[ ABSTRACT] AIM:To investigate the effect of triptolide on the inhibition of microglial activation in 1-methyl-4-phenyl pyridinium ( MPP+)-induced hemiparkinson disease rats.METHODS:The rat model of Parkinson disease was es-tablished by intranigral injection of MPP +.The rats were randomly divided into sham group, MPP+group, triptolide group and vehicle group.The survival of dopaminergic neurons was detected by the immunofluorescence of tyrosine hydroxylase ( TH) in the substantia nigra ( SN) .The activation of microglia was determined by immunofluorescence of OX-42 ( micro-glia marker) in the SN.The expression of chemokine receptor CX3CR1 in SN was measured by Western blotting.RE-SULTS:Intranigral injection of MPP+increased the fluorescence intensity of the microglial marker, and promoted DA neu-ron degenerative death.Immunohistological analysis showed that the OX-42 density was decreased (P<0.01) and tyrosine hydroxylase (TH) positive neurons were increased in the triptolide group (P<0.01).The expression of CX3CR1 was lower in triptolide group than that in model group (P<0.05).CONCLUSION:Triptolide may improve PA neurons func-tion in MPP+-induced rats through inhibiting CX3CR1 expression and microglial activation.

Objective To observe the therapeutic effects of arsenic trioxide combined with transcatheter arterial chemoembolization on treatment of primary liver cancer with pulmonary metastases.Methods Sixty patients were randomly divided into two groups:group A (treatment group,n =30) and group B (control group,n =30).Group A was received periodic transcatheter arterial chemoembolization (TACE) and 10 mg arsenic trioxide by intravenous infusion for 5 hours per day,3 days after TACE.Each cycle consisted of 14 days' administration,and repeated after 2 weeks.Each patient was received 3-4 successive cycles.Group B was received periodic TACE alone.Objective efficiency,benefit rate,quality of life and the correlates with metastatic tumor size and number in the both groups were recorded.Results The objective efficiency was 26.7％ (8/30),and the benefit rate was 60.0％ (18/30) in group A,while they were 0 and 16.7％ (5/30) in group B with significant statistics differences (x2 =7.067,P =0.008;x2 =11.915,P =0.001).The quality of life was improved in 4 patients and stable in 18 of group A,while no patient was improved and 13 were stable in group B (x2 =9.669,P =0.008).There was a significantly positive correlation between the tumor burden and therapeutic effect (Kendall r =-0.765,P ＜ 0.001 ;Spearman r =-0.821,P ＜ 0.001).Conclusion Arsenic trioxide combined TACE is an effective treatment method in treating primary liver cancer with pulmonary metastases.

Objective To assess the therapeutic effect of thermochemotherapy infusion combined with chemoembolization in the treatment of primary hepatocellular carcinoma.Methods Ninty six patients with hepatic carcinoma were randomly diveded into two groups.In A group,the patients underwent thermochemotherapy infusion combined with chemoembolization.In B group,chemotherapy infusion was done combined with chemoembolization.Before the therapy,the basic examinations of patients were improved,including liver function,renal function,immune function.At the same time,each patient was performed with enhanced CT scan.Three days and a month after treatment,main outcome measures,containing liver function,renal function,and immune function were examined,the volumes of tumor were measured on CT.Repeat treatment were performed between four and six weeks.Follow-up was performed after the third treatment,patients survival periods were observed.Results A and B groups of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were higher than pre-treatment after 3 days (all P ＜ 0.05),but the ALT and AST in group B were both higher than those in group A (P =0.001,P =0.002),there were no changes after 30 days.No significant difference of renal function were found in the both groups.In the A group,the total efficiency was 75.00 ％ (36/48),and that of the B group was 39.58 ％ (19/48),showing statistically significant difference (P ＜ 0.01).In the A group,the immunity state of patients were improved after treatment.In the A group,the median survival time was 24.0 months (95 ％ CI was 20-29 months).In the B group,the median survival time was 18.9 months (95 ％ CI was 18-20 months).There was significant difference between the two groups (P ＜ 0.01).Conclusion The gemcitabine transcatheter arterial heated chemotherapy combined carboplatin with transcatheter arterial chemoembolization is effective treatment for primary hepatocellular carinoma.

Objective To assess the diagnostic value of MR imaging in follow-up evaluation of patients with hepatocellular carcinomas ( HCC ) treated with radiofrequency ablation ( RFA ) and to compare it with that of multi-slice CT.Methods From December 2009 to September 2011,there were 48 patients (56 HCCs) treated with RFA after transcatheter arterial chemoembolization (TACE). MR imaging and multi-slice CT were performed for follow-up.Two radiologists independently reviewed these images,detection of residual or recurrent tumor were assessed on a five-point scale and compared with Kappa test and with the method of receiver operating characteristic (ROC) curve analysis.Sensitivity,specificity and accuracy were evaluated.Results The observer agreement rate for MR imaging was higher ( 0.925 ) than for multi-slice CT (0.701,P ＜ 0.05).The area under the ROC curve (AUC)of MR imaging( 0.987 and 0.971 by two radiologists respectively) was significantly higher than that of CT( 0.674 and 0.598 by two radiologists respectively),P ＜0.05. The sensitivity, specificity and accuracy of detection rate for MRI [100％(22/22),95.5％ (86/90) and 95.5％ ( 107/112),respectively] were significantly different with that for multi-slice CT [40.9％ ( 9/22 ),57.8％ ( 52/90 ) and 60.7％ ( 68/112 ),respectively]. Conclusion Diagnostic accuracy and detection rate of residual or recurrent tumor were found to be superior with MR imaging than with multi-slice CT.

Objective To assess the therapeutic value of transcatheter arterial chemoembolization combined 125iodine seed implantation for primary hepatic carcinoma with portal vein tumor thrombus.Methods The data of 23 patients ranging from 34 to 70 years old [ average age ( 56 ± 8) years ] with primary hepatic carcinoma with portal vein tumor thromhosis of type Ⅱ and type Ⅲ were retrospectively collected.The tumor number of liver parenchyma ranged from 1to 15 ( median number 4).The average diameter of tumor thrombus was (20.5 ± 1.5 ) mm and average length was ( 37.4 ± 2.6 ) mm.All of the tumors of liver parenchyma in 23 patients were treated by transcatheter arterial chemoembolization (TACE) and tumor thrombus were treated with 125iodine seed implantation.Before the 125iodine seed implantation,the formula dosage,the number,the spatial distribution,the intensity of radioactivity and the matched peripheral dosage of seed were calculated by treatment planning system (TPS).Then the 125iodine seeds were implanted in different levels and locations of port vein thrombosis under CT guided.Results The follow-up period ranged from 1to 26 months.The times of transcatheter arterial chemoembolization were 1to six times (median time 3.1±0.4) and the 125iodine seed implantation in the port vein thrombosis were 1to 2 times ( median time 1.4 ± 0.5 ).The numbers of implanted 125iodine seeds were 4 to 17 ( median number 7.0 ± 1.0).The median survival time was 18.0 months (3-24 months).The 3,6 and 12 months survival rates were 91.3％ ( 21/23 ),69.6％ ( 16/23 ),and 60.9％ ( 14/23 ).There was no severe side-effect related to therapy.Conclusions Transcatheter arterial chemoembolization combined 125iodine seed implantation for portal vein tumor thrombosis could significantly prolong the median survival time of patient with primary hepatic carcinoma with portal vein tumor thrombosis.

Objective To study the effect of scalp acupuncture plus facilitation technique on the temporal and spatial parameters of gait in spastic cerebral palsy. Method Thirty eligible patients with spastic cerebral palsy were randomized into a treatment group and a control group based on the inter-group balance in age, palsy type, and the Gross Motor Function Classification System (GMFCS), 15 cases in each group. The treatment group was intervened by scalp acupuncture, together with the facilitation technique during the retaining of the needles; the control group was also by scalp acupuncture and facilitation techniques but with over 1 h interval between the two methods. The treatment was given once a day, totally for 3 months. The walking, running, and jumping items (E category) of the Gross Motor Function Measure-66 (GMFM-66), temporal and spatial parameters of gait, and vertical ground reaction force during stance were compared before and after the treatment. Result There were no significant inter-group differences in comparing the rates of E category of the GMFM-66 before the treatment (P>0.05), the rates were significantly changed after the treatment in both groups (P<0.05), and there were significant differences in comparing the rates between the two groups after the intervention (P<0.05);after the intervention, the step length, walking speed, and step frequency were increased significantly in both groups (P<0.05), while the double-stance phase was decreased significantly, and swing phase was increased significantly (P<0.05); after the intervention, the step length, walking speed, and step frequency of the treatment group were significantly better than that of the control group (P<0.05). Conclusion Acupuncture plus facilitation technique can mitigate the spasticity in spastic cerebral palsy, improve the gross motor function, especially the function of standing and walking, enhance the activities, and benefit the improvement of the step length, step width, and walk speed.

Objective: To explore the methods of establishing and maintaining community injecting drug user (IDU) cohort. Methods: From June 2014 to June 2017, a community survey was conducted on basis of local needle and syringe exchange site to recruit 200 HIV sero-negative IDU for a prospective cohort study in Longyang district of Baoshan city, Yunan province. Follow-up was carried out every six month to investigate high risk drug use behavior and sexual behavior, and blood samples were collected from them for the tests of HIV and HCV serum antibodies. The cohort would be opened every 12 months to replenish the cohort to 200 subjects. Results: The follow up was conducted for 3 years in 229 IDUs. Cohort follow-up rate was 93.0% (213/229) for 6 months, 92.1% (211/229) for 12 months, 91.7% (200/218) for 18 months, 87.2% (190/218) for 24 months, 86.0% (172/200) for 30 months and 86.0% (172/200) for 36 months. Conclusion The community IDU cohort has a high follow-up rate.