1.Severe complications after microwave ablation in 7 403 cases with liver cancer
Yanming WANG ; Neng WANG ; Yun XU ; Qiang SHEN ; Guojun QIAN
Chinese Journal of Hepatobiliary Surgery 2016;22(10):655-660
Objective To identify the types,frequency and risk factors of major complications using microwave ablation (MWA) to treat liver malignancies in a single center.Methods Using the electronic medical record system,patients with liver cancer who were treated with MWA from January 2010 to November 2015 were retrospectively studied,and the risk factors of severe complications were analyzed.Results Of the 7 403 patients who were treated with MWA (12 558 ablations).96 cases experienced severe complications (1.3%) and 5 patients died (0.07%).The complications included liver abscess (n = 34,0.46%),pleural effusion (n = 20,0.27%),bile duct injury (n = 15,0.20%),hemorrhage (n = 6,0.08%),liver failure (n = 6,0.08%),extrahepa-tic organ injuries (n = 5,0.07%),cancerous cells implantation of abdominal walls (n = 2),cardiac arrest (n = 1),vascular thrombosis (n = 1),renal insufficiency (n = 1),and patients with other associated diseases which developed after the MWA therapy (n =2).Metastatic liver cancer and earlier treatment of MWA sessions were associated with a higher major complication rate (P < 0.05).Conclnsions MWA is a well-tolerated local treatment for liver cancer,with an acceptably low incidence of severe complications.Liver abscess was the most common postoperative severe complication.The surgeons' experience and tumor type were associated with the incidence of severe complications,however,not relavant with the frequency of preoperative ablations.Appropriate measures can be taken to effectively reduce the risk of serious complications.
2.Analysis on severe complications of percutaneous radiofrequency ablation for hepatic malignancy
Neng WANG ; Guojun QIAN ; Qiang SHEN ; Yuehong SHENG ; Lei ZHANG
Chinese Journal of Hepatobiliary Surgery 2011;17(3):186-188
Objective To study the prevention and treatment of severe complications of percutaneous radiofrequency ablation(PRFA)for hepatic malignancy. Methods A series of 939 patients with primary hepatic carcinoma or hepatic metastasis confirmed by pathological examinations or clinical manifestations underwent 1098 treatments of PRFA between January 2006 and December 2009. All the patients were followed up to study the short-or long-term complications related to PRFA. Results Complications developed in 9 patients: bile duct injury (4 patients), hemothorax (2 patients), and intra-abdominal hemorrhage (3 patients). The incidence of complication was 0.82% (9/1098) and the complication-related mortality was 11.1% (1/9). Conclusions Although PRFA which is minimally invasive, is a safe and effective treatment, there were still risks for this procedure, especially when the tumor is located at the portahepatic region or the patient has coagulopathy. Some serious complications can be prevented. It is important to observe the strict indications for RFA and to carry out the procedure carefully. Early detection of complication is important.
3.Efficacy analysis of percutaneous microwave ablation for patients with unresectable early stage hepatocel-lular carcinoma
Neng WANG ; Qiang SHEN ; Yun XU ; Guojun QIAN
The Journal of Practical Medicine 2016;32(13):2164-2167
Objective To investigate the efficiency and prognostic factors for the patients with hepatocel-lular carcinoma (HCC) at unresectable early stage when treated with percutaneous microwave ablation. Methods From January 2007 to January 2010 , 105 cases of at unresectable early stage were treated with percutaneous microwave ablation. Complete response rate, major complication rate, overall survival rates, disease-free survival rate were observed and prognostic risk factors were analyzed. Results The complete response rate was 95.7%. The major complication ratewas 3.8%. The 1-, 3-, and 5-year overall survival rates were 97.1%, 66.7%, 46.7%, and the corresponding disease-free survival rates were 82.9%, 48.6%, 31.4%, respectively. Age > 65 year and tumor size > 3 cm were independent risks for disease-free survival. Age > 65 year and recurrence were independent risks for overall survival. Conclusions Percutaneous microwave ablation is a safe and efficient ther-apy for HCC at unresectable early stage.
5.THE IMPACTS OF FOLIC ACID, RIBOFLAVIN AND MTHFR C677T POLYMORPHISM ON HUMAN LYMPHOCYTES GENOMIC STABILITY
Xu WANG ; Xiaoling XIA ; Xiayu WU ; Xiangxu KAN ; Neng CAO
Acta Nutrimenta Sinica 2004;0(05):-
Objective: To explore the comprehensive effects of folic acid (FA), riboflavin (RF) and MTHFR C677T polymorphism on genomic stability. Method: Cytokinesis-block micronucleus assay was used to detect the effects of different concentration combination of FA (20 and 200nmol/L, i.e. LF and HF) , RF (1 and 500 nmol/L, i.e. LR and HR) and MTHFR C677T polymorphism on genomic stability of 9 d cultured human lymphocytes. Results: The genetic damage was significantly higher in LFHR group regardless the genotype (P
6.Effects of Propafenone, Amiodarone and Dilthiazem on the potassium channel of c-Type Kv1.4△N
Zhiquan WANG ; Xuejun JIANG ; Shimin WANG ; Lin XU ; Neng WANG ; Dong ZHANG
Chinese Journal of Emergency Medicine 2011;20(7):692-697
Objective To study the effects of the antiarrhythmic drugs of propafenone, amiodarone and dilthiazem on c-type Kv1. 4 channels in Xenopus laevis oocytes with two-electrode voltage-clamp technique. Methods Defolliculated oocytes ( stage Ⅴ - Ⅵ) had transcribed cRNAs of ferret Kv1. 4△N channels injected. The oocytes were continuously perfused with control solution or propafenone, amiodarone and dilthiazem under monitoring of software of Clampfit v 9. 0. Results All of the three drugs blocked ferret Kv1. 4△N channel in voltage-, frequency- and concentration-dependent manners. The values of IC50 (50%inhibiting concentration ) of propafenone, amiodarone and dilthiazem were ( 103.4± 2. 2 ) μ mol/L,(501.22 +5.9) μmol/L and (353.62 +9.9) μmol/L, respectively. The currents under the actions of propafenone , amiodarone and dilthiazem were decreased to 41%, 32% and 21% of control group, respectively. Propafenone (100μ mol/L), Amiodarone (500μmol/L), dilthiazem (350μmol/L) inhibited currents to (54. 6 + 1.9 ) %, ( 46. 3 + 3.5 ) %, ( 52. 8 ± 2. 8 ) % of control group in voltage-dependent blockage. Conclusions The results suggested that all the three drugs blocked the kv1. 4△N channel in the open state. The three drugs block the kv1. 4△N channel maybe had the similiar effects in some respects, but each had its unique characteristics.
7.Supercondylar humeral osteotomy and tension band fixation for the treatment of cubitus varus in adults.
Nian-Fang WANG ; Xin-Neng WANG ; Jin-Ke SUN
China Journal of Orthopaedics and Traumatology 2010;23(9):659-660
Adolescent
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Adult
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Female
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Humans
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Humeral Fractures
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complications
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Humerus
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surgery
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Joint Deformities, Acquired
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surgery
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Male
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Orthopedic Fixation Devices
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Osteotomy
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methods
8.Microwave ablation for solitary hepatocellular carcinoma sized less than 5 cm: analysis of prognosis and its influence factors
Pingsheng ZHOU ; Yanming WANG ; Guojun QIAN ; Sheng LIU ; Neng WANG ; Yuehong SHENG
Journal of Interventional Radiology 2017;26(8):712-717
Objective To evaluate the curative effect of microwave ablation (MWA) for solitary hepatocellular carcinoma (HCC) sized less than 5 cm,and to discuss the prognosis and its influence factors.Methods The clinical data of 603 HCC patients,who were admitted to authors' hospital during the period from 2011 to 2013 to receive MWA,were retrospectively analyzed.The patients were followed up till March 2016.Results According to the inclusion criteria,a total of 603 patients were enrolled in this study.Complete ablation of HCC lesions was obtained in 5.8% of patients (35/603).No statistically significant difference in complete ablation rate existed between each other among groups of different tumor diameter (P=0.056).The incidence of severe complications was 1.7% (10/603).The median survival time was (59.6±1.9)months,while the 1-,2-and 3-year overall survival rates were 94.7%,81.9% and 71.8% respectively.In terms of overall survival rate,no statistically significant difference existed between groups of different age as well as between groups of different tumor diameter (P=0.225 and P=0.777 respectively),but statistically significant difference existed between groups of different sex as well as between groups of different recurrence interval (P=0.029 and P<0.001 respectively).Univariate and multivariate analysis showed that gender,preoperative albumin level and recurrence interval were the factors influencing overall survival rate (P=0.035,P=0.006 and P<0.001 respectively).Conclusion For the treatment of solitary HCC sized less than 5 cm,MWA has reliable curative effect,it is a safe and minimally-invasive therapy for HCC.The overall survival rate between patients with different age or between patients with different HCC size is not obviously different.The gender,preoperative albumin level and recurrence interval are independent factors that affect the overall survival rate.
9.Dual effects of extract of Schisandra chinensis Baill on rat hepatic CYP3A.
Qian CHEN ; Yu-jing WU ; Neng-neng CHENG ; Ya-lin LI ; Yong-ming WANG
Acta Pharmaceutica Sinica 2010;45(9):1194-1198
This study is to investigate the effects of aqueous extract of Schisandra chinensis Baill (WWZ), kadsurin, schisandrin A, schisandrin B and schisandrol B on rat hepatic CYP3A. Rats received a daily gavage of aqueous extract of WWZ for different times. The livers were harvested after gavage and subjected to microsome preparation. Microsomal CYP3A activity was determined by measuring the amount of the metabolite of testosterone (6 beta-hydroxytestosterone) with HPLC. Aqueous extract of WWZ, kadsurin and schisandrin A were incubated with microsomes obtained from rat. Microsomal CYP3A activity was determined by HPLC. Primary hepatocytes were separated and extracted from rat, then were treated with aqueous extract of WWZ, schisandrin A, schisandrin B and schisandrol B. Then, the expression of CYP3A1 mRNA was analyzed by RT-PCR. As for the in vivo assay, aqueous extract of WWZ significantly inhibited the enzyme activity of CYP3A after 12 h gavage. The inhibitory effect was converted to inductive effect after 3-day gavage. Aqueous extract of WWZ could induce the enzyme activity of CYP3A after 6-day gavage. Aqueous extract of WWZ and kadsurin showed a dose-dependent inhibition of CYP3A (IC50 of 487.8 microg mL(-1) and 6.2 micromol L(-1), separately). In rat primary hepatocytes, aqueous extract of WWZ (2.5 mg mL(-1)), schisandrin A (0.1 micromol L(-1)), schisandrin B (0.1 micromol L(-1)) and schisandrol B (10 micromol L(-1)) increased significantly the expression of CYP3A1 mRNA by 23%, 55%, 42% and 27%, respectively. Aqueous extract of WWZ could show dual effect on the enzyme activity of CYP3A in rat in vivo. Meanwhile, kadsurin showed a dose-dependent inhibition of the enzyme activity of hepatic CYP3A in vitro. And schisandrin A, schisandrin B and schisandrol B showed significant inductive effect on the expression of rat CYP3A1 mRNA.
Animals
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Cyclooctanes
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administration & dosage
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isolation & purification
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pharmacology
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Cytochrome P-450 CYP3A
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genetics
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metabolism
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Dioxoles
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administration & dosage
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isolation & purification
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pharmacology
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Dose-Response Relationship, Drug
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Drugs, Chinese Herbal
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administration & dosage
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isolation & purification
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pharmacology
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Hepatocytes
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drug effects
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enzymology
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Inhibitory Concentration 50
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Lignans
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administration & dosage
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isolation & purification
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pharmacology
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Male
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Microsomes, Liver
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enzymology
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Plants, Medicinal
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chemistry
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Polycyclic Compounds
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administration & dosage
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isolation & purification
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pharmacology
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RNA, Messenger
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metabolism
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Rats
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Rats, Sprague-Dawley
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Schisandra
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chemistry
10.Meta-analysis on the effect and adverse reaction on patients with osteoarthritis and rheumatoid arthritis treated with non-steroidal anti-inflammatory drugs.
Wen SHI ; Yong-ming WANG ; Neng-neng CHENG ; Bin-yan CHEN ; Duan LI
Chinese Journal of Epidemiology 2003;24(11):1044-1048
OBJECTIVETo observe the rate of efficacy and adverse drug reaction of non-steroidal anti-inflammatory drugs (NSAIDs) in the population with osteoarthritis and rheumatoid arthritis, based on available clinical data.
METHODSUsing Meta analysis to evaluate the data of effect and safety profile of NSAIDs from 19 articles on randomized clinical trials published from 1990 to 2001 in Chinese journals. The total number of patients enrolled for evaluation on rates of effectiveness and adverse drug reaction were 1 732 and 2 925, respectively.
RESULTSData on the effect and safety were comparatively heterogeneous among different kinds of NSAIDs. The effective rates (95% CI) were as follows: nabunetone, 66.7% (61.9% - 71.4%); meloxicam, 68.4% (59.2% - 77.6%); naproxen, 64.5% (59.8% - 69.1%); nimesulide, 79.8% (75.7% - 84.0%); ibuprofen, 77.2% (70.7% - 83.8%); diclofenac, 77.1% (69.2% - 85.0%); oxaprozin, 65.8% (59.5% - 72.0%). Rates of adverse drug reaction (95% CI) were as follows: nabunetone, 16.3% (12.5% - 20.0%); meloxicam, 10.2% (4.2% - 16.2%); naproxen, 29.2% (24.8% - 33.6%); nimesulide, 20.2% (16.0% - 24.3%); ibuprofen, 16.7% (14.7% - 18.8%); diclofenac, 19.3% (11.9% - 26.7%); oxaprozin, 12.7% (8.9% - 16.7%) respectively.
CONCLUSIONThe rates of effect and adverse reaction on patients having osteoarthritis and rheumatoid arthritis with NSAIDs treatment would largely depend on the drugs being used. Within 2 - 8 weeks of treatment, the effective rate and rate of adverse drug reaction with commonly used NSAIDs as nabumeton, meloxicam, etc., were 59.2% - 85.0% and 4.2% - 33.6%, respectively.
Anti-Inflammatory Agents, Non-Steroidal ; adverse effects ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Butanones ; adverse effects ; therapeutic use ; China ; Diclofenac ; adverse effects ; therapeutic use ; Humans ; Ibuprofen ; adverse effects ; therapeutic use ; Naproxen ; adverse effects ; therapeutic use ; Osteoarthritis ; drug therapy ; Propionates ; adverse effects ; therapeutic use ; Randomized Controlled Trials as Topic ; Sulfonamides ; adverse effects ; therapeutic use ; Thiazines ; adverse effects ; therapeutic use ; Thiazoles ; adverse effects ; therapeutic use