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Biomedical subjects

X D Zhou

Publications and source records attributed to X D Zhou.

At least 19 recordsLinked to original sources

[Improved cryosurgery for primary liver cancer].

Cryosurgery with liquid nitrogen was employed in treating 70 patients with primary liver cancer (PLC). There were 25 cases with small PLC (less than or equal to 5 cm). The postoperative course was uneventful in all. The 1-5 year survival rates were 59.1% (39/66), 37.5% (24/64), 27.0% (17/63), 17.5% (10/57), 12.5% (7/56), respectively in the whole series. The 1-5 year survival rates were 48.4% (15/31), 16.1% (5/31), 6.5% (2/31), 6.5% (2/31), 3.2% (1/31) for 31 cases treated 1973-1977, and 68.6% (24/35), 57.6% (19/33), 46.9% (15/32), 30.8% (8/26), 24.0% (6/25) for 39 cases treated 1978-1989. It is suggested that hepatic cryosurgery is a promising and safe treatment for non-resectable PLC. The remarkable improvement in survival in the latter time period might be attributed to the increased incidence of small PLC, the combined use of hepatic artery ligation and/or regional chemotherapy by hepatic artery cannulation and multimodality treatment.

Adult

[Cryosurgery for primary hepatic cancer of 87 patients].

From november 1973 to June 1991, cryosurgery with liquid nitrogen was performed on 87 patients with primary liver cancer (PLC). Of these, 27 patients was of stage I (31.0%), 52 in stage II (59.8%), and 8 stage III (9.2%). There were 30 patients with PLC of < or = 5 cm (34.5%). Liver cirrhosis was found in 73 patients (83.9%). In the beginning, plate-like cryoprobes and thermocouples were used to monitor the frozen area. Later on we designed single- and multiple-needle cryoprobes for freezing tumors deeply into the hepatic parenchyma and intraoperative ultrasound was used to monitor hepatic cryolesions. The 1-year, 3-year, and 5-year survival rates were 60.5%, 32.0%, and 20.2%, respectively. Among the 30 patients with PLC of < or = 5 cm, the 1-year, 3-year, and 5-year survival rates were 92.6%, 66.6%, and 50.8%, respectively. There were no operative mortality and complications such as rupture of the tumor, delayed bleeding, and bile leakage. These results indicate that cryosurgery is a safe and effective local treatment for unresectable PLC.

Adult

Analysis of one hundred and twenty five patients with primary liver cancer surviving more than five years.

During the period of 1958-1986, a series of 125 patients with pathologically proven hepatocellular carcinoma (HCC) surviving more than 5 years was collected in authors' institute. Thirty seven of them survived more than 10 years, the longest being 30 years. Of the entire series, 55.2% of patients was discovered by screening, 48.0% of patients was subclinical HCC, 80.0% of patients had solitary tumor, and 53.6% of patients had tumor size smaller than 5 cm. Pathological findings revealed that 90.2% of tumor was grade I and II (Edmondson grading) and 81.6% of patients associated with cirrhosis. The serum HBsAg was positive in 63% and anti-HBc in 80% of the patients who had checked the HBV markers. Of the 125 patients, 108 patients received resection, 67 patients were small HCC resection, 41 patients were non-small HCC resection, re-resection for subclinical recurrence or solitary lung metastasis was done in 26 patients with resection. Limited resection amounted to 54.6% of patients with resection. Of the 125 patients, 17 patients received palliative surgery other than resection, including hepatic artery ligation, cannulation, or their combination, etc. Eight out of the 17 patients received second stage resection due to marked shrinkage of tumor. It is concluded that early resection remained the major approach to get a long-term survivor, re-resection for subclinical recurrence is also of proved merit. Resection of huge tumor is still useful but less effective. Cyto-reduction and sequential resection is a new trend. Primary liver cancer (PLC) has long been recognized as incurable malignancy with extremely low 5-year survival rate. According to the cancer statistics in the United States, the relative 5-year survival rates for patients with PLC was 2% in 1960-1963, 3% in 1970-1973, 4% in 1974-1976, 3% in 1977-1980 and 5% in 1981-1986. Patients with PLC survived more than 5 years were rarely reported in the literature. In 1971, Curutchet collected worldwide data from 45 authors covering the period for 65 years (1905-1970), only 45 patients with PLC were found to be 5-year survivors. Thanks to the progress in tumor markers, particularly alpha fetoprotin (AFP) and new localization measurements, diagnosis and treatment are possible in subclinical stage. Based on combined strategies to the treatment of PLC including resection of small liver cancer, re-resection of subclinical recurrence after curative resection, multimodality treatment, and sequential resection after shrinkage of tumor, the 5-year survival of PLC has gradually increased.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent

Multibacterial artificial plaque. A model for studying carious process.

A multibacterial artificial plaque was established in vitro on enamel slabs incubated in mixed culture of Streptococcus sanguis, Streptococcus mutans (serotype c), Streptococcus salivarius, Lactobacillus casei and Actinomyces viscosus. Typical structure same as natural plaque was seen under microscope. The caries-like lesion produced under the plaque was observed in enamel sections. The lesion was similar in appearance to natural ones under optic and scanning electron microscopes. The acids produced in both culture media and artificial plaque were similar in composition and type to those produced in natural plaque after sugar attack. It is suggested that this kind of plaque model may be useful in studying carious process in vitro, because it is easily controlled either by changing the composition of bacteria or by adding different kinds of nutrient in the media. Moreover, the results will be easier to explain than those produced in natural ones.

Dental Caries

Solitary minute hepatocellular carcinoma. A study of 14 patients.

Fourteen patients with clinical Stage I hepatocellular carcinoma (T1N0M0) were studied. All patients were asymptomatic, and their conditions were detected by alpha-fetoprotein (AFP) serosurvey and/or ultrasonography (US) either in the natural population in the early years of the study or in the high-risk population in the later years of the study. Cirrhosis was present in all patients. Radical resection was performed in all patients. There were no operative deaths or hospital deaths in this series. The 5-year survival rate after resection was 100%. There were seven long-term survivors in this series (14.2 years (alive), 11.3 years (alive), 8.8 years (alive), 8.8 years, 7.9 years, 7.6 years (alive), and 7.2 years after resection). The authors discuss aspects concerning early diagnosis, treatment, and prognosis of hepatocellular carcinoma (HCC).

Adult

Resection of the primary liver cancer of the hepatic hilus.

Primary liver cancer (PLC) of the hepatic hilus was designated as a tumor situated at the main branch of the portal vein or pedicle of the hepatic veins in contact with the intrahepatic vena cava. That is, the main tumor located at segment I, IV, V, or VIII and concentrating on the central part of the liver was called "the central type of PLC," which differed from a tumor located at segment II, III, VI, or VII; the latter was called "the peripheral type of PLC." Surgical treatment of the PLC has been significantly improved in the past two decades, but the resection of the central type of PLC is difficult and hazardous. This institution admitted 903 PLC from January 1970 to April 1988, of which 118 cases were the central type; 65 cases were resected successfully, a resectability of 55.1%. One patient died from sepsis within 1 month of operation (mortality 1.53%). The modes of operation for the different segments are described, and suggestions for improvements are presented. The survival rates were compared with a similar number of patients with the peripheral type of tumor in the same period and treated by the same surgeons. The results show noticeable differences. The one-year, three-year, and five-year survival rates after resection were 70.9%, 43.2%, and 39.2% in the central type of PLC; they were 98.3%, 85.0%, and 76.4% in the peripheral type of PLC (P less than 0.001). Further discussion of improvements in surgical techniques and mental awareness are suggested.

Adenoma, Bile Duct

Cytoreduction and sequential resection: a hope for unresectable primary liver cancer.

For decades, unresectable primary liver cancer (PLC) determined by operation was incurable. However, a retrospective study of 24 years' materials with unresectable PLC indicated that 5-year survival of unresectable PLC has increased from 0% in 1966-1977 (n = 137) to 16.9% in 1978-1989 (n = 345). This encouraging improvement was mainly a result of cytoreduction therapy followed by sequential resection. Multimodality combination treatment with hepatic artery ligation, plus hepatic artery infusion with chemotherapy, plus radioimmunotherapy (or radiotherapy) yielded the highest sequential resection rate (30.6%) and 5-year survival (28.0%) as compared with double combination and single modality treatment. The 5-year survival of 33 patients receiving sequential resection after cytoreduction therapy was 63.2%. It is suggested that cytoreduction and sequential resection might offer a hope for surgically verified unresectable PLC.

Adolescent

Amniotic fluid contains tissue factor, a potent initiator of coagulation.

A primary clinical manifestation of amniotic fluid embolism is coagulopathy. Prior studies have identified a poorly characterized yet potent procoagulant property in amniotic fluid that increases with gestational age. One possible source of procoagulant activity is tissue factor, a primary biologic initiator of coagulation. We used sensitive immunoassays and functional assays to identify substantial quantities of tissue factor antigen and tissue factor-specific procoagulant activity in amniotic fluid, which increased with gestational age. Moreover, tissue factor accounted for virtually all of the coagulant potential of amniotic fluid. Amniotic tissue factor appeared intact and membrane bound and, when reconstituted into synthetic microvesicles of optimal phospholipid content, displayed nearly full activity. Calcium chelation and sonication experiments suggested that the presence of inhibitors and the physical configuration of membrane-bound tissue factor in amniotic fluid might explain the modest reduction in tissue factor procoagulant activity relative to total antigen levels observed in vivo. We postulate that the substantial quantities of functionally active tissue factor in amniotic fluid account for the coagulation changes accompanying amniotic fluid embolism and could indirectly contribute to the characteristic hemodynamic derangements of amniotic fluid embolism.

Amnion

[Hepatic artery ligation and intrahepatic arterial chemotherapy for nonresectable primary liver cancer].

We reported the results of hepatic artery ligation (HAL) and infusion (HAI) with chemotherapy in the treatment of 356 patients with nonresectable primary liver cancer (PLC). A comparison of data between the periods 1958-1977 (81 cases) and 1978-1989 (275 cases) revealed that remarkable improvement in survival in the latter period might be attributed to the accurate site of hepatic artery cannulation, long-term infusion with chemotherapy, and combined treatment with subsequent tumor resection. During 1978-1989, the 5-year survival rates of different treatment modalities were 0% in HAL (n = 36) alone, 7.9% in HAI (n = 67) alone, 24.4% in HAL + HAI (n = 112, with subsequent resection in 10 cases), 36.5% in HAL + HAI + radiation (internal and/or external) (n = 60, with subsequent resection in 19 cases). The results indicate that HAL + HAI + combined treatment might provide a hope for the prolongation of survival or even resection in some patients with nonresectable PLC.

Adolescent

Hepatic artery ligation and infusion chemotherapy for unresectable primary liver cancer.

During the period of 1958-1989, 356 patients with pathologically proven primary liver cancer (PLC) were determined by laparotomy to be unresectable. Of the 356 patients, 51 (14.3%) were of subclinical stage, 287 (80.6%) of moderate stage and 18 (5.1%) of late stage. The association of liver cirrhosis was present in 310 patients (87.1%). Treatment modalities in 356 patients were divided into 4 groups: hepatic artery ligation (HAL) (51), hepatic artery infusion (HAI) of chemotherapeutic agents (114), HAL + HAI (117), and HAL + HAI + radiotherapy (74). The 5-year survival rate was zero in the 4 groups in the period of 1958-1977. During 1978-1989, however, the 5-year survival rate was zero in HAL, 7.9% in HAI, 24.4% in HAL + HAI (with second look resection in 10 patients), and 36.5% in HAL + HAI + radiotherapy (with second look resection in 19). The marked improvement in survival in later period was attributable to the accurate site of hepatic artery catheter, longer infusion chemotherapy, and combination treatment, particularly second look resection in some of the patients. These results indicate that HAL + HAI + combination treatment might provide a possible prolongation of survival or even resection in some patients with original unresectable PLC.

Adolescent

Current management of hepatocellular carcinoma.

After a long, hopeless period in the management of hepatocellular carcinoma (HCC), the diagnosis and treatment of HCC have progressed remarkably in the past decade. In particular the discovery of asymptomatic HCC in the early 1970s opened up a new era in clinical research of HCC. With the progress in the diagnostic imaging of liver tumors, a 1 cm hepatic mass can now be detected. It is especially worth noting that a 5-year survival rate of 72.9% has been achieved after the resection of the tumor in asymptomatic HCC patients. The role of surgery in the treatment of HCC has become more important. Various modalities of medical treatment and combination therapy have been recommended and used. Despite the progress in the early diagnosis and treatment of HCC, a complete cure is very rare. Problems to be studied include new tumor markers for the early detection of alpha-fetoprotein (AFP)-negative HCC, the development of more specific treatments for unresectable HCC with uncompensated cirrhosis, and an effective approach to preventing recurrence and metastasis after radical resection.

Carcinoma, Hepatocellular

Hemiparkinsonism in monkeys following unilateral common carotid artery infusion of MPTP. A study of behavior, biochemistry and histology.

After local surgical exposure, we administrated 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) directly into the right common carotid artery of 5 rhesus monkeys. All the monkeys manifested akinesia, rigidity and postural tremor of the contralateral limbs, and spontaneous circling toward the MPTP treated side. These disturbances began to appear 3-4 days after injection, peaking at one month, and continued until the day of sacrifice. After treatment with madopar and apomorphine, marked improvements of the motor impairments appeared and a striking reversal of the direction of rotation away from the MPTP-treated side occurred in a dose-dependent manner. The ipsilateral neurotoxicity was confirmed biochemically by 99% reduction in the caudate-putamen dopamine levels and histologically by selective cell loss in the substantia nigra of the MPTP-treated side. It is concluded that this primate model of hemiparkinsonism is easy to reproduce and life is maintained with good health otherwise. So it may be more feasible for behavioral and pharmacological studies of Parkinson's disease.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine

A new silent mutation found in the Chinese PAH locus and its role in the prenatal diagnosis of phenylketonuria.

A silent mutation or sequence polymorphism. A to T substitution at codon 399 in exon 11 of the PAH gene from a Chinese PKU patient, was found by sequence analysis. The frequencies of this new mutation in normal and abnormal (PKU) genes were 0.005 and 0.09, respectively, based on the analyses of 100 normal individuals and 39 PKU patients using DNA amplification with polymerase chain reaction (PCR) and oligonucleotide hybridization methods. This silent mutation can be used as a "genetic marker" for PKU prenatal diagnosis. Recently, a fetus at risk for PKU, who could not be completely predicted by RFLPs linkage analysis, was prenatally diagnosed with this genetic marker.

Asian People

Radioimmunotherapy in the multimodality treatment of hepatocellular carcinoma with reference to second-look resection.

Experimental study using nude mice human hepatocellular carcinoma (HCC) xenograft indicated that the combination treatment with iodine 131 (131I)-anti-human HCC isoferritin (131I-isoFtAb), cisplatin, and mixed bacterial vaccine (MBV) yielded better inhibition rate as compared with double combination or 131I-isoFtAb alone. Based on these findings, 25 patients with surgically proven nonresectable and pathologically proven HCC have been treated by radioimmunotherapy using 131I-isoFtAb intrahepatic arterial infusion as a part of multimodality treatment. Of the 25 patients, seven (28.0%) received second-look resection after marked shrinkage of tumor. The 1-year survival was 52.5% (12/23) and 2-year survival 27.7% (five of 18) in the entire series. Of the five patients with 2-year survival, four were in the second-look resection group. Patients with tumor less than or equal to 8 cm showed higher second-look resection rate (62.5% versus 11.8%) and 1-year survival (85.7% versus 37.5%) as compared with tumor greater than 8 cm. Mixed bacterial vaccine as adjuvant immunotherapy seemed effective to prolong survival. The 2-year survival was higher in patients with second-look resection as compared with those without (75.0% versus 14.3%). Thus, radioimmunotherapy using 131I-isoFtAb might be one of the modalities of choice, particularly in the conversion of nonresectable to resectable HCC in a well-designed multimodality treatment regimen.

Animals

Prenatal detection of an Arg----Ter mutation at codon 111 of the PAH gene using DNA amplification.

A CGA----TGA mutation at codon 111 in exon 3 of the phenylalanine hydroxylase (PAH) gene was recently identified in a Chinese phenylketonuria (PKU) patient. This paper reports the prenatal diagnosis of a Chinese fetus at risk for PKU using DNA amplification with PCR and oligonucleotide hybridization. RFLP analysis revealed that the fetus had inherited a PKU gene from his mother, but his paternal PAH gene was uninformative. PCR amplification of 300 bp which included exon 3 plus the flanking intronic sequences of the PAH gene was performed. The amplified DNA was hybridized with a pair of allele-specific oligonucleotide probes. The results indicated that the fetal DNA carried a PAH 111 Arg----Ter mutant gene inherited from his father. Thus, the fetus was predicted to be affected with PKU.

Adult

Detection of beta-thalassemia mutations in the Chinese using amplified DNA from dried blood specimens.

This paper describes DNA polymerase chain reaction (PCR) amplification directly from dried blood specimens for the detection of the beta-thalassemia mutation in China. Target DNA was amplified to span the beta-globin gene regions, which included ten types of mutation sites specific for Chinese beta-thalassemias. Ten kinds of oligonucleotide probes were constructed and used to hybridize with the amplified DNA. A total of 170 beta-thalassemia alleles originating from eastern, southwestern and southern China were analyzed. The results revealed that the distributions of different types of mutations were different in the three regions. The most common types in southern China were a frameshift at codons 41/42 and a C----T substitution at IVS II n.654, the most frequent types in southwestern China were codon 17 and IVS II n.654 mutations, and the predominant mutations in eastern China were frameshifts at codons 41/42 and 71/72.

Base Sequence

[Pathological changes in an animal model of acute pulmonary injury induced by hemorrhagic shock and E. coli infection].

An animal model of API similar to RDS was established by feeding the rabbits with live E. Coli (10(11)/kg B.W.) and bleeding them till a mean arterial pressure of 6.0 kPa was maintained for 90 minutes. After resuscitation, there were decrease of PaO2, increase of respiratory rate as well as lung edema. Histological and electron microscopic examination showed interstitial and alveolar edema. The tight junctions both in alveolar epithelium and capillary endothelium showed alterations including discontinuity, irregularity, and free-ended strands being present as early as the 4th hour by freeze-fracture technique. Impairment of the tight junctions is considered to be the main route of fluid leakage from pulmonary capillaries inducing pulmonary edema.

Animals