Objective To evaluate the effect of sequential intrahepatic arterial FAM for the treatment of metastatic gastric cancer to the liver. Methods 14 patients with multiple hepatic metastases from gastric cancer were treated with sequential intrahepatic arterial FAM using the hepatic artery infusion port. Results Of 14 patients, CR, PR, NC and PD were observed in 1, 7, 4 and 2 cases respectively. The overall median survival was 15 months. The survival rate at 1, 2 and 3 years was 80.0%; 57.1% and 14.3% respectively. No severe complication was observed. Conclusions Sequential intrahepatic artery FAM is effective to increase the survival rate in patients with hepatic metastases from gastric cancer.

Objective To evaluate the efficacy of FAP combined intrahepatic artery with intravenous infusion chemotherapy in the treatment hepatic metastatic carcinoma. Methods 23 patients with metastatic hepatic carcinoma were diagnosed with CT or MRI. EPI 40mg/m 2, CDDP 60mg/m 2 were given intrahepcic arterial by means of one shot infusion and 5-FU 500mg/m2 (d1, d8) intravenously respectively. All patients were reexamined by with CT or MRI after 2～4 weeks. Results The total response rates was 74%. The survival rates at 1 year, 2 year and 3 year were 88 8%?7 9%;66 9%?12 3% and 24 6%?23 4% respectively. The median survival time was 25 months. Conclusions FAP was a traditional regimen,combined intrahepatic arterial and intravenous chemotherapy can improve response rate and prolong median survival to metastatic liver cancer .

Objective To explore the value of center vein catheter thoracostomy in the chemotherapy of malignant pleural effusion. Methods Carboplatin and ?-2b Interferon were infused into pleural cavity by implanted center vein catheter in the group observation (n=17). After repeated thoracocentesis, the same drugs were introduced into pleural cavity in the group control (n=29). At the end of the 1st, 3rd and 6th month after drug administration, follow-up was carried out to assess the response rates. Results At the end of the 1st, 3rd and 6th month after intrapleural therapies, the number of intrapleural therapies in the group observation was (2.2?1.9) times and in the group control (5.3?1.3)times, with statistically significant difference between the two groups (t=5.924, P=0.00). Numbers of complete remission (CR) in the group observation was 10 of 16, 11 of 16 and 10 of 15, respectively and in the group control 9 of 29, 11 of 29 and 5 of 19, respectively, producing significant difference (P=0.043, 0.050, 0.020, respectively). Overall response rates in the group observation were 87.5%, 87.5% and 80.0%, respectively, while in control were 62.5%, 68.7% and 66.7%, respectively, without significant difference (P=0.356, 0.114, 0.178, respectively). Compared with the control, long-term follow-up (six months) showed higher response rates in the group observation: 10 of 15 patients remained CR at 6th month after therapies. No significant difference was seen in respect to adverse effects(?2=2.491,P=0.114). Conclusions Intrapleural chemotherapy by center vein catheter may increase CR and decrease application times of Carboplatin and ?-2b Interferon in the treatment of malignant pleural effusion, with fewer side effects.

Objective To explore the effects of interstitial brachytherapy with permanent seed implants on peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of natural killer cells (NK). Methods Ultrsound-guided or intraoperative implants of radioactive seed 125I were used in 25 patients with pathologically diagnosed and ineradicable malignant tumors. Clinical data of peripheral blood cells, liver functions, renal functions, T cells subgroups and the activity of NK cells prior and after the treatment were compared. Results The white blood cells, hemoglobin and platelet prior the treatment were (6 3?2 2)?10 9/L, (122 7?17 3) g/L and (219 9?117 5)?10 9/L, respectively, while at the 1st and 3rd months after the treatment, these were (6 4?1 8)?10 9/L, (114 5?30 9)g/L, (191 5?59 6)?10 9/L, respectively and (6 1?1 2)?10 9/L, (116 3?16 0) g/L, (191 7?108 2)?10 9/L, respectively, without statistically significant differences ( F =1 893, 0 616, 0 596; P =0 072, 0 779, 0 762). In addition, no significant differences were found in values of ALT, AST, BUN, Cr, CK and CK-MB at different times ( F =1 861, 0 551, 1 740, 1 934, 0 412, 0 052; P =0 118, 0 737, 0 142, 0 105, 0 837, 0 998). The values of TB and DB in patients with pancreatic carcinoma obviously decreased within 1 month after the treatment. Interstitial brachytherapy had little effects on T-cell immunity (CD3, CD4 and CD8) and the activity of NK cells ( F =0 287, 0 520, 0 497, 1 101; P =0 752, 0 598, 0 612, 0 342). Conclusions Interstitial brachytherapy with permanent seed implants has no effects on vital organs and immunologic functions, being a safe and minimally invasive technique for cancer.

Purpose:To find out the clinical biology value of p53 overexpression on Chinese breast cancer by Meta analysis. Methods:Reviewed all the published studies during the recent 10 years regarding p53 and breast cancer, and used standard techniques of Meta-analysis to combine the results of these studies to produce a more precise estimate of the prognostic significance of p53 mutations.Results:the mean of p53 positive express was 45%,95% confidence interval (43-47)%:, p53 positive was related with node metastasis, recurrence after surgery, over survival, tumor size and nuclear grade, but not related with age and pathology type, p53 was a special and sensitive prognostic factor for breast cancer.Conclusions:p53 can be an independent molecular marker to definitive prognostic of breast cancer, and possibly can be a reliable marker for choice of standard and individulized therapy.

Objective:To analyse the anatomical change of the human temporomandibular joint(TMJ) in the position of mandibular lateral displacement and to provide the anatomical data for temporomandibular disorder.Methods:3 of the 8 samples of selected fresh cadavers were adjusted to mandibular lateral displacement position, and 5 to edge-to-edge occlusion position,then samples were fixed and sectioned according to coronal and sagittal planes by using plastination technique. The feature of the thin plastination sections of the TMJ in the mandibular lateral displacement position and were compared with that in edge-to-edge occlusion position.Results:On the working side in mandibular lateral displacement position, condylar moved backwords,upwards and outside in the articular fossa. Articular discs of TMJ did not move following condylar movement,but posterior band of the articular disc was suppressed by the condylar and articular fossa. On the non-working side in mandibular lateral displacement position, condylar moved ahead,downwards and inwards along posterior incline of articular tuberculum,then articular discs did not move,and middle band of articular discs was suppressed by the condyle and articular tuberculum.Conclusions:The TMJ disc does not shift as TMJ condylar process turns in articular fossa.When the condylar turns and slides at the same time,the articular discs shift.

Objective To evaluate the value and feasibility of tissue mitral annular displacement (TMAD) in the assessment of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy.Methods The study population consisted of 39 on-obstructive hypertrophic cardiomyopathy (nHCM) patients and 39 healthy volunteers matched by gender and age.Left ventricular global and segmental longitudinal were measured by speckle tracking imaging(STI).The mitral annular displacement (MAD) (anterioseptal,posterioseptal,anterior,lateral,posterior and inferior sites,respectively),peak of time (PT) and left ventricular systolic dyssynchrony index (SDI) were measured by TMAD.The correlation between LSR and MAD was analyzed,and the parameters of MAD and SDI for tow groups were compared.Results The rate of effectively track segments of TMAD was significantly higher than that of STI(98.7％ vs 77.9％,P ＜0.001).There were high correlationship between segmental LSR and MAD(r =-0.784,P ＜0.001),and global and MADglobal (r =-0.897,P ＜0.001).Compared with the control group,MAD of six spots and MADglobal were significantly decreased (P ＜ 0.001,respectively),SDI was significantly increased(P ＜0.001).Conclusions TMAD is a sensitive and reproducible method for the assessment of LV longitudinal functionin patients with nHCM.

Objective To evaluate the efficacy of systemic glucocorticoids and intravenous immunoglobulin (IVIG)for the treatment of toxic epidermal necrolysis (TEN). Methods Clinical data on TEN inpatients treated with systemic glucocorticoids alone or in combination with IVIG were collected from the Department of Dermatology, First Affiliated Hospital of Nanjing Medical University from January 2006 to December 2012. Therapeutic outcomes were evaluated in these patients. Statistical analysis was carried out by using a multiple linear regression analysis, binary logistic regression analysis and Cox regression analysis with the SPSS 16.0 software. Results A total of 48 inpatients with TEN were included in this study. Multiple linear regression analysis showed that the maximum daily dose of glucocorticoids for disease control was decreased gradually over years (β=-0.461, P=0.004). However, binary logistic regression analysis revealed no obvious changes in the frequency of administration of IVIG over years. Cox regression analysis showed that both hospitalization duration (RR=0.351, 95.0%CI:0.150-0.825)and the time required for the control of skin lesions (RR=0.492, 95.0%CI:0.245-0.986)decreased with the increase in the frequency of IVIG administration. In addition, with the increase in the maximum daily dose of glucocorticoids for disease control, the time required for the control of skin lesions was also shortened (RR=0.997, 95.0%CI:0.994 -1.000), while no obvious changes were observed in hospitalization duration. Conclusions IVIG shows superiority in controlling lesions, reducing complications and improving the prognosis of TEN. Compared with systemic glucocorticoids, IVIG shows better therapeutic efficacy and less adverse effects, and may be preferentially selected.

Objective To evaluate the dynamic changes of left ventricular systolic blood flow hemodynamics in patients with acute myocardial infarction(AMI) before percutaneous coronary intervention (PCI) and short-term after PCI by vector flow mapping (VFM).MethodsTwenty-five patients with AMI were examined by color Doppler two-dimensional echocardiography respectively before PCI and three days and one month after PCI.The standard apical three-chamber color images in three sequent cardiac cycles were acquired and analyzed on off-line by VFM.In systole,the parameters of vortex including horizontal length,longitudinal length,transverse position,vertical position,and maximum vector velocity were measured respectively,and all parameters three days and one month after PCI were compared with those before PCI respectively.Results In systole,there were not statistically significant differences between parameters three days after PCI and those before PCI( P ＞0.05).Compared parameters one month after PCI with those before PCI,horizontal length was longer( P ＜0.05),longitudinal length was shorter (P ＜0.05),the transverse position was closer to anterior ventricular septum( P ＜0.05),and the maximum vector velocity of vortex was increased ( P ＜ 0.05).Conclusions VFM may serve as an ideal tool to quantitatively evaluate the blood flow hemodynamics of left ventricle in patients with AMI after short-term therapy by PCI.

Objective To compare the impact of anterior and inferior-posterior regional wall motion abnormalities on the vortex in systolic phase by vector flow map(VFM) technique.Methods Sixty patients with myocardial infarction were divided into 2 groups:the left anterior descending artery single branch lesion group (LAD group) and the left circumflex artery and/or right coronary artery lesion group (LCX/RCA group).By VFM technique,left ventricular systolic blood flow field was observed.Parameters such as the vortex duration were calculated and compared between two patient groups and also with healthy control group.Results LAD group did not show significant difference from the control group in isovolumic systolic vortex,this group was characterized with large size of vortex and usually forming local vortex at the apex in early ejection.On the contrary,LCX/RCA group had small isovolumic systolic vortex,the early ejection vortex of this group was significantly smaller than that of LAD group and larger than that of control group.The phenomenon was usually observed in the center of the lumen.Both LAD and LCX/RCA group had longer total vortex duration and vortex collapse time than the healthy control group,these differences were not significant between LAD and LCX/RCA group.There were no significant differences in isovolumic vortex duration among the three groups.Conclusions Anterior wall infarction had more impact on systolic blood flow field than inferior-posterior wall infarction.The VFM technique could be applied for observation and evaluation of the changes in vortex characteristics.