The clinical effect of stereotactic radiation therapy combined with sorafenib in the treatment of primary hepatic cancer / 中国医师进修杂志

Objective:To investigate the clinical effect of stereotactic radiation therapy combined with sorafenib in the treatment of primary hepatic cancer (PHC).Methods:Ninety-two PHC patients admitted to Cancer Hospital of China Medical University from January 2017 to May 2018 were selected and divided into the observation group and the control group according to the random number table method, with 46 cases in each group. The control group was treated with stereotactic radiation therapy, and the observation group was treated with sorafenib on the basis of the control group. Clinical efficacy and incidence of adverse reactions in the two groups were compared; the scores of Karnofsky performance scale (KPS) and the levels of serum vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), hypoxia-inducing factor (HIF-1α), soluble interleukin-2 receptor (sIL-2R), transforming growth factor (TGF-β1) and alpha-fetoprotein (AFP) before and after the treatment between the two groups were compared. The overall survival (OS) of patients in both groups was recorded after 36 months of follow-up.Results:The total effective rate in the observation group was higher than that in the control group: 84.78%(39/46) vs. 65.22%(30/46), there was statistical difference ( χ2 = 4.70, P<0.05). After the treatment, the score of KPS in the observation group was higher than that in the control group: (85.06 ± 7.19) scores vs. (71.16 ± 7.08) scores; the levels of VEGF, bFGF, HIF-1α, AFP, TGF-β1, sIL-2R in the observation group were lower than those in the control group: (189.52 ± 31.47) ng/L vs. (235.81 ± 35.45) ng/L, (3.89 ± 0.97) ng/L vs. (6.74 ± 1.85) ng/L, (50.17 ± 6.09) ng/L vs. (53.07 ± 6.28) ng/L, (85.76 ± 14.09) μg/L vs. (131.51 ± 18.74) μg/L, (81.07 ± 12.96) μg/L vs. (106.58 ± 15.07) μg/L, (311.58 ± 74.81) kU/L vs. (405.97 ± 85.74) kU/L, there were statistical differences ( P<0.05). The results of 36 months follow-up showed that the 1-year and 3-year OS in the observation group were higher than those in the control group: 69.57% (32/46) vs. 58.70% (27/46), 43.47% (20/46) vs. 28.26 %(13/46), there were significant differences ( χ2 = 4.78, 3.94, P<0.05). Conclusions:Stereotactic radiation therapy combined with sorafenib can effectively improve the efficacy of PHC patients, reduce the expression of VEGF and bFGF, effectively inhibit tumor growth, but also prolong the survival time of patients, with both safety and high effectiveness, and good use value.

Glutathione S-transferase genetic polymorphisms and fluoride-induced reproductive toxicity in men with idiopathic infertility / 亚洲男科学杂志(英文版)

Male infertility caused by idiopathic oligoasthenospermia (OAT) is known as idiopathic male infertility. Glutathione S-transferase (GST) and fluoride may play important roles in idiopathic male infertility, but their effects are still unknown. Our study examined the relationship between GST polymorphisms and fluoride-induced toxicity in idiopathic male infertility and determined the underlying mechanism. Sperm, blood, and urine samples were collected from 560 males. Fluoride levels were measured by a highly selective electrode method, and GST genotypes were identified using polymerase chain reaction (PCR) and PCR-restriction fragment length polymorphism (PCR-RFLP). Semen parameters, DNA fragmentation index (DFI), mitochondrial membrane potential (MMP), and oxidative stress (OS) biomarkers were statistically assessed at the P < 0.05 level. Compared with healthy fertile group, semen parameters, fluoride levels, OS biomarkers, sex hormone levels, and MMP and DFI levels were lower in the idiopathic male infertility group. For glutathione S-transferase M1 (GSTM1[-]) and glutathione S-transferase T1 (GSTT1[-]) or glutathione S-transferase P1 (GSTP1) mutant genotypes, levels of semen fluoride, OS, MMP, and DFI were considerably higher, and the mean levels of sperm parameters and testosterone were statistically significant in GSTM1(+), GSTT1(+), and GSTP1 wild-type genotypes. Both semen and blood fluoride levels were associated with oxidative stress in idiopathic male infertility patients. Elevated fluoride in semen with the genotypes listed above was linked to reproductive quality in idiopathic male infertility patients. In conclusion, GST polymorphisms and fluorine may have an indicative relationship between reproductive quality and sex hormone levels, and OS participates in the development of idiopathic male infertility.

Analysis on characteristic of stage Ⅰ occupational cement pneumoconiosis patients / 中华劳动卫生职业病杂志

Objective: To analyze the clinical and imaging characteristics of stage Ⅰ occupational cement pneumoconiosis patients. Methods: In October 2021, the data of patients with occupational cement pneumoconiosis diagnosed by the Third Hospital of Peking University from 2014 to 2020 were collected, and the data of the patients' initial exposure age, dust exposure duration, diagnosis age, incubation period, chest X-ray findings, lung function and other data were analyzed retrospectively. Spearman grade correlation was used for correlation analysis of grade count data. The influencing factors of lung function were analyzed by binary logistic regression. Results: A total of 107 patients were enrolled in the study. There were 80 male patients and 27 female patients. The inital exposure age was (26.2±7.7) years, the diagnosis age was (59.4±7.9) years, the dust exposure duration was (17.9±8.0) years, and the incubation period was (33.1±10.3) years. The initial dust exposure age and the dust exposure duration in female patients were less than those in men, and the incubation period was longer than that in men (P<0.05). The imaging analysis showed the small opacities as"pp"accounted for 54.2%. 82 patients (76.6%) had small opacities distributed in two lung areas. The lung areas distribution of small opacities in female patients was less than that in male patients (2.04±0.19 vs 2.41±0.69, P<0.001). There were 57 cases of normal pulmonary function, 41 cases of mild abnormality and 9 cases of moderate abnormality. The number of lung regions with small opacities on X-ray was the risk factor for abnormal lung function in cement pneumoconiosis patients (OR=2.491, 95%CI=1.197-5.183, P=0.015) . Conclusion: The patients with occupational cement pneumoconiosis had long dust exposure duration and incubation period, light imaging changes and pulmonary function damage. The abnormal lung function was related to the range of pulmonary involvement.

Research progress on corneal nerves and substance P in viral keratitis / 国际眼科杂志(Guoji Yanke Zazhi)

Diseases like viral keratitis can harm corneal nerves, which are necessary for maintaining the health and functionality of the cornea. Recent research has shown that corneal nerve pathology affects the infected eye as well as the contralateral one, and that aberrant changes in sympathetic nerves can be seen, with the exception of sensory nerves that correspond to corneal sensation. However, apart from in vivo confocal microscopy and corneal sensation, there have been no additional prognostic indicators that allow clinicians to assess the severity of corneal nerve damage. While multiple functions of corneal nerves are mediated by neuropeptides, substance P, the first topical neuropeptide used in ocular clinical practice, was proved to regulate the process of viral infections, and it is involved in bilateral corneal pathologies through pro-inflammatory and neurotrophic functions in viral keratitis, so it may be used as a diagnostic biomarker or a therapeutic target. Therefore, this review summarized the changes and roles of corneal nerves as well as substance P in viral keratitis, which may serve as a reference for further study into associated mechanisms and clinical applications.

Research progress on ocular lesions of Stevens-Johnson syndrome / 国际眼科杂志(Guoji Yanke Zazhi)

Stevens-Johnson syndrome(SJS)refers to a type of adverse reactions of the skin and mucosa mainly caused by drug allergy, which can be life-threatening in serious cases. For SJS survivors, ocular damage are accepted as the most severe complications. In recent years, because of the extensive research of its genetic susceptibility and immune pathogenesis, varied susceptibility genes which are involved in the ocular complications of SJS have been discovered. However, further efforts are still needed to clarify relevant mechanisms due to the high ethnicity and drug specificity. Ocular lesions of SJS are prone to be neglected in the early stage, and patients often receive ophthalmic treatment after a severe visual loss. Especially in China, the ocular surface of most patients has already been seriously damaged when they went to the ophthalmology department, while existing treatments achieve unsatisfactory results in improving visual acuity. Therefore, recent research progress is reviewed in this article on etiology and treatment of SJS ocular lesions, in order to raise clinicians' awareness of ocular complications, and provide references for the diagnosis and treatment of diseases and research in related fields.

Activating effect of extracellular histones on heparinase in chlorine-induced acute lung injury / 中国职业医学

OBJECTIVE: To investigate the induction and activation of heparinase by extracellular histones in acute respiratory distress syndrome(ARDS) induced by chlorine in mice.METHODS: The specific pathogen free adult male C57 BL/6 mice were randomly divided into control group, chlorine injured group, histone injured group, anti-histone antibody group and heparinase inhibitor group, with six mice in each group.The mice in the control group and histone injured group were exposed to clean air, and the mice in the other three groups were exposed to chlorine gas at a dose of 580.0 mg/m~3 for 30 minutes by systemic dynamic inhalation.Mice in the histone injured group were injected with 50 mg/kg body weight calf thymus histone by tail vein.One hour before exposure, mice in the anti-histone antibody group were pretreated with 20 mg/kg body weight anti-histone H4 antibody by tail vein injection, and mice in the heparinase inhibitor group were injected with 2 mg/kg body weight OGT2115(heparinase inhibitor). The other three groups were given equal volume of 0.9% sodium chloride solution by tail vein injection. After 24 hours of exposure, arterial blood was collected for blood gas analysis and the lung tissue was collected for histopathological examination. The protein level of heparinase in lung tissue were detected using enzyme-linked immunosorbent assay, and the activity of heparinase were detected by measuring the product of heparan degradation. The protein expression of pro-heparinase and active heparinase were detected by Western blotting.RESULTS: The dyspnea developed of mice in the chlorine injured group and histone injured group, diffuse inflammation occurred in lung tissue, the oxygenation index in arterial blood decreased(all P<0.05), and the protein level and activity of heparinase in lung tissue, as well as the relative expression of pro-heparinase and active heparinase were increased compared with the control group(all P<0.05). The dyspnea, hypoxemia and acute lung injury of mice in the anti-histone antibody group were alleviated, and the protein level of heparinase in lung tissue, as well as the relative expression levels of pro-heparinase and active heparinase were decreased(all P<0.05), compared with chlorine injury group and histone injury group.The dyspnea, hypoxemia and acute lung injury were alleviated in the heparinase inhibitor group, and the activity of heparinase and the relative expression of pro-heparinase in the lung tissue were decreased compared with the chlorine injury group(all P<0.05). CONCLUSION: During the occurrence and development of chlorine-induced ARDS in mice, extracellular histones aggravate lung injury by inducing the expression and activation of heparinase. Acute lung injury can be alleviated by inhibiting the expression and activation of heparinase.

TRPC6 channels expression in endometrial cancer and their role in regulating proliferation of endometrial cancer cells / 中国实用妇科与产科杂志

OBJECTIVE: To study the expression of transient receptor potential canonical-6(TRPC6)channels in endometrial cancer tissues and their role in regulating proliferation of endometrial cancer cells.METHODS: Thirty patients with endometrial cancer who were treated from January 2011 to June 2015 in Henan Provincial People's Hospital and Xuchang People's Hospital were chosen as the study group;the controls group consisted of 24 atypical hyperplasia patients and 28 uterus leiomyoma patients.Molecular biological techniques were used to examine the expression of TRPC6 channels in 30 endometrial cancer specimens,24 atypical hyperplasia specimens and 28 normal endometrial specimens.SKF96365(an inhibitor of TRPC6 channel)and siRNA interference(RNAi)targeting TRPC6 channel were used to block TRPC6 so as to explore the role of TRPC6 channels in regulating the proliferation of endometrial cancer cells by[3 H]thymidine incorporation and cell number.RESULTS: The expression levels of TRPC6 in endometrial cancer were notably elevated than those in the atypical hyperplasia endometrial and normal endometrial tissues. The expression levels of TRPC6 in endometrial cancer vs. the control:mRNA:(0.98±0.56)vs.(0.30±0.24 and0.23±0.13)(P<0.01):protein:(1.22±0.39)vs.(0.75±0.27 and 0.73±0.26)(P<0.01);The expression level of TRPC6in endometrial cancer tissues was not related to the surgical pathological staging, but was related to pathological staging; SKF96365 caused a dosedependent decline in cell amount of HEC-1 A cell. The expression quantity of TRPC6 in whole lysates of the celltransfected with target-TRPC6 small interference RNA(siRNA)was(38.51±6.21)% of that found in the cells transfected with non-silencing RNA;[3 H]thymidine incorporation in HEC-1 A transfected with target-TRPC6 siRNA was also reduced,siRNA inhibited HEC-l A cells proliferation,compared with the cells transfected with non-silencing RNA.CONCLUSION:s TRPC6 channels mignt be closely related to the proliferation of endometrial cancer cells and down regulation of its expression may suppress its development.

Risk factors analysis for acute lower deep venous thrombosis in multiple injury patients / 上海交通大学学报（医学版）

Objective • To explore the incidence and analyze the risk factors of acute lower deep venous thrombosis (ALDVT) in multiple injury patients. Methods • A total of 175 multiple injury patients in trauma emergency center of The Sixth People's Hospital, Shanghai Jiao Tong University, from Jan. to Jun. in 2017 were chosen, and their clinical data were collected. The ALDVT group and the non-ALDVT group were differentiated according to the results of ultrasound, and the incidence of ALDVT was calculated. Univariate analysis and multivariate Logistic regression analysis were used to investigate the correlations between the occurrance of ALDVT and the factors, including demographic characteristics, vital signs and hematological parameters. Results • Fifty-six patients (32%) developed ALDVT in 175 multiple injury patients. Univariate analysis showed that there were statistically significant differences in the numbers of multiple injury patients with upper limb fracture, lower limb fracture, spinal injury, pelvic fracture, chest and abdomen injury, higher injury severity score (ISS) (≥ 25 scores), or higher glucose (≥ 10 mmol/L) between two groups (all P<0.05). In the coagulation parameters, compared with the non-ALDVT group, the levels of D-dimer and fibrinogen degradation products in the ALDVT group were significantly elevated (both P=0.001). Multivariate Logistic regression analysis showed that the level of glucose (≥ 10 mmol/L) (P=0.009), ISS (≥ 25 scores) (P=0.024), multiple injury with spinal injury (P=0.048), and multiple injury with pelvic fracture (P=0.029) were the independent risk factors of the ALDVT patients. Conclusion • There is a high occurrence of ALDVT in multiple injury patients. The level of glucose, ISS, multiple injury with spinal injury, and multiple injury with pelvic fracture have important predictive significance for the diagnosis of ALDVT.

Effect of Feining granule on expression of cytokines in rats with radiation-induced lung injury / 中国生化药物杂志

Objective To investigate Feining granule on prevention and treatment of rat with radiation-induced lung injur ( RILI) and its effect on cytokine transforming growth factor-β1(TGF-β1), interleukin-1 (IL-1), interleukin-6 (IL-6).Methods 105 SD female rats were selected, according to random number table, and divided into seven groups: normal group, model group, dexamethasone group(positive drug), Feining granule low-dose group (FN low-dose group), FN medial-dose group, FN high-dose group and FN prevention group, 15 rats in each group.Except for normal group, all remaining groups received the X-ray irradiation of 15Gy, DT30Gy/2f/1w.FN prevention group were intragastric infused with FN granule one week before irradiation, and the other groups 48 h after irradiation.Five rats were sacrificed randomly at 2, 4, 6 weeks respectively, and right lung tissues were taken out.The contents of TGF-β1, IL-1 and IL-6 were detected by immunohistochemical method.ResuIts TGF-β1, IL-1 and IL-6 contents in lung tissue of model group at 2, 4, 6 weeks were higher than those of normal group (P<0.05).The above indicators after treated by Feining granule were lower than those of model group at each time (P<0.05),with a concentration-dependence manner to some extent.The above indicators in FN high-, medial-and low-dose group were higher than those in dexamethasone group (P<0.05), to some extent.However, the above indicators in FN prevention group were lower than those in dexamethasone group ( P<0.05 ) .ConcIusion Feining granule could prevent and cure radiation induced lung injury through decreasing TGF-β1, IL-1 and IL-6 content.The efficacy of dexamethasone is stronger than FN treatment groups, but is weaker than FN prevention.

Effect of combined administration of Angelica polysaccharide and cytarabine on liver of human leukemia NOD/SCID mouse model / 中国中药杂志

Leukemia is a type of malignant tumors of hematopoietic system with the abnormal increased immature leukemia cells showing metastasis and invasion ability. Liver is one of the main targets of the leukemia cells spread to, where they may continue to proliferate and differentiate and cause liver function damage, even liver failure. Our previous studies showed that Angelica polysscharides (APS), the main effective components in Angelica sinensis of Chinese traditional medicine, was able to inhibit the proliferation and induced differentiation of the leukemia cells, however, its effect on the liver during the treatment remains elucidated. In the present study, the human leukemia NOD/SCID mouse model were established by implantation human leukemia K562 cells line, then the leukemia mouse were treated with APS, Ara-c or APS + Ara-c respectively by peritoneal injection for 14 days, to explore the effect and mechanism of the chemicals on the mouse liver. Compared to the human leukemia NOD/SCID mouse model group with the treatments of APS, Ara-c and APS + Ara-c, We found that severe liver damage and pathological changes of the liver were able to alleviate: First, the number of white blood cells in the peripheral blood was significantly lower and with less transplanted K562 leukemia cells; Second, liver function damage was alleviated as liver function tests showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBiL) were significantly reduced, while the albumin (Alb) was notably increased; Third, liver antioxidant ability was improved as the activities of the antioxidant enzymes glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD) were significantly increased, and the contents of GSH and malonaldehyde (MDA) were decreased significantly in the liver; Fourth, the inflammation of the liver was relieved as the level of IL-1beta and IL-6, the inflammatory cytokines, were decreased significantly in the liver. Fifth, liver index was increased as the pathological observation showed that leukemia cells with diffused infiltration into the liver lobules were significantly reduced and with a remarkable increase of apoptotic positive cell rate by TUNEL test. Furthermore, the APS + Ara-c combined administration showed an even more significant positive effect. In conclusion, the APS, Ara-c therapy reduced the accumulation of leukemia cells within the liver, reduced the liver function damage and levels of inflammatory factors, improved antioxidant capacity of the liver tissue and thus alleviate the pathological changes of the liver. Moreover, the APS + Ara-c combination therapy may have an additive effect.

The role of human serum albumin therapy in the post-operative management of patients with hepatocellular carcinoma associated with cirrhosis / 中华肝胆外科杂志

Objective To determine the role of human serum albumin therapy in the post-operative management of patients with hepatocellular carcinoma (HCC) associated with cirrhosis.Methods Between January 2011 and December 2012,we treated 171 consecutive cirrhotic patients with HCC.88 patients were treated with 5％ human serum albumin for 48 hours followed by 20％ human serum albumin in the post-operative period (the observer group) ; 81 patients were only treated with 20％ human serum albumin during the same time duration (the control group).The prognosis,complications,average amount of human serum albumin and plasma used as well as the in-hospital stay were observed.Results There were no deaths or major complications in either of these 2 groups.After treatment,the observer group was lower than the control group in the amount of intravenous fluid infused,the volume of peritoneal drainage,the amount of human serum albumin and plasma used as well as the mean post-operative hospitalization days (P ＜ 0.05).At the same time,the daily urine output,the central venous pressure and the mean arterial pressure within 48 hours after surgery were higher in the observer group than the control group.Furthermore the observer group had a smoother post-operative recovery in liver function,and the difference was significant between the two groups (P ＜ 0.05).Conclusion Not only did treatment with 5 ％ and 20％ human serum albumin gave the advantages of a more stable blood circulation,better organ perfusion and improved liver function recovery but it also reduced the amount of consumption of human serum albumin and plasma and shortened the hospital stay.

Preparation of paclitaxel-loaded mixed micelles and its in situ absorption in rat intestine / 中国药学杂志

OBJECTIVE: To study the oral absorption of paclitaxel-loaded mixed micelles made of D-α-tocopherol polyethylene glycol 1000 succinate(TPGS) and sodium cholate(NaC) in rats. METHODS: Paclitaxel-loaded mixed micelles were prepared by film dispersion method. The Zeta potential and diameter distribution of TPGS/NaC mixed micelles were measured using laser size scattering determinator. The morphology of micelles was observed by transmission electron microscope. Dialysis method was used to evaluate the release behavior of drug-loaded micelles in vitro. The absorption kinetics was obtained by in situ perfusion method in rats. RESULTS: Most of the mixed micelles were spherical with an average diameter of 24.2 nm and the Zeta potential was -7.84 mV. Compared to the bulk drug, the apparent absorption rate constant (Ka)of paclitaxel-loaded mixed micelles was increased significantly. CONCLUSION: TPGS/NaC mixed micelles can improve the oral absorption of paclitaxel and increase its oral bioavailability.

Application of electric detachable stent in the embolization therapy of intracranial aneurysms / 中华外科杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of Solitaire(TM) AB neurovascular stenting-assisted coil embolization for patients with wide-necked or dissecting aneurysms.</p><p><b>METHODS</b>The clinical results and prognosis from a consecutive series of 38 patients with 40 wide-necked or dissecting aneurysms aneurysms who treated by Solitaire(TM) AB neurovascular stenting-assisted coil embolization from August 2010 to January 2012 was retrospectively analyzed. There were 12 male and 26 female patients, the age was 21 - 78 years (mean 55 years). Thirty-one cases were confirmed wide-neck aneurysms and 9 cases were dissection aneurysms by DSA. Acute subarachnoed hemorrhage due to the rupture of aneurysms was seen in 28 cases (according Hunt-Hess scale, 1 case of Class I, 20 cases of Class II, 4 cases of Class III, 3 cases of Class IV), 1 case was traumatic intracranial aneurysm, 1 case was misdiagnosed during the operation of pituitary adenoma by the approach of transsphenoid, and unruptured aneurysms were seen in 8 cases. The aneurysms were located at the posterior communicating segment of internal carotid artery (21 cases), the supraclinoid segment of internal carotid artery (6 cases), the cavernous segment of internal carotid artery (3 cases), the anterior communicating artery (1 case), and the vertebral artery (9 cases). The patients were performed DSA and Glasgow outcome score (GOS) to evaluate the prognosis 6 months after surgery.</p><p><b>RESULTS</b>Forty stents were used and all remodeling device were achieved successful position. Owing to acute thrombosis in 3 patients, the stents were retrieved successfully. The proportion of patients in whom Raymond class 1 occlusion was obtained in 31 cases (77.5%), Raymond class 2 occlusion in 5 cases (12.5%) and Raymond class 3 occlusion in 4 cases (10.0%). The follow-up was 3 to 12 months (median 6 months). The results of DSA indicated none of the patients' anuerysm was recurred; and GOS was applied to evaluate the prognosis of patients after 3 months. Of 38 patients, 34 recovered well, 3 moderately disabled, 1 patient died.</p><p><b>CONCLUSIONS</b>It is safe to embolize aneurysms with Solitaire(TM) AB neurovascular stenting-assisted coil; meanwhile, the stents can be retrieved when acute thrombosis to reduce the complications.</p>

Laparoscopic liver tumor resection of clinical experience in 126 patients / 中华外科杂志

<p><b>OBJECTIVE</b>To explore the clinical application technology of completely laparoscopy hepodectomy (LH).</p><p><b>METHODS</b>From June 2006 to December 2011, the 126 cases of LH were performed, the data including operating time, blood loss and postoperative complications, etc, were analyzed retrospectively. The patients included 87 males and 39 female and they were 28-83 years old with an average age of 44.5 years old. The parenchyma was transected using laparoscopic ultrasonic scalpel and ligasure, accomplished with endoscopic linear stapler. Of all the patients, the diseases performed LH including primary liver carcinoma (45 cases), liver hemoangioma (58 cases), colon carcinoma with livermetastasis (23 cases), liver focar (5 cases), liver granuloma (1 case), liver adenoma (4 cases). The operations included left hemihepatectomy (n = 17), left lateral lobectomy (n = 34), right hemihepatectomy (n = 15), segmentectomy (n = 22), local resection (n = 59).</p><p><b>RESULTS</b>Of all the patients, mean blood loss was 180 ml (10-1250 ml), mean surgical time was 142 minutes (43-220 minutes), mean postoperative hospital day was 2.2 days (3-12 days). Postoperative complications including eight cases of bile leakage, recovered after 1-3 weeks by appropriately draining. The patients with malignant tumor were followed up for 18 months (12-46 months), recurrence happened in 12 cases and four cases was died of recurrence and metastasis.</p><p><b>CONCLUSIONS</b>LH is a safe, feasible and effective procedure for the treatment of benign liver disease and malignant liver neoplasm as long as the patient is properly selected, it should be recommended for radical resection of hepatocellular carcinoma.</p>

Clinicopathologic features, diagnosis and treatment with solid-pseudopapillary tumor of the pancreas: a report of 33 cases / 中华外科杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic and immunohistochemical features, biological behavior, diagnosis and treatment of solid pseudopapillary tumor of the pancreas (SPTP).</p><p><b>METHODS</b>A retrospective clinical and clinicopathologic analysis was made on 33 cases of SPTP admitted from May 2001 to 2010 July. There were 7 male and 26 female patients, aging from 13 to 66 years with a mean of 34.3 years.</p><p><b>RESULTS</b>The tumor was located in pancreatic head of 10 patients, in pancreatic neck of 5 patients, in pancreatic body and tail of 18 patients. Of the 33 patients treated with surgery, 8 underwent simple resection of pancreatic tumor, 6 underwent pancreaticoduodenectomy, 3 underwent tumor resection plus pancreaticojejunostomy, 1 underwent tumor resection plus pancreaticogastrostomy, 11 underwent distal pancreatectomy, 4 underwent distal pancreatectomy plus spleen resection (1 underwent mesohepatectomy for hepatic metastasis). Sixteen of the 33 operations were completed by laparoscopy. Histologically, tumors were composed of papillary and microcystic solid structures, with uniformed population of cells. The pancreas and blood vessels invasion were identified in 3 cases, one of them was combined with liver metastasis, and they are male. Immunohistologically, the tumors were positive for α1-antitrypsin, α1-antichymotrypsin, β-catenin, CD10, CD56 and vimentin (all cases), neuron-specific enolase (3 cases), synaptophysin (6 cases), chromogranin A (4 cases), progesterone receptor (28 cases), estrogen receptor (3 cases), S-100 (6 cases). Totally 33 cases were followed up with a median period of 49 months without tumor recurrence.</p><p><b>CONCLUSIONS</b>SPTP is of low graded malignancy. It primarily affects young women. It may be located in any part of pancreas. Immunohistochemistry is very important for the diagnosis and differential diagnosis of SPTP. Surgical resection is recommended as the treatment of choice. Laparoscopic distal pancreatectomy or tumor resection is feasible and safe for some selected patients, and the prognosis is good.</p>

The pathological feature of primary hepatic carcinoma on explanted liver and its significance / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the pathological feature of primary hepatic carcinoma and the clinical significance.</p><p><b>METHODS</b>From August 2000 to December 2007, there were 89 patients with cirrhosis and carcinoma of liver who accepted whole liver resection. The whole liver was cut into 10 mm slices to examine the tumor size, number, distribution, capsule, satellite nodes, portal vein tumor thrombi (PVTT). The invaded adjacent tissue and lymph nodes were recorded, the distance from satellite to major tumor was measured, then histological examinations were carried out, and the final diagnosis was made by pathologists.</p><p><b>RESULTS</b>The total of 89 cases included hepatocellular carcinoma in 86 cases and cholangiocarcinoma in 3 cases; 53 cases with multiple tumors and 36 cases with solitary tumor; complete capsule only in 14 cases, no obvious margin in 11 cases, 13 cases had a major tumor in the right lobe and a small tumor in the left lobe; 8 of 25 cases with gross invaded tissue were confirmed by histological examination, 7 of 16 cases with swollen lymph nodes were infiltrated by cancer cells. There were 47 cases with PVTT (47.2%) and 39 cases with satellite nodes (43.8%). PVTT and satellite nodes increased with the increase of sizes and the numbers of the tumors. The distance from satellite node to major tumor mostly were 0.5 - 3.0 cm.</p><p><b>CONCLUSIONS</b>The whole explanted liver can completely reflect the characteristics of growth and infiltration of hepatic carcinoma. Attention must be paid to the small cancer lesions in another lobe, distal satellite nodes from major tumor, and tumor thrombi in a small branch of portal vein, which can not be found by imaging, and might influence the curative effectiveness after liver resection or transplantation.</p>

Cause of micromotion in distal femoral prosthesis / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate possible causes of micromotion in distal femoral prosthesis.</p><p><b>METHODS</b>Based on the assumption that the femur and prosthesis were considered as concentric cylinders with completely bonded interface, a theoretical model simulating the interfacial stress transfer was established. The distributions of the interfacial shear and radial stresses with the changing of z were obtained through mathematics and mechanics deducing.</p><p><b>RESULTS</b>The maximum interfacial shear stress occurred at the position of z=0, namely, the cross section of the femur neck. The interfacial shear stress sharply decreased with the increasing of z and came to nearly zero at the range of z> 0.1 m. While the interfacial radial stress increased with the increasing of z,at the range of z >0.05 m it was constant and reached the maximum.</p><p><b>CONCLUSION</b>The micromotion in distal prosthesis is caused by the interfacial radial stress.</p>

Changes in serum electrolyte levels after seawater immersion of open abdominal wound and drowning in dogs / 南方医科大学学报

<p><b>OBJECTIVE</b>To assess the effects of seawater immersion of open abdominal wound and drowning on plasma electrolyte levels in dogs.</p><p><b>METHODS</b>Twenty-one dogs with open abdominal wounds were randomly divided into 3 groups, namely the control group (n=7), seawater immersion group (n=7) and seawater immersion and drowning group (n=7). The dogs in the control group were subjected to simple open abdominal wound, and those in the latter two groups were immersed into seawater after the abdominal injury. The changes in the plasma electrolytes and osmotic pressure were observed after the treatments. RESULTS AMD CONCLUSION: Seawater immersion of the open abdominal wound results in hypematremia, hyperkalemia and hypertonic dehydration, and the effect is proportional to the length of immersion time, but seawater airway perfusion does not cause obvious changes of the plasma electrolytes and osmotic pressure in dogs.</p>

Finite element analysis of impact loads on the femur / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the stress distribution and fracture mechanism of proximal femur under impact loads.</p><p><b>METHODS</b>The image data of one male's femur were collected by the Lightspeed multi-lay spiral computed tomography. A 3D finite element model of the femur was established by employing the finite element software ANSYS, which mainly concentrated on the effects of the directions of the impact loads arising from intense movements and the parenchyma on the hip joint as well as those of the femur material properties on the distribution of the Mises equivalent stress in the femur after impact.</p><p><b>RESULTS</b>The numerical results about the effects of the angle sigma of the impact loads to the anterior direction and the angle gamma of the impact loads to the femur shaft on the bone fracture were given. The angle sigma had larger effect on the stress distribution than the angle gamma, which mainly represented the fracture of the upper femur including the femoral neck fracture when the posterolateral femur was impacted. This result was consistent with the clinical one. The parenchyma on the hip joint has relatively large relaxation effect on the impact loads.</p><p><b>CONCLUSIONS</b>A 3D finite element analysis model of the femoral hip joint under dynamic loads is successfully established by using the impact dynamic theory.</p>

Treatment of wide-necked cerebral aneurysms using stent and balloon-assisted technique / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the avail of balloon and stent-assisted Guglielmi detachable coil (GDC) placement in treatment of wide-necked cerebral aneurysm.</p><p><b>METHODS</b>Eighty-seven patients with 92 wide-necked aneurysms undergone endovascular procedures using the balloon and stent-assisted remodeling technique. Respectively, appropriate Neuroform stents delivered with a 5 mm landing zone on either side of the aneurysm neck, the microcatheter entered through the interstice, aneurysms were embolized at one or several times. Two catheters were used in balloon-remodeling technique, balloon were inflated across the neck of the aneurysms after the microcatheter entering the aneurysms, then the GDC were used to embolize the aneurysms.</p><p><b>RESULTS</b>Thirty-one aneurysms were completely occluded, 3 subtotally (> 90%) and 1 incompletely (70% - 90%) occluded using stent-assisted technique, all carry arteries were unblocked, 3 patients with mild neurological dysfunction and no mortality. Fifty aneurysms were completely occluded and 4 incompletely occluded using balloon-assisted technique, 1 patients with mild neurological dysfunction and no mortality. Two aneurysms were completely occluded and 1 incompletely occluded using stent-assisted and balloon-assisted technique. The mean period of follow-up was 5.8 months. Rates of recanalization were 16.7% for stent-remodeling group and 12.5% for balloon-remodeling group.</p><p><b>CONCLUSIONS</b>The stent and balloon-assisted remodeling technique are safe and effective in treating wide-necked aneurysms. Balloon-remodeling technique has more security comparing with stents.</p>