Objective To investigate the expression and correlation of serum hypoxia inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) level pre-and post-transcatheter arterial chemoembolization (TACE) in patients with primary liver cancer (PLC) .Methods Expression of serum HIF-1α and VEGF were studied in 40 patients of PLC pre-and 1 day,1 week,1 month post-TACE and 20 healthy volunteers (as control group) .Results The expression of HIF-1α and VEGF was (154.94±83.29) pg/ml and (264.00±148.10) pg/ml before TACE,higher than those in control group (P＜0.01) .The expression of HIF-1α and VEGF was (570.64±230.87) pg/ml and (362.07±102.25) pg/ml in PLC patients 1 day post-TACE,higher than those before TACE (P＜0.01) ; (198.62±92.11) pg/ml,and (283.52±145.46) pg/ml 1 week post-TACE; (133.96±57.02) pg/ml and (150.96±84.89) pg/ml in the complete response (CR) group 1 month after TACE, (255.74±123.44) pg/ml and (368.95±161.90) pg/ml in partial response (PR) and stable disease (SD) group (P＜0.05) .The expression of serum HIF-1α was positively correlated with VEGF before TACE,and the serum HIF-1α also correlated with portal vein tumor thrombosis and metastasis.Serum VEGF was also correlated with clinical stage,portal vein tumor thrombosis and capsule.Conclusion The expression of serum HIF-1α and VEGF plays an important role in relapse of tumor,and contributes to the evaluation of the efficacy of TACE and metastasis of PLC.

Objective To study the diagnoses and treatment of alimentary tract bleeding of unknown causes. Methods All cases were undergone angiographic exarmination. Results 23 cases of angiographic display of alimentary tract bleeding showed the localization and causes of bleeding were clear in 21 casses. 2 cases were negative in radiography. 8 had been given the treatment of interventional embolization. Conclusions This article showed the angiographic display for the diagnosis, and the interventional treatment of alimentary tract bleeding with points for attention.

Objective To investigate the effects of rhubarb combined with glutamine on repair of gut mucosal barrier injury after gastrointestinal surgery in rats. Methods Fifty male healthy Sprague-Dawley(SD)rats were randomly divided into five groups:control(C group),enteral nutrition(EN group),rhubarb with EN(R-EN group), glutamine with EN(G-EN group)and rhubarb combined with glutamine and EN(R-G-EN group)groups(each n=10). The rats of C group received no treatment and were fed normally. Cecectomy and gastrostomy were performed in EN,R-EN,G-EN and R-G-EN groups,and in 24 hours after surgery,they were interfered with the use of amoxicillin 50 mg/d and metronidazole 20 mg twice a day. From the first day after operation,each group was treated with the same prescription of enteral isocaloric and isonitrogenous nutrition for consecutive 7 days. Seven days later, under anaesthesia,laparotomy was performed,and a specimen of 1 cm intestinal segment was taken from the terminal 5 cm long ileum for all the groups;under the light microscope,the morphological examination of intestinal mucosal epithelial tight junctions(including villus height and mucosal thickness)was carried out. For each group,enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of plasma citruline and D-lactate,and the serum concentration of TNF-αwas detected by utilizing double antibody ABC-ELISA. Results The levels of D-lactate and TNF-αin EN,R-EN,G-EN and R-G-EN groups were obviously higher than those in C group(all P<0.01). The level of plasma citruline(μmol/L:16.13±0.58 vs. 14.52±0.28)of R-G-EN group was remarkably higher than that in R-EN group(P<0.05),and its levels of serum D-lactate(mmol/L:3.12±0.56 vs. 3.62±0.52)and TNF-α(ng/L:2.82±0.62 vs. 3.54±0.49)were markedly lower than those of G-EN group(both P<0.05). The mucosal villus height(μm:126.50±6.31 vs. 175.67±11.91),mucosal thickness(μm:223.67±11.94 vs. 277.00±14.06)and the level of plasma citruline(μmol/L:13.25±0.36 vs. 15.67±0.55)in EN group were obviously lower than those of C group(all P<0.01);the above indexes of R-EN,G-EN and R-G-EN groups were higher than those of EN group (P<0.05 or P<0.01),but in the comparisons of the villus height and mucosal thickness among the three groups there were no statistical significant differences(all P>0.05). Conclusion The application of rhubarb combined with glutamine can protect gut mucosa,reduce the level of inflammatory reaction and elevate the level of plasma citruline, that is beneficial to the repair of gut mucosal barrier injury and its functional recovery after gastrointestinal surgery in rats.

Objective To evaluate the clinical application of embolization therapy using N-butyl 2-cyanoacrylate(NBCA)for hepatocellular carcinoma(HCC)complicated with arterio-portal fistula(APF).Methods Eighty patients with HCC and APF underwent embolothempy with NBCA(NBCA group,26 patients)or absolute alcohol(alcohol group,54 patients).The APF wag first treated with liquid embolic agent during the TACE procedure.We used NBCA-Lipiodol mixtures in concentration of 20%-50% according to tlle different circulation times of these APF in NBCA group,Absolute alcohol plus gelfoam or other materisis were used for embolization of APF in alcohol group.The pain reaction during the procedure,influence for liver function(X2 test).occlusive suceessfxil rate after single embolization(Fisher's exact test)and the survival rate of 1 year(log-rank analysis)between two groups were compared after the embolotherapy.Results Four patients in NBCA group and 52 patients in alcohol group felt painful during the pmcedures.There wag statistically significant difference between two groups(x2=58.86,P＜0.001).The APF disappeared after only sin~e embolization in 24(92.3%,24/26)cages of NBCA group and in 37(68.5%,37/54)patients of alcohol group.There wag also significant difference between two groups (P=0.024).There were no statistical ditierence in the post.embolization liver function change and 1 year survival rate between two groups.Conclusions The embolization therapy using NBCA for HCC complicated with APF is safe.effective and more accurate.It can be used as a new technique for these patients.

BACKGROUND:More and more evidence suggests that macrophages and inflammation reactions are involved in the formation and development of nephrolithiasis. Previous studies have found that calculi crystals can stimulate macrophages to release high mobility group protein B1.
OBJECTIVE:To investigate the synergistic effect of high mobility group protein B1 in calcium phosphate induced release of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages.
METHODS:(1) The induced U937 cells were respectively stimulated with RPMI (blank), 100 mg/L calcium phosphate, 100μg/L high mobility group protein B1 and 100 mg/L calcium phosphate+100μg/L high mobility group protein B1 for 1, 2 and 4 hours to col ect cellsupernatant. (2) The induced U937 cells were respectively stimulated with 100 mg/L calcium phosphate, 100 mg/L calcium phosphate+10μg/L high mobility group protein B1, 100 mg/L calcium phosphate+50μg/L high mobility group protein B1, 100 mg/L calcium phosphate+100μg/L high mobility group protein B1 for 4 hours to col ect cellsupernatant. Levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 were determined by ELISA.
RESULTS AND CONCLUSION:The levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 in the cellculture supernatant of 100 mg/L calcium phosphate group and 100μg/L high mobility group protein B1 group were both higher than those in the blank group in a time-dependent manner (P<0.05). The levels of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 in the cellculture supernatant of different concentrations of high mobility group protein B1 groups were al higher than those in the 100 mg/L calcium phosphate group in a concentration-dependent manner (P<0.05). The results suggest that both calcium phosphate and high mobility group protein B1 can induce the release of interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages and the high mobility group protein B1 has the synergistic effect with calcium phosphate to induce interleukin-1β, interleukin-6, tumor necrosis factorαand monocyte chemotactic factor 1 from human macrophages.

OBJECTIVESTo analyze the technical aspects of uterine artery embolization with dextran microspheres and to evaluate the effectiveness of this technique as the primary treatment of uterine fibroids in a series of 38 patients.

METHODSThirty-eight volunteers (age range, 24-48 years; mean, 37.2 years) with symptoms caused by uterine fibroids (menorrhagia, mass-related symptoms, and pelvic pain) were randomly included in this study. The fibroids were single in 32 patients and multiple in 6 patients. According to the tumor location, subserous fibroids were found in 4 patients and interstitial or submucosal fibroids in 34. Tumor size was from 2 to 10.9 cm in diameter. We performed embolization with a single Headhunter catheter using the right-femoral artery approach, injection of dextran microspheres (225-450 micro m), and an absorbable gelatin sponge. Follow-up included clinical and sonographic examinations at one-month intervals for 6 months.

RESULTSEmbolization was successfully performed in all patients. Post-procedural pain control was good in 35 (92%) patients. In most patients, symptoms were improved at 3 months (36/38, 95%). Clinical failure of the treatment occurred in only 2 patients (2/38, 5%). Progressive reduction in leiomyoma size was revealed during sonographic follow-up, and the reduction rate at the sixth month after embolization was 68%. The tumor had vanished in five submucosal fibroid patients. Histopathological tests showed that the tumor was degenerative as fibrosis and hyalinosis.

CONCLUSIONSUterine artery embolization with dextran microspheres is a micro-invasive method for the treatment of uterine fibroids. It is clinically effective in most patients and induces a progressive reduction in the size of fibroids. Based on this study, we believe that this new technique is much more suitable for submucosal fibroids with massive menorrhagia.

Adult ; Dextrans ; administration & dosage ; Embolization, Therapeutic ; adverse effects ; Female ; Follow-Up Studies ; Humans ; Leiomyoma ; therapy ; Middle Aged ; Uterine Neoplasms ; therapy ; Uterus ; blood supply