BACKGROUND:The three-dimensional structure of acupoint anatomy was integrated into the teaching of acupuncture manipulation. Combined with the implementation and application of the acupuncture and moxibustion in digital virtual human, it can greatly improve the teaching effect and learning interest. OBJECTIVE:To investigate the acupuncture virtual human with integration of virtual reality force feedback technology and tissue deformation. METHODS:Using virtual reality technology, with computer as the core, we generated a specific range of virtual environment with realistic visual, auditory and tactile integration, col ected clinical expert acupuncture technique, matched the sensing equipment that can reflect the intensity, displacement and speed sensing of acupuncture. Based on image segmentation of virtual human, we constructed human tissue mechanics model, built virtual acupuncture-force-feedback system, and faithful y transmitted to the operator by a force feedback device. On one hand, based on VOXEL-MAN virtual human development platform, we finished the three-dimensional browser redevelopment of the science of acupuncture and moxibustion of Shu acupoint, which provided visual perception for people. On the other hand, based on modern biomechanics theory, we established models by graphics and image processing technology and force feedback technology. The stress process of the structure of each layer in the acupuncture point area was given to people in a sense of touch by the manner of virtual reality and force feedback. RESULTS AND CONCLUSION:With the man-machine interactive operation platform of virtual acupuncture force feedback system, operator could see the dynamic process of acupuncture needle into human body, and could feel the real counterforce in the control terminal of force feedback instrument. By operating acupuncture needle in virtual environment of force feedback instrument, acupuncture was performed in virtual human. The system meets the two requirements:the feedback changes produced by tissue interaction were similar to real acupuncture feedback force data measured by instrument. The acupuncture needle entered into different tissues, a sense of power changed significantly;there was progressive feeling with different layers, reaching a realistic experience. During the whole training, the image was smooth;virtual needle was responsive, which better meets the requirements of virtual reality.

Background and purpose:DNMT3B has nearly 40 known splice variants expressed in a tissue-and disease-speciifc manner, but the roles of these splice variants in the cell are still unclear. The aim of this study was to investigate the effects of overexpression of DNA methyltransferase 3B4 (DNMT3B4) gene on proliferation of human embryo kidney 293A cells. Methods:293A cells were transfected with plasmid pCMV-DNMT3B4 or pCMV-2B and then treated with G418 to get the stable cell line. The stable cell lines were determined for proliferation level by MTT method, and for cell cycle distribution by lfow cytometry. The expression of p21 was detected by real-time PCR and Western blot. The methylation status of p21 gene promoter was detected by methylation-speciifc PCR (MS-PCR). Results:The absorbance value in DNMT3B4-1 and DNMT3B4-2 clone were (58.92±3.47)%and (68.82±5.64)%as compared to 293A-vector cells using MTT method. DNMT3B4 overexpression signiifcantly decreased cell proliferation (P<0.05). S phase fraction of 293A-vector cells was (40.44±0.91)%. While in DNMT3B4-1 and DNMT3B4-2 clone cells, the S phase fraction was (35.88±2.00)%and (37.00±1.79)%respectively. Overexpression of DNMT3B4 could significantly decrease S phase fraction (P<0.05). The expression of p21 in DNMT3B4 overexpressed cells was increased, but the methylation status of p21 gene promoter was unchanged.Conclusion:Overexpression of DNMT3B4 can inhibit 293A cell proliferation and can facilitate p21 expression.

Objective To analyze the use of multidisciplinary team approach (MDT) for advanced and refractory hepatic alveolar echinococcosis in individualized treatment.Methods A retrospective study was conducted on the use of multidisciplinary team approach in individualized diagnosis and treatment for 137 patients with advanced and refractory hepatic alveolar echinococcosis (with invasion of major blood vessels and bile ducts,and/or with lung and brain metastasis) in our hospital from January 2005 to December 2013.The patients were divided into two groups:The MDT group (n =49) and the non-MDT group (n =88).The MDT group was further divided into two subgroups:subgroup A was the surgical treatment group (n =26),and subgroup B was the non-surgical treatment group (n =26).In the subgroup B,13 patients underwent late radical surgery.The non-MDT group was also further divided into two subgroups:subgroup a was the surgical treatment group (n =61),and subgroup b was the non-surgical treatment group (n =27).In subgroup b,5 patients underwent late radical surgery.The time taken to confirm the diagnosis,perioperative hospital stay,operation time,blood loss,postoperative drainage time,postoperative hospital stay,early postoperative complications (pleural and peritoneal effusions,bile leak,anastomotic leak),late postoperative complications (jaundice,anastomotic stenosis,recurrence),and rates of radical surgery were compared between subgroup A and subgroup a.The rates of late radical resection were compared between subgroup B with subgroup b.All data were analyzed using the Mann-Whitney rank sum test or the Chi-square test.Results Subgroup A had significantly shorter perioperative hospital stay,postoperative hospital stay,and total length of hospital stay than subgroup a (P ＜ 0.05).The incidence of late postoperative complications (jaundice,anastomotic stenosis,recurrence) was also significantly less than subgroup a (P ＜ 0.05),and the radical surgery rate was significantly higher than subgroup a (P ＜ 0.05).There was no significant difference in the time taken to confirm the diagnosis,operation time,blood loss,postoperative drainage time,early postoperative complications (pleural and peritoneal effusions,bile leak,anastomotic leak) (P ＜ 0.05) between subgroup A and subgroup a.The ratio of subgroup B receiving chemotherapy alone or drainage + chemotherapy,and the rate of late implement of radical resection were significantly higher than subgroup b (P ＜0.05).Conclusions A multidisciplinary team approach in individualized treatment comprehensively combined the advantages of the effects of drugs,intervention,surgery and systemic nutritional support.The best individualized treatment plan could be used which improved the rates of radical surgery in advanced and refractory hepatic alveolar echinococcosis,reduced postoperative complications,improved quality of life,and offered chances of radical resection in the patients who had lost the opportunities for surgery.

Objective To investigate the ability of induction of specific cytotoxic T lymphocytes (CTL) stimulated by dendritic cells (DCs) co-transfected with MUC1 and survivin mRNA of human pancreatic cancer,and to provide the experimental basis for the treatment of human pancreatic cancer with multi-epitope DC vaccine.Methods DCs were isolated and cultured from peripheral blood mononuclear cells (PBMCs) of 6 patients with pancreatic cancer.Human pancreatic cancer cell line MiaPaCa-2 was routinely cultured,after being transcripted and amplified by RT-PCR,MUC1 and survivin mRNA were co-transfected or individually transfected into DCs by electroporation,and they were named as DC-MUC1,DC-survivin,DC-MUC1 + survivin.The expression of MUC1 and survivin mRNA in DCs were detected by real-time PCR.The survival rate of transfected DCs were determined by MTT method.The lymphocyte proliferation ability was evaluated by mixed cell culture method.The Th1 cytokine releasing of antigen-specific CTLs were measured by ELISA assay.Results Mature DCs were obtained,the positive expression rates of surface markers CD40,HLA-DR,CD83 and CD86 were 34.31％,50.21％,89.17％ and 73.62％,respectively.The expression amount of MUC1 mRNA of DC-MUC1 was 36.24 ± 5.17,and the expression amount of survivin mRNA of DC-survivin was 34.53 ± 4.02,while the expression amounts of MUC1,survivin mRNA of DC-MUC1 + surviving were 31.79 ±4.26 and 14.67 ± 2.96,which were significantly lower than that in individual transfection group (P ＜ 0.05).The survival rate of DC-MUC1 + surviving was decreased in a time dependent manner,which was significantly lower than that in individual transfection group (about 50.21％ vs 80％ at 24 h,P ＜0.05).When DC/T cells ratio was 1∶ 10,1∶ 20,the autologous T cell proliferation index of MUC1 and survivin mRNA in co-transfection DC group was significantly higher than that in individual transfection group (P ＜ 0.05) ;when DC/T cells ratio was 1∶ 40,1∶ 80,the difference of proliferation index was not statistically significant.When DC/T cells ratio was 1∶ 10,after 14 d culture,the expressions of IL-2 in DC-MUC1,DC-survivin,DC-MUC1 + surviving were (892.73 ± 32.9),(713.62 ± 56.37),(1884.37 ± 95.21) pg/ml,and the expressions of granzyme B were (501.62 ± 12.30),(203.84 ± 12.55),(1193.15 ± 86.04) pg/ml ; and the expressions of IFN-γ were (981.50 ± 47.82),(696.05 ± 41.66),(2237.94 ± 189.55) pg/mL.The corresponding values in DC-MUC1 + surviving group were significantly higher than those in individual transfection group (P ＜ 0.05) ; while the difference of IL-10 was not statistically significant.Conclusions DCs co-transfected with MUC1 and survivin mRNA have a stronger ability to stimulate specific CTL in vitro than individual antigen loaded DCs.

Objective To analyze the efficacy of different treatment methods for end-stage hepatic alveolar echinococcosis combined with obstructive jaundice.Methods A retrospective study was conducted on the diagnosis and treatment of 55 patients with end-stage hepatic alveolar echinococcosis combined with obstructive jaundice managed from January 2000 to January 2013 at the First Affiliated Hospital of Xinjiang Medical University.The patients were divided into two groups according to the treatment options:group A,the palliative surgery group (n =38,69.1％) using palliative resection and biliary decompression ; and group B,the interventional group (n =17,30.9％) using percutaneous transhepatic cholangial drainage (PTCD).We analyzd the general data,preoperative and postoperative liver function,operation time,blood loss,average hospital stay,duration of postoperative tube drainage of abscess cavity,degree of lesion with invasion into the first porta hepatis,progressive lesion,continuous invasion and/or distant metastasis,biliary complications,mortality,and cumulative survival rates.The t-test or t'-test was used to analyze continuous data and the chi-square test was used to analyze categorical data.Parallel log rank test and Kaplan-meier method were used to calculate survival rates in survival analysis.Results When compared with group B,group A had significantly longer operative time,more blood loss,and longer average hospital stay (P ＜0.05).The postoperative total bilirubin,direct bilirubin,γ-glutamyl transpeptidase and alkaline phosphatase,aspartate aminotransferase,alanine aminotransferase were significantly higher than in group B (P ＜0.05).The level of post operative albumin was lower in group A than in group B.The two groups of patients (A and B) had similar background including general data (gender,age,nation),preoperative liver function,duration of postoperative tube-drainage of abscess cavity,degree of lesion-invasion into first porta hepa tis,progressive lesion-invasion and/or distant metastasis,biliary complications,mortality,cumulative survival rates and survival curves.Conclusions Interventional treatment is an effective treatment for end-stage hepatic alveolar echinococcosis combined with obstructive jaundice.It has the advantages of minimal invasiveness,simplicity,safety and repeatability.It may replace traditional palliative surgery in the future.

Objective To evaluate the effectiveness and safety of radical versus conservative surgery for hydatid liver cysts.Methods The Pubmed, EMBASE, MEDLINE, Cochrane Library, Chinese Biomedicine Database, CNKI, Wan Fang Databases, VIP Databases, Chinese scientific and technical journals full-text database and Chinese Journal of full text database were searched for randomized clinical trials or none-randomized clinical trials from January 2000 to January 2015.A Meta-analysis was performed with RevMan5.1.Results 10 studies with 2 123 patients were included into the final analysis.Meta-analysis demonstrated that the radical group was significantly longer in operation time [weighted mean difference (WMD) =25.11;95％ CI: 16.18-34.05;P ＜ 0.05], was significantly shorter in the length of hospital stay (WMD =-3.94;95％CI:-7.57-0.32;P ＜0.05), was significantly lower in the incidence of bile leak (OR =0.19;95％ CI: 0.07-0.49;P ＜ 0.05), was significantly lower in the incidence of residual cavity infection (OR =0.08;95 ％ CI: 0.04-0.15;P ＜ 0.05), and in the incidence of local recurrence (OR =0.10;95 ％ CI: 0.05-0.18;P ＜ 0.05) when compared with the conservative surgery group.Conclusions For hydatid liver cysts, radical surgical procedures had significantly lower rates of complications and recurrence.Thus, they are better treatments for hepatic cystic echinococcosis.

Objective To investigate the double T tube drainage method in the treatment of hepatic echinococcosis which ruptured into the common bile duct.Methods A retrospective study was conducted on 86 patients who were treated surgically for hepatic echinococcosis which had ruptured into the common bile duct at the First Affiliated Hospital of Xinjiang Medical University from June 2012 to December 2014.The average postoperative hospitalization,postoperative complications (residual cavity bile leakage and residual cavity effusion,residual cavity infection) and biliary complications of biliary tract infection were analyzed.Results Significant differences were found on the postoperative residual cavity complications in group A:(2,7.1％) when compared with Group B:(9,15.5 ％),and also on the postoperative hospitalization between the double T tube drainage group [group A:(7.1 ± 1.3) d] and the traditional T type tube decompression group [B group:(8.2 ± 1.5) d] (P ＜ 0.05).Conclusions The doubleT tube drainage in the treatment of hepatic echinococcosis which had ruptured into the common bile duct was simple,safe and effective.This treatment could completely cure residual cavity bile leakage,and it had the advantage of avoiding occurrence of common bile duct related complications caused by the traditional suture method for bile leakage.

Objective To investigate the induction of specific anti-tumor immune response by transfected dendritic cells (DCs) with MUC1 mRNA of human pancreatic cancer,and to provide the experimental evidences for the treatment of human pancreatic cancer with DC vaccine.Methods DCs were isolated and cultured from peripheral blood mononuclear cells (PBMCs),and then were identified by cell morphology and surface markers.After being transcripted and amplified,MUC1 mRNA was transfected into DCs by electroporation.The expression of MUC1 in DCs at different time points was detected by quantitative real-time PCR and Western blot.The survival rate of DCs before and after tramrfection was determined by MTT method.The induction of specific cytotoxic T lymphocyte (CTL) response by MUC1 mRNA transfected DCs was measured by 51Cr standard cytotoxicity test.The released amount of IFN-γ was evaluated by ELISA method.Results The cultured cells appeared typical characteristics with regard to morphology and phenotype (CD40 +,HLA-DR+,CD83 +,CD86 + ).After MUC1 mRNA transfection for 48 h,the expression of MUC1 mRNA of DCs reached the highest point ( 38.43 ) and the MUC1 protein expression also reached the highest point at 72 h.The survival rate of DCs was stabilized around 80％ after transfection.The DCs transfected with MUC1 mRNA could effectively induce HLA-A2+/MUC1 + specific CTL immune responses.Stimulated by pancreatic cancer cell line Capan-2 cells or the DCs transfected with MUC1 mRNA,the IFN-γ released in 24 h by MUC1 specific CTL were ( 28.44 ± 4.96 ) U/m1 and ( 16.31 ± 2.54) U/ml,respectively.The difference between the two groups was statistically significant (P ＜0.05 ).Conclusions DCs transfected with human pancreatic cancer MUC1 mRNA could induce CTLs and produce specific anti-tumor immunity.

BACKGROUND:Based on the integration of virtual reality technology with acupoints, acupuncture can be expressed three-dimensional y.
OBJECTIVE:To explore the structure of points through reconstructing digitalized three-dimensional visualization of Neiguan (PC6) structure based on VOXEL-MAN and Micro-XCT.
METHODS:Muscles and other tissues adjacent with Neiguan (PC6) were segmented and merged based on the VOXEL-MAN system combined with the anatomical knowledge of acupoints;nerves and blood vessels were performed with three-dimensional reconstruction;the needle-inserting animation of Neiguan (PC6) was obtained by running script file. Three-dimensional visualization and virtual needle-inserting researches of Neiguan (PC6) were performed. Nature of the acupoints was detected by the Micro-XCT-200 machine additional y.
RESULTS AND CONCLUSION:The visualization of the anatomical structure of local Neiguan (PC6) was completed, and the localization and expression of Neiguan (PC6) in the digitized virtual human were realized. The Neiguan (PC6) structure was researched with Micro-XCT-200, and showed there was no new tissue. Local three-dimensional reconstruction of the acupoint structure could help to display the anatomical structure of acupoints and simulate the acupuncture process. It could also help to observe the relationship between the needle body and the surrounding tissues during needle-inserting, which supplying a good basis not only for exploring the security of needle-inserting, but also for improving the clinical effect of acupuncture. The research on the structure of acupoint Neiguan (PC6) by Micro-XCT-200 provides further experimental evidence for the hypothesis of three-dimensional acupoint.

Objective To analyze the results of survival and local regional control of early-stage breast cancer patients treated with breast-conserving surgery and whole breast radiation therapy, and to explore the factors influencing local control. Methods From October 1995 to September 2005,335 patients with early-stage breast cancer were treated with breast conservative therapy, including 25 with post-operative radiotherapy alone( group A), 194 with sequential chemo-radiotherapy( group B) ,80 with concurrent chemoradiotherapy( group C), and 36 with chemo-radio-chemotherapy (group D). Axillary dissection was performed in 312 patients and sentinel node biopsy in 2. Adjuvant chemotherapy was given to 310 patients. Radiation of 50 Gy in 25 fractions was delivered to the whole breast in 256 patients,and to the breast and regional nodes in 79. Another 10 Gy in 5 fractions was boosted to the tumor bed. The proportion of patients with surgery-radiation interval of less than 4 weeks,4-8 weeks,8-20 weeks and over 20 weeks was 16.4%, 23.6% ,37.3% and 22.7% ,respectively. Concurrent chemo-radiation and" sandwich" modality were delivered in 80 and 36 patients,respectively. Results The median follow-up was 48(25.3-146.7) months. The 5-year local-regional control and ipsilateral breast control rates were 94.5% and 95.6%, respectively. The 5-year disease-free survival,metastasis-free survival and overall survival rates were 88.6% ,93.2% and 98.8% ,respectively. Lymph-vascular invasion and neural invasion were significant factors influencing local control in univariate analysis. No significant differences were found in local control rates among different surgery-radiation intervals or different sequencing of radiotherapy and chemotherapy. Multivariate analysis showed that lymph-vascular invasion and reexcision for positive or unknown margin were independent prognostic factors influencing local control. In group A + B, C and D, the frequency of grade Ⅲ skin toxicity was4.5%.80.0%.and 77.0%,respectively(χ2=226.00,P=0.000).Conclusiom Breast conservative therapy for early-stage breast eancer results in good local-regional control and overall survival.Lymph-vascular invasion and reexcision are independent prognostic factors for local control.Surgery-radiation interval and sequencing of radiotherapy and chemotherapy have no impact on local contr01.Grade Ⅲ skin toxicity of the concurTent radio.chemotherapy and the chemo.radio.chemotherapy group is significantly higher than that of the sequential chemotherapy-radiotherapy plus radiotherapy alone group.