Objective To investigate the clinicopathologic characteristics,therapy and prognostic factors of small cell carcinoma of the cervix.Methods Clinical and pathological data of eight patients were analyzed retrospectively.Results Eight patients all presented with symptoms of abnormal vaginal bleeding or postcoital spotting.One patient had stage Ⅰ b1 disease,2 had stage Ⅰ b2 disease.2 had stage Ⅱ b disease and 3 had stage Ⅲ b disease.Histopathologic findings showed the small tumor cells had scant cytoplasm,round nuclei,absence of nucleoli,and finely dispersed chromatin.Immunohistochemical findings were positive in 7 cases for neuron-specific enolase.Three patients with stage Ⅰ b disease and 1patient with stage Ⅲb disease underwent radical hysterectomy and postoperative chemotherapy.with or without radiotherapy,and the survival period was 64,22,14 and 6 months respectively.Two patients with stage Ⅱ b disease and 2 with stage Ⅲ b disease underwent chemotherapy and radiotherapy,and the survival period was 25,9,10 and 5 months respectively.Conclusions Immunohistochemical analysis using several kinds of neuroendocrine markers is helpful in establishing the correct diagnosis in addition to focusing on characteristic histopathological features.It is necessary to use comprehensive treatment including surgery,chemotherapy and radiotherapy for patients with small cell carcinoma of the cervix.Chemotherapy may play an important role in the treatment.

Objective: To observe the effects of electroacupuncture on the histopathological changes and serum indexes of rats' liver, and to investigate the mechanism of electroacupuncture in treating hepatic fibrosis of rats. Methods: The rat model of hepatic fibrosis was induced with carbon tetrachloride. Then, the rats were divided into electroacupuncture group, medicine group, and model group. The collagen of liver, and serum hyaluronic acid (HA), laminin (LN), procollagen (PⅢNP), and collagen Ⅳ (C-Ⅳ) were detected with morphologic methods and radioimmunoassay. Results: Compared with normal rats, the collagen was hyperplasia in the liver tissue, and the contents of the serum HA, LN, and PⅢ NP were higher in the model group. The collagen area of liver tissue, and the contents of the serum HA, and LN were lower in rats treated with electroacupuncture than model rats. The contents of serum of PⅢ NP, and C-Ⅳ changed little. Conclusion: Electroacupuncture had some effects of prevention and treatment, and the mechanism may relate to the effects of electroacupuncture in protecting liver cells, inhibiting synthesis of extracellular matrix, and promoting the breakup of collagen.

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)

BACKGROUNDMost HCC patients with decompensation of liver function lost the chance of surgical and/or interventional treatment. The aim of this study was to evaluate feasibility and outcome of radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) patients with poor liver function (Child-Pugh class C), who are not suitable for surgery or hepatic artery chemo-embolization.

METHODSThirteen HCC patients (the number of tumors was 17) with liver function of Child-Pugh C (scores: 10.2 +/- 0.4) were included in the study. Among the patients, 8 were male and 5 were female with the average age of (61.6 +/- 10.9) years old. The average size of HCC was (3.8 +/- 1.0) cm. Two patients were recurrent HCC and 30.8% of the patients had multiple tumors (2 - 3 tumors). All the patients were treated with RFA.

RESULTSThere were 22 RFA sessions (1 - 4 sessions per patient) in all, average ablations per tumor at first session was 3.1. One week after RFA, the liver enzymes elevated in 9 patients (69.2%), in 7 of them, the liver enzyme returned to pre-RFA level in 1 - 3 months. One month after RFA, the Child-Pugh grading was 10.3 +/- 0.8 (Child-Pugh C), while that of pre-RFA was 10.2 +/- 0.4 (Child-Pugh C), with no significant difference. Computer tomography (CT) one month after RFA showed that the tumor necrosis rate was 88.2% (15/17). Five patients had 2 - 4 repeated RFA due to HCC recurrence. During the follow-up of 2- 69 months in this group, survival rate of one year was 53.8%, two years was 30.8%, and three year was 15.4%. The incidence of RFA-related complications was 13.6% (3/22 sessions), including 1 case of GI hemorrhage and 1 sub-capsular hemorrhage of the liver. One patient with HCC over 5 cm who had fever and liver abscess after RFA, and was dead 2 months later due to liver function failure.

CONCLUSIONSMinimal invasive RFA provides possible treatment modality for HCC patients with poor liver function, who are not candidates for surgical and/or interventional therapy. For large HCC, due to the required extended treatment region, special attention should be paid to the possibility of acute liver failure.

Adult ; Aged ; Carcinoma, Hepatocellular ; therapy ; Catheter Ablation ; methods ; Female ; Humans ; Liver Cirrhosis ; therapy ; Liver Neoplasms ; therapy ; Male ; Middle Aged ; Treatment Outcome

ObjectiveTo investigate the clinical effect of interferon (IFN) in the treatment of genotype B or C chronic hepatitis B (CHB) patients. MethodsPubMed, Web of Science, The Cochrane Library, CNKI, Wanfang Data, and VIP were searched for articles on IFN in the treatment of genotype B or C CHB patients published up to November, 2018. Two researchers performed screening, data extraction, and quality assessment of the articles independently, and then a meta-analysis was performed. ResultsA total of 20 articles were included. The results of the meta-analysis showed that compared with the genotype C CHB patients, the genotype B CHB patients had significantly higher HBV DNA clearance rate (odds ratio ［OR］=2.95, 95% confidence interval ［CI］: 2.22-3.91,P＜005), HBeAg clearance rate (OR=3.16, 95%CI: 2.38-4.20,P＜005), HBeAg seroconversion rate (OR=1.83, 95%CI: 1.44-2.33，P＜005), HBsAg clearance rate (OR=2.59, 95%CI: 1.05-6.38，P＜005), and alanine aminotransferase normalization rate (OR=2.31, 95%CI: 1.69-316，P＜005). The subgroup analysis showed that the clinical effect of IFN in genotype B or C CHB patients was not affected by the type of IFN. ConclusionThe antiviral effect of IFNs is affected by HBV genotype, and the patients with genotype B CHB have a better antiviral outcome than those with genotype C CHB. Therefore, HBV genotype is an important factor for predicting the clinical effect of IFN therapy.

Due to the difference in spatial configuration and charge of the bases in a DNA molecule, characteristic translocation current pulses through a single nanopore could be obtained. This could become the basis of DNA sequencing method. However, due to the fast translocation speed (sub-micro seconds) and the small current change (about pA), it is still a challenge to obtain the accurate molecular substructure with present electronic techniques. In this work, in order to control the translocation behavior of ssDNA, two kinds of ionic liquids with high viscosity and conductivity were introduced to establish a viscosity gradient with the α-hemolysin single nanopore interface and the acidity of the solution was optimized. The trans chamber contained pure BmimPF6 and the cis chamber contained 1 mol/ L BmimCl and 10 mmol/ L Tris-HCl ( pH 5. 5 ). Preliminary experiment results under this electrolyte configuration showed that poly ( dC) 15 , poly ( dC) 15 , poly(dC) 30 and poly(dC) 50 exhibited obvious long duration pulses with high current suppression ratio. The blocking depth reached more than 95％ of long blocking events. The duration time of long blocking events prolonged to tens or hundreds of milliseconds. Meanwhile, the peak-peak of baseline noise was reduced by about 30％ .

Glomerular hypertrophy is the main pathological characteristic in the early stage of diabetic nephropathy (DN), and its regulatory mechanism is closely related to mammalian target of rapamycin (mTOR) signaling pathway activity. mTOR includes mTOR complex 1 (mTORC1) and mTOR complex 2(mTORC2), in which, the upstream pathway of mTORC1 is phosphatidylinositol-3-kinase (PI3K)/serine-threonine kinase(Akt)/adenosine monophosphate activated protein kinase(AMPK), and the representative signaling molecules in the downstream pathway of mTORC1 are 4E-binding proteins(4EBP) and phosphoprotein 70 S6Kinase(p70S6K). Some Chinese herbal extracts could improve cell proliferation via intervening the expressions of the key molecules in the upstream or downstream of PIK/Akt/mTOR signaling pathway in vivo. As for glomerular mesangial cells(MC) and podocyte, mTOR plays an important role in regulating glomerular inherent cells, including adjusting cell cycle, energy metabolism and matrix protein synthesis. Rapamycin, the inhibitor of mTOR, could suppress glomerular inherent cell hypertrophy, cell proliferation, glomerular basement membrane (GBM) thickening and mesangial matrix deposition in model rats with DN. Some Chinese herbal extracts could alleviate glomerular lesions by intervening mTOR signaling pathway activity in renal tissue of DN animal models or in renal inherent cells in vivo and in vitro.
Animals ; Diabetic Nephropathies ; drug therapy ; enzymology ; genetics ; pathology ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Hypertrophy ; drug therapy ; enzymology ; genetics ; pathology ; Kidney Glomerulus ; drug effects ; metabolism ; pathology ; Signal Transduction ; drug effects ; TOR Serine-Threonine Kinases ; genetics ; metabolism

Objective To introduce a new technique for urethral coverage in Snodgrass hypospadias repair,and to evaluate its effectiveness and complications.Methods From April 2003 to February 2006, this new procedure was performed in 289 children with hypospadias aged 3 months to 12 years (mean age,2. 4 years).The native meatus of urethra was identified subcoronal in 78 cases,penile/shaft in 136,penoscrotal in 36 and scrotal in 16;and 23 cases had undergoneⅡstage operation and re-operation.The overlapping coverage with bilateral shaft based vascularized dartos pedicle was done in the new urethra by Snodgrass hy- pospadias repair in these children.Results All the cases were followed for 3 months to 2 years.Postoper- atively,urinary fistulas developed in 32 cases (11%).Of them,11 were cured spontaneously within 4 weeks. The incidence of actual urinary fistula was 7% (21/289).Of the 21 fistulas which were not cured,11 (5%) occurred in 214 cases of distal hypospadias;and 10 (13%) in 75 cases of proximal hypospadias,Ⅱstage and re-operation.No dehiscence and diverticulum was found.Combined with mucosal collar technique,the ventral skin of the penis was sewn on the midline.During the follow-up,excellent cosmetic results with normal-ap- pearing circumcised penis were achieved in most patients.Conclusions Bilateral shaft based vascularized dartos pedicle urethral coverage procedure is a reliable and effective method for preventing urethral cutaneous fistulas and dehiscence.This method can reconstruct a satisfactory cosmetic appearance of the penis.

Objective Objective To verify the accuracy of dose calculation and the precision of beam modeling in a Pinnacle three-dimension treatment planning system(TPS).Methods Based on the photon beam model data of a Varian 600C Linac,output factor verification and 12 tests were carried out ac- cording to the recommendation of Netherlands Commission on Radiation Dosimetry(NCS).The results of ion chamber measurement and TPS calculation at selected points were compared.Deviation and confidence limit were used to evaluate dose calculation accuracy.Results The Pinnacle TPS had a high precision of dose calculation when compared with the measurement data.Deviation of calculated output factors was＜1% on all opening patrols,and was＜3% on wedged portal except one with the size of 15 cm?40 cm and angled 60?.The results of 12 tests were in accordance with the criteria of NCS recommendation,with maximum av- erage deviation＜1%.The overall accuracy is better than those of other TPS reported in the literature. Conclusions Dose verification is a prerequisite before a three-dimension treatment planning system is used in the clinical practice.Pinnacle treatment planning system installed in our institute is reasonably acceptable and satisfactory.

Objective To explore the ameliorative effects of standardized tertiary rehabilitation(STR)on the quality of life(QOL)of stroke patients with hemiplegia.Methods Eighty-two stroke patients were randomly divided into two groups:a rehabilitation group(R group)and a control group.All patients were given routine inter- nal medicine treatment,but STR was also administered to the R group.The QOL of all of the patients was assessed with the brief scale of quality of life(QOL-BREF)at the beginning,and at the end of the Ist month,3rd month and 6th month after stroke.Results There were two deaths in the control group,but no deaths in the R group.At ever- y stage,the R group returned better scores for physiological health,psychological state,social and environment rela- tionships,the subjective QOL and health items,and in comprehensive self-evaluation.QOL scores,except for social relationships,were consistently,significantly higher in the R group.The R group's QOL scores improved obviously in the first 3 months after stroke,and then more slowly in the next 3 months.Conclusions STR markedly improved the QOL of stroke patients.Their QOL scores improved obviously soon after stroke,but slowly later on.