Objective: To observe the short-term efficacy and safety of TACE with CalliSpheres in treatment of unresectable primary hepatic carcinoma (PHC). Methods: Totally of 22 patients with unresectable PHC were treated with CalliSpheres (drug-loaded microspheres) embolization. The therapeutic effect and adverse reactions were then observed. Results: All patients were successfully treated with CalliSpheres embolization. Three days after embolization, the levels of alanine transaminase (ALT), aspartate transaminase (AST) and total bilirubin (TBIL) were higher than those before embolization, while albumin (ALB) was lower than that before embolization (all P<0.05). One month after treatment, there was no significant difference of ALT, AST, TBIL nor ALB compared with those before embolization (all P>0.05). ALT, AST, TBIL 1 month after treatment were lower but ALB was higher than 3 days after treatment (all P<0.05). The objective response rates 1, 3 and 6 months after embolization were 86.36% (19/22), 68.18% (15/22) and 50.00% (11/22), and the disease control rates were 86.36%(19/22), 81.82%(18/22) and 68.18%(15/22), respectively. The postoperative adverse reactions were mainly fever and abdominal pain, and all eased after symptomatic treatment. No serious adverse reaction occurred. Conclusion: TACE with CalliSpheres has good short-term efficacy and safety for treating unresectable PHC.

A new type of fluorescent gold nanoclusters (MU-Au NCs) was prepared by hydrothermal synthesis method using ammonium benzoate murexide (MU) as reducing agent and protecting agent.The synthesis method was simple and rapid.Based on the fluorescence quenching ability of spermine, a turn off type fluorescence analysis method was established for rapid and ultra sensitive detection of spermine.The linear range for detection of spermine was 0.003-300 μmol/L and the detection limit was 1 nmol/L (S/N=3).The established analytical method of spermine provided theoretical basis and reference for construction of spermine biosensor and actual sample detection.

Objective To investigate in vitro activities of 5 fungal agents(amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole)against Penicillium marneffei,providing references for clinical treatment.Methods E-test was used to test the in vitro susceptibilities of 5 antifungal agents (amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole)against yeast form and mycelial form of 52 Penicillium marneffei strains isolated from our hospital.Results The 90% minimal inhibitory concentrations(MIC90)of amphotericin B,ketoconazole,fluconasole,5-fluorocytoaine and itroconazole against yeast form of Penicillium marneffei were 0.250,0.160,24.000,4.000,0.006 mg/L,the minimal inhibitory concentration(MIC)ranges were 0.004-0.500,0.002-0.016,1.000-256.000,0.002-32.000 and 0.002-0.008 mg/L,respectively;the MIG90 of the 5 agents against mycelial form of Penicil lium marneffei were 1.500,0.125,256.000,24.000 and 0.012 mg/L,respectively;the MIC ranges were 0.064-4.000,0-006-0.940,1-000-256.000,0.125-32.000 and 0.002-0.064 mg/L respectively.Five antifungal agents had different susceptibility patterns against both forms of Penicillium marneffei.And itroconazole was the most susceptible one,ketoconazole follows as the second.There was significant difference between the MICs of the same agent against yeast form of Penicillium marneffei and mycelial form of Penicillium marneffei.Conclusion In vitro antifungal agents suscepbibility tests of Penicillium marneffei can provide important references information for clinical treatment.

Objective To study the influence of total flavonoids of hemerocallis fulva(TFHF) on hepatocyte apoptosis and related protein expression in mice with alcoholic hepatic injury.Methods A total of 40 mice were randomly divided into four groups:blank control,model control andsmall and high dose TFHF groups,10 cases in each group.The mice were given the continuous gavage administration for 7 d.Then the model group was given once gavage by 50％ ethanol 12.0 mL/kg after 1 h of the last administration.The blank control group was given the equal volume of distilled water.The activity levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in serum as well as the superoxide dismutase(SOD) activity and malondialdehyde (MDA) content in liver tissue hemogenate were detected.Hematoxylin and Eosin(HE) staining was performed for observing the pathological changes of the liver tissue.The flow cytometer was used to test the apoptosis ratio in hepatocyte suspension.The expressions of caspase-3,Bcl-2 and Bax protein were detected by Western blot.Results The various TFHF groups could decrease the activities of ALT and AST in serum (P＜0.05),while could decrease the MDA content in liver tissue hemogenate (P＜0.01) and increased the SOD activity;the liver tissue pathological examination showed that the high dose TFHF group could make the liver cell degeneration,alleviated the necrosis degree and relieved the pathological change of hepatic tissue;compared with the model group,the hepatocyte apoptosis rate in each TFHF group was decreased significantly;Western blotting results showed that the caspase-3 protein level in each TFHF group was decreased,expression of Bcl-2 protein was increased,whereas which of Bax protein was decreased and Bax/Bcl-2 ratio was reduced.Conclnsion TFHF has obvious protective effect on mice acute hepatic injury induced by ethanol,and can inhibit the hepatocyte apptosis,its action mechanism may be related to its antioxidation and regulation of caspase-3,Bcl-2 and Bax expression.

Objective:To develop a Supportive Service Demand Scale for Family Caregivers of the Disabled Elderly and test its reliability and validity.Methods:The first draft of the scale was formed through literature review, expert correspondence and pre-investigation. From March to August 2023, a total of 216 family caregivers of disabled elderly people in Qingyang District and Xindu District of Chengdu were selected as the research objects by the convenient sampling method. The items of the scale were screened by item analysis, the ontent validity and structure validity were used to evaluate the validity of the scale. Cronbach's α coefficient and split half reliability coefficient were used to evaluate the reliability of the scale.Results:A total of 216 questionnaires were sent out in this study, and 209 were effectively collected, with an effective recovery rate of 96.759% (209/216). The Supportive Service Demand Scale for Family Caregivers of Disabled Elderly People included 17 items in four dimensions. Four common factors were extracted from exploratory factor analysis, and the cumulative variance contribution rate was 63.248%. The content validity index at the average scale level was 0.983, the content validity index at the overall consistency scale level was 0.822, and the content validity index at the item level of the scale was 0.857-1.000. The Cronbach's α coefficient of the scale was 0.875 and the broken half reliability coefficient was 0.760.Conclusions:The Supportive Service Demand Scale for Family Caregivers of the Disabled Elderly has good reliability and validity, which can be used as an effective tool to evaluate the supportive service demand of family caregivers of the disabled elderly .

Congenital renal arteriovenous fistula complicated with multiple renal arteries malformation is rare and hard to diagnose at early stage. Blood loss and complications after embolization are both severe. Some cases can be diagnosed by ultrasound, enhanced CT scan or digital subtraction angiography (DSA). Cystoscopy and ureteroscopy can identify the location of bleeding, exclude tumors, and discharge ureteral obstruction. A case of congenital renal arteriovenous fistula complicated with multiple renal arteries malformation was reported to investigate the pathogenesis, clinical characteristics, diagnosis and treatment of congenital renal arteriovenous fistula with multiple renal arteries malformation. A 36-year-old female patient with congenital renal arteriovenous fistula with multiple renal arteries malformation was hospitalized in the Department of Urology of Peking University People's Hospital. Five days before admission, the patient experienced whole course painless gross hematuria for 5 days with many blood clots. The patient's blood pressure was 90/70 mmHg, and hemoglobin was 60 g/L. The urinary CT scan showed a right hydronephrosis associated with dilatation of the upper ureter which was obstructed by space occupying lesion of the lower ureter. Many clots in the bladder could also be found in the CT scan. Cystoscopy showed many blood clots in the bladder and confirmed that the bleeding was fromthe right ureteral orifice. Ureteroscopy confirmed that the bleeding was from the right renal pelvis and many blood clots in the right ureter, and found no tumor in the right ureter and renal pelvis. We cleared the blood clots in the right ureter and inserted a ureteral stent.We thought that renal vascular malformation of the right kidney might lead to the hematuria from right renal pelvis. DSA showed a double renal arteries malformation in the right kidney. The diagnosis of "renal arteriovenous fistula" was considered with renal arteriovenous fistula in the right kidney. Selective arteriography revealed the presence of tortuous, coiled, dilated, and multichannelled vessels in the middle of the right kidney. With stainless steel coils, we embolized the vessels which supplied the fistula. Four days after the procedure, gross hematuria disappeared. Five days after the procedure, the patient's anemia improvedand the patient was discharged in good condition. Four months after the procedure, gross hematuria did not recur. The Doppler showed that the right kidney was normal and the renal dynamic showed that the right kidney function was normal. So DSA is the golden standard for diagnosis of congenital renal arteriovenous fistula complicated with multiple renal arteries malformation. Confirming the number of renal arteries by abdominal aorta angiography is necessary to avoid missed diagnosis. Renal arterial embolization is safe and effective.
Adult ; Arteriovenous Fistula/therapy* ; Embolization, Therapeutic ; Female ; Humans ; Kidney ; Kidney Diseases/therapy* ; Renal Artery/pathology* ; Ureteral Diseases

OBJECTIVETo investigate whether or not the gamma-aminobutyric acid (GABA) receptor subtype A genes GABRA5 and GABRB3 are associated with childhood absence epilepsy (CAE).

METHODSTwo microsatellite DNA, GABRA5 and GABRB3, adjoining to chromosome 15q11.2-q12 were used as genetic markers. Both case-control study and transmission/disequilibrium test (TDT) as well as fluorescence-based semi-automated genotyping technique were used in 90 trios with CAE and 100 controls to conduct association analysis.

RESULTSThe allele frequencies of the 2 microsatellite DNA in Chinese normal population are in good agreement with Hardy-Weinberg equilibrium. The polymorphism information content of microsatellite DNA GABRA5 and GABRB3, are 0.80 and 0.66 respectively. The allele 2 frequency of microsatellite DNA GABRA5 and the allele 5 frequency of microsatellite DNA GABRB3 are significantly higher in CAE patients than those in normal controls(P<0.001).

CONCLUSIONBoth microsatellite DNA GABRA5 and GABRB3 are good genetic markers. The gamma-aminobutyric acid receptor subtype A genes GABRA5 and GABRB3 may be directly involved either in the etiology of CAE or in linkage disequilibrium with disease-predisposing sites.

Adolescent ; Alleles ; Case-Control Studies ; Child ; DNA ; genetics ; Epilepsy, Absence ; genetics ; Female ; Gene Frequency ; Humans ; Linkage Disequilibrium ; Male ; Microsatellite Repeats ; Receptors, GABA-A ; genetics ; Receptors, GABA-B ; genetics

Objective To explore the CTV to PTV external expansion boundary and the effect of the dose of normal lung tissue under different fixed modes by a comparative analysis of combined body position and thermoplastic film fixed set-up error of radiation therapy for lung cancer. Methods From October 2016 to March 2018, the patients who received chest radiology at the Tangshan people's hospital were enrolled as subjects retrospectively divided into two groups, including 50 patients with lung cancer radiotherapy with combined body position fixation, and 40 patients with lung cancer with thermoplastic film fixation. The two groups of patients drew the target areas in accordance with the unified standard, and the set-up error of left and right, up and down, front and rear ( x, y, z axis) were recorded respectively after 1 time/week cone CT( CBCT) matched with the planned CT image and analyzed by t test. According to the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position group were calculated. And the V5、V20 and V30 of two groups of patients were calculated and analyzed by TPS system. Results The set-up error of the combined body position group and thermoplastic film group were respectively (1. 00 ± 0. 58) mm and (3. 28 ± 0. 43) mm on the x axis, (1. 42 ± 0. 28) mm on the y axis and (4. 03 ± 0. 41) mm, (1. 06 ± 0. 44) mm and (3. 18 ± 0. 34) mm on the z axis. The set-up errors of the two groups were statistically significant on x, y and z axis( t= -20. 740, -35. 596, -25. 015,P<0. 05). There was no significant difference in set-up errors between the central and peripheral lung cancer patients and between left and right lung cancer patients(P>0. 05). Through the MPTV =2. 5Σ+0. 7δ, CTV to PTV external expansion boundary in the combined body position fixation group was 2. 906 , 3. 746 and 2. 958 mm on x, y and z axis respectively. The comparison between group A and B showed that the mean values of V5 , V20 and V30 in group B were reduced by 1. 5％, 3. 1％ and 4. 8％ respectively compared with group A. Conclusions The combined body position technique can improve the accuracy of lung cancer patients after radiation therapy,and further reduce the boundary of CTV to PTV, which is of certain value to reduce the occurrence of radiation pneumonitis.

Objective:To investigate the safety, economic effect, and short-term clinical efficacy of ambulatory total hip arthroplasty (THA) in the treatment of hip osteopathy within.Methods:This study retrospectively reviewed patients who underwent 48-hour outpatient THA and conventional primary THA from July 2020 to July 2021. Gender, age, body mass index (BMI), clinical diagnosis, place of resident, length of hospital stay, duration of the surgery, hemoglobin, albumin, C-reactive protein (CRP) and D-dimer before and 1 day after surgery, the visual analogue scale (VAS) was obtained postoperative day 2, hip joint modified Harris score before and 1 month after surgery, readmission and reoperation within 1 month after operation as the data of evaluations were extracted and compared in this study.Results:A totally of 150 cases were involved in this study, which including 75 cases with 48-hour outpatient primary THA and 75 cases with conventional primary THA. There was no significant difference between the two groups in terms of age, sex, BMI, education level, preoperative diagnosis, and preoperative Harris score ( P>0.05), but a significant difference was found in term of residence (χ 2=6.29, P=0.043), that the patients in the outpatient group were all from Zhejiang Province and 48% (36/75) of them were from Hangzhou City. While, in the conventional group, 6 patients were from other provinces. The length of stay was 2.13±0.52 days and operation time was 59.73±18.91 minutes in the outpatient group, which were both shorter than those (6.71±1.44 days and 66.91±22.40 min) in the conventional group ( t=25.91, P<0.001 for the length of hospital stay; t=2.12, P=0.036 for operation time). Compared with the conventional group, outpatient group saved the average hospital cost (4.60±0.44 vs. 5.20±0.72 ten thousand yuan, t=6.16, P<0.001). The VAS on the second day after surgery 3.45±0.75 was higher in the outpatient group than in the conventional group (3.45±0.75 vs. 3.16±0.94 points, t=2.09, P=0.039). The modified Harris score was without statistical significance ( t=0.42, P=0.677) 1 month after surgery in both groups. 75 patients in the outpatient group, 7 patients delayed discharge (were not discharge within 48 hours), and the rate of delayed discharge was 9.3%. Reasons for delayed discharge included poor pain control in two cases, one case had postoperative nausea and vomiting, one case had failed to meet rehabilitation standards, hypotension in one case, the intraoperative infection in one case and postoperative fever within 48 hours in one case. Conclusion:Outpatient THA can reduce the length of hospital stay, operative time and total cost of hospitalization. It has similar safety and early clinical efficacy as conventional THA. However, a small proportion of patients would delay discharge.

Renal angiomyolipoma (AML) is a common benign tumor in the urinary system, mainly composed of adipose tissue, blood vessels and muscle tissue. Renal AML is sporadic in most of patients, while a few are associated with tuberous sclerosis. Classical renal AML occurs predominantly in middle-aged females. Most cases are found incidentally during imaging examinations. The fat content makes AML have unique imaging characteristics and is easy to be identified with other renal tumors. However, the amount of fat varies in each tumor. AML that contains only microscopically detectable fat and whose amount of intratumoral fat may be too small to be identified on unenhanced computed tomography (CT) images is termed minimal fat or fat-poor renal AML, which appears as a high density shadow in the renal parenchyma on unenhanced CT images. Thus, it can be difficult to distinguish it from renal cell carcinoma (RCC) on imaging. Since the imaging findings are atypical, the diagnosis depends on pathological results. In addition, a few of AML can mimic malignant neoplasms. Recent studies suggested that AML might involve to peri-renal or renal sinus fat, regional lymphatics and other visceral organs, as well as inferior vena cava, which further makes the diagnosis more difficult. However, there is currently no reports about involvement of regional limphatics in minimal fat renal AML. In this article, we report a 27-year-old female patient without family history of tuberous sclerosis, who came to visit the hematologist because a high density shadow near the left kidney was found during CT scan which was accompanied by neck, armpits, groin, abdominal cavity and retroperitoneal lymph nodes enlargement. She was suspected of lymphoma in the beginning and transferred to Department of Urology to perform laparoscopic left renal mass and retroperitoneal lymph node excision and pathological examination for a definitive diagnosis. Finally, pathologic results revealed AML. Postoperative continuous lymphatic fistula developed and the retroperitoneal drainage of chylous fluid was 100-200 mL per day, lasting for 12 weeks. The fistula was successfully closed after conservative treatment including fasting and rehydration. This article summaries and discusses the diagnosis and treatment of renal AML with lymph nodes enlargement and the management of postoperative refractory lymphatic fistula by reviewing the related cases and literature.
Adult ; Angiomyolipoma/pathology* ; Carcinoma, Renal Cell/diagnosis* ; Female ; Fistula ; Humans ; Kidney Neoplasms/pathology* ; Lymph Nodes/pathology* ; Middle Aged