Objective To discuss the clinical val ue of internal radiation therapy with hepatic intra-arterial iodine-131 labele d material for the treatment of hepatocellular carcinoma (HCC). Methods This summarized paper was made on literatu re review. Results Iodine-131-lipiodol and several reported iodine-131-labeled antibodies to HCC associated antigens were concentrated in the foci of HCC with a high tumor-to-normal-tissue absorbed dose ratios. No s evere side effects occurred. It was used in various kinds of HCC patients, and m ostly showed a significant tumor response. Survival rate of HCC patients was rai sed in several clinical trials.Conclusion Internal radiotherapy with hepatic intr a-arterial iodine-131 labeled material may be considered as an effective metho d to treat HCC.

To study the electrophysiological mechanism of atrial fibrillation induced by acetylcholine(Ach). The results showed that:①Ach decreased ERP of four atrial sites.When the concentration of Ach was incseased, ERP of 4 sites became shorter but COVERP became bigger.②As the concentration of Ach was increased, the percent of AF induced by Ach and AF was increased with the duration prolonged( P 0 05).③There was a significant correlation between atrial vulnerability with ERP and COVERP( P

BACKGROUND: Radiofrequency catheter ablation (RFCA) in dog triggers myocardial nerve sprouting and sympathetic hyperinnevation. It is possible that RFCA in humans has the same effect. Nerve growth factor (NGF) is a neurons nurture that supports the survival and differentiation of sympathetic neurons and enhances target innervation. Therefore, it is hypothetic that RFCA can increases plasma NGF concentration in humans.OBJECTIVE: To test the hypothesis that RFCA increases plasma NGF concentration in humans.DESIGN: Self-control experiment.SETTING: Department of Cardiology, Tangdu Hospital, the Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Forty-three patients were selected from the Cardiological Department of Tangdu Hospital, the Fourth Military Medical University of Chinese PLA from January to June 2005, including atrioventricular nodal reentrant tachycardia (AVNRT) (n=18), right-sided accessory pathways (RSAP) (n=13) and left-sided accessory pathways (LSAP) (n=12), 20 males and 23 females, ages 28-65 years, all agreed to participate in the study voluntarily.METHODS: Blood samples were obtained from the peripheral veins before ablation and at 6 hours, 1, 3, 5, 7 days after ablation. The plasma concentration of NGF was determined with enzyme-linked immunosorbent assay (ELISA).MAIN OUTCOME MEASURES: The plasma concentration of NGF was determined with ELISA before RFCA and at 6 hours, 1, 3, 5, 7 days after RFCA in each patient.RESULTS: Total 43 patients who were referred for ablation therapy for AVNRT, RSAP and LSAP were involved in the result analysis without loss. Plasma NGF increased at 6 hours after RFCA. Increased NGF continued to 7 days in the RFCA treated patients. The plasma NGF concentrations at 6 hours, 1, 3, 5, 7 days after RFCA in AVNRT, RSAP and LSAP ablations treated patients were (29.72±7.04), (30.94±5.68),(31.39 ±4.92), (31.06 ±4.56), (29.11 ±4.59), (31.77 ±6.25), (30.69 ±5.10),(31.46±4.96), (30.15±4.01), (30.43±3.14), (31.42±6.75), (31.00±5.20),(32.08±4.62), (30.67±3.71), (29.27±2.75) μg/L, respectively, and all more than that before RFCA [(14.89±2.84), (15.00±2.71), (15.51±2.75) μg/L, P ＜ 0.01]. However, there were no significant differences in the NGF levels at 6 hours, 1, 3, 5 and 7 days after RFCA (P ＞ 0.05). The plasma NGF concentration was not significant different among AVNRT, RSAP and LSAP ablation patients at any given time (P ＞ 0.05). The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.CONCLUSION: RFCA increases plasma NGF concentration in humans and lasts for at least 7 days. The number of RFCA applications, the procedure time and the total energy have no correlation with NGF concentration at any given time instance.

Objective To investigate the effect of continuous quality improvement on venous transfusion exosmosis in elderly patients.Methods Through the investigation into venous transfusion exosmosis in 160 elderly patients,the causes for exosmosis were identified,followed by regulating and enforcing improvement measures and assessing the effect.Results The incidence of venous transfusion exosmosis in elderly patients was reduced from 6.40%to 2.57%and the satisfaction of patients improved from 90.00%to 97.50%.Conclusion The continuous quality improvement may effectively reduce the incidence of venous transfusion exosmosis and improve patients’satisfaction.

Objective To analyze the effects and the complications of partial splenic artery embolization(PSE)and splenectomy offering a feasible way to choose different therapeutic methods for hypersplenism. Methods Forty-six patients treated with PSE and thirty-three undergone splenectomy were compared for their effectivenesses and complications in treating hypersplenism. Results Thrombocyte and leucocyte counts increased markedly after the two kinds of treatment(P 0.05). The complication rate of the PSE was far more than that of the splenectomy(P

Objective To study the possible different effects on primary liver cancer of various types of blood supply demonstrated by DSA via hepatic artery radioimmunotherapy with 131Ⅰ-HAb18F(ab')2.Methods Under thyroid protection and negative dermal sensitivity test,46 times of intraarterial injection with a 0.75 mCi/kg dose of 131Ⅰ labeled murine HCC monoclonal antibody fragment [HAb18F(ab')2] were performed in 30 patients of PLC using the Seldinger technique.The shrinkage rates of tumor volume were analyzed according to hyper,moderate and hypo vascular three types provided by DSA.Results The volume shrinkage rates of hyper and moderate vascular HCC were 60% and 37.5% respectively,while that of 2 cases of hypovascular HCC showed significantly reduction.Conclusion 131Ⅰ-HAb18F(ab')2 internal radioimmunotherapy prossesses certain signification volume shrinkage efficacy on different blood supplies provided by DSA.(J Intervent Radiol,2007,16:243-245)

Objective To analyze the clinical effects of 131I-HAb18F(ab')2 radioimmunotherapy via hepatic artery on PLC with portal vein tumor emboli. Methods Under the condition of thyroid protection and negative dermal sensitivity test, 12 times of intraarterial injection with 131I labeled murine HCC monoclonal antibody fragment HAb18F(ab')2 were performed in 8 patients of PLC complicated with portal vein tumor emboli. A 0.75 mCi/kg dose of 131I was administrated individually into certain target vessel after hepatic artery angiography using Seldinger technique. Results 3 of 7 patients with symptoms of pains showed remission with simultaneous improvement and stabilization in Karnofsky score in 3 and 4 patients respectively. AFP levels decreased about 50%(3/6)in 3 cases among those 6 positives and the values of I.B. and ALT changed within a very narrow range to a certain extent after the treatment. The overall rate of CR + PR was 28.6% and similar better result was obtained in a non-symptomatic diffuse PLC patient.1 year survival rate was 12.5%. Conclusion 131I-HAb18F(ab')2 radioimmunotreating drug(0.75 mCi/kg)with hypotoxicity to liver-function can be used as an acceptable method for unresectable PLC with portal vein tumor emboli, especially for those without tumor emboli in the main trunk.

Objective To evaluate the risk factors associated with in-hospital death in patients co-infected with human immunodeficiency virus and Mycobacterium tuberculosis (HIV-TB). Methods A retrospective case-control study was performed in patients admitted to Shanghai Public Health Clinical Center from November 2004 to May 2009. Fifty-three HIV-TB patients who died during hospitalization were matched with 79 HIV-TB co-infected patients who survived during hospitalization.Clinical, demographic, and radiological characteristics of the two groups were compared by the retrospective case-control study method. Multivariate Logistic stepwise regression analysis was performed to explore the risk factors contributing to death in HIV-TB co-infected patients. Results Among the 459 co-infected patients, 53 (11.5%) cases died during hospitalization and 25 cases died during the first week in hospital. Sixty-four point two percent dead patients (34/53) died from tuberculosis. Several factors were associated with worse prognosis in the death group compared to the survival group, which included body weight≤50 kg (χ2 = 7.50), positive for acid-fast bacilli in sputum smear or culture exam (χ2= 4. 04, 14. 27), drug-resistant/multi-drug resistant Mycobacterium tuberculosis infection (χ2 =9.00,6.39), extra-pulmonary tuberculosis infection (χ2 =6.99), retreated tuberculosis (χ2 = 5. 92), non-standardized anti-tuberculosis treatment (χ2 = 12. 07), extensive pulmonary TB infection (lesions ≥50% of lung fields, χ2 = 20. 21), co-infection with fungi (χ2 =3.46), respiratory failure (χ2 = 4.27), non-pulmonary organ impairment (χ2 = 3.46), HIV infection longer than 5 years (χ2 = 7. 19), non-standardized highly active antiretroviral therary treatment (χ2 =5.16) and CD4+ T lymphocyte count ≤ 200 × 106/L (χ2= 12.99) (all P＜0. 05). Multivariate Logistic regression analysis showed that non-standardized anti-TB treatment, extensive pulmonary TB infection, multi-drug resistant TB infection and CD4+ T lymphocyte count ≤ 200 × 106/L were the major risk factors related to in-hospital mortality. Conclusions Non-standardized anti-TB treatment,extensive pulmonary TB infection, multi-drug resistant TB infection and CD4+ T lymphocyte count ≤200 × 106/L are the major risk factors related to in-hospital mortality in the patients co-infected with TB and HIV.

Objective To evaluate the value of enzyme-linked immunospot assay (TB ELISPOT) combined with serum latex agglutination test (LA) for diagnosis of pulmonary tuberculosis plus pulmonary cryptococcosis.Methods Serum and biopsy specimens of 76 patients, who were suspected of pulmonary tuberculosis and/or pulmonary cryptococcosis based on clinical and imaging features, were collected from March 2006 to September 2008 in Shanghai Public Health Clinical Center. TB ELISPOT assay, LA and histopathological examination were performed in all the patients. Results Histopathological and pathogenic examination confirmed pulmonary cryptococcosis in 15 cases and pulmonary tuberculosis in 22 cases, pulmonary tuberculosis plus pulmonary cryptococcosis in 8 cases. The sensitivity and specificity of TB ELISPOT were 91% and 94.4%. The sensitivity and specificity of LA were both 100%. TB ELISPOT assay and LA test were both positive in the 8 cases of pulmonary tuberculosis plus pulmonary cryptococcosis.Conclusions The value of enzyme-linked immunospot assay combined with serum latex agglutination test is high for diagnosis of pulmonary tuberculosis plus pulmonary cryptococcosis.

Objective Discuss medical health integration continuance management mode in the prevention of elderly patients after discharge in bed household application effect of pressure ulcers. Methods To 120 cases of elderly patients in bed in hospital time order is divided into control group and experimental group,by the medical health outreach group respectively in the hospital two days before the assessment of patients and family rehabilitation plan,the control group given conventional discharge and telephone follow-up after discharge,the experimental group according to the medical health integration management mode,made up of medical health outreach team to stay in bed for elderly patients after discharge pressure ulcer risk factors assessment,targeted prevention of pressure sores rehabilitation plan,group management,remote care joint family supervision,timely follow up the capa and the exami-nation of the effect,the pressure ulcer management and quality of life scale to compare two groups of patients at discharge,6 months after hospital discharge,the quality of life of 12 months after discharge and the incidence of pressure ulcers in a year. Results The experimental group was lower than those of control group,the incidence of pressure ulcers was statistically significant difference(P<0.05); 6 months and 12 months after discharge physiological field,psychological field in the quality of life score were higher than control group,the difference was statistically significant(P<0.05); Score compared two groups of environmental and social sciences has no statistical significance (P>0.05). Conclusion Medical health integration continuance management can effectively reduce the incidence of pressure ulcers that occupy the home stay in bed for elderly patients,improve their quality of life.