Progress and strategies of surgical treatment of hepatocellular carcinoma with portal vein tumor thrombus / 中华消化外科杂志

The incidence of portal vein tumor thrombus (PVTT) in patients with hepato-cellular carcinoma (HCC) is high and the prognosis is poor. The treatment mode of HCC+PVTT is changing to multidisciplinary comprehensive treatment. The authors make a deep investigation on the occurrence basis, classification, surgical treatment indication, postoperative adjuvant treatment and preoperative conversion treatment plan of HCC+PVTT, in order to provide reference for the diagnosis and treatment of this disease.

Severe Acute Respiratory Syndrome Coronavirus 2 Receptor Angiotensin Converting Enzyme 2 and Its Related Intervention Drugs / 中国药学杂志

The coronavirus disease 2019 (COVID-19) outbreak is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) around the world, which has posed a great threat to global public health security. Angiotensin converting enzyme 2 (ACE2) has been identified as the major functional receptor of SARS-CoV-2, which plays an essential role in mediating virus invasion into host cells. Thus, an in-depth understanding of the recent progress of ACE2, its relationship with the virus and related drugs is of great significance for the prevention and treatment of COVID-19. Here, from the aspects of structure, expression and function, this article reviews the latest research progress of ACE2 and SARS-CoV-2. Meanwhile, this article also summarizes the mechanism of ACE2-mediated virus invasion and ACE2-related drugs, which will provide theoretical reference for viral prevention and treatment.

Angiotensin II type 1 receptor autoantibody induces myocardial fibrosis by activating cardiac fibroblasts / 生理学报

Myocardial fibrosis (MF) is an important pathological process of cardiac remodeling in patients with heart failure; however its etiology has not been clear. It has been known that the angiotensin II type 1 receptor autoantibody (AT1-AA) is present in patients with heart failure, but it is unclear whether this antibody directly causes MF. In this study, we investigated the role of AT1-AA in MF and its effects on cardiac fibroblasts (CFs). The AT1-AA positive rat model was established by active immunization method, and the measurement of indexes were made in the 8th week after active immunity. The results of heart echocardiography showed that the cardiac systolic and diastolic functions of AT1-AA positive rats were impaired with reduced left ventricular wall thickness and enlarged heart chambers. HE staining results showed that the myocardial fibers were disorganized and ruptured, and Masson staining revealed that the area of collagen fibers around the myocardium and coronary arteries was significantly increased in AT1-AA positive group compared with that of the control group (P < 0.05). Moreover, primary CFs isolated from neonatal rats were cultured and treated with AT1-AA for 48 h. CCK-8 and immunofluorescence staining results showed that AT1-AA enhanced proliferation rate of CFs (P < 0.001), and Western blot results showed that AT1-AA significantly increased expressions of collagen I (Col I), Col III, matrix metalloproteinase-2 (MMP-2) and MMP-9 in CFs (all P < 0.05). Taken together, these results suggest that AT1-AA may induce MF and cardiac dysfunction via activating CFs.

Influence of Qileng Decoction on Serum Visfatin Level and Degree of Carotid Atherosclerosis in Patients with Cerebral Infarction / 广州中医药大学学报

Objective To observe the influence of Qileng Decoction on the level of serum visfatin and the degree of carotid atherosclerosis in patients with acute atherosclerotic cerebral infarction(AACI). Methods One hundred and eighty AACI patients were classified into non-AACI control group (group A;N = 30), stable carotid atherosclerotic plaques group(group B;N = 75)and unstable carotid atherosclerotic plaques group(group C;N= 75)according to the results of carotid color ultrasonography. The serum visfatin level of the three groups was detected at the time of AACI attack. Group B and group C were separately randomized into conventional treatment subgroup (N = 37)and Qileng Decoction subgroup (N = 38). The conventional treatment subgroup was given basic therapy for AACI including nutrition support and symptomatic treatment , and Qileng Decoction subgroup was treated with Qileng Decoction (mainly composed of Radix Astragali,Rhizoma Sparganii, Fructus Mori,Radix Trichosanthis, Rhizoma Curcumae,Hirudo,and Fructus Aurantii)orally on the basis of treatment for the conventional treatment group. Before treatment and 15,90 and 180 days after treatment,we detected the level of serum visfatin,and measured the carotid intima-media thickness(IMT)and plaque scores(PS). Results (1)At the time of AACI attack,serum visfatin level of group B and group C was significantly higher than that of group A,and the level of serum visfatin of group C was significantly higher than that of group B,the difference being significant (P < 0.05). After treatment,serum visfatin over-expression was improved in both conventional treatment subgroup and Qileng Decoction subgroup of groups B and C at various time points (P< 0.05 compared with that before treatment), and the improvement in Qileng Decoction subgroup was superior to that in conventional treatment subgroup (P < 0.05). (2)At the end of treatment, IMT was improved in conventional treatment subgroup and Qileng Decoction subgroup of groups B and C (P < 0.05 compared with that before treatment), and the improvement in Qileng Decoction subgroup was superior to that in conventional treatment subgroup (P < 0.05). (3) The total effective rate for PS improvement of conventional treatment subgroup in groups B and C was 74.3％,68.6％ respectively,and that of Qileng Decoction subgroup in groups B and C was 94.4％, 91.7％ respectively, indicating that Qileng Decoction subgroup had better effect on improving PS than conventional treatment subgroup(P < 0.05). Conclusion Qileng Decoction exerts certain effect on regulating the over-expression of serum visfatin and improving the degree of carotid atherosclerosis in AACI patients.

Application of CT scan in diagnosis of pathological type and origin of metastatic ovarian tumors / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To evaluate the application of CT scan in diagnosis of pathological types and origins of metastatic ovarian tumors.</p><p><b>METHODS</b>Clinical data, histopathological results and CT images of 43 patients with pathologically-proved metastatic ovarian tumor were retrospectively analyzed. Diagnostic values of CT imaging for pathological type and origin of metastatic ovarian tumors were evaluated.</p><p><b>RESULTS</b>The pathological types of metastatic ovarian tumor were related to the size of the lesion (<0.01), while not related to the sites of lesion (unilateral or bilateral), the cystic-solid and mixed lesions with or without separation (all>0.05). Metastatic ovarian tumors of colorectal origin were usually unilateral lesions, and showed cystic or cystic-solid masses, while those of gastric origin were usually bilateral lesions, and showed solid or solid-based masses.</p><p><b>CONCLUSIONS</b>CT imaging may be of value in diagnosis of pathological types and origin of metastatic ovarian tumor.</p>

Changes and clinical significance of TLR4 and nuclear factor kappa B in peripheral blood mononuclear cells of patients with ulcerative colitis / 重庆医学

Objective To investigate the changes of TLR4 and nuclear factor kappa B(NF-κB) levels in peripheral blood mononuclear cells(PBMC) of the patients with ulcerative colitis(UC) and its possible pathogenesis mechanism.Methods In our hospital from January 2014 to January 2015,30 cases of UC were selected as the observation group,and other 10 individuals undergoing healthy physical examination in this hospital were selected as the control group.Flow cytometry was used to detect the positive expression rate of TLR4 on surface of peripheral blood CD14+ mononuclear cells.The levels of TLR4,MyD88,NF-κB(P65)mRNA expression were detected by RT-PCR.Western blot was adopted to detect the levels of TLR4,MyD88,NF-κB(P65) protein.Results The positive expression rate of TLR4 on the surface of peripheral blood CD14+ mononuclear cells in the observation group was significantly higher than that in the control group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) B mRNA and protein in the control group were significantly lower than those in the observation group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) protein were positively correlated with the severity of UC.Conclusion The levels of TLR4 and NF-κB in PBMC of the patients with UC are significantly increased,clinic can judge the UC development degree by detecting TLR4 and NF-κB levels.

Experience and feelings of parents of children with strabismus:a qualitative research / 现代临床护理

Objective To explore the feeling of parents of children with strabismus. Methods A semi-structured interview was conducted among 20 parents of children with strabismus. The data were analyzed based on Colaizzi phenomenotogical research methods. Result The parents' feeling was classified into 4 themes:negative emotional experience, parent-child relationship disorder, social communication disorders, and lack of support system. Conclusion According to the parents' real experience and feelings, medical staffs should pay attention to parents' psychological conditions, giving them necessary knowledge and psychological nursing so as to reduce the parents' psychological tension, improve the quality of life and promote the recovery after surgery.

Effects of interim hemodialysis on survival and clinical outcomes in patients with maintenance peritoneal dialysis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the effects of interim hemodialysis (HD) on survival and clinical outcomes in patients with maintenance peritoneal dialysis (PD).</p><p><b>METHODS</b>The clinical data of 908 patients undergoing maintenance PD from January 2010 to December 2014 registered in Zhejiang Dialysis Regisration System were retrospectively analyzed. Among all PD patients, 176 cases received interim HD for less than 3 months, and then transferred to PD (transfer group) and 732 cases had initial PD (non-transfer group). The demographic parameters, biochemical data, comorbidity, details of peritonitis and transplantation were documented. Survival curves were made by the Kaplan-Meier method; univariate and multivariate analyses were performed with Cox proportional hazard regression model to identify risk factors of mortality.</p><p><b>RESULTS</b>Compared with patients in transfer group, patients in non-transfer group had significantly higher serum albumin and total Kt/V levels. The survival rate was significantly higher in non-transfer group, but there was no significant difference in technique survival between two groups. After multivariable adjustment, initial dialysis modality (HR=1.60, 95% CI: 1.01~2.56), age (HR=1.07, 95% CI:1.05~1.09) and serum albumin (HR=0.96, 95% CI: 0.93~0.99) and Charslon comorbidity index (HR=2.54, 95% CI:1.63~3.94) were independent factors for long-term survival.</p><p><b>CONCLUSION</b>Patients who transfer to PD after interim HD have lower survival rate than patients who start with and are maintained on PD. HD is an independent risk factor for PD patients, therefore, patients with PD should be well informed and educated with dialysis protocols.</p>

Influence of peritoneal transport characteristics on nutritional status and clinical outcome in Chinese diabetic nephropathy patients on peritoneal dialysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>High peritoneal transport status was previously thought to be a poor prognostic factor in peritoneal dialysis (PD) patients. However, its effect on diabetic nephropathy PD patients is unclear in consideration of the adverse impact of diabetes itself. The purpose of this study was to investigate the influence of peritoneal transport characteristics on nutritional status and clinical outcome in diabetic nephropathy patients on PD.</p><p><b>METHODS</b>One hundred and two diabetic nephropathy patients on PD were enrolled in this observational cohort study. According to the initial peritoneal equilibration test result, patients were divided into two groups: Higher transport group (HT, including high and high average transport) and lower transport group (LT, including low and low-average transport). Demographic characteristics, biochemical data, dialysis adequacy, and nutritional status were evaluated. Clinical outcomes were compared. Risk factors for death-censored technique failure and mortality were analyzed.</p><p><b>RESULTS</b>Compared with LT group (n = 37), serum albumin was significantly lower and the incidence of malnutrition by subjective global assessment was significantly higher in HT group (n = 65) (P < 0.05). Kaplan-Meier analyses showed that death-censored technique failure and mortality were significantly increased in HT group compared with that in LT group. On multivariate Cox analyses, higher peritoneal transport status and lower residual renal function (RRF) were independent predictors of death-censored technique failure when adjusted for serum albumin and total weekly urea clearance (Kt/V). Independent predictors of mortality were advanced age, anemia, hypoalbuminemia, and lower RRF, but not higher peritoneal transport status.</p><p><b>CONCLUSIONS</b>Higher peritoneal transport status has an adverse influence on nutrition for diabetic nephropathy patients on PD. Higher peritoneal transport status is a significant independent risk factor for death-censored technique failure, but not for mortality in diabetic nephropathy patients on PD.</p>

Diagnosis study of pathological findings,CT and MRI in primary centralnervous system lymphoma / 中国基层医药

Objective To investigate the pathological findings and diagnosis value of CT and MRI in detec-tion of primary centralnervous system lymphoma (PCNSL)so as to improve diagnostic accuracy of the condition. Methods The results of CT and MRI for 32 patients with PCNSL were analyzed retrospectively,and the results were compared with the finally obtained surgical-pathological examination.Results Of 32 cases,the foci were single in 29 cases and multiple in 4 cases,and there were 41 foci in total.Most foci were located near the surface or middle line of brain.On CT scan appearances,most foci were hyperdensity or slightly hyperdensity masses with the well definite margin,on MRI,it showed low signal of T1 -weighted imaging (T1 WI)and slightly increased non-uniform signal of T2 -weighted imaging (T2 WI).All the foci were equally and markedly enhanced after enhancement.The diagnostic coincident rate of combination diagnosis (93.8%)was significantly higher than that of CT (71.9%)and MRI (75.0%)(χ2 =7.234 6,P=0.003 2;χ2 =6.953 8,P=0.003 7).Conclusion CT,MRI have characteristic mani-festation for PCNSL,and according to the manifestation of CT,MRI,predilection site,mass effect,and combined with pathological examination,which can effectively improve the sensitivity and accuracy of diagnosis.

Clinical analysis of 49 cases with Pseudo-Meigs' Syndrome: a report of two cases and a review of literatures over the last decade / 中华全科医师杂志

Retrospective analyses were conducted for the clinical data of two cases with pseudoMeigs' syndrome at our hospital.Both had respiratory symptoms,such as cough and dyspnea.Radiological examinations revealed ascites,pleural effusion and pelvic mass.The definite pathological diagnosis was pelvic malignant tumor.After surgical tumor removal,ascites and pleural effusion disappeared without recurrence.Along with reviewed cases from PubMed in the last decade,a total of 49 cases had pseudoMeigs' syndrome.The age range was 11-73 years.Their clinical manifestations include dyspnea (78％),abdominal distension (69％),cough (14％),abdominal pain (12％),fatigue (10％),weight loss (6％) chest pain (4％),fever (4％),abdominal mass (4％),and oliguria (2％).CA125 was commonly elevated.The primary tumors in pelvic cavity accounted for 78％.And ovarian metastasis from colon cancer was one of the most common in metastatic tumor.

Efficacy of prostaglandin E1 administered via pulmonary artery for treatment of pulmonary hypertension / 中华麻醉学杂志

Objective To investigate the efficacy of prostaglandin E1 administered via the pulmonary artery for treatment of pulmonary hypertension in patients.Methods Thirty ASA Ⅱ or Ⅲ patients undergoing offpump coronary artery bypass grafting complicated with pulmonary hypertension,with pulmonary arterial systolic pressure (PASP) ＞ 40 mm Hg,were randomly divided into 2 groups (n =15 each):administration via the central vein group (group C) and administration via the pulmonary artery group (group P).Anesthesia was induced with midazolam,etomidate,cisatracurium and sufentanil.The patients were tracheal intubated and mechanically ventilated.Swan-Ganz catheter was placed via the right internal jugular vein for monitoring of hemodynamic parameters after induction of anesthesia.The central vein and pulmonary artery were cannulated for infusion of prostaglandin E1.Prostaglandin E1 was infused at a rate of 20-50 ng· kg-1 · min-1 starting from the end of skin incision until PASP was decreased to 20-30 mm Hg.Heart rate (HR),mean arterial pressure (MAP),central venous pressure (CVP),PASP,pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) were recorded at 5 rain before administration (To) and 5 min after administration (T1).The pulmonary vascular resistance (PVR) and systemic vascular resistance (SVR) were calculated.The amount of prostaglandin E1 consumed was recorded.Results Compared with group C,the amount of prostaglandin E1 consumed was significantly reduced,PASP and PVR were decreased at T1,while MAP and SVR were increased at T1 in group P(P ＜ 0.05).Conclusion Administration via the pulmonary artery can increase the potency of prostaglandin E1 for treatment of pulmonary hypertension and exerts no influence on the systemic hemodynamics.

Modern documentary research on disease menu of acupuncture-moxibustion for mental and behavioral disorder / 中国针灸

<p><b>OBJECTIVE</b>Dominant disease menu of mental and behavioral disorder of acupuncture therapy was summarized and obtained in this article.</p><p><b>METHODS</b>Literatures on clinical treatment of mental and behavioral disorder with acupuncture were picked up from CBMdisc and CNKI during 1978 to 2007. Types of mental and behavioral disorder and report frequency of each disease treated with acupuncture were counted. And dominant diseases which were favorable to be treated with acupuncture were acquired through analysis and inductive method.</p><p><b>RESULTS</b>Twenty-nine diseases of mental and behavioral disorder are favorable to be treated with acupuncture which were mentioned in totally 1967 related documents. It is found that the number of reports of sleep disorder, depression, hysteria aphronesia, dementia and sexual disorder are ranked as the top five.</p><p><b>CONCLUSION</b>It is concluded that the preponderant diseases of mental and behavioral disorder treated by acupuncture are dementia, withdrawal syndrome, mental retardation, obsessive-compulsive disorder, sleep disorder, gastrointestinal neurosis (gastrointestinal disorders), depression, alcoholism and globus hystericus.</p>

Effects of dexmedetomidine on cerebral oxygen and glucose metabolism in patients undergoing mitral valve replacement under cardiopulmonary bypass / 中华麻醉学杂志

ObjectiveTo investigate the effects of dexmedetomidine on cerebral oxygen and glucose metabolism in patients undergoing mitral valve replacement under cardiopulmonary bypass (CPB).Methods Fiftyeight ASA Ⅱ or Ⅲ patients of both sexes aged 32-64 yr weighing 52-90 kg undergoing mitral valve replacement were randomly divided into 2 groups (n =29 each): control group (group C) and dexmedetomidine group (group D).Dexmedetomidine was infused iv at 0.5 μg· kg- 1 · h- 1 starting after tracheal intubation until the end of operation in group D,while in group C equal volume of normal saline was infused instead of dexmedetomidine.Blood samples were collected from radial artery and jugular venous bulb for blood gas analysis and determination of glucose and lactate concentrations before CPB (T1,nasopharyngeal temperature =36 ℃ ),during CPB (T2,nasopharyngeal temperature =30 ℃ ),immediately and 30 min after restoration of spontaneous heart beat ( T3,T4 ).Arterial O2 content ( CaO2 ),arteriovenous O2 content difference ( Da-jvO2 ),cerebral extraction of O2 ( CEO2 ),arteriovenous glucose and lactate content differences (Da-jvGlu and Da-jvLac) were calculated.ResultsThe Da-jvO2 and CEO2 were significantly decreased at T2 in group D as compared with group C.There was no significant difference in CaO2,Da-jvGlu and Da-jvLac between the 2 groups.ConclusionDexmedetomidine can reduce cerebral O2 metabolism and help maintain the balance between cerebral O2 supply and demand but has no effect on cerebral glucose metabolism in patients undergoing mitral valve replacement under CPB.

Cardioprotective effect of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

Objective To evaluate the cardioprotective effect of dexmedetomidine in patients undergoing off-pump coronary artery bypass grafting. Methods Forty-six ASA Ⅱ or Ⅲ patients aged 37-64 yr weighing 54-81 kg undergoing off-pump coronary artery bypass grafting were randomized into 2 groups ( n = 23 each): control group (group C) and dexmedetomidine group (group D) . Dexmedetomidine was infused at 0.5 μg·kg-1·h-1 starting after induction of anesthesia until the end of operation in group D. Radial artery was cannulated and Swan-Ganz catheter placed via right internal jugular vein. HR, MAP, mean pulmonary arterial pressure, pulmonary capilary wedge pressure, central venous pressure, and cardiac output were recorded and stroke volume index, left and right ventricular stroke work index, systemic vascular resistance and pulmonary vascular resistance were calculated at the beginning of operation (T1 ), immediately (T2 ) and at 30 min after reestablishment of coronary blood flow (T3 ) and the end of operation (T4 ) . Venous blood samples were taken before induction of anesthesia (T0 , baseline) , at T4 and 4 h (T5 ) and 24 h (T6 ) after operation for determination of plasma concentration of cardiac troponin I by ELISA. Results Stroke volume index and left ventricular stroke work index were significantly higher at T4 while systemic vascular resistance was lower at T34 in group D than in group C. Plasma cardiac troponin Ⅰ concentration was significantly lower at T6 in group D than in group C. Conclusion Dexmedetomidine infusion at 0.5 μg ·kg-1·h-1 during operation can protect myocardium in patients undergoing off-pump coronary artery bypass grafting.

Expression and clinical significance of X-box binding protein 1 in liver cancer / 肿瘤研究与临床

Objective To investigate the possible role of X-box binding protein (XBP1) expression at mRNA level in the hepatocarcinogenesis. Methods The expression of XBP1 at mRNA level was determined with RT-PCR method in liver carcinoma (42 cases), liver tissue adjacent to carcinoma (15 cases) and normal liver tissue (15 cases). XBP1 mRNA relative expression level was obtained by comparing with GAPDH mRNA level. The correlation between XBP1 expression and clinicopathological features of liver carcinoma were respectively analyzed. Results RT-PCR results showed that the expression of XBP1 mRNA in liver carcinoma cases (0.4396 ±0.0241) was significantly higher that that of liver tissues adjacent to carcinoma (0.4152±0.0252) and normal liver tissue (0.4095 ±0.0149), (F =12.79,P =0.001). No significant differences in the expression of XBP1 were found among different age and sex of the patients, different location, histological types, grade and metastatic status in liver carcinoma (P >0.05). Conclusion Increased expression of XBP1 mRNA is found in liver carcinoma but no correlation could be seen between XBP1 expression and clinicopathological features, which XBP1 is involved in the hepatocarcinogenesis.

The placement of Y-shaped titanium-nickel memory alloy stent in the carina: a fundamental study in experimental canines / 介入放射学杂志

Objective To investigate the pathological changes of local airway tissue after inserting Y-shaped titanium-nickel memory alloy stent in carina, and to evaluate CT three-dimensional reconstruction technique in postoperative and follow-up observation. Methods Twelve healthy adult canines were enrolled in this study. Based on the information of the carina obtained from CT three-dimensional reconstruction images, the preparation of Y-shape netlike stent was made by knitting method with single Ni-Ti memory alloy wire. The stent was then inserted in canine's carina with the help of a releasing system. After the operation fiberbronchoscopy and CT three-dimensional reconstruction were performed. The animals were sacrificed 12 weeks after the procedure and the bronchus of the stenting segment was removed and sent for histopathologic examination. Results Technical success was achieved in all canines with the stent fight in the carina. The airway remained unobstructed 12 weeks after the procedure. Histopathologic examination revealed that the stent became partial epithelialization. Conclusion The Y-shaped titanium-nickel memory alloy stent has good histecompatibility and physicochemical stability and no re-stenosis of the airway develops in the follow-up period of three months. The stent-releasing technique is easy and simple. As a non-invasive and convenient exam, CT three-dimensional reconstruction technique is of great value in postoperative follow-up observation.

Exploration on neoadjuvant chemoradiation in the treatment for locally advanced low rectal cancer / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the possibility of further improvement of the efficacy of neoadjuvant chemoradiotherapy in locally advanced lower rectal cancer and the management of patients with clinical complete regression.</p><p><b>METHODS</b>From May 2001 to August 2007, 192 cases with locally advanced lower rectal cancer (T3/T4 or N(+)) received preoperative radiotherapy 40 - 46 Gy/20 - 23 fractions and concomitant oral capecitabine 625 mg/m(2) bid for 10 weeks prior to surgery. Curative resection with total mesorectal excision (TME) was carried out 6 weeks after the end of radiation.</p><p><b>RESULTS</b>As a result, 117 cases (60.9%) experienced adverse events but only 2 suffered from G3 side effects. Seventeen cases (8.9%) had a clinical complete tumor regression without surgery; 175 patients underwent curative resection, of them 134 cases with low anterior resection (LAR), 32 cases with ultra-low anterior resection with Park's coloanal anastomosis (6 cases with diverting temporary colostomy) and 9 cases with abdominal pelvic resection (APR). Sphincter preservation was achieved in 94.9%. Twenty-four patients (12.5%) got pathological complete response (CR), 17 patients with clinical CR and the overall CR rate was 21.4%. According to the pathological staging post operation: T0N0 41 cases, T2N0 43 cases, T3N0 77 cases, T4N0 5 cases, T2N1 11 cases, T3N1 13 cases, T4N1 2 cases; Graded under Dworak's tumor regression: TRG0 8 patients, TRG1 32 patients, TRG2 28 patients, TRG3 83 patients and TRG4 24 patients, with an overall pathological tumor downstaging in 77.14%. No operative death occurred, 5 patients suffered from rectovaginal fistulas and 4 anastomotic leakages with an overall anastomotic leakage rate of 5.1% (9/175) and all the patients recovered uneventfully after properly managed. All patients were followed up for a median time of 42 months (range, 12 - 87 months). During the time, 11 patients developed lung metastases, 6 liver metastases and 7 had local recurrences. The 3 years disease-free survival (DFS) was 86.6% and overall survival (OS) was 92.6%.</p><p><b>CONCLUSIONS</b>Neoadjuvant chemoradiotherapy has high efficacy in locally advanced lower rectal cancer, resulting in tumor down-staging, improved resectability and sphincter preservation, and reduced local recurrences. Meanwhile the cases with clinical complete response can be followed up closely and safely without surgery.</p>

Effect of injectable Xuebijing on proliferation of murine brain microvascular endothelial cell line bEnd.3 / 中华急诊医学杂志

Objective To investigate the effect of injectable Xuebijing on the proliferation of mouse brain microvascular endothelial cell in vitro.Methods Cultured mouse brain microvascular endothelM cell line bEnd. 3 was treated by injectable Xuebijing of different concentrations,0 (control),5,25 and 50 mg/ml.The regulatory. effect of Xuebijing on the proliferation of cell line bEnd.3 was observed and studied by means of MTT method and cell cycle analyzed with flow cytometry.Results Compared to the control group,MTT and proliferation index (PI) of 5 and 25 mg/ml groups were significantly increased at 12 and 24 h,and PI,but not MTT,of these 2 groups was decreased remarkably at 48 h.Meanwhile,50 mg/ml group showed significantly decreased MTT at 24 and 48 h,and PI of this group was increased obviously at 12 and 24 h,but decreased significantly at 48 h. Conclusions Injectable Xuebijing at certain concentrations might promote the proliferation of cultured mouse brain microvascular endothelial,cells within specific time frame.

Endurance of normal New Zealand Rabbits' brain tissue after high intensity focused ultrasound ablation / 重庆医科大学学报

Objective:The purpose of this study is to determine if HIFU is feasible for the treatment of brain diseases by observing New Zealand Rabbits' reaction,living status and variation in microscope after different dosages of ablation.Methods:By using the same total time of HIFU exposure,we took different divided time to sonicate localized brain tissues of 24 New Zealand Rabbits for several times,to observe the rabbits' reaction and living status.All animals were sacrificed after 5 weeks.Then we applied TTC stain to observe the gross changes and HE stain to observe histological changes in microscope.Results:During the observation period,the rabbits' living status was apparently getting worse when the single exposure was ≥ 20 second(s).The times of exposure were not correlated with living status.According to our observation,the rabbits could tolerate the dose of HIFU exposure