Objective To investigate the prognostic factors of sorafenib treatment in patients with advanced hepatocellular carcinoma (HCC) underwent surgical therapy or transcatheter arterial chemoembolization (TACE).Methods 62 patients with advanced HCC underwent surgical therapy or TACE were post-treated with sorafenib (400mg,bid).The overall survival (OS) and progress-free survival (PFS) were evaluated by Kaplan-Meier method.Results There were 30 patients in surgical group and 32 patients in TACE group.The median OS in surgical group and TACE group were 12.2 and 5.7 months (P =0.019) and the median PFS were 16.7 and 10.6 months (P =0.033),respectively.The liver cancer volume / liver volume ＞50 ％ and Child-Pugh classification were independent risk factors for PFS in surgical group,the Child-Pugh classification and vascular invasion were independent risk factors for OS in surgical group.Conclusion The patients' PFS and OS in surgical group by oral sorafenib are better than those of patients in TACE group.The effective ways to prolong the PFS include decreasing volume of liver cancer and the better liver function.

Objective To study the effects of XiaoAiping (XAP) with different concentrations and action time on the proliferation and apoptosis of hepatocellular carcinoma cells Hepa1-6. Methods The hepatocellular carcinoma cell line Hepal-6 was treated with XAP at doses of 30 mg/ml(the high concentration group), 20 mg/ml (the moderate concentration group) and 10 mg/ml (the low concentration group) for 24 h, 48 h and 72 h, respectively. The MTT assay was used to detect the inhibitory effects of XAP on cell growth. The cell morphological alteration was observed after HE staining, and the apoptosis rates were assayed by flow cytometry. Results XAP produced an obvious time-and-dose-dependent inhibitory effect on the Hepa1-6 cells (P<0.01), and the cell differentiation trend was benign on light microscopy. After 48 h Hepa1-6 cells were incubated by XAP, there was an apoptosis peak, and the apoptosis rate was increased statistically in XAP group with the increasing XAP concentration [(7.65±0.40)%, (11.26±1.09)% and (26.71±0.85)% in low, moderate and high concentration group, respectively]compared with that in the controls (2.88 ±0.30)%, P < 0.01). Conclusion XAP produced obvious time-and-dose-dependent inhibitory effects on Hepa1-6 cells. Inhibiting DNA synthesize and inducing apoptosis of tumor cells may involve in the mechanisms of antineoplastic effect.

Objective To study the expression and significance of antiapoptosis facter-clusterin in prostate neoplasm. Methods Reverse transcriptive polymerase chain reaction(RT PCR) was used to examine the expression level of clusterin in prostate cancer tissues(3 cases),prostate cancer cell line PC3M and normal prostate tissues(3 cases). Results Compared with the internal marker gene ? actin , the expression level of clusterin in prostate cancer is much higher than that of normal prostate. Conclusions The high expression level of clusterin in prostate cancer indicates that clusterin may play an important role in the biological characteristics of prostate cancer through the antiapoptosis pathway.

Objective To study the expression of dihydrodiol dehydrogenase (DD) in prostate cancer and its significance. Methods With reference to expression of ?-actin gene,the expression level of a human dihydrodiol dehydrogenase isoform (DD2) mRNA was examined in prostate cancer tissues (11 cases) and normal prostate tissues (10 cases) by reverse transcriptive-polymerase chain reaction(RT-PCR). Quantitative determination of relevant band densities was performed using densitometry-scanning techniques. Results Strong expression of DD2 mRNA was detected in prostate cancer tissures with absorbance in the range of 0.550 to 1.018 (median,0.726),and low expression of DD2 mRNA in normal prostate tissues with absorbance in the range of 0.248 to 0.420 (median,0.333). The difference of the expression of DD2 mRNA between cancer and normal prostate was significant ( P

Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P ＜ 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.

Background Retinal hemorrhage in newborns is a common clinical finding,and serious retinal henorrhage resulting in poor prognosis.The factors affecting retinal henorrhage in newborns are unelucidated now.Identifying these factors is helpful for the early prevention and treatment.Objective This study was to explore the underlying maternal,obstetric,and neonatal clinical factors for degree of retinal hemorrhages in healthy full-term newborns.Methods A cross-sectional study was performed in the approval of Ethic Committee of Zhongshan City People's Hospital.A total of 1 311 full-term infants,with gestational age more than 37 weeks and Apgar ≥9 scores were included in this study.Infants with severe systemic diseases or any other eye diseases were excluded.Ocular fundus of the infants were examined with Ret Cam Ⅲ within 4 days of birth and were independently identified by 2 eye doctors.The newborns of retinal hemorrhage were divided into grade Ⅰ,Ⅱ and Ⅲ groups based on Egge criteria,and the infants without retinal hemarrhage served as the normal control group.Maternal,obstetric,neonatal parameters and general factors were analyzed and compared among different groups,and the risk factors that affected the newborns retinal hemorrhage were analyzed by logistic regression analysis.Results Retinal hemorrhage was seen in 28.30％ infants (371/1 311),and 152,116 and 103 infants were identified as grade Ⅰ,Ⅱ and Ⅲ,with the percentage of 11.59％,8.85％ and 7.86％,respectively.Among the factors that examined in the study,cord around fetal neck was the risk factor of aggravation of degree of retinal hemorrhage in newborns (OR =1.308,95％ CI:1.011-1.693,P =0.041).In the mode of delivery,spontaneous vaginal delivery appeared to be the positive factor of the incidence of retinal hemorrhage (OR=0.134,95％ CI:0.132-0.137,P＜0.001),but cesarean section was not a main risk factor.Conclusions Spontaneous vaginal delivery and cord around fetal neck are the potential risk factors for the aggravation of degree of retinal hemorrhage in full-term infants.Accordingly,infants with these risk factors should be paid more attention to prevent the progression of retinal hemorrhage.

Objective To discuss the correlation between the VEGF-C/D expressions in tumor associated macrophage (TAM) and lymph node metastasis in colon cancer. Methods Forty-five colon cancer samples proven pathologically to be adenocarcinoma were stained by immunohistochemical method for VEGF-C/D and CD68. The correlation of VEGF-C/D expressions, macrophage counting and lymph node metastasis were analyzed statistically. Results The expressions of VEGF-C/D were detected in TAMs. VEGF-C expression was obviously higher in the samples with lymphatic metastasis. VEGF-C expression in colon cancer was related to the number of TAMs. Conclusion TAMs are important in the lymph node metastasis, because they can express VEGF-C/D and affect the lymphangiogenesis of colon cancer.

Objective To review the outcome of coronary artery bypass grafting (CABG) using left internal thoracic artery (LITA) grafts in these patients aged more than 70 years old.Methods 1471 patients aged more than 70 years old[mean (73.3 ± 3.9) years] from July 2010 through August 2012,who underwent CABG in Anzhen hospital,form the cohort of this study.Among them,1395 cases underwent off-pump CABG,while 76 cases underwent on-pump CABG which includes onpump beating heart CABG in 12 cases.The average number of the grafts is 3.12 ±0.68.All of the patients were divided into two groups on base of the graft:Group A:only saphenous vein graft was used in 564 cases; Group B:The left internal thoracic artery to the left anterior descending artery was used in 907 cases,which also include total arterial grafting,facilitated by the use of the radial artery,right gastroepiploic artery was operated in 42 cases,beside these artery grafts,saphenous vein graft was used to anastomosis with other vessels.Results Operative mortality was 2.12％ in group A and 2.09％ in group B.There was no significance between the 2 groups.The volume of blood drainage was larger in group B than that in group A.At the same time,there was no significance in the incidence rate of second thoractomy,malignant arrhythmia,stroke,poor wound healing,and usage of IABP between the 2 groups.Conclusion It did not increase the mortality and morbidity of serious complications using the left internal thoracic artery to the left anterior descending artery in those elderly patients aged more than 70 years old during the CABG operation.With consideration of the obvious advantages in the long term patency,LITA was proposed to be used in CABG even in those age ＞ 70 patients.

Objective The surgery time for patients with infective endocarditis (IE) has been transformed.It has been supported that,for the patients with surgical indications,the surgery time should be as early as possible to improve the clinical outcome.The purpose of the research is to identify whether the patients with IE could get further benefit from early surgery.Methods Between June 1996 and July 2011,135 IE patients'data has been collected retrospectively,all of whom were verified through the modified Duke categories.The patients were devided into group A( the new therapeutic schedule group after 2008 ) and group B( the traditional therapeutic schedule group before 2008 ) by the year of 2008.The end points of observation were death associated with IE,cardiac failure,embolism,and re-infection.The comparison between the groups was by means of non-parameter rank and inspection test,variance analysis,t test,chi-square test,fisher exact test.The outcome comparison between the groups was via the Kaplan-Meier survival analysis.Results There were no significant differences in baseline data between the groups.No survival differences could be observed via the Kaplan-Meier analysis( Log Rank P =0.189).During the following-up visit,compared with the patients in group B,the mortality in group A is lower(9.4％ vs.23.0％,P=0.016),the incidence of heart failu re was less in group A (5.4％ vs.26.2％,P ＜0.001 ).No differences could be found in re-infection between the two groups(0 vs.4.9％,P =0.112 ). More patients in group A underwent surgery (67.6％ vs.32.8％,P ＜0.001 ).Conclusion The new therapeutic sehedule of IE coull reduce the mortality rate and promote the cardiae funetion.The incidence of re-infeetion didn't increase.

AIM　To investigate the relationship between sinomenine distribution and its organic toxicology in rats so as to give some pharmacological data for clinical application of sinomenine. METHODS　Three kinds of administration plans were designed in the experiment, ie sinomenine was ip administered at the dosage of l50 mg*kg-1 per day, repreat-dosed for 6 wk and suspended the drug for 1 wk after 6wk repeat-doses．At the end of the each administration plan，the animals were sacrificed and their blood and their main internal organs were collected for the purpose of measurement of sinomenine concentration in each sample by HPLC. Meanwhile，the histopathological and serological examinations were also done in the experiments. RESULTS　The sinomenine concentration in rats internal organs were in order of liver, heart, lung and brain either in single-dosed treated animals or in repeat-dosed treated animals for 6 wk. However，the concentration of sinomenine could not be detected by HPLC after l wk drug-suspension，the histopathological examination showed that sinomenine at the dosage of l50 mg*kg-l per day for 6wk treatment could slightly damage liver ce11s, dominant1y caused the cell edema，but no any influence on the sero1ogy of liver and kidney. Sinomenine ip could also cause a mild hyperaemia of the rats heart tissues but no any histopathological changes had been observed. In testis tissues no sinomenine had beed detected although the animals were treated by repeat treatment for 6 wk and no any histopathological changes had been found yet. However, Sinomenine could partialy inhibit the sperm vitalities and amount of the dead sperms were a1so augmented. It was similar to in vitro eperiments. These influences of sinomenine on testis could be quickly recovered by drug suspension. CONCLUSION　Sinomenine concentration were in order of liver, heart, kidney, lung and brain either in treatment by single dose or by repeat-dose administration. The histopathological changes were only abserved in liver cells of the animals which indicates that it should be in consideration of the liver functions during treatment course of the drug.