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Objective:To realize automatic delineation of rectal cancer target volume and normal tissues and improve clinical work efficiency.Methods:The deep learning method based on convolutional neural network was adopted to construct neural network, learn and realize automatic delineation, and compare the differences between automatic delineation and manual delineation.Results:Two hundred and ten cases with rectal cancer were randomly assigned to a training set of 190 and a validation set of 20. The complete delineation of a single case took about 10s; the average Dice of CTV was 0.87±0.04; the average Dice of other normal tissues was bigger than 0.8; the Hausdorff distance (HD) index of CTV was 25.33±16.05; the mean distance to agreement (MDA) index was 3.07±1.49, and the Jaccard similarity coefficient (JSC) index was 0.77±0.07.Conclusion:The deep learning method based on full convolutional neural network can realize the automatic delineation of rectal cancer target volume and improve work efficiency.
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Animal research of medical devices/medical materials is an essential part of preclinical safety and efficacy evaluation. Many questions should be taken in considerations when it comes to design and conduction animal research of medical devices/medical materials because of its uniqueness. This kind of research has widespread studying objects while has no universal standard method, and should be designed case-by-case. This article is aimed at serving as a reference for sponsors and researchers when performing preclinical safety and efficacy evaluation of medical devices/medical materials.
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Animals , Animal Experimentation , Equipment Design , Equipment and SuppliesABSTRACT
Neoadjuvant chemoradiotherapy is the standard treatment for locally advanced rectal cancer. Fudan University Shanghai Cancer Center has carried out multiple series of studies to explore the optimization of the neoadjuvant therapy since 2005. On the one hand, the "addition" method refers to a higher intensity treatment at the neoadjuvant stage to obtain better tumor regression. On the other hand, the "subtraction" method reduces some unnecessary treatment from the current triad of surgery, radiotherapy and chemotherapy to improve the quality of life of patients. However, locally advanced rectal cancer is associated with great heterogeneity, and therefore, any single treatment mode will not be optimal for all. Notably, the treatment decision-making should be based on clinical presentations, imaging findings, and molecular biology to precisely stratify patients. Besides, the scheme should be dynamically adjusted according to the therapeutic response, so as to realize the dual goals of prolonging patients′ life and improving their quality of life. Meanwhile, the treatment decision-making for target population under the guidance of biomarker should be dynamically and self-adaptively adjusted based on the therapeutic effect. This approach will become the future development direction and objective for the precise medical treatment for rectal cancer.
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Biological tests of medical devices is an important part to evaluate its biological safety. Good quality management of the test is a powerful guarantee to ensure the authenticity, integrity and reliability of the test results. This paper is based on the biological tests of medical devices, compares GLP and ISO/IEC 17025 which is widely used in China medical device testing institutions, describes the implementation of the GLP reference points to strengthen the quality management of biological tests of medical devices under the ISO/IEC 17025 system, to provide reference for quality management of medical device testing institutions.
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China , Equipment Safety , Equipment and Supplies , Reproducibility of ResultsABSTRACT
Histone acetylation is one of the most important reactions of post-translational modification of histones, which plays an important role in the regulation of epigenetic processes. Histone deacetylase 2 as a member of type I histone deacetylases,involved in the catalytic regulation of histone and a variety of non-histone deacetylation,regulates a variety of life processes. This paper summarizes the basic structure of histone deacetylase 2 and the role of histone deacetylase 2 in various diseases,and provides a theoretical basis for conducting related studies.
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Objective To develop the Elderly Frailty Assessment Scale and test its reliability and validity.Methods The primary item pool was formulated through literature review,compounding existing instruments measuring elderly frailty and group meeting.The items were selected by expert consultation.Totally 420 elderly adults were selected to test the reliability and validity and SPSS 20.0 was used to analyze data.Results The Elderly Frailty Assessment Scale consisted of 35 items;the exploratory factor analysis identified four principal factors which explained 72.685％ of the total variance.The item content validity index ranged from 0.824 to 1,and the scale content validity index was 0.932.The Cronbach's α coefficient of the scale was 0.952 and test-retest reliability was 0.937.Conclusion The Elderly Frailty Assessment Scale is reliable and valid,which can be used to evaluate elderly frailty.
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Objective To describe the status quo of Aged care willingness among nursing undergraduates,and to explore its influencing factors. Methods A total of 382 nursing undergraduates were enrolled by convenience sampling method. They were investigated with a self-designed questionnaire about the demographic data, the Kogan′s Attitudes toward Old People Scale, the Palmore′s Facts on Aging Quiz Scale and College Students′ Gratitude Trait Questionnaire. Results The overall aged care willingness score for nursing undergraduates was 17.75 ± 3.62. Appreciation, old training, happiness, retribution and living with the older people entered the multiple regression equation. Conclusions The Aged care willingness level of 382 nursing undergraduates is at medium level. Appreciation, old training, happiness, retribution and living with the older people are important influencing factors.
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BACKGROUND: Core decompression alone for osteonecrosis of femoral head easily causes fovea of femoral head and colapse of inner microstructure. Therefore, autologous bone is needed for filing and supporting. Moreover, bone marrow stem cel transplantation can decrease the incidence of femoral head colapse. OBJECTIVE:To discuss the clinical effects of core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels for osteonecrosis of femoral head. METHODS: A total of 33 patients were treated by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels in the Fourth Department of Bone Surgery, Central Hospital Affiliated to Shenyang Medical Colege in China from December 2012 to May 2013. RESULTS AND CONCLUSION:After the treatment by core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels, Harris hip function score increased and pain disappeared in patients with osteonecrosis of femoral head. They could do various labors. Radiographs or CT examination displayed normal femoral head in 30 hips, accounting for 79%. Pain significantly reduced. Normal or slight limp walking was found in 15 hips, accounting for 40%. There were 35 hips in patients, whose walking distance was extended, accounting for 92%. 24 hips dysfunction was improved markedly, accounting for 63%. Al results suggested that core decompression and bone grafting combined with autotransplantation of bone marrow mesenchymal stem cels improved the local blood supply of femoral head, and played a positive role in promoting the necrotic bone absorption and bone repairing.
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Objective To assess the health status of rodent laboratory animals by pathological diagnosis, our lab has being take apart in investigating the quality of laboratory animals in Beijing area for years and offer some advices for standardized breeding to ensure accurate results of scientific research.This paper focuses on the analysis of laboratory rodent samples that collected in October 2014.Methods We collected the heart, liver, spleen, lung, kidney, large intestine and small intestine, and put these organs into 10%Calcium formaldehyde solution for fixation, and then prepared into two different sections for optical microscopy observation including all paraffin specimens stained with H&E and the frozen sections stained with Oil Red-O and PAS.Results The vast majority of laboratory rodents were up to standard, but there still a problem in individual units.The main problem is liver and lung disease.The rate of Hepatocyte swellingis 6%(mouse), 2.5% (rat), 8.2% (guinea pig), moreover part of them were lipidosis, according to Oil Red-O stain.the mainly problem of lung is congestion ,edema and Interstitial pneumonia ,the detectable rate of pulmonarydiseases is 15.5%(guinea pig).Conclusions The vast majority of laboratory rodents were pathologically diagnosed as healthy animals.The liver disease may be caused by improper feeding.And disease of lung may led by haze, unqualified bedding and low temperature.
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BACKGROUND:Recently, there are many documents al over the world reporting hypotoxicity infection after fracture internal fixation surgery, but reports are different on whether it is necessary for chronic hypotoxicity infection internal fixation removal post surgery. There are no fixed judgment criteria of curative effects, which leads to inexact conclusion of treatment method. ＜br> OBJECTIVE:To observe the curative effects of taking rifampicin and ciprofloxacin with transfer of skin flap in the treatment of chronic hypotoxicity infection with sinus formation after fracture surgery on tibial plateau and ankle. METHODS:A total of 56 cases of chronic hypotoxicity infection after fracture surgery of tibial plateau and ankle were col ected from September 2005 to December 2012. 30 cases in the therapy group were treated with ＜br> levofloxacin and rifampicin with transfer of skin flap. 26 cases in the control group were treated with conventional intravenous antibiotics with local debridement to remove internal fixation. In both groups, the course of disease was 3 to 6 months. The erythrocyte sedimentation rate, kidney function and radiographic indices were reviewed every 1 to 3 months, and curative effects were evaluated. ＜br> RESULTS AND CONCLUSION:During the fol ow-up visit of 6-24 months, no recurrence happened to the cured and improved patients. In the therapy group, 24 cases were cured, 4 cases were improved, and 2 cases were invalid, with a total effective rate of 93%. In the control group, 11 cases were cured, 6 cases were improved and 9 cases were invalid with the total effective rate of 65%.χ2 test showed that therapeutic effects were significantly better in the therapy group than in the control group (P＜0.05). These data indicated that rifampicin and ciprofloxacin with transfer of skin flap for chronic hypotoxicity infection with sinus formation after fracture surgery of tibial plateau and ankle showed good curative effects.
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Objective Mongolian gerbil can make themself urine concentration for saving water and adapt to the harsh desert environment, due to their very unique moisture control system in the body.Methods Mongolian gerbil is resistant to drought on account of their special kidney. Histology of the kidney, ureter and bladder in Meriones Unguiculataus were observed by light microscopy using HE staining.Results The results showed that compared with rats and mice, the Mongolian gerbils have more developed distal tubules, and well developed inner renal medulla.Conclusions We hope that the findings of this study enrich our understanding of the histology of urinary system in Mongolian gerbils and provide support for the laboratory animalization of this animal.
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<p><b>OBJECTIVE</b>To investigate the association of mesorectal invasion depth before neoadjuvant radiochemotherapy with pathological outcome and to provide evidence for individualized treatment in T3 rectal cancer.</p><p><b>METHODS</b>Retrospective analysis was performed on the clinical records of 73 consecutive rectal cancer patients treated with neoadjuvant radiochemotherapy and radical surgery in the Shanghai Cancer Center from January 2010 to December 2012. All the patients underwent high-resolution MRI and the depth of mesorectal invasion, lymph node status, tumor length, and mesorectal fascia status were evaluated. The category T3 was subdivided according to the measurement of the maximal tumor invasion beyond the outer border of the muscularis propria: T3a(<5 mm), T3b(5-10 mm) and T3c(>10 mm). The association of mesorectal invasion depth,other MRI and clinical features with short-term efficacy was analyzed,especially with pathological complete response(pCR).</p><p><b>RESULTS</b>T3a, T3b and T3c accounted for 19.2%, 64.4% and 16.4% in 73 rectal cancer patients who underwent high resolution MRI, respectively. There were 42.9% of T3a patients achieved pathological complete response,significantly higher than those of T3b(14.9%)and T3c(0%) (P=0.017).</p><p><b>CONCLUSIONS</b>T3a rectal cancer patients are more likely to achieve pCR than those of T3b and T3c after neoadjuvant radiochemotherapy. The maximal tumor invasion beyond the outer border of the muscularis propria less than 5 mm may act as a predictive factor and guide the follow-up treatment of T3 rectal cancer.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Chemoradiotherapy , Neoadjuvant Therapy , Neoplasm Invasiveness , Rectal Neoplasms , Pathology , Therapeutics , Retrospective Studies , Treatment OutcomeABSTRACT
BACKGROUND:Studies have shown that human placenta-derived mesenchymal stem cells with strong proliferative ability have rich sources and can remarkably promote tendon-bone healing after celltransplantation. OBJECTIVE:To observe the effect of human placenta-derived mesenchymal stem cells on tendon-bone healing in a bone tunnel. METHODS:Human placenta-derived mesenchymal stem cells were separated using adherent separation screening method. Thirty 8-week-old male Sprague-Dawley rats were randomly divided into two groups, 15 rats as experimental group and 15 rats as control group. Experimental group were subjected to transplantation of human placenta-derived mesenchymal stem cells and the control group were injected with saline solution. RESULTS AND CONCLUSION:Stem cells, new vessels, and fibrocartilage hyperplasia were observed on the tendon-bone interface with microscope at 2, 4 and 6 weeks after celltransplantation in the experimental group. Biomechanical y, the maximum pul out load in the experimental group was significantly higher than that in the control group at 4 and 6 weeks after celltransplantation (P<0.05). These findings suggest that human placenta-derived mesenchymal stem cells can accelerate early tendon-bone healing in a bone tunnel and strengthen the biomechanical strength.
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Objective To evaluate the clinical efficacy and side effects of sunitinib in the treatment of advanced renal cell carcinoma. Methods Forty-five patients with advanced renal cell carcinoma and an average age of 48.6 yrs were treated with sunitinib. Among the study group, 25 were male and 20 were female. In group one, patients received sunitinib treatment in repeated six week cycles consisting of four weeks of sunitinib 50 mg daily followed by two weeks off treatment (schedule 4/2). In group two, a single daily dose of sunitinib 37.5 mg was administrated to 20 patients without off treatment. A CT scan was used to evaluate the treatment efficacy after each cycle and the side effects were recorded accordingly. Results Clinical efficacy could be evaluated in 40 patients. Of these, two achieved complete response, eight achieved partial response, 27 were stable and the remaining eight experienced disease progression with four patients dying during the study period. The side effects of sunitinib in group one and in group two included hypertension 32% (8/25) and 10% (2/20), P=0.02; liver function impairment 32% (8/25) and 20% (4/20), P=0.011; hand-foot skin reaction 68% (17/25) and 60% (12/20), respectively. The incidence of major side effects of sunitinib were different in Chinese patients than from what had been previously reported in studies conducted in US and Europe. Generally, most of the sunitinib side effects were easy to manage. Conclusions There weredifferences between the two groups of Chinese patients treated with different sunitinib protocols. The protocol of sunitinib 37.5mg daily without off-treatment was better than the protocol of sunitinib 50mg daily (schedule 4/2) in regard to liver function impairment and hypertension.
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Objective To investigate the efficacy of Sunitinib in treating metastatic non-clear cell renal cell carcinoma (RCC).Methods Twenty-two metastatic non-clear cell subtype renal cell carcinoma patients with a median age of 46 years (29 -76 years) were treated with Sunitinib.Fourteen cases were found have metastasis post radical nephrectomy,and the remaining eight cases with metastasis received cytoreductive surgery.Pathological diagnosis showed 12 papillary RCCs,one chromophobe RCC,three collecting duct RCCs,and six unclassified RCCs.The metastatic lesions were located in the lung,lymph nodes,adrenal gland,bone,liver,and thyroid gland.The patients were given the treatment of sunitinib 50 mg qd four weeks on and two weeks off.The median time of treatment was 11 months (4.5 - 24 months).Results The objective control rate was 73％.Three papillary RCC and one chromophobe RCC reached partial remission (PR) and 12 cases maintained stable disease (SD) for more than 12 weeks.And the remaining six cases progressed (PD).Conclusions Sunitinib has definitive efficacy in metastatic papillary RCC,chromophobe RCC,collecting duct RCC and unclassified RCC.Metastatic lesions in lungs and lymph nodes might be more sensitive to Sunitinib.
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Objective To review the diagnosis and treatment of basal cell carcinoma of the scrorum. Methods Clinical data of 7 patients with basal cell carcinoma of the scrotum were analyzed retrospectively. The mean age of the patients was 66 years. The most common presenting symptom was a plaque or nodular lesion with pruritis on the scrotum. The lesions ranged from 1.5 cm to 4.5 cm in diameter. Five of the 7 patients had a history of misdiagnosis. The diagnosis was established by biopsy of the lesion in all the patients. All of the 7 patients had no distant metastasis at the time of diagnosis and were treated by wide surgical resection.Results Histopathologic examination of the specimens confirmed the negative surgical margins in all cases.The most common histological feature was lobules, columns, bands and cords of basaloid cells associated with a surrounding loose fibromucinous stroma.One patient developed left inguinal lymph node metastasis at 21 months postoperatively,and was treated by bilateral inguinal lymph node dissection.The patient was free of cancer for 36 months after that. Another patient developed lung metastasis 48 months after the first operation.He was treated by systemic chemotherapy with cyclophosph amide, epirubicin and cisplatin for 6 cycles and obtained complete remission.This patient was free of cancer for 13 months after the chemotherapy.The remaining 5 patients were all free of cancer after the operation. Conclusions Basal cell carcinoma of the scrotum is rare.Wide surgical resection alone is usually considered to be curative. Because of its potential of metastasis, long-term followup is indicated for this disease.
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Objective To analyze the predictive factors of anti-androgen withdrawal in the treatment of androgen independent prostate cancer. Methods 347 cases of advanced metastatic prostate cancer in our prostate cancer database were filtered. All the cases were treated with maximal androgen blockade and had full pathological and clinical information. 237 cases developed to the androgen independent stage during the maximal androgen blockade treatment. Among them, 90 cases were treated with anti-androgen withdrawal. This 90 cases were followed up and the last follow-up date was 30 September 2009. The Logistic regression of univariate and multivariate analysis were used to find the predictive factors for the effectiveness of anti-androgen withdrawal, which including baseline PSA, Gleason score, clinical stage, way of castration, kind of anti-androgen, PSA nadir during maximal androgen blockade, time to PSA nadir, PSAV at the time of AIPC, PSADT at the time of AIPC, the effective duration of maximal androgen blockade, age at the time of AIPC and PSA at the initiation of anti-androgen withdrawal. Results Of the 90 cases treated with anti-androgen withdrawal, 3 cases were excluded for analysis because of the incomplete information. Among the 87 cases, 17 cases were effective with the anti-androgen withdrawal treatment while the other 70 cases were ineffective. At the last follow-up, 3 cases were still effective. The median effective duration of anti-androgen withdrawal was 4 months. The univariate analysis indicated that PSAV at the time of AIPC (P=0.033), PSADT at the time of AIPC (P=0.009) and PSA at the initiation of anti-androgen withdrawal (P=0.002)were predictive factors. The multivariate analysis indicated that PSAV (P=0.042) and PSADT at the time of AIPC (P= 0.036) were independent predictive factors for the effectiveness of anti-androgen withdrawal. Conclusions Among the androgen independent advanced metastatic prostate cancer patient, there were about 19. 5% cases effective with the anti-androgen withdrawal treatment and the median effective duration was 4 months. PSAV and PSADT at the time of AIPC were independent predictive factors for the effectiveness of anti-androgen withdrawal.
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Objective To investigate the mechanism of the permeability change in the blood brain barrier(BBB)at early stage of infectious brain edema which was pretreated with LPS.Methods PMNs were isolated and purified.The concentration of Glu was measured in the supernatant without cells.The rat BMECs were primarily isolated and cultured.The permeability of BMECs waB evaluated by measuring the passing rate of 125 I-BSA via γ ray counter.The expression of NMDAR1 on BMECs was evaluated.Results The concentration of Glu in the LPS preconditioning PMNs subgroup at 5 rain time point was highest.In each group conditioned for 240 min,the permeability index of Bake average of the LPS preconditioning PMNs extract group was highest(P＜0.01).The expression of NMDARI increased in the LPS preconditioning PMNs extract group was more than that in other groups.Conclusions The research showed for the first time that the concentration of Glu increased after LPS preconditioning and the Glu excreted by PMNs can promote the permeability of BMECs and change the function of BBB,which possibly may be related the mechanism of NMDAR1 expression increased in BMECs.
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Objective To find the predictive factors that related to the effect of hormonal therapy and the survival of advanced metastatic prostate cancer. Methods Three hundred and Sixty-four cases of metastatic prostate cancer were treated with hormonal therapy in Cancer Hospital Fudan University in Shanghai from December 1996 to March 2008. The patients were followed up to the 31 March 2008 and the median follow-up time was 24 months. Two hundred and fifty cases have progressed into the stage of hormonal independent. The statistic software used in this study was SPSS 15. 0. Cumulative survival was analyzed by Kaplan-Meier method. Cox regression was used for univa-riate and multivariate analysis. Log-rank method was used for the significance test. The statistical difference was accepted when the P-value was lower than 0. 05. Results The effective rate of hormonal therapy for advanced metastatic prostate cancer was 98%. The median time of progression free survival of hormonal therapy was 20 months, and the one-year, two-year, three-year progression free survival rate was 69%, 39%, 27%, respectively. The survival analysis indicated that baseline PSA level more than 20ng/ml, with visceral organ metastasis, the PSA nadir more than Ing/ml during hormonal therapy, the time from the start of hormonal therapy to the PSA nadir less than 5 months were poor prognostic factors of progression free survival. Conclusions The baseline PSA level, clinicalstage, the PSA nadir during hormonal therapy and the time form the start of hormonal therapy to the PSA nadir could be the factors that predict the progression free survival time during hormonal therapy.
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Hemocompatibility is an important component of biocompatibility; it reflects the degree of interaction between material and blood. Hemocompatibility is multifaceted, so that the material's impact on the blood and the underlying mechanism are very complicated. This article presents a review of researches probing the impact of material on blood via contact activation and plasma protein adsorption; via the platelet activated and the formation of thrombin; via the complement system activated and the activation of leukocytes as well as other mechanisms of hemolysis. The current methods for evaluation and the future trend of development are also introduced.