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Refractory ascites is one of the common complications of portal hypertension in decompensated liver cirrhosis and is characterized by extremely poor prognosis and high mortality rate. Transjugular intrahepatic portosystemic shunt (TIPS) is recommended by several international and national guidelines as one of the treatment methods after failure of large volume paracentesis combined protein infusion therapy. TIPS can effectively control the recurrence of ascites, but it can increase the risk of hepatic encephalopathy, and there are still controversies over whether it can prolong survival time. With a deeper understanding of TIPS, the maturity of surgical techniques, and the update of stent materials, it is urgent to reevaluate the position of TIPS in the treatment of refractory ascites due to portal hypertension. This article reviews the current status and advances in TIPS for the treatment of refractory ascites due to portal hypertension.
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Objective To evaluate the safety and clinical short-term efficacy of interventional emboliz-ation with hepasphere-loaded microspheres in treating inoperable hepatocellular carcinomas. Methods A total of 15 patients with unresectable hepatocellular carcinoma underwent transcatheter arterial chemoembolization ( TACE ) using hepasphere-loaded microspheres as embolic agent . The clinical data , imaging follow-up materials, complications of interventional treatment, prognosis, etc. were summarized and analyzed. The results were evaluated with modified response evaluation criteria in solid tumors (mRECIST); monthly follow-up was made for all patients. A total of 23 TACE procedures were performed in 15 patients. Results The following-up period ranged from 6 months to 15 months , the median follow-up time being 10 months . According to mRECIST, the 3-month objective response rate (CR+PR) was 73.3% and disease control rate (CR+PR+SD) was 93.3%;the 6-month objective response rate (CR+PR) was 73.3%and the disease control rate (CR+PR+SD) was 86.7%. No severe complications, such as bile leak complicated by infection, liver abscess, abdominal hemorrhage, bleeding due to tumor rupture, gastrointestinal bleeding, etc. occurred in all patients . Conclusion In treating unresectable hepatocellular carcinomas , TACE using newly-developed hepasphere microspheres carries satisfactory clinical short-term efficacy and safety, although thelog-term results need to be further investigated with larger sample trial.
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Objective To explore the application of transcatheter arterial chemoembolization (TACE) combined with selective portal vein embolization (SPVE ) in two-stage hepatectomy of hepatocellular carcinoma (HCC).Methods From September 2010 to September 2013,a total of 107 patients with HCC in the right liver lobe who were not suitable for one stage hepatectomy received TACE or TACE combined with SPVE treatment were enrolled.Among them,55 received TACE therapy and 52 accepted TACE combined with SPVE treatment.The technique success rate,complication,adverse reactions,the volume change of each liver lobe and the rate of hepatectomy of HCC were observed.Chi-square test was used for numerical data comparison and Student′s t test for measurement data.Results TACE or TACE combined with SPVE therapy was successfully applied in all the 107 patients,the technique success rate was 100%.During treatment period,no complications such as ectopic embolization, liver function failure,puncture tract bleeding,gastrointestinal bleeding,bile leakage and hepatic abscess were observed.After treatment,the adverse reactions included liver function impairment,pain in hepatic region,fever,nausea and vomiting.Four weeks after the treatment,the volumes of tumor and right liver lobe decreased to certain degree in patients with HCC of both TACE group and TACE combined with SPVE group.The volume of left liver lobe in TACE group had no obvious change,while remarkably increased in TACE combined with SPVE group.The pre-treatment residual liver volume (RLV)of TACE group and TACE combined with SPVE group was (404.0 ± 46.3 )cm3 and (393.9 ± 65 .7 )cm3 , respectively,and the difference was not statistically significant (t=0.927,P =0.356).Four weeks after the treatment,RLV was (415.4 ±45.7 )cm3 and (567.3 ±88.7 )cm3 ,respectively,and the difference was statistically significant (t= -11 .219,P <0.05).Patients were followed up for three to six months,the rates of hepatectomy were 38.2%(21/55)and 86.5 %(45/52)in TACE group and TACE combined with SPVE group,and the difference was statistically significant (χ2 =26.440,P <0.01 ).Conclusion For patients with HCC not suitable for one stage hepatectomy,the treatment of TACE combined with SPVE before operation could effectively control the growth of the tumor,decrease the volume of tumor,increase RLV,and then increase the rate of two-stage hepatectomy.
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Objective:To compare the effect of the frequency of transcatheter arterial chemoembolization (TACE) on preventing tumor recurrence after hepatectomy. Methods:A total of 45 post-operative patients who had received prophylactic TACE once or thrice were retrospectively examined between January 2008 and June 2009. Of the 45 patients, 23 underwent TACE once, and the others un-derwent it thrice. TACE was administered to all patients via the hepatic artery one to two months after operation and was repeated every two to four months with patients who underwent TACE three times. All cases were followed up for 36 to 40 months after surgery. The rates of cumulative recurrence between the two groups were compared. Results:In the group that underwent TACE once, the 1-, 2-and 3-year cumulative recurrence rates were 30.43%, 47.83%, and 47.83%, respectively. In the group that underwent TACE thrice, the 1-, 2-and 3-year cumulative recurrence rates were 4.55%, 27.27%, and 36.36%, respectively. Statistical analysis showed that the relapse rate within one year was lower in the group that underwent TACE thrice than in the group that underwent TACE only once (P=0.022). How-ever, no significant difference in the cumulative recurrence rate was found between the two groups in two and three years (P=0.086, 0.225). Conclusion:Hepatocellular carcinoma patients who undergo preventive TACE three times after hepatectomy exhibit reduced re-currence rates during the peak time of tumor recurrence and extended disease-free survival intervals.
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<p><b>OBJECTIVE</b>To investigate the effect of the iron chelator deferoxamine (DFA) in suppressing microglia activation and protecting against secondary neural injury in a rat model of intracerebral hemorrhage (ICH).</p><p><b>METHODS</b>SD rats were randomly divided into sham-operated group, ICH group and DFA treatment group. ICH model was established by infusion of type IV collagenase into the right basal ganglia, and starting from 1 h after the operation, the rats received intraperitoneal DFA injections every 12 h for 7 days. The iron content in the perihematoma brain tissue was determined at different time points after DFA administration, and OX42 immunohistochemistry was used to observe the changes in the microglia. The contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the brain tissue were detected by ELISA. The neural death and neurological deficiency were measured using Nissl staining and neurological scores, respectively.</p><p><b>RESULTS</b>The iron content in the brain tissues around the hematoma was significantly increased 3 days after ICH and maintained a high level till 28 days, accompanied by a marked increase of microglial cells as compared to the sham-operated group. DFA injection caused significantly decreased iron content in the brain tissue, reduced number of microglial cells, and lowered levels of IL-1β and TNF-α. Neuronal loss around the hematoma was obviously reversed after DFA injections, which resulted in improved neurological deficiency.</p><p><b>CONCLUSION</b>DFA can suppress microglia activation by removing iron overload from the perihematoma brain tissue, thus reducing secondary neuronal death and neurological deficiency in rats with ICH.</p>
Subject(s)
Animals , Male , Rats , Cerebral Hemorrhage , Metabolism , Pathology , Deferoxamine , Pharmacology , Interleukin-1beta , Metabolism , Iron , Metabolism , Microglia , Metabolism , Pathology , Rats, Sprague-Dawley , Tumor Necrosis Factor-alpha , MetabolismABSTRACT
Objective To study the apoptotic induction of Aspisol on melanoma A375 cells.Methods The growth inhibition effect of Aspisol on A375 cells was evaluated by MTY assay.Morphological assay was observed by inverted microscope.Early apoptofic rate in A375 cells Was anyzed by flow cytometry.Results The results of MTT assay demonstrated that the growth of A375 cells was inhibited by Aspisol in a time-and concentration-dependence (P＜0.01).FCM analysis showed that Aspisol could markedly induce apeptosis;the early apoptotie rate of A375 cells exposed to different concentrations of Aspisol for 24 h were significant differences(P＜0.05)compared with control group.Conclusion Aspisol could inhibit proliferation and induce apoptosis of A375 cells.
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Background and purpose:Many studies indicate that nonsteroidal anti-inflammatory drugs(NSAIDs) may inhibit cancer growth.However,the molecular mechanisms may involve different pathway and still remain unclear.The aim of this experiment was to investigate the influence of aspisol against breast cancer lines,including MDA-MB-231(estrogen receptor-negative),MCF-7(estrogen receptor-positive),and reveal the potential signaling pathway mechanism of aspisol effect on breast cancer lines.Methods:MDA-MB-231 and MCF-7 human breast cancer cell lines were treated with aspisol in vitro.Cell proliferation was evaluated by MTT assay and rate of apoptosis were determined by flow cytometry.Extracellular signal regulated kinase(ERK),phosphor-ERK(P-ERK) protein expressed in breast cancer cell lines were analyzed by Western blot.Results:①The results of MTT assay demonstrated that the growth of MDA-MB-231,MCF-7 cells were inhibited by aspisol in a time-and dose-dependent fashion(P0.05).Conclusions:aspisol inhibits proliferation and induces apoptosis not only in ER-positive but also in ER-negative breast cancer cells.The mechanism may relate to ERK signal pathway.
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Objective To study the expression of interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R),determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function.Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P＜0.01), and the content of sIL-2R increased. Red blood cell C3b receptor (RBC. C3b R)and RBC immune adherence enhancing factor (RFEB) dropped greatly (P＜0.01), while RBC immune complex rosette (RBC. ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4decreased (P＜0.01) and there was no obvious change in CD8 (P＜0.05). Conclusion The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence,development, treatment, and prognosis of hypertensive cerebral hemorrhage.
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Objective To investigate the proliferative response and time course of endogenous neural stem/progenitor cells after cerebral cortical concis in the adult rats. Methods Eighty adult male Sprague-Dawley rats were used in this study. Cumulative BrdU labeling was employed to detect the proliferating cells. At 1 d, 3 d, 7 d, 14 d, and 21 d after cerebral cortical concis, the rats were killed for BrdU immunohistochemical staining and cell counting in the injured ipsilateral SVZ. Results Little BrdU immunoreactivity cells was present in SVZ of the control rats from day 7 to day 21 after sham operation. The number of BrdU immunoreactivity cells in the injured ipsilateral SVZ increased at day 1 and peaked at day 7 after cerebral cortical concis. Conclusion After cerebral cortical concis of the adult rats, neural stem/progenitor cells in the injured ipsilateral SVZ markedly proliferated with a peak at day 7. This finding may be important for manipulating SVZ cells to promote the recovery from cerebral cortical concis.
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Objective: To study the expression of interleukin-2(IL-2), soluble interleukin-2 receptor (sIL-2R), determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods: Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function. Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results: The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P<0.01), and the content of sIL-2R increased. Red blood cell C3b receptor (RBC. C 3bR) and RBC immune adherence enhancing factor (RFEB) dropped greatly (P<0.01), while RBC immune complex rosette (RBC. ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4 decreased (P<0.01) and there was no obvious change in CD8 (P<0.05). Conclusion: The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence, development, treatment, and prognosis of hypertensive cerebral hemorrhage.
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Objective: To investigate the proliferative response and time course of endogenous neural stem/ progenitor cells after cerebral cortical concis in the adult rats. Methods: Eighty adult male Sprague-Dawley rats were used in this study. Cumulative BrdU labeling was employed to detect the proliferating cells. At 1 d, 3 d, 7 d, 14 d, and 21 d after cerebral cortical concis, the rats were killed for BrdU immunohistochemical staining and cell counting in the injured ipsilateral SVZ. Results: Little BrdU immunoreactivity cells was present in SVZ of the control rats from day 7 to day 21 after sham operation. The number of BrdU immunoreactivity cells in the injured ipsilateral SVZ increased at day 1 and peaked at day 7 after cerebral cortical concis. Conclusion: After cerebral cortical concis of the adult rats, neural stem/progenitor cells in the injured ipsilateral SVZ markedly proliferated with a peak at day 7. This finding may be important for manipulating SVZ cells to promote the recovery from cerebral cortical concis.
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Objective To study the content of interleukin- 6 (IL-6) and the altering pattern of erythrocyte immunity and T cell subgroup in the blood of outer circulation in the patients with cerebral glioma, and to expl ore their relationship and the clinical significance. Methods Enzyme linked immunosorbent assay (ELISA) was used to determine the content o f IL-6. The immunoabsorption was employed to examine the erythrocytic immune ac tivity and its regulatory function. Streptavidin-Peroxidase (S-P) was used to determine the cell number of CD3 (cluster of differentiation 3), CD4, CD8. Results The content of IL-6 in the group with cerebral glioma i s significantly lower than that in the control group (P0.05). Conclusion The weakening of immune function is obse rved in the patients with cerebral glioma. Testing of the content of IL-6, eryt hrocyte immunity and the activity of T subgroup has important clinical significa nce in the occurrence, development, treatment, outcome and prognosis of the cere bral glioma.
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Aim To study the inhibitory and apoptosis-inducing effects of aspisol on proliferation of B16 melanoma in vitro and in vivo. Methods The effect of aspisol on the proliferation of B16 cells was analyzed by MTT assay; its effect on cell apoptosis was measured by flow cytometry. The suspension of melanoma cells was injected subcutaneously into forelimb axillas of C57BL/6J mice to establish xenograft models. From the next day, the mice received intraperitoneal injection of aspisol in different concentrations once a day for 28 days; the mice received injection of dacarbazine (DTIC) were used as positive controls,and received injection of normal saline (NS) were used as negative controls. The inhibition rate of tumor growth was calculated .The apoptosis rate was detected by TUNEL assay. The expression of Survivin and C-erbB-2 was detected by immunohistochemistry. Results Aspisol inhibited the proliferation of B16 cells, with the inhibition rate up to (68.78?1.27)%, and induced the apoptosis with the highest apoptosis rate up to 15.8%.The inhibition rate of tumor growth was 15.0% in 200 mg?kg-1 aspisol group, 32.3% in 400 mg?kg-1 aspisol group, 49.4% in 800 mg?kg-1 aspisol group,and 51.4% in 40 mg?kg-1 DTIC group. Typical apoptotic morphologic changes were seen in the 4 groups. Survivin and C-erbB-2 expression was significantly lower in aspisol groups than in NS group. Conclusion Aspisol could inhibit proliferation and induce apoptosis of B16 melanoma cells in vitro and in vivo, which may be correlated to down-regulation of Survivin and C-erbB-2.
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Objective To describe the characterstics of intraoperative ultrasound imaging of patients with neurosurgical operation and to discuss the sonographic technique in practice.Methods Combined with preoperative image data,B-mode ultrasound probe was used to detect brain lesion after craniotomy,and to analyze resection degree.Results Total definite orientation was achieved in all the 42 cases,total lesion resection in 34 cases,and subtotal resection in 6,2 cases died.Conclusion We can get the real-time position and determine the nature of brain lesion with intraoperative ultrasound.B-mode ultrasound is helpful for total resetion of lesion and can decrease the side effect injury.