Objective To compare the concordance among RECIST, EASL and modified RECIST criteria for the evaluation of tumor response after transarterial chemoembolization of primary liver cancer.Methods Fifty patients with primary liver cancer underwent 2 TACE cycles separated by 30-40 days.Triphasic helical CT or MRI scans were performed at baseline, at 4 weeks after TACE procedure, and 2 independent radiologists evaluated tumor response according to above-mentioned three different criteria. Chisquare test was used to compare the response rate, and kappa coefficients were used to evaluate the coherence. Results When tumor responses were evaluated using the RECIST-EASL and modified RECIST criteria, the numbers of the patients achieved complete response, partial response, stable disease,progressive disease were 0, 10, 30, 10; 6,21,14,9; 6,21,13,10 respectively. The objective response rates for three different criteria were 20%, 54%, 54% respectively ( P ＜ 0. 01 ). Kappa coefficients between RECIST and EASL, between RECIST and modified RECIST, between EASL and modified RECIST were 0. 382, 0. 170, and 0. 857 (P = 0. 000). Conclusions RECIST criteria underestimates the extent of tumor response after TACE in primary liver cancer. Both EASL and modified RECIST criteria appear to agree with each other in determining treatment response. Furthermore, the modified RECIST is more convenient in clinical practice compared with EASL criteria.

AIM: To study the relationship between Chlamydia pneumoniae (Cpn) and spontaneous brain bleeding. METHODS: The IgG and IgM antibody titers to Cpn in peripheral blood from 9 patients of spontaneous brain bleeding were detected by microimmunofluorescence antibody technique (MIF). The Cpn DNA of arteries in brain bleeding region from these cases was detected by polymerase chain reaction (PCR). The Cpn major outer membrane protein (MOMP) expression of arteries in brain bleeding region from these cases were tested by Western blot. RESULTS: All the geometric average titer to IgG antibody (190 3?3 2) and the positive rate of IgG antibody (85 2%) and IgM antibody (30 8%) were significantly higher in spontaneous brain bleeding patients than those (48 1?2 0, 48 1% and 4 8%) in control ( P

Objective To evaluate the technical feasibility and safety of a single-incision technique via axillary vein (AV) for placement of totally implantable venous access port (TIVAP) guided by ultrasound combined with DSA in clinical application. Methods We retrospectively analyzed clinical data of 240 patients who received TIVAP by single incision technique via AV access guided by ultrasound combined with DSA. We observed and recorded operation-related information such as AV width, AV puncture success rate, implantation success rate, ultrasound-guided puncture time, operation time and intraoperative and postoperative complications, etc. Results All 240 patients were successfully implanted with TIVAP, and the success rate was 100%. In 229 cases, TIVAP was implanted through single-incision AV puncture under the guidance of ultrasound combined with DSA, and the success rate of AV puncture was 95.42% (229/240). In 11 cases, TIVAP was implanted through the ipsilateral internal jugular vein (IJV) under the guidance of ultrasound combined with DSA due to the failure of AV puncture. In the 240 patients, the average width of AV of the intended puncture segment was (7.56±1.26) mm measured by preoperative ultrasound exploration and positioning, in which 195 cases were successfully punctured once, 26 cases were successfully punctured twice, and 8 cases were successfully punctured three times, with the success rate of 81.25%, 10.83% and 3.34%, respectively. The average puncture time under ultrasound guidance was (0.85±0.52) min, and the average operation time was (25.9±4.8) min. The incidence of intraoperative complications was 1.67% (4/240). No hemothorax, hemopneumothorax or serious fatal complications occurred. The incidence of complications during TIVAP retention was 2.92% (7/240). No complication such as catheter-related bloodstream infection, catheter-related venous thrombosis, catheter rupture/displacement, clipping syndrome or drug extravasation was observed. Conclusion Ultrasound combined with DSA guided single-incision technique via AV access in the implantation of TIVAP is a feasible and safe implantation method with high technical success rate, short operation time and low risk of complications. It can be used as another choice of TIVAP implantation method.