Value of dual-layer detector spectral CT quantitative parameters in evaluating treatment response of neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer / 中华放射学杂志

Objective:To explore the value of dual-layer detector spectral CT quantitative parameters in evaluating the treatment response of neoadjuvant chemoradiotherapy (nCRT) in patients with locally advanced rectal cancer (LARC).Methods:The study was a cross-sectional study. From May 2021 to March 2023, a total of 52 patients with LARC who received complete nCRT and were pathologically confirmed rectal adenocarcinoma at the Guangdong Province Hospital of Traditional Chinese Medicine were retrospectively enrolled. Each patient underwent spectral CT examination before and after nCRT, including plain scan, arterial phase (AP), and venous phase (VP) scans. According to the tumor regression grade, the patients were divided into the good response ( n=20) and the poor response group ( n=32). Measurements of the primary tumor′s spectral CT parameters, including effective atomic number (Z eff) at plain scan, iodine concentration (IC), CT values of 40 keV and 100 keV virtual monochromatic image (VMI) at dual-enhanced phases, were taken before and after nCRT. Additionally, the normalized iodine concentration (NIC), spectral curve slope (λHU), and the change rate of the above parameters before and after nCRT were calculated. The independent sample t-test or Mann-Whitney U test was used to compare the differences between the two groups. The receiver operating characteristic (ROC) curve was used to assess the efficacy of various metrics in evaluating the tumor treatment response of nCRT. A binary logistic regression analysis of combined parameter results was performed for the parameters with the areas under curve (AUC)>0.75, and the AUC of the combined parameter was evaluated. Results:There were significant differences in NIC AP and λHU VP before nCRT, NIC VP and λHU VP after nCRT, and the change rates of Z eff, NIC AP, NIC VP and λHU AP between the good response group and the poor response group ( P<0.05). The remaining parameters showed no statistically significant difference ( P>0.05). The ROC curve results showed that the AUCs of the above 8 parameters for evaluating tumor treatment response of nCRT were 0.702, 0.655, 0.695, 0.769, 0.738, 0.807, 0.791, and 0.677, respectively. The AUC of the combined model of the three parameters with AUC>0.75 (λHU VP after nCRT, the change rate of NIC AP and NIC VP) was 0.869, with 80.0% sensitivity and 84.4% specificity. Conclusion:The quantitative parameters derived from spectral CT may provide new markers for evaluating the response to nCRT treatment in patients with LARC. The multi-parameter combined model can improve diagnostic efficacy.

The Predictive Value of Magnetic Resonance Imaging-based Texture Analysis in Evaluating Histopathological Grades of Breast Phyllodes Tumor / 한국유방암학회지

Purpose@#Knowing the distinction between benign and borderline/malignant phyllodes tumors (PTs) can help in the surgical treatment course. Herein, we investigated the value of magnetic resonance imaging-based texture analysis (MRI-TA) in differentiating between benign and borderline/malignant PTs. @*Methods@#Forty-three women with 44 histologically proven PTs underwent breast MRI before surgery and were classified into benign (n = 26) and borderline/malignant groups (n = 18 [15 borderline, 3 malignant]). Clinical and routine MRI parameters (CRMP) and MRI-TA were used to distinguish benign from borderline/malignant PT. In total, 298 texture parameters were extracted from fat-suppression (FS) T2-weighted, FS unenhanced T1-weighted, and FS first-enhanced T1-weighted sequences. To evaluate the diagnostic performance, receiver operating characteristic curve analysis was performed for the K-nearest neighbor classifier trained with significantly different parameters of CRMP, MRI sequence-based TA, and the combination strategy. @*Results@#Compared with benign PTs, borderline/malignant ones presented a higher local recurrence (p = 0.045); larger size (p < 0.001); different time-intensity curve pattern (p = 0.010); and higher frequency of strong lobulation (p = 0.024), septation enhancement (p = 0.048), cystic component (p = 0.023), and irregular cystic wall (p = 0.045). TA of FS T2-weighted images (0.86) showed a significantly higher area under the curve (AUC) than that of FS unenhanced T1-weighted (0.65, p = 0.010) or first-enhanced phase (0.72, p = 0.049) images. The texture parameters of FS T2-weighted sequences tended to have a higher AUC than CRMP (0.79, p = 0.404). Additionally, the combination strategy exhibited a similar AUC (0.89, p = 0.622) in comparison with the texture parameters of FS T2-weighted sequences. @*Conclusion@#MRI-TA demonstrated good predictive performance for breast PT pathological grading and could provide surgical planning guidance. Clinical data and routine MRI features were also valuable for grading PTs.

Comparison of laparoscope-assisted D2 radical total gastrectomy and open gastrectomy for gastric cancer / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To evaluate the clinical feasibility of laparoscope-assisted D2 radical total gastrectomy for gastric cancer.</p><p><b>METHODS</b>From March 2011 to March 2013, 216 gastric cancer patients underwent D2 radical total gastrectomy in our hospital, including 118 laparoscopic and 98 open procedures. The intraoperative and postoperative outcomes between the two groups were compared.</p><p><b>RESULTS</b>Compared with open surgery group, laparoscopic group had longer operation time [(253.9 ± 26.1) min vs. (206.2 ± 23.9) min, P<0.01], less intraoperative blood loss [(138.4 ± 34.0) ml vs. (266.3 ± 58.7) ml, P<0.01], shorter postoperative hospital stay [(10.3 ± 1.4) d vs. (13.9 ± 2.0) d, P<0.01], and lower morbidity of postoperative complication [16.1% (19/118) vs. 29.6% (29/98), P<0.05]. There were no significant differences in the number of lymph node removed [(26.2 ± 6.2 vs. 27.6 ± 5.6)], postoperative morbidity of complication [1.7% (2/118) vs. 2.0% (2/98)], and 2-year survival rate(99.0% vs. 98.6%) between the two groups (all P>0.05).</p><p><b>CONCLUSION</b>As compared to open surgery, laparoscope-assisted D2 radical total gastrectomy is safe, feasible with the advantage of rapid postoperative recovery.</p>

Comparative study of laparoscopic gastrectomy D2 radical surgery and open gastrectomy for upper stomach cancer / 肿瘤研究与临床

Objective To evaluate the safety,tumor radical and early postoperative efficacy through comparison of laparoscopic gastric D2 radical surgery with traditional open gastric D2 radical surgery.Methods 254 patients with upper stomach cancer underwent surgery were selected,132 cases using conventional open gastrectomy (the traditional laparotomy group),122 patients underwent laparoscopic radical gastrectomy (laparoscopic surgery group).Laparoscopic surgery group with traditional open surgery group had no statistically significant differences in gender,age,tumor location,histological type and TNM staging.Results Open surgery group and laparoscopic surgery group had statistically significant differences in operative time [(235.78±31.56) min,(256.43±54.08) min,P ＜ 0.001],blood loss [(326.69±89.73) ml,(158.31±62.98) ml,P ＜ 0.001],incision length [(16.53±2.34) cm,(5.51±1.15) cm,P ＜ 0.001],gastrointestinal recovery time [(4.22±0.91) d,(3.31±0.83) d,P ＜ 0.001],first time eating liquid [(5.78±0.95) d,(5.56±0.78) d,P ＜ 0.001] and postoperative hospital stay [(12.62±2.89) d,(11.18±1.78) d,P ＜ 0.001].The total number of lymph node dissection and complications was not statistically significant.Conclusions Laparoscopic gastric D2 radical surgery is a safe,minimally invasive surgical method.Laparoscopic gastric D2 radical surgery has the same lymph node dissection and good early outcome compared with the traditional gastric D2 radical surgery,but postoperative recovery fast and less invasive.

Comparative study of clinical and pathological features of atypical lupus nephritis / 中国基层医药

Objective To explore the clinical value of renal biopsy in the diagnosis of atypical lupus nephri-tis(LN). Methods The clinical and renal pathological data of 28 cases with atypical LN were analyzed retrospective-ly. Results All 28 patients could not fulfill the ACR diagnostic criterion,misdiagnosed as primary nephritic syndrome 21 eases,chronic glomerulone-phritis syndrome 4 cases ,asymptomatic hematuria 2 cases and asymptomatic proteinuria 2 cases,all renal biopsy showed changes consistent to lupus nephritis,pathological types:3 cases were class Ⅱ,4 cases were class Ⅲ,21 cases were class Ⅳ ,7 cases were class Ⅴ,2 cases was class Ⅳ+ Ⅴlupus nephritis,the clinical manifestations of nephritic syndrome were mostly pathological type Ⅳ and Ⅴ, the chronic glomerulonephritis syndrome showed diversification of pathological type, asymptomatic hematuria and/or proteinuria were mostly pathological type Ⅱ and Ⅲ. Conclusion clinical manifestations of atypical LN is no specific and easy to be misdiagnosed. Renal bi-opsy has great value in the diagnosis of atypical LN.

Effect of tripterygium wilfordii together with prednisone in treatment of elderly primary nephrotic syndrome / 中国基层医药

Objective To investigate the therapeutic effect of tripterygium wilfordii and prednisone in old patients with primary nephrotic syndrome. Methods 78 elderly primary nephrotic syndrome patients were randomly divided into two groups. 42 patients in treated-group were treated with tripterygium wilfordii and prednisone while 36 patients in control-group were treated with prednisone only. The curative effect,24 hours urinary protein, serum albumin,plasma lipid and renal function were detemined after six months. The responses of the patients were classified as complete remission(CR) ,partial remission(PR) and NO-response. Results After six months treatment, there were 24 patients got to CR,12 patients to PR,and 6 patients remained refractory to treatment group. While there were 13 patients got to CR,10 to PR,and 13 as refractory in the control group. The general effective rate in the treatment group was 85.7% ,which was markedly higher than that of the control group,which is 66. 67% (P＜0. 05). The recurrence rate in the treatment group and control group were 14. 3% and 36. 1% respectively (P＜0. 05 ). Conclusion The curative effect of tripterygium wilfordii and prednison on elderly primary nephrotic syndrome is markedly better than prednisone only.

Lipoprotein lipase activity anti its relationship to serum lipid levels in elderly / 中国综合临床

Objective To evaluate lipoprotein lipase (LPL) activity and its relationship to serum lipid. Methods Serum triglyceride (TG) ,total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and postheparin LPL activity in 40 elderly subjects and 45 subjects in control group. Results TG,TC and LDL-C levels were much higher in the elderly than in control group (P <0.05 orP <0.01) ;postheparin LPL activity was lower in elderly (P <0.05) ; and showed a negative correlation with serum TG level (r = -0. 513 ,P < 0.01), but was positively correlated with serum HDL-C concentration (r = 0. 390, P < 0.05). Conclusion The decreased activity of LPL in the elderly may contribute to hypertriglyceridemia associated with low level of high density lipoprotein cholesterol, and could be a risk factor for atherosclerosis.

A cellular protein specifically binds to the 3'-terminal sequences of hepatitis C virus intermediate negative-strand RNA / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To study the mechanism of the cellular proteins involved in the process of replication of hepatitis C virus (HCV) negative-strand RNA.</p><p><b>METHODS</b>Ultraviolet (UV) cross-linking was used to identify the cellular proteins that would bind to the 3'-end of HCV negative-strand RNA. Competition experiment was used to confirm the specificity of this binding, in which excess nonhomologous protein and RNA transcripts were used as competitors. The required binding sequence was determined by mapping, then the binding site was predicted through secondary structure analysis.</p><p><b>RESULTS</b>A cellular protein of 45 kD (p45) was found to bind specifically to the 3'-end of HCV negative-strand RNA by UV cross-linking. Nonhomologous proteins and RNA transcripts could not compete out this binding, whereas the unlabeled 3'-end of HCV negative-strand RNA could. Mapping of the protein-binding site suggested that the 3'-end 131-278nt of HCV negative-strand RNA was the possible protein-binding region. Analysis of RNA secondary structure presumed that the potential binding site was located at 194-GAAAGAAC-201.</p><p><b>CONCLUSION</b>The cellular protein p45 could specifically bind to the secondary structure of the 3'-end of HCV intermediate negative-strand RNA, and may play an important role in HCV RNA replication.</p>

Expression of Nitric Oxide Synthase 3 and Vascular Endothelial Growth Factor in Hepatocellular Carcinoma / 中山大学学报(医学科学版)

【Objective】To investigate the expression of nitric oxide synthase 3 (NOS3) and vascular endothelial growth factor (VEGF) in hepatocellular carcinoma (HCC).【Methods】The expression of NOS3 and VEGF were detected by immunohistochemistry in 51 cases of HCC.【Results】The positive of NOS3 and VEGF in HCC were 53% and 63%.The expression rate of NOS3 in the recurrent group was significantly higher than that in the non-recurrent group (P<0.01).The expression rates of VEGF in the group with carcinoma embolus of portal vein and the recurrent group were significantly higher than those in the group without carcinoma embolus and non-recurrent group (P<0.05).The expression of NOS3 was closely related with the expression of VEGF positively in HCC.【Conclusions】NOS3 and VEGF are related with the biological behavior of HCC closely.

Apoptosis induced by 5-fluorocytosine in human pancreatic cancer cells genetically modified to express cytosine deaminase / 中国病理生理杂志

AIM: To elucidate the pattern of 5-fluorocytosine(5-FC) induced apoptosis and its role in gene therapy for human pancreatic cancer. METHODS: The human pancreatic cancer SW1990 cells(CEA-producing) were infected with recombinant adenoviruses(Adex1CEA-prCD or Adex1CEA-prZ).Cytosine deaminase(CD) expression was examind by western blot. Apoptosis induced by 5-FC in human pancreatic cancer SW1990 cells genetically modified to express cytosine deaminase was investigated by applying electron microscopy, DNA electrophoresis and flow cytometry analysis techniques. RESULTS: The SW1990 cells infected with Adex1 CEA-prCD were treated with 5-FC at 100 ?mol?L -1 for 48 h, cell apoptosis occurred. Typical apoptosis morphological feature appeared and DNA ladder could be demonstrated on DNA electrophoresis. Apoptosis peak was also showed by flow cytometry. Apoptotic cells accounted for 34.6% of the cell population. Cells in G 1, S and G 2/M phase of cell cycle were 64%, 11% and 7%, respectively. CONCLUSION: The apoptosis induced by 5-FC may be a primary mechanism in CD gene therapy for pancreatic cancer.

Effects of aspirin on cell cycle in pancreatic carcinoma cells / 中国病理生理杂志

AIM: To observe the effects of aspirin and prostaglandin E_2 (PGE_2) on the cell viability and cell cycle in SW1990 human pancreatic carcinoma cell lines, and to investigate the mechanisms of aspirin-induced growth inhibition and cell cycle arrest. METHODS: After incubated with aspirin or PGE_2 and their combination, the viability of SW1990 cells was measured by MTT assay. The levels of intracellular PGE_2 were determined by ELISA. The effects of aspirin or PGE_2 on cell cycle were investigated by flow cytometry (FCM). The expression of p21~ Wafl/cipl and p27~ Kipl/pic2 (the cyclin-dependent kinase inhibitors) were analyzed by Western blotting. RESULTS: Aspirin could inhibit the growth of cells and level of intracellular PGE_2 in a dose-dependent manner. Aspirin enhanced the expression of p21~ Wafl/cipl and p27~ Kipl/pic2 and induced cell cycle arrest at G_0/G_1 phase. PGE_2 increased the cell viability of SW1990 cells. However, it couldn't antagonize the changes of cell viability and cell cycle that induced by aspirin. CONCLUSIONS: The inhibitory effects of aspirin on growth and cell cycle of pancreatic carcinoma cells might not be mediated by a COX-dependent pathway completely. Cell cycle arrest induced by aspirin might be associated with up-regulation of p21~ Wafl/cipl and p27~ Kipl/pic2 .