Objective To evaluate the safety and effectiveness of TACE with radiofrequency ablation (RFA) in treatment of renal cell carcinoma.Methods Data of 23 cases of renal cell carcinoma were retrospectively analyzed.Firstly all patients were treated with renal TACE,and then RFA under the guidance of ultrasound and CT was performed 3 to 4 weeks later.The therapeutic effects were evaluated by enhanced CT or MR scans during the follow-up period.Meanwhile,the changes of Karnofsky Performance Status (KPS) scores and renal functions between preoperative and postoperative periods were also evaluated.Results To the end of the follow-up,in all 23 patients 21 cases (21/23,91.30％) survived and 2 cases died (2/23,8.70 ％).KPS scores and serum creatinine levels were observed in all 23 patients at the initial stage and the end of the follow-up period,there were no significant differences (all P＞0.05).At the end of follow-up,16 cases were complete remission,5 were partial remission and 2 were progressive disease.Conclusion TACE combined with RFA is a safe and effective method in treatment of renal cell carcinoma with less trauma,less complication and more effective.

Objective To investigate the effectiveness and safety of TACE combined with radiofrequency ablation (RFA) and simple RFA in the treatment of hepatocellular carcinoma (HCC) with Meta-analysis.Methods The randomized controlled trials comparing of TACE combined with RFA and simple RFA in the treatment of HCC from January 2000 to November 2016 in Chinese and English literatures were included.Results A total of 12 articles were enrolled in this study.Meta-analyses showed that the 1-year,3-year overall survival rate and 1-year,3-year recurrence-free survival rate of TACE combined with RFA group were better than those of simple RFA group (all P＜0.05).And there was no significant difference between TACE combined with RFA group and simple RFA group in 5-year overall survival rate (P =0.07).There was no significant difference of the 1-year,3-year overall survival and 1-year and 3-year recurrence-free survival rate between TACE combined with RFA group and simple RFA group for tumor with maximum diameter ＜3 cm in HCC (all P＞ 0.05).There was no significant difference in the incidence of serious complication in both two groups (P=0.82).Conclusion The short-term and mid-term efficacy in the treatment of HCC using TACE combined with RFA is better than those using simple RFA,while the long-term efficacy of two kinds of therapy have no significant differences.

Objective To explore the clinical value of lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors.Methods Totally 1 252 patients with hepatic tumors treated by radiofrequency ablation were analyzed.RITA cluster multipole radio needles were used in all cases.Local anesthesia with lidocaine was used before percutaneous puncture,and the dosage was 2 mg/kg of body mass.The initial dose of remifentanil was injected with pump at 0.05 μg/(kg · min) during operation.Mean arterial pressure (MAP),heart rate (HR) and saturation of peripheral oxygen (SPO2) were recorded 24 h before radiofrequency ablation (T0),at the beginning of operation (T1),30 min after operation (T2) and at the end of surgery (T3).Visual analogue scale (VAS) was used to assess the analgesic effect during the whole ablation procedure.Results Radiofrequency ablation were successfully performed in 1 250 patients (1 250/1 252,99.84％).The average time was (59.02 ±14.63) min.The average dosage of remifentanil was (242.22± 22.73)μg.The average VAS score was (2.42± 1.13) points.Compared with the preoperative T0 time point,SPO2 did not change significantly at each time of T1,T2 nor T3,but MAP and HR were significantly higher than those before operation (both P＜0.05).VAS scores were significantly higher in patients with tumors size ＞5 em than those in patients with tumors size ≤5 cm (P＜0.05).VAS scores were significantly higher in patients with lesions under hepatic capsule and in diaphragm dome than in patients with lesions in other parts (both P＜0.05).Severe anesthesia related complications occured in 2 patients,related to the respiratory inhibitory effect of remifentanil,and the patients were completely recovered after corresponding treatment.Conclusion Lidocaine combined with remifentanil intravenous anesthesia for radiofrequency ablation of liver tumors can effectively relieve the pain in patients.Tumor size and tumor location are the main impact factors on analgesic effect.

Objective:To evaluate the safety and effectiveness of transjugular intrahepatic portosystemic shunt (TIPS) in hepatocellular carcinoma (HCC) patients with Vp4 portal vein tumor thrombus (PVTT).Methods:Data of 15 patients undergoing TIPS for HCC with Vp4 PVTT and portal hypertension (PTN) in Peking University First Hospital from July 2018 to February 2023 were retrospectively analyzed, including 14 males and 1 female, aged (61.5±11.1) years old, ranging from 40 to 78 years old. The success rate of TIPS, portal pressure gradient (PPG) before and after procedure, perioperative adverse effects and complications were recorded. The survival status of patients was followed up by telephone review after surgery. Kaplan-Meier method was used for survival analysis.Results:The procedure of TIPS was performed uneventfully in all patients, with a technical success rate of 100% (15/15). PPG before and after TIPS were (31.73±5.48) mmHg (1 mmHg=0.133 kPa) and (17.60±3.66) mmHg, respectively, and the difference was statistically significant ( P<0.001). No perioperative death, hepatic artery or bile duct injury, acute liver failure or other major complications occurred. Compared with the preoperative status, the performance status scores [0(0, 0) vs. 3(3, 3)] and Child-Pugh scores [6(5, 8) vs. 9(8, 10)] were lower in patients one month after TIPS (all P<0.05). The median survival time was 228 d. Kaplan-Meier curves showed that the cumulative survival rates at 3, 6, 12 and 24 months after TIPS were 100%, 64.3%, 32.7% and 8.2%, respectively. Conclusion:TIPS could be safe and effective for HCC with Vp4 PVTT and severe PTN.

Objective: By means of network pharmacology, potential targets and molecular pathways of QiZhenYuanDan in the treatment of atherosclerosis (AS) were studied. Methods: TCMSP database was used to obtain the main active components and target information of Astragali Radix, Fructus Ligustri Lucidi, Corydalis Rhizoma and Salvia Miltiorrhiza in QiZhenYuanDan. Disease targets were retrieved by OMIM and other databases. Molecular networks were constructed using Cytoscape. STRING database was searched and PPI network diagram was drawn to obtain the key targets of QiZhenYuanDan in the treatment of AS; and the targets were uploaded to Metascape data platform for GO and KEGG analysis. Results: There were 118 targets of intersection between QiZhenYuanDan and AS, which were used as the predicted targets of QiZhenYuanDan on AS. GO analysis showed that the biological functions of QiZhenYuanDan in the treatment of AS targets mainly involved biological processes, such as the cytokine-mediated signaling pathway, cytokine receptor binding. KEGG pathway was mainly enriched in 155 signaling pathways, including PI3K-Akt, HIF-1, NF-κB signal pathway and inflammatory bowel disease pathway. Conclusion: Based on the result of network pharmacology study, the mechanisms of Qizhenyuandan for AS treatment was preliminarily revealed. The active ingredients such as quercetin and kaempferol act on targets such as IL-6 and PI3K-Akt, and exert anti-AS effects by inhibiting apoptosis, oxidative stress, as well as inflammatory responses. Our result indicates that QiZhenYuanDan exhibits anti-AS effect via a multi-component, multi-target and multi-route synergistic process.
Atherosclerosis/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Medicine, Chinese Traditional ; Network Pharmacology ; Phosphatidylinositol 3-Kinases ; Proto-Oncogene Proteins c-akt