Clinical trial: percutaneous acetic acid injection vs. percutaneous ethanol injection for small hepatocellular carcinoma – a long-term follow-up study

Background  The long-term outcome of percutaneous acetic acid injection (PAI) and percutaneous ethanol injection (PEI) for treating small hepatocellular carcinoma (HCC) remains unclear.
Aim  To compare the long-term outcome of PAI vs. PEI for treating small HCC.
Methods  From July 1998 to July 2004, 125 patients with small HCC were enrolled. Seventy patients receiving PAI and 55 patients receiving PEI were enrolled. There were no significant differences in the clinical characteristics between the two groups. Tumour recurrence and survival rates were assessed.
Results  Mean follow-up time was 43 months. The local recurrence rate and new tumour recurrence rate were similar between the PAI and PEI groups. The PAI group had significantly better survival than the PEI group ( P  = 0.027). Multivariate analysis revealed that PAI was the significant factor associated with overall survival [PAI vs. PEI, RR: 0.639, 95% CI: (0.419–1.975), P  = 0.038]. The treatment sessions required to achieve complete tumour necrosis were significantly fewer in the PAI group than in the PEI group (2.4 ± 1.0 vs. 2.9 ± 1.3, P  = 0.018).
Conclusion  Percutaneous acetic acid injection required fewer treatment sessions than PEI and provided better survival after long-term follow-up.     

Immunohistological characterization of malignant lymphomas of the Waldeyer''s ring other than the nasopharynx

Among extranodal lymphomas, the Waldeyer's ring is the second most frequently involved site after the gastrointestinal tract. Fresh tissue from 23 consecutive cases of malignant lymphoma of the faucial tonsil, palate and base of tongue were studied histologically and with a panel of 25 monoclonal antibodies. Twenty cases were primary Waldeyer's ring lymphoma, and all were found to express B-cell phenotype. Most cases were classified as diffuse centroblastic lymphoma, polymorphic subtype, in which there were immunoblast-like, centrocyte-like and/or multilobated centroblasts. All except one case expressed all three B-cell lineage antigens CD19, CD20 and CD22, but they showed inconsistent expression of the B-cell antigens CD9 and CD24. Four cases lacked surface immunoglobulin. Six cases expressed interleukin-2 receptor, suggesting that they were composed of highly activated B-cells. Three cases represented relapse in the tonsil or tongue in patients with known malignant lymphoma in other sites; one case expressed T-cell and two cases B-cell phenotype (both of which also expressed interleukin-2 receptor). The clinical features and immunohistological findings suggest that Waldeyer's ring lymphomas, other than those of the nasopharynx, share some of the characteristics of 'mucosa-associated lymphoid tissue' lymphomas. In contrast, nasopharyngeal lymphomas are more related to nasal lymphomas, and are almost exclusively peripheral T-cell neoplasms.     

广东省老年人失牙、义齿修复状况和咬牙对

:【目的】描述广东省老年人失牙、指征失牙 (有拔牙指征的牙齿 )、义齿修复情况和咬牙合牙对 ,并分析影响失牙的因素。【方法】通过多阶段整群抽样抽取 6 5～ 74岁老年人 15 15人 ,经培训人员进行问卷调查并按世界卫生组织标准进行临床检查。【结果】平均失牙数 11 9颗 ,指征失牙数 2 5颗 ,农村老人有较多指征失牙。协方差分析结果表明失牙与社会经济因素和性别有关。无牙老年人占 4%。有义齿老年人只有 47%。仅有 49%老年人有 8对以上咬牙合牙对。【结论】广东省老年人中约一半牙列功能低于可接受水平 ,需努力保存他们的自然牙齿     

Imaging of follicular dendritic cell tumours of the liver

Follicular dendritic cell tumour of the liver is a recently recognized entity. To date, only two cases have been described, both in the pathology literature. Histologically, it resembles an inflammatory pseudotumour and immunohistochemical and ultrastructural studies are required for its diagnosis. The ultrasound, computed tomography and angiographic features of two cases of follicular dendritic cell tumour of the liver are described in detail. One of the patients had multiple recurrences of this tumour. The imaging features are very similar to those of hepatocellular carcinoma. As follicular dendritic cell tumour is considered to be of low-grade malignant potential, in contrast to the dismal prognosis for hepatocellular carcinoma, it is important to be able to accurately distinguish between the two types of tumour prior to initiating definitive therapy.     

尿动力检查对女性压力性尿失禁Stamey1、2级的意义

目的通过评价Stamey分级为1、2级压力性尿失禁患者的棉签试验与尿动力检查参数腹压漏尿点压ALPP的关系,初步判断Stamey 1、2级压力性尿失禁患者行尿动力检查的意义。方法入选40例[42~72岁,平均(54±7.5)岁]因压力性尿失禁行尿动力检查、Stamey分级1、2级中进行棉签试验角度测量的患者,分析ALPP分型与棉签试验角度Pearson相关性。结果40例患者Stamey分级:1级28例,2级12例;棉签试验:角度差明显27例,角度差改变一般11例,角度差不明显2例;ALPP范围96~132cm H2O,平均(104±15.6)cm H2O,其中Ⅰ型26例,Ⅱ型14例。8例诉间断性轻度尿急患者镇定药物治疗有效。ALPP值与棉签试验角度具有负相关性(R=-0.486,P0.01)。结论 Stamey分级处于1,2级的压力性尿失禁患者中,以压力性尿失禁为主诉,病程小于3年,压力试验、膀胱颈抬高试验阳性,棉签试验角度改变明显的,伴有或不伴有轻度尿急(镇静药物治疗有效)、无盆腔脏器脱垂的患者,做尿动力膀胱测压检查的意义不大。     

TNF-α induces CXCL1 chemokine expression and release in human vascular endothelial cells in vitro via two distinct signaling pathways

Aim： Chemokines usually direct the movement of circulating leukocytes to sites of inflammation or injury. CXCL1/GRO-a has been shown to be upregulated in atherosclerotic lesions and various cancers. The aim of this study was to investigate the mechanisms underlying the TNF-α-induced release of CXCL1 from human vascular endothelial cells in vitro. Methods： Human umbilical vein endothelial cells （HUVECs） were treated with different proinflam-matory mediators and growth factors. CXCL1 expression and secretion were determined using RT-PCR and ELISA, respectively. TNF-a-induced cell signaling was assayed with Western blotting. Cell viability/growth was determined using MTTassay. Monocyte migration was measured with transwell migration assay. Results： Among the 17 mediators and growth factors tested, TNF-α, LPS and thrombin induced marked increase in CXCL1 release from HUVEC cells. TNF-α （2, 5 ng/mL） induced CXCL1 release and mRNA expression in the cells in concentration- and time-dependent manners. TNF-α （5 ng/mL） caused activation of JNK, p38 MAPK, PI3K and Akt, whereas pretreatment with JNK inhibitor （SP600125）, p38 MAPK inhibitor （SB202190） or PI-3K inhibitor （LY294002） significantly suppressed TNF-a-induced CXCL1 release from the cells. But only SP600125 significantly reduced TNF-a-induced CXCL1 mRNA expression in the cells. Moreover, dexamethasone （up to 500 nmol/L） failed to affect TNF-a-induced CXCL1 release from the cells. In functional studies, recombinant CXCL1 enhanced HUVEC proliferation, and both recombinant CXCL1 and TNF-a-induced CXCL1 from HUVECs attracted human monocyte migration. Conclusion： TNF-a stimulates CXCL1 release from human ECs through JNK-mediated CXCL1 mRNA expression and p38 MAPK- and PI-3K-mediated CXCL1 secretory processes.     

Physiological time structure of the tibialis anterior motor activity during sleep in mice,rats and humans

The validation of rodent models for restless legs syndrome (Willis–Ekbom disease) and periodic limb movements during sleep requires knowledge of physiological limb motor activity during sleep in rodents. This study aimed to determine the physiological time structure of tibialis anterior activity during sleep in mice and rats, and compare it with that of healthy humans. Wild‐type mice (n = 9) and rats (n = 8) were instrumented with electrodes for recording the electroencephalogram and electromyogram of neck muscles and both tibialis anterior muscles. Healthy human subjects (31 ± 1 years, n = 21) underwent overnight polysomnography. An algorithm for automatic scoring of tibialis anterior electromyogram events of mice and rats during non‐rapid eye movement sleep was developed and validated. Visual scoring assisted by this algorithm had inter‐rater sensitivity of 92–95% and false‐positive rates of 13–19% in mice and rats. The distribution of the time intervals between consecutive tibialis anterior electromyogram events during non‐rapid eye movement sleep had a single peak extending up to 10 s in mice, rats and human subjects. The tibialis anterior electromyogram events separated by intervals <10 s mainly occurred in series of two‐three events, their occurrence rate in humans being lower than in mice and similar to that in rats. In conclusion, this study proposes reliable rules for scoring tibialis anterior electromyogram events during non‐rapid eye movement sleep in mice and rats, demonstrating that their physiological time structure is similar to that of healthy young human subjects. These results strengthen the basis for translational rodent models of periodic limb movements during sleep and restless legs syndrome/Willis–Ekbom disease.     

T lymphocyte function in patients with malignant biliary obstruction

Abstract The T lymphocyte function in 59 patients with malignant biliary obstruction undergoing pre-operative endoscopic drainage (group Ia, n = 24) or surgery (group Ib, n = 35) was evaluated by mitogen stimulation test with phytohaemagglutinin. The T lymphocyte function before endoscopic or surgical intervention was found to be impaired as compared with patients with gastric cancer (group II, n = 27) and with normal persons (group III, n = 19). Regression analysis showed a significant negative correlation between T lymphocyte function and the serum bilirubin level (correlation coefficient - 0.3, P = 0.01) and a positive correlation with serum albumin level (correlation coefficient 0.34, P = 0.01) and serum transferrin level (correlation coefficient 0.45, P = 0.001). After 18 ± 3 days of endoscopic biliary drainage, the T lymphocyte function of group Ia patients did not change substantially. At postoperative day 14, there were more patients in both groups Ia and Ib having deterioration of T lymphocyte function than those with improvement. The incidence of postoperative sepsis was found to be significantly higher in patients with deterioration than those with improvement of T lymphocyte function (18/31 vs 7/26, P = 0.036). It is concluded that endoscopic biliary drainage and surgery could not reverse the T lymphocyte dysfunction in patients with malignant biliary obstruction.     

雅安地震重灾区居民心理行为和社会支持调查

目的了解4．20雅安地震重灾区居民灾后1个月心理行为和相关社会支持情况,探讨影响其心理健康的因素,为心理社会支持服务提供参考信息。方法采用自制的“震后1个月内心理行为和社会支持情况调查问卷”对雅安地震重灾区不同年龄、职业、地域的群体进行问卷调查。结果不同群体震后第一时间行为、震后1～3d获干部组织救援情况不完全相同;震后2周～1个月,不同群体行为有差异。震后1个月,47．94％的灾民受到武警官兵帮助最多,只有10．31％的灾民受到心理专家的帮助;31．96％的灾民最希望得到心理帮助;46．91％的灾民最希望通过政府人员宣讲灾后重建的相关政策获得帮助。结论震后1个月内,灾民们遇到各种各样的情况。受到各方面社会支持程度不同;不同职业、年龄群体,影响他们心理健康的因素不完全相同,表现出不同的行为,需要不同的心理干预。