Objective To investigate the surgical method,safety,and clinical effect of laparoscopic left lateral hepatectomy in the treatment of intrahepatic bile duct stones.Methods A total of 30 patients with intrahepatic bile duct stones who were admitted to our hospital from January 2015 to December 2016 were enrolled,and according to the surgical procedure,these patients were divided into conventional group (15 patients) and laparoscopic group (15 patients).The patients in the conventional group were treated with open left lateral hepatectomy,and those in the laparoscopic group were treated with minimally invasive laparoscopic left lateral hepatectomy.Surgical indices were observed,and postoperative complications and liver function parameters were compared between the two groups.The t-test was used for comparison of normally distributed continuous data,and the Wilcoxon rank sum test was used for comparison of non-normally distributed continuous data.The chi-square test was used for comparison of categorical data.Results The laparoscopic group had significant reductions in the time to passage of gas by anus (1.02 ± 0.51 d vs 1.98 ± 0.36 d,t =5.956,P ＜0.001) and length of postoperative hospital stay (8.83 ±0.81 d vs 11.83 ± 0.42 d,t =5.830,P ＜ 0.001) compared with the conventional group.Compared with the conventional group,the laparoscopic group had a significantly lower alanine aminotransferase level (125.8 ± 91.9 U/L vs 214.1 ± 99.6 U/L,t =2.52,P =0.02) and a significantly higher serum albumin level (33.2 ± 3.7 g/L vs 28.9 ± 4.3 g/L,t =2.94,P =0.01) at 5 days after surgery.Conclusion Compared with conventional open surgery,laparoscopic left lateral hepatectomy has the features of litde trauma,rapid postoperative recovery,and little influence on liver function in the treatment of intrahepatic bile duct stones and has a marked clinical effect.Therefore,it holds promise for clinical application.

Objective To explore the role of phosphatidylinositol 3-kinase (PI3K) signal pathway in interleukin-8 (IL-8)/chemokine (C-X-C Motif) receptor 2 (CXCR2)-mediated growth and metastasis of liver cancer.Methods Eighty-two cases of liver cancer tissues and serum samples,and 21 cases of normal tissues and serum samples were collected.The level of serum IL-8 was measured by enzyme-linked immunesorbent assay (ELISA).Expression of CXCR2 was detected by immunohistochemical method,and its correlation with clinicopathological parameters was also analyzed.Different stages of liver cancer fresh tissues were selected,and expressions of CXCR2,PI3Kγ,AKT,and NF-κB were detected by Westeru blotting analyses.Results The levels of serum IL-8 in liver cancer patients (stages Ⅰ,Ⅱ,Ⅲ,Ⅳ) were (120.34 ±15.52) pg/ml,(221.60 ±23.10) pg/ml,(279.50 ±24.25) pg/ml,(324.81 ±22.50) pg/ml,respectively.With the increasing degree of liver cancers,levels of IL-8 were increased,most significant was in the Ⅳ period of liver cancer; the expression of CXCR2 was significantly correlated with pathological stages,degree of differentiation,lymph node and distant metastases of liver cancer (P ＜ 0.05) ; serum IL-8 levels were consistent with expression of CXCR2 in liver cancer tissues,which had a strong correlation with activation of PI3K γ,AKT,and NF-κ B proteins.Conclusions IL-8/CXCR2 was able to mediate the growth and metastasis of liver cancers,which might be through the activation of PI3K signaling pathway.

Objective To preliminarily evaluate the feasibility,therapeutic effect and normal tissue complications of stereotactic γ-ray body radiation therapy for patients with asynchronous bilateral renal cell carcinoma.Methods Nine patients with inoperable asynchronous bilateral renal cell carcinoma with a median time from the resection of the primary focus and discovery of the contralateral focus underwent stereotactic γ-ray body radiotherapy with OUR-QGD stereotactic γ-ray whole body therapeutic planning system.50％ isodose line,as the prescription dose line,was to cover the planning target volume (PTV) and the 70％ isodose line was to cover the gross target volume (GTV).Radiotherapy was delivered,with a single dose of 3-5 Gy per fraction,one fraction per day,5 fractions per week,and totally 10-17 fractions.The PTV edge total dose was 36-51 Gy,and the GTV edge total dose was 60-85 Gy.The patients were followed up for a median time of 24 months to evaluate the local control rate and overall survival rate.Results Of the 9 patients,1 presented complete remission (11.1％) and 4 partial remission (44.5％),with a total effective rate of 55.6％.The 1-,3-,and 5-year local control rates were 64.8％,43.2％,and 43.2％ respectively.The 1-,3-,and 5-year overall survival rates were 66.7％,53.3％,and 35.6％ respectively.Four patients (44.4％) had acute radiation reaction:2 cases with grade l leukocytopenia and 2 cases with grade 1 gastrointestinal reactions.Two patients showed grade 2 late radiation-induced reaction in gastrointestinal system.The Karnofsky score was significantly increased and the renal function was normal after radiotherapy.Conclusions Stereotactic γ-ray body radiation therapy is safe and effective in the treatment of asynchronous bilateral renal cell carcinoma.

Objective To construct sigF deletion mutant of Bacillus anthracis and the complementary strain of sigF deletion mutant in order to analyze the effect of losing sigF on formation of spores.Methods The spectinomycinadenyltransferase gene(spc) was inserted to replace sigF of B.anthracis by homologous recombination.A plasmid which contained sigF and sigF promotor was constructed and then transferred to the mutant to get a complementary strain of sigF deletion mutant.The characters of the mutant were analyzed by measuring growth curves, the ability of carbohydrate metabolism was compared, and spore formation was observed under a microscope.Results The sigF deletion strain A16D2△sigF was constructed from A16D2,which had a similar growth rate to the wild type A16D2 in logarithmic phase, but was not significantly different from the initial strain in the ability to use carbohydrates,although unable to form spores.The strain was found to maintain the state of asymmetric division by microfluidics experiment.Conclusion It is showed by this study that sigF is the essential gene of B.anthracis for spore formation, but not essential for vegetative growth.

Objective To compare the separation effects of protein samples extracted by two different methods with two -dimensional gel electrophoresis (2-DE) .Methods Ultrasonic disruption and glass-beads grounding were used to prepare protein samples of Gram-negative bacteria , Gram-positive bacteria and animal tissues .The actual results of the two sample preparation methods were compared by 2-DE.Results The 2-DE maps of samples extracted by the two methods were obtained.Conclusion The 2-DE maps of glass-beads grounding samples are better than those of ultrasonic disruption thanks to their lower backgrounds , which are beneficial for further image analyses .

Background Clinical study showed that FP-7/FP-8 Ahmed glaucoma valve implantation is effective and safe for the adult refractory glaucoma.However,it is welt-known that childhood glaucomatous eyes have different pathogenesis and protean clinical manifestations.So the efficacy of FP-7/FP-8 Ahmed glaucoma valve implantation in child deserves some attention.Objective This study was to retrospectively evaluate the efficacy and safety of FP-7/FP-8 Ahmed glaucoma valve implantation for refractory glaucoma in children.Methods The clinical data of 30 eyes of 26 children with refractory glaucoma who undergone FP-7/FP-8 Ahmed glaucoma valve implantation in the Center Hospital of Cangzhou from October 2008 to April 2011 were retrospectively analyzed.The age of patients was 4 months to 16.5 years.The patients included ocular hypertension after trabculectomy/goniotomy for cogenital glaucoma,later stage of cogenital glaucoma,aphakic or pseudophakic glaucoma,traumatic glaucoma and Sturge-Weber syndrome.The follow-up ranged from 1 week to 24 months to obverse the changes of intraocular pressure (IOP),postoperative complications and cumulative success rate.Results The mean IOP was significantly different among various time points (F=58.929,P＜0.05).The IOP was (36.93± 10.56) mmHg in preoperation and (13.13± 3.34),(14.13±3.15),(15.93±4.76),(17.96±5.37),(19.74±5.43) mmHg 1 week,1 month,6 months,12 months,24 months following surgery,showing significant reduce after operation.Compared with preoperative IOP,the IOP of 1 week,1 month,6,12,24 months after AGI was significant decreased,with significant differences between them (t =11.641,11.458,10.688,7.988,8.018,all at P ＜ 0.05).The total cumulative success rate after Ahmed glaucoma valve implant was 100％,96.67％,93.21％,85.76％ and 71.46％ 1 week,1 month,6 months,12 months,24 months after surgery.The postoperative complications occurred in 8 eyes,including shallow anterior chamber,drainage tube obstruction,hyphema of anterior chamber and valve exposure,and these were cured by medicine and surgery.No serious complication appeared in all patients after operation.Conclusions FP-7/FP-8 Ahmed glaucoma valve implantation is an effective and safe method for the treatment of refractory glaucoma,and it can be considered as one of the first choices for management of refractory glaucoma in childhood.

Objective To explore the efficacy and security of helical tomotherapy (radical radiotherapy) combined with targeted therapy for stage Ⅳ non-small cell lung cancer (NSCLC).Methods The data of 19 patients with stage Ⅳ NSCLC were retrospectively analyzed.The efficacy and security were observed by SPSS 20.0 statistical software.Results Among 19 patients, there were 6 cases complete remission (CR), 8 cases partial remission (PR), 4 cases stable disease (SD), 2 cases progressive disease (PD).The response (CR+PR) rate was 73.7 ％ (14/19).The 1-and 2-year local control rates were 73.7 ％, 47.4 ％,respectively.The 1-year progression-free survival rate was 31.6 ％.The median survival time was 13 months, and the 1-and 2-year overall survival rates were 52.6 ％, 26.3 ％, respectively.The median survival time of females, non-smokers or targeted therapy synchronous radiotherapy was longer than that of male, smokers or targeted therapy sequential radiotherapy, respectively (21 months vs 8 months, P =0.014;21 months vs 6 months, P =0.007;18 months vs 6 months, P =0.026).There were no significant differences of age, number of metastatical organs or targeted drug categories between two groups (P ＞ 0.05).All patients could tolerate the adverse reactions without treatment-related death.Conclusion The effect of helical tomotherapy combined with targeted therapy for stage Ⅳ NSCLC is desirable.

Objective To evaluate the efficacy and side effects of whole body γ/-knife in patients with limited pancreatic carcinoma. Methods 111 patients with limited pancreatic carcinoma treated with the Stereotactie Gamma Ray Whole-Body Therapeutic System (Whole Body T-knife) were retrospectively an-alyzed. Patients were supine, fixed with a stereotactic body frame and vacuum bag, and then simulated by low-speed computed tomography. GTV, CTV and PTV were defined on the contrast-enhanced CT scans. It was required that 50% isedose line covered 100% of PTV and 70% isedose line covered more than 80% of GTV. The prescription dose was defined as 50% isodose. All patients were treated 5 fractions per week. The fractionated dose was 3-4 Gy for pancreatic head carcinoma, and 4-5 Gy for pancreatic body/tail carcino-ma. Irradiation of 40-51 Gy and 60-70 Gy were delivered to PTV and GTV margins, respectively. Re-suits The complete response rate, partial response rate and overall response rate of the primary tumors were 29.7%, 42.3% and 72.1%, respectively. The follow-up rate was 95.5%. The number of patients fol-lowed-up at 1-,2- and 3-year was 105,89 and 60. The 1-, 2- and 3-year overall survival rates were 49.3%,24.5% and 18.1%. For patients with stage Ⅰ/Ⅱ disease,the number of patients followed-up at 1-,2-,3-,4-and 5-year was 55,44,29,16 and 11 ;The 1-, 2-, 3-,4- and 5-year overall survival rates were 68%,34%, 30%, 21% and 17%, respectively. For patients with stage Ⅲ disease,the number of patients fol-lowed-up at 1-,2- and 3-year was 50,45 and 31 ;The 1-, 2- and 3-year overall survival rates were 28%,14% and 4%, respectively (χ~2=16.67, P=0.000). The acute side effects including nausea, vomiting and diarrhea were 71.2% of RTOG grade 1 -2 and 3.6% of RTOG grade 3. No treatment delay occurred.Conclusions With fractionated dose of 3-5 Gy,5 fractions per week and 40-51 Gy as total dose to PTV,whole body γ-knife is safe and effective to treat limited pancreatic carcinoma. The local control and overall survival could be improved.

Fourteen patients with pancreatic carcinoma were selected. Two treatment plans were designed for each patient, including gamma knife and Tomotherapy. The dose characteristics were evaluated by DVH and were compared. The results showed that the gamma knife plan had the higher maximal and mean target dose than Tomotherapy. Body gamma knife can increase the target dose significantly, and decrease the OAR dose. Tomotherapy had excellent dose-target conformality, and it can control doses of duodenum and stomach easily, but it had larger low dose region.
Humans ; Pancreatic Neoplasms ; radiotherapy ; Radiosurgery ; methods ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted ; methods

Objective To preliminarily evaluate the efficacy and safety of intensity-modulated radiotherapy (IMRT) in the treatment of inoperable stage ⅣA thymoma.Methods A retrospective analysis of 15 patients with inoperable stage ⅣA thymoma receiving IMRT from January 2010 to December 2017 was performed.Among them,9 patients were male and 6 female,aged 31-83 years with a medianof 59 years.The dose of radiotherapy was 50 Gy/60 Gy/70 Gy/ 15-20 fractions for PTV/CTV/GTV.The short-term efficacy,overall survival rate and adverse reactions were analyzed.Results The follow-up rate was 100％.The median follow-up time was 48 months.The short-term partial remission rate was 93％(14/15).The 1-,3-and 5-year overall survival rates were 100％,75％ and 75％,respectively.One patient presented with grade 3 hematological reaction.Four patients died of tumors.Conclusion Preliminary findings demonstrate that IMRT is an efficacious and safe treatment of stage ⅣA thymoma,which can be applied for patients with unresectable thymoma.