Percutaneous ethanol ablation of intrahepatic arterial pseudoaneurysm: A case report

Hepatic arterial pseudoaneurysm is a rare but potentially fatal condition that requires prompt management. We report a case of hepatic arterial pseudoaneurysm developed after radiofrequency ablation of a hepatocellular carcinoma. The patient was successfully treated with percutaneous absolute ethanol injection under ultrasound guidance. Follow-up studies with ultrasound and computed tomography for 2 years after treatment revealed no evidence of local recurrence of hepatocellular carcinoma and of the pseudoaneurysm.     

Efficacy and safety of gemcitabine-oxaliplatin combined with huachansu in patients with advanced gallbladder carcinomaTian-Jie Qin,Xin-Han Zhao,Jun Yun,Ling-Xiao Zhang,Zhi-Ping Ruan,Bo-Rong Pan

AIM:To evaluate the efficacy and safety of gemcitabine-oxaliplatin(GEMOX)cornbined with huachansu(cinobufagin)injection treatment in patients with locally advanced or metastatic gallbladder carcinoma(GBC),and to assess the quality of life(QOL)of such patients.METHODS:Twenty-five patients with locally advanced or metastatic GBC were treated with intravenous gemcitabine(1000 mg/m2)over 30 min on days 1 and 8,2 h infusion of oxaliplatin(120 mg/m2)on day 1,and 2-3 h infusion of huachansu(20 mL/m2)on days-3-11,every 3-4 wk.Treatment was continued until occurrence of unacceptable toxicity or disease progression.QOL of patients was assessed by the EORTC QLQ-C30 at baseline,at the end of the first,third and sixth chemotherapy cycles,and 1 mo after the treatment.RESULTS:Among the 25 patients with a median age of 64 years(range 42-78 years),23 were evaluable in the study.A total of 137 cycles of therapy were performed and the median cycle was 5(range 1-8)per patient.Out of the 23 patients whose response could be evaluated,8 partial responses(PR)were observed(34.8%),while 7 patients(30.4%)demonstrated a stable disease(SD).The disease control rate was 65.2%.Progression of cancer was observed in 8(34.8%)patients.The median progression-free and overall survival time was 5.8 mo(95% CI:4.5-7.1 mo)and 10.5 mo,respectively.The therapy was well tolerated,with moderate myelosuppression as the main toxicity.Anemia grade 2 was seen in 16.0%,neutropenia grade 3 in 8.0% and thrombocytopenia grade 3 in 24.0% of patients,respectively.Non-hematologic toxicity ranged from mild to moderate.No death occurred due to toxicity.The QOL of patients was improved after chemotherapy,and the scores of QOL were increased by 10 t0 20 points.CONCLUSION:GEMOX combined with huachansu(cinobufagin)injection is well tolerated,effective,thus ireproving the QOL of patients with advanced GBC.(C)2008 The WJG Press.All rights reserved.     

榄香烯乳注射液联合高渗葡萄糖胸腔注射治疗难治性自发性气胸的临床研究作者: 任先杰1 S谢俊刚2 S 杨正武3 S廖德英4

【】目的S探讨榄香烯乳液联合高渗葡萄糖胸腔注射治疗难治性自发性气胸的临床疗效及安全性。方法S按随机数字表法将70例难治性自发性气胸患者分为治疗组30例(使用榄香烯乳液40～60 ml联合20 ml 50％葡萄糖胸腔内注射),和对照组(20 ml 50％葡萄糖胸腔内注射)。两组患者均行胸腔闭式引流。结果S治疗组治疗总有效率为93.3%(28/30),一次注药有效率66.7%(20/30)；对照组治疗总有效率为57.5%(23/40),一次注药有效率32.5%(13/40),两组比较差异均有统计学意义(P<0.05)；治疗组发热率为70.0%(21/30)明显高于对照组47.5%(19/40)差异有统计学意义(P<0.05),两组患者胸痛发生率情况比较,差异无统计学意义(P>0.05)。结论S榄香烯乳液联合高渗葡萄糖胸腔注射可有效的治疗难治性自发性气胸。     

Long-term safety of subcutaneous immunotherapy with TO-204 in Japanese patients with house dust mite-induced allergic rhinitis and allergic bronchial asthma: Multicenter,open label clinical trial

Background

To evaluate the long-term safety of subcutaneous immunotherapy with TO-204, a standardized house dust mite (HDM) allergen extracts, we conducted a multicenter, open label clinical trial.

The inverse relationship between chronic HBV and HCV infections among injection drug users is associated with decades of age and drug use

Summary.  Infection with hepatitis C virus (HCV) may suppress co-infection with hepatitis B virus (HBV) during acute or chronic HBV infection. We examined relationships between HBV infection, HCV infection and other factors among injection drug users (IDUs) with antibodies to both viruses. Participants enrolled in a cross-sectional study during 1998–2000 were considered to have been infected with HBV if they had core antibody, to be chronically infected if they had hepatitis B surface antigen (HBsAg), to have been infected with HCV if they had HCV antibody and to be chronically infected if they had HCV RNA. Among 1694 participants with antibody to both viruses, HBsAg prevalence decreased with increasing age among those positive for HCV RNA [from 4.55% in those 18–29 years to 1.03% in those ≥50 years old ( P _trend = 0.02)], but not among those who were negative for HCV RNA. Chronic HBV infection was less common overall among those with chronic HCV infection (odds ratio [OR], 0.25; P  < 0.0001), but this inverse relationship was much stronger in the oldest (>50 years; OR = 0.15) than the youngest (18–29 years; OR = 0.81) participants ( P _trend = 0.03). Similar results were obtained when duration of injection drug use was substituted for age ( P _trend = 0.05). Among IDUs who have acquired both HBV and HCV, chronic HBV infection is much less common among those with chronic HCV infection, but this inverse relationship increases markedly with increasing years of age and injection drug use. Co-infection with HCV may enhance the resolution of HBsAg during the chronic phases of these infections.     

Does age influence the success of intra-tympanic steroid treatment in idiopathic sudden deafness?

Conclusions: The present study shows that AGE, DELAY, and PTA_PRE may be considered factors influencing therapeutic success in intra-tympanic steroid therapy. Objective: The aim of the study is to evaluate the relationship between the therapeutic success of intra-tympanic prednisolone therapy and age, in patients affected by idiopathic sudden sensorineural hearing loss (ISSNHL), considering the influence of factors such as delay, gender, and pure tone average (PTA) pre-therapy. Method: This retrospective study involved 402 consecutive patients, affected by unilateral ISSNHL between January 2009 and January 2014. Patients were divided into two groups based on age: group one with 94 patients aged over 65 years and group two with all 402 patients enrolled in the study, including those over 65. Results: PTA recorded before the beginning of the therapy (PTA_PRE) in group one was worse than for group two. In both groups the therapy was significantly effective in improving hearing thresholds, even if PTA_PRE was significant and negatively correlated with success rate. This effect disappeared within the population over 65. On average, each day of DELAY from the onset of hearing loss to the beginning of therapy cuts almost 2% of the possibility to recover. AGE was negative and significant when specified continuously for group two.     

丹参酮ⅡA璜酸钠注射液治疗脑梗死的临床疗效观察

目的：观察并分析丹参酮ⅡA璜酸钠注射液治疗脑梗死的临床效果。方法：选取2011年1月-2014年1月本院诊治的62例脑梗死患者的临床资料,按照完全随机法1：1分成对照组和研究组各31例,对照组行常规西医对症治疗,研究组在对照组基础上加用丹参酮ⅡA璜酸钠注射液,观察比较两组患者的神经功能与生活能力改善,自由基与血液流变学指标水平变化情况。结果：与治疗前比较,两组治疗后的SOD活性均明显升高,MDA与LPO水平均明显降低（P〈0.05）。研究组治疗后的SOD活性（5.96±0.13）U/mL明显高于对照组的（4.85±0.11）U/mL,MDA水平（8.36±0.93）mmol/mL与LPO水平（10.57±2.16）mmol/mL均明显低于对照组（10.54±0.52）mmol/mL和（13.25±2.61）mmol/mL,差异均有统计学意义（P〈0.05）。治疗2周、4周时,两组NIHSS、NDS评分均明显降低,ADL、BI评分均明显升高,且同期组间比较差异显著,均有统计学意义（P〈0.05）;研究组治疗后的全血比粘度、血浆比粘度与红细胞聚集指数均明显低于治疗前与同期对照组,差异均有统计学意义（P〈0.05）。结论：丹参酮ⅡA璜酸钠注射液治疗脑梗死的临床效果显著,值得临床推广与应用。     

冠心宁注射液治疗心绞痛临床观察

目的：观察冠心宁治疗冠心病心绞痛的疗效。方法：选取2010年11月-2012年11月在本院就诊的86例冠心病患者,其冠心病符合诊断标准。包括男57例,女29例。并且对这86例冠心病患者进行冠心宁注射液20 mL加入5%葡萄糖注射液或生理盐水250 mL中静脉滴注,1次/d,14 d为一疗程。一个疗程之后,患者病情平稳,观察以下指标：应用消心痛药物的量来控制症状在治疗前后有无改变;每天心绞痛发作的次数有无变化;血液流变学的变化;十二导连心电图ST段压低的总和。观察患者应用冠心宁注射剂治疗后的效果。结果：心绞痛症状缓解总有效率81.4%,治疗后心绞痛发作次数、缺血性ST段改善、血液流变学与治疗前相比均明显改善,差异均有统计学意义（P〈0.01）,在治疗过程中患者发生不良反应的例数明显降低,且症状都比较轻微。结论：冠心宁注射液治疗冠心病心绞痛有显著疗效,值得临床推广应用。     

三种不同来源精子行卵胞浆内单精子注射临床结局的比较

目的：比较三种方法获得的精子行卵胞浆内单精子注射的临床结局。方法：回顾性分析笔者所在医院2011年1月-2012年12月374个卵胞浆内单精子显微注射（ICSI）治疗周期的妊娠结局,依据精子来源不同分为三组：射出精液组（A组）,经皮附睾穿刺和经皮睾丸穿刺取精子组（B组）,供精组（C组）,比较三组的受精率、卵裂率、优质胚胎率和临床妊娠率。结果：A组的优胚率高于C组（P〈0.017）,三组患者的受精率、卵裂率、临床妊娠率比较差异无统计学意义（P〉0.05）。结论：精液、附睾或睾丸精子、供精行ICSI助孕的结局相近。精子的成熟度、精子的冷冻可能并不影响最终的妊娠率。     

主动脉阻断后经主动脉根部注射葛根素注射液对二尖瓣置换术患者心肌损伤的影响

目的：评价主动脉阻断后经主动脉根部注射葛根素注射液对二尖瓣置换术患者心肌损伤的影响。方法：拟行二尖瓣置换术患者60例,性别不限,年龄〈60岁,ASA分级Ⅱ或Ⅲ级,采用随机数字表法,将患者随机分为C组和P组,每组30例。在体外循环下,P组于阻断升主动脉后,立即经升主动脉根部注射葛根素注射液5mg/kg,随后灌注4℃高钾（K＋浓度22 mmol/L）含血心脏停搏液20 mL/kg;C组注射等容量生理盐水,随后灌注4℃高钾（K＋浓度22 mmol/L）含血心脏停搏液20 mL/kg,两组患者每30 min复灌不含葛根素的相同成分含血心脏停搏液10 mL/kg。分别于主动脉阻断前即刻（T1）、主动脉阻断后4 h（T2）和术后24 h（T3）时,采集中心静脉血样8 mL,测定血浆心肌肌钙蛋白I（cTnI）浓度、肌酸激酶（CK）和肌酸激酶同功酶（CK-MB）的活性。记录阻断升主动脉至心脏停搏所用时间、心脏自动复跳率、心脏复跳期间利多卡因使用剂量及术后2h多巴胺用量。结果：与C组比较,P组心脏复跳期间利多卡因用量和术后2 h多巴胺用量减少,两组比较差异均有统计学意义（P〈0.05）。与C组比较,P组T2~T3时血浆cTnI、CK和CK-MB的活性降低,两组比较差异均有统计学意义（P〈0.05）。结论：主动脉阻断后经主动脉根部注射葛根素注射液可减轻二尖瓣置换术患者心肌损伤。