Objective To measure and analyze the set-up errors of postoperative intensity modulated radiation therapy of rectal cancer (PIMRTRC)with electronic portal imaging device (EPID),and to provide theoretical foundation for clinical realizing of accurate PIMRTRC.Methods Totally 30 patients after rectal carcinoma resection underwent sagittal and coronal photographing with EPID before the first time of therapy and one time per week during the treatment course.The obtained images were compared with DRR images in treatment planning system to get the setup errors at X(left-right),Y(head-foot) and Z (front-back)directions,and the extending margins of CTV and PTV in postoperative intensity modulated radiation therapy were calculated.EPID was used for setup correction,and SPSS 19.0 was involved in to execute statistical analysis. Results The linear displacement had the mean values plus/minus standard deviation at X, Y and Z directions before and after error correction being(-1.392 4±3.670 9)mm vs(-0.816 5±2.670 5)mm,(0.969 7±4.076 1)mm vs(0.418 2±2.911 4)mm, and(0.704 4±1.805 6)mm vs(0.471 7±1.641 3)mm respectively;the extending margin had the values being 7 mm vs 5 mm, 6 mm vs 4 mm, and 4 mm vs 3 mm respectively.Conclusion EPID ensures the correctness and accuracy in postoperative intensity modulated radiotherapy of rectal cancer,which makes target area gifted with maximized dose,the surrounding tissue and organs at risk protected adequately,and provides theoretical support for extending CTV margin.[Chinese Medical Equip-ment Journal,2018,39(5):59-63]

OBJECTIVETo evaluate the blood supply of low density viable area of primary heptocellular carcinoma after transcatheter hepatic artery chemoembolization using lipiodol (LP-TACE), by helical dual-phase CT scanning and three dimensional CT (3DCT).

METHODSThirty-four patients with primary heptocellular carcinoma after LP-TACE were examined by hepatic helical dual-phase CT. 3DCT model of the maximum intensity projection (MIP), surface shaded display (SSD) reconstruction of the hepatic artery and portal vein were simultaneously done in 5 cases.

RESULTSViable tumor areas of 34 cases of primary heptocellular carcinoma after LP-TACE were divided into four types: peripheral, lateral, central and diffused types. Enhanced tumor vessel or tissue in viable tumor area was found during hepatic dual-phase in 17 cases, during hepatic artery-phase only in 8 and hepatic portal vein-phase only in 3. The viable tumor areas were found to have blood supply from the hepatic vein in 2 cases. The viable tumor area unenhanced during hepatic dual-phase was found in 6 cases. In 5 cases, the relation between the viable tumor area and branches of hepatic artery and portal vein was showed by MIP and SSD of hepatic artery and portal vein.

CONCLUSIONHepatic helical dual-phase CT scan with 3DCT is effective in evaluating the blood supply of viable tumor areas and the therapeutic effect of primary heptocellular carcinoma after LP-TACE.

Adult ; Aged ; Carcinoma, Hepatocellular ; Catheterization ; Chemoembolization, Therapeutic ; Contrast Media ; Female ; Hepatic Artery ; Humans ; Iodized Oil ; Liver Neoplasms ; diagnostic imaging ; therapy ; Male ; Middle Aged ; Tomography, Spiral Computed

Global Health ; History, 20th Century ; Humans ; Influenza A Virus, H2N2 Subtype ; genetics ; isolation & purification ; Influenza A Virus, H3N2 Subtype ; genetics ; isolation & purification ; Influenza, Human ; epidemiology ; history ; mortality ; virology

OBJECTIVETo explore the effects of the magnetic c-erbB-2 antisense probe of different concentrations on the morphology and expression of SK-Br-3 cancer cells in vitro.

METHODSBreast cancer SK-Br-3 cells were transfected for 24 h by antisense probe at an iron concentration of 5, 10, 25, 50, and 100 mg/L, respectively. The distribution and content of iron particles in SK-Br-3 cells was determined by Prussian blue staining, electron microscopy, and atomic absorption spectrometry. Cell viability was observed by trypan-blue exclusion and CCK-8 test. The protein expression of c-erbB-2 was assessed by the Western blot analysis. The changes of the signal strength were considered by magnetic resonance imaging (MRI).

RESULTSc-erbB-2 antisense probe was uptake by SK-Br-3 cells in a concentration-dependence manner within a certain range (5, 10, and the Medicine Scientific Research Project of Chongqing Health Bureau (062025)25 mg/L). When the probe concentration was 25 mg/L, iron content in cells was (18.38±0.28) pg, the cell vitality, survival, and c-erbB-2 protein expression were reduced significantly (all P<0.05), and the T2 value was lower significantly (P<0.05). However, the results of 50 mg/L or 100 mg/L group showed no significant difference with the 25 mg/L group (P>0.05).

CONCLUSIONThe magnetic c-erbB-2 antisense probe can effectively transfect and specifically inhibit the expression of SK-Br-3 cell lines at the iron concentration of 25 mg/L.

Antisense Elements (Genetics) ; genetics ; Apoptosis ; Breast Neoplasms ; metabolism ; pathology ; Cell Line, Tumor ; Cell Proliferation ; Humans ; Magnetics ; Receptor, ErbB-2 ; genetics ; metabolism ; Transfection

Objective:To investigate the association between dopamine receptor D2(DRD2) polymorphisms and smoking in male patients with schizophrenia.Methods:Totally 773 patients with schizophrenia (567 smokers and 206 non-smokers) and 302 normal controls (168 smokers and 134 non-smokers) were recruited.The two single nucleotide polymorphisms (SNPs) (rs1800497 and rs1079597) were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RELP).SHEsis genetic analysis platform was used to calculate linkage disequilibrium index and infer allele distribution and haplotype frequency.Results:There was no significant difference in two SNPs genotype and allele distributions between the patients and normal controls or between smokers and non-smokers in either patients or normal controls alone (Ps ＞ 0.05);the frequency estimations of haplotype C-A and T-G in patients with schizophrenia were higher than in normal controls (8.0％ vs.5.2％,10.2％ vs.4.1％,Ps ＜0.05),T-A (34.6％ vs.40.2％,P ＜0.05),whereas the frequency estimation of haplotype T-A in patients with schizophrenia was lower than in normal controls,and all the differences were statistically significant (34.6％ vs.40.2％,P ＜ 0.05).It was also observed that the frequency estimation of haplotype T-A in normal smokers was significantly lower than in normal non-smokers (2.5％ vs.6.1％,P ＜0.05).Conclusion:There may be a correlation between DRD2 polymorphisms and the susceptibility to schizophrenia,but not between DRD2 polymorphisms and smoking neither in patients with schizophrenia nor in normal controls.

OBJECTIVETo discuss the value of a new technique of the binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy.

METHODSFrom May 2008 to October 2008, 15 patients were performed with BPG, included pancreatic head cancer in 7 cases, duodenal adenocarcinoma in 2 cases,mass-type chronic pancreatitis with pancreatolithiasis in 1 case, ampullary carcinoma in 1 case, gallbladder cancer in 1 case, islet cell tumor in 1 case and cholangiocarcinoma in 2 cases. The main procedures of BPG included: isolating remnant pancreas; slitting partial posterior wall of stomach and preplaced with seromuscular purse-string suture; cutting gastric anterior wall; performing pancreaticogastrostomy (binding of outer seromuscular and inner mucous layer of stomach).

RESULTSThe procedures were successful in 15 patients. Postoperative complications included small amount of pleural effusion in 2 cases, delayed gastric emptying in 2 cases and bile leakage in 2 cases. All patients were cured in 2 weeks. No mortality and anastomosis leakage occurred.

CONCLUSIONThe application of BPG technique can prevent the anastomosis leakage and improve the safety for pancreaticoduodenectomy.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Female ; Fistula ; etiology ; prevention & control ; Humans ; Male ; Middle Aged ; Pancreas ; surgery ; Pancreaticoduodenectomy ; adverse effects ; Postoperative Complications ; prevention & control ; Stomach ; surgery ; Surgical Stomas

INTRODUCTIONThere is limited utilisation of acute stroke reperfusion treatments which have narrow therapeutic windows, with delayed hospital presentation being a major limiting factor in Singapore. Most patients who wake up with symptoms are ineligible for reperfusion treatments as duration from onset time is not known. We studied the profile of wake-up strokes, onset-to-door duration and their associated factors among ischaemic stroke patients in the context of potential new treatments.

MATERIALS AND METHODSThis is an observational study of consecutive ischaemic stroke patients presenting within 2 weeks of symptom onset to the Singapore General Hospital in 2012.

RESULTSOf the 642 ischaemic stroke patients studied, 33% of the cases were wake-up strokes [median age 64 years, 88%<80 years; median NIHSS score 4, 98%<20]. The median onset-to-door duration was 14.3 hours (Interquartile range, 4.8 to 38.2 hours), 20% of them arrived <3.5 hours (considering eligibility for intravenous alteplase in the proven 4.5 hours window accounting for a one hour door-to-needle duration), 14%: ≥3.5 to <8 hours, 11%: ≥8 to <12 hours, and 56%: ≥12 hours. Most patients with known stroke risk factors including atrial fibrillation (66%), hypertension (78%) and prior stroke (81%) presented beyond 3.5 hours.

CONCLUSIONThe one- third proportion of wake-up stroke in this cohort and low prevalence of relative contraindications suggest this is a promising group for emerging thrombolysis indications. With the majority of patients presenting after 8 hours, widening of the therapeutic window with new potential reperfusion treatments would not appreciably increase treatment utilisation. This study reaffirms the urgent need for public education to improve stroke awareness in Singapore.

Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Prospective Studies ; Reperfusion ; Singapore ; Stroke ; epidemiology ; surgery ; therapy ; Time-to-Treatment ; statistics & numerical data

OBJECTIVETo explore the feasibility and safety of type II binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy and mid-segmentectomy of pancreas.

METHODSFrom November 2008 to May 2009, 26 patients underwent pancreaticoduodenectomy and mid-segmentectomy of pancreas with type II BPG reconstruction, including 13 cases of pancreatic head cancer, 3 cases of duodenal adenocarcinoma, 2 cases of ampullary carcinoma, 4 cases of cholangiocarcinoma, 1 case of bile duct cell severe atypical hyperplasia, and 1 case of stomach cancer. The process of type II BPG was described as the following: after pancreas remnant was mobilized for 2-3 cm, a piece of sero-muscular layer at the posterior gastric wall was excised and then a sero-muscular depth purse-suturing with 3-0 prolene was pre-placed (outer purse-string). Incising anterior gastric wall or opening part of the closed distal gastric stump, the mucosa layer at the sero-muscular defect was incised and then purse-suture at the mucosal tube was pre-placed (inner purse-string). Through the two pre-placed purse-strings, the pancreas remnant was pulled into the gastric lumen and then posterior gastric wall was pushed backward to keep it closely in contact with the retro-peritoneal wall. Thereafter, the outer purse-string was tied (outer binding) and then the inner purse-string was tied (inner binding).

RESULTSAll cases underwent BPG of type II. The operative time ranged from 3 to 5.5 hours. The postoperative hospital stay ranged from 6 to 48 days. Postoperative complications included 1 case of ascites, 2 cases of delayed gastric emptying and 1 case of intra-abdominal bleeding. All cases with complications were cured after nonsurgical treatment. No mortality or pancreatic leakage occurred.

CONCLUSIONSPancreaticogastrostomy is good for accommodating a large pancreas stump. Binding technique is very helpful in minimizing the leak rate of pancreaticogastrostomy. While type I BPG is safe and easy to perform, type II is even safer and easier to be done.

Adult ; Aged ; Anastomosis, Surgical ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pancreas ; surgery ; Pancreaticoduodenectomy ; Stomach ; surgery ; Treatment Outcome

OBJECTIVETo investigate peripheral blood monocyte (PBMC) gene expression profile in patients with fulminant hepatic failure (FHF) by cDNA microarray.

METHODSMicroarrays consisting of 8,192 human cDNAs and labelled cDNAs prepared from PBMC in both 10 FHF patients and 10 asymtomatic surface antigen carriers (ASC) were applied to analyze gene expression. Relative ratios of gene expression in individuals were obtained by comparing the hybridization results, by GenePix 4000B scanning and by ImaGene3.0 software analysis, of Cy5-labelled cDNA from FHF patients with those of Cy3-labelled cDNA from ASC.

RESULTS249 genes out of 8,192 were identified differently, at least two times. Most of the genes (79%) involved in cell signaling transduction, cell cycles, metabolism, inflammatory response and apoptosis, whose mRNAs were differently regulated.

CONCLUSIONSThese results suggest that HBV infection alters a broad range of cellular genes expression during developing into FHF and provide a framework for future functional study on the genes expressed differently.

DNA, Complementary ; genetics ; Female ; Gene Expression ; Gene Expression Profiling ; Hepatitis B ; genetics ; pathology ; Hepatitis B, Chronic ; genetics ; pathology ; Humans ; Leukocytes, Mononuclear ; metabolism ; Male ; Oligonucleotide Array Sequence Analysis

Objective To compare the efficacy of infiltration of vestibular white spot lesions (incipient caries) in incisors and canines shortly after removal of orthodontic brackets.Methods In this study,thirty subjects with age between 15 and 18 years old were selected and treated with one kind of infiltration resin:Icon-infiltrant (DMG,Hamburg,Germany).Standardized intraoral images were taken before and after treatment for 1 month,3 months and 6 months.Image analysis software:Image-Pro Plus 6.0 (Media Cybernetics,U S A) was used to quantify the visible areas of the demineralized lesions.The measurement data before and after using the infiltrant resin for 1 month,3 months and 6months were analyzed using SPSS 20.0 software package.Results In the incisor,the aera of white spot lesions was greatly reduced after using it[(29.29 ± 9.62)％] and for 1 month[(22.21 ±6.94)％],3 months [(26.43 ± 7.85) ％] and 6 months [(22.82 ± 8.11) ％] compare to that before treatment [(41.36 ± 13.21)％] (P＜ 0.001).And the outcome of the lateral incisor and the canine was similar to the incisor.Conclusions During the observing period of this study,infiltrant resin is effective in reducing the white spot lesion size,but further researches are needed for long-term results.