Objective To study the diagnosis,management and prognosis of persistent m?llerian duct syndrome (PMDS). Methods 2 cases of PMDS associated with transverse testicular ectopia were reported.Clinically there was azoospermia or testis tumor.Corporeal hysterectomy and orchidopexy were performed and the testis tumor was excised. Results Vascular supply and hormonal function of the testis were normal in both 2 patients after 2 year's follow up. Conclusions PMDS is an inherited male pseudohermaphroditism. Every effort should be made to preserve the testis and its fertility function when surgical management is needed.The possible development of testis tumor should be kept in mind and closely observed.

Objective To explore the fibrotic stroma characteristics of orthotopic liver cancer in rat and the relationship with MR delayed contrast enhancement.Methods 4 Wistar rats with orthotopic liver cancer underwent conventional triphasal and longer-de-layed contrast-enhancement MR scanning.12 HCC specimens obtained from the four Wistar rats were sliced and stained with HE, picric-sirius red,Verhoeff Van-Gieson elastic fiber,Gordon-Sweets reticular fiber and anti-α-SMA immunohistochemical staining.The relationshp between intratumoral fibrotic stroma and MR delayed phases of the 1 2 tumors were analyzed.Results Collagen fiber was expressed mainly in tumor fibrous septum.Elastic fiber distributed in tumor fibrous septum and the artery wall.Reticular fiber dis-tributed in fibrous septum of the regenerative nodules,portal area and tumor psuedocapsule.Integrated optical density (IOD)value of collagen fiber,elastic fiber and reticular fiber analyzed by Image-pro Plus6.0 were 0.102±0.020,0.063±0.018 and 0.109±0.032, respectively.As a result,the amount of collagen and elastic fibers were statistically different (P<0.01),and so were reticular fibers and elastic fibers (P<0.01).And there was a positive correlation between collagen fiber and MR delayed contrast enhancement (P<0.05).Conclusion MR delayed contrast enhancement of hepatic cancer in rat is closely associated with the collagen fiber,thus this fiber in liver cancer can be evaluated noninvasively by MRI.

Objective To explore the effect of transcatheter arterial chemoembolization ( TACE ) on the apoptosis proteins fas,bax,and bcl-xl in hepatocellular carcinoma ( HCC ) . Methods Sixty-three cases with HCC proved by histopathologically were studied, which included 42 cases treated with surgical resection alone,and 21 cases underwent TACE . The expressions of fas,bax,bcl-2 and bcl-xl were detected with immunohistochemical SP method .Results The positive rate of fas was 47.62% ( 10/21 ) in HCCs treated with TACE,and 21.43%(9/42) in those treated with surgical resection alone, there was significantly difference between the two groups(?0.05). Conclusion TACE can increase the expression of fas and decrease the expression of bcl-xl, it can increase the rate of apoptosis of HCC, make HCC lesion contract. The effect of TACE to bax need more research.

Objective To study the correlation between the contrast enhancement features on spiral computed tomography (SCT) and different clinicopathological characteristics in hepatocellular carcinoma (HCC).Methods Fifty cases (54 lesions) of HCC proved pathologically and examined with enhancement dual-phase SCT scanning (arterial phase and portal vein phase) were included in this study. The SCT features and the clinical details about resection and pathological differentiation were recorded. All the features of SCT were compared with some clinical and histopathological characteristics of HCC.Results The features of SCT were correlated with pathological characteristics of HCC. The pseudocapsula patterns were related with Edmondson's grade, and the enhancement patterns were associated with the diameter of tumor and intratumoral necrosis. There was a significant correlation between the high infiltration and severity (intrahepatic daughter foci, tumor-emboli in portal veins, lymphatic metastasis) on the SCT images and the diameter of tumor. The same correlation was found between the diameter of tumor on the SCT images and AFP value, and also between hepatic cirrhosis on the SCT images and HBsAg, the diameter of tumor.Conclusion This research confirms that SCT features are correlated with some clinicopathological characteristics of HCC.

Objective To investigate the significance of modified gold nanocages ( GNCs ) in photothermal therapy and radiosensitivity enhancement for murine mammary carcinoma 4T1 cells.Methods A molecule probe, CD44-PEG-GNCs, was constructed on the basis of GNCs.Inductively coupled plasma mass spectrometry ( ICP-MS) and transmission electron microscopy ( TEM) were used to analyze Au uptake by 4T1 cells.The cell counting kit-8( CCK-8) assay was used to determine the impact of the probe on the viability of 4T1 cells.The CCK-8 assay and the Hoechst/PI double staining were used to evaluate the photothermal killing effects of near infrared laser (NIR).The colony forming assay and the Hoechst/PI double staining were used to measure the viability of 4T1 cells after irradiation with 6 MV of X-ray.Results ICP-MS and TEM showed that 4T1 cells had an uptake of a large number of GNCs, in which the number of CD44-PEG-GNCs taken up by 4T1 was 3-4 times larger than that of PEG-GNCs.The cell toxicity assay revealed that in a certain range of concentration, GNCs showed little effect on the viability of 4T1 cells, which was reduced to 81.2%in 48 hours.The CCK-8 assay, the Hoechst/PI double staining, and the colony forming assay showed that after NIR irradiation and radiotherapy, large-scale apoptosis was induced in CD44-PEG-GNCs-contained tumor cells by photothermal therapy combined with radiotherapy, which had substantially better outcomes than other groups.Conclusions The GNC-based molecular probe actively targets 4T1 cells with little cytotoxicity, indicating that it enhances the sensitivity of tumor towards photothermal therapy and radiotherapy.

Objective:To study the differences in angiogenesis and its maturation between the periphery and center. of hepatocellular carcinoma (HCC). Methods:Thirty-one cases proved surgically and pathologically were selected. After surgery, two sections were gotten from the tumor periphery and center. Continuous slices were stained with immunohistochemistry of five antibodies against VEGF, Flk-1, PCNA.The expressions of VEGF,Flk-1, and PCNA, and some vascular parameters were counted including the number, mean area, total area, circumference, diameter, distance between adjacent vessels(DAV), variety index of microvessel and mature vessels. The arterioles , veinlets, mature vessel index and mean perfused fraction (mPF)were also calculated. The differences of the vascular parameters above between the periphery and center were analyzed. Results: The differences in the number, diameter, and variety index of microvessel, the number and total area of mature vessel, the arterioles and the ratio of arteriole or veinlet, mature vessel index and mPF were statistical differences between the periphery and center of the tumor (P

Objective: To evaluate the liver function status in patients with obstructive jaundice using in vivo 31-phosphorus magnetic resonance spectroscopy (31P-MRS). Methods:31P-MRS scan with a single voxel on hepatic parenchyma was carried out in 31 patients with obstructive jaundice and in 40 healthy controls. Intracellular pH value (pHi), and some metabolic parameters including phosphomonoester (PME), phosphodiester (PDE), inorganic phosphate (Pi), ?-ATP, ?-ATP, ?-ATP, lower energetic phosphate (LEP), and the ratios of PME/ATP, Pi/ATP, PME/PDE, PME/Pi, PDE/Pi and PDE/ATP were calculated. Serum markers of liver function including AST, ALT, TBIL, DBIL, IBIL, TP, ALB, GLO, A/G, ALP and GGT were also recorded. The relationship between themwas analyzed. Results: 31P-MRS showed an increase in PME, PDE, PME/ATP, PME/Pi, PDE/ATP and LEP in jaundice patients compared with controls (P

Objective To investigate the potential value of VEGF-C targeted ultrasmall superparamagnetic particles of iron oxide (USPIO)molecular probe in specific detection of hepatocellular carcinoma (HCC)in a rat model using MRI.Methods The targeted probe was synthesized by conjugating VEGF-C antibody with amino modified USPIO.Cell counting kit-8 assay was conducted to as-certain the probe’s effect on the growth of HepG2 cells.Rat models with HCC were divided into two groups (targeted group with VEGF-C-USPlO and a contrast with USPIO)with 3 rats for each group at random.Pre-and post-contrast enhanced MR imaging with different time points of 0.5,1 and 1.5h was performed with an injection into caudal vein.The signal intensities of the tumor on T2 WI and T2 * WI were measured,and the differences of the signal intensities between pre-and post-enhancements or between both groups were analyzed.The iron particles within the tumors in two groups were confirmed by Prussian blue iron staining.The ex-pression of VEGF-C in HCC was proved by immunohistochemistry.Results The signal intensities of HCC on T2 WI and T2 * WI af-ter VEGF-C-USPI0 injection were decreased obviously with a minimum value at 1 h ,indicating a significant difference (P <0.05). However,those in USPIO group were decreased less without statistical differences (P >0.05).Statistical differences in signal inten-sity on T2 * WI after enhancement between both groups were also showed (P <0.05).Prussian blue staining results showed more iron particles within the tumor tissues in VEGF-C-USPI0 group,whereas less ones in USPIO group.Immunohistochemical results showed that VEGF-C was over expressed in cytoplasm and membrane.Conclusion VEGF-C-USPI0 molecular probes can initiatively target to the liver cancer in rat models with expressed VEGF-C,which may help to achieve the specific MR imaging of HCC,indica-ting a potential of the metastasis.

Objective To investigate the potential of AFP-targeted ultrasmall superparamagnetic particles of iron oxide (USPIO) molecular probe in specific detection of hepatocellular carcinoma (HCC) with MRI.Methods The targeted probe was synthesized by conjugating AFP antibody with modified USPIO.Two groups treated with AFP-USPIO and USPIO were set up in the study.The HepG2 cells were incubated with AFP-USPIO or USPIO (100 μg/ml) respectively with the dosage of 50 μ1,100 μl or 150 μl for 4 hours,followed by MR imaging in vitro.The signal-noise ratio (SNR) of the cells on T2-weighted image (T2WI) was measured.The rat models with orthotopic HCC were divided into two groups with 5 rats for each group at random.Pre-and post-contrast enhanced (after 1 hour) MR imaging were performed with caudal vein injection at a dosage of 20μg/ml.The contrast noise ratio (CNR) on T2WI and the difference of CNR between pre-and post-enhancement or between both groups were calculated.The relationship of SNR or CNR with the iron particles in cells or tumors was confirmed by Prussian blue iron staining.Results Cytology experiment showed the SNR in both groups was decreased with the increase of the dosage of AFP-USPIO or USPIO,indicating statistically significantdifference in SNR among three different doseage groups (P＜0.05).Prussian blue iron staining showed that the iron particles in cells were increased with the increase of AFP-USPIO dosage,and was negatively correlated with SNR (P=0.00,r=-0.926).However,the iron particles were less in cells in USPIO group.The CNRs of liver tumors in Wistar rat of pre-and post-AFP-USPIO injection were 2.05±0.88 and 0.96±0.31 respectively,indicating a significant difference (P=0.028,t=3.380).However,the CNRs in USPIO group,2.25±1.50 and 2.57±1.49,showed no statistical difference (P=0.275,t=1.263).The CNR after enhancement also had a statistical difference between both groups(P=0.042,t=3.487).Pathological results confirmed more iron particles in tumor tissues in AFP-USPIO group,whereas less in USPIO group.Conclusion AFP-USPIO molecular probes can initiatively target to the HepG2 cells and the liver cancer of rat models expressing AFP,which may help to achieve the specificity of MR imaging in the diagnosis of HCC.

Objective:To discuss the feasibility and clinical efficacy of laparoscopic ureteroplasty with buccal mucosa graft for ureteral stricture.Methods:The clinical data of 10 patients with ureteral stricture admitted to the Second Affiliated Hospital of Anhui Medical University from July 2018 to November 2019 were retrospectively analyzed, including 7 males, 3 females, 5 cases on each side, with an average age of (47.9±7.8)years. All patients had a history of operation related to ureteral calculi. The median value of preoperative serum creatinine was 71(68~610)μmol/L. The status of hydronephrosis and ureteral stricture was evaluated by ultrasonography, CTU and ureteral retrograde angiography.The separation of the renal pelvis on the affected side was (3.1±0.7)cm.There were 7 cases of upper segment stenosis, 2 cases of middle segment stenosis, and 1 case of multiple stenosis. The length of ureteral stenosis was (3.2±0.7)cm. Laparoscopic buccal mucosa ureteroplasty was performed in all 10 cases under general anesthesia. After the stricture ureter segment was separated during the operation, the ureteral stenosis segment was longitudinally cut. According to the stenosis, the buccal mucosa with a length of 3.0-4.5 cm and a width of 1.0-1.5 cm was cut. Buccal mucosa grafts were harvested and placed in the ureter as an anterior onlay with omental wrapping.Results:Ureteral repair was performed laparoscopically in all cases, with no conversion to open and no serious complications. The operative time was (199.2±27.4)min, the blood loss was (101.5±54.7)ml, the median postoperative indwelling time of the drainage tube was 4.5(3.0-7.0)d, and the postoperative hospital stay was (7.9±1.9)days. The patients had clear pronunciation and barrier-free eating one week after the operation.The double J tube was removed one to two months after surgery. The patients were followed up for (11.3±4.2)months after the operation. Follow-up patients underwent imaging and other examinations, which showed significant improvement in hydronephrosis on the affected side, and the median value of renal pelvis separation on the affected side was 1.8(0-2.2)cm. The median value of serum creatinine was 82(66~235)μmol/L. The serum creatinine in 2 patients with renal insufficiency decreased significantly after operation.Conclusions:Laparoscopic buccal mucosa graft ureteroplasty could be a safe and feasible option for the treatment of ureteral stricture with less trauma and rapid recovery. The results of the initial experience are encouraging.