Objective To improve the CT image quality of the anorectal junction in venous phase using a new deep learning image reconstruction(DLIR)algorithm.Methods A retrospective analysis was conducted on 71 patients undergoing pelvic computed tomography(CT)scans.All CT images were reconstructed at a thin slice thickness of 0.625 mm using 50%ASiR-V,low-,medium-and high-intensity DLIR(DLIR-L,DLIR-M and DLIR-H).The CT attenuations and standard deviation values of anal canal and hip fat were measured for each reconstruction group.With the standard deviation of hip fat as background noise,the contrast-to-noise ratio(CNR)and signal-to-noise ratio(SNR)of anal canal were calculated.Two radiologists independently assessed image quality and diagnostic confidence for local invasion of rectal cancer using the 5-point Likert scale.The objective measurement indicators and subjective scores were analyzed and compared,and Kappa test was used to evaluate the consistency.Results The differences in CT value of anal canal and hip fat among the groups were trivial(P>0.05),but fat SD,anal canal SNR and CNR(P<0.05)differed significantly,with lowest fat SD,highest anal canal SNR and CNR in DLIR-H group,while highest fat SD,lowest anal canal SNR and CNR in 50%ASiR-V group.Compared with 50%ASiR-V group,DLIR-H group decreased fat SD by 44.3%,but increased anal canal SNR and CNR by 89.5%and 92.1%,respectively(P<0.05).The subjective score of 4 groups were significantly different(P<0.05),decreasing from DLIR-H to 50%ASiR-V,and the inter-group differences were significant(P<0.05),except the difference between 50%ASiR-V group and DLIR-L group(P>0.05).There was a statistically significant difference in the diagnostic confidence for local invasion of rectal cancer among different groups(P<0.05),and the scores were significantly higher in DLIR-M and DLIR-H groups than in 50%ASiR-V and DLIR-L groups(P<0.05).Conclusion Compared with the standard 50%ASiR-V image,DLIR-M and DLIR-H reconstruction algorithms can effectively improve the image quality for the anorectal junction in CT imaging.The higher-intensity DLIR results in better image quality and stronger ability to display fine structures,which can provide more evidences for clinical precision evaluation and personalized precision treatment.

Post-traumatic hydrocephalus (PTH) is one of the common secondary lesions after severe craniocerebral injury.Shunt surgery is the most important surgical treatment in clinic.There are many kinds of shunt methods,but there is no uniform standard for method selection.Lumboperitoneal shunt (LP),as an important alternative operation,has gradually become one of the mainstream shunt operations.This article reviews the new operative indications of LP,the advantages of LP over traditional ventriculoperitoneal shunt (VP),the latest preoperative evaluation system and preoperative evaluation score of Huaxi LP,the technical points of LP operation,follow-up key points,common postoperative complications and management,so as to provide reference for exploring better technical routes and operative concepts of LP.

BACKGROUND:Anterior cruciate ligament (ACL) injury is a commonly sport-induced knee joint injury that does serious harm to the knee stability. ACL reconstruction is a commonly used treatment method, but researches on 1/2 peroneus longus tendon (PLT) graft are rarely reported. OBJECTIVE: To investigate the clinical outcomes of removing the autologous ipsilateral 1/2 PLT under arthroscopy for ACL reconstruction. METHODS:106 patients with complete ACL rupture in the Affiliated Hospital of Traditional Chinese Medicine, Southwest Medical University from December 2010 to December 2014 were enrolled, and autologous ipsilateral 1/2 PLT was removed under arthroscopy for ACL reconstruction. At baseline, 3, 6 and 12 months postoperatively, the knee stability was evaluated manually through the anterior drawer test, Lachman test, and pivot-shift test, and the knee function was evaluated by Tegner activity scale, Lysholm and International Knee Documentation Committee scores. RESULTS AND CONCLUSION: Postoperative anterior drawer test, Lachman test, and pivot-shift test tests were negative in all patients. In terms of Tegner activity scale, Lysholm and International Knee Documentation Committee scores, there were significant differences at baseline and postoperative 3 months as compared with postoperative 6 months (P < 0.05); the scores at baseline and postoperative 3 months showed significant differences compared with 12 months postoperatively (P < 0.05); the scores showed no significant difference between 6 and 12 months postoperatively (P > 0.05). These results indicate that autologous ipsilateral 1/2 PLT is a good choice for ACL reconstruction under arthroscopy, achieving rapid and satisfactory functional recovery of the knee joint, which is not only minimally invasive and easy to operate, but also exhibits good therapeutic efficacy.

Objective: To establish a new scoring system based on the clinicopathological features of hepatocellular carcinoma (HCC) to predict prognosis of patients who received hepatectomy. Methods: A total of 845 HCC patients who underwent hepatectomy from 1999 to 2010 at Cancer Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed. 21 common clinical factors were selected in this analysis. Among these factors, the cut-off values of alpha-fetoprotein (AFP), alkaline phosphatase (ALP) and intraoperative blood loss were evaluated by using a receiver operating characteristic (ROC) curve analysis.The Kaplan-Meier method and Cox regression model were used to evaluate the independent risk factors associated with the prognosis of HCC patients after hepatectomy. HCC postoperatively prognostic scoring system was established according to the minimum weighted method of these independent risk factors, and divided the patients into 3 risk groups, including low-risk, intermediate-risk and high-risk group. The relapse-free survival (RFS) and overall survival (OS) were compared among these groups. Results: The univariate analysis showed that clinical symptoms, preoperative α-fetoprotein (AFP) level, serum alkaline phosphatase (ALP) level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with median RFS of these HCC patients (P<0.05). Alternatively, clinical symptoms, preoperative AFP level, serum ALP level, tumor size, tumor number, abdominal lymph node metastasis, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, the severity of hepatic cirrhosis, intraoperative blood loss, the liver operative method, pathological lymphocyte invasion, pathological tumor thrombus, intraoperative blood transfusion, perioperative blood transfusion were significantly associated with the median OS of these HCC patients (P<0.05). The multivariate analysis showed that AFP ≥20 ng/ml, clinical symptoms, tumor diameter ≥5 cm, multiple tumors, macrovascular invasion or tumor thrombus, extrahepatic invasion or serosa perforation, moderate and severe liver cirrhosis, non- anatomic resection were the independent risk factors of RFS and OS (P<0.05). The independent risk factor of RFS was intraoperative bleeding loss ≥325 ml (P<0.05); The independent risk factors of OS were abdominal lymph node metastasis and pathological tumors thrombus (P<0.05). The respective weight of 11 independent factors was used to establish the scoring system (scores range from 0 to 26). In the score system, 0 to 5 points were defined as the low-risk group (286 cases), 6 to 12 points were determined as the intermediate-risk group (503 cases), more than 13 points were classified as the high-risk group (56 cases). The median RFS of the low-risk, intermediate-risk and high-risk group were 80, 27 and 6 months, respectively. The differences were statistically significant (P<0.001). The median OS of the three groups were 134, 51 and 15 months, respectively, and the differences were statistically significant (P<0.001). Conclusion This new score system provides effective prediction of postoperative prognosis for HCC patients.

The community rehabilitation model for stroke patients was developed based on the experiences of Quyang Community Health Service Center in Shanghai under the guidance of Lean Six Sigma.The validity of the process and results were evaluated by a expert group according to validity theory.The developed Manual of Home-based Rehabilitation mode for Stroke Patients in Community had good validity,which may provide guidance for stroke patients rehabilitation in the community,and also provide reference for clinical application.

This study investigated the conjoined cellular oxidative damage of human embryo kidney 293T (HEK293T) cells induced by cadmium chloride (CdCl(2)) and nanometer titanium dioxide (nano-TiO(2)). RT-PCR technique was used to detect the expressions of Heme oxygenase-1 (HO-1) and 8-oxoguanine DNA glycosylase (OGG1). The activities of superoxide dismutase (SOD) and catalase enzyme (CAT) and concentrations of reactive oxygen species (ROS) and maldondialdehyde (MDA) were measured by different approaches. The results showed that CdCl(2) and nano-TiO(2) at a low concentration of 0.75 total toxic unit (TU) exerted an additive effects on HO-1 gene expression, CAT activities and MDA concentrations. When the total TU was increased to 1 or 1.25 TU, the interaction was synergetic. Moreover, the mixture with high proportion of CdCl(2) produced an additive effect on the OGG1 gene expression, and the interaction was changed to be synergetic when the concentration of CdCl(2) was lower than or equal to that of nano-TiO(2). Synergetic effects of CdCl(2) and nano-TiO(2) on cellular oxidative damage of HEK293T cells were found as indicated by the changes in the SOD activities and ROS concentrations. It was concluded that CdCl(2) and nano-TiO(2) exerts synergistic effects on the cellular oxidative damage of HEK293T cells, and the sensitivity of these indicators of oxidative damage varies with the proportion of CdCl(2) and nano-TiO(2) in the mixture.
Cadmium Chloride ; toxicity ; Drug Synergism ; HEK293 Cells ; Humans ; Kidney ; cytology ; Nanoparticles ; Oxidative Stress ; drug effects ; Reactive Oxygen Species ; metabolism ; Superoxide Dismutase ; metabolism ; Titanium ; toxicity

This study investigated the conjoined cellular oxidative damage of human embryo kidney 293T (HEK293T) cells induced by cadmium chloride (CdCl2) and nanometer titanium dioxide (nano-TiO2).RT-PCR technique was used to detect the expressions of Heme oxygenase-1(HO-1) and 8-oxoguanine DNA glycosylase (OGG1).The activities of superoxide dismutase (SOD) and catalase enzyme (CAT) and concentrations of reactive oxygen species (ROS) and maldondialdehyde (MDA)were measured by different approaches.The results showed that CdCl2 and nano-TiO2 at a low concentration of 0.75 total toxic unit (TU) exerted an additive effects on HO-1 gene expression,CAT activities and MDA concentrations.When the total TU was increased to 1 or 1.25 TU,the interaction was synergetic.Moreover,the mixture with high proportion of CdCl2 produced an additive effect on the OGG1gene expression,and the interaction was changed to be synergetic when the concentration of CdCl2 was lower than or equal to that of nano-TiO2.Synergetic effects of CdCl2 and nano-TiO2 on cellular oxidative damage of HEK293T cells were found as indicated by the changes in the SOD activities and ROS concentrations.It was concluded that CdCl2 and nano-TiO2 exerts synergistic effects on the cellular oxidative damage of HEK293T cells,and the sensitivity of these indicators of oxidative damage varies with the proportion of CdCl2 and nano-TiO2 in the mixture.

This study investigated the conjoined cellular oxidative damage of human embryo kidney 293T (HEK293T) cells induced by cadmium chloride (CdCl(2)) and nanometer titanium dioxide (nano-TiO(2)). RT-PCR technique was used to detect the expressions of Heme oxygenase-1 (HO-1) and 8-oxoguanine DNA glycosylase (OGG1). The activities of superoxide dismutase (SOD) and catalase enzyme (CAT) and concentrations of reactive oxygen species (ROS) and maldondialdehyde (MDA) were measured by different approaches. The results showed that CdCl(2) and nano-TiO(2) at a low concentration of 0.75 total toxic unit (TU) exerted an additive effects on HO-1 gene expression, CAT activities and MDA concentrations. When the total TU was increased to 1 or 1.25 TU, the interaction was synergetic. Moreover, the mixture with high proportion of CdCl(2) produced an additive effect on the OGG1 gene expression, and the interaction was changed to be synergetic when the concentration of CdCl(2) was lower than or equal to that of nano-TiO(2). Synergetic effects of CdCl(2) and nano-TiO(2) on cellular oxidative damage of HEK293T cells were found as indicated by the changes in the SOD activities and ROS concentrations. It was concluded that CdCl(2) and nano-TiO(2) exerts synergistic effects on the cellular oxidative damage of HEK293T cells, and the sensitivity of these indicators of oxidative damage varies with the proportion of CdCl(2) and nano-TiO(2) in the mixture.

Objective To establish whether Wnt-signaling pathway plays a role in mice β-cell function and/or survival in vitro. Methods Mice NIT-1 beta cells were cultured in media with glucose concentration of 33.3 mmol/L and the cytokines interleukin-1β, interferon-γand tumor necrosis factor-α with or without the addition of purified Wnt3a protein in vitro. Subsequently, β-cell apoptosis by Tunnel and flow cytometry, and β-cell proliferation by BrdU were analyzed. Total RNA was extracted to measure gene expressions by real-time PCR.Results Incubations of NIT-1 cells with high glucose and cytokines resulted in an increase in β-cell apoptosis and decrease in β-cell proliferation (P<0.01). In contrast, treatment with Wnt3a protein protected β-cell from glucose and cytokines-induced apoptosis through up-regulating the expressions of above Pitx2、 TCF7L2. Conclusions Wnt-signaling regulates the proliferation of pancreatic β-cell, and protectes β-cell from glucotoxicity and cytokine toxicity with respect to proliferation and apoptosis.

Objective To investigate the clinicopathologic features and treatment of thyroid microcarcinoma (TMC). Methods From January 1997 to December 2006,311 patients who underwent surgery and defined as TMC(tumor size≤1 cm)were enrolled. Results TMC was identified incidentally by frozen pathologic examination on thyroidectomy specimens in tentative benign goiters in 181 patients; another 130 patients with clinically detectable primary tumors or suspected nodal metastases were grouped to as clinically overt TMC. The clinically overt TMC had a higher incidence of bilateral multifocal tumors (18.5%vs.9.4%,P=0.03),and cervical lymph node metastases(27.7%vs.10.5%,P=0.000)than that in clinically occult TMC group. Conclusion TMC may vary considerably in clinical and biologic behaviors between these two subtypes: clinically overt and occult. Lobectomy for single lesion, total or near total thyroidectomy for multifocal with central compartment nodal dissection should be performed, lateral nodal dissection was not carried out unless US or physical examination detected nodal metastases. Lobetomy, subtotal or more limited thyroidectomy for occult TMC, diagnosed incidentally following thyroid surgery for initially tentative benign thyroid disease, could all be treatment of choice depending on the preference of surgeons.