Objective To study the prevention and treatment of severe complications of percutaneous radiofrequency ablation(PRFA)for hepatic malignancy. Methods A series of 939 patients with primary hepatic carcinoma or hepatic metastasis confirmed by pathological examinations or clinical manifestations underwent 1098 treatments of PRFA between January 2006 and December 2009. All the patients were followed up to study the short-or long-term complications related to PRFA. Results Complications developed in 9 patients: bile duct injury (4 patients), hemothorax (2 patients), and intra-abdominal hemorrhage (3 patients). The incidence of complication was 0.82% (9/1098) and the complication-related mortality was 11.1% (1/9). Conclusions Although PRFA which is minimally invasive, is a safe and effective treatment, there were still risks for this procedure, especially when the tumor is located at the portahepatic region or the patient has coagulopathy. Some serious complications can be prevented. It is important to observe the strict indications for RFA and to carry out the procedure carefully. Early detection of complication is important.

Objective To evaluate the curative effect of microwave ablation (MWA) for solitary hepatocellular carcinoma (HCC) sized less than 5 cm,and to discuss the prognosis and its influence factors.Methods The clinical data of 603 HCC patients,who were admitted to authors' hospital during the period from 2011 to 2013 to receive MWA,were retrospectively analyzed.The patients were followed up till March 2016.Results According to the inclusion criteria,a total of 603 patients were enrolled in this study.Complete ablation of HCC lesions was obtained in 5.8％ of patients (35/603).No statistically significant difference in complete ablation rate existed between each other among groups of different tumor diameter (P=0.056).The incidence of severe complications was 1.7％ (10/603).The median survival time was (59.6±1.9)months,while the 1-,2-and 3-year overall survival rates were 94.7％,81.9％ and 71.8％ respectively.In terms of overall survival rate,no statistically significant difference existed between groups of different age as well as between groups of different tumor diameter (P=0.225 and P=0.777 respectively),but statistically significant difference existed between groups of different sex as well as between groups of different recurrence interval (P=0.029 and P＜0.001 respectively).Univariate and multivariate analysis showed that gender,preoperative albumin level and recurrence interval were the factors influencing overall survival rate (P=0.035,P=0.006 and P＜0.001 respectively).Conclusion For the treatment of solitary HCC sized less than 5 cm,MWA has reliable curative effect,it is a safe and minimally-invasive therapy for HCC.The overall survival rate between patients with different age or between patients with different HCC size is not obviously different.The gender,preoperative albumin level and recurrence interval are independent factors that affect the overall survival rate.

Objective To study the treatment of a or toiliac occlusive disease and prevention and management of early complications. Methods From Mar 1998 to Mar 2005, 83 aortoiliac arterial occlusion patients were treated with embolectom y by Forgaty catheter as the main therapy for acute occlusion. In cases of chron ic occlusion percutaneous transluminal angioplasty and stenting, prosthesis graf t bypass surgery as well as proximal endovascular procedure combining with dista l arterial reconstructions were adopted on case to case basis. Results There was acute aortoiliac occlus ion in 14 cases, 6 cases (42.9%) suffered from early complications after embole ctomy, with mortality of 7.1%. In chronic aortoiliac occlusion of 69 cases,va rious complications developed in 16 cases(23.2%),of which aortoiliac arteri al stent placement in 17 cases with complications of 23.5%;prosthesis bypass in 23 cases, with complications of 30.4%, and mortality of 4.3%;aortoili ac stenting combining with femoral-popliteal bypass in 29 cases(58 legs)with complications in 5 cases(17.2%). Conclusion The expansion and development of minimally invasive tech niques along with minimal invasive surgery may reduce surgical risks,decrease m obidity and mortality rate.

Objective:To investigate the short-term therapeutic effect and long-term survival of multiple myeloma patients with extramedullary disease (EMD) in the new drug era.Methods:The data of 74 patients with multiple myeloma diagnosed and treated in Anhui Wanbei Coal and Electricity Group General Hospital from January 2015 to January 2020 were retrospectively analyzed, including 17 patients with soft tissue infiltration (EM-S), 9 patients with bone infiltration (EM-B), and 48 patients without EMD (No-EMD). The short-term efficacy, the 4-year progression-free survival (PFS) rate and overall survival (OS) rate, and their influencing factors in three groups of patients after receiving bortezomib regimen were analyzed.Results:After 3-4 courses of early induction therapy of bortezomib regimen, the overall response rate of patients in the EM-S group was lower than that in the No-EMD group and the EM-B group [58.8% (10/17) vs. 85.4% (41/48), 100.0% (9/9)], and the differences were statistically significant ( χ2 = 13.7, P = 0.036; χ2 = 26.5, P = 0.003), while the difference between No-EMD group and EM-B group was not statistically significant ( χ2 = 12.7, P = 0.211). Survival analysis showed that the 4-year PFS rate of No-EMD group was higher than that of the EM-S group and EM-B group (41.0% vs. 7.6%, 0), and the differences were statistically significant ( χ2 = 10.835, P < 0.01; χ2 = 8.276, P = 0.004). Meanwhile, the 4-year OS rate of EM-S group was lower than that of the No-EMD group and EM-B group (16.5% vs. 54.3%, 59.3%), and the differences were statistically significant ( χ2 = 9.146, P = 0.002; χ2 = 4.066, P = 0.044). Conclusion:The early treatment effect of bortezomib regimen, PFS and OS in multiple myeloma patients with EM-S are poor, while the EM-B has no effect on OS.

Objective To investigate prevalence of metabolic syndrome (MS) in population at high-risk for diabetes in Changfeng community of Shanghai. Methods Totally, 982 persons aged 40-79 years without previous history of diabetes, but with risk factors for diabetes from Changfeng community in Shanghai were screened by questionnaire, physical examinations, lipid profile and oral glucose tolerance test. Prevalence of MS and its clinical characteristic were observed. Results Overall prevalence of MS was 44. 6% (438/982) in Changfeng community, significantly higher in women of 48.6% (341/701) than that in men of 34. 5% (97/281) (P<0.01). Prevalence of MS increased with age in women (P <0. 01 ), but not in men (P>0.05). Components of MS ranking from high to low were hypertension of 66. 5% (653/982), abdominal obesity of 62.8% (617/982), decreased high-density lipoprotein-cholesterol (HDL-C) of 49. 4% (485/982), increased triglyceride (TG) of 46. 0% (452/982) and increased fasting glucose of 35.7% (351/982). There were 55.9% (245/438) of MS patients with three or more MS components in addition to abdominal obesity. Conclusions Prevalence of MS is higher in community population at high-risk for diabetes and more than half of the MS patients have three or more risk factors for cardiovascular disease.

Objective: To investigate the efficacy of microwave ablation in the treatment of hepatocellular carcinoma (HCC) within the Milan criteria and to investigate the differences in clinical efficacy of microwave ablation in tumors with different sizes. Methods: A retrospective analysis was performed on the clinical data of the patients with HCC within the Milan criteria who received microwave ablation in our hospital from January 2011 to January 2013. The complete ablation rate, incidence rate of major complications, recurrence rate, and overall survival rate were analyzed and the treatment outcomes were compared between two groups with different tumors sizes. The patients were followed up for 3.4-61.8 months. The Kaplan-Meier method was used to calculate overall survival rate, local recurrence rate, and distant recurrence rate. Comparison of rates between groups was made by the chi-square test and comparison of survival rates between groups was made by the log-rank test. Results: A total of 696 patients with HCC within the Milan criteria involving 801 tumors were included in this study. The complete ablation rate was 93.8% (653/696) and the incidence rate of major complications was 1.7% (12/696). The median survival time was 59.6 months and the 1-, 2-, and 3-year overall survival rates were 94.8%, 82.2%, and 71.7%, respectively. The local recurrence rate was 13.4% (93/696) and the rate of intrahepatic distant metastasis was 40.1% (279/696). The overall intrahepatic recurrence rate was 48.1% (335/696), and the 1-, 2-, and 3-year recurrence rates were 22.9%, 38.4%, and 46.8%, respectively. There were no significant differences in complete ablation rate, incidence rate of major complications, and overall survival rate between the two groups with different tumor sizes (diameters≤3 cm and 3-5 cm) (P = 0.12; P = 0.61; P = 0.61). Conclusion Microwave ablation is a safe and effective treatment modality for HCC within the Milan criteria. And there are no significant differences in safety, effectiveness, and long-term efficacy of microwave ablation between the two groups with different tumor sizes (diameters ≤3 cm and 3-5 cm). However, if the operator’s experience is not rich and cannot accurately use conformal ablation and make an individualized treatment, the tumors with a diameter of 3-5 cm should be carefully treated using microwave ablation to avoid residual tumor after treatment.

OBJECTIVETo analyze the functions of differentially expressed genes between abdominal aortic aneurysm and normal aortic tissue by cDNA microarray.

METHODSTotal RNAs were respectively isolated from the normal aorta and aortic aneurysm, purified into mRNAs by oligotex. Subsequently they were reverse-transcribed into cDNAs incorporated with fluorescent dUTP to make hybridization probes, which were hybridized as the cDNA microarray for scanning of fluorescent signals and differentially expressed genes between the normal aortic and aortic aneurysm by using GenePix Pro 3.0 software.

RESULTSA total of 18 differentially expressed genes were detected, accounting for 0.44% of total genes. Among these genes, 11 were related to cell cycle and the remaining 7 to cell apoptosis. The number of upregulated genes in the aortic aneurysm was 9 (mean ratio: 3.860) and that of the downregulated 9 (mean Ratio: 0.294). Bio-informative analysis showed that these 18 genes might influence the growth and apoptosis of smooth muscle cells in abdominal aortic aneurysms.

CONCLUSIONSDuring the development of abdominal aortic aneurysms, modulations of multi-gene expression would undergo various changes. Cell cycle and apoptosis-related genes were related to the growth and apoptosis of smooth muscle cells in abdominal aortic aneurysms. Further research into these genes will clarify the mechanisms of abdominal aortic aneurysms.

Aortic Aneurysm, Abdominal ; genetics ; pathology ; Apoptosis ; physiology ; Cell Cycle ; genetics ; Cells, Cultured ; Gene Expression ; Gene Expression Profiling ; Humans ; Myocytes, Smooth Muscle ; metabolism ; pathology ; Oligonucleotide Array Sequence Analysis