Local recurrence is an important prognostic factor of hepatocellular carcinoma

AIM: To clarify the importance of complete treatment by PEIT. METHODS: A total of 140 previously untreated cases of HCC were enrolled in this study from 1988 to 2002. The inclusion criteria were: a solitary tumor less than 4 cm in diameter or multiple tumors, fewer than four in number and less than 3 cm in diameter, without extrahepatic metastasis or vessel invasion. As general principles for the treatment of HCC, the patients underwent transcatheter arterial chemoembolization (TACE) prior to PEIT. After the initial treatment of the patients, ultrasonography and computed tomography were performed, and measurement of serum levels of afetoprotein (AFP) was determined. When tumor recurrences were detected, PEIT and/or TACE were repeated whenever the hepatic functional reserve of the patient permitted. We then analyzed the variables that could influence prognosis, including tumor size and number, the serum levels of AFP, the parameters of hepatic function (albumin, bilirubin, ALT, hepaplastin test, platelet number, and indocyanine green retention at 15 min [ICG-R15]), combined therapy with TACE, distant recurrence, and local recurrence. RESULTS: Univariate analysis identified the ICG test, serum levels of AFP and albumin, tumor size and number, and local recurrence, but not distant recurrence, as significant prognostic variables. In multivariate analysis using those five parameters, the ICG test, tumor size, tumor number, and local recurrence were identified as significant prognostic factors. In both univariate and multivariate analyses, the relative risk for the ICG test was the highest, followed by local recurrence. CONCLUSION: We found that local recurrence is an independent prognostic factor of HCC, indicating that achieving complete treatment for HCC on first treatment is important for improving the prognosis of patients with HCC.     

Mechanism of superoxide anion production by hepatic sinusoidal endothelial cells and Kupffer cells during short‐term ethanol perfusion in the rat

Abstract: Background/Aims: The aim of this study was to clarify the candidate cells for and the mechanism of superoxide anion (O₂^·?) release into the hepatic sinusoids during short‐term exposure to ethanol. Methods: The rat liver was perfused continuously with ethanol (a substrate for alcohol dehydrogenase) or tert‐buthanol (not a substrate for alcohol dehydrogenase) for 20 min at a final concentration of 40 mM. In order to detect O₂^·? production, MCLA (2‐methyl‐6‐[p‐methoxyphenyl]‐3,7‐dihydroimidazo[1,2‐a]pyrazin‐3‐one), a Cypridina luciferin analogue, was simultaneously infused and MCLA‐enhanced chemiluminescence was measured. The effects of gadolinium chloride (GdCL₃) (a suppressor of Kupffer cells (KCs)), staurosporine (ST) (an inhibitor of serine–threonine kinases, including protein kinase C), diphenyleneiodonium chloride (DPI) (an inhibitor of NADPH oxidase), ibuprofen (IB) (an inhibitor of cyclooxygenase) and 4‐methylpyrazole (4MP) (an inhibitor of ethanol metabolism) on the ethanol‐induced chemiluminescence were also evaluated. Sites where O₂^·? could be released were determined by histochemical detection of nitro blue tetrazolium reduction. Results: Both ethanol and tert‐buthanol rapidly caused O₂^·? release. GdCL₃ suppressed the ethanol‐induced O₂^·? release by 61%. Staurosporine and DPI, but neither IB nor 4‐MP, also significantly inhibited the ethanol‐induced O₂^·? release. In the histochemical examination, ethanol‐stimulated liver showed blue formazan precipitate on both sinusoidal endothelial cells (SECs) and Kupffer cells (KCs), whereas the GdCl₃‐pretreated liver had the precipitate only on SECs. Conclusions: This study shows that ethanol itself stimulates both SECs and KCs to release O₂^·? via activation of NADPH oxidase probably involving protein kinase C (PKC).     

乙酸钙的纯化工艺

碳酸钙和冰乙酸在水中反应得到乙酸钙溶液,室温下加入约2.5倍体积的95%乙醇,静置2~4 h,以300目滤布挤压过滤,滤液浓缩后重复操作1次,合并2次所得乙酸钙,80℃热风循环干燥3 h,即得乙酸钙纯品,收率可达82%以上。本工艺产品中镁含量大大降低,质量指标符合美国药典(USP40)要求。     

C臂CT引导经皮乙醇消融术在巨块型肝癌经肝动脉化疗栓塞后的近期疗效

目的 评价C臂CT引导经皮无水乙醇消融术(PEI)在巨块型肝癌经肝动脉化疗栓塞术(TACE)后的可行性及近期疗效.方法 回顾分析巨块型肝癌患者95例,其中40例行单纯TACE治疗(对照组),55例行TACE联合PEI治疗(联合组).对照组1个月后重复TACE治疗1次.联合组TACE1周后行PEI.术前经C臂CT扫描评估碘油沉积情况,定位穿刺路径及注入部位.2周后对碘油沉积缺损部分追加PEI.3个月后两组复查CT,对碘油沉积分布情况进行统计学分析.结果 联合组初次PEI术后显示碘油沉积为Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为41.8％ (23/55)、49.1％(27/55)、7.3％ (4/55)和1.8％(1/55);2周后分别为25.4％ (14/55)、50.9％(28/55)、16.4％(9/55)和7.3％(4/55).再次对除Ⅰ型病灶外的41例患者行PEI.3个月后复查CT,对照组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为7.5％ (3/40)、30％(12/40)、42.5％(17/40)、20％(8/40);联合组碘油沉积Ⅰ型、Ⅱ型、Ⅲ型及Ⅳ型病灶分别为30.9％(17/55)、40％ (22/55)、23.6％(13/55)、5.5％(3/55).两组差异有统计学意义.结论 C臂CT成像技术在TACE术后联合PEI治疗巨块型肝癌的指导和评估中具有重要价值,保证了手术的安全性、准确性和有效性.     

三种消毒剂对体检中心物体表面消毒效果与使用成本的比较研究

目的对3种消毒剂在体检中心物体表面消毒的消毒效果及使用成本进行比较,为体检中心优选合适的物体表面消毒方式提供依据。方法分别使用I型复合双链季铵盐卫生湿巾、500mg/L含氯消毒剂、75%乙醇擦拭消毒健康体检中心采血台、彩超机和乳腺红外线诊断仪的表面,在消毒前、消毒后即刻、消毒后30min及1h分别对各区域进行棉拭子涂抹采样及培养。结果受检物体表面细菌菌落数采血台为(78.4±6.2)cfu/cm2,彩超机为(36.2±2.1)cfu/cm2,乳腺红外线诊断仪为(45.9±3.0)cfu/cm2。3种消毒剂消毒后各时间点采样菌落数与消毒前比较,差异有统计学意义(均P0.01)。I型复合双链季铵盐卫生湿巾消毒效果在消毒后即刻、消毒后30min及1h优于500mg/L含氯消毒剂、75%乙醇(P0.05,P0.01);每次消毒成本I型复合双链季铵盐卫生湿巾最低。结论 3种消毒剂对各监测表面均有良好的消毒效果,但I型复合双链季铵盐卫生湿巾的消毒持续效果优于其他两种,且使用成本低,使用方便、侵蚀性小,适用于体检中心物表消毒。     

Impact of acute and chronic ethanol exposure on prolactin in both male and female rats

The deleterious effects of ethanol (EtOH) on reproduction have been well documented. This disruption is usually associated with alterations in prolactin (PRL) levels, which is relevant since this hormone is an important participant in the reproductive system. Reported EtOH-induced changes in PRL (i.e., stimulation or inhibition) have varied. These differences may have been owing to the gender or age/sexual maturity of the animal and the mode of the administration of EtOH. Therefore, to clarify the impact of EtOH on PRL, a series of experiments were conducted utilizing rats of both genders, exposed to EtOH acutely or chronically, as adults and as they progressed through puberty. In general, in younger animals of both genders, EtOH depressed serum PRL whether given acutely or chronically. In adult males, acute EtOH actually stimulated PRL levels while chronic administration had no effect. In adult females, EtOH’s effect was highly dependent on the stage of the estrous cycle in which EtOH was given and during which PRL was measured. In conclusion, our studies have shown that the PRL response to EtOH is dependent on the gender and age/sexual maturity of the animals as well as on the mode of administration.     

一种葡萄糖酸氯己定醇消毒液相关性能试验观察

目的研制一种复方葡萄糖酸氯己定醇消毒液,并观察相关性能。方法采用悬液定量杀菌试验、现场消毒试验和动物实验方法,对葡糖糖酸氯己定乙醇消毒液性能进行试验观察。结果复方消毒液原液含葡萄糖酸氯己定20 g/L与体积分数70%乙醇。以该葡萄糖酸氯己定消毒液原液作用1 min,对悬液内大肠杆菌、金黄葡萄球菌、铜绿假单胞菌平均杀灭对数值6.00,对白色念珠菌平均杀灭对数值5.00。用该葡萄糖酸氯己定醇作擦拭消毒,对临床护士皮肤上自然菌杀灭对数值平均为1.56。该复方葡萄糖酸氯己定醇消毒液对小鼠急性经口毒性LD50值5 000 mg/kg(体重),对小鼠骨髓嗜多染红细胞微核试验结果为阴性,其原液对皮肤无刺激性。结论该复方葡萄糖酸氯己定醇消毒液对细菌繁殖体和真菌及皮肤上自然菌具有快速杀灭作用,属无毒级物质,无致突变作用,无皮肤刺激性。     

Beneficial effects of polydatin on learning and memory in rats with chronic ethanol exposure

The purpose of this paper is to examine the effects of polydatin on cognitive function in rats self-administered with chronic ethanol levels. The levels of cyclin-dependent kinase 5 (Cdk5) were also determined. In the in vivo study, adult male Sprague-Dawley rats were used to establish an ethanol-administered rat model. Cognitive function was measured using the Morris water maze and the level of Cdk5 expression was measured to evaluate the effect of polydatin treatment. Cdk5 kinase activity and cell survival rate in primary hippocampal neuron cultures treated with ethanol or ethanol and polydatin were measured in the in vitro study. Polydatin reversed the performance impairments in chronic ethanol treated rats in Morris water maze test, and decreased unregulated Cdk5 expression. Moreover, polydatin increased cell survival rate, and decreased Cdk5 activity in the ethanol-treated primary culture of hippocampal neurons. The study results suggest that polydatin exhibits neuroprotective potential for ethanol induced neurotoxicity, both in vivo and in vitro, which is most likely related to its ability to target Cdk5 in neurons.     

2%葡萄糖酸氯己定皮肤消毒液在经外周静脉置入中心静脉导管维护中的应用

目的探讨2%葡萄糖酸氯己定皮肤消毒液在经外周静脉置入中心静脉导管(peripherally inserted central catheter,PICC)维护中的应用效果。方法 2013年5-9月便利选择南京大学医学院附属鼓楼医院肿瘤中心行PICC置管并在门诊进行导管维护的肿瘤患者60例,按置管先后将其分为观察组和对照组各30例,对照组按照传统方法消毒,观察组采用2%葡萄糖酸氯己定局部皮肤消毒2次,比较两组患者皮肤细菌学培养结果、导管相关性感染的发生情况、PICC维护时间及耗材成本。结果两组患者均随访4周,均未出现导管相关性感染;PICC维护耗材成本,观察组为1.45元/(例·次),对照组为0.74元/(例·次),两组比较,差异有统计学意义(P0.05);贴膜下皮肤细菌学培养结果及PICC导管维护时间观察组均少于或短于对照组,差异均有统计学意义(均P0.01)。结论 2%葡萄糖酸氯己定皮肤消毒液应用于PICC维护,安全性高,效果好,且省时方便,有利于降低人力成本,提高临床工作效率。