Objective To investigate the efficacy of laparoscopic hepatectomy for giant hepatic hemangioma . Methods We retrospectively evaluated treatment outcomes of 23 cases of giant hepatic hemangioma undergoing laparoscopic hepatectomy from January 2010 to August 2013.The surgery was carried out by using the method of priority block or ligation of the feeding artery of hepatic hemangioma . Results Total laparoscopic hepatectomy was accomplished in 22 patients and a conversion to open surgery was required in 1 patient because of hepatic vein bleeding .There were 8 cases of left lateral segmentectomy , with a mean operative duration of (131 ±36) min, mean blood loss of (105 ±68) ml, and mean postoperative hospital stay of (4.9 ±1.6) d.There was 1 case of left lateral combined Spiegel segmentectomy , with an operative duration of 180 min, blood loss of 200 ml, and postoperative hospital stay of 6 d.There were 4 cases of left hemihepatectomy , with respective operative durations of 210 min, 80 min, 180 min, and 180 min, blood loss of 150 ml, 700 ml, 200 ml, and 100 ml, and postoperative hospital stay of 5 d, 5 d, 6 d, and 6 d.There was 1 case ofⅣ,Ⅴ, andⅧsegmental hepatectomy , with the operative duration of 420 min, blood loss of 1400 ml and postoperative hospital stay of 8 d.There were 2 cases of right hemihepatectomy , with respective operative durations of 240 min and 260 min, blood loss of 800 ml and 400 ml, and postoperative hospital stay of 12 d and 7 d.There were 2 cases of right posterior lobe hepatectomy , with respective operative durations of 180 min and 190 min, blood loss of 200 ml and 400 ml, and postoperative hospital stay of 8 d and 7 d.There were 4 cases of Ⅲ,Ⅵnonanatomical segmental hepatectomy , with respective operative durations of 110 min, 150 min, 120 min, and 120 min, blood loss of 100 ml, 200 ml, 200 ml, and 120 ml, and postoperative hospital stay of 5 d, 6 d, 5 d, and 5 d.No operative death was seen.Postoperative complications occurred in 2 cases, including 1 case of hydrothorax and 1 case of bile leakage.All the patients were followed up for 3 -12 months ( mean, 6 months ) and no recurrence was found . Conclusions Laparoscopic hepatectomy of hepatic hemangioma is safe and feasible .Priority block or ligation of feeding artery of hepatic hemangioma can reduce the blood supply of tumor and be convenient for operation .Application of multiple methods of liver blood inflow occlusion flexibly and proper management of cutting surface of liver can ensure the operation successfully .

Mycosis fungoides (MF) is the most common subtype of primary cutaneous T-cell lymphoma, and its pathogenesis remains unclear. Recent studies have uncovered high-frequency chromosomal copy number variations in MF, such as gain of chromosomes7q,1q,17q and loss of 9p21,10q,17p, which lead to the gain of proto-oncogenes and loss of tumor suppressor genes, and finally result in tumor development and progression. Moreover, low-frequency single-nucleotide variants have been found in MF, and these mutated genes are mostly enriched in the pathways associated with cell cycle regulation, cell apoptosis, chromatin remodeling as well as T cell activation. Gene-fusion variation is rarely reported in MF. In addition, large cell transformation may occur in some MF cases, and often indicates poor prognoses such as disease progression and drug resistance. In conclusion, MF is a complex disease with highly molecular genetic heterogeneity, and more extensive and intensive researches on its pathogenesis are needed in the future.

OBJECTIVE:To compare the dissolubilities among nimodipine tablets produced by5different factories.METHODS:Measuring the dissolubilities of nimodipine tablets from different factories by HPLC and making the dissolu?tion curves according to Chinese WS-(X)-100-2000Z.Calculating T 50 、T d 、m,the data obtained were detected with t test. RESULTS:There were differences in the T 50 、T d and m(P

Objective To obtain I50 anti-idiotype antibody and identify its activity in vitro.Methods I50 anti-idiotype (Id) antibody gene was amplified from the template of fuse 5-I50 by PCR to construct a prokaryotic expression vector pET25b-I50. The expression of pET25b-I50 in E. coli BL21(DE3) was induced by isopropylthio-β-D-galactopyranoside (IPTG) and was confirmed by SDS-PAGE and Western blot with Ab1(FC2) monoclonal antibody and an anti-hexahistidine tag antibody. The method of dialysis refolding was used to restore the activity of I50 anti-Id antibody, which was measured by Dot-ELISA and lymphocyte proliferation assay. Results The recombinant vector was successfully constructed and the recombinant protein was successfully expressed and purified with 90% purity. The relative molecular weight of the expressed protein was 15 kD, which was in accordance with expectation. The activity of I50 anti-Id antibody could be restored and could promote the proliferation of lymphocyte in a dose-dependent manner. Conclusion These results suggested that I50 anti-Id protein vaccine is likely an option in the therapy against nasopharyngeal carcinoma in vivo.

Objective To study the significance of Helicobacter pylori (Hp) infection and the expression of caudal-related homeobox transcription factor 2 (CDX2),mucin 2 (MUC2) proteins in gastric cancer,and elucidate the prognostic significance of CDX2,MUC2 proteins in gastric cancer.Methods Ninety cases of gastric cancer were available for the study.Hp was studied by Warthin-Starry bacterium stain and CDX2 and MUC2 proteins were studied by immunohistochemical stain.Results There was no Hp infection and no expression of CDX2 and MUC2 proteins in normal gastric mucosa.The positive rate in the cases of intestinal-type gastric cancer was 67.86%(38/56) for Hp,75.00% (42/56) for CDX2,and 66.07%(37/56) for MUC2,respectively,and it was higher than that in the cases of diffuse-type gastric cancer,which was 35.29%(12/34),41.18%(14/34) and 38.24%(13/34) respectively (P<0.01 or < 0.05).In intestinaltype gastric cancer,the positive rate of CDX2 and MUC2 proteins was also higher in Hp positive cases than that in Hp negative cases,and it was the same as CDX2 protein in diffuse-type gastric cancer.Higher positive rates of CDX2 and MUC2 proteins were observed in the cases of early gastric cancer than those in the cases of advanced gastric cancer (P < 0.01 or < 0.05),also it was observed in the cases of no lymph node metastasis than in the cases of lymph node metastasis (P < 0.01 or < 0.05).Moreover,the positive rate of CDX2 protein in the cases of stage Ⅰ～Ⅱwas higher than that in the cases of stage Ⅲ～Ⅳ (P < 0.05).Conclusions Hp infection and the expression of CDX2 and MUC2 proteins are related with gastric cancer,and has close relationship with intestinal-type gastric cancer.The expressions of CDX2 and MUC2 proteins may inhibit the infiltration and metastasis of gastric cancer.

Objective To analyze the risk factors associated with acute renal failure (ARF) in critically ill obstetric patients in intensive care unit (ICU).Methods A retrospective analysis of 192 critically ill obstetric patients admitted to the ICU for postpartum complications was conducted. There were 10 patients excluded because 3 died of amniotic embolism with massive hemorrhage in ICU and 7 had incomplete records, therefore, only 182 critically ill obstetric patients were enrolled in this study. According to the occurrence of ARF or not, the patients were divided into ARF group (68 cases) and non-ARF group (114 cases). The indicators of preeclampsia, HELLP syndrome (hemolysis, elevated liver enzymes, thrombocytopenia), acute fatty pregnancy liver, postpartum hemorrhage, sepsis were collected in the two groups. The main drugs used in the 4 days after delivery were as follows: ① plasma volume expanders: fluids (crystalloids, artificial colloids, hypertonic albumin and 4% serum albumin) and blood products (packed red cells, concentrated platelets, fibrinogen, fresh frozen plasma and activated factor Ⅶ); ② antifibrinolytic drug: tranexamic acid; ③ anti-hypertensive drugs: angiotensin-converting enzyme inhibitors (ACEI), diuretics; ④ nephrotoxic drugs: aminoglycosides, contrast agent. The above indexes were firstly analyzed by the univariate method, and the risk factors with statistical significance were further analyzed by multivariate logistic regression method to screen out the independent risk factors of developing ARF in critically ill obstetric patients in ICU.Results Univariate analysis showed that HELLP syndrome, tranexamic acid and hypertonic albumin infusion used in 4 days after delivery were the risk factors of ARF (χ2 value was 4.92, 4.29, 5.53, respectively, allP < 0.05). The multivariate logistic regression analysis showed: HELLP syndrome [odds ratio (OR) = 10.478, 95% confidence interval (95%CI) was 1.248 - 17.953,P = 0.030] and hypertonic albumin infusion used in 4 days after delivery [OR = 6.632, 95%CI was 1.211 - 16.328,P = 0.029] were the independent risk factors to develop ARF.Conclusions The occurrence of ARF in a critically ill obstetric patient in ICU is a process involving multiple factors, therefore, it is necessary to fully recognize the risk factors influencing the development of this disease; the presence of HELLP syndrome and hypertonic albumin infusion used in 4 days after delivery are the independent risk factors of developing ARF. Thus, particular attention should be paid to those patients with such high risk factors to decrease the incidence of ARF.

Objective To investigate the correlation between methylation status of UNC 5C gene promoter with colorectal cancer UNC5C .Methods 54 cases of sporadic colorectal cancer and related normal mucosal tissue ,as well as 6 colon cancer cell lines and fiber cell lines(FCL) in the oncology department of the Kailuan General Hospital from February 2010 to March 2013 were selected as the research objects and performed the mRNA and methylation analysis for exploring the correlation between the netrin‐1 receptor UNC5C defects with colorectal cancer disease .Results mRNA of UNC5A and UNC5B was expressed in the detected colorectal cancer cell lines .Except FCL for UNC5C ,all of the cancer cell lines had no mRNA expression .In colorectal cancer tissue , UNC5C methylation was significantly higher than that in the normal mucosa ,the difference was statistically significant (P<0 .05) . The methylation levels of UNC5C gene in the stage Ⅰ to Ⅱ ,and the stage Ⅲ to Ⅳwere significantly higher than non‐methylation levels ,the differences were statistically significant (P<0 .05) .The correlation analysis by the Spearman method showed that the UNC5C defects was positively correlated with colorectal cancer disease (r= 0 .856 ,P< 0 .05) .Conclusion Netrin‐1 receptor UNC5C defect has certain correlation with colorectal cancer disease .

Objective To investigate the safety and long-term therapeutic results of anatomical hepatectomy for hepatocellular carcinoma (HCC).Methods 90 patients underwent anatomical hepatectomy from January,2003 to January,2010.The tumor size was ≤5 cm in 38 patients,and ＞5 cm in 52 patients.The tumor number was a single lesion in 58 patients,and multiple lesions in 32 patients.Cirrhosis was present in 46 patients (55.42％); cancer embolus was present in 34 patients (37.78％).There were 64 patients in Child-Pugh A and 26 patients in B.The operating time,blood loss and blood transfusion were recorded and analyzed.Complications and liver function were monitored after surgery.The Kaplan-Meier method was used to calculate the survival rates.Log-rank test was used to analyze factors associating with postoperative recurrence.Independent factors influencing tumor-free survival and overall survival were analyzed by Cox-model logistic regression.Result There was no perioperative death.The incidence of complications was 31.1％ (28/90).The recurrence rate was 51.1％ (46/90).The 1-,3-,5 year tumor-free survivals were 92.2％,67.3％ and 49.7％％00,respectively.Positive resection margin and satellite nodule were independent factors for recurrence (RR19.22,95 ％ confidence interval 5.85～63.17).The 1-,3-,5-year overall survivals were 94.4％,80.0％ and 60.0％,respectively.Positive resection margin and TNM were independent factors for overall survival (RR 2.013,95％ confidence interval 1.28～3.17).Conclusions Anatomical hepatectomy was a safe and efficacious procedure to treat HCC.Positive resection margin and TNM were independent factors associated with overall survival.Anatomical hepatectomy had the advantages in ensuring a lower rate of negative resection margin.

Objective To investigate the practicability and safety of laparoscopic anatomical hepatectomy.Method 40 patients with space occupying lesions in the liver underwent laparoscopic anatomical hepatectomy between Jan.2008 and Mar.2012.The diagnoses were hepatocellular carcinoma (HCC) (n=13),recurrent HCC (n =1 ),cholangiocarcinoma ( n =1 ),metastatic cancer ( n=6),hepatolithiasis (n=10),hemangioma (n=7),FNH (n=1) and liver cell adenoma (n =1).Intraoperative ultrasound was routinely performed to locate lesions and intrahepatic structures.Selective hemihepatic vascular occlusion was applied during resection. High frequency cautery,CUSA and Ligasure were used to transect liver parenchyma. Hemolocks were applied when large blood vessels and bile ducts were encountered.Endo-GIA was used if necessary.The operations included right hemihepatectomy (n =3),left hemihepatectomy (n =10),resections of segment Ⅴ and Ⅵ (n=5),segment Ⅴ (n=3),segment Ⅵ (n =4),and segment Ⅳb (n =1).Result34 hepatectomics were performed laparoscopically.6 patients were converted to open surgery.There was no perioperative death. The operating time was 250.21±50.94 min,and intraoperative blood loss was 420.20± 120.10 ml.Bile leakage was diagnosed in 2 patients after operation.Conclusion With careful patient selection,and improvement in surgical technique and apparatus,laparoscopic anatomical hepatectomy has become safe and practicable.The operation has the advantages of minimal invasion and rapid recovery. It can be regarded as a standard procedure for selected benign and malignant lesions.

Associating liver partition and portal vein ligation for two-staged hepatectomy(ALPPS) is a novel approach for hepatectomy.The case we reported was a 68 years old male patient diagnosed with hilar cholangiocellular carcinoma and obstructive jaundice.ALPPS surgery was operated.Since the patient's left lateral lobe volume was less than 40％ of the whole liver volume (merely 33.91％),the ligation of the right portal vein,plus in situ split of the junction zone between left medial and left lateral liver lobe and the dissection of portal lymph nodes as the first stage operation was conducted.Abdominal CT on the 8th day after the operation reported an increase on the volume of left lateral lobe by 32％ to 41.5％ of the whole liver volume.On the 12th day after the first stage operation,an extended right trilobate hepatectomy combined with left hepatic duct intra-jejunum drainage was performed as the second operation.The patient completely recovered and was discharged three weeks after the second stage operation.