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Objective To investigate the efficacy and safety of using various sedative regimens during transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).Methods 156 HCC patients were randomly divided into four groups.The control group (n =30):intramuscular injection of 10 ml saline;The diazepam group (n =42):intramuscular injection of 10 mg of diazepam;The promethazine group (n =42):intramuscular injection of promethazine 25 mg;and The combined group (n =42):intramuscular injection of 10 mg of diazepam and promethazine 25 mg.Results The blood pressure and heart rate of the control group was significantly higher than the other three groups,while the combined group was significantly lower than the diazepam and the promethazine groups.The sedative rating:Grade 0 of the four groups were:30,11,18,0 patients respectively;Grade 1 of the four groups were:0,21,15,24 patients respectively;Grade 2 of the four groups were:0,10,9,18 patients respectively;No patients were in grades 3 and 4.The anxiety score of the control group was significantly higher than the other three groups.There was no significant difference in complications among the four groups.Conclusion Diazepam and/or promethazine could be used effectively and safely during TACE,and they could reduce stress response of HCC patients during TACE,and improved tolerance of TACE.
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Objective To investigate the efficacy and safety of endovascular treatment for subclavian steal syndrome (SSS). Methods During the period from April 2004 to Feb. 2013 at authors’ hospital, a total of 12 patients with SSS, including subclavian artery stenosis (n = 7) and occlusion (n = 5), underwent endovascular treatment. Percutaneous transluminal angioplasty (PTA) was carried out in 4 cases and stent implantation in 8 cases. The clinical data were retrospectively analyzed. Results Technical success rate was 100%(12/12). The diseased side/healthy side blood pressure ratio increased from preoperative (0.46 ± 0.28) to postoperative (0.89 ± 0.32), and the difference was statistically significant (P < 0.05). After the treatment, the clinical symptoms were improved in different degrees in all patients. During the follow - up period lasting for (16.7 ± 7.9) months, restenosis occurred in one case with left SSS thirteen months after PTA, and the condition was improved after stenting angioplasty. Another patient with severe subclavian artery stenosis developed peripheral micro- vascular thrombosis of the diseased limb in 23 days after PTA, which was relieved after medication to improve microcirculation and vasodilation. No severe complications such as stroke occurred. Conclusion For subclavian artery steal syndrome, endovascular management is a minimally invasive, safe and effective treatment. It can significantly relieve the clinical symptoms due to vertebral- basilar artery insufficiency caused by subclavian steal syndrome, and improve limb weakness, low body temperature, etc. Therefore, this technique should be recommended in clinical practice.
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Objective To investigate the distribution and severity of cerebral artery stenosis and the prognosis in elderly patients with acute cerebral infarction using digital subtraction angiography (DSA). Methods The 432 elderly patients with acute cerebral ischemia infarction underwent DSA,and they were divided into two groups: elderly group (n= 320) and non-elderly group (n= 112). The characteristics of distribution and severity of cerebral artery stenosis, the relationship between artery stenosis and relative risk factors, and the prognosis of acute cerebral infarction were analyzed.Results In elderly group, 270 cases (84.3%) had intra- and extra- cranial artery stenosis, of which 98 patients (30.6%) with pure extracranial arterial stenosis, 132 patients (41.3%) with combined extra- and intra-cranial artery stenosis. They were both significantly higher than the corresponding data in non-elderly group [23 cases (20.5%) and 28 cases (25%), P＜0.05 and 0.01]. The prevalences of moderate and severe cerebral artery stenosises were higher in elderly group than in nonelderly group [224 locations (52.1%) vs. 51 locations (40.8%), P＜0. 05]. The number of patients with previous history of cerebrovascular disease was much more and the prognosis was much worse in elderly group than in non-elderly group (both P＜0.05), Conclusions The elderly patients with cerebral infarction have severer cerebral artery stenosis, increased proportion of multivessel disease and poor prognosis. So it is very important to take aggressive treatment as soon as possible, and to make secondary prevention and effective rehabilitation so as to improve their prognosis.
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Objective To develop a method of loop-mediated isothermal amplification(LAMP) to Staphyloccocus aureus rapidly, specifically, sensitively and simply suited for the primary health agency. Methods According to conserved nucleotide of Staphyloccocus aureus and principle of LAMP, we designed a set of LAMP primers and set up an LAMP reaction system. We evaluated the specificity, sensitivity and re-peatability of the method. In addition,we evaluated the linearity between initial template copies 1g value and reaction time (the time when the fluorescent value is 1×10~4). Results The optimal assay showed that it was no cross-reaction with other closely related members of pathogens, and was 10 times more sensitive than PCR. The coefficient of variance between tests was less than 5% ,and the kinetics curves showed a good line-arity between initial template copies lg value and reaction time(r~2=0. 9501). The detection activity could be finished within 1 h with the sensitivity of LAMP was 100% and the specificity was 94.4%, and the accuracy was 96.6%. Conclusion These findings demonstrated that the LAMP had the potential clinical application for detection and differentiation of Staphyloccocus aureus in the public health agency for its sensitive, specific and simple feature.
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Objective To explore the significance of serum VEGF-A and VEGF-C levels in relation to conventional clinopathological parameters of gastric carcinoma,investigate the relationship between serum VEGF-C level and expression of VEGF-C in carcinoma tissue.Methods 28 patients with gastric carcinoma and 21 healthy controls were included in the current study.Serum VEGF-C and VEGF-A levels were assessed by enzymed-linked immunosorbent assay(ELISA).The expression of VEGF-C protein in gastric carcinoma tissue from 28 patients who underwent curative gastrectomy was examined by immunohistochemistry.Results Serum VEGF-C and VEGF-A levels were higher in patients with gastric carcinoma than those in the healthy controls(P