Neoadjuvant chemoradiotherapy (nCRT) is used to downstage locally advanced rectal cancer before surgery, in order to increase the chance of radical resection, reduce local recurrence, and improve overall survival. Accumulating data suggest that tumor response to nCRT is time dependent. A delay between nCRT and surgery may increase the proportion of patients that achieve a favorable response, and 4-6 weeks are considered to be a universal interval. However, delayed surgery beyond 6-8 weeks may increase the technical dififculty, and the risks of surgical complications and recurrence or metastasis. This article brielfy reviews the relevant literature to evaluate the efifciency and safety of delayed surgery.

OBJECTIVETo explore different regulatory effects of electroacupuncture (EA) at the same acupoint on the heart and the stomach.

METHODSEighty male SD rats were randomly divided into eight groups equally, i.e., the Neiguan (PC6) group, the Quchi (LI11) group, the Tianshu (ST25) group, the Danzhong (RN17) group, the Zusanli (ST36) group, the Sanyinjiao (SP6) group, the Xinshu (BL15) group, and the Weishu (BL21) group, 10 in each group. The regulatory effects of EA (2/15 Hz, 3 mA, 2 min) at different acupoints on the gastric motility (intragastric pressure) and the cardiac function (the left ventricular pressure) were observed. The mean values of effect of two-min pre-EA and after-EA were compared.

RESULTSCompared with the pre-EA in the same group, the left ventricular pressure decreased in the Neiguan (PC6) group, the Quchi (LI11) group, the Danzhong (RN17) group, the Sanyinjiao (SP6) group, and the Xinshu (BL15) group (P <0.05). The intragastric pressure increased in the Quchi (LI11) group, the Zusanli (ST36) group, the Sanyinjiao (SP6) group, and the Xinshu (BL15) group, while it decreased in the Tianshu (ST25) group, the Danzhong (RN17) group, and the Weishu (BL21) group (P <0.05). The difference of the left ventricular pressure was sequenced from high to low as Xinshu (BL15) >Danzhong (RN17) >Neiguan (PC6) >Sanyinjiao (SP6) >Quchi (LI11). The difference of the intragastric pressure was sequenced from high to low as Tianshu (ST25) >Weishu (BL21) > Xinshu (BL15) > Danzhong (RN17) > Zusanli (ST36) > Sanyinjiao (SP6) > Quchi (LI11).

CONCLUSIONSEA at the same acupoint (2/15 Hz, 3 mA) showed different regulatory effects on the heart and stomach. There existed some difference in the direction and size due to the acupoint location, meridians, dominant nerve segment or relating organs. A fixed effect direction to the specific target was also shown.

Acupuncture Points ; Animals ; Electroacupuncture ; Heart ; physiology ; Male ; Meridians ; Rats, Wistar ; Stomach ; physiology

Objective To compare the effects of sevoflurane versus propofol on a tourniquet-induced lower extremity ischemia-reperfusion (I/R) injury in patients undergoing orthopedic operation.Methods Fifty-four ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 44-85 kg,scheduled for elective orthopedic operation,were randomly assigned into 3 groups (n =18 each)∶ control group (group C),propofol group (group P) and sevoflurane group (group S).After lumbar plexus-sciatic nerve block,the laryngeal mask airway insertion was facilitated with propofol 2-4 mg/kg and anesthesia was maintained with infusion of propofol at 2-4 mg· kg-1 · h-1 during operation in group P.In group S,8 ％ sevoflurane was inhaled,the laryngeal mask airway was inserted and anesthesia was maintained with inhalation of 2％ sevoflurane during operation.A tourniquet was applied and inflated (300 mm Hg)during 15-20 min after administration of propofol or sevoflurane in groups P and S,and a tourniquet was also applied at the same time point in group C.The tourniquet was released at the end of operation.Postoperative analgesia was performed with oral meloxicam or intramuscular pethidine and VAS score was maintained ＜ 3.Blood samples were taken after admission to the operating room (T1) and 30 min after tourniquet release (T2) to determine the plasma concentrations of MDA and TNF-α.The changing rate of MDA and TNF-α concentrations was calculated.The tourniquet-related adverse events and amount of analgesics consumed within 24 h after operation were recorded.Results No tourniquet-related adverse events occurred in all the patients.Compared with group C,the plasma concentrations of MDA and TNF-α and changing rate were significantly decreased at T2 in groups P and S (P ＜ 0.05).There were no significant differences in the plasma concentrations of MDA and TNF-α and changing rate between group S and group P (P ＞ 0.05).Compared with the baseline value at T1,no significant change was found in the plasma concentrations of MDA and TNF-α at T2 in groups P and S (P ＞ 0.05),and the plasma concentrations of MDA and TNF-α were significantly increased at T2 in group C (P ＜ 0.05).There was no significant difference in the amount of analgesics consumed within 24 h after operation between the three groups (P ＞ 0.05).Conclusion Both sevoflurane and propofol can reduce a tourniquet-induced lower extremity I/R injury in patients undergoing orthopedic operation and the efficacy is comparable.

Objective To investigate the methods for localization of the lung segments on three-dimentional (3D) pulmonary perfusion SPECT/CT imaging.Methods Twelve healthy adults were recruited into this study.Lung segments were defined based on the anatomical criteria of CT on transaxial, sagittal and coronal images, including apical, posterior, anterior segments in right upper lobe ( RUL), lateral, medial segments in right middle lobe ( RML), superior, anterior basal, lateral basal, posterior basal segments in right lower lobe (RLL); apical posterior, anterior, superior lingual, inferior lingual segments of left upper lobe ( LUL), superior, medioanterior basal, lateral basal, posterior basal segments of left lower lobe (LLL).Results (1) Eleven typical sections were selected on transaxial SPECT pulmonary perfusion imaging:sternoclavicular joint, supra-arch vessels, aortic arch, azygous arch, right upper lobar bronchus, left upper lobar bronchus, middle lobar or lingual bronchus, basal trunk of bronchus, lower lobar vein, superior and inferior basal vein and basal vein.(2) Twelve typical sections were defined on sagittal imaging:left hilum, bifurcation of left principal bronchus, septa of left pulmonary artery, cardiac apex, the first and second sections left to cardiac apex; right hilum, bifurcation of intermite bronchus, interlobar artery, bifurcation of interlobar artery, the second and third sections right to right atrium.(3) Seven typical sections were defined on coronal imaging:sternoclavicular joint, ascending aorta, bifurcation of pulmonary artery, bifurcation of trachea, intermite bronchus, basal vein and thoracic aorta.Conclusion The developed method was able to localize lung segments on pulmonary perfusion SPECT imaging.

Objective To explore the molecular mechanism of hypophrenia induced by Down syndrome (DS).Methods Ts65Dn mice were used as DS animal model.Three female mice and three male mice of three to twelve weeks old were mated.Among the 17 first-generation mice alive,five mice remained Ts65Dn trisomy and 12 mice were normal.Five Ts65Dn mice and five normal mice were selected randomly as Ts65Dn group and control group,and bred till 16 to 18 weeks old for experiments.Differential proteins in hippocampus of mice were tested by isobaric tags for relative and absolute quantitation (iTRAQ).Expressions of the differential proteins in Ts65Dn group were detected compared with those in control group.Results A total of 2805 proteins were identified in hippocampus of Ts65Dn group and control group,and significant differences were observed in the expressions of 374 proteins.Compared with those in control group,expressions of 195 proteins increased and 179 reduced in Ts65Dn group.Sorted by P value from low to high,the seven proteins with the lowest P value were uncharacterized protein C2orf47 homolog,isoform 2 of filamin A-interacting protein 1-like,zinc finger protein,isoform 1 of pericentriolar material 1 protein,SEC23 interacting protein,BAG family molecular chaperone regulator 3 and serpin H1.Conclusions Differential proteins are observed in hippocampus of Ts65Dn mice,perhaps closely correlating to neurological defects.The new technology of iTRAQ helps to screen and identify differential proteins in hippocampus.

Objective To explore the relationship between high-risk human papillomavirus (HPV) DNA and biological behavior of cervical carcinoma. Methods Sixty-six patients of cervical carcinoma with cytological examinations and 103 patients of cervical carcinoma followed-up after surgical operation were selected for high-risk HPV DNA test with second-generation hybrid capture technique (HC2 Ⅱ). Results ①HPV DNA was positive in 62 and negative in four of 66 patients of cervical carcinoma with an overall prevalence of 94%. ②There was no significant difference in positive HPV DNA of patients with cervical carcinoma between their varied clinical stages and pathologic grades. But, HPV positivity and HPV DNA load in patients with myometrial invasion were higher than those in patients without invasion (P < 0. 05).③ HPV DNA conversed to negative in 99 of 103 patients (96%) with cervical carcinoma after surgical operation from positivity before operation. Conclusions High-risk HPV infection may correlate with angiogenesis, invasion and metastasis of cervical carcinoma and HC2 Ⅱ can be used as an effective method to detect HPV DNA.

Cheek ; pathology ; Head ; pathology ; Humans ; Keratosis ; diagnosis

ObjectiveTo explore the surgical techniques, efficacy and the management of complicated ocular trauma with anterior-posterior segment complications such as cyclodialysis. Methods Fifty-five patients (55 eyes) with complicated ocular trauma were enrolled in this study. Among them, there were 35 cases with eyeball contusion and 20 cases of eyeball rupture. Preoperative visual acuity was from no light perception to 0. 15, intraocular pressure (IOP) ranged from one to 10 mm Hg (1 mm Hg=0. 133 kPa).Cyclodialysis, vitreous hemorrhage or retinal detachment were revealed by B-ultrasound and ultrasound biomicroscopy (UBM). Cyclodialysis clefts ranged from one to 12 clock-hours. All patients underwent 3-port pars plana vitrectomy with gas/silicone oil tamponade and ciliary body reattachment by cryotherapy (cyclodialysis clefts ≤ three clock-hours) or suture fixation ( cyclodialysis clefts ＞ three clock-hours).Healing after surgical trauma, visual acuity, intraocular pressure, intraocular hemorrhage, ciliary body and retinal reattachment were followed up. Results In one month after surgery, UBM showed 54 patients out of 55 patients had good ciliary body reattachment. Gonioscopy revealed cyclodialysis still existed in one patient, and this was cured by a second surgical suture fixation. In three months after surgery, ocular trauma healed in all 55 patients, the visual acuity ranged from no light perception to 0. 15, with a best corrected visual acuity of 0.8. The ciliary body and retina had good reattachment. IOP of 52 patients was normal; IOP of three patients was still lower than 10 mm Hg. Three patients had secondary glaucoma which was treated by glaucoma surgery. Conclusions Complicated ocular trauma with cyclodialysis can be treated with vitrectomy and cryotherapy or transscleral sutures. The procedure is safe and effective.

Objective To investigate the correlation among Lp (a),cerebral infarction and carotid atherosclerosis.Methods 180 cases were equally divided into 3 groups (60 cases in each group).The patients with both cerebral infarction and carotid atherosclerosis composed one group(cerebral infarction group for short) ;the patients of carotid atherosclerosis which without cerebral infarction composed another group(no cerebral infarction group for short) ;the control group composed with those who had neither cerebral infarction nor carotid atherosclerosis.The level,outlier detection rate about Lp(a) and usual risk factors of cerebral infarction were compared in this research.Results The level and detection rate of Lp(a) in the cerebral infarction group were (512 ± 156) mg/L and 46.7％ ;the level and detection rate of Lp(a) in the no cerebral infarction group were (316 ± 87)mg/L and 20.0％ ;the level and detection rate of Lp(a) in the control group were (199 ± 123) mg/L and 5.0％.The differences of the level and outlier detection rate of Lp(a) among the three group were significant(F=13.87,x2 =29.394,P ＜0.01).Cerebral infarction patients had more usual risk factors of cerebral infarction (hypertension,diabetes,hyperlipemia,drinking,smoking,obesity and lack of exercise) than those who without cerebral infarction (x2 =15.523,P ＜ 0.01).Conclusion The abnormal of Lp(a) was an important risk factor of cerebral infarction.The general survey of Lp(a) was significant in the primary and secondary prevention of stroke.To the people whose assay of Lp(a) was abnormal,the control of governable risk factors of cerebral infarction should actively be carried out.

This article was aimed to observe the intracardiac pressure under different states by electric acupuncture (EA) on yuan-source point of PC7-Daling and to explore the acupuncture effect features. Catheterization was applied through the right common carotid artery to the left ventricle in order to record the left intraventricular pressure. The intracardiac pressure was used as an indicator. The effects of EA on PC7-Daling to the left intraventricular pressure of rats were observed under the states of normal physiology, isoproterenol and propranolol, respectively. The results showed that for the immediate effects of acupuncture, EA on PC7-Daling can obviously excited the intracardiac pressure of normal rats. Under the state of intravenous application of propranolol and isoproterenol, no obvious reac-tions during EA on PC7-Daling. From the effects of acupuncture, under normal conditions, EA on PC7-Daling had excitatory effect; under propranolol state, it had inhibitory effects; and the effect of isoproterenol state was variable. It was concluded that according to the specificity of acupoint effect, PC7-Daling can excite intracardiac pressure.