Purpose:To study the therapeutic effects of beta-ultrasound guided percutaneous alternating cryogenic- heating therapy(ACHT) through liver puncture combined with other regional therapy for advanced hepatocellular carcinoma. Methods:68 patients with advanced hepatocelluar carcinomas were divided into 4 groups.Group A,17 patients are treated with ACHT plus transcatheter hepatic arterial chemoembolization(TACE).Group B,16 patients were treated with ACHT plus intravenous chemotherapy;GroupC,19 patients were treated with TACE only;GroupD,16 patients were treated with in- travenous chemotherapy only.Results:In ACHT+TACE group,the rate of complete response(CR) plus partial response (PR) was 88.2%,the 0.5-,1-year survival rates were 94.1%,94.1%,the rate of AFP decreased was 84.6%.In ACHT+ ICT group,the rate of complete response(CR) plus partial response(PR) was 87.5%,the 0.5-,1-year survival rates were 87.5%,68.8%,the rate of AFP decreased was 78.6%.In the TACE group,the rate of complete response(CR) plus par- tial response(PR) was 57.6%,the 0.5-,1-year survival rates were78.9%,42.1%,the rate of AFP decreased was 69.2%. In ICT group,the rate of complete response(CR) plus partial response(PR) was 25.0%,the 0.5-,1-year survival rates were 50.0%,18.8%,the rate of AFP decreased was 41.7%.For CR+PR,ACHT+TACE group and ACHT+ICT group were significantly higher than TACE group and ICT group,but significant changes between ACHT+TACE group and ACHT +ICT group were not found.For survival rates,ACHT+TACE group was significantly higher than the other 3 groups, ACHT+ICT group was significantly higher than ICT group.There were no serious side effects after chemotherapy except that 5 patients' leucocytes decreased to degree Ⅲ.The postoperative complications after ACHT included bleeding,hemoglo- binuria and reactive thoracic,which disappeared after short term treated.Conclusions:Alternating cryogenic-heating therapy (ACHT) through liver puncture combined with other regional therapy is effective in treating advanced hepatocellular carci- noma and its side effects and postoperative complications are mild.

Immobilization conditions of Candida tropicalis to be absorbed in polyurethane foam carrier materials were studied on the xylitol production from corn hemicellulosic hydrolysate. Optimum batch-fermentation conditions were as follows: inoculum amount, 7% (volume ratio); polyurethane foam quantity, 1.0 g/100 mL; 30?C; initial pH, 6.0. Shaking speed was divided into two-phase to accommodate the dissolved oxygen, with 200 r/min at 0~24 h and 150 r/min at 24 h~46 h. The immobilized cells on polyurethane foam carrier have high density and good resistance to inhibitors in the hydrolysates. Average xylitol yield and volumetric productivity of polyurethane foam immobilized fermentation were much higher than the fermentation without immobilization. Corn cob hydrolysates can be directly biotransformed to xylitol without decoloration or ion-exchange treatment. This process can effectively reduce production costs, and it shows broad prospects of applications. Average xylitol yield was 67.6% and xylitol volumetric productivity was 1.92 g/(L?h).

Quite recently,among new emerging contaminants,pharmaceutical and personal care products(PPCPs)and their active metabolites are an emerging environmental issue,due to their presence in the aquatic environment and potential for impacts on wildlife and humans.Carbamazepine is one of the most frequently and at the relatively high concentration levels detected pharmaceuticals in surface water and even in drinking water.Moreover,this drug has displayed high chronic ecotoxicity.A strain of carbamazepine-degrading bacterium was isolated from activated sludge treating pharmaceutical wastewater in Suzhou,China.It was identified as Acinetobacter sp.HY-7,based on biochemical test,16S rRNA and gyrB gene se-quence analysis.Strain HY-7 could grow in liquid mineral salt medium with carbamazepine as sole source of carbon,nitrogen and energy.HPLC analysis revealed the carbamazepine degradation percentage by HY-7 after 10 days was 48% at pH 6.0 and 25?C.Among carbamazepine and the similar structure compounds,in-dole,catechol,naphthalene,anthracene could also be utilized by strain HY-7 for growth,which exhibited a very broad substrate profile.

Objective To evaluate the feasibility of composite material of bone morphogenetic protein (BMP) and PLGA/TCP in repair of peri-porous-titanium bone defects in adult rabbits.Meth- otis The composite of PLGA/TCP scaffold with bovine BMP was made and implanted in distal bone de- fects peri-porous-titanium in femur of adult rabbits.The effect of BMP with PLGA/TCP on peri-prosthesis was evaluated by means of scanning electron microscope (SEM),energy dispersive X-ray analysis (EDX) and biomechanics.Results BMP with PLGA/TCP showed obvious peak of Ca and P of EDX in the pores of titanium in experiment group six weeks after operation and higher than that in control group (P＜0.05).Push-out test demonstrated that the bonding strength between the composite of HA coating/ porous titanium and bone was increased significantly with time (P＜0.05).In experiment group,at 6 and 12 weeks,peri-porous-titanium had higher shearing force compared with control group (P＜0.05). Conclusion BMP loaded with PLGA/TCP is a promising bone graft for bone defects in revision arthro- plasty,as indicates that bone induction of BMP plays an important role in biological stabilizaiton.

Objective To explore the effects and mechanism of bexarotene in combination with tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) on apoptosis of leukemic cell line KG1a. Methods KG1a cells at logarithmic growth phase were obtained, and were divided into TRAIL group, bexarotene group, 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group. Cell apoptosis rate was detected in each group by flow cytometry. Flow cytometry was also employed to determine the apoptosis rates of KG1a cells after treatment with bexarotene and TRAIL in different sequences. The expression of Fas associated death domain-like IL-1 beta converting enzyme inhibitory protein (c-FLIP) was detected by Western blotting. Results There was no significant difference in cell apoptosis rates between TRAIL group and bexarotene group of each concentration (except for bexarotene 2.0 μmol/L) (P > 0.05). The cell apoptosis rates of 300 ng/mL TRAIL in combination with bexarotene group and 2.0 μmol/L bexaroten in combination with TRAIL group were significantly higher than those in TRAIL group and bexarotene group of each corresponding concentration (P <0.01). Sequential analysis revealed that bexarotene could reverse the resistance of KG1a cells to TRAIL (P < 0.001). Compared with single use of 2.0 μmol/L bexarotene or 300 ng/mL TRAIL, combination use could significantly down-regulated the expression of c-FLIP (P < 0.05). Conclusion Bexarotene can significantly enhance the apoptosis of KG1a cells induced by TRAIL, which may be attributed to the down-regulation of c-FLIP expression.

Objective: To evaluate the therapeutic effect of cystic de compression (CD) operation autosomal dominant polycystic kidney disease(APKD) based on clinical material, experience and related theory. Methods: Thirty-nine APKD received CD operation(unilateral 31 cases, bilateral 8 cas e s) in our hospital from 1985 to 1995. Four main parameters, cystic renal enlargi ng rate(CRER)，lumbar pain recurring rate(LPRR)，blood pressure elevating rate(B PER) and renal function abnormal rate(RFAR), were observed 3, 6, 12, 36 and 60 months after CD operation. And the changes were analyzed based on related theory . Results: The changes of 4 main parameters on 5 different time points post operation in unilateral 31 cases were:（1）CRER 19.4%,38.7%,61.3%,1 0 0% and 100%; （2）LPRR 12.9%,48.4%,71.0%,100% and 100%; （3）BPER 6.5%,22.6%,4 1.9%,71.0% and 96.8%;（4） RFAR 3.2%, 12.9%,22.6%,74.2% and 96.8% respectively. Conclusion: During a short period, CD operation can relieve th e lumbar pain, but it is not certain for improving CRER,BPER and RFAR. in the lo ng run, the therapeutic effect is not sure.

This article reviews a large number of recent years' literatures about surgical treatment for children with spinal tuberculosis on the characteristics of children with spinal tuberculosis, and analyzes the development of surgical treatment for children with spinal tuberculosis. Then it summarizes the indications of surgical treatment for children with spinal tuberculosis, and analyzes the clinical effect of various surgical methods of spinal tuberculosis, assesses that anterior debridement combined with anterior and posterior interbody autografting can be a good growth rate and deformity correction. Pedicle fixation on the children with spinal tuberculosis is safe and feasible. The positive early surgery can control children kyphosis. Minimally invasive surgery is the development direction of treatment for children spinal tuberculosis.
Child ; Humans ; Internal Fixators ; Minimally Invasive Surgical Procedures ; Spine ; surgery ; Tuberculosis, Spinal ; surgery

OBJECTIVETo observe the therapeutic effect and major complications of haploidentical nonmyeloablative allogeneic peripheral blood stem cell transplantation (NST) for refractory or relapsed leukemia.

METHODSThe results of 30 patients, including 14 cases of acute myeloid leukemia (AML), 11 cases of acute lymphoblastic leukemia (ALL), 5 case of chronic myelogenous leukemia (CML) (accelerated and blastic phase) with refractory or relapsed leukemia (RF/RL) who underwent haploidentical NST from August 2000 to April 2009 were analyzed. The conditioning regimen consisted of fludarabine (flu), antithymocyte globulin (ATG), cyclophosphamide (CTX), total body irradiation (TBI) and cytarabine (Ara-C) or myleran (Bu). Graft-versus-host disease (GVHD) prevention programmes consisted of Cyclosporine (CsA), mycophenolate mofetil (MMF), CD25 monoclonal antibody combined with mesenchymal stem cells (MSC).

RESULTSTwenty six cases of patients were full donor engraftment and 4 cases mixed chimerism into full donor chimerism. The average duration of neutrophil >0.5×10⁸/L after NST was 11 (9-16) days, and platelet >20×10⁸/L 17 (12-60) days. Upon follow-up of 16 to 120 months, 12-month transplant-related mortality (TRM) was 46.7%, acute Ⅱ-Ⅳgraft-versus-host disease (aGVHD) incidence was 40.0%. The probability of 3-year disease relapse, EFS and overall survival (OS) rates were 16.7%, 46.2% and 50.0% respectively.

CONCLUSIONHaploidentical NST could improve OS and EFS of refractory or relapsed leukemia and reducce TRM to some extent.

Adolescent ; Adult ; Child ; Disease-Free Survival ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; methods ; Humans ; Leukemia ; therapy ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the value and inadequacy in clinical practice of the concept of gastric high-grade intraepithelial neoplasia (HIN).

METHODSForty-five cases with gastric HIN diagnosed by the esophagogastroduodenoscopy (EGD) biopsy were treated from 2003 to 2009. The clinical and histopathological data were analyzed retrospectively.

RESULTSRadical surgeries were successfully performed on all the patients, among whom 33 underwent distal subtotal gastrectomy, 3 proximal partial gastrectomy, 7 total gastrectomy, and 2 endoscopic mucosal resection. In postoperative pathological examination, only 15 cases (33.3%) were HIN, while 14 cases (31.1%) were found to be early gastric cancers, and 16 (35.6%) were advanced cancers. Twelve(40.0%) out of 30 cancers had regional lymph nodes metastasis. When the maximum diameter of the HIN lesion was greater than 3.0 cm, or when ulcer or the features of poorly-differentiated carcinoma or signet-ring cell carcinoma were present in preoperative biopsy, the likelihood of cancer in postoperative pathological examination was higher (P<0.05), and when malignancy was confirmed, the presence of the features above was associated with lymph nodes metastasis and advanced cancer.

CONCLUSIONSCarcinoma is identified in a large proportion of patients with gastric HIN by the EGD biopsy. Lymph nodes metastasis or advanced cancer may be detected in these cases. Cautions must be taken when the new concept of HIN is widely used for diagnosing gastric lesion. Radical resection should be considered when the maximum diameter of the HIN lesion is greater than 3.0 cm, or when ulcer, or the feature of poorly-differentiated carcinoma or signet-ring cell carcinoma are present in the EGD biopsy.

Adult ; Aged ; Biopsy ; methods ; Carcinoma ; diagnosis ; pathology ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms ; diagnosis ; pathology ; Young Adult

Objective To compare and analyze the epidemiological features of adult patients with distal femoral fracture between the east and west areas in China from 2010 to 2011.Methods The data of adult patients with distal femoral fracture treated from January 2010 through December 2011 in 63 hospitals were collected through the PACS system and case reports checking system.The data from 35 hospitals in the east area were classified as group A and those from 28 hospitals in the west area as group B.The analytic items included gender,age and AO classification.Results A total of 2,523 adult distal femoral fractures were collected,involving i,544 males and 979 females,with a male to female ratio of 1.58:1.The adult femoral fractures predominated in an age range from 41 to 50 years (18.94％) and their high-risk type was 33-A (50.18％).In group A of 1,650 cases,there were 1,027 males and 623 females,with a male to female ratio of 1.65:1 and a median age of 48 years;in group B of 873 cases,there were 517 males and 356 females,with a male to female ratio of 1.45:1 and a median age of 45 years.There were no significant differences in the age distribution and gender proportion between groups A and B (P ＞ 0.05).The age distribution showed that the peak ranges were from 31 to 60 years in both groups.The proportion of type 33-A was the most and that of type 33-B the least in both groups.The proportion of type 33-A in group B (53.49％) was significantly higher than in group A (48.42％) while that of type 33-B in group B (16.84％) was significantly lower than in group A (21.39％) (P ＜ O.05).Conclusions Adult distal femoral fractures were common in middle-aged males and their high-risk type was 33-A.Their peak age was from 31 to 60 years in both east and west areas in China.They were more common in men.The predominant fracture type was 33-A in both areas.The east area witnessed a significant higher proportion of type 33-B and a significant lower proportion of type 33-A than the west area.