Objective To evaluate endoscopic ultrasonography (EUS) for TN restaging and predicting response to advanced gastric cancer after neoadjuvant chemotherapy. Methods A total of 22 patients,15 males and 7 females, mean age 64 (36-80 years ), with advanced gastric cancer were recruited to the study from June 2007 to December 2009 with written informed consents. All patients underwent 3 cycles of neoadjuvant chemotherapy ( Folfox 6 ), and subsequent surgery ( R0 resction) in 3-4 weeks after chemotherapy. EUS was performed 1-2 weeks before and 1-2 weeks after chemotherapy. EUS TN staging was compared with pathological findings. The correlation of peri-chemotherapy EUS TN staging with postoperative pathological response was evaluated. Results After chemotherapy, the overall accuracy of EUS T staging was 63.6% (14/22), with overstaging (36. 4%, 8/22) more frequent than understaging (0). The overall accuracy of N staging was 54. 5% (12/22) with 4 ( 18. 2%, 4/22) overstaging and 6 ( 27. 3%, 6/22 ) understaging. EUS revealed T and/or N downstaging ( concyrrence of T and N downstaging was accounted once) after chemotherapy in 10 patients, with 9 T downstaging (4 from T3 to T2, 5 from T4 to T3) and 4 N downstaging (4 from N1 to N0). TN downstaging was correlated with pathological response, with 7 patients achieving pathological response 2 and 1 patient 3. Conclusion T and N restaging by EUS after neoadjuvant chemotherapy in patients with locally advanced gastric cancer is not accurate enough. However, T and/or N downstaging confirmed by EUS is well correlated with a better degree of pathological response to chemotherapy.

Collagen Type I ; analysis ; Collagen Type III ; analysis ; Fluorescent Antibody Technique, Indirect ; Humans ; Liver ; chemistry ; Microscopy, Confocal

OBJECTIVETo evaluate the efficacy and safety of three different spinal rotation manipulations for the treatment of lumbar disc herniation.

METHODSFrom September 2011 to April 2013,180 patients diagnosed as lumbar disc herniation were randomly divided into seat fixed rotation group (A), lateral position rotation group (B) and supine position rotation group (C) by using a digital table. Finally 10 patients were excluded and dropped, 170 patients were included in the study. There were 57 patients in group A, 57 patients in group B and 56 patients in group C. Baseline demographic characteristics of patients, clinical findings and indexes of health status had no statistically differences among three groups (P > 0.05). The manipulation was performed every other day, and the treatment duration for all patients was 3 weeks. Body pain (BP), Physical function (PF) in SF-36, Oswestry Disability Index (ODI) and adverse reactions were observed statistically 6 weeks, 3 months, 6 months, one year and two years after finishing treatment.

RESULTSBP, PF scores in 3 groups were significantly improved and ODI scores were significantly lower than those before treatment and the differences were statistically significant (P < 0.05); However, there was no significant difference among three groups in the BP, PF and ODI scores (P > 0.05). There were no obvious and serious adverse reactions among these groups.

CONCLUSIONBased on the theory of dislocation of bone joints in TCM, three kinds of spinal rotation manipulations can be used safely for the treatment of lumbar disc herniation, and the efficacy was similar.

Adolescent ; Adult ; Case-Control Studies ; Female ; Humans ; Intervertebral Disc Displacement ; physiopathology ; therapy ; Male ; Manipulation, Spinal ; methods ; Middle Aged ; Rotation ; Treatment Outcome ; Young Adult

OBJECTIVE: In order to assess the significance of Ezrin and E-Cadherin in invasion and metastasis of papillary thyroid carcinoma (PTC). METHOD: The 81 paraffin-embedded specimen PTC and normal thyroid tissues adjacent to cancer operated from 2005 to 2008 were tested. The expressions of Ezrin, E-Cadherin in the specimen were assayed by immunohistochemical staining. The correlation between the 2 factors (Ezrin, E-Cadherin) and clinical features of PTC such as gender, age, tumor size, invasion, lymph node metastasis, and TNM stage were studied. RESULTS: The rates of immuno-positive staining Ezrin in PTC was higher than the normal thyroid tissues adjacent to cancer with significant difference respectively (chi2 = 61.691, P < 0.01). The rates of immuno-positive staining E-Cadherin in PTC was lower than the normal thyroid tissues adjacent to cancer with significant difference respectively (chi2 = 64.241, P < 0.01). The expressions of Ezrin and E-cadherin were related to age, invasion, lymph node metastasis, and TNM. There was correlation between the expressions of Ezrin and E-Cadherin in PTC (r = -0.471, P < 0.01). CONCLUSION The high expressions of Ezrin and the low expression of E-Cadherin were related to invasion and metastasis in PTC. Between the 2 factors has cooperative. Combined detection of the expression of Ezrin and E-Cadherin in PTC might served as invasion, metastasis and important prognostic predictors.
Adult ; Aged ; Antigens, CD ; Cadherins ; metabolism ; Carcinoma ; metabolism ; pathology ; Carcinoma, Papillary ; Cytoskeletal Proteins ; metabolism ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Prognosis ; Thyroid Cancer, Papillary ; Thyroid Neoplasms ; metabolism ; pathology ; Young Adult

OBJECTIVE: To investigate the expression of caspase-3 in different posttraumatic intervals and severity of brain injury. METHODS: The study examined brain tissue samples of slight (n = 24), severe (n = 24) brain injury and control (n = 6) of rat, using immunohistochemical staining, western-blot and RT-PCR method. RESULTS: Up-regulating of caspase-3 expression was found in tissue from traumatic brain injury compared with controls in early 1 hour after TBI, and lasted for 14 days. The gray degree and threshold area of caspase-3 positive cells is different in different severity of brain injury. CONCLUSION The increasing of caspase-3 expression indicates that TBI exists. The gray degree, threshold area of caspase-3 positive cells and the cleavage degree of pro-caspase-3 have association with the severity of brain injury.
Animals ; Apoptosis ; Blotting, Western ; Brain Injuries/pathology* ; Caspase 3 ; Caspases/genetics* ; Immunohistochemistry ; RNA, Messenger/biosynthesis* ; Rats ; Reverse Transcriptase Polymerase Chain Reaction ; Time Factors

Adolescent ; Adult ; Aged ; DNA Mutational Analysis ; DNA, Viral ; genetics ; Drug Resistance, Viral ; drug effects ; genetics ; Female ; Hepatitis B virus ; drug effects ; genetics ; isolation & purification ; Hepatitis B, Chronic ; genetics ; virology ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo evaluate the efficacy of postoperative chemoradiation for stage III low rectal cancer.

METHODSA total of 132 patients with stage III low rectal cancer, including 69 males and 63 females, were identified and divided into two groups: group A received chemoradiation while group B underwent chemotherapy alone.

RESULTSEighteen patients developed local recurrence after five years of follow-up, with 6 cases(8.3%) in group A and 12(22.2%) in group B(P<0.05). In patients with distant metastasis(n=65), 37(47.4%) were in group A and 28(51.9%) in group B, and the difference was not statistically significant(P>0.05). The 5-year survival rates for group A and group B were 47.4% and 29.6%, respectively(P<0.05). Radiation proctitis was found in 6 cases in group A.

CONCLUSIONSPostoperative chemoradiation can reduce local recurrence rate and improve 5-year survival compared to chemotherapy alone. However, it has little effect on the distant metastasis. Postoperative chemoradiation is safe and effective for low rectal cancer.

Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; prevention & control ; Neoplasm Staging ; Postoperative Period ; Rectal Neoplasms ; drug therapy ; radiotherapy ; therapy ; Treatment Outcome

OBJECTIVETo evaluate the feasibility of MRI navigation in identifing the safe surgical margin of the maxillofacial malignancy.

METHODSThe pathology results of the surgical margin identified by the technique of MRI navigation form 20 patients with maxillofacial malignancy were compared with those of 45 patients with maxillofacial malignancy who underwent the routine operation without MRI navigation.

RESULTSThere was no difference between the two groups of patients in age, sex, size of tumor, tumor stages, pathologic diagnosis (P > 0.05). The negative rate of the surgical margin of the lesions treated by surgery with the technique of MRI navigation was significantly lower than that of the lesions treated without MRI navigation (P = 0.007) and highly correspondent with the pathology results.

CONCLUSIONSMRI navigation was helpful in identifying the safe surgical margin of the maxillofacial malignancy.

Aged ; Carcinoma ; pathology ; surgery ; Facial Neoplasms ; pathology ; surgery ; Female ; Humans ; Magnetic Resonance Imaging, Interventional ; Male ; Maxillary Neoplasms ; pathology ; surgery ; Middle Aged ; Monitoring, Intraoperative ; methods ; Sarcoma ; pathology ; surgery ; Surgery, Computer-Assisted ; methods ; Tumor Burden

In order to explore the regulatory effects of Egr-1 promoter sequences induced by doxorubicin (ADM) in transcriptional targeting on the expression of hematopoietic growth factor genes. The human GM-CSF cDNA and enhanced green fluorescent protein (eGFP) cDNA were linked together with internal ribozyme entry site (IRES) and then inserted into the expression vector pCIneo under control of the Egr-1 promoter (Egr-EG). The vector was transferred into human bone marrow stromal cell line HFCL by lipofectin. The transfected cell clones (HFCL/EG) were selected by the addition of G418. The cells were exposed to the clinically important anticancer agent doxorubicin. The activity of eGFP in HFCL/EG cells was detected by flow cytometry. The amounts of GM-CSF in HFCL/EG postchemotherapy were confirmed with ELISA. The effect of GM-CSF in HFCL/EG cultural supernatants on expansion of CFU-GM derived from cord blood was also studied. The effect of N-acetylcysteine (a free radical scavenger) on GM-CSF production following exposure to ADM was examined. The results indicated that the activity of eGFP and the amounts of secreted GM-CSF in HFCL/EG cells exposed to ADM increased as compared to non-ADM group. The effect of GM-CSF in HFCL/EG cultural supernatants on expansion of CFU-GM was significantly higher than that of non-ADM group. N-acetylcysteine significantly decreased the concentration of GM-CSF produced by HFCL/EG treated with ADM. It is concluded that these in vitro data provide an experimental basis for the use of gene therapy of hematopoietic growth factor gene regulated by Egr-1 promoter to protect hematopoiesis from ADM-injury.
Base Sequence ; Bone Marrow Cells ; cytology ; Cell Line ; Doxorubicin ; pharmacology ; Early Growth Response Protein 1 ; genetics ; Gene Expression Regulation ; Genetic Vectors ; Granulocyte-Macrophage Colony-Stimulating Factor ; genetics ; Humans ; Promoter Regions, Genetic

Objective To evaluate the development of the sphincter muscle complex(SMC)and defecation function in pediatric patients with congenital anorectal malformations(ARM).Methods A total of 64 children underwent MRI,among whom 39 were patients with ARM,and the others were patients without ARM undergoing MRI because of other dieases.The dimensions of the SMC in different planes were evaluated with different sequences and coils.The relationship between the SMC development and the defecation function was investigated.Results In control group,the absolute value of SMC width was (3.63?0.22)mm,which had a high correlation with age(r=0.998,P0.05).The SMCs in intermediate ARM patients[muscle index(MI)=0.47?0.05]and low ARM patients(MI=0.49? 0.05)were well developed.The SMCs in a portion of patients with high ARM(MI=0.28?0.06)were poorly developed,when MI≤0.18,anorectal contraction pressurewas significantly lower(t=3.55, P0.18[(0.85?0.20)vs(2.24?1.02)kPa].The length of anal canal with high-pressure[(10.88?3.64)vs(20.26?4.34)mm]was shorter(t=5.18,P0.18,the anorectal angle was less than 90 degrees,and normal continent function was found in 21 of 23 cases(91%).Conclusion MRI can be employed to evaluate the development of SMC in patients with ARM,MI was an objective criteria to evaluate the development of SMC.When MI≤0.18, maldevelopment of SMC will be highly suspected.