Cognition and reflection on the "lateral ligament of rectum" / 中华胃肠外科杂志

As total mesorectal excision (TME) for rectal cancer is widely carried out in China, lateral ligament of rectum, as an important anatomical structure of the lateral rectum with certain anatomical value and clinical significance, has been the focus of attention. In this paper, by comparing and analyzing the characteristics about ligaments of the abdomen and pelvis, reviewing the membrane anatomy and the theory of primitive gut rotation, and combining clinical observations and histological studies, the author came to a conclusion that lateral ligament of rectum does not exist, but is only a relatively dense space on the rectal side accompanied by numerous tiny nerve plexuses and small blood vessels penetrating through it.

Imaging Features of Soft-Tissue Calcifications and Related Diseases: A Systematic Approach

Soft-tissue calcification refers to a broad category of lesions. Calcifications are frequently identified by radiologists in daily practice. Using a simple algorithm based on the distribution pattern of the lesions and detailed clinical information, these calcified lesions can be systematically evaluated. The distribution pattern of the calcific deposits enables initial division into calcinosis circumscripta and calcinosis universalis. Using laboratory test results (serum calcium and phosphate levels) and clinical history, calcinosis circumscripta can be further categorized into four subtypes: dystrophic, iatrogenic, metastatic, and idiopathic calcification. This pictorial essay presents a systematic approach to the imaging features of soft-tissue calcifications and related diseases.

Comparison of six irradiation techniques for delivering hypofractionated whole-breast radiotherapy with a simultaneous integrated boost after breast-conserving surgery

Background: to compare the following techniques for hypofractionated whole-breast irradiation [WBI] with simultaneous integrated boost [SIB] after breast-conserving surgery [BCS]: three-dimensional conformal radiation therapy plus electron boost [3DCRT-EB], intensity-modulated radiation therapy [IMRT] plus EB [IMRT-EB], field-in-field IMRT plus EB [FIF-IMRT-EB], FIF-IMRT plus IMRT boost [FIF-IMRT-IB], IMRT plus IMRT boost [IMRT-IB], and volumetric-modulated arc therapy [VMAT] plus VMAT boost [VMAT-VB]

Materials and Methods: twenty patients with left breast cancer were enrolled. The prescribed dose was 40.05 Gy in 15 fractions to the whole breast and an SIB to the tumor bed of 3.2 Gy/fraction [total, 48 Gy]. Target-volume coverage, dose-conformity index, homogeneity index [HI], doses to organs at risk [OAR], and costs were compared

Results: FIF-IMRT-EB performed the best, while FIF-IMRT-IB, IMRT-IB, and VMAT-VB performed the worst. The mean dose to the planning target volume for breast evaluation [PTV Eval-breast] was significantly lower for IMRT-EB and FIF-IMRT-EB than for the other plans. For both PTV Eval-breast and PTV Eval-boost, VMAT-VB had the lowest target-volume coverage for 95% of the prescription dose and the highest target-volume coverage for >105% of the prescription dose. Among the six plans, VMAT-VB had the best HI for PTV Eval-boost and the highest doses to all OAR, except the coronary artery. Plans with EBs had lower mean doses for the contralateral lung and contralateral breast than plans with IMRT boosts. FIF-IMRT-EB had a low cost; plans with IMRT boosts had the highest costs

Conclusion: FIF-IMRT-EB may be the most suitable irradiation technique for hypofractionated WBI with SIB after BCS

Chemiluminescence Study of Pe roxynitrite in Experimental Autoimmune Uveitis

The purpose of this study is to evaluate the extent of peroxynitrite generation in the pool of radicals/oxidants from intraocular inflammation using luminol-dependent chemiluminescence(LDCL)method. S-antigen induced uveitis was produced in Lewis rats. The rats were killed at the peak of inflammation, and the retinas and choroids were collected for the LDCL. Sodium bicarbonate was used to confirm the peroxynitrite signal. Superoxide dismutase(SOD), N-nitro-L-arginine methyl ester(LNAME)and aminoguanidine(AG)were tried to evaluate the inhibitory effect of superoxide and nitric oxide. LDCL counts for 6 inflamed and 6 control retina/choroid preparations were 66, 429+/-413 cpm and 13, 941+/-105 cpm, respectively(p<0.01). In the presence of bicarbonate, emission was increased by 125.3+/-6.6%(n=6)and the signal was sustained for 2 hours. SOD, L-NAME and AG suppressed the LDCL by 39.8+/-6.1%(n=3), 20.4+/-4.4%(n=3) and 35.9+/-4.0 %(n=3), These observations suggest that peroxynitrite contributes considerably to the generation of the total pool of reactive species by the cellular infiltrate. The presence of a high level of peroxynitrite, a potent oxidizing and nitrating agent, in inflamed retina may cause irreversible tissue damage to the photoreceptors.