Objective To evaluate the clinical value of 18F-FDG PET-CT in detecting or diagnosing the recurrence and metastasis of colorectal cancer in the postoperative patients with rising CEA or CA19-9 during the follow-up.Methods 87 colorectal cancer patients were entered in the trial,all were postoperative,and during the follow-up were rising CEA or CA19-9 found, and then had the whole body 18F-FDG PET-CT examination.The final diagnosis of all patients were based on pathology results of re-operation,colonoscoply,a variety of imaging examination or clinical follow-up. Results For the diagnosis of recurrence or metastasis of postoperative colorectal cancer with rising CEA or CA19-9,PET-CT sensitivity was 91.0%(71/78),specificity 66.7%(6/9),accuracy 88.5%(77/87).Among the 61 patients who have recently (in 3 months) had conventional chest,abdominal and pelvic imaging examination (ultrasound,CT and MRI),32 patients PET-CT found the lesions that the conventional imaging did not found.The treatment programs of 21 patients have been changed,correction rate was 34.4%(2 1/61). Conclusion The 18F-FDG PET-CT imaging had a significant value in the diagnosis of recurrence and metastasis and restaging in the postoperative colorectal cancer with rising CEA or CA19-9 during the follow-up.

Objective To investigate the correlation between human epidermal stem cell (hESCs) and hypertrophic scar or keloid. Methods Improved collagen Ⅳ-coated adhesion methods was used to isolate and culture the epidermal stem cells after neutral protease selectively digested the dermo-epidermal junctions. After the cells were cultured and expanded in vitro, and passage 3 hESCs were induced by different concentrations of TGF-β1 (0.1, 5.0, and 10.0 ng/ml). Morphological fea-tures and identification of these cells were meseasured by HE, Masson, immunohistochemical staining on the days 3 and 7, respectively. Results After induced by TGF-β1 for 3 and 7 days, the morpholo-gy of the epidermal stem cell (hESCs) was changed into fusiform shape, similar to fibroblasts. 70 % ofthe cell which was induced by TGF-β1 were blue stained in the cytoplasm by Masson stain, which is the distinctive method for collagen, suggesting collagen appeared or increased in the cells. The collagen concentrations in supernatants of hESCs were 0.4150±0.0014, 0.3380±0. 0020, and 0.3870±0.0020, much higher than that in control group (0.0780±0.0025) and normal skin fibro-blast group (0.15004±0.0051) (P<0.05). Immunohistochemical staining revealed that positive rates of these cells for anti-vimentin staining were more than (95.00±1.20)% in experiments and (5.70±0.20)% in control group. Conclusion The differentiantion of hESCs induced by TGF-β1 into fibro-blasts indicates that hESCs may play a role in the pathogenesis of hypetrophic scar and keloid.

In this study, a novel technique for the preparation of (125)I-5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FIAU) was developed, (125)I-FIAU biodistribution profile was detected in Kunming mice and the possibility of using FTAU radio-labeling for reporter gene imaging was explored. 5-trimethylstannyl-1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FTAU) was labeled with radioiodine ((125)I). A rotary evaporation method was used to remove excess methanol. The reactant was purified through a Sep-Pak C18 reversal phase column. The radiochemical purity and in vivo stability were determined using silica gel thin layer chromatography (TLC). The biodistribution of (125)I-FIAU in Kunming mice was also detected. The results showed that (125)I-FIAU could be radiolabeled effectively with FTAU, with mean labeling rate being (81±0.38)% (n =5). The mean radiochemical purity of (98.01±0.40)% (n=5) was achieved after a reversal phase Sep-park column purification. (125)I-FIAU was stable when incubated in normal human serum or in saline at 37°C, with a radiochemical purity >96% during a 0.5-24 h time period. Biological experiments exhibited rapid clearance of (125)I-FIAU from the blood pool. (125)I-FIAU was mostly excreted by kidneys. (125)I-FIAU in myocardium dropped conspicuously after 8 h and there was hardly retention at 24 h. We were led to concluded that the new method of radioiodinization of FTAU for the preparation of (125)I-FIAU is easy, highly effective and stable in vivo. The biodistribution of (125)I-FIAU in Kunming mice showed it can serve as an imaging probe for myocardial reporter genes.

Objective To prepare 18F-5-fluoro-N-(2-(diethylamino) ethyl) picolinamide (18F-5-FPN) and evaluate its binding affinity with melanin.Methods 5-bromo-N-(2-(diethylamino) ethyl)picolinamide (precursor) was synthesized and the structure was characterized by ultraviolet (UV),nuclear magnetic resonance (NMR) and mass spectrometry.18F-5-FPN was prepared with FX-XN module through nucleophilic substitution reaction.The product was purified and identified by HPLC.The binding specificity of 18F-5-FPN with melanin was demonstrated by in vitro study of cellular uptake,and in vivo static PET imaging of pigmented B16F10 and amelanotic A375m allografts.Biodistribution study was performed to evaluate the pharmacokinetics of 18F-5-FPN in vivo.Two-sample t test was used for data analysis.Results The structure of precursor was characterized by UV,1H NMR,13C NMR and mass spectrometry.18 F-5-FPN was successfully prepared with radiochemical yield of 5％-8％,radiochemical purity ＞95％ and the specific activity of 100-120 GBq/μmol.The cell uptake study showed that the uptakes of 18F-5-FPN in B16F10 cells at 30,60 and 120 min ((9.80±0.46) ％,(10.34±0.32) ％,(7.27±0.26)％) were significantly higher than those in A375m cells ((1.36±0.14)％,(1.75±0.12)％,(1.54±0.09)％;t =30.3,46.8,38.4,all P＜0.05),and the optimal uptakes were observed at 60 min for both cells.In static PET imaging,the tumors in B16F10-bearing mice were clearly visible with the uptake value of (18.20±3.21) ％ID/g and the T/B ratio of 19.17±10.03 at 1 h postinjection,while no tumor uptake was seen in A375m-bearing mice.The main clearance pathway of 18F-5-FPN was the renal system,which cleared the unbound tracer rapidly.Conclusions 18F-5-FPN can specifically target the melanin in vitro and in vivo with favorable pharmacokinetics and good T/B ratio.18F-5-FPN may be an ideal molecular probe for diagnosis of malignant melanoma.

Objective To explore the methods and effects of improving facial appearance on volume defect and aging,and recovery of aesthetic looks by autologous fat granules graft.Methods We designed the filling areas according to gender,age,individual face characteristics and desire of the case before operation.By liposuction technology with low pressure from the trunk,fats were taken with cleaning and purifying.Then pure fats were injected to the marked areas of the face by multi-level and multi-tunnel injection.It was able to supply the facial volume for lost soft tissue,to improve the aging appearance and to achieve smooth facial contour.Results All cases were followed-up for 3 months to 2 years,facial appearances were satisfied or improved,without fat liquefaction,infection,scleroma and other complications.Only a few cases needed complementary transplantation.The overall results were satisfactory.Conclusions Autologous fat granules graft is a safe and effective facial soft tissue filling technology.It can effectively improve facial aging appearance,restore natural,young and beautiful looks,and be worth for clinical application.

Objective To improve the quality of the management of the elderly patients with cancer in Sichuan province,and to understand the attitudes and perspectives of elderly surgeons and oncologists for the management and treatment of elderly patients with cancer.Methods A face-toface questionnaire interview was conducted with oncologists (n 64) and geriatricians (n =64).128 physicians were involved in this study.Results The cancer management and therapeutics were deemed appropriate at present by 9.38％ (6/64)of the geriatricians and 25.00％ (16/64)of the oncologists.The 39.06％ (25/64) of geriatricians used to notice geriatric syndromes,while 81.25％ (52/64)of oncologists never concerned about the geriatric syndrome(P=0.011).As for the causes of the therapy-associated toxicity,oncologist versus geriatrician payed an attention to malnutrition (100.00％ vs.100.00％ in both groups),to mobility disorders(65.63％ vs.65.63％,84/128 in both groups),to cognitive impairment/mood disorder (89.06％ in geriatrician group vs.75.00％ in oncologist group,P=0.038).For the factors affecting treatment decisions,a physical ability attention (oncologists vs geriatricians:70.31％ vs.92.19％;P =0.002),and comorbidity (oncologists vs geriatricians:62.50％ vs.79.69％,P =0.032) had statistically significant difference.In addition,lack of geriatrics knowledge was also reported by more oncologists.However,one hundred percent of participants wanted very much to cooperate with each other in their clinical work.When responding to the clinical scenario,the 10.94％ (7/64)of geriatricians and 32.81％ (21/64)of oncologists chose modified treatment for 65-74 years old patient with cancer(P =0.003).When the age of the patients was 75-84 years old,only 12.50 ％ (8/64) of geriatricians prefer end-of-life care,while 31.25 ％ (20/64) of oncologists chose it (P =0.010).Conclusions Selection of treatment decisions in the elderly patients with cancer affect by ageing.Both oncologists and geriatricians are concerned with the elderly patients with cancer,ageing syndrome,total sickness and functional status.And these doctors support an establishment of a multi disciplinary team cooperation for the elderly patients with cancer.Therefore,the establishment of mutual cooperation between the two professionals is necessary and feasible.

Objective To investigate the short- and long-term prognostic factors for patients with spontaneous rupture and bleeding of primary liver cancer (liver cancer). Methods Clinical data of 167 patients with spontaneous rupture and bleeding of liver cancer admitted to Jiangmen Hospital, Southern Medical University and Nanshan Hospital, Guangdong Medical College between January 2005 and December 2012 were retrospectively analyzed. There were 140 males and 27 females with the average age of (58±7) years. The informed consents of all patients were obtained and the local ethical committee approval was received. Seventy-eight cases were diagnosed with Child-Pugh classiifcation A, 44 with Child-Pugh classiifcation B and 45 with Child-Pugh classiifcation C. According to the tumor, node, metastasis (TNM) stage, 31 cases were in stageⅡ, 54 in stageⅢ, 73 in stageⅣA and 9 in stageⅣB. The 30-d and long-term survival rates were analyzed. The inlfuencing factors of survival rates were analyzed by Cox's proportional hazard regression model. Results The 30-d survival rate was 71.3%, and the 1-, 3-, 5-year accumulative survival rate was 40.1%, 16.5%, 5.4% respectively. Multiviariate Cox's regression analysis revealed that Child-Pugh classiifcation C, hypovolemic shock, number of tumors≥2, TNM stage Ⅲ and conservative therapy were the independent risk factors for 30-d survival rate (HR=9.503, 2.919, 4.760, 0.283, 32.004; P<0.05). Liver cirrhosis, Child-Pugh classification C, total bilirubin (TB)≥34 μmol/L, number of tumors≥2, TNM stageⅢand conservative therapy were the independent risk factors for long-term survival rate (HR=9.167, 5.950, 1.037, 2.821, 0.680, 8.147; P<0.05). Conclusions For patients with spontaneous rupture and bleeding of liver cancer, Child-Pugh classiifcation C, hypovolemic shock, number of tumors≥2, TNM stageⅢand conservative therapy are the independent risk factors for short-term pronosis, whereas liver cirrhosis, Child-Pugh classiifcation C, TB≥34μmol/L, number of tumors≥2, TNM stageⅢand conservative therapy are the independent risk factors for long-term pronosis.

Objective To investigate the effect of erector spinae plane block on ultrasound-based hemodynamic parameters of the arteries of the four limbs and biochemical stress indicators in patients with thoracoscopic lobectomy. Methods A total of 120 patients with thoracoscopic lobectomy were randomly divided into study group and control group, with 60 cases in each group.The study group received erector spinae plane block during surgery, while the control group received conventional anesthesia measures.Pulmonary function indicators[peak expiratory flow rate (PEFR), forced vital capacity (FVC), forced expiratory volume in the first second (FEV₁)], ultrasound-based hemodynamic parameters of the arteries of the four limbs (maximum systolic velocity, minimum diastolic velocity, mean velocity, arterial pulsatility index, and arterial resistance index), stress indicators[cortisol (Cor), norepinephrine (NE), angiotensin Ⅱ(Ang Ⅱ), and adrenocorticotropic hormone (ACTH)], and analgesic effect were compared between the two groups at different time points[before anesthesia induction (T₀), after extubation (T₁), and after drainage tube removal (T₂)]. Results FEV₁, FVC and PEFR in both groups were significantly lower at T₁ and T₂ than at T₀, and FEV₁, FVC and PEFR in the study group were significantly higher than those in the control group at T₁ and T₂(P < 0.05).The maximum systolic velocity and arterial resistance index in both groups were significantly lower at T₁ and T₂ than at T₀, while the minimum diastolic velocity, mean velocity and arterial pulsatility index were significantly higher at T₁ and T₂ than at T₀(P < 0.05).The maximum systolic velocity and arterial resistance index in the study group were significantly higher than those in the control group at T₁ and T₂, but the minimum diastolic velocity, mean velocity and arterial pulsatility index were significantly lower than those in the control group (P < 0.05).Cor, ACTH, Ang Ⅱ and NE in both groups were significantly higher at T₂ than at T₀, and Cor, ACTH, Ang Ⅱ and NE in the study group were significantly lower than those in the control group at T₂(P < 0.05).The Prince-Henry pain score, effective compression times, and actual compression times in the study group were significantly lower than those in the control group (P < 0.05). Conclusion Application of erector spinae plane block in thoracoscopic lobectomy causes smaller fluctuations in hemodynamic parameters of the arteries of four limbs and biochemical stress indicators, with a better anesthetic effect.

Objective To investigate the effects of esketamine on hypoxic-ischemic myocardial injury in neonatal rats based on glycogen synthase kinase-3β/NOD-like receptor thermal protein domain-containing protein 3 (GSK-3β/NLRP3) pathway. Methods Thirty neonatal rats were randomly divided into sham operation group, model group and esketamine group, with 10 rats in each group. The rats in the sham operation group underwent a median incision in the neck to expose the bilateral common carotid arteries; the rats in the model group and the esketamine group underwent ligation of the common carotid arteries combined with a hypoxic environment to establish a model ofischemia and hypoxia; the rats in the esketamine group were given esketamine intervention (50 mg/kg). Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), serum creatine kinase isoenzyme (CK-MB), cardiac troponin I (cTnI), lactate dehydrogenase (LDH), tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-1β levels, myocardial injury, myocardial cell apoptosis and apoptosis protein caspase 1/3/9 levels, neutrophil infiltration in myocardial tissue, and changes in GSK-3β and NLRP3 protein levels in myocardial tissue were detected in each group. Results Compared with the sham operation group, the LVEF and LVFS were significantly decreased and the LVEDD and LVESD were significantly increased in the model group, while the LVEF and LVFS were significantly higher and the LVEDD and LVESD were significantly lower in the esketamine group than in the model group (P < 0.05). The serum levels of CK-MB, cTnI, LDH, TNF-α, IL-6, IL-1β, myocardial injury and apoptosis, caspase 1/3/9 protein levels in myocardial tissue sections, neutrophil counts, and GSK-3β and NLRP3 protein levels were significantly increased in the model group, and these indicators were significantly lower in the esketamine group than in the model group (P < 0.05). Conclusion Esketamine improves hypoxic-ischemic myocardial injury in neonatal rats by inhibiting inflammation, and its mechanism of action is related to the GSK-3β/NLRP3 pathway.

In this study,a novel technique for the preparation of 125I-5-trimethylstannyl1-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail (FIAU) was developed,125I-FIAU biodistribution profile was detected in Kunming mice and the possibility of using FTAU radio-labeling for reporter gene imaging was explored.5-trimethylstannyl-l-(2-deoxy-2-fluoro-beta-D-arabinofuranosyl) urail.(FTAU) was labeled with radioiodine (125I).A rotary evaporation method was used to remove excess methanol.The reactant was purified through a Sep-Pak C18 reversal phase column.The radiochemical purity and in vivo stability were determined using silica gel thin layer chromatography (TLC).The biodistribution of 125I-FIAU in Kunming mice was also detected.The results showed that 125I-FIAU could be radiolabeled effectively with FTAU,with mean labeling rate being (81±0.38)％ (n =5).The mean radiochemical purity of (98.01±0.40)％ (n=5) was achieved after a reversal phase Sep-park column purification.125I-FIAU was stable when incubated in normal human serum or in saline at 37℃,with a radiochemical purity ＞96％ during a 0.5-24 h time period.Biological experiments exhibited rapid clearance of 125I-FIAU from the blood pool.125I-FIAU was mostly excreted by kidneys.125I-FIAU in myocardium dropped conspicuously after 8 h and there was hardly retention at 24 h.We were led to concluded that the new method of radioiodinization of FTAU for the preparation of 125I-FIAU is easy,highly effective and stable in vivo.The biodistribution of 125I-FIAU in Kunming mice showed it can serve as an imaging probe for myocardial reporter genes.