Objective To compare the curative effect of transcatheter arterial chemoembolization (TACE) combined with microwave ablation (MWA) with that of simple TACE in treating large liver cancers.Methods A computer-based search assisted by manual searching for TACE+MWA vs simple TACE clinical control trials for large liver cancers was conducted.The patient survival,tumor response and complications were enrolled in the scope of analysis.Results A total of 16 papers met the inclusion criteria,which included 1199 patients in total.Meta-analysis indicated that one-,2-and 3-year survival rates of TACE+MWA group were better than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The complete response (CR) rate and partial response (PR) rate of TACE+MWA group were higher than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).The stable disease (SD) rate and progressive disease (PD) rate of TACE+MWA group were lower than those of simple TACE group,and the differences between the two groups were statistically significant (P＜0.01).Conclusion For the treatment of large liver cancers,TACE +MWA is superior to simple TACE.(J Intervent Radiol,2017,26:225-231)

Objective To investigate the effect of stress level on blood coagulation and fracture healing in fracture patients.Methods The clinical data of 50 fracture patients (fracture group) and 50 healthy volunteers (control group) were analyzed retrospectively.The oxidative stress indexes [superoxide dismutase (SOD) and malondialdehyde (MDA)] and blood coagulation indexes [plasma fibrinogen (Fib),activated partial thromboplastin time (APTT),thronbin time (TT),and prothrombin time (PT)] were compared between the 2 groups.Correlation between stress level and coagulation indexes in the fracture patients was analyzed by Spearman correlation coefficient.The correlation between stress level and the progress of fracture healing in fracture patients was analyzed.Results There were no significant differences in APTT,TT,PT or other blood coagulation indexes between the 2 groups (P ＞ 0.05).The fracture group had a significantly lower SOD level but significantly higher MDA and Fib levels than the control group (P ＜ 0.05).Spearman analysis showed that the SOD level was negatively correlated to the Fib level (P ＜ 0.05) while the MDA level was positively correlated to the Fib level in the fracture group (P ＜ 0.05).The MDA level was negatively correlated to the process of fracture healing (P ＜ 0.05) while the SOD level was positively correlated to the process of fracture healing in the fracture group (P ＜ 0.05).Conclusions Traumatic fracture can cause stress reaction.It should be kept in mind that the severity of stress reaction is closely related to the Fib level and the process of fracture healing.

AIM:To explore the effect of FOXQ1 gene silencing on angiogenesis and proliferation ability of co-lon cancer cells induced by Sonic hedgehog (Shh).METHODS:Lentivirus expressing different FOXQ1-shRNA or nega-tive cantrol (NC)-shRNA was used to infect the SW480 cells.The best silencing condition was screened and used in the following experiments .The SW480 cells were divided into interfered group ( FOXQ1-shRNA) and control group ( NC-shR-NA) .The MTT assay was used to observe the doubling time and cell activity .Tube formation assay was performed to detect the ability of angiogenesis.Meanwhile, the expression of vascular endothelial growth factor (VEGF)-A, matrix metallopro-teinase ( MMP) 2 and cyclin D1 at mRNA and protein levels was determined by real-time PCR and Western blot .After in-duction of the cells by recombinant Shh proteins , the changes of angiogenesis and proliferation ability in each group were detected.At the same time, the transformation of related gene was examined .RESULTS:Compared with control group , the angiogenic ability in interfered group was decreased , and no obvious difference of proliferation ability was observed .The expression of VEGF-A and MMP2 was declined significantly , and the expression of cyclin D 1 was not obviously changed . Recombinant Shh proteins improved the expression of FOXQ1 gene.Compared with NC-shRNA group, after induction, the angiogenic ability of FOXQ1-shRNA group was decreased , and the proliferation ability was not obviously changed .CON-CLUSION:FOXQ1 gene mediates the angiogenic ability but does not affect the proliferation ability of SW 480 cells.Mean-while, it may be regulated by shh pathway .

Objective To evaluate the clinical effect and safety of oxycodone in the anesthesia for percutaneous microwave ablation (PMWA) in liver cancer when the scope of ablation involving liver capsule.Methods Thirty-eight patients scheduled for percutaneous microwave ablation of liver cancer abutting capsule, including 32 males and 6 females, aged 41-75 years, with ASA grade Ⅰ or Ⅱ.Patients were randomly divided into 2 groups:oxycodone group (group O,n=20) and fentanyl group (group F, n=18).Before the puncture, a loading dose of oxycodone 0.1 mg/kg was given intravenously in group O, a loading dose of fentanyl 1 μg/kg was given intravenously in group F.After successful puncture, both groups were induced by Propofol 1.5 mg/kg, followed by Propofol infusion at 4-7 mg·kg-1·h-1 in two groups.The changes of MAP, HR, SpO2 and RR before, during and after operation were recorded.Body movement and respiratory depression were recorded.The total amount of propofol,the postoperative recovery time, postoperative nausea and vomiting, and postoperative 4 h VAS scores were recorded.Results There was no significant difference in general condition and intraoperative condition of ablation operation between the two groups.The incidences of respiratory depression and body movement in group F were significantly higher than those in group O.There was no significant difference in the incidences of postoperative nausea and vomiting between the two groups.VAS score 4 h after operation in group F [(3.9±2.0) score] was significantly higher than that in group O [(1.7±0.9) score] (P＜0.01).There was no significant difference in HR between the two groups at each point.Compared with before surgery, the MAP during surgery in group F was significantly increased (P＜0.05),the RR during surgery in groups F and O were significantly lower (P＜0.01 or P＜0.05).The RR during surgery in group F was significantly lower than that in group O(P＜0.05),but there was no significant difference at the other points between the two groups.Conclusion Oxycodone can be used safely and effectively for percutaneous microwave ablation of liver cancer when the scope of ablation involving liver capsule.It has lower incidence of respiratory depression, effectively alleviates intraoperative pain and reduces postoperative pain.

Objective: To investigate the differentially expressed genes in osteosarcoma cell lines with various metastatic potentialities, and to screen for new candidate genes related to metastasis of osteosarcomas. Methods: The total RNAs of a lowly metastatic and a highly metastatic osteosarcoma cell lines (M6 and M8) were extracted. Differentially expressed genes in the two osteosarcoma cell lines were studied by cDNA microarray. The hybridization signals were scanned with a Generation Ⅲ array scanner and analyzed by Imagequant 5.0 software. Typical differentially expressed genes were further verified by real-time quantitative PCR. Results: There were 330 differentially expressed genes between M6 and M8 cells. In the high-metastasis M8 cells, 178 genes were up-regulated and 152 genes were down-regulated compared to the low-metastasis M6 cells, with 43 extremely up-regulated and 49 extremely down-regulated. The differentially expressed genes were mainly associated with cell proliferation, indicating these genes might be related to the inhibition of M6 cells. Other differentially expressed genes included those associated with the regulation of gene expression and signal transduction, indicating these genes might be correlated with tumor metastasis. Conclusion: cDNA microarray shows an advantage in identifying genes associated with metastasis of osteosarcoma. In M8 subset of MG63 osteosarcoma cells,43 genes are up-regulated and 49 genes are down-regulated, which may be related with metastasis of osteosarcoma.

Objective To make an interpretation for the time-related evolving process of magnetic resonance imaging (MRI) signal of hepatic tumors after microwave ablation (MWA) treatment.Methods A total of 56 patients with malignant hepatic tumors (56 lesions in total) were enrolled in this study.Upper abdominal MRI plain scan and enhanced scan were performed in all patients at the second day,one month and 6 months after MWA treatment.The MRI signal features of ablation zones at different time points on T1WI,T2WI,DWI as well as on contrast-enhanced T1WI were documented,and the judgment of whether there was tumor recurrence was made.Results Two days after MWA,the ablation zone was manifested as target-like structure on T1WI and T2WI,which was characterized by central high signal ablation zone with low signal band around on T1WI and low signal ablation zone surrounded by high signal band on T2WI.One and 6 months after MWA,the volume of ablation area was atrophied,the target-like structure could still be observed on T1WI and T2WI,and the signal of ablation zone became intensified.Contrast-enhanced MRI revealed that abnormal high perfusion sign could be observed around the ablation zone,and on MRI scans performed at two days,one and 6 months after MWA,the ablation zone showed no enhancement.DWI indicated that two days after MWA the signal around the ablation zone was heightened,which decreased gradually in one and 6 months after MWA.Conclusion The signal of the ablation zone of hepatic tumor after MWA is evolving over time.Correct interpretation of MRI signal of ablation zone is helpful for the judgment of curative effect and for the making of therapeutic plan.

Objective To clarify the source of infection of a student brucellosis case in Ningde City, make clear its influencing range as well as risk factors of transmission, then take measures to effectively control the epidemic.Methods Clue sampling was carried out, then the survey site village was chosen where the student case came from.①Fundamental state survey: resident population as well as the situation of livestock were collected.②Human outbreak investigation: detailed interview was carried out on the first case.Base on the principle of informed consent, serum samples were collected from breeders and those who had once contacted with sheep in order to detect brucellosis antibodies, then investigation was conducted on farmers to collect cognitive information;case searching was conducted by reviewing outpatient and inpatient records as well as government broadcasting.③Livestock epidemic: serum samples from some of the sheep were collected by agricultural sector.Results There were 200 households with 500 inhabitants in the survey site of Ningde City, among which there were 5 sheep feeding families and totally 154 sheep on hand.Patient was male, 12 years old, student.Sick on June 2nd, 2014,confirmed on July 5th.The patient's neighbor was a sheep farmer, he had once contacted with the sheep.Totally we collected 8 serum samples from livestock personnel, positive Brucella antibody was 4, with a positive rate 50％ (4/8);collected 15 serum samples from those contacted with sheep, positive Brucella antibody was 2, with a positive rate 13％ (2/15).Meanwhile, agricultural sector collected 17 sheep serum samples from these two sheep farms, among which there were 7 serum samples showing a positive Brucella antibodies, with a positive rate 41％ (7/17).After surveyed of 8 livestock breeding personnel and 15 livestock non-breeding personnel, we found that no one was familiar with the clinical characteristics and transmission of brucellosis.Conclusions The direct source of brucellosis infection is local infected sheep, general population has been involved in this epidemic.Brucellosis surveillance should be seriously carried out on both human and animal.Furthermore, improving the awareness of brucellosis among professionals as well as general population is eagerly needed and health education must be carried out immediately.

Objective To evaluate the prognosis-related factors of colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy. Methods We reviewed retrospectively the clinical data of 68 colorectal cancer patients with positive PD-L1 expression in liver metastases receiving personalized comprehensive treatment which was mainly consisted of surgical resection. We observed the results and prognosis after surgical resection and analyzed related factors. Results Univariate analysis showed that no radiotherapy, N stage, RAS mutation status, T stage, dMMR, Duck stage, disease free interval from primary to metastases≤12 months and largest hepatic tumor diameter > 5 cm had obvious significance (all P < 0.05). Multivariate logistic analysis regression revealed that without dMMR (P=0.012), Duck A stage (P=0.000), disease free interval from primary to metastases > 12 months (P=0.020) and largest hepatic tumor diameter < 5 cm (P=0.006) were independent protective factors for the prognosis of colorectal cancer patients with positive PD-L1 expression in liver metastases after surgical resection. Conclusion Personalized comprehensive treatment which is mainly consisted of surgical resection still has a good effect on colorectal cancer patients with positive PD-L1 expression in liver metastases after hepatectomy. Without dMMR, Duck A stage, disease free interval from primary to metastases > 12 months and largest hepatic tumor diameter ≤5cm are independent protective factors for patients' prognosis.

OBJECTIVETo investigate changes in the expression of sarcoplamic reticular Ca(2+)-ATPase (SERCA) and IP(3)-I receptors (IP(3)R(1)) mRNA in patients with atrial fibrillation.

METHODSThirty-eight patients with mitral stenosis undergoing open heart surgery were studied. 100 mg of atrial tissue was obtained during surgery from the right appendage and the right atrium. The amount of messenger ribonucleic acid (mRNA) amount of SERCA and IP(3)R(1) was measured by reverse transcription-polymerase chain reaction (RT-PCR) and normalized to the mRNA levels of glyceraldehyde 3-phosphate dehydrogenase (GAPDH).

RESULTSLevels of mRNA expression of SERCA in patients with AF, as compared with subjects in sinus rhythm, was lower and that of IP(3)R(1) was higher. The longer AF was sustained, the higher the levels of mRNA. There was no significant difference between right atrial free wall and right appendage.

CONCLUSIONSThe expression changes of SERCA and IP3R mRNA may correlate with the initiation or maintenance of AF.

Adult ; Aged ; Atrial Fibrillation ; genetics ; pathology ; Calcium Channels ; genetics ; Calcium-Transporting ATPases ; genetics ; Female ; Gene Expression ; Humans ; Inositol 1,4,5-Trisphosphate Receptors ; Male ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Receptors, Cytoplasmic and Nuclear ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Sarcoplasmic Reticulum Calcium-Transporting ATPases

Objective To investigate the application value of diameter change of superior rectal vein (SRV) and inferior mesenteric vein (IMV) by CT examination in the efficacy evaluation of neoadjuvant therapy for locally advanced rectal cancer.Methods The retrospective descriptive study was conducted.The clinicopathological data of 40 patients with locally advanced rectal carcer who underwent neoadjuvant therapy in the First Affiliated Hospital of Chongqing Medical University were collected.There were 28 males and 12 females,aged from 12 to 75 years,with the age of (55± 12)years.All patients underwent radical resection of rectal cancer according to the principle of total mesorectal resection after neoadjuvant therapy.Observation indicators:(1) MRI examination;(2) CT examination;(3) surgical situations;(4) follow-up.Follow-up was performed using outpatient examination to detect postoperative complications up to June 2019.The measurement data with normal distribution were represented as Mean±SD,and paired sample t test was used for intra-group comparison.Count data were described as absolute numbers or percentages.Results (1) MRI examination:there were 22 patients with positive extramural vascular invasion (EMVI) and 18 with negative EMVI.(2) CT examination:the diameter of SRV was (3.9 ± 0.9) mm and (3.0 ± 0.6) mm before and after neoadjuvant therapy,showing a significant difference (t=5.75,P＜0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of SRV changed significantly after neoadjuvant therapy [(4.1 ± 1.0) mm vs.(3.4±0.7) mm,t =6.20,P＜0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of SRV showed no significant difference after neoadjuvant treatment [(3.6±0.6)mm vs.(3.5±0.8)mm,t=1.13,P＞0.05].The diameter of SRV was (4.2±0.8)mm in 22 patients with EMVI and (3.7±0.8)mm in 18 patients with negative EMVI,showing a significant difference between the two groups (t =2.45,P＜0.05).The diameter of IMV was (5.1 ± 0.9)mm and (4.2±0.9)mm before and after neoadjuvant therapy,showing a significant difference (t=4.16,P＜ 0.05).Subgroup analysis:for the 30 patients with response to neoadjuvant therapy,the diameter of IMV changed significantly after neoadjuvant treatment [(5.1 ± 0.9) mm vs (4.6± 0.8) mm,t =0.76,P＜ 0.05];for the 10 patients without response to neoadjuvant therapy,the diameter of SRV showed no significant difference after neoadjuvant treatment [(5.0±0.9)mm vs (4.8±1.0)mm,t=0.76,P＞0.05].The diameter of IMV was (4.8± 0.9) mm in 22 patients with EMVI and (4.6±0.8) mm in 18 patients with negative EMVI,showing no significant difference between the two groups (t =2.45,P＞ 0.05).(3) Surgical situations:40 patients underwent radical resection of rectal cancer,including 4 with synchronous liver metastases undergoing resection of metastases.(4) Follow-up:40 patients were followed up for 3.0-6.0 months,with a median follow-up time of 4.5 months.One of 40 patients with perineal incision infection was improved and discharged after dressing change,1 with anastomotic leakage on the 5th day after operation was improved and discharged after conservative treatment,1 of 2 with adhesive intestinal obstruction was improved after surgery and 1 was improved after conservative treatment,other 36 patients were discharged and no obvious abnormality occured during the follow-up.Conclusions The diameters of SRV and IMV in patients with locally advanced rectal cancer can be significantly decreased significantly after neoadjuvant therapy.The diameters of SRV and IMV can be used as potential indices to evaluate the effects of neoadjuvant therapy for rectal cancer,and the SRV had a higher evaluation value.