Objective To evaluate the clinical efficacy of transcatheter arterial chemoembolization (TOCE) and percutaneous absolute ethanol injection (APEI) in moderate or advanced liver cancer.Method During May,1993～Aug,1999, 137 patients with unresectable advanced liver cancer were retrospectively studied. 85 cases only received TOCE, 52 cases were treated by TOCE+APEI by B-US guidance.Results The effect in TOCE+APEI group was significant better than that in only TOCE group,the half year, 1-year,2-year and 3-year survival rates of the TOCE+APEI group were 86 54%,67 31%,43 55% and 21 77%,while those of the TOCE group were 65 89%,47 92%,22 12% and 1 48% respectively. There was significant difference between the two groups in survival rate(P

Objective To explore the effect of hepatectomy or cholangiolithotomy on patients with hepatocholangic stones. Methods The clinical data of surgical treatment of 316 patients with hepatocholangic stones combined with bile duct stricture was retrospectively analyzed. The patients were divided into two groups:172 patients chiefly underwent hepatectomy,and the other 144 patients chiefly underwent cholangiolithotomy. Results The ratio of residual stones and reoperation in the hepatectomy group was significantly lower than those in the cholangiolithotomy group (P

OBJECTIVE:To discuss the improvement in Soxhlet extraction with ore and shell hard Chinese meteria madica taking Plastrum Testudinis as example.METHODS:On the basis of normal Soxhlet extracter,larger Soxhlet extracter on Plastrum Testudinis was experimented using saturated salt-water-bath,quadruplicity cover circle and timer.Large Soxhlet extracter was compared with normal Soxhlet extracter and stirring-reflux method by HPLC analysis,yield and clearance rate of DPPH.RESULTS:There were no significant difference between normal and larger Soxhlet extracters,but the stirring-reflux method was inferior to these two methods.CONCLUSION:The improved larger Soxhlet extraction is a thorough,high-efficient,convenient,economical and healthy extracting method for ore and shell hard Chinese materia medica.

Objective To establish TaqMan probe real‐time Fluorescent Quantitative PCR in detecting Cryptococcus neoformans genomic DNA ,and to provide important method for detection of cryptococcal meningitis .Methods According to the Cryptococcus neoformans ITS‐rDNA sequences obtained from NCBI ,specific primers and probe were designed based on the conserved sequences , a specific 114 bp fragment was amplified by primers and probe ,then recombinant plasmid was constructed .Eight different concen‐trations from 1 .42 × 10 copy/μL to 1 .42 × 10 copy/μL were used as templates by 2 μL .In the optimum reaction condition ,the sen‐sitivity ,specificity and repeatability were evaluated and standard curve was established .15 clinical cryptococcal meningitis strains i‐solated from clinical diagnosis patients were detected .Results The real‐time PCR showed high sensitivity and specificity and was a‐ble to detect 2 .84 × 102 copies of plasmid DNA .The detection sensitivity was 2 .84 × 102 copies plasmid DNA by real‐time PCR ,no amplification curve was detected with human genomic DNA ,other fungus ,bacterias and viruses .The CV of inter‐assay were 2 .86% ,1 .48% and 1 .36% respectively with excellent reproducibility .Fifteen clinical isolated strains could be detected accurately . Conclusion A method of detection of Cryptococcus neoformans DNA by real‐time PCR is established successfully with high sensi‐tivity and specificity ,and the results are stable ,could diagnose cryptococcal meningitis rapidly and early .

Objective To study the correlation of HLA-G levels with acute rejection and CMV active infection post-kidney transplantation.Methods A total of 132 initial kidney transplantation recipients were divided into kidney function stable group (F),acute rejection group (AR),CMV group according to whether they had active CMV infection and acute rejection.Forty-one healthy donors served as control group (H).HLA-G levels and mRNA expression were analyzed by using flow cytometry,ELISA,RT-PCR and Western blotting.Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies.Results The expression levels of mHLA-G1 were low in all 4 groups pre-transplantation.Only CMV group had significantly more CD14+ mHLA-G1+ cells post-transplantation (P＜0.05).sHLA-G5 levels were higher in F group than in H group (P＜0.05),but there was no significant difference among other groups pre-transplantation (P＞0.05).sHLA-G5 levels were increased significantly in CMV group as compared with F group (P＜0.05),and those in F group were higher than in H and AR groups (P＜0.05).Renal tissue biopsies from 21 renal transplantation recipients with AR indicated that HLA-G5 was expressed negatively in 17 patients,positively in 3 patients and 1 weakly positively.HLA-G was positive in the kidney tissue of 9 patients out of 9 patients with active CMV infection.In total 132 recipients,AR incidence was significantly lower in CMV ( + ) group (7.1 ％,2/28) than that in CMV ( - ) group (24.0 ％,25/104).Conclusion The sHLA-G5 may contribute to predict AR and CMV active infection; AR and CMV active infection may be correlation with immune balance in kidney transplantation recipients.

ObjectiveTo determine the correlation of human leukocyte antigen-G (HLA-G)expression with CMV active infection after kidney transplantation. MethodsA total of 215 first-time kidney transplantation recipients in one transplantation center were divided into CMV ( + ) group and CMV ( - ) group according to whether they had active CMV infection. mhla-g1 expression on leukocytes was analyzed by flow cytometry. The concentrations of soluble HLA-G5 were detected by using ELISA. The sHLA-G5 cutoff levels by ROC curve was employed to predict the active CMV infection. The expression of sHLA-G5 mRNA and protein in leukocytes was analyzed by using RTPCR and Western blotting respectively. Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies of 12 cases. ResultsThe expression of mHLA-G1 in peripheral blood was low in both CMV ( + ) group and CMV ( - ) group. Also when CMV-PP65 was positive, there was no significant change in mHLA-G1. In CMV ( + ) group, the proportion of CD14+ mHLA-G1 +cells[(45. 53 ± 17.32)％]in peripheral blood was increased as compared with that in CMV (-)group[(10. 22 ± 5.78)％]. The expression of sHLA-G5 was increased significantly in CMV ( + )group. The optimal cutoff value of sHLA-G5 predicting the active CMV infection was 202. 9 μg/L,with high diagnostic accuracy. HLA-G was positive in the kidney tissue of 10 patients out of 12 patients with active CMV infection. Both RT-PCR and Western blot analysis showed that sHLA-G5 was significantly higher in CMV ( + ) group than that in CMV ( - ) group. ConclusionROC curve analysis of sHLA-G5 with the cutoff value of 202. 9 μg/L can be used to predict the active CMV infection. The HLA-G levels in peripheral blood were significantly increased and HLA-G expression in the tubular epithelial cells of the graft could be a protection mechanism of the kidney function.

Objective To investigate the role of r-aminobutyric acid B receptor in the development of liver fibrosis.Methods Thirty-two Sprague-Dawley (SD) rats were divided into four groups including a control group,a model group,a baclofen group,and a CGP35348 group.Liver fibrosis was then induced by carbon tetrachloride (CCl4).Baclofen and CGP35348 treatment were carried out after the formation of liver fibrosis,followed by complete extraction of the eyeball to obtain blood sample to test liver function.Liver tissue specimens were cut and stored for histological staining,histochemistry,real-time polymerase chain-reaction (RT-PCR),and western blot analysis.Results Histological staining indicated that the degree of liver fibrosis was more severe in the CGP35348 group than in the baclofen group (P＜0.001).The levels of alanine transaminase (ALT),aspartate aminotransferase (AST),gamma-glutamyl transferase (GGT),total bilirubin (TBil),and direct bilirubin (DBil) were significantly lower in the baclofen group than in the CGP35348 group (P＜0.01).The levels of ALT,AST,GGT,TBil,and DBil were significantly higher in the CGP35348 group than in the model group (P＜0.05).Immunofluorescence results show that the hepatic cell migration was inhibited in the baclofen group.Western blot results showed that the expression levels of α-SMA protein were significantly lowered in the baclofen group when compared to that of the CGP35348 group and model group (P＜0.01).Conclusion GABAB receptor might play a role in the liver protection by inhibition of migration of hepatic cells in liver fibrosis.Further studies into the mechanism behind this function are further needed and may be a potential source of future anti-fibrotic treatment.

Objective To measure the cytokines levels in peripheral blood from kidney transplantation recipients by using cytometric bead array and to analyze their change and the clinical significance in pre- and post- kidney transplantation, inducting with basiliximab and graft rejection. Methods A total of 72 renal transplantation recipients were divided into two groups, kidney function stable group(n =53) and acute rejection group (n = 19). And they were also grouped by induction with basiliximab or not,32 in basiliximab group and 40 in without basilixmab group. The levels of IFN-γ, TNF-α, IL-10, IL-5,IL-4, IL-2 were measured by cytometric bead array in peripheral blood of 72 kidney transplantation recipients and 30 healthy donors at differential time. The data was analyzed according to the following grouping:donors and recipients, kidney function stable group and acute rejection group post transplantation and with or without basiliximab group. Results The levels of TNF-α, IL-10, IL-5, IL-4, IL-2 in recipients before transplantation were ( 1.65 ±0. 10) ,(2. 55 ±0. 19) ,( 1.88 ±0. 14) ,(1.85 ±0. 12) ,(2. 12 ±0. 09) ng/L,respectively. While they were (3.04 ±0. 17), (3.33 ±0. 26), (4.03 ±0.25), (2.73 ±0. 16), (4.03 ±0. 26) ng/L respectively in healthy donors. There was statistical significance between the two groups ( t =6. 890, 2. 375, 7. 851,3.955,7.153, P<0. 01, <0. 05, <0.01, <0.01, <0.01). While the level of IFN-γ in recipients before transplantation was (2. 50 ±0. 18) ng/L,compared with (3. 00 ±0. 24) ng/L in healthy donors. There was no statistical significance between the two groups( t = 1. 625, P > 0. 05 ). The levels of IFN-γ and IL-10 in kidney function stable group were (2. 71 ± 0. 11 ) ng/L and (3.91 ± 0. 52) ng/L,while they were ( 3.30 ± 0. 36 ) ng/L and ( 12. 01 ± 5.35 ) ng/L in acute rejection group. There were statistical dirrerences between the two groups ( t = 5. 061, 11. 465, P < 0. 01, < 0. 05 ). Before induction with basiliximab, the levels of IFN-γ, TNF-α, IL-10 in recipients were (2.90 ±0. 21 ), ( 1.67 ±0. 12),(2. 45 ± 0. 16) ng/L respectively. But they were ( 2. 78 ± 0. 17 ), ( 1.58 ± 0. 07 ), ( 2. 77 ± 0. 24 ) ng/L respectively after induction with basiliximab, which showed significantly different ( t = 5. 605, 6.011,4. 126, P <0. 01, <0. 01, <0. 05). Four weeks after kidney transplantation in recipients with basiliximab,the levels of IFN-γ, IL-10, IL-4 were (2. 90 ± 0. 31 ), (9. 08 ± 0. 16), (2. 73 ± 0. 11 ) ng/L. While they were (3.28 ±0. 11 ), (4. 17 ±0. 21 ), (2. 11 ±0. 20) ng/L respectively in recipients without basiliximab induction, which were significantly different from those with basiliximab induction (t = 4. 268,4. 263,3.762, P <0. 01, <0. 01, < 0. 05 ). Conclusions Six kinds of cytokines can be measured by cytometric bead array simultaneously and accurately. The data suggests that the detection of multiple cytokines in kidney transplantation recipients by cytometric bead array can provide more guidance for clinical diagnosis and therapy.

Objective To discuss feasibility and therapeutic effect of the interventional management through biliary tract drainage with percutaneous transhepatic puncture technique for biliary tract stricture after orthotopic liver transplantation. Methods A retrospective review of the clinical and imaging materials of 292 postoperative orthotopic liver transplantation cases was made. Of these 292 cases, 30 patients suffered from biliary tract complications and treated with billiary balloon dilatation, bile drainage and biliary stenting techniques. Results After biliary balloon dilatation, 3 cases of biliary tract strictures and leaks, 3 cases of simple biliary anastomosis site strictures and 7 out of the 8 cases of multiple biliary tract strictures were cured. In one of the multiple biliary tract stricture patients, a hepatic hematoma after biliary balloon dilatation was found and a second liver transplantation was done. In the 14 cases of multiple biliary tract strictures accompanied with biliary sludge, balloon dilatation technique was repeatedly performed. In 12 of the 14 cases, the strictures were improved remarkably and jaundice was subsided; In one of 14 cases, biliary tract stenting procedure was performed, but liver re-transplatation was carried out because of stent obstruction by much sludge. In the remaining 1 of the 14 cases, because there was no improvement of the strictures and relief of jaundice was revealed after the repeated procedures, liver re-transplantation was finally done In 2 cases of strictures at the opening segment of the T tube, the procedure of percutaneous transhepatic puncture for bile drainage was managed. After the procedure, the strictures were alleviated and the jaundice relieved. Conclusion The interventional managements through percutaneous transhepatic puncture techniques were effective, convenient and minimally invasive for treating biliary tract strictures after orthotopic liver transplantation.

Objective To explore the characteristics of diffusion weighted imaging (DWI) of lumbar sacral nerve roots (LSNR)in normal and degenerative lumbosacral vertebrae. Methods The research recruited 20 normal volunteers and 31 patients with spinal stenosis on conventional MRI and DWI scans in lumbosacral spine. We measured the areas from lumbar 3 to sacral 1 at the intervertebral spaces and reconstructed the 3D maximum intensity projection (MIP) and counted the apparent diffusion coefficient (ADC)of LSNR and ganglions. Results In the control group, 196 (98%) LSNR ran symmetrically and lateroinferiorly and 200 ganglions were well defined on MIP of DWI. In the patients group, 74 LSNR showed changes of compression on both T1WI and T2WI, in which DWI appeared thin and distorted in 59 (80%). The ADC value of LSNR were(1.70 ± 0.40)× 10-3 mm2/s and(1.98 ± 0.57) × 10-3 mm2/s separately in normal volunteers and patients (P=0.000), while the ADC values of ganglions were(1.42 ± 0.21)× 10-3 mm2/s and (1.54 ± 0.53)× 10-3 mm2/s respectively in normal volunteers and patients (P=0.000). Conclusion DWI can display the pattern and course of LSNR and ganglions, which indicate that ADC values of compressed LSNR and ganglions are higher than normal ones.