1.Transcatheter selective hepatic arteriography and embolization in treatment of hepatic hemangioma
Kai FENG ; Bin DENG ; Yong ZUO
Chinese Journal of Interventional Imaging and Therapy 2009;6(4):324-326
Objective To investigate the features of transcatheter selective hepatic arteriography and efficacy of embolization in hepatic hemangioma. Methods Twenty-six patients of hepatic hemangioma underwent transcatheter selective hepatic arteriography and embolization with Lipiodol-ultrafluida as well as Pingyangmycin, and were followed-up for 3 - 12 months after treatment. Results The popcorn-like tumor stain sign and early fill-in and persistant staining sign of hepatic arterial angiography were observed in all patients before embolization. After one time of embolization, the tumor size decreased more than 25% in 22 patients (84.62%), less than 25% in 4 patients. No severe complication occurred. Conclusion Transcatheter selective hepatic arteriography and embolization is a favorable method of diagnosis and treatment for hepatic hemangioma.
2.Relationship between tumor recurrence and immunosuppressants after liver transplantation
Kai CHEN ; Zuo WANG ; Zhengrong SHI
Chinese Journal of Hepatobiliary Surgery 2021;27(3):192-196
Objective:To clarify the relationship between postoperative tumor recurrence and the type and dosage of immunosuppressants in patients undergoing liver transplantation.Method:A retrospective analysis was conducted on the clinical data of patients who underwent liver transplantation for liver cancer from September 2007 to January 2019 at the Department of Hepatobiliary Surgery, First Affiliated Hospital of Chongqing Medical University. According to whether there was tumor recurrence after liver transplantation, the patients were divided into the case group and the control group. The etiology, alpha-fetoprotein level, Child-Pugh score, model for end-stage liver disease (MELD) score, and cancer nodules, number of tumors, diameter of largest cancer nodule, microvascular infiltration (MVI), large vessel infiltration, Edmondson grade of tumor differentiation, postoperative immunosuppression regimen, and blood trough concentration of tacrolimus or cyclosporine were compared between the two groups. The effects of calcineurin inhibitor (CNI) exposure in groups of patients on tumor recurrence were compared, and statistically significant factors were included in the Cox regression analysis. Using the BCLC staging standard of liver cancer, all the subjects were stratified, and the influence of CNI exposure on tumor recurrence was further analyzed.Results:This study included 50 patients. There were 15 patients in the case group, aged (45.8±8.2) years, with 13 males (86.7%). There were 35 patients in the control group, aged (45.4±12.0) years, 31 males (88.6%). The diameter of the largest cancer nodule in the case group was significantly larger than that in the control group [(5.9±3.0) cm vs (3.5±1.8) cm, P<0.05]. The tacrolimus exposure levels in the case group at 14 d after operation were significantly higher than the control group[(11.7±7.7)ng/ml vs (5.9±3.0)ng/ml, t=2.48], 1 month after operation [(12.2±4.5) ng/ml vs (7.8±4.3) ng/ml, t=2.82], 9 months after operation [(6.9±4.0) ng/ml to (4.7±2.0) ng/ml, t=2.21] and the area under the curve at 1 year after operation [(100.1±21.1) vs (74.4±19.2), t=3.66], all P<0.05. Survival analysis showed that the cumulative tumor-free survival rate of the CNI high-exposure group was significantly lower than that of the CNI low-exposure group (52.2% vs 85.2%, χ 2=6.52, P<0.05). Multivariate analysis using the Cox proportional hazards regression model showed that the largest cancer nodule diameter ( RR=1.23, 95% CI: 1.01-1.60) and high CNI exposure ( RR=4.02, 95% CI: 1.10-14.74) were independent risk factors for tumor recurrence after liver transplantation. Stratified analysis showed that of the 17 patients with BCLC stage B, 6 patients (66.7%) with high CNI exposure developed tumor recurrence, while only 1 patient (12.5%) with low CNI exposure developed tumor recurrence. The difference was statistically significant ( P<0.05). Survival analysis showed that the cumulative tumor-free survival rate of patients with CNI high-exposure was significantly lower than that of patients with CNI low-exposure (33.3% vs 87.5%, χ 2=5.74, P<0.05). Of the 8 patients with BCLC stage C, 4 patients developed tumor recurrence with CNI high-exposure (100.0%). There was no tumor recurrence in patients with low CNI exposure. The difference between groups was statistically significant ( P<0.05). Survival analysis showed that the cumulative tumor-free survival rate of patients with high CNI exposure was significantly lower than that of low CNI exposure (0 vs 100.0%, χ 2=6.80, P<0.05). Conclusions:Tumor recurrence after liver transplantation was not significantly related to the type of immunosuppressant used. High CNI exposure was a risk factor for tumor recurrence after liver transplantation.
3.Effect of Tanshinone IIA in Preventing and Treating Oxaliplatin Induced Peripheral Neuropathy.
Kai XU ; Wei-ting CHENG ; Zuo-wei HU ; Wang SHAN
Chinese Journal of Integrated Traditional and Western Medicine 2016;36(5):559-563
OBJECTIVETo observe preventive and therapeutic effects of Tanshinone IIA (T II A) on oxaliplatin induced peripheral neuropathy (OlPN) and to explore its effects on the expression of calcitonin gene related peptide (CGRP) and never growth factor (NGF).
METHODSTotally 36 phase II - III patients with malignant tumor of digestive tract undergoing chemotherapy program with oxaliplatin, were equally assigned to the T II A group (using THA at 80 mg/day 1 day before oxaliplatin chemotherapy for 3 successive days) and the control group (using chemotherapy program with oxaliplatin alone) by segmented randomization. After 4 cycles of chemotherapy, the incidence degree and incidence of OlPN were evaluated. Sensory nerve conduction velocity (SNCV) and motor nerve conduction velocity ( MNCV) were tested by EMG evoked potential device. Serum levels of CGRP and NGF were also detected in the two groups before and after chemotherapy. The correlation of serum levels of CGRP and NGF to OIPN was assessed using linear correlation analysis.
RESULTSAfter chemotherapy the OlPN incidence was 27.8% (5/18 cases) in the T II A group, obviously lower than that in the control group (55.6%, 10/18 cases; P < 0.05). Compared with before treatment in the same group, SNCV and MNCV of common peroneal nerve were slowed down, serum NGF levels decreased, and serum CGRP levels obviously increased in the two groups (all P < 0.05). Compared with the control group after treatment, SNCV and MNCV of common peroneal nerve were obviously accelerated, serum NGF levels increased, and serum CGRP levels obviously decreased in the THA group (all P < 0.05). Results of linear correlation analysis indicated serum NGF level was negatively correlated with peripheral neuropathy (PN), serum CGRP expression was positively correlated with neurotoxicity (P < 0.05).
CONCLUSIONT II A could reduce the incidence of OlPN, which might be associated with inhibiting the expression of CGRP and up-regulating NGF activities.
Calcitonin Gene-Related Peptide ; blood ; Diterpenes, Abietane ; therapeutic use ; Gastrointestinal Neoplasms ; drug therapy ; Humans ; Nerve Growth Factor ; blood ; Neural Conduction ; drug effects ; Organoplatinum Compounds ; adverse effects ; Peripheral Nervous System Diseases ; chemically induced ; drug therapy ; Up-Regulation
4.Expressions of IL-10, IL-23 and CD86 in lesions of epidermodysplasia verruciformis
Si LIANG ; Yuehua LIU ; Yagang ZUO ; Kai FANG ; Baoxi WANG
Chinese Journal of Dermatology 2010;43(3):196-198
Objective To measure the expressions of IL-10, IL-23 and CD86 in lesions of epidermodysplasia verruciformis (EV), and to explore the relationship between cellular immune abnormality and EV pathogenesis. Methods Immunohistochemistry was used to measure the expressions of IL-10, IL-23 and CD86 in tissue samples from 10 patients with EV and 10 normal human controls. Results Three cytokines were observed in all the samples of EV, with the expression score ranging from 3 to 6 and expression intensity from moderate to high. However, of the control specimens, only 1 was positive for IL-10 with the expression score being 3, and expression intensity being moderate. Conclusion The pathogenesis of epidermodysplasia verruciformis may be correlated with the expression abnormality of some cytokines secreted by keratinocytes.
5.Expression and clinical significance of PI3K, Akt and E-cadherin in thyroid papillary carcinomas
Dong XUE ; Li KONG ; Kai ZUO ; Xinjun LI ; Tongjun ZHANG
Journal of Chinese Physician 2015;(3):357-360
Objective To investigate the expressions of phosphatidylinositol 3-kinase (PI3K), Akt and E-cadherin and their clinical significance in thyroid papillary carcinomas.Methods Expressions of PI3K, Akt, and E-cadherin were detected in 62 cases of thyroid papillary carcinomas,30 cases of thyroid goiter and 30 cases of normal thyroid by immunohistochemistry (EnVison),and simultaneously compared with age, sex, tumor size, clinical tumor node metastasis( TNM) stages, and lymph node metastasis in thy-roid papillary carcinomas.Results The expression rate of PI3K, Akt, and E-cadherin was 74.2%(46/62), 66.1%(41/62), 16.1%(10/62),respectively.Expressions of three proteins in thyroid papillary carcinomas were significantly different from those in thyroid goiter and normal thyroid tissues ( P <0.05). The lower positive rates of PI3K and Akt proteins were obtained in the group of stageⅠ~Ⅱthan that in the group of stageⅢ~Ⅳ(χ2 =4.976, P =0.026;χ2 =6.233, P =0.013).Higher positive rates of PI3K and Akt proteins were obtained in the group of lymph-node metastasis than that in group of non-lymph-node metastasis (χ2 =6.675, P =0.010;χ2 =7.511, P =0.006).Higher positive rate of E-cadherin protein was obtained in the group of stage Ⅰ~Ⅱ than that in the group of stage Ⅲ ~Ⅳ (χ2 =6.558, P =0.010 ) .Higher positive rate of E-cadherin proteins was obtained in the group of non-lymph-node metastasis than that in the group of lymph node metastasis(χ2 =5.678, P =0.017).There was significant positive correlation between expressions of PI3K and Akt through Spearman correlation analysis ( r =0.423, P <0.05).PI3K was negatively correlated with E-cadherin with Spearman correlation analysis ( r =-0.527, P <0.05).Akt was also negatively correlated with E-cadherin ( r =-0.417, P <0.05).Conclusions PI3K/Akt pathway might regulate thyroid papillary carcinoma cells proliferation, invasion and metastasis.
6.The effects of compound danshen dripping pills combined with triamcinolone acetonide in the treatment of oral submucous fibrosis
Wenxin ZUO ; Xiaoyu LI ; Ganying CAI ; Kai LIU
Journal of Practical Stomatology 2014;(6):846-848
Objective:To observe the efficacy and safety of compound danshen dripping pills(DDP)combined with intralesional tri-amcinolone acetonide(TA)injection in the treatment of oral submucous fibrosis(OSF).Methods:34 patients with clinically con-firmed OSF were randomly divided into 2 groups(n =17)and treated with DDP +TA and TA respectively,meanwhile the VAS of pain and mouth opening were recorded and compared.Results:Before treatment there was no statistical difference of the VAS scores and mouth opening between 2 groups(P >0.05),12 weeks after treatment,the difference was significant(P <0.05).The clinical condi-tion of treatment group were improved(χ2 =6.051,P <0.05),but there were no improvement in control group(χ2 =3.429,P >0.05).Conclusion:Compound danshen dripping pills combined with intralesional triamcinolone acetonide injection can significantly enhance the effects safely in the treatment of OSF.
7.Expressions and significance of CIP2A and VEGF in hepatocellular carcinomas
Kai ZUO ; Dong XUE ; Li KONG ; Xinjun LI ; Tongjun ZHANG
Journal of Chinese Physician 2014;16(8):1082-1084,1088
Objective To investigate the expressions of cancerous inhibitor of protein phosphatase 2A (CIP2A) and vascular endothelial growth factor (VEGF) in hepatocellular carcinomas and their clinical significance.Methods The expressions of CIP2A and VEGF proteins were tested with immunohistochemistry in 60 cases of hepatocellular carcinomas and adjacent paracancerous tissues.Results The positive rate of CIP2A in hepatocellular carcinomas was significantly higher than adjacent paracancerous tissues (83.3% vs 9.5%,P < 0.05).Significant differences were also observed in the expression rate of VEGF between the patients with hepatocellular carcinomas and paracancerous tissues (75.0% vs 14.3%,P <0.05).The expression of CIP2A in hepatocellular carcinomas was significantly positively correlated with its pathological grading,differentiation,and tumor node metastasis (TNM) stage (P < 0.05).The expression of VEGF in hepatocellular carcinomas was significantly positively correlated with its pathological grading,differentiation,and TNM stage (P < 0.05).Significantly positive correlation was found between expressions of CIP2A and VEGF with Spearman correlation analysis (rs =0.465,P < 0.01).Conclusions The abnormal expressions of CIP2A and VEGF gene may promote tumor angiogenesis and progression of a hepatocellular carcinoma.The study supports positive regulation between expressions of CIP2A and VEGF in a hepatocellular carcinoma.
8.Familial hemophagocytic lymphohistiocytosis with the MUNC13-4 mutation after unrelated hematopoietic stem cell transplantation: a case report.
Xiang-feng TANG ; Zuo LUAN ; Nan-hai WU ; Bo ZHANG ; Kai WANG
Chinese Journal of Pediatrics 2013;51(12):944-945
Child
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Graft vs Host Disease
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prevention & control
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Hematopoietic Stem Cell Transplantation
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methods
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Humans
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Immunosuppressive Agents
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therapeutic use
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Lymphohistiocytosis, Hemophagocytic
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genetics
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therapy
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Male
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Membrane Proteins
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genetics
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Mutation
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Prognosis
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Transplantation Conditioning
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methods
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Treatment Outcome
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Unrelated Donors
9.Expression of endostatin in serum and bronchoalveolar lavage fluid in patients with lung cancer
Yong JI ; Guoqiang CHEN ; Bin HUANG ; Zhitong ZUO ; Song WU ; Kai SHEN
Chinese Journal of Thoracic and Cardiovascular Surgery 2010;26(6):400-402
Objective To evaluate the expression of endostatin in bronchoalveolar lavage fluid (BALF) and serum in patients with lung cancer, and to analysis the relationship between endostatin expression and clinical prognosis as well as pathophysiological characteristics. Methods The samples of serum and BALF were obtained from 57 patients with untreated primary lung cancer ( lung cancer group) and 27 patients with benign pulmonary diseases (control group). The levels of endostatin were analyzed by enzyme-linked immunosorbent assay (ELISA). Results The expression of endostatin in serum and BALF in lung cancer group was significantly higher than that in control group ( P <0. 01 ). The levels of endostatin in serum and BALF in late-stage ( stage Ⅲ or Ⅳ ) lung cancer patients were significantly higher than that in early-stage ( stage Ⅰ or Ⅱ , P < 0. 01 ).The expression of endostatin both in serum and BALF were significantly higher in adenocarcinoma patients than that in squamous cell carcinoma or SCLC patients. Endostatin concentrations in BALF and serum were significantly greater in patients with lymph node and distant metastasis than those patients without. the expressions of endostatin in serum were closely related to that in BALF in patients with lung cancer ( P = 0. 000). Conclusion The expression of endostatin in serum and in BALF is higher in lung cancer than benign pulmonary diseases and it was associated with TNM stage, lymph node metastasis and clinicopatholgical variables. The level of endostatin in BALF is higher than that in serum and may be used as a significant marker to direct clinic therapy and estimation of prognosis.
10.A study of the mobilization, collection and selection of autologous peripheral blood stem cells in patients with autoimmune diseases undergoing autologous hematopoietic stem cell transplantation in juvenile severe autoimmune disease
Xiangfeng TANG ; Zuo LUAN ; Fengqi WU ; Jianming LAI ; Nanhai WU ; Kai WANG ; Xiaojun GONG ; Youzhang HUANG
Chinese Journal of Rheumatology 2010;14(8):546-549
Objective To explore the safety of mobilization and collection as well as the feasibility of selection of autologous peripheral blood stem cells (auto-PBSC) from patients with juvenile severe autoimmune diseases (AID) for autologous hematopoietic stem cell transplantation (auto-HSCT). The clinical significance of these procedure is evaluated. Methods Eight patients with AID, including four patients with systemic lupus erythematosus(SLE),two patients with dermatomysoitis, one patient with juvenile rheumatoid arthritis (JRA), one patient with multiple sclerosis(MS),underwent auto-HSCT. Auto-PBSCs were mobilized in 8 patients using cyclophosphamide(CTX) and granulocyte colony-stimulating factor (G-CSF), and their PBSCs were collected by CS-3000 Blood Cell Separator, then the CD34+cells were selected and purified by CliniMACS CD34+cell selection device. The CD34+ cells were frozenand preserved under -80 ℃ ALL patients received non-myeloablative or lymphoablative conditioning regimens which consisted of CTX/Mel/ATG or CTX/ATG or BEAM/ATG. All patient received CD34+ cells transplantation. The safety of mobilization and collection process of auto-PBSC as well asthe feasibility of selection and purification of CD34+cells were recorded and hematopoietic reconstruction were evaluated. Results All patients tolerated the collection process well, and there was no mobilization-related mortality. The number of collected MNCs and CD34+ cells were 8.35×108/kg and 7.92×106/kg respectively. The number of CD34+ and CD3+ cells after purification was 6.28×106/kg and0.71 ×105/kg respectively. The mean granulocytes and platelet engraftment occurred on days 11 and 15 after G-CSF regimen, and they can be collected using CS-3000 instrument. PBSC mobilization and collection from patients with juvenile severe AID is safe. The CD34+ cell can be highly purified. The auto-PBSC CD34+cell transplantation is an alternative therapy for severe AIDs that do not respond to conventional treatments.