Application value of CT/MRI examination in clinical diagnosis and treatment of Crohn′s disease / 中华消化外科杂志

Accurate evaluation of Crohn′s disease is critical for determination of a therapeutic plan. Computed tomography (CT)/magnetic resonance imaging (MRI) can not only display the intraluminal and intraperitoneal inflammation objectively, but also reveal accurately the affected mesentery and related complications comprehensively, which attracted more and more attention in recent years. This review discussed the choice of CT/MRI examination methods, their roles in determining the severity of intestinal and mesenteric inflammation, the nature of intestinal stenosis, the extent of fistula, abscess and cellulitis, and the value in diagnosing postoperative complications, in order to investigate the application value of CT/MRI examination in clinical diagnosis and treatment of Crohn′s disease.

Application value of CT/MRI examination in clinical diagnosis and treatment of Crohn's disease / 中华消化外科杂志

Accurate evaluation of Crohn's disease is critical for determination of a therapeutic plan.Computed tomography (CT)/magnetic resonance imaging (MRI) can not only display the intraluminal and intraperitoneal inflammation objectively,but also reveal accurately the affected mesentery and related complications comprehensively,which attracted more and more attention in recent years.This review discussed the choice of CT/MRI examination methods,their roles in determining the severity of intestinal and mesenteric inflammation,the nature of intestinal stenosis,the extent of fistula,abscess and cellulitis,and the value in diagnosing postoperative complications,in order to investigate the application value of CT/MRI examination in clinical diagnosis and treatment of Crohn's disease.

Effect of breast invasive ductal carcinoma with extensive intraductal components on local recurrence after breast conserving surgery / 中华普通外科杂志

Objective To analyze the clinicopathological features and prognostic factors of patients with breast invasive ductal carcinoma with extensive intraductal components (EIC).Methods The clinical data of 182 patients of early breast invasive ductal carcinoma undergoing breast-conserving surgery were analyzed retrospectively in the Second Affiliated Hospital of Soochow University,and the clinicopathological features and prognosis of two groups of breast cancer patients with EIC positive (n =23) and EIC negative (n =159) were compared.Results In the EIC positive group,ipsilateral breast tumor recurrence (IBTR) was 21.7％ (5/23) and the distant metastasis rate was 4.3％ (1/23);in the EIC negative group,ipsilateral breast tumor recurrence (IBTR) was 1.9％ (3/159) and the distant metastasis rate was 3.8％ (6/159).The Kaplan-Meier curve showed that the 5-year local recurrence-free survival rates in the EIC positive group was lower than that of the EIC negative group (78％ vs.97.7％) (P ＜ 0.001),and the difference was statistically significant,but the 5-year distant metastasis-free survival rates in the two groups was similar (95.7％ vs.96.2％) (P =0.892).COX multivariate analysis showed that EIC was an independent risk factor for local recurrence after breast-conserving surgery in breast invasive ductal carcinoma patients.Conclusions EIC increases the local recurrence rate in patients with breast invasive ductal carcinoma undergoing breast-conserving surgery.

Mechanism of coagulation dysfunction in the recipients mediated by tissue factor activation after liver xenotransplantation / 器官移植

Objective To investigate the mechanism underlying the activation of tissue factor (TF) that leads to coagulation dysfunction in the recipients after liver xenotransplantation. Methods Auxiliary heterotopic liver xenotransplantation was performed in 3 minipigs with α-1,3-galactosyltransferase gene-knockout (GTKO) as the donors and Tibetan macaque (Macaca thibetana) as the recipients. Postoperative coagulation function changes in the recipients were observed. Reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemical staining were adopted to quantitatively measure the expression levels of monkey and minipig TF messenger RNA (mRNA) and protein in the liver tissues of the primary and transplant livers at different time points before and after transplantation. The recalcification time of peripheral blood mononuclear cell (PBMC) was recorded in the normal control monkeys and the recipient monkeys before and 2 h after liver transplantation to evaluate the coagulation status in the recipients. Results All three recipients presented with different degrees of coagulation dysfunction after surgery, manifested as a decrease in fibrinogen level and a reduction in platelet count. The monkey TF protein was positively expressed in the primary livers after surgery, whereas negatively expressed in transplant livers before and after liver transplantation. The minipig TF protein was negatively expressed in both primary livers and transplant livers. At postoperative 2 h, monkey TF mRNA was up-regulated by (2.10±0.24) times in the primary liver compared with the preoperative level, whereas the minipig TF mRNA was up-regulated by (1.42±0.15) times compared with preoperative level. There was statistical significance between the primary livers and transplant livers (P=0.014). Compared with PBMC in the normal control monkeys and recipient monkeys before liver transplantation, the recalcification time of the PBMC in the recipient monkeys was significantly shortened at postoperative 2 h (both P<0.001). Conclusions At the presence of coagulation dysfunction after liver xenotransplantation, the level of TF activation in the primary livers is significantly higher than that in the transplant livers. The TF activation in the primary livers is the main cause of coagulation dysfunction after liver xenotransplantation.