Objective:To evaluate the value of 2D-3D registration method which combines improved mutual information and image pyramid.Methods:The continuous image representation of the cubic B-spline curve and Parzen histogram estimation were fused into the algorithm. The chest was used as the research object. The reconstruction of the orthogonal X-ray image generated by the radiographic image and the image after a certain transformation with itself were used for registration experiments to study the registration accuracy and time.Results:After 50 sets of controlled experiments, compared with the traditional registration method, the displacement accuracy of this method in the X and Y directions was improved by 53.39% and 21.33%, and the registration time was shortened by 91.93%. Compared with the modified algorithms in recent years, the displacement accuracy of the improved algorithm in the X and Y directions was increased by 17.65% and 13.79%. And the registration time was further increased by 19.64%.Conclusions:This method can effectively improve the registration accuracy and efficiency of 2D and 3D images, and both meet the requirements of image registration within 2 mm during surgery. The high efficiency and accuracy of this method provide beneficial information for clinical diagnosis and radiotherapy automation, which also lays the foundation for tumor position error correction and automatic positioning of medical robotic arms.

Herpes simplex viruses (HSV-1 and HSV-2) cause global morbidity and synergistically correlate with HIV infection.HSV exists life-long in a latent form in sensory neurons with intermittent reactivation,in despite of host immune surveillance.While abundant evidence for HSV interfering with innate immune responses so as to favor the replication and propagation of the virus,several lines of evidence declare that HSV attenuates adaptive immunity by various mechanisms,including but not limited to the ablation of antigen presentation,induction of apoptosis,and interruption of cellular signaling.In this review,we will focus on the perturbative role of HSV in Tcells signaling.

BACKGROUND:Impaired balance between osteogenesis and adipogenesis of bone marrow mesenchymal stem cels is a crucial pathological mechanism of osteoporosis. Mechanical loads applied to bone tissue can increase bone formation and improve bone strength, and meanwhile lead to the release of extracelular nucleotides, such as adenosine triphosphate.
OBJECTIVE: To determine the effects of adenosine triphosphate on the osteogenic and adipogenic differentiation of bone marrow mesenchymal stem cels and to investigate the underlying mechanisms.
METHODS:The effect of adenosine triphosphate (10, 50, 250 μmol/L) on differentiation of bone marrow mesenchymal stem cels were measured by osteogenic and adipogenic related genes expression, alizarin red staining and oil red O staining. The activation of ERK1/2 signaling pathway by adenosine triphosphate was tested using western blot assay.
RESULTS AND CONCLUSION: Incubation of bone marrow mesenchymal stem cels with adenosine triphosphate resulted in the dose-dependent increase of osteogenic genes expression and calcium deposition, and inhibition of adipogenic genes expression and lipid droplet formation, but had no effects on cel proliferation. Adenosine triphosphate activated ERK1/2 signaling pathway, and U0126 as an ERK1/2 inhibitor restrained the effect of adenosine triphosphate on the differentiation of bone marrow mesenchymal stem cels.

Prolonged postoperative ileus(PPOI), as a common surgical complication, has attracted more and more attention of domestic scholars in recent years. PPOI is often manifested as intolerance of oral feeding, nausea and vomiting, abdominal pain, abdominal distention, delayed exhaust and defecation, and prolonged hospital stay and increased medical expenditure. At present, the pathogenesis of PPOI has not been determined, but it is certain that the disease is mediated by a variety of mechanisms. In clinical work, PPOI still have no general diagnostic criteria, treatment methods and prevention strategies. The theory and practice of accelerated rehabilitation surgery may bring new ideas for the prevention and treatment of PPOI. This paper reviews the research status and prevention strategies of PPOI.

Objective:To compare the safety and efficacy of continuous transversus abdominis plane (CTAP) block and patient-controlled intravenous analgesia (PCIA) in abdominal surgery postoperatively.Methods:PubMed, Embase, Web of Science, CNKI and other English and Chinese databases were searched since their establishment to February 2021 with "continuous/modified, transversus/transverse abdominis plane block, TAP block, patient controlled analgesia, patient-controlled analgesia, patient controlled intravenous analgesia, patient-controlled intravenous analgesia, PCA/PCIA/IV-PCA" as the search keywords. According to the analgesia treatment methods, patients were divided into continuous transversus abdominis plane block group (CTAP group) and patient-controlled intravenous analgesia group (PCIA group). Review Manager 5.4 software was used to conduct a Meta-analysis on outcome indicators such as postoperative nausea and (or) vomiting (PONV), dizziness, pain score and recovery status after abdominal surgery. Risk ratio ( RR) was calculated for counting data, Mean ± SD was calculated for measurement data. Heterogeneity was measured by I2, and related data were analyzed by using either a fixed effects model or a random effects model. Results:(1) The results of literature search: A total of 6 randomized controlled trials, including 2 published in English and 4 published in Chinese were analyzed, involving 479 patients. The results of the Meta-analysis: Compared with PCIA, CTAP block had lower incidence of PONV ( RR=0.22, 95% CI: 0.08-0.62, P<0.01), lower incidence of dizziness ( RR=0.27, 95% CI: 0.09-0.79, P=0.02), lower pain scores on movement at 24 h ( MD=-0.75, 95% CI: -1.42--0.08, P=0.03) and 48 h ( MD=-0.68, 95% CI: -1.05--0.31, P<0.001) postoperatively, and earlier time of first mobilization ( MD=-0.49, 95% CI: -0.69--0.30, P<0.001) and first exhaust ( MD=-10.47, 95% CI: -13.53--7.41, P<0.001), with statistically significant differences. However, there were no statistically significant differences in pain scores at rest at 24 h ( MD=-0.25, 95% CI: -0.57-0.08, P=0.14) and 48 h ( MD=-0.15, 95% CI: -0.39-0.09, P=0.22) postoperatively and postoperative length of hospital stay ( MD=-1.01, 95% CI: -2.28-0.26, P=0.12). Conclusion:CTAP block is a relatively safe and effective analgesic method, and it′s more consistent with the concept of enhanced recovery after surgery (ERAS) and can be recommended as an alternative method of PCIA.

Objective To prepare specific mouse monoclonal antibodies against Homo sapiens dynein,axonemal, heavy chain 2 (DNAH2). Methods Firstly, recombinant plasmid encoding His tagged immunogen, targeting N-terminal sequence of DNAH2 protein (1-300 aa), in E. coli was constructed. IPTG was used to induce the expression of His-immunogen, which was then purified and immunized in BALB/c mice. Hybridoma cells were obtained through the fusion between myeloma cells and splenocytes isolated from BALB/c mice. Finally, ELISA and Western blot assays were performed to screen the positive hybridoma. Results IPTG was used efficiently to induce the expression of DNAH2 immunogen in E. coli. DNAH2 protein bands were detected in screened positive hybridoma. Conclusion Mouse monoclonal anti-DNAH2 antibody is prepared successfully.

Objective To summarize the diagnostic and therapeutic experiences for multiple insulinoma. Methods Clinical data of 34 cKsefl of multiple insulinoma treated in Peking Union Medical College Hospital between 1984 and 2007 were analyzed retrospectively. Results Multiple insulinoma was identified in these 34 cases for 37 instances.Malignant insulinoma was found in 2 cases.Three cases suffered from postoperative recurrent multipie tumors.35.3% cases belonged to MEN1;13.5% cases were of insulinoma combined with islet hyperplasia;43.2% cases had 3 or more than 3 insulinomas;Fifteen cases (40.5%)had had a misdiagnosis.45.2%tumors were smaller than 1 cm in diameter:88.9%multiple insulinonla located at the body and tail of the pancreas.Enucleation of multiple tumors was performed for 48.7 percent of cases. Conclusions Most multiple insulinomas were small,it was difficult for preoperative examination to locate all the tumors therefore.Being on the alert against multiple insulinoma and such measures as careful exploration,intraoperative blood glucose determination.fine needle aspiration biopsy,frozen sections helps to avoid missing multiple imuhnoma.

Recently, with the development and widespread application of total mesorectal excision and neoadjuvant chemoradiotherapy, the long-term overall survival and disease-free survival of patients with middle & low rectal cancer have been greatly improved. Moreover, there are also researches in minimally invasive techniques, such as laparoscopy and robotic surgical system in the radical rectal surgery, as well as the combination of tumor molecular targeting markers and gene sequencing technology. Nowadays, the treatment of rectal cancer has entered a new era of individualized precise medicine. However, there are still some controversies in lateral lymph node dissection. The criteria of diagnosis and treatment, neoadjuvant therapy, indications of lateral lymph node dissection, the area of dissection and neuroprotection are still unsatisfactory. It is necessary to explore the personalized treatment strategies of lateral lymph node dissection in the precise medical era.

OBJECTIVETo verify the clinical safety of complete mesocolic excision (CME) and manufacture pathological large slices.

METHODSA prospective analysis clinical data of 85 right colon cancer in patients by the same group of surgeons at the Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from January 2012 to December 2013 which were divided into two groups: CME group (n=39) and traditional radical operation group (n=46) by surgical approach. CME group and control group were compared the differences of clinic and pathologic variables, precise tissues morphometry, lymph nodes harvest, mesocolic area and so on. By comparison to operation time, blood loss, postoperative complications, flatus restoring time, drainage removal time and length of stay, the security of CME was analyzed. Statistical methods included independent sample t-test, Wilcoxon rank sum test and χ(2) test. In order to manufacture pathological large slices, the CME operation specimens were fixed. The large slices were stained by routine HE staining to detection of circumferential resection margin.

RESULTSMean number of total lymph nodes was increased obviously in CME group (26.8±1.9 vs. 23.2±3.4, t=4.261, P=0.000). Mean number of lymph nodes of stage Ⅰ, Ⅱ were different between two groups (25.8±3.6 vs. 18.2±4.5, 26.8±7.7 vs. 24.9±6.2, t=8.776, 2.802, P=0.000). The positive lymph nodes of CME group was higher than control group (4(7) vs. 1.5(2), P=0.032), above all with statistically significant difference. Comparing CME group with the control group, there were the larger area of mesentery ((15 555±1 263) mm(2) vs. (12 493±1 002) mm(2,) t=12.456, P=0.000), the greater distance between the tumor and the high vascular tie ((116±22) mm vs. (82±11) mm, t=9.295, P=0.000), the greater distance between the normal bowel and the high vascular tie ((92±17) mm vs. (74±10) mm, t=8.132, P=0.000) of CME, with statistically significant difference. There were no statistically significant differences from operation safety when CME group was compared with the control group. The pathological large slices of colon cancer were prepared successfully and dyed evenly than those large slices were used to observe whether the lymph tube and lymph node metastasis inside the mesocolon. Existence of direct tumor invasion could be confirmed by investigating the large slices. Cancer embolus in intravascular and micro infiltration in mesocolon also could be found.

CONCLUSIONSCME operation can get the standard excision according the mesocolic area and integrity, as well as to harvest the maximum number of lymph node. The clinical application of CME is safe and does not increase the risk of operation. Circumferential resection margins can be detected by pathological large slices.

Colectomy ; Colonic Neoplasms ; surgery ; Device Removal ; Humans ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis ; Mesocolon ; surgery ; Operative Time ; Postoperative Complications ; Prospective Studies

Objective: To detect circulating tumor cells (CTC) in patients with colorectal carcinoma and to evaluate the relationship among CTC, clinic-pathological characteristics and prognosis of colorectal carcinoma. Methods: Peripheral blood samples were obtained from 109 patients with colorectal carcinoma in Department of General Surgery, Beijing Friendship Hospital, Capital Medical University from April 2014 to October 2016. There were 60 male and 49 female patients, aging from 33 to 86 years with a mean age of (65±10) years.CTC were detected using density-gradient centrifugation and immunofluorescence staining. χ² test, Fisher exact test and rank-sum test were used to analyze the relation between positive rate of CTC and clinical characteristic, respectively. The correlation analysis of CTC and common tumor markers was detected by χ² test and Spearman test. The overall survival of patients was analyzed by Kaplan-Meier curve and Cox proportional hazard model. Results: CTC were found in 71 of the 109 patients with colorectal carcinoma. The presence of CTC was significantly correlated with N stage (Z=4.422, P=0.035) and M stage (χ²=4.424, P=0.049). However, CTC was not significantly correlated with age, sex, tumor location, tumor size, differentiation, T stage, Ki-67 and TNM stage (P>0.05). Meanwhile, there was significant correlation between CTC and carcino-embryonic antigen (CEA) (χ²=4.897, P=0.027; r=0.212, P=0.027) indicated by χ² test and Spearman correlations analysis. The positive rate of CTC was higher than that of CEA (χ²=15.45, P=0.000). Survival analysis suggested that positive CTC was poor for overall survival in colorectal cancer with adjusted HR as 3.023(95%CI: 1.330 to 6.872, P=0.008). Conclusions CTC is helpful to early diagnosis tumor recurrence and metastasis. Hence, combined multiple tumor markers, including the CTC as common indicators of tumor diagnosis, relapse and metastasis could effectively improve the accuracy of diagnosis.