Objective To investigate the correlative factors influencing long-term efficacy of patients with liver neoplasms after interventional therapy. Methods A total of 495 patients underwent transcatheter arterial chemoembolization (TACE), and the data were retrospectively analyzed. The patients were divided into two groups according to the survival time after interventional therapy: ≥5 years and ＜5 years. Correlative factors were compared in both two groups. Results In 31 patients survived longer than 5 years, 18 patients with Lipiodol filling type Ⅰ tumor, and 13 with type Ⅱ tumor. The 5, 7, 10 years survival rate in all 495 patients was 6.26% (31/495), 1.41% (7/495) and 0.40% (2/495), respectively. Factors including tumor pattern, clinical classification, the features of angiography, with or without heptic arteriovenous fistula, the pattern of Lipiodol filling, with or without invasion and metastasis, hepatic function, patient's age, tumor diameter, AFP value before and after TACE, the variety of AFP value after TACE influenced the long-term survival rate after interventional therapies (P＜0.05). Conclusion The characteristics of tumor, patient's status, the quality of TACE, whether combined with PEI, and/(or) anti-virus treatment have significant influence on long-term efficacy after interventional therapy in patients with liver neoplasms.

Objective To investigate the efficacy and safety of hypertonie saline enhanced radiofrequency ablation (RFA) in the treatment of liver cancer. Methods The clinical data of 42 patients with primary liver cancer (n = 28) or metastatic liver eancer (n = 14) who had been admitted to First Affiliated Hospital of Nanjing Medical University from September 2001 to December 2007 were collected. Forty-eight lesions were detected with a diameter ranging from 1.2 cm to 7.5 cm. RFA electrode and 20G needle were pricked into the target lesion under the guidance of B ultrasound or computed tomography (CT) through percutaneoas puncture or open approaches. An amount of 5-10 ml hypertonie saline was infused through the needle at regular intervals during RFA. All patients were followed up for 3-79 months. Contrast-enhanced ultrasound and CT scanning were performed postoperatively to determine the efficacy of RFA. The levels of alpha-fetoprotein (AFP) before and after treatment were compared using t test, and the survival of the patients were analyzed using a Kaplan-Meier survival curve. Results The AFP expression changed to negative in 14 out of the 18 AFP-positive patients, with statistical difference (t =7.703, P <0.05). The complete necrosis rate of tumors was 94% (45/48), and the necrosis rate of tumors with diameter of ≤4.0 cm reached 100% (35/35). The incidence of complication was 5% (2/42). No perioperative mortality occurred. The 1-, 2-, 3-year survival rates were 91%, 85% and 70%, respectively. Conclusions Hypertonic saline enhanced RFA in the treatment of liver cancer was proved to be safe and effective.

Objective To evaluate the safety and effectiveness of the treatment by selective β 1 receptor blockers on patients with chronic obstructive pulmonary disease (COPD).Methods Eighty cases of COPD Ⅲ (stable period) inpatient with or without coronary heart disease were collected in The Second People's Hospital of Shanghai from September 2012 to November 2013.The patients were randomly divided into testing group (Metoprolol treatment group) and control group (regular treatment group) with 40 cases for each group.Metoprolol group therapy based on the use of conventional metoprolol tablets,an initial dose of metoprolol 12.5 mg/d,titrated to the appropriate dose based on heart rate and tolerance of the morning resting heart rate of 55 to 60 times/min that reached the target dose of metoprolol continuous medication for 12 months.Blood gas analysis were recorded before and after treatment,pulmonary function,and 6 min walk test (6MWT) and were chronic lung disease Assessment Test (CAT) Rating.The control group was administrated regular treatment while the testing group added small dose of Metoprolol with titration to an appropriate dose on this basis.12 months in a row,and assessed the end stage.Results (1) After the application of selective β receptor blockers on testing group,no statistically significant difference (P＞0.05) in the values of FEV1 in anticipation value％ (testing group:(45.45 ± 4.68) ％ vs.(43.32 ± 4.84) ％;control group:(44.23 ± 4.68) ％ vs.(42.58 ±4.24)％),PaO2(testing group:(75.92± 10.78) mmHg vs.(74.86± 11.21) mmHg;control group:(70.23 ±6.45) mmHg vs.(72.36±7.28) mmHg) and PaCO2(testing group:(46.28±8.28) mmHg vs.(47.46±10.22) mmHg);control group:(44.54 ± 8.89) mmHg vs.(42.36 ± 7.45) mmHg) before and after treatment.But the 6MWD (testing group:(287 ± 23) m vs.(384± 34) m;control group:(284 ± 25) m vs.(295 ±21) m) and COPD appraisal test(CAT) (testing group:(21±7) score vs.(17±6) score);control group:(22 ±5) score vs.(20± 6) score) had improved significantly compared with that before treatment,with significant difference(t=4.903,4.784;P＜0.05).Conclusion Selective β receptor blockers have no effect on the airway resistance of COPD patients and reduction on pulmonary function.It can also increase the exercise tolerance and enhance the living quality for improving clinical prognosis.

OBJECTIVE: This article summarizes the matters warranting consideration in adult cochlear implants before and after operation with different deafness causes and investigates the impact of etiological variables that affect hearing and speech ability rehabilitation after cochlear implantation. METHOD: We retrospectively reviewed the preoperative data of 30 adults who have received cochlear implantation, switch on, and periodical post operative mapping. 'Nijmegen Cochlear Implant Questionnaire' was used for every patient during follow-up and test their hearing thresholds at one year after switched-on. The average score of every patient in the six aspects of questionnaire, along with the average hearing threshold, has been gathered. RESULT: The average hearing threshold of every patient is lower than 35 dBHL. The average score of 28 patients is more than or equal to 75 in the basic sound perception, advanced sound perception as well as self-esteem. The average score of 26 patients is more than or equal to 75 in capacity for action. Besides, as for sociability and speech ability, the average score of 22 patients is more than or equal to 75. CONCLUSION Auditory perception can be greatly improved regardless of deafness causes, on the premise that appropriate candidate is selected. The primary disease should be brought under control before and after the operation. The influence of various causes to the language ability rehabilitation largely depends on the development of the language center at deafness onset. Self-esteem and social identity can be significantly enhanced after cochlear implantation in adult patients, particularly those with acquired deafness.
Adolescent ; Adult ; Aged ; Auditory Perception ; Cochlear Implantation ; psychology ; Follow-Up Studies ; Humans ; Middle Aged ; Retrospective Studies ; Self Concept ; Social Identification ; Treatment Outcome ; Young Adult

OBJECTIVEEvaluation of two different methods of treatment of distal tibial fractures of the clinical indications, complications and efficacy.

METHODSForty-five cases of closed distal tibial fractures were assigned to two groups, 25 cases in group A included 18 males and 7 females, according to the AO/ASIF classification: 4 cases of type A, 14 cases of B, 7 cases of C, open reduction and anatomic plate fixation were used. Twenty cases in group B included 12 males and 8 females, 5 of type A, 9 of B, 6 of C, minimally invasive percutaneous locking compression plate osteosynthesis were used. Observed on the postoperative pain, skin necrosis of the incision, the incidence of deep infection and other complications, as well as the healing of fractures, ankle motor function for comparative study.

RESULTSAll patients were followed up 10 to 15 months, according to the visual analogue scale (VAS) score, group A were moderate to severe in, group B were mild to moderate between. Bone healing time: group A averaged (16.0+/-4.2) weeks, group B averaged (13.0+/-3.2) weeks, the difference was significant (P<0.01). Postoperative complications of group A was more than that of group B (P<0.05), there were significant differences. Ankle function in accordance with the assessment criteria Kofoed, the good and excellent rate of group B was higher than that of group A (P<0.05), there were significant differences.

CONCLUSIONMinimally invasive percutaneous locking compression plate osteosynthesis compared open reduction and anatomic plate fixation for distal tibial fractures with less trauma surgery, bone blood supply to the affected small, fracture healing faster, less complications, and ankle function better advantage of. It is consistent with the biomechanics of internal fixation, and is the treatment of tibial fractures ideal method.

Adult ; Ankle Injuries ; complications ; surgery ; Bone Plates ; Female ; Fracture Fixation, Internal ; methods ; Fracture Healing ; physiology ; Fractures, Closed ; complications ; surgery ; Humans ; Knee Injuries ; complications ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Tibial Fractures ; complications ; surgery ; Treatment Outcome ; Young Adult

Objective We will discuss the related factors affecting the rehabilitation efficacy after the opera-tion of adults cochlear implantation .Methods Nijmegen Cochlear Implant Questionnaire'was adopted .There were questionnaire surveys on 29 adult patients with cochlear implantation .The individual scores and total scores of all subjects were collected together with the personal information ,including age ,bilateral effects and other factors . They were grouped in accordance with different grouping standards of different affecting factors .Results Compared to the communication manner of long -term hearing loss ,the rehabilitation efficacy of the group using lip -reading preoperatively was greater than the group using sign language or writing ;the rehabilitation efficacy of the group with the aggregate time of using CIs more than two years was superior to that similar group of less than two years , and the average P within the group of these two factors was <0 .05 .There was no statistical significance among group comparisons for other factors as the P was >0 .05 .Conclusion Ages ,the bilateral deafness ,and auditory dep-rivation have no obvious effects on the rehabilitation efficacy after the operation .The patients with postlingual deafness can improve their hearing with proper rehabilitation .Lip-reading preoperatively has positive effects on the rehabilitation effica-cy after the operation ;the length of using CIs has become the major factor affecting the rehabilitation efficacy .

Adolescent ; Adult ; Aged ; Blood Coagulation ; Factor XII ; genetics ; Factor XII Deficiency ; blood ; genetics ; Female ; Humans ; Male ; Point Mutation

OBJECTIVETo investigate the molecular mechanism of haemophilia B caused by the novel mutation of Arg327Ile (R327I) in FIX gene.

METHODSThe R327I, R327Ala(A), R327Lys(K), R327Asn(N) and a replacement mutant (FIXβFVII), in which FIX β strand 324-329 was replaced by that of FVII 298-303, expression plasmids were constructed with site-directed mutagenesis method based on the wild-type (WT) FIX expression plasmid. The HEK293 cell was transiently transfected, then the activity of FIX (FIX:C) was assayed by one stage method in the conditioned medium, while the FIX:Ag in both the conditioned media and the cell lysates was measured by ELISA. The molecular weight and the semi-quantity of expressed FIX were analyzed by Western blot. Fluorescent protein expression plasmid was constructed to investigate the synthesis and secretion of the FIX R327I mutation in the viable cells.

RESULTSFIX:C of the R327I mutant protein was 4.49% of the level of the WT in the conditioned medium, and the FIX:Ag of the R327I mutant protein in the conditioned medium and the cell lysates was 31.02% and 129.29% compared to that of WT, respectively. The mutation was characterized as cross-reaction material reduced (CRMR). The viable cell fluorescent assays showed that the R327I protein was more in both the viable cells and in lysosome than that of WT. The FIX:C of the R327A, R327K, R327N and FIXβFVII mutants was reduced compared to that of WT, the reduction of FIX:C of FIXβFVII was the most significantly amount among all the mutants in medium. FIX:Ag of all the mutants in the medium, except that the R327K increased, was reduced. The result of Western blot showed that the molecular weight of R327I protein was the same as that of WT, but the amount of the protein was much less compared with WT in the conditioned medium.

CONCLUSIONThe abnormal synthesis and secretion as well as the abnormal function of the R327I mutant protein causes haemophilia B. The residue of R327 as well as the β strand domain of R327 located play important roles of the specific function of FIX.

Factor IX ; genetics ; HEK293 Cells ; Hemophilia B ; genetics ; pathology ; Humans ; Mutagenesis, Site-Directed ; Mutation ; Transfection

OBJECTIVETo examine the association between long-term oral low-dose aspirin and overall survival in colorectal cancer patients after diagnosis.

METHODSThe literature databases, such as PubMed, Embase, Cochrane Library, Web of Science, CBM, CNKI, and Wanfang database, were extensively searched to retrieve the comparative studies about the association between low-dose aspirin use after colorectal cancer diagnosis and overall survival published before June 2014. The state 12.0 version software was used for meta-analysis. The quality of these studies was assessed using the Newcastle-Ottawa scale.

RESULTSThere were eight studies meeting the inclusion criteria for meta-analysis. The total sample size of these studies included 28 103 cases and the score of all the studies was more than 6 points. Meta-analysis of the data using I(2) test showed significant heterogeneity (I(2)=78.2%, P<0.01), therefore, a random effect model was performed. Aspirin use after diagnosis was associated with longer overall survival (HR=0.732, 95% CI:0.613-0.875, P<0.01). There were seven studies with the same design or tumor stage in I-IIII period respectively for sensitivity analysis. The results of studies showed that the sensitivity was low and accurate (HR=0.687, 95% CI: 0.557-0.849, P<0.01; HR=0.682, 95% CI: 0.539-0.864, P<0.01).

CONCLUSIONMeta-analysis shows that long-term oral low-dose aspirin after diagnosis of colorectal cancer is identified as a significant prognostic factor.

Aspirin ; Colorectal Neoplasms ; Humans

Objective To compare the safety and efficacy of direct and remedial rotational atherectomy in the treatment of heavily calcified coronary artery lesions.Methods We retrospectively reviewed 58 patients admitted in the Shanghai Chest Hospital and Liaocheng People Hospital from May 2012 to July 2015 who had received stent implantation and rotational atherectomy.The 58 patients were divided into two groups which were the direct atherectomy group (n =27) and the remedial atherectomy group (n =31).General clinical date,lesion and procedural characteristics,intraoperative complications,in-hospital and follow-up MACCE were compared between the two groups.Results There were no differences between the two groups in general clinical date intraoperative complications,amount of contrast agent used,proceduraltime,rates of in-hospital and follow-up MACCE.Nevertheless,compared with the direct artherectomy group,the remedial group had more number of balloon dilations during procedure [3 (1,5) vs.2 (1,2),P ＜ 0.001] and higher peak cardiac troponin levels [1.1 (0.3,3.0) μg/L vs.0.5 (0.1,2.3) μg/L,P =0.032].Conclusions Remedial rotational atherectomy with drug-eluting stent had the same safety and efficacy as direct atheretomy with drug-eluting stent in treating patients with heavily calcified coronary lesions.It is reasonable and safe to transform routine PCI to remedial rotational atherectomy when the 2.0 mm semi compliant balloon or/and 2.5 mm non-compliant balloon cannot pass through or dilate the lesions.