Objective To explore the efficacy and safty of sorafenib in Child-Pugh class B to class C hepatocellular carcinoma (HCC).
Methods In this three-center open-label study from November 2011 to May 2013, we randomly assigned 189 patients with advanced Child-Pugh class B or C HCC patients into two groups, one group with 95 patient to receive sorafenib (400 mg a time, twice a day) and the other group with 94 patients to receive best supportive care. The primary end points were progression-free survival and overall survival.
Results The median progression-free survival was 2.2 months and 1.9 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.55; 95% confidence interval, 0.40-0.75;P=0.002). The median overall survival was 4.0 months and 3.5 months in the sorafenib group and best supportive care group respectively (Hazard ratio in the sorafenib group, 0.48;95%confidence interval, 0.35-0.68;P<0.001). The main adverse effect of sorafenib was rash and acne of the skin (in 51.7%patients). The incidences of severe rash, diarrhea, and dry skin were 5.6%, 5.6%, and 2.2%in the sorafenib group. One patient reached partial response in the sorafenib group.
Conclusions Sorafenib is safe in patients with liver function impaired advanced HCC. It is effective in terms of progression-free survival and overall survival compared with best supportive care. Liver functions are the important predictive factors.

Objective To compare the therapeutic effects and safety of monopolar and bipolar radiofrequency (RF) ablation used during cardiac surgery to treat atrial fibrillation.
Methods We retrospectively studied a total of 81 patients with chronic atrial fibrillation who underwent open cardiac surgery with concomitant RF ablation between January 2007 and March 2011. Fifty-eight patients received bipolar RF ablation and 23 received monopolar RF ablation, respectively. The sinus rhythm restoration rate, the procedural duration, the frequency of severe perioperative complications, and mortality were compared between the two groups.
Results The sinus rhythm restoration rate did not differ significantly between the two groups after follow-up of 15.1 ± 12.6 months (P=0.199). The frequencies of severe perioperative complications and mortality were also similar in the two groups. The total procedural time using bipolar RF ablation was significantly shorter than that using monopolar ablation (19.7±4.6 minutes vs. 28.1±8.5 minutes, P<0.001).
Conclusions Both monopolar and bipolar RF ablation are safe and effective in treating chronic atrial fibrillation patients during open cardiac surgery, but bipolar RF ablation is more convenient in practice.

Objective To investigate the efficacy of hematopoietic stem cell (HSC) transplantation via the hepatic artery vs. the portal vein for end-stage liver disease (ESLD).
Methods Patients with hepatic decompensation were prospectively recruited from September 2010 to September 2012 to receive HSC transplantation via the hepatic artery or the portal vein. Liver function was examined at 3, 6, and 12 months after transplantation. Liver biopsy results were analyzed using the Knodell score.
Results Eighty patients (58 males and 22 females) were enrolled in the study. The Child-Pugh score was grade B in 69 cases, and grade C in the remaining 11 cases. HSC transplantation was performed via the portal vein in 36 patients and via the hepatic artery in 44 patients. ALT levels decreased while serum albumin levels increased significantly in both groups at 6 and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Total bilirubin levels decreased significantly in both groups at 3, 6, and 12 months after HSC transplantation (P<0.05 compared with pre-transplantation levels). Additionally, prothrombin time decreased in both groups at 12 months after HSC transplantation (P<0.05 compared with pre-transplantation level). There were no significant differences in ALT, total bilirubin and prothrombin time between the two groups either before or after transplantation. Moreover, Knodell score decreased significantly at 6 and 12 months. Histological examination showed that liver cell edema, degeneration, necrosis, and inflammation were significantly relieved at 3, 6, and 12 months after transplantation. The incidence of portal vein thrombosis, upper gastrointestinal bleeding, and hepatic encephalopathy were 1.25%, 3.75%, and 2.5%respectively.The one-year survival rate was 100%.
Conclusions Autologous HSC transplantation improves liver function and histology in ESLD patients. The administration route of HSC has no significant impact on the efficacy of transplantation.

Objective To investigate the relevant factors of coronary artery disease (CAD) in young people under 40 years of age.
Methods The study population was 292 young patients accepting coronary angiography in Fuwai Hospital from July to December 2006, including 272 men and 20 women, with the mean age being 36.7±3.7 years. The diagnosis of CAD was made in the cases presenting ≥50%stenosis in coronary lumen in coronary angiography. Based on the diagnosis, 217 patients (204 men, 13 women) were assigned to CAD group, and 75 (68 men, 7 women) to non-CAD group. Clinical data and metabolic characteristics of the patients were collected and analyzed using t-test,χ2 test, and multinomial logistic regression with SPSS 8.0 software.
Results Most study subjects were current smokers (209/292, 71.6%), and more than half had body mass index (BMI)>24 kg/m2 (230/292, 78.8%) and usually took high-fat diet (162/292, 55.5%). The proportion of heavy smokers (smoking history ≥10 years and ≥20 cigarettes per day) were significantly higher in the CAD group than in the non-CAD group [20.7%(45/217) vs. 9.3%(7/75), P=0.015)]. Heavy smoking [odds ratio (OR), 1.89;95%confidence interval (CI), 1.74-2.05], hypertension (OR, 1.56;95%CI, 1.48-1.65), alcohol (OR, 1.37;95%CI, 1.30-1.46), type 2 diabetes mellitus (OR, 1.37;95%CI, 1.25-1.50), high-fat diet (OR, 1.35;95% CI, 1.28-1.43), and BMI>24 kg/m2 (OR, 1.09;95% CI, 1.03-1.17) were factors related to CAD in the young patients (all P<0.05). Total cholesterol (4.56±1.46 mmol/L vs. 4.09±1.00 mmol/L), low-density lipoprotein cholesterol (2.38±1.11 mmol/L vs. 2.14±0.63 mmol/L), lipoprotein a (134.97±109.70 mg/L vs. 101.58±58.39 mg/L), uric acid (359.89±100.09 μmol/L vs. 336.75±94.36μmol/L), erythrocyte sedimentation rate (9.98±12.19 mm/hour vs. 4.89±4.92 mm/hour), high-sensitivity C-reactive protein (3.42±4.39 mg/L vs. 2.80±3.77 mg/L) and Big endothelin-1 (1.41±1.50 fmol/mL vs. 0.77±1.13 fmol/mL) in plasma were significantly increased in the CAD group compared with the non-CAD group (all P<0.05).
Conclusions Heavy smoking, hypertension, alcohol consumption, type 2 diabetes mellitus, high-fat diet and BMI>24 kg/m2 were significantly related to CAD in patients aged ≤ 40, with heavy smoking presenting the highest OR. Metabolic syndrome and inflammation were also more common in young CAD patients than in non-CAD patients.

Objective To identify the possible association between C(-106)T polymorphism of the aldose reductase (ALR) gene and diabetic retinopathy (DR) in a cohort of Chinese patients with type 2 diabetes mellitus (T2DM).
Methods From November 2009 to September 2010, patients with T2DM were recruited and assigned to DR group or diabetic without retinopathy (DWR) group according to the duration of diabetes and the grading of 7-field fundus color photographs of both eyes. Genotypes of the C(-106)T polymorphism (rs759853) in ALR gene were analyzed using the MassARRAY genotyping system and an association study was performed.
Results A total of 268 T2DM patients (129 in the DR group and 139 in the DWR group) were included in this study. No statistically significant differences were observed between the 2 groups in the age of diabetes onset (P=0.10) and gender (P=0.78). The success rate of genotyping for the study subjects was 99.6%(267/268), with one case of failure in the DR group. The frequencies of the T allele in the C(-106)T polymorphism were 16.0%(41/256) in the DR group and 19.4%(54/278) in the DWR group (P=0.36). There was no significant difference in the C(-106)T genotypes between the 2 groups (P=0.40). Compared with the wild-type genotype, odds ratio (OR) for the risk of DR was 0.7 (95% CI, 0.38-1.3) for the heterozygous CT genotype and 0.76 (95%CI, 0.18-3.25) for the homozygous TT genotype. The risk of DR was positively associated with microalbuminuria (OR=4.61; 95% CI, 2.34-9.05) and insulin therapy (OR=3.43;95%CI, 1.94-6.09).
Conclusions Microalbuminuria and insulin therapy are associated with the risk of DR in Chinese patients with T2DM. C(-106)T polymorphism of the ALR gene may not be significantly associated with DR in Chinese patients with T2DM.

Objective To determine the efficacy of palliative radiotherapy in treating tumor-stage cutaneous T-cell lymphoma/mycosis fungoides (MF).
Methods From January 2008 to January 2013, a total of 11 patients with tumor-stage MF were treated with local radiation therapy in Peking Union Medical College Hospital. The median age of these patients was 53.36±14.45 years. Female-male ratio was 1:1.2. The average course of disease was 10.82±3.37 years. All the patients were treated with local electronic beam irradiation with a total median dosage of 48.55±9.51 (40-74) Gy in an average of 24.55±5.57 (20-40) fractions, 5 fractions per week.
Results The median follow-up time was 55.27±29.3 (13-103) months. No severe acute or chronic side effects of irradiation were observed. Complete clinical response (CR) rate of the radiated sites was 54.5%(6/11), partial response (PR) rate was 36.4%(4/11), and the overall response rate (CR+PR) was 90.9%. One patient showed no response.
Conclusion Local radiotherapy with psolaren plus ultraviolet A and/or interferon maintaining treatment is an effective palliative therapy in the treatment of tumor-stage MF patients.

Objective To evaluate the effectiveness and safety of a computer-controlled periodontal ligament (PDL) injection system to the local soft tissues as the primary technique in endodontic access to mandibular posterior teeth in patients with irreversible pulpitis.
Methods A total of 162 Chinese patients who had been diagnosed with irreversible pulpitis in their mandibular posterior teeth without acute infection or inflammation in the periodontal tissues were enrolled in this clinical study. The patients were divided into 3 groups according to the position of the involved tooth:the premolar group (PM, n=38), first molar group (FM, n=66), and second molar group (SM, n=58). All the patients received computer-controlled PDL injection with 4%articaine and 1∶100 000 epinephrine. Immediately after the injection, endodontic access was performed, and the degree of pain during the treatment was evaluated by the patients using Visual Analogue Scale for pain. The success rates were compared among the 3 groups. The responses of local soft tissues were evaluated 3-8 days and 3 weeks after the procedure.
Results The overall success rate was 76.5%. There was a significant difference in success rates among the PM, FM, and SM groups (92.1%, 53.0%, 93.1%, respectively;χ2=34.3, P<0.01). Both the PM and SM groups showed higher success rates than that of the FM group (v=1, χ2=16.73, P<0.01; v=1, χ2=24.5, P<0.01). No irreversible adverse effects on the periodontal soft tissues at the injection sites were observed in the follow-up visits in any of the groups.
Conclusion The computer-controlled PDL injection system demonstrates both satisfactory anesthetic effects and safety in local soft tissues as primary anesthetic technique in endodontic access to the mandibular posterior teeth in patients with irreversible pulpitis.

This paper summarized the Chinese literatures in the previous 5 years about the pre-clinical animal researches on the application of electro-acupuncture (EA) treatment for depression, searched in China National Knowledge Infrastructure (CNKI). The efficiency of EA treatment for depression and the mechanism of it were discussed, to shed light on new ideas and new fronts for the further research on depression in clinical or pre-clinical fields.