Objective To study the safety of transcatheter arterial chemoembolization(TACE)via the intercostal artery(ICA)for hepatic carcinoma.Methods A total of 24 patients with hepatic carcinoma(HCC)fed by the ICA underwent TACE via the artery in our hospital.Among the cases,15 were mass type and 9 were nodular type.Plain and enhanced CT or MRI scan were performed before the operation.During the procedure,we carried out intercostal arteriography.Selected catheterization of the feeding branch and then TACE were done.The ICA angiographic features,tumor location,clinical observation,laboratory tests,and imageology were evaluated after the surgery.Results In our cases,the HCCs supplied by the ICA collaterals were located at segments six and/or seven.Angiography showed that all the ICA collaterals originated from the right side at the levels of T8(7.5%,3/40),T9(15.0%,6/40),T10(47.5%,19/40),or T11(30.0%,12/40).The procedure was completed in 22 of the patients.CT scan performed after the procedure showed that the tumor was completely filled with lipiodol in 87.5%(21/24)of the cases.The serum level of AFP decreased significantly in 82.6%(19/23)of the patients.Three patients complained of severe pain at the shoulder after the operation,1 patient had skin itching during TACE,and 5 developed skin erythema after the procedure.Conclusions HCC supplied with ICA collaterals are often detected in the patients who have the tumor at the right posterior segment(S6 and S7)and had received TACE for several times.TACE via the ICA is safe but may leads to skin injuries.

[Objective] To investigate X-ray and CT manifestations of tobereulosis of ankle joint and to discuss the differentiation with other diseases.[Method]The X-ray and CT findings in 5 cases with pathalogically proved tuberculosis of ankle joint were retrospectively analyzed.The differentiation with other diseases was discussed.[Result]The lesions involved entire right ankle joint in all 5 cases,The typical signs were as follows:(1)indistlnct and erosive joint surface,insect bitten-like of bony destruction ofjotht surface,digging-like shape of cancellous bone's destruction;(2)narrowed or irregular widened joint space;(3)ostooporosis of diseased region and surrounding;(4)extensive periostoal reaction of distal fibia and fibula;(5)to form cold abscess and sinus tract.[Conclusion]The tuberculosis of ankle joint earyies certain characteristic X-ray and CT signs,CT is better than X-ray in diagnosis.Highly alert of ankle joint tuberculosis is the key of early correct diagnosis.

Relative deficiency of serum insulin and insulin resistance of tissues are the main causes of postburn hypercatabolism.In order to evaluate the clinical effects of tolbutamide to improve postburn hypermetabolism,9 burn patients were given tolbutamide and observed for 10 days after the drug had gone through animal experiments.It was found that tolbutamide could improve postburn hyper-metabolism through following ways:1.To stimulate the secretion of insulin and enhance the effect of insulin.2.To reduce the insulin resistance of tissues and promote glucose utilization of skeletal muscles.3.To inhibit the secretion of glucagon.

The rate of resting energy expenditure (REE) was determined in 75 cases of burn patients with different total areas of burned wounds.Itwas found that.1.The rate of REE increased with the increase of the total area of burned wounds.2.When the total burned body surface area was equal,the rate of ERE increased more signficantly in the case with more extensive third degree burns.3.In the period immediately after the healing of the burned wounds,the rate of REE remained significantly higher than in the normal subjects.

Thirty-two adult patients with burn wounds over 50% TBSA were randomized into the nutritioal and the control group.Energy supplement Ifor the patients of the nutritional group was given according to the burn nutrition formula of the Third Military Medical College as follows,Energy (kJ) /day=4184 (1000 cal)?body surface area (m2) +105 (25 cal)?burn surface area (%)glucose,fat:protein=55~60:20~30:15~20calorie (cal):nitrogen (g)=150~170:1The patients of the control were prescribed to eat the hospital diet freely.All the patients of the 2 groups were observed for 28 days postburn with their burn wounds similarly and properly treated.It was found that most of the nutritional indices observed were better in the nutritional group than in the control.

The resting energy expenditure (REE) and the relative ratio of carbohydrate,fat and protein were investigated on the 1st to the 28th dqy postburn in 75 adult burn victims with burn area ranged between 5~98% TBSA.It was found that there was high catabolism of fat and protein but relatively low consumption of carbohydrate after burns.The more severe the burn injury,the more marked the above changes.On the basis of the metabolic characteristics of burn patients and on the traditional dietary habits of Chinese,a reasonable relative ratio among carbohydrate,fat and protein,the 3 main nutritional elements,in the diet of burn patients was suggested,viz,carbohydrate:fat:protein=55~60:20~30:15~20.

Objective To investigate the targeted capacity of ultrasound contrast agent with a galactosepoly-L-lysine ligand,and lay the foundation for targeted imaging in vivo and the treatment of liver cancer.Methods The small molecular targeted ligand was synthetized by a method of reductive amination,the targeted lipid microbubbles were performed by combining lipid microbubbles with the targeted ligand,the targeted effectiveness was observed by fluorescence microscopy.Results Galactose and poly-L-lysine were combined effectively after 24 h with the molar ratio 1:1 00,the average particle size of the targeted lipid microbubbles was 2 micron,the targeted combine of the HepG2 liver cancer cells with the targeted ultrasound contrast agent was observed by laser scanning confoeal microscope.Conclusions The targeted lipid miembubbles can target effectively to the HepG2 cells.

Objective To compare the effects of different antiplatelet therapy on outcomes in patients with acute coronary syndrome (ACS). Methods 338 hospitalized patients with ACS were enrolled. They were assigned to three groups: group 1, aspirin alone after discharge, n=93; group 2, dual antiplatelet treatment of aspirin and clopidogrel after discharge for 6～12 months, then aspirin, n=127; and group 3, dual antiplatelet treatment of aspirin and clopidogrel after discharge for 2 years, n=118. All the patients were followed up for 2 years. The clinical data (basic clinical data, platelet count and serum lipids indeices), primary end point (cardiovascular death, nonfatal myocardial infarction and stroke) and hemorrhagic events (major hemorrhage, moderate hemorrhage and minor hemorrhage) within 1 and 2 years were analyzed. Results During 1 and 2 years, compared with group 1, the incidence of cardiovascular death and all primary end points of groups 2 and 3 decreased significantly (P＜0.05), but the nonfatal myocardial infarction and stroke did not （P＞0.05）. The difference was not statistically significant between groups 2 and 3 in all the end points （P＞0.05）. The difference of hemorrhagic events was not statistically significant among the 3 groups（P＞0.05）. Conclusion Dual antiplatelet treatment of clopidogrel plus aspirin for 2 years may decrease the mortality of cardiovascular disease while the incidence of severe hemorrhage doesn't increase.

Objective　To study the effects of measures for preventing early postburn damage in improving survival rate of burn patients during the third stage. Methods　12 568 burn cases admitted to our institute were chronically divided into three groups (1958-1980;1981-1990;1991-2000). Total burn surface area (TBSA), survival rate, incidence of burn shock, systemic infection and organ damage as well as the main treatments adopted in the recent decade were retrospectively analyzed. Results　Incidence of burn shock, systemic infection and organ damage were significantly lower, and the total survival rate and the survival rate in patients with different TBSA were markedly higher in the third group as compared with those in the first and the second group. Incidence of organ damage in patients treated with delayed fast fluid infusion, early escharectomy en masse, early enteral feeding, early prevention of inhalation injury and gut bacterial translocation were also significantly lower than in the control. Conclusion Measures taken in the third group for preventing early postburn damage play an important role in improving the survival rate of burn patients.

OBJECTIVE To investigate the effect of arctigenin(ATG) on liver fibrosis in rats induced by carbon tetrachloride(CCl4)and to explore its underlying mechanism. METHODS Sprague-Dawley rats were randomly divided into six groups:vehicle,ATG 3.0 mg · kg-1 group,CCl4 model group,CCl4+ATG 1.0 and 3.0 mg·kg-1 groups,and CCl4+colchicine(COL)0.1 mg·kg-1(toxicity)group. Liver fibrosis was induced by subcutaneous injection of CCl4 in rats for 8 weeks. ATG and colchicine were administrated ig once a day starting from the fifth week after the CCl4 treatment for 4 weeks subsequent. At the end of the study,glutamic pyruvic transaminase (GPT),glutamic oxaloacetic transaminase(GOT),albumin(ALB),and total bilirubin (TBIL) as well as the contents of hydroxyproline (HYP) in liver tissues were measured. Histopathological changes were observed in the liver tissues using hematoxyline-eosin(HE)and Masson’s trichrome staining. The proliferation of hepatic stellate cells (HSC) and expression of cell cycle-related proteins were assayed by indirect immunofluores?cence staining and Western blotting,respectively. RESULTS Compared with CCl4 model group,ATG 1.0 and 3.0 mg · kg-1 improved the liver function by decreasing serum contents of GPT,GOT and TBIL (P<0.05),and increasing serum content of albumin(P<0.05). Histological results indicated that ATG 1.0 and 3.0 mg · kg-1 alleviated liver damage and reduced the formation of fibrous septa. Moreover, ATG 1.0 and 3.0 mg · kg-1 significantly decreased liver HYP when compared with CCl4 model group(P<0.05). In addition,CCl4-induced proliferation of activated HSC was inhibited by ATG 1.0 and 3.0 mg·kg-1, and this was accompanied by down-regulation of cyclin D1,cyclin-dependent kinase(CDK)2,CDK4, and proliferating cell nuclear antigen (PCNA)(P<0.05),and up-regulation of p27kip1 in activated HSC (P<0.05). CONCLUSION ATG can alleviate hepatic injury and fibrosis induced by CCl4,which is probably associated with suppression of the proliferation of activated HSC.