OBJECTIVETo evaluate the safety of iodine-125 seed implantation in the liver.

METHODSTwenty New Zealand rabbits were divided into control and treatment groups and in the latter, iodine-125 seeds of 37 MBq were implanted into the liver under CT guidance whereas nonradioactive seeds were implanted in the control rabbits. Four weeks after implantation, white blood cell count, liver functions, and renal functions were measured or evaluated for comparison with those before implantation. The rabbits were then anesthetized to collect the liver tissue for pathological examination with HE staining and cell apoptosis assay.

RESULTSObvious hepatic tissue necrosis was observed around the radioactive seeds in the treatment group. At a 5 mm distance to the seeds, a distinct boundary occurred between the necrotic hepatic cells and normal cells. The control rabbits, however, had normal liver structure around the seeds implanted. In situ cell apoptosis examination showed a distinct band of apoptotic cells in the liver tissue of rabbits in the treatment group, which was not found in the control group. Two weeks after iodine-125 irradiation, alanine aminotransferase significantly increased in the treatment group (t=6.285, P<0.001), but recovered two weeks later (t=2.002, P=0.06). No significant alterations occurred in aspartate aminotransferase, blood urea nitrogen, serum creatinine, hemoglobin, serum total bilirubin, white blood cell count, or platelet count after the seed implantation.

CONCLUSIONIodine-125 seed implantation in the liver results in conformal irradiation dose distribution without obvious effects on the vital organs, demonstrating iodine-125 seed implantation as a safe and minimally invasive technique for hepatic cancer treatment.

Alanine Transaminase ; blood ; Animals ; Apoptosis ; radiation effects ; Dose-Response Relationship, Radiation ; In Situ Nick-End Labeling ; Iodine Radioisotopes ; adverse effects ; Liver ; pathology ; physiopathology ; radiation effects ; Male ; Rabbits ; Radiation Injuries, Experimental ; blood ; etiology ; pathology ; Random Allocation ; Time Factors

OBJECTIVETo investigate the changes of ataxia-telangiectasia mutated (ATM) phosphorylation in HepG(2) cells in relation to HepG(2) cell survival under continuous low dose-rate irradiation.

METHODSHepG(2) cells were exposed to equivalent irradiation doses delivered at either a continuous low dose-rate (7.76 cGy/h) or a high dose-rate (4500 cGy/h), and the phosphorylated ATM proteins and surviving fraction of HepG(2) cells after the exposures were compared.

RESULTSThe phosphorylation of ATM protein was maximal at 0.5 Gy irradiation delivered at either a high doserate or a continuous low doserate. As the radiation dose increased, ATM protein phosphorylation decreased under continuous low dose-rate irradiation, but remained stable under high dose-rate irradiation. With comparable ATM protein phosphorylation induced by continuous low dose-rate irradiation and high dose-rate irradiation, there was no significant difference in the surviving fraction of HepG(2) cells (P>0.05), but at a significantly lower ATM protein phosphorylation level than that induced by high dose-rate irradiation, continuous low dose-rate irradiation resulted in increased cell killing (P<0.01).

CONCLUSIONContinuous low dose-rate irradiation increases HepG(2) cells radiosensitivity as compared with high dose-rate irradiation. Increased cell killing following continuous low dose-rate irradiation is associated with reduced phosphorylated ATM protein, and inhibition of ATM phosphorylation may increase the radiosensitivity of HepG(2) cells.

Animals ; Ataxia Telangiectasia Mutated Proteins ; Cell Cycle Proteins ; metabolism ; Cell Line, Tumor ; Cell Survival ; radiation effects ; DNA-Binding Proteins ; metabolism ; Dose-Response Relationship, Radiation ; Humans ; Mice ; Phosphorylation ; radiation effects ; Protein-Serine-Threonine Kinases ; metabolism ; Radiation Tolerance ; radiation effects ; Time Factors ; Tumor Suppressor Proteins ; metabolism

OBJECTIVETo evaluate the feasibility of no antibiotic administration to prevent infection during the perioperative period of percutaneous intradiscal ozone-injection for treatment of lumbar disc herniation.

METHODSSeventy-two patients with lumbar disc herniation but normal body temperature as well as normal results of three routine tests (blood, urine, stool) and C-reactive protein (CRP) level were randomly divided into two groups. The patients in prophylaxis group were given cephalothin V(2.0 g) intravenous 30 min before the operation, and the control group did not use any antibiotics. All the patients were injected with 6-10 ml ozone (40 microg/ml) for medical use into the discs with 21G needles under fluoroscopic guidance, followed by 10 ml ozone into the paravertebral space. Three days later the general examinations and CRP measurement were repeated.

RESULTSNo infection was found in these patients, nor were any significant differences noted in the results of the examinations between the two groups after controlling in patients with above-normal white blood cell count, neutrophil percentage and CRP level.

CONCLUSIONProphylaxis antibiotics is not necessary during the perioperative period of percutaneous intradiscal ozone injection for lumbar disc herniation.

Adult ; Aged ; Anti-Bacterial Agents ; therapeutic use ; Cefazolin ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Injections, Intralesional ; Intervertebral Disc Displacement ; diagnostic imaging ; drug therapy ; Lumbar Vertebrae ; Male ; Middle Aged ; Oxygen ; administration & dosage ; Ozone ; administration & dosage ; Perioperative Care ; Radiography

BACKGROUNDEndothelial progenitor cells (EPCs) derived from bone marrow may differentiate into endothelial cells and participate in endothelial repair. These cells can be mobilized into peripheral blood by cytokines, including granulocyte colony-stimulating factor (G-CSF). In the present study, we investigated the effects of G-CSF on neointimal formation and restenosis in a canine model of arterial balloon injury.

METHODSSixteen male beagle dogs were injected subcutaneously with 20 microg x kg(-1) x d(-1) recombinant human G-CSF (n = 8) or normal saline (n = 8) for 1 week. On the fifth day of treatment, the dogs underwent renal arterial angioplasty. At 8 weeks after arterial balloon injury, angiographic observations were made and injured arteries were processed for morphometric analysis of neointimal formation.

RESULTSPeripheral white blood cell counts were increased by 3.34-fold compared to baseline on the fifth day of administration of G-CSF. Angiographies revealed that one stenosis had occurred among the eight injured renal arteries from dogs treated with G-CSF, whereas all injured renal arteries from dogs treated with normal saline remained patent. The mean extent of stenosis among injured arteries was 18.3% +/- 17.9% in the G-CSF treated group compared to 12.5% +/- 7.6% in the saline treated control group (P = 0.10). G-CSF treatment slightly increased neointimal thickness (0.42 +/- 0.15 mm vs 0.25 +/- 0.06 mm, P = 0.08) with an intima to media ratio of 0.83 +/- 0.49 vs 0.54 +/- 0.18 (P = 0.11).

CONCLUSIONSG-CSF treatment does not attenuate neointimal hyperplasia and restenosis formation in a canine model of renal arterial injury, suggesting that the therapeutic strategy for preventing restenosis by stem cell mobilization should be investigated further.

Animals ; Dogs ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Hematopoietic Stem Cell Mobilization ; Hyperplasia ; Male ; Recombinant Proteins ; Renal Artery ; injuries ; pathology ; Tunica Intima ; pathology

OBJECTIVETo assess value of endovascular graft exclusion (EVGE) with digital subtraction angiography (DSA) in the treatment of Stanford type B aortic dissection (AD).

METHODSOn the basis of diagnosis with multi-slice spiral CT (MSCT), DSA was performed in 20 Stanford B AD cases for further diagnostic confirmation and EVGE was conducted for treatment. The DSA findings of the cases and the therapeutic effect of EVGE were evaluated.

RESULTSIn the 20 cases of Stanford type B AD, altogether 22 stents were implanted during EVGF with a stent release success rate of 100%. Postoperative examination revealed no obvious leakage or false lumen in 15 cases, and death occurred in 1 case 6 days after the operation due to right renal hemorrhage and infection, and the rest 19 patients were cured and discharged. Follow-up of the patients demonstrated improvement in the clinical symptoms, and MSCT showed that all the dissections were sealed successfully. No severe complications were observed 3 months after the treatment in these patients.

CONCLUSIONDSA can identify the fine anatomy of AD and allowed intraoperative monitoring in EVGE, which is an effective and safe means for treatment of Stanford type B AD.

Adult ; Aged ; Aneurysm, Dissecting ; diagnostic imaging ; surgery ; Angiography, Digital Subtraction ; methods ; Aortic Aneurysm ; diagnostic imaging ; surgery ; Blood Vessel Prosthesis Implantation ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Stents ; Tomography, Spiral Computed ; Treatment Outcome

OBJECTIVETo summarize our 10-year experience with percutaneous fluoroscopically guided removal (PFGR) of metallic foreign body (MFB) in the soft tissue.

METHODSPFGR was performed in 65 patients for removing a total of 368 MFBs from the soft tissues. The MFBs ranged from 0.2 to 0.3 cm in length embedded in the soft tissue for 7 days to 8 years. For superficial MFBs, the MFBs were removed directly with curved forceps under real time fluoroscopy. For deep MFBs, trocar technique was applied using the instruments for percutaneous diskectomy, with the outer cannula inserted toward the foreign body under real-time fluoroscopy followed by MFB removal by grasping forceps.

RESULTSA total of 346 MFBs were successfully removed without any serious complications (success rate 94.0%), including 154 removed directly and 192 MFBs with trocal technique. The time of the procedures and radiation exposure for MFB removal was 30 s to 20 min and 1-6 min, respectively.

CONCLUSIONPGFR of MFBs in the soft tissue under fluoroscope is safe and effective. Direct removal using curved forceps is suitable for MFBs in superficial soft tissues, while trocal techniques needs to be utilized for deep MFBs.

Adolescent ; Adult ; Child ; Female ; Fluoroscopy ; methods ; Foreign Bodies ; diagnostic imaging ; surgery ; Humans ; Lower Extremity ; Male ; Metals ; Radiography, Interventional ; Young Adult

Objective To evaluate the efficacy and safety of intensity modulated radiation therapy (IMRT) for whole-brain radiotherapy with simultaneous integrated boost for brain metastases.Methods From January 2015 to January 2017,120 patients with brain metastases undergoing hospital radiotherapy at the First People's Hospital and the Second People's Hospital of Yulin City of Guangxi Zhuang Autonomous Region were randomly divided into three dimensional conformal radiation therapy (3DCRT) group (n =60) and IMRT group (n =60) by envelope method.The curative effects of the two groups and the changes of patient's mental states before and after radiotherapy were compared.Results The median survival times of patients in 3DCRT group was 11.5 months,and the 6 months and 1 year survival times rates were 83.3％ and 35.0％ respectively.The median survival times of patients in IMRT group was 12.9 months,and the 6 months and 1 year survival rates were 86.7％ and 38.3％ respectively.There was no significant difference in prognosis between the two groups (x2 =0.143,P =0.705).There were 8 cases with complete remission,38 cases with partial remission,11 cases with stable disease,3 cases with progressive disease in 3DCRT group,and there were 9,40,9,2 cases in IMRT group respectively.There was no statistically significant difference in short-term efficacy between the two groups (Z =-0.641,P =0.520).Univariate analysis results showed that recursive partitioning analysis (RPA) classification (x2=53.484,P ＜0.001),extracranial lesions control (x2=13.392,P ＜ 0.001),whether the midline offset (x2 =4.427,P =0.035) were prognostic factors.Multivariate analysis results showed that RPA classification (HR =2.631,95 ％ CI:1.884-3.673,P ＜ 0.001),extracranial lesions control (HR =1.697,95％ CI:1.034-2.786,P =0.037),whether the midline offset (HR =1.787,95％ CI:1.118-2.856,P =0.015) were the independent prognostic factors for the overall survival.According to the results of activities of mini-mental state examination,the scores of 3DCRT group before and after radiotherapy were 27.12 ± 2.42 and 26.08 ± 2.42 respectively,with a significant difference (t =2.723,P =0.009);and the scores of IMRT group before and after radiotherapy were 26.57 ± 3.09 and 27.20 ± 2.46 respectively,with no significant difference (t =-1.610,P =0.1 13).Conclusion IMRT for whole-brain radiotherapy with simultaneous integrated boost is an effective treatment for multiple brain metastases,which can relieve symptoms,prolong survival time and improve quality of life.

Metabolic associated fatty liver disease (MAFLD) has become a prevalent chronic liver disease worldwide because of lifestyle and dietary changes. Gut microbiota and its metabolites have been shown to play a critical role in the pathogenesis of MAFLD. Understanding of the function of gut microbiota and its metabolites in MAFLD may help to elucidate pathological mechanisms, identify diagnostic markers, and develop drugs or probiotics for the treatment of MAFLD. Here we review the pathogenesis of MAFLD by gut microbiota and its metabolites and discuss the feasibility of treating MAFLD from the perspective of gut microbes.
Gastrointestinal Microbiome ; Fatty Liver/microbiology* ; Humans