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Intra-arterial therapy of neuroendocrine tumour liver metastases: comparing conventional TACE, drug-eluting beads TACE and yttrium-90 radioembolisation as treatment options using a propensity score analysis model
Minh, DD;Chapiro, J;Gorodetski, B;Huang, Q;Liu, CH;Smolka, S;Savic, LJ;Wainstejn, D;Lin, MD;Schlachter, T;Gebauer, B;Geschwind, JF
EUROPEAN RADIOLOGY 2017年 27卷12期 页码:4995-5005
TRANSARTERIAL CHEMOEMBOLIZATION; HEPATIC METASTASES; ARTERIAL EMBOLIZATION; CARCINOID-TUMORS; ENDOCRINE TUMORS; MANAGEMENT; GUIDELINES; SURVIVAL; RATES
To compare efficacy, survival outcome and prognostic factors of conventional transarterial chemoembolisation (cTACE), drug-eluting beads TACE (DEB-TACE) and yttrium-90 radioembolisation (Y90) for the treatment of liver metastases from gastroenteropancreatic (GEP) neuroendocrine tumours (NELM).;-;This retrospective analysis included 192 patients (58.6 years mean age, 56% men) with NELM treated with cTACE (N = 122), DEB-TACE (N = 26) or Y90 (N = 44) between 2000 and 2014. Radiologic response to therapy was assessed according to Response Evaluation Criteria in Solid Tumours (RECIST) and World Health Organization (WHO) criteria using periprocedural MR imaging. Survival analysis included propensity score analysis (PSA), median overall survival (MOS), hepatic progression-free survival, Kaplan-Meier using log-rank test and the uni- and multivariate Cox proportional hazards model (MVA).;-;MOS of the entire study population was 28.8 months. As for cTACE, DEB-TACE and Y90, MOS was 33.8 months, 21.7 months and 23.6 months, respectively. According to the MVA, cTACE demonstrated a significantly longer MOS as compared to DEB-TACE (p <.01) or Y90 (p = .02). The 5-year survival rate after initial cTACE, DEB-TACE and Y90 was 28.2%, 10.3% and 18.5%, respectively.;-;Upon PSA, our study suggests significant survival benefits for patients treated with cTACE as compared to DEB-TACE and Y90. This data supports the therapeutic decision for cTACE as the primary intra-arterial therapy option in patients with unresectable NELM until proven otherwise.;-;aEuro cent cTACE achieved a significantly longer overall survival in patients with unresectable NELM.;-;aEuro cent Patients treated with cTACE showed a prolonged hepatic progression-free survival.;-;aEuro cent cTACE, DEB-TACE and Y90 radioembolisation demonstrated comparable safety and toxicity profiles.;-;aEuro cent Age > 70 years, extrahepatic metastases and tumour burden > 50% were identified as negative predictors.;-;aEuro cent Propensity score analysis suggests the superiority of cTACE over DEB-TACE and Y90.
An innovative technique of perventricular device closure of a coronary artery fistula through a left parasternal approach
Zhang, Q;Duan, YH;Li, HX;Guo, WB
EUROPEAN HEART JOURNAL 2017年 38卷42期 页码:3177-3177
Increased expression of microRNA-31-5p inhibits cell proliferation, migration, and invasion via regulating Sp1 transcription factor in HepG2 hepatocellular carcinoma cell line
Zhao, GL;Han, CY;Zhang, Z;Wang, L;Xu, J
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 2017年 490卷2期 页码:371-377
CANCER CELLS; BREAST-CANCER; TUMOR-SUPPRESSOR; C-MYC; MIR-31; CARCINOGENESIS; METASTASIS; ONCOGENE; PATHWAYS; PROTEIN
Accumulating evidence has suggested that microRNA-31-5p (miR-31-5p) is dysfunctional in hepatocellular carcinoma (HCC). However, the molecular mechanism of HCC remains unclear. In this study, we investigated the role of miR-31-5p in tumor formation and development of HCC. The expression of miR-31-5p was detected in HCC tissues, corresponding adjacent tissues, normal liver tissues, and HCC cell lines. miR-31-5p mimics and an inhibitor were transfected into HepG2 cells to assess the effects of miR-31-5p on cell proliferation, apoptosis, cell cycle, migration, and invasion assays. Western blotting was used to detect the expression of Sp1 transcription factor (SP1), cyclin D1, and survivin in transfected HCC cells and control cells. The expression of miR-31-5p was significantly decreased in HCC cells and HCC tissues. Overexpression of miR-31-5p inhibited HCC cell growth, migration, and invasion. Overexpression of miR-31-5p reduced the expression of SP1 and cyclin D1, and knockdown of SP1 decreased cyclin Dl expression. The dual luciferase assay showed that miR-31-5p directly targeted SP1 in HepG2. Together, the results suggested that miR-31-5p acted as a tumor suppressor to regulate SP1, and that miR-31-5p could be used as a therapeutic target for the treatment of HCC. (C) 2017 The Authors. Published by Elsevier Inc.
Differential diagnostic performance of acoustic radiation force impulse imaging in small (<= 20 mm) breast cancers: Is it valuable?
Wang, SD;Wang, L;Li, ZX;Wei, KL;Liao, XH;Chen, YY;Huang, X
SCIENTIFIC REPORTS 2017年 7卷
SHEAR-WAVE ELASTOGRAPHY; OF-THE-ART; TISSUE QUANTIFICATION; LESIONS; ULTRASOUND; MASSES; MULTICENTER; MAMMOGRAPHY; COMBINATION; CARCINOMAS
To evaluate acoustic radiation force impulse (ARFI) inthe differential diagnosis of small (<= 20 mm) solid breast lesions and identify the most efficient ARFI parameters. Conventional ultrasonography and ARFIwere performed in 120 patients with 121 small solid breast lesions. The area ratios (ARs) of the lesion on virtual touch tissue compared to B-mode were calculated. The shear wave velocity of the inner (SWVi) and boundary (SWVb) of the lesions and surrounding fatty tissue (SWVf) was measured. The ratio of SWVi to SWVf (SWVrat) was calculated. AR, SWVi, SWVb, and SWVrat were significantly larger in malignant lesions (all P < 0.001). A cutoff AR of 1.17 yielded the highest area under the receiver operating characteristic curveamong the various parameters (91.2% sensitivity, 85.9% specificity, 88.4% accuracy) for the differential diagnosis of small breast lesions, but this value did not significantly differ from SWVi (P = 0.1144). This AR cutoff indowngradingcategory 4a to category 3 would avoid 83.3% unnecessary biopsies, and improved diagnostic specificity up to 73.4% without decreasing sensitivity. AR and SWVi are efficient parameters for the differential diagnosis of small breast lesions, whichwill improve diagnostic specificity and reduce unnecessary biopsies.
KLF15 protects against isoproterenol-induced cardiac hypertrophy via regulation of cell death and inhibition of Akt/mTOR signaling
Gao, L;Guo, YD;Liu, XF;Shang, DY;Du, YJ
BIOCHEMICAL AND BIOPHYSICAL RESEARCH COMMUNICATIONS 2017年 487卷1期 页码:22-27
TRANSCRIPTION FACTOR KLF5; KRUPPEL-LIKE FACTORS; ANGIOTENSIN-II; EXPRESSION; ACTIVATION; DIFFERENTIATION; KLF5/BTEB2; FIBROSIS
Increasing evidence indicate that the Kruppel-like factor KLF15, a member of Cys2/His2 zinc-finger DNA-binding proteins, attenuates cardiac hypertrophy. However, the role of KLF15 in cardiovascular system is largely unknown and the exact molecular mechanism of its protective function is not fully elucidated. In the present study, we established a mouse model of cardiac hypertrophy and found that KLF15 expression was down-regulated in hypertrophic hearts. To evaluate the roles of KLF15 in cardiac hypertrophy, we generated transgenic mice overexpressing KLF15 of KLF15 knockdown mice and subsequently induced cardiac hypertrophy. The results indicated that KLF15 overexpression protects mice from ISO-induced cardiac hypertrophy, with reduced ratios of heart weight (HW)/body weight (BW) and cross-sectional area. We also observed that KLF15 overexpression attenuated cardiac fibrosis, inhibited apoptosis and induced autophagy in cardiomyocytes compared with KLF15 knockdown mice. More importantly, we found that the KLF15 overexpression inhibited the Akt/mTOR signaling pathway. Taken together, our findings imply that KLF15 possesses potential anti-hypertrophic and anti-fibrotic functions, possibly via regulation of cell death pathways and the inhibition of Akt/mTOR axis. KLF15 may constitute an efficient candidate drug for the treatment of heart failure and other cardiovascular diseases. (C) 2017 Elsevier Inc. All rights reserved.
Perventricular double-device closure of wide-spaced multi-hole perimembranous ventricular septal defect
Liang, F;Li, HX;Zhang, HZ;Guo, WB;Zou, CW;Farhaj, Z
JOURNAL OF CARDIOTHORACIC SURGERY 2017年 12卷
MIDTERM FOLLOW-UP; CARDIOPULMONARY BYPASS; TRANSCATHETER CLOSURE; SURGICAL REPAIR; EXPERIENCE; OCCLUDER; SAFE
Background: Device closure of a wide-spaced multi-hole PmVSD is difficult to succeed in percutaneous approach. This study is to evaluate the feasibility, safety and efficacy of perventricular device closure of wide-spaced multi-hole PmVSD using a double-device implanting technique.;-;Methods: Sixteen patients with wide-spaced multi-hole PmVSD underwent perventricular closure with two devices through an inferior median sternotomy approach under transesophageal echocardiographic guidance. The largest hole and its adjacent small holes were occluded with an optimal-sized device. The far-away residual hole was occluded with the other device using a probe-assisted delivery system. All patients were followed up for a period of 1 to 4 years to determine the residual shunt, atrioventricular block and the adjacent valvular function.;-;Results: The number of the holes of the PmVSD was 2 to 4. The maximum distance between the holes was 5.0 to 10. 0 mm (median, 6.4 mm). The diameter of the largest hole was 2.5 to 7.0 mm (median, 3.6 mm). The success rate of double-device closure was 100%. Immediate residual shunts were found in 6 patients (38%), and incomplete right bundle branch block at discharge occurred in 3 cases (19%). Both complications decreased to 6% at 1-year follow-up. Neither of them had a severe device-related complication.;-;Conclusions: Perventricular closure of a wide-spaced multi-hole PmVSD using a double-device implanting technique is feasible, safe, and efficacious. In multi-hole PmVSDs with the distance between the holes of more than 5 mm, double-device implantation may achieve a complete occlusion.
Prenatal Diagnosis of Right Dominant Heart in Fetuses: A Tertiary Center Experience over a 7-year Period
Feng, J;Zhu, M;Liang, H;Li, Q
CHINESE MEDICAL JOURNAL 2017年 130卷5期 页码:574-580
FETAL ECHOCARDIOGRAPHY; Z-SCORES; DISEASE; ANOMALIES; DATABASE
Background: Right dominant heart (RDH) in fetuses can occur with a number of cardiac as well as noncardiac anomalies. Analysis of the enlargement of the right cardiac chamber in the fetus remains a major challenge for sonographers and echocardiographers. The aim of this study was to report the experience with prenatal diagnosis of RDH in the fetuses over a 7-year period.;-;Methods: Fetuses with prenatal diagnosis of RDH from July 2009 to July 2016 were evaluated in two different categories: according to the gestational age, Group I(n = 154, second trimester) and Group II (n = 298, third trimester); and according to the fetal echocardiography diagnosis, Group A (n = 452, abnormal cardiac structure) and Group B (n = 90, normal cardiac structure). Differences in categorical variables were assessed by Chi-square exact test and continuous variables were evaluated by independent Student's t-test or MannuWhitney U-test depending on parametric or nonparametric nature of the data.;-;Results: Over a 7-year period, 452 fetuses were referred for the assessment of suspected RDH. Left-sided obstructive lesions were observed most frequently in the fetuses with RDH. When comparing Group I with Group II and Group A with Group B, the latter groups exhibited significant differences in the right/left ventricle (RV/LV) ratio (1.435 vs. 1.236, P = 0.002; 1.309 vs. 1.168, P = 0.047), RV width Z-score (1.626 vs. 1.104, P < 0.001; 1.553 vs. 0.814, P = 0.014), and above +2 cutoff percentages (14.3% vs. 22.5%; P = 0.038; 21.5% vs. 12.2%, P = 0.046). Multivariable logistic regression revealed no variables associated with perinatal survival.;-;Conclusions: The study demonstrates that RDH warrants careful attention to the possible presence of a structural cardiac anomaly, especially left-sided obstructive lesions. A diagnosis of RDH is best supported by a combination of the RV Z-score and RV/LV ratio. Most of the fetuses with RDH and structurally normal hearts had favorable outcomes.
Insulin-like growth factor 1 and metabolic parameters are associated with nonalcoholic fatty liver disease in obese children and adolescents
Liang, S;Cheng, XD;Hu, YY;Song, RX;Li, GM
ACTA PAEDIATRICA 2017年 106卷2期 页码:298-303
I IGF-I; HEPATIC STEATOSIS; PUBERTAL CHANGES; STEATOHEPATITIS; HORMONE; PATTERN; MODEL; MASS; GH
Aim: Few studies have investigated the relationship between paediatric nonalcoholic fatty liver disease (NAFLD) and insulin-like growth factor 1 (IGF-1). This study, carried out from July 2013 to September 2015, aimed to fill the gap and added metabolic parameters to the analysis.;-;Methods: This was a cross-sectional study of 168 obese children and adolescents (84% male), divided into two groups based on the presence (n = 90) or absence (n = 78) of NAFLD. All participants underwent clinical examinations, anthropometric and laboratory examinations and liver ultrasonography.;-;Results: Nonalcoholic fatty liver disease patients had significantly lower IGF-1 standard deviation score (IGF-1 SDS) and higher body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR) and uric acid levels than the control group. The prevalence rate of NAFLD was negatively correlated with the IGF-1 SDS. IGF-1 SDS was negatively associated with NAFLD, while BMI, HOMA-IR and uric acid were positively associated with NAFLD. The combined analysis of the area under the receiver operating characteristic curve for multiple variables, including IGF-1 SDS, BMI, HOMA-IR and uric acid, was 0.812, with a sensitivity of 78.89% and specificity of 74.36%.;-;Conclusion: IGF-1, BMI, HOMA-IR and uric acid were useful markers of NAFLD in obese children and adolescents.
Breast osteoblastoma and recurrence after resection: Demonstration by color Doppler ultrasound
Li, X;Xin, H;Yang, SF;Zhao, MQ;Wang, XM;Zhang, N
JOURNAL OF X-RAY SCIENCE AND TECHNOLOGY 2017年 25卷5期 页码:787-791
MALIGNANT-TRANSFORMATION; MRI
Osteoblastoma is a rare benign primary bone tumor, which occurs in any part of the skeleton. Extraskeletal osteoblastoma is rather rare. We presented an extremely rare case of extraskeletal osteoblastoma located in the breast. The tumor recurred 7 months later after resection and transformed to aggressive osteoblastoma. The histopathological features, ultrasonic manifestations and ultrasonic differential diagnoses of the primary and recurrent tumors were discussed. The recommended treatment of the tumor is surgical excision. Due to its tendency of recurrence and potential malignant transformation, adequate resection and careful follow up is essential.
Benefits of Levothyroxine Replacement Therapy on Nonalcoholic Fatty Liver Disease in Subclinical Hypothyroidism Patients
Liu, L;Yu, Y;Zhao, M;Zheng, DM;Zhang, X;Guan, QB;Xu, C;Gao, L;Zhao, JJ;Zhang, HQ
INTERNATIONAL JOURNAL OF ENDOCRINOLOGY 2017年
THYROID-STIMULATING HORMONE; DENSITY-LIPOPROTEIN CHOLESTEROL; RANDOMIZED CONTROLLED-TRIAL; UP-REGULATION; RISK-FACTORS; WEIGHT-LOSS; PREVALENCE; STEATOHEPATITIS; POPULATION; DIAGNOSIS
Objectives. To evaluate the effect of levothyroxine (LT4) replacement therapy on nonalcoholic fatty liver disease (NAFLD) in subclinical hypothyroidism (SCH) patients. Methods. This study was a post hoc analysis of a randomized controlled trial and involved 33 significant and 330 mild SCH patients. All of the significant SCH patients received LT4 supplement. The mild SCH patients were grouped as LT4 treated or not. After 15 months of follow-up, prevalence of NAFLD in each group was reevaluated. Subgroup analysis was conducted in mild SCH patients with dyslipidemia. Results. After treatment with LT4, the prevalence of NAFLD in significant SCH patients reduced from 48.5% to 24.2% (p = 0 041). In mild SCH patients, prevalence of NAFLD and serum alanine aminotransferase (ALT) was not significantly affected by LT4 supplementation. Nonetheless, mild SCH patients with dyslipidemia who received LT4 treatment experienced decreases in the prevalence of NAFLD and serum ALT levels (p < 0 05 for both). In contrast, these parameters remained comparably stable in patients who were not treated. Conclusion. LT4 supplementation has benefits on NAFLD in significant SCH patients or mild SCH patients with dyslipidemia. For NAFLD patients with SCH, appropriate supplementation of LT4 may be an effective means of controlling NAFLD.
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