Colorectal cancer is one of the most common malignant tumor with high mortality rate.About a third of patients with colorectal cancer have either simultaneously or metachronous liver metastasis with poor prognosis.Therefore,the studies on the mechanisms of colorectal liver metastasis is significant.Recently,the research on the molecular mechanisms of colorectal liver metastasis is increasing,this paper summarizes some of them,and we hope providing new ideas for the diagnosis and treatment of colorectal cancer patients with liver metastasis.

Objective To investigate histopathological change of axillary lymph nodes and ecto-node encroachment of breast cancer following neoadjuvant chemotherapy in locally advanced breast cancer.Methods Second Hospital Affiliated to University of South China had received 86 patients with breast carcinoma from June 2002 to August 2009,these patients suffered lump over 5 cm and homonymy nonfusion lymphadenectasis.All samples were grouped on the basis of wether or not accept neoadjuvant chemotherapy.The first group included 46 patients,who were reluctant to receive neoadjuvant chemotherapy,operated after pricking pathological diagnosis.There were 40 patients with metastatic axillary lymph nodes and 17 patients with axillary ecto-node encroachment in the first group.The second group included 40 patients,who were voluntary to receive neoadjuvant chemotherapy,and operated after pricking pathological diagnosis and received three cycles of neoadjuvant chemotherapy on average.There were 26 patients with metastatic axillary lymph nodes and 6 patients with axillary ecto-node encroachment in the second group.Results The rate of metastatic axillary lymph nodes was 86.9% and the rate of axillary ecto-node encroachment was 36.9% in the first group,while 65% and 15% respectively in the scond group.There were significant deference in the rate of metastatic lymph node and axillary ecto-node encroachmen between two groups.Conclusion Neoadjuvant chemotherapy is effective to treat metastatic lymph node and axillary ecto-node encroachment in breast cancer.

Digestive tract reconstruction is an important part of gastric carcinoma operation as well as tumor resection and lymph node dissection.Surgeons are seeking the optimal reconstruction method that reduces the occurrence of complications and maintains better quality of postoperative life extremely.Uncut Roux-en-Y anastomosis is a modified procedure in which an artificial jejunal occlusion is devised to avoid Roux stasis syndrome based on Billroth Ⅱ and Braun's anastomosis.Compared to the conventional Roux-en-Y anastomosis,the uncut Roux-en-Y anastomosis retains the advantage of preventing biliary and pancreatic secretions reflux,furthermore,it can decrease the symptoms associated with Roux stasis owing to the abnormal myoelectrical conduction of Roux limb.Because the early studies indicated that there was higher incidence of dehiscence or recanalization of the jejunal occlusion,the uncut Roux-en-Y anastomosis has not been widely applied.Since jejunal occlusion has been optimized recently,the uncut Roux-en-Y reconstruction may be an optional and appropriate method of digestive tract reconstruction after distal gastrectomy.

Objective To investigate the type of plasmid map of Y. pestis in the R. opimas natural plague loci in Junggar Basin. Methods A total of 39 plasmid DNA of Y. pestis which were isolated from the natural plague loci of Junggar Basin, Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and In-ner Mongolia were extracted by the methods of Kado and Liu. The plasmid map was analyzed by the methods of agarose gel eleetrophoretogram. Results Two types of plasmid map were found in 26 Y. pestis which were isolated from Junggar Basin. Of them 23 were 6 × 106, 45 × 106 and 65 × 106 type of plasmid map, and 3 were 6 × 106, 45 × 106 and 72 × 106 type. Conclusion There are two types of plasmid map in the R. opi-mus natural plague loci in Junggar Basin. One type, which is the dominant type in this area, is 6 × 106, 45 × 106 and 65 × 106 type. This type is also similar to the dominant plasmid map type of the nature plague loci of Tianshan Mountain, Kunlun Mountain, Qinghai-Tibet Plateau and Inner Mongolia. The other type is 6 × 106, 45 × 106 and 72 × 106 type, and this type is new plasmid map type of Y. pestis in our country.

Objective To evaluate diagnostic value and clinical significance of procalcitonin (PCT)in infection in intensive care unit (ICU)patients.Methods 96 ICU patients in a hospital between September 2011 and March 2012 were selected for study,levels of patients’PCT,high-sensitivity C-reactive protein (HsCRP)and white blood cell (WBC)count were detected,statistical analysis were conducted.Results Compared with non-bacteria infected patients,serum PCT and HsCRP levels in all bacteria infected patients increased,the difference were significant (Z=-6.102;-3.918,both P <0.05 );WBC count was not significantly different(Z =0.212.P >0.05).PCT sensi-tivity,specificity,positive predictive value,and negative predictive value for diagnosing infection was 82.35%, 67.86%,86.15%,and 61 .29% respectively;receiver operating characteristic (ROC)curve of PCT,HsCRP,and WBC was 0.898,0.755,and 0.581 respectively.Conclusion There are higher sensitivity and specificity of PCT to predict infection,which is helpful for early detection of infection in critically ill patients.

Objective To investigate the MRI features of the brain in patients with neuromyelitis optica (NMO), and to evaluate the correlation between the brain abnormalities and related risk factors.Methods Fifty-four patients with definite NMO according to 2006 Wingerchuk diagnosis criteria were enrolled in this study. MRI scanning of the brain was performed in these patients. Distribution and signalfeatures of all the lesions were analyzed. A Logistic regression analysis was used to evaluate the risk factors of brain abnormalities. Results Twenty-four NMO patients (44. 4%) showed unremarkable findings and thirty (55.6%) showed abnormalities on brain MRI. Multiple and non-specific small lesions in the subcortical white matter and grey-white matter junction were the most frequent abnormalities on brain MRI (13/30, 43. 3%). Typical lesion locations included corpus callosum, subependyma of ventricles,hypothalamus and brain stem. The lesions showed punctate, patchy and linear abnormal signals. Postcontrast MRI showed no abnormal enhancement in 16 cases. Logistic regression analysis showed that coexisting anto-immune disease or infection history had correlations with abnormalities of the brain on MRI (OR=3.519,P ＜0.05). Conclusions There was a high incidence of brain abnormalities in NMO.Subependymal white matter, corpus callosum, hypothalamus and brain stem were often involved in NMO.NMO patients with coexisting anto-immune disease and infection history had higher risk of brain abnormalities.

Objective To evaluate the clinical efficacy and safety of endovascular treatment for intracranial venous sinus thrombosis based on individual condition. Methods Twelve patients with intracranial venous sinus thrombosis were treated with endovascular management according to the severity and course of disease after they failed to respond to anticoagulant therapy. The clinical signs and symptoms,cerebrospinal fluid pressure and arteriovenous circulation time were observed and followed up (including MRV). Intravenous thrombolysis and mechanical thrombus maceration were carried out in all 12 patients,while intravenous thrombolysis, mechanical thrombus maceration in combination with intra-arterial thrombolysis were employed in 3. After the treatment, anticoagulant therapy was carried out for 6 months.The patients were followed up for 12 to 24 months. Results Of the twelve patients, clinical signs and symptoms included slight headache (2 cases), mild hemiplegia (1 case), ambiopia or blurred vision (3 cases). The cerebrospinal fluid pressure returned to under 26 cm H2O (1 cm H2O =0.098 kPa)following treatment from 28 to 38 cm H2O [ mean (32. 4 ±3.0) cm H2O] in preoperative measurement and the arteriovenous circulation time returned to below 10 s in all patients following treatment. Neither recurrence of thrombosis nor new symptoms of neurologic dysfunction was observed. No procedure-related intracranial or systemic hemorrhagic complications occurred both during and after the operation with the exception of a subcutaneous bleeding at the venopuncture site. Conclusion Endovascular treatment is effective and safe for patients with intracranial venous sinus thrombosis.

Objective To evaluate the usefulness of MR imaging in follow-up of osteosarcomas treated with high intensity focused ultrasound (HIFU). Methods The images of nonenhanced and multiphase gadolinium-enhanced MR imaging before and after HIFU treatment in 16 patients with osteosarcomas pathologically confirmed were interpreted prospectively and correlated with the results of ~ 99mTc-MDP bone scan. Results The results of HIFU in 14 osteosarcomas were evaluated correctly. Before HIFU, 16 osteosarcomas demonstrated hypointensity on T1WI and heterogenous hyperintensity on T2WI and obvious enhancement during capillary and delayed phases and abnormal radioactivity accumulation were detected.One to Four weeks after HIFU treatment, the osteosarcomas became slightly hyperintense on T1WI and heterogenously hyperintense on T2WI, and no enhancement during capillary and delayed phase was noted. There was a clear boundary presenting between the targeted and untreated areas, and abnormal radioactivity accumulation disappeared. Both the signal intensity on T2WI and the tumor size reduced gradually after HIFU treatment 3 to 25 months. Conclusion HIFU is an effective local therapy for osteosarcomas, and MRI can accurately evaluate the efficacy of HIFU.

Objective To evaluate the safety and efficacy of induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapywith capecitabine in patients with locally advanced pancreatic cancer (LAPC).Methods A total of 42 patients with locally advanced pancreatic cancer were enrolled.All patients received seven cycles of induction chemotherapy of gemcitabine 1 000 mg/m2,once a week.Concurrent chemoradiotherapy began 1 week after completion of induction chemotherapy.Radiotherapy was delivered with a median dose of 54 Gy (34-64 Gy) with 1.8-2.0 Gy in a fraction.The radiotherapy was combined with capecitabin at a dosage of 825 mg/m2 twice daily,5 d/week.Results Twenty patients (47.6％) were evaluated as clinical benefit response (CBR).Two cases were observed with complete remission (CR),8 with partial remission (PR),27 with stable disease (SD),and 5 with progressive disease (PD).The median overall survival was 10.1 months (range of 4-36 months).The 1-,2-year overall survival rate was 38.2％ and 18.2％,respectively.Myelosuppression was recorded in 20 patients with grades 1-2,and 5 patients with grade 3.Twenty-two patients suffered from grade 1-2 gastrointestinal toxicities,while 4 patients suffered from grade 3.Conclusions The preliminary results showed that induction chemotherapy with gemcitabine followed by concurrent chemoradiotherapy with capecitabine in patients with LAPC might achieve encouraging efficacy with better tolerance.

In order to strengthen the graduate management in scientific research platform and to ensure the quality of graduate training,the ideological and moral education was invigorated through establishing virtual party branch,the behavior was regulated through establishing and amplifying the daily management system,the student interests were protected through establishing financial management system and the cultivation quality was guaranteed through perfecting the academic management system.Satisfactory results were achieved in molecular medicine and cancer research center in Chongqing Medical University.