Objective: To investigate the feasibility of one-step coronary and carotid-cerebrovascular computed tomography angiography (CTA) using high-pitch Double Turbo Flash mode and to analyze the image quality and radiation dose in patients with heart rate variability using multi-slice detector dual-source CT. Methods: A total of 79 patients with heart rate variability higher than 3 beat/min (bpm) were retrospectively analyzed. They were grouped by the scanning methods. Group A (n=40) were performed double turbo flash mode for one-step coronary and carotid-cerebrovascular arteriesinjected with one injection of contrast agent.further divided into Single A (only the phase 1 image)and Double A(combined images of phases 1 and 2). Group B (n=39) were performed separately with twice injection of contrast agent. Subjective scoring was performed on the image quality of the group Single A, Double A and B using a 4-point. Then the objective parameters of image quality, CT attenuations, image noise, signal-to-noise (SNR), and contrast-to-noise (CNR), were evaluated. Then subjective scores, objective evaluation indicators, and radiation dose were compared with one-way ANOVA analysis among the three groups.Contrast agent were compared by using t test in group A and B. Results: No significant difference was found (F=2.093, P=0.128) for the subjective scores of the head and neck CTA among the three groups with (3.47±0.51), (3.53±0.51), (3.69±0.47). Significant difference was found (F=50.955, P<0.01) for the subjective scores of coronary CTA among the three groups with (2.70±0.76), (3.35±0.66), (3.58±0.50), and there was no statistically significant difference between Double A and B groups (P=0.104), met the requirements for diagnosis. The objective evaluation of the three groups compared the head and neck CTA images were statistically significant (P<0.05), of which the difference between the Single A and the Double A was not statistically significant (P>0.05), met the requirements for diagnosis; the differences in SNR and CNR of coronary CTA images are statistically significant (F=12.991, 12.236, P<0.01), and there was no statistically significant difference between Double A and B (P>0.05), met the requirements for diagnosis. Radiation dose in the group Double A was lower than group B (decreased by 46.15%,P<0.01).The amount of the contrast agent in the group Double A was lower than group B (decreased by 44.13%, t=-45.455;P<0.01). Conclusion The double turbo flash mode is feasibility for one-step coronary and carotid-cerebrovascular CTA in patients with the heart rate variability using multi-slice dual-source CT.This scan mode can maintain the diagnostic image quality with low contrast agent and radiation dose.

Objective To investigate the related factors for the survival of the patients with pancreatic cancer.Methods A total of 1 620 patients confirmed as pancreatic cancer admitted in Sun Yat-sen Memorial Hospital affiliated with Sun Yat-sen University,Tumor prevention and treatment center affiliated with Sun Yat-sen University and People's Hospital of Guangdong Province from 2004 to 2016 were retrospectively analyzed,and the effects of TNM staging,surgical treatment,palliative chemotherapy and postoperative assisted chemotherapy on the survival of the patients with pancreatic cancer were examined by life table and Log-rank test.Results The median survival time of all 1 620 cases was 7.15 months.The median survival time of TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ was 12.50 months,10.12 months,9.56 months and 5.43 months,and there was statistically significant difference (P =0.001).The median survival time of cases who did not undergo surgery was 6.10 months,which of patients who underwent radical surgery was 13.67 months,and the difference was statistically significant (P =0.001).The median survival time of cases without chemotherapy was 5.55 months,which of patients who underwent palliative chemotherapy was 7.58 months,and the difference was statistically significant (P =0.001).The median survival time of cases with pure radical surgery without chemotherapy was 12.38 months,which of patients who underwent adjuvant chemotherapy was 14.50 months,and the difference was no statistically significant (P =0.561).Conclusions Early diagnosis followed closely by radical surgery is the key to prolong the survival of pancreatic cancer patients.And adjuvant chemotherapy for patients who lose surgery opportunity may improve clinical prognosis to a certain extent.

Objective To explore the effect of inhibiting placental growth factor ( PIGF ) by small interfering RNA ( siRNA) on migration, invasion and chemoresistance of human pancreatic cancer cell line PANC1.Methods Three specific siRNAs targeting PIGF (siRNA-PIGF) were designed.PANC1 cells were transfected with siRNA-PIGF by liposome transfection using untransfected cells as blank controls and nonspecific siRNA ( siRNA-NC) transfected cells as negative controls .The PIGF mRNA and protein expression was examined by real-time RT-PCR and ELISA.MTT method was used to assess the inhibition rate of chemotherapeutic reagents on cell proliferation .The abilities of migration and invasion were evaluated by Transwell assay.Results The inhibition rate of PIGF mRNA in PANC1 cells transfected by 3 siRNA-PIGF were (64.38 ±8.92)%, (70.48 ±7.72)% and (81.25 ±6.02)%, which was lowest in siRNA-PIGF-3 transfected cells.The expression of PIGF mRNA in PANC1 cells were decreased by (63.72 ±8.20)%at 24 h after siRNA-PIGF transfection compared with siRNA-NC transfected cells;and the level of PIGF protein in the supernatant of cultured PANC1 cells was lowered by (42.92 ±1.34)% compared with siRNA-NC transfected cells and by (46.25 ±3.64)% compared with untransfected cells at 48h after transfection, which all had significant difference .There was no statistical difference between untransfected and siRNA-NC transfected cells.After 3 ng/L gemicitabine treatment , the inhibition rate of cell proliferation in siRNA-PIGF group was even higher than that in siRNA-NC and untransfected group [(44.35 ±5.05)% vs(34.29 ±3.60)% and (31.01 ±1.08)%;both P<0.05], and no significant difference was not observed after 5-FU and adriamycin treatment.In migration and invasion assay , the number of transmembrane cells from siRNA-PIGF group was 38.1%and 28.2%of that from siRNA-NC group and 40.8% and 36.2% of that from untransfected group , which had statistical difference (all P<0.05).Conclusions PIGF silencing could significantly suppress the migration and invasion of PANC 1 cells and improve the sensitivity to gemicitabine .

OBJECTIVETo investigate the risk factors on initial surgery in Crohn's disease.

METHODSThe clinical data of 173 patients with Crohn's disease who were treated during 2010 and 2014 years in the Second Affiliated Hospital of Sun Yat-Sen University, were analyzed retrospectively. The patients who had received intestinal resection or whose initial symptoms occurred at least 5 years at the end of the follow-up were recruited. Montreal classification was used to evaluate lesion location and disease behavior. The risk factors of the initial surgery were analyzed by using Logistic regression model.

RESULTSEighty-five patients (49.1%) received intestinal resection in 5 years after the onset of symptoms. The result of univariate analysis showed that the probability of surgical treatment is high in patients who were male and those older than 40 years at diagnosis (P<0.05). Lesions involving upper digestive tract, stenosis and penetrating lesions were also the risk factors on initial surgery in Crohn's disease (P<0.05). The result of multivariate analysis showed the relative risk of initial surgery was increased in male gender (OR=2.02, 95%CI:1.04-3.92) and in those who were older than 40 years at diagnosis (OR=2.34,95%CI:1.05-5.22). However, in patients with Crohn's disease involving colon alone, the relative risk of initial surgery was decreased (OR=0.35, 95%CI:0.13-0.97).

CONCLUSIONAbdominal pain is the most common clinical presentation in Crohn's disease. Disease behavior and operation is closely related. Older than 40 years at diagnosis and male gender is high risk factor for surgery while colonic lesion alone is protective factor.

Abdominal Pain ; Colon ; Constriction, Pathologic ; Crohn Disease ; Follow-Up Studies ; Humans ; Logistic Models ; Male ; Protective Factors ; Retrospective Studies ; Risk Factors

BACKGROUND:Borosilicate cannot only be mineralized to form hydroxy carbonate apatite layer, but also have strong chemical reactivity to promote bone cel regeneration. OBJECTIVE:To investigate the effect of the borosilicate bioglass on the growth behavior of rabbit osteoblasts through in vitro culture experiment. METHODS:The initial and secondary extracts of borosilicate bioglass were prepared according to the requirement of ISO10993-12: 2007. The bone marrow mesenchymal stem cels of rabbits were isolated and cultured. The second generation bone marrow mesenchymal stem cels were induced to differentiate into osteoblasts. The osteoblasts of the 5th-15th RESULTS AND CONCLUSION:The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cel number in Transwel between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in generations were obtained and cultured with the initial and secondary extracts of borosilicate bioglass and α-MEM medium, respectively. The effects of borosilicate bioglass on the osteoblasts proliferation, protein synthesis, alkaline phosphatase activity, cel apoptosis, and cel migration in horizontal and vertical direction were observed.RESULTS AND CONCLUSION: The osteoblasts proliferation in the initial extract and secondary extract groups was better than that in the α-MEM medium group (P < 0.05). The osteoblasts proliferation in the initial extract group was better than that in the secondary extract group (P < 0.05). The total protein content of osteoblasts in the initial extract group was higher than that in the secondary extract and α-MEM medium group (P < 0.05). There were no significant differences in the alkaline phosphatase activity, apoptosis rate, horizontal migration distance of osteoblast and transmembrane cell number in Transwell between these three groups. These results demonstrate that borosilicate bioglass has good biocompatibility and has a certain benign regulatory role in osteoblast proliferation.

Objective:To study influencing factors for in‐stent restenosis (ISR) during one year in patients with coro‐nary heart disease (CHD) after coronary sirolimus‐eluting stent (SES) implantation .Methods :According to results of coronary angiography (CAG) ,a total of 275 patients ,who hospitalized in our department from Jan 1st ,2012 to Dec 30th ,2013 and have received SES implantation and reviewed CAG after one year ,were divided into non‐ ISR group (n=247) and ISR group (n=38) .Clinical characteristics were compared between two groups ,and Logistic regression analysis was used to analyze influencing factors for ISR .Results:Compared with non‐ISR group ,there were significant rise in percentages of occlusion lesions (17. 9% vs .31. 9% ) ,multiple overlapping stents (16. 7% vs . 31.9% ) ,and significant reduction in percentage of stent post‐dilatation (34.9% vs .10.6% ) in ISR group ,P<0.05 or <0. 01 ;Logistic regression analysis indicated that coronary occlusion lesion was a risk factor (OR :2. 855 ,95%CI :1.197~6.808 ,P=0.018) ,and post‐dilatation was a protective factor (OR :0.198 ,95% CI :0.057~0.691 , P=0.011) for ISR occurrence .Conclusion:Multiple overlapping stents and coronary occlusion lesions increase one‐year in‐stent restenosis rate ;stent post‐dilatation can reduce one‐year in‐stent restenosis rate ;coronary occlusion le‐sions is a risk factor , and stent post‐dilatation is a protective factor for restenosis during one‐year after coronary drug‐eluting stent implantation .

Objective To investigate the risk factors on initial surgery in Crohn's disease. Methods The clinical data of 173 patients with Crohn's disease who were treated during 2010 and 2014 years in the Second Affiliated Hospital of Sun Yat-Sen University, were analyzed retrospectively. The patients who had received intestinal resection or whose initial symptoms occurred at least 5 years at the end of the follow-up were recruited. Montreal classification was used to evaluate lesion location and disease behavior. The risk factors of the initial surgery were analyzed by using Logistic regression model. Results Eighty-five patients(49.1%) received intestinal resection in 5 years after the onset of symptoms. The result of univariate analysis showed that the probability of surgical treatment is high in patients who were male and those older than 40 years at diagnosis(P<0.05). Lesions involving upper digestive tract, stenosis and penetrating lesions were also the risk factors on initial surgery in Crohn's disease (P<0.05). The result of multivariate analysis showed the relative risk of initial surgery was increased in male gender(OR=2.02, 95%CI:1.04-3.92) and in those who were older than 40 years at diagnosis (OR=2.34,95%CI:1.05-5.22). However, in patients with Crohn's disease involving colon alone, the relative risk of initial surgery was decreased (OR=0.35, 95%CI:0.13-0.97). Conclusion Abdominal pain is the most common clinical presentation in Crohn's disease. Disease behavior and operation is closely related. Older than 40 years at diagnosis and male gender is high risk factor for surgery while colonic lesion alone is protective factor.

Objective To investigate the risk factors on initial surgery in Crohn's disease. Methods The clinical data of 173 patients with Crohn's disease who were treated during 2010 and 2014 years in the Second Affiliated Hospital of Sun Yat-Sen University, were analyzed retrospectively. The patients who had received intestinal resection or whose initial symptoms occurred at least 5 years at the end of the follow-up were recruited. Montreal classification was used to evaluate lesion location and disease behavior. The risk factors of the initial surgery were analyzed by using Logistic regression model. Results Eighty-five patients(49.1%) received intestinal resection in 5 years after the onset of symptoms. The result of univariate analysis showed that the probability of surgical treatment is high in patients who were male and those older than 40 years at diagnosis(P<0.05). Lesions involving upper digestive tract, stenosis and penetrating lesions were also the risk factors on initial surgery in Crohn's disease (P<0.05). The result of multivariate analysis showed the relative risk of initial surgery was increased in male gender(OR=2.02, 95%CI:1.04-3.92) and in those who were older than 40 years at diagnosis (OR=2.34,95%CI:1.05-5.22). However, in patients with Crohn's disease involving colon alone, the relative risk of initial surgery was decreased (OR=0.35, 95%CI:0.13-0.97). Conclusion Abdominal pain is the most common clinical presentation in Crohn's disease. Disease behavior and operation is closely related. Older than 40 years at diagnosis and male gender is high risk factor for surgery while colonic lesion alone is protective factor.

AIM:To establish an effective and rapid method to develop transplanted subcutaneous pancreatic carcinoma by inducing PANC-1 cells into nude mice, and then use this mouse model to evaluate the tumor-homing and gene-silencing effects of siRNA-loading nanoparticles in vivo.METHODS:Different numbers of PANC-1 cells in 100 μL or 300 μL PBS were inoculated subcutaneously into the right flank of BALB /c (nu/nu) mice.When the tumor volume reached 100 mm 3 , siRNACY 5.5 nanoparticles were injected through the mouse tail vein to perform in vivo imaging assay.Be-sides, the mice were randomly divided into 3 treatment groups treated with PBS, scrambled control RNA nanoparticles and siKras nanoparticles, respectively.The protein expression of Kras was detected by Western blotting and immunohistochemi-cal staining.RESULTS:After inoculated with 1 ×10 7 PANC-1 cells in 300 μL PBS, all mice developed tumors within 2 weeks.The in vivo results showed that siRNA-loading nanoparticles accumulated in the tumor tissues and exerted gene si-lencing effect.CONCLUSION:In the present study, an effective and rapid method was established for PANC-1 cells to induce transplanted subcutaneous pancreatic carcinoma in nude mice within 2 weeks, which is suitable for in vivo imaging and treatment evaluations as a reproducible and reliable way for the further experiments .

AIM:To synthesize a safe , efficient and targeted nanoparticulate carrier for siRNA delivery to pan-creatic cancer cells .METHODS: Iron oxide nanocrystal with carboxylic acid group-polyethyleneimine ( IONP-PEI ) was synthesized and investigated as a nonviral carrier of siRNA to the pancreatic cells .The size, surface and charge using zeta potential were characterized .The perfect charge ratio between amino groups of IONP-PEI and phosphate groups of siRNA ( N/P) was determined by the transfection efficiency detection , gel retardation assay and MTS assay .An antibody-directed nonviral vector , scFvCD44v6-IONP-PEI nanoparticle attaching to the cancer-associated CD44v6 single-chain variable frag-ment, was constructed as a cancer-targeting nanocarrier for siRNA delivery .Prussian blue staining and immunofluorescent staining were performed to detect the distribution of scFv CD44v6-IONP-PEI/siRNA complexes in the cells .The transfection efficiency , fluorescence intensity and the expression of KRAS at mRNA and protein levels in the cells transfected by IONP -PEI/siRNA and scFv CD44v6-IONP-PEI/siRNA were detected by flow cytometry , fluorescence microscopy , real-time PCR and Western blotting, respectively.RESULTS:The mass ratio of IONP to PEI was 0.75.The suitable ratio of N/P was 20. The averaged size and surface zeta potential of IONP-PEI/siRNA in deionized water were (51.3 ±2.2)nm (diameter) and (21.73 ±8.07)mV, respectively.Red fluorescence was seen in both targeting and nontargeting groups , which clearly re-vealed the intracellular distribution of siRNA and delivery agents .Transfection efficiencies in targeting and nontargeting groups were (89.75 ±1.81)%and (59.87 ±4.52)%, respectively.Down-regulation of the KRAS mRNA in Panc-1 cells transfected with siKRAS by scFvCD44v6-IONP-PEI and IONP-PEI was up to (34.02 ±6.15)%and (51.09 ±6.70)%, re-spectively .The protein level of KRAS was lower in targeting group than that in nontargeting group .CONCLUSION:scFvCD44v6-IONP-PEI is a safe and efficient nanoparticulate carrier for gene delivery .It is more effective to transfer siRNA into the cells and mediate gene silencing effect in vitro than the nontargeting group .