Objective:To assess the radiation dose and clinical value of "one-stop" whole-brain CT perfusion (CTP) imaging in the evaluation of collateral circulation for patients with acute ischemic stroke (AIS), regarding the digital subtraction angiography (DSA) as the reference.Methods:This retrospective study included 32 AIS patients, for whom both CTP and DSA were obtained <24 h since onset. All CTP scans were acquired in whole-brain volume perfusion mode using a 320-row CT with the phase-specific settings of tube currents to optimize the image quality of CTA images, where multiple-phase (mp) CTA images were extracted from the CTP data in post-processing. The volume CT dose index (CTDI vol), dose length product (DLP), and effective dose were compared to those reported in previous studies. The perfusion parameters of the infarct lesions and their contralateral regions were compared using the paired t-tests. One radiologist scored the collateral circulation with only the CTP and with the CTP plus mp-CTA using a 5-point scale. Another radiologist performed the same evaluation on the DSA. The diagnostic accuracy was calculated referring to the result based on DSA. The scores were analyzed using the Pearson correlation coefficient. The agreement of scores was quantified with the Kappa test. Results:The mean CTDI vol was 184.18 mGy, which was comparable to the result of a previous study (184.19 mGy), and the mean effective dose was reduced 39% compared to that reported in the literature for combined CTP and CTA scanning (6.1 vs 10 mSv). There were statistically significant differences in cerebral blood volume (CBV), cerebral blood flow (CBF), mean transit time (MTT), transit time to peak (TTP), and time-to-maximum (Tmax) between the infarct lesions and their contralateral regions ( P<0.01). The scores between CTP and DSA were significantly correlated ( r=0.95, P<0.01), as well as the scores between CTP plus mp-CTA and DSA ( r=0.98, P<0.01). The Kappa value was 0.64 ( t=7.53, P<0.01) between CTP and DSA, while it increased to 0.88 ( t=9.99, P<0.01) for CTP plus mp-CTA. With the result of DSA as a reference, the diagnostic accuracy was 71.9% and 90.6% for CTP and CTP plus mp-CTA, respectively. Conclusions:The "one-stop" whole-brain CTP imaging with phase-specific settings of tube currents can provide reliable CTP and multiple-phase CTA images simultaneously, which could reasonably reduce the radiation dose. Combined use of multi-phase CTA and CT perfusion improves the diagnostic accuracy of collateral circulation in AIS patients.

Objective:To investigate the correlation between the iliac cortical density line and pelvic tilt (PT) in X-ray films of patients with kyphosis.Methods:The imaging data of 67 patients with kyphosis treated in Tianjin Beichen Hopsital from August 2016 to December 2019 were analyzed retrospectively. PT and iliac tilt (IT) were measured on lateral X-ray of the spine. IT was defined as the angle between the density line of the iliac cortex and vertical direction. The correlation between PT and IT was analyzed, and a linear regression model was established.Results:PT and IT can be determined by X-ray lateral films of spine in 67 patients. Pearson correlation analysis results showed that PT was significantly correlated with IT( r=0.852, P<0.05). Subgroups analysis was conducted by gender. The linear regression formulas for females and males were PT=IT-12.9° and PT=IT-16.7°, respectively. Conclusions:When it is difficult to identify the femoral head on X-ray film, IT can be measured conveniently and directly through the density line of the iliac cortex, and then PT can be reliably evaluated through IT.

OBJECTIVETo explore the feasibility of short-term neoadjuvant chemotherapy (NACT) in patients with advanced gastric cancer (AGC), and to compare clinical efficacy of short-term neoadjuvant chemotherapy with different ways.

METHODSClinical data of 310 AGC patients treated with one course of NACT using EOF regimen(epirubicin, oxaliplatin and fluorouracil plus calcium folinate) in our hospital from January 2008 to December 2011 were retrospectively analyzes. Efficacy was compared between regional arterial infusion chemotherapy and intravenously chemotherapy.

RESULTSAll the 310 AGC patients completed one course of NACT and none was interrupted by adverse events. Postoperative pathological remission rate was 33.9% (105/310) and 5 patients (1.6%) had complete pathological remission. The pathologic response rate in the regional arterial infusion chemotherapy group was higher than that in the intravenously chemotherapy group(42.4% vs. 23.6%, P = 0.001). Multivariate analysis revealed that chemotherapy method(HR=1.827, 95% CI:1.006-3.316, P = 0.048) was associated with significantly higher pathologic response.

CONCLUSIONSPathological response rate is quite low following short-term NACT. Regional arterial infusion chemotherapy with short-term NACT can improve the pathological response rate of advanced gastric cancer.

Antineoplastic Combined Chemotherapy Protocols ; administration & dosage ; therapeutic use ; Epirubicin ; Fluorouracil ; Humans ; Infusions, Intra-Arterial ; Leucovorin ; Neoadjuvant Therapy ; Organoplatinum Compounds ; Remission Induction ; Retrospective Studies ; Stomach Neoplasms ; drug therapy

Objective To detect the expression of GHR in colorectal cancer cell lines and determine whether recombinant human growth hormone can promote the proliferation of colorectal cancer cells in vitro.Methods GHR distribution was assessed by flow cytometry and immunofluorescence method in 9 colorectal cancer cell lines.The effect of recombinant human growth factor on colorectal cancer cell line proliferation was assessed by MTT method.Results Different GHR expression was determinated in 9 colorectal caner cell lines.GHR was highly expressed in HCT-8 while GHR expression could hardly be detected in LoVo.r-hGH could promote GHR(+) HCT-8 cell proliferation at 50 ng/ml and 100 ng/ml (P ＜0.05).But this effect was not dose dependent.When the neutralizing antibody was used to block GHR activity,this r-hGH dependent proliferation effect was eliminated.r-hGH could not promote GHR (-) LoVo cell proliferation (P ＞0.05).Conclusion The results demonstrates that r-hGH could promote GHR (+) tumor cell proliferation and this effect is mediated by GHR.The use of r-hGH on the colorectal cancer patients should be cautious.

Objective To test the effect of recombinant human growth hormone (rhGH) on the radiotherapy sensitivity of colorectal cancer cell line, and to explore its relationship with apoptosis. Methods Flow cytometry and immunofluorescence were used to detect growth hormone receptor(GHR) expression on 9 human colorectal cancer cell lines. The colony forming assay was performed to measure the post-radiotherapy colorectal cancer cell proliferation as an indicator of radiotherapy sensitivity. Flow cytometry (Annexin V-FITC staining) was used to detect the radiotherapy induced apoptosis; Westem blot was performed to detect the phosphorylated Akt level within the same cell lines. Results HCT-8 GHR positive expression cell and LoVo GHR negative expression cells were selected for further studies. The colony formation rate was significantly enhanced in HCT-8 cells pre-incubated with thGH as compared to the radiotherapy group ceUs and in a dose dependent manne(0-100 mg/L); under high doses (8 Gy), this effect was more dramatic (52.1±2.9 vs 21.0±2.7, P<0.001). thGH pre-incubation also reduced radiotherapy induced HCT-8 cell apoptosis (P<0.05). When GHR was blocked with neutralizing antibodies, this protective effect was eliminated. By contrast, thGH pre-incubation did not change the colony formation rate in GHR negative expression LoVo cells. GH rapidly induced Akt phosphorylation in HCT-8 cells by GH/GHR signaling, and this effect was blocked by PI-3 kinase inhibitor. Conclusions The protective effect of GH on colorectal cancer cells may occur after radiotherapy exposured by GHR, which is related to the reduction of apotosis.

Objective To observe the morphology, quantity and migration of Langerhans cells in normal or HPV-infected skin treated with localized hyperthermia. Methods Tissue specimens obtained from 16 patients with condyloma accuminatum (CA) and 15 normal controls were divided into three equal parts, and irradiated by a self-made hyperthermia equipment at 37℃, 42℃ and 45℃ respectively for 30 minutes. Immunohistochemistry and flow cytometry were applied to detect the morphology, quantity and migration of Langerhans cells (LCs), respectively, in these treated specimens. Results With a rise in temperature, the number of LCs in epidermis decreased, the dendrites shortened, decreased in number or even disappeared. After exposure to hyperthermia at 37℃, 42℃ and 45℃, the number of LCs was 782.40±114.8, 649.44±119.40 and 510.88±118.64 per square millimeter respectively, in normal tissue, 646.04±135.67, 489.38±118.19 and 387.93±110.15 per square millimeter respectively in HPV-infected skin tissue.The percentage of migratory LCs expressing CD1a was 0.19%±0.18%, 0.89%±0.19% and 1.59%±0.28% in normal skin tissue treated with hyperthermia at 37℃, 42℃ and 45℃ respectively, 0.62%±0.31%,2.31%±0.54% and 6.33%±0.98%, respectively, in HPV-infected skin tissue; the differences were significant among these different temperatures. Furthermore, the migration of LCs from tissue into culture was enhanced by the treatment with hyperthermia. Conclusions Hyperthermia can promote the migration of LCs, and accordingly enhance the antigen presenting effect of these cells in immune response.

Tertiary peritonitis is manifested by immunodeficiency and serious diseases which is different with secondary and primary peritonitis. It is a complex nosocomial infection in surgical patients. The pathogenesis, clinical features, diagnosis and treatment of tertiary peritonitis is reviewed.

Objectives:To study the relationship between angiogenesis,proliferation and lymph node metastasis in rectal cancer. Methods: Forty six rectal cancer specimens were examined immunohistochemically. The intratumor microvessel density(MVD), vascular endothelial growth factor (VEGF)expression positive rate and Ki 67 label index(Ki 67 LI) were detected and their relationship with tumor invasion and lymph node metastasis were analyzed. Results: The MVD, VEGF expression positive rate and Ki 67 LI increased significantly( P

To investigate the monitoring of acute rejection of porcine pancreaticoduodenal allografts, 12 pigs were subjected to pancreaticodudenal allografts, among them 6 pigs received triple therapy for 7 days. Serial biopsies were performed in pancreas allografts for diagnosis of pancreatic acute rejection. Amylase secretion was determined periodically.The levels of TNF ? and NO in serum were serially monitored.The results showed that amylase secretion decreased,TNF ? and NO concentration in serum increased significantly as acute rejection was detected histo pathologically in pancreatic grafts. It suggested that monitoring of amylase secretion, serum TNF ? and NO concentration could be used to decide the proper time of performing biopsy for early diagnosis of acute rejection of the pancreas allograft.

Objectives: To investigate the effect of growth hormone on liver protein synthesis in patients with portal hypertension following TIPS. Methods: Ten patients with liver cirrhosis and portal hypertension were injected with rhGH (8 U/day) for 7days after TIPS. The serum levels of Alb, PA and FN were detected before and days 3 and 7 after TIPS and use of rhGH. Plasma insulin like growth factor 1 (IGF 1) was also measured by immunoradiological method. Results: As compared with the day before TIPS and rhGH, the levels of IGF 1, Alb , PA and FN were significantly increased on the 7th day after TIPS and rhGH treatment( P