Objective To evaluate the impact on long-term survival using elective transcatheter arterial chemoembolization (TACE) before liver transplantation (LT) to treat patients with hepatocellular carcinoma (HCC).Methods A medical literature search was conducted up to October 2011 to identify comparative studies which evaluated survival rates,recurrence rates,and disease free survival.Pooled odds ratios (OR) and 95 ％ confidence intervals (95 ％ CI) were calculated using either the fixed or random effect model.Results 571 patients were included into this meta-analysis:326 patients were treated with elective TACE before LT and 245 patients were not treated before LT.A comparison between the elective pretransplantation TACE group and the LT only group showed the odds risks (95％CI) of 1-,3-,5-years overall survival rate were 1.90 (0.09-3.33),1.19 (0.67-2.14),1.23(0.63-2.39),respectively.The odds risks (95％CI) of 1,3,5-years disease free survival rates were 1.36 (0.65-2.83),0.91 (0.48-1.75),1.16 (0.76-1.79),respectively.The odds risk (95％CI of recurrence was 1.60 (0.65-3.89).Conclusion Pretransplatation TACE improved 1-year overall survival,but it did not improve the 3 and 5 years overall survival,disease-free survival and recurrence rates.

To explore a new method for identification of Mongolian patent medicine (MPM) by PCR amplification of specific alleles. Eight kinds of MPM were used to study the identification of "Digeda" raw materials. The total DNA of Lomatogonium rotatum and Corydalis bungeana samples were extracted through modified CTAB method, psbA-trnH sequence was amplified by PCR and sequenced directionally. Specific primer was designed. The DNA of 8 kinds of MPM also was extracted and purified by the commercial DNA purification kits. The rbcL and two pair of specific primers sequences were amplified. The specific amplified products were sequenced in forward directions. All specific sequences were aligned and were analyzed. The results indicated that L rotatum can be identified by specific primers from Digeda-4 Tang, Digeda-8 San, Digeda-4 San, and C. bungeana medicinal materials can be identified by specific primers from Li Dan Ba Wei San, Yi He Ha Ri-12 and A Ga Ri-35. PCR amplification of specific alleles can stably and accurately distinguish raw medicinal materials in MPM.
Alleles ; DNA Primers ; genetics ; DNA, Plant ; genetics ; Medicine, Mongolian Traditional ; Molecular Sequence Data ; Plants, Medicinal ; classification ; genetics ; Polymerase Chain Reaction ; methods

Objective To explore the method and application value of near-infrared fluorescence-guided total parathyroidectomy (TPTX) in patients with secondary hyperparathroidism (SHPT) using indocyanine green (ICG).Methods The clinical data of 38 patients with SHPT undergoing fluorescence-guided TPTX from Dec.2013 to Jun.2017 were collected.All patients were treated with intravenous injection of ICG 30 minutes before operation.Near-infrared fluorescence imaging of parathyroid glands during surgery was observed and all parathyroid glands were resected.The preoperative and postoperative levels of parathyroid hormone,serum calcium and serum phosphorus were recorded to assess total resection and surgical efficacy.The complications such as hemorrhage and wound infection were observed.Results The fluorescence-guided TPTX was successful in all patients.The operation time was 75 to 225 mins.A total of 149 parathyroid glands were localized by fluorescence imaging,including 11 escaped glands by preoperative imaging examination.However,another 7 fluorescence-labeled tissue was inflammatory lymph node or fibrous adipose tissue.Intraoperative fluorescence-guided technique could identify the location and number of parathyroid glands.The level of parathyroid hormone before operation and 30 minutes after resection was (1797.3±838.8) pg/ml and (187.2±109.2) pg/ml,respectively,and maintained low level after operation.The differences were statistically significant(F=155.001,P=0.000).Compared with the level before surgery,the postoperative level of serum calcium and serum phosphorus decreased to normal range with significant differences (F=41.842,P=0.000;F=49.491,P=0.000).No perioperative death happened.One patient sufferred neck hematoma due to heparin,and one patient developed hypertension.No complications such as wound infection and pulmonary infection occurred to any patient.Conclusions Intraoperative fluorescence-guided TPTX using ICG in the patient with SHPT is safet and feasible,and is expected to be a novel technique for intraoperative dynamic examination and real-time localization of parathyroid gland.

OBJECTIVETo study the chemical constituents from the root of Actinidia chinensis.

METHODThe roots of A. chinensis were extracted with 95% EtOH. The EtOH extract was suspended in H2O and extracted with petroleum ether, EtOAc and BuOH successively. The compounds were isolated with column chromatography from the EtOAc fraction, and elucidated on the basis of spectral analysis(MS, IR, 1H-NMR, 13C-NMR).

RESULTSeven compounds were isolated from the root of A. chinensis, and the structures were identified as 2alpha-hydroxyoleanolic acid (1), 2alpha-hydroxyursolic acid (2), euscaphic acid (3), 23-hydroxyursolic acid (4), 3beta-O-acetylursolic acid (5), ergosta4, 6, 8, (14), 22-tetraen-3-one (6), beta-steriol (7).

CONCLUSIONAll the compounds were obtained from the root of A. chinensis for the first time.

Actinidia ; chemistry ; Oleanolic Acid ; analogs & derivatives ; chemistry ; isolation & purification ; Plant Roots ; chemistry ; Plants, Medicinal ; chemistry ; Sitosterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

Objective No study has been reported on the association between the abnormal methylation of drug metabolic enzymes and anti-tuberculosis drug-induced liver injury (ATLI). This article aimed to investigate the relationship of ATLI with the methylation of the CpG islands in the promoter regions of cytochrome P450 2E1 (CYP2E1) and glutathione s-transferase M1 (GSTM1) in Chinese Mongolian patients with tuberculosis (TB). Methods This retrospective study included 93 cases of TB diagnosed and treated in the TB prevention and treatment institutions of Tongliao, Inner Mongolia, between September 2016 and December 2017, which were divided into an ATLI (n = 31) and a non-ATLI group (n = 62), the former with and the latter without ATLI within 6 months after anti-TB medication. We compared the methylation levels of the CYP2E1 and GSTM1 genes between the two groups of patients and analyzed the risk factors of ATLI. Results In comparison with the non-ATLI controls, the patients of the ATLI group showed significantly lower methylation levels in the promoter regions of CYP2E1 (0.759 ± 0.066 vs 0.694 ± 0.091, P < 0.05) and GSTM1 (0.207 ± 0.093 vs 0.187 ± 0.092, P < 0.05). Multivariate logistic regression analysis revealed that the main risk factors of ATLI included alcohol consumption (OR = 5.329, 95% CI: 1.442-19.697, P < 0.05) and methylation in the CYP2E1 promoter region (OR = 0.312, 95% CI: 0.165-0.591, P < 0.05) in the TB patients. Conclusion ATLI is associated with the methylation level in the promoter region of the CYP2E1 gene in Chinese Mongolian patients with tuberculosis, indicating that the methylation of CYP2E1 could be used as a biomarker in the prevention and control of ATLI.

OBJECTIVETo assess the diagnostic value of magnetic resonance imaging (MRI) in the follow-up of patients with hepatocellular carcinomas treated with radiofrequency ablation (RFA) and to compare it with that of computed tomography (CT).

METHODSFrom December 2009 to September 2011, 40 patients (47 hepatocellular carcinomas) were treated with RFA after transcatheter arterial chemoembolization and underwent MRI and CT for follow-up. RFA margins were assessed on a five-point scale with receiver operating characteristic curve analysis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were evaluated.

RESULTSThe interobserver agreement rate for MRI was significantly higher (Kappa=0.935) than for CT (Kappa=0.714; P < 0.05). The scores of 1 and 5 points for MRI, which confirms the presence or absence of residual tumor, accounted for 89.4% (84/94), while for CT accounting for only 31.9% (30/94). The area under the receiver operating characteristic curve of MRI was significantly higher than that of CT (P < 0.05), as were the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of detection rate (mean, 100%, 96.4%, 76.9%, 100%, and 96.8% for MRI, respectively, vs. 30.0%, 57.1%, 10.3%, 87.7%, and 63.8% for CT).

CONCLUSIONMRI is superior to CT in assessing the RFA margins in terms of the diagnostic accuracy and detection rate .

Adult ; Aged ; Carcinoma, Hepatocellular ; diagnosis ; pathology ; surgery ; Catheter Ablation ; Female ; Humans ; Liver Neoplasms ; diagnosis ; pathology ; surgery ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neoplasm, Residual ; diagnosis ; Retrospective Studies ; Sensitivity and Specificity ; Tomography, X-Ray Computed

Three cases of flagellate shiitake mushroom dermatitis caused by Pleurotus ostreatus, Auricularia auricula, and Flammulina velutipes respectively were reported. Case 1, a 45-year-old male patient, developed multiple flagellate erythematous patches and papules on the trunk, axillae and abdomen without any subjective discomfort 8 hours after ingestion of a large amount of grilled Pleurotus ostreatus. Case 2, a 33-year-old female patient, developed multiple flagellate erythematous patches with mild swelling and itching on the back 1.5 days after consuming a fresh Auricularia auricula salad, and millet-sized papules were densely distributed on the erythematous patches. Case 3, a 54-year-old female patient, developed cord-like, flagellate edematous erythema and papules on the neck, trunk and proximal extremities 72 hours after consuming Flammulina velutipes. Histopathological examination of the dorsal lesions in case 3 showed epidermal spongiosis, intraepidermal blisters, papillary dermal edema, superficial dermal vasodilation, erythrocyte extravasation, inflammatory infiltration composed mainly of lymphocytes around dilated blood vessels, and a few scattered eosinophils. The 3 patients were all diagnosed with flagellate shiitake mushroom dermatitis. Case 1 received no treatment, while cases 2 and 3 were symptomatically treated with topical fluticasone propionate ointment, and achieved recovery of skin lesions after 1 week.

Objective To construct a human tumor necrosis factor (hTNF-a) plasmid and identify it to optimize the fermentation conditions of hTNF-α protein so as to achieve high expression in Escherichia coli.Methods The gene of hTNF-a was cloned into pET24a vector to obtain the pET24a-hTNF-a expression plasmid that was transformed into Escherichia coli BL21(DE3),and the expression conditions of BL21 (DE3) were optimized.Results The plasmid of pET24a-hTNF-α was successfully constructed and identified by PCR and digestion,which was consistent with the target fragment hTNF-α.The plasmid was transformed into Escherichia coli BL21(DE3),the best induced expression conditions of Escherichia coli BL21 (DE3) were as follows:M9+LB medium,37℃,0.5 mmol/L IPTG,pH =7.5,and induction time was 5 h.The results showed that dry weight of the cells and the rate of TNF were increased by 2.56 times and 3.68 times,respectively,and the expression rate of hTNF-α was increased by 3.49 times from 9.38％ to 32.74％.Conclusion The optimal conditions for the expression of plasmid pET24a-hTNF-α in Escherichia coli were determined.

Fluorescence intraoperative cholangiography (IOC) is a potential alternative for identifying anatomical variation and preventing iatrogenic bile duct injuries by using the near-infrared probe indocyanine green (ICG).However,the dynamic process and mechanism of fluorescenceIOC have not been elucidated in previous publications.Herein,the optical properties of the complex of ICG and bile,dynamic fluorescence cholangiography and iatrogenic bile duct injuries were investigated.The emission spectrum of ICG in bile peaked at 844 nm and ICG had higher tissue penetration.Extrahepatic bile ducts could fluoresce 2 min after intravenous injection,and the fluorescence intensity reached a peak at 8 min.Inaddition,biliary dynamics were observed owing to ICG excretion from the bile ducts into the duodenum.Quantitative analysis indicated that ICG-guided fluorescence IOC possessed a high signal to noise ratio compared to the surrounding peripheral tissue and the portal vein.Fluorescence IOC was based on rapid uptake of circulating ICG in plasma by hepatic cells,excretion of ICG into the bile and then its interaction with protein molecules in the bile.Moreover,fluorescence IOC was sensitive to detect bile duct ligation and acute bile duct perforation using ICG in rat models.All of the results indicated that fluorescence IOC using ICG is a valid alternative for the cholangiography of extrahepatic bile ducts and has potential for measurement of biliary dynamics.

BACKGROUNDPostconditioning has been shown to reduce infarct size, ischemic/reperfusion injury and myocardial injury in patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). This study tested the hypothesis that postconditioning attenuates the elevation of tumor necrosis factor-alpha (TNF-alpha) and improves heart function in patients with AMI after PCI.

METHODSA total of 75 patients were randomly assigned to 1 of 3 groups: the routine group (n = 26), in which no intervention was given at the onset of reperfusion; and the Postcon-30s (n = 25) or Postcon-60 s (n = 24) groups, in which 3 cycles of 30- or 60-second balloon deflation and inflation were repetitively performed. TNF-alpha serum concentration was measured by ELISA. Global and regional left ventricular systolic function was determined by echocardiography at 1 year. Thirty-four normal controls (NC) were enrolled in the study.

RESULTSThe TNF-alpha concentration in patients with AMI was significantly elevated at baseline compared to controls (P < 0.01). Concentration levels increased in the routine and Postcon-30s, but not in Postcon-60s group at 7 days (P < 0.05). As for linear associations among the three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) were ranked as follows: Postcon-60s > Postcon-30s > routine (P values all < 0.05, 65% vs. 57% vs. 52% and 1.10 vs. 1.27 vs. 1.53) after 1 year. More importantly, there was a significant relevance between the soluble TNF-alpha serum concentration at 7 days and LVEF or WMSI after 1 year (P values all < 0.0001).

CONCLUSIONSPostconditioning, in particular Postcon-60s was associated with long-term cardioprotective effects for inhibition of the inflammatory response and reperfusion injury. The soluble TNF-alpha serum concentration provided powerful prognostic information of global and regional left ventricular systolic function in patients with AMI.

Angioplasty, Balloon, Coronary ; methods ; Female ; Humans ; Ischemic Preconditioning, Myocardial ; methods ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Myocardial Reperfusion Injury ; prevention & control ; Tumor Necrosis Factor-alpha ; blood