Comparative Study of Percutaneous Transhepatic Biliary Stent Placement with or without Iodine-125 Seeds for Treating Patients with Malignant Biliary Obstruction.

PURPOSE: To prospectively evaluate safety and efficacy of biliary stent placement with iodine-125 (125I) seeds in patients with malignant obstructive jaundice (MOJ). MATERIALS AND METHODS: From July 2011 to June 2014, 55 patients were enrolled (group A, 11 men and 17 women, mean age 70.93 y ± 8.58; group B, 14 men and 13 women, mean age 70.26 y ± 9.71). All patients were randomly assigned to placement of a biliary stent with 125I seeds (group A) or biliary stent only (group B). After stent placement, outcomes were measured regarding relief of MOJ. Clinical success rate, survival time, and safety were recorded. P < .05 was considered to indicate significant difference. RESULTS: Stents were successfully placed in all 55 patients. MOJ was relieved in all patients, and there were no significant differences in complications related to stent insertion between the 2 groups. Mean and median stent patency were 191 days ± 19.8 (95% confidence interval [CI], 152-230 d) and 179 days ± 191.4 (95% CI, 87-267 d) in group A and 88.3 days ± 16.3 (95% CI, 61-114 d) and 77 days ± 88.2 (95% CI, 65-86 d) in group B (P < .001, log-rank test). Mean and median survival time were 222.6 days ± 21.0 (95% CI, 181-263 d) and 241 days ± 18.2 (95% CI, 179-270 d) in group A and 139.1 days ± 14.5 (95% CI, 110-167 d) and 142 days ± 16.3 (95% CI, 83-177 d) in group B (P < .001, log-rank test). CONCLUSIONS: 125I seeds combined with biliary stent placement could significantly improve stent patency. The procedure seems to be safe and to extend survival compared with self-expandable biliary stent placement.

Effects of albendazole nanoparticles in mice with hepatic echinococosis: Portal vein cannulation versus intravenous administration.

To compare the ABZ and its metabolites concentration in cyst tissue of hepatic alveolar echinococcosis administered by different routes, forty male Wistar rats receiving albendazole nanoparticles from tail vein and portal vein were divided into two groups, the concentration of ABZ and its metabolites ABZSO, ABZSO2, in the cyst tissue, were analyzed by HPLC at 2, 4, 8, 24, 36 h after administration. The parent drug and its metabolites were detected in plasm and the cyst tissue after portal cannulation and intravenous administration. The last results were the concentration of ABZ in the portal cannulation group was higher than in the intravenous group at every time point (p < 0.05). Compared to the intravenous group, the portal cannulation administration of ABZ led to a lower plasm concentration of ABZ. The concentration of ABZ and the active ABZSO were significantly higher in the portal cannulation group than that of the intravenous group.

[Pathological changes of after trans-portal vein chemoembolization Echinococcus multilocularis in the liver of infected rats].

OBJECTIVE: To observe the morphological change in the pathological process of Echinococcus multilocularis in liver of infected rats after treatment with liposome entrapped albendazole and iodized oil suspension through portal vein, and investigate its efficacy against hepatic alveolar echinococcosis. METHODS: One Echinococcus multilocularis-infected rat served as control. Another 19 infected rats were infused with 0.2ml liposome entrapped albendazole and iodized oil suspension through portal vein. At 4, 7 and 10 d after treatment, the rats were sacrificed for further observation. The E. multilocularis metacestodes were collected, and the pathological change of alveolar hydatid was observed with hematoxylin-eosin staining and toluidine blue staining. RESULTS: In four days post treatment, E. multilocularis metacestodes were normal On the 7th day and 10th day post treatment, the major pathological change was degeneration and necrosis, respectively. A great quantity of liposomes and iodized oil deposited in the metacestodes, and caused breakdown of E. multilocularis tissue, collapse of cysts, cataplasia of germinal layer and laminated layer. CONCLUSION: Interventional therapy trans-hepatic vein may be an effective way to treat hepatic alveolar echinococcosis.

Omics-imaging signature-based nomogram to predict the progression-free survival of patients with hepatocellular carcinoma after transcatheter arterial chemoembolization.

BACKGROUND: Enhanced magnetic resonance imaging (MRI) is widely used in the diagnosis, treatment and prognosis of hepatocellular carcinoma (HCC), but it can not effectively reflect the heterogeneity within the tumor and evaluate the effect after treatment. Preoperative imaging analysis of voxel changes can effectively reflect the internal heterogeneity of the tumor and evaluate the progression-free survival (PFS). AIM: To predict the PFS of patients with HCC before operation by building a model with enhanced MRI images. METHODS: Delineate the regions of interest (ROI) in arterial phase, portal venous phase and delayed phase of enhanced MRI. After extracting the combinatorial features of ROI, the features are fused to obtain deep learning radiomics (DLR)_Sig. DeLong's test was used to evaluate the diagnostic performance of different typological features. K-M analysis was applied to assess PFS in different risk groups, and the discriminative ability of the model was evaluated using the C-index. RESULTS: Tumor diameter and diolame were independent factors influencing the prognosis of PFS. Delong's test revealed multi-phase combined radiomic features had significantly greater area under the curve values than did those of the individual phases (P < 0.05).In deep transfer learning (DTL) and DLR, significant differences were observed between the multi-phase and individual phases feature sets (P < 0.05). K-M survival analysis revealed a median survival time of high risk group and low risk group was 12.8 and 14.2 months, respectively, and the predicted probabilities of 6 months, 1 year and 2 years were 92%, 60%, 40% and 98%, 90%,73%, respectively. The C-index was 0.764, indicating relatively good consistency between the predicted and observed results. DTL and DLR have higher predictive value for 2-year PFS in nomogram. CONCLUSION: Based on the multi-temporal characteristics of enhanced MRI and the constructed Nomograph, it provides a new strategy for predicting the PFS of transarterial chemoembolization treatment of HCC.

[Garlicin ameliorated pressure overload induced myocardial fibrosis in rats through partial inhibiting TGF-beta1 mediated Smads signal].

OBJECTIVE: To observe whether garlicin could ameliorate pressure overload induced myocardial fibrosis in rats through partial inhibiting transforming growth factor beta1 (TGF-beta1) mediated Smads signal. METHODS: Forty male SD rats were randomly divided into 4 groups, i. e., the sham-operation group, the model group, the garlicin group, and the Tetramethylpyrazine (TMP) group, 10 in each group. The pressure overload induced myocardial fibrosis rat model was prepared using coarctation of aorta. Three days after modeling 5.0 mg/kg garlicin injection was administered to rats in the garlicin group, 20 mg/kg TMP injection to rats in the TMP group by peritoneal injection, while normal saline was peritoneally injected to rats in the sham-operation group and the model group. Four weeks after medication, the changes of myocardial collagen were observed by picrosirius red staining. The myocardial collagen volume fraction (CVF) and perivascular collagen areas (PVCA) were calculated. The serum transforming growth factor beta1 (TGF-beta1) expression was detected using ELISA. The TGF-beta1 protein expression in the myocardial tissue was observed using immunohistochemical assay. The changes of myocardial Smad2 and Smad7 mRNA expressions were detected using Real-time RT-PCR. The effects of garlicin on TGF-beta1 mediated Smad Signaling through luciferase assay were further verified using Mv1 Lu-(CAGA) 12-Luc cell line response to TGF-beta1. RESULTS: Compared with the sham-operation group, the myocardial levels of CVF and PVCA, the serum TGF-beta1 level, and the TGF-beta1 protein expression in the myocardial tissue obviously increased in the model group (P < 0.05, P < 0.01). Compared with the model group, the PVCA level, the serum TGF-beta1 level, and the TGF-beta1 protein expression in the myocardial tissue of the garlicin group and the TMP group obviously decreased (P < 0.05, P 0O 01). The Smad2 mRNA expression was up-regulated while Smad7 mRNA expression down-regulated in the model group. The Smad2 mRNA expression was obviously down-regulated in the garlicin group and the TMP group (P < 0.05). The Smad7 mRNA expression was obviously up-regulated in the TMP group (P > 0.05). One to 2 microg/mL garlicin could obviously inhibit the luciferase activities of corresponding TGF-beta1, under the stimulation of 2 ng/mL TGF-beta1 (P < 0.05). CONCLUSION: Garlicin ameliorated pressure overload induced myocardial fibrosis in rats through partial inhibiting TGF-beta-Smads signal pathway.

[Therapeutic effect of hepatic artery infusion with albendazole microspheres on hepatic alveolar echinococcosis in rats].

OBJECTIVE: To observe therapeutic effect of hepatic artery infusion of albendazole solid dispersion-chitosan microspheres on hepatic alveolar echinococcosis (HAE) in rats. METHODS: After the establishment of hepatic alveolar echinococcosis model, 30 rats were randomly divided into control group (A), blank microspheres group (B), and albendazole microspheres group (C) with 10 rats in each group 0.3 ml normal saline, 27mg/kg blank microspheres and 2.7 mg/kg albendazole solid dispersion-chitosan microspheres with 0.3 ml normal saline were injected through hepatic artery of rats in the groups of A, B and C, respectively. At 1 d, 3 d, 7 d, 14 d, and 42 d after injection, venous blood were collected, and white blood cells (WBC), aspartate aminotransferase (AST), and alanine aminotransferase(ALT) were evaluated. All the rats were sacrificed on 42 d after injection, and HAE pathological changes were observed. RESULTS: Transient elevation of white blood cells was observed in all groups at 1 d after infusion [Group A (86.11 +/- 19.14) x 10(9)/L, B (117.11 +/- 21.76) x 10(9)/L, C (118.11 +/- 24.52) x 10(9)/L], at 7d WBC fell to normal level [A (7.85 +/- 6.57)x10(9)/L, B (11.73 +/- 4.85) x 10(9)/L, C (8.49 +/- 136)x10(9)/L]. In groups B and C, AST, ALT reached their peaks on day 3 after infusion [B: AST (193.15 +/- 21.57) U/L, ALT (78.39 +/- 9.78) U/L; C: AST (189.91 +/- 14.06) U/L, ALT (88.43 +/- 9.23) U/L], and decreased to normal level at 14d after infusion [B: AST (109.31 +/- 15.48) U/L, ALT(47.855 +/- 9.49) U/L; C: AST(105.37 +/- 8.16) U/L, ALT (49.53 +/- 6.75) UL]. Histopathological examination at 42d after infusion showed that in groups A and B structure of the cysts was virtually normal, but in group C most cysts showed necrosis in germinal layer. CONCLUSION: Hepatic artery infusion with albendazole solid dispersion-chitosan microspheres shows certain therapeutic effect on hepatic alveolar echinococcosis in rats.

[Effect of Pingtang recipe containing drug-serum on INS-1 pancreatic beta cells lipoapoptosis].

OBJECTIVE: To observe the effect and mechanism of Pingtang Recipe containing drug-serum (DS-PTR) in improving INS-1 beta pancreatic cells lipoapoptosis. METHODS: Experimental INS-1 beta cells were divided into 5 groups (6 pools for each group), namely, the blank control group treated with rat's serum (C), the other 4 model groups induced into lipoapoptosis by palmitic acid and treated respectively by rat's serum (M), high, middle and low dose DS-PTR (DSh, DSm and DSI). Cell apoptosis was detected by TUNEL staining; Caspase-3 activity of cells was measured by chemiluminescence method; intracellular production of reactive oxygen species (ROS) was detected by DCHF-DA incorporation, and expressions of uncoupling protein-2 (UCP-2) was determined by RT-PCR. RESULTS: INS-1 beta cell apoptosis in Group M was significantly higher than that in Group C (P < 0.01), while that showed a decreased trend in the three DS-PTR treated groups. Caspase-3 activity was enhanced in Group M, it decreased significantly in Group DSm (P < 0.05). The over-produced ROS in cells after modeling was inhibited in Groups DSm and DSI (P < 0.05), meantime, expression of UCP-2 excited by PA (2.244 +/- 0.421) was reduced significantly in Group DSI and Group DSm to 1.286 +/- 0.373 (P < 0.01) and 1.627 +/- 0.348 (P < 0.05) respectively. CONCLUSION: DS-PTR shows a protective effect on INS-1 beta pancrentic cells against lipoapoptosis, which is possibly play its mechanism through regulating ROS and UCP-2.

Effects of ginkgo biloba extract on the cognitive function and expression profile of inflammatory factors in a rat model of hemorrhagic stroke.

Hemorrhagic stroke is a major risk factor for cognitive impairment. Our study aimed to measure the effect of ginkgo biloba extract (EGB761) on the cognitive ability and inflammatory expression in hemorrhagic stroke model SD rats and to analyze their relationship. Forty SD rats were divided randomly into an SD group (normal control SD rats), an SD+EGB761 group (normal control SD rats supplemented with 45 mg/kg EGB761), a CO group (hemorrhagic stroke model SD rats using collagenase), and a CO+EGB761 group (hemorrhagic stroke model SD rats supplemented with 45 mg/kg EGB761) consisting of 10 rats, respectively. The Y-electric maze test was selected to measure the cognitive function in four groups. Furthermore, enzyme-linked immunosorbent assay and real-time PCR were, respectively, applied for detecting the protein and gene expression profiles of inflammatory factors in primary cultured microglia. Compared with rats in the SD group, the average time of electrical simulation for mastering criteria was prolonged in the CO group (P<0.05). Furthermore, expression levels of proinflammatory cytokines interleukin-1ß (IL-1ß), IL-6, and tumor necrosis factor-α and anti-inflammatory cytokines IL-4, IL-10, and tumor necrosis factor-ß were significantly increased and decreased, respectively, in rats of the CO group compared with the SD group (P<0.05). The results of electrical simulation time, inflammatory factors protein, and gene expression profile in rats of the CO+EGB761 group compared with the CO group were opposite to above contrast (P<0.05). Ginkgo biloba extract could alleviate the cognitive dysfunction after hemorrhagic stroke in SD rats; this is associated with regulating the expression of inflammatory factors secreted by microglia.

[Effects of garlicin on NIH3T3 cell proliferation and collagen synthesis].

OBJECTIVE: To investigate the effects of garlicin on fibroblasts proliferation and type I collagen synthesis and explore its anti-fibrosis mechanism. METHODS: Garlicin was added into the culture fluid of NIH3T3 cell, taking Radix Salviae miltiorrhizae as the control medicine. The spiking of H3-thymidine DNA was detected, also the hydroxyproline (HOP) concentration in the culture fluid by alkali digestion method and the protein expression of type I collagen in NIH3T3 cells by immunofluorescent staining. RESULTS: The NIH3T3 cell growth and proliferation rate were obviously reduced after garlicin treatment concentration-dependently in range of 0.2 - 5 microg/mL; HOP level and protein expression of type I collagen also lowered. CONCLUSION: Garlicin could inhibit NIH3T3 cell proliferation, reduce the synthesis and protein expression of type I collagen so as to exert the anti-fibrosis effect.

[Progress in integrative Chinese and Western medicine study on prevention and treatment of myocardial fibrosis].

Myocardial fibrosis is an inevitable process of many heart diseases, such as coronary heart disease, myocardial infarction, hypertension, cardiomyopathy, etc. in development from earlier period to terminal stage. To prevent or reverse the process of fibrosis is one of the most important approaches to retard the occurrence of heart failure and reduce the accidence of arrhythmia. In traditional Chinese medicine myocardial fibrosis belongs to the category of "Xinbi". Studies on the occurrence and regulation of myocardial fibrosis, and its treatment by using integrative Chinese and Western medicine or by Chinese drugs singly and their components were reviewed in this paper.