Objective To evaluate effects of three modalities with intravenous immrnoglobulin(IVIG) infusion in the treatment of Kawasaki disease(KD). Methods 76 KD cases were treated by the IVIG in the Deparment of Pediatric of Kaiping Central Hospital from 1998 to 2004.The three modalities were as follows: four days treatment(0.4 g/kg,for four days continuance),two days treatment(1 g/kg,for two days continuance),one day treatment(2 g/kg,for one day).Results(1) In treatment of fever,conjunctiva congest and mouth change,and recover in white blood cell and erythrocyte sedimentation,one day treatment and two days treatment had better curative effects with significantly difference(P0.05).(3)In the prevention of coronary artery dilate(CAD),one day treatment and two days treatment had better curative effects significantly difference(P

OBJECTIVETo investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein (AFP) negative (AFP < 20 ng/ml) and positive (AFP ≥ 20 ng/ml) hepatocellular carcinoma (HCC) patients.

METHODSClinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent RO radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.

RESULTSCompared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P < 0.05 for all). Furthermore, the 1-, 3-, and 5- year overall survival rates were 94.4%, 82.4% and 61.0% in the AFP-negative group and 87.2%, 61.1% and 40.2%, respectively, in the AFP-positive group (P < 0.001). The multivariate analysis with Cox's proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients (P < 0.05) , and large tumor and Edmondson-Steiner grades III/IV are independent risk factors for worse survival in AFP-negative patients (P < 0.05). However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P < 0.05).

CONCLUSIONHigh levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.

Asian Continental Ancestry Group ; Carcinoma, Hepatocellular ; chemistry ; mortality ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Liver Neoplasms ; chemistry ; mortality ; pathology ; surgery ; Male ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Survival Rate ; alpha-Fetoproteins ; analysis

Objective To investigate the mechanism and role of ?-ray of 103Pd in the treatment of biliary duct cancer.Methods A series of biliary duct cancer cells were treated with different ?-ray dose,and MTT [3-(4,5-dimethy thiazol-2-yl)-2,5-diphenyl terazolium-bromide] technique was used to determine the inhibition rate of ?-ray of 103Pd on the biliary duct cancer cells;and electron micro-technique,DNA agarose gel electrophoresis and flow cytometry to evaluate the morphological characteristics and apoptosis rate of the biliary duct cancer cells were also used.Results The ?-ray radiation of 103Pd resulted in significant inhibition of the biliary duct cancer cells.The features of biliary duct cancer cells apoptosis(e,g:apoptic bodies,DNA ladders band hypodiploid DNA peak) could be seen in the group with lower dosage(5.333mci),and cell necrosis was seen in higher dosage(more than 6.645 mci).Conclusions The ?-ray radiation could induce apoptosis of the biliary duct cancer cells,but with dose dependence,and apoptosis can be an important mechanism for radiation treatment of biliary duct cancer.

Objective To evaluate preliminarily the clinical efficacy of two types of hepatic inflow occlusion in hepatectomy for hepatocellular carcinoma ( HCC) .Methods A total of 54 patients with HCC who underwent hepatectomy were divided into two groups:RIP group ( regional ischemic preconditioning with continuous clamping,n=15) and HHV group(hemi-hepatic vascular inflow occlusion, n=39).HHV was performed by placing a clamp on the right hepatic artery and right portal vein, and was maintained until the liver resection was completed.In the RIP group, HHV was preceded by a 5-min period of ischemia followed by 5 min of reperfusion.The clinical indicators of the two groups were compared.Results The volume of intraoperative blood loss had significant difference between the two groups (P=0.039).One case (6.7%) in the RIP group and 17 cases ( 43.6%) in the HHV group received postoperative blood transfusion, showing a significant difference (P=0.010).No postoperative 30-day mortality happened in all patients. No significant differences were found between the two groups in hospital stay or postoperative morbidity, including hepatic insufficiency, infection, ascites, pleural effusion, cardiopulmonary complications and intestinal ventilation time ( P >0.05 for all).The RIP group had a significantly higher PTA level at postoperative days 3 and 5 (P<0.001).Although no significant differences were found between the two groups regarding total bilirubin, albumin, prealbumin and aminotransferase ( P >0.05 ) during any postoperative stage, the ALT recovered to normal level in 5 patients (33.3%) of the RIP group and only in one case (2.7%) of the HHV group, with a significant difference between the two groups (P=0.006). Conclusion The results of this study indicate that regional ischemic preconditioning may have better hemostatic effect on hepatectomy, can reduce postoperative blood transfusion and promote early recovery of liver function than hemi-hepatic vascular inflow occlusion.

Objective To explore the surgical risk, perioperative outcome and the response of patients with hepatocellular carcinoma ( HCC ) after preoperative transcatheter arterial chemoembolization ( TACE) . Methods A retrospective case?matched study was conducted to compare the characteristics and corresponding measures of patients in the preoperative TACE group and the control group without TACE. A total of 105 patients ( 82 patients with selective and dynamic region?specific vascular occlusion to perform hepatectomy for patients with complex hepatocellular carcinoma) was included in this study, in which 35 patients underwent TACE therapy, and a 1 ∶ 2 matched control group of 70 subjects. Results The patients of preoperative TACE therapy group had a higher level of γ?glutamyl transpeptidase before operation (119.52± 98.83)U/L vs. (67.39±61.25) U/L (P=0.040). The operation time was longer in the TACE group than that in the control group but with a non?significant difference (232.60±95.43) min vs. (218.70±75.13) min ( P=0.052) . The postoperative recovery of liver function and severe complications in the preoperative TACE group were similar to that in the control group ( P>0.05) . There were no massive hemorrhage, biliary fistula and 30?d death neither in the treatment group and matched control group. Conclusions Preoperative TACE therapy has certain negative effect on liver function. It is preferable to use selective and dynamic region?specific vascular occlusion technique during hepatectomy and combine with reasonable perioperative treatment for this group of patients, that can ensure safety of patients and promote their rapid recovery.

Objective To evaluate preliminarily the clinical efficacy of two types of hepatic inflow occlusion in hepatectomy for hepatocellular carcinoma ( HCC) .Methods A total of 54 patients with HCC who underwent hepatectomy were divided into two groups:RIP group ( regional ischemic preconditioning with continuous clamping,n=15) and HHV group(hemi-hepatic vascular inflow occlusion, n=39).HHV was performed by placing a clamp on the right hepatic artery and right portal vein, and was maintained until the liver resection was completed.In the RIP group, HHV was preceded by a 5-min period of ischemia followed by 5 min of reperfusion.The clinical indicators of the two groups were compared.Results The volume of intraoperative blood loss had significant difference between the two groups (P=0.039).One case (6.7%) in the RIP group and 17 cases ( 43.6%) in the HHV group received postoperative blood transfusion, showing a significant difference (P=0.010).No postoperative 30-day mortality happened in all patients. No significant differences were found between the two groups in hospital stay or postoperative morbidity, including hepatic insufficiency, infection, ascites, pleural effusion, cardiopulmonary complications and intestinal ventilation time ( P >0.05 for all).The RIP group had a significantly higher PTA level at postoperative days 3 and 5 (P<0.001).Although no significant differences were found between the two groups regarding total bilirubin, albumin, prealbumin and aminotransferase ( P >0.05 ) during any postoperative stage, the ALT recovered to normal level in 5 patients (33.3%) of the RIP group and only in one case (2.7%) of the HHV group, with a significant difference between the two groups (P=0.006). Conclusion The results of this study indicate that regional ischemic preconditioning may have better hemostatic effect on hepatectomy, can reduce postoperative blood transfusion and promote early recovery of liver function than hemi-hepatic vascular inflow occlusion.

Objective To explore the surgical risk, perioperative outcome and the response of patients with hepatocellular carcinoma ( HCC ) after preoperative transcatheter arterial chemoembolization ( TACE) . Methods A retrospective case?matched study was conducted to compare the characteristics and corresponding measures of patients in the preoperative TACE group and the control group without TACE. A total of 105 patients ( 82 patients with selective and dynamic region?specific vascular occlusion to perform hepatectomy for patients with complex hepatocellular carcinoma) was included in this study, in which 35 patients underwent TACE therapy, and a 1 ∶ 2 matched control group of 70 subjects. Results The patients of preoperative TACE therapy group had a higher level of γ?glutamyl transpeptidase before operation (119.52± 98.83)U/L vs. (67.39±61.25) U/L (P=0.040). The operation time was longer in the TACE group than that in the control group but with a non?significant difference (232.60±95.43) min vs. (218.70±75.13) min ( P=0.052) . The postoperative recovery of liver function and severe complications in the preoperative TACE group were similar to that in the control group ( P>0.05) . There were no massive hemorrhage, biliary fistula and 30?d death neither in the treatment group and matched control group. Conclusions Preoperative TACE therapy has certain negative effect on liver function. It is preferable to use selective and dynamic region?specific vascular occlusion technique during hepatectomy and combine with reasonable perioperative treatment for this group of patients, that can ensure safety of patients and promote their rapid recovery.

Objective To investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein ( AFP ) negative ( AFP<20 ng/ml ) and positive ( AFP≥20 ng/ml ) hepatocellular carcinoma ( HCC) patients.Methods Clinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent R0 radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.Results Compared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC ) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P<0.05 for all).Furthermore, the 1-, 3-, and 5-year overall survival rates were 94.4%, 82.4%and 61.0%in the AFP-negative group and 87.2%, 61.1%and 40.2%, respectively, in the AFP-positive group ( P<0.001 ) .The multivariate analysis with Cox′s proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients ( P<0.05) , and large tumor and Edmondson-Steiner gradesⅢ/Ⅳare independent risk factors for worse survival in AFP-negative patients ( P<0.05) .However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P<0.05).Conclusion High levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.

Objective To investigate the differences between clinicopathological features and prognosis of alpha-fetoprotein ( AFP ) negative ( AFP<20 ng/ml ) and positive ( AFP≥20 ng/ml ) hepatocellular carcinoma ( HCC) patients.Methods Clinicopathological data of 142 AFP-negative and 109 AFP-positive HCC patients who underwent R0 radical hepatectomy in the Cancer Hospital of Chinese Academy of Medical Sciences between January 2006 and December 2011 were retrospectively reviewed and analyzed in this study.Results Compared with the AFP-negative patients, a higher female to male sex ratio, the later Barcelona Clinic Liver Cancer ( BCLC ) stage, more liver capsule invasion and poorer Edmondson-Steiner grade were in the AFP-positive cases (P<0.05 for all).Furthermore, the 1-, 3-, and 5-year overall survival rates were 94.4%, 82.4%and 61.0%in the AFP-negative group and 87.2%, 61.1%and 40.2%, respectively, in the AFP-positive group ( P<0.001 ) .The multivariate analysis with Cox′s proportional hazards model showed that AFP status, tumor size and Edmondson-Steiner grade are independent risk factors for survival of all the patients ( P<0.05) , and large tumor and Edmondson-Steiner gradesⅢ/Ⅳare independent risk factors for worse survival in AFP-negative patients ( P<0.05) .However, large tumor diameter was proved to be an independent risk factor leading to poor prognosis of AFP-positive cases (P<0.05).Conclusion High levels of AFP indicate that the tumors are more malignant and with unfavorable prognosis.

OBJECTIVER0 resection, Pringle maneuver, intraoperative massive blood loss and perioperative blood transfusion have been definitely recognized to be surgery-related risk factors of recurrence of hepatocellular carcinoma (HCC) in recent years. The aim of this study was to investigate the post-operative risk factors of recurrence of HCC after control of the above mentioned risk factors.

METHODS288 consecutive HCC patients underwent hepatectomy with selective regional vascular occlusion by the same surgical team. All patients had R0 resection, less than 800 ml blood loss and had no perioperative blood transfusion. The clinical and pathological factors were retrospectively analyzed.

RESULTSThe total 1-year, 3-year and 5-year disease-free survival rate (DFS) was 74.9%, 49.3% and 34.3%, respectively. Univariate analysis showed that serum gamma-glutamyl-transferase rise >55 U/L, AFP > 400 ng/ml, tumor diameter >5 cm, multi-focal lesions, satellite nodules, poor differentiation, microvascular invasion, envelope invasion, postoperative liver insufficiency, preoperative TACE and postoperative TACE were significantly associated with poor DFS. Multivariate Cox analyses revealed that tumor size, satellite nodules, poor differentiation, microvascular invasion and postoperative liver insufficiency were independent prognostic predictors associated with shorter DFS. According to the results of multivariate Cox analysis of 158 cases with at least one risk factor selected from the whole group, further analysis demonstrated that perioperative TACE was not significantly associated with the median DFS (P > 0.05 for all).

CONCLUSIONSSelective regional vascular occlusion may effectively control the surgiury-related risk factors of recurrence of HCC. Tumor features are the main affecting factors of DFS. Preoperative or postoperative TACE do not benefit patients who received curative resection.

Blood Loss, Surgical ; Carcinoma, Hepatocellular ; epidemiology ; surgery ; Disease-Free Survival ; Hepatectomy ; Humans ; Liver Neoplasms ; epidemiology ; surgery ; Multivariate Analysis ; Neoplasm Recurrence, Local ; epidemiology ; surgery ; Postoperative Period ; Prognosis ; Retrospective Studies ; Risk Factors