Objective To determine the value of dynamic contrast enhanced (DCE?MRI) in predicting treatment response before preoperative chemoradiotherapy in locally advanced rectal cancer. Methods A cohort of consecutive patients with histologically confirmed rectal adenocarcinoma treated with preoperative chemoradiotherapy followed by total mesorectal excision (TME) surgery was enrolled in a prospective, pilot trial. All enrolled patients were examined using DCE?MRI at two time points: 2 to 5 days before neoadjuvant chemoradiation, 1 to 4 days before surgery. The following perfusion parameters (Ktrans, Kep, Ve) were measured for tumor. The patients were classified into pathological complete response (pCR) and non?pCR group according to the pathological results after operation. Those perfusion parameters were compared between the pCR and the non?pCR group and between before and after CRT in pCR and the non?pCR group with the t test. Receiver?operating curves (ROC) were constructed to further investigate the predictive value of Ktrans, Kep, Ve before neoadjuvant chemoradiation and were used to determine a threshold value at which patents with pCR could be distinguished from patients without complete response. Results The final study population consisted of 38 patients. There were 12 patients with a pCR and 26 patients with non?pCR. Before neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (1.25 ± 0.56)/min, (2.10 ± 1.61)/min and 0.73 ± 0.34, respectively, for non?pCR group they were (0.46 ± 0.39)/min, (1.15 ± 0.77)/min and 0.32±0.12, respectively. All perfusion parameters showed significant difference between those two groups(t values were 3.45,5.67 and 6.23 respectively, all P<0.05). After neoadjuvant chemoradiation, the mean tumor Ktrans, Kep and Ve for pCR group were (0.28 ± 0.13)/min, (0.62 ± 0.27)/min and 0.21 ± 0.13 respectively, for non?pCR group, they were (0.32±0.12)/min, (0.83±0.42)/min and 0.17±0.10, respectively. All perfusion parameters showed no difference between those two groups(P>0.05), as well as the changes before and after neoadjuvant chemoradiation in those groups(P>0.05). ROC analysis for Ktrans pre?treatment revealed that Ktrans had an AUC of 0.837 in predicting pCR. A Ktrans of 0.66/min was emerged as the optimal cut?off for distinguishing pCR from non?pCR and for Ktrans>0.66/min, the sensitivity and specificity for predicting pCR were 75.0% (9/12) and 96.2% (25/26). Kep and Ve showed an AUC of 0.655 and 0.654 in predicting pCR. Conclusions In locally advanced rectal cancer, DCE?MRI can aid in predicting treatment response before preoperative chemoradiotherapy. Ktrans may become a better predictor to classify which patients will benefit from neoadjuvant chemoradiation.

Background and purpose:The lymph node metastatic model of rectal tumor is a useful tool for the research on tumor occurrence, development, metastasis and antineoplastic therapy. There are few reports about establishment of larger animal model. This study aimed to establish feasible and reproducible lymph node metastatic models of VX2 tumor in rabbits.Methods:The VX2 tumor tissue was put into the puncture needle. The VX2 tumor tissue in the needle was orthotopically transplanted into the rectal wall of the New Zealand white rabbits successfully. Twenty New Zealand white rabbits were transplanted. Two experimental rabbits were scanned by MR weekly. Tumor growth curve and lymph node numbers were observed on MR. Experimental rabbit tumor volumes were measured by MR post-processing software. The rectal tumor and surrounding lymph nodes were resected, and the specimens were ifxed. The sections were stained with HE. We explored the relationship between tumor volume and growth time, the number of metastatic lymph nodes and tumor volume, respectively.Results:Thirteen models were successfully established with a rate of 65%. Tumors limited in the rectal wall were observed on the fourth week. Tumor size increased over time. There was significant difference in the tumor volume between different periods (growth cycle number) (F=52.865,P<0.05). There was a signiifcantly positive correlation between tumor volume and the growth cycle number (r=0.910,P<0.05). The metastatic lymph nodes could be observed when VT>9 cm3. The number of metastatic lymph node increased obviously from the ninth week. The more tumor volume, the greater the number of metastatic lymph nodes was observed (F=92.531,P<0.05). There was a signiifcantly positive correlation between the number of metastatic lymph nodes and the tumor volume (r=0.945,P<0.05).Conclusion:Metastatic lymph node models of VX2 tumor in New Zealand white rabbits were established successfully. This model has some value in the research on local growth, invasion mechanism, lymph node metastasis and biological characteristics of rectal cancer.

Objective To explore the efficacy of high-resolution MRI in the prediction of tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.Methods The clinical data of 108 patients with T3 rectal cancer who were admitted to Shanghai Cancer Center of Fudan University from 2010 to 2012 were retrospectively analyzed.The TNM stage of tumor,extramural depth of tumor invasion (mrT3 stage),involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor were the main items of evaluation using the high-resolution MRI.A total of 108 patients underwent surgical resection of tumor after neoadjuvant chemoradiation therapy.The tumor complete response after neoadjuvant chemoradiation therapy was evaluated by tumor node metastasis (TNM) stage and tumor regression grade (TRG).The categorical data and multivariate analysis were done by the single factor analysis of variance (ANOVA) and Logistic regression analysis.Results The positive response rate of the T3a,T3b and T3c in the patients were 61.5％ (16/26),36.9％ (24/65) and 11.8％ (2/17) after neoadjuvant chemoradiation therapy,respectively.The mrT3,mrN and tumor diameter were the potential factors affecting response of neoadjuvant chemoradiation therapy by the univariate analysis of pathological restaging (x2 =50.474,30.985,8.318,P ＜ 0.05).The mrT3 was an independent risk factor affecting response of neoadjuvant chemoradiation therapy by the multivariate analysis of pathological restaging (OR =4.473,95 ％ confidence interval:2.003-9.991,P ＜ 0.05).There was no significant difference between the mrT3 stage,N stage,involvement of mesorectum and rectal fascia,tumor diameter and distance from anal edge to lower edge of tumor before therapy and the response after neoadjuvant chemoradiation therapy based on the tumor regression grade(TRG) (x2 =6.264,6.159,2.949,2.189,6.335,P ＞ 0.05).Conclusion The mrT3 in patients undergoing high-resolution MRI before neoadjuvant chemoradiation therapy could predict the tumor complete response after neoadjuvant chemoradiation therapy for T3 rectal cancer.

Adult ; Aged ; China ; epidemiology ; Female ; Gold ; Humans ; Male ; Middle Aged ; Mining ; Silicosis ; mortality ; Young Adult

Bacillus licheniformis TS 01 was separated The SSF medium for TS 01 strain was investigated The result showed that the optimal fermentation medium contained (g/kg dry solid materials): water 600, brown sugar 7, rice bran 420, wheat bran 580 when the medium and inoculum size 10% (v/w) were adopted, aspore concentration of 7 50?10 9 CFU/g (wet qu) was obtained after two days' fermentation with a spore percentage of greater than 80% and a maximum live cell concentration of 9 15?10 9 CFU/g (wet qu)

0.05). Conclusions Low dose continuous infusion of CAZ to treat low respiratory infections is efficacious ,safe and economical.

Objective To systematically evaluate the efficacy and safety of telmisartan and amlodipine in treatment of hypertension complicated with diabetes.Methods Retrieved from PubMed, EMBASE, Cochrane library, CNKI, VIP and Wanfang database by computer, randomized controlled trials( RCTs) about telmisartan versus amlodipine in treatment of hypertension and diabetes were collected, then relevant date were extracted, Meta-analysis was drawn by RevMan 5.3 statistical software.Results A total of 11 RCTs were included involving 914 patients.The results of Meta-analysis revealed that telmisartan was better than amlodipine in fasting blood glucose reduction[MD =-0.54,95%CI( -0.87, -0.21),P =0.001], glycosylated hemoglobinreduction[MD=-0.60,95%CI( -1.12,-0.07),P =0.03] and HOMA insulin resistance index reduction[MD =-1.27, 95%CI( -1.81,-0.73),P<0.001],there were statistical significance.There were no significant difference in systolic blood pressure[MD =2.39, 95%CI( -0.21,4.98),P=0.07],diastolic blood pressure[MD =0.17,95%CI( -0.95,1.29),P =0.77] and adverse drug reaction[RR=0.70, 95%CI(0.41,1.19),P=0.19].Conclusion For patients with hypertension and diabetes, telmisartan in decreasing fasting blood glucose, glycosylated hemoglobinand HOMA insulin resistance index is more effective than that of amlodipine, blood pressure in patients with equivalent,antihypertensive and safety are similar.

Sterols are one of the active classes of compounds in Inonotus obliquus for their effective therapy of many diseases. In field environment, this fungus accumulates large amount of sterols. In cultured mycelia, however, this class of compounds is less accumulated. For analyzing the factors responsible for differing sterol composition, the field-grown and cultured mycelia were extracted with 80% ethanol at room temperature and total sterols were prepared using silicon gel column chromatography followed by identification using either GC-MS or spectroscopic methods. For culturing Inonotus obliquus, the seed culture was grown either in basic medium consisting of glucose (2%), yeast extract (0.5%), KH2PO4 (0.01%), MgSO4·7H2O (0.05%) and distilled water at pH 6.5, or the basic medium supplemented with serial concentrations of AgNO3. The results indicated that field-grown mycelia contained lanosterol and inotodiol (comprised 45.47% and 25.36% of the total sterols, respectively) and other 10 sterols (comprising the remaining 30.17%) including ergosterol biosynthetic intermediates such as 24-methylene dihydrolanosterol, 4,4-dimethylfecosterol, 4-methyl fecosterol, fecosterol and episterol. Column chromatography also led to the isolation of lanosterol, Inotodiol, trametenolic acid, foscoparianol B and a new triterpenoid foscoparianol D in field-grown mycelia. In comparison, the cultured mycelia only contained three sterols with ergosterol as the predominant one (82.20%). Lanosterol only accounted for 3.68%. Supplementing Ag+ into the culture at 0.28 μmol·L-1 greatly enhanced content of lanosterol (accounting for 56.81%) and decreased the content of ergosterol (18.5%) together with the presence of intermediates for ergosterol biosynthesis. These results suggested that the sterol composition in mycelia of the fungus can be diversified by supplementing substances inhibiting enzymatic process towards the synthesis of ergosterol. Harsh growth conditions in field environment (I.e. temperature variation, UV irradiation etc.) can delay the synthesis of ergosterol and hereby diversify the sterol composition in the mycelia of Inonotus obliquus.

Objective To investigate the effect of 23.4% hypertonic saline(HTS)on intracranial pressure(ICP), cerebral peffusion pressure(CPP), cerebral blood flow(CBF)in poor-grade patients with subarachnoid hemorrhage(SAH).Methods Sixteen patients(Glasgow coma score ≤ 8)with poor-grade SAH received 23.4% hypertonic saline intravenously for elevated ICP.ICP, mean arterial pressure(MAP), CPP and the middle cerebral artery flow velocity(FV)were observed and recorded before and at 30, 60, 90,120, 150, 180 min after the injection respectively.Results Thirty minutes postinfusion, a significant increase in MAP, CPP, FV was seen together with a decrease in ICP(P<0.05).ICP remained reduced for 180 minutes, CPP and FV remained elevated for 90 minutes(P < 0.05).Conclusions HTS can significantly decrease ICP and improve CBF in patients with poor-grade subarachnoid hemorrhage and may be used for reversal of pathophysiologic changes caused by cerebral ischemia.