Objective:To investigate the effects of thalidomide on vascular endothelial growth factor(VEGF) and quality of life in patients with primary hepatocellular carcinoma after transcatheter arterial chemoembotization.Methods:A total of 60 patients with HCC,who were treated with transcatheter arterial chemoembolization (TACE) in Affiliated Hospital of Chengde Medical University from January 2014 to January 2016,were randomly divided into group A (n=30)and group B (n=30).Group A was treated with Thalidomide in combination with TACE,oral 200 mg every night for 1 month;group B was treated with TACE alone.The levels of VEGF in the two groups were detected before treatment and 3 weeks after treatment;the quality of life of patients before treatment and 1 month after treatment was evaluated by quality of life scale (QOL);the weight of two groups before and after treatment and adverse reactions during treatment were compared.Results:There was no significant difference in VEGF levels between the two groups before treatment (P＞0.05).After treatment,the levels of VEGF in the two groups were higher than those before treatment,and the VEGF levels in the group A was significantly lower than that in the group B,the difference was statistically significant (P＜0.01).There was no significant difference in QOL score and body weight between the two groups before treatment (P＞0.05).The QOL scores of the two groups after treatment were lower than those before treatment,but the QOL scores of patients in group A were significantly higher than those in group B (P＜0.05).There was no significant difference in weight between the two groups before and after treatment (P＞0.05).In group A,1 patients (3.33％) had severe somnolence,2 (6.67％) patients stopped taking thalidomide due to severe dry mouth,and the remaining 27 patients were able to tolerate.Conclusion:Thalidomide combined with TACE in the treatment of patients with HCC can reduce the levels of VEGF and improve the quality of life of cancer patients,which is worthy to be popularized in clinic.

Objective To describe the echocardiographic and clinical findings of patients with accessory mitral valve(AMV).Methods Four adult patients were diagnosed to have AMV by Doppler echocardiography.Results All the four patients had cardiac murmur but 2 were asymptomatic.Echocardiogram showed that two cases had isolated AMV with significant left ventricular outflow tract (LVOT)obstruction.Another patient was complicated by idiopathic hypertrophic subaortic stenosis and his systolic pressure gradient across the LVOT reduced to normal after taking negative inotropic drugs.The fourth patient was associated with complex congenital cardiac anomalies but without LVOT obstruction.Conclusions AMV may not be very rare as previously reported.An echocardiographic examination Can detect AMV and difierentiate it from other causes of LVOT obstruction.

Aged ; Aortic Valve Insufficiency ; diagnostic imaging ; Echocardiography ; Humans ; Male

Objective To investigate the value of bone marrow imprints in the cytomorphology diagnosis.Methods A total of 354 cases of bone marrow smears,imprints,and sections were analyzed from January 2011 to December 2013 to detect morphological diagnosis difference.Results Bone marrow imprints in groups of extremely reduced,significantly reduced,normal,slightly increased,increased significantly,and extreme increase were better than that of smear which nucleated cells quantity assessment(P ＜ 0.01).Smears and imprints were similar (P ＞0.05).Imprints nucleated cell number decreased mostly were the same as smear,but smear reduced imprints mostly normal or increased.The bone marrow sections nucleated cells quantity as the standard,smears and imprints had high coincidence rate in the group of nucleated cells reduced (87.5％ and 96.9％),and imprints were higher than smear in the group of nucleated cells quantity in normal and increased(87.8％ and 95.7％ vs 68.3％ and 55.8％),and the difference was statistically significant.Imprints were better than smear in specificity,Youden index,and sensitivity.Patients with plasma cell myeloma (PCM) imprint plasma cell volume and immature plasma cells were higher than that of smear (42.73 ± 10.47 and 13.60 ± 4.83 vs 24.67 ± 11.18 and 11.07 ± 5.82) with a statistically significant difference (P ＜ 0.05).Conclusions Imprints have characteristics both smear and sections,and imprints are superior to smears in assessment of nucleated cells and tumor cell invasion degree.Smear combined with imprints can improve the diagnosis level of bone marrow cell cytomorphology.

Objective To investigate the correhtion between cognitive impairment and cerebral atherosclerosis in patients with acute ischemic stroke.Methods Acute ischemic stroke patients without cognitive impairment were recruited before symptom onset.The Montreal cognitive assessment (MoCA) was used to evaluate the cognitive function.Magnetic resonance imaging (MRI) was used to identify the infarct locations and sides.Magnetic resonance angiography,CT angiography and digital subtraction angiography were used to identify atherosclerotic arteries.Resul~ A total of 101 patients with acute ischemic stroke were enrolled,including 75 (74.3％) with cognitive impairment.The proportions of age (54.54 ± 12.59 years vs.64.43 ± 10.37 years;t =-3.960,P ＜0.001),years of education ≤6 years (50.7％ vs.11.5％;x2 =12.257,P ＜ 0.001),and cerebral atherosclerosis (89.3％ vs.50.0％;x2 =18.137,P ＜0.001) of the cognitive impairment group were significantly higher than those of the normal cognitive function group.Multivariate logistic regression analysis showed that cerebral atherosclerosis was an independent risk factor for cognitive impairment in patients with acute ischemic stroke (odds ratio 1.720,95％ confidence interval 1.005-2.942;P=0.048).MoCA score was negatively correlated with the offending vessels (r=-0.365,P＜ 0.001) and the most severe vessels of atherosclerotic degree (r=-0.243,P =0.014).Conclusions Most patients with acute ischemic stroke had cognitive impairment in the early stage after onset,and the MoCA scores was negatively correlated with the degree of cerebral atherosclerosis.Cerebral atherosclerosis was an independent risk factor for cognitive impairment in patientswith acute ischemic stroke.

Objective To study the effect of postoperative ileus of laparoscopic surgery versus open surgery for colorectal canc-er .Methods 220 patients of colorectal cancer were selected from October 2009 to June 2012 .The patients were randomly divided into the observation group(n=110 cases) and the control group(n=110 cases) .The patients of the observation group were treated with laparoscopic surgery ,and the patients of the control group were treated with conventional open surgery .The postoperative anal exhaust time and hospital stay time ,the incidence of postoperative ileus of the two groups were observed and compared .Results The postoperative anal exhaust time and hospital stay time of the patients after radical resection of left colon ,right colon and rectal cancer of the observation group were significantly less than that of the control group (P<0 .05) .The incidence of postoperative ileus of the observation group was 5 .45% (6/110 ) ,significantly lower than 11 .82% (13/110 ) of the control group ( P< 0 .05 ) . Conclusion Laparoscopic colorectal surgery is a minimally invasive surgery ,the patient′s trauma is smaller ,the postoperative re-covery is rapidly .The incidence of intestinal obstruction is smaller than that of the conventional open surgery .

Aim To investigate the influence of iridosides of cornus officinalis(ICO) on morphology, cell cycle and oxidative stress of glomerular mesangial cells(GMC) cultured with advanced glycation end products(AGEs). Methods GMC were incubated in culture medium containing AGEs in the presence of ICO and aminoguanidin for 48 hours. At the same time, the control and model groups were added. Then the cultured GMC were stained by mixed fluorescence liquid and observed under fluorescence microscope. Cell cycle of GMC were analyzed using flowcytometry. The content of MDA, activity of SOD and GSH-Px in GMC supernatant were measured. The level of ROS was detected using flowcytometry. Result Morphology analysis showed that the morphology and structure of normal GMC were normal. The structure of most cells in AGEs were unclear, cell counts increased largely and they grow intensively. Cell cycle analysis showed that cell percentage of S phase increased and G_0/G_1 reduced. The level of ROS, MDA remarkably increased, and SOD, GSH-Px activity reduced. When the ICO were added, cell morphology tended to be basically normal and cell counts decreased, the percentale of S phase also decreased. The level of ROS, MDA and the SOD, GSH-Px activity restored in comparison with the model groups. Conclusion ICO can prevent the cultured GMC from lesion caused by AGEs. ICO may protect GMC from AGES to retard the progression of diabetic nepropathy by partially inhibiting the occurrence of oxidative stress.

Objective: To study the relation of plasma Se to oxidative stress in the patients with primary glomerular diseases (PGS) and its clinical significance. Methods: Plasma Se concentration ,GSH-Px and SOD activities and contents of MDA in 45 patients with PGS and 20 normal control (NC)were measured by catalytic polarography and colorimetric assay. Serum creatinine, urea nitrogen and uric acid concentrations in these patients were determined simultaneously. Results: 1. Plasma Se contents of both PGS patients of normal(groupⅠ) and impaired renal function (groupⅡ) were significantly lower than those in NC;2. PGS patients of groupⅠandⅡhad significantly lower plasma GSH-Px and SOD activities than NC and their MDA contents were siginificantly higher. 3. Plasma GSH-Px and SOD activities and MDA contents between groupⅠand Ⅱ were not different; 4. Multiple logistic regression analysis showed that plasma Se content in patients with PGS was positively related to plasma GSH-Px , SOD activities and negatively correlated with MDA. Serum creatinine concentrations were negatively correlated significantly with plasma Se, GSH-Px, SOD and positively related to MDA. Conclusion: Plasma Se deficiency may be an important non-immune factor resulting in or worsening PGS through weakening body抯 antioxidative defence. It is suggested that sufficient Se supplementation in practice may be obviously beneficial to oxidative stress in the patients with PGS.

Objective To summarize imaging appearances of brain in AIDS patients,as to supply the evidences of imaging diagnosis for this disease . Methods CT or/and MRI appearances of brain in 19 patients with AIDS of nervous system type were reviewed . Results 3 cases showed the symmetry signal abnormal in bilateral whiter matter and 2 cases showed brain atrophy in 5 patients with HIV encephalitis.2 cases of toxoplasma encephalitis appeared multiple abnormal density or/and signal intensity in the brain and multiple ring enhancement . 3 patients with lymphoma displayed single or multiple nodule in the brain and nodular-enhancement or inhomogenous enhancement.3 patients with brain infarction displayed lower density in the basal ganglia on CT.2 patients with progressive multifocal leukoencephalopathy displaied multiple patch abnormal signal intensity of the white matter in frontal and parietal lobus.1 patient with cryptococcal infection showed abnormal signal and ring enhancement of the pons.1 patient with cryptococcal meningitis and 2 patients with intracranial hypertension had not abnormal imaging appearances.Conclusion Most lesions of the brain in AIDS patient may be detected by CT and MRI,but the definite diagnosis is still in need of combining with clinical appearances and other relative examination.

OBJECTIVETo analyze the changes of patients with type 2 diabetes in different stages in glucagon (GC) and free fatty acid (FFA) in fasting, OGT and L-Arg experiments, and discusses the role of pancreatic alphabeta cells in diabetes pathogenesis by studying the relations among indexes such as glucagon (GC), free fatty acid (FFA) and blood glucose (BG), insulin, insulin homeostasis model (HOMA) and glucose metabolism hormone secretion curve, in order to provide theoretical basis for the treatment of diabetes.

METHODStudy objects were divided into the T2DM group (45 cases), the IGT group (28 cases) and the NGT group (30 cases) for an OGTT experiment and then an L-Arg experiment on the next day. Under the fasting state, their blood glucose (FBG), insulin (F), glucagon (FGC), free fatty acid (FFA) were detected to calculate HOMA-beta, insulin sensitivity index (ISI) and HOMA-IR of different groups. Meanwhile, efforts were made to calculate different time quantum detected in OGTT and L-Arg experiments and area under the curve AUC(BG), AUC(INS) and AUC(GC).

RESULTObvious overall differences were observed in FFA and FGC of the three groups. FGC of each group was negatively correlated with HOMA-beta and ISI. Among all of the 103 study objects, FGC was positively correlated with FBG and HOMA-IR and negatively correlated with HOMA-beta and ISI, with no correlation with FINS; FFA was positively correlated with FBG, HOMA-IR and negatively correlated with FINS, HOMA-beta, ISI. FGC and FFA were positively correlated in the T2DM group and the IGT group, but with no statistical correlation in the NGT group. The sequence of the three study objects was T2DM > IGR > NGT in AUC(GC) in the OGTT experiment and T2DM > IGR > NGT in in AUC(GC) in the L-Arg experiment, with the significant positive correlation between AUC(GC) and AUC(BG) and significant negative correlation with AUC(INS).

CONCLUSIONGlucagon and free fatty acid of T2DM and IGT patients increased, which was positively correlated with blood glucose and HOMA-IR and negatively correlated with INS, HOMA-beta and ISI. The increase in glucagons of T2DM and IGT patients indicated inappropriate secretion of pancreatic alphabeta cells among patients with type 2 diabetes.

Adult ; Blood Glucose ; metabolism ; Diabetes Mellitus, Type 2 ; metabolism ; Fatty Acids, Nonesterified ; metabolism ; Female ; Glucagon ; blood ; Humans ; Insulin ; secretion ; Islets of Langerhans ; secretion ; Male ; Middle Aged