Objective To explore the diagnosis and re-operation of the recurrent retroperitoneal soft tissue sarcoma(RPS).Methods Clinical data of 25 patients with recurrent RPS were retrospectively analyzed.Results All of 25 cases of recurrent RPS were diagnosed by operation and postoperative pathologic examination.They underwent a total of 42 time operations,with mean time of re-operations was 1.68.Of the 42 time operations,26 time were complete resection,11 time partial resection and 5 time only biopsy.A total of 19 cases underwent removal of contiguous intra-abdominal organs and 5 underwent resection of major invaded blood vessel.The 1-,3-and 5-year survival rate of recurrent RPS was 52.0%,40.0% and 28.0% respectively.The rate of complete resection in recurrent RPS with major blood vessel invasion was 35.7%.In contrast,the complete resection rate in recurrent RPS without major blood vessel invasion was 75%(P=0.013).On the other hand,there was no significant difference in complete resection rate between the recurrent RPS with adjacent organs invasion and the recurrent RPS with no adjacent organs invasion(P=0.462).Conclusions Preoperative imaging results are crucial factor for assessment of operative resectability.Unless there are obvious comtraindications,recurrent RPS should undergo aggressive surgical excision.

Objective To review the advance of gene diagnosis and gene therapy on gastric cancer. Methods Literatures about the advance of gene diagnosis and therapy on gastric cancer were reviewed. Results Detection of tumor marker by gene technique is important for early diagnosis, follow-up and therapy evaluation of gastric cancer in clinic. But there are still many problems in gene therapy of gastric cancer. Conclusion Gene detection and gene therapy will become important supplementary means for diagnosis and treatment of gastric cancer.

Objective To study the influence of combined anti-CD-40L and low dose CsA immunotherapy on the induction of immune tolerance in orthotopic liver transplantation rats.Methods Recipients were divided into the following groups.Group A,SD→SD;Group B,SD→Wistar without any treatment;Group C,SD→Wistar with CsA therapy from d1 to d5;Group D,SD→Wistar with CsA from d1 to d5 and anti-CD40L mAb in d0 and d2,and Group E,SD→Wistar with CsA from d1 to d5 and anti-CD40L mAb in d0 and d2 plus autotransfusion before operation.The recipient survival time,histologic changes of allograft and the level of cytokines in peripheral blood were observed.Results The survival period of recipients in Groups A,D and E was significantly longer than that in Groups B and C.The acute rejection response in Groups D and E decreased prominently.The serum level of IL-2 and IFN-? in Group B were significantly higher than those in other groups,while the serum level of IL-4 and IL-10 in Groups D and E was elevated much more than those in Group B(P

Objective To evaluate the role of MRA,IPVG and DUS in the hemodynamics studies of portal hypertension.Methods Thirty-eight patients with portal hypertension were examined with Philips Gyroscan 1.0 Tesla MR imaging system.3D-DCE MRA and 2D-PC MR were used for study of portal venous anatomy and its hemodynamics.The results were compared with those obtained from IPVG and DUS.Results 3D-DCE MRA could clearly display the anatomical imaging of portal venous system and its imaging quality was better than that of IPVG.The data of hemodynamics from 2D-PC MR including diameter,blood velocity and blood flow were closely correlated to those from DUS.Conclusion As a non-invasive technique,MRA can display the anatomy of portal venous system and measure its hemodynamics exactly.It should be applied as the first choice in hemodynamics evaluation for portal hypertension.

Objective[WT5”BZ] To evaluate the role of radionuclide 99m Tc EHIDA for hepatobiliary imaging in rats with orthotopic liver transplantation (OLT) [WT5”HZ]Methods[WT5”BZ] Male SD rats were divided into 2 groups: normal controls (NL, n =10)and normal rats with OLT (NL OLT, n =8). Dynamic scintigraphy using single photon emission computed tomography (SPECT) was used for hepatobiliary imaging. [WT5”HZ] Results[WT5”BZ] The time of peak activity (t max ) and half peak activity(t 1/2 ) in the liver and intestine (GI) imaging time (min) in NL and 6 uncomplicated NL OLT rats were 3 05?0 31 vs. 3 63?0 65 ( P 0 05), respectively. The time active curves and imaging of NL OLT rats were similar to that in NL rats.The t max and t 1/2 in the liver, GI imaging time and the time active curves in 2 complicated NL OLT rats were significantly different compared with that of NL rats. Radionuclide leak occurred in 1 NL OLT rat.[WT5”HZ] Conclusions [WT5”BZ] Radionuclide 99m Tc EHIDA effectively monitors both structural and functional changes of the liver graft. [WT5”HZ]

Objective To investigate the effects of hemoglobin concentration on portal hypertension associated with hyperdynamic state.Methods According to blood hemoglobin level below or above 110g/L,55(nontreated) portal hypertension patients were divided into anemic and nonanemic groups,and the relevant(hemodynamic) and clinical data were examined and analyzed retrospectively.In order to avoid the effects of differences in hepatic function,data were analyzed separately according to the Child class.Results(Compared) to the nonanemic group,the anemic group had markedly increased cardiac output [(7.4?(1.7L))/min vs(6.3?1.9L)/min,P=0.028] and increased free portal pressure [(29.1?3.1)mmHg vs(26.8?3.3)mmHg,P=0.012],and a markedly decreased mean arterial pressure [(84?10.7)mmHg vs(97.1?12)mmHg,P

Post stroke depression (PSD) is a common complication after senile cerebrovascular diseases. It influences both physical and mental health of the elderly severely. So, the attention should be paid to not only the medical cares but also the function and mental rehabilitation, in order to improve the qualities of PSD patients' lives and decrease the death rate.

Objective To investigate the efficacy and toxicity of neoadjuvant regional arterial chemotherapy in the treatment of advanced gastric cancer. Methods The clinical data of 158 patients with advanced gastric cancer and with the same clinical stages who were admitted to Renji Hospital of Shanghai Jiaotong University from February 2002 to May 2005 were retrospectively analysed. Preoperative regional arterial chemotherapy was applied to 76 patients (test group) and the remaining 82 patients only received surgical treatment (control group). The chemotherapy regimen was epirubicin (50 mg/m2) + cisplatin (60 mg/m2) + 5-fluorouracil (1000 mg/m2).This regimen was modified to oxaliplatin (130 mg/m2) + 5-fluorouracil (1000 mg/m2) since 2003, and surgery was performed 6-11 days after the chemotherapy. All patients received postoperative intravenous chemotherapy.The clinical effects, radical resection rate, operative complications and long-term survival of the two treatment methods were evaluated. All data were analysed using the chi-square test and Kaplan-Meier analysis. Results The radical resection rate was significantly higher at 86% (65/76) in the test group compared with 71% (58/82)in the control group ( x2 = 5.01, P ＜ 0. 05 ). The toxicity of the chemotherapy in the test group was mild. The postoperative complication rate was 20% (15/76) in the test group and 16% (13/82) in the control group, with no significant difference between the two groups (x2 = 0.41, P＞0.05). The median survival time was 41 months in the test group and 23 months in the control group. The 5-year overall survival rate was higher in the test group (44.6%) than that in the control group (29.1%) (x2 =3.95, P＜0. 05). Conclusions Neoadjuvant regional arterial chemotherapy is well tolerated by patients with advanced gastric cancer. It is also effective for increasing the radical resection rate and improving the long-term survival.

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.

BACKGROUND:The bony crista has been found in the distal humeral medullary cavity,but its specific morphological characteristics and clinical significance are not clear.OBJECTIVE:To study the morphology of bony crista inside the distal intramedullary of the human humerus and its potential clinical relevance.DESIGN,TIME AND SETTING:CT scanning and measurement as well as visualized observation to the specimen for the dry adult humeri was performed at CT Room and Department of Orthopaedics,First Affiliated Hospital,Nanchang University from June to December 2007.MATERIALS:A total of 80 dry adult humeri (left:49;right:31) were purchased from the Department of Anatomy,Medical College of Nanchang University,excluding the fractured and lesion humerus.METHODS:The low 1/3 of eighty human humeri were scanned by 16 layer spiral CT.The morphological features of the intramedullary bony prominence above the olecranon fossa was described in terms of coronal plane,sagittal plane and transverse section after three-dimensional reconstruction.The low 1/3 of twenty humeri were then split vertically in the middle line in coronal plane,to view the intramedullary bony crista directly.MAIN OUTCOME MEASURES:The bony crista mainly located on the medial or lateral side,the range of the bas'dar part of the bony crista,alinement characteristic of the bony crista.RESULTS:The extent of intramedullary bony crista ranged from 1.9 to 3.2 cm (mean 2.6 cm) above the olecranon fossa,the density similar to cortical bone,with an basement posterior,and medial part and lateral side intero-inferiody incline.59 out of the 80 humeri,medial side dorminated;on the rest humeri the lateral side dorminated.2 or 3 parallel lines on the dorminate side,irregular alignment on the other side.CONCLUSION:The study described the morphology of the distal intramedullary bony crista of the humerus,which has never been reported so far.In addition,its clinical relevance in terms of the internal fixation of fracture on the distal humerus and elbow arthroplasty was also demonstrated.