehabilitation group, acupuncture, hyperbaric oxygen (HBO) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment. In the rehabilitation group, HBO and cognitive rehabilitation training were adopted. The efficacy and safety were assessed.

RESULTS(1) After treatment of 2 months, the intelligent state, cognitive function and activity of daily life of patients were improved in the both groups (all P < 0.01). (2) After treatment of 2 months, the score of MMSE and the score of activity of daily life were (24.11 +/- 4.08) and (75.45 +/- 13.95) in the acupuncture + rehabilitation group, which were more significant as compared with (17.05 +/- 43.84), (66.06 +/- 12.75) in the rehabilitation group, respectively (both P < 0.01). In 6-month follow-up visit after treatment, the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group, which was more significant as compared with the rehabilitation group (P < 0.01, P < 0.05).

CONCLUSIONThe integrated Chinese and western medicine of acupuncture, HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury. The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine.

Activities of Daily Living ; Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Brain Injuries ; psychology ; rehabilitation ; therapy ; Cognition ; Earthquakes ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Young Adult

The cDNA of human FGF-21 was subcloned into the pSUMO expression vector and the fusion protein was induced to express in Escherichia coli Rosetta (DE3). The recombinant hFGF-21 was expressed in soluble form in the pSUMO expression system. The recombinant fusion protein was purified by Ni-NTA column. The purified recombinant protein was dialyzed against PBS for re-nature. To obtain pure and active recombinant protein, the fusion protein was subjected to cleavage with SUMO protease I. To examine glucose regulation activity of hFGF-21, 3T3-L1 pre-adipocytes were differentiated into adipocytes, glucose up-take activity of hFGF-21 was examined by glucose oxidase and peroxidase (GOD-POD) assay. Compared with no stimulation control, the recombinant hFGF-21 treatment led to a significant increase in glucose consumption of adipocytes and a significant decrease in concentration of glucose in the medium (P < 0.05, P < 0.001).
3T3-L1 Cells ; Adipocytes ; metabolism ; Animals ; DNA, Complementary ; genetics ; Escherichia coli ; genetics ; metabolism ; Fibroblast Growth Factors ; genetics ; metabolism ; pharmacology ; Glucose ; metabolism ; Humans ; Mice ; Plasmids ; Recombinant Fusion Proteins ; genetics ; metabolism ; pharmacology ; Small Ubiquitin-Related Modifier Proteins ; genetics ; metabolism ; Solubility

OBJECTIVETo evaluate the efficacy, survival and toxicity in patients with brain metastases from non-small cell lung cancer (NSCLC), treated with concurrent systemic chemotherapy and whole brain radiation therapy (WBRT) or sequential systemic chemotherapy/WBRT.

METHODSA total of 60 NSCLC patients with brain metastases were divided into two groups in this prospective clinical study: concurrent systemic chemotherapy and WBRT group (concurrent group) and sequential systemic chemotherapy/WBRT group (sequential group).

RESULTSOf 59 assessable patients, the overall response rate was 22.0%, and the brain response rate was 35.6%; the median progression-free survival time was 3.0 months, and the overall 1- and 2-year survival rates were 55% and 24.4%, respectively, with a median survival time of 16.0 months. The overall response rate was 20.0% in the concurrent group and 24.1% in sequential group (P > 0.05). The brain response rates of 43.3% in concurrent group and 27.6% in sequential group were also not significantly different (P > 0.05). The median progression-free survival time for the patients in the concurrent group was 3.0 months versus 4.0 months in the sequential group, and the median survival time was 16.0 months versus 13.0 months (all P > 0.05). The 1- and 2-year survival rates were 58.5% and 37.2% versus 52.9% and 18.9%, respectively, with a significant difference in the 2-year survival rate between the two groups (P = 0.011). In the sequential group, leukopenia was more frequent during chemotherapy than that in the concurrent group (P = 0.029).

CONCLUSIONConcurrent systemic chemotherapy and WBRT is effective with tolerable adverse events in treating brain metastasis from NSCLC with an encouraging survival, and deserves further large sample and randomized multicenter clinical trials.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Brain Neoplasms ; drug therapy ; radiotherapy ; secondary ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; radiotherapy ; secondary ; Cisplatin ; administration & dosage ; Combined Modality Therapy ; Cranial Irradiation ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Leukopenia ; chemically induced ; Lung Neoplasms ; pathology ; Male ; Middle Aged ; Prospective Studies ; Survival Rate ; Vinblastine ; administration & dosage ; analogs & derivatives