Objective To observe the value of preoperative magnetization transfer imaging(MTI)for predicting postoperative pancreatic fistula(POPF)after distal pancreatectomy(DP).Methods A total of 65 patients with pancreatic tumor who underwent DP and preoperative MR scanning were retrospectively enrolled and divided into clinically relevant POPF(CR-POPF)group(n=14,with grade B or C fistula),biochemical fistula group(n=31,postoperative drain fluid amylase level exceeding 3 times the upper limit of normal)and non-fistula group(n=20,postoperative drain fluid amylase level not exceeding 3 times the upper limit of normal)based on postoperative records.Clinical data and magnetization transfer ratio(MTR)of pancreatic tissue at the surgical margin were compared among 3 groups.The predictive value of MTR for CR-POPF was evaluated according to the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Results Patients' age,intraoperative blood loss and the proportion of pancreatic ductal adenocarcinoma in both CR-POPF group and biochemical fistula group were lower than those in non-fistula group(all adjusted P＜0.05),while no significant difference was found between the former two groups(all adjusted P＞0.05).MTR of pancreatic tissue at the surgical margin in CR-POPF group was lower than that in both biochemical fistula group and non-fistula group(both P＜0.05),whereas no statistical difference was detected between the latter two groups(P＞0.05).The AUC of MTR for predicting CR-POPF after DP was 0.727.Conclusion Preoperative MTI could be used to predict POPF after DP.

Objective To observe the value of preoperative magnetization transfer imaging(MTI)for predicting postoperative pancreatic fistula(POPF)after distal pancreatectomy(DP).Methods A total of 65 patients with pancreatic tumor who underwent DP and preoperative MR scanning were retrospectively enrolled and divided into clinically relevant POPF(CR-POPF)group(n=14,with grade B or C fistula),biochemical fistula group(n=31,postoperative drain fluid amylase level exceeding 3 times the upper limit of normal)and non-fistula group(n=20,postoperative drain fluid amylase level not exceeding 3 times the upper limit of normal)based on postoperative records.Clinical data and magnetization transfer ratio(MTR)of pancreatic tissue at the surgical margin were compared among 3 groups.The predictive value of MTR for CR-POPF was evaluated according to the area under the curve(AUC)of receiver operating characteristic(ROC)curve.Results Patients' age,intraoperative blood loss and the proportion of pancreatic ductal adenocarcinoma in both CR-POPF group and biochemical fistula group were lower than those in non-fistula group(all adjusted P＜0.05),while no significant difference was found between the former two groups(all adjusted P＞0.05).MTR of pancreatic tissue at the surgical margin in CR-POPF group was lower than that in both biochemical fistula group and non-fistula group(both P＜0.05),whereas no statistical difference was detected between the latter two groups(P＞0.05).The AUC of MTR for predicting CR-POPF after DP was 0.727.Conclusion Preoperative MTI could be used to predict POPF after DP.

Objective To explore the clinical prognostic value of rapid detection for plasma NT-proBNP levels on admission in patients with acute myocardial infarction.Methods 56 patients with AMI were measured plasma NT-proBNP imediately in hospital,and then they were divided into A,B and C group according to NT-proBNP levels (A group:＜ 500ng/L,B group:500-2 000ng/L,C group:＞ 2 000ng/L).The incidence of major adverse cardiac events (MACE including congestive heart failure,malignant arrhythmia,cardiogenic shock and sudden cardiac death) in subjects were observed respectively during hospitalisation and 30 days.Results The three group subjects with different NT-proBNP levels presented different incidence of MACE(A group:1,0;B group:3,1;C group:8,6) at duration of hospital stay,30days (x2 =6.705,P =0.035 ; x2 =7.957,P =0.008).With the NT-proBNP levels rising in AMI paitents,the inciedence of MACE increased.The incidence of MACE in A,B and C group were 6.6％,18.18％ and 73.69％ respectively.Conclusion In AMI patients,plasma NT-proBNP levels could predict early MACE incidence,which has an important value to evaluate the early clinical prognosis.

OBJECTIVETo construct an double-layered tube-shaped poly (lactic-co-glycolic acid) (PLGA) scaffold composited with vascular endothelial growth factor (VEGF)/ platelet-derived growth factor (PDGF), and to evaluate in vivo the axial vascularization from femoral arteriovenous bundle encapsulated.

METHODSEighteen male adult New Zealand rabbits were assigned randomly into 3 groups: Experimental group (n = 8), experimental control group (n = 8), empty control group (n=2). The femoral arteriovenous bundle were separated and encapsulated in double-layered tubeshaped PLGA scaffold prepared by solution casting and particle leaching. According to the way of cell factors being composited to the prepared double-layered scaffold: 1) experimental group: VEGF in inner layer and PDGF in outer layer; 2) experimental control group: VEGF in inner layer with blank outer layer; 3) empty control group: Pure blank. Specimens were retrieved at 7, 10, 14, 21 days postoperatively (7, 10 days in empty control group). The histological evaluation was performed.

RESULTSAt 7 days postoperatively, blood vessel sprouts were observed in experimental group and experimental control group, radially from the central femoral arteriovenous bundle. At 10 days postoperatively, completely penetrations of the double-layered scaffold by abundant new generated blood vessel sprouts were observed, and density descended gradiently from inside to outside. At 14 days postoperatively, new blood vessels in experimental group showed more thickness and layered structure of the wall, while monolayer endothelial cells in experimental control group. At 21 days postoperatively, new blood vessels in experimental group showed more mature characteristics, while less density of blood vessels in experimental control group. There was no obvious blood vessel structure in empty control group.

CONCLUSIONThe double-layered tube-shaped PLGA scaffold composited with VEGF/PDGF could induce early angiogenesis.

There is increasing interest in the clinical use of flattening filter-free (FFF) beams. In this study, we aimed to investigate the dosimetric characteristics of volumetric modulated arc radiotherapy (VMAT) with FFF beams for nasopharyngeal carcinoma (NPC). Ten NPC patients were randomly selected to undergo a RapidArc plan with either FFF beams (RA-FFF) or conventional beams (RA-C). The doses to the planning target volumes (PTVs), organs at risk (OARs), and normal tissues were compared. The technical delivery parameters for RapidArc plans were also assessed to compare the characteristics of FFF and conventional beams. Both techniques delivered adequate doses to PTVs. For PTVs, RA-C delivered lower maximum and mean doses and improved conformity and homogeneity compared with RA-FFF. Both techniques provided similar maximum doses to the optic nerves and lenses. For the brain stem, spinal cord, larynx, parotid glands, oral cavity, and skin, RA-FFF showed significant dose increases compared to RA-C. The dose to normal tissue was lower in RA-FFF. The monitor units (MUs) were (536 ± 46) MU for RA-FFF and (501 ±25) MU for RA-C. The treatment duration did not significantly differ between plans. Although both treatment plans could meet clinical needs, RA-C is dosimetrically superior to RA-FFF for NPC radiotherapy.
Adult ; Aged ; Feasibility Studies ; Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; radiotherapy ; Organs at Risk ; radiation effects ; Radiometry ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods ; Radiotherapy, Intensity-Modulated ; methods

Nasopharyngeal carcinoma (NPC) is sensitive to radiotherapy and chemotherapy.Combined chemoradiotherapy improved the survival of the patients with locally advanced NPC.However,a part of these patients did not gain the survival benefit from the combined chemoradiotherapy because of the additional serious adverse reaction.In order to achieve the best therapeutic gain after balancing the benefit and cost,all kinds of influencing factors of individualized chemoradiotherapy including the clinical and biological molecular factors which has a broad developing prospect must also be considered.

Objective To investigate the local-regional recurrence of nasopharyngeal carcinoma (NPC) 5 years after conventional radiotherapy and its prognosis.Methods From August 1989 to Decem ber 1999,1384 patients with newly histo-pathologicatly diagnosed NPC were treated with conventional radia tion.350 out of 1277 followed-up patients were diagnosed as local-regional failure.The intervals between completion of radiation and tumor relapse ranged from 6 months to 171 months.There were 62 patients with local-regional recurrence 5 years after the radiotherapy,including 41 in nasopharynx,19 in neck and 2 in na sopharynx and neck simultaneously.Thirty-seven patients with late local-regional recurrence received a sec ond course conventional radiotherapy.Results The median survival time was 44 months(95% CI = 30.4 -57.6) of patients with re-irradiation comparing with 14 months (95% CI = 7.1-20.8) of those without. The 5 year survival rate after re-irradiation was 42%.Conclusions Local-regional recurrence of nasopha ryngeal carcinoma can oeoure 5 years after radiotherapy.Second course converntional radiotherapy possesses good results.

OBJECTIVE: To establish a CDDP-resistant cell line from human nasopharyngeal carcinoma and evaluate its biological characteristics. METHOD: By continuously exposing and gradually increasing dose of cisplatin (CDDP), a resistant nasopharyngeal carcinoma cell line (HNE1/CDDP) was established. Drug sensitivity of this cell line was detected by MTT assay; the alterations of its biological characteristics were determined using light microscopy, cell counting and flow cytometry (FCM); its ability of adhesion, migration and invasion were also evaluated. RESULT: HNE1/CDDP cell line was developed after 10 months with stable resistance to cisplatin with the resistance index was 5.83. HNE1/CDDP cell exhibited cross-resistance to many other chemotherapeutic agents (carboplatin, oxaliplatin and etoposide, etc). The morphology of HNE1/CDDP changed; doubling time prolonged; and the cell number of S-phase and G2/M-phase decreased while of G0/G1 phase increased compared with parental cells. The ability of adhesion, migration and invasion had no difference between the parental and the resistant cells. CONCLUSION HNE1/CDDP cell line shows the typical and stable resistant phenotype and can be used as a research model.
Antineoplastic Agents ; pharmacology ; Cell Line, Tumor ; Cisplatin ; pharmacology ; Drug Resistance, Multiple ; Drug Resistance, Neoplasm ; Humans ; Nasopharyngeal Neoplasms

This paper introduces the application of motor medical equipment independently developed by ourselves in combined medical succor action between China and Gabon.Problems about equipment using are summarized,and the corresponding resolvent to every different problem is listed,which will help to provide some references to the evolution,demonstration and development of medical equipment in the future.