Objective To compare the therapeutic efficacy and adverse effects between transcather arte-rial chemoembolization(TACE) and comprehensive therapy in primary advanced heptocellular carcinoma(HCC).Methods 216 patients with primary HCC were arranged randomly into two groups:104 (group A) were treated with TACE alone,the rest(group B)were treated with TACE combined with intraperitoneal perfusion chemothera-py, Chinese herbs and immunotherapy.The therapeutic efficacy and adverse effects were analysed and compared between two groups.Results The CR + PR rates were 28.84% in group A and 34.82% in group B.The 4-year survival rates were 1.92% in group A and 3.87% in group B(P < 0.05).There were no severe side effects in both groups.Conclusions The short-term effective rate and 4-year survival rate in comprehensive treatment group were superior to the control group.Therefore, the comprehensive treatment is worthwhile to use in primary advanced hepatocellular carcinoma.

In the embryonic period, myosin regulatory light chain (MYL2) plays a pivotal role in the development and function of the heart. A large number of studies have previously confirmed that the mutation of MYL2 gene, also known as MLC2, confers intimate associations with hypertrophic cardiomyopathy. MYL2 gene mutation impacts the structure and function of myosin, thereby leading to the occurrence and progression of hypertrophic and dilated cardiomyopathy as well as the following chronic heart failure. Importantly, MYL2 phosphorylation renders crucial effects in the processes of cardiac contraction, ventricular torsion and cardiac function.

BACKGROUND: Changes of physiological structure, changes of phenotype and first basic excision are all the changes of gene expression. The technique of DNA microarray is a new method to filtrate target genes fleetly and largely by using the theory of base-partnershin, which can holistically and magnificently study the expression and function of organics genes. OBJECTIVE: To study early differential expression genes of rats with cerebral hemorrhage with DNA microarray and establish academic foundation for exploring mechanism of cerebral hemorrhage.DESIGN: Randomized controlled research.SETTING: Department of Neurology, Affiliated Hospital of North Sichuan Medical College. MATERIALS: The experiment was conducted at the Affiliated Hospital of North Sichuan Medical College from October 2002 to December 2003. Twenty Wistar rats, of either gender, with body mass of 220-260 g, without special pathogen, provided by Experimental Animal Center of Chongqing University of Medical Sciences, were selected and randomly divided into control group and cerebral hemorrhage group, with 10 in each group. METHODS: Animal models with cute cerebral hemorrhage of rats were established with type Ⅶ collagenase tridimensional localization method,and 4 hours later tissues around hematom and normal cerebral tissue at the same part were detected with gene chip. Fluorescent signal was scanned with scanning apparatus and analyzed with computer. Result of genic expressive pattern was researched with reverse transcriptase-polymerase chain reaction (RT-PCR). MAIN OUTCOME MEASURES: Result of gene chip in cerebral tissue of rats and result of RT-PCR.RESULTS: Four hours after acute cerebral hemorrhage, 129 differential expression genes were screened out, in which there were 114 up-regnlation genes and 15 down-regulation genes. Those genes were mostly related to the following aspects: stress, immunological response, apoptosis, energy metabolism and signal transmitting. Genes related with inflammatory impairment were mostly obvious. The result of RT-PCR suggested that the level of genic expression was as the same as the result of Cdna chip, which indicated that genic expressive pattern based on gene chip had great reliability.CONCLUSION: Early cerebral hemorrhage has many differential expression genes, which can play an important role in hemorrhagic brain damage.

lnsulin-like growth factor (IGF) system has multiple bioactivities,such as regulating cell proliferation and differentiation,and inhibiting apoptosis and so on.In vivo and in vitro experiments have confirmed that IGF system takes part in the malignant transformation of cells and is related to the growth,invasion and metastasis of toumor.IGF system will be applied to early screening and target therapy for colorectal cancer.

Objective To investigate the effect of CD147 monoclonal antibody (mAb) on the natural resistance to paclitaxel (TAX) in the human cervical cancer line (HCE1) multicellular spheroid (HCE1/MCS) model and if CD147 mAb can reverse the HCE1/MCS resistance to TAX. Methods HCE1/MCS was obtained by liquid overlay and rotating technique. HCE1/MCS morphological changes were observed before or after the interference of CD147 mAb. The effects of TAX on HCE1/MCS (including inhibition ratio, IC50 and index of multicellular resistance) before or after CD147 mAb treatment were determined by the method of WST-1 and the inhibition ratio curve was mapped. Cell cycle and apoptosis were detected by flow cytometer (FCM). The expression of CD147 and P-gp of both HCE1/MC and HCE1/MCS was detected by immunocytochemistry. Results HCE1/MCS was established successfully. CD147 mAb could inhibit HCE1/MCS from forming spheroids. CD147 mAb could enhance the sensitivity of HCE1/MCS to TAX. IC50 in different concentrations of CD147 mAb (5,10,20 μg/mL) HCE1/MCS group were (40.31±3.73), (32.43±1.56), and (30.69±1.01) μg/mL. CD147 mAb resulted in G1/G0 arrest in HCE1/MCS. CD147 mAb of low concentrations (0-10 μg/mL) caused a dose-dependent inhibition of HCE1/MCS (P<0.05). Combined with TAX, CD147 mAb could also induce HCE1/MCS cell cycle arrest in both G1/S and G2/M stage. The expression of CD147 and P-gp was consistent in HCE1/MCS groups. Conclusion CD147 plays an important role in muliticellular resistance of cervical cancer and inhibition of CD147 can synergistically reverse the multicellular drug resistance (MCR) in cervical cancer. The MCR of HCE1/MCS mediated by CD147 is related to P-gp.

Objective: To evaluate the effect of standard management for hypertension in community population of Suzhou city. Methods: We conducted a prospective study of standard management for hypertension in community population of Suzhou city. The project included 3 groups: Standard group, the patients received standardized management,n=81 711, Control group, the patients received general management, n=38 944, and No-management group,n=1 644 249. The incidence rate of stroke and coronary artery disease (CAD) were compared among different groups according to 2010 chronic disease report of Suzhou city. Results: Compared with initial condition, the final average blood pressure drop in Standard group was (13.78/7.06) mmHg, which was better than that in Control group, X2=1852.91,P<0.01. The incidence rate of stroke in Standard group, Control group and No-management group were 1.72%, 2.41% and 3.59%, the incidence rate of CAD were 0.43%, 0.66% and 1.29% respectively. Conclusion: Standard management for hypertension was better than general management for preventing and controlling the incidence of stroke and CAD in community population.

Objective To investigate the role of temporary placement of fully covered self-expandable metal stent (cSEMS) for treatment of uncontrolled bleeding after endoscopic sphincterotomy (EST).Methods From January 2000 to present,a total of 3460 cases of EST were performed,and bleeding after the procedure was complicated in 29 (0.84％) of them,in which 4 could not to be stopped by conventional managements.Covered SEMSs were placed across the major papilla in these 4 patients.Results The stents were successfully placed and hemostasis was achieved in all patients.The stent was removed in 1 patient 1 week later,and spontaneous stent dislodgment occurred in 1 patient within 4 weeks.The other 2 patients rejected to remove the stents,and the patency maintained for more than 6 and 12 months respectively.No complication was observed in procedures of placing and removing stents.Conclusion Covered SEMS placement is a safe,effective and simple method for patients with uncontrolled bleeding after EST.

Objective To investigate clinical characteristics and outcome of patients with liver cirrhosis complicated with diabetes,and to explore the differences of clinical characteristics and prognosis between hepatogenous diabetes (HD) and type 2 diabetes mellitus (T2DM).Methods From November 2010 to April 2012,246 patients with liver cirrhosis were collected and divided into liver cirrhosis complicated with diabetes (LC-DM) group (n=72) and liver cirrhosis without diabetes (LC) group (n=174).LC-DM group was then sub-divided into HD group (n=33) and T2DM group (n =39).All the patients were followed up until death or the study endpoint.The clinical characteristics,prognosis and indicators of glucose metabolism were compared and analyzed.Oral glucose tolerance test and insulin C-peptide release test were conducted in part of patients in LC-DM group.Student t test was performed for mean comparison between two groups.Chi-square test was used for count data and rate comparison between two groups.The death related factors of liver cirrhosis were analyzed by Logistic regression analysis.Results The percentage of alcoholic liver cirrhosis of LC-DM group was 18.1 ％ (13/72),which was higher than that of LC group (6.9％,12/ 174) and the difference was statistically significant (x2=6.946,P=0.008).In HD group,the percentage of patients with diabetes family history was 9.1％ (3/33),which was lower than that of T2DM group (30.8％,12/39),the percentage of alcoholic liver cirrhosis was 30.3％ (10/33),which was higher than that of T2DM group (7.7％,3/39),the total bilirubin level ((43.4±57.7) μmol/L) was higher than that of T2DM group ((22.6 ± 13.3) μmol/L),the total cholesterol level ((3.3 ±1.2) mmol/L) was lower than that of T2DM group ((4.0±1.6) mmol/L),and the differences were statistically significant (x2=5.093 and 6.177,t=2.178 and 2.014,P=0.024,0.013,0.033 and 0.048).The duration of hospitalization,Chiid-Pugh score,the incidence of upper gastrointestinal bleeding,the incidence of hepatic encephalopathy,electrolyte disturbances and mortality of LC-DM group were all higher than those of LC group and the differences were statistically significant(t=2.389 and 2.270,x2 =6.496,5.572,5.194,19.646,all P＜0.05),and there was no significant difference between HD group and T2DM group(all P＞0.05).The blood glucose levels of HD group at different time point (0,30,60,120,180 min) were all lower than those of T2DM group and the differences were statistically significant (t=3.175,2.345,3.444,3.090,3.542,all P＜0.05).The fasting insulin level of HD group was close to that of T2DM group,the insulin levels of HD group at other time point (30,60,120,180 min) were all higher than those of T2DM group and the differences were statistically significant (t =3.084,2.881,3.648,2.840,all P＜ 0.05).There was obvious hyperinsulinemia in HD group.At 0,30,60,120,180 min,C-peptide level of HD group was at normal levels,and which of T2DM group was lower than normal.Child-Pugh grade C was an independent predictor factor of death in patients with liver cirrhosis (OR =3.056,95 ％ CI:1.268 ～ 7.346,P=0.013).Conclusions Compared with liver cirrhosis patients without diabetes,the liver function of patients complicated with diabetes was worse,and the incidence of complication and mortality was higher.However there was no significant difference between HD group and T2DM group.

Objective To explore the diagnostic value of EUS-guided aspiration biopsy for wall-thickened gastric lesions. Methods A retrospective study was performed in 45 patients who were diagnosed as having thickened gastric wall by EUS examination.Pathological and follow-up results of routine endoscopy and EUS-guided aspiration biopsy were analyzed,with the surgical results and follow-up outcome as the golden standard.The positive rate of routine endoscopy and EUS-guided aspiration biopsy were compared. Results In routine biopsy,gastric cancer was confirmed in 6,lymphoma in 3,dysplasia in 6,Menetrier′s disease in 2 and inflammatory changes in 28.EUS-guided aspiration biopsy was conducted in 45 patients,and gastric cancer was confirmed in 18,lymphoma in 5,dysplasia in 4,Menetrier′s disease in 2 and inflammatory changes in 16.The final pathological and follow-up results confirmed 21 gastric cancer,6 lymphoma,2 dys-plasia,2 Menetrier′s disease,other tumors in 4 and inflammatory changes in 10. The accuracy rate of routine biopsy and EUS-guided aspiration biopsy was 51. 11%( 23/ 45 ) and 82. 22%( 37/ 45 )respectively. Conclusion EUS-guided aspiration biopsy can yield a higher positive rate than endoscopic biopsy.

Glutathione ; metabolism ; Humans ; Lipoxygenase ; metabolism ; Oxidation-Reduction ; Xenobiotics ; metabolism