Objective To assess the clinical value of transcatheter arterial chemoembolization (TACE) together with radiofrequency ablation (RFA) and sorafenib in treating recurrent hepatocellular carcinoma (HCC) after surgery.Methods A total of 40 patients with recurrent HCC after surgery, who were encountered at authors' hospital during the period from December 2009 to May 2014, were collected. The patients were divided into the study group (n=20) receiving TACE combined with RFA and sorafenib and the control group (n=20) receiving TACE plus RFA. Within 7-10 days after TACE, RFA was carried out. In the study group, oral sorafenib therapy (400 mg, two times everyday) started at 4 days after TACE. Withdrawal of sorafenib would be ordered if drug resistance occurred. Each patient underwent TACE combined with RFA not less than two times. Results The median survival time of the study group and the control group was 31.0 months and 24.8 months respectively, and statistically significant difference existed between the two groups (P<0.05). The one-year, 2-year and 3-year survival rates of the study group were 85%, 70% and 50%respectively, while the one-year, 2-year and 3-year survival rates of the control group were 80%, 55% and 30% respectively; the differences between the two groups were not statistically significant (P>0.05). The progression free survival (PFS) time of the study group and the control group was 6.8 months and 5.7 months respectively, the difference between the two groups was statistically significant (P<0.05). Conclusion TACE combined with RFA and sorafenib can prolong the overall survival time and the progression free survival time of patients with recurrent HCC after surgery.

Objective To evaluate the short-term efficacy, safety and effectiveness of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) combined with radioactive 125I seed implantation in treating advanced non-small-cell lung cancer (NSCLC). Methods A total of 48 patients with inoperable and EGFR mutation-positive advance NSCLC were included in this study. The patients were divided into study group (n = 26) and control group (n = 22). Patients in the study group were treated with EGFR-TKIs combined with radioactive 125I seed implantation; while patients in the control group only received EGFR-TKIs treatment, which was kept on until the disease progressed. The clinical efficacy, and the incidence of side effect as well as the survival rate were determined, and the results were compared between the two groups. Results Local disease control rate of the study group and the control group was 92.3% and 68.2%respectively, the difference was statistically significant (P= 0.033), while the effective rate was 76.9% and 54.5%respectively, the difference was not significant (P=0.101). Progression-free survival (PFS) time of the study group and the control group was 14.1 months and 9.7 months respectively (P< 0.05). The one-year survival rate of the study group and the control group was 80.8%and 63.6%respectively (P<0.05), and the median survival time was 26.9 months and 17.1 months respectively (P < 0.05). The major complication caused by radioactive 125I seed implantation was pneumothorax. Conclusion For EGFR mutation-positive advance NSCLC, EGFR-TKIs together with radioactive 125I seed implantation is a safe and effective treatment.Its short-term efficacy is superior to pure EGFR-TKIs therapy. At present, this combination therapy is a new alternative for the treatment of EGFR mutation-positive advance NSCLC.

Objective To evaluate the feasibility, safety, and efficacy of Y-shaped jogged stent in patients with malignant hilar biliary obstruction. Methods During the period of January 2010 to June 2015,We retrospectively reviewed 98 cases of malignant hilar biliary obstruction who were received implantation of biliary tract stent. 17 consecutive patients who were treated with Y-shaped jogged stent were identified (group A) during January 2012 to June 2015. Group A was carefully matched according to patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment, and 17 patients who were underwent unilateral stent placement alone with PTCD were chosen as control group (group B). Patients' baseline characteristics, stenting strategy, complications, stent patency time and survival rates were analyzed, and continuous variables of the two groups were compared using Student's t-test. Categorical variables were analyzed using the Fisher exact test. Results Y-shaped jogged stent implantation group and control groups were closely matched in terms of patients' age, sex, type of tumor, stage, type of biliary obstruction, level of bilirubin at diagnosis, presence of metastasis and treatment ( P>0.05). The bilirubin decreased rate in the two groups was 88.2%and 53.0%respectively (P<0.05). The median time of stent patency after stent implantation was(7.3 ± 1.0)months and(5.7 ± 0.9) months respectively (χ2=4.04,P=0.044), and the median survival time was(9.1 ± 1.5)months and(7.2 ± 1.1)months (χ2=4.60,P=0.032), with significant difference according to Kaplan-Meier analysis. There were no severe complications such as massive hemorrhage, perforation, biliary fistula and severe pancreatitis, which were associated with stent implantation. Conclusions The application of Y-shaped jogged stent is safe, feasible and effective in patients with malignant hilar biliary obstruction. It can relieve the clinical symptoms of biliary obstruction effectively with prolongation of stent patency time and survival rate significantly.

Objective To evaluate the clinical efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) in treating hepatocellular carcinoma (HCC) under liver capsular. Methods Forty three patients with 62 lesions of HCC under liver capsular received TACE followed by CT?guided percutaneous RFA after 1 to 2 weeks were analyzed retrospectively. The subjects were observed and follow?up imaging with enhanced MRI was performed to evaluate the therapeutic efficacy after combined treatment. The patients were followed up for 10 to 69 months. The patients with residual lesions received a second RFA, the patients with recurrence or new lesions received another TACE combined with RFA. The overall survival rates, median survival time and median time to progression were calculated by using Kaplan?Meier. Results A total of 55 TACE and 68 ablations were performed in 43 patients with 62 lesions. The procedure was successfully accomplished in all patients. The complete ablation rate after the first ablation was 90.3%(56/62). The 1, 3, 5?year overall survival rates were 95.3%, 78.1%and 43.9%, the median survival time was 58 months and the median time to progression was 32 months. Conclution For the treatment of hepatocellular carcinoma under liver capsular, TACE combined with RFA is safe and effective.

Objective To investigate the reasons and the methods of prevention and cure for serious complications of radiofrequency ablations in the treatments of hepatocellular carcinomas. Methods A total of 410 patients with BCLC at A or B stage of hepatocellular carcinomas in our hospital were enrolled between November 2014 and June 2009. These patients underwent a total of 504 times radiofrequency ablations for the treatments of liver lesions. This retrospective study analysed the reasons and the strategies of prevention and cure for the serious complications. Results In the patients with a total of 504 times radiofrequency ablations, 2 patients had massive hemorrhage caused by puncture injuries, 2 patients had the tumors which were close to the liver capsules and 1 patient had bile peritonitis caused by the injury of thermal ablation on the gallbladder. The maximum diameter of tumor was 5 cm. That tumor was close to the gallbladder. 2 patients had needle tract metastases caused by incompletely needle path ablations. 1 of the 2 patients had a tumor near the liver capsule, and the other patient had un-enough temperature for needle path ablation. Tumor outbreaks were happened in 2 patients. 1 of the 2 patients had a tumor which was located in the liver capsule and close to the portal vein. The other patient had a 12 cm diameter tumor with rich blood supplement. 2 patients had liver abscesses. 1 of the 2 patients had a tumor near the ascending colon, and the other patient had diabetes. 1 patient had colonic perforation caused by thermal ablation. The tumor in that patient was located in the right hepatic lobe segment and adjacent to the ascending colon. The incidence of serious complications was 1.98% (10/504). Conclusions The incidence of the serious complications of radiofrequency ablations for the treatments of hepatocellular carcinomas is relatively low. The main reasons for the serious complications were direct injuries caused by punctures, heat radiation injuries, tumors adjacent to large blood vessels, gallbladders and intestines, tumors with abundant blood supplement, needle paths fail to cross normal liver tissues, low scores of liver function, weak immune system and diabetes. The key points for avoiding and reducing the serious complications are preoperative evaluations of patients' basic situations, choices of appropriate puncture channels and control ranges of ablations when tumors are close to important blood vessels, intestines and gallbladders.

Sulfur fumigation, which is traditional method for preservation, pest control, insecticide and sterilization, has long been widely used in processing and storage and played a positive role of traditional Chinese medicine (TCM). As some businesses sided pursuit of profit, abused and repeated use of sulfur fumigation, have resulted in a large number of harmful residues, such as sulf dioxide (SO2) and harmful heavy metals, which brings a significant impact and danger on human health. This article summarizes the sulfur species and the sulfur fumigation methods and analyzes the harmful substances in TCM after sulfur fumigation, to provide a reference of the choice of species for the sulfur, the optimization of sulfur fumigation process and the standardized processing of TCM after sulfur fumigation.
Animals ; Drug Contamination ; Fumigation ; methods ; Humans ; Medicine, Chinese Traditional ; methods ; Safety ; Sulfur ; chemistry ; Technology, Pharmaceutical ; methods

OBJECTIVETo study the clinical characteristics of human bocavirus (HBoV) among children and to understand the association of HBoV with human diseases.

METHODTotally 148 nasopharyngeal aspirate (NPA) samples were collect from hospitalized children with acute respiratory infection during Oct. 2005 to Feb. 2006. Two serum samples were obtained from HBoV positive patients. PCR was used to assay all these samples and PCR products were sequenced.

RESULTHBoV was positive in 11 of 148 NPA samples. The positive rate was 7.4 percent. The serum samples of HBoV infected patients showed that serum contained HBoV by PCR assay. All these HBoV positive patients had the clinical symptoms of bronchitis, bronchopneumonia and pneumonia. Some patients had diarrhea.

CONCLUSIONAll patients infected with HBoV had upper and lower respiratory tract infections. HBoV is a probable important pathogen of upper and lower respiratory tract infection. The HBoV could cause viremia. In addition, some HBoV patients had diarrhea. HBoV infection probably could also result in intestinal disease and other related symptoms.

Bocavirus ; genetics ; isolation & purification ; Child ; Child, Preschool ; DNA, Viral ; blood ; Female ; Humans ; Infant ; Male ; Parvoviridae Infections ; virology ; Respiratory Tract Infections ; virology

OBJECTIVETo explore and evaluate the combined conservative managements in the treatment of cervical chylous leakage.

METHODSThirty nine cases of cervical chylous leakage from June 1992 to June 2008 were retrospectively analyzed in this hospital. All of the 39 cases were cured by treating with conservative individualized therapy, including the applying of diet with high calorie, high protein and low fat and fatty food should only contains medium-chain triglycerides, total parenteral nutrition, keep the balance of hydrogen and electrolyte and correct hypoproteinemia, local pressure dressing, high persistent vacuum drainage (-50 approximately -80 kPa) and/or somatostatin analogue.

RESULTSAll the cases of chylous leakage happened 2nd to 5th days after the operation. Among the 39 cases, 7 were high flow (drainage>or=500 ml/d) chylous leakage, the amount of drainage reached as high as 1440 ml per day. The time of chylous leakage closure was 3 approximately 12 days, and the mean time was 7 days. No one experienced re-operation, wound hydrops or wound infection.

CONCLUSIONSThe conservative individualized therapy may play a key role in the treatment of cervical chylous leakage.

Adolescent ; Adult ; Aged ; Chylous Ascites ; etiology ; therapy ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Parenteral Nutrition, Total ; Postoperative Complications ; therapy ; Retrospective Studies ; Young Adult

Objective To study the HIV-1 drug resistance (DR) situation among newly infected persons in Dehong.Methods 1048 HIV-1 positive blood samples from July to December in 2006 from Dehong prefecture of Yunnan,were collected.HIV drug resistance were tested using TruGene in newly infected people that were distinguished with BED-CEIA,while the subtype were determined with phylogenetic analysis using a set of reference sequences available on the Los Alamos Database.Results Of sixty-four successfully analyzed samples,drug resistance mutations were detected in 4 samples with the resistance rate as 6.25%.Minor mutation in PR region such as M36I/V,L63P and H69K appeared frequently and the rates were 81.25%,70.31%and 65.63%respectively.The predominantly prevalent strains were seen as C/CRF07_BC/08_BC(65.63%,42/64) in this study.Conclusion The prevalence of genotypic drug resistances in HIV-1 recent infections in Dehong prefecture appeared to be at moderate level.Drug-resistance surveillance program among HIV-1 infections should be continued and strengthened.

Objective To compare the effectiveness of implementation of multi-teaching model ( MT) and case based teaching ( CBT) in pediatric teaching among undergraduate medical students. Methods Eighty one trainee students were divided into CBT and MT groups. Scenario based teaching ( SBT) , sandwich teaching ( ST) and CBT were given to students of MT group. Results The self evaluation scores of " how much have you grasp before the class"by students after class in MT group were higher than those of CBT group[5.0(2.5,7,5) vs 4.0(3.0,5.0), Z=2.011,P＜0.05]. The scores of obstructive structured clinical examination after training of MT group were higher than those of CBT group[ 93.0(90.3,97.0) vs 83.25(78.3,86.4),Z=7.752,P＜0.001]. Conclusions MT is better than CBT in pediatric training among undergraduate medical students.