Lactic acid inhibits the formation of semen-derived amyloid fibrils / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the inhibitory effect of lactic acid on semen-derived amyloid (SEVI) fibril formation.</p><p><b>METHODS</b>PAP248-286 (2 mg/mL) was incubated with 4.0, 2.0, 1.0, 0.5, 0.25, and 0.125 mg/mL of lactic acid. After incubation for different times, aliquots were drawn from each sample for Thioflavin T (ThT) and Congo red staining to monitor semen-derived amyloid fibril formation. The β sheet structure formation of PAP248-286 was measured by circular dichroism spectrum, and the morphology of amyloid fibrils incubated with or without lactic acid was observed with transmission electron microscopy (TEM). The enhancing effect of amyloid fibril incubated with lactic acid at different time points was determined using virus infection assay. PAP248-286 (2 mg/mL) was incubated with dilutions of vaginal secretion from healthy women, and amyloid fibril formation was detected with ThT and Congo red staining.</p><p><b>RESULTS</b>Lactic acid inhibited SEVI fibril formation in a dose-dependent manner in vitro. Lactic acid at 0.5 mg/mL completely inhibited 2 mg/mL SEVI fibril formation within 48 h. After incubation for 48 h, lactic acid at 1 mg/mL inhibited the formation of β-sheet structure of SEVI (2 mg/mL) and completely inhibited 2 mg/mL PAP248-286 aggregation as observed with TEM. In the presence of lactic acid, PAP248-286 lost the ability to enhance virus infection. Vaginal secretion inhibited SEVI fibril formation in a dose-dependent manner, and virtually no SEVI fibril occurred after incubation of 2 mg/mL PAP248-286 with 67% vaginal secretion.</p><p><b>CONCLUSION</b>Lactic acid inhibits SEVI fibril formation in vitro.</p>

Risk factors of survival for recurrent hepatocellular carcinoma treated by percutaneous radiofrequency ablation / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the efficacy and determine the risk factors of survival for recurrent hepatocellular carcinoma(HCC) treated by percutaneous radiofrequency ablation (PRFA).</p><p><b>METHODS</b>From January 1999 to December 2008, 82 patients with recurrent HCC, with the diameter less than 7 cm for solitary tumor, or the largest tumor less than 5 cm for multiple tumors(the number of tumors less than 3), were treated by PRFA. The significance of 12 clinical or pathological variables in the risk factors of overall survival were assessed.</p><p><b>RESULTS</b>The overall survival 1-, 3-, and 5-year survival rates were 75.8%, 43.9% and 34.5% (from the date of PRFA), and 95.1%, 63.2% and 46.6% (from initial hepatectomy), respectively. Univariate analysis indicated that tumor size before initial hepatectomy, recurrence interval from initial hepatectomy, number of recurrent tumors, diameter of largest recurrent tumor, serum glutamyl transpeptidase (GGT) and serum albumin (ALB) level were significant prognostic factors (P < 0.05, Kaplan-Meier Log-rank test). Multivariate analysis showed recurrence interval from initial hepatectomy, diameter of largest recurrence tumor, serum GGT and ALB level were significant prognostic (P < 0.05).</p><p><b>CONCLUSION</b>PRFA is effective for recurrent HCC. Recurrence interval from initial hepatectomy, diameter of largest recurrent tumor, serum GGT and ALB level are significant prognostic factors.</p>

Efficacy of combining temperature- and power-controlled radiofrequency ablation for malignant liver tumors / 癌症

<p><b>BACKGROUND AND OBJECTIVE</b>Single mode of radiofrequency ablation (RFA) often leads to limited ablation in the zone of necrosis. This study clarifies the efficacy of combining temperature- and power-controlled RFA for malignant liver tumors.</p><p><b>METHODS</b>Between April 2008 and August 2008, 58 patients with malignant liver tumors received RFA at Sun Yat-sen University Cancer Center. The patients were divided into 2 groups using a random number table: one group received combined temperature- and power-controlled RFA (the combination group), and the other group received power-controlled RFA alone (the control group).</p><p><b>RESULTS</b>Three patients were lost to follow-up and 55 patients were included for evaluation. Twenty-five patients with 29 tumors were treated by the combination RFA, and 27 tumors (93.1%) achieved either complete response (CR) or partial response (PR). One patient had a seriously decreased heart rate. In the control group, 30 patients with 32 tumors received power-controlled RFA, and 29 tumors (90.6%) achieved CR or PR. There were no serious complications. There was no difference between the combination and control groups in treatment time ((13.3 +/- 1.3) min vs. (10.2 +/- 2.3) min, P = 0.459). The number of sessions of RFA for the combination group was less than that of control group (1.3 sessions vs. 2.4 sessions), but the difference was not significant (P = 0.579).</p><p><b>CONCLUSION</b>RFA controlling both temperature and power is effective and safe for patients with malignant liver tumors, and the number of sessions of RFA for the combination group was less than that of the control group.</p>

Clinical significance of regulatory T cells proportion in the peripheral blood and tumor tissue in primary hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the clinical significance of the amount of regulatory T cells (Treg) in the peripheral blood CD4+ cells and tumor tissue in primary hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>From January 1999 to December 2000, 63 HCC patients underwent radical resection in Sun Yatsen University Cancer Center. Tregs in those patients were detected in the samples of preoperative peripheral blood by flow cytometry and also in tissue samples of the resected tumors by immunohistochemistry. All patients had been followed up till Dec 30, 2005. The correlations of Treg amount in the peripheral blood CD4+ cells and tumor tissue with clinicopathologic characteristics and prognosis of HCC were analyzed.</p><p><b>RESULTS</b>The proportion of Treg/CD4+ in the peripheral blood was significantly higher in the patients with HCC than that in those with HBsAg positive (P < 0.01) and in the normal controls (P < 0.01). The mean number of Treg in tumor tissue was (15.69 +/- 13.29)/mm2, but none or very few Treg was detected in the normal liver tissue, para-cancerous liver tissue, and HBV-infected liver tissue. The proportion of Treg/ CD4+ in the peripheral blood was significantly positively correlated with the number of Treg in tumor tissue (P = 0.024). The 5-year survival in patients with high amount of Treg in both peripheral blood and tumor tissue was significantly poorer than that in the patients with low amount of Treg (P = 0.042, 0.019). The 5-year disease-free survival rate was significantly lower in the patients with high amount of Treg in tumor tissue than that in the patients with lower amount (P = 0.001).</p><p><b>CONCLUSION</b>Regulatory T cells in the circulatory blood and tumor tissue are increased in patients with hepatocellular carcinoma. The increased amount of regulatory T cells either in peripheral blood or in the tumor tissue is pertaining to poor prognosis. Detection of regulatory T cells both in the preoperative peripheral blood CD4+ cells and tumor tissue may be used as a potential immunological prognostic indicator for the hepatocellular carcinoma patients after radical resection.</p>

Therapeutic effect of vacuum-assisted closure technology on infected explosion wound of pig / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the effect of vacuum-assisted closure (V. A. C.) technology in the treatment of infected wound of skin and soft tissue as a result of explosion injury in pig.</p><p><b>METHODS</b>Sixteen explosion wounds were established by electric detonators on the shoulders and hips on both sides of 4 small white domestic pigs ,and they were divided into A group [(without treatment and infection occurred on 1-2 post burn day (PBD), then treated with vaseline gauze on 3 (PBD)], and B group (with the same treatment as in A group, except for treatment of vacuum assisted closure (V. A. C) with pressure of - 15 kPa after 3 PBD). The data of wound depth, wound area, wound healing time were collected and analyzed at 3 PAD and 1, 3, 6, 9, 14, 19, 24 days after treatment. Specimens from wounds were collected for histopathology observation, including also cell proliferation index, the number of vascular endothelial cells, the activity of myeloperoxidase (MPO) and the number of bacteria.</p><p><b>RESULTS</b>Compared with those in A group on land 3 days after treatment, wound area, wound depth were not enlarged or deepened in B group, while the number of inflammatory cells, vascular endothelial cells, proliferative cells were increased, the activity of MPO was enhanced and the number of bacteria was decreased. There were obvious differences between two groups in following indices: wound area ,wound depth, the number of vascular endothelial cells and bacteria during 1 to 19 days after treatment (P < 0.01)), the number of cell proliferation from 1 - 9 days after treatment (P < 0.01)), and the activity of MPO on 3, 6 days after treatment (P < 0. 01). The wound healing time was (32.8 +/- 1.6) d in A group, which was longer than that in B group (25.8 +/- 1.0 d, P < 0.01).</p><p><b>CONCLUSION</b>Compared with conventional dressing change, V. A. C can decrease bacteria load, lessen secondary necrosis, prompt the inflammatory response, accelerate the formation of granulation tissue, shorten wound healing time in infectious wound of porcine skin and soft tissue resulted from explosion injury.</p>

Adsorption and sustained release of epirubicin from carbon-coated iron nanocrystals / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the adsorption and desorption of epirubicin (EADM) by carbon-coated iron nanocrystals (CCIN).</p><p><b>METHODS</b>EADM standard curve was generated. After thorough mixture of CCIN and EADM with sonication, the mixture solution was centrifuged at high speed to obtain dissociated EADM for evaluating the adsorption capacity of CCIN. A dialyzer was used to evaluate the desorption of drug-loaded CCIN particles in different media (PBS, normal saline, or distilled water), at different temperatures, and with different quantities of loaded drug.</p><p><b>RESULTS</b>The adsorption of EADM by CCIN presented linear adsorption before saturation and saturation adsorption, with an adsorption saturation point of about 160 microg/mg. The desorption of EADM from CCIN particles was affected by such factors as the extraction media, temperature, and quantity of the loaded drug. Compared to distilled water, PBS and normal saline improved the release rate of EADM from the drug-loaded CCIN particles. Higher temperature also contributed to higher release rate of EADM. Higher release rate of EADM occurred after the CCIN particles adsorbed greater amount of EADM.</p><p><b>CONCLUSION</b>CCIN shows an EADM adsorption pattern of Langmuir isotherm adsorption. Such factors as higher temperature, PBS solution, higher speed of medium replacement, and more drug adsorbed all contribute to a higher release rate of EADM.</p>

Percutaneous radiofrequency ablation combined with other minimally invasive treatments for recurrent hepatocellular carcinoma after hepatectomy / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of percutaneous radiofrequency ablation (PRFA) and combined with other minimally invasive treatments for recurrent hepatocellular carcinoma (RHCC) after hepatectomy.</p><p><b>METHODS</b>Eighty-four patients with RHCC after hepatectomy who were treated with PRFA or combined with other minimally invasive therapies between August 1999 and February 2008 were analyzed retrospectively.</p><p><b>RESULTS</b>There was no treatment related mortality in the study population, and the morbidity was 2.4% (2/84). The complete ablation rate was 94.0% (79/84), and the 1-, 3- and 5-year overall survival rates were 74.9%, 54.9% and 48.2%, respectively. The 1-, 3- and 5-year overall survival rates of patients with recurrent interval after hepatectomy less than 1 year and over 1 year were 72.1%, 36.2%, 24.2% and 76.8%, 70.6% and 65.1%, respectively (P = 0.040). The 1-, 3- and 5-year overall survival rates of patients with tumor size <or= 3 cm and > 3 cm were 83.2%, 67.7%, 67.7% and 59.1%, 24.2%, 12.1%, respectively (P = 0.003). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with percutaneous ethanol injection (PEI) were 66.7%, 33.3%, 22.2% and 76.5%, 57.3%, 57.3%, respectively (P = 0.017). The 1-, 3- and 5-year overall survival rates of patients treated with PRFA alone and combined with transcatheter hepatic arterial chemoembolization (TACE) were 55.6%, 24.7%, 24.7% and 81.6%, 66.0%, 57.5%, respectively (P = 0.001).</p><p><b>CONCLUSIONS</b>PRFA is an effective and safe treatment for RHCC, and tumor size and recurrent interval after hepatectomy are important prognostic factors. Combination with PEI or TACE may improve the efficacy of PRFA for treatment of RHCC.</p>

Effects of carbon-coated iron nanocrystals combined with epirubicin on HepG-2 cells and its acute toxicity in mice / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the cytotoxicity of carbon-coated iron nanoparticles (CCIN) and epirubicin-loaded CCIN on Hep-G2 cells in vitro and compare the acute toxicities of epirubicin and epirubicin-loaded CCIN in mice.</p><p><b>METHODS</b>The cytotoxicities of CCIN and epirubicin-loaded CCIN on HepG2 cells were assessed using MTT assay, and the uptake of CCIN by the tumor cells was observed by optical and electron microscopy. Different doses of epirubicin and equivalent doses of epirubicin-loaded CCIN were injected intravenously in mice to compare their acute toxicities.</p><p><b>RESULTS</b>Optical and electron microscopy revealed cytoplasmic uptake of CCIN in the tumor cells without obvious destruction of the cell structural integrity. Incubation of the HepG-2 cells with different concentrations of CCIN suspension did not result in significant variation in the mean absorbance. MTT assay showed reduced cytotoxicity of epirubicin-loaded CCIN in HepG2 cells as compared with that of epirubicin alone. The cell growth inhibition rate was significantly higher with epirubicin-CCIN mixture that contained a lower proportion of CCIN. In acute toxicity experiment with mice, the median lethal dose (LD(50)) of epirubicin was 16.9 mg/kg, while that of epirubicin-CCIN mixture was 20.7 mg/kg.</p><p><b>CONCLUSION</b>CCIN uptake by HepG-2 cells does not cause obvious cytotoxicity in vitro within a certain concentration range, epirubicin-loaded CCIN has reduced cytotoxicity against HepG2 cells as compared with epirubicin, and the cytotoxicity of the mixture decreases with the increase in the CCIN content in the mixture. Epirubicin delivery in mixture with CCIN can reduce its acute toxicity in mice.</p>

Experience of radiofrequency ablation on liver malignancies: a report of 803 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the 8-year experience of radiofrequency ablation (RFA) on liver malignancies and explore the effect and prognostic factors.</p><p><b>METHODS</b>From August 1999 to February 2007, 803 patients with liver malignancies, among which there were 672 with primary liver cancer (PLC) and 131 with liver metastasis, were treated with RFA. There were 781 cases who were performed percutaneously under the guidance of ultrasound, 8 cases under CT, 9 cases with laparoscopy and 5 cases with laparotomy. And there were 117 cases who were treated by RFA combined with percutaneous ethanol injection and 108 cases by RFA combined with trans-catheter arterial chemoembolization.</p><p><b>RESULTS</b>In the treatment of all the 803 patients with liver malignancies, the mortality was 0.25%, the rate of severe complications was 0.37%. The rate of complete ablation was 92.5%, the loco-recurrence rate was 13.8% and the 1, 2, 3, 4, 5-year survivals were 95.1%, 85.6%, 75.7%, 60.7% and 47.5%, respectively. For the 672 patients with PLCs, the 1, 2, 3, 4, 5-year survivals with stage Ia (Chinese staging system) were 97.8%, 91.5%, 84.6%, 77.1% and 61.9%, respectively, with stage Ib were 93.9%, 83.7%, 69.8%, 45.1% and 42.2%, respectively, with stage II were 86.2%, 67.3%, 47.3%, 17.2% and 0, respectively, and the 1, 2-year survivals with stage III were 67.8% and 0, respectively (P < 0.01).</p><p><b>CONCLUSIONS</b>RFA is a safe and effective method for liver malignancy, and the tumor size and stage are important prognostic factors.</p>

The influence of vacuum-assisted drainage on the growth of capillaries in the wound produced by explosion in pig / 中华烧伤杂志

<p><b>OBJECTIVE</b>To investigate the influence of vacuum-assisted closure (VAC) technique on the growth of capillaries in the wound of the pig produced by explosion.</p><p><b>METHODS</b>Four small white pigs were inflicted with 16 explosion wounds [(7.3 +/- 1.0) cm2 in area] on both sides of the buttocks, shoulders and hips by detonation of a specific type of explosive, and the wounds were randomly divided into 2 groups, i. e, control (C, with conventional treatment from 2 post-injury day (PID) on and treatment (T, with VAC treatment after debridement from 2 PID on) groups, with 8 wounds in each group. Wound tissues of 2mm x 2mm x 2mm in size were harvested for pathological examination before treatment and on 1 and 3 post-treatment day (PTU). The differentiation of adventitial cells were examined with light microscope, and the pixel value of desmin positive particles and the luminal area of newly formed capillaries were assessed with Image C software.</p><p><b>RESULTS</b>Most of vessels in the wound of both groups were in elliptic shape when observed in longitudinal section. In C group, few newly formed capillaries vessels with lack of pericytes were observed before treatment and on 1, 3 PTD, then the number began to increase on 6 PTD. In T group, the number of newly formed capillaries with pericytes was increased on 1 PTD, and it continued to increase thereafter. The pixel values of desmin positive particles in C group on 1, 3, and 6 PTD were (91 +/- 54), (199 +/- 85), and (1552 +/- 298), respectively, which were obviously higher than those in T group [(2569 +/- 330), (3984 +/- 377), (9611 +/- 960), P < 0.01]. The area of vessel lumen in C group was (59 +/- 36), (250 +/- 70), and (938 +/- 287) microm2, respectively on 1, 3, and 6 PTD, which was also smaller than those in T group [(818 +/- 234), (4518 +/- 1080), and (9058 +/- 1656) microm2, P < 0.01].</p><p><b>CONCLUSION</b>Compared with conventional therapy, VAC can not only accelerate the formation of new capillaries, but also enhance the differentiation of pericytes and the process of enwrapping them around the vessels, and increase the luminal area of newly formed capillaries.</p>

Acute toxicity of carbon-coated iron nanocrystal and its effect on liver and kidney functions and hematological system / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the acute toxicity of carbon-coated iron nanocrystal (CCIN) in mice and its effects on hepatic, renal and hematological functions.</p><p><b>METHODS</b>Acute toxicity of CCIN was evaluated by observing the toxic reactions in mice within 14 days following intravenous injection of different doses of CCIN particles. The liver and kidney functions and blood chemistry were tested in rats before and at different time points after CCIN injection.</p><p><b>RESULTS</b>The median lethal dose (LD(50)) of CCIN particles given by intravenous injection was 203.8 mg /kg in mice. Within the intravenous dose of 80 mg /kg injection, CCIN caused only mild alterations of the rats' biochemical and hematological indices that recovered without intervention in two weeks.</p><p><b>CONCLUSION</b>CCIN is characterized by low acute toxicity and mild side effects on the hepatic, renal and hematological functions within a certain dose range.</p>

The changes in blood flow in sciatic nerve after electrical injury in rabbit / 中华烧伤杂志

<p><b>OBJECTIVE</b>To study the changes in sciatic nerve blood flow and the expression of collagen type I after electric injury of rabbit nerve with different voltages.</p><p><b>METHODS</b>Thirty-six healty rabbits were randomized into 3 groups before receiving injury with electricity in voltages, i.e. 50 v, 75 v, and 100 v groups. The changes in blood flow of sciatic nerve were observed with Laser Doppler Flowmeter immediately after injury and 1, 4, 8 weeks after injury. The changes in the expression of collagen type I was observed by immunohistochemical method, and the positive expression rate was calculated.</p><p><b>RESULTS</b>The sciatic nerve blood flow increased in all groups immediately after electric injury. In the 75 v and 100v groups, the nerve blood flow [(53 +/- 3 ), (48 +/- 5) PU] was obviously lower than that of normal value [(62 +/- 4) PU, P < 0.05]. There was little collagen type I deposition in 50 v group, while brown collagenous fibers in epineurium and perineurium were observed in 75 v and 100v groups 4 and 8 weeks after injury. The expression of collagen type I in all groups were obviously higher than that of normal value, and that in 75v and 100 v groups were higher than that in 50 v group at bachl time-point (P < 0.01).</p><p><b>CONCLUSION</b>The restoration of sciatic nerve blood flow is postponed following by the injury with increase of the electrical voltage. The collagen deposition after electrical injury may be one of the reasons for nerve blood flow decrease.</p>

Expression and clinical significance of certain apoptosis and angiogenesis factors in hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the expression and clinical significance of some apoptosis and angiogenesis factors in hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The expression of p53, Survivin, matrix metalloproteinases (MMP)-2, MMP-9 and vascular endothelial growth factor (VEGF) in 90 specimens of HCC was detected by immunohistochemistry. Correlations of the factors to the recurrence of HCC after hepatectomy were analyzed.</p><p><b>RESULTS</b>The positive rate of p53, Survivin, MMP-2, MMP-9 and VEGF in HCC tissue was 33.3%, 51.1%, 60.0%, 37.8% and 76.7%, respectively. Of the 5 factors, positive correlation only occurred between the expression of MMP-2 and VEGF, MMP-9 and VEGF. The expression of MMP-2, MMP-9 and VEGF was correlated to the recurrence of HCC. The 1-, 2-, and 3-year tumor-free survival rates were significantly higher in MMP-2 (-) group than in MMP-2 (+) group, and the same results were found with MMP-9 and VEGF. Multivariate analysis revealed that macroscopically disseminated nodules, tumor micrometastasis, serum alpha fetal protein (AFP) level, the expression of MMP-9 and VEGF were independent recurrence risk factors in HCC.</p><p><b>CONCLUSIONS</b>Neither p53 nor Survivin is correlated to the recurrence of HCC; MMPs and VEGF are correlated to the recurrence, and can be used to estimate the risk of postoperative recurrence of HCC.</p>

Clinical treatment of small hepatocellular carcinoma / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the suitable treatment methods of small hepatocellular carcinoma (SHCC).</p><p><b>METHODS</b>From 2000 to 2004, 849 cases of SHCC (< or = c5 cm) were enrolled and divided into two groups: resection group (n = 406) and minimally invasive treatment (MIT) group (n = 443). The survival rates, recurrence rates, and post-treatment complications were compared retrospectively.</p><p><b>RESULTS</b>The 3-year survival rate in the resection group was 72.1%. The 3-year survival rates in tumor < or = 3 cm and tumor 3-5 cm of resection group were 73.3% and 70.5% (P = 0.46), respectively. The 1-year, 2-year, and 3-year recurrence rates in resection group were 13.5%, 29.9%, and 39.8%, respectively. The 3-year survival rates in MIT group was 73.8%. The 3-year survival rates in tumor < or = 3 cm and tumor 3-5 cm of MIT group were 74.7% and 72.2% (P = 0.45), respectively. The 1-year, 2-year, and 3-year recurrence rates in MIT group were 12.6%, 28.7%, and 40.4%, respectively. The 3-year survival rate was significantly different between these two group in tumor < or = 3 cm (P < 0.05). The post-treatment complication rates of these two group were 30.8% and 6.1% (P < 0.01), respectively.</p><p><b>CONCLUSIONS</b>MIT is as effective as the traditional resection in SHCC. However, MIT is superior to the traditional resection in terms of minimal invasion and less post treatment complication rate. The recurrence rate of HCC was still high after treatment. Comprehensive therapies, including MIT, may increase the survival rate and life quality in SHCC patients.</p>

Influence of surgical resection margin in hepatectomy on survival of patients with hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare the effect of different resection margin in hepatectomy on recurrence and survival of patients with hepatocellular carcinoma (HCC), and to determine an appropriate resection margin of hepatectomy for HCC patients.</p><p><b>METHODS</b>152 untreated HCC patients were randomly divided into two groups based on the distal and proximal resection margin according to direction of the portal vein flow. Seventy-four patients in the wide-margin group had a distal resection margin of 2 cm and a proximal of 1 cm away from the edge of the primary tumor, while 78 patients in the narrow-margin group had a resection margin of < 1 cm away from the edge of the primary tumor provided that the margin was proven to be histologically free of cancer cells. The distal and proximal margins were defined. The data were analyzed and compared using Kaplan-Meier survival analysis and Log rank test.</p><p><b>RESULTS</b>The mean overall survival time of patients in wide-margin group and narrow-margin group were 42.0 months and 37.5 months, respectively. The mean tumor-free survival time of these two groups of patients were 35.5 months and 28.8 months, respectively. Patients in wide-margin group had significantly longer overall survival (t = 6.23, P = 0.0125) and tumor-free survival (t = 6.01, P = 0.0142) than patients in the narrow-margin group.</p><p><b>CONCLUSION</b>In hepatectomy for hepatocellular cell carcinoma patients, wide distal resection margin of 2 cm and a proximal of 1 cm away from the edge of the primary tumors according to direction of the portal vein flow may reasonably improve the overall and tumor-free survival.</p>

Effect of vacuum assisted closure on collagenase activity in human chronic wound / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the variations of collagenase activity in exudates of human chronic wound before and after treatment of VAC so as to partly disclose the mechanisms of VAC in promoting chronic wound healing.</p><p><b>METHODS</b>The exudates of acute wounds (postoperative breast cancer) were postoperatively collected at day 1, 2, 3, and in 6 chronic wounds (4 cases of venous ulcer, 2 cases of pressure sore) the exudates were also collected before and 2, 4, 6 days after the treatment with VAC. The type-III collagen degradation from the exudates was checked with zymography timepoint. The types of the collagenase in exudates were evaluated by using doxycycline inhibition.</p><p><b>RESULTS</b>Drainage fluids from acute wound might degrade type-III collagen partly with no changes at day 1, 2, 3. There were high collagenase activities in chronic wound exudates. Exudates from patients before treatment with VAC can degrade type-III collagen completely. But collagenase activities became less and less after VAC. Doxycycline inhibition tests indicated that it can't inhibit the activity of collagenase at 100 micromol/L concentration, until it reached 600 micromol/L.</p><p><b>CONCLUSIONS</b>Collagenase activity is elevated in chronic wounds. VAC may be lower the collagenase activity, prevent collagen from degrading abundantly and promote wound healing. Collagenase is mainly MMP-1 type (fibroblast-type) in chronic wound exudates.</p>

Expression and clinical impact of vascular endothelial growth factor and matrix metalloproteinase-2 in hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To investigate the expression and clinical impact of vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) in hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Ninety specimens obtained from HCC patients were examined immunohistochemically using anti-VEGF and anti-MMP-2 monoclonal antibodies.</p><p><b>RESULTS</b>The positive rates of VEGF and MMP-2 expression in HCC tissues were 76.7% and 60%, respectively. The expression of MMP-2 in HCC tissues was positively correlated with the expression of VEGF (r(s) = 0.32) and both were positively correlated with recurrence (or metastasis) after hepatectomy (r(s) = 0.31, r(s) = 0.32). 2-year tumor-free survival rates of VEGF- group, VEGF+ group and VEGF++ group were 71.4%, 43.5%, 30.4%, respectively, (P < 0.01), while MMP-2- group 66.7% and MMP-2+ group 32.8% (P < 0.01). Multivariate analysis revealed that the expression of VEGF and MMP-2 in HCC tissues, tumor microthrombus and pre-operative dissemination to lymph nodes were independent recurrence (or metastasis) risk factors.</p><p><b>CONCLUSION</b>The expression of VEGF and MMP-2 in HCC tissues, and clinicopathological features (tumor microthrombus and pre-operative dissemination to lymph nodes), could be regarded as valuable indicators for prediction of recurrence (or metastasis) risk in HCC patients.</p>

Transcatheter arterial chemoembolization in the treatment of hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To evaluate the effect of transcatheter arterial chemoembolization (TACE) on the result and the prognosis of hepatocellular carcinoma (HCC) at systemic, cellular, genetic and molecular levels.</p><p><b>METHODS</b>Patients with histologically proven HCC were divided into two groups: 81 patients in Group A undergoing TACE before operation and 58 patients in Group B treated with surgical resection alone. The degree of apoptosis was analyzed by transferase -mediated dUTP nick end labeling (TUNEL) stain. The expressions of bcl-2, bax, p53, Ki-67 and PCNA proteins were detected by immunohistochemical method. The changes of these markers, tumor necrosis, encapsulation, volume, metastasis, recurrence and cumulative survival in each group were retrospectively analyzed.</p><p><b>RESULTS</b>The more tumor necrosis, apoptosis, encapsulation and tumor shrinkage observed, and the less recurrence resulted from TACE in group A than in group B. The cumulative 1-, 2-, and 3-year survival rates and median survival time were 84.0%, 67.9%, 40.7%, and 803.3 days in group A patients; they were 72.4%, 55.2%, 24.1%, and 742.5 days in group B patients (P < 0.05).</p><p><b>CONCLUSION</b>Preoperative transcatheter arterial chemoembolization is safe and effective as an auxiliary preparatory means before surgical treatment of hepatocellular carcinoma as it may improve the survival of HCC patients.</p>

Randomized clinical trial of percutaneous radiofrequency ablation plus absolute ethanol injection compared with radiofrequency ablation alone for small hepatocellular carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To compare percutaneous radiofrequency ablation (RFA) alone and RFA combined with percutaneous absolute ethanol injection (RFA-PEI) in the treatment of single hepatocellular carcinoma smaller than 5.0 cm in diameter.</p><p><b>METHODS</b>From Jan. 2002 till Dec. 2003, eighty-six patients were put on a randomized clinical trial. For RFA, the American Radiotherapeutics RF 2000 machine and 3.5 cm/LEE VEEN + electroradiofrequency needle was introduced under ultra-beta sound guide. For tumor < 3 cm, the needle was left in center of tumor and for tumor > 3 cm, the needle was first left in situ and twisted by 180 as it was withdrawn for every 1 cm, till the surface border was reached. Power output was increased from 20 W and raised by 10-20 W per minute until the impedance became rapidly raised and the output decreased. Forty-five patients were treated with RFA-PEI and 41 with RFA, with each group divided into group A (diameter < or = 3.0 cm) and group B (diameter = 3.1-5.0 cm) according to tumor size. The overall and local recurrence-free survival was used to evaluate the treatment effect.</p><p><b>RESULTS</b>There was no mortality or serious morbidity in either group. The 6-, 12-, 18-, 24-month survival rate of RFA-PEI and RFA was 88.9%, 84.0%, 80.6%, 73.9% and 87.7%, 78.3%, 73.7%, 61.4% (P = 0.6181), respectively; and the local recurrence-free survival rates was 95.4%, 95.4%, 87.8%, 73.7% and 94.9%, 72.7%, 68.4%, 57.1% (P = 0.0393), respectively. The local recurrence-free survival rate in group A was 95.7%, 95.7%, 79.1%, 79.1% and 92.3%, 83.2%, 81.3%, 65.9% (P = 0.3679), respectively; while in group B was 95.0%, 95.0%, 95.0%, 72.6% and 100.0%, 58.3%, 45.4%, 45.4% (P = 0.0440).</p><p><b>CONCLUSION</b>Percutaneous radiofrequency ablation combined with percutaneous absolute ethanol injection is safe, and more effective and easily practiced than percutaneous radiofrequency ablation alone in the treatment of small hepatocellular carcinoma, especially when the tumor is greater than 3 cm in diameter, for which RFA-PEI may be able to reduce local recurrence and improve long-term survival.</p>

Effect of vacuum-assisted closure on the expression of proto-oncogenes and its significance during wound healing / 中华整形外科杂志

<p><b>OBJECTIVE</b>To study the effects of VAC on starting the process of wound healing and decreasing apoptosis.</p><p><b>METHODS</b>To examine the variations in expression of proto-oncogenes c-myc, c-jun and Bcl-2 in pig wound model with acute full-thickness skin defect and human chronic wounds by immunohistochemistry, calculate the numbers of expressive positive cells and the labelling index (LI), and observe the process of wound healing.</p><p><b>RESULTS</b>(1) In pig experiment, the wound in experimental group was very clean and without obvious exudates, many neoepiderm and granulation tissue rapidly appeared or formed after 6 days, and healed completely by the 25th day. On the contrary, in the wound of control group, more exudates and blood crust could be seen and fewer neoepiderm and granulation tissue appeared after 6 days and was healed by 30th day. Immediately after the wound was created, the expression of c-myc, c-jun and Bcl-2 was lower and mainly situated in nucleus or cytoplasma of the basilar cells. After the wound was created in control group, or after starting the VAC treatment in experimental group, their expression rapidly and obviously increased, the distribution of the positive cells also became enlarged, but the amount of expression decreased rapidly after the expressive peak have reached. In the successive 12 days following the wound was created, the expression of c-myc, c-jun and Bcl-2 in the experimental group was constantly higher than that of the control group. (2) In human chronic wounds, there wasn't obvious secretions and more healthy granulation tissue was rapidly formed after VAC treatment. The expression of c-jun was mainly located in cytoplasma of basilar cells of epithelium, dermal fibroblasts and inflammatory cells, and the positive cell and labelling index obviously decreased. The expression of c-myc and Bcl-2 was mainly in cytoplasma of basilar cells, but the amount of expression and the labelling index became obviously increased after VAC treatment.</p><p><b>CONCLUSIONS</b>VAC could rapidly start the healing course of the pig' s acute skin wound and human chronic wound, decrease apoptosis of the reparative cells, so as to accelerate wound healing.</p>