Objective To determine the feasibility, safety and techniques of transumbilical single-port laparoscopic liver cyst fenestration. Methods From November 2009 to June 2010, four cases of transumbilical single-port laparoscopic liver cyst fenestration were completed through three adjacent 5 mm trocars around the umbilicus. Normal 5 mm laparoscopic instruments and a 5 mm 30° laparoscope were utilized, and the procedures were similar to conventional multi-port laparoscopic liver cyst fenestration. Results All operations were completed successfully, with no conversion to laparotomy or the multi-port laparoscopic procedure. The mean operation time was 38 minutes (25-70 minutes). All patients were discharged at postoperative days 1-3, and no complications or cyst recurrence occurred during hospitalization and follow-up. Conclusions Transumbilical single-port laparoscopic liver cyst fenestration is safe and feasible. It has the advantages of less pain, cosmetic incision and quick recovery, but is technique-demanding.

Objective To evaluate the value of diffusion weighted imaging (DWI)in diagnosing active sacroiliitis of ankylosing spondylitis(AS)Methods 63 cases with AS confirmed clinically were included.The patients were evaluated by Bath ankylosing spondylitis disease activity index (BASDAI)score and examined by MRI with oblique coronal DWI and STIR sequence in the sacroili-ac joint.The ADC value and Spondyloarthritis Research Consortium of Canada (SPARCC)score were measured in all patients.Cor-relative analysis was performed among BASDAI score,SPARCC score and ADC value.Patients were divided into activity and stability group according to the condition,which were compared with the ADC features of the sacroiliac joint in healthy volunteers.Results The Spearman correlation analysis showed that in patients SPARCC score and ADC values (r =0.781,P <0.001 ),BASDAI score and ADC values (r=0.854,P <0.001),SPARCC score and BASDAI score (r =0.805,P <0.001)were positively correlated.The median ADC values in the sacroiliac joint of activity group (0.704×10 -3 mm2/s)was higher than that in the stable group(0.543× 10 -3 mm2/ s )and the control group (0.431×10 -3 mm2/ s).The ADC values between the activity、stability and control group were statistically significant differences.Conclusion SPARCC score and DWI are important indexes for MRI evaluation of sacroiliac ar-thritis activity.DWI is a fast imaging sequence,can be quantified by measuring the ADC value of the lesion area,and is the ideal choice for sacroiliac joint imaging.

Objective To study the imaging features of spinal giant cell tumors (GCTs)including multi-slice spiral CT (MSCT) and MRI in order to improve the diagnosis.Methods A retrospective study was conducted in 27 patients with GCTs in the spine at our institute.The data of MSCT and 3.0T MRI were recorded and analyzed.Results Of the 27 patients,4 were found in the cervi-cal spine,12 in the thoracic spine,5 in the lumbar spine and 6 in the sacral spine.Typical imaging features showed eccentric,expan-sive and lytic bone destruction of the involved vertebra.The tumor showed soft-tissue density on CT with inner visible cystic change, necrosis and trabecula remnants in most tumors,without calcification and periosteal reaction.Most lesions showed hypointensity or isointensity on T1 WI and hypointensity,isointersity or heterogeneous high signal on T2 WI.When aneurysmal bone cyst (ABC)was detected,MRI revealed hyperintensity with a fluid-fluid interface.Conclusion Radiographic features of the GCTs in the spine are specific for diagnosis to some extent.CT and MRI may contribute to the accuracy of preoperative diagnosis.The methods have a good value in GCT diagnosis,clinical staging,surgical strategies and postoperative evaluation.

Objective To compare two different methods to detect the differences of gene mutation rate, sensitivity, specificity and coincidence rate of epidermal growth factor receptor (EGFR) in non-small-cell lung cancer (NSCLC) so as to assess the clinical value of qRT-PCR method and its environmental-friendly technologyplatforms.One uses environmental fixative poly hydroxyl acrylic acid and green transparent liquid dewaxing Van-clear alone or in combination to replace the traditional fixative 4％ (volume fraction) neutral buffered formalin and the traditional transparent dewaxing liquid xylene in application of quantitative real-time polymerase chain reaction (qRT-PCR).The other uses traditional reagents in direct sequencing.Methods We selected 91 cases of primary NSCLC specimens resected between May 2013 and March 2016 in Zhongshan Bo`ai Hospital and Zhongshan Hospital of Traditional Chinese Medicine.Five samples were taken from the same tumor lesion.We used a random number table to randomly divide these samples into Groups A, B , C, D, and E.Group A received direct sequencing method in detection of EGFR gene mutations.Besides, during the experiment, 4％ neutral buffered formalin was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group B received qRT-PCR method to detect EGFR gene mutations.Meanwhile, during the experiment, 4％ neutral buffered formalin was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group C received qRT-PCR method in detection of EGFR gene mutations.At the same time, during the experiment, polyhydroxy acrylic acid was used for fixing, and xylene transparent dewaxing was used to make slices for DNA extraction dewaxing.Group D received qRT-PCR method to detect EGFR gene mutations.In the meantime, 4％ neutral buffered formalin was used for fixing, Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.Group E received qRT-PCR method in detection of EGFR gene mutations.In addition, during the experiment, polyhydroxy acrylic acid was used for fixing, and Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.In addition, during the experiment, polyhydroxy acrylic acid was used for fixing, and Van-clear transparent dewaxing was used to make slices for DNA extraction dewaxing.The mutations of Exons 18, 19, 20, and 21 in EGFR genes were respectively determined in the five groups of NSCLC.Results ① Groups B, C, D, E and A did not significantly differ in the percentage of people with mutations or target site mutation rates of EGFR genes in NSCLC (P> 0.05).② The detection results of EGFR target site mutation in Groups B, C, D, E and A had good sensitivity, strong specificity, and high compliance rate.Conclusion The green transparent liquid dewaxing Van-clear alone or in combination to replace the traditional fixative 4％ neutral buffered formalin and the traditional transparent dewaxing liquid xylene in the application of qRT-PCR so as to detect EGFR gene mutations in NSCLC has good consistent results compared with the method that uses traditional reagents in direct sequencing.It has the significance and value in clinical application.

[Abstract] Objective: To explore the mRNA molecular targets for diagnosis of hepatic carcionoma and to investigate their functional roles in proliferation and cell cycle of hepatic cancer cells. Methods: Based on the statistical analysis of miRNA expression data from 377 hepatic carcionoma samples and 37 adjacent non-cancerous samples in TCGAdatabase, a group of 33 differentially expressed miRNAs were identified.A further screen of these differentially expressed miRNAs was performed using the receiver operating characteristic curve (ROC curve) and Kaplan-Meier survival analysis; and with referring to the current publications, miR-451 was screened as the study subject. HepG2 cells were transfected with pLVX-shRNA2-miR-451 to over-express miR-451. The effect of miR-451 over-expression on the proliferation of HepG2 cell was determined by CCK-8 assay; while the effect on cell cycles was detected by flow cytometry. Results: The expression of miR-451 in the adjacent non-cancerous tissues was significantly lower than that in cancer tissues ([473.40±390.24] vs [1 990.47±2 118.04], P<0.05). MiR-451 could be used as an early diagnostic biomarker of hepatic carcionoma, with a high ROC value of 0.91 (sensitivity 0.89, specificity 0.87). The results of in vitro experiments showed that the proliferation of HepG2 cells was significantly decreased after miR-451 over-expression (48 h: [0.69±0.04] vs [1.08±0.05]; 72 h: [0.76±0.07] vs [1.52± 0.02]; all P<0.01), and a large number of cells were blocked in S phase(P<0.05). Conclusion: miR-451 has the potential to be used as a biomarker for hepatic carcionoma diagnosis and prognosis; moreover, it also exhibits the inhibitory effect on proliferation of hepatic cancer cells.