ABSTRACT
Objective:To study the prognostic factors in patients with occult ruptured hepatocellular carcinoma (HCC) after hepatectomy.Methods:The clinical data of 31 patients with occult ruptured HCC who underwent hepatectomy at the Heze Multiple Hospital from January 2001 to December 2014 were retrospectively analyzed. There were 27 males and 4 females, with ages ranging from 29 to 73 years. Kaplan-Meier survival analysis was carried out for survival analysis, and compared by the log-rank test. Multivariate analysis was conducted using the Cox proportional hazards regression model.Results:Of 31 patients in this study, 27(87.1%) had died, and 25(80.6%) had developed tumor recurrence and metastasis. The median overall survival was 8 months and the median tumor-free survival was 4 months. On Cox regression analysis, non-R 0 resection was an independent risk factor of overall survival ( RR=2.816, 95% CI: 1.006-7.887) and disease-free survival ( RR=3.295, 95% CI: 1.215-8.940). Poor tumor differentiation was an independent risk factor of overall survival ( RR=3.120, 95% CI: 1.193-8.160). Conclusions:The prognosis of patients with occult rupture HCC who underwent no R 0 resection was poor. However, the prognosis of patients who underwent non-R 0 resection was even poorer.
ABSTRACT
Objective To establish a stable lung cancer A549 cell line transfected by AMP-activated protein kinase (AMPK) expression vector,and to observe the effect of AMPK on proliferation as well as on the invasive ability of A549 cells.Methods Full-length of AMPK gene was amplified and its target gene was digested,then inserted into the GV358 plasmid.Co-tranfected 293T cells were subjected to the lentivirus equipment package.Subsequently,we collected the lentivirus supernatant to infect the A549 cells and establish a stably,overexpressed cell line A549.The mRNA and protein of AMPK were examined by real-time quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and Western blotting.The proliferation and invasion abilities of A549 cells were detected by methyl thiazolyl thiazolium (MTT) and Transwell assay.Results GV358-AMPK lentivirus vectors was successfully constructed by restrictive enzyme digestion and plasmid sequencing.There were significantly increased expressions of AMPK protein (5.87 times,P =0.002) and mRNA (16.12 times,P ＜ 0.001) after transfected with GV358-AMPK compared with the Vector group.Meanwhile,AMPK overexpression showed significantly lower proliferation (the forth day:0.53 ± 0.03 vs.0.64 ±0.05,P=0.021;the fifth day:0.58 ± 0.04 vs.0.80 ± 0.07,P =0.002) and weaken invasive ability [(1.6±0.5) ×l05 vs.(3.4±0.3) ×105,P=0.004] ofA549 cells.Conclusion The lentiviralAMPK expression vector and its A549 cell line is successfully constructed.AMPK overexpression inhibits the proliferation and invasive ability of A549 cells.
ABSTRACT
Objective To investigate the cerebral blood flow in migraine without aura with three-dimensional arterial spin labeling technology .Methods From January 2013 to February 2016, magnetic resonance perfusion imaging was operated in 20 migraine patients without aura and 20 healthy controls by using arterial spin labeling, to determine their regional cerebral blood flow (rCBF) during migraine attacks and attack-free period.The significant difference was analyzed in rCBF between the two groups .Results The rCBF was significantly lower at the headache side during migraine period ( ( 52.77 ±5.97 ) ml? 100 g-1? min-1 ) than symmetrical side in the migraine patients without aura ((62.72 ±6.65) ml? 100 g-1?min-1 , t=3.780,P<0.01).The rCBF of temporosphenoid lobe in headache side in the migraine patients without aura ((53.97 ±5.87) ml? 100 g-1? min-1) was significantly lower than corresponding region in the control group ((59.21 ±2.35) ml? 100 g-1? min-1, t=4.449, P=0.001).And no significant difference in rCBF was found in migraine patients without aura under attack-free period. Conclusions Three-dimensional arterial spin labeling could quantitatively analyze the cerebral blood flow .Monitoring the perfusion difference in migraine patients could provide some references in the pathogenesis research and therapy.
ABSTRACT
Objective To study the impact of regional lymph node metastasis on the prognosis of patients with hepatocellular carcinoma (HCC) after hepatectomy.Methods Three hundred and twenty-two HCC patients who underwent elective hepatectomy in the Heze Municiple Hospital were retrospectively studied from January 1999 to December 2013.The clinical data and follow-up results were analyzed.The diagnosis of lymph node metastasis was based on preoperative imaging data and intraperative findings.Results There were 16 patients (5.0％) with lymph node metastasis (the metastasis group) and 306 patients (95.0％) without lymph node metastasis (the no-metastasis group).On Kaplan-Merier analysis,the overall survival (OS) rates at 1,2,5 years were 43.8％,31.3％,7.5％ in the metastasis group and 83.7％,70.9％,46.1％ in the no-metastasis group,respectively (Log-rank test:P ＜ 0.05).The corresponding disease-free survival (DFS) rates were 30.0％,22.5％,6.3％ in the metastasis group and 69.8％,52.8％,34.5％ in the no-metastasis group,respectively,(P ＜0.05).On follow-up,the mid-and shortterm HCC recurrence rates (≤6 months) were 71.4％ in the metastasis group (10 patients) and 31.6％ in the no-metastasis group (142 patients,x2 =9.754,P ＜ 0.05),respectively.Absence of cirrhosis,hepatectomy extent of ＞ 1 Section,max-diameter of tumor ＞ 5 cm,poor differentiation and absence of tumor encapsulation were significant factors of DFS in the metastasis group (P ＜ 0.05).On COX regression analysis,absence of tumor encapsulation was the only independent risk factor of DFS.Conclusions Regional lymph node metastasis was one of the significant factors for OS and DFS in HCC patients who underwent hepatectomy.Resection of metastatic lymph nodes and post-operation adjuvant treatment should be helpful to improve patients' prognosis.
ABSTRACT
Objective To apply 3 .0T MRI in diagnosing injuries of anterior bundle of medial collateral ligament after elbow dislo‐cation .Methods The MRI features of the injuries of medial collateral ligament anterior bundle were analyzed retrospectively in 20 patients with elbow dislocation .The coronal ,sagittal ,axial and lamina oblique coronal were scanned routinely with SE T1WI ,T2WI‐FS sequences .Results Varying degrees of anterior bundle injuries of medial collateral ligament were observed in all the 20 patients ,in‐cluding the mild injury(n=8) ,part avnlsion(n=5) ,completely rupture(n=7) .Furthermore ,concomitant injuries including lateral collateral ligament(n=11) ,ringlike ligament(n=5) ,flex/stretch muscle tendon(n=9) ,and the fracture(n=7) were also observed . Conclusion The injuries of medial collateral ligament anterior bundle after elbow dislocation could be diagnosed accurately with 3 .0T MRI and the degree of injuries could also be defined on image .The 3 .0T MRI could be recommended as regular examination to pa‐tients with elbow dislocation .
ABSTRACT
Objective:A study was conducted to determine the expression of acetyl-coa carboxylase product of phosphorylation (P-ACC) and an enzyme called cyclooxygenase 2 (COX-2) in non-small cell lung cancer (NSCLC) tissue, as well as the relationship and correlations between tumor size, lymph node metastasis, clinical stage, and pathological type. Methods: Sixty-two patients with NSCLC lung cancer tissues were included in the patient group, whereas 20 patients who underwent lobectomy for other reasons and had normal lung tissues were included in the control group. Immunohistochemical streptavidin peroxidase method was used to detect the expression of P-ACC and COX-2 in lung cancer and normal lung tissues. Results:The positive expressions of P-ACC and COX-2 in NSCLC lung cancer and normal lung tissues were significantly different (P<0.05). In NSCLC tissues, the positive expression of P-ACC was significantly associated with tumor size (P<0.05), but was not significantly associated with lymph node metastasis, clinical stage, and pathological type. We found no correlation between the positive expression of COX-2 and tumor size, lymph node metasta-sis, clinical stage and pathological type. Further analysis revealed that the positive expression of P-ACC and COX-2 in NSCLC was sig-nificantly and negatively correlated (r=-2.37, P=0.032). Conclusion:The positive expression of COX-2 in NSCLC greatly increased compared with that of P-ACC, and a significantly negative correlation was observed between them. We propose that the positive expres-sion of P-ACC reduction may activate the positive expression of COX-2 and promote the occurrence, development, invasion, and metas-tasis of NSCLC.
ABSTRACT
Objective To determine the most appropriate method in the treatment of choledocholithiasis. Methods The clinical data of 135 patients who received either laparoscopic common bile duct exploration (LCBDE) or laparoscopic transcystic common bile duct exploration (TC-BDE) from May 2005 to July 2009 were retrospectively studied. Results All patients were cured of choledocholithiasis. In 13 patients three trocars were used, in 89 patients four trocars were used, and in 33 patients conversion to open operation was done. Of the 102 patients in whom minimal invasive surgery was successfully carried out, TC-BDE was done in 6 patients and LCBDE in 96 patients. Primary closure of common bile duct (CBD) was carried out in 33 patients while T-tube drainage was done in 63 patients. Six patients had a transient bile leak which healed spontaneously in 3 to 4 days. Retained stone was detected in 2 patients which was successfully retrieved through choledochoscopy. Conclusion An individualized treatment approach is the most reasonable way to manage CBD stones. The choice of the procedure depends on the number and size of stones, the surgeons experience and the patient's choice.
ABSTRACT
Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.
ABSTRACT
OBJECTIVE To observe xerostomia and its effect on quality of life of nasopharyngeal carcinoma patients after radiotherapy and discuss related factors that may improve the patients' quality of life. METHODS Seventy-nine nasopharyngeal carcinoma patients were given a questionnaire in clinic regarding xerostomia 1 year following radiotherapy. Its severity and effect on the quality of life were studied. RESULTS Xerostomia was found in all 79 patients. Moderate to severe xerostomia occurred in 74.7 % of the patients. Of the 79 patients, 13.9 % often drank water at night, 74.7 % needed to drink water while eating, 59.5 % felt difficulties speaking and 91.1 % thought that their daily life was effected significantly. CONCLUSION The occurrence rate of xerostomia was very high in nasopharyngeal carcinoma patients after radiotherapy. 74.7 % of the patients suffered from moderate to severe xerostomia and the daily life of the 91.1 % of patients was effected significantly.
ABSTRACT
Objective To evaluate contrast-enhanced ultrasound (CEUS) for the diagnosis and follow-up of hepatocellular carcinoma ( HCC) patients after percutaneous radiofrequence ablation ( RFA). Methods The data of 46 HCC cases were reviewed in our study. Results of contrast enhanced computed tomography (CT) , ultrasound contrast agent sonography and grey ultrasound were compared with each other pre- and after percutaneous radiofrequence ablation. Results Contrast agent ultrasound imaging had the same value with CT in preoperative diagnosis of HCC, with postive likelihood ratio of 1.26 and 1.31, respectively,sensitivity of 97% and 91% and specificity of 23% and 31% respectively. For grey ultrasound the positive likelihood ratio was 0.99, sensitivity and specificity was 76% and 23% respectively. The sensitivity and specificity of contrast-enhanced ultrasound after percutaneous radiofrequence ablation was 60% and 90% respectively, and the postive likelihood ratio and negative likelihood ratio was 6. 18 and 0. 44 respectively. The difference was significant while compared with CT (P = 0. 012). All cases were followed-up from 1 to 9 months, and all were alive with recurrence found by contrast-enhanced ultrasound in 3 cases. Conclusions Contrast agent ultrasound imaging is sensitive and effective in the diagnosis of HCC and follow-up after percutaneous radiofrequence ablation.