Objective To explore the application of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE ) in two-stage hepatectomy of hepatocellular carcinoma (HCC).Methods From September 2010 to September 2013,a total of 107 patients with HCC in the right liver lobe who were not suitable for one stage hepatectomy received TACE or TACE combined with SPVE treatment were enrolled.Among them,55 received TACE therapy and 52 accepted TACE combined with SPVE treatment.The technique success rate,complication,adverse reactions,the volume change of each liver lobe and the rate of hepatectomy of HCC were observed.Chi-square test was used for numerical data comparison and Student′s t test for measurement data.Results TACE or TACE combined with SPVE therapy was successfully applied in all the 107 patients,the technique success rate was 100%.During treatment period,no complications such as ectopic embolization, liver function failure,puncture tract bleeding,gastrointestinal bleeding,bile leakage and hepatic abscess were observed.After treatment,the adverse reactions included liver function impairment,pain in hepatic region,fever,nausea and vomiting.Four weeks after the treatment,the volumes of tumor and right liver lobe decreased to certain degree in patients with HCC of both TACE group and TACE combined with SPVE group.The volume of left liver lobe in TACE group had no obvious change,while remarkably increased in TACE combined with SPVE group.The pre-treatment residual liver volume (RLV)of TACE group and TACE combined with SPVE group was (404.0 ± 46.3 )cm3 and (393.9 ± 65 .7 )cm3 , respectively,and the difference was not statistically significant (t=0.927,P =0.356).Four weeks after the treatment,RLV was (415.4 ±45.7 )cm3 and (567.3 ±88.7 )cm3 ,respectively,and the difference was statistically significant (t= -11 .219,P <0.05).Patients were followed up for three to six months,the rates of hepatectomy were 38.2%(21/55)and 86.5 %(45/52)in TACE group and TACE combined with SPVE group,and the difference was statistically significant (χ2 =26.440,P <0.01 ).Conclusion For patients with HCC not suitable for one stage hepatectomy,the treatment of TACE combined with SPVE before operation could effectively control the growth of the tumor,decrease the volume of tumor,increase RLV,and then increase the rate of two-stage hepatectomy.

OBJECTIVETo evaluate the expression of cytokeratin 19(CK19) and connexin 43(Cx43) in various stages of oral carcinogenesis and investigate the relationship of CK19 and Cx43 in the process of oral cancer.

METHODS4-nitroquinoline-1-oxide(4NQO) was used to induce oral carcinogenesis in the mucosa of SD rats and immunohistoche-mical technique was used to study the expression of CK19 and Cx43 in various stages of oral carcinogenesis.

RESULTSThe CK19 positive staining were distributed in the basal cell layer in the normal rat lingual mucosa. While CK19 positive staining were distributed in cytoplasm of supra-basal layers in the mild dysplasia, moderate dysplasia and severe dysplasia. In oral squamous cell carcinoma(OSCC) tissue, CK19 were expressed in all the stratum of epithelium. The positive rate of CK19 in normal, mild, moderate, severe dysplasia and OSCC tissues were respectively 30.00%, 50.00%, 58.33%, 80.00%, and 91.67%. With the lesions getting worse, the positive rate and the intensity of CK19 raised significantly (P<0.05). In normal tongue mucosa, Cx43 proteins were mainly expressed in the membrane of the epithelial cells of the rat tongue. It was weakly positive in the basal cell layer, increased in the stratum spinosum and stratum granulosum, and negative in the stratum corneum. Compared with normal epithelia, the expression of Cx43 in dysplastic and OSCC epithelia decreased significantly. The positive rate of Cx43 in normal, mild, moderate, severe dysplasia and OSCC tissues were respectively 100.00%, 85.71%, 66.67%, 40.00%, and 33.33%. The expression of Cx43 was significantly decreased with severity increasing (P<0.05).

CONCLUSIONThe expression of CK19 protein significantly increases with the development of rat tongue carcinoma, suggesting that CK19 is associated with carcinogenesis. The expression of Cx43 protein dramatically decrease with the development of rat tongue carcinoma, suggesting that the abnormal expression of Cx43 protein is associated with oral mucosa carcinoma origination. The expression of CK19 and Cx43 has negative correlation. Combined detection of CK19 and Cx43 has an important role in the early diagnosis of OSCC and can help to improve the sensitivity and specificity of the early diagnosis of OSCC.

4-Nitroquinoline-1-oxide ; Animals ; Carcinogenesis ; Carcinoma, Squamous Cell ; Connexin 43 ; Epithelial Cells ; Epithelium ; Keratin-19 ; Keratins ; Male ; Mouth Mucosa ; Mouth Neoplasms ; Oxides ; Rats ; Rats, Sprague-Dawley ; Tongue ; Tongue Neoplasms

Objective: To study the inhibitory effect of ozone water on bad breath pathogens in vitro. Methods: In vitro cultured bad breath pathogens Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi) and Fusobacterium nucleatum (Fn) were identified by Gram stain and a PCR test. Ozonated water by was prepared by ozone generator and the concentration of ozone in water was measured using iodine titration. Artificial saliva was used to observe its interference on ozone function. Results: Gram stain and PCR results were consisted with strain characteristics. The ozone concentration of ozonated water reached to the maximum of 0. 2 mg/L. Ozone water with the concentration was 0. 05, 0. 1 and 0. 2 mg/L inhibited the proliferation of Pg, Pi and Fn. But the inhibitory effect was weakened when the concentration decreased. The artificial saliva reduced the effect of ozone water. Conclusion: The Pg, Pi and Fn can be inhibited by ozone water. Artificial saliva may reduce the effects of ozone water on the bacteria.

Objective:To compare the effect of the frequency of transcatheter arterial chemoembolization (TACE) on preventing tumor recurrence after hepatectomy. Methods:A total of 45 post-operative patients who had received prophylactic TACE once or thrice were retrospectively examined between January 2008 and June 2009. Of the 45 patients, 23 underwent TACE once, and the others un-derwent it thrice. TACE was administered to all patients via the hepatic artery one to two months after operation and was repeated every two to four months with patients who underwent TACE three times. All cases were followed up for 36 to 40 months after surgery. The rates of cumulative recurrence between the two groups were compared. Results:In the group that underwent TACE once, the 1-, 2-and 3-year cumulative recurrence rates were 30.43%, 47.83%, and 47.83%, respectively. In the group that underwent TACE thrice, the 1-, 2-and 3-year cumulative recurrence rates were 4.55%, 27.27%, and 36.36%, respectively. Statistical analysis showed that the relapse rate within one year was lower in the group that underwent TACE thrice than in the group that underwent TACE only once (P=0.022). How-ever, no significant difference in the cumulative recurrence rate was found between the two groups in two and three years (P=0.086, 0.225). Conclusion:Hepatocellular carcinoma patients who undergo preventive TACE three times after hepatectomy exhibit reduced re-currence rates during the peak time of tumor recurrence and extended disease-free survival intervals.

Objective To evaluate the safety and clinical short-term efficacy of interventional emboliz-ation with hepasphere-loaded microspheres in treating inoperable hepatocellular carcinomas. Methods A total of 15 patients with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization ( TACE ) using hepasphere-loaded microspheres as embolic agent . The clinical data , imaging follow-up materials, complications of interventional treatment, prognosis, etc. were summarized and analyzed. The results were evaluated with modified response evaluation criteria in solid tumors (mRECIST); monthly follow-up was made for all patients. A total of 23 TACE procedures were performed in 15 patients. Results The following-up period ranged from 6 months to 15 months , the median follow-up time being 10 months . According to mRECIST, the 3-month objective response rate (CR+PR) was 73.3% and disease control rate (CR+PR+SD) was 93.3%;the 6-month objective response rate (CR+PR) was 73.3%and the disease control rate (CR+PR+SD) was 86.7%. No severe complications, such as bile leak complicated by infection, liver abscess, abdominal hemorrhage, bleeding due to tumor rupture, gastrointestinal bleeding, etc. occurred in all patients . Conclusion In treating unresectable hepatocellular carcinomas , TACE using newly-developed hepasphere microspheres carries satisfactory clinical short-term efficacy and safety, although thelog-term results need to be further investigated with larger sample trial.

Objective: To explore the clinical features, the serotype distribution and drug resistance of the isolates in patient with invasive pneumococcal disease (IPD). Methods: By retrieving the laboratory information system in 18 children′s hospitals from 2012 to 2017, the children with IPD were enrolled. Streptococcus pneumoniae (Spn) must be isolated from the sterile sites (blood, cerebrospinal fluid, hydrothorax and joint effusion etc.). The clinical characteristics, serotype, drug resistance, treatment and prognosis were reviewed and analyzed. According to the telephone follow up results, the patients were divided into death group and recovered group. The index as an independent risk factor of mortality was demonstrated by multivariate logistic regression analysis. Results: There were 1 138 children with IPD, including 684 male and 454 female. The proportion of male to female was 1.5∶1. The age ranged from one day to 16 years. The median age was 1 year 3 month. The majority was under 5 years of age (89.3%, n= 1 016), especially under 2 years of age (61.9%, n=704). In all cases, 88.2% (n=1 004) were community acquired infection. The infections included meningitis (n=446, 39.2%), pneumonia with bacteremia (n=339, 29.8%), and bacteremia without focus (n=232, 20.4%). Underlying diseases were found in 242 cases (21.3%). Co-infections were determined in 62 cases (5.4%) with mycoplasma, 27 cases (2.4%) with adenovirus and 34 cases with influenza virus (3.0%). The penicillin insensitivity (PNSP) rates in meningitis and non-meningitis isolates were 69.5% (276/397) and 35.9% (221/615), respectively. There were 81 strains serotyped, in which 93.8% (76/81) were covered by 13-valent protein-polysaccharide conjugate vaccine (PCV13). In the 965 patients who were followed up by phone call, 156 cases (16.2%) were confirmed dead. The independent risk factors for the death were under 2 years of age (OR=2.143, 95%CI 1.284-3.577, P=0.004), meningitis (OR=3.066, 95%CI 1.852-5.074, P<0.01), underlying disease (OR=4.801, 95%CI 2.953-7.804, P<0.01), septic shock(OR=3.542, 95%CI 1.829-6.859, P<0.01), disseminated intravascular coagulation (DIC) (OR=4.150, 95%CI 1.468-11.733, P=0.007), multiple organ failure (OR=12.693, 95%CI 6.623-24.325, P<0.01) and complications of central nervous system (OR=1.975, 95%CI 1.144-3.410, P=0.015). Conclusions Most children with IPD were under 5 years of age, having underlying diseases and acquired the infection in community. The independent risk factors for death were under two years old, meningitis, underlying diseases and multiple organ failure. The problem of drug resistance was severe. The universal immunization of PCV13 would be effective to prevent IPD in Chinese children.