Oncolytic adenoviruses (Ads), which are live, replication-competent viruses that can selectively replicate in tumor cells and lead to cell lysis, have been used in tumor therapy. But due to the complexity and high mutability of human tumors, it becomes a major strategy to improve the selectivity, efficacy, and safety of oncolytic Ads. The oncolytic Ads that can express short hairpin RNA, cytokines, suicide gene, and matrix-modulating proteins have higher antitumor activity than the wild type. Tumor-specific promoters, especially hTERT and HRE promoters, increase the selectivity of oncolytic Ads for tumor cells. Moreover, oncolytic Ads surface-modified by polyethylene glycol (PEG), liposomes, biodegradable nanoparticles, and polypeptides have reduced immunogenicity and hepatotoxicity and improved antitumor activity when systemically administered, and the selectivity of oncolytic Ads can be significantly increased when linking PEG to antibodies, small peptides, cytokines, and ligands. Therefore, engineered oncolytic Ads combining the advantages of viral and non-viral vectors, as well as immunotherapy, are a promising strategy for improving the efficacy of targeted virotherapy.
Adenoviridae ; genetics ; physiology ; Animals ; Humans ; Neoplasms ; therapy ; virology ; Oncolytic Virotherapy ; trends ; Virus Replication

Objective To investigate the selection and efficacy of operative medality for pancreatic transec-tion with major duct injury. Methods The clinical data were retrospectively analyzed in 21 patients with pancreatic disruption. They were treated in our hospital from Jan. 1995 to Feb. 2009. There were 14 males and 7 females in these cases with a mean age of 26 years (range 9-53 years). The trauma causes of them were blunt injuries in 13 and patent injuries in 8 cases. The injury grade (according to American Association for the Surgery of Trauma) distribution for these patients was grade Ⅲin 8 cases, grade Ⅳ in 8 cases, and grade V in 3. The early emergency operation was performed in eighteen within 12 hours, and delayed opera-tion was in three cases. Of these operative medalities, Roux-en-Y distal panereatojejunostomy was in 10 ca-ses, pancreatoduodenectomy was in 3, modified duodenal diverticulizatian was in 2, distal pancreatectomy was in 3, tube installing in major duct and external drainage, and suture of pancreatic section was in 2, su-ture of two broken sides in 1 (Roux-en-Y distal pancreatojejunostomy in second time). Results Twenty patients were cured, and one was died after a procedure of pancreatoduodenectomy. The postoperative pan-creatic fistula happened in 3 cases and recovered well with conservative line of management. Conclusions For improving the outcome of pancreatic transection, the earlier exploratory laparotomy and carrying out concept of "Damage Control Surgery" are critical. The individual operative modality based on the grade should be a-dopted in the surgical procedure.

Objective To summarize the experience in diagnosis and management for severe and complicated pancreatic trauma. Methods The clinical data of 21 patients with severe pancreatic trauma treated in our hospital were retrospectively analyzed. Of the 21 with a mean age of 26 (9-53), 14were male and 7 female. The causes of trauma were blunt injuries in 13 and patent injuries in 8 of them. The injury grade distribution for these patients was grade Ⅲ in 8 cases, grade Ⅳ in 8, and grade V in 3. The main diagnostic modalities included amylase measurement, ultrasonography, CT,endoscopic retrograde cholangiopancreatography (ERCP), and magnetic resonance cholangiopancreatography (MRCP) etc. All patients received surgical procedures. Roux-en-Y distal pancreatojejunostomy was performed in 10 patients, pancreatoduodenectomy in 3, modified duodenal diverticulization in 2, distal pancreatectomy in 3, tube installing in major duct and external drainage, and suture of pancreatic section in 2, and suture of two broken side respectively (delayed distal pancreatojejunostomy in the second time) in 1. Results Pancreatic injury was confirmed in 11 cases preoperatively and intraoperatively in the others. The early emergency operation was performed in 18 patients within 12hours, and delayed operation was done in 3 cases. Twenty patients were cured and 1 died after a procedure of pancreatoduodenectomy. The postoperative pancreatic fistula happened in 3 cases and recovered well with conservative line of management. Conclusion The diagnosis of severe and complicated pancreatic trauma is difficultly yet, so the earlier exploratory laparotomy should be suggested. The individual surgical modality based on the grade should be adopted in the operation and the concept of "Damage Control Surgery" should be carried out in the procedure. Extended operation should be avoided.

Adult ; Cholesteatoma, Middle Ear ; Humans ; Male

Humans ; Male ; Middle Aged ; Pneumoconiosis ; diagnosis

AIM: To evaluate the effect of flavored Siwu granules in the clinical adjuvant treatment for phlegm and blood stasis mutual junction retinal vein occlusion.
METHODS: Sixty patients (60 eyes) were randomly divided into treatment group and control group, both with retinal laser photocoagulation and intravitreal injection of triamcinolone acetonide, but the treatment group used flavored siwu granules. Vision, fundus change, fundus fluorescein angiography, clinical syndrome of traditional Chinese medicine ( TCM ), hemorheology examination and safety assessment were evaluated before and 8wk after treatment.
RESULTS: At 8wk after treatment, there were differences on vision improvement, retinal circulation time, whole blood low shear viscosity and total efficient rate of clinical syndrome of TCM, compared with control group(P<0. 05).
CONCLUSION: Flavored siwu granules adjuvant for phlegm and blood stasis mutual junction retinal vein occlusion can improve visual acuity and reduce the eye complications.

Objective To investigate the possible association between two single nucleotide polymorphisms (SNPs) loci of apolipoprotein E (ApoE) gene and epileptic drug resistance in a central Chinese Han population.Methods A case control study was performed in 364 epileptic patients.According to the criteria of drug resistant epilepsy proposed by International League Against Epilepsy in 2010,143 patients were classified into drug resistant group and 221 patients into drug responsive group.The peripheral venous blood of each patient was collected for DNA extraction after clinical evaluation.The candidate ApoE SNPs loci,including rs7412 and rs769450,were genotyped by BeadChip Scanning and GoldenGate Assay following the Illumina protocols.The differences in allelic and genotypic frequency were compared between groups.Linkage disequilibrium was calculated through SHEsis platform.Results There was no significant difference for genotype or allele of rs7412 between groups.The GG genotype (OR =2.038,95％ CI 1.196-3.475,P=0.009) and G allele (OR =1.618,95％CI 1.193-2.193,P=0.002) of rs7412 were significantly more abundant in the drug resistant group.As for idiopathic epileptic patients,the GG genotype (OR =2.110,95％ CI 1.189-3.744,P =0.011) and G allele (OR =1.641,95％ CI 1.187-2.270,P =0.003) of rs7412 were still significantly more abundant in the drug resistant group.There was no linkage disequilibrium between the two loci with D' value of 0.072.Conclusion The GG genotype and G allele of ApoE rs769450 may be associated with epileptic drug resistance in a central Chinese Han population.

To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with radiofrequency ablation (RFA) and TACE alone for hepatocellular carcinoma (HCC), Pubmed, Cochrane Library, Web of Science, China National Knowledge Infrastructure (CNKI) and Wanfang Datebases were searched for the randomized controlled trials (RCTs) and retrospective cohort studies from the establishment of the databases to January 2014. The bibliographies of the included studies were searched, too. After study selection, assessment, data collection and analysis were undertaken, we performed this meta-analysis by using the RevMan5.2 software. Seventeen studies involving 1116 patients met the inclusion criteria with 530 treated with RFA-plus-TACE and 586 with TACE alone. The results of meta-analysis showed that the combination of TACE and RFA was obviously associated with higher 1-, 2-, and 3-year overall survival rates (OR1-year=3.98, 95% CI 2.87-5.51, P<0.00001; OR2-year=3.03, 95% CI 2.10-4.38, P<0.00001; OR3-year=7.02, 95% CI 4.14-11.92, P<0.00001) than TACE alone. The tumor complete necrosis rate in patients treated with TACE and RFA was higher than that of TACE alone (OR=13.86, 95% CI 8.04-23.89, P<0.00001). And there was a significant difference in local recurrence rate between two different kinds of treatment (OR=0.24, 95%CI 0.14-0.44, P<0.00001). Additionally, combination of TACE and RFA was associated with higher complete tumor necrosis rates than TACE mono-therapy in the treatment of HCC. However, RFA plus TACE was found to be associated with a lower local recurrence rate than TACE monotherapy. TACE-plus-RFA treatment was associated with a higher response rate (RR) than the TACE-alone treatment (OR=3.90, 95% CI=2.37-6.42, P<0.00001). TACE-plus-RFA treatment did not differ from the TACE-alone treatment in terms of stable disease (SD) rate (OR=0.38, 95% CI=0.11-1.26, P=0.11). Meta-analyses showed that the combination of RFA and TACE was associated with a significantly lower progressive disease (PD) rate (OR=0.15, 95% CI=0.05-0.43, P=0.0005). The rate of AFP reducing or returning to normal in serum in RFA plus TACE group was obviously lower than TACE alone group (OR=4.62, 95% CI 2.56-8.34, P<0.00001). The effect of TACE plus RFA for HCC is better than TACE mono-therapy. The combined therapy can elevate the patients' overall survival rate, tumor necrosis rate and the rate of AFP reducing or returning to normal in serum and decrease local recurrence rate, PD rate compared with TACE alone.

Objective To explore a more reasonable and effective therapeutic regimen and evaluate prognostic factors in hepatoblastoma patients after combined therapy.Methods Sixteen patients diagnosed on hepatoblastoma between Jan.2000 and Nov.2007 were reviewed and followed-up.Resection with chemotherapy was taken among 16 cases.Chemotherapy included pre-operation and post-operation.Five cases were cured by transcatheter arterial chemombolization(TACE).Six cases were cured by single chemotherapy(both TACE and single chemotherapy were taken in 2 cases).Five cases weren't cured by pre-operation chemotherapy.Nine cases were subjected to curative resection,3 cases to alleviative resection,2 cases with single chemotherapy,1 case with single TACE,and 1 case refused operation and left hospital.Their mean survival duration was 13.5 months(3-98 months).SPSS 13.0 software was used to analyze the data.Results The total survival rate of cases as stage Ⅳ as lower than cases as stage Ⅰ,Ⅱand Ⅲ.Both alpha-fetoprotein(AFP)100 000 ?g/L cases had worse survival rate.The prognosis of mixed type was better than fetal type,embryonal type and anaplasia type.The survival rate of cases with standard chemotherapy was higher than cases with unstandard chemotherapy.And the surgical resection cases had better survival chance than non-surgical resection cases.The survival rate of surgical residual cases was worse than non-surgical residual cases.Conclusions Chemotherapy can improve the total survival rate and long-term survival rate of hepatoblastoma patients.TACE is a safe and effective choice for hepatoblastoma patients.We need to be alert and make the diagnosis as early as possibe,and treat it early and properly.

Objective To explore the relationship between serum adiponectin concentration and hyperuricemia in Han people in Hunan.Methods Cluster random sampling method was used to carry out the survey during October to December 2008 in Changsha Health Checkup Center of the Second Xiangya Hospital.All subjects completed the questionnaires,physical examination,biochemical measurements,and the data were analyzed by t test,Pearson's correlation analysis and multiple linear regression analysis.Results The Age,WC,TG,SBP,DBP,SUA,BMI were significantly higher in hyperuricemia group compared with the normal uric acid group.The concentration of adiponectin in hyperuricemia group was significantly lower than that in the normal uric acid group (5.0±2.7 vs 6.8±4.2 μg/ml,t=3.961,P＜0.05).In the normal serum uric acid group,the serum adiponectin concentration in female was significantly higher than that in male (t=4.99,P＜0.05).Pearson's correlation analysis showed that serum adiponectin concentration was negatively correlated with the serum uric acid level,but the adiponectin level was not significantly correlated with Age and blood pressure.Stepwise analysis showed that the main factors that could affect the adiponectin level were SUA,gender and BMI (P＜0.05).Conclusion The decreasing of serum adiponectin concentration might be one of the mechanisms of hyperuricemia,therefore,detecting serum adiponectin concentration may provide the basis for the prevention and treatment of hyperuricemia.