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Objective:To study the relationship between compartmental kneeosteoarthritis (KOA) and osteoporosis (OP).Methods:A total of 118 KOA patients with 50~80 years old and 16.5~38 of body mass index (BMI) were selected as the KOA group, in which the patient with OP caused by secondary factors were excluded. 42 patients who did not suffer from KOA who matched the age of patients in the KOA group were selected. The age, BMI, bone mineral density (BMD) and other data of the two groups of patients were collected. The correlation analysis between KOA and OP was conducted to determine the degree of correlation, so as to reveal the relationship between the incidence, progression, prognosis of KOA and OP.Results:BMD was correlated with BMI. BMD was negatively correlated with age. The incidence of KOA and OP was correlated with age. There is a large correlation between KOA and OP, and the probability of KOA associated with OP is high. For KOA patients, OP is less likely to be accompanied by a higher BMI, while OP is more likely to be accompanied by a lower BMI.Conclusions:OP is one of the pathogenic factors of KOA. KOA patients should be treated with anti-OP before and after surgery.
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Objective To investigate the effect of gastric filling degree on the thickness of advanced gastric carcinoma and the clinical value of the thickness measured by CT.Methods Totally 38 patients with advanced gastric carcinoma were enrolled and 21 patients were newly diagnosed,17 patients were reexamination after non surgical treatments.The stomach cavity was filled with oral gas-producing powder.The plain scanning (before filling) and enhanced scanning in venous phase (after filling) were performed.The thickness of the normal gastric wall and gastric carcinoma before and after filling were measured on axial images,and the differences were compared.The patients were measured again one month later by the same investigator,and the consistency between the twice measurements was evaluated.Results Before and after filling,the normal gastric wall thickness of each regions was significantly different (all P＜0.001),and the change was greatest at the region of greater curvature.Carcinoma thickness was similar in newly diagnosed patients (P＜0.05),but significantly different in patients for reexamination (P＜0.05).The twice measurements had a good consistency.Conclusion The thickness of gastric carcinoma can be considered as a baseline measurement indicator in newly diagnosed patients.It is critical to maintaining a similar gastric filling degree during reexamination,which is helpful to evaluate the efficacy of treatment accurately.
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Objective To study the relationship between CDC25A (cell division cycle 25A) expression and the development of gastric adenocarcinoma. hTe effect of artesunate (Art) on CDC25A and gastric cancer cells were also investigated.Methods hTe CDC25A protein expression in gastric adenocarcinoma was detected by lfow cytometry assay. SGC-7901 cells were divided into four groups: control group and 30, 60, 120μmol/L Art groups. Cell apoptosis, cell cycle and CDC25A protein expression in SGC-7901 cells were determined by lfow cytometry atfer the treatment of different concentrations of Art (30, 60, 120μmol/L) for 24h, while the same volume of saline was used in the control.Results CDC25A protein expression level in gastric adenocarcinoma (419.69±21.91) was signiifcantly higher than that in normal gastric tissues (316.11±24.23,P<0.01). hTe cell apoptosis rates of 30, 60, 120μmol/L Art groups (5.48%±0.67%, 12.55%±1.17%, 23.43%±2.18%) were significantly higher than that of control group (0.87%±0.14 %,P<0.05), with an Art dose dependent manner. hTe cell proliferation indices of 30, 60, 120μmol/L Art groups (39.18%±0.53%, 35.71%±0.99%, 31.73%±1.02%) were signiifcantly lower than that of control group (44.12%±2.51%,P<0.01). hTe CDC25A protein expression levels of 30, 60, 120μmol/L Art groups (414.80±4.06, 397.86±3.61, 345.68±7.11) were significantly lower than that of control group (433.99±1.56,P<0.01).ConclusionhTe abnormally increased expression level of CDC25A may be involved in the development of gastric adenocarcinoma. Art can inhibit the growth of SGC-7901 cells by down-regulating the expression of CDC25A protein.
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Objective To investigate the parameters of diffusion?weighted magnetic resonance imaging ( DWMRI) for prediction of the efficacy of chemoradiotherapy ( CRT) for esophageal squamous cell carcinoma ( ESCC) , to determine the optimal time point and threshold for prediction, and to provide a basis for clinical practice. Methods From 2010 to 2011, 38 patients with ESCC were consecutively enrolled as subjects. All patients received three?dimensional conformal radiotherapy with 60 Gy in 30 fractions for 6 weeks. They also received concurrent or consolidation chemotherapy ( FP or TP scheme ) as adjuvant treatment. Patients received DWMRI scans before radiotherapy and at weeks 1?6 during radiotherapy. The apparent diffusion coefficient ( ADC ) values and tumor lengths obtained from serial DWMRI scans were recorded and analyzed. Comparison was made by paired t test. Repeated measurements were analyzed by analysis of variance ( ANOVA) and multivariate ANOVA. The prognosis was predicted by the Logistic model. The effectiveness analysis and threshold screening were performed using the receiver operating characteristic (ROC) curve. Results In all patients, 20(52?6%) had complete response (CR) and 18(47?4%) had partial response ( PR) . There were no significant differences in the ADC values before radiotherapy and at weeks 1?6 during radiotherapy between patients with CR and PR ( 1?82 vs. 1?42;1?92 vs. 1?49;2?06 vs. 1?67;2?35 vs. 1?79;2?62 vs. 2?11;2?71 vs. 2?18;2?96 vs. 2?28×10-3 mm2/s;P=0?006,0?003,0?012, 0?001,0?003,0?008,0?002) . The ADC value at third week during radiotherapy was the only independent prognostic factor for short?term treatment outcomes in patients with ESCC ( OR=0?134, P=0?007) . These results were also supported by the multivariate ANOVA analyses. The analysis of the ROC curve showed that at the third week during radiotherapy, the area under the ADC curve was the largest ( A z=0?857) and the diagnostic effectiveness was the best;the threshold value, sensitivity, and specificity were 2?02×10-3 mm2/s, 80?0%, and 92?9%, respectively. Eight patients who had tumor out of control or recurrence within 1 year after treatment had the ADC curve fall down at the end of the fifth week and the reduction of tumor length substantially slow down from the fifth week. Conclusions DWMRI is an effective imaging approach for monitoring tumor response to CRT in patients with ESCC. The ADC value at the end of the third week during radiotherapy may be the optimal time point for prediction of treatment outcomes. The reduction in the ADC value or non?reduction in tumor length at the end of the treatment indicates a high risk of recurrence.
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Objective To investigate the accuracy of measurement of lesion length by computed tomography (CT) scan and diffusion?weighted imaging (DWI) for esophageal carcinoma, and to provide an optimized imaging method as a reference for target delineation in esophageal carcinoma. Methods Thirty?five patients with thoracic esophageal carcinoma from 2012 to 2013 were prospectively enrolled as subjects. All patients underwent examinations of esophageal endoscopy, CT scan of the thorax and abdomen, and DWI before radical surgery. Lesion lengths were measured by the above methods and compared with the real length of pathological specimen resected at surgery. The consistency between the lesion length measured by each imaging method and the pathological standard were evaluated using the intraclass correlation coefficient (ICC) and the Bland?Altman method. Results Four patients had no hyperintense signal on DWI, resulting in a false?negative rate of 11% in all patients and a false?negative rate of 44%(4/ 9) in patients with stage T1 esophageal carcinoma. Thirty?one patients had lesion lengths measured by DWI for analysis. The tumor length of pathological specimen after surgery was 4?? 58 cm, while the tumor lengths measured by endoscopy, CT scan, and DWI with b?values of 600, 800, and 1000 s/ mm2 were 4?? 56, 5?? 58, 4?? 41, 3?? 99, and 3?? 83 cm, respectively. The ICC values were 0?? 703, 0?? 764, 0?? 946, 0?? 890, and 0?? 882, respectively, with P value of 0?? 000 for all. According to the results of the Bland?Altman method, the highest degree of consistency was achieved between the tumor lengths measured by endoscopy and DWI with a b?value of 600 s/ mm2 and the pathological standard. Conclusions The esophageal tumor lengths measured by DWI are close to the real tumor length of the pathological specimen, in which the lesion length measured by DWI with a b?value of 600 s/ mm2 is most reliable. However, the value of DWI in the early diagnosis of esophageal carcinoma is limited.
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Objective To investigate the feasibility of new criteria for evaluating the radiotherapeutic effect on esophageal cancer by barium meal (BM) combined with CT scans.Methods A total of 189 patients who were diagnosed with esophageal cancer (confirmed by biopsy) from January 2004 to December 2010 were enrolled as subjects.All patients underwent BM and CT scans before and after radiotherapy.The maximal esophageal wall thickness (EWT) and changes in the volumes of regional lymph nodes measured by CT scans were analyzed.New criteria for evaluating the short-term radiotherapeutic effect on esophageal cancer was studied considering the analysis results as well as the BM-based criteria for evaluating short-term radiotherapeutic effect and follow-up results.Results The BM-based evaluation criteria were still useful,but had certain limitations.There were 115 patients who had regional lymph node metastasis as detected by CT scans before radiotherapy,and they were divided into complete remission (CR) group and partial remission (PR) group according to BM results after radiotherapy; the local control rate (LCR) of CR group was significantly higher than that of PR group,but there was no significant difference in survival rate (SR) between the two groups.There were 65 patients who had no regional lymph node metastasis,and they were also divided into CR group and PR group according to BM results after radiotherapy;the LCR and SR of CR group were significantly higher than those of PR group.In summary,the patients who had a CR as evaluated by BM and had the maximal EWT of ≤ 1.20 cm and the volumes of residual lymph nodes of ≤ 1.00 cm3 on CT were defined as CR ; the patients who had a PR as evaluated by BM or had the maximal EWT of ＞ 1.20 cm or those who had a CR evaluated by BM and had the maximal EWT of ≤ 1.20 cm and the volumes of residual lymph nodes of ＞ 1.00 cm3 on CT were defined as PR.The cases evaluated by BM as no remission (NR) or showing metastasis were defined as NR or progressive disease.There were significant differences in LCR and SR between the CR group and PR group determined by the new criteria.Conclusions Simply using BM to evaluate the short-term radiotherapeutic effect on esophageal cancer has certain limitations; instead,the evaluation based on both BM and CT scans is more accurate.