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Objective To investigate whether 5 different chemotherapeutic drugs and their combination of either two drugs could further promote the inhibition on the cell growth of HCC cell line (HepG2) in vitro in the hypoxic and hyponutritional culture medium (HHCM) mimicking the different scenarios of transcatheter arterial chemoembolization (TACE).Methods The cells were treated by 5 drugs for 2 h, 4 h,6 h and 24 h, which include epirubicin (EPI), cisplatin (DDP), mitomycin-C (MMC), oxaliplatin (OXA) and 5-fluorouracil (5-FU) in four concentrations of HHCM (5％, 10％, 25％ and 50％) mimicking the scenarios during TACE and the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.The combinations of dual drugs treated for 24 h were also tested.Results The sensitive drugs with inhibition rates more than 30％ were EPI, MMC and OXA in 4 different concentrations of HHCM.The sensitivity of the drugs treated for 24 h was significantly increased compared with that for 2 h in 5％, 10％ and 25％ HHCM.The dual combinations did not increase the chemosensitivity of HepG2 cells.Conclusions EPI, MMC and OXA exhibited cytotoxic activity against HepG2 cells in various hypoxia and hyponutrition states.Prolonging the exposure time could increase the sensitivity of drug in HHCM, and the combination of dual drugs cannot enhance the cytotoxic effect.
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Objective:To investigate the onset of hepatic artery-portal vein shunts (HAPVS) in primary liver cancer (PLC) pa-tients through digital subtraction angiography (DSA) and to devise a suitable strategy for treating both lesions and shunt tracts. In the process, the therapeutic effect on such patients can be enhanced. Methods:A total of 769 PLC patients who accepted transarterial che-moembolization (TACE) were analyzed retrospectively. We examined the image characteristics of 112 cases with HAPVS based on shunt type. For patients with middle or severe fistula, we initially attempted to overpass the fistula. Then, we either embolized the tumor lesions or merely provided chemotherapy to the patients. For patients with mild peripheral fistula, we embolized the tumor and fistula si-multaneously. Then, the accompanying arterial-vein shunt and portal vein tumor thrombus (PVTT) were handled at the same time. Re-sults: DSA findings showed that portal veins were observed in the early stage of angiography. A total of 52 of the 112 cases with HAPVS involved mild shunts, 34 exhibited moderate shunts, and 26 reported severe shunts. Among these cases, 31 involved central-and central peripheral-type artery-portal vein fistula, whereas 81 involved peripheral-type artery-portal vein fistula. Seven cases were examined in combination with hepatic artery-liver vein shunts, and 50 cases were investigated in conjunction with PVTT. Tumor embo-lization was successful in 101 cases (90.1%). Moreover, catheters successfully overpassed shunt tracts and embolized the tumors in 48 cases (42.9%). Shunt tracts were successfully closed in 74 cases (66.1%), and no serious complication was observed. Conclusion:Pe-ripheral-type artery-portal vein fistula and mild-to-moderate shunts were easier to close than central-type artery-portal vein fistula and severe shunts were. Tumor embolization and shunt closure were successful in most patients. Therefore, TACE is a safe and reliable method for treating HAPVS in PLC.
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Objective To investigate the clinical application of a new thermosensitive embolic agent in interventional arterial embolization treatment, and to evaluate its effectiveness and safety in treating inoperable advanced hepatocellular carcinoma (HCC). Methods Prospective, open and single center clinical study of a new thermosensitive embolic agent was conducted. A total of 10 patients with clinically confirmed inoperable advanced HCC were treated with percutaneous arterial embolization using thermosensitive embolic agent; a maximum of 4 therapeutic cycles were performed until the disease progressed. Objective effect was evaluated at (30 ±7) days after the treatment according to mRECIST standard; the progression free survival (PFS) time and the survival period (OS) were recorded. The adverse reactions and adverse events were determined by NCI-CTC 3.0 version standard. Results Ten patients (23 target lesions in total) were enrolled in this study. After the treatment, complete remission (CR) was obtained in one patient, partial remission (PR) in 3 patients, stable disease (SD) in 5 patients, and progress disease (PD) in one patient. The objective response rate (CR+PR) was 40%, and the disease control rate (CR+PR+SD) was 90%. The PFS of hepatic lesions was 18.4 weeks (95%CI:14.15-22.65), the cumulated median survival period was 46.2 weeks (95%CI:38.18-54.22). The most common adverse reactions included pain, fever, hepatic function damage, small amount of ascites, diarrhea, etc. Conclusion The new thermosensitive embolic agent is not sticky to vessel and is visible under X-ray; it has reliable embolization effect, and the therapeutic results can be easily evaluated. This embolic agent is not perfect, and it has some limitations in clinical use. The adverse reactions are mild, which can be easily tolerated by the patients. It is worth trying to carry out large sample and randomized controlled studies in order to open up more areas for arterial chemoembolization therapy of tumors.
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Objective To explore the role of transemetil combined with various chemotherapy agents under the circumstance of continuous arterial infusion.Method MTT assays in cultured HepG2 and 7702 in vitro were used to detect the effects different sequences among different chemotherapy agents combined with transemetil.Results When combined with docetaxel,epirubicin,5-fluorouracil,pemetrexed disodium,cisplatin,or gemcitabine,transemetil had a synergistic effect.When combined with other agents,there was no synergistic or antagonistic effect.The synergistic effects were observed when transemetil acted during or after the use of chemotherapy agents.However,when chemotherapy agents were mixed with transemetil in advance,their effects decreased.Conclusion Transemetil showed an obvious synergistic effect when combined with certain chemotherapy agents.Different sequences between transemetil and chemotherapy agents showed different effects,and the mechanisms need further research to fully understand.
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Objective Under the circumstance of continuous arterial infusion,role of magnesium isoglycyrrhizinate combined with different kinds of chemotherapy agents respectively were detected on the HepG-2 and 7702cell lines.Method MTT assay in cultured HepG-2 and 7702 in vitro were used to detect different chemotherapy agents combined with transemetil with different sequence; interaction of MgSO4 with chemotherapy agents were observed in HepG-2 cell lines.Results When combined with docetaxel,gemcitabine,epirubicin,5 fluorouracil,pemetrexed disodium,magnesium isoglycyrrhizinate had synergistic effect; when combined with other agents,there were no antagonism effect; 4 kinds of chemotherapy agents had slight synergistic effect with magnesium sulfate.Conclusion Magnesium isoglycyrrhizinate showed obvious synergistic effect when combined with chemotherapy agents; different sequence between magnesium isoglycyrrhizinate and chemotherapy agents showed different effect; the mechanism need more study.
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Referring to the anatomical characterization of natural spongy bone and channel network in cortical bone, we designed a new pattern of biomimetic impalnt with preset channel for blood vessel inserting to treat early femoral head necrosis. The surgical ptrocedure was simulated by CAD model. Ceramic stereolithography was applied to fabricate the green part. Other process, such as dehydration, rinsing, drying and sintering, were taken successively. The final ceramic part kept identical with the engineered part either in the shape or in the internal structure. No deformation or crack happened. Pore size, interconnected pore size, porosity and interconnected porosity of ceramic part could satisfy cellular grouth. Spectrum analysis showed that no phase transition or chemical reaction happened during fabrication process. The biocompatibility of the final part kept the same with original during beta-TCP powder. The compressive strength was 23.54 MPa, close to natural spongy bone. It is an ideal implant to treat early femoral head necroseis because it makes preimplantation of cells and biological factors, blood velssel inserting, early establishment of blood supply possible. At the same time, it could provide enough mechanical support to prevent collapse of femoral head. It could provide a wide clinical foreground.
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Humans , Biocompatible Materials , Chemistry , Bone Substitutes , Chemistry , Calcium Phosphates , Chemistry , Computer-Aided Design , Femur Head Necrosis , Therapeutics , Porosity , Prostheses and Implants , Tissue Engineering , Tissue Scaffolds , ChemistryABSTRACT
Objective:To explore the appearances o f digital subtraction angiograph y (DSA) and therapeutic efficacy of interventional therapy of hepatic carcinoma accompanied with arteriovenous shunting (AVS). Methods: To retro spectively analy ze clinical material of 97 patients with hepatocellular carcinoma with hepatic artery-portal vein shunting(HA-PVS) , of whom, 16 had upper gastrointestinal hemorrhage, 51 had middle to l arge amounts of ascites, and 53 had varices of esophagus and fundus gastricus . All the patients were treated with transcatheter arterial chemoembolization (TACE) or transcatheter arterial infusion chemotherapy (TAI). Shunts were embolized by lipidol i n 40 patients, by lipidol and spon-gia gelatinosa particle in 34 patients, and by coi l in 6 patients. The remaining 17 were treated only with TAI. Results:Twelve (12.4%) case s had hepatic artery-hepatic vein shunting (HA-HVS),while 32 (33%)cases had portal vein tumor thrombosis (PVTT). In 70(72.2%) patients, all shunts we r e completely closed successfully, in 15(15.5%) patients, the shunts were partly closed, and in 12(12.3%)patients, the shunts were not closed. In 12 patients, the shunts reopened in later therapy, their blood flow was smaller than before and they were closed after second embolization. In 17 patients, new shunts emerged. After TACE therapy,the tumors were smaller in 57(58.7%),bi gger in 24 (24.7%),and 16(16.5%) were the same in size before and after TACE. Ascit es disappeared in 29 patients, decreased in 18 patients and had no change in 4 pati ents. Five patients who had upper gastrointestinal hemorrhage pre-operation had n ew hemorrhage. Of the 47 patients who had diarrhea, 23 improved. In 67 alph a fetoprotein (AFP) positive patients, degree of AFP in 53 patients decreased. Eighty-one patients died and their Corresp onding author’s e-mail, renjieyang2007@163.commiddle survival period was 12.9 months. No serious dama ge to hepatic function due to the treatment was observed in most patients. Concl usion:Primary hepatic carcinoma with AVS increases difficulty of interv entional therapy,but as long as we take active and proper treating measure,we could ac quire satisfactory curative effect without serious syndrome. DSA can demonstrate the type, the site and the degree of AVS completely and directly, thus having import ant value in treating primary hepatic carcinoma and improving prognosis.
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Objective To investigate methods and feasibility of percutaneous regional isolated hepatic perfusion combined with charcoal hemoperfusion(PRIHP-CHP).Methods Four out of 12 dogs underwent the procedure of routine transhepatic arterial infusion(TAI) as control group, 8 underwent PRIHP-CHP as experimental group. Adriamycin was used in our study, the concentration of plasma in hepatic vein and systemic vein was detected in both groups. Results All the procedures were successful in the PRIHP-CHP group eight, but 1 dog died because of air embolization. The average procedure duration for each was (132.3?15.3) minutes. The peak level of adriamycin concentration in hepatic vein and systemic in TAI were (3709.676?385.723) ng/ml and (1576.140?226.933) ng/ml respectively. In PRIHP-CHP, the peak level were (4653.420?430.204) ng/ml and (433.612?40.501) ng/ml. There were statistically significant differences between TAI and PRIHP-CHP (?