ABSTRACT
Objective: Severe radiation-induced late rectal injury (sRLRI) directly affects the quality of life of patients with rectal cancer. Effective prediction of sRLRI before surgery may provide important information for the selection of surgical strategies and perioperative managements. The purpose of this study is to evaluate the feasibility of predicting sRLRI based on magnetic resonance imaging (MRI) features before and after radiotherapy for rectal cancer. Methods: This was a diagnostic study. Clinical and imaging data of 90 patients with rectal cancer receiving long-term radiotherapy from June 2013 to July 2018 in the Sixth Affiliated Hospital of Sun Yat-sen University were collected retrospectively. Case inclusion criteria: (1) rectal cancer was diagnosed by pathology and age of ≥ 18 years old; (2) patients received neoadjuvant chemoradiotherapy and anterior rectal resection; (3) follow up time ≥ 3 years; (4) patients had no history of other neoplasm. Exclusion criteria: (1) patients did not receive MRI examination in our hospital within 2 weeks before and/or 8 weeks after radiotherapy; (2) images were not good enough for evaluation; (3) medical records were incomplete; (4) patients had severe gastrointestinal diseases. According to the RTOG/EORTC classification criteria for radiation reactions, severe complications of grade 3-4 requiring surgical management were defined as sRLRI. T2WI and DWI images before and after radiotherapy were evaluated. The rectal wall thickness, bladder wall thickness, rectal sacral spacing and apparent diffusion coefficient (ADC) were measured. The receiver operating characteristic (ROC) curve was used to evaluate the predictive value of the above indicators for sRLRI. Results: Among the 90 patients with rectal cancer, 34 (37.8%) developed sRLRI. Before radiotherapy, the median rectal wall thickness of sRLRI and non-sRLRI patients was 4.530 mm and 4.355 mm, respectively; the median bladder wall thickness was 3.962 mm and 3.868 mm, respectively; the median rectal sacral spacing was 15.557 mm and 12.433 mm, respectively; the median ADC value of rectal wall was 1.620 ×10(-3) mm(2)/s and 1.653 ×10(-3) mm(2)/s, respectively. There were no significant differences in above indicators between sRLRI and non-sRLRI patients (all P>0.05). After radiotherapy, compared with non-sRLRI patients, sRLRI patients had increased rectal wall thickness (median: 8.239 mm vs. 6.223 mm, Z=-3.512, P=0.001), rectal sacral spacing (median: 17.728 mm vs. 13.885 mm, Z=-2.247, P=0.025), and change of rectal wall thickness after radiotherapy (median: 98.106% vs. 49.584%, Z=-4.169, P<0.001). After radiotherapy, there were no significant differences in the bladder wall thickness and its change value, the ADC value of rectal wall and its change rate before and after radiotherapy between the two groups (all P>0.05). The area under the curve (AUC) of the change rates of rectal wall thickness after radiotherapy, rectal wall thickness and rectal sacral spacing after radiotherapy for predicting sRLRI was 0.763, 0.722 and 0.642, respectively, while the sensitivity was 85.3%, 70.6% and 76.5%, respectively, and the specificity was 64.3%, 71.4% and 57.1%, respectively. Conclusion: Based on MRI examinations, assessments of rectal wall thickness after radiotherapy, the change rate of rectal wall thickness after radiotherapy, and rectal sacral spacing after radiotherapy are helpful for evaluating the risk of sRLRI after radiotherapy for patients with rectal cancer.
Subject(s)
Adolescent , Humans , Chemoradiotherapy , Diffusion Magnetic Resonance Imaging , Magnetic Resonance Imaging , Neoadjuvant Therapy , Quality of Life , Rectal Neoplasms/radiotherapy , Retrospective Studies , Treatment OutcomeABSTRACT
OBJECTIVE: To report a modified transvaginal non-mesh repair surgery based on "double hammock" pelvic floor support theory,and to observe the perioperative characteristics and short-term follow-up effect.METHODS: We collected 72 patients who underwent modified transvaginal non-mesh repair surgery from October 2017 to July 2018 in the First People's Hospital of Yunnan Province.Data of perioperative,3-month,6-month and 12 month follow-up were analyzed.RESULTS: The procedures were performed successfully in 72 patients,the average operation time was(119±31)min,and the mean blood loss was(47.75±30.55)mL.No traumatic compliacations were found during the operation.The objective response rate evaluated postoperatively by POP-Q stage in short-term follow-up were 100%,and no subjective symptoms of recurrence were observed.CONCLUSION: Modified vaginal non-mesh pelvic floor repair based on the "double-layer hammock" pelvic floor support theory has the advantages of simple surgical procedure, fewer complications and good effect in the short-term. Further observation is needed to determine its long-term effectiveness.
ABSTRACT
Objective: To investigate the influence of edaravone on the expression of growth arrest and DNA damage-inducible protein 34 (GADD34). Methods: A total of 108 healthy male Sprague-Dawley rats were randomly divided into sham operation group, model group and edaravone group (36 cases for each group). Transient focal cerebral ischemia was induced by middle cerebral artery occlusion for 2 h followed by reperfusion in Sprague-Dawley rats. Then, GADD34 expression was measured with immunohistochemistry at different time-points after reperfusion in the peri-infarct regions of all rats. Results: The GADD34 expression was detected in the peri-infarct regions of rats 1 h after reperfusion, which reached its peak 24 h after reperfusion. And edaravone could significantly down-regulate the GADD34 expression. Conclusions: Edaravon could down-regulate GADD34 expression, which suggests that edaravone may exert an important function in inhibiting endoplasmic reticulum stress reaction by scavenging free radicals in the upper stream.
ABSTRACT
<p><b>OBJECTIVE</b>To identify the HBV genotype-specific tag sequence.</p><p><b>METHODS</b>The large S region sequences from 930 HBV genomes were aligned to identify the genotype-specific tag sequences. PCR was used to check the genotyping effect of these tags.</p><p><b>RESULTS</b>Two tag sequences, sequence between 149-169 and sequence between 461-483, were identified in the large S region. Using primers specific to these tag sequences, the genotype of HBV can be specifically identified.</p><p><b>CONCLUSION</b>These tag sequences can be used for HBV genotyping.</p>
Subject(s)
Humans , Base Sequence , DNA Primers , Gene Library , Genes, Viral , Genotype , Hepatitis B virus , Classification , Genetics , Hepatitis B, Chronic , Virology , Molecular Sequence Data , Polymerase Chain Reaction , Methods , Protein Precursors , Genetics , Sequence Analysis, DNAABSTRACT
EMG, This paper introduces a slope variability algorithm which uses the CU Database and the AHA Database. The sensitivity, specificity, positive predictivity and accuracy are calculated and these values are compared with the results from two earlier detection algorithms. The results show this algorithm is more effective and fast than other algorithms.
Subject(s)
Algorithms , Defibrillators , Electric Countershock , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
This paper proposes a method of automatic ECG analysis and arrhythmia diagnosis for telemonitoring system. A multi-buffer technique is applied to organize dispersive ECG data. Then, according to second order derivatives of ECG signals, peaks of R waves are automatically detected. Finally, real-time heart rhythm is decided by results of R wave detection. Tests prove that the proposed method is precise, efficient and stable to be applied in real-time ECG telemonitoring system.
Subject(s)
Algorithms , Automation , Methods , Electrocardiography, Ambulatory , Methods , Remote Consultation , Methods , Signal Processing, Computer-AssistedABSTRACT
Biomedical Engineering of Electronic Engineering Deparment, Fudan University Shanghai, 200433 Based on the pulse-coded transmitting and wide-band receiving system, this paper describes a research of phase design a special power management circuit according to the particular demands of a real-time and continuously monitor system is essential. Combined with the requirement of voltage and current in separated module, three aspect must be considered, that is, how to select the functional component, how to accomplish voltage converting and how to carry on battery management. The test at last shows that, using this circuit and the 4400 mAh battery the energy utilization is more than 88%, and the work time is more than 20 hours.
Subject(s)
Electric Power Supplies , Equipment Design , Monitoring, Ambulatory , Monitoring, Physiologic , TelemedicineABSTRACT
<p><b>OBJECTIVE</b>The aim of this study was to evaluate the recognition and defibrillation efficiency of a newly developed automated external defibrillator (AED).</p><p><b>METHOD</b>Ventricular tachycardia (VT)/ventricular fibrillation (VF) was induced by alternating current (50 Hz) through an electrode placed on apex of right ventricle in 23 anesthetized swine and recorded, recognized and defibrillated by a newly developed AED.</p><p><b>RESULTS</b>A total of 96 VF was induced and 145 defibrillations were recorded. We analyzed available 167 electrocardiosignal with a total length of 103,740 seconds. The accuracy, sensitivity and the specificity of the AED on VT/VF recognition are 99.5%, 98.2% and 99.6%, respectively. The success rate of defibrillation was 33.4% which increased in proportion to defibrillation energy. The defibrillation threshold of energy is 29.10-116.91 (78.75 +/- 35.64) J, the defibrillation threshold of electric quantity is (0.11 +/- 0.04) C and the defibrillation threshold of voltage is (1216.67 +/- 260.87) V.</p><p><b>CONCLUSIONS</b>This newly developed AED has high sensitivity and the specificity on recognizing VT/VF. The lower success rate of defibrillation of this AED is associated with the low defibrillation energy during defibrillation which needs to be improved on further development.</p>
Subject(s)
Animals , Defibrillators , Disease Models, Animal , Electric Countershock , Equipment Design , Sensitivity and Specificity , Swine , Ventricular Fibrillation , TherapeuticsABSTRACT
According to the instruction of the operator, the designed programmable multichannel stimulator will deliver stimuli with an assigned amplitude and a proper width to the electrode-array in various modes. Each stimulation time is controlled by the internal timer of the MCU, while the stimulated electrodes' spatial parameter is controlled by the CPLD. Having abandoned conventional isolation using the transformer, we have adapted optical coupling and stable float ground connection to achieve the safety standard required by physiological measurements.
Subject(s)
Electric Stimulation , Methods , Electric Stimulation Therapy , Electrodes, Implanted , Electrophysiology , MethodsABSTRACT
<p><b>AIM</b>To study the effects of ginkgolides (Gin) on the expression of hypoxia-inducible factor-1alpha (H1F-1alpha) in primary cultured cortical neurons treated with CoCl2 and the relationship with ERK signal pathway.</p><p><b>METHODS</b>We observed the effects of Gin (37.5 mg/L) on morphology and viability on primary cultured cortical neurons with treatment of CoCl2 (125 micromol/L). The expression of HIF-1alpha and p-ERK of neurons induced by CoCl2 pretreated with Gin were assessed by Western-blot. We analyzed the relationship between HIF-1alpha expression activated by Gin and ERK signal pathway with treatment of PD98059 (100 micromol/L), a selective inhibitor of ERK.</p><p><b>RESULTS</b>It was shown that Gin had protective effects on CoCl2 damaged neurons by raising the neuronal viability. Some basic expression of HIF-1alpha and p-ERK were observed in normal cultured cortical neurons. The expression of HIF-1alpha and p-ERK increased strikingly when treated with CoCl2 for 4 h. The levels of HIF-1alpha and p-ERK increased even more in the neurons pretreated with Gin for 24 h before CoCl2. The levels of HIF-1alpha and p-ERK were notably inhibited with pretreatment of PD98059, while Gin could prevent this inhibition.</p><p><b>CONCLUSION</b>Gin has protective effects on neurons damaged by CoCl2 which might be related to the increase of the level of HIF-1alpha and the activation of ERK signal pathway.</p>
Subject(s)
Animals , Mice , Cell Hypoxia , Cells, Cultured , Ginkgolides , Pharmacology , Hypoxia-Inducible Factor 1, alpha Subunit , Metabolism , MAP Kinase Signaling System , Mice, Inbred ICR , Neurons , MetabolismABSTRACT
A method based on wavelet transform has been developed for detecting QRS-waves.The MIT-BIH database is used to evaluate this method, and the accuracy is over 99.5%. Then the method is implanted into the embedded system to implement the real-time detection of ECG. This method has good performances in time-delay and computation.
Subject(s)
Algorithms , Electrocardiography , Methods , Wavelet AnalysisABSTRACT
<p><b>OBJECTIVE</b>To evaluate the value of magnetic resonance imaging (MRI) in diagnosis and preoperative staging of uterine cervical cancer.</p><p><b>METHODS</b>MRI findings and staging in 72 patients with cervical carcinoma were retrospectively analyzed, and the size, location, signal intensity and invasion of the tumor were observed. MRI sequence included SE T1WI, (TSE)T2WI, T2WI/SPIR and contrast-enhanced T1WI.</p><p><b>RESULTS</b>MRI identified uterus cervical cancer in all cases with the exception of only 1 case of IA stage. The tumor was represented by hypointensity and isointensity on T1WI, heterogeneous and homogeneous hyperintensity on T2WI, mildly heterogeneous enhancement after bolus intravenous GD-DTPA injection. MRI had an accuracy of 86% in localization of the tumor, but its accuracy in clinical staging was only 64% (chi2=6.453, P<0.05). The tumor volume measured by MRI was similar with that by pathological measurement (1.94-/+1.15 vs 1.94-/+1.11, P>0.05).</p><p><b>CONCLUSION</b>MRI can accurately describe the size and invasion of uterine cervical cancer, especially useful in detecting parametrial invasion, but for diagnosis of IA uterine cervical cancer, MRI findings are not sufficient without considerations of clinical findings and cellular examination.</p>
Subject(s)
Adult , Aged , Female , Humans , Middle Aged , Carcinoma, Squamous Cell , Pathology , General Surgery , Magnetic Resonance Imaging , Methods , Neoplasm Invasiveness , Neoplasm Staging , Methods , Preoperative Care , Reproducibility of Results , Uterine Cervical Neoplasms , Pathology , General SurgeryABSTRACT
The external defibrillator is an emergency instrument used very widely in clinics. It plays an important role in rescuing ventricle fibrillation (VF) patients. We have designed an external defibrillator using the truncated exponential biphasic waveform. The system consists of three parts: the ECG collection module, the control module and the defibrillator module. They are introduced respectively, listing the main problems and the methods to solve them. Some experiments have been done and the corresponding results are given.
Subject(s)
Animals , Defibrillators , Equipment Design , Swine , Ventricular FibrillationABSTRACT
@#ObjectiveTo explore the effective methods to improve the pulmonary function and life quality of patients with idiopathic pulmonary fibrosis (IPF).Methods48 IPF patients were randomly divided into two groups, each group includes 24 cases. Group A was treated with prednisone 0.5 mg/kg per day orally, reduce half of the dosage 4 weeks later and Fluimucil 600 mg three times per day orally, while group B with prednisone 0.5 mg/kg per day orally, reduce half of the dosage 4 weeks later. The clinical manifestation, pulmonary function testing, high-resolution CT of the chest, arterial blood gas analysis were observed before and 3 months after treatment. ResultsThere was significant difference in Group A (P<0.05) but no significant difference in Group B (P>0.05) before and after treatment in the pulmonary function testing and arterial blood gas analysis. There was significant difference after treatment in the pulmonary function testing and arterial blood gas analysis between Group A and Group B (P<0.05).There was significant difference after treatment in the clinical manifestation, high-resolution CT of the chest and between Group A and Group B (P<0.05). ConclusionHigh dose Fluimucil can ameliorate the pulmonary function, relieve the symptom of short breath of patients with idiopathic pulmonary fibrosis.
ABSTRACT
<p><b>AIM</b>To study the effects of ginkgolides (Gin) on the expression of hypoxia inducible factor-1 (HIF-1alpha) in hypoxic/ischemic neurons.</p><p><b>METHODS</b>The gene expression of HIF-1alpha pretreated with or without Gin (37.5 microg/ml) was observed by RT-PCR on primary cultured cortical neurons in the condition of hypoxia and oxygen-glucose deprivation.</p><p><b>RESULTS</b>Some basic expression of HIF-1alpha mRNA were observed in cultured cortical neurons. The expression of HIF-1alpha mRNA increased after 24 h treatment with Gin. The level of HIF-la mRNA increased also after 1 h hypoxia and further enhanced after the pretreatment with Gin. The expression of HIF-1alpha mRNA decreased with the deprivation of both oxygen and glucose, which reversed after the pretreatment of Gin.</p><p><b>CONCLUSION</b>Gin could increase the expression of HIF-1alpha mRNA in hypoxic/ischemic cortical neurons.</p>
Subject(s)
Animals , Mice , Cell Hypoxia , Gene Expression , Ginkgolides , Pharmacology , Hypoxia-Inducible Factor 1, alpha Subunit , Genetics , Metabolism , Mice, Inbred ICR , Neurons , Metabolism , RNA, Messenger , GeneticsABSTRACT
Objective To evaluate the difference of internal diameter of bronchial artery in big lung cancer,small lung cancer,and normal lung with multiple slice CT.Methods MSCT angiographies of 44 patients with lung cancer confirmed by pathology were retrospectively analyzed,and 29 patients were with big lung cancer(≥3 cm)and 15 patients with small lung cancer(