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Objective To analyze the effect of diabetes mellitus (DM) on the prognosis of patients with unresectable hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE).Methods A total of 858 HCC patients,who were admitted to the Affiliated Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,China,during the period from January 2010 to June 2015 to receive TACE,were selected.Among the 858 HCC patients,175 patients suffered from coexisting DM (DM group) and 683 patients had no DM (non-DM group).The differences in general clinical data and overall survival between the two groups were analyzed.Kaplan-Meier method was used to calculate the survival rate,the difference between the two groups was evaluated by log-rank method,and Cox proportional hazards regression was adopted to analyze the prognostic factors of HCC patients after receiving TACE.Results There were no statistically significant differences in sex,age,serum albumin,total bilirubin,prothrombin time,alpha fetoprotein (AFP),Child-Pugh grade,tumor size and number,cirrhosis,number of TACE treatment times and BCLC staging between the two groups (P＞0.05);the fasting blood glucose (FPG)level in DM group was higher than that in non-DM group (P＜0.05).The 1-,3-and5-year survival rates of the DM group were 60.9％,27.5％ and 10.7％ respectively,which were 70.9％,36.0％ and 17.6％ respectively in the non-DM group;the Log-rank test showed that the difference between the two groups was statistically significant (P=0.008).Multivariate Cox proportional hazard regression analysis revealed that the largest tumor diameter ＞5 cm,multiple tumor lesions,AFP＞20 ng/ml,BCLC stage and coexisting DM were independent risk factors that affected the prognosis of HCC patients after receiving TACE.Conclusion The coexisting DM is an independent risk factor that may affect the prognosis of patients with inoperable HCC after receiving TACE.
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Objective To study the influence of ultralow‐frequency transcranial magnetic stimulus(TMS) on the cognitive a‐bility of rats with cerebral ischemia and its mechanism .Methods 60 healthy rats were divided into 4 groups(15 cases each):A (sham‐operation) ,B(model) ,C(TMS) and D(TMS+ H89) .The escape latency time ,times of passing through platform ,expression level of VEGF ,BDNF and nestin protein were compared among 4 groups .Results In the group A ,the escape latency time was (16 .31 ± 2 .33)s ,times passing through platform were (8 .02 ± 1 .76) times ;in group B ,which were (57 .14 ± 2 .89)s and (3 .15 ± 0 .88) times;in group C ,which were (29 .18 ± 1 .95)s and (5 .44 ± 0 .75) times ;in group D ,which were (45 .87 ± 2 .06)s and (4 .16 ± 1 .02) times .Compared with the group A ,the escape latency time in the group B ,C and D was significantly extended ,more‐over that in the group B was longer than that in the group D and C ,the differences were statistically significant (P<0 .05);the times of passing through platform decreased ,which in the group B was less than that in the group D and C ,the differences had sta‐tistical significance(P<0 .05) .The expression levels of VEGF ,BDNF and nestin had statistical differences among various groups (P<0 .05) .Conclusion Low‐frequency TMS can significantly improve the cognitive ability of rats with cerebral ischemia ,its effect is related to the expression of cAMP‐response element binding protein and its following genes(VEGF and BDNF) .
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Objective To investigate whether repeated low-frequency transcranial magnetic stimulation (rTMS) can affect the expression of Kca1.1,Nav1.6,NMDAR1 and/or GAD65 protein in the pyramid layer of the CA3 region of the hippocampus.Methods Fifty rats were randomly divided into an experimental group and a sham group.The former was administered low-frequency rTMS on 14 consecutive days ; the latter were given sham stimulation for 14 days.After the protocols were completed,each group was sub-divided into 6 h,24 h,1 week,3 week and 6 week sub-groups.The rats of each sub-group were sacrificed at the corresponding time points and the expression of KCa1.1,Nav1.6,NMDAR1 and GAD65 in the CA3 region of the hippocampus was examined using immunohistochemical techniques.Results Compared with the sham group,KCa1.1-positive neuron densities increased significantly in the period 6 h to 3 weeks after rTMS.GAD65-positive neuron densities were also elevated significantly from 6 h to 3 weeks.NaV1.6-and NMDAR1-positive neuron densities decreased transiently at 6 h after the completion of the rTMS protocol.Conclusions These results show that low-frequency rTMS can upregulate the expression of KCa1.1 and GAD65,and that the effect lasts for at least 3 weeks.It transiently downregulates the expression of NaV 1.6 and NMDAR1 in the hippocampal CA3 region,at least in rats.These changes may be one of its anti-epileptic mechanisms.
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Objective To study the effects of low-frequency transcranial magnetic stimulation (TMS) on rats with seizures induced by lithium-pilocarpine. Methods Rats were randomly divided into five groups and pre-treated with TMS at 75% of the stimulator's maximum output, but at 0 Hz (the sham group), 0.3 Hz, 0.5 Hz, 0.8 Hz and 1.0 Hz, respectively. After stimulation every day for 2 weeks, a model of acute epilepsy was induced u-sing iithium-pilocarpine. Subsequent behavior and the latencies of seizures were observed, and the severity of the sei- zures was quantitatively evaluated for 90 rain. Results The seizure latencies were significantly prolonged in all the other groups relative to the sham group (P<0.05). The prolongation in the 0.5 Hz and 0.8 Hz groups was signifi-cantly greater than in the 0.3 Hz and 1.0 Hz groups. The severity of seizures in the 0.3 Hz and 1.0 Hz groups was not significantly different from that in the sham group, but most of the rats in the 0.5 Hz group and the 0.8 Hz group experienced much lighter seizures, with seizure severity scores significantly lower than those in the other 3 groups. Conclusions Pretreatment with TMS at 0.3 to 1.0 Hz led to a longer latency of seizure onset. 0.5 Hz and 0.8 Hz gave the longest latencies and showed conspicuous antiepileptie effects.
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Objective To evaluate the efficacy and safety of embolization therapy with NBCA for intracranial arteriovenous fistula (AVF) in infants. Methods Four patients with cerebral arteriovenous fistula were reported, including 3 males and 1 female with nonspecific symptoms and signs, and the diagnosis was made by DSA. Three of them were treated by embolization therapy with NBCA. Results Three of the cases were treated by NBCA, neither death nor complication occurred. Conclusion Intracranial AVF is rare in childhood. Endovascular treatment with NBCA is effective and safe, but the long-term effect has to be comfirmed by follow-up study. (J Intervent Radiol, 2006, 15: 451-452)
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BACKGROUND: Since the discovery of the fact that activin can promote the survival of retinal neurocyte in chicken,the effects of activin in nervous system receives recognition. As discovered recently,hippocampal activin βA mRNA expression up-regulates in multiple brain injury animal models including ischemia and hypoxia; however,the change of activin βA mRNA expression after epilepsy is waiting for investigation.OBJECTIVE: To observe hippocampal activin βA mRNA expression at different time point after pilocarpine (PC) -induced epilepsy in mouse to explore its mechanism.DESIGN: A randomized controlled experimental study based on the experimental animals.SETTING: Department of neurology in a university affiliated hospital and the institute of neurology in a university.MATERIALS: The study was conducted in the Institute of Neurology of Huashan Hospital Affiliated to Fudan University and the Department of Pathology of Shanghai Medical College between November 2001 and July 2002. Totally 168 eight to ten-week old healthy male C57BL/6 mice with a body mass between 20 g and 25 g were obtained from Shanghai Experimental Animal Center,Chinese Academy of Science.INTERVENTIONS: 350 mg/kg(10 g/L) of PC was injected into the abdominal cavity in the mice of study group,in which 1 mg/kg of scopolamine (SC) was injected at 30 minutes before the injection of PC to antagonize its peripheral cholinergic reaction. Status epilepticus(SE) model mouse was the mouse with continuous mgoelonus or generalized seizure of rigid clonus that lasted for 1 hour after the injection of PC. Valium(4 mg/kg) was immediately injected after the modeling to terminate seizure. Same dose of Valium was injected into non-SE(NSE) mice after 1.5 hours of PC injection. Saline was used to replace PC to inject into mice of control group,and the rest disposals of control group were as same as that of study group. SE mice,NSE mice and control mice were randomly divided into six subgroups including 0hour,1 hour,3 hours,6 hours,24 hours and 48 hours subgroups according to the time point after modeling with 6 mice of each subgroup(mice of NSE group and subgroups of 0 hour time point were not included into analysis of hybridization in situ).MAIN OUTCOME MEASURES: Hippocampal activin βA mRNA expression of different time point in SE mice and NSE mice were observed by RT-PCR; the distribution of hippocampal activin βA mRNA expression at different time points in mice were observed by hybridization in situ.RESULTS: There was no significant change of hippocampal activin βA mRNA expression at different time point in mice of NSE group and control group. In SE group,activin βA mRNA(0.49 ± 0. 11) had a transient significant decrease at the beginning(0 hour),which rapidly returned to control level(0. 74 ±0. 13) at 1 hour(0.73 ±0. 12) . Activin βA mRNA continuously increased and reached (0.97 ±0. 24) at 3 hours,(1.34 ±0. 19) at 6 hours,maintained (0.98 ±0. 17) until 24 hours,and decreased to (0. 83 ± 0.09) at 48 hours afterwards,which was slightly higher than control level. Compared with control group,the increases at 3 hours,6 hours and 24hours were significant( t = 2. 668,6. 289,2. 916,P ＜ 0. 001 - 0. 05). The significant up-regulation of activin βA mRNA expression was occurred earliest in hippocampal CA2 and DG regions at 3 hours after SE,and the significant expressions also could be seen in CA3 region after 6 hours. There were expressions in only CA2 and CA3 regions after 24 hours,while there were very few positive cells in CA2 region after 48 hours.CONCLUSION: PC-induced SE could significantly up-regulate hippocampal activin βA mRNA expression,while NSE has no such up-regulative effect. The up-regulation of hippocampal activin βA mRNA expression might be an endogenous protective effect of neuron on antagonizing excitatory injury.
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Objective To evaluate the methods and effect of balloon catheter dilation of esophageal caustic ingestion stenosis in children. Methods We analysed 18 cases, including 10 cases of esophageal stenosis due to ingestion of sulphuric acid, 7 cases of esophageal stenosis caused by ingestion of sodium carbonate and the last one through ingestion of chemical materials include zinc sulphate. Barium esophagogram was taken before dilation for every patient and the balloon size varied from 4 mm?40 mm to 16 mm?40 mm or 20 mm?40 mm in diameter was selected for the procedure. Results 18 cases were all successful in dilation by balloon catheter, without esophageal perforation and other complications. The satisfactory results maintained from six months to thirty months with remarkable improvement clinicoly. Conclusions Balloon catheter dilation is a simple, safe and reliable method for the treatment of esophageal caustic ingestion stenosis in children, and should be recommended as the first choice.
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Objective To study the effect of proteasome on nigral degeneration and Lewy body formation. Methods By stereotaxic unilateral injection of different doses of lactacystin, a selective proteasome inhibitor, into the substantia nigral pars compacta of rats, the spontaneous and apomorphine induced contralateral behaviors of rats were observed. Nigral degeneration and Lewy body were viewed by HE staining; expressions of ? synuclein and tyrosine hydroxylase in nigral cells were investigated by immunohistochemistry. Contents of dopamine and homovanillic acid were determined by HPLC. Results There were no difference between 0 2 ?g group and control. Animals treated with 2 ?g and 8 ?g lactacystin developed progressively bradykinetic and displayed contralateral head tilting and tremor; apomorphine induced contralateral behavior was notably observed in rats of 8 ?g group; 3 weeks later, nigral degeneration were present in 2 ?g and 8 ?g groups; some of nigral cells contained acidophilic Lewy body with intense immune response to ? synuclein; the number of tyrosine hydroxylase positive cells in 2 ?g and 8 ?g groups were decreased by 68 24% ( P
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Objective To evaluate the methods and effect of balloon catheter dilation of benign esophageal stenosis in children. Methods 9 cases had an anastomotic stenosis after surgical correction of esophageal atresia; 11 cases of esophageal stenosis due to ingestion of caustics; one case had an lower esophageal stenosis after Nissen surgery and one case after gastroesophagoplasty. Age ranged from 17 days to 7 years. Each case had a barium esophagram before balloon dilation. The balloon size varied from 3 to 10 mm in diameter. Results 21 cases were successful after dilation of balloon catheter. There were no esophageal perforation and complications. The satisfactory results maintained from six months to thirty months. Conclusions Balloon catheter dilation is a simple、safe and reliable method for the treatment of benign esophageal strictures in children as the first choice.
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Objective To evaluate the application and safety of angiography in infants.Methods Eighteen infants with diagnosis of clinics,CT and MRI as hemangioma, hepatic and renal tumor and cerebral vascular diseases were undertaken digital subtraction angiography(DSA). Results All the cases were found to have anomalous lesions including hemangioma racemosum in 3 cases, capillary hemangioma in 1, hepatoblastoma in 3, renal Wilm's tumor in 1, renal rhabdomyosarcoma in 1, liver arteriovenous fistula (AVF) in 1, Galenic arteriovenous malformation (AVM) in 1,Sturge-Weber Syndrome in 1, AVM OR AVF in the craniofacial region in 2 and pre-operation cerebral angiography of PNET in 2. Conclusions DSA in infants is safe and reliable with extensive clinical application.
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Objective To evaluate the role of interventional therapy in Wilm's tumor, renal vascular lesions and ureter stricture in children. Methods Thirty-eight cases were analysed, including 18 cases of Wilm's tumor treated with preprocedural chemotherapy and embolization through renal artery, and 13 cases of unknown-reason hypertension with selective renal arterial angiography for venous blood renin including undergone some patients PTA. Six cases of ureter stricture were dilated with balloon and 1 with hematurea by small aerial embolization. Results After embolization, Wilm's tumors showed reduction in vascularization and reduction in size too. The surrounding tissue of the tumor had a clear demarcation with the normal tissue, decreasing the dissemination to blood and distal metastasis. Renal vascular hypertension was clearly diagnosed and treated, and the increase of renin was helpful to the diagnosis of unknown-reason hypertension. And the obstruction of ureter was improved. Conclusions Interventional therapy is feasible in the application of urinary system diseases with great significance clinically.
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Objective To report the results of balloon catheter dilation in 13 infants with anastomotic stenosis after surgical correction of esophageal atresia. Methods Thirteen cases of anastomotic stenosis after surgical correction of esophageal atresia were enrolled, age ranging from 3 to 10 years. Barium esophagography before balloon dilation showed the diameter of esophageal stenosis ranging 1 to 3 mm and the stenosis was dilated by using balloons of 6 to 12 mm diameter. Results All the 13 cases obtained complete resolution of the stenosis after dilation for twice or thrice. There was no esophageal perforation or other complications with a period of clinical symptomless of 6 to 30 months. Conclusions Ballon catheter dilation is a simple, safe and reliable method for treating anastomotic esophageal stenosis in infants.