Objective To observe the value of pseudo-continuous arterial spin labeling(PCASL)MRI for evaluating renal function in patients with renal occupying lesions.Methods Totally 56 patients with single renal occupying lesion were retrospectively enrolled.The left and right side kidneys were divided into normal renal function group(normal group,30 ml/min)and damaged renal function group(damaged group,＜30 ml/min)according to glomerular filtration rate(GFR)measured with 99Tcm-DTPA dynamic renal imaging,respectively.The total renal blood flow(tRBF)and cortical renal blood flow(cRBF)were calculated using total nephrometry and cortical nephrometry based on PCASL MRI,respectively,then GFR,tRBF and cRBF were compared between groups on the same side.Receiver operating characteristic curve was drawn,and the area under the curve(AUC)was calculated to evaluate the efficacy of tRBF and cRBF for assessing unilateral renal injury.Pearson correlation analysis was performed to observe the correlations of tRBF and cRBF with GFR.Results GFR,tRBF and cRBF in left/right damaged group were all significantly lower than those in ipsilateral normal group(all P＜0.05).AUC of tRBF and cRBF for assessing left renal injury was 0.823 and 0.813,respectively,being not significantly different(P＞0.05).AUC of tRBF and cRBF for assessing right renal injury was 0.940 and 0.922,respectively,being not significantly different(P＞0.05).No obvious correlation of bilateral tRBF nor cRBF with GFR was found(all P＞0.05).Conclusion PCASL MRI could effectively evaluate renal function in patients with renal occupying lesion,and the efficacy of total nephrometry was comparable to that of cortical nephrometry.

Objective:To explore the efficacy and adverse reactions of nimotuzumab combined with induction chemotherapy (IC) based on albumin-bound paclitaxel plus cisplatin (TP regimen) for patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC).Methods:Clinical data were collected from 65 patients with LA-HNSCC (stages Ⅲ/Ⅳ A/Ⅳ B; excluding nasopharyngeal carcinoma) who received 2-3 cycles of IC followed by concurrent chemoradiotherapy (CRT) in the Second Hospital of Dalian Medical University from January 2018 to June 2022. Based on the IC regimen, these patients were categorized into a nimotuzumab combined with TP (Nimo-TP) group ( n = 34) and a TP group ( n = 31), and their short-term efficacy [i.e., the objective response rate (ORR)], survival outcomes [e.g., overall survival (OS), progression-free survival (PFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS)], and adverse reactions were compared. Additionally, factors affecting their survival outcomes were analyzed. Results:There were statistically significant differences in 1- and 2-year DMFS between both groups (90.4% vs. 69.5%, 90.4% vs. 66.0%, χ2=1.81, P < 0.05), so did the ORRs after IC and CRT of both groups (after IC: 67.6% vs. 41.9%, χ2=4.34, P = 0.037; after CRT: 88.2% vs. 67.7%, χ2=4.03, P = 0.045). However, there was no statistically significant difference in the 2-year OS, PFS, and LRFS between both groups ( P > 0.05). Multivariate analysis revealed that nimotuzumab combined with TP-based IC served as an independent prognostic factor for DMFS ( HR = 0.27, 95% CI: 0.07-0.97, P = 0.045), while complete/partial response after IC acted as an independent prognostic factor for both PFS and local relapse-free survival ( HR = 0.36, 95% CI: 0.17-0.76, P = 0.008; HR = 0.28, 95% CI: 0.11-0.69, P = 0.006). Notably, adding nimotuzumab did not aggravate the adverse reactions in the patients during IC and CRT( P > 0.05). Conclusions:Nimotuzumab combined with TP-based induction chemotherapy followed by CRT significantly improved the DMFS of LA-HNSCC patients, exhibiting high safety. However, such therapy failed to significantly improve their OS, PFS, and LRRFS, and, thus, further research is required.

Objective To discuss the safety and clinical efficacy of modified traction method using endoloop and clip for endoscopic submucosal dissection(ESD).Methods Fifty patients who underwent ESD at Renmin Hosptial of Wuhan University between August 2016 and February 2017 were randomly divided into two groups, including 25 patients in modified ESD group and 25 patients in conventional ESD group as control. The therapeutic conditions, dissection time and incidence of complications were compared between the two groups. Results In the modified ESD group, the dissection time of submucosal exposure to the full dissection (19. 9±6. 5 min VS 26. 4±9. 2 min, P＝0. 001), total dissection time (27. 5±8. 1 min VS 35. 1± 10. 7 min, P＝0. 003), and dissection time per unit area (2. 4±1. 1 min/cm2VS 3. 3±1. 3 min/cm2, P＝0. 009) were significantly shorter compared with those in the control group. There were 1 case of delayed bleeding in the modified group and 2 cases in the control group with no significant difference ( P＝0. 248). No perforation occurred. Conclusion The modified traction method using endoloop and clip for ESD is safe and effective with a shorter operation time.

Objective To compare the effectiveness and safety of endoscopic submucosal dissection ( ESD) with endoscopic piecemeal mucosal resection ( EPMR) for early esophageal cancer and precancerous lesions with length more than 5 cm. Methods A retrospective analysis was performed on data of 85 patients diagnosed as early esophageal cancer and precancerous lesions with length more than 5 cm in Fujian Medical Association of Early Esophageal Carcinoma from January 2012 to July 2017. The patients were divided into ESD group (52 cases) and EPMR group (33 cases), and the effectiveness and safety between the two groups were compared. Results There was no significant difference on the complete resection rate between the two groups[86. 5％ (45/52) VS 87. 9％ (29/33), P>0. 05]. The operative time (58. 53±30. 50 min VS 32. 06±9. 12 min), postoperative fasting time (4. 18±1. 30 d VS 3. 67±0. 96 d), postoperative hospital-stay time (7. 45±2. 44 d VS 6. 54±1. 73 d), and postoperative antibiotics using time (3. 48±2. 33 d VS 1. 96±2. 20 d) in ESD group were higher than those in EPMR group (all P<0. 05). There were no significant difference in the rate of intraoperative complication and short-term postoperative complication, such as fever, chest pain, and postoperative bleeding, between the two groups ( all P>0. 05 ) . But the postoperative stricture rate of ESD group was higher than that of EPMR group[23. 1％ (12/52) VS 6. 1％(2/33), P<0. 05]. During the follow-up of 3-63 months, 5 cases recurred in ESD group and 1 case in EPMR group, with no significant difference ( P>0. 05). Conclusion ESD and EPMR have equivalent efficacy and safety on the treatment of early esophageal cancer and precancerous lesion. EPMR has a shorter operative time, lower rate of post-operative stricture, and is easier to master.

[Summary] A more conservative approach for endometrial cancer ( EC ) is desirable in women who have requirement to preserve fertility, without compromising their survival .In this article, we tried to formulate clinical recommendations of preserving fertility based on suggestions of European Society of Gynaecological Oncology ( ESGO) in 2015 and relevant research progress .

Objective To investigate the clinical effect of "pre-purse-string" suture on submucous gastric lesions of external growth type in endoscopic patients. Methods Clinical data of 27 patients with gastric lesions of external growth type admitted to the digestive endoscopy center of Renmin Hospital of Wuhan University from August 2016 to October 2016 for endoscopic submucosal dissection ( ESD ) were analyzed. Patients were randomly divided into two groups, the experiment group receiving the "pre-purse-string" suture, the control group receiving purse-string suture after ESD. Mean size of the lesions, procedure time, withdrawal time of gastric decompression, and hospitalization time were compared. Results In the 15 patients of the experiment group, there were 3 cases whose lesions were located in gastric antrum, 6 in gastric body and 6 in gastric fundus. In the 12 cases of the control group, 3 lesions were located in gastric antrum, 5 in gastric body and 4 in gastric fundus. All procedures were successfully completed in endoscopy. No obvious postoperative complications occurred. The mean size of lesions was 2. 5 cm × 3. 2 cm in the experiment group,and 2. 4 cm×3. 0 cm in the control group (P=0. 63). The operation time was 28. 0-43. 0 min (35. 8±6. 1 min) in the experiment group, and 45. 6-68. 8 min (48. 8±5. 3 min) in control group ( P<0. 01) . Conclusion "Pre-purse-string" technique is of clinical effect on gastric submucosal tumor of external growth.

This study was aimed to investigate the changes of hemodynamic parameters, pathology and c kit mRNA expression in myocardium after acute myocardial infarctionin (AMI) in rats, and to elucidate the relationship between these three kinds of changes. Sixty six adult male SD rats were randomly divided into normal group, Sham groups and ligation groups. The rat model of AMI was set up by ligating the left anterior descending artery. Hemodynamic parameters, pathological changes and c kit mRNA expression in myocardiam were examined. The results revealed that there were no statistically significant differences in hemodynamic parameters between normal group and Sham groups. Compared with the normal group, all ligation groups exhibited significantly decreased left ventricular systolic pressure (LVSP) and +/-dp/dtmax (P<0.01), and increased left ventricular end diastolic pressure (LVEDP, P<0.01). In the other ligation groups, compared with 6th hour group after ligation, there appeared striking increase of LVSP, LVEDP and +/-dp/dtmax (P<0.05). HE staining in myocardiam showed that there are necrosis and derangement at 24th hour group after ligation ,and a great number of inflammatory cells infiltration around the infarct zone at 3rd day group after ligation, and granulation tissue infiltrated into the infarct zone at 14th day group after ligation. In all five time points groups after ligation, the levels of c-kit mRNA expression were 0.99 fold, 1.06 fold, 1.46 fold, 1.91 fold and 2.67 fold, respectively, compared with Sham groups. The results suggest that cardiac stem cells in myocardium might contribute to the role of regenerating myocardium via self proliferation after acute myocardial infarction, but further investigation is still needed.
Animals ; Hemodynamics ; physiology ; Male ; Myocardial Infarction ; metabolism ; pathology ; physiopathology ; Myocardium ; metabolism ; pathology ; Myocytes, Cardiac ; cytology ; Proto-Oncogene Proteins c-kit ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stem Cells ; cytology

This study was aimed at observing the effects of ovariectomy and estradiol on the microarchitecture of cancellous bone and exploring the influence of microarchitectural change on the biomechanical properties. Thirty 6-month-old unmated female SD rats were randomly divided into 3 groups (10 rat each): sham-operated control group (Sham), ovariectomized group (OVX)and Estradiol Benzoate treated group (EBT). All rats were housed in standard environmental conditions. Five months after operation, the rats were sacrificed. The biomechanical properties of the third lumbar vertebras (L3) were measured with compression testing in vitro. Micro-CT scanning was performed on the fourth lumbar vertebras (L4) in vitro. In comparison with the corresponding variables of Sham, the bone volume fraction (BV/TV) and the trabecular number (Tb. N) of OVX were reduced remarkably, and the trabecular separation (Tb. Sp) and the structural model index (SMI) of OVX were enhanced obviously. These facts implicated that the bone trabecular plate-like structure of OVX were decreased. BV/TV, Tb. N and the trabecular thickness (Tb. Th) of EBT were greater than those of OVX. Tb. Sp and SMI of EBT were much smaller than those of OVX. The results of mechanical test showed that the maximum forioe (Fmax), the maximum stress (sigmamax) and the elastic modeulus (E) of the lumbar vertebral cancellous bone of OVX were declined sharply, while the aforesaid biomechanical index of EBT was improved distinctly. The performance of three-dimensional micro-CT and the mechanical testing to assess microarchitecture of cancellous bone are useful for evaluating the state of osteoporosis and the antiosteoporotic effect of agents.
Animals ; Biomechanical Phenomena ; Estradiol ; pharmacology ; Female ; Imaging, Three-Dimensional ; Lumbar Vertebrae ; diagnostic imaging ; pathology ; Osteoporosis ; pathology ; Ovariectomy ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Tomography, X-Ray Computed

The effect of chitosan with different molecular weight and deacetylation degree on blood hemostasis was tested. The experiments found evident alteration of red blood cell morphology and unusual coagglutination between erythrocytes in the anticoagulant blood which was treated by chitosan acetic acid solution. The red blood cells clot formation experiments showed that chitosan with low deacetylation degree (60%-70%) caused more red blood cells to assemble when compared versus chitosan with other deacetylation degrees. The effect of molecular weight between 10(5)-10(6) was not obvious. The thrombin time (TT), prothrombin time (PT), activated partial thromboplastin time (APTT), and concentration of fibrinogen (FIB) of blood treated by chitosan acetic acid solution were measured. The results proved that the hemostasis property of chitosan acetic acid solution was independent of the platelets and the normal "Cascade-like" coagulation pathway.
Acetic Acid ; chemistry ; pharmacology ; Animals ; Chitosan ; chemistry ; pharmacology ; Fibrinogen ; analysis ; Hemostatics ; chemistry ; pharmacology ; Partial Thromboplastin Time ; Prothrombin Time ; Rabbits ; Thrombin Time

The effects of chitosan and N,O-carboxymethyl chitosan on blood hemostasis are tested.The dynamic blood coagulation experiments show chitsan with low deacetylation degree has higher absorption ability.The experiments can't find that any altered red blood cell morphology or an unusual affinity between erythrocytes appears evidently in the ACD blood treated with chitosan.The concentration of the platelets on the chitosan surface may be one of causes that platelets produce blood coagulation.Chitosan is substituted by the carboxymethyl and has water solubility.But N,O-carboxymethyl chitosan can lead torouleau and not toaltering the morphology of the erythrocyte.The blood hemostasis effect is not obvious.The values of TT,PT,APTT and FIB are measured from blood and the results fail toprove that chitosan and N,O-carboxymethyl chitosan can activate the coagulation factors.