ObjectiveTo evaluate prognostic factors affecting local tumor progression after radiofrequency ablation (RFA) of hepatocellular carcinoma (HCC).MethodsA total of 246 HCC patients (343 lesions) underwent RFA treatment in our department and were enrolled into this study.The average tumor size was 3.7 cm ( range 0.9 ～ 3.7 cm).Regular follow-up with enhanced CT was performed to evalutate the treatment results.Kaplan-Meier model and log-rank test were used in univariate analysis and COX regression model was used in multivariate analysis to identify risk factors for local tumor progression.ResultsThe local tumor progression rate was 11.4％ (39/343 lesions),and the average time from initial RFA to local tumor progression was 12.0 months.Univariate analysis indicated tumor size ( P ＜0.001 ),close to intrahepatic vessels ( P ＜0.001),tumor boundary ( P =0.020),pathological grade( P =0.010) and CEUS before RFA ( P =0.001) as risk factors for local progression.The following factors were identified as independent prognostic factors for local tumor progression by multivariate model:tumor size (P ＜ 0.001),isolated or close to intrahepatic vessels( P ＜0.001) and CEUS before RFA(P =0.018).ConclusionsTumor size,CEUS before RFA and close to intrahepatic vessels are the most important factors for local progression after RFA.Being awaring of possible risk factors for local tumor progression may increase the treatment efficacy and help to promote the use of RFA technique.

OBJECTIVE:To select a technique for preparation of fluconazole for injection and to establish a method for determination of its content.METHODS:The formula was selected on the basis of pH value and species of solution adjuvant.The content was determined by HPLC.RESULTS:The preparation was stable when pH value was between6.5～8.5,and its clarity could be increased by propylene glycol.The detectable concentration of fluconazole showed a good linear correlation in the range of40～200?g/ml.The average recovery was100.37%,RSD=1.37%(n=3).CONCLUSION:The fluconazole for injection prepared by the present technique is stable in quality and the method for content determination is accurate and practicable.

Objective To evaluate the role of contrast-enhanced ultrasound (CEUS) on the the detection of hepatic metastases in comparison with conventional ultrasonography (US) and contrastenhanced computed tomography (CECT).MethodsNinety-seven patients with hepatic metastases underwent US,CEUS and CECT images.Their detection of hepatic metastases were compared.Results Hepatic metastases showed five enhancement patterns with CEUS,including bolus hyper-enhancement,peripheralrimenhancement,inhomogeneousenhancementwithnecrosis,hypo-enhancement,isoenhancement with liver parenchyma,all hepatic metastases showed dark defects in portal and delayed phase.The mean number of metastases at CEUS was greater than that of US (2.6±1.9 vs 1.6 ±1.2,P＜0.05).The detection of hepatic metastases was 53.4％ and 87.1％ respectively(P＜0.05).CEUS and CECT have no statistically significant difference in the detection of hepatic metastases (P＞0.05).ConclusionsCEUS can improve detection of hepatic metastases.

Objective To investigate the value of contrast enhanced ultrasonography (CEUS) in the treatment of small hepatic malignancies with radiofrequency ablation(RFA). Methods Seventy patients with 104 pathologically proved malignant liver lesions treated by RFA (size 0.7 -2.7 cm) were divided into 2 groups including CEUS group and control group. In CEUS group,39 patients(54 lesions) were treated with RFA guided by CEUS, while in control group 31 patients (50 lesions) were guided by conventional ultrasonography. There was no significant difference between clinical data of the two groups. Results Seventeen tumors(among them,12 lesions were less than 1.5 cm in diameter) in 13 patients showed more clearly on CEUS image than on conventional ultrasonography image (31.5% ) in CEUS group. The tumor necrosis rate at one month after RFA was 100% in CEUS group,and 92% in control group ( P = 0. 034).The number of RFA sessions per tumor was 1.00± 0.00 in CEUS group,and 1.08 ± 0.27 in control group (P = 0.000). Local tumor progression rate was 0 in CEUS group and 4% in control group ( P = 0. 138)during the period of 8 - 52 months follow-up (average 21 months). Conclusions CEUS can not only improve the display of small hepatic malignancies but also provide precise guidance in contrast with conventional ultrasonography. Compared with control group, RFA of small hepatic malignancies guided by CEUS lower the number of RFA sessions, enhance the tumor necrosis rate, decrease post-RFA local progression and therefore it has extensive clinical value.

The objective of this work was to develop a valuable adsorbent for recovery of platinum by studying the properties of Pt4+ -adsorption with immobilized Citrobacter freudii XP05 biomass. Five methods for immobilization of Citrobacter freudii XP05 biomass were compared. The method with gelatin-alginate sodium as entrapment matrix was considered to be the optimal. Spherical and uniform beads were produced and the SEM micrograph indicated that the cell of strain XP08 were uniformly dispersed within the matrix. The adsorption of Pt4+ by immobilized XP05 biomass was affected with adsorptive time, pH value of the solution, immobilized biomass concentration, Pt4+ initial concentration The adsorption was a rapid process. The optimal pH value for Pt4+ adsorption was 1.5, and its adsorptive capacity increased linearly with increasing Pt4+ initial concentrations in the range of 50 - 250 mg/L. The experimental data could be fitted to Langmuir and Freundlich models of adsorption isotherm. The adsorptive capacity reached 35.2 mg/g under the conditions of 250 Pt4+ mg/L, 2.0 g/L immobilized biomass, pH 1.5 and 30 degrees C for 60 min. 98.7% of Pt4+ adsorbed on immobilized biomass could be desorbed with 0.5 mol HC1/L. The characteristics of dynamic adsorption and desorption of immobilized XP05 biomass in packed-bed reactor were investigated. The saturation uptake was 24.66 mg Pt4+ /g under the conditions of flow rate 1.2 mL/min, pH 1.5, 50 mg Pt4+/L and 1.85 g biomass(dry weight) . Adsorptive efficiency of Pt4 + by the immobilized XP05 biomass was above 78% for 4 cycles of adsorption and desorption. The recovery of platinum from waste platinum catalyst was studied. The adsorptive capacity was 20.94 mg Pt4+/g immobilized biomass under the conditions of 4.0 g/L immobilized XP05 biomass, 117.76 mg Pt4+/L and pH 1.5 for 60 min. The immobilized XP05 biomass is potentially applicable to the recovery of platinum from waste and wastewater containing platinum.
Biomass ; Bioreactors ; microbiology ; Citrobacter ; metabolism ; Microscopy, Electron, Scanning ; Microspheres ; Platinum ; isolation & purification ; metabolism ; Waste Disposal, Fluid ; methods ; Water Pollutants, Chemical ; isolation & purification ; metabolism

OBJECTIVETo investigate the status of clinical practices and side effects related to Shenfu injection.

METHODIt was searched the Chinese medical citation index (CMCI) database and China national knowledge infrastructure (CNKI) database using the word "Shenfu injection". Original clinical studies of Shenfu injection which were published from January 1 987 to March 2012 in Chinese magazines were included.

RESULTA total of 1 433 relevant clinical studies were identified. It was investigated and analyzed the side effects of Shenfu injection. For cases with side effects, the diseases for treatment, the medication dosage, the course, and menstrum of treatment for the side effects were evaluated. All the side effects were mild except five cases of serious adverse reaction.

CONCLUSIONShenfu injection has been widely used in clinical patients since it came into the market in 1987. However, there are some problems in its clinical practices, such as deficiency in selecting and expanding diseases for treatment, evaluating the dosage and treatment method. Therefore, it is imperative to evaluate drugs by literature and good clinical application after the drugs come into the market with evidence-based medicine.

Clinical Trials as Topic ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Humans ; Male

OBJECTIVETo evaluate the clinical significance of full volume real-time three-dimensional echocardiography (RT-3DE) in the assessment of general and local systolic functions of the left ventricle in children with Kawasaki disease (KD).

METHODSA total of 73 KD children (40 with and 33 without coronary artery lesions) and 35 healthy control children were recruited. Left ventricular ejection fraction (LVEF) was measured by M-mode ultrasound and full volume RT-3DE imaging. A left ventricular volume-time curve and a segmental speed-time curve were generated. Differences between control subjects and patients with and without coronary artery lesions were analyzed.

RESULTSThe M-mode ultrasound measurements of LVEF in KD patients with coronary artery lesions were significantly lower than in KD patients without coronary artery lesions and control children (P<0.05), while there was no significant difference between KD patients without coronary artery lesions and control children. RT-3DE measurements of LVEF were significantly different between the three groups analyzed (P<0.05): coronary artery lesion group < no coronary artery lesion group < control group. RT-3DE-based segmental ventricular wall analysis revealed that Tmsv16-SD and Tmsv12-SD in KD patients with coronary artery lesions were significantly higher than other two groups and Tmsv6-SD was also significantly higher than in the normal control group (P<0.05) and that Tmsv16-SD in KD patients without coronary artery lesions increased significantly compared with the normal control group (P<0.05).

CONCLUSIONSRT-3DE can be used in the quantitative evaluation of the left ventricular function and therefore has significant clinical implications.

Child ; Child, Preschool ; Echocardiography, Three-Dimensional ; methods ; Female ; Humans ; Infant ; Male ; Mucocutaneous Lymph Node Syndrome ; diagnostic imaging ; physiopathology ; Ventricular Function, Left

Compared with the traditional health service industry, the new health service industry tends to be more comprehensive and integrated, and the various factors are in a dynamic change process, which is characterized by larger scale,intensive,agglomerative and special business methods. Compared with the traditional medical and health industry supervision, its regulatory content has greatly changed in the new system. Under the new market relationship,the supply and demand sides have put forward higher requirements for supervision,and the emerging business forms are networked, fragmented and flexible. The service boundary has broken through the traditional supervision mode,and it simultaneously faces the challenge of defining the supervision responsibilities,complexity,the current tax system management,the current supervision mechanism hindrances,and the balance between the new health service industry and health quality access regulation which are undergoing an exponential trend of development. Therefore,this paper puts forward some suggestions such as the establishment of a new health service industry supervision mechanism with information supervision as the core,the realization of the transition from direct control to bottom-line supervision, the establishment of multi-sectoral organic coordination, and a coordinated supervision mechanism which involves the participation of all social subjects.

Objective To observe the effects of therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory on the related factors in granulation tissue during the healing of chronic skin ulcer in rats based on drug-wound interaction. Methods Twenty-four rats were randomly divided into normal group, model group, control group, and treatment group, 6 rats in each group. The rats in the normal group had no skin ulcer and was given normal feeding,and the rats with chronic skin ulcer in the other 3 groups were induced by compound factors-overlapped method of hormone intervention-skin defect-bacterial infection. After modeling,the model group was given external use of saline gauze dressing,the control group given external use of vaseline gauze dressing,and the treatment group given external use of Shengji Xiangpi Ointment,changing fresh dressing for wound daily,the treatment lasting for 14 days. Wound sample was taken from the left back of rats, and therapeutic effect was evaluated according to the changes in the wound surface of the rat right back. After intervention for 3,7,and 14 d,the secreta and granulation tissue in the wound surface of rats were observed, the expression levels of vascular endothelial growth factor (VEGF), inducible nitric oxide synthase(iNOS), arginine-1 (Arg-1), and Notch1 in granulation tissue of rat ulcer wound were measured by enzyme-linked immunosorbent assay (ELISA). Results The wound in the treatment group has been healed after treatment for 14 days (P < 0.05 or P < 0.01 as compared with the diameter of the ulcer in the model group and the control group) . At the early stage of wound repairing (3 d),the expression levels of VEGF and Arg-1 in the treatment group were increased, and Notch1 expression level was decreased, the difference being statistically significant as compared with those of the model group and the control group (P < 0.05). At the late stage of wound repairing (14 d),the expression level of iNOS in the treatment group was increased,and the difference was statistically significant as compared with that of the model group(P < 0.05). Conclusion The therapy of wound-pus promoting granulation tissue growth guided by drug-wound interaction theory can promote the healing of chronic skin ulcerative wound in rats and improve the general condition of rats. The therapeutic mechanism may be associated with firstly inhibiting the expression of iNOS induced by M1 type macrophage at early stage and then promoting M2 type macrophage phenotype index Arg-1 expression,and regulating the expression of VEGF and Notch1 in the granulation tissue.

OBJECTIVETo study the relation between the nitric-oxide synthase (NOS) expression and nitric oxide (NO) content in the skeletal muscles and the injury condition of soft tissue in the 3rd lumbar vertebrae syndrome model rats, and to observe the effect of acupotomology therapy.

METHODSOne hundred and twenty-eight adult SD rats were allocated to 4 groups randomly: normal group, model group, aminoguanidin group and acupotomology treatment group, 32 rats in each group. NOS expression, NO content and injury of the soft tissue in the 3rd lumbar vertebra were observed on the 1st, 3rd, 7th and 14th day after the acupotomology treatment and aminoguanidine intervention.

RESULTS1) Inducible NOS (iNos) activity and NO content in model group was significantly higher (F = 522.860, P < 0.01), in acupotomology group and aminoguanidine group was significantly lower than the model group (FiNOS = 28.894, P < 0.01), and iNOS activity and NO content in all groups was in competence with the condition of soft tissue injuries. 2) Endothelium NOS (eNOS) expression raised in model group and acupotomology group, and achieve peak on the 7th day. There was significant difference between the eNOS expression in acupotomology group and the model group (FeNOS = 3.454, P < 0.05). 3) The expression of neuron NOS (nNOS) in the model group, aminoguanidine group and acupotomology group had no significant (FnNOS = 0.962, P > 0.05).

CONCLUSIONAcupotomology treatment can restrain the development of high content NO, release the inflammatory reaction and injury condition, improve microcirculation, prevent the development of scar tissue of the injured soft tissue, and has significant recovering effectiveness in the soft tissue injured model rats.

Animals ; Disease Models, Animal ; Gene Expression Regulation, Enzymologic ; Guanidines ; therapeutic use ; Lumbar Vertebrae ; drug effects ; metabolism ; pathology ; surgery ; Male ; Muscle, Skeletal ; drug effects ; metabolism ; pathology ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; metabolism ; Rats ; Rats, Sprague-Dawley ; Syndrome ; Time Factors