Objective To explore the effectiveness of minimally invasive targeted Argon-Helium cryoablation in the treatment of hepatic carcinoma. Methods Ultrasound-guided Argon-Helium targeted cryoablation using the Cryo-Hit system was performed percutaneously or through laparotomy in 27 cases of hepatic neoplasms, including 10 cases of primary hepatic carcinoma, 11 cases of recurrent hepatic carcinoma, and 6 cases of metastatic carcinoma. Results No surgical death was found. There were no complications such as hepatic rupture, hemorrhage, or bile leakage. In 12 cases that had an increased AFP levels before the treatment (36.5~1200 ?g/L), a decrease was observed (8.0~254 ?g/L) and a recovery below the normal levels was noted in 6 cases. In 3 cases that had an increased CEA levels before the treatment, the levels reduced after the treatment and went down to the normal ranges in 2 cases. A follow-up survey was carried out for 1~3 months. CT scannings or MRI examinations found a complete tumor necrosis in 59.2% (16/27) of cases and a reduction of tumor size with various degrees in 25.9% (7/27) of patients. Conclusions Ultrasound-guided targeted Argon-Helium cryoablation using the fine-probe Cryo-Hit system is a safe, effective, and simple procedure for the treatment of hepatic carcinoma, although its effectiveness still needs further verification.

OBJECTIVE: To evaluate the treatment outcome of patients with idiopathic sudden sensorineural hearing loss (ISSHL) with concomitant benign paroxysmal positional vertigo (BPPV). METHOD: Out of 252 ISSHL patients, 96 patients were diagnosed with complicating vertigo and examined using electronystagmography. All patients were divided into three groups, namely, ISSHL without vertigo group (n=156), ISSHL with non-BPPV vertigo group (n=70) and ISSHL with BPPV group (n=26). All patients received daily intravenous infusion of 200,000 U urokinase for 3 consecutive days and 100,000 U for 3 additional days. Concomitant medications included intravenous Ginkgo biloba leave compound and vitamin B6 and intramuscular vitamins B1 and B12 for 2 weeks. Twenty-six patients diagnosed with BPPV on electronystagmography positioning test also received canalith repositioning maneuver. RESULT: Vertigo-associated symptoms completely resolved after canalith repositioning maneuver in ISSHL patients with complicating BPPV. With respect to post-treatment hearing, ISSHL patients without vertigo exhibited a similar improvement as compared to those with BPPV, while those with non-BPPV vertigo had a significantly less improvement than those without vertigo and with BPPV. CONCLUSION ISSHL patients with complicating BPPV exhibit a relatively favorable outcome with respect to hearing and vertigo-associated symptoms after medical and repositioning treatment.
Adult ; Aged ; Aged, 80 and over ; Benign Paroxysmal Positional Vertigo ; complications ; therapy ; Female ; Hearing Loss, Sudden ; complications ; therapy ; Humans ; Male ; Middle Aged ; Prognosis

Objective To observe the value of contrast-enhanced ultrasound (CEUS) in the evaluation of efficacy of Argon-Helium cryoablation therapy for liver malignancies.Methods A total of 27 patients with 27 lesions of liver malignancies underwent ultrasound-guided Argon-Helium cryoablation therapy.CEUS was used to evaluate the local response and compared with contrast-enhanced CT (CECT).Results One month after Argon-Helium cryoablation therapy,21 lesions (77.78%) were diagnosed as complete ablation with CEUS and 22 (81.48%) with CECT.Contrast enhancement within lesions was demonstrated in 6 lesions (22.22%) with CEUS and 5 (18.52%) with CECT.As compared to CECT,the sensitivity,specificity,positive and negative predictive value,and accuracy of CEUS in diagnosing tumor residue 1 month after treatment was 80.00% (4/5),90.91% (20/22),66.67% (4/6),95.24% (20/21),and 88.89% (24/27) .respectively.Conclusion CEUS is an effective alternative for the evaluation of efficacy of Argon-Helium cryoablation in the treatment of liver malignancies.

OBJECTIVE: To explore the curative effect of endoscopic myringoplasty with modified sandwich technique. METHOD: Endoscopic myringoplasty was performed with modified sandwich technique for traumatic perforation of tympanic membrane and chronic suppurative otitis media (simple type) of 43 patients. RESULT: All the perforating tympanic membranes were repaired successfully in one time. Six months after the operation, 1 case was out of follow-up and 2 cases were failed: one got a small perforation when the transplantation shifted and the transplantation of the other one was lost because of infection. The closure rate of tympanic membrane perforations was 95.2%. The air-bone gap of speech frequency of 28 ears increased by > 15-20 dB, 8 ears were enhanced by 10-15 dB, while 6 ears (including 2 failed cases) without improvement. The acoustic immittance test showed that "Type A", "Type As", "Type Ad", "Type B" and "Type C" tympanogram were in 30 ears,12, 4, 6 and 4, respectively. CONCLUSION The endoscopic myringoplasty with modified sandwich technique has the advantages of simple operation, better security, less trauma and better efficacy, and it is worth popularizing.
Adolescent ; Adult ; Aged ; Ear ; surgery ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Myringoplasty ; methods ; Tympanic Membrane Perforation ; surgery ; Young Adult

Objective To observe the influence of Hemin on both the expression of neuroglobin (Ngb) and Tau protein phosphorylation in rats with vascular dementia (VD),and explore the effect and mechanism of Ngb in VD. Methods VD model was established in rats with a permanent bilateral common carotid arteries occlusion(2-VO). Fifty four healthy male SD rats were randomly divided into 3 groups:sham operation group,VD group and Hemin group. According to ischemic time,the animals in each group were randomly allocated into 1 week subgroup,4 weeks subgroup and 8 weeks subgroup(n=6 in each subgroup). The learning and memory ability of rats were evaluated by Morris water maze test. The brain histopathological changes were observed by HE staining and the expression of Ngb and phosphorylated Tau ( p-Tau) was de-termined by Western blot. Results Compared with the sham operation group,after 2-VO the escape latency extended (all P<0. 05) and cross-platform performance reduced in rats in both VD group and Hemin group (all P<0. 05). The learning and memory ability of rats in Hemin group was better than that in VD group at the corresponding time point:the increase in the number of crossing platforms(1 week:Hemin group (7. 00± 0. 89) times vs VD group (5. 50±1. 22) times,t=2. 42,P<0. 05;4 weeks:Hemin group (5. 33±0. 52) times vs VD group (3. 50±1. 04) times,t=3. 84,P<0. 01;8 weeks:Hemin group (6. 50±0. 55) times vs VD group (4. 50±1. 05) times,t=4. 14,P<0. 01). The expression of Ngb and phosphorylated Tau (p-Tau) increased in VD group and Hemin group (P<0. 01). Compared with VD group,the expression of Ngb in Hemin group was increased(1 week:Hemin group (3. 45±0. 23) vs VD group (2. 56±0. 08),t=5. 67,P<0. 01;4 weeks:Hemin group (3. 08±0. 13) vs VD group (2. 28±0. 08),t=7. 96,P<0. 01;8 weeks:Hemin group (2. 82± 0. 12) vs VD group (2. 05±0. 10),t=7. 28,P<0. 01),while p-Tau was decreased (1 week:Hemin group (1. 57±0. 12) vs VD group (2. 40±0. 15),t=7. 62,P<0. 01;4 weeks:Hemin group ( 2. 14±0. 21) vs VD group (3. 18±0. 14),t=8. 23,P<0. 01;8 weeks:Hemin group (1. 83±0. 13) vs VD group (2. 79±0. 19), t=4. 91,P<0. 01). In VD group and Hemin group,the learning and memory ability exhibited a negative cor-relation with Ngb (r=-0. 892,P<0. 01),whereas a positive correlation with p-Tau (r=0. 932,P<0. 01). Conclusion Hemin induces high expression of Ngb and inhibits Tau phosphorylation in VD rats. Ngb may play a neuroprotective role in the development of VD by regulating Tau phosphorylation.

Objective:To explore the action mechanism of suppressing expression of mitogen- activated protein kinase 14（MAPK14）to alleviate glutamate excitatory toxicity and its neuronal protection effect.Methods:Lentivirus-mediated MAPK14 interference vector was synthetized by Shanghai Jikai Gene Chemical Technology Co.，Ltd. Astrocytes were obtained from SD rats 48 hours after birth，which were cultured in vitro and transfected by lentivirus-mediated transfection. According to the random number table，the cells were divided into three groups：（1）un-transfected group（normal group）with normal astrocytes and the cells were cultured in regular medium composed of Dulbecco's?modified Eagle's?medium（DMEM）；（2）negative control group with astrocytes transfected by MAPK14 no-loaded interference vector；（3）lentivirus transfected group with astrocytes transfected by MAPK14 interference vector. Seventy-two hours after transfection，astrocytes were co-cultured with neurons for 48 hours，and then they were cultured in a medium containing glutamate for 2 hours. The detection indexes included the optimal multiplicity of infection（MOI）value for astrocytes transfected by lentivirus vector，mRNA levels of MAPK14 and glial glutamate transporter 1（GLT-1）detected by rPCR 72 hours after transfection，protein levels of MAPK14 and GLT-1 detected by Western blot 72 hours after transfection，level of lactate dehydrogenase（LDH）and mortality of neurons measured by spectrophotometry and flow cytometry 2 hours after culturing in the medium with glutamate. Results:（1）The optimal MOI value for lentivirus transfecting astrocytes was 30，and astrocytes grew well after transfection.（2）Seventy-two after transfection，the mRNA level of MAPK14 in lentivirus transfected group（0.005 7±0.000 6）was significantly decreased as compared with un-transfected group（0.013 1±0.001 1）and negative control group（0.013 9±0.001 0）（ P<0.01），the mRNA level of GLT-1 in lentivirus transfected group（0.009 1±0.001 2）was not significantly changed as compared with un-transfected group（0.008 7±0.000 3）and negative control group（0.008 9±0.001 1）（ P>0.05）.（3）Seventy-two hours after transfection，the protein level of MAPK14 in lentivirus transfected group（0.29±0.04）was significantly decreased as compared with non-transfected group（0.61±0.05）and negative control group（0.63±0.01）（ P<0.01），the protein level of GLT-1 in lentivirus transfected group（0.73±0.06）was significantly increased as compared with un-transfected group（0.20±0.03）and negative control group（0.23±0.09）（ P<0.01）.（4）After astrocytes were co-cultured with neurons and subsequently cultured in the medium containing glutamate for 2 hours，the level of LDH in lentivirus transfected group［（109.67±2.40）U/L］was significantly lower than that in un-transfected group［（141.52±3.88）U/L］and negative control group［（141.29±3.61）U/L］（ P<0.01）. The mortality of neurons in lentivirus transfected group［（38.72±0.26）%］was significantly lower than that in un-transfected group［（52.94±1.36）%］and negative control group［（54.30±1.23）%］（ P<0.01）. Conclusions:The transfection with lentivirus-mediated MAPK14 interference vector can increase expression of GLT-1 in astrocytes to increase glutamate re-uptake and relieve the glutamate excitatory toxicity in neurons，which may provide a new experimental basis for future use of astrocyte gene regulation to alleviate neuronal injury caused by glutamate excitatory toxicity after traumatic brain injury.

OBJECTIVES: Heparin is mainly used as an anticoagulant in clinic, and it also has a certain anti-inflammatory effect. At present, after portal vein islet transplantation in diabetic patients, heparin is mainly infused through the peripheral veins of the limbs to achieve the purpose of anticoagulation and protection of the graft, rather than through the portal vein. In this study, animal experiments were conducted to investigate the effect of heparin infusion via the portal vein and marginal ear vein on the instant blood-mediated inflammatory reaction (IBMIR) after portal vein islet transplantation, which is the choice of anticoagulation methods for clinical islet transplantation to provide a basis for decision-making. METHODS: A total of 50 neonatal pigs (Xeno-1 type, 3-5 days) were selected. Islets were isolated and purified from the pancreas of neonatal pigs. Ten non-diabetic Landrace pigs (1.5-2.0 months) served as recipients, and 12 000 IEQ/kg neonatal porcine islets were transplanted into the liver through the portal vein. All recipients received bolus injection of 50 U/kg of heparin 10 minutes before transplantation. After the bolus injection of heparin, the experimental group received heparin via the portal vein [10 U/(kg·h), 5 recipients], and the control group received heparin via the marginal ear vein [10 U/(kg·h), 5 recipients]. The superior vena cava blood was collected from the 2 groups pre-operation at 1, 3, 24 h post-operation of the transplantation. The portal vein blood was collected from the experimental group at 1 and 3 h after the transplantation as well. The levels of complement C3a, C5a, thrombin-antithrombin complex (TAT), β-thromboglobulin (β-TG), and D-dimer as well as activated partial thromboplastin time (APTT) in superior vena cava blood from 1 and 3 h post-transplantation were detected in the 2 groups, and the levels of anti-Xa and anti-IIa in the portal vein and superior vena cava blood from 1 and 3 h post-transplantation in the experimental group were detected. Twenty four hours after the transplantation, the liver tissues in the 2 groups were collected for pathological examination to observe the inflammatory cell infiltration and peripheral thrombosis around the islets graft in liver. RESULTS: Before transplantation, there was no statistically significant difference in C3a, C5a, TAT, β-TG, D-dimer levels and APTT between the 2 groups (all P>0.05). At 1 and 3 h after transplantation, the C3a, TAT, and D-dimer levels in the experimental group were significant decreased than those in the control groups (all P<0.05), and at 3 h after transplantation the C5a was significant decreased than that in the control group (P<0.05). At 1 and 3 h after transplantation, the anti-Xa and anti-IIa levels in the portal vein blood were significantly increased than those in the superior vena cava blood in the experimental group (all P<0.05). Pathological results showed the presence of islet cell clusters in the liver blood vessels. The thrombus formation and neutrophil infiltration around islet graft was not obvious in the experimental group, while massive thrombus formation and neutrophil infiltration in the control group. CONCLUSIONS Compared with marginal ear vein infusion of heparin, the direct infusion of heparin in the portal vein has a certain inhibitory effect on complement system, coagulation system activation and inflammatory cell infiltration in portal vein islet transplantation, which may attenuate the occurrence of IBMIR.
Animals ; Anticoagulants/therapeutic use* ; Heparin/therapeutic use* ; Humans ; Islets of Langerhans/pathology* ; Islets of Langerhans Transplantation/physiology* ; Portal Vein ; Swine ; Vena Cava, Superior