ABSTRACT
Form 2008 to 2009, four patients with complex thoracic aortic disease, including aortic aneurysms and dissections, were successfully treated in our department with a new treatment approach: hybrid procedure. Combined open surgery and endovascular repair were performed in these patients without deep hypothermia or circulatory arrest. Compared to those who underwent traditional open surgery in the same period, time of mechanical ventilation and ICU stay was decreased in these four patients. All of them were discharged soon after operation without postoperative complications or death. The result suggests that this new approach could be an option for thoracic aortic disease, but long-term and large-population studies are still required to demonstrate the safety and validity.
ABSTRACT
To examine the effect of transcatheter arterial embolization (TAE) of liver tumors on hypoxia-inducible factor-1α (HIF-1α) expression in the residual viable tumor,a total of 30 New Zealand White rabbits implanted with VX2 liver tumor were divided into 2 groups. TAE-treated group animals (n=15) were subjected to TAE with 150-250 μm polyvinyl alcohol particles. Control group animals (n=15) underwent sham embolization with distilled water. Six hours,3 days or 7 days after TAE,the animals were sacrificed,and samples of tumor and adjacent normal liver tissue were harvested. Expression of HIF-1α protein was examined immunohistochemically. Real-time PCR was performed to examine the HIF-1α mRNA levels. Our results showed that HIF-1α protein was expressed in the VX2 tumors but not in the adjacent normal liver tissue. The HIF-1α-positive tumor cells were located predominantly at the periphery of necrotic tumor regions. The mean levels of HIF-1α protein were significantly higher in TAE-treated tumors than those in control tumors (P=0.002). Among the three sacrificing time points,the difference in increase in HIF-1α protein was significant between the two groups at the sacrificing time point of 6 h and 3 days after TAE (P=0.020,P=0.031,respectively),whereas no significant increase was noted 7 days after TAE (P=0.502). In contrast,although HIF-1α mRNA was expressed in TAE-treated and control VX2 tumors,there existed no significant difference in the HIF-1α mRNA level between the two groups (P=0.372). It is concluded that TAE of liver tumors increases the expression of HIF-1α at protein level in the residual viable tumor,which could be attributed to hypoxia generated by the procedure.
ABSTRACT
This study investigated the inhibitory effect of the extract of fungi of Huaier (EFH) on the growth of hepatocellular carcinoma (HCC) cells.Hep-G2 cells,a human HCC cell line,were cultured in DMEM containing 10% fetal bovine serum and treated with EFH of different concentrations (1,2,4,8 mg/mL) for 24,48 and 72 h respectively.The apoptosis rate of the cells was flow cytometrically measured.Thirty-six tumor-bearing New Zealand rabbits were randomly divided into 3 groups:group A (control group),in which the rabbits were infused with 0.2 mL/kg normal saline via the hepatic artery;group B (transhepatic artery chemoembolization [TACE] group),in which the rabbits were given lipiodol at 0.2 mL/kg plus MMC at 0.5 mg/kg via the hepatic artery;group C (TACE +EFH group),in which EFH (500 mg/kg) were orally administered after TACE.Two weeks after TACE,the rabbits were sacrificed and the implanted tumors were sampled.The tumor volume and the necrosis rate were determined.The tumor tissues were immunohistochemically detected for the expressions of factor Ⅷ,VEGF,P53,Bax and Bcl-2.The microvessel density (MVD) was calculated by counting the factor Ⅷ-positive endothelial cells.Our results showed that after treatment with EFH,the apoptosis rate of Hep-G2 cells was enhanced in a concentration- and time-dependent manner.Two weeks after the treatment,the average tumor volume,the necrosis rate and the growth rate of the implanted tumor in group C were significantly different from those in groups A and B (P<0.05).MVD and VEGF expressions were significantly decreased in the group C when compared with those in groups B (P<0.05 for all).The Bax expression was weakest in group A and strongest in group C.The expressions of P53 and Bcl-2 were minimal in group C and maximal in group A.There were significant differences in the expressions of P53,Bax and Bcl-2 among the 3 groups (P<0.05 for all) and there was significant difference between group B and group C (P<0.05).It was concluded that EFH could suppress not only the growth of HCC cells but also tumor angiogenesis and it can induce the apoptosis of HCC cells.EFH serves as an alternative for the treatment of HCC.
ABSTRACT
This study investigated the changes of CD4+CD25+ regulatory T cells (Tregs) in peripheral blood of patients with hepatocellular carcinoma before and after transcatheter arterial chemoembolization (TACE). The proportion of CD4+CD25+ Tregs among CD4+ T lymphocytes in peripheral blood of 33 patients with hepatocellular carcinoma was determined by flow cytometry before, 1 week and 1 month after TACE. And 25 healthy volunteers served as control. One month after TACE, the patients were divided into two groups: 22 in group A, who were in stable condition or getting better;and 10 in group B, who were deteriorating. One patient died and was excluded. The results showed that the percentage of CD4+CD25+ Tregs among CD4+ T lymphocytes did not significantly change in the 33 patients 1 week after TACE as compared with that before TACE, however, the difference was significant (P<0.01) between the patients with hepatocellular carcinoma and the healthy subjects. The percentage of CD4+ CD25+ Tregs among CD4+ T lymphocytes in group A 1 month after TACE was decreased significantly in comparison with that before and I week after TACE (P<0.01), whereas,that in group B was increased significantly 1 month after TACE (P<0.01). It was concluded that patients with hepatocellular carcinoma had a higher proportion of CD4~CD25+ Tregs in peripheral blood. TACE did not significantly affect the level of CD4+ CD25+ Tregs within short time (such as 1 week). The proportion of CD4+CD25+ Tregs in peripheral blood 1 month after TACE was related to the prognosis of hepatocellular carcinoma.
ABSTRACT
The clinical application of 16-slice CT coronary angiography (CTCA) and the impact of plaques differently characterized on assessing coronary artery stenosis were evaluated. Thirty-eight patients with coronary artery disease diagnosed by conventional coronary angiography (CAG) un- derwent 16-slice CTCA (collimation: 16×0.75 mm; rotation time: 420 msec; kernel: 35f; effective current: 500 mAs; tube voltage: 120 kV). The interval between CTCA and CAG was within one month. CTCA was evaluated by consensus of two independent experienced radiologists unknowing CAG findings. Original images, maximum intensity projections and multiplanar reconstructions were used to assess coronary artery stenosis. For a determined plaque an attenuation value≥130 HU was considered as calcified, and ＜130 HU noncalcified. The plaques were then classified into significant calcification (extensive calcification), medium calcification (small isolated calcification) and noncal- cification. The diagnostic accuracy of 16-slice CTCA findings as well as to detect ≥50% stenoses caused by plaques was evaluated respectively regarding CAG as the standard of reference. In com- parison with CAG findings, the sensitivity, specificity, positive and negative predictive value derived from CTCA for mild stenosis (＜50%) were 72.7%, 38.5%, 50%, 62.5%, respectively; for moderate stenosis (50%-75%) 82.4%, 72.7%, 70%, 84.2%, resepctively; and for severe coronary stenosis (＞75%) 85%, 90.5%, 81%, 92.7% respectively. With the increase of stenoses degree, the value of CTCA was greater. For the classification of the plaque calcification with ≥50% stenosis CTCA at- tained the sensitivity, specificity, positive and negative predictive value for severe calcificatoin 73.3%, 22.2%, 61.1% and 33.3%, respectively; for moderate calcification 70%, 55.6%, 63.6% and 62.5%, respectively; for noncalcification 93.8%, 85.7%, 93.8% and 85.7% respectively. CTCA was restricted in assessing coronary artery stenosis in the presence of calcification, but CTCA value was much im-proved in assessing non-calcified stenosis. It was concluded that 16-slice CTCA could provide useful information about coronary artery stenosis, especially for severe stenosis (≥50%) and non-calcified plaque. Since CTCA is a noninvasive technique, it may be useful in screening coronary artery dis-ease.