Résumé
Objective Toinvestigatetheshort-termefficacyoftranscatheterarterialchemoembolization(TACE)combinedwith microwaveablation (MWA;TACE-MWA)inthetreatmentofmultinodularhepatocellularcarcinoma (HCC).Methods 58patients withmultinodularHCCtreatedintheinterventionalmedicinecenterfromJanuary2015toJanuary2017wereincludedingradeAor B.34cases(groupA)receivedTACEand24cases(groupB)underwentTACE-MWAtherapy.Theshort-termefficacywasevaluatedbyfollow-upandanalysisofthetimetoprogression (TTP),localrecurrencerate,newlesionrate,andpostoperativecomplicationsinboth groups.Results TheTTPinthetwogroupswas38-240 (106.2±63.1)daysand90-630 (328.5±178.8)daysrespectively.The incidenceofpostoperativecomplicationsintwogroupswas2.9% (1/34)and4.2% (1/24)respectivelyI.ngroupA,thelocalrecurrenceratewas 52.9% (18/34)andthenewfocusratewas76% (26/34);inthegroupB,thelocalrecurrenceratewas8.3% (2/24)andthenewfocusratewas 66.7% (16/24).Thedifferenceoflocalrecurrenceratebetweenthetwogroupswasstatisticallysignificant(P<0.05),whiletheincidenceofnew lesionwasnotsignificantlydifferent (P>0.05).Conclusion TACE-MWAissafeandeffectiveinthetreatmentofmultinodular HCC.ComparingwithtraditionalTACEtreatment,TACE-MWAcansignificantlyimprovedTTPandlocalcontrolrate.
Résumé
BACKGROUND: Scholars have been trying to create a microenvironment similar to the human body, which can induce the directional differentiation of mesenchymal stem cells from human bone marrow, placenta and umbilical cord blood. OBJECTIVE: To compare the neuronal differentiation of human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells induced by co-culture with nerve cells. METHODS: Human bone marrow mesenchymal stem cells, human placental mesenchymal stem cells and human umbilical cord blood mesenchymal stem cells cultured in vitro were co-cultured with nerve cells using the Transwell system. The morphological changes of three kinds of cells in the co-culture system were detected. After co-culture for4-5 days, immunofluorescence staining was used to measure the expression of neuron-specific enolase in cells. Mesenchymal stem cells only cultured in low glucose DMEM medium were used as controls. RESULTS AND CONCLUSION: These three kinds of mesenchymal stem cells were extended, and interconnected processes were detective. The positive expression of neuron-specific enolase was highest in the human umbilical cord blood mesenchymal stem cells followed by human placental mesenchymal stem cells and human bone marrow mesenchymal stem cells in order. In the control group, none of the three kinds of mesenchymal stem cells have neuronal morphology, and the expression of neuron specific enolase was negative for the immunofluorescence staining. To conclude, microenvironment provided by nerve cells can induce these three kinds of mesenchymal stem cells todifferentiate into neurons.