Objective To evaluate the value of multi-modality imaging (PET/CT+CAG+CMRI) in post myocardial infract (MI) patients followed coronary artery bypass graft (CABG) and autologous bone marrow stem cell (BMSC) therapy.Methods A total of 43 patients with MI (27 males, 16 females, age range: 47-72 years) were prospectively enrolled in the year 2012 between January and December.All patients underwent CABG+BMSC transplantation and were divided into 3 groups according to the time interval between two treatments (group 1: 0-3 d;group 2: 4-14 d;group 3: 15-30 d).All patients were orderly scanned with CMRI, PET/CT (13N-NH3·H2O/18F-FDG) and CAG at different time-points pre-/post-treatment.The quantitative parameters included vascular stenosis degree(VSD), LVEF, percentage size of infarction (PSI), the number of segments in mismatched myocardial perfusion/metabolic and the K value for radioactive distribution grading.One-way analysis of variance and the least significant difference t test were used to compare parameters before and after treatment in the same group and among three different groups.Results Regarding PET/CT diagnostic efficacy of abnormal myocardial segments, the sensitivity, specificity, positive predictive value and negative predictive value were 95.4%(540/566), 87.3%(144/165), 96.3%(540/561) and 84.7%(144/170), respectively.After CABG and BMSC transplantation treatments for 12 months, VSD decreased significantly((69.1±9.5)%;F=12.854, P<0.05), comparing with the baseline ((74.8±7.9)%;t=3.074, P<0.05).Comparing to the baseline, LVEF in 3 groups increased slightly(F values: 0.906,0.298,0.059, all P>0.05).PSI of patients in group 2 decreased greatly after 12 months treatment ((35.70±12.59)%;F=3.792, t values:-2.916-4.059, all P<0.05).K values for radioactive distribution grade decreased obviously after 1 month and 12 months treatment comparing to the baseline (11.79±1.87,12.39±2.35,14.05±2.15;F=4.212, t values:-4.619,-0.989, all P<0.05).Number of myocardial perfusion/metabolic abnormal segments in group 2 after 1 month treatment was lower comparing to the baseline and 24 months treatment (10.17±0.66, 12.92±0.99, 14.17±1.21;F=3.543, t values:-2.146,-2.898, all P<0.05).The PSI, mismatched segments and K values post-treatment were not significantly different between group 1 and 3 (F values: 0.093-1.364, all P>0.05).Conclusions Multi-modality imaging may be used for accurately detecting abnormal myocardium and predicting prognosis.CABG+BMSC therapy during day 4-14 post-MI may temporarily improve perfusion and metabolism in viable myocardium, but the long term prognosis seemed not be improved.

OBJECTIVETo explore use of interleukin-10 receptor (IL-10R) gene mutation in diagnosis and pathogenesis of neonatal inflammatory bowel disease (IBD) in 2 suspected cases.

METHODTwo cases of sibling brothers who had suspected IBD from Guangzhou Women and Children's Medical Center Affiliated to Guangzhou Medical University during the year 2010-2014 were enrolled in the study. The proband, male, 26 days old, weight 3.73 kg, presented with recurrent fever, increased stool frequency since 9 days of age, and was hospitalized at the age of 6 months in 2014. The proband's brother, male, 6 months old, weight 8 kg, had repeated bloody and mucous diarrhea for more than five months, recurrent fever five days, and was hospitalized in 2010. The blood samples were collected from the children and their families for IL-10 receptor genes including IL-10 receptor α subunit (IL-10RA) and β subunit (IL-10RB) PCR amplification. Reverse transcription polymerase chain reaction (RT-PCR) was used to amplify the proband IL-10RA transcripts. Sequencing was performed on the PCR products forward and reversely. Western blot analysis was used for protein expression of the proband and normal control's IL-10RA and P-STAT3 (Tyr705) expression after IL-10 stimulation, TNF-α level was detected using Human TNF-α ELISA Kit after PBMC was cultured and stimulated.

RESULTThe proband and his brother were IBD patients. Genome sequencing showed mutation in c.537G>A, namely the exon 4 and intron 4 connections changed CA/GT for CG/GT. Sequencing of the RT-PCR products and T-A clone showed that the mutation was (c.519-537del GGTGCCGGGAAACTTCAC, p.LYS173ASNfs*7), as the splice mutation. Two gene mutations were novel mutation. The parents were the mutations carrier. Both of the children were compound heterozygous mutations in IL-10RA. The Western blot analysis showed that the patient and normal children can express IL-10RA protein, however, the function of IL-10RA had obvious defects in the patient, IL-10RA downstream signaling pathways P-STAT3 had no expression. The average level of TNF-α secreted by PBMC after LPS + IL-10 co-stimulation in patient was significantly increased as compared with control group ((2 100±356) vs. (200±50) ng/L, t=9.154, P=0.001), suggesting that interleukin-10-dependent negative feedback regulation is disrupted in the patient.

CONCLUSIONIL-10 receptor mutations can cause neonatal-IBD, for which common treatment effect is poor. Early diagnosis and allogeneic stem-cell transplantation performed may save the children's life.

ObjectiveTo compare the effects of different surgical approaches on SiewertⅡ (esophageal invasion ≤3 cm) adenocarcinoma of esophagogastric junction.MethodsThis retrospective study included 251 cases of Siewert Ⅱ adenocarcinoma of esophagogastric junction undergoing D2 or D2 + total gastrectomy by transabdominal approach ( TA group, 128 cases) or left thoracoabdominal approach ( LTA group, 123 cases).Operation time,blood loss, extent of esophageal resection, number of lymph nodes dissected,morbidity, mortality and the survival rate were a analyzed between the two groups.ResultsThe 3,5-year overall survival rates were 62. 5％, 39.0％ ( TA group) and 54. 9％, 31.9％ ( LTA group),respectively (P ＞ 0. 05). Length of esophageal resection in the LTA group were slightly longer than that in the TA group (5. 6 ± 1.1) cm vs. (5.4 ± 1.1 ) cm (P ＜0. 05), the positive surgical margin between two groups were not statistically different[1.6％ ( LTA group) vs. 3. 1％ ( TA group), ( P ＞ 0. 05 )]. The mean number of removed lymph node were not significantly different between two groups[23.4 ± 8.7 ( TA group) vs. 23.7 ± 8.4 ( LTA group)], ( P ＞ 0. 05 ). The operation time (227 ± 24) min, blood loss (270 ± 78)ml, and perioperative morbidity( 13.3％ ) and mortality( 1.6％ ) in TA group was significantly better than the LTA group[(261 ±32) min, (342 ±59)ml, 26.8％, 6.5％](P＜0.05).ConclusionsFor Siewert Ⅱ adenocarcinoma at esophagogastric junction (esophageal invasion ≤3 cm) ,total gastrectomy with D2 or D2 + lymph node dissection through the transabdominal approach could achieve curative purposes, with a low morbidity and mortality rate.

Objective To explore the efficacy and feasibility of laparoscopy-assisted radical total gastrectomy in the treatment of cancer of the cardia and fundus. Methods The clinical data of 176 patients with cancer of the cardia and fundus who received total gastrectomy at the Union Hospital of Fujian Medical University from April 2007 to April 2009 were retrospectively analysed. Among the patients, 81 received laparoscopic total gastrectomy ( LATG group) and 95 received open total gastrectomy ( OTG group). The patients' intra- and postoperative conditions, clearance of lymph nodes, morbidity and mortality were analysed using the chi-square test and t test. Results All the operations were successfully carried out. The intraoperative blood loss was (98 ± 84) ml in the LATG group and (339±245) ml in the OTG group. Three patients in the LATG group and 19 in the OTG group received blood transfusion. The time to first flatus and postoperative hospital stay were (3.9 ± 1.1) days and (13 ± 5) days in the LATG group, and (5.0 ± 1.6) days and (15 ± 5) days in the OTG group, respectively.There were significant differences in the time to first flatus and postoperative hospital stay between the LATG group and OTG group (t = 4.16, x2 = 6.82, t = 4. 57, 2. 83, P ＜ 0. 05). The mean number of lymph nodes dissected was 28 ± 12 in the LATG group and 29 ± 11 in the OTG group, with no significant differences between the two groups (t = 0. 42, P ＞0.05). The number of lymph nodes dissected in patients with T1, T2 and T3 stages were 21 ±8, 25 ±7 and 29 ± 11 in the LATG group, and 29 ± 12, 31 ±9 and 28 ± 11 in the OTG group, respectively,with no significant differences between the two groups (t = 1.53, 1.90, 0. 65, P ＞ 0.05). The morbidity and mortality rates of the LATG group were 11%( 9/81 ) and 0, and 19% ( 18/95 ) and 1% ( 1/95 ) in the OTG group, with no significant differences between the two groups (x2 = 2.07, 1.18, P ＞ 0.05). Conclusion The efficacy of laparoscopy-assisted radical total gastrectomy is similar to that of open gastrectomy. Laparoscopy-assisted radical total gastrectomy is a safe and feasible procedure that leads to quick postoperative recovery.

Objective To explore the predictive value of microvessel density(MVD)and blood vessel invasion(BVI)in hepatic metastasis from early-stage rectal cancer.Methods MVD and BVI in the tumor tissue from 380 patients with stage I and II rectal cancer was determined by immunohistochemical S-P method with anti-CDIOS antibody and anti-CD34 antibody,respectively.Multinomial logistic regression was performed to analyze the predictive value of MVD and BVI in hepatic metastasis from early-stage rectal cancer.Results CD105 was expressed in newborn blood vessels,not in normal blood veseels.in the rectal cancer tissue.MVD was correlated with histological type and infiltration depth(P＜0.05).Besides histological type and infiltration depth,BVI was also correlated with histological grade.Multivariate analysis revealed that histological type,tumor infiltration depth,BVI,adjuvant therapy,and MDV were independent predictors of hepatic metastasis from rectal cancer.The risk of hepatic metastasis in patients with postive expression of either MVD or BVI or both were significant higher than that in patients with low expression of MVD and those without BVI expression[hazard ratio(95%CI),4.210(2.182-11.214)].Conclusion BVI and MVD are independent predictors of hepatic metastasis from stage I and II rectal cancer.Combined detection of MVD and BVI may help to predict the clinical outcome of patients with early-stage rectal cancer.

Objective To investigate the effect of Intedeukin-18 (IL-18) on Th1/Th2 balance and its antitumor mechanism in C57BL/6 mice Lewis lung cancer model. Methods 24 C57BL/6 mice were randomly divided into three equal groups: group A(IL-18 injec-tion group, n = 8), group B (Lewis lung cancer model, n = 8) and group C (normal control group, n = 8). The Lewis lung cancer cells were cultured and implanted subcutaneously into the group A and group B. IL-18 and NS were given to group A and B respectively by intrap-eritoneal injection on the 7th day (once every day, 7 times altogether), but group C was not given any treatment. Enzyme-linked immunosor-bent assay (ELISA) was used to detect the Th1/Th2 cytokines. Health status in all the animals was evaluated; the volume and weight ofsubcutaneous tumors were measured. Results The concentration of IFN-γ in group A and C were significantly higher than those in group B (P <0.05), and the concentration of IL-4 in group A and C were significantly lower than those in group B (P<0.05), but there was no significant difference between group A and C (P>0.05). The tumor growth inhibitory rate was 75%. Conclusion IL-18 can effectively induced IFN-γ and inhibit IL-4 production, regulate Th1/Th2 balance in the C57BL/6 mice Lewis lung cancer model, and elicit the antitu-mor immunity of the host, which could obviously inhibit the growth of tumor cells and decelerate the proliferation of tumor cells.

Objective To detect the clinical factors related with liver metastasis in young patients with rectal cancer.Methods Three hundred and fifty young patients with rectal cancer were collected to set up the database.Single and multi-factor Logistic regression was applied to indicate the independent factors relating to liver metastasis.The regression equation to predict probability of liver metastasis from rectal cancer was established.Results Liver metastasis was 120 cases (34.3%).Single-factor analysis revealed that patho-organization type,pathologytype,infiltration extent,blood vessel invasion (BVI),TNM stage,operation character,the preoperative level of carcino-embryonic antigen,histology grading were related with liver metastasis.Multi-factor analysis revealed that only BVI (P=0.001),TNM stage (P=0.001),pathoorganization type (P=0.005),the preoperative level of CEA (P=0.008) and operation character (P=0.032) were independent factors to predict probability of liver metastasis.Conclusions Rectal cancer of young patients who being with BVI,advanced phase,high preoperative level of CEA,radical operation or poor differentiation degree,are apt to develop liver metastasis.They should be given further individualized intensive adjuvant treatment.

RNA interference (RNAi) refers to homologous complementary messenger RNA (rnRNA)degradation induced specifically by double stranded RNA (dsRNA),which actually leads to gene silencing phenomenon.The application of RNAi technique in liver cancer gene therapy has got continual development along with deeply studying of RNAi,and showed its tremendous advantages,which are reviewed in this article.

Survivin is a recently identified member of the inhibitor of apoptosis protein (IAP) family which is a multifunctional protein with inhibition of apoptosis and regulation of cell division, and other functions. It is highly expressed in transformed cell lines and in a large number of malignancies, but undetectable in terminally differentiated adult tissues. Survivin play an important role in tumorigenesis of lung cancer. On the basis of these findings, Survivin will be of great interest as both a diagnostic tumor marker and as a potential suitable target for anti-lung cancer therapies.

BACKGROUNDEndostar™ (rh-endostatin, YH-16) is a new recombinant human endostatin developed by Medgenn Bioengineering Co. Ltd., Yantai, Shandong, P.R.China. Pre-clinical study indicated that YH-16 could inhibit tumor endothelial cell proliferation, angiogenesis and tumor growth. Phase I and phase II studies revealed that YH-16 was effective as single agent with good tolerance in clinical use.The current study was to compare the response rate , median ti me to progression (TTP) ,clinical benefit andsafety in patients with advanced non-small cell lung cancer ( NSCLC) , who were treated with YH-16 plus vi-norelbine and cisplatin (NP) or placebo plus NP.

METHODSFour hundred and ninety-three histologically or cy-tologically confirmed stage IIIB and IV NSCLC patients , withlife expectancy > 3 months and ECOG perform-ance status 0-2 , were enrolledin a randomized ,double-blind ,placebo-controlled , multicenter trial ,either trialgroup : NP plus YH-16 (vinorelbine 25 mg/m² on day 1 and day 5 ,cisplatin 30mg/m² on days 2 to 4 , YH-167.5mg/m² on days 1 to 14) or control group : NP plus placebo (vinorelbine 25 mg/m² on day 1 and day 5 ,cis-platin 30 mg/m² on days 2 to 4 ,0.9% sodium-chloride 3 .75 ml on days 1 to 14) every 3 weeks for 2-6 cycles .The trial endpoints included response rate ,clinical benefit rate ,time to progression,quality of life and safety .

RESULTSOf 486 assessable patients , overall response rate was 35.4% in trial group and 19.5% in controlgroup (P=0 .0003) . The median TTP was 6 .3 months and 3 .6 months for trial group and control group respectively (P < 0 .001) . The clinical benefit rate was 73 .3 %in trial group and 64.0% in control group (P=0 .035) .In untreated patients of trial group and control group ,the response rate was 40 .0% and 23.9%(P=0 .003) ,the clinical benefit rate was 76 .5 % and 65 .0 % (P=0 .023) ,the median TTP was 6 .6 and 3 .7months (P=0 .0000) ,respectively .In pretreated patients of trial group and control group ,the response ratewas 23.9% and 8.5%(P=0 .034) ,the clinical benefit rate was 65.2% and 61.7%(P=0 .68) ,the median TTP was 5 .7 and 3 .2 months (P=0 .0002) ,respectively . The relief rate of clinical symptoms in trial groupwas higher than that of those in control group ,but no significance existed (P > 0 .05) . The score of quality oflife in trial group was significantly higher than that in control group (P=0 .0155) after treatment . There were no significant differences in incidence of hematologic and non-hematologic toxicity , moderate and severe sideeffects betweentrial group and control group .

CONCLUSIONSThe addition of YH-16 to NP regimen results in significantly and clinically meaningful improvement in response rate , median time to tumor progression,and clinical benefit rate compared with NP alone in advanced NSCLC patients . YH-16 in combination with chemotherapy shows a synergic activity and a favorable toxic profile in advanced cancer patients .