Objective:To evaluate the different effect of TACE and TACE combined with PEI and RF in treating liver metastasis.Methods:67 patients with liver metastasis were classified as group TACE(46 cases)and combined group including TACE+PEI(7 cases) and group TACE+RF(14 cases).All patients were analyzed after treatment by follow-up、CT and their blood biochemical tests.Results:The rate of tumor shrinkage and necrosis was 46.8% and 20.7%,while the contrast group was 78.9%,49.2% respectively(P

Recently numerous studies have demonstrated that Notch signaling pathway plays a critical role in regulating cell proliferation and differentiation in hematopoietic microenvironment,which is associated with MM occurrence and the drug resistance.The latest researches show that there are close relations between hypoxia and Notch signaling pathway in tumor occurrence and progression.Exploring the interactions of microenvironment of hypoxia,HIF-1α and Notch signaling pathway will provide theoretical basis for MM targeted therapy.

Notch signal pathway can regulate the morphogenesis,apoptosis and cellular proliferation of normal tissues and organs,which plays an important role in regulating hematopoietic cells proliferation and differentiation in bone marrow microenvironment.The occurrence and development of multiple myeloma(MM)are closely related to the bone marrow microenvironment in which many signal pathways are involved.Recent studies show that Notch signal pathway promotes the development and progression of many cancers including MM,which plays key roles in tumor invasion and drug resistance.This review focus on the recent findings on Notch signal pathway in MM,and reveals that Notch signal pathway will be identified as a potential new therapeutic target in MM.

Hypoxia environment plays an important role in the pathogenesis of multiple myeloma such as stimulating angiogenesis,increasing bone destructiong,epithelial-mesenchymal transition and drug resis-tance.Thus,there are many therapeutic strategies targeting the hypoxic environment of multiple myeloma,such as hypoxia-activated prodrug and molecular targeting inhibitors.Targeting the hypoxic environment is a promis-ing therapy for multiple myeloma in the future.

Objective To investigate the role of cytokines combined with CLIF Consortium organ failure score (CLIF-COFs) in determining the prognosis of liver transplant in hepatitis B-related acute-on-chronic liver failure (HB-ACLF) patients.Methods Thirty-seven cases of HB-ACLF patients undergoing liver transplantation were divided into HB-ACLF patients with complications group (n =15) and those without complications (n =22).Plasma were prospectively collected immediately before LT and on the 1st,3rd,5th,7th day after LT in HB-ACLF patients.The serum levels of twenty-seven cytokines were determined by 200 LUMINEX liquid chip technology.Cytokines and CLIF-COFs were analyzed with logistic regression and the receiver operating characteristic to confirm the correlation with the total complications post-LT.Results The serum levels of post-transplant G-CSF and MCP-1 in HB-ACLF patients with complications were higher than those of without complications (P ＜ 0.05).The COX analysis indicated that MCP-1 and CLIF-COFs were predictors of post-LT complications [A UC:0.821,95％ CI:0.668-0.974;AUC:0.738,95％ CI:0.578-0.898].The discriminatory power of MCP-combined with CLIF-COFs [AUC:0.839,95％ CI:0.703-0.975] was better than that of either.Conclusions MCP-1 combined with CLIF organ failure score can better predict the short-term outcomes of liver transplantation in HB-ACLF patients.

Objective To analyze the benefits and risks of preoperative aspirin treatment in elderly patients undergoing off-pump coronary artery bypass (OPCAB) grafting.Methods From January 2010 to June 2014 in Tianjin Chest Hospital,1 501 consecutive patients aged ＞65 years with mean age (71.1 ± 4.2) years who underwent selective first-time isolated off-pump coronary artery bypass surgery were included in this research.They were divided into 2 groups:aspirin group (longterm use of entericcoated aspirin tablets within 5 days before operation,n =369) and aspirin withdrawal group (aspirin withdrawal for 5 days and over before operation,n=1 132).Univariate analysis and a logistic regression were used to compare the postoperative events between the two groups.To adjust for the remaining differences between groups,propensity score was enrolled into the logistic regression model.Results There were no significant differences between the two groups in all-cause in-hospital mortality,postoperative myocardial infarction,cerebrovascular events,postoperative renal failure,blood dialysis and reoperation for bleeding (all P＞＞ 0.05),but more frequency of red blood cell transfusions were found in aspirin group than in aspirin withdrawal group [74.0％(273/369)vs.62.5％(707/1 132),adjusted OR=1.50,95％CI:1.13-2.00,P＜0.01].Conclusions Preoperative aspirin treatment can increase the incidence of red blood cell transfusion,but cannot increase the incidence of reoperation for bleeding,and has no effect on the postoperative outcomes such as all-cause in-hospital mortality,cerebrovascular events,postoperative myocardial infarction,postoperative renal failure or blood dialysis in patients undergoing selective isolated OPCAB.

Objective To investigate the effect of hypoxic preconditioning on the biological function of bone mar-row-derived endothelial progenitor cells (BM-EPCs). Methods Mononuclear cells were collected by density gradient cen-trifugation from the bone marrow of rats. The isolated cells were cultivated in dishes coated with the vitronectin from rat plas-ma,filled with the endothelial cell basal medium-2. Cells were then cultured under the conventional culture conditions (37℃and 5%CO2). The cultured cells were divided into control group and hypoxia training group after four-day culture. Cells of the control group were cultured in previous conditions for another three days. However, cells of the hypoxia training groups were cultured in previous conditions for 0, 1 and 2 days,and then under the hypoxic condition (1%O2+5%CO2+94%N2) for another 72 hours, 48 hours and 24 hours, respectively. After seven days,cells in all of groups were collected for the following study. The immunofluorescence labeling and cell analyzer were used to indentify BM-EPCs. The tube formation of BM-EPCs was tested by Matrigel assay. Annexin V/PI antiapoptotic assay was used to detect the apoptotic rate of BM-EPCs. Results The early apoptotic rate of BM-EPCs was increased obviously with extended hypoxia. There was no significant dif-ference in the early apoptotic rate of BM-EPCs between control group (0.89±0.20)%and hypoxic 24-h group (1.33±0.07)%(P>0.05). There was significant increase in the early apoptotic rate of BM-EPCs in hypoxic 48-h group (3.25±0.12)%and hypoxic 72-h group (7.48 ± 1.53)%(P<0.05). Compare with control group, the tube formation ability was significantly in-creased in hypoxic 24-h group (P<0.01), but the tube formation ability was significantly decreased in hypoxic 48-h group and hypoxic 72-h group (P<0.01). Conclusion After hypoxic preconditioning for 24 hours, the apoptotic rate was not obvi-ous in BM-EPCs, but the tube formation ability was markedly increased.

Objective To study the clinical efficacy of Off-Pump Coronary Artery Bypass Grafting (OPCABG) in the patients who have left main coronary artery stenosis and three-vessel lesion with low ejection fraction.MethodsFrom January 2010 to December 2010,28 cases with low ejection fraction,left main coronary artery stenosis and three-vessel lesion and received OPCABG were analyzed retrospectively.All cases underwent OPCABG under general anesthesia.The Hb,PLT,ALT,AST,BUN and Cr count before and 3 days after operation were recorded.LVEF andLVEDbeforeand 3monthsafter operationwererecorded.Thedata were compared.Results one case died of respiratory failure caused by pulmonary infection.The mortality rate was 3.75 ％.The value of six parameters are: Hb ( [ 137.94 ± 19.40 ],[ 111.06 ± 12.71 ] g/L),PLT ( [ 210.43 ±48.26 ] × 109/L,[ 148.4 ± 52.20 ] × 109/L),ALT ( [ 27.66 ± 11.51 ] U/L,[ 29.02 ± 16.40 ] U/L),AST ([26.55 ± 10.12] U/L,[27.75 ±8.14] U/L),BUN([6.51 ± 1.00] mmol/L,[6.88 ± 2.53] mmol/L),Cr ([96.35 ± 15.25]μmol/L,[95.11 ± 24.38 ] μmol/L).Comparison of the values showed that Hgb and PLT were different significantly before and 3 days after operations.There was no significant difference in the levels of ALT,AST,BUN and Cr before and after the treatment.Three months later,LVEF and LVED were significantly different from that before treatment ( P ＜ 0.05 ),with LVEF of( [ 36.23 ± 3.41 ] ％,[ 47.23 ± 5.13 ] ％ ) and LVED of( [62.23 ±5.93]mm,[58.08 ±5.02] mm).ConclusionOPCABG produces a satisfactory outcome in the patients who have left main coronary artery stenosis and three-vessel lesion combined with low ejection fraction.There is limited impact of OPCABG on the other organs.The long-term effect and prognosis are still need to be followed-up and analyzed.

Objective To explore the technique and effect of selected three-field lymphadenectomy by left thoracotomy in treatment of thoracic middle or lower section esophageal squamous carcinoma. Methods From Jun. 2005 to Mar. 2009, 213 patients with thoracic middle or lower section of esophageal carcinoma received esophagectomy, bilateral mediastinal lymphadenectomy and pleural membrane resection.Group 1 -5, 7 - 12a, 16al, and 19 were performed to dissect abdominal lymph node and extended thoracic and abdominal lymphadenectomy and only lymph node extraction of mesoesophagus in neck field. Results 14197 lymphatic nodes(LN) were detected in 213 case. The average number of resected LN was 66. 65 ±24. 73. The metastatic lymph node was detected in 105 cases. The metastatic rate was 49.05% (105/213).There were 423 metastatic lymph nodes. The lymph nodes metastasis was 2. 97% (423/14197) of all dissected lymphatic nodes. No remnant carcinoma in the upper and lower cutting edge was found in pathological examination. The operation time ranged from 2. 92 ～ 4. 67 ( 3. 37 ± 0. 42) hours. Blood transfusion during perioperative period was 0 ～ 6u ( 1.08 ± 0. 93 ) u. Perioperative plasma transfusion was 0 ～ 1400( 103.77 ± 184. 89) ml. The hospital-time was 14 ～ 39 ( 17.64 ±4. 12) days. There were no anastomotic leakage and recurrent laryngeal nerve injury. One case died from respiratory failure, the mortality was 0. 04% ( 1/213). Conclusion Surgical approach in the management of left thoracotomy in the sixth intercostals could extend resection of chest-field lymph node dissection, decrease neck field lymph node dissection. Abdomen-field lymph node dissection reached selected D3. The selected lymphadenectomy procedure had the advantages of small traumas and few complications.

Objective To improve the 2,3,5-triphenyl tetrazolium chloride (TTC) solution method for measuring the viability of Cistanche deserticola seeds and investigate the change in viability during storage at 5 ℃. Methods The effect of the testa,TTC concentration,sodium hypochlorite concentration (NaClO),and staining time were studied,and seed viability during storage at 5 ℃ was measured with the improved method. Results Seeds were kept for 48 h in 0.5% TTC solution at 40 ℃,and then for 2 h in 0.2% NaClO solution;Seed viability was measured under a stereomicroscope. Storing seeds of C. deserticola for 1 to 2 years at 5 ℃ had no significant effects on their viability. However,the percentage of seeds with high viability was increased with the extension of the storage time at 5 ℃. Conclusion A convenient and rapid method for measuring the viability of C. deserticola seeds is developed. Storing C. deserticola seeds at 5 ℃ could improve their viability