Objective To investigate the blood-saving effect of controlled low central venous pressure (CLCVP) in different types of hepatectomy.Methods Ninety ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 37-76 yr,weighing 40-75 kg,undergoing elective hepatectomy,were divided into 6 groups according to the surgical approach and whether CLCVP was used during surgery (n =15 each):CLCVP1-3 groups and nonCLCVP1-3 groups (NCLCVP1-3 groups).The standard hepatectomy,half liver resection and irregular hepatectomy were performed in CLCVP1-3 groups,respectively,with CLCVP.The standard hepatectomy,half liver resection and irregular hepatectomy were performed in NCLCVP1-3 groups,respectively,without CLCVP.In CLCVP1-3 groups,from skin incision to the end of liver resection,CVP was maintained ≤ 5 cm H2 O through adjustment of the position,fluid restriction and iv infusion of nitroglycerin,and norepinephrine was infused simultaneously to maintain mean arterial pressure ≥ 60 mm Hg.In NCLCVP1-3 groups CVP was maintained at 6-12 cm H2O.Intraoperative blood loss and blood transfusion were recorded.Results Compared with NCLCVP1-3 groups,intraoperative blood loss was significantly decreased in CLCVP1-3 groups (P ＜ 0.05).Compared with NCLCVP3 group,the amount of blood transfusion was significantly decreased,the constituent ratio of intraoperative blood loss ＜ 200 ml was increased,and the constituent ratio of intraoperative blood loss ＞ 1000 ml was decreased in group CLCVP3 (P ＜ 0.05).Conclusion CLCVP can decrease the intraoperative blood loss and blood transfusion in patients undergoing irregular hepatectomy.

Objective To analyze the relationship between different rectal volume,bladder volume and dose of organs at risk (OARs) in intracavitary brachytherapy for cervical cancer.Methods A total of 47 patients with cervical cancer were selected.All of them were treated with high dose rate (HDR) intracavitary brachytherapy with a 600 cGy dose for the dosage point.The effects of different volume of rectum bladder and small intestine for corresponding exposure dose under the standard planning were evaluated using a dose-volume histogram (DVH).According to bladder volume,patients were divided into three groups,＜ 80 cm3 group,80-120 cm3 group and ＞ 120 cm3 group.And according to rectum volume,patients were divided into ＞ 60 cm3 group and ≤ 60 cm3 group.The relationship between the volume and dosage were analyzed.The ANOVA test and t test were used for analyzing D1 cm3,D2 cm3,D30％ and D50％.Results Compared with the group with ＜ 80 cm3 bladder volume,D30％,D50％ value of bladder in groups with 80-120 cm3 and ＞ 120 cm3 of bladder volume increased (F =5.074,5.088,P ＜ 0.05).The difference of D1 cm3 and D2 cm3 value of the small intestine between 80-120 cm3 and ＞ 120 cm3 bladder volume groups were not statistically significant (P ＞ 0.05).D1 cm3 of rectum in groups with ≤ 60 cm3 rectum volume was decreased than that of ＞ 60 cm3 group (t =-2.045,P ＜ 0.05).Conclusions Keeping an appropriatly full bladder and reducing rectal volume in cervical cancers treated with intracavitary brachytherapy can make the exposure dose of bladder,rectum and small intestine relatively small,and reduce the adverse reactions of radiotherapy.

Objective To investigate the effect of controlled low central venous pressure(CLCVP) on blood loss and prognosis in different types of hepatectomy .Methods Two hundred and fifty seven patients underwent standard hepatectomy ,half liver resec‐tion or irregular partial hepatectomy from January 2011 to December 2012 in the First Affiliated Hospital of Chongqing Medical U‐niversity were retrospectively studied .Patients treated with CLCVP during hepatectomy were attributed to the CLCVP group .CVP of these patients were lowed to below 5 cm H2 O by minimizing fluid infusion and one or both of the following maneuvers :posture adjustment ,nitroglycerin administration .Alpha agonists were used when necessary to maintain the mean arterial pressure MAP at ≥60 mm Hg .Other patients been maintained with normal level of CVP by adjusting fluid administration were included in normal CVP group (NCVP) .Blood loss and transfusion volume ,length of hospital stay of the two groups were compared ,and the effects of different surgery type on CLCVP blood protection were evaluated .Results In the patients underwent standard hepatectomy or half liver resection ,intraoperative blood loss and transfusion were not statistically different between the two groups .While in the pa‐tients underwent irregular partial hepatectomy ,the CLCVP group suffered less blood loss and transfusion(P<0 .05) .Percentage of the patients with less than 200 mL blood loss and no transfusion of concentrated red cell in CLCVP group was higher than that of in NCVP group(P<0 .05) .Differences between the two groups in postoperative hospital stay were with no significance in all the operation types(P>0 .05) .Conclusion The efficiency of CLCVP on blood protection during hepatectomy is influenced by the sur‐gery type ,the blood protection is found to be significant only in irregular partial hepatectomy .No relationship was found between CLCVP and postoperative hospital stay in all types of hepatectomy .

Objective To explore the more effective measures for the prevention of deep vein thrombosis (DVT ) by comparing the different efficacy between the multimodal strategy and liberal measures .Methods From July 2011 to June 2013 ,medical records of 289 patients who had accepted total knee replacement (TKR) were collected .Patients were divided into two groups according to whether exploring to the multimodal strategy or liberal measures after TKR .The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,intermittent pneumatic compression ,and postoperative continues femoral nerve block analgesia .Patients in group A were treated during July 2011 to June 2012 ,and accepted liberal measures for the prevention of DVT .Patients in group B were treated after June 2012 ,and accepted multimodal strategy .The data of each group were collected for statistical analysis on the following aspects :DVT occurrence rate ,DVT distribution ,age ,gender ,body mass index ,disease ,operation duration ,volume of blood loss and transfusion during operation phase ,drainage volume after TKR .Results The DVT occurrence rate of patients in group B were significantly lower than that of patients in group A (P<0 .05) .No significant difference were foun-ded in the DVT distribution between the two groups(P>0 .05) .Conclusion The multimodal strategy consisted of sequentially used perioperative intermittent pneumatic compression ,postoperative low molecular weight heparin ,and postoperative continues femoral nerve block analgesia is more effective than liberal measures for the prevention of DVT .

Objective To retrospectivel y analyze the abdominal CT findings and pathological results of the chronic schist osomiasis so as to improve the diagnostic accuracy of the disease. M ethods The plain abdominal CT scanning was performed in 103 cases an d enhanced CT scanning in 81 cases. The pathological specimen which was consist ent with the section of CT scan was obtained in each cases. Results On CT scanning, liver cirrhosis was seen in 84 cases, various calci fication in liver in 71 cases, liver cancer in 12 cases, enlargement of sple en in 78 cases, calcification in spleen in 13 cases, wall-thickening in colon i n 27 cases, calcification in colon in 31 cases, and colon cancer in 9 cases. Pa thological examination revealed various fibrosis and formation of pseudolobule. The eggs and calcification could be seen in pseudolobule and septa, colonic sub mucosa, and regional lymph nodes. Fibrous hyperplasia in colonic wall and hyper plasia in mucous membrane were obvious. Fibrous hyperplasia and calcification w ere seen in spleen, but the eggs were not found. Conclusion The liver and colon are the major organs affected by chronic schistosomias is in abdomen, and the CT findings are obvious too. The pathological features o f spleen are accompanied with liver cirrhosis. CT is the important imaging meth od in diagnosing chronic schistosomiasis and pathological changes.

Objective To study the technique and clinical significance of percutaneous biopsy of transplanted liver guided by CT.Methods 19 transplanted liver were undergone 25 times of percutaneous biopsy and the pathomorphologic changes were demonstrated by HE staining.Results The successful rate of the percutaneous biopsy was 100% for all the 25 times of this procedure,including acute rejection on 9 episodes,preservation perfusion retrauma in 6,bile duct strictures in 4,drug-induced injury in 4,chronic rejection in 1 and acute hepatic necrosis in 1.Conclusions CT-guided percutaneous biopsy is an important method for diagnosing transplanted liver injury and providing great value for distinguishment of the causes for transplanted liver injury.(J Intervent Radiol,2007,16:855-857)

Objective To investigate whether the percutaneous ethanol injection (PEI)under sedation and analgesia can in-crease the energy deposition and curative efficiency of the high intensity focused ultrsound(HIFU)in treating unresectable middle and advanced stages of primary liver cancer.Methods Thirty-six cases of clinically diagnosed unresectable middle and advanced sta-ges of primary liver cancer were randomly divided into the PEI+ HIFU group(combination group,n = 23)and the simple HIFU group (HIFU group,n=13);10mL of the mixture of 99.7% ethanol and iodized oil (9:1)was given by intratumoral injection at 30 min before ablation in the PEI+HIFU group,while 0.9% physiological saline 10mL was replaced in the simple HIFU group.The ablation energy efficiency factor(EEF)and irradiation time were compared between the two groups.Results The ablation EEF in the PEI+HIFU group and the simple HIFU group were (13.82+4.26)J/mm3 and (25.63+6.31)J/mm3 respectively,the PEI+HIFU group was significantly lower than the simple HIFU group (P <0.05);the irradiation time were (1 468.28+253.21)s and (2 352.56+463.34)s respectively;which in the PEI+ HIFU group was significantly shortened (P <0.05).Conclusion PEI can enhance the HIFU ablation energy deposition and improve the efficiency of HIFU for treating unresectable primary liver cancer.

Objective To understand the enterovirus infection in family close contacts of patients with hand,foot and mouth disease (HFMD) and the contamination of environment.Methods Forty-one HFMD cases confirmed by laboratory from web-based surveillance system during July to August 2010 in Guangdong Province were selected.All members of the cases′ family were investigated by collecting their information on demography,habit of domestic hygiene and hygiene status in household.The stool samples of all members and the smear samples from the surface of family belongings from 16 families were collected and the enterovirus was detected by real time quantitative polymerase chain reaction.The data were analyzed by chi square teat and t test.ResultsForty-one HFMD cases′ families and 135 close contacts were included in this survey.The infection rate of the enterovirus was 39.2％ (53/135) in all close contacts.Of all the investigated families,the infectionrate was 58.5％ (24/41) in family with one or more close contacts and 9.8％ (4/41) in family with all close contacts.The differences of infection rates of enterovirus among the members of parents (32.5％,25/77),grandparents/aunts/ uncles (43.3％,13/30) and cousins (53.6％,15/28) didn′t show statistical significance (χ2 =4.07,P=0.131).The infection rate of enterovirus in close contacts from family with more than 5 members was higher than that from family with 4 or less members (OR=1.4,95％CI 1.1-1.9).Among 135 close contacts,27.4％ (37/135) were infected with the same types of entervirus as that of HFMD case in the family and 11.9％ (16/135) were infected with the different virus types.In 33 family belongings samples from 16 families,the positive rate of enterovirus detection was 6.1％ (2/33).Between 17 families with enterovirus testing negative and 23 families with enterovirus testing positive in close contacts,there were no statistical differences of the family hygiene status,hand-washing of babysitter,disinfection of tableware and drinking,sharing towels,airing bedding articles and toy cleaning (P＞0.05).ConclusionsThe infection rate of enterovirus in close contacts of HFMD cases is high and the enterovirus contamination exists in case family environment.Management of close contacts of HFMD cases and disinfection of the family environment are important in HFMD controls.

With the development of therapeutic monoclonal antibodies, the therapeutic antibodies have increasingly dominated the global pharmacy market in recent years, which are concentrated on the treatment of carcinoma, transplant rejection, auto-immune diseases etc. Meanwhile, the therapeutic antibodies could be categorized on the humanized proportion into several different types, such as murine-derived antibody, chimeric antibody, humanized antibody and human antibody. Herein, we focused both on antibody research hot spots and humanized anti-tumor antibody drugs. Moreover, in accordance with the classical examples of humanized anti-tumor antibody drugs approved by relevant authorities worldwide, we explained the research status and situation from both the humanized technologies and production of humanized antibodies. Additionally, it seemingly rational and reasonable to demonstrate the trend of further humanized anti-tumor antibody drugs in the prospect of the present situation either domestic or overseas.
Animals ; Antibodies, Monoclonal, Humanized ; immunology ; therapeutic use ; Antineoplastic Agents ; immunology ; therapeutic use ; Humans ; Neoplasms ; therapy

Objective To establish rabbit model of remnant carcinoma after RFA therapy, and to observe pathomorphological changes of remnant carcinoma in different time. Methods Forty-eight New Zealand white rabbits underwent ultrasound-guided percutaneous inoculation with VX2 carcinoma, then RFA therapy was performed to made models of remnant carcinoma. These models were averagely divided into 6 groups randomly (each n=8). Rabbits in each group was killed and pathologically observed before RFA and 1 d, 3 d, 1 week, 2 and 3 weeks after operation, respectively. Results The expression of MVD,VEGF and PCNA in remnant VX2 carcinomas tissues decreased significantly, but increased 2-3 weeks after RFA. The remnant VX2 carcinomas tissues were in inhibitory state 2 weeks after RFA. Conclusion The growth of remnant carcinoma could be inhibited in short term after RFA. Further therapy is necessary.