ObjectiveTo study the efficacy of transcatheter arterial chemoembolization (TACE) combined with surgical resection in the treatment of ruptured hepatocellular carcinoma (HCC).MethodsThe clinical data of 26 patients who presented with ruptured HCC to our hospital from January 2008 to December 2011 were retrospectively studied. These patients received TACE (n=19),surgical resection (n=7),and surgical resection after TACE (n=8).ResultsShock in the 19 patients who received TACE was promptly corrected and the vital signs were stabilized.On subsequent CT,the tumors shrunk in size.Salvage liver resection was carried out in 8 patients 1 month after TACE.After treatment,AFP decreased or became normalized,thus the treatment results were good. A one-stage liver resection was carried out in 7 patients. One patient died after operation and peritoneal metastases occurred in 4 patients. Conclusions TACE stopped bleeding from ruptured HCC efficaciously,reduced the need for open exploration,and improved the rate of resection of HCC.TACE combined with surgical resection significantly lowered the rate of abdominal tumor metastases.

Objective To investigate the influential factors for the colonoscopic polyp detection rate (PDR) and adenomade detection rate(ADR) in high-risk population in community colorectal cancer screening.Methods Data of patients who were determined as high-risk population in community colorectal cancer screening tests and received colonoscopy in the Digestive Endoscopic Center of Tongji Hospital from May 2014 to November 2014 were collected.PDR and ADR were calculated by different genders, ages, history of abdominal operation, anesthesia assistance, quality of bowel preparation and experience of operators.Thex2 test and logistic regression analysis were used to compare the PDR and ADR between different groups.Results A total of 417 patients received complete colonoscopies.The total PDR was 35.25％.Univariate analysis revealed that gender (OR =2.298,95％ CI: 1.525-3.463), history of abdominal operation (OR =0.596,95％CI:0.390-0.910), anesthesia assistance (OR =1.864,95％ CI: 1.086-3.200) and quality of bowel preparation were significantly associated with PDR while multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for PDR.The total ADR was 30.22％.Like PDR, univariate analysis revealed that gender(OR =2.113,95％CI: 1.382-3.229), history of abdominal operation(OR =0.604,95％ CI:0.387-0.941), anesthesia assistance(OR =2.344,95％ CI: 1.283-4.281) and quality of bowel preparation were significantly associated with ADR.However, multivariate analysis revealed that only gender, history of abdominal operation and quality of bowel preparation were independent influential factors for ADR.Conclusion For patients who were highrisk in community colorectal cancer screening, men have greater risk to develop polyps and adenomas than women.Colonoscopy should be more careful in patients with history of abdominal operation, for quality of bowel preparation is directly related to PDR and ADR.

Objective To investigate the role of TLR4/NF-κB signaling pathway under the action of TAK-242 in the cardiomyocyte apoptosis after coronary micro-embolism (CME) in rats.Methods Fortyfive rats were randomized (random number) into three groups:sham operation,CME and CME plus TAK242 groups (n =15 per group).CME was induced by injecting polyethylene microspheres (42 μm) into the left ventricle except the sham group.CME plus TAK-242 group was treated with TAK-242 (2 mg/kg) via the tail vein of mice 30 min before CME modeling.Cardiac function was evaluated 6 h after operation.Tissue biopsy was stained with HBFP to measure the size of infarction area.TUNEL assay was used to detect cardiomyocyte apoptosis.Western blot and qPCR were used to evaluate the protein levels and mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3,respectively.Statistical analysis was performed using one-way analysis of variance followed by LSD-t test.Results Compared with the sham group,left ventricular ejection fraction (LVEF) in the CME group was significantly decreased [(68.91 ± 4.12) ％ vs.(84.80 ± 2.51) ％,P ＜ 0.05],and the infarction area (P ＜ 0.05),the apoptosis index [(3.36 ± 0.63) ％ vs.(0.19 ± 0.08) ％,P ＜0.05],the mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3 in CME group were increased significantly (all P ＜ 0.05).Compared with CME group,LVEF in the CME plus TAK-242 group was significantly improved [(75.58 ± 5.01) ％ vs.(68.91 ± 4.12) ％,P＜0.05],and the infarction area [(8.58 ± 2.12) ％ vs.(14.65 ± 4.23) ％,P＜0.05],the apoptosis index [(1.43 ± 0.51) ％ vs.(3.36 ± 0.63) ％,P ＜ 0.05],the mRNA expressions of TLR4,NF-κB p65 and cleaved caspase-3 in CME + TAK-242 group were decreased significantly (all P ＜ 0.05).Conclusions TAK-242 effectively improved CME-induced cardiac dysfunction by regulating TLR4/NF-κB signaling pathway and then reducing the cardiomyocyte apoptosis.

Objective To study the clinical efficacy of the combination of sephedex and docetaxel used in transcatheter arterial chemoembolization (TACE) for clinical treatment of primary liver cancer.Methods 120 patients with primary liver cancer in our hospital were divided into the experimental group and the control group randomly and equally, the 60 cases in experimental group were treated with sephedex suspensoid (Sephedex, G-50, 300-500 μm) and docetaxel-iodized oil, while other 60 cases in control group were treated with docetaxel-iodized oil suspension liquid.Results The success rate of surgical intubation in the two groups was 100%.After an average follow-up of 12 months, the postoperative tumor diameter of the experimental group was reduced by (4.4±1.4) cm, while that of the control group was (1.8±1.0) cm;The overall response rate was 70% in the experimental group in contrast to 30% in the control group;the alpha fetal protein (AFP) value was decreased by (33.2±15.2) μg/L in the experimental group and (10.4±9.8) μg/L in the control group.Conclusion The combination of sephedex, docetaxel suspensoid and iodized oil shows great potential in TACE treatment of primary liver cancer, from which the treatment effect can be improved significantly.

Objective To explore MRI manifestations of extrapleural solitary fibrous tumor(SFT)and to analyze the reasons of misdiagnosis.Methods MRI data of 9 cases with extrapleural SFT proved by pathology were analyzed retrospectively.Lesions location, size,shape,intensity,degrees and patterns of enhancement were assessed,and the imaging features and causes of misdiagnosis were also analyzed.Results Among 9 lesions,1 was located in the right cerebellopontine angle region,2 were in subdural-extramedullary region,4 were in the abdominal cavity and 2 were in the pelvic cavity.7 cases were misdiagnosed before operation including 1 as meningioma, 2 as schwannoma,2 as mesenchymal stem cell tumor,1 as pancreatic carcinoma and 1 as Castleman disease.8 lesions were isointense and 1 was mixed iso-or slightly hyperintense on T1WI.3 lesions were isointense,4 were mixed iso-or slightly hyperintense and 2 were mixed slightly hyperintense,iso-or hypointense on T2WI.3 lesions showed significant homogeneous enhancement after the administration of contrast agent,1 lesion showed varying degrees of enhancement and the enhancement was more remarkable in isointense area on T2WI than peripheral hyperintense area.4 lesions showed heterogeneous peripherial enhancement in the early phase,progressive filling in the late phase and finally remarkable homogeneous enhancement.1 lesion showed predominant peripheral striped enhancement in the early phase,and progressive filling and mildly inhomogeneous enhancement with patchy unenhanced area in the center of the lesion in the late phase.Conclusion The MRI features of extrapleural SFT have certain characteristics.It needs to be carefully diagnosed to improve the diagnostic accuracy.

The pandemic of human immunodeficiency virus type one (HIV-1), the major etiologic agent of acquired immunodeficiency disease (AIDS), has led to over 33 million people living with the virus, among which 18 million are women and children. Until now, there is neither an effective vaccine nor a therapeutic cure despite over 30 years of efforts. Although the Thai RV144 vaccine trial has demonstrated an efficacy of 31.2%, an effective vaccine will likely rely on a breakthrough discovery of immunogens to elicit broadly reactive neutralizing antibodies, which may take years to achieve. Therefore, there is an urgency of exploring other prophylactic strategies. Recently, antiretroviral treatment as prevention is an exciting area of progress in HIV-1 research. Although effective, the implementation of such strategy faces great financial, political and social challenges in heavily affected regions such as developing countries where drug resistant viruses have already been found with growing incidence. Activating latently infected cells for therapeutic cure is another area of challenge. Since it is greatly difficult to eradicate HIV-1 after the establishment of viral latency, it is necessary to investigate strategies that may close the door to HIV-1. Here, we review studies on non-vaccine strategies in targeting viral entry, which may have critical implications for HIV-1 prevention.
AIDS Vaccines ; immunology ; therapeutic use ; Antibodies, Monoclonal ; immunology ; therapeutic use ; Antibodies, Neutralizing ; immunology ; therapeutic use ; Genetic Therapy ; HIV Infections ; drug therapy ; prevention & control ; HIV-1 ; drug effects ; immunology ; physiology ; Humans ; Peptides ; chemistry ; immunology ; Small Molecule Libraries ; chemistry ; pharmacology ; therapeutic use ; Virus Internalization ; drug effects

Objective To investigate the MRI characteristics of abdominal leiomyosarcoma and literature review.Methods Preoperative MRI data of 9 cases with leiomyosarcoma proved by pathology were analyzed retrospectively.The size,shape,signal intensity and enhancement type of the lesion were analyzed and some related literatures were reviewed in order to summarize its imaging features.Results In the 9 cases,1 was located in the liver,5 cases in the abdominal retroperitoneul space and other 3 case in the pelvic retroperitoneul space.Before operation,6 cases had wrong diagnosis,including 1 case misdiagnosed as hepatocellular carcinoma with intrahepatic metastases,3 cases as ganglioneuroma and 2 cases as uterine myoma.On plain MRI,5 cases showed iso-/slightly hypo-mixed signal and 4 cases showed hypointensity on T1 WI.Five cases showed iso-/slightly hyper-mixed signal and 4 cases showed iso-/slightly hyper/ hyper-mixed signal on T2WI.On diffusion weighted images (DWI),5 cases showed significant diffusion restriction and 4 cases showed moderate diffusion restriction.On contrast-enhanced MRI,3 cases showed obvious peripheral inhomogeneous enhancement,the enhancement degree in portal vein phase was more obvious than that in arterial phase and was sustained in delayed phase.The lesions showed progressive enhancement and the enhancement was higher in peripheral than central areas.Six cases demonstrated obviously inhomogeneous enhancement in arterial phase,no obvious washout was observed in portal vein phase and delayed phase,and non-enhanced area was still observed in late delayed phase.One lesion in the liver had the sign of pseudocapsule.Conclusion Abdominal leiomyosarcoma has certain characteristic MRI manifestations.Leiomyosarcoma should be considered in the differential diagnosis list,when the lesion is large,with cystic degeneration,necrosis,moderate to significant diffusion restriction on DWI and obvious peripheral enhancement.

Objective:To evaluate the clinical effectiveness and safety of Jiuwei-Zhuhuang San plus amoxilcillin sodium and sulbactam sodium in the treatment of bacterial pneumonia in children. Methods:A total of 120 patients with bacterial pneumonia in children from 1 year to 14 years old were randomly divided into the study group ( n=90) and the control group ( n=30) with ratio 3 to 1, the random sequence created by SAS software. Both groups were treated with amoxilcillin sodium for basic treatment, the observation group was treated with Jiuwei-Zhuhuang San. Both groups were treated for 1 week and followed up for 1 week. The cough frequency, clinical effective rate, symptoms and signs score, Traditonal Chinese medicine (TCM) pattern scores and adverse event rate were observed. Results:Eighteen cases were dropped and eliminated in the observation group, and 4 cases were dropped and eliminated in the control group, so 72 of observation group and 26 of control group were analyzed. After treatment, the clinical effective rate of the observation group was 27.8% (20/72), and the control group was 0% (0/26), where the difference was significant ( χ2=7.445, P=0.006). The difference of TCM syndrome score before and after treatment in the observation group (-16.8 ± 8.2 vs. -11.0 ± 5.8, t=-3.858) was lower than that of the control group ( P<0.01). There was significant difference between the two groups ( Z=-2.347, P= 0.019) in the TCM syndrome. The cough frequency of the observation group was 41.7% (30/72), and the control group was 26.9% (7/26). There wasn’t any significant differences in the cough frequency between two groups ( P>0.05). There was no statistical difference in symptoms and signs score or adverse event rate between two groups ( P>0.05). Conclusion:On the basis of amoxicillin sodium and sulbactam sodium, combined use of Jiuwei-Zhuhuang San can improve the clinical effectiveness of children with bacterial pneumonia.

Disulfiram, a drug that has been used for alcohol dependence. As an approved drug in clinical medicine, disulfiram can be used as the anticancer drug in the treatment of breast cancer, prostate cancer, glioblastoma, lung cancer, etc. This paper summarized the mechanism of disulfiram for anticancer treatment and the function for liver cancer therapy, and we also analyzed the potential mechanism of disulfiram for the treatment of liver cancer and its’ value in the clinical application.