Objective To evaluate the diagnostic and differential value of triphasic, especially the arterial phase, contrast enhanced CT scans for the hepatocellular adenoma, and to improve CT diagnostic accuracy. Methods Spiral CT scanning of pre and post contrast arterial phase, portal venous phase and delayed phase was performed in 5 patients with hepatocellular adenomas proved surgically and pathologically. The enhancement was administrated with venous injection of 3 ml/sec, totally 100 ml angiografin. Arterial phase of contrast enhanced scanning started 20～30 sec, portal venous phase 60～70 sec and delay scanning 3 min after the injection of contrast medium. The degrees of the enhancement of adnoma and normal tissues of liver in the three contrast enhanced phases were calculated and compared statistically. Results In plain CT, the lesions were iso density in 4 cases and slight hypodensity in 1 case, which was hardly distinguished from the normal tissue. In all 5 cases, the lesions showed marked enhancement in the arterial phase compared with normal tissue of liver (38 HU high), and there were markedly statistical difference ( t =18 94, P 0.05). The mean CT value of hepatocellular adenoma in the arterial phase was much higher than that in portal venous and delay phase, there were statistical differences between them ( F =18.39, P

Objective:To construct an adenovirus-mediated anti-sense RNA targeting K-ras exon 1 of SW1990 cell line and observe its effect on ceil proliferation and apoptosis after transferred into SW1990 cell line.Methods:K-ras exon 1 cDNA was cloned into shuttle vector pShuttle-CMV and the resultant plasmid was confirmed by enzyme digestion and PCR.Clones with inverted insertion were selected and co-transferred into E.coli BJ5183 with an adenoviral backbone plasmid pAdEasy-1 to produce recombinant plasmid by homologous recombination.Recombinants were then selected and transfected into 293 cell line to produce recombinant adenovirus.Recombinant adenovirus production was confirmed by PCR analysis and was amplified and purified;the virus titer was determined.Ad-LacZ was used to infect SW1990 cells and the infection efficiency was observed by X-gal staining.SW1990 cells was infected with the recombinant adenovirus and their proliferation and apoptosis were determined by MTT and annexin V/PI FCM assay.Results:A 282 bp target gene fragment was acquired by PCR;the titer of recombinant adenovirus was 7.6?10~8 pfu/ml before purification by CsCl_2 gradient centrifugation and 5.0?10~(10)pfu/ml after CsCl_2 gradient centrifugation.When the recombinant adenovirus was at 100 MOI,the infection efficiency of SW1990 cells nearly reached 100%.The transfection of recombinant adenovirus significantly inhibited SW1990 cell proliferation(P

Objective To assess the diagnostic value of MRCP before LC.Methods 944 cases with chronic calculous cholecystitis underwent MRCP before LC from June 2004 to June 2007 in our department.incidence rate of cholecvstolithiasis together with common bile duct stones and incidence rate of anatomic abnormity of bile duct were collected.Results The incidence rate of cholecvstolithiasis together with common bile duct stones were 8.1%(77/944),and the oecurence ofACBDS were 1.2%(11/944).The incidence rate of anatomic abnormity of bile duct were 3.7%(35/944).ConclusionMRCP can not only offer a excellent diagnostic value of ACBDS and anatomic abnormity of bile duct,but also reduce the occurrence of CBDS remainder and iatrogenic bile duct iniuries.

Objective To evaluate the efficacy of flurbiprofen axetil for treatment of break-through pain (BTP) in patients with metastatic bone cancer pain.Methods Ninety-seven patients with metastatic bone cancer pain complicated with BTP were randomly divided into morphine group (M group,n =51) and flurbiprofen axetil group (F group,n =46).In group M,immediate release morphine sulfate was given orally,and the single dose for pain relief was about 10％ to 15％ of the daily slow-release dose,and the administration was repeated until BTP was relieved.In group F,flurbiprofen axetil 50 mg was infused intravenously over 30 min,and the maximum dose was 150 mg.The BTP frequency was recorded within one month after the first BTP relief.The drug consump-tion for treatment of primary cancer pain,and adverse reaction were recorded.Results The onset time of flurbiprofen axetil and immediate release morphine sulfate was (18± 9) and (35± 11) min,respectively (P ＜ 0.05).The onset time of BTP treatment was significantly shorter,and the incidence of constipation was lower in group F than in group M (P ＜ 0.05).There was no statistical significance in the BTP frequency between the two groups (P ＞ 0.05).As compared with that before BTP treatment,the drug consumption for treatment of primary cancer pain was significantly increased after treatment in group M (P ＜ 0.05) and no significant changes were found after treatment in group F (P ＞ 0.05).Conclusion Flurbiprofen axetil is safer and more effective in relieving BTP in patients with metastatic bone cancer pain than immediate release morphine sulfate,and it does not affect the drug tolerance for treatment of primary pain.

Objective To determine the effect of mild hypothermia on neonatal piglet cardiac hemodynamic function after hypoxia-ischemia (HI).Method Twenty five 7-day-old piglets were used for hypoxic ischemic brain damage (HIBD) model by the method of temporary occlusion of the bilateral carotid arteries and followed by mechanical ventilation with low concentration of oxygen (FiO_2=6%) for 30 minutes.The piglets were randomly divided into three groups:group A (normothermia with body temperature to 39℃,n=9),group B (body temperature to 36℃for 72 hours,n=8),and group C (body temperature to 34℃for 72 hours,n=8).Mild hypothermia was initiated at 4 hours after HI,the systolic and diastole function were evaluated by Doppler echocardiography at pre-HI,post-Hi 4 hours and post-HI 72 hours.Results There were no significant differences in left ventrieular ejection time/left ventrieular ejection time (LPEP/LVEF),right ventricular ejection acceleration time/right ventricular ejection time (RACT/RVET) and CO at post-HI with hypothermia 72 hours in three groups,but the heart rate decreased in B and group C group.Compared with nonnothermia,mild hypothermia treatment showed no significant differences in MAP,LPEP/LVET,RACT/RVET,CO,SV at post-HI with hypothermia 72 hours.Conclusions Body temperature decreased by 3～5℃for 72 hours will not aggravate hemodynamic abnormity.

To explore the status of cancer pain management among hospitalized elderly patients.Pain intensity,use of analgesic drugs and incidence of adverse reactions were surveyed for 620 cancer pain patients.And 218 of them were aged over 65 years.The proportions of mild,moderate and severe pain were 29.8％,36.2％ and 34.0％ respectively.And the corresponding rates in young and middle-aged patients were 28.4％,34.8％ and 36.8％ respectively (P ＞ 0.05).In elders with cancer pain,28％ used no analgesic.For severe pain patients,only 71.6％ received potent opioids and 5.4％ nonsteroidal antiinflammatory drugs.And the corresponding rates in young and middle-aged patients were 26.1％,73.0％ and 4.7％ respectively (P ＞ 0.05).The rates of constipation,dysuria and delirium in elderly patient group were higher than young and middle-aged patient group (P ＜ 0.05).Pain management is unsatisfactory and rational uses of analgesic drugs should be strengthened for preventing the relevant adverse reactions.

Objective:To search for a method for radical resection of pancreatic and duodenal malignancy involving the mesentery root and for the long post-operation survival of patients.Methods:From Jan.2004 to Aug.2006,a total of 26(16 male and 10 female. aged 27-70)patients with pancreatic and duodenal malignancy involving the mesentery root were treated in our department.The patients included 3 with duodenal malignancy and 23 with pancreatic malignancy.Curative resection was performed by the extended pancreaticoduodenetomy(Whipple procedure)combined with mesentery root resection(MRR)for all patients.The outcomes,safety and the post-operation survival rate were analyzed retrospectively.Results:Thirteen patients were treated with Whipple procedures combined with MRR,9 were treated with partial portal vein/superior mesenteric vein(PV/SMV)and reconstruction of the vessel,and 4 patients received pre-shunt between PV and SMV with artificial vessel graft before the extended Whipple and MRR procedures.The operation time was 2.5 to 7(4.4?1.1)hour,and blood loss was 300 to 5 000(1892?1414)ml with the blood transfusion of 0 to 5 600(2 100?1 586)ml.There was no death in our group and 7(27%)had post-operation complication.The post-operation hospital stay was 10 to 30 days.The pathologic examination showed negative surgical margins for all specimens.The tumor size was 4 to 10 (6.17?2.03)cm.After a follow-up of 9 to 38 months,the pain was relieved in all patients.One of the 3 patients with duodenal adenocarcinoma had liver metastasis at 10 months after operation,and the other 2 survived 10 months and 27 months without evidence of tumor reccurence.The patient with pancreatic micro-adenocarcinoma died of local reccurence 9 months after operation.The patient with neuroendocrine carcinoma died of organ failure 24 months after operation.The patient with lymphoma have survived for 24 months after operation.The 1-year and 2-year accumulated survival rates in the 20 cases with pancreatic ductal cancer were 86.6% and 45.6%. respectively.Conclusion:The extended Whipple procedure with MRR is safe and effective.It can obtain R0 resection in patients with malignant tumors(over 5 cm in diameter)in the head,neck and uncinate process of the pancreas and duodenal.

OBJECTIVETo study the relationship between estrogen and the development of hemangioma.

METHODSThe expression of EST and ER in samples from the thirty-eight cases of hemangioma and six cases of normal control group was examined with the immunohistochemical steptavidin peroxidase conjugated method (SP method).

RESULTSThe EST in capillary hemangioma expressed significantly higher than in the cavernous hemangioma, the racemose hemangioma or the control group. Although the EST in cavernous hemangioma and racemose hemangioma also expressed higher than in the control, there are no statistical differences among them. The ER only expressed in some cases in the capillary hemangioma group. No sexual difference was shown in the expressions of the EST and the ER.

CONCLUSIONThis study shows that there may be a relationship existed between the estrogen and the capillary hemangioma. It may indicate that some capillary hemangioma may be possibly treated by the drugs.

Case-Control Studies ; Estrogens ; metabolism ; Female ; Hemangioma, Capillary ; metabolism ; Hemangioma, Cavernous ; metabolism ; Humans ; Male ; Receptors, Estrogen ; metabolism

Adult ; Air Pollutants ; adverse effects ; Humans ; Male ; Military Medicine ; Monitoring, Physiologic ; Noise, Occupational ; adverse effects

Objective To measure the expression of CC chemokine ligand 18(CCL18)in cutaneous malignant melanoma (CMM) tissues, and to explore its clinical significance, as well as relationship with vascular endothelial growth factor (VEGF) and Ki67 antigen expressions. Methods Immunohistochemistry was performed to measure CCL18, VEGF and Ki67 expressions in 58 paraffin?embedded CMM tissue specimens, as well as CCL18 expression in 20 paraffin?embedded pigmented nevus specimens, and immunofluorescence assay to confirm the expression of CCL18 in fresh CMM tissue specimens. Correlations of CCL18 expression with CMM clinicopathologic features, VEGF and Ki67 expressions were analyzed. Results CCL18 was detected in 49 (84.48%) of 58 paraffin?embedded CMM specimens, but in none of the 20 paraffin?embedded pigmented nevus specimens, with a significant difference in the positive rate of CCL18 between the CMM group and pigmented nevus group(χ2=45.46, P<0.01). The expression of CCL18 in paraffin?embedded CMM tissues was positively correlated with Clark′s level and Breslow thickness of CMM (rs = 0.609, 0.644 respectively, both P < 0.01), and was significantly different between ulcerated and non?ulcerated CMM(P<0.05), as well as between patients with and without lymphatic metastasis(P<0.05). However, there were no significant differences in the expression of CCL18 among patients of different age, gender, or between acral and non?acral CMM(all P>0.05). In addition, the expression of CCL18 in CMM tissues was positively correlated with that of VEGF(rs = 0.727, P < 0.05), but unrelated to that of Ki67(P > 0.05). Immunofluorescence assay showed CCL18 expression in the cytoplasm of tumor cells in CMM tissues. Conclusion CCL18 is highly expressed in CMM tissues, and may be involved in tumor invasion and metastasis.