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.

Objective To assess the clinical significance of serum high sensitive C-reactive protein (hs-CRP) in patients undergone prostate biopsy.Methods A total of 273 consecutive patients were enrolled,aged 44-95 years (mean,69 years).All the patients underwent prostate biopsy.The pathological findings showed 96 cases with prostate cancer (PCa) and 177 cases with benign prostate hyperplasia (BPH).The difference of hs-CRP level between patients with PCa and those with BPH was analyzed.The positive prostate biopsy rate was compared between the patients with high hs-CRP level and those with normal hs-CRP level.Logistic regression was used to evaluate the effect of factors such as hs-CRP,tPSA,PSA density,prostate volume and age on prostate biopsy.Results The medians (interquartile range) of hs-CRP were 3.22 mg/L (1.22-9.84 mg/L) in patients with PCa and 1.24 mg/L (0.55-2.76 mg/L) in those with BPH,respectively,with significant difference(P＜0.05).The positive prostate biopsy rate in patients with high hs-CRP (＞ 3 mg/L)was 55％ (51/92),higher than that in those with normal hs-CRP (≤ 3 mg/L).The odds ratio of hs-CRP was larger than that of all other factors analyzed including tPSA,prostate volume and age according to the Logistic regression analysis.Conclusions Elevated serum hs-CRP level is associated with increased positive prostate biopsy.Serum hs-CRP acts as an independent factor increasing the positive prostate biopsy rate in patients undergone prostate biopsy.

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.

[Abstract] Objective To define the age-specific normal reference values of prostate specific antigen (PSA) and related parameters in Chinese middle-aged and elderly men.Methods From April 2007 to November 2011,serum PSAs of over 22 055 men aged more than 40 years old in our medical examination center were statistically analyzed.The men was divided into five groups by a 10-year-old interval.Total PSA (tPSA),free PSA (fPSA) and prostate ultrasound results were recorded.The free-total PSA ratio (f/t),PSA density (PSAD) and PSA velocity (PSAV) were calculated.By convention,the 95th percentile (P95)was used as the upper limit value,and the 5th percentile (P5) as the lower limit value.Results The tPSAs were positively correlated with age (r=0.349,P＜0.001).f/t was negatively correlated with age (r=-0.154,P＜0.01).Although f/t was significantly different (P＜0.001) among each age group,P5 of all groups were 0.18.PSAD was significantly different (P＜0.001) between men over and under 70 years,with P95 as 0.09 and 0.15,respectively.PSAD had a positive correlation with age (r =0.263,P＜0.01).The significant difference of PSAV raised between men over and under 60 years,with P95 as 0.21 and 0.58,respectively.PSAV was positively correlated with age (r=0.130,P＜0.01).Conclusions PSA,PSAD and PSAV are positively correlated with age,while f/t is negatively correlated with age.The normal range of f/tis 0.18-1.00 for Chinese men over 40 years old.PSAD's normal ranges are ＜0.09 and ＜0.15 in Chinese men over and under 70 years,respectively.The normal range of PSAV are ＜0.21 and ＜0.58 for Chinese men over and under 60 years,respectively.

Objective The effects of candesartan,an angiotensin Ⅱ type 1 receptor blocker (ARB) were investigated on advanced glycation end-products accumulation and the receptor for AGE (RAGE) expression in type 2 diabetic KK/Ta mouse kidneys.MethodsKK/Ta mice(n=72)were random divided into three groups(n=24) and it was treated with candesartan [4 mg/(kg·d)] or vehicle from 6 or 12 to 28 weeks of age.BALB/c mice(n=24) treated with vehicle were used as controls.Body weight,blood pressure,blood glucose,urinary microalbumin,urinary creatinine and serum creatinine were measured every four weeks.At 28 weeks,renal expressions of carboxymethyllysine and RAGE were evaluated by immunohistochemistry and/or competitive RT-PCR.Results KK/Ta mice developed high body weight,high blood glucose,and high urinary microalbumin/creatinine ratio in KK/Ta mice at 28 weeks of age,and it was significantly higher than that of BALB/c mice [(427.49±89.37)mg/g vs (9.54±3.25)mg/g,P＜0.01 ].Protein and mRNA expressions of RAGE were upregulated in KK/Ta kidneys with increased immunostaining intensities of carboxymethyllysine.Candesartan treatment has markedly reduced urinary microalbumin/creatinine ratio [Early treatment group (32.18±9.41)mg/g,Late treatment group (53.20±7.26)mg/g,P＜0.01 ].Treatment with candesartan down-regulated the protein and mRNA expressions of RAGE and reduced the accumulation of carboxymethyllysine.There were no significant differences between the two treatment groups (from 6 or 12 weeks).ConclusionsThe results suggest that candesartan,an ARB,reduces advanced glycation end-products accumulation and subsequent albuminuria by down-regulating RAGE expression in type 2 diabetic KK/Ta mouse kidneys.

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 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 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.