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.

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

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.

Objective To investigate the changes of the intervertebral angle and retrolisthesis of the last instrumented vertebrae (LIV) after anterior correction and instrumentation in adolescent idiopathic scoliosis patients. Methods By reviewing the medical records and roentgenograms of adolescent idiopathic scoliosis patients who underwent anterior correction and instrumentation in recent 4 years, their Cobb angle of the curve, correction rate, trunk shift, LIV rotation, obliquity between LIV and the pelvis, intervertebral angle and retrolisthesis of the LIV were measured and analyzed. Results There were total 50 patients included. The apex of the main curve was located at thoracolumbar junction or lumbar spine. The coronal Cobb angle of the main curve were 47.78??9.39? and 10.32??8.50? before and after surgery respectively, with an average correction rate of 79.05%. The average rotation of LIV before surgery was 1.54??0.58?, and improved to 1.06??0.47? after surgery. The obliquity between LIV and the pelvis before and after surgery were 23.80??7.91? and 9.16??9.46? respectively. The intervertebral angle was 3.72??3.05? before surgery, and -2.22??5.85? on Bending films, 1.56??5.97? after surgery respectively. The changes were of significance in the intervertebral angle after surgery compared with that before surgery(P=0.029). The angle was 4.87??7.95? at final follow up, the change was also significant compared with that after surgery(P=0.038). 19 patients had LIV retrolisthesis postoperatively, and the average retrolisthesis distance was (4.79?1.75) mm. There were significant differences between the patients with retrolisthesis and the patients without retrolisthesis in apical vertebral rotation and intervertebral angle on Bending films(P=0.047 and P=0.033) respectively. Conclusion The intervertebral angle is much improved after anterior correction and instrumentation surgery, but it increases gradually at follow up. The retrolisthesis of LIV may be correlated with the apical vertebral rotation before surgery and the intervertebral angle on Bending films.

Objective To report the design and manufacture of a novel orientation device of elbow rotation center.Methods The anatomical data of distal humeral elbow were obtained from 3 reports on the anatomy of the distal humerus retrieved from CNKI from 2004 through 2014.Software UGS.0 NX,CAD/CAM animation and video were used to design the 3D model of our novel orientation device of elbow rotation center.The glass fiber physical model of the device was manufactured using 3D printing technology.Five healthy volunteers were recruited for a simulated surgery experiment to test the efficacy and accuracy of the device,including 4 males and 1 female,from 25 to 36 years of age.Results No change was observed before and after the device was disinfected regarding the length (129 mm),width (116 mm) or height (215 mm),or other shapes.Satisfactory X-ray images of the elbow were obtained in the 5 volunteers.The fluoroscopy frequency required ranged from 6 to 11 times,averaging 8.2 times.The time needed for orientation ranged from 442.2 to 554 seconds,averaging 489.2 seconds.Conclusions Our self-designed orientation device can be used to accurately position and orientate the rotation center of elbow joint,showing its reasonable design.Glass fiber materials can be used to manufacture our orientation device.

OBJECTIVE:To study the influence package on weight and appearance and active ingredient content of unguent.METHODS:Unguent samples from6hospitals were examined and their appearance observed by adopting Ch.P.2000“Determination of least volume”and active ingredient content of analytic methods for each sample and observe appearance.RESULTS:No remarkable change of airtight packing samples and differ change of general packing samples.CONCLUSION:Suggested to improve the packing and original validity can be suitable for unguent of airtight packing.