Objective To assess response of rectal carcinoma to preoperative chemoradiation therapy(CRT)using DWI and tumor ADC values,and to investigate the value of ADC in predicting and monitoring therapeutic effect of CRT.Methods Twenty-six patients with primary rectal carcinoma undergoing preoperative CRT were recruited to the study.DWI was performed on a 1.5 T MR scanner in all patients at the time point of pre-therapy,the end of the 1st,2nd week of therapy and pre-operation,respectively.ADC values of the tumors were calculated on the workstation.Randomized block design was applied to analyze change in ADCs following treatment Results All patients were divided into T-downstaging group(n=12)and T-non-downstaging group(n=14).In T-downstaging group,the mean tumor ADC values were(1.10±0.13)×10~(-3),(1.32±0.19)×10~(-3),(1.35±0.13)×10~(-3),(1.32±1.00)×10~(-3) mm~2/s at the time point of pretreatment,week 1,week 2,pre-operation,respectively(F=16.420,P＜0.01).The mean tumor ADC value in T-non-downstaging had a slight increase from(1.16±0.16)×10~(-3) mm~2/s to(1.23±0.13)×10~(-3) mm~2/s at the time of week 1(P＞0.05).The ADC value in T-non-downstaging group continuously increased to(1.30±0.16)×10~(-3) mm~2/s at the end of the 2nd week of CRT(F=5.023,P＜0.01)and appeared statistical difference.The evolution of tumor ADC values in the two groups was significantly different.Early increases in tumor ADC were observed in T-downstaging group.Regarding the increase percentage of ADC value at 1st week as a diagnostic marker of tumor downstaging,when it was set as 11.6%,the sensitivity,specificity,positive predictive value and negative predictive value is 75.0%,78.6%,75.0% and 78.6% respectively,the area under curve(Az)was 0.774(95% confidence interval:0.583 to 0.964).Conclusions An early significant increase of mean tumor ADC value in rectal carcinoma has a potential to predict therapeutic effect of CRT.One week after beginning CRT is an early time point to monitor therapy efficacy.

OBJECTIVETo evaluate the application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease (GERD).

METHODSThe clinical data of 20 consecutive GERD patients underwent anti-reflux surgery in Sir Run Run Shaw Hospital from December 2012 to April 2014 were retrospectively analyzed. The laparoscopic hiatal repair with 360 fundoplicaiton was performed and the biological mesh (BiodesignTM, Surgsis) was implanted for reinforcement of hiatal repair.

RESULTSAll laparoscopic procedures were successful, no conversion and no intra-operative complications occurred. The pre-operative complains were relieved in all patients, and no recurrence was observed during 3-18 month of follow-up. Six patients got dysphagia after operation; 5 of them were controlled through medication and psychological induction; 1 received esophageal dilatation by bougie.

CONCLUSIONThe application of biological mesh in laparoscopic anti-reflux procedure for gastroesophageal reflux disease is satisfactory.

Fundoplication ; Gastroesophageal Reflux ; surgery ; Hernia, Hiatal ; surgery ; Humans ; Laparoscopy ; methods ; Recurrence ; Retrospective Studies ; Surgical Mesh

OBJECTIVETo explore the mechanisms of muscovite gastric mucosal protective effect.

METHODRat model of chronic gastritis were used. After gastric mucosal injury was induced, the rats were divided into 6 groups and were treated with different drugs. 2 weeks later, the tissue and blood samples were obtained and measured.

RESULTThe general conditions, the observations under macroscopy, microscope and electron microscope of the middle and high dose of muscovite groups resembled those of the normal group. Their PH levels were higher than those of the model group, and the rates of intestinal metaplasia were lower, but the PGE2 level of the middle dose of muscovite group was the highest.

CONCLUSIONMuscovite can be adsorbed on the surface of the gastric mucosa. It has gastric mucosal protective effect by improving excretion of mucus and synthesis of PGE2 in gastric mucosa, restraining gastric acid, reversing of intestinal metaplasia and decreasing inflammation cells.

Aluminum Compounds ; pharmacology ; Animals ; Dinoprostone ; blood ; Gastric Juice ; chemistry ; Gastric Mucosa ; pathology ; ultrastructure ; Gastritis ; blood ; chemically induced ; pathology ; Hydrogen-Ion Concentration ; Materia Medica ; pharmacology ; Microscopy, Electron, Scanning ; Potassium Compounds ; pharmacology ; Protective Agents ; pharmacology ; Rats ; Rats, Wistar ; Silicates ; pharmacology ; Sodium Salicylate

To determine the pharmacokinetics of gemcitabine (2',2'-difluorodeoxycytidine) in Chinese non-small-cell lung cancer (NSCLC) patients. Six study subjects were administered gemcitabine at a fixed dose rate of 10 mg/m2 per min (1200 mg/m2,two hours infusion) and carboplatin, and plasma gemcitabine concentrations were measured by ion-pair reversed-phase high-performance liquid chromatography (HPLC). 3P97 Pharmaceutical Kinetics Software was used for the calculation of pharmacokinetic parameters. The obtained mean parameters, elimnation half life (t1/2) (10.67±3.38 min), area under the curve hematologic toxicology result showed that the regimen was effective on and tolerated by the patients.

BACKGROUNDLaparoscopic resection (LAP) for small bowel gastrointestinal stromal tumors (GISTs) is not as common as for stomach. This study aimed to evaluate the safety and efficacy of LAP for small bowel GISTs with systematic review and meta-analysis.

METHODSThe Web of Science, Cochrane Library, Embase, and PubMed databases before December 2016 were comprehensively searched to retrieve comparative trials of LAP and conventional open resection (OPEN) for GISTs of small bowel with a relevance of review object. These researches reported intraoperative and postoperative clinical course (operation time, blood loss, time to first flatus and oral intake, hospital stay, morbidity, and mortality), oncologic outcomes, and long-term survival status.

RESULTSSix studies involving 391 patients were identified. Compared to OPEN, LAP had associated with a shorter operation time (weighted mean difference [WMD] = -27.97 min, 95% confidence interval [CI]: -49.40--6.54, P < 0.01); less intraoperative blood loss (WMD = -0.72 ml; 95% CI: -1.30--0.13, P = 0.02); earlier time to flatus (WMD = -0.83 day; 95% CI: -1.44--0.22, P < 0.01); earlier time to restart oral intake (WMD = -1.95 days; 95% CI: -3.31--0.60, P < 0.01); shorter hospital stay (WMD = -3.00 days; 95% CI: -4.87--1.13, P < 0.01); and a decrease in overall complications (risk ratio = 0.56, 95% CI: 0.33-0.97, P = 0.04). In addition, the tumor recurrence and long-term survival rate showed that there was no significant difference between the two groups of patients.

CONCLUSIONSLAP for small bowel GISTs is a safe and feasible procedure with shorter operation time, less blood loss, less overall complications, and quicker recovery. Besides, tumor recurrence and the long-term survival rate are similar to open approach. Because of the limitations of this study, methodologically high-quality studies are needed for certain appraisal.

BACKGROUNDBone marrow mesenchymal stem cell (MSC) transplantation is a promising strategy in the treatment of myocardial infarction (MI). However, the time for transplanting cells remains controversial. The aim of this study was to find an optimal time point for cell transplantation.

METHODSMSCs were isolated and cultured from Sprague-Dawley (SD) rats. MI model was set up in SD rats by permanent ligation of left anterior descending coronary artery. MSCs were directly injected into the infarct border zone at 1 h, 1 week and 2 weeks after MI, respectively. Sham-operated and MI control groups received equal volume of phosphate buffered saline (PBS). At 4 weeks after MI, cardiac function was assessed by echocardiography; vessel density was analyzed on hematoxylin-eosin stained slides by light microscopy; the apoptosis of cardiomyocytes was evaluated by terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay; the expressions of proteins were analyzed by Western blot.

RESULTSMSC transplantation improved cardiac function, reduced the apoptosis of cardiomyocytes and increased vessel density. These benefits were more obvious in 1-week group than in 1-h and 2-week groups. There are more obvious increases in the ratio of bcl-2/bax and the expression of vascular endothelial growth factor (VEGF) and more obvious decreases in the expression of cleaved-caspase-3 in 1-week group than those in other two groups.

CONCLUSIONMSC transplantation was beneficial for the recovery of cardiac function. MSC transplantation at 1 week post-MI exerted the best effects on increases of cardiac function, anti-apoptosis and angiogenesis.

Animals ; Apoptosis ; Cells, Cultured ; Male ; Mesenchymal Stem Cell Transplantation ; Mesenchymal Stromal Cells ; cytology ; Myocardial Infarction ; pathology ; physiopathology ; surgery ; Rats ; Rats, Sprague-Dawley ; Time Factors

BACKGROUNDGastrojejunostomy is one of the most frequently used procedures for general surgeons. The creation of anastomosis between various parts of the gastrointestinal tract is a basic technical component and major task in the daily practice of almost all gastrointestinal procedures. This research evaluated a new procedure of making gastrointestinal anastomosis with stent.

METHODSTwenty experimental mini-pigs were randomized into two groups. In stent anastomosis group (SA), the anastomoses were constructed with a poly-levolactic acid stent. In hand-sewn group (HA), the anastomoses were performed with a single-layer continuous suture. Abdominal X-ray with intraluminal contrast was performed on the 10th postoperative day. Five pigs of each group were sacrificed on the postoperative days 3 and 14 to determine anastomotic bursting pressure in situ, hydroxyproline concentration, and histopathological evaluation of the anastomotic sites.

RESULTSThere was no intraoperative morbidity or mortality. The median time needed for the sutured anastomosis was (21.7 ± 2.3) minutes and for the stent anastomosis was (11.9 ± 1.9) minutes (P < 0.001). Abdominal X-ray with intraluminal contrast demonstrated normal gas distribution and showed no evidence of leakage or obstruction. Macroscopic appearance at the longitudinal opening of anastomosis was always good in both groups. The median anastomotic bursting pressure was (18.2 ± 1.6) kPa in SA group on postoperative day 3, compared with (11.7 ± 3.2) kPa in HA group (P = 0.003). The anastomotic bursting pressure on day 14 was not significantly different between SA group ((27.1 ± 2.6) kPa) and HA group ((28.3 ± 1.7) kPa) (P = 0.388). The hydroxyproline concentrations were not significantly different.

CONCLUSIONSThe stent anastomosis was not considered to be more difficult than a sutured anastomosis. This method is proved to be safe and feasible compared with the traditional hand-sewn method in the porcine model. The method increases early anastomotic strength in this study.

Anastomosis, Surgical ; methods ; Animals ; Female ; Gastric Bypass ; methods ; Hydroxyproline ; metabolism ; Male ; Stents ; Swine

OBJECTIVETo investigate the feasibility, safety and oncological effect of totally laparoscopic total gastrectomy (TLTG).

METHODSThe clinical data of TLTG cases and open total gastrectomy (OTG) patients between November 2007 and October 2011 were analyzed. Also compared the feasibility, safety and short-term outcomes of TLTG with OTG.

RESULTSNinty cases were analyzed. There were 18 cases in the TLTG group and 72 cases in the OTG group. Operation time was significantly longer in the TLTG group ((310 ± 86) minutes) than in the OTG group ((256 ± 57) min, t = 4.963, P = 0.002), However, the blood loss were significantly lower in the TLTG group ((136 ± 84) ml vs. (359 ± 141) ml, t = -11.734, P = 0.000). The post operative morbidity was similar between the TLTG and OTG group. First flatus time (t = -7.020), first diet time (t = -6.166 and -5.698), and post operative hospital stay (t = -4.610) were significantly shorter in the TLTG group than in the OTG group (P < 0.05).

CONCLUSIONSLTG is a safe and feasible procedure with quick post-operation recovery. The laparoscopic side-to-side esophagojejunal anastomosis is a safe and feasible method of alimentary reconstruction after laparoscopic total gastrectomy.

Adult ; Aged ; Female ; Gastrectomy ; methods ; Humans ; Laparoscopy ; Laparotomy ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Stomach Neoplasms ; surgery ; Treatment Outcome

OBJECTIVETo identify the volatile organic compounds (VOCs) in lung cancer tissue and lung cancer cell lines.

METHODSThe lung cancer tissue samples from 18 patients were cultured and 4 lung cell lines (A549, NCI-H446, SK-MES-1, BEAS-2B) were also included in the study. Air samples in the headspace of culture flasks were analyzed for VOCs with solid-phase micro-extraction and gas chromatography-mass spectroscopy technique (SPME-GC/MS).

RESULTTwo kinds of VOCs 2-pentadecanone and nonadecane were detected in lung cancer cell lines A549, NCI-H446 and SK-MES-1. The concentration of 2-pentadecanone were (1.382 + or -0.171) X 10(-5)mg/L, (1.681 + or - 0.190) X 10(-4)mg/L and (2.835 + or - 0.401) X 10(-6)mg/L, respectively; the concentrations of nonadecane were (8.382 + or - 0.606 ) X 10(-6)mg/L, (1.845 + or - 0.130) X 10(-5)mg/L and (6.220 + or - 0.362) X 10(-6)mg/L), respectively. The eicosane was detected in A549 and NCI-H446 with the concentration of (8.313 + or - 1.130) X 10(-6)mg/L and (1.020 + or - 0.141) X 10(-5)mg/L), respectively. All the 3 VOCs were not detected in cell line BEAS-2B. The concentrations of 12 VOCs including decane, 2- pentadecanone, nonadecane and eicosane were high in 18 lung cancer tissue samples; the concentrations of 2-pentadecanone were 5.421 X 10(-6)mg/L-3.621 X 10(-5)mg/L,those of nonadecane were 5.805 X 10(-6)mg/L-1.830 X 10(-5)mg/L, those of eicosane were 2.730 X 10(-6)mg/L-2.343 X 10(-5)mg/L. There were no differences of VOCs levels among patients with different cancer differentiation (P>0.05). The concentration of eicosane in the non-squamous carcinoma was higher than that in squamous carcinoma, the same results were confirmed in the lung cancer cell lines.

CONCLUSIONThis study has identified VOCs produced by lung cancer tissue, which may support to use breath test as a complementary noninvasive diagnostic method for lung cancer.

Adult ; Aged ; Alkanes ; metabolism ; Biomarkers, Tumor ; metabolism ; Cell Line, Tumor ; Female ; Humans ; Lung Neoplasms ; diagnosis ; metabolism ; Male ; Middle Aged ; Tumor Cells, Cultured ; Volatile Organic Compounds ; metabolism

China/epidemiology* ; Coronary Angiography ; Coronary Artery Disease/epidemiology* ; Cross-Sectional Studies ; Humans ; Risk Assessment ; Risk Factors