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 discuss the diagnosis and treatment of the benign tumors of pancreas,especially the surgical options and the prevention and cure of the postoperative complications.Methods Clinical data of 23 patients with benign lesions of the pancreas were retrospectively analyzed in our hospital from Jan.2004 to Dec.2009.All of the patients underwent surgical operation.Five patients were treated with pancreatic enucleation,8 patients were treated with distal pancreatectomy with splenectomy,1 patient was treated with central pancreatectomy,5 patients were treated with pancreaticoduodenectomy,4 patients were treated with pancreatic cyst- jejunum R-Y anastomosis.Eighteen patients were treated with somatostatin analogue.Results The pathological diagnosis included pancreatic cyst in 8,islet cell tumor in 4,mucous cystadenomas in 6,serous cystadenomas in 3,solid-pseudopapillary tumor in 2.Seven of 10 cases having pancreatic leak occoured secondary abdominal infection.One patient died of multiple organ dysfunction syndrome after pancreaticoduodenectomy.Conclusion There is no specific symptoms and serologic laboratory examinations for pancreatic benign tumors.CT and ERCP is very helpful for diagnosis and treatment.Surgical option is according to the location of the lesion and the judgement of the tumor whether being benign or malignant.Pancreaticoduodenectomy,central pancreatectomy,distal pancreatectomy with or without splenectomy and pancreatic enucleation is the reasonable surgical option.Pancreatic leakage is the main post-operation complication.Ligation the pancreatic duct reliably,treating the pancreatic raw surface appropriately,external drainage of the pancreatic fluid can reduce the rate of pancreatic leakage.

Objective:This study aimed to investigate the clinical significance of hormone receptor status detection in simultane-ous axillary metastasis for hormone receptor-negative primary breast cancer patients. Methods:Using immunohistochemical methods, hormone receptor status detection in axillary lymph node metastasis was performed among breast cancer patients with simultaneous ax-illary metastasis in the First Affiliated Hospital of Chongqing Medical University. The subjects comprised patients who visited the clin-ic for follow up or those who were hospitalized from July 2012 to January 2013. Endocrine therapy was given for patients diagnosed with positive hormone receptor in their simultaneous axillary metastasis. Results:Out of 56 patients with hormone receptor-negative primary breast cancer, 14.3%gained estrogen receptor (ER), 3.6%gained progesterone receptor (PR), and 5.4%gained ER and PR in their simultaneous axillary metastasis, and then underwent endocrine therapy. The discordance rate of hormone receptor expression be-tween primary tumor and axillary metastasis was 23.3%. Conclusion:Some discordance rates of hormone receptor status between pri-mary tumor and simultaneous axillary metastasis were observed. Through hormone receptor status detection in simultaneous axillary metastasis, we may possibly distinguish patients with negative ER and PR, among whom endocrine therapy may be active.

Objective To evaluate the effects and safety of uterine artery embolization for uterine leiomyoma. Methods Total of 185 patients with uterine leiomyoma were treated by UAE. They were followed for one to 6 years to observe the changes of leiomyoma size and improvement in clinical symptoms. Ovarian function was evaluated in 44 cases. Results Bilateral embolization of uterine arteries was performed in 185 patients. Follow-up of 1 ～6 years for 292 leiomyoma indicated that one to 9 months after embolization, shrinkage of leiomyoma size was the most significant factor. One year after embolization, leiomyoma sizes decreased a little. Shrinkage of submucous leiomyoma was more significant than that of intratumoral one, and the latter was more significant than subserous one. Shrinkage of leiomyoma with large size ( volume ≥ 150cm~3) was less than that of small one. Menorrhagia, anemia and pressure symptoms were all resolved. There was no significant difference between pre- and post embolization ovarian hormone level. Conclusions The significant reduction in leiomyoma volume and resolution of clinical symptoms confirmed that the treatment validity of symptomatic leiomyomas by UAE. UAE is an effective therapeutic procedure which has no adverse effect on the ovarian function.

Objective To establish an ideal focal cerebral ischemia reperfusion model in monkeys.Methods Adult healthy rhesus monkeys(Macaca mulatta) 12 cases(male 6 and female 6),aged 4-7 years and weighted 4.8-7.5kg.were used in this study.The middle cerebral artery occlusion/reperfusion(MCAO/R) model was established by inserting a standard micro-balloon catheter intraluminally from the carotid common artery or femoral artery into the proximal segment of the middle cerebral artery(MCA).The regional cerebral blood flow of MCA was occluded by expanding the micro-balloon to cause ischemia,and withdrawing the micro-ballon catheter to reperfuse the MCA.The MCAO/R model was evaluated by angiography,magnetic resonance angiography(MRA),magnetic resonance imaging(MRI),tetrazolium chloride(TTC) staining and neurological behavoral function scores.Results By inserting a micro-balloon catheter intraluminally from the carotid common artery or femoral artery into the MCA,the micro-balloon catheter could be inserted into the MCA to occlude blood flow,and no image of MCA shown on TV screen.In MCA blood flow supplied area,magnetic resonance T1,T2 and DWI showed high signals,TTC staining showed cerebral ischemic infarction,and correspondly the monkeys showed neurological function disorders.This method used a simple operatire procedure had a high successful rate,and could be repeated.Conclusion We showed ideal method to establish the MCAO/R model in monkeys by inserting intraluminally a micro-balloon catheter into the MCA.

Objective To investigate the value of double contrast-enhanced ultrasonography (DCEUS) in combination with three-dimension (3D) contrast-enhanced ultrasound in diagnosis of benign or malignant gastric ulceration. Methods A total of 47 patients with gastric lesions were enrolled in this study. All have the pathological results, 22 of them were benign ulceration and 25 were malignant. All patients underwent DCEUS and 3D contrast-enhanced ultrasound. On the basis of oral contrast-enhanced ultrasound agents, intravenous contrast-enhanced ultrasound agents were given at the same time. Images and data were recorded. The arrival time (AT), time to peak (TTP), infusion time (IT), baseline intensity (BI), peak intensity (PI) and enhanced intensity (EI) were calculated using the time-intensity curve (TIC). Results All benign ulcerations were imaged as small pits with slight thicken of gastric wall [(8.66±2.87) mm] using DCEUS,while malignant lesions were relatively large irregular-shape, unevenly-bottom pits with significant thicken of gastric wall [(13.98±3.63)~(20.83±3.69) mm]. 3D-DCEUS images were analyzed for gastric mucosal folds, ulceration lesions, as well as local vascularity. All ulceration lesions showed broken of gastric mucosal folds, and malignant lesion showed thickness of gastric wall as“crater”, with rich and irregular vascularity. There were no statistical differences between benign gastric ulcerations and adjacent normal gastric wall (P>0.05). Malignant gastric ulceration were compared with adjacent normal gastric wall tissue, TTP, IT and BI had no statistical differences (P>0.05), while AT, PI, and EI had statistical differences [(9.00±2.02) s vs (10.90±2.75) s, P=0.008], [(35.46±5.77) dB vs (29.73±8.72) dB, P=0.009] and [(30.76±5.76) dB vs (23.45±6.84) dB, P=0.000]. PI and EI in malignant tumors were higher than those in benign ones (P<0.05). Conclusion DCEUS could be a new method in differentiating benign and malignant gastric ulceration, which can get both the anatomy and perfusion information of gastric wall as well as lesions. 3D-DCEUS can improve the quality of the conventional ultrasound image.

Objective To study the pathogenesis and the effect of early drugs therapy of symptoms after concussion.Methods One-hundred and thirteen patients with symptoms after suffered concussion enrolled in the study and divided randomly into three groups.The patients of different groups were treated respectively with drugs,i.e.erigeron breviscapus,nimodipine,energy mixture.Symptom Check-List 90 ( SCL-90 ) and electroencephalogram(EEG) and cerebral blood flow of trancranial Doppler(TCD) were examined in the early and late stage of post-concussion.Normal population were recruited as control.All examination results and the effect of treatment were compared between treatment group and control group.Results In the scores of SCL-90,the factor scores of somatization symptom,compulsion,depressive disorder,anxiety disorders,and hostile symptom in 113 post-concussion patients in early stage were all higher than those in the normal( t =10.78,2.08,9.53,11.09 and 2.52,P ＜0.01or P ＜0.05),and as well as that of somatization symptom,depressive disorder,anxiety disorders,terror and mental disorder symptom in 12 post-concussion patients in late stage compared to normal( t =3.21,6.85,3.07,3.14 and 4.73,Ps ＜ 0.01 ).The test of EEG was abnormal in 57.4 ％ of patients in early stage and in 33.3％ in the late stage.Of all TCD results,67.0 ％ was abnormal in the early stage and 25.0％ in the late stage,The disappearance rate of post-concussion symptoms in the 14th day was significantly higher in the erigeron breviscapus group ( 45.0％ ) than in the nimodipine group ( 23.7％ ) ( x2 =3.91,P ＜0.05 ) and in the energy mixture group ( 20.0％ ) ( x2 =5.25,P ＜ 0.05 ).The disappearance rate of postconcussion symptoms in the 30th day in the energy mixture group(40.0％ ) was significantly lower than those in nimodipine group( 68.4％ )( x2 =5.94,P ＜ 0.05 ) and in erigeron breviscapus group( 75.0％ )( x2 =9.43,P ＜ 0.01 ).The occurrence rate of post-concussion sequelae was higher in the energy mixture group ( 22.9％ )than in the nimodipine group ( 5.2％ ) ( x2 =4.77,P ＜ 0.05 ) and in the erigeron breviscapus group (5.0％ )( x2 =5.15,P ＜ 0.05 ) three month after injuries.Conclusion The occurrence of symptoms originated from the organic damage of brain tissue.However,its changes were influenced by psychologic factors after concussion.Early vasodilative drugs therapy could improve the recovery of patients with post-concussion symptoms in time and decrease the occurrence of post-concussion sequelae.

Objective To investigate the relationship between the anti-earthquake military rescuers' psychosomatic health and social support, and observe the effect of intervention to the army men who suffered troubles.Methods By cluster random sampling, 152 military rescuers and 139 army men not taking part in the rescues were investigated by Facility Psychosomatic Health Scale and Social Support Rating Scale. Mental intervention or medication was performed to those produced psychosomatic health. Results The scores of somatic symptoms,mental status,psychosomatic health and social support of military rescuers and the control group were (4.09±4.70) ,(2.18 ±3.16) ,(6.27 ±7.08) ,(6.14 ±4.20) and (2.11 ±4.16) ,(1.37 ±3.09),(3.47 ±6.55),(4.57 ± 4.17 )respectively, the difference was significant(P＜0.05). The somatic symptoms had significantly positive correlation with mental status in military rescuers (r=0.17～0.52, P＜ 0.05 or 0.01 ). Failure of social support had positive correlation with mental disorders (r=0.18～0.40, P＜0.05 or 0.01). The degree of social support was the main factor which had affected on the psychosomatic health of military rescuers. The somatic symptoms of military rescuers were apparently higher than their mental symptoms. Mental and pharmaceutical intervention showed good effect on them. Conclusion There is an apparent effect for military rescuers injured seriously psychosomatic health through medication or mental intervention.

ObjectiveTo investigate the expression and activity of p38 mitogen-activated protein kinase (p38 MAPK)in hippocampus CA1 and CA3 area of rats with conditioned fear.Methods 24 h after rat model of conditioned fear was established,rats were sacrificed,then expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182) in hippocampus CA1 and CA3 area of rats were detected by western blot.ResultsCompared with control group ( ratios of value of gray scale were 1.0 ± 0.1 and 1.0 ± 0.2,respectively),expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182) in hippocarpus CA1 area of rats with conditioned fear (9.4 ± 2.6 and 7.8 ± 2.1,respectively) were significantly increased ( n =9,P ＜ 0.05 ).Compared with control group ( 2.1 ± 0.5 and 1.4 ± 0.5,respectively),expression of p38 MAPK and phosphorylated p38 MAPK (Thr180/Tyr182 ) in hippocampus CA3 area of rats with conditioned fear (6.2 ± 3.3 and 2.6 ± 0.6,respectively)were also significantly increased ( n =9,P ＜ 0.05 ).Conclusionp38 MAPK may play important role in the formation of long term memory of conditioned fear.