Objective To analyze the complications associated with pelvic intraarterial therapy in patients with recurrent and advanced gynecologic cancer and to discuss the causes, the prevention and management measures of the complications in details. Methods One hundred and thirty procedures of pelvic intraarterial therapy were performed in 78 patients with pathologically confirmed recurrent and advanced gynecologic cancer, with one to six procedures per case. The Seldinger technique was used in all patients. The catheter was introduced via femoral artery on one side (mostly on the right side), and the combined antineoplastic agents were infused into contralateral internal iliac artery and(or) ipsilateral branches supplying the involved area. Common iliac arteries and inferior mesenteric arteries were also used in some cases. Results Six patients (7.69%) developed severe skin and subcutaneous necrosis (erosion or ulceration) on the buttock and vulvae. Five of them recovered from the injuries after heteropathy in less than 2 months. One patient received surgical debridement 4 months after the pelvic chemotherapy, whose wound healed one month later. Conclusion The causes of the severe complications of pelvic intraarterial therapy were as follows: the infusing chemotherapeutic agent was too large in dosage and too dense in concentration; the infusing time was too short; the internal iliac artery gave off a lot of abnormal skin branches; the catheter was placed too distal in small branches; the embolic pieces was too small; and the development of collateral arteries was poor especially in pretreated patients with pelvic surgery and(or) radiotherapy, etc. Heteropathy should be given in no time when the severe complications were encountered, and surgical debridement and(or) skin grafting was a need in some cases. So the interventional performers should be familiar with pelvic arteriograms to select the proper location of catheter, administer the suitable dosage of therapeutic agents dilutedly and slowly, and use large emboli, such as larger Gelfoam particles or strips.

Objective To study the sub chronic toxicity of silver nanoparticles on medaka.Methods Adult fish were divided into silve nenopartides and control group.Animals were collected on 14 days after exposure, and some toxicological endpoints such as death rate, tissue distributed of silver irons, oxidative stress and histopathological damage were measured.Results There were significant difference in death rate of medaka treated with silver nanoparticles and control group.Compared with the control group, the content of silver in gill, intestine and liver of medaka treated with silver nanoparticles were increased significantly.Compared with control group, the activity of LDH in liver and SOD in liver and gill were significantly decreased(P<0.01).The content of MDA in liver of medaka treated with silver nanoparticles was significantly increased(P<0.01).The liver and gill of mekada treated with silver nanoparticles were damaged, compared with control group.Conclusion Nano silver has a certain subchronic toxicity to aquatic life.

AIM: To test the contents of tanshinone Ⅱ_A and salvianolic acid B in 56 batches of samples by HPLC,evaluate the current quality of Compound Danshen Tables. METHODS: HPLC,chromatographic conditions: The detection column was Agela-C_(18)(5 ?m,46 mm?250 mm) for tanshinone Ⅱ_A,mobile phase was methanol-water(73(∶)27),UV detection wavelength was set at 270 nm.The flow rate was 1 mL/min.The detection column of Agela-C_(18)(5 ?m,4.6 mm?250mm) was used for salvianolic acid with mobile phase of acetonitrile-methanol-formic acid-water(10(∶)30(∶)1(∶)59). UV wavelength was set at 286 nm.The flow rate was 1 mL/min.(RESULTS:) The most of samples conform to the requirement of Chinese Pharmacopoeia(2005),but the content of tanshinone Ⅱ_A was widely different and three batches of salvianolic acid B were lower than the requirement of Chinese Pharmacopoeia(2005). CONCLUSION: The quality of Compound Danshen Tables will be improved.

Objective To develop a kind of patient transferring trolley with special machinery. Methods A bedplate could upturn and slide both sides for more than one breadth. The trolley's bedrail with special design could be kept from capsizing. Results In the practice of patient transferring, the trolley was safe, steady and laboursaving. Conclusion The trolley is useful for transferring severe patients or patients after operation.

Objective To investigate the efficacy of preoperative transcatheter artery chemoembolization (TACE) correlates with outcome after orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). Methods Sixty-seven patients with HCC underwent TACE before OLT. In all the patients, there were 52 males and 15 females with age ranging from 34 to 67 years old (average 48). Sixty-one patients met the Milan' standard, and 6 patients exceeded Milan' standard. Classic OLT was done in 62 patients and pigyback liver transplantation was done in 5 patients. Immunosuppression regimen after operation included Tacrolimus (or Ciclosporin,Sirolimus), mycophynolate, steroid hormone. The efficacy of TACE was assessed according to histological findings after OLT. Tumor recurrence rate of 1-and 2-year tumor recurrence rate, and 1-and 2-year survival rate in different groups with different responses to preoperative TACE were compared. Results Tumor necrosis rate was greater than 50% in 50 patients and new tumor nodi occurred in 2 patients. Tumor necrosis rate after TACE was 73. 77%. Tumor necrosis rate was less than 50% in 17 patients and new tumor nodi occurred in 7 patients. Forty-eight patients had satisfactory efficacy after TACE and no new tumor nodi occurred, 1-and 2-year tumor recurrence rate was 2. 08/ (1/48) and 6. 25% (3/48) respectively, and 1- and 2-year survival rate was 97. 92% (47/48) and 95. 83% (46/48) respectively. Nineteen patients had worse efficacy after TACE and new nodi occurred, 1- and 2-year tumor recurrence rate was 36. 84% (7/19) and 57. 89% (11/19), and 1-and 2-year survival rate was 73.68% (14/19) and 47. 37% (9/19) respectively. There were statistically significant difference between the two groups (P＜0.05). Conclusion TACE provides good local control in preoperatively diagnosed HCC, but its impact is limited in lesions not detected preoperatively. Patients with satisfactory efficacy after TACE before OLT had a good prognosis. The response to preoperative TACE may predict long-term outcome after LT.

Objective To investigate the incidence and the risk factors of anxiety or depression and in the first degree relatives (FDRs) of patients with type 2 diabetes mellitus ( T2DM ). Methods A total of 102 T2DM patients who visited our hospital from May to July 2010 and their FDRs completed SAS,SDS,and life satisfaction evaluation. The medical history of T2DM patients was collected and compared with their FDRs with or without mental disorders. The correlations of risk factors with anxiety or depression were analyzed, t test or X2 test were used for statistical analysis and a P value less than 0. 05 was considered statistically significant. Results The incidence of anxiety or depression of FDRs was 31.4% and 17.6%,respectively. The life satisfaction score of FDRs with mental disorders was significantly decreased ( t = 4. 26 and 4. 09, P＜0. 05 ). Fasting glucose level of T2DM patients with anxious or depressive FDRs was significantly increased ( t = -2. 48 and -2. 15, P＜0. 05 ). Higher medical cost and multiple treatment strategies were positively correlated with SAS and SDS score of the FDRs. Conclusion Higher incidence of mental disorders and lower satisfaction scores could be found in the FDRs of T2DM patients. Better control of blood glucose and reduced treatment cost and strategies may be useful in improving metal condition and life satisfaction of the FDRs of T2DM patients.

Objective To analyze the prognostic factors and trerapy strategy of lung cancer in the patients aged 80 years and over.Methods Totally 107 patients aged ≥ 80 years with lung cancer were retrospectively reviewed.Patients' clinical characteristics and treatment were analyzed.Results Median survival time of the patients was 6.9 months.92.9％ (13/14) of small cell lung cancer patients and 34.4％ (31/90) of non small cell lung cancer patients were treated.Life cycle of patients who accepted effective treatments and supportive treatments were 16.5 months and 8.7 months,respectively (P=0.008).In the early stage of tumors,survival time of patients undergoing surgery was 36.7 months,15.5 months in patients without surgery (P=0.023),while in the late stage,survival time of patients receiving combined chemotherapy was 13.4 months,4.6 months in patients receiving single agent chemotherapy(P=0.002).In small cell lung cancer,survival time of patients who received radiotherapy was 12.8 months,6.4 months in patients who did not receive radiotherapy (P=0.049).Performance status (PS),clinical stage,early surgery,late chemotherapy and radiotherapy(x2=38.236,18.831,5.187,9.827,4.186,P＜0.05),but not sex and pathology type affected the prognosis.PS score (P=0.003)and clinical stage(P=0.046) were the independent influencing factors.Conclusions Performance status and clinical stage are the independent influencing factors of lung cancer in the patients aged over 80 years.Patients may improve survival if receiving surgery,chemotherapy and/or radiotherapy when they have good PS,otherwise patients may choose best supportive care.

Objective To investigate the clinical significance of precursor of gastrin‐releasing peptide(ProGRP) for the differen‐tial diagnosis between small cell lung cancer (SCLC) and non‐small cell lung cancer(NSCLC) and efficacy assessment .Methods The levels of ProGRP were detected by ELISA in 210 healthy adults ,200 patients with lung benign disease ,260 patients with NSCLC and 182 patients with SCLC before treatment and after chemotherapy .Results The level of ProGRP in the SCLC group was significantly higher than that in the NSCLC group ,healthy control group and lung benign disease group(P<0 .01) .The sensi‐tivity of ProGRP for detecting SCLC was 56 .3% and the specificity was 92 .6% .When combination detection of ProGRP and NSE was used ,the sensitivity increased to 82 .6% ;the level of ProGRP in the patients with SCLC after 2‐cycle chemotherapy was signifi‐cantly lower than before treatment (P<0 .01) .Conclusion The tumor marker ProGRP has very important guidance significance to assisted diagnosis ,differential diagnosis and efficacy assessment of chemotherapy in the patients with SCLC .

Objective To investigate the prognostic significance of postoperative radiotherapy (PORT) for locally advanced pulmonary adenocarcinoma with micropapillary pattern(MPPAC).Methods A total of 45 completely resected pN2-3 cases that occured from January 2012 to December 2014 at Tianjin Medical University Cancer Hospital were retrospectively analyzed.All of them were diagnosed with MPPAC by pathological diagnosis.Based on whether receiving PORT, patients were divided into radiotherapy and non-radiotherapy groups.General characteristics, overall survival and disease-free survival characteristics of the two groups were compared, respectively.Results The median overall survival (OS) of patients was 19.8 months, 1-year and 2-year overall survival rate was 79.4％ and 30.3％ , respectively.The median disease free survival (DFS) of patients was 13 months, 1-year and 2-year, and the disease free survival rate was 59.3％ and 28.9％ , respectively.The radiotherapy and non-radiotherapy groups exhibited median OS of 22.3 and 11.4 months,respectively (x2=13.329, P＜ 0.05) , and corresponding D FS of 16.2 and 10.4 months(x2 =7.972 ,P ＜0.05).The epidermal growth factor receptor gene (EGFR) mutation rate of patients was 57.14％ (20/35), In the subgroup analysis, for patients with EGFR mutation, the radiotherapy and non-radiotherapy groups showed median OS of 25.6 and 18.4 months, respectively(x2 =9.268,P ＜ 0.05) , and corresponding DFS of 21.6 and 12.6 months (P ＞ 0.05).For patients with wildtype EGFR, the radiotherapy and non-radiotherapy groups showed median OS of 21.8 and 10.6 months,respectively(x2 =9.595,P ＜ 0.05) , and corresponding DFS of 15.2 and 6.6 months(x2 =4.538,P ＜0.05).Conclusions PORT could improve survival of patients with pN2.3 MPPAC.For patients with locally advanced MPPAC after curative resection, PORT is still an integral part of treatment.

Objective To study the therapeutic effect of recombinant adeno-associated virus carrying human endostatin gene therapy on endometriosis in mice model. Methods Recombinant adeno-associated virus vector carrying human endostatin gene and enhanced green fluorescent proteins gene (rAAV2-endostatin-EGFP) was constructed. Endometrium was from 12 patients with leiomyoma undergoing hysterectomy in Second Hospital, Tianjin Medical University between November and December 2008. Endometriosis models of nude mice were established by transplanting human endometrial fragments intooperitoneal surface. After 1 week, those 60 mice were divided into 3 groups: treatment group including 20 mice injected with rAAV2-endostatin-EGFP to ectopic lesion, control group including 20 mice injected with rAAV2-EGFP to ectopic lesion and blank control group including 20 mice injected with phosphate buffered saline (PBS) to the ectopic lesion. At 1, 2 and 3 weeks after treatment, those mice underwent laparotemy to observe the location and size of ectopic lesion in abdominal cavity. The expression of endostain protein, number of gland, microvessel density (MVD) and vascular endothelial growth factor (VEGF) were measured in ectopic lesions. The serum level of estradiol and progesterone were detected in nude mice among every groups. Results (1) All endometriosis of nude mice models were established successfully through peritoneum transplanting. After 1 week's treatment, flat lesion nodes, decreased gland number and narrow and atrophy glandular cavity were observed by light microscope. (2) The endostatin gene was transferred into nude mice successfully and expressed effectively. It was observed that endostatin protein expression was shown with enhanced green fluorescent proteins in ectopic lesion. (3) Glands number of ectopic lesion in rAAV2-endostatin-EGFP group(7.8±1.9,7.0±1.5 and 5.5±1.7) were significantly less than 10.1± 1.7, 10.2±2.0 and 9.8±2.4 in rAAV2-EGFP control group and 10.2±2.2,10.0±2.0 and 9.7±2.2 in PBS control group at 1,2 and 3 weeks after treatment(all P<0.05). Glands number of ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment (P<0.05). (4) MVD of ectopic lesion in rAAV2-endostatin-EGFP group (12.2±1.5,11.4±2.1 and 9.0±1.4) was significantly less than those at rAAV2-EGFP control group (16.5±1.7,16.5±1.9 and 16.9±1.9) and PBS control group (16.2±1.6,16.0±1.6 and 16.3±1.7) at 1,2 and 3 weeks after treatment (all P<0.05) . MVD of ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment(P<0.05). (5) The rate and density of VEGF expression at ectopic lesion in rAAV2-endostatin-EGFP group (35%, 30%, 25% and 1.60±0. 43,1.33± 0. 30,1.03±0.36) were significantly less than those at rAAV2-EGFP control group (80% ,75% ,85% and 2.43±0.53,2.43±0.29,2.66±0.45) and PBS control group (85% ,90% ,90% and 2.36±0.53,2.64± 0.57,2.53±0.52) at one 1, 2 and 3 ,weeks after treatment (all P<0.05). The expression of VEGF at ectopic lesion in rAAV2-endostatin-EGFP group at 3 weeks was significantly less than those at 1 and 2 weeks after treatment (P<0.05). (6) The level of estradial and progesterone in serum of nude mice of rAAV2-endostatin-EGFP group [ E_(2)> : (48±7 ) pmol/L, P: (61±8 ) nmol/L ] did not reach statistical difference when compared with those at rAAV2-EGFP control group [ E_(2): (50±9) pmol/L, P: (60±10) nmol/L] and PBS control group [E_(2):(48±7)pmol/L,P: (58±10)nmol/L,P>0.05]. Conclusions The recombinant adeno-asseciated virus carrying human endostatin gene therapy could inhibit angiogenesis at endometriotic lesions and not influence steroid level. The antiangiogenic gene therapy might become a novel option for endometriosis.