多层螺旋CT在进展期大肠癌诊断及治疗中的应用

目的:探讨多层螺旋CT(MSCT)在进展期大肠癌诊断及治疗中的应用价值。方法:选自经手术治疗的进展期大肠癌患者165例,所有病例术前均行16层螺旋CT和纤维大肠镜检查。其中42例经新辅助化疗后再次行16层螺旋CT检查并行手术治疗。阅CT图像,诊断病变的Borrmann类型、T-分期,判定新辅助化疗疗效,并与术后病理对照。结果:应用MSCT判定进展期大肠癌Borrmann分型的准确率为95.8%(P<0.01);判定T-分期的准确率为82.4%(P<0.05);判定新辅助化疗疗效准确率为88.1%(P<0.05)。结论:MSCT影像因反映了进展期大肠癌的生物学行为,而与病理所见具有一致性。MSCT在诊断进展期大肠癌的Borrmann类型、T-分期、新辅助化疗疗效上具有明显的价值。

Anther Dehiscence Disturbed by High Temperature and Water Stress Presented in Os DIR Gene Expression in Rice(Oryza sativa L.)

In future climates, rice could more frequently be subjected to simultaneous high temperature （HT） and water stress （WS） during sensitive developmental stages such as flowering. In this study, two rice genotypes were exposed to HT, WS and combined high temperature and water stress （WS ＋ HT） during flowering to quantify their response through anther dehiscence. Gene expression profiles of 15 selected OsDIRs revealed differences among stresses and between varieties. The targeted gene OsDIR-08, which was considered to be a HT stress candidate gene, was de- creasingly expressed from the 1st d to the 4th d under HT stress in Nagina 22 （N22） while increased in Moroberekan. Varies of the expression of OsDIR genes in stresses intuitively reflects on the lignin-staining at the anther dehisced sites, which implied a negative relationship between the lignin biosynthesis and OsDIRs＇ ex- pression. Anther dehiscence disturbed by HT and WS ＋ HT stress showed a nega- tive cumulative effect in HT sensitive variety Moroberekan but not in N22. Higher level of anther dehiscence in /V22 under HT and WS ＋ HT stress indicated its true tolerance of HT and to WS ＋ HT during anthesis. The differentially expressed of OsDIR（s） under various managed stresses caused the difference of the lignin-stain- ing at the anther dehisced site in N22, and thus transformed anther dehiscence correspondingly might be one of the main reasons for the tolerance.

Is combined extra-hepatic bile-duct resection justified for advanced gallbladder carcinoma?

Background:Whether the extra-hepatic bile duct(EHBD)should be routinely resected for gallbladder carcinoma(GBC)remains controversial.The current study aimed to determine the clinical impact of combined EHBD resection during curative surgery for advanced GBC.Methods:In total,213 patients who underwent curative surgery for T2,T3 or T4 GBC were enrolled.The clinicopathological features were compared between the patients treated with EHBD resection and those without EHBD resection.Meanwhile,univariable and multivariable Cox-proportional hazards regression models were used to identify risk factors for overall survival(OS).Results:Among the 213 patients identified,87(40.8%)underwent combined EHBD resection.Compared with patients without EHBD resection,patients with EHBD resection suffered more post-operative complications(33.3%vs.21.4%,P=0.046).However,the median OS of the EHBD resection group was longer than that of the non-EHBD resection group(25 vs.11 months,P=0.008).Subgroup analyses were also performed according to tumor(T)category and lymph-node metastasis.The median OS was significantly longer in the EHBD resection group than in the non-EHBD resection group for patients with T3 lesion(15 vs.7 months,P=0.002),T4 lesion(11 vs.6 months,P=0.021)or lymph-node metastasis(12 vs.7 months,P<0.001).No survival benefit of EHBD resection was observed in GBC patients with T2 lesion or without lymph-node metastasis.T category,lymph-node metastasis,margin status,pre-operative CA19-9 level and EHBD resection were identified as independent prognostic factors for OS of patients with advanced GBC(all P values<0.05).Conclusions EHBD resection can independently affect the OS in advanced GBC.For GBC patients with T3 lesion,T4 lesion and lymph-node metastasis,combined EHBD resection is justified and may improve OS.