Plasma quinolone concentrations are not routinely measured in clinical practice.However,in order to optimize quinolone treatment,monitoring of plasma concentrations could sometimes be useful particularly in critically ill patients.In this study,anti-sparfloxacin antibody was obtained by immunizing rabbits with sparfloxacin conjugated with bovine serum albumin using isobutyl chloroformate method.After the assay procedure was optimized,the standard curve of sparfloxacin was established.The practical measuring range of the competitive ELISA extended from 5 ng/mL to 2 μtg/mL.The recovery rates and coefficients of variation for rat plasma,urine and tissues were 87.7-106.2％ and 4.8-15.3％,respectively.To demonstrate the potential of the ELISA,a preliminary pharmacokinetics and tissue distribution study of sparfloxacin in rats and quantitative analysis of sparfloxacin in several pharmaceuticals were performed and compared with high-performance liquid chromatography (HPLC).The experimental data indicated that the proposed method would be a valuable tool in therapeutic drug monitoring (TDM) for sparfloxacin.

Objective To discuss the safety and efficacy of using ExoSealTM vascular closure device to obtain rapid hemostasis of puncture site in interventional procedure via retrograde femoral artery access.Methods The clinical data of 124 patients,who were admitted to authors' hospital during the period from March 2016 to April 2016 to receive interventional procedure via retrograde femoral artery access,were retrospectively analyzed.During the performance of intervention,ExoSealTM vascular closure device (ExoSealTM group,n=52) or manual compression (MC group,n=72) was employed to make femoral artery puncture point hemostasis.The time spent for hemostasis,the manual compression time,the limb immobilization time,the amount of blood loss during compression process,and the procedure-related complications were recorded and the results were compared between the two groups.Results Technical success rate in ExoSealTM group was 98.1％(51/52).In ExoSealTM group and MC group,the time spent for hemostasis was (0.28±0.08) min and (5.83±1.46) min respectively,the manual compression time was (2.65 ±0.57) min and (7.70± 1.88) min respectively,the limb immobilization time was (2.72±0.43) h and (6.15±0.69) h respectively;all the differences between the two groups were statistically significant (P＜0.01).In ExoSealTM group subcutaneous hemotoma occurred in one patient,while in MC group subcutaneous hemotoma occurred in 3 patients and pseudoaneurysm in one patient;the complication rates were 1.92％ (1/52) and 5.56％ (4/72) respectively,but the difference was not statistically significant (P＞0.05).In MC group the amount of blood loss during compression process was (1.11±0.86) ml,which was remarkably less than (7.83±2.08) ml in ExoSealTM group,the difference between the two groups was statistically significant (P＜0.01).Conclusion For hemostasis of puncture site in interventional management via retrograde femoral artery access,the use of ExoSealTM vascular closure device is safe and effective.

Objective To compare the therapeutic efficacy of preventive transcatheter arterial chemoembolization (TACE) with that of preventive transhepatic arterial infusion (TAI) for patients with primary hepatocellular carcinoma (HCC) after hepatectomy. Methods During the period from June 2011 to June 2012 at authors’ hospital, preventive transhepatic interventional therapy was employed in 79 HCC patients within three months after hepatectomy. The followed-up endpoint was in June 2013. The clinical data were retrospectively analyzed. The patients were divided into TACE group (n=41) and TAI group (n=38). No significant differences in age, sex, preoperative liver function, Child-Pugh scores, tumor size and AFP level existed between the two groups. During interventional procedure , catheterization of proper hepatic artery was performed first, which was followed by angiography in order to clarify that there were no newly-developed tumor vessels or tumor lesions in the residual liver, then the chemotherapeutic agents were infused through the catheter. The emulsion of iodized oil with chemotherapeutic agent was used in the patients of TACE group, while only chemotherapeutic agent was adopted in the patients of TAI group. By using Chi-square test the one-year recurrence rate was determined. Kaplan-Meier estimation method was used to calculate the disease-free survival time, and t test was adopted to estimate the mean hospitalization days. The results were compared between the two groups. Results Of the 79 patients, postoperative recurrence was confirmed in 11, and the overall one-year recurrence rate was 13.9%. The one-year recurrence rate of TACE group and TAI group was 12.20% and 15.79% respectively , and no significant difference in one- year recurrence rate existed between TACE group and TAI group (χ2= 0.213, P = 0.645). The average disease-free survival time of TACE group and TAI group was (21.60 ± 1.52) months and (17.38 ± 3.01) months respectively, the difference between the two groups was of statistical significance (P = 0.038). The mean hospitalization days of TACE group and TAI group were (6.30 ± 1.84) days and (5.89 ± 2.08) days respectively, and the difference between the two groups was not statistically significant (P = 0.522). Conclusion No significant difference in one-year recurrence rate exists between the patients receiving preventive TACE and the patients receiving preventive TAI after hepatectomy for HCC. Nevertheless , preventive TACE can probably improve the disease-free survival time after hepatectomy.

Objective To investigate the clinical effect of polyvinyl alcohol (PVA) particles combined with chemoembolization using chemotherapeutic agents or chemotherapeutic agents lipiodol emulsion (CALE)in the treatment of hepatocellular carcinoma (HCC) complicated by hepatic arteriovenous shunt (HAVS) and related prognostic factors.Methods A retrospective analysis was performed for the clinical data of 133 patients with HCC complicated by HAVS.HAVS was classified into slow-flow HAVS,intermediate-flow HAVS,and high-flow HAVS,which were treated with 300-500 μm,500-710 μm,and 710-1000 μm PVA particles,respectively.The patients with slow-flow and intermediate-flow HAVS underwent embolization with PVA combined with chemotherapeutic agents followed by CALE,while those with high-flow HAVS underwent the treatment with PVA combined with chemotherapeutic agents alone.The survival time,progression-free survival time,and postoperative complications were followed up and analyzed.The Kaplan-Meier method was used to calculate cumulative survival rate and the Cox proportional hazards model was used to determine prognostic factors.Results The median overall survival (OS) of 133 patients was 9.1 months,and the 6-,12-,and 24-month survival rates were 73.7％,36.2％,and 10.2％,respectively.The median OS of slow-flow group (36 patients),intermediate-flow group (58 patients),and high-flow group (39 patients) were 7.3,9.1,and 10.8 months,respectively.And the 6-and 12-month survival rates were 69.2％/19.0％,72.4％/39.2％,and 77.8％/42.7％,respectively.There was no significant difference in survival time between the patients with different types of HAVS (x 2 =2.865,P =0.239).The incidence rates of postoperative gastroesophageal variceal bleeding and acute liver failure were 1.1％ and 0.4％,respectively.The results of Cox regression analysis showed that preoperative alpha-fetoprotein level ≥ 400 ng/ml (HR =2.105,P =0.006) was an independent risk factor,while multiple embolizations (H7 =0.482,P =0.011),tumor remission (HR =0.431,P =0.041),and multimodality therapy (HR =0.416,P =0.004) were independent protective factors.Conclusion PVA particles combined with chemotherapeutic agents or CALE is safe and effective in the treatment of HCC complicated by HAVS.Patients with multiple embolizations,tumor remission,and multimodality therapy tend to have good prognosis,while those with a high level of alpha-fetoprotein before embolization often have poor prognosis.

Objective To investigate the value of the quantitative analysis of digital subtraction angiography(DSA)and dynamic contrast-enhanced CT in evaluating the efficacy of hepatic artery infusion chemotherapy(HAIC)for liver cancer.Methods Fifty patients who were clinically diagnosed with primary liver cancer and treated with HAIC at least 3 times were enrolled in the study.Based on the enhanced CT scans taken within 1 week before the 1st and 3rd HAIC,patients were divided into good response group(CR+PR)and poor response group(SD+PD)according to the modified response evaluation criteria in solid tumor.The hemodynamic parameters[time to peak(TP),peak density(PV),and slope of the rising edge of the time-density curve(SU)]of liver cancer on DSA before treatment and after two HAIC,as well as the changes in the CT values of liver cancer in each phase of CT enhancement were compared,and then sensitivity analysis was conducted.Significant indicators were further analyzed with Logistic regression and ROC curve to assess their efficacies in evaluating HAIC response in liver cancer.Results The differences in pre-treatment CT values and DSA indicators between two groups were trivial(P>0.05).All patients successfully completed HAIC twice.The enhanced CT taken 1 week before the 3rd HAIC showed reductions in the arterial-and venous-phase CT values in good response group(P<0.05),while no significant difference was found in the delayed-phase CT value(P>0.05).At the 3rd HAIC,DSA angiography demonstrated significant reductions in PV and SU,and a significant prolongation of TP in good response group(P<0.05);while there were no significant differences in various indicators in poor response group.Regression analysis showed that arterial-phase CT values and DSA angiography SU were significantly correlated with therapeutic efficacy.ROC curve results indicated that arterial-phase CT values and SU were effective indicators for evaluating therapeutic efficacy.Conclusion The SU from DSA angiography and the CT values from dynamic contrast-enhanced CT which can objectively reflect the changes in blood supply of liver cancer after HAIC and are associated with HAIC efficacy can serve as radiological evidence for evaluating HAIC response.