Objective To explore the effect of recombinant human endostatin combined with transcatheter arterial chemoembolization on vascular endothelial growth factor (VEGF), hypoxia inducible factor-1 alpha(HIF-1α), osteopontin (OPN) and connective tissue growth factor (CTGF) levels in serum of HCC patients.Methods 90 cases of primary liver cancer patients were randomly divided into control group and observation group, 45 cases in each group.The control group received the routine chemotherapy of hepatic artery embolization, and the observation group received recombinant human vascular endostatin combined with hepatic arterial chemoembolization.The serum levels of VEGF, HIF-1α, OPN, and CTGF were detected by enzyme-linked immunosorbent assay before treatment, 3 days and 5 days after operation, then the correlations were analyzed.Results The VEGF, HIF-1α, OPN, CTGF levels after 3 days and 5 days were higher than those before surgery in control group and observation group (P<0.05), the above indexes after 5 days were lower than those after 3 days in both groups (P<0.05), and VEGF, OPN and CTGF levels except for HIF-1αin observation group were significantly lower than those in control group after 5 days (P<0.05).There existed significant positive correlation between serum VEGF and HIF-1α, OPN, CTGF concentration levels(r=0.985, 0.995, 0.959,P<0.05) in 90 cases of liver cancer patients, highly positive correlation between HIF-1αand OPN, CTGF levels (r=0.842,0.874, P<0.05), and moderately positive correlation between OPN and CTGF concentrations (r=0.755,P<0.05).Conclusion The efficacy of recombinant human vascular endostatin combined with transcatheter arterial chemotherapy and embolization in the treatment of primary hepatocellular carcinoma is good.There exsits closely correlation of VEGF, HIF-1α, OPN and CTGF levels in serum, which could reflect clinical efficacy.

Objective To investigate the effect of an anti-HER-2 engineered antibody,chA21,on the expression of MMP-2 and TIMP-2 in human ovarian cancer SKOV3 cells that highly express HER-2.Methods After exposure to chA21 at concentrations of 6 mg/L and 12 mg/L for 36 hours,respectively,the expression of MMP-2 and TIMP-2 proteins was detected by immunocyctochemistry.SKOV3 cells were inoculated into nude mice to establish animal models.The mice were respectively administered with normal saline and chA21(30 mg/kg) via injection twice a week for 6 consecutive weeks,and then were killed after 44 days' administration of the drugs.Immnohistochemical staining of MMP-2 and TIMP-2 was observed on tissue microarray sections.Results After exposed to chA21,TIMP-2 protein was increased(P

Objective To compare the executive functions and releases function of hypothalamus-pituitary-adrenal (HPA) axis in patients with single and bipolar depression disorder. Methods 32 single-phase depression (the single group) and 31 bipolar depression patients (the bipolar group) were enrolled in this study. The trail making test A and B and Stroop test (Stroop-C and Stroop-CW) were tested at 0,4 week and 8 week later. In addition,levels of 24-h urine 17-OH cortisol,24-h urine free corticosterone and plasma cortisol were also detrmined. The related results were compared among the two groups and 28 healthycontrol group. Results The TMT-A,TMT-B,Stroop-C and Stroop-CW of the baseline and at 4 week were significantly longer in the depression group than those in the control group(P<0.01,respectively), and the plasma cortisol was also higher in the depression group than that in the control (P<0.01). On baseline, the single group showed significantly longer TMT-B and Stroop-C than those in the bipolar group (P < 0.01, respectively). At 0 week, lower plasma cortisol concentrations did not appear at 12.00 AM, and the midnight deep valley secretion disappeared. However, the midnight deep valley secretion recoveried at 4 week. Conclussion The differences on executive dysfunction and excessive release of HPA-axis function between the single and the bipolar depression should be followed with interest.

Objective To evaluate the additional efficiency of aldosterone blockers (AB) during angiotensin Ⅱ receptor blockers (ARB) treatment on hypertensive left ventricle hypertrophy in the elderly. Methods Forty-five cases of hypertensive left ventricular hypertrophy detected by Doppler ultrasonic cardiogram examination were enrolled,and were randomized to receive treatment with ARB plus AB (Group A) or ARB plus diuretics (Group B) for 48 weeks. The indicators of left ventricle hypertrophy were checked before and after the treatment. Results The both regimens could significantly decrease the blood pressure,and there was significant difference in the effects on lowering blood pressure between the regimens. Both regimens could alleviate left ventricle hypertrophy,but the regimen of ARB plus AB was superior to the regimen in Group B. Conclusion The addition of AB treatment during the ARB treatment was a good antihypertensive regimen for reducing left ventricle hypertrophy.

Objective To study the immunoreaction of the recombinant proteins encoded by the fragments of ORF2 ( second open reading frames) gene of hepatitis E virus ( HEV). Methods The aimed sequence from the full-length ORF2 in clone PEH2 , which was derived from a Chinese strain of HEV,was amplified and cloned it into vector pcDNAS. 1 which was then transfected to 293 cell. Results The ORF2 protein was present in the soluble fractions of the cell lysate. The expressed protein of HEV ORF2 in 293 cells by using a plasmid pcDNA3. 1-based system showed positive on immunoblots probed against antibodies raised in BALB/c mice. Conclusion The experimental results laid a foundation for developing diagnostic reagent to detect HEV by using the expressed products of ORF2 protein.

Adjuvants, Immunologic ; therapeutic use ; Adult ; Aged ; B-Lymphocytes ; immunology ; CD4-CD8 Ratio ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Killer Cells, Natural ; immunology ; Liver Neoplasms ; drug therapy ; immunology ; surgery ; Male ; Middle Aged ; Perioperative Care ; Phytotherapy ; T-Lymphocyte Subsets ; immunology

Objective To investigate the clinical features, diagnosis and treatment of malignant pancreatic endocrine tumor. Methods The clinical data of 38 patients with malignant pancreatic endocrine tumor who had been admitted to First Affiliated Hospital of Nanjing Medical University from January 1969 to December 2008 were analyzed retrospectively. Of all patients, 6 were with insulinoma, 23 with pancreatic polypeptide tumor, 4 with glucagonoma and 5 with pancreatic carcinoid. Results All patients except 1 with insulinoma were found with pancreatic lesion by imaging examination. The resection rate was 87% (33/38). Pathological examination found 7 patients with liver metastasis, 5 with lymph node metastasis, 1 with tumor thrombus in vessels and lymphatic vessels, and 28 with local invasion. Twenty-four patients were followed up, and neither recurrence nor metastasis was found except 1 patient with insulinoma who received reoperation for local recurrence and 1 patient with pancreatic carcinoid who received radiofrequency ablation for liver metastasis. Conclusions The diagnosis of pancreatic endocrine tumor mainly depends on imaging examination. The malignancy of pancreatic endocrine tumor is determined after the comprehensive analysis of preoperative imaging findings, intraoperative examination, post-operative pathological examination and the data obtained during follow-up. The malignant pancreatic endocrine tumor should be managed actively by resection because of its relatively low malignancy, high operative resectability and relatively good prognosis.

Objective To compare the safety and efficacy of carotid artery stenting (CAS) and carotid endarterectomy(CEA) for the treatment of carotid stenosis. Methods The electronic databases (PubMed, EMbase, Cochrane Central Register of Controlled Trials, CNKI, VIP and Wanfang) were searched in order to retrieve randomized controlled trials (RCTs) about comparing CAS and CEA for the treatment of carotid stenosis. Cochrane collaboration's RevMan 5.0.24 were used for analyzing data. Results Twelve RCTs totalling 6903 patients (3460 patients were randomized to CAS and 3443 randomized to CEA) with symptomatic or asymptomatic stenosis were included in the meta-analysis. There were significantly higher 30-day relative risks after CAS than after CEA for death or any stroke [RR=1.64, 95%CI (1.33-2.03), P＜0.00001] and for stroke [RR=1.70, 95%CI (1.34-2.14), P＜0.00001]. The relative risks of myocardial infarction [RR=0.62, 95%CI (0.39-0.97), P=0.04] and cranial neuropathy [RR=0.07, 95%CI (0.03-0.16), P＜0.00001] was significantly less after CAS than after CEA. The relative risks of death [RR=1.27, 95%CI (0.82-1.96), P=0.29] or disabling stroke within 30 days [RR=1.33, 95%CI (0.78-2.28), P=0.29] and any stroke or death at 1 year after the procedures [RR=0.96, 95%CI (0.63-1.46), P=0.84] did not differ significantly between CAS and CEA operation. Conclusions CEA remains the first choice for treatment of carotid stenosis for patients with low surgery risk. For patients with high surgery risk and unsuitable for surgery, CAS has more advantages. It is reasonable to view CAS and CEA as complementary rather than competing modes of therapy.

Objective To discuss how to reduce the incidence of postoperative infection and am-putation of patients after earthquake.Methods The wound infection and corresponding therapeutic outcome were analyzed in 592 patients in front line hospitals and station hospitals.Results The inci-dence of infection was 30. 7% in patients treated in front hospital within 8 hours post-trauma but 79. 9% after 8 hours post-trauma. There included 1 patient(0. 2%) with amputation due to clostridial myonecro-sis and 5(1. 2%)with amputation due to serious infection. Incidelice of postoperative wound infection was 7. 1% after selective operation for close injury. The incidence of infection in patients in station hospi-tals was 50. 8%, with no amputation, because they received debridement and antibiotics in site or front line hospitals. No postoperative infection was found in patients with close injury treated with selective op-eration in station hospitals. The major bacteria of wound infection in either front line hospitals or station hospitals were enterococcus faecalis and Eschrichia Coli. Incidence of combined infection was higher than that of single infection. And Gram-Negative bacillus infection exceeded Gram-Positive bacillus infection. The major wound infection obrained effective control through treatment with sensitive antibiotics.Con-clusions After earthqiale, the incidence of infection in patients with open injury is high, with high am-putation rate due to serious infection. Therefore, we propose performing as soon as possible debridement and external fixation with antibiotic treatment but reducing internal fixation. The postoperative infection late of patients with close injury in front line hospitals is much higher than that in station hospitals;their-fore, patients with stable vital signs should be transported to station hospitals as early as possible in order to reduce incidenee of infection.

Objective To analysis the clinical outcome at discharge and its risk factors of extremely preterm infants.Method To retrospectively analysis the clinical outcome at discharge and it's risk factors of extremely preterm infants (less than 28 weeks gestation) admitted from September 2008 to August 2014 in our Hospital.Result A total of 179 cases were enrolled.Survival rate was 59.2％ (106/179).Unfavorable outcome rate was 74.3％ (133/179),among them 73 cases died.The top five causes of death were severe bronchopulmonary dysplasia (BPD) (28 cases),Ⅲ ～ Ⅳ o intraventricular hemorrhage (IVH) (19 cases),sepsis (16 cases) and necrotizing enterocolitis (NEC) (6 cases).Among the 60 survivals with unfavorable outcomes,35 cases had either severe neurologic or ophthalmological sequela,and 25 cases had severe pulmonary sequela.Univariate analysis showed that,comparing with improved group,unfavorable outcome group had higher rates of not receiving prenatal steroids,placental abruption,male,small for gestation age,resuscitation with chest compression,admission age older than 72 hour,severe respiratory distress syndrome (RDS),without pulmonary surfactant (PS) usage,mechanical ventilation beyond 2 weeks and sepsis (P ＜ 0.05).Logistic regression analysis showed that those without prenatal steroids (OR =9.402,P =0.002),small for gestational age (OR =8.271,P =0.018),resuscitation with chest compression (OR =6.325,P =0.023),admission age older than 72 hour (OR =4.174,P =0.028) were independent risk factors for unfavorable outcome of extremely premature at discharge.Conclusion Extremely preterm infants have a higher rate of unfavorable outcome at discharge.Avoid small for gestational age,transfer properly and in time both in utero and after birth,and conduct prenatal steroids could improve their clinical outcome at discharge.