A radiomic nomogram based on T2WI for predicting synchronous liver metastasis of rectal cancer / 中华放射学杂志

Objective To explore the clinical feasibility of predicting synchronous liver metastases based on MRI radiomics nomogram based on T2WI in rectal cancer. Methods The imaging and clinical data of 261 patients with primary rectal cancer admitted to Zhejiang People′s Hospital from April 2012 to May 2018 were retrospectively analyzed. 101 patients were accompanied by synchronous liver metastasis All cases were divided into training group (n=182) and verification group (n=79). T2WI image of each patient was selected to extract texture features by AK analysis software of GE company. A radiomics signature was constructed after reduction of dimension in training group by the least absolute shrinkage and selection operator (LASSO). Univariate logistic regression was used to select for independent clinical risk factors and multivariate logistic regression along with imaging omics tags were used to construct predictive models and nomogram. ROC was used to assess the accuracy of the nomogram in the training group and to verify them by the validation group. Finally, the clinical efficacy of each patient′s synchronized liver metastasis risk factor was calculated based on the nomogram. Results A total of 328 texture features were extracted from the T2WI. Seven most valuable features were selected after reducing the dimension by LASSO algorithm, including 3 co-occurrence matrices (GLCM) and 4 run-length matrices(RLM). Tumor staging and radiomic signatures were included in the Multifactor logistic regression to build the prediction model and nomogram. The accuracy of predicting SRLM was 0.862 and 0.844 in the training and the verification group, respectively. To evaluate the accuracy of the nomogram, radiomics signature and the tumor staging in all cases were 0.857, 0.832 and 0.663, respectively. There was no significant difference in the number of SRLM cases between the high risk group and the low risk group based on nomogram (P>0.05). Conclusion The radiomics nomogram based on T2WI can be used as a quantitative tool to predict synchronous liver metastases of rectal cancer.

Research advances of clinical applications in repairing surgery for orbital fracture / 眼科新进展

As one of the common type of ocular injuries,orbital fracture can result in enophthalmos,diplopia and infraorbital nerve injury,which affects the physiological function of eyeball.Repairing surgery for orbital fracture should be treated for reconstructing the orbital anatomical structure in case of severe enophthalmos and diplopia,or infraorbital nerve injury.Meanwhile,it's crucial to identify the suitable surgery approach and implants because of the specificity and complexity of the orbit.What a clinician expected most is the ideal prognosis obtained easily with minimal operation complication.Transconjunctival approach should be applied as one of the standard approaches for repairing surgery of orbital fracture,offering good operative field with less complications.Titanium mesh and resorbable materials are the ideal implants at present,for their high level of stable quality and plasticity.More and more applications of 3D-printed rapid prototyping technique can guide the new directions of individualization and precision of repairing surgery for orbital fracture.

Clinical use of AO three-dimensionally preformed titanium mesh plates for orbital fractures / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AlM:To evaluate the accuracy and practicability of three - dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.?METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall ( n = 26, 55%), medial wall ( n = 12, 26%), and floor ( n = 9, 19%) . The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three -dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography ( CT) scan. The practicability of clinical use of AO three - dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.?RESULTS: Postoperative orbital CT scan showed an anatomic three- dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients ( 87%) had a successful enophthalmos correction. 25 patients ( 86%) had a successful recovery from diplopia.?CONCLUSlON: Three- dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.

Relationship between E-CD and TWIST expression in colorecral cancer and tumor invasion,metastasis and prognosis / 中华普通外科杂志

Objective To study Twist,E-CD expression in colorectal cancer tissues and its relationship with colorectal cancer invasion,metastasis and prognosis.Methods Immunohistochemical staining (EnVision) was used to detect E-CD,Twist expression of normal colon mucosa in 30 cases,colorectal adenoma in 30 cases and colorectal cancer tissues in 142 cases.Chi-square、Fisher's and Spearman test were used to analyze E-CD and Twist protein expression,Kaplan-Meier survival analysis and multivariate COX regression were used to analyze prognosis of patients.Results E-CD in the normal mucosa were positively expressed in 90％ cases,which was significantly higher than that in colorectal adenomas (63％) (P =0.046) and colorectal cancer tissues (42％) (P =0.000).E-CD expression was related to tumor differentiation (P =0.048),invasion depth (P =0.000),vein (P =0.000) and lymph vessel invasions (P =0.030),lymph node metastasis (P =0.001) and Dukes' stage (P =0.016),but not related to patient's age(P =0.174),gender(P =0.159),tumor size (P =0.628) and tumor histological type (P =0.153).1,3,5 year survival rate in patients with positive E-CD expression was significantly higher than that in patients with negative expression (P =0.000).Positive expression rate of Twist in colorectal cancer tissues (68％) was significantly higher than that in normal mucosa (20％,P =0.000) and colorectal adenomas (30％,P =0.000).Twist expression was related to tumor histological type (P =0.000),differentiation(P =0.000),invasion depth(P =0.000),vein(P =0.000) and lymph vessel invasions(P =0.000),lymph node metastasis(P =0.010) and Dukes' stage(P =0.000).1,3,5 year's survival rate of Twist-negative expression patients was significantly higher than that in patients with positive expression (P =0.000).E-CD and Twist in colorectal cancer tissues were negatively correlated (r =-0.530,P =0.000).COX multivariate analysis shows that vein invasion (P =0.045),lymph node metastasis (P =0.040),Dukes' stage (P =0.000),E-CD (P =0.003) and Twist (P =0.031) were independent prognostic indicators.Conclusions E-CD and Twist expression in colorectal cancer are related to tumor invasion,metastasis and prognosis.Low E-CD expression and high Twist expression are related to poor prognosis of colorectal cancer patients.

Preliminary study on relationship between multi-drug resistance-associated protein 4 and radiosensitivity of rectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To explore the correlation between multi-drug resistance-associated protein 4(MRP4) and the sensitivity of rectal cancer to radiation.</p><p><b>METHODS</b>A total of 95 patients with advanced rectal cancer and received radiation therapy between January 2000 and January 2009. MRP4 and P53 protein expression in the paraffin-embedded specimen were detected by immunohistochemistry. Logistic regression analysis was used to evaluate factors associated with the sensitivity of rectal cancer to radiation.</p><p><b>RESULTS</b>Forty patients(42%) were sensitive to radiation therapy, of whom 10(11%) achieved pathological complete remission. Fifty-five patients were (58%) not responsive to radiation. Patients with low expression of MRP4 had a 66.7%(24/36) response rate, significantly higher than that of patients with high MRP4 expression (29.1%,16/59)(P<0.05). Patients with low expression of P53 had a 63.9%(23/36) response rate, significantly higher than that of patients with high P53 expression(28.8%,17/59)(P<0.01). The response rate after long course radiation therapy was 83.3%(20/24), significantly higher than that of patients who underwent short and medium course radiation[(31.3%, 5/16) and(27.3%,15/55)](P<0.01). Multivariate Logistic regression analysis showed radiation regimen, the expression of P53 and MRP4 protein were independently associated with the sensitivity of rectal cancer to radiation(P<0.05).</p><p><b>CONCLUSION</b>MRP4 may serve as a predictive marker for the sensitivity of rectal cancer to preoperative radiation.</p>

Analysis of risk factors associated with lymph node metastasis and prognosis of T1-2 colorectal cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate factors associated with lymph node metastasis and prognosis in patients with T1-2 colorectal cancer.</p><p><b>METHODS</b>Patients with pT1-2 colorectal cancer between January 1999 to January 2005 were included. Chi-square test and multivariable logistic analysis were performed to evaluate risk factors associated with lymph node metastasis. Survival outcomes were analyzed using Kaplan-Meier and Cox regression model.</p><p><b>RESULTS</b>Tumor location and depth of invasion were independent risk factors for lymph node metastasis(P<0.01 and P<0.05). Gender, age, tumor gross pattern, tumor differentiation, carcinoembryonic antigen level, and tumor diameter were not associated with lymph node metastasis. Lymph node metastasis and distant metastasis on postoperative follow-up were independent risk factors for survival(P<0.05 and P<0.01).</p><p><b>CONCLUSION</b>Factors associated with lymph node metastasis in pT1-2 colorectal cancer do not affect the survival. However, lymph node metastasis and distant metastasis are predictive for survival.</p>

Lymph node metastasis and its risk factors in T1-2 staging invasive rectal carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the lymph node metastasis and its risk factors in T1-2 staging invasive rectal carcinoma.</p><p><b>METHODS</b>The data of 1116 patients with rectal cancer treated with total mesorectal excision (TME) technique from January 2000 to April 2009 was analyzed retrospectively. The clinicopathological factors analyzed included gender, age, primary symptom type, number of symptoms, duration of symptom, synchronous polyps, preoperative serum carcino-embryonic antigen level, preoperative serum CA19-9 level, the distance of tumor from the anal verge, tumor size, tumor morphological type, tumor circumferential extent, tumor differentiation and tumor T staging. Statistical analysis was performed by using Logistic regression analysis and Chi-square test.</p><p><b>RESULTS</b>A total of 1116 patients were enrolled, and 358 cases (32.1%) were classified as with T1-2 staging tumor. Two cases (5.6%, 2/36) in patients with a T1 staging tumor were found with lymph node metastasis, and 75 cases (23.3%, 75/322) in patients with a T2 staging tumor, respectively. Compared with patients with T3-4 staging tumor, lymph node metastasis rate of the patients with T1-2 staging tumor was significantly lower [21.5% (77/358) vs. 51.6% (391/758), P < 0.05]. Only the tumor T staging was found as the independent risk factor for the lymph node metastasis in patients with T1-2 staging tumor on multivariate Logistic regression analysis (odds ratio: 5.162; 95%CI: 1.212 to 21.991; P = 0.026).</p><p><b>CONCLUSIONS</b>A substantial proportion of T1-2 staging rectal cancers harbor metastatic lymph nodes and the clinicopathological features except for T staging fail to predict the lymph node metastasis. Further research is warranted to identify the risk factors and guide the clinical practice in patient with T1-2 staging tumor.</p>

Effects of tangshen tang on glomerular mesangial cell proliferation in rats / 中国组织工程研究

BACKGROUND: Glomerular mesangial cell (GMC) is the chief target cell of diabetic nephrosis. A series of functional alternations on mesangial cell (MC) in high glucose condition results in constant development of the disease. Intervention of Chinese herb is very significant in retarding the progression of diabetic nephrosis.OBJECTIVE: To probe into GMC proliferation in high glucose condition and the effects of serum with tangshen tang contained on it.DESIGN: Controlled experiment was designed.SETTING: Laboratory Room of Second Affiliated Hospital to Zhejiang College of Traditional Chinese Medicine.MATERIALS: MCs of SD rats were taken as experimental objects collected from Internal Department of Kidney of Shanghai First People's Hospital in August 2003.Totally 45 SD rats of clean grade were employed from Experimental Animal Center of Zhejiang College of Chinese Medicine, of either sex,weighted with (180±20)g in October 2003 and they were prepared as the animals with herb-contained serum. Tangshen tang [composed of dahuang (Rhubarb), taoren (Semen Persicae), chong (insects), huangqi (Radix Astragali seu Hedysari), digupi (Cortex Lycii Radicis), huanglian (Rhizoma Coptidis),etc.] was concentrated as 3 g/mL after decoction and infiltration at ratio.METHODS: SD rats were randomized as normal group, tangshen tang group and captopril group, 15 rats in each. The serums with tangshen tang and captopril of different doses were applied in MCs. In normal group,gastric perfusion of equal volume of distilled water was applied everyday.Trypan blue staining and MTT method were used respectively to assay the effects on MC toxicity and proliferation after medication.MAIN OUTCOME MEASURES: Activity of GMC in rats after stimulation of medical-contained serums and cellproliferation.liferation was inhibited (P ＜ 0.05 , vs blank group) in constant high-glucose condition and the inhibited proliferation due to high glucose was reversed to various extents after the intervention of tangshentang and captoter the intervention of medical-contained serums on GMCs in rats in every group (cell activity was up to over 94% and P ＞ 0.05, vs blank group).CONCLUSION: High glucose inhibits MC proliferation and tangshentang stimulates MC proliferation.

Effect of CART55-102 protein vaccine on morphine analgesia and tolerance / 第二军医大学学报

0.05).CART vaccine at 10?g significantly depressed the analgesic effect of morphine analgesia (P