Chemotherapy with laparoscope-assisted continuous circulatory hyperthermic intraperitoneal perfusion for malignant ascites

AIM:To investigate the procedure, feasibility and effects of laparoscopeassisted continuous circulatory hyperthermic intraperitoneal perfusion chemotherapy (CHIPC) in treatment of malignant ascites induced by peritoneal carcinomatosis from gastric cancers. METHODS: From August 2006 to March 2008, the laparoscopic approach was used to perform CHIPC on 16 patients with malignant ascites induced by gastric cancer or postoperative intraperitoneal seeding. Each patient underwent CHIPC three times after laparoscopeassisted perfusion catheters placing. The first session was completed in operative room under general anesthesia, 5% glucose solution was selected as perfusion liquid, and 1500 mg 5 fluorouracil (5FU) and 200 mg oxaliplatin were added in the perfusion solution. The second andthird sessions were performed in intensive care unit, 0.9% sodium chloride solution was selected as perfusion liquid, and 1500 mg 5FU was added in the perfusion solution alone. CHIPC was performed for 90 min at a velocity of 450600 mL/min and an in flow temperature of 43 ± 0.2℃.RESULTS: The intraoperative course was uneventful in all cases, and the mean operative period for laparoscopeassisted perfusion catheters placing was 80 min for each case. No postoperative deaths or complications related to laparoscopeassisted CHIPC occurred in this study. Clinically complete remission of ascites and related symptoms were achieved in 14 patients, and partial remission was achieved in 2 patients. During the followup, 13 patients died 29 mo after CHIPC, with a median survival time of 5 mo. Two patients with partial remission suffered from port site seeding and tumor metastasis,and died 2 and 3 mo after treatment. Three patients who are still alive today survived 4, 6 and 7 mo, respectively. The Karnofsky marks of patients (5090) increased significantly (P < 0.01) and the general status improved after CHIPC. Thus satisfactory clinical efficacy has been achieved in these patients treated by laparoscopic CHIPC. CONCLUSION: Laparoscopeassisted CHIPC is a safe, feasible and effective procedure in the treatment of debilitating malignant ascites induced by unresectable gastric cancers.

Resection of a giant hepatocellular carcinoma weighing over ten kilograms

The authors report a giant hepatocellular carcinoma(HCC)with a diameter over 30 cm and weight over 10 kg that was resected completely.A 62-year-old man was admitted because of continuous abdominal uplift.A computed tomography scan demonstrated that the entire abdomen was filled with a giant tumor containing both cystic and solid components with a size of 29 cm×22 cm.The huge tumor was successfully resected without any complication,such as massive hemorrhage or visceral injuries.The size and weight of the tumor were 35 cm×30 cm×15 cm and 10050 g,respectively.Pathological examination showed that the tumor was a well-differentiated HCC,and α-fetoprotein was positive.Postoperative syndrome,characterized by hypovolemic shock,diarrhea and urine retention,was observed and induced by abdominal decompression.This syndrome was resolved with expectant treatment.The patient was still alive without recurrence after a 27-mo follow-up.

Preparation,physicochemical characterization and cytotoxicity in vitro of gemcitabine-loaded PEG-PDLLA nanovesicles

AIM:To investigate the preparation,physicochemical characterization and cytotoxicity in vitro of Gemcitabine-loaded poly(ethylene glycol)-block-poly(D,L-lactide) (PEG-PDLLA) nanovesicles. METHODS:The nanovesicle carriers were prepared from the amphiphilic block copolymer of PEG-PDLLA by a double emulsion technique,and gemcitabine was used as the model drug. The morphology of the nanovesicles was determined by scanning and transmission electron microscopy,and the drug content,drug entrapment and drug-release curve in vitro were detected by UV-Vis-NIR spectrophotometry. Cytotoxicity in the human pancreatic cancer cell line SW1990 was tested by 3-(4,5-dimethyl) ethiazole (MTT) assay.RESULTS:The gemcitabine-loaded nanovesicles were hollow nanospheres with a mean size of 200.6 nm,drugloading of 4.14% and drug embedding ratio of 20.54%. The nanovesicles showed excellent controlled release that was characterized by a fast initial release during the first 72 h,followed by a slower and continuous release. The MTT assay demonstrated that gemcitabine-loaded nanovesicles exhibited dose-dependent and time-delayed cytotoxicity in the human pancreatic cancer cell line SW1990.CONCLUSION:Gemcitabine-loaded PEG-PDLLA nanovesicles prepared by a double emulsion technique exhibited good performance for controlled drug release,and had similar cytotoxic activity to free gem-citabine.

Safety and efficacy of polymer-free paclitaxel-eluting microporous stent in real-world practice： 1-year follow-up of the SERY-I registry

Background Polymer coating on coronary stents induces vascular inflammatory response, reduces re-endothelialization, and affects long-term outcome after percutaneous coronary intervention （PCI）. The SERY-1 registry aimed to determine whether a novel polymer-free paclitaxel-eluting microporous Yinyi stent could improve 1-year outcome after index procedure in real-world clinical practice. Methods Clinical and angiographic data and follow-up outcome were collected in 1045 patients who underwent PCI with implantation of 〉1 Yinyi stents between June 2008 and August 2009 at 27 medical centers. The primary endpoint was the cumulative rate of composite major adverse cardiac events （MACE） and the secondary endpoint was the incidence of stent thrombosis at 1 year. Results Overall, 1376 lesions were treated successfully with 1713 Yinyi stents, and 1019 （98.7%） patients received dual antiplatelet therapy for at least 12 months. During 1-year follow-up, 8 patients （0.78%） had cardiac death, 6 （0.58%） suffered non-fatal myocardial infarction, and 46 （4.46%） underwent repeat PCI due to recurrence of angina, resulting in 1-year MACE-free survival of 94.09%. Stent thrombosis occurred in 10 （0.97%） patients, and the rate of Academic Research Consortium （ARC） definite or probable stent thrombosis was 0.78%. Conclusions Polymer-free paclitaxel-eluting microporous Yinyi stent is effective and safe for interventional treatment of coronary artery disease in real-world clinical practice, without recourse to carrier polymer. Potential long-term clinical advantages of this stent deserve further investigation.

The combination of recombinant rAd-p53 and adriamycin for management of primary drug resistance in chemotherapy of lung squamous cell cancer

Objective To investigate the combination of wildtype p53 (wtp53) gene substitution and adriamycin (ADM) on the lung cancer in vivo. Methods The effect of combination of recombinant Adeno-wtp53 (rAdp53) and ADM on reversing primary drug resistance to ADM was studied for the nonsmall cell lung cancer (NSCLC) in a nude mice model developed by subcutaneously transplanting with the 16HBE lung cancer

Specific induction of anti-leukemia effects by umbilical cord cell-derived CD8^+ T cytotoxic lymphocytes

Objective To explore the specific anti-leukemia immune response of CD8+ cytotoxic T lymphocyte (CTL) derived from cord blood (CB) ex vivo and evaluate the feasibilities and values of the CTL for specific immunotherapy. Methods Dendritic cells (DC) were induced from mononuclear cells (MNC) by combination cytokines in 10 CB samples. Loading U937 cell lysate antigen

The possible mechanism of lung injury induced by severe acute respiratory syndrome coronavirus spike glycoprotein

Objective To investigate the role of severe acute respiratory syndrome coronavirus (SARS-CoV) in the induction of acute lung injury by promoting the synthesis of chemokine/cytokines in human endothelial cells. Methods Twenty-three SARS patients were enrolled in this study, comprising 15 males and 8 females, aged 27～55 years, mean (36±6) years. They were treated at Guan-

The study of hydrogen proton magnetic resonance spectroscopy of the hippocampus of patients with dementia with Lewy bodies and Alzheimer's disease

Objective To investigate the characteristics of hydrogen proton magnetic resonance spectroscopy(1H-MRS) in the bilateral hippocampus in patients with dementia with Lewy bodies(DLB) and Alzheimer’s disease(AD) and their value in differentiating DLB from AD.