AIM: To investigate mutations of oncogene k-ras in colorectal cancer tissues and the relationship between mutations of k - ras and biological behavior of colorectal carcinoma. METHODS:The specimens of 123 patients with colorectal cancer were collected. Real - time fluorescence quantitative PCR were performed to detect k-ras mutations at codon 12 and codon 13 of exon 1, and the results were analyzed with the corresponding clinical pathological data. RESULTS: Among 123 colorectal cancer cases, point mutations were detected in 53 cases (40.8% ) , point mutations at codon 12 were found in 42 (34.1 % ) cases, and 11(8.9% ) cases at codon 13.No closely relationship between mutations of k-ras and tumor size, location, invasive depth and differentiation extent was observed. The rate of k-ras mutation in the cases with more invaded lymph nodes was higher than that in the cases without invaded lymph nodes ( P < 0.05 ) , and the rate of k-ras gene mutation in the cases with hepatic metastases was higher than that in no hepatic metastases (P <0.05). The rate of k - ras gene mutation was higher in TNM staging Ⅲ/Ⅳ than that in Ⅰ/Ⅱ( P < 0.05 ). CONCLUSION: Mutation of oncogene k-ras plays an important role in the carcinogenesis and development of colorectal cancer, and it is closely associated with invaded lymph notes and hepatic metastases, suggesting that mutation of k- ras indicates a poor prognosis.

Objective To examine the effects of intravenous thrombolysis with Tissue-type plasminogen activator (rt-PA) combined with mild hypothermia therapy on patients with acute cerebral infarction and further investigate under?lying mechanism for the treatment of cerebral infarction. Methods Sixty cases of cerebral infarction patients were random?ly divided into three groups with 20 patients in each group:①The control group was given rt-PA intravenous thromboly?sis;②The treatment group 1:intravenous thrombolytic therapy combined with local mild hypothermia treatment for 12 h;③The treatment group 2:intravenous thrombolytic therapy and local mild hypothermia in the treatment of 24 h. We col?lected NIHSS score before and after thrombolytic therapy, patient monitoring (ICP) changes during thrombolytic therapy, March (MRS) score and complications during follow-up after thrombolysis, The serum levels of SOD and MDA were as? sessed before and after thrombolytic therapy. Results NIHSS score was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 72 h, 7 d, 14 d after thrombolysis. MRS was lower in both treatment group 1 and treatment group 2 than in the control group (P<0.05) at 3 months after thrombolytic therapy. MRS were lower in treat?ment group 2 than in the treatment group 1 (P<0.05). ICP in treatment group 1 and the concentration of MDA in treat?ment group 2 were lower, compared with control group (P<0.05) at 24 h, 72 h and 7 d after thrombolysis. ICP was lower in treatment group 2 than treatment group 1 at 7d after thrombolysis. The concentration of SOD was higher in treatment groups than in control group (P<0.05) at 24, 72 h and 7d after thrombolysis. ICP and MDA concentration were lower in treatment group 2 than in treatment group 1(P<0.05) at 72h and 7d after thrombolysis. The concentration of SOD was higher in treatment group 2 than in the treatment group 1 at 7 d after thrombolysis (P<0.05). There was no significant dif?ference in adverse events and mortality among groups (P>0.05). Conclusion Rt-PA intravenous thrombolysis combined with mild hypothermia treatment can improve the prognosis of patients with cerebral infarction without increasing the inci?dence of adverse reactions. In addition, thrombolysis combined with mild hypothermia 24 h has better effect than with mild hypothermia 12 h. The beneficial effects may be accomplished by reducing oxidative stress reaction.

Objective To investigate the technique,safety and efficacy of percutaneous chemoablation of single and multiple confluent metastatic lymphatic nodes (LNs).Methods Forty six patients of malignant metastatic LNs were treated with percutaneous chemoablation with CT guidance,and they were divided into two groups,including 30 patients of single isolated metastatic LN (group A) and 16 patients of multiple and/or confluent metastatic LNs (group B).A mixture of 5 ml absolute ethyl alcohol,2 ml iodized oil and 10 mg epirubicin was injected into the lymph node(s).The average tumor diameter was (2.0 ± 0.5) cm in group A and (3.8 ± 0.6) cm in group B.The intratumoral drug coverage rate and the occurrence of reflux were recorded.Enhanced CT scans were performed to observe the therapeutic effects at the intervals of 3,6 and 12 months.Results The coverage rate was 100％ in group A,which was significantly higher than group B (70％ to 80％).The occurrence of reflux was 70％ for group A versus 40％ for group B.For group A,a complete response (CR) patients of 14,21,28 and a partial response (PR) patients of 16,9,2 were obtained at 3,6 and 12 months after therapy respectively.For group B,a CR patient of 0,0,0 and PR patients of 3,8,9 were observed at 3,6 and 12 months after therapy respectively.Standardized rate by direct method was performed and the CR rate (74.4％) for group A was higher than that for group B (0) (P =0.0001).The tumor FDG uptake was lower compared with the preoperative images.No serious complications were observed.A few patients had mild pain during the procedure,which was relieved after 2.0 to 3.0 ml of 2％ lidocaine injection adjacent to the tumor.No needle tract seeding or infection were observed.There was no effect on patients' overall survival.Conclusions CT-guided chemoablation is an effective,low-cost and minimally invasive procedure,which is better for treating single metastatic LN than multiple and/or confluent oues.

Objective To evaluate the safety and efficacy of the CT-guided percutaneous cryoablation of osteoid osteoma in children.Methods Nine children with osteoid osteoma proved by histopathology were treated with CT-guided cryoablation from January 2007 to January 2010.There were 6 boys and 3 girls.Their mean age was ( 13.0 + 1.6 ) years ( ranging from 10.0-15.0 years ).The procedures were performed under local anesthesia.Eight G bone biopsy needles for biopsy and 17 G freezing needles were used in the procedure.CT guidance was used for procedural planning,instrument guidance,and monitoring.Each cryoablation included two freezing-thawing cycles.Follow-up was performed to assess technical and clinical outcome.A visual analog scale (VAS) was used to assess severity of pain pre- and post-procedure,and mean VAS for the group was compared pre- and post-procedure with Kruskal-Wallis rank sum test.Results Biopsy and cryoablation were successfully performed in all children.No major immediate or postponed complications were observed.Significant pain relief ( P ＜ 0.01 ) was observed in all patients after procedure.The VAS of preoperation(8 points 1 case,7 points 3 cases,6 points 4 cases,5 points 1 case) compared with that of one month after operation ( 1 point 4 cases,0 point 5 cases),the difference was statistically significant( H =32.838,P ＜ 0.01 ).These patients were allowed to fully weight-bear and function without limitation 3 days after the procedure.Pain was obviously released.Pain recurrence was not observed in all patients.Moderate fever (37.8 ℃ ) was observed in a patient one day after operation and fully recovered 2 days later.Conclusion CT-guided percutaneous cryoablation is a safe and effective minimally invasive method for the treatment of osteoid osteoma in children.

ObjectiveTo investigate the technique,safety and clinical value of CT-guided percutaneous interstitial brachytherapy for metastatic carcinoma of lymph nodes in mediastinum.Methods Eight patients with metastatic carcinoma of lymph nodes in mediastinum were treated by CT-guided interstitial implant of radioactive seeds in our department.Anterior approach were performed on all cases,125I radioactive seeds were implanted by setting CT Gantry at an oblique angle,three-dimensional reconstruction with SCT and separation the narrow gap between aortic arch and superior vena cava with fiatscalp core.Dose distributions were checked by TPS after operation.The improvement in clinical symptoms and lymph node sizes were documented in order to investigate the therapeutic effects.ResultsThe particle coverage rate was 93.5％ ± 1.5％.According to the CT scans two months later,3 patients ( 37.5％ ) had complete ablation,4 (50％) partial ablation,and 1 ( 12.5％ ) stable disease.Overall response rate (CR + PR) for this group of patients was 87.5％.The symptoms of all patients including shortness of breath (5 patients),cough (4 patients),dysphagia (4 patients) showed varying degree of improvement.No edema of head-and-neck and upper extremity was observed.There was no major vascular,tracheal and esophageal injury.A small amount of pneumothorax was observed in one patient.ConclusionsCT-guided percutaneous interstitial brachytherapy,a minimally invasive procedure associated with favorable therapeutic results,is a promising technique for treatment of metastatic carcinoma of lymph nodes with local pressure symptoms which may not respond to conventional therapy.

Objective To investigate the preparation of biodegradable vena cava filter(BVCF) with poly-l-lactic acid (PLLA),and to evaluate its mechanical properties,delivery performance,the ability of capturing thrombus and the degradation property.Methods Three-dimensional design software was used to design the shape of BVCF.The BVCF was prepared by using PLLA with molecular weight of 100 000 unit.Twelve minipigs were used to test the feasibility of this BVCF.They were randomly divided into four groups.At first the BVCFs were placed into the inferior vena cava of pigs in three experimental groups.The fourth group was used as a blank control group.The thrombi were injected into all pigs after 1 week,and CT examinations were performed at different time points to observe the filter locations and pulmonary artery.The animals were sacrificed according to a fixed time table for histopathological assessment.Results The BVCF was successfully designed and produced,which could expand by stretching the center-thread.In vitro test results showed the radial force of BVCF was approximately 1.6 N and could capture the thrombus more than 5 mm in diameter,and it was easy to release.Through the animal experiment confirmed that the filter could capture the lethal thrombus and all 9 pigs of experimental groups were survived,two of those had the symptoms of respiratory frequency and heartbeat accelerated slightly in the operation.In control group,the symptoms such as accelerate of respiratory rate,shortness of breath were observed in varying degree.The pig which was injected with 8 strips of thrombus died in the same day after surgery.Postoperative CT and pathological examinations showed that 2 pigs in the experimental group developed peripheral pulmonary embolism,while the dead pig in the control group developed central pulmona-y embolism.Histological findings showed that the intima covered the BVCF lateral branch partly after one week,and thoroughly after six weeks.The vessel wall structure remained normal and no signs of the obvious inflammatory cells infiltration were detected.Twelve weeks after the implantation,the vessel wall structure was normal,and the lumen was unobstructed,and the collateral of the filter was partly degradated.Conclusions The BVCF has the advantage of good mechanical strength and good biocompatibility.It is easy to release and can capture the lethal thrombus,but its degradation performance remains to be studied.

Objective To investigate the clinical value of CT-guided percutaneous bone biopsy in skeletal lesions.Methods Totally 857 patients with skeletal lesions who underwent CT-guided percutaneous bone biopsy were analyzed retrospectively.The position and path of puncture were selected according to the adjacent and safety principle after CT localization.Lesions were penetrated with 8-13G bone puncture needles or 16-18G trigger-type biopsy needles for obtaining specimens.Results The whole procedures were generally finished within 20-40 min,and adequate samples were obtained for pathologic examinations in all patients.The pathological findings of biopsy for 766 patients were consistent with that of surgeries (89.38%) .No false positive patient was found.Postoperative complications occurred in 27 patients (3.15%) ,including local hematomas in 22 patients,nerve injury in 1 patient and infection in 4 patients.Conclusion CT-guided percutaneous bone biopsy is safe and with high diagnostic accuracy.It can be used to diagnose metastases,primary bone tumors,tumor-like lesions and inflammatory lesions.The reasonable selection of the path of puncture,puncture needles and biopsy methods can improve the success rate of biopsy.

Objective To investigate the mechanism by which Colony Stimulating Factor-1(CSF1)inhibits apoptosis in neurons subjected to oxygen-glucose deprivation(OGD).Methods Primary rat cortical neurons were divided into the OGD damaged neuron model group(OGD group),the rh-CSF1 intervention group(rh-CSF1 group),and control group.The sample size for each group was 3.After intervention with recombinant human CSF1(rh-CSF1),neuronal apoptosis rate and intracellular ATP content,reactive oxygen species levels,mitochondrial membrane potential,and mitochondrial DNA copy number were measured.The content of malondialdehyde within mitochondria and the activity of superoxide dismutase were also assessed.Results Intervention with rh-CSF1 increased mitochondrial membrane potential(0.55±0.03 vs.0.43±0.06,P<0.01),mitochondrial DNA copy number(0.88±0.05 vs.0.72±0.06,P<0.05),ATP content[(15.70±0.99)mmol/mg vs.(11.70±1.00)mmol/mg,P<0.01)],and superoxide dismutase[(18.47±1.38)U/mg vs.(14.78±1.81)U/mg,P<0.05)]activity in neurons injured by OGD.It also reduced levels of rectivereactive oxygen species(3.64±0.21 vs.4.45±0.33,P<0.05)and malondialdehyde within mitochondria[(2.13±0.19)mmol/mg vs.(2.78±0.20)mmol/mg,P<0.05)],and inhibited neuronal apoptosis(10.12±0.78 vs.17.04±1.23,P<0.01)Conclusion rh-CSF1 may alleviate the damage in neurons induced by OGD by improving mitochondrial function,reducing oxidative stress,and inhibiting cell apoptosis.

Objective:To automatically synthesize Al 18F-1, 4, 7-triazacyclononane-1, 4, 7-triacetic acid (NOTA)-fibroblast activation protein inhibitor (FAPI)-04, perform PET/CT imaging in vivo, and evaluate its diagnostic efficacy on tumors. Methods:Al 18F-NOTA-FAPI-04 was produced in All-in-one automatic synthesis module and its quality control was conducted by high performance liquid chromatography (HPLC) equipped with a radioactive detector. Al 18F-NOTA-FAPI-04 PET/CT imaging was performed in normal BALB/c mice ( n=3) and 4T1 breast cancer models ( n=3) to determine its biodistribution. Then Al 18F-NOTA-FAPI-04 and 18F-FDG PET/CT imaging were performed in a hepatocellular carcinoma patient (male, 51 years old). Results:The synthesis time of Al 18F-NOTA-FAPI-04 was about 35 min, and the radiochemical yield was (25.2±1.9)% (attenuation correction, n=3). The product was colorless transparent solution with pH value of 7.0-7.5, and the specific activity was (46.11±3.07) GBq/μmol (attenuation correction, n=3). The radiochemical purity was above 99.0% and was still above 98.0% at room temperature after 6 h. PET/CT imaging in mice showed that physiological uptake of Al 18F-NOTA-FAPI-04 was mainly in biliary system and bladder, and Al 18F-NOTA-FAPI-04 highly concentrated in tumor xenografts. PET/CT imaging in the patient showed that Al 18F-NOTA-FAPI-04 obtained high tumor background ratio (TBR) values of 4.1, 8.9, 5.4, 4.8, 2.2 in parasternal lymph nodes, anterior diaphragmatic lymph nodes, hilar lymph nodes, pancreaticoduodenal ligament lymph nodes, abdominal aortic lymph nodes, respectively, while TBR values were 1.0, 2.8, 5.0, 2.1, 1.1 by 18F-FDG. Conclusions:Al 18F-NOTA-FAPI-04 can be synthesized with short time, high radiochemical yield and good stability using All-in-one module. Al 18F-NOTA-FAPI-04 PET/CT imaging has high contrast and excellent diagnostic efficacy on tumors.

Fragile X syndrome(FXS)is caused by abnormal duplication and amplification of the FMR1 gene CGG.This article reports a pair of brothers diagnosed with FXS by genetic testing.Two patients,aged 15 and 14 years old respectively,both had clinical manifestations such as language disorders,intellectual disabilities,attention deficit disorder,autism spectrum disorder,and FXS's characteristic facial features.The proband had a rare late-onset epileptic seizure,which was well treated with levetiracetam,while his younger brother had no electroencephalogram abnormalities after repeated follow-up.This pair of cases suggests that the clinical phenotype of FXS has diversity and heterogeneity.