OBJECTIVETo study whether antisense oligonucleotides and ultrasonic microbubble intensifier transfection combined with ultrasound irradiation is an effective and directional way in reversing multidrug resistance (MDR) in tumors.

METHODSMdr1, mrp, and lrp genes antisense oligonucleotides on the ultrasound microbubble intensifier were transfected for the human HepG2/ADM cell lines and then the cells were radiated with low intensity ultrasound. The effects of the reversion of carcinoma cells' MDR and the reduction of their malignancy and growth capability in vitro and in vivo were assessed using RT-PCR, Western blot and MTT.

RESULTSThe treatment restrained the multiplication of the human HepG2/AMD cell lines. The levels of their mRNA and protein of cells' mdr1 and mrp genes dropped significantly. Growth of the subcutaneous transplanted tumors in the nude mice decreased.

CONCLUSIONSTransfection of MDR genes antisense oligonucleotides on the ultrasonic microbubble intensifier combined with low intensity ultrasound radiation may serve as a new treatment method for hepatocellular carcinoma.

ATP-Binding Cassette, Sub-Family B, Member 1 ; genetics ; Animals ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; Drug Resistance, Multiple ; genetics ; Drug Resistance, Neoplasm ; genetics ; Humans ; Liver Neoplasms ; pathology ; Male ; Mice ; Mice, Inbred BALB C ; Microbubbles ; Oligonucleotides, Antisense ; genetics ; Transfection ; Ultrasonics

BACKGROUNDEmbolization of collateral arteries is important for transcatheter hepatic arterial chemoembolization (TACE) in patients with hepatocellular carcinoma (HCC). We evaluated the efficacy and safety of TACE, and the prevention and management of complications among patients in whom the internal thoracic artery (ITA) was involved.

METHODSA total of 3614 cases of HCC were treated with 12 645 TACEs and 211 of these cases were given ITA angiography, including 156 cases of which the ITA was involved. We performed 562 TACEs in the 156 cases. We analyzed imaging examinations, types of embolization, and the incidence, prevention, and treatment of complications.

RESULTSThe ITA was successfully embolized in 156 cases. Angiography of the ITA showed that the major trunks were thickened with an increased number of branching vessels, contributing to intrahepatic and extrahepatic tumor blood supply. Different embolization methods were selected according to the blood supply, to effectively embolize the tumor and mitigate or avoid serious complications. TACE with ITA embolization extended the mean interval time between two treatments from 2.54 months (1 - 17 months) to 4.23 months (1 - 30 months) compared with that without ITA embolization. The ITA supplied the HCC in the following instances: HCC was located in the ventral hepatic area and abutted the diaphragm (P = 0.0064) and repeated TACE (P = 0.0003). The survival rate of TACE with ITA embolization for HCC was better than TACE without ITA embolization (P < 0.00001).

CONCLUSIONSIn cases with massive HCC or nodular HCC, the ITA may be involved in supplying blood to the tumor. This occurs when the tumor is positioned in the ventral hepatic area and abuts the diaphragm (S2, S4, and S8), and especially if cases have a previous history of TACE. In this case series, embolization was effective, extended the mean interval time of interventional therapy, and prolonged survival time.

Adult ; Aged ; Carcinoma, Hepatocellular ; therapy ; Chemoembolization, Therapeutic ; methods ; Female ; Humans ; Liver Neoplasms ; therapy ; Male ; Mammary Arteries ; Middle Aged ; Treatment Outcome

OBJECTIVEThis research aimed to explore the application of ARIMA model of time series analysis in predicting influenza incidence and early warning in Jiangsu province and to provide scientific evidence for the prevention and control of influenza epidemic.

METHODSThe database was created based on the data collected from monitoring sites in Jiangsu province from October 2005 to February 2010. The ARIMA model was constructed based on the number of weekly influenza-like illness (ILI) cases. Then the achieved ARIMA model was used to predict the number of influenza-like illness cases of March and April in 2010.

RESULTSThe ARIMA model of the influenza-like illness cases was (1 + 0.785B(2))(1-B) ln X(t) = (1 + 0.622B(2))ε(t). Here B stands for back shift operator, t stands for time, X(t) stands for the number of weekly ILI cases and ε(t) stands for random error. The residual error with 16 lags was white noise and the Ljung-Box test statistic for the model was 5.087, giving a P-value of 0.995. The model fitted the data well. True values of influenza-like illness cases from March 2010 to April 2010 were within 95%CI of predicted values obtained from present model.

CONCLUSIONThe ARIMA model fits the trend of influenza-like illness in Jiangsu province.

Humans ; Influenza, Human ; prevention & control ; Models, Statistical ; Time Factors

Background Embolization of collateral arteries is important for transcatheter hepatic arterial chemoembolization (TACE)in patients with hepatocellular carcinoma (HCC). We evaluated the efficacy and safety of TACE, and the prevention and management of complications among patients in whom the internal thoracic artery (ITA) was involved.Methods A total of 3614 cases of HCC were treated with 12 645 TACEs and 211 of these cases were given ITA angiography, including 156 cases of which the ITA was involved. We performed 562 TACEs in the 156 cases. We analyzed imaging examinations, types of embolization, and the incidence, prevention, and treatment of complications.Results The ITA was successfully embolized in 156 cases. Angiography of the ITA showed that the major trunks were thickened with an increased number of branching vessels, contributing to intrahepatic and extrahepatic tumor blood supply. Different embolization methods were selected according to the blood supply, to effectively embolize the tumor and mitigate or avoid serious complications. TACE with ITA embolization extended the mean interval time between two treatments from 2.54 months (1-17 months) to 4.23 months (1-30 months) compared with that without ITA embolization.The ITA supplied the HCC in the following instances: HCC was located in the ventral hepatic area and abutted the diaphragm (P=0.0064) and repeated TACE (P=0.0003). The survival rate of TACE with ITA embolization for HCC was better than TACE without ITA embolization (P ＜0.00001 ).Conclusions In cases with massive HCC or nodular HCC, the ITA may be involved in supplying blood to the tumor.This occurs when the tumor is positioned in the ventral hepatic area and abuts the diaphragm (S2, S4, and S8), and especially if cases have a previous history of TACE. In this case series, embolization was effective, extended the mean interval time of interventional therapy, and prolonged survival time.

Triggering receptor expressed on myeloid cells-1 (TREM-1) is a member of the immunoglobulin superfamily. As an amplifier of the inflammatory response, TREM-1 is mainly involved in the production of inflammatory mediators and the regulation of cell survival. TREM-1 has been studied in infectious diseases and more recently in non-infectious disorders. More and more studies have shown that TREM-1 plays an important pathogenic role in kidney diseases. There is evidence that TREM-1 can not only be used as a biomarker for diagnosis of disease but also as a potential therapeutic target to guide the development of novel therapeutic agents for kidney disease. This review summarized molecular biology of TREM-1 and its signaling pathways as well as immune response in the progress of acute kidney injury, renal fibrosis, diabetic nephropathy, immune nephropathy, and renal cell carcinoma.

OBJECTIVETo summarize the reasons for bile duct injury (BDI) after laparoscopic cholecystectomy (LC), and to determine the effect of multiple treatment after BDI.

METHODSA retrospective cohort study was performed. The medical records of 110 patients diagnosed with BDI after LC from October 1993 to November 2007, in ten large hospitals in Guangdong of China, were reviewed.

RESULTSAmong 110 patients with BDI, 58 cases (52.7%) were local patients, whereas 52 cases (47.3%) were transferred from outside hospitals. Reasons for BDI following LC were: (1) Lack of experience of the LC operator (48.2%); (2) LC performed during acute cholecystitis (20.0%); (3) The structure of Calot triangle was unclear (15.5%); (4) Variable anatomical position (11.8%); (5) Intra-operation bleeding (4.5%). The commonest sites of injury were the choledochus and common hepatic duct (76.4%). Following BDI, endoscopic stenting or operative repair was performed in 106 patients. The overall success rate was 95.3% (101/106), with a mortality rate was 0.9% (1/106). Cholangitis occurred in 3.8% (4/106) cases. Choledocho-enterostomy operation was performed in almost 60.0% (63/106) cases, and the success rate was 93.7% (59/63). Endoscopic stenting or operative repair was performed immediately following BDI in 23.6% (25/106) patients, the success rate was 100%; and within 30 days in 63.2% (67/106) patients. Eighty-eight out of 106 patients who underwent repair were successful following the first operative procedure.

CONCLUSIONSFactors such as an un-experienced operator and unclear anatomical position were causes of BDI following LC. Early operative repair should be regarded as the treatment of choice, in patients diagnosed with BDI. Early refer to an experienced hepatobiliary operator ensures a high success rate.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Bile Ducts ; injuries ; surgery ; Cholecystectomy, Laparoscopic ; adverse effects ; Female ; Humans ; Iatrogenic Disease ; Intraoperative Complications ; diagnosis ; etiology ; surgery ; Male ; Middle Aged ; Retrospective Studies

Objective:To summarize the reason and treatment of ventricular electrical storm (VES) in adult patients after cardiac surgery.Methods:A total of 36 adult patients with VES after cardiac surgery in our hospital from 2011-08 to 2015-05 were retrospectively analyzed for their peri-operative and clinical conditions before and after VES occurrence.Results:All 36 patients suffered from VES after cardiac surgery during ICU stay including 23 patients with coronary artery bypass grafting (CABG),5 with CABG and ventricular aneurysm resection,5 with valve replacement,2 with Bentall operation and 1 with Marrow operation.There were 32/36 (88.89％) patients out of the breathing machine upon VES disappearing and discharged smoothly,4 (11.11％) patients died of multiple organ failure.There were 22 (61.11％) patients with myocardium ischemia induced VES.32 patients were followed-up for 1 year,28/36 (77.78％) patients recovered to sinus rhythm,2 (5.56％) received endocardial pacemaker placement and 2 (5.56％) suffered from atrial fibrillation;no cardiac death during follow-up period.Conclusion:VES was often occurred at the early stage in adult patients after cardiac surgery;it usually had clear reason or inducement,rapid and efficient treatment could achieve satisfactory results.

Objective To quantitatively evaluate the effectiveness of prevention and control measures against pandemic influenza A (H1N1) in Beijing, 2009 and to provide evidence for developing and adjusting strategies for prevention and control of the disease. Methods Considering the seasonality and the number of vaccination on pandemic influenza A (H1N1) , data regarding pandemic influenza A (H1N1) in Beijing were collected and analyzed. Based on the dynamics of infectious disease transmission, a quantitative model for evaluation of prevention and control measures was developed. Results Both latency and infectious periods of pandemic influenza A (H1N1) were estimated to be 1.82 days and 2.08 days, respectively. The effective reproduction numbers of the three periods were 1.13,1.65 and 0.96, respectively. Thanks to the implementation of a series of measures to prevent and control pandemic influenza A (H1N1), the cumulative number of laboratory-confirmed cases of pandemic influenza A (H1N1) was reduced, making it much smaller than what would have been under the natural situation. Specifically, the program on pandemic (H1N1) 2009 vaccination reduced the cumulative number of laboratory-confirmed cases by 24.08% and postponed the peak time. Conclusion Measures that had been taken during this period, had greatly contributed to the successful prevention and control of pandemic influenza A (H1N1). The 2009 Pandemic (H1N1)vaccination was confirmed to have contributed to the decrease of cumulative number of laboratoryconfirmed cases and postponed the peak arrival time.

·AIM: To evaluate the effect of bupivacaine in non-catheter infiltration anesthesia during vitretomy operation.·METHODS:Fifty-eight patients (58 eyes) with vitreous retinal surgery were selected. Patients were randomly divided into observation group ( 28 eyes ) and control group ( 30 eyes ) . The observation group were received non-catheter infiltration anesthesia. The control group were received traditional Sub- Tenon's block ( STB ) . Degree of pain, basic vital signs, the duration of anesthesia and analgesia grade were recorded and compared between two groups.·RESULTS: No significant difference was found in the 11-point numeric rating scale ( NRS - 11 scoring ) of anesthesia process, sclera incision, intraocular operation and the end of operation between two groups (P>0. 05). The difference were not significant in heart rate and blood pressure between two groups(P>0. 05). There was statistically significant difference in the duration of anesthesia between two groups (P<0. 05).·CONCLUSION: Both groups can provide the same anesthetic effect. Compared to STB, non - catheter infiltration anesthesia takes short time, and it is a safe and effective anesthesia methods. In addition, compare to the mixture of bupivacaine and lidocaine injection, bupivacaine injection can provide the same anesthetic effect.

Objective To analyze the results of detection on influenza A (H1N1) 2009 virus in Beijing from May 2009 to December 2009 and to understand the epidemiologic characteristics during the pandemic period. Methods The study was conducted from the May 1 to December 27,2009. A total of 101 852 throat swab samples were detected with the real-time RT-PCR assay by the Beijing Network Laboratory. Data was statistically analyzed. Results 9843 samples showed influenza A (H1N1) 2009 positive, with an overall positive rate as 9.66%. In terms of the positive rates, they were 2.85% from May to June, 3.32% from July to August and 8.35% from September to October. The peak month fell in November (29.67%) and December (24.33%). The positive rates among the following subpopulations were: 8.40% among the suspected cases, 4.75% among close contact cases, 11.46% among the influenza-like illness cases and 7.33% among the cluster cases with fever. Positive cases mainly fell in age groups 5-14 and 15-24. The ratio of male to female was 1.5:1.Conclusion During the pandemic period of influenza A (H1N1) 2009, positive cases gradually increased during May to November but slowly decreasing in December.