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Objective::In this study, a network pharmacology-based method was applied to analyze the mechanism of modified Erzhiwan combined with epimedium in treatment of atherosclerosis. Method::The compounds and targets of modified Erzhiwan combined with epimedium were screened in traditional Chinese medicine(TCM) systems pharmacology database and analysis platform (TCMSP) and bioinformatics analysis tool for molecular mechanism of TCM (BATMAN-TCM). Mang related databases were applied to find the target-related to atherosclerosis.The common targets of modified Erzhiwan combined with epimedium and atherosclerosis were got by venn diagrams.Cytoscape 3.6.1 was used to construct ingredients-disease-targets networks.Then protein-protein interaction (PPI) analysis of ingredients-disease-targets was builed in STRING database, and was visualized by Cytoscape 3.6.1, then important modules were analyzed with Moleculaar complex detection(MCODE). Biological information annotation databases (DAVID) was used to carry on gene ontology (GO) analysis and enrichment analysis of gene encyclopedia kyoto encyclopedia of genes and genomes (KEGG) pathway. Result::A total of 38 active ingredients and 266 potential targets of modified Erzhiwan combined with epimedium were obtained from TCMSP and BATMAN-TCM, 254 atherosclerosis-related targets were retrieved from disease database.Then 52 common targets were obtained and 14 core genes were screened.Biological processes were related to inflammatory response, regulation of insulin secretion, positive regulation of nitric oxide biosynthetic process, etc.The biological pathways mainly included tumor necrosis factor signaling pathway, NF-kappa B(NF-κB)signaling pathway, peroxisome proliferators-activated receptors signaling pathway and so on. Conclusion::Modified Erzhiwan combined with epimedium may play the anti-atherosclerosis role by estrogen-like effect through attach estrogen receptor, inhibiting inflammation and improving insulin resistance, which may provide guidance for further experimental research.
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<p><b>BACKGROUND</b>Giant cell tumors (GCTs) are benign, locally aggressive tumors. We examined the rate of local recurrence of spinal GCTs and sought to identify recurrence factors in patients who underwent surgery.</p><p><b>METHODS</b>Between 1995 and 2014, 94 mobile spine GCT patients were treated at our hospital, comprising 43 male and 51 female patients with an average age of 33.4 years. Piecemeal intralesional spondylectomy and total en bloc spondylectomy (TES) were performed. Radiotherapy was suggested for recurrent or residual GCT cases. Since denosumab was not available before 2014 in our country, only interferon and/or zoledronic acid was suggested.</p><p><b>RESULTS</b>Of the 94 patients, four underwent conservative treatment and 90 underwent operations. Seventy-five patients (79.8%) were followed up for a minimum of 24 months or until death. The median follow-up duration was 75.3 months. The overall recurrence rate was 37.3%. Ten patients (13.3%) died before the last follow-up (median: 18.5 months). Two patients (2.6%) developed osteogenic sarcoma. The local recurrence rate was 80.0% (24/30) in patients who underwent intralesional curettage, 8.8% (3/34) in patients who underwent extracapsular piecemeal spondylectomy, and 0 (0/9) in patients who underwent TES. The risk factors for local recurrence were lesions located in the cervical spine (P = 0.049), intralesional curettage (P < 0.001), repeated surgeries (P = 0.014), and malignancy (P < 0.001). Malignant transformation was a significant risk factor for death (P < 0.001).</p><p><b>CONCLUSIONS</b>Cervical spinal tumors, curettage, and nonintact tumors were risk factors for local recurrence. Intralesional curettage and malignancy were the most important significant factors for local recurrence and death, respectively.</p>
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Objective To analyze the effect of diabetes mellitus (DM) on the prognosis of patients with unresectable hepatocellular carcinoma (HCC) after receiving transcatheter arterial chemoembolization (TACE).Methods A total of 858 HCC patients,who were admitted to the Affiliated Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,China,during the period from January 2010 to June 2015 to receive TACE,were selected.Among the 858 HCC patients,175 patients suffered from coexisting DM (DM group) and 683 patients had no DM (non-DM group).The differences in general clinical data and overall survival between the two groups were analyzed.Kaplan-Meier method was used to calculate the survival rate,the difference between the two groups was evaluated by log-rank method,and Cox proportional hazards regression was adopted to analyze the prognostic factors of HCC patients after receiving TACE.Results There were no statistically significant differences in sex,age,serum albumin,total bilirubin,prothrombin time,alpha fetoprotein (AFP),Child-Pugh grade,tumor size and number,cirrhosis,number of TACE treatment times and BCLC staging between the two groups (P＞0.05);the fasting blood glucose (FPG)level in DM group was higher than that in non-DM group (P＜0.05).The 1-,3-and5-year survival rates of the DM group were 60.9％,27.5％ and 10.7％ respectively,which were 70.9％,36.0％ and 17.6％ respectively in the non-DM group;the Log-rank test showed that the difference between the two groups was statistically significant (P=0.008).Multivariate Cox proportional hazard regression analysis revealed that the largest tumor diameter ＞5 cm,multiple tumor lesions,AFP＞20 ng/ml,BCLC stage and coexisting DM were independent risk factors that affected the prognosis of HCC patients after receiving TACE.Conclusion The coexisting DM is an independent risk factor that may affect the prognosis of patients with inoperable HCC after receiving TACE.
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Objective To investigate the diagnostic value of multi‐slice spiral CTA on the SAH patients ,and serum S‐100B pro‐tein in the evaluation of brain damage and cerebral vasospasm in SAH patients .Methods One hundred and sixty six patients with SAH were selected ,and all underwent CTA examination ,the serum S‐100B protein level were detected 1 d ,2 d ,3 d and 7 d after ad‐mission .Results In the 166 patients ,CTA showed 119 aneurysms .With the treatment ,on day 1 S‐100B protein level of Ⅰ - ⅡHunt‐Hess grade patients was (0 .71 ± 0 .11)μg/L ,on day 7 the level was (0 .62 ± 0 .09)μg/L ;S‐100B level of Hunt‐Hess Ⅳ stage patients on day 1 and 7 were (2 .12 ± 0 .23)μg/L and (1 .97 ± 0 .06)μg/L .After treatment ,S‐100B level was proportional to Hunt‐Hess grade .S‐100B protein level of GCS(3-8) score patients were (1 .87 ± 0 .23)μg/L on day 1 and (1 .87 ± 0 .23)μg/L on day 7 .S‐100B protein level of GCS(13-15) score patients were(0 .63 ± 0 .17)μg/L on day 1 ,(0 .44 ± 0 .15)μg/L on day 7 .After treat‐ment ,the S‐100B level was inversely proportional to GCS score .Conclusion CTA could display three‐dimensional structure and the surrounding relations ,and could contribute to the choice of treatment and assessment of the degree of difficulty .Serum and cerebro‐spinal fluid concentration of S‐100B protein level could be used to assess the gravity of the secondary brain damage and the possibili‐ty of cerebral vasospasm .
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<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion for pancreatic cancer with liver metastases (PCLM).</p><p><b>METHODS</b>We retrospectively selected 292 patients with PCLM who were treated by Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion at Tianjin Medical University Cancer Hospital from January 2001 to December 2010. All patients were assigned to the Western medicine treatment group (157 cases) and the integrative medicine treatment group (135 cases). Patients in the Western medicine treatment group were treated with gemcitabine (GEM)-based chemotherapy, and partial of them received regional arterial perfusion. Those in the integrative medicine treatment group additionally took Chinese herbs of clearing heat and eliminating mass for at least 4 weeks. The median survival time (MST) , adverse reactions and the incidence of complications were observed.</p><p><b>RESULTS</b>There was no statistical significance in general data between the two groups (P > 0.05). There was statistical difference in MST between the two groups (4.8 months vs 5.5 months, P < 0.05). No death occurred during chemotherapy or regional arterial perfusion. All toxic or adverse reactions were tolerable.</p><p><b>CONCLUSION</b>Chinese herbal medicine combined with systemic chemotherapy and/or regional arterial perfusion was effective and safe, and it could be optimally selected as palliative therapy for PCLM.</p>
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Humans , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Complementary Therapies , Methods , Deoxycytidine , Drugs, Chinese Herbal , Therapeutic Uses , Liver Neoplasms , Drug Therapy , Pancreatic Neoplasms , Drug Therapy , Pathology , Retrospective StudiesABSTRACT
Objective: To study the acute and long-term toxicity of brucea javanica oil subnanoemulsion injections ( BJOSI ) . Methods:The mice were given BJOSI by intravenous injection. The acute toxicity was observed and LD50 in mice was calculated by Bliss method. To observe the long-term toxicological effects, Beagle dogs were injected intravenously BJOSI once a day for 8-week du-ration with the dose of 20, 10 and 6 ml·kg-1 , respectively followed by 3-week recovery period. Results:LD50 of BJOSI in mice was 7. 388 g·kg-1 with 95% confidence limits of 6. 306-8. 656 g·kg-1 . The long term toxicity test showed that all the detected indices were within normal range in all groups, including general state, weight changes,hematological indices,biochemical indices,EEG,organ coefficients, morphological and histological changes, while there was an upward tendency of ALT and Cr in every BJOSI group without dose-effect correlation. The dogs could completely recover in three weeks after the administration. Conclusion:The results suggest that BJOSI has low toxicity,while the pathological changes are reversible, and attention should be paid to the function of liver and kidney.
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Objective To analyze the treatment of transplant renal artery stenosis (TRAS) by percutaneous transluminal angioplasty (PTA) and stenting. Methods The average time duration from transplantation to the on set symptom of TRAS was 6.9 months (3 - 18 months) in 35 TRAS patients. BP and creatinine level were recorded before and after the procedure. PTA was performed through contralateral femoral or left brachial approach with ordinary balloon (5 F, length 20 ～ 30 mm) and / or small balloon catheters (2. 6 F, length 36 mm) in all patients, and stents were embedded in 11 of them. Results A total of 46 PTA were successfully performed (1 time, 20 cases; 2 times, 12 cases, and 3 times, 3 cases) via contralateral femoral approach (26) and left brachial approach (15). Stenosis were significantly decreased from 75% ～ 98% pre-PTA to 10% ～ 30% post-PTA.Systolic pressure decreased from 170 mmHg (150 ～ 210 mmHg) pre-PTA to 135 mmHg (100 - 190 mmHg) post-PTA and diastolic pressure decreased from 120 mmHg (90 - 145 mmHg) to 85 mmHg (80 - 125 mmHg) respectively. Restenosis rates were 39% after first PTA and 15% after the second time. All 46 times of PTA used 26 ordinary balloon catheters and 20 microballoon catheters. 8 self-expandable stents (Wallstent) and 3 balloon-dilatation stents (Palmaz) were released in 11 cases. There were healed case (n = 11) , melioration (n = 15), improvement (n = 7), and inefficiency (n = 2) after follow - up of 23 months (3 - 60 month). No complication occured except puncture site hematoma via the brachial artery approach in 1 case. Conclusions PTA is safe and effective in the treatment of TRAS and high rate of procedure success may be achieved with the help of brachial approach and micro-balloon catheter.Reasonable use of stents is beneficial in decreasing the restenosis.
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Objectvive To evaluate the blood supply of pulmonary metastases using small volume of lipiodol through pulmonary arterial infusion. Methods 10 cases of lung metastasis were enroled including the primary tumors of liver cancer(n = 5), renal carcinoma(n = 3), chordoma(n = 1) and malignant neurofibroma (n = 1). Plain CT scan was performed to exclude calcification or ossification within metastasis and then pulmonary arterial DSA was undertaken to evaluate tumor vessels or staining. After pulmonary arteriovenous fistula or other anomalous circulation was excluded by lobar arterial DSA, small volume of lipiodol was infused under fluoroscopy (0.5 -1.5 ml for each lobar artery, total volume less than 3.0 ml). CT scan was immediately performed. Blood supply of the pulmonary metastases was assessed according to the accumulation of lipiodol on CT scans. Results No cases but one experienced cough, expectoration, suffocating or dyspnea. No complication of cerebral or visceral embolism occurred. Totally 27 nodules were studied including 6 nodules with cloudy lipiodol accumulation and 6 nodules with tiny granules of lipiodol accumulation. No enlarged tumor vessel or tumor stain was observed within all 27 nodules on pulmonary arterial DSA. Conclusions Pulmonary artery supplys only parts of pulmonary metastases, especially those sited at the peripheral region of the lung. Infusion of small volume of lipiodol through pulmonary artery is safe, and the increased density of lung field could return normal after several days.
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As an important branch of interventional radiology and pediatric radiology, pediatric interventional radiology has been widely accepted by both clinicians and patients' parents due to its marked efficacy and less invasiveness, but its prevalence is still yet to be recommended. This paper overviews the current status of pedatric interventional radiology in our country, its specificity during the clinical management, and existing problems to be solved.
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Objective To evaluate the safety and feasibility of portal CO 2-DSA with fine needle splenic puncture. Methods The splenic tails of seven adult white rabbits were exteriorized by laparotomy, and followed by a 25 gauge fine needle inserting about 1.0 cm into the splenic parenchyma. Portal CO 2-DSA was performed (2.0 ml/s, 10ml) and the images were evaluated. After removal of the needle, the puncture site was observed for bleeding till coagulation occurred. The spleen were taken for gross and histological examination. Results All the CO 2-DSA clearly showed the portal trunk with intrahepatic branches above 3～4 orders, the main splenic vein, and the main mesenteric veins with parts of its branches. CO 2 disappeared from the intrahepatic portal vein over 2～3 minutes. In one animal, the left renal vein and the inferior vena cava were also displayed by CO 2 through communication between splenic vein and renal vein. After removal of the needle, there was small amount of bleeding at the puncture site which ceased spontaneously over 3～5 minutes. In all animals, no extravasation of CO 2 at the puncture site, no subcapsular dissection or intrasplenic hematoma was observed. Microscopically, the splenic capsule appeared intact and there was no evidence of subcapsular hematoma formation.Conclusions Portal CO 2-DSA with fine needle splenic puncture is feasible, safe and efficient. In normal adult rabbit, CO 2 may help to visualize the left renal vein and inferior vena cava through communication between splenic and renal vein.
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Objective To evaluate the clinical efficiency of partial splenic embolization on portal hypertension patients of hepatocellulocarcinoma(HCC).Methods 110 patients of hepatocellulocarcinoma with portohypertension were treated with 1-3 times of TACE, and partial splenic embolization, with PVA of 355～500 ?m injecting into the arteries of inferior splenic pole. In order to control the area of splenic embolization, multi-embolizations were done according to the various conditions. Results 172 times of embolization were performed in 110 patients involving 134 times of fever lasting for 3-30 days and 126 times of bellyache with 27 times appealing for morphine. Treatable hydrothorax appeared in six, and no serious complications occurred. The area of embolization covered 30%～60%. WBC and BPC counts were increased after the 24 hour (P
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0.99.The quantitive restriction was 0.1 ?g/mL,the recovery rate was over 70%.The RSD of intra-and inter-day was less than 15%.The pharmacokinetic parameters of flavonoids were different from each other after ig and iv administration.The absolute bioavailability of flavonoids were 12.9%,10.8%,2.2%,10.2% and 5.9%,respectively.Conclusion The method is sensitive,specific,accurate,and is not only useful for guiding the bioavailability study on the corolla of A. manihot,but also for establishing a reasonable clinical dosage program.The four flavonols in the corolla of A.manihot can be rapidly distributed and eliminated in rats,the pharmacokinetics of two routes of administration are different.A novel integrated pharmacokinetic approach to describing the holistic pharmacokinetic properties of Chinese materia medica has been successfully developed and validated using four flavonols of A.manihot as a model herbal medicine.This study would be a new try for guiding the holistic pharmacokinetic study in consistence with the intrinsic theory and characteristics of traditional Chinese medicine.
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Objective To evaluate the clinical effect of interventional therapy in treating intestinal ischemia of mesenteric venous thrombosis.Methods Twelve cases(male 7 cases,female 5 cases;ranging from 33 to 86 years of age)of mesenteric venous thrombosis(MVT)were treated with percutaneous transhepatic mesenteric venous thrombectomy and thrombolysis associated with papaverin perfusion via superior mesenteric artery.Results Seven of the 12 cases recovered;3 cases were undertaken laparotomy;2 died within 30 days respectively.No severe complications occurred in all of the 12 cases.Conclusions Interventional therapy of MVT is a safe and effective method with reduction of the mortality.(J Intervent Radiol,2006,15:202-205)
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Objective To evaluate the effects of percutaneous embolectomy for treament of acute superior mesenteric artery embolism.Methods 34 cases(atrial fibrillation 14 cases;left atrium myxoma 2 cases;SMA thrombosis 15 cases and chronic mesenteric ischemia 3 cases)of acute mesenteric artery embolism were treated with percutaneous embolectomy using long sheath aspiration method and/or thrombolysis via catheterization of the SMA.Results Successful recanalizations were achieved in all of the 34 superior mesenteric arterial embolism including recovery in 31 cases,laparotomy for 2 cases,and 1 died within 24 hours.Conclusions Percutaneous embolectomy using long sheath aspiration is a simple and effective method for treatment of acute superior mesenteric artery embolism.A correct pathogenetie diagnosis is the key to improve the curative effect and avoid the severe complication.(J Intervent Radiol,2005,15:206-208)
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Objective To discuss the clinical value of preoperative embolization of vertebral tumors. Methods Data of 54 patients were retrospectively studied. Thirteen lesions were in the cervical, 17 in the thoracic, 15 in the lumber and 9 in the sacral regions. The vertebral tumors were embolized prior to operation with gelatin sponge particles, polyvinyl alcohol (PVA) particles or coils. Surgical operations were performed within 1-7 days after the embolization. Results Totally 79 vessels of 43 patients were embolized, which included ascending cervical artery,1;vertebral artery,1;intercostal artery,39; lumber artery,19;internal iliac artery,15 and median sacral artery,4. Intraoperative hemorrhage showed a mean value of 1312 ml with range of 300-3000 ml in patients after embolization, and a mean value of 2375 ml with range of 1500-5000ml in patients without embolization at the same period(P