OBJECTIVE:To investigate the effect of different doses of oxaliplatin on the efficacy and safety and related index-es of patients with hepatocellular carcinoma(HCC)after transcatheter arterial chemoembolization(TACE). METHODS:100 HCC patients were randomly divided into control group (50 cases) and observation group (50 cases). After TACE,control group re-ceived arterial infusion chemotherapy of 40 mg/m2 oxaliplatin,once a day+20 mg Epirubicin hydrochloride for injection,once a day,with little lipiodol. Observation group received arterial infusion chemotherapy of 80 mg/m2 oxaliplatin (the same usage with control group)+Epirubicin hydrochloride for injection(the same dosage with control group),with little lipiodol. Alanine aminotrans-ferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBIL),white blood cell count (WBC) and alpha-fetoprotein (AFP) in 2 groups after 3 d treatment were observed,and the total overall survival (OS) and the incidence of adverse reactions were followed-up. RESULTS:Abdominal pain,incidences of nausea and vomiting,ALT,AST and TBIL in observation group were significantly higher than control group,WBC was significantly lower than control group,the differences were statistically sig-nificant (P<0.05). There were no significant differences in fever,hair loss,incidence of peripheral neurotoxicity,OS in 1 year and 3 years,and AFP in 2 groups(P>0.05). CONCLUSIONS:Compared with 40 mg/m2 oxaliplatin,80 mg/m2 can reduce the in-cidence of abdominal pain,nausea,vomiting,but other effects are poor than 40 mg/m2,and it can not prolong the survival time of patients.

OBJECTIVE:To observe the clinical efficacy of entecavir combined with intervention in the treatment of liver cancer patients with HBV DNA-negative hepatitis B. METHODS:100 liver cancer patients with HBV DNA-negative hepatitis B were random-ly divided into observation group and control group,50 cases in each group. Control group received intervention,percutaneous punc-ture of femoral artery,then injected Pirarubicin hydrochloride for injection + lipiodol in parent artery until blood stagnation,and also conventional liver protection therapy was conducted;observation group additionally received 1 mg Entecavir tablet,qd,for continuous 6 months. Clinical efficacy,HBV DNA quantification,Child-Pugh score and liver function indexes in 2 groups were compared. RE-SULTS:The total effective rate in observation group was 44.0%,which was significantly higher than control group(26.0%),the dif-ference was statistically significant(P<0.05). There were no significant differences in HBV DNA quantification,Child-Pugh score and liver function indexes between 2 groups(P>0.05). After treatment,HBV DNA quantification,Child-Pugh score,fetoprotein,alanine aminotransferase, total bilirubin and aspartate aminotransferase significantly decreased in observation group,the differences were statis-tically significant compared with control group (P<0.05). CONCLUSIONS:Entecavir combined with intervention can obviously im-prove the clinical efficacy and liver function indexes of liver cancer patients with HBV DNA-negative hepatitis B.

Objective To evaluate the value of ATP content of CD4+ T lymphocytes in the diagnosis of infection and its correlation with drug concentrations in renal transplant recipients.Methods 45 renal transplant recipients were reviewed from May 2010 to October 2011.There were 33males and 12 females,aged from 21 to 58 years old.The recipients were divided into non-infection group (n =34) and infection group (n =11) according to their clinical manifestation.11 cases of infection were diagnosed by the chest X-ray,CT imaging manifestations and etiological examination,among them 5 cases were pulmonary infection,4 cases were upper respiratory infection,1 case was urinary tract infection and 1 case was perineal abscess.23 healthy volunteers were enrolled as the control group.They were detected ATP content of CD4+T lymphocytes by Immuknow method.Thetrough concentrations of the FK506 and CsA were detected by microparticle enzyme immunoassay and fluorescence polarization immunoassay,respectively.The hs-CRP concentration was detected by immunoturbidimetry.Results The ATP content of CD4+ T lymphocytes of the control group,non infection group and the infection group were (295±74) μg/L,(35± 189) μg/L and (212± 155) μg/L respectively.The levels of ATP of infection group were obviously lower than the control group and non-infection group.There were statistically differences (P ＜0.05).24 recipients were followed up dynamicly.There were 4 cases whose ATP value was lower than the postoperative average levels in 5 infection recipients.The hs-CRP concentration of infection group were (12.4±4.8) mg/L,obviously higher than the non infection group's (3.3 ± 4.7) mg/L and the control group' s (0.5 ± 0.5) mg/L.There were statistically differences (P＜0.05).The ATP content of CD4+ T lymphocytes were no significant associated with drug trough concentrations (P＞0.05).Conclusions Low ATP level after renal transplantation is a risk factor for infection recipients.Immuknow cell function assay can make up for the inadequacy of the drug concentration monitoring,reduce the risk of infection,and guide clinical immunosuppressive adjustment.

ObjectiveTo investigate the morphologic features of coronary sinus (CS)-left atrium muscle connections,and evaluate the function and anatomical features of coronary sinus on dual-source CT coronary angiography (DSCTCA).MethodsImages of DSCTCA of 144 patients [ control group consisted of 96 patients,and atrial fibrillation (AF) group consisted of 48 patients] were reviewed.The existence of coronary sinus-right atrium muscle connections was indirectly evaluated by measuring the cross-sectional area changes of the CS during atrial systole and atrial diastolic.The number,location,length of the CS-left atrium muscle connections andthe relationship between CS-left atrium muscle connections and CS morphological characteristics were studied.The t test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results( 1 )The anatomic course of the CS in relation to the mitral ring was straight,mild curvature and high riding of 62,16 and 18 cases in control group and 10,8 and 30 cases in AF group,respectively.There was not statistical significance between the 2 group (x2 =0.093,P=0.954). (2)The CS length was (34.1 ±9.1),(33.8 ±8.9)mm in Control group and AF group,respectively.There was no statistical significance between the 2 group ( t =- 0.486,P =0.628 ).(3) Coronary sinus-left atrium muscle connections were seen in 131 of the 144 patients (91.0％).A single connection was seen in 103 of the 144 patients,with a mean length of (22.6 ± 12.7)mm within (6.3 ± 5.8 ) mm of the coronary sinus ostium.28 patients had two connections; distal connections measured ( 13.2 ± 6.2)mm in length within (16.7 ± 6.8 ) mm of the coronary sinus ostium,and proximal connections measured ( 11.1 ± 3.6 ) mm in length within (2.1 ± 1.9) mm of the coronary sinus ostium.And there was no statistical difference the number and length of CS-left atrium connections in between Control group and AF group (P ＞ 0.05 ).(4)The CS narrowed 22.4％ (44.5/198.8 )in cross-sectional area from atrial diastolic to atrial systole in control group( t =- 21.076,P ＜ 0.01 ),while the CS had no obvious contraction in AF group(t =0.374,P ＞ 0.05).The cross-sectional area of the coronary sinus during diastole was obviously larger in the AF group than in the control group[( 230.4 ±77.0) mm2 vs (198.8 ±65.4) mm2,respectively,t =- 2.579,P =0.01 ].In control group ( n =9 ),the coronary sinus-left atrium connection was not seen,however,all showed a CS constriction during atrial systole,indicating that coronary sinus-left atrium muscle continuity is not likely the primary cause for coronary sinus contractions. Conclusions DSCTCA can clearly show the anatomical characteristics of CS,it can help to understand the length,number and location of the CS-left atrium muscle connection.

Objective To assess the clinical value of measuring the concentration of serum osteoprotegerin (OPG) in detecting the bone metastases in patients with prostate cancer. Methods The concentration of serum OPG in 40 patients was determined by ELISA. The data of ECT bone scan and Gleason score was collected simultaneously. The correlations between serum OPG and bone metastases, Gleason score were tested. Results The concentration of serum OPG in patients with bone metastases by ECT scan was( 16 237. 19 ±5144. 26) ng/L,which was significantly higher than the concentration in patients without bone metastases , which was (12 123.32 ±4136. 50)ng/L. There was no significant correlation between serum OPG and Gleason score. Conclusions The serum OPG has an important clinical value in prediction of prostate cancer with bone metastases. There is no significant correlation between serum OPG and the Gleason score.

Objective To explore the influence of different methods of bandaging on the postoperative intracranial pressure of patients with severe brain injury patients after decompression craniectomy. Methods The standard decompressive craniectomy was use for the 36 cases of severe traumatic brain injury patients, and the intracranial pressure monitoring sensor probe was indwelled in operaion. Two different dressing methods of elasticity mesh cap and applicator were used for the patients respectively at 0h, 72h, 120h and 168h after operation, and the value of intracranial pressure was monitored and recorded. Result The intracranial pressure of elastic cap were significantly higher than the applicator respectively in operation immediate postoperative 72h, 120h and 168h (P<0.05), the difference was statistically significant. Conclusions The intracranial pressure of elastic cap is significantly higher than the applicator at different times after the surgery group.

Objective To study the changes of insulin- like growth factor- 1(IGF-1)in blood and cerebrospinal fluid (CSF) in children with viral encephalitis (VE).Methods The IGF-1 levels in blood and CSF were determined before treatment by ELISA in 25 children who admitted with VE, including 15 cases with severe VE and another 10 cases with mild VE, 10 children served as con-trols. Results Before treatment, the blood IGF-1 levels in VE group were significantly lower than those of controls, but the CSF IGF-1 levels were significantly higher than those of controls(P0.05), but the blood IGF-1 levels in serve VE group were significanfly lower than those of mild VE group and controls(P

Objective To investigate the morphologic features of Bachmann bundle (BB) and its vascular supply on dual-source CT coronary angiography(DSCTCA) in healthy volunteers and patients with coronary artery lesion (CAL). Methods Clinical histories, electrocardiograms (ECGs), and images of DSCTCA of 106 patients ( CAL group) and 100 healthy volunteers ( Control group) were reviewed. All 106 patients underwent conventional coronary angiography ( CCA ). The Gensini scoring system was used to assess the results of CCA. The patients were divided into three groups according to their Gensini scores. The length, width and superoinferior diameter, CT value, and vascular supply of BB were studied. Rank sum test for continuous variables and Chi-square test for categorical variables were used in statistical analysis.Results ( 1 ) BB visualization rate of control group was higher than CAL group [86.0% (86/100) vs 51.9%(55/106), x2 = 27.726, P ＜ 0.01]. The higher the Gensini score of CAL subgroup, the lower the visualization rate of its BB [80.0% ( 28/35 ), 55.6% ( 20/36 ), 20.0% ( 7/35 ), x2 = 25.530, P ＜ 0.01].(2)The median of measurements of length,width and superoinferior diameter of control and CAL group were 13.0 vs 13.8,5.0 vs 5.2 and 5.9 vs 6.2 mm, respectively ( P ＞ 0.05 ). (3) The CT value of the BB region in control group( median :42.6 HU ) was higher than that of CAL group( median: 13.0 HU) ( Z = - 7.061, P ＜0.01). The CT values of BB regions in patients with nonvisualized BB (median: -16.0 HU) were lower. The CT values of the BB regions in CAL group were negatively-correlated with Gensini scores( median:19.0) (r = -0.553, P ＜0.01 ). (4)The blood supply of BB and BB region was provided by right sinuatrial node artery ( SNA, 58.7%, 121/206 ), left SNA ( 35.9%, 74/206 ) or both SNAs ( 5.3%, 11/206 ).Conclusions DSCTCA could can show the anatomical characteristics of BB and its arterial supply. The serious the degree of CAL , the lower the BB display rate, and the higher the abnormal ECG incidence,which indicate that the occurrence of BB lesions is probably related to ischemia.

Objective To evaluate the value of renal parenchymal volume and thickness by non-contrast spiral CT in evaluating the differential glomerular filtration rate (GFR) for chronic obstructed kidneys, and to compare the correlations between the two morphologic indices of renal parenchyma and the GFR for chronic obstructed kidneys. Methods Seventy-one patients who had a diagnosis of unilateral chronic upper urinary tract obstruction were included in this analysis. (1) The renal parenchymal volume was mea-sured by non-contrast spiral CT. Both kidneys were scanned by non-contrast spiral CT. The renal parenchymal area of each section was marked manually. Renal parenchymal volume was calculated as the sum of renal parenchymal area multiplied by the width of each section. The volume percentage of obstructed kidney (%CTvol) was also calculated. (2) Renal parenchymal thickness was measured on the first and last non-contrast CT image levels from the anterior, posterior and lateral locations of the kidney that clearly contained the collecting system. The mean of these measurements was defined as the renal parenchymal thickness. The differential renal parenchymal thickness of the obstructed kidney (%CTt) was defined as the percentage of the obstructed renal parenchymal thickness to the total renal parenchymal thickness for both kidneys. GFR was determined with 99Tcm-DTPA dynamic imaging system by Gates method. The differential GFR for obstructed kidney (%GFR) was the GFR percentage of obstructed kidney to the total GFR for both kidneys. The Pearson relation test was carried out between the %CTvol, %CTt and the %GFR respectively. Results %CTvol and %CTt correlated well with %GFR in chronic obstructed kidneys among the 71 test group patients. Pearson correlation coefficient r was 0.80 (t=11.20, P＜0.05) and 0.66 (t=7.24, P＜0.05), respectively. The linear correlation equation respectively was %GFR=0.05+0.80×%CTvol (F=125.48, P＜0.05) and %GFR=0.12+0.66×%CTt (F=52.36, P＜0.05). Conclusions Renal parenchymal volume and thickness by non-contrast spiral CT might be used as clinical practical parameters to evaluate the differential GFR for chronic obstructed kidneys. Renal parenchymal volume is more accurate than renal parenchymal thickness.

Objective To evaluate the effect of transurethral feedback microwave thermotherapy with the ProstaLund CoreTherm Device(PLFT) in high risk patients with benign prostate hyperplasia (BPH). Methods Sixty-six high risk patients diagnosed with BPH, including aged ≥80 in 32 pa-tients, hypertension in 31 patients, diabetes in 5 patients, heart failure in 8 patients, chronic obstruc-tive pulmonary disease in 8 patients, cerebral infarction in 11 patients, fracture, amputation or joint stiffness unsuitable for lithotomy position in 3 patients, abnormal blood coagulation in 4 patients, pan-creatitis in 2 patients, cardiac arrhythmia in 6 patients and malignant tumor in 3 patients, were treated with PLFT using individual power at urethral local anesthesia, resulting in coagulation necrosis in 15%-30% of prostate tissue around urethra. Meanwhile, real-time monitoring the temperature of prostate and the tissue around it was used. All patients were evaluated by comparing volume of pros-tate, maximal urinary flow (Q_max), international prostate symptom score (IPSS) and quality of life questionnaire (QOL) in pre-treatment and three months after respectively. Results All of patients well tolerated PLFT. There was bleeding lightly, infection lightly and temporary incontinence. There was no severe surgical complication. After three months, the volume of prostate reduced from 62. 2 ml to 44.5 ml; IPSS decreased from 23. 4 to 11.7; QOL decreased from 4.5 to 2.4; Q_max rised from 4, 2 ml/s to 11.2 ml/s. All differences reached significance. Conclusion PLFT is one of effective and safe treatments for patients with BPH especial BPH complicating with severe conditions.