Short-term efficacy assessment of transarterial chemoembolization combined with radioactive iodine therapy in primary hepatocellular carcinoma.

BACKGROUND: Transarterial chemoembolization (TACE) is an effective treatment for primary hepatocellular carcinoma (PHC). Radioactive iodine therapy has been used in the treatment of advanced PHC, especially in patients with portal vein tumor thrombosis. However, data on the therapeutic effect of TACE combined with radioactive iodine therapy in PHC are scarce. AIM: To investigate the clinical efficacy of TACE combined with radioactive iodine implantation therapy in advanced PHC via perfusion computed tomography (CT). METHODS: For this study, 98 advanced PHC patients were recruited and divided randomly into the study and control groups. Patients in the study group were treated with TACE combined radioactive iodine implantation therapy. Patients in the control group were treated with only TACE. The tumor lesion length, clinical effect, serum alpha-fetoprotein (AFP) and CT perfusion parameters were compared before and after therapy, and statistical analysis was performed. RESULTS: There was no significant difference in tumor length and serum AFP between the study and control groups (P > 0.05) before treatment. However, the tumor length and serum AFP in the study group were lower than those in the control group 1 mo and 3 mo after therapy. After 3 mo of treatment, the complete and partial remission rate of the study group was 93.88%, which was significantly higher than the control group (77.55%) (P < 0.05). Before treatment, there were no significant differences between the two groups on the perfusion CT variables, including the lesion blood volume, permeability surface, blood flow, hepatic artery flow and mean transit time (P > 0.05). After 3 mo of treatment, all perfusion CT variables were lower in the study group compared to the control group (P < 0.05). The survival time of patients in the study group was 22 mo compared to 18 mo in the control group, which was significantly different [log rank (Mantel-Cox) = 4.318, P = 0.038]. CONCLUSION: TACE combined with radioactive iodine implantation in the treatment of advanced PHC can inhibit the formation of blood vessels in tumor tissue and reduce the perfusion level of tumor lesions, thereby improving the clinical efficacy and prolonging the survival time of patients.

Posterior spinal canal decompression with screw fixation and reconstruction of three vertebral column for thoracolumbar burst fractures complicated with nerve injury / 中国骨伤

<p><b>OBJECTIVE</b>To explore the feasibility and clinical effect of posterior spinal canal decompression with pedicle screw fixation and reconstruction of anterior and middle vertebral column for thoracolumbar burst fractures complicated with nerve injury.</p><p><b>METHODS</b>A total of 36 patients with thoracolumbar burst fractures treated from March 2011 to April 2016 were enrolled in the retrospective study. There were 20 males and 16 females, aged from 21 to 52 years old with an average of 37.6 years. All the fractures were located on a single segment, 8 cases of T11₁₁, 10 cases of T₁₂, 12 cases of L₁, 6 cases of L₂. According to thoracolumbar injury classification and severity score(TLICS) system, the score was 7 to 9 points, with an average of 7.4 points. According to the America Spine Injury Association(ASIA) grade, 4 cases were type A, 10 cases were type B, 14 cases were type C, 8 cases were type D. All the patients underwent posterior spinal canal decompression with pedicle screw fixation and reconstruction of anterior and middle vertebral column. The recovery of nerve function was evaluated by ASIA grading. The correction of kyphosis(Cobb angle), the volume change of injuried spinal canal, the change of anterior border height of injury vertebra which can be observed by X-rays;the internal fixation loosening and breakage and all the information of bone fusion were recorded.</p><p><b>RESULTS</b>All the operations were successful, the mean operative time and intraoperative blood loss were(2.8±0.3) h (2.1 to 3.5 h) and (880±120) ml(550 to 1 350 ml), respectively. All the incisions got primary healing. All the patients were followed up for 12 to 28 months with an average of 18.4 months. All the patients obtained satisfactory bone fusion. No pseudoarticulation formation was found, and there was no loosening, breakage of pedicle screws or displacement of titanium mesh. Neurological function was improved in different degree, except in one patient with grade A and another one with grade B. According to the ASIA grade, there were 1 case of type A, 1 case of type B, 7 cases of type C, 10 cases of type D and 17 cases of type E, postoperatively. At 3 days after operative, the anterior border height of injury vertebra, Cobb angle and the volume changes of injury spinal canal were obviously improved(<0.05), and there was no significant difference between postoperative at 3 days and final follow-up(>0.05).</p><p><b>CONCLUSIONS</b>Spinal canal decompression with screw fixation and reconstruction of anterior and middle vertebral column through posterior midline approach is a safe and effective method in the treatment of thoracolumbar burst fractures with nerve injury, it is worthy to be popularized. It can complete the spinal canal decompression of 360 degree, reduction of fractures and reconstruction of vertebral three-column at the same time through a single posterior approach. The advantages includes less trauma, perfect decompression, good stability and etc.</p>

Perioperative safety analysis of transcatheter arterial chemoembolization for hepatocellular carcinoma patients with preprocedural leukopenia or thrombocytopenia.

Patients with hepatocellular carcinoma (HCC) exhibit a high incidence of concomitant cirrhosis with leukopenia and/or thrombocytopenia. In the present study, perioperative changes in the white blood cell (WBC) and platelet (PLT) counts and associated complications were investigated to assess the safety of transcatheter arterial chemoembolization (TACE) for HCC patients with preprocedural leukopenia or thrombocytopenia. The records of 1,461 HCC patients who received TACE between January 2012 and December 2013 were retrospectively reviewed. The incidence of complications during the perioperative period and changes in the WBC and PLT counts were recorded. A Chi-squared test was used to evaluate the associations between postoperative infection and preprocedural WBC count and between bleeding at the puncture site and preprocedural PLT count. The WBC count of the majority of the patients increased within 3 days and returned to the preprocedural level within 30 days after TACE. The PLT count decreased within 3 days and returned to the preprocedural level within 30 days after TACE. The major complications were liver decompensation (n=66), puncture site bleeding (n=45), infection (n=33), severe thrombocytopenia (n=8), upper gastrointestinal bleeding (n=6), tumor bleeding (n=4) and agranulocytosis (n=3). A Chi-squared test revealed that postoperative infection was not associated with preprocedural WBC count and puncture site bleeding was not associated with decreased PLT count due to hypersplenism. Therefore, TACE was found to be safe for HCC patients with preprocedural thrombocytopenia or leukopenia due to hypersplenism, with a low incidence of major complications during the perioperative period.

Chromosomal and Genetic Analysis of a Human Lung Adenocarcinoma Cell Line OM.

BACKGROUND: Lung cancer has become the leading cause of death in many regions. Carcinogenesis is caused by the stepwise accumulation of genetic and chromosomal changes. The aim of this study was to investigate the chromosome and gene alterations in the human lung adenocarcinoma cell line OM. METHODS: We used Giemsa banding and multiplex fluorescence in situ hybridization focusing on the human lung adenocarcinoma cell line OM to analyze its chromosome alterations. In addition, the gains and losses in the specific chromosome regions were identified by comparative genomic hybridization (CGH) and the amplifications of cancer-related genes were also detected by polymerase chain reaction (PCR). RESULTS: We identified a large number of chromosomal numerical alterations on all chromosomes except chromosome X and 19. Chromosome 10 is the most frequently involved in translocations with six different interchromosomal translocations. CGH revealed the gains on chromosome regions of 3q25.3-28, 5p13, 12q22-23.24, and the losses on 3p25-26, 6p25, 6q26-27, 7q34-36, 8p22-23, 9p21-24, 10q25-26.3, 12p13.31-13.33 and 17p13.1-13.3. And PCR showed the amplification of genes: Membrane metalloendopeptidase (MME), sucrase-isomaltase (SI), butyrylcholinesterase (BCHE), and kininogen (KNG). CONCLUSIONS: The lung adenocarcinoma cell line OM exhibited multiple complex karyotypes, and chromosome 10 was frequently involved in chromosomal translocation, which may play key roles in tumorigenesis. We speculated that the oncogenes may be located at 3q25.3-28, 5p13, 12q22-23.24, while tumor suppressor genes may exist in 3p25-26, 6p25, 6q26-27, 7q34-36, 8p22-23, 9p21-24, 10q25-26.3, 12p13.31-13.33, and 17p13.1-13.3. Moreover, at least four genes (MME, SI, BCHE, and KNG) may be involved in the human lung adenocarcinoma cell line OM.

Clinical classification of Caroli's disease: an analysis of 30 patients.

BACKGROUND: Caroli's disease (CD) is a rare congenital disorder. The early diagnosis of the disease and differentiation of types I and II are of extreme importance to patient survival. This study was designed to review and discuss observations in 30 patients with CD and to clarify the clinical characteristics of the disease. METHODS: The demographic and clinical features, laboratory indicators, imaging findings and pathology results for 30 patients with CD were reviewed retrospectively. RESULTS: Caroli's disease can occur at any age. The average age of onset in the study cohort was 24 years. Patients who presented with symptoms before the age of 40 years were more likely to develop type II CD. Approximately one-third of patients presented without positive signs at original diagnosis and most of these patients were found to have type I CD on pathology. Anaemia, leucopoenia and thrombocytopoenia were more frequent in patients with type II than type I CD. Magnetic resonance cholangiopancreatography (MRCP) and computed tomography (CT) examinations were most useful in diagnosing CD. CONCLUSIONS: No typical symptoms, signs or laboratory indicators are able to distinguish CD from other conditions. Both MRCP and CT were most valuable in diagnosis. The two types of CD may be differentiated by age of onset and routine blood tests.

Validity of complex figure test in differentiation of Alzheimer's disease from non-dementia / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the validity of Complex Figure Test(CFT)in differentiating Alzheimer's disease(AD)from non-dementia.</p><p><b>METHODS</b>Using CFT,we tested 183 AD patients(AD group),1283 cognitively intact individuals(normal control group),and 134 individuals suffered from other diseases that could be easily confused with dementia(confused control group).</p><p><b>RESULTS</b>The CFT score was 38.7±0.2 in the normal control group,35.3±0.8 in confused control group,23.7±0.8 in mild AD group,and 13.2±1.1 in moderate AD group after adjusted for educational level,age,and sex(all P<0.05).With the 5(th) percentage of the overall score as cutoff point,this tool showed a sensitivity of 73.8% and a specificity of 93.8% in differentiating AD from non-dementia.</p><p><b>CONCLUSION</b>CFT is a sensitive and specific tool in the differentiation of AD from non-dementia.</p>

Validity of auditory verbal learning test in diagnosis of Alzheimer's disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>To assess the validity of World Health Organization-University of California-Los Angeles Auditory Verbal Learning Test (WHO-UCLA AVLT) in the diagnosis of Alzheimer's disease (AD).</p><p><b>METHODS</b>Using WHO-UCLA AVLT, we assessed 183 AD patients (AD group),1283 subjects with normal cognitive status (normal control group), and 134 individuals suffered from other diseases easy to be confused with AD (confused control group).</p><p><b>RESULTS</b>The AVLT score was 40.9∓0.3 in normal control group, 30.7∓0.9 in confused control group, 16.6∓1.0 in mild AD group, and 10.2∓1.2 in moderate AD group after adjustment for educational level, age, sex, and rural/urban residence (all P<0.05). With the 5th percentage of the overall score as the cutoff point, this tool showed a sensitivity of 86.3% and a specificity of 93.3%.</p><p><b>CONCLUSION</b>WHO-UCLA CVLT is highly sensitive and specific in the diagnosis of AD.</p>

Segmental root palsy (SRP) after cervical decompression surgery / 中国骨伤

<p><b>OBJECTIVE</b>To explore the occurrence, prevention and cure prognosis of segment root polsy (especially in C5 palsy) after cervical decompression surgery.</p><p><b>METHODS</b>From February 2006 and December 2008,162 patients were operated with cervical decompression through approach for anterior or posterior in our hospital. Among them, 10 cases occurred SRP after operation included 6 males and 4 females aged from 40 to 68 with an average of 53 years old. These cases were treated with dehydration, trophic nerve, hyperbaric oxygenation. The clinical data were retrospective analzed.</p><p><b>RESULTS</b>Ten patients were followed up from 8 months to 3 years with an average of 2.4 years. It was observed that all the patients recovered during a period of 4.4 months on average (ranging from 3 weeks to 8 months).</p><p><b>CONCLUSION</b>SRP(especially in C5 palsy) is one of the common complications of anterior or posterior cervical decompression surgery. SRP is usually the result of various nosogenesis. As there was no effective treatment, conservative treatment is usually adopted with optimistic prognosis.</p>

Technology of minimally invasive percutancous plate osteosynthesis for the treatment of fractures of the distal tibia / 中国骨伤

<p><b>OBJECTIVE</b>To explore the technique and clinical results of minimally invasive percutancous plate osteosynthesis (MIPPO) for the treatment of fractures of the distal tibia.</p><p><b>METHODS</b>A retrospective study was conducted to analyze 65 patients with the distal tibia fractures who had been treated with MIPPO. The average age of the patients was 35 years old (ranging from 13 to 75). There were 42 males and 23 females. According to AO fracture classification for the distal tibial fractures, there were 5 cases of type-A1 fracture, 22 type-A2, 32 type-A3 and 6 type-C1.</p><p><b>RESULTS</b>All the patients were followed up and ranged from 6 to 18 months (averaged 11 months). All the fractures showed union. The time required for the bony union ranged from 3 to 6 months (averaged 4.5 months). The patients were evaluated with respect to functional recovery according to Mazur Grating System for the Ankle. Forty patients obtained excellent results, 19 good and 6 fair. The total satisfactory rate was 90.7%.</p><p><b>CONCLUSION</b>The technology of minimally invasive percutancous plate osteosynthesis (MIPPO)is a safe and effective procedure for the distal tibial fractures with the benefits of limited invasion,less complications and high rate of bone union.</p>

[Design of a novel fuzzy FHR monitor and its applications].

The paper presents a novel fetal heart rate (FHR) detecting system which is a fuzzy counter using the auto-correlation and fuzzy mathematic algorithm. This system is able to deal with the increase and decrease phenomena of FHR, caused by the various interference and noises. It has a higher detection level than ever and a better robust system based on the DSP.

[Low-temperature crystallization on porous titanium and in vivo evaluation on bone-bonding mechanics of the treated titanium].

By the bioactivity technology of Low-Temperature Preparation of Anatase and Rutile Layers on porous Titanium Substrates, CPTi(Commercially pure titanium Phi4.0 mm x 20 mm) was processed and treated as experiment specimens while CPTi was treated as control specimens. Experiment specimens and control specimens were implanted into the holes (4.0 mm in diameter) in rabbit's right and left tibias respectively. After implantation for predetermined periods of 4,8,12, 16 weeks, the specimens were taken out with bone tissues, and were examined by a press-out tester to evaluate the shearing force between the implant and the bone tissue. It is found that the shearing force between the experiment specimen and the bone is more significantly higher than that between the control specimen and the bone, and the bonding time is shorter, the stabilization time is faster. This study has laid down a good foundation for the titanium metal's innovative applications in clinical orthopaedics.

Clinical,cerebrospinal fluid and imaging characteristics of diffuse meningeal melanomatosis:a report of 5 cases / 中华神经科杂志

Objective To investigate the clinical, cerebrospinal fluid and imaging characteristics of 5 cases of diffuse meningeal melanomatosis.Methods The clinical manifestation, features of cerebrospinal fluid and image of 5 patients with meningeal melanomatosis diagnosed by biopsy or autopsy were retrospectively summarized.Results Clinical manifestations of these 5 cases included intracranial hyperpressure, meningeal irritation sign, intracranial nerves impairment, root pain of spinal nerve.In all of these 5 cases, retina hyperpigmentation above left discus opticus was found by funduseope in one case, and congenital melanocytic nevi were found in 4 patients, in which 2 cases were giant congenital melanocytic nevi.Increased lumbar puncture cerebrospinal fluid(CSF)pressure occurred in all cases.Subarachnoid hemorrhage was found in 3 cases.Analysis of CSF revealed increased protein in 4 cases and decreased glucose in 3 cases.Cranial MRI obtained after the intravenous administration of Gd-DTPA showed leptomeningeal enhancement.Malignant melanoma cells were found in CSF of 3 cases.Metastatic malignant melanoma cells were found by biopsy of axillary fossa lymph node in one case.Autopsy of one case revealed diffuse black pigmentation of the leptomeninges, especially in base of skull.Two cases were diagnosed as metastatic meningeal melanomatosis and 3 cases were possible primary meningeal melanomatosis. Conclusions Menings, root of cranial nerve and spinal nerve are impaired in meningeal melanomatosis, which is usually accompanied by congenital melanocytic nevi.Subarachnoid hemorrhage implies meningeal melanomatosis.Diagnosis can be identified when malignant melanoma cells are found in CSF.

Memory-assessing methods which help the clinical diagnosis of early Alzheimer's disease / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate distribution and influence factors of logic memory (LM) modified in assessing and scoring method in normal population and Alzheimer's disease (AD) patients, and definite the cut-off point of the modified scale.</p><p><b>METHODS</b>Totally 183 AD patients, including 118 mild and 65 moderate in degree, 1,417 controls, including 1,283 normal individuals and 134 individuals suffered from other diseases, were recruited in this study. Modified LM was conducted.</p><p><b>RESULTS</b>Educational level (F=354.36, STB=0.46, P=0.0001) was the most obvious factor in demographic data to influence total score in normal control group by a fitting of multiple regression models. The total score increased with the rising of educational level in normal controls (P=0.0001) and other diseases controls (P=0.0001), but not in AD cases (P=0.1365). The total scores were significantly different among normal controls (20.2 +/- 0.2), other diseases controls (17.5 +/- 0.5), mild AD patients (9.6 +/- 0.5) and moderate AD patients (7.1 +/- 0.7) (P=0.0001, P=0.0059), after adjusted educational level, age, sex and rural/urban status by multiple analysis covariance. The sensitivity of cut-off points using modified methods to diagnose AD reasonably increased to 71.98%, while the specificity was 94.11%. According to the sum of long-delayed recall and long-delayed recognition, the sensitivity increased with the rising of educational levels. For education levels at illiteracy, elementary school, junior middle school, senior middle school and above senior middle school, the cut-off points for total score of modified method were 6.5, 9.5, 10.8, 13 and 15.8, respectively, and for sum of long-delayed recall and long-delayed recognition the cut-off points were 5, 6, 8, 9, 10.</p><p><b>CONCLUSIONS</b>When modified LM used as a neuropsychological assessment, it is with high specificity, high accuracy and reasonable sensitivity. It is suitable for the diagnosis of AD in early stages, especially for individuals with high educational levels.</p>