Showing papers by "Chinese PLA General Hospital published in 2005"

Prognostic factors for survival in patients with hepatocellular carcinoma after percutaneous microwave ablation.

Abstract: PURPOSE: To determine the long-term survival and prognostic factors in patients with hepatocellular carcinoma treated with percutaneous microwave ablation. MATERIALS AND METHODS: Institutional review board approval and informed consent were obtained. A database of cases of hepatocellular carcinoma in 288 patients (259 men, 29 women; mean age, 54.8 years ± 11.4 [standard deviation]; age range, 25–82 years) with 477 histologically proved lesions who underwent percutaneous microwave coagulation therapy between May 1994 and October 2002 was retrospectively analyzed. Prognostic factors for survival were evaluated by means of univariate and multivariate analyses. RESULTS: The mean follow-up period after microwave ablation was 31.41 months ± 20.43 (range, 5–106 months). The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates among all 288 patients were 93%, 82%, 72%, 63%, and 51%, respectively. Ninety-three patients (32%) died. Local recurrence or new tumors occurred in 100 patients (35%). Age (P = .836), sex (...

Activation of Peroxisome Proliferator-Activated Receptor-γ and Retinoid X Receptor Inhibits Aromatase Transcription via Nuclear Factor-κB

Abstract: Our previous studies demonstrated that a peroxisome proliferator-activated receptor (PPAR)-γ ligand, troglitazone (TGZ),and/or a retinoid X receptor (RXR) ligand, LG100268 (LG), decreased the aromatase activity in both cultured human ovarian granulosa cells and human granulosa-like tumor KGN cells. In the present study, we further found that a combined treatment of TGZ+LG decreased aromatase promoter II (ArPII) activity in both ovarian KGN cells and fibroblast NIH-3T3 cells in a PPARγ-dependent manner. Furthermore, the inhibition of both aromatase activity and the transcription of ArPII by TGZ+LG was completely eliminated when nuclear factor-κB (NF-κB) signaling was blocked by specific inhibitors, suggesting NF-κB, which is endogenously expressed in both fibroblast and granulosa cells, might be a mediator of this inhibition. Interestingly, activation of NF-κB by either forced expression of the p65 subunit or NF-κB-inducing kinase up-regulated ArPII activity. Positive regulation of aromatase by endogenous ...

Dynamic changes of serum SARS-Coronavirus IgG, pulmonary function and radiography in patients recovering from SARS after hospital discharge

Abstract: The intent of this study was to examine the recovery of individuals who had been hospitalized for severe acute respiratory syndrome (SARS) in the year following their discharge from the hospital Parameters studied included serum levels of SARS coronavirus (SARS-CoV) IgG antibody, tests of lung function, and imaging data to evaluate changes in lung fibrosis In addition, we explored the incidence of femoral head necrosis in some of the individuals recovering from SARS The subjects of this study were 383 clinically diagnosed SARS patients in Beijing, China They were tested regularly for serum levels of SARS-CoV IgG antibody and lung function and were given chest X-rays and/or high resolution computerized tomography (HRCT) examinations at the Chinese PLA General Hospital during the 12 months that followed their release from the hospital Those individuals who were found to have lung diffusion abnormities (transfer coefficient for carbon monoxide [DLCO] < 80% of predicted value [pred]) received regular lung function tests and HRCT examinations in the follow-up phase in order to document the changes in their lung condition Some patients who complained of joint pain were given magnetic resonance imaging (MRI) examinations of their femoral heads Of all the subjects, 812% (311 of 383 patients) tested positive for serum SARS-CoV IgG Of those testing positive, 273% (85 of 311 patients) were suffering from lung diffusion abnormities (DLCO < 80% pred) and 215% (67 of 311 patients) exhibited lung fibrotic changes In the 12 month duration of this study, all of the 40 patients with lung diffusion abnormities who were examined exhibited some improvement of lung function and fibrosis detected by radiography Of the individuals receiving MRI examinations, 231% (18 of 78 patients) showed signs of femoral head necrosis The lack of sero-positive SARS-CoV in some individuals suggests that there may have been some misdiagnosed cases among the subjects included in this study Of those testing positive, the serum levels of SARS-CoV IgG antibody decreased significantly during the 12 months after hospital discharge Additionally, we found that the individuals who had lung fibrosis showed some spontaneous recovery Finally, some of the subjects developed femoral head necrosis

Cosegregation of the G7444A mutation in the mitochondrial COI/tRNASer(UCN) genes with the 12S rRNA A1555G mutation in a Chinese family with aminoglycoside‐induced and nonsyndromic hearing loss

Abstract: We report here on the characterization of a three-generation Chinese family with aminoglycoside-induced and nonsyndromic hearing impairment. Ten of 17 matrilineal relatives exhibited bilateral and sensorineural hearing impairment. Of these, nine matrilineal relatives, who had a history of exposure to aminoglycosides, exhibited variable severity and audiometric configuration of hearing loss. The dose and age at the time of drug administration seemed to be correlated with the severity of the hearing loss experienced by affected individuals. Sequence analysis of the complete mitochondrial genome in the pedigree showed the presence of homoplasmic A1555G mutation and 37 variants belonging to haplogroup D4a. Of those variants, the G7444A mutation is of special interest as the mutation at this position results in a read-through of the stop condon AGA of the COI message, thereby adding three amino acids (Lys-Gln-Lys) to the C-terminal of the polypeptide. Alternatively, the G7444A mutation is adjacent to the site of 3' end endonucleolytic processing of L-strand RNA precursor, spanning tRNA(Ser(UCN)) and ND6 mRNA. Thus, the G7444A mutation, similar to the deafness-associated A7445G mutation, may lead to a defect in the processing of the L-strand RNA precursor, thus influencing the phenotypic expression of the A1555G mutation. These data also imply that nuclear background plays a role in the aminoglycoside ototoxicity associated with the A1555G mutation in this Chinese pedigree.

Autologous skeletal myoblast transplantation improved hemodynamics and left ventricular function in chronic heart failure dogs.

Abstract: Background Previous studies have suggested that autologous skeletal myoblast transplantation (ASMT) improves left ventricular (LV) function in small animals after myocardial infarction. We tested the effects of ASMT on hemodynamics, LV function and remodeling in coronary microembolization-induced chronic heart failure (CHF) in conscious dogs. Methods Nineteen dogs were continuously instrumented with LV pressure sensors and mid-myocardial sonomicrometry crystals for dP/dt max and LV volume determination. Each dog underwent baseline assessment in a conscious state. CHF (20% to 30% reduction in dP/dt max and LV end-diastolic pressure >16 mm Hg) was created by daily coronary microembolizations via a continuously implanted coronary catheter. Skeletal muscle biopsy was performed and myoblasts were isolated and expanded. Then 2.7 × 10 8 to 8.3 × 10 8 myoblasts were injected into the infarcted region of 11 dogs after establishment of CHF. Saline injection (sham) was performed in 8 control dogs. Animals were evaluated every 2 weeks for up to 10 weeks. Global ejection fraction was determined by echocardiography. The end-systolic pressure–end-systolic volume relationship (ESPVR) was analyzed by the Sonomicrometic system. Results Compared with saline injection, ASMT significantly increased dP/dt max (105 ± 9% vs 97 ± 7%, values were expressed as percentage change from baseline CHF, p = 0.013) and ejection fraction (46 ± 3% vs 40 ± 2%, p = 0.034) at 10 weeks after myoblast transplantation. There was a significant leftward and upward shift of the ESPVR back toward normal at 10 weeks after myoblast transplantation ( p = 0.034). Three animals labeled with BrdU myoblasts showed no histologic evidence of viable engraftment. Conclusions ASMT provided mild improvements in hemodynamics and LV function and reduced LV remodeling in conscious dogs with CHF.

Clinical and molecular characterization of a Chinese patient with auditory neuropathy associated with mitochondrial 12S rRNA T1095C mutation.

Abstract: Mutations in mitochondrial DNA (mtDNA), particularly those in the 12S rRNA gene, have been shown to be associated with sensorineural hearing loss. Recently, a systematic and extended mutation screening of the mitochondrial 12S rRNA gene has been initiated in the large clinical population of the Otology Clinic at the Chinese PLA General Hospital with the aim of identifying mtDNA mutations associated with hearing loss. Here we report the clinical and molecular characterization of a Chinese patient with auditory neuropathy. Sequence analysis of mtDNA in this patient identified a T-to-C transition at position 1095 (T1095C) in the 12S rRNA gene and other nucleotide changes. The T1095C mutation is expected to disrupt an evolutionarily conserved A-to-U base-pair, which is at the highly conserved P-site of 12S rRNA. The T1095C mutation has also been found to be associated with hearing loss in several unrelated families. Among other nucleotide changes, two novel variants: the I175V mutation in the CO2 and the V112M mutation in the ND6 localize at highly evolutionarily conserved residues from different organisms. Furthermore, the absence of mutation in the otoferlin related to auditory neuropathy showed that otoferlin may not be involved in the phenotypic expression of T1095C mutation in this subject. These data suggest that the T1095C mutation may be associated with auditory neuropathy in this subject, and two novel variants I175V and V112M may play a role in the phenotypic expression of the T1095C mutation.

Mechanism of transcriptional regulation of LRP16 gene expression by 17-β estradiol in MCF-7 human breast cancer cells

Abstract: LRP16 gene expression is induced by 17- estradiol (E2) via estrogen receptor alpha (ER) in MCF-7 human breast cancer cells. A previous study also demonstrated that ectopic expression of LRP16 gene promoted MCF-7 cell proliferation. To explore the mechanism of hormone-induced LRP16 gene expression, the LRP16 gene promoter region (–2600 to –24 bp upstream of the LRP16 gene translation starting site) was analyzed in the present study by using different 58-truncated constructs, and a luciferase reporter. The 58-flanking sequence of –676 to –24 bp (pGL3-S5) was found to be E2-responsive. After exchange of the fragment from –213 to –24 bp with the TK gene proximal promoter region in pGL3-S5, E2 still induced reporter gene activity in MCF-7 and HeLa cells. Sequence analysis showed that the pGL3-S6 (–676 to –214) sequence contains two motifs that may contribute to E2-induced transactivation; namely, an estrogen-responsive element (ERE) half-site/Sp1 at –246 to –227 bp and an E-box site at –225 to –219 bp. Further deletion and mutation analysis of these two motifs indicated that both the 1/2 ERE and Sp1 binding sites were required for E2 action, while E-box deletion did not affect the luciferase activity in MCF-7 and HeLa cells. The results of gel mobility shift and chromatin immunoprecipitation assays confirmed that both ER and Sp1 were required for hormone-induced transactivation, which involved both ER and Sp1 directly binding to DNA. Taken together, these findings suggest that ER and Sp1 play a role in activation of the human LRP16 gene promoter.

A comparison of urinary albumin excretion rate and microalbuminuria in various glucose tolerance subjects.

Abstract: Aims To investigate the difference of urinary albumin excretion rate (UAER) and microalbuminuria (MAU) in various glucose tolerance subjects, especially between isolated-impaired glucose tolerance subjects and isolated-impaired fasting glycaemia subjects. Methods A total of 2934 subjects were divided into five groups with various glucose tolerances, based on a 75-g oral glucose tolerance test. Microalbuminuria was defined when urinary albumin excretion rate was between 20 and 200 µg/min. Results (i) The UAER in the newly diagnosed Type 2 diabetes mellitus group, impaired glucose tolerance/impaired fasting glycaemia group and isolated-impaired glucose tolerance group were all higher than that in the isolated-impaired fasting glycaemia group and normal glucose tolerance group, but it was comparable between isolated-impaired fasting glycemia group and normal glucose tolerance group. The prevalence of MAU and the odds ratio for MAU with adjustment for age and sex in various glucose tolerance groups showed the same trend as the UAER. (ii) After adjusting for age and sex, there is a significant association between logUAER and independent risk factors (partial correlation coefficients: r = 0.26 for 2-h post-challenge blood glucose, r = 0.26 for systolic blood pressure, r = 0.27 for diastolic blood pressure, r = 0.27 for body mass index and r = −0.13 for high density lipoprotein-cholesterol, all P < 0.001). The risks for MAU were 2-h post-challenge blood glucose, body mass index and diastolic blood pressure, while high density lipoprotein-cholesterol was protective. Conclusions The urinary albumin excretion rate and prevalence of microalbuminuria were higher in isolated-impaired glucose tolerance subjects than those in isolated-impaired fasting glycaemia subjects. At early abnormal glucose tolerance stage, the increasing post-challenge glycaemia might be a more important risk factor for urinary albumin excretion rate and microalbuminuria than increasing fasting glycaemia.

Selection of rifampicin-resistant Staphylococcus aureus during tuberculosis therapy: concurrent bacterial eradication and acquisition of resistance

Abstract: Background and objectives: Acquired antimicrobial resistance is commonly attributed to regimens that expose bacteria to subinhibitory concentrations; consequently, eradication of susceptible cells is advocated. The mutant selection window hypothesis predicts that resistance can be acquired even when inhibitory concentrations are exceeded and susceptible bacteria are eradicated. The objective was to test that prediction clinically. Methods: Tuberculosis patients (n = 372) were sampled for nasal colonization by Staphylococcus aureus at the beginning of anti-tuberculosis therapy with rifampicin-containing regimens and again after 2 and 4 weeks. Rifampicin susceptibility of S. aureus was determined, and S. aureus isolates from patients developing acquired resistance were examined by molecular strain typing. Diabetes patients (n = 200) served as untreated controls. Results: Nasal colonization was 17% and 20% for the tuberculosis and diabetes patients, respectively. Four patients were initially colonized with rifampicin-resistant S. aureus and were excluded from further sampling. Initiation of anti-tuberculosis therapy eradicated S. aureus nasal colonization in 53/58 tuberculosispatientswhileallowingacquisitionofrifampicinresistancein5/58.Pulsed-fieldgelelectrophoresis (PFGE) band patterns and protein A repeat sequence determination differed in S. aureus isolated from different patients but was identical in isolates obtained from the same patient before and after acquisition of resistance. No resistance was acquired in untreated control patients, which differed statistically from treated patients (P = 0.025).

Evaluation of modifying collagen matrix with RGD peptide through periodate oxidation.

Abstract: The aim of the study is to evaluate the effect of modifying collagen matrices with Arg-Gly-Asp (RGD) peptide through periodate oxidation. The collagen matrices were modified with RGD peptide, by periodate activation. The modified collagen matrices and unmodified matrices were characterized by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), and electron spectroscopy for chemical analysis (ESCA). Mesenchymal stem cells (MSCs) were used to evaluate the cell compatibility of collagen matrices. In terms of cell growth, the MSCs attached much better on the modified matrix than on the unmodified one. But there was no significant difference between two groups regarding the MSC proliferation. Compared to the unmodified matrices, the mechanical strength of the modified matrix decreased sharply, and its 3D structure was destroyed. Introducing specific RGD receptor-mediated adhesion sites on matrices obviously enhanced the MSC adhesion on collagen matrices, but the coupled method of periodate oxidation would likely result in the declination of the mechanical strength of the matrix, as well as the destruction of the matrix structure. This would affect the cell growth on the matrix, and decrease the histocompatibility of the matrices.

Differential diagnosis of hepatic cystic lesions with gray-scale and color Doppler sonography.

Abstract: Purpose This study was conducted to evaluate the effectiveness of sonography, especially color Doppler sonography, in the differential diagnosis of cystic hepatic lesions. Methods Ninety-two pathologically or clinically proven hepatic cystic lesions (20 cystic malignancies, 24 abscesses, and 48 simple cysts) were evaluated with gray-scale and color Doppler sonography. The sonographic features were analyzed retrospectively. The percentage, sensitivity, specificity, and positive and negative predictive values of the sonographic features of each disease category were calculated. Results On gray-scale sonography, the simple cysts were easily distinguished from cystic malignancies and abscesses. While no significant differences were found between hepatic cystic malignancies and hepatic abscesses with respect to the number, shape, margin status, and presence of thick wall of the lesion, the presence of septation and mural nodules was significantly higher in the cystic malignancies than in abscesses. The sensitivity and specificity of color Doppler sonography in differentiating cystic malignancies from abscesses and simple cysts were 85% and 96%, respectively. Conclusions Color Doppler sonography provides information about blood flow that supplements that gained on gray-scale sonography, and the presence of color signals in the solid portion of the cystic lesions carries a high diagnostic value in differentiating hepatic cystic malignancies from abscesses and simple cysts. © 2005 Wiley Periodicals, Inc. J Clin Ultrasound 33:100–105, 2005

Age-related decrease in expression of peroxisome proliferator-activated receptor alpha and its effects on development of dyslipidemia.

Abstract: BACKGROUND: Ageing is associated with increased incidence of dyslipidemia. To investigate potential molecular mechanisms, the effects of age and fibrate administration on peroxisome proliferator-activated receptor alpha (PPARalpha) expression in livers of young and old rats were studied. METHODS: A total of 16 young (2-month-old) and 16 old rats (24-month-old) were randomly assigned to a control group and fenofibrate group (fenofibrate in a total therapeutic dosage of 0.5% in ratio to each treated rat weight in 14 days). RT-PCR was applied to evaluate hepatic mRNA expression of PPARalpha and its target genes. Western blotting was used to determine PPARalpha protein level in liver tissue. RESULTS: When compared with 2-month-old rats, the liver tissue from 24-month-old rats showed reduced expression of PPARalpha mRNA (52%, P < 0.05) and protein (109%, P < 0.01). Consequently, the mRNA levels of PPAR target genes, LPL, ACO, ACS and CPT-1 were markedly lowered by 19%, 8%, 13% and 9% respectively, and apoCIII increased by 24% in livers from 24-month-old rats, compared with values obtained from 2-month-old rats (P < 0.05). Fenofibrate therapy significantly lowered plasma triglyceride and total cholesterol levels in old rats, accompanied with improvement in hepatic expression of genes, including LPL, ACO, ACS, CPT-1 and apoCIII, but no change was found in PPARalpha expression in livers from either 24-month or 2-month-old rats. CONCLUSIONS: The decrease in the hepatic PPARalpha expression is probably directly related to the lipid metabolic disturbances observed in old animals. The beneficial effects of fenofibrate administration in old rats suggests that fibrates may be useful for treating lipid disturbances in old people.

Diagnosis and management of regional portal hypertension.

Abstract: OBJECTIVE: Regional portal hypertension (RPH) results from splenic vein thrombosis/occlusion, with emergence of gastric varices and severe upper gastrointestinal bleeding. Its diagnosis and management are summarized below. METHODS: We reviewed our experience in 16 consecutive patients with RPH at Chinese PLA General Hospital between 2001 and 2004. The clinical manifestations, diagnostic methods and therapeutic modalities were analyzed retrospectively. RESULTS: Among the 16 patients with RPH, 12 had co-existing pancreatic diseases and 4 were of obscure origin. The main clinical findings were splenomegaly in 16 (100%), epigastric pain (mainly left upper abdomen) in 10 (63%), gastrointestinal bleeding in 7 (44%) and abdominal mass in 3 (19%). All had normal liver function tests. The main diagnostic methods used were ultrasound (US), computerized tomography (CT) and endoscopy. Splenic vein thrombosis could be identified by color Doppler ultrasound (7/7), enhanced CT could show its enlarged and tortuous short gastric vein, gastroepiploic vein, and collateral vessels around the splenic hilum (16/16). Isolated gastric varices (4/5) were mainly shown by esophagogastroscopy. Splenectomy was effective in controlling the variceal bleeding, but portal vein thrombosis occurred in 1 case. Endoscopic sclerotherapy had been carried out repeatedly in 2 cases, but was less effective (1/2, 50%). CONCLUSIONS: Precise diagnosis of RPH can be achieved by clinical manifestations, US and CT. Therapeutic options should be individualized basing on the underlying diseases, however, splenectomy is more preferable for patients with bleeding varices, and endoscopic sclerotherapy can be tried.

Property and contrast-enhancement effects of lipid ultrasound contrast agent: a preliminary experimental study.

Abstract: This work investigated the influence of some factors on the property in vitro of a self-made lipid ultrasound (US) contrast agent (LCA) and evaluated the relationship of acoustic pressure and enhancement effect in normal rabbit kidney parenchyma. In the in vitro studies, filling gas, solvent and concentration of LCA solution were investigated. Morphologic characteristics, concentration and mean diameter of microbubbles were considered as indices. In the in vivo studies, contrast-tuned imaging (CnTi) technique was used to investigate the enhancement effects in kidney parenchyma under nine acoustic pressure levels. Among the samples saturated with different filling gases, perfluoropropane (C 3 F 8 ) resulted in the highest concentration of microbubbles and air, the lowest. Microbubbles filled with C 3 F 8 or sulfur hexafluoride (SF 6 ) were quite stable and remained at a high level of concentration (above 2 × 10 9 microbubbles per mL) much longer than did air-filled microbubbles. Among the four solutions tested, 5% glucose solution and 0.9% saline solution showed higher initial concentrations and greater longevity than dextran 40 glucose solution (6%) or distilled water. The concentration of LCA solution had a positive correlation with the microbubble concentration. All microbubble samples under different test conditions remained shape-complete and no aggregation or fusion was observed. The mean diameter of microbubble samples was about 3.4 μm. Contrast intensity and longevity of CnTi enhancement in vivo showed an acoustic-pressure-dependent decrease. At 1 kPa, contrast intensity increased 224-fold (4.47/0.02) and the longevity of CnTi enhancement in the kidney parenchyma remained longer. (E-mail: lctuua@yahoo.com.cn )

Construction and clinical significance of a predictive system for prognosis of hepatocellular carcinoma.

Abstract: AIM: The aims of this study were to explore individualized treatment method for hepatocellular carcinoma (HCC) patients whose maximum tumor size was less than 5 cm to improve prognosis and survival quality. METHODS: Thirty cases of primary HCC patients undergoing tumor resection were retrospectively analyzed (resection group). All the tumors were proved as primary HCC with pathologic examination. The patients were divided into two groups according to follow-up results: group A, with tumor recurrence within 1 year after resection; group B, without tumor recurrence within 1 year. Immunohist-ochemical stainings were performed using 11 kinds of monoclonal antibodies (AFP, c-erbB2, c-met, c-myc, HBsAg, HCV, Ki-67, MMP-2, nm23-H1, P53, and VEGF), and expressing intensities were quantitatively analyzed. Regression equation using factors affecting prognosis of HCC was constructed with binary logistic method. HCC patients undergoing percutaneous microwave coagulation therapy (PMCT) were also retrospectively analyzed (PMCT group). Immunohistochemical stainings of tumor biopsy samples were performed with molecules related to HCC prognosis, staining intensities were quantitatively analyzed, coincidence rate of prediction was calculated. RESULTS: In resection group, the expressing intensities of c-myc, Ki-67, MMP-2 and VEGF in cancer tissue in group A were significantly higher than those in group B (t = 2.97, P = 0.01; t = 2.42, P = 0.03 0.05). The regression equation predicting prognosis of HCC is as follows: P(1) = 1/[1+e-(3.663-0.412mycc-2.187Ki-67c-0.397vegfc)]. It demonstrates that prognosis of HCC in resection group was related with c-myc, Ki-67 and VEGF expressing intensity in cancer tissue. In PMCT group, the expressing intensities of c-myc, Ki-67 and VEGF in cancer tissue in group A were significantly higher than those in group B (t = 4.57, P = 0.000 0.05). The coincidence rate of patients undergoing PMCT in group A was 88.00% (22/25), in group B 68.75% (11/16), the total coincidence rate was 80.49% (33/41). CONCLUSION: The regression equation is accurate and feasible and could be used for predicting prognosis of HCC, it helps to select treatment method (resection or PMCT) for HCC patients to realize individualized treatment to improve prognosis.

Distraction osteogenesis for bony repair of cleft palate by using persistent elastic force: experimental study in dogs.

Abstract: Objective: The purpose of this study was to investigate the possibility of closing a cleft and lengthening the hard palate by the technique of distraction osteogenesis with elastic forces and to evaluate the influence of the management on the facial structure. Design: Thirty 6-month-old mongrel dogs were assigned randomly to two groups with five subgroups for different purpose. Interventions: An 8- × 25-mm cleft was surgically created in the posterior hard palate in experimental and sham control dogs. Bone markers were implanted in the hard palate. Osteotomies were carried out followed by the installation of a distractor made of NiTi-shape memory alloy. Outcome measures: The results were evaluated clinically, radiographically, and histologically. Anthropometric data that represented the length, width, and height of the maxilla were taken on the dry skull of the control and experimental dogs and were analyzed statistically. Results: The cleft was closed and the hard palate was lengthened after 2 t...

Efficacy and safety of salmeterol/fluticasone propionate delivered via a hydrofluoroalkane metered dose inhaler in Chinese patients with moderate asthma poorly controlled with inhaled corticosteroids.

Abstract: A randomised, open-label, multicentre study compared the efficacy and tolerability of salmeterol 25 microg/fluticasone propionate 125 microg (two puffs, twice daily) delivered via a hydrofluoroalkane metered-dose inhaler (HFA-MDI) and salmeterol 50microg/fluticasone propionate 250 microg (one puff, twice daily) delivered via a Diskus inhaler in Chinese patients with moderate asthma uncontrolled with inhaled corticosteroids (ICSs). Morning peak expiratory flow (PEF) was the primary efficacy endpoint. Secondary endpoints included evening PEF, forced expiratory volume in 1 s, day and night symptom scores, rescue medication and patient self-evaluation of efficacy. Safety was assessed according to adverse events recorded. Both treatments were equipotent and significantly improved morning PEF (HFA-MDI 40 l/min; Diskus 42 l/min; p < 0.05) and all secondary endpoints (p < 0.05) from baseline, over 1-4 weeks. Similarly, both treatments were well tolerated. Salmeterol/fluticasone propionate delivered via an HFA-MDI or Diskus inhaler provides a choice of efficacious delivery systems in Chinese patients whose asthma is poorly controlled on ICSs alone.

Investigation of bile duct injury after transcatheter arterial chemoembolization

Abstract: Objective To investigate the image findings of bile duct injury after transcatheter arterial chemoembolization （TACE） for hepatic malignancy. Methods During the past 3 years, 1240 patients with different hepatic malignancies had undergone a total of 2680 TACE procedures. Eighteen patients （1.4%）developed bile duct injuries from 3 weeks to 3 months after TACE. All of the 18 patients received follow-up CT and uhra-sonography, 14 MRI and 15 digital subtract angiography （DSA）. The image data was retrospectively reviewed, with the potential predisposing factors correlated to TACE-induced bile duct injury. Results TACE-induced bile duct injuries developed in 13 of 148 patients with liver metastasis （8.8%）, 5 of 1092 patients with hepatocellular carcinoma （HCC） （0.5%）. On image examination, focal peripheral intrahepatic bile duct dilatation was detected in 4 cases, multiple bile duct dilatations with segmental or sub-segmental distribution in 8, and a large lobular cystic lesion or biloma in 6 cases, and progressive atrophy of the corresponding hepatic parenchyma in 6 patients in whom the TACE induced-bile injury developed at different intervals after TACE. The incidence of bile duct injury was higher in noncirrhotic patients with metastatic liver lesions than in patients with hepatocellular carcinoma associated with cirrhosis （ P 〈0.01 ）, and it was also higher in patients using an emulsion of lipiodol-cisplatin or carboplatin than in patients using other emboliging agents （P 〈0.01 ）. The incidence was higher either in patients with hypovascular lesions than in patients with hypervascular lesions （ P 〈 0. 05 ）. Conclusion Biliary abnormalities, including focal and multiple intrahepatic bile duct dilatation, and cystic lesion or biloma, may develop and can be detected during the follow-up examination imaging in patients with hepatic malignancy after TACE. Noncirrhotic liver and intact function, due to the lack of peri-biliany collateral circulation, are the significant predisposing factors to the development of TACE-induced bile duct injury. Key words: Transcatheter arterial chemoembolization; Liver neoplasms; Bile duct injury; Imaging investigation

Sonography-guided percutaneous microwave ablation of high-grade dysplastic nodules in cirrhotic liver.

Abstract: OBJECTIVE. Our objective was to evaluate the effect of sonography-guided percutaneous microwave ablation of high-grade dysplastic nodules in the cirrhotic liver.MATERIALS AND METHODS. From July 1997 to May 2003, 49 histologically proven high-grade dysplastic nodules in 30 patients with liver cirrhosis were treated by microwave ablation. Three patients had concomitant small hepatocellular carcinomas (D < 3.0 cm), whereas another three had undergone liver segmentectomy for hepatocellular carcinoma 1 year earlier. The mean size of the nodules was 1.8 cm (range, 0.9–4.6 cm). Sixty-eight insertions with 78 applications were administered to the 49 nodules.RESULTS. The follow-up period was 12–82 months (mean, 45.1 ± 19.0 months). Five patients died during this study: three from advanced hepatocellular carcinoma, one from bleeding in the upper gastrointestinal tract, and another from cerebral hemorrhage. All nodules showed decreased density on unenhanced CT and no enhancement on contrast-enhanced CT after microwa...

Acupuncture therapy for experimental stomach ulcer and c-Fos expression in rats.

Abstract: AIM: To determine the role of acupuncture therapy in treating experimental gastric ulcer in rats. METHODS: Twenty-eight adult male Sprague-Dawley rats were randomly divided into four groups (pre-acupuncture group; acupuncture group; paradistance-acupuncture group; and control group), and pre-acupuncture, paradistance-acupuncture, and control groups received 5 μL acetic acid (200 mL/L HAc) injection after a same course of electroacupuncture (EA) treatment (4 Hz, 0.6 mA, 0.45 ms, 45 min for 4 d). The rats in these three groups recovered within 4 d. The acupuncture group received EA therapy for 4 d, after HAc injection. The stomach was dissected to compare the pathological structures of ulcer. Also c-Fos activation in the nuclei of solitary tract (NTS) was observed under microscope after regular immunohistochemistry staining of brain stem sections. RESULTS: The number of ulcers was different among the four groups, especially between control group and paradistance-acupuncture group or pre-acupuncture group. In the latter group, the number of ulcers was much less. The gastric ulcer area was consistent with the histopathological results, indicating that pre-acupuncture had an obvious therapeutic effect on gastric ulcers. Acupuncture had a very modest effect and paradistance-acupuncture had no effect on gastric ulcers. No therapeutic effect was found in the control group. Fos-Li neurons in NTS induced by noxious gastric ulcer showed a significant difference between pre-acupuncture and control groups. CONCLUSION: Acupuncture before ulceration can obviously alleviate ulcer. The production of c-Fos proves that the vagus nerve mediates the induction of c-Fos in nuclei of solitary tract following experimental ulceration, suggesting that parasympathetic afferents promote the process of noxious visceral stimulation.