Objective To summarize the blood supply to the sources and characteristics of advanced breast cancer，and explore the method，efficacy，and clinical applications of preoperative super-selective arterial catheterization chemoembolization under DSA for it. Methods Sixty patients with advanced breast cancer confirmed by the aspiration biopsy from February 2007 to October 2011 in this hospital were selected. Seldinger method was used，distributing of the tumor blood supply artery was identified and intubated the target artery by super-selective arterial catheterization via the femoral artery puncture under the DSA. Then，pirarubicin 60 mg plus paclitaxel 120 mg of two chemotherapy drugs was injected into slowly the target artery and the intervention infusion chemotherapy was performed，finally the tumor blood supply artery was embolizated by gelatin sponge particle. Results A total of 112 conclusive blood supply artery in 60 patients with DSA were found，including eight cases of single blood supply artery，52 cases of multiple blood supply arteries，mainly in the lateral thoracic artery and （or） internal thoracic artery-based. The complete remission rate was 25.0% （15/60），partial remission rate was 73.3% （44/60），stable disease rate was 1.7% （1/60），the total effective rate was 98.3% （59/60）. There was no progression disease. The median remission duration was 19 months，median survival time was 40 months. Conclusions The location of the original foci of breast cancer is closely related to blood supply arteries. The tumor in the lateral of the breast mainly dominates by the lateral thoracic artery blood supply. The tumor in the inner breast mainly dominates by the internal thoracic artery blood supply. The preoperative super-selective arterial catheterization chemoembolization under DSA can obviously improve the therapeutic effect，long-term survival，and the target of interventional chemoembolization.
Patients with coronavirus disease 2019 may have systemic symptoms of varying degrees. These symptoms are related to inflammatory response, massive release of pro-inflammatory cytokines and cytokine storm. In recent years, programmed necrosis, as a controllable type of necrosis, is considered to be an important factor that mediates inflammation. Recent studies have shown that programmed necrosis is involved in the inflammatory response and pulmonary fibrosis of coronavirus disease 2019. This article mainly reviews the mechanism of programmed necrosis, its participation in the occurrence and development of coronavirus disease 2019, and the research progress of programmed necrosis inhibitors in the treatment of coronavirus disease 2019, aiming to provide a certain basis for the diagnosis and treatment of coronavirus disease 2019.
Objective To study the mechanism of alleviating lung ischemia-reperfusion injury by postischemic treatment with namefene hydrochloride, and explore the optimal timing of drug treatment throughout the disease course. Methods A total of 60 rats were randomly divided into six groups with 10 rats in each group: a sham group, a model group, a nalmefene A (NA) group, a nalmefene B (NB) group, a nalmefene C (NC) group and a nalmefene D (ND) group. The sham group without drug treatment was not treated with ischemia-reperfusion. The lung ischemia-reperfusion model was established by occlusion of the left pulmonary hilum in the model group without drug treatment. After ischemic treatment, the NA, NB, NC and ND groups were respectively injected with nalmefene (15 μg/kg) by the tail vein at 5 min before, 10 min, 30 min and 60 min after pulmonary circulation reperfusion. At the 3rd hour after reperfusion, all rats were sacrificed and the specimens from the upper lobe of the left lung tissue were preserved to observe pulmonary lesions, detect wet/dry weight ratio and the activity of myeloperoxidase (MPO), the expressions of tumor necrosis factor-α (TNF-α), Toll-like receptor 2 (TLR2) mRNA and MyD88 mRNA as well as the expressions of TLR2, MyD88, NF-κB p65 and p-NF-κB p65 in lung tissue. Results There were different degrees of alveolar septal destruction, obvious pulmonary interstitial edema, the infiltration of inflammatory cell, the exudationred of blood cell in the mesenchyme, and the collapse of partial alveolar in the model group and the NA, NB, NC, ND groups. In terms of wet/dry weight ratio, the score of lung tissue injury, the activity of MPO, the expressions of TNF-α, TLR2 mRNA and MyD88 mRNA as well as the expressions of TLR2, MyD88, NF-κB p65 and p-NF-κB p65 in lung tissue, the model group were significantly higher than the sham group (P<0.01); there was no significant difference between the ND group and the model group (P>0.05). The corresponding test values of the nalmefene groups with post-ischemic treatment showed the characteristics of ND group> NC group> NB group> NA group (P<0.01). Conclusion The effect of nammefene on alleviating lung ischemia-reperfusion injury is closely related to the inhibition of TLR2, MyD88, NF-κB p65 and phosphorylation of NF-κB p65 with a characteristic of time-dependent manner.