Incidence And Risk Factors Of Contrast Nephropathy After Tace In Patients With Liver Cancer And Chronic Kidney Disease.

PURPOSE: Incidence of contrast induced nephropathy (CIN) and related risk factors in patients with liver cancer and chronic kidney disease after trans-catheter arterial chemoembolization (TACE) is higher. The purpose of this study was to investigate the feasibility and safety of TACE therapy in such patients. METHODS: A retrospective analysis was performed on 103 patients with liver cancer and chronic kidney disease who underwent TACE treatments. TACE was performed according to Seldinger's technique of arterial embolization with minor modifications. Based on CIN diagnostic criteria, patients were divided into non-CIN (n=89) and CIN (n=14) groups. Multiple clinical parameters were assessed for the two groups after TACE. Serum creatinine levels were measured 48-72 h after TACE. RESULTS: Tumor size (>5 cm), TACE frequency, contrast agent dosage, solitary kidney, volume of iodized oil used in the TACE (ml) and urea levels were significantly higher in CIN group in comparison with the non-CIN group, while serum albumin and haemoglobin levels were significantly lower. Multivariate logistic regression analysis confirmed that the volume of iodized oil and TACE frequency were significantly positively correlated, and serum albumin level was negatively correlated in the CIN group. CONCLUSION: Volume of iodized oil, TACE frequency and low serum albumin levels were found to be independent risk factors for CIN after TACE. Thus, it is safe and feasible for hepatocellular carcinoma patients with chronic kidney disease to receive TACE treatment, but adverse events management after TACE needs to be addressed.

Biological Mechanism of Specific Relationship between Gan (Liver) Meridian of Foot-Jueyin and Genitals.

From the perspective view of Chinese medicine, the Gan (Liver) meridian of Foot-Jueyin starts from the great toe, running upward along the medial side of the thigh to the perineal area, where it curves around the external genitalia and goes up to the lower abdomen. In clinical practice, acupoints in the feet of the Gan meridian of Foot-Jueyin are used to treat the genitourinary and external genitalia diseases. Studies have shown that reproductive system diseases have specific pathological reactions in the places (radial side of tibia and foot) where Gan meridian of Foot-Jueyin passes by. Why does this happen? In this article, we begin by briefly reviewing the evidences linking foot and genitalia. We then explore the potential mechanism of the relationship between genitals and the Gan meridian of Foot-Jueyin. The brain cerebral cortex is characterized by cortical interactions. Numerous studies show that different cerebral cortex function areas (especially the adjacent areas) are overlapping and interact with each other. Finally, we presume that there is a specific connection between the feet and the genitals. Physiologically in the cortical homunculus, the genital area lies adjacent or overlapped to the foot areas, the two areas may interact with each other. The functional reorganization between different areas of the cerebral cortex under pathological conditions may be the underlying mechanism of the relationship between the feet and the genitals.

[Electroacupuncture-induced plasticity between hand and face representations in the motor cortex in healthy subjects].

OBJECTIVE: To observe the plasticity between hand and face representations of the motor cortex of healthy volunteers after electroacupuncture(EA) at Hegu(LI4), so as to provide a scientific basis for the theory of "Hegu is indicated for orofacial problems". METHODS: Using a cross-over design (self-controlled study), 10 healthy volunteers were randomly assigned to an acupuncture group and a sham acupuncture group (two-weeks wash-out period between the two groups). Subjects in the acupuncture group received EA stimulation (2 Hz, 0.5 to 1 mA, 30 min) at LI4 on their left hands. Adhesive pads sticked on the left hands of subject in the sham acupuncture group, thus, the placebo needle provided participants with a similar appearance to that in the acupuncture group but no skin penetration, and the placebo needles were connected to an EA device with a broken wire inside. Using transcranial magnetic stimulation technology, the motor evoked potentials (MEPs) of the first dorsal interosseous muscle and the orbicularis oculi muscle in hand and face representations in the contralateral motor cortex were recorded before and after EA and sham EA, and the total amplitude, effective stimulation area and center of gravity of MEPs were calculated. RESULTS: Compared with that before intervention, for acupuncture group, the total amplitude of MEPs in hand representation in the contrala-teral motor cortex was significantly increased(P<0.05),while the total amplitude of MEPs in face representation was significantly decreased (P<0.05). The effective stimulation area in hand representation was significantly increased(P<0.01), and there was no difference in face representation(P>0.05). The difference in the center of gravity of the X-axis in hand representation was statistically significant (P<0.05)，with the center of gravity moved an average of 0.6 cm to the outside, and there was no difference in face representation (P>0.05). There was no difference in the center of gravity of the Y-axis in hand and face representations(P>0.05). For sham acupuncture group, there were no differences in total amplitude of MEPs, effective stimulation area and the center of gravity in hand and face representations (P>0.05). CONCLUSION: EA at LI4 can induce plasticity between the hand and face representations of the motor cortex in healthy volunteers (exciting the hand representation of the motor cortex, while inhibiting the motor cortex representation), which provides a scientific basis for treating facial and mouth diseases by acupuncture at LI4 and the theory of selecting acupoints of the corresponding meridian distal to the disease location.