Objective To investigate the curative effect and influential factors of small hepatocellular carcinoma (SHCC) treated by interventional therapy. Methods 42 patients with SHCC were treated by interventional therapy. Some possible prognostic factors were analysed with COX proportional hazard regression model. Results (1)Hepatic arteriographic manifestations: 26 of 42 cases SHCC revealed rich tumor vessels, 37 had tumor stain including 34 with nodular stain. (2)The overall 1 , 3 , 5 year survival rates of SHCC using Kaplan Meier method were 88%(37/42),74%(31/42),51%(21/42), respectively. (3)Clinical staging and typing of the patients,and accumulation of Lipiodol within the tumor obviously influenced interventional effects of SHCC. Conclusion (1) The most important diagnostic angiographic sign of SHCC is tumor staining, besides tumor vessels. (2) Interventional therapy of SHCC has an ideal effect and should be an important nonoperable curative method.

Objective To investigate the safety and efficacy of placement of self expandable metallic stent within right atrium and inferior vena cava (ICV) in patients with malignant ICV obstruction involving right atrium. Methods There were 5 male patients with advanced hepatocellular carcinoma, aged from 42 to 65 years (mean 56 3 years). The malignancies invaded right atrium and ICV simultaneously, and caused obstruction of ICV. These patients presented symptoms and signs of obstruction of ICV such as hepatomegaly, ascites, edema of lower extremities. “Z” type stainless steel stents (7 5～10.0 cm in length and 2 5 cm in diameter) were selected for these patients. Part (1.0～3.0 cm in length ) of stent was placed in right atrium and the rest was in ICV. Results All of stents were placed successfully and obstructed ICV reopened. The symptoms of obstruction of ICV relieved or disappeared. There were no recurrence of symptoms of obstruction of ICV and any cardiac complication related to placement of stents in follow up period (67～188 days). Conclusion Placement of self expandable metallic stent within right atrium and ICV in treatment of patients with malignant ICV obstruction involving right atrium is one of the safe and effective methods.

Objective To investigate the MR features of uterine leiomyomas and evaluate its diagnostic value. Methods Twenty six patients with probable uterine leiomyomas underwent preoperative ultrasound, T 1 weighted spin echo and T 2 weighted fast spin echo MR examinations. Among them, 11 cases were performed with dynamic contrast enhancement. Comparative analysis between MRI findings and pathologic results was done. Results MRI diagnosis in all cases was consistent with the results given by surgery and pathology, except 2 being pathologically proven as endometrial polyp or inflammatory pseudoplasma. The diagnostic accuracy of MRI was 92%, while the accuracy of ultrasound was 85%. The difference between the number of lesions detected by two modalities had statistical significance (89% for MRI vs 69% for ultrasound, ? 2=17.86, P

Objective To evaluate the clinical effect in patients with primary liver cancer (PLC) well filled with Lipiodol after transcatheter arterial chemoembolization (TACE). Methods 144 patients with PLC well filled with lipiodol after TACE were analysed retrospectively, and the survival rates were calculated by Kaplan Meier method. Results The overall cumulative survival rates for 1,2,3,4 and 5 year were 85.0%, 63.7%, 51.7%, 33.9% and 16.9% respectively. Significant differences were found for 1,2,3 and 4 year survival rates and that of 400 patients with PLC treated by TACE reported previously by our department ( P

BACKGROUND: Growth differentiation factor-5 (GDF-5) plays an important role in the development and formation of cartilage, extremities, and joints, which is a widely used joint development marker.OBJECTIVE: To express mature peptide of human GDF-5 in E. coil by the way of genetic engineering, and to explore the inductive activity of recombinant protein in vivo.DESIGN, TIME AND SETTING: The observation experiment based on gene was performed at the Analysis and Testing Center of Southern Medical University from January to June 2006.MATERIALS: Human fetus cartilage tissue was harvested from Department of Gynaecology and Obstetrics, and the consent was obtained from the family. Ten KM mice were purchased from experimental animal center of Southern Medical University, half male and half female, weighing 18-22 g, aged 6-8 weeks.METHODS: The hGDF-5 gene encoding mature peptide was gained by RT-PCR from the total RNA which was extracted from fetus cartilage tissues, and was inserted into the pET22b(+) vector to construct recombinant prokaryotic expression plasmid pET22b(+)-GDF5, which was transformed into E. coil BL-21 to be expressed after IPTG induction. Proteins of interest were purified with sepharose chelated with nickel ions (Ni2+) and then implanted in mouse hindlimb muscle to evaluate the biological activities by routine hematoxylin-eosin staining.MAIN OUTCOME MEASURES: The expression, sequencing of target gene was observed by agarose gel electrophoresis, and the protein expression was detected by SDS-PAGE electrophoresis, meanwhile, the GDF5-inducing activity was evaluate by histological observation.RESULTS: RT-PCR product was about 350 bp in length, which was confirmed by double enzyme digestion of the recombinant plasmid, sequencing result was in agreement with the reported hGDF-5 sequence in Genbank. SDS-PAGE analysis showed a conspicuous band representing a new foreign protein with relative molecular mass of approximately 14 KD after induced expressioin. Cartilage tissues were formed in the mouse muscle where the purified proteins were implanted. CONCLUSION: The integral human GDF-5 mature peptide gene was cloned successfully from human fetus cartilage tissue and a high-yield expression was achieved in E. coli, the pudfied protein has chondrogenic activities in vivo.

Objective To evaluate the diagnostic value of dynamic contrast-enhanced MR angiography(DCE MRA)of the renal arteries.Methods 18 patients suspected with renal arterial diseases underwent DCE MR Angiography examinations.After 20 ml(0.15～0.20 mmol/kg)Gd-DTPA being injected quickly via cubital vein,a scaning and data acquisition with coronal three-demensional fast spoiled gradient(FSPGR)sequence was performed in a breath-hold time,the source images were introduced into work station for post processing,including maximum intensity projection(MIP)and multiplanner reconstruction(MPR),finally 3D DCE MRA images were obtained.Results A comparative study on renal artery stenosis and its degree between DCE MR angiography and DSA was done in 25 arteial segments of 12 cases.In 12 normal renal arteries shown by DSA,DCE MRA found 11 normal and one mild stenosis;Four moderate and one severe stenosis was shown by DCE MRA in five renal arteries with moderate stenosis identified by DSA;DCE MRA found five severe stenosis and three occlusion of renal anteries,which had accordance with DSA findings.Conclusion Dynamic contrast-enhanced MR angiography can accurately assess renal arterial diseases,the accuracy was especially higher in patients with severe arterial stenosis and occlusion.

Objective To compare the ability of CT and MRI in evaluating the residual of tumor of hepatocellular carcinoma (HCC) and its stability after treated by transcatheter arterial chemoembolization (TACE) with Lipiodol.Methods 28 patients with HCC underwent CT, MRI and angiography within 2～6 months after 1～4 procedure(s) of TACE. These three examinations were completed sequentially within one month. CT and MRI findings were thus compared on the basis of the results of arteriography and clinical follow-up at least 6 months.Results 46 lesions were found in 28 patients. 31 lesions with and the other 15 lesions without residual viable tumor were confirmed by arteriography and clinical follow-up. 20 lesions with and 26 lesions without residual viable tumor were found on CT images, and CT displayed 64.5% sensitivity, 100% specificity, and 76.1% accuracy respectively. 29 lesions with and 17 lesions without residual viable tumor were found on MRI images, and its sensitivity, specificity, and accuracy were 93.5%, 100%, and 95.7% respectively. The sensitivity and accuracy between CT and MRI in evaluating the residual viable tumor of HCCs after TACE were significant different(?

Objective To investigate the effects of siRNA silencing enhancer of zeste homolo 2 (EZH2) on invasion and migration of cervical cancer cells and the molecular mechanisms.Methods The small interfering RNAs (siRNA) targeting EZH2 were transiently transfected into C33A cell line by lipofectamin2000.The effects of EZH2 on cell invasion and migration were detected by wound-healing assay, Transwell assay and soft agar colony assay.The expression of MMP2 was detected by Western blot.Results Downregulation of EZH2 expression by siRNA in C33A cell line significantly inhibited cell invasion and migration in vitro.Meanwhile, siRNA-mediated depletion of EZH2 reduced the expression of MMP2.Conclusion Knocking down EZH2 expression by siRNA could surpress invasion and migration of human cervical cancer cells, which might be related to downregulating MMP2 expression.

Objective To evaluate the accuracy of 3D contrast-enhanced MR portography (3D CE MRP) by correlating with direct X-ray portography. Methods Twenty-six patients underwent 3D CE MRP study. The findings of 3D CE MRP including the patency of the portal vein and its intrahepatic left and right branches, as well as collaterals were evaluated and compared with those from direct x-ray portography. Causes of disagreement between the two methods were analyzed. Results The main portal vein appearance was accordant with 3D CE MRP and direct x-ray portography in all cases. For intrahepatic portal veins, the results agreed in 21 patients but disagreed in 5. In one patient with a huge tumor in right liver, the right posterior portal vein was classified as occluded at 3D CE MRP, but displaced and diffusely narrowed at direct x-ray portography. The findings of left intrahepatic portal vein were discordant in three patients with hepatocelluar carcinoma in the left lobe. 3D CE MRP demonstrated complete occlusion of the left portal veins, whereas direct x-ray portography showed proximal narrowing and distal occlusion. In another patient with hepatocelluar carcinoma, a small non-occlusive thrombus involving the sagittal segment of the left portal vein was seen on MRP but not on direct x-ray portography. With demonstration of portosystemic collaterals, 3D CE MRP showed results similar to those of X-ray portography, except one recanalized para-umbilical vein was excluded from the limited scan coverage. Conclusion 3D CE MRP correlated well with direct x-ray portography in most cases. Compared with direct portography, 3D CE MRP had limitation in distinguishing narrowing of an intrahepatic portal vein from occlusion. But it showed advantage in demonstrating small thrombus within portal vein.

Objective To summarize the successful experience of three cases of heart-lung transplantations performed in our institute.Methods From July 2003 to August 2012,three patients,with diagnosis of end-stage heart-lung diseases,received heart-lung transplantation in our institute.One case was diagnosed as congenital atrial septal defect,Eisenmanger syndrome,NYHA class Ⅳ; one was dilated cardiomyopathy with moderate/severe pulmonary arterial hypertension,NYHA class Ⅲ-Ⅳ,one was diagnosed as double outlet left ventricle (DOLV) with ventricle septal defect and stenosis of pulmonary artery and its left and right branches,NYHA class Ⅲ-Ⅳ.Donor hearts were preserved with UW solution,donor lungs were preserved with Euro-Collin solution in case one and with low potassium dextran containing prostaglandin E1 in the others.Extensive disinfection and strict scrutiny were implemented postoperatively.Immunosuppressive therapy included administration of zenapax or basiliximab preoperatively,methylprednisolone during the operation,and cyclosporine a/tacrolimus + prednisone + mycophenolate postoperatively.Surgical hemostasis is of great importance,as the total pleural effusion reaches 14 640 ml within 31 days postoperatively in case two.Strict postoperative disinfection and isolation were implemented,and management of the respiratory tract was intensified.Therapeutic bronchoscopy was performed frequently for sputum suction.In case two,bronchoscopy was used thirteen times within 40 days after transplantation.Broad-spectrum antibiotics and antifungal antibiotics were used for infection control.Results All three patients were discharged after recovery from operation.Case one died of obstructive bronchitis and lung failure caused by chronic rejection four years and ten months postoperatively.Case two died of sudden cerebrovascular accident 68 days after operation.Case three survives more than one year postoperatively so far and is still alive.Conclusion Proper preservation of the donor heart and lung,perfect surgical hemostasis,strict infection control,frequent application of bronchoscopy and appropriate immunosuppressive management are critical to the success of heart-lung transplantation.