Objective To observe the antiangiogenesis of panaxoside-Rg3 on mice intraperitoneally implanted with ascites tlnnor cells.Methods 25 female and 25 male Kunming mice were random divided into five groups:Group I injected with normal saline (0.9%NS),Group Ⅱ with cisplatin(DDP 0.5mg/kg),Group Ⅲ,with low-dose panaxoside-Rg3(LPD 0.3mg/kg),Group Ⅳ with middle-dose panaxoside-Rg3(MPD 1.0mg/kg),Group Ⅴ with high-dose panaxoside-Rg3(HPD 3.0mg/kg).Experimental ascitic hepatocarcinoma of H22 lines model were successfully established among all groups,and 24 hours later intraperitoneal infusion of 0.2ml medicines was given to each mouse once every day for 14 days.24 hours after the over of the treatment,all mice were executed.Enzyme linked immunosorbent assay(ELISA)method was used to detectt he different VEGF level in the ascites and serum of all groups and expressions of micmvessel density (MVD)of peritoneum tumor node was calculated by immunohistochemical staining with CD31 antibody.Morphological of tumor cell in abdominal cavity and new vascular in peritoneum tumor node were observed by transmission electron microscope.Results With the increase of concentration of panaxoside-Rg3,expressions of the VEGF level of the ascites and the serum and MVD in peritoneum dropped(P＜0.05)and decreased more than that in the NS group and the DDP group(P＜0.05).Morphological changes of tumor ceHs in panaxoside-Rg3 group were observed with electronic scope,more apoptosis and necrosis cells were found.Capillary vessel basal lamina was smoothing.Condusion Panaxoside-Rg3 decreases the permeability of mierangium and inhibit the neovascula-rization of peritoneum by decreasing the VEGF level,accordingly,panaxoside-Rg3 inhibit the formation of malignant ascites.This would offer foundation of theory for clinical application.

To demonstrate the possibility of radiotherapy for echinococcosis of rats and to explore its mechanism of action, the effects of different doses of 6 MV X-ray radiotherapy on the activity of Echinococcus granulosus in rats were investigated. After being irradiated by 10, 20, 30 and 40Gy of 6 MV X-ray, a lot of examinations were carried out, such as examination of the ultrastructure of the Echinococcus granulosus cysts in rat with electron microscope, the total amount of proteins and Ca2+ ion in hydatid cyst fluid(HCF) .The potassium-pyroantimonate(PPA) cytochemical method was used to demonstrate whether the blocked calcium channels would be one reason for radiotherapy on Echinococcus granulosus cysts in rat. It was found that the ultrastructures of E.granulosus cysts showed different extents of alterations or damages with abnormal changes and destruction in tissues or cells of cysts. The total protein amount in HCF was increased, while Ca2+ ions in HCF were reduced obviously in the treated groups of rats , especially in high dose groups. With PPA, some electron-dense precipitates were observed on the mitochondria and endocytoplasmic reticulum in the treated groups. It is evident that the structure of cysts of Echinococcus granulosus in rat can be damaged by radiotherapy with certain extent of the quantity-efficiency relationship.

BACKGROUND:Repairing tuberculosis bone defect has become a research focus with the development of anti-tuberculosis functional bone tissue engineering scaffold. OBJECTIVE:To evaluate the preparation, drug release performance and osteogenic properties of the anti-tuberculosis functional bone tissue engineering scaffold. METHODS:PubMed, Chinese Journal Ful-text Database, Wanfang databases were searched by computer for articles addressing functional bone tissue engineering scaffold for repair of tuberculosis bone defect. The keywords were“bone tissue engineering scaffold;tuberculosis;bone defect”in English and Chinese. RESULTS AND CONCLUSION:The anti-tuberculosis functional bone tissue engineering scaffold has good drug delivery, biocompatibility, osteogenic properties and anti-tuberculosis properties. As a good choice to avert bone defect relapse, the scaffold enables a long and stable drug release into bone defects to enhance the therapeutic efficacy of anti-tuberculosis drugs topical y. Given the technical deficiencies, we can only combine two drugs with the anti-tuberculosis bone tissue engineering scaffold, although the combined use of three or four anti-tuberculosis drugs is preferred. Additional y, a complete course of anti-tuberculosis treatment often lasts for 6-12 months, which cannot be achieved by the existing anti-tuberculosis bone tissue engineering scaffold. Up to now, the effect of this scaffold has not yet been confirmed in animal models, although how to prepare this scaffold has been reported.

The incidence of deep vein thrombosis has increased year by year in the world, and it has become one of the serious diseases that threaten human life. In severe cases, it can lead to fatal pulmonary embolism. The pathogenesis of deep vein thrombosis is the result of the interaction of multiple genetic environmental factors. Therefore, regulation of gene expression by modification of DNA and histones may help to further reveal the pathogenesis of deep vein thrombosis, and reactivation or silencing of some genes that are inhibited or overexpressed by aberrant methylation may be a major therapeutic target for deep vein thrombosis. The author reviews the current status of DNA methylation studies related to deep vein thrombosis.

OBJECTIVETo evaluate the role of the small intestinal decompression tube (SIDT) and Gastrografin in the treatment of early postoperative inflammatory small bowel obstruction (EPISBO).

METHODSTwelve patients presented EPISBO after abdominal surgery in our department from April 2011 to July 2012. Initially, nasogastric tube decompression and other conventional conservative treatment were administrated. After 14 days, obstruction symptom improvement was not obvious, then the SIDT was used. At the same time, Gastrografin was injected into the small bowel through the SIDT in order to demonstrate the site of obstruction of small bowel and its efficacy.

RESULTSIn 11 patients after this management, obstruction symptoms disappeared, bowel function recovered within 3 weeks, and oral feeding occurred gradually. Another patient did not pass flatus after 4 weeks and was reoperated. After postoperative follow-up of 6 months, no case relapsed with intestinal obstruction.

CONCLUSIONFor severe and long course of early postoperative inflammatory intestinal obstruction, intestinal decompression tube plus Gastrografin is safe and effective, and can avoid unnecessary reoperation.

Decompression ; Diatrizoate Meglumine ; therapeutic use ; Humans ; Intestinal Obstruction ; drug therapy ; Intestine, Small ; Intubation, Gastrointestinal ; Postoperative Complications ; Postoperative Period ; Prospective Studies ; Reoperation

OBJECTIVEPrevention of the misdiagnosis of acute appendicitis when it first manifested as acute intestinal obstruction, and to search proper way of diagnosis and treatment for such event to provide the reference.

METHODSClinical data of 33 acute appendicitis cases presented with acute intestinal obstruction in Beijing Tong Ren Hospital during January 2000 and December 2015 were analyzed retrospectively.

RESULTSAll 33 patients were admitted to the Emergency Department with symptoms of various degrees abdominal pain and abdominal distension. There was no passage of gas and feces. The mean time of onset was (62.2±25.0) hours. The imaging examination showedthat all patients had complete bowel obstruction. Twenty one patients(63.6%) had peritonitis, three of whom developed with septic shock. Abdominal CT was performed in 17 patients preoperatively, which showed retention of gas and fluid in the small intestine in all the patients and 13 were suggestive of acute appendicitis. All of these patients received surgical treatment, 12 patients underwent laparoscopic exploration, and the remaining 21 patients received exploratory laparotomy during which acute appendicitis was confirmed to be the cause of intestinal obstruction, of whom 14(42.4%) was identified as mechanical intestinal obstruction. Nine patients underwent appendectomy and lysis of adhesion, five appendectomy and partial excision of the greateromentum. Nineteenpatients(57.6%) were identified as paralytic ileus and underwent appendectomy only. Twelve patients required respiratory and circulatory support and were admitted to ICU postoperatively. The mean duration time in ICU was(8.8±5.2) days. Postoperative pathology showedgangrene accompanied with perforation in the appendix. All patients were discharged without any complication. The length of hospital stay was (15.4±4.6) days. All patients were followed up for 3 ~ 12 months. One patient with chronic obstructive pulmonary disease developed repeated pulmonary infection and died of respiratory failure at 185 days postoperatively. The remaining patients were followed up and there were no patients developed intra-abdominalsepsis, intestinal obstruction, surgery-related complications, or death.

CONCLUSIONPatients with acute appendicitis presenting with acute intestinal obstruction are mostly in severe condition. Clinical diagnosis for this patients is difficult and surgery should be performed as soon as possible.

Abdominal Pain ; Acute Disease ; Appendectomy ; Appendicitis ; diagnosis ; pathology ; surgery ; Diagnostic Errors ; Humans ; Intestinal Obstruction ; diagnosis ; Intestine, Small ; Laparoscopy ; Laparotomy ; Length of Stay ; Physical Examination ; Postoperative Period ; Retrospective Studies

Objective To investigate the clinical application of chemokine receptor 4 (CXCR4)-targeted PET/CT imaging in breast cancer using 68Ga-1,4,7-triazacyclononane-1,4,7-triacetic acid-TN14003 (NOTA-NFB) and the correlation between 68Ga-NOTA-NFB uptake and pathology.Methods From June 2014 to December 2014,11 female patients (age range:38-68 years) with non-specific invasive breast cancer were recruited in this study.All patients underwent neoadjuvant chemotherapy before surgery.68GaNOTA-NFB and 18F-fluorodeoxyglucose (FDG) PET/CT imaging were performed before the chemotherapy.Three patients also underwent 68Ga-NOTA-NFB PET/CT imaging after the fourth cycle of chemotherapy.The region of interest (ROI) method was used to measure the maximum standardized value (SUVmax) and tumor/non-tumor (T/NT) ratio was calculated.Paired t test and Spearman correlation analysis were used for statistical analysis.Results The SUVmax values of primary lesions were 3.78±2.03 and 8.11±5.14 (t=-3.01,P＜0.05) respectively in 68Ga-NOTA-NFB imaging and 18F-FDG imaging.The T/NT ratios for primary lesions were not significantly different between the two imaging methods (9.36±7.81 vs 15.62±14.51;t=-1.63,P＞0.05).In the metastatic lymph nodes,SUVmax values were not significantly different between 68Ga-NOTA-NFB imaging and 18F-FDG imaging (t=-2.02,P＞0.05),but T/NT ratios were significantly different (t=-2.43,P＜0.05).After neoadjuvant chemotherapy,T/NT ratios were decreased in the 3 patients.Correlation was not found between T/NT in 68Ga-NOTA-NFB imaging and Ki-67,but the P value was close to 0.05 (rs =0.600,P=0.051).Conclusion 68Ga-NOTA-NFB PET/CT can be used as a new CXCR4-targered imaging in diagnosis of breast cancer,and it may be beneficial to evaluate the effect of neoadjuvant chemotherapy.

Objective To evaluate the value of 68 Ga-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid-1-Nal3-octreotide ( DOTANOC) PET/CT imaging in the diagnosis and staging of pancreatic neuroendocrine neoplasms ( pNENs) . Methods Data of 48 patients ( 18 males, 30 females, age: 23-86 (50.0±14.7) years) who underwent 68Ga-DOTANOC PET/CT imaging from June 2016 to June 2018 were retrospectively analyzed. The histopathological results were considered as the gold standard. The diagnostic efficacies of 68 Ga-DOTANOC PET/CT imaging and conventional imaging ( CI) for pNENs were analyzed and compared ( McNemar test) . Imaging characteristics of true positive lesions in 68 Ga-DOTANOC PET/CT ima-ging were analyzed. The maximum standardized uptake value ( SUVmax ) in different pathological grades of pNENs lesions were compared (Kruskal-Wallis rank sum test). Accuracy for TNM staging by 68Ga-DOTANOC PET/CT imaging and the correlations between the staging results and clinical TNM stages were analyzed (R× C contingency table). Results (1) The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of 68Ga-DOTANOC PET/CT imaging were 93.8％(30/32), 14/16, 93.8％(30/32), 14/16 and 91.7％(44/48). All true positive lesions detected by PET/CT showed focal up-take of 68 Ga-DOTANOC with SUVmax of 30. 52 ± 23. 57. There were 26 patients with confirmed pathological grades of G1 (n=10;SUVmax:28.20 (17.60, 49.22)), G2 (n=13; SUVmax: 27.60 (13.05, 56.08)) and G3 (n=3;SUVmax:13.68(10.02, 27.80)), with no significant difference in SUVmax among 3 groups (H=0.495, P>0.05). (2)Of the 48 patients, 95.8％(46/48) also underwent CI concurrent with PET/CT. The sensitivity, specificity, PPV, NPV and accuracy of CI were 60.0％(18/30), 9/16, 72.0％(18/25), 9/21 and 58.7％(27/46). The diagnostic efficacy of 68Ga-DOTANOC PET/CT imaging was significantly higher than that of CI ( P=0.041) . ( 3) The accuracies of 68 Ga-DOTANOC PET/CT imaging for T, N, M staging were 93.3％(28/30), 6/6, 9/10, respectively, and the staging results were significantly correlated with clinical TNM stages (r=0.880, P<0.05). Conclusion 68Ga-DOTANOC PET/CT imaging has great values in the diagnosis and staging of pNENs.

Objective:To exploring the uptake of fibroblast activation protein (FAP) inhibitor (FAPI) in pancreatic cancer through 68Ga-FAPI-04 PET/CT imaging, and provide a basis for the FAP-targeted imaging of pancreatic cancer. Methods:Pancreatic cancer-patient-derived tumor xenograft (PDX) mouse models ( n=8) were developed, then 68Ga-FAPI-04 and 18F-FDG microPET/CT imaging were performed (4 in each group). The differences of percentage activity of injection dose per gram of tissue (%ID/g) of 68Ga-FAPI-04 and 18F-FDG were analyzed by independent-sample t test. 68Ga-FAPI-04 and 18F-FDG PET/CT imaging were performed in 5 patients (4 males, 1 female, age: 46-74 (63.0±11.9) years) with pancreatic cancer, and the maximum standardized uptake value (SUV max) of 68Ga-FAPI-04 and 18F-FDG in primary pancreatic cancer and the SUV max ratio of liver metastases to liver tissue were compared by paired t test. Results:MicroPET/CT imaging showed that 68Ga-FAPI-04 was obviously uptaken at all time points in the tumor of PDX mice. The uptake of 68Ga-FAPI-04 in PDX mice 60 min after injection was significantly higher than that of 18F-FDG ((6.58±0.44) and (4.29±0.13) %ID/g; t=4.152, P=0.008 9). PET/CT showed that the SUV max of 68Ga-FAPI-04 in pancreatic cancer was significantly higher than that of 18F-FDG (16.82±3.08 and 5.14±2.20; t=6.893, P=0.000 1) and the SUV max ratio of liver metastases to liver tissue of 68Ga-FAPI-04 was also significantly higher than that of 18F-FDG (4.57±1.47 and 1.30±0.16; t=3.803, P=0.019 1). Conclusion:68Ga-FAPI-04 can be highly uptaken in pancreatic cancer, suggesting that FAP can be a potential target for PET/CT imaging of pancreatic cancer.

Objective To compare the diagnostic efficacy of 68Ga-prostate specific membrane antigen (PSMA)-617 PET/CT and multi-parameter MRI for primary prostate cancer.Methods From June 2017 to November 2017,24 patients (age (67.6±7.0) years) with suspected prostate cancer were prospectively enrolled.All patients underwent 68Ga-PSMA-617 PET/CT and multi-parameter MRI.Pathological diagnosis was considered as the gold standard.The diagnostic efficacy of the two methods was analyzed and the difference was evaluated by receiver operating characteristic (ROC) curve analysis(Z test).Results Based on the puncture biopsy and/or excision biopsy,18 patients were diagnosed as prostate cancer and 6 patients were diagnosed as benign diseases.According to the five-zone analysis for the prostate (24 patients with 120 zones),48 and 56 zones were detected accurately in prostate cancer patients by PET/CT and multi-parameter MRI respectively,which was 54 and 41 for benign patients.The cut-off value of maximum standardized uptake value (SUVmax) in 68Ga-PSMA-617 PET/CT for diagnosing prostate cancer was 4.85,the area under curve (AUC),sensitivity,specificity,positive predictive value,negative predictive value,accuracy and Youden index were 0.890,75.00％ (48/64),96.43％ (54/56),96.00％ (48/50),77.14％ (54/70),85.00％(102/120),71.43％ respectively for prostate cancer by PET/CT,and 0.837,87.50％(56/64),73.21％ (41/56),78.87％ (56/71),83.67％ (41/49),80.83％ (97/120) and 60.71％ respectively by multi-parameter MRI.The difference of AUC was statistically significant (Z=2.82,P＜0.01).Conclusions The diagnostic accuracy of 68Ga-PSMA-617 PET/CT imaging for prostate cancer is higher than that of multi-parameter MRI.Both modalities have high diagnostic efficiency and can be used scientifically as complementary.