Objective:To study the treatment outcome of percutaneous image-guided radiofrequency ablation(RFA)for larger hepatocellular carcinomas(with the maximal diameter longer than 4 cm)and to summarize our experience.Methods:From December,1999 to March,2007,441 patients with larger hepatocellular carcinomas,who had missed the best time for surgery, received RFA treatment in our department.The maximal diameter of the tumor was 4-8.2 cm,with a mean of(4.6?0.63)cm. The patients were followed up and the necrosis of the tumor,complication,local recurrence and survival of patients were observed.Results:The complete necrosis rate of tumors was 72.9%.The rate of RFA-associated complication was 20.9% and the rate of severe complication was 9.5%.Seven patients died of RFA.Valid follow-up data of 359 patients were obtained, including 379 tumors with diameter longer than 4 cm.A total of 302 tumors were completely necrotic and 130 of them had recurrence,with a recurrence rate of 43.0%.For patients with a tumor diameter of 4-5 cm,the 1-year,3-year,and 5-year survival rates were 78.2%,48.1%s,and 17.6%,respectively,with a median survival period of 27 months;for patients with a tumor diameter of 5-6 cm,the rates were 66.3%,36.4% and 9.7%,respectively,with a median survival period of 18 months;for patients with a tumor diameter longer than 6 cm,the rates were 53.6%,28.1%,and 0,respectively,with a median survival period of 11 months.Conclusion:RFA is an effective treatment for patients with larger HCC who are not suitable for surgery,but the patients should be selected according to the indications.

Nuclear reconstitution around Lambda DNA in a cell-free system from Xenopus eggs involves distinct steps at ultrastructural level. First, Lambda DNA polymers were induced to form chromatin-like structures with the proteins in egg extracts. Then, along with membrane vesicles and nuclear pore components attached to them to assemble double nuclear membranes, these chromatin-like structures underwent variations from condensation to decondensation, simultaneously. It is different from the nuclear reconstitution induced by chromatin in that, while membrane vesicles were attaching to the chromatin-like structures to fuse each other, the assembly of nuclear pore complexes occurred practically.

Objective:To study the risk factors and treatment of lymphatic fistulas after the radical operation of gastric cancer.Methods:Observed the clinical data of 631 cases after the radical operation of gastric cancer that had been received in our hospital from February 1998 to February 2008.Multiple factor analysis with logistic regression was performed for the risk factors.Results:The level of post-operative serum albumin on the first day and Ultrasonically activated shears are protective facrors against lymphatic fistulas(P

Objective: To analyze the risk factors, prevention and treatment of needle-tract bleeding after percutaneous image-guided radiofrequency ablation (PRFA) for hepatocellular carcinomas (HCC). Methods: A total of 1 567 RFA sessions were performed on 1 203 patients with 3 067 focuses of hepatocellular carcinoma between December 1999 and January of 2008. The clinical data of patients suffering from needle-tract bleeding were analyzed for risk factors, prevention, and treatment. Results: Seventeen (1.08%,17/1 567) patients developed needle-tract bleeding. Univariate analysis showed that the incidence of needle-tract bleeding was significantly correlated with the lower platelet count,prolongation of prothrombin time,the degree of liver cirrhosis,subcapsular HCCs and pattern of RF needle electrode (P=0.039; P=0.023; P=0.012; P=0.032 and P=0.016, respectively). Logistic regression model found that only lower platelet count,prolongation of prothrombin time,degree of liver cirrhosis and subcapsular HCCs were the independent risk factors for needle-tract bleeding after PRFA in patients with hepatocellular carcinoma (OR=4.032,P=0.040;OR=5.611,P=0.009;OR=3.871,P=0.046 and OR=5.216,P=0.026, respectively). Of the 17 patients 5 received only medicine therapy in the internal department,4 received surgery and 10 received transcatheter embolization. Thirteen patients survived and 4 died. Conclusion: It is indicated that prolongation of prothrombin time,lower platelet count, sub-capsular HCCs and pattern of RF needle electrode can influence the needle-tract bleeding after PRFA in hepatocellular carcinoma patients. The most effective methods to control the bleeding are transcatheter embolization and DSA or surgery for HCC patients after PRFA.

Objective: To investigate the factors affecting the intrahepatic infection after percutaneous radiofrequency ablation (PRFA) for liver cancers. Methods: The clinical data of 1 567 patients with intrahepatic infection after PRFA for liver cancers (from Dec. 1999 to Oct. 2007) were retrospectively summarized. Logistic regression method was used to analyze the possible affecting factors. Results: Twenty-eight person-times of intrahepatic infection occurred in 1 635 patients who received a total of 2 035 times of PRFA, with the infecting rate being 1.38%. The intrahepatic infection-related mortality was 0.13% (2/1 567). Univariate analysis indicated that the intrahepatic infection was significantly correlated with metastatic liver cancer, pattern of past abdominal operation, tumor location, tumor size and tumor numbers (P<0.05). Multivariate analysis showed that the types of liver cancer, tumor number, tumor location and pattern of past abdominal operation were independent risk factors for intrahepatic infection after PRFA for liver cancers(r=3.647, P=0.004; r=1.155, P=0.042; r=1.701, P=0.019; r=2.213, P=0.010, respectively). Conclusion: Our findings suggested that patients with metastatic liver cancer(especially for the patients who have received gastroenterostomy or cholangioenterostomy), multi-liver cancer, and cancers locating near the cavity organs are liable to intrahepatic infection after PRFA.

Objective: To study the treatment outcome of percutaneous image-guided radiofrequency ablation (RFA) for larger hepatocellular carcinomas (with the maximal diameter longer than 4 cm) and to summarize our experience. Methods: From December, 1999 to March, 2007, 441 patients with larger hepatocellular carcinomas, who had missed the best time for surgery, received RFA treatment in our department. The maximal diameter of the tumor was 4-8. 2 cm, with a mean of (4.6 ± 0.63) cm. The patients were followed up and the necrosis of the tumor, complication, local recurrence and survival of patients were observed. Results: The complete necrosis rate of tumors was 72.9%. The rate of RFA-associated complication was 20.9% and the rate of severe complication was 9.5%. Seven patients died of RFA. Valid follow-up data of 359 patients were obtained, including 379 tumors with diameter longer than 4 cm. A total of 302 tumors were completely necrotic and 130 of them had recurrence, with a recurrence rate of 43.0%. For patients with a tumor diameter of 4-5 cm, the 1-year, 3-year, and 5-year survival rates were 78.2%, 48.1%s, and 17.6%, respectively, with a median survival period of 27 months; for patients with a tumor diameter of 5-6 cm, the rates were 66.3%, 36.4% and 9.7%, respectively, with a median survival period of 18 months; for patients with a tumor diameter longer than 6 cm, the rates were 53.6%, 28.1%, and 0, respectively, with a median survival period of 11 months. Conclusion: RFA is an effective treatment for patients with larger HCC who are not suitable for surgery, but the patients should be selected according to the indications.

Objective To investigate clinical effect of patients with PICU multiple organ dysfunction by continuous blood filtration combined with naloxone.Methods 42 patients with multiple organ function failure were selected and randomly divided into 2 groups.The control group were treated by PICU conventional therapy, the experiment group were treated by continuous blood filtration combined with Naloxone.Vital signs, creatinine, creatine kinase and aspartate aminotransferase levels, length of stay and blood filtration were compared after 1 day and 3 days treatment.ResuIts Compared with control group,heart rate, oxidation index,creatinine and aspartate aminotransferase levels of the experiment group were lower(P<0.05).After 1 day and 3 days, compared with cnontrol group, length of stay and blood filtration of the experiment were lower(P<0.05).ConcIusion Continuous blood filtration combined with naloxone in treatment of multiple organ dysfunction syndrome PICU is effective and reliable.It can significantly improve renal function, shorten the length of hospital stay, and remove inflammatory mediators in plasma of patients.

Sorafenib is a molecular targeted drug for the treatment of advanced primary liver cancer.However,along with the occurrence of drug resistance,the therapeutic effect was effected.At present,there is clear evidence that the emergence of drug resistance of live cancer is closely related to the epithelial-mesenchymal transition,liver cancer stem cells and the heterogeneity of liver cancer,and the PI3K/AKt signaling pathway as the vital common signaling channel was involved in the above mentioned process.From this we can conclude that complementary inhibtion of PI3K/AKt signaling pathway at the same time is the method that can strengthen the effect of sorafenib on the treatment of liver cancer so far.

Objective To investigate the expression of serum microRNA-210 (miR-210) in patients with acute cerebral infarction(ACI),and to evaluate its clinical significance. Methods A retrospective study was conducted. Eighty patients with ACI admitted to Tianjin Hospital from January 2011 to March 2014 within 48 hours of onset were enrolled,and 30 healthy volunteers served as controls. The peripheral blood was collected,and the expression of serum miR-210 was determined by reverse transcription-polymerase chain reaction(RT-PCR). The receiver operating characteristic curve(ROC)was drawn to analyze the role of miR-210 in the diagnosis of ACI. According to the pathological and physiological characteristics of patients receiving treatment,the relationship between miR-210 and clinical physiology index was analyzed. Results The expression of miR-210 in serum of patients with ACI was significantly lower than that of the healthy control group(2-ΔΔCt:1.349±0.043 vs. 1.923±0.107,t=6.567, P<0.000). ROC analysis results showed that the sensitivity of miR-210 in the diagnosis of ACI was 90.4%,the specificity was 76.2%,and the area under the ROC(AUC)was 0.804〔95%confidence interval(95%CI)=0.700-0.908〕. No difference in expression of miR-210(2-ΔΔCt)in serum was found in patients of different gender,age, and infarction area(male and female:1.33±0.13 and 1.31±0.06,t=3.562,P=0.473;≤60 years and>60 years:1.32±0.12 and 1.31±0.09,t=2.351,P=0.264;large infarction,small infarction,lacunar infarction:respectively 1.31±0.02, 1.33±0.11, 1.31±0.06, F=1.236, P=0.087), or with the severity of cerebral infarction,and there was a tendency in lowering of expression of miR-210(2-ΔΔCt,light,medium,severe:1.53±0.11, 1.33±0.11,1.08±0.04,F=5.394,P=0.014).Conclusion The serum level of miR-210 in ACI was significantly lower than that in normal healthy persons,and it may be an important new serological marker in screening and diagnosis of ACI.

Objective To investigate the feasibility,safety and effectiveness of percutaneous biliary stenting combined with brachytherapy in treating unresectable Klatskin's tumor,and to discuss the effect of this combination treatment on jaundice recurrence and survival.Methods The clinical data of 21 patients with unresectable Klatskin's tumor (combination group),who were admitted to Department of Interventional Oncology,Shanghai Renji Hospital during the period from February 2014 to December 2015 to receive percutaneous biliary stenting combined with brachytherapy,were retrospectively analyzed;and other 28 patients,who were admitted to hospital to receive pure biliary drainage or bare metal stent implantation during the same period,were collected and used as the control group.The success rate of operation,the effect of reducing jaundice and postoperative complication rate were calculated,and the differences in survival time and jaundice recurrence time were compared between the two groups.Results A total of 32 bare metal stent sand 580 125I seeds were implanted in the 21 patients of the combination group,the success rate of operation was 100％,and the effective rate of treatment was 85.7％.The early postoperative complication rate was 9.5％,and no procedure-related death occurred.The median jaundice recurrence time in the combination group was 344 days,while it was 193 days in the control group (P=0.035).The median survival time in the combination group was 387 days,which was strikingly longer than 256 days in the control group (P=0.022).Conclusion For the treatment of unresectable Klatskin's tumor,percutaneous biliary stentingcombined with brachytherapy,used as a palliative therapeutic regimen,is safe,effective and feasible,it can delay the recurrence of jaundice and prolong the survival time.(J Intervent Radiol,2017,26:243-248)