Objective To investigate the clinical value of contrast-enhanced ultrasonography(CEUS) in evaluating treatment response of hepatocellular carcinoma after interventional therapy. Methods One hundred and three patients with 136 lesions of hepatocellular carcinoma confirmed by pathology were examined by common color ultrasound (US), contrast-enhanced CT, CEUS and DSA pre- and post-interventional treatment respectively. Results The sensitivity,specificity and accuracy of CEUS for focus judgment after interventional therapy were 95.8%, 95.6% and 98. 5% respectively. The sensitivity, specificity and accuracy of US in detecting tumor deactivation and residue were 92.3% ,77.4% and 83.1% respectively. CEUS were highly consistent with the results of enhanced CT/DSA (Kappa = 0.93) and significantly higher than those of US (Kappa = 0.66). Conclusions CEUS is useful to monitor the efficacy and guide treatment after interventional therapy.

Objective To identify the blood perfusion characteristics of different kinds of liver cancer and individualize interventional treatment models by color Doppler ultrasound(CDUS) and contrast-enhanced ultrasonography (CEUS). Methods The blood perfusion characteristics of 315 patients with liver cancer comfirmed by pathology were analyzed and classified using CDUS and CEUS. Individual interventional therapy models were selected based on the classification. Therapeutic effects were evaluated by EUS,contrast-enhanced CT(CECT) and DSA simultaneously. Results Liver cancer can be classified by the blood perfusion characteristics from CEUS examination. The individualized interventional treatment models were selected and evaluated according to the characteristics:①Solitary small HCC of diameter ≤3 cm group were treated via percutaneous ethanol injection(PEI),radiofrequency(RF) or percutaneous microwave coagulation therapy(PMCT). Necrosis rates of the lesions were 95.0% - 97.9%, 1 and 3 years survival rates were 98.0% and 87.8% ,respectively. ②Diameter ≤5 cm and lesions ≤3 group were treated with RF or PMCT combined PEI. Necrosis rates of the lesions were 93.7% - 94.8% ,1 and 3 years survival rates were 89.8% and 81.4% ,respectively. ③Diameter ＞5 cm and hypervascular tumor main fed by the hepatic artery group were treated with TACE,PEI combined RF or PMCT. Necrosis rates of the lesions were 71.4% - 73.8%, 1 and 3 years survival rates were 66.2% and 47.6%, respectively. ④ Diameter ＞5 cm and hypervascular tumor fed by double blood supply or accompanied by portal vein tumor thrombus group were treated with selective portal vein embolization(SPVE) based on the above treatments. Necrosis rates of the lesions were 53.3% - 55.6%, 1 and 3 years survival rates were 64.7% and 40.0%, respectively. Conclusions Classifying the blood perfusion characteristics and choosing individualized interventional treatment models by CEUS are of important clinical significance in non-surgical treatment of liver cancer.

Objective To investigate the symptoms and the needs of transitional care for the patients with lung cancer at the intermission of chemotherapy and provide references for the symptom management and carrying out transitional care. Methods Totally 156 patients with lung cancer were investigated by questionnaire survey. Results With the increase of chemotherapy, symptoms such as cough, sputum, dyspnea were relieved after chemotherapy(F=18.266, 20.463, 17.371, P < 0.05), but symptoms like fatigue, nausea, vomiting, loss of appetite, sleep uncomfortable were worse than before(F=15.821, 20.116, 16.439, 13.541, 9.528, P<0.05,<0.01). Negative emotions like bitterness and sadness had no obvious change. Symptoms affected the patients′mood, the incidence and severity were higher after chemotherapy(χ2=43.162, F=11.683, P < 0.05), as for general activity and walking, the incidence and severity were higher after the first cycle chemotherapy and the second cycle(χ2=42.589, 37.689, 39.125, F=9.148, 15.325, 14.758, P < 0.05), but after 4 cycles of chemotherapy, it did not change significantly (P>0.05). 79.49%(124/156)patients did not know the content and function of transitional care, 98.72%(154/156)patients hope to get transitional care through the hospital. Conclusions Symptoms by side effects were getting worse for patients with lung cancer and influenced their daily life. Patients got to know less about transitional care, however they had a strong need for transitional care. We should
reinforce the management of symptoms and transitional care to improve their quality of life.

OBJECTIVETo assess the feasibility, the risks and the advantages of endoscope-assisted submandibular gland resection using a retroauricular hairline incision (RAHI) by comparing it with the conventional submandibular gland resection.

METHODSTwenty eight patients with benign lesions of the submandibular gland were included in the prospective clinically controlled study. Thirteen patients had endoscope-assisted resection using the RAHI approach and 15 cases had conventional transcervical approach resection. The size, location and adjacency of all lesions were evaluated by CT or MRI before surgery. The pathologic diagnoses of all cases were identified as benign diseases using fine needle aspiration biopsy. The two groups were compared for incision length, operation time, bleeding, incision cosmetic result, and complications.

RESULTSAll 28 operations were successfully performed. Incision length in the endoscopic group was significantly longer than that in the transcervical group (Z = -4.516, P < 0.01), and the surgical time was longer in the endoscopic group (Z = -3.263, P < 0.01). After three months the mean subjective satisfaction score for the incision scar in the endoscopic group was significantly higher than that in the transcervical group (Z = -4.472, P < 0.01). In the endoscopic group, 2 cases (15.4%) with temporary numbness of the earlobe and 1 case (7.7%) with a temporary marginal mandibular nerve paralysis were found postoperatively. However, they recovered within 1 month. All 28 patients were disease free with a follow-up of 10 to 24 months (median of 18 months).

CONCLUSIONSEndoscope-assisted submandibular gland resection via RAHI is feasible and safe for the treatment of benign submandibular gland lesions. In comparison with the transcervical approach, this method can provide better cosmetic results without significant complications.

Adult ; Endoscopy ; methods ; Female ; Humans ; Male ; Middle Aged ; Oral Surgical Procedures ; methods ; Prospective Studies ; Submandibular Gland ; surgery ; Submandibular Gland Diseases ; surgery ; Treatment Outcome ; Young Adult

P-glycoprotein (P-gp) located in the apicalmembranes of intestinal absorptive cells is an energy-dependent efflux pump which can reduce the bioavailability of a wide range of substrate drugs. There is increasingly interest in enhancing the bioavailability of these molecules by inhibiting intestinal P-gp. A classification of excipient inhibitors of intestinal P-gp nonionic surfactants, poly (ethylene glycol), derivates of beta-cyclodextrin and thiolated chitosan will be presented and then the inhibition mechanism will be discussed. Compared with traditional P-gp inhibitor, excipient inhibitors appear to have minimal nonspecific pharmacological activity, thus potential side effects can be mostly avoided. These excipient inhibitors, which hold the promise of replacing the traditional ones, will be extensively employed to significantly improve the intestinal absorption of poorly soluble and absorbed drugs as a result of P-gp inhibition, and thus to enhance the bioavailability of these drugs. However, the further studies of both the mechanism and clinical application are urgently needed.
ATP-Binding Cassette, Sub-Family B, Member 1 ; antagonists & inhibitors ; pharmacokinetics ; Animals ; Biological Availability ; Chitin ; analogs & derivatives ; pharmacology ; Excipients ; pharmacology ; Glycerol ; analogs & derivatives ; pharmacology ; Humans ; Intestinal Absorption ; drug effects ; Polyethylene Glycols ; pharmacology ; Surface-Active Agents ; pharmacology ; beta-Cyclodextrins ; pharmacology

Diterpenes, an important class of natural compounds, are widely distributed in nature. As the valuable diterpenoids continue to be found, diterpene synthase in the course of diterpene synthesis get as much attention as possible. The multiformity of end-product-diterpenoids were also due to the diversity of diterpene synthase. This paper focuses on the advances in recent biosynthesis pathway of diterpene and types, cloning, catalytic mechanism, synthetic biology application.
Alkyl and Aryl Transferases ; metabolism ; Biosynthetic Pathways ; Diterpenes ; metabolism ; Isomerases ; metabolism ; Phosphorus-Oxygen Lyases ; metabolism ; Plant Proteins ; metabolism

With improved overall survival of cervical cancer patients, the importance of the quality of life (QOL) is increasingly recognized. This study was conducted to compare the QOL of women with different stage cervical cancer before and after treatment to facilitate improved cervical cancer prevention and treatment. We used the generic Medical Outcomes Study Short Form-36 (MOS SF-36) to collect QOL information. Based on SF-36, we interviewed cervical cancer patients at West China Second Affiliated Hospital and Sichuan Cancer Hospital between May 2010 and January 2011. A total of 92 patients with precancerous lesions, 93 with early cancer, and 35 with advanced cancer responded to our survey. Average physical component summary (PCS) scores were significantly different between the three groups at every time point (P < 0.05). Average mental component summary (MCS) scores were significantly different between the three groups after treatment (P < 0.05). Average PCS and MCS scores increased gradually from the pretreatment to posttreatment period for patients with precancerous lesions. However, they reached the lowest at 1 month after treatment for patients with early and advanced cancers and rebounded between 1 and 6 months after treatment. Our results indicate that patients with precancerous lesions and early cervical cancer show better overall QOL than do those with advanced cervical cancer. Additionally, patients with early cancer recover more quickly than do those with advanced cancer in terms of both physical and mental functions. Thus, early detection and treatment initiatives may improve the QOL for patients with precancerous lesions and cervical cancer.
Adult ; Aged ; Carcinoma in Situ ; pathology ; therapy ; Cervical Intraepithelial Neoplasia ; pathology ; therapy ; Chemoradiotherapy ; China ; Female ; Follow-Up Studies ; Humans ; Hysterectomy ; methods ; Lymph Node Excision ; Middle Aged ; Neoplasm Staging ; Precancerous Conditions ; pathology ; therapy ; Quality of Life ; Surveys and Questionnaires ; Uterine Cervical Neoplasms ; pathology ; therapy ; Young Adult

OBJECTIVETo investigate the safety and efficacy of the transabdominal-hiatal approach of radical gastrectomy for the advanced proximal gastric cancer.

METHODSThe clinical data of 40 advanced proximal gastric cancer patients with involvement of distal esophagus admitted in Tongcheng People's Hospital from June 2003 to September 2006 were analyzed retrospectively. Patients included 27 men and 13 women with a mean age of 56.1 years (range: 37 to 76 years). The data were compared with those of 40 proximal gastric cancer patients undergoing standard thoracoabdominal approach (control group) during the same period.

RESULTSAs compared with the control group, the transabdominal-hiatal approach showed less blood loss [(181.3 ± 63.7) ml vs.(248.8 ± 79.7) ml], shorter operating time [(4.1 ± 0.6) h vs. (5.3 ± 0.7) h], shorter ICU stay [(6.5 ± 5.7) d vs. (19.4 ± 18.0) d] and shorter postoperative hospital stay [(14.0 ± 2.3) d vs.(18.7 ± 3.0) d] (all P<0.05). The complication rates of transabdominal-hiatal approach group and thoracoabdominal approach group were 7.5% (3/40) and 10.0% (4/40), and the 5-year survival rates were 51.3% and 60.0%, respectively (both P>0.05).

CONCLUSIONThe transabdominal-hiatal approach of radical gastrectomy for proximal gastric cancer is safe and effective, which may substitute the standard thoracoabdominal technique.

Adult ; Aged ; Female ; Follow-Up Studies ; Gastrectomy ; methods ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Stomach Neoplasms ; surgery ; Treatment Outcome

AIMTo determine whether repetitive exposure to high sustained +Gz acceleration induces persisting changes in the myocardial free radical metabolism and observe the protective effects of low-G training and antioxidant tea polyphenols (TP).

METHODSThirty-two male Wistar rats were randomly divided into four groups (n=8 each): group A, restrained, was only submitted to +1 Gz for 5 min. Group B, centrifuged, was exposed to five plateaus of 30 s at +10 Gz for intermittent times, three times a week, for three weeks. Group C, low-G trained, was exposed to +2 Gz for 5 min about 1 h prior to +10 Gz stress, and group D was orally given TP at dose of 200 mg/kg about 1 h prior to +10 Gz stress. On the next day morning after last centrifuge run, the rats were decapitated and the hearts were quickly removed. Malondialdehyde (MDA) concentration and superoxide dismutase (SOD) activity were measured. Additionally, CuZn-SOD and inducible NO synthase (iNOS) enzymatic contents were examined by immunohistochemical staining and their mRNA were analyzed by semi-quantitative reverse transcription polymerase chain reaction(RT-PCR).

RESULTSCompared with group A, MDA concentration and iNOS enzymatic content in myocardial mitochondria were increased significantly (P < 0.05) in group B. Compared with group B, mitochondrial SOD activity was significantly increased in group C (P < 0.05). iNOS enzymatic content was significantly decreased in group C and D. There were no significant differences of CuZn-SOD content, CuZn-SOD and iNOS mRNA levels among the four groups.

CONCLUSIONRepeated high +Gz exposure can induce myocardial free radical metabolic disorder and mainly result in mitochondrial peroxidative injury. But low-G training and natural antioxidant TP have protective effects, and the former is better.

Acceleration ; Adaptation, Physiological ; physiology ; Animals ; Free Radicals ; metabolism ; Male ; Myocardium ; metabolism ; Polyphenols ; pharmacology ; Rats ; Rats, Wistar ; Tea ; chemistry