Objective To evaluate the efficacy and safety of TACE combined with Apatinib versus TACE monothcrapy in the treatment of advanced hepatocellular carcinoma (HCC).Methods A total of 44 patients with advanced HCC were enrolled and divided randomly into group A (n=22) and group B (n=22).The patients in group A were treated with TACE monotherapy while group B were treated with TACE combined with Apatinib.The serum alpha fetoprotein (AFP) levels were compared between the two groups three months after treatment.The objective response rate (ORR) after 3,6,9 and 12 months,the progression-free survival (PFS) and incidence of adverse reactions were also compared.Results The serum AFP levels decreased apparently in two groups three months after treatment,and statistic differences were observed in each group (Z=-2.289,-2.953,both P ＜0.05),while no statistic differences was obtained between the two groups after treatment (Z=-0.126,P＞0.05).No statistic differences were found in ORR between the two groups 3 and 6 months after treatment (both P ＞0.05),while statistic differences were manifested after 9 and 12 months (both P ＜0.05).The medium PFS in group A significantly lower than that in group B (x2 =6.576,P=0.01).The apatinib-related adverse reactions including hypertension,hand-foot syndrome and proteinuria in group B were higher than those in group A,and statistically significant difference were obtained (allP＜0.05).The adverse reactions were relieved after symptomatic treatment.Conclusion TACE combined with apatinib may improve the mid-long term efficacy in patients with advanced HCC.And the relatively safety of TACE combined with apatinib is confirmed.

Objective To assess the feasibility and the reliability of emergency temporary cardiac pacing under fluoroscopy and nofluoroscopy,and compare to the superiority and inferiority between two groups.Methods Fifty-seven patients were temporarily paced under fluoroscopy and nofluoroscopy by the way which the common bi-pole temporary endocardium pacing electrode was introduced into the right ventricle by the bi-subclavian vein and right internal jugular.Result Twenty-six patients were successfully paced under fluoroscopy,and 27 patients of 31 were successfully paced without fluoroscopy,the other 4 patients were not paced successfully.Besides,there was no any complication in all patients.Conclusion Emergency temporary cardiac pacing without fluoroscopy is utility,saving time and safety,Compared to other method,the effect is proximity and even superior than the way under fluoroscopy.The way of the emergency temporary cardiac pacing without fluoroscopy is applied widespreadly in the work of clinical first aid.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

0.05).Conclusions Our results suggest that ascites contributes to the exaggerated fibrinolysis in cirrhosis, whereas cirrhosis self, in the absence of ascites, leads to a slightly fibrinolynic state. The t-PA/PAI imbalance was not a main cause of hyperfibrinolysis in patients with cirrhosis.

AIM:To study the role of heme oxygenase (HO)-1 in the mechanism of cholecystokinin-octapeptide (CCK-8) for attenuation of acute lung injury (ALI) induced by lipopolysaccharide (LPS). METHODS: Adult male rats were randomly divided into five groups: control group, LPS group, CCK-8+LPS group, LPS+ Hm (hemin, HO-1 donor) group and LPS+ZnPP (zinc protoporphyrin, specific inhibitor of HO-1) group. PMN number in bronchoalveolar lavage fluid (BALF), the structure of the lung, MDA content, HO-1 activity, the expressions of HO-1 mRNA and protein in the lung were detected respectively. RESULTS: The lung injury in LPS group was observed, at the same time the numbers of PMN, the content of MDA, the activity and the expression of HO-1 were all higher than those in control group (all P

China Food and Drug Administration didn't issue any guideline on the pre-clinical study of drug-eluting coronary stent system, the basic requirement of the authorized administration was summarized to help manufacture prepare the document during the registration process.
China ; Drug Evaluation, Preclinical ; methods ; Drug-Eluting Stents ; Guidelines as Topic

BACKGROUND:Previous studies have shown that a certain dose of acidic fibroblast growth factor can promote skeletal muscle satelite cel proliferationin vitro. OBJECTIVE:To investigate the effects of transfection with acidic fibroblast growth factor by electroporation on growth, proliferation and differentiation of skeletal muscle satelite cels. METHODS: Skeletal muscle satelite cels were cultured and purified, and then transfected with plasmid pSectag-GFP-aFGF by electroporation. The expression of green fluorescent protein was observed under fluorescence microscope, and the transfection efficiency was calculated. After transfection, cel cycle was analyzed by flow cytometry to draw the growth curve of skeletal muscle satelite cels. Western blot assay was employed to measure protein level of acidic fibroblast growth factor. RESULTS AND CONCLUSION: (1) Immunocytochemistry detection: The skeletal muscle satelite cels were positive for a-sarcomeric actin. (2) Transfection efficiency: At 12 hours after transfection with pSectag-aFGF, several cels showed green fluorescence, and the green fluorescent expression reached the peak at 72-96 hours after transfection with a positive rate of about 90%. (3) Cel cycle: After electrotransfection, the proportion of cels at S phase in the electroporation group was higher than that in the control group (P < 0.05). (4) Cel growth curve: At 3 days after electrotransfection, the cels entered logarithmic growth phase but the proliferation slowed down at 5 days. (5) Differentiation capacity: There were fewer myotubes and aging cels in the electroporation group than the control group. (6) Western blot assay: Acidic fibroblast growth factor protein was highly expressed in the cels transfected with target gene detected by western blot assay. These findings indicate that by using electroporation method, acidic fibroblast growth factor can be transferred into skeletal muscle satelite cels and have a high-efficiency and long-term expression, which can promote the proliferation of skeletal muscle satelite cels and inhibit formation of myotubes.

Objective:To observe cellular,humoral and mucosal immune responses induced by DNA-or protein-based of FimH of UPEC type 1.Methods:After mice were immunized respectively with recombinant plasmid pcDNA3.1/fimH or pcDNA3.1/fimC,and the combinant FimH and FimC protein,the anti-FimH protein IgG of sera and SIgA in bladders were detected by ELISA.The lymphocyte phenotypes of CD3,CD4 and CD8 were analyzed by FCM.Results:The titers of IgG in sera and SIgA in the bladders were all low in the group immunized by recombinant FimH plamid,but the percentage of CD4+T cells in spleen was high,which revealed that recombinant FimH plamid was able to trigger better cellular immune response.The titers of IgG were very high in the group immunized by FimH protein,which suggested that the FimH protein was able to trigger better humoral immune response,but SIgA in the bladders was not detectable.Conclusion:The DNA for FimH can induce humoral,mucosal and cellular immune response.FimH protein can only induce humoral immune response.FimC protein is able to enhance the immunogenicity of FimH protein.

Objectives To explore the role of hydrogen sulfide(H_(2)S) in lipopolysaccharide(LPS)-induced acute lung injury(ALI) in rats and the underlying mechanisms.Methods Sixty-four Sprague-Dawley rats were randomly divided into four groups: control,LPS(instilled intratracheally to induce ALI),NaHS(H_(2)S donor)+LPS,propargylglycine [inhibitor of cystathionine-?-lyase(CSE),PPG]+LPS.Animals were sacrificed at(4 h) or 8h after agent administration.Lung weight/body weight ratio(LW/BW) was measured and calculated.Morphological changes of lung tissues were observed,H_(2)S concentration and carbon monoxide(CO) level in plasma were tested.Malondialdehyde(MDA) content,CSE activity and heme oxygenase(HO) activity of the lung were determined.Immunohistochemisty technique was performed to examine the expression and the absorbance value of(HO1) protein in lung tissues.Results Compared with control conditions,severe injuries of lung tissues and a raised LW/BW and MDA content were observed in rats treated with LPS.LPS also lead to a drop in plasma H_(2)S concentration and lung CSE activity.The enzyme activity of HO,the protein expression of(HO-1) and plasma CO level increased after LPS instillation. Administration of NaHS before LPS could atten-uated the changes induced by LPS.Pre-administration of PPG exacerbated the injuries induced by LPS,but there was no prominent variation in CO level,HO activity and(HO-1) protein expression compared with those of LPS group.Conclusions Downregulation of H_(2)S/CSE was involved in the pathogenesis of acute lung injury induced by LPS.Exogenous(H_(2)S) provided protection against the lung injuries to some extent,which may be explained by its anti-oxidative effects and the upregulation of CO/(HO-1) system.

Objective:To explore the strategies and complications of the submucosal tunneling endoscopic resection (STER) in the treatment of esophageal duplicated cyst (EDC).Methods:From January 2013 to December 2019, at Department of Gastroenterology, Taizhou Hospital of Zhejiang Province, the clinical data of 11 hospitalized patients with EDC diagnosed by pathological examination who underwent STER were collected. The clinical featured, computed tomography (CT) findings, endoscopic findings, postoperative efficacy, complications and pathological results after operation were summarized.Results:Among the 11 patients, there were 6 males and 5 females, the age ranged from 13 to 67 years, and the mean age was (43.0±18.2) years. One case presented with swallowing obstruction, 1 case with belching, 4 cases with upper abdominal pain, and the remaining 5 cases had no specific clinical symptoms. Under endoscopy, the lesions of 11 patients were hemispherical or mound-shaped with smooth surface submucosal masses in the esophageal cavity, which were soft to touch. Under endoscopic ultrasonography, they all appeared as hypoechoic masses with clear boundary located in the esophageal muscularis propria. The results of CT scan of 9 patients showed round low-density cystic masses, among them 7 cases showed mild enhancement. The maximum diameter of the cysts was 1.5 to 4.4 cm, with mean maximum diameter being (2.8±0.8) cm, and the maximum diameter of most patients (7 cases) were 2 to 3 cm. The other two patients showed only slightly thickened esophageal wall on CT. Five lesions occurred in the horizontal mediastinum of the lower esophagus. All the 11 patients underwent STER operation successfully, among them 6 patients received simple STER and the cysts were completely resected, and the other 5 patients received STER and cauterization with argon ion for the residual cyst wall. The pathological results after operation indicated that 6 cases were congenital esophageal cysts and 5 cases were bronchogenic cysts. The median follow-up time (range) of 11 patients was 42 months (12-86 months). Ten patients recovered well after the operation, and local recurrence, malignant transformation or metastasis were not found. One case had recurrence, and was treated with STER and cauterization with argon ion for residual cyst wall and cured. No complications such as bleeding, fistula, mediastinal infection or death occurred during and after operation in all the 11 patients.Conclusions:STER is a minimally invasive, safe and effective treatment for EDC, and may be a new treatment for EDC.