Objective: To validate the clinical value of CT-guided curve-needle percutaneous ethanol injection (CNPEI) for celiac plexus block analgesia. Methods: Thirty-two patients with end-stage cancer, including 13 complicated with extensive retroperitoneal lymph node enlargement and fusion, were enrolled in this study. All patients complained of refractory upper abdominal pain and had received narcotic analgesics and radiotherapy, but the analgesic effect was not good. CT-guided CNPEI was therefore prescribed. Results: The effective rates of CT-guided CNPEI were 100%, 100%, 96.9%, 90.6%, 87.5%, and 84.4% immediately, and at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after treatment, respectively. All enlarged lymph nodes had obvious necrosis and became shrunk. Conclusion: Combined application of bilateral anterior and posterior diaphragmatic crura block and trans-lymph node block can produce good analgesic effects, and curve-needle puncture make the above technique simpler.

Objective To determine the expression of Notch pathway receptors (Notch1 and Notch4) and ligands (Jagged1 and Dll4) in cutaneous malignant melanoma (CMM) tissues,and to preliminarily explore the role of the Notch signaling pathway in the pathogenesis of CMM.Methods Immunohistochemical study was performed to determine the expression pattern and intensity of Notch1,Notch4,Jagged1 and Dll4 in 40 paraffin-embedded CMM specimens and 15 paraffin-embedded pigmented nevus specimens.Statistical analysis was carried out by chi-square test and Spearman rank correlation analysis with the SPSS 21.0 software.Results Notchl was detected in 31 (77.5％) of 40 CMM specimens,as well as in 3 of 15 pigmented nevus specimens,and the positive rates significantly differed between the two groups (x2 =15.281,P ＜ 0.001).However,no significant difference in the expression intensity of Notch1 was observed between 18 in situ melanoma tissues and 22 invasive melanoma tissues (x2 =0.631,P =0.427).In addition,the positive rates of Notch4,Jagged1 and Dll4 were also significantly higher in the CMM group than those in the pigmented nevus group (all P ＜ 0.05),and the expression intensity of Notch4,Jagged1 and Dll4 significantly differed between in situ and invasive melanoma tissues (all P ＜ 0.05).In CMM tissues,the expression of Notch1 was positively correlated with that of Jagged1 (rs =0.350,P =0.027) and Dll4 (rs =0.562,P ＜ 0.001),while the expression of Jaggedl was negatively correlated with that of Dl14 (rs =-0.734,P ＜ 0.001).Conclusion Abnormality of the Notch signaling pathway may be involved in the pathogenesis of melanoma,but further researches are still needed to elucidate the detailed mechanism.

Objective:To study the influence of thrombus aspiration combined tirofiban on patients with acute ST seg-ment elevation myocardial infarction (STEMI)after primary percutaneous coronary intervention (PCI).Methods:A total of 98 patients,who received primary PCI because of STEMI in our hospital from Jan 2012 to Mar 2013,were selected.They were divided into thrombus aspiration group (n=48,received pure thrombus aspiration)and com-bined treatment group (n = 50,received thrombus aspiration combined intracoronary tirofiban injection during PCI).Coronary angiography (CAG)instantly after PCI and follow-up condition during hospitalization and six months after discharge were compared between two groups.Results:(1)Compared with thrombus aspiration group after PCI,there were significant rise in TIMI blood flow grade [(2.3±0.6)grades vs.(2.7±0.3)grades],per-centage of TIMI flow grade 3 (72.9% vs.90.0%)and ST segment regression >50% rate within 90min after PCI (52.1% vs.74.0%),P < 0.05 or < 0.01,and significant reduction in percentage of postoperative no-reflow (18.8% vs.4.0%,P =0.038)in combined treatment group in hospital;(2)After six-month follow-up,left ven-tricular ejection fraction (LVEF)of combined treatment group was significantly higher than that of thrombus aspi-ration group [(58±6.3)% vs.(51±5.6)%,P <0.05].Conclusion:Thrombus aspiration combined tirofiban can effectively reduce coronary thrombus burden and improve cardiac function in STEMI patients during primary PCI.

Human papilloma virus (HPV) infection is closely correlated with the occurrence of cervical cancer and precancerous lesion, high risk HPV can induce cervical cancer by the corresponding protein of E6 and E7 gene expression. Earlier diagnosis and earlier prevention of HPV infection are the key points in blocking cervical cancer, and combined use of Chinese herbal preparations with Western medicine is the important way for preventing HPV infection and prohibiting cervical canceration. So, to develop anti-viral chemical compound from natural drugs has become the hotspot of research today.
Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interferons ; therapeutic use ; Oncogene Proteins, Viral ; analysis ; Papillomavirus E7 Proteins ; analysis ; Papillomavirus Infections ; drug therapy ; Phytotherapy ; Repressor Proteins ; analysis ; Uterine Cervical Neoplasms ; drug therapy ; virology

Objective To study the optimal enhancement phase and exact triggering scan time on spiral CT angiography of vertebral and carotid artery,and to improve the rate of 3D-CT display in vertebral and carotid artery.Methods One hundred and thirty-three cases of CT angiography of vertebral and carotid artery(87 vertebral and 46 carotid artery)were examined with SmartPrep software,which controled the scan at real time after 100 ml contrast medium(350 mg I/ml Omnipaque)were quickly injected through foot back vein.One hundred and thirteen cases of control group were examined by triggeing off the scanning with a delay time of 18—22 s after blous injection through foot back vein.The vertebral and carotid arteries were demonstrated with 3 dimensional reconstruction.Results The successful rate in SmartPrep group was 100% with the enhancement situated in best(n=130)or good(n=3)scanning phase.The threshold concentration values of target vessel were kept on 100 HU in the whole scan period[(18?4)s].However, the triggering time of enhancement scanning was not equal(15—43s)and the deviation was up to 28 s.The average concentration of target vessel was obviously higher in SmartPrep group[(161.4?2.0)HU]than in the control group[(133.3?2.2)HU](t=-9.456,P

Animals ; Epithelial-Mesenchymal Transition ; Fibrosis ; Kidney ; pathology ; Kidney Tubules ; cytology ; Male ; Rats ; Rats, Sprague-Dawley ; Ureteral Obstruction ; pathology

Objective To investigate the therapeutic effect of single stage cavernostomy and myoplasty on the aspergillus thoracic empyema. Method Four patients suffering from aspergillus thoracic empyema were treated with single stage cavernostomy and myoplasty. They got the inflammation of aspergillus after the operation for tuberculosis in 2, bronchiectasis in 1 and lung cyst in 1. They were performed rib resection, cavernostomy, closure of the bronchial openings and total/partial obliteration of the cavity with a muscle flap as a single stage technique. Pectoralis major muscle was used for the myoplasty in 1, latissimus dorsi in 1 and intercostal muscle in 2. All patients were given the therapy of nutritional support, local pressure dressing and oral anti-fungus drugs. Result Two patients got the primary healing, the chest tube were pulled out 2 days later and they were discharged 12 days after the operation. One patient′s cavity became little and there was pus drained from the chest tube, he cured after prolonged draining and washed with the anti-fungus drugs. One patient dead for pneumonia 67 days after the operation. Conclusion Cavernostomy and myoplasty as a single stage technique is safe and reliable in the management of patients with aspergillus thoracic empyema.

Objective To investigate the diagnosis and therapy of the sclerosing hemangioma of the lung.Mothods The case history of 15 patients were analyzed retrospectively and summarized the diagnosis and therapy of the Sclerosing hemangioma of the lung.Results There were 2 males and 13 females(1:6.5).No patients were diagnosed this disease before operation for there were no specific imageology features.The tumor cell indicated pantomorphia and there were 3 cases were misdiagnosed during the operation frozen section pathology.The optimization therapy methods was to resect the tumor with the VATS.The prognosis of this disease was well and there were no cases recurrence in these 15 patients.Conclusion The sclerosing hemangioma of the lung was the benign tumor and there were no specific imageology features.The misdiagnosis was frequently before operation.To resect the tumor with the VATS was the optimal therapy method.

To investigate the metabolic rate and metabolites of 9-dehydro-17-dehydro-andrographolide, which is the main active ingredient in Xiyanping injection, by using the in vitro rat liver microsome incubation system. 9-dehydro-17-dehydro-andrographolide was incubated together with liver microsome mixed with NADPH. Its metabolic rate was studied by determining its residual concentrations with the UHPLC-MS/MS method; Its metabolites were identified by the UPLC-TOF-MS(E) method. The results showed that 9-dehydro-17-dehydro-andrographolide was metabolized faster than rat liver microsomes mixed with coenzymes, with t½ and CL of (19.7 ± 0.5) min and (35.1 ± 0.8) mL x min(-1) x g(-1) (protein), respectively. Based on the high resolution mass spectrum data and information from literatures, altogether nine metabolites of 9-dehydro-17-dehydro-andrographolide were identified in the incubation system, particularly hydroxylated and dehydrogenized products. The results of identification would provide a basis for screening out more active andrographolide derivatives.
Animals ; Chromatography, High Pressure Liquid ; Diterpenes ; chemistry ; metabolism ; Drugs, Chinese Herbal ; chemistry ; metabolism ; Microsomes, Liver ; chemistry ; metabolism ; Molecular Structure ; Rats ; Tandem Mass Spectrometry