Objective To evaluate the value of the mRECIST criteria in assessing the efficacy of transcatheter arterial chemoembolization(TACE) combined with sorafenib in the treatment of hepatocellular carcinoma (HCC).Methods A total of 35 patients who were treated with a combination of TACE and sorafenib for unresectable hepatocellular carcinoma fulfilled the mRECIST and RECIST criteria in our hospital from June 2011 to November 2012.Enhanced CT and/or enhanced MRI were used before (baseline) and after (3 month reexamination) combination treatment in our hospital.The mRECIST and RECIST criteria were used to evaluate the efficacy,and these efficacy assessments were compared.Results In the RECIST criteria,complete remission (CR) was 0％,partial remission (PR) was 2.9％,stable disease (SD) was 85.7％％,and progressive disease (PD) was 11.4％％.In the mRECIST criteria,CR was 8.6％,PR was 51.4％,SD was 34.3％,and PD was 5.7％.For the RECIST criteria,the objective response rate (CR+-PR) was 2.9％,the disease control rate (CR+PR+SD) was 88.6％,and the disease progression rate was 11.4％.For the mRECIST criteria,the objective criteria was 60％,the disease control rate was 94.3％,and the disease progression rate was 5.7 ％.The difference between the efficacy assessment results of mRECIST and RECIST was statisti cally significant(P＜0.001).Conclusion The mRECIST criteria can evaluate the efficacy of target le sions based on viable tumors,which is more adaptive to TACE and targeted drugs with new mecha nisms.

Objective To evaluate the efficacy of transarterial interventional therapy (TAIT) in treating patients with metastatic liver cancer, and to investigate the factors influencing the prognosis of patients. Methods From January 1997 to June 2000, 470 patients with metastatic liver cancer had undergone TAIT 1231 times in the Cancer Hospital of the Chinese Academy of Medical Sciences. The clinical data of the patients were retrospectively analyzed. The short-term and long-term efficacy and the side effect of TAIT were assessed. The potential factors influencing the prognosis of the patients were determined by Cox regression analysis. Results Complete remission was observed in 94 patients, and partial remission in 143. The total effective rate was 50.4% (237/470). The median survival time was 13.5 months. The O. 5-, 1-, 2-, 3-, 5-year survival rates were 86.4%, 66. 8%, 35.6%, 16.9%, 7.3%, respectively. No severe complication occurred. The factors influencing the prognosis of the patients were: the resection of the primary tumor, blood supply of the tumor, multiple metastases of liver cancer, thrombus in the portal vein, adjuvant chemotherapy after TAIT, tumor originated from breast cancer, tumors invading multiple lobes, concurrent metastasis in other sites (X2= 17. 322, 12. 593, 8.721, 8.573, 8.492, 7. 838, 5. 623, 5. 463, P < 0.05). Conclusions TAIT is an effective palliative therapy for metastatic liver cancer which cannot be resected. The factors mentioned above influence the prognosis of patients after TAIT.

Objective To investigate the clinical efficacy of transarterial chemoembolization (TACE) combined with sorafenib for the treatment of inoperable hepatocellular carcinoma (HCC), and to discuss the influence of treatment interval on the survival time. Methods During the period from July 2008 to May 2011 at authors’ hospital, a total of 50 patients with inoperable HCC were treated with TACE together with sorafenib. The treatment intervals between each TACE procedure were recorded. The results were analyzed. Results Up to Dec. 31, 2011, the median follow-up time of the 50 patients was 310 days. The mean interval between TACE treatments was 69 days before the combination treatment was employed , while the mean interval was 112 days after the combination treatment started , and the longest interval was 648 days. Conclusion Combination treatment TACE with sorafenib can remarkably prolong the treatment interval in patients with inoperable HCC, thus the patient can get more survival benefits.

Objective To investigate the application of C- arm CT imaging technique in evaluating the efficacy of transarterial chemoembolization(TACE) for hepatocellular carcinoma(HCC). Methods During the period from Sep. 2012 to Mar. 2013 at authors’ hospital, C- arm CT scanning was employed during the performance of TACE in 80 patients with HCC. The residual active tumor lesions, Lipiodol deposition and the embolization of the feeding arteries after TACE therapy were assessed by C- arm CT plain scan images and the images of early artery phase and parenchymal phase, as well as the post- processing images. The efficacy of TACE was thus evaluated. Results A total of 139 hepatic tumors were detected in 80 patients by C- arm CT imaging. C- arm CT scanning performed immediately after TACE showed that satisfactory result was obtained in 128 lesions of 75 patients(128/139, 92.9%). Fewer, medium and more residual active tumors were seen in 78, 29 and 21 lesions respectively, while dense, moderate and thin Lipiodol deposition was seen in 64, 39 and 25 lesions respectively. After TACE therapy obvious decrease in blood supply was demonstrated in 101 lesions, while no obvious decrease in blood supply was seen in 27 lesions. Conclusion C- arm CT scanning after TACE for patients with HCC can conveniently, accurately and comprehensively reveal the residual active tumors, Lipiodol deposition and embolization status of feeding arteries. Therefore, this technique should be regarded as an important means to evaluate the efficacy of TACE.

BACKGROUNDWe have recently reported that RhoA may regulate the invasion and metastasis of breast cancer cells as an upstream signal of ezrin in vitro. In this study, we examined the relationship of RhoA signaling activity with ezrin expression in breast cancer and its prognostic significance in patients with breast cancer.

METHODSParaffin tumor sections of breast cancer were collected retrospectively from 487 patients diagnosed between 2001 and 2004. Immunohistochemical methods were used to detect the expression of RhoA, phosphorylated (activated) RhoA, and ezrin.

RESULTSEzrin overexpression was detectable in 15.2% of 487 invasive breast cancers. The majority (85.1%) of ezrin-overexpressing tumors coexpressed phosphorylated RhoA; 78.8% of tumors with phosphorylated RhoA cooverexpressed ezrin. Patients whose cancers showed overexpression of ezrin or expression of phosphorylated RhoA had shorter survival rates.

CONCLUSIONSRhoA activation is important in human breast cancer due to its upregulation of ezrin; thus, agents that target phosphorylated RhoA may be useful in the treatment of tumors with ezrin overexpression.

Adult ; Aged ; Breast Neoplasms ; chemistry ; mortality ; Cytoskeletal Proteins ; analysis ; Female ; Humans ; Middle Aged ; Phosphorylation ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Signal Transduction ; physiology ; Survival Rate ; rhoA GTP-Binding Protein ; analysis ; physiology

OBJECTIVETo study the effects of GSM 1800 MHz radiofrequency electromagnetic fields (RF EMF) exposure on protein expression profile of human breast cancer cell line (MCF-7), as to exploring the possible effects on normal cell physiological function.

METHODSMCF-7 cells were continuously or intermittently (5 minutes field on followed by 10 minutes off) exposed to RF EMF for different duration (1 hour, 3 hours, 6 hours, 12 hours, or 24 hours) at an average specific absorption rate (SAR) of 3.5 W/kg. The extracted proteins were separated by 2-dimensional electrophoresis and the protein-spot distribution of the silver-stained gels was analyzed by using PDQuest software 7.1. Each experiment was repeated three times.

RESULTSOn the average, around 1100 proteins were detected using pH 4 - 7 IPG strip. There were no differential proteins found under continuous exposure at SAR of 3.5 W/kg for 6 hours. Under other exposure conditions, we found various differentially expressed proteins in exposure groups as compared with the sham-exposed controls. Especially in 3 hours intermittent exposure and 12 hours continuous exposure, eighteen and seven differential proteins were detected, respectively. The categories and functions of these differentially expressed proteins were analyzed by searching of SWISS-PROT protein database, which suggested that these proteins should be related to the functions of biosynthesization, signal transduction, and DNA damage and repair.

CONCLUSIONSData indicated that the protein expression changes induced by RF radiation might depend on exposure duration and mode. Many biological processes might be affected by RF exposure.

Cell Line, Tumor ; radiation effects ; Dose-Response Relationship, Radiation ; Electromagnetic Fields ; adverse effects ; Female ; Gene Expression ; Humans ; Proteome ; Radio Waves

OBJECTIVETo study the effects of GSM 1800 MHz radiofrequency electromagnetic fields (RF EMF) on DNA damage in Chinese hamster lung (CHL) cells.

METHODSThe cells were intermittently exposed or sham-exposed to GSM 1800 MHz RF EMF (5 minutes on/10 minutes off) at a special absorption rate (SAR) of 3.0 W/kg for 1 hour or 24 hours. Meanwhile, cells exposed to 2-acetylaminofluorene, a DNA damage agent, at a final concentration of 20 mg/L for 2 hours were used as positive control. After exposure, cells were fixed by using 4% paraformaldehyde and processed for phosphorylated form of H2AX (gammaH2AX) immunofluorescence measurement. The primary antibody used for immunofluorescence was mouse monoclonal antibody against gammaH2AX and the secondary antibody was fluorescein isothiocyanate (FITC)-conjugated goat anti-mouse IgG. Nuclei were counterstained with 4, 6-diamidino-2-phenylindole (DAPI). The gammaH2AX foci and nuclei were visualized with an Olympus AX70 fluorescent microscope. Image Pro-Plus software was used to count the gammaH2AX foci in each cell. For each exposure condition, at least 50 cells were selected to detect gammaH2AX foci. Cells were classified as positive when more than five foci were detected. The percentage of gammaH2AX foci positive cells was adopted as the index of DNA damage.

RESULTSThe percentage of gammaH2AX foci positive cell of 1800 MHz RF EMF exposure for 24 hours (37.9 +/- 8.6)% or 2-acetylaminofluorene exposure (50.9 +/- 9.4)% was significantly higher compared with the sham-exposure (28.0 +/- 8.4)%. However, there was no significant difference between the sham-exposure and RF EMF exposure for 1 hour (31.8 +/- 8.7)%.

CONCLUSION1800 MHz RF EMF (SAR, 3.0 W/kg) for 24 hours might induce DNA damage in CHL cells.

Animals ; Cells, Cultured ; Cricetinae ; Cricetulus ; DNA Breaks, Double-Stranded ; radiation effects ; DNA Damage ; radiation effects ; Electromagnetic Fields ; adverse effects ; Fibroblasts ; chemistry ; radiation effects ; Radio Waves

OBJECTIVETo explore the effect of millimeter wave (MW) at low power density on gap junctional intercellular communication (GJIC) in human keratinocytes (HaCaTs).

METHODSFluorescence recovery after photobleaching (FRAP) technique was employed to determine effect of 30.16 GHz MW exposure at 1.0 and 3.5 mW/cm(2) on GJIC with laser confocal scanning microscope.

RESULTSFRAP analysis revealed that 12-O-tetradecanoylphorbol-13-acetate (TPA) at a dose of 5 microg/L could inhibit GJIC in HaCaTs. Fluorescence recovery rate fell from (55 +/- 17)% in the controls to (34 +/- 13)% after photobleaching, with a very significant difference (P < 0.001). Exposure to MW alone for one hour at either 1.0 mW/cm(2) or 3.5 mW/cm(2) did not affect GJIC, with fluorescence recovery rates of (52 +/- 16)% and (50 +/- 17)%, respectively. GJIC suppression induced by TPA was weakened by MW combined with 5 microg/L TPA treatment for one hour, which could be partially recovered by exposure to 1.0 mW/cm(2) MW with fluorescence recovery rate of (47 +/- 16)%, P < 0.01, and fully recovered by exposure to 3.5 mW/cm(2) MW with fluorescence recovery rate of (50 +/- 16)%, P < 0.001, with a very significant difference.

CONCLUSIONSGJIC suppression induced by TPA could be eliminated or diminished by exposure to millimeter wave in HaCaTs.

Cell Communication ; drug effects ; radiation effects ; Cell Line ; Fluorescence Recovery After Photobleaching ; methods ; Gap Junctions ; drug effects ; physiology ; radiation effects ; Humans ; Keratinocytes ; cytology ; physiology ; Microwaves ; adverse effects ; Tetradecanoylphorbol Acetate ; pharmacology

Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.

OBJECTIVETo explore the efficacy and prognosis of first-line autologous hematopoietic stem cell transplantation (ASCT) for newly diagnosed patients with multiple myeloma(MM).

METHODSFrom January 2005 to December 31, 2012, 60 patients with MM were enrolled. All patients received thalidomide or/and bortezomib-based induction therapy, then received high-dose melphalan (200 mg/m²) and autologous stem cell support to get a ≥ partial response (PR), and followed by thalidomide-dexamethasone (TD) ±bortezomib as consolidation or maintenance treatment. With the follow up to December 31, 2012, the overall survival (OS), progression free survival (PFS) and the prognostic factors, including ISS stage, response and fluorescent in situ hybridization (FISH) data of cytogenetics were analyzed.

RESULTSWith a median follow up of 36.8 (12.0-102.5) months, the median OS and PFS estimate were not reached and 86.5 months, respectively. After transplantation, all (100%) patients received very good partial response (VGPR), and 34 (56.7%) patients achieved complete response (CR) after consolidation or maintenance treatment. The patients that achieved CR resulted in long term PFS (P=0.030), with no difference in OS (P=0.942). The univariate analysis showed that the abnormalities, including 13q14 deletion, 1q21 gain, IgH location and p53 deletion had the prognostic impacts. If the t(4;14) or p53 deletion was excluded, there would be no correlation between 13q14 deletion or 1q21 gain with PFS and OS. The patients with p53 deletion had a worst survival.

CONCLUSIONThere has been significant improvement in the outcome for young MM patients by using ASCT and novel drugs. Cytogenetic abnormalities and response to therapy are the main factors affecting the survival of patients.

Adult ; Aged ; Chromosome Aberrations ; Female ; Follow-Up Studies ; Hematopoietic Stem Cell Transplantation ; Humans ; Male ; Middle Aged ; Multiple Myeloma ; diagnosis ; genetics ; therapy ; Prognosis ; Transplantation, Autologous ; Treatment Outcome