Objective To investigate the liver function of patients with chronic liver diseases undergoing gynecologic laparoscopic operations.Methods Twenty-six asymptomatic HBV carriers,28 mild chronic hepatitis,21 compensatory cirrhosis were assigned to undergo gynecologic laparoscopic operations.Liver function were tested and compared in these three groups before operation and on the 1st、3rd、7th day after operation.Results 1st day after operation,ALT and AST in asymptomatic carriers and mild chronic hepatitis groups were significantly higher than preoperation ( asymptomatic carriers:ALT P ＜ 0.05,AST P ＜ 0.05 ; mild chronic hepatitis:ALT P ＜ 0.05,AST P ＜ 0.05 ).Then they recovered on the 3rd day after operation ( asymptomatic carriers:ALT P ＞ 0.05,AST P ＞ 0.05 ; mild chronic hepatitis:ALT P ＞ 0.05,AST P ＞ 0.05 ).ALB,total bilirubin (Tbil) after operation were not significantly different from those before operation on every tested day in these two groups ( asymptomatic carriers:ALB P ＞ 0.05,Tbil P ＞ 0.05 ; mild chronic hepatitis:ALB P ＞ 0.05,Tbil P ＞ 0.05 ).In compensatory cirrhosis group,ALT,AST,Tbil were significantly higher on the 1st day,3rd day after operation than preoperation ( 1st day:ALT P ＜0.01,AST P ＜0.01,Tbil P ＜0.01 ;3rd day:ALT P ＜ 0.05,AST P ＜ 0.05,Tbil P ＜ 0.05 ).ALB levels were significantly lower on the 1st day,3rd day after operation than preoperation ( 1st day:P ＜0.01 ;3rd day:P ＜0.05 ).All the indexes recovered to the levels of preoperation on the 7th day after operation( ALT P ＞ 0.05,AST P ＞ 0.05,Tbil P ＞ 0.05,ALB P ＞0.05).Conclusions To some extent,gynecologic laparoscopic operations have some adverse effects on short-term liver function after operation in patients with chronic liver diseases.Compensatory cirrhosis patients present delayed recovery compared with asymptomatic carriers and mild chronic hepatitis patients.

A novel system was developed for the rapid determination of vitexin, vitexin-2″-O-rhamnoside, rutin, and hyperoside in the extract of hawthorn(Crataegus pinnatifida Bge.) leaves with microemulsion liquid chromatography(MELC). The effect on the chromatography of varying the operating paramers was studied. The optimized MELC system with microemulsion was consisting of 1.0%(w/w) brij35-1.1%(w/w) n-butanol-0.1%(w/w) n-octanol-0.3%(v/v) triethylamine, the pH was adjusted to 2.5 with phosphoric acid. The type and concentration of surfactant, types of oil phase, the pH and triethylamine as the organic additive in microemulsion played an important role for separation of four flavonoids. MELC analysis was performed on a Venusil ASB C_(18) analytical column (150 mm× 4.6 mm, i.d., 5 μm). The flow rate was set at 0.8 mL/min and the eluent was detected at 340 nm for the four flavonoids. The calibration curves of the four flavonoids are linear(r>0.9995) over the concentration range of 0.95-140.0 mg/L. The mean recoveries are 98.6% to 101.6%. The results indicate that the optimized method was successfully applied to the analysis of four important flavonoids in the extract of hawthorn leaves.

With the continuous development of tumor immunology,cancer vaccines have become a hot spot of tumor immunotherapy.Companion member antigen peptide tumor vaccine attracts widely attention because of its chemical stability,easy preparation and no carcinogenic potential advantage.Companion member antigen peptide tumor vaccine may work through many kinds of ways including the function of antigen presenting,enhancing the body's non-specific line of anti-tumor mechanisms and activating the tumor-specific immune mechanism.Its different anti-tumor mechanisms merits and so on will have positive function in the tumor clinical immunity treatment.

Objective To comparatively analyze CEUS features of hepatitis B virus (HBV)-related combined hepatocellular-cholangiocarcinoma (CHC) and hepatocellular carcinoma (HCC).Methods Thirty-one patients with HBV-related CHC and 31 patients with HBV-related HCC confirmed by pathology were enrolled and CEUS features were compared.Results On CEUS,HBV-related CHC and HBV-related HCC mainly manifested as hyper-enhanced in arterial phase and hypo-enhanced in portal phase and delayed phase.No significant differences of enhancement level on CEUS were found between HBV-related CHC and HBV-related HCC.When the maximum diameter of tumor ≤3.0 cm,both HBV-related CHC and HBV-related HCC were mainly homogeneous enhancement (P=1.000).When the maximum diameter of tumor more than 3.0 cm,diffuse heterogeneous enhancement and peripheral irregular rim-like enhancement were more commonly observed in HBV-related CHC,while diffuse heterogeneous enhancement was more commonly noted in HBV-related HCC (P=0.001).Conclusion The enhancement pattern of HBV-related CHC ＞3.0 cm has relative specific performance.

Objective To investigate the utility of virtual endoscopy ultrasound Fly-Thru in the diagnosis of obstructive bile duct diseases.Methods One-hundred patients with obstructed bile duct diseases underwent Fly-Thru examination.All Fly-Thru images were reviewed by two radiologists with different experience.The capabilities of Fly-Thru for bile duct obstructive degree evaluation and distinguishing malignant lesion from benign one were assessed respectively.Results The accuracy and sensitivity of Fly-Thru image in obstruction degree evaluation were 70.59％ and 89.2％ (95％CI 74.6％-96.9％).The diagnosis accuracy of 2DUS for lesion characteristics increased from 80％ to 84％,accompany with Fly-Thru images,especially for lesions in common bile duct from 77.2％ to 86.0％ (x2 =14.399,P =0.001).Conclusions The virtual endoscopy ultrasound Fly-Thru is only partly capable to display the obstructed degree of some bile ducts,but it can improve the diagnostic accuracy of common bile duct diseases.

Objective To evaluate the correlation between the imaging features on contrast-enhanced ultrasound (CEUS) and pathological characteristics of combined hepatocellular-cholangiocarcinoma (CHC).Methods Forty patients with pathologically proven hepatic CHC were evaluated,the CEUS imaging findings and pathological characteristics of CHC were retrospectively analyzed.Results On CEUS,peripheral irregular rim-like enhancement,diffuse heterogeneous enhancement and diffuse homogeneous enhancement were illustrated in 13(32.5 ％),21 (52.5 ％) and 6(15.0％) lesions,respectively.Pathological findings showed that HCC-predominance,CC-predominant,and similar proportions of the two components were illustrated in 16 (40.0 ％),19 (47.5 ％) and 5 (12.5 ％) cases,respectively.The presence of necrosis were illustrated in 28 (70.0％) cases.On CEUS,when the enhancement pattern was peripheral irregular rim-like enhancement,CC-predominance and necrosis were presented in 11(84.6％) and 10(76.9％) cases,respectively.When the enhancement pattern was diffuse heterogeneous enhancement,CC-predominance and necrosis were presented in 11(52.4％) and 18(85.7％) cases,respectively.When the enhancement pattern was diffuse homogeneous enhancement,HCC-predominance and necrosis were presented in 4(66.6％) and 0 (0％) cases,respectively.There were significant differences in relative proportion of HCC,CC components and tumor necrosis among the three types of enhancement pattern on CEUS (P =0.009 and P ＜ 0.001).When CHCs were ≤ 5 cm,peripheral irregular rim-like enhancement,diffuse heterogeneous enhancement and diffuse homogeneous enhancement were illustrated in 5,3 and 5 cases,respectively.When CHCs were ＞5 cm,peripheral irregular rim-like enhancement,diffuse heterogeneous enhancement and diffuse homogeneous enhancement were illustrated in 8,18 and 1 cases,respectively.There were significant differences in the three types of enhancement pattern between lesion size of ≤5 cm and ＞5 cm on CEUS (P =0.006).Conclusions The imaging findings of CHC on CEUS depends on the relative proportions of HCC and CC component and on size-dependent patterns.

Objective To prepare targeted micorbubble with low immunogenicity. Methods The microbubbles were produced with different phospholipids and identified by the fluorescent method. Detect the level of C3a after reaction with human serum in vitro with enzyme-linked immunosorboent assay (ELISA) method and the number of microbubble binding with the streptavidin packed on the dish by using the parallel plate flow chamber. Results The level of C3a was (1.037±0.047)ng/ml in MBb group,(1. 326 ± 0. 042)ng/ml in MBe group and ( 1.004 ± 0.031 ) ng/ml in MBc group. The level of C3a in MBb group was significantly lower than that in MBe group( P ＜0.05),and there was no significantly difference between MBb group and MBc group ( P ＞ 0. 05). The parallel plate flow experiments showed that the number of MBb(15.2 ± 11.3) in each field of view binding with the streptavidin packed on the dish was significantly fewer than that of MBe ( 103.2 ± 28.3) ( P＜0.05 ), and there was no significantly difference between MBb and MBc(17.8 ± 11.9) ( P ＞0.05). Conclusions The targeted microbubble with low immunogenicity has been prepared successfully,which can be used for further experiment in vivo.

Objective To identify microbubbles targeted (MBt) to alpha(v)beta(3) (αvβ3) via biotin-avidin bridge and evaluate the adhesion to human umbilical vein endothelial cells (HUVECs) in vitro.Methods MBt produced via biotin-avidin bridge were validated using fluorescence in vitro.Adhesion of αvβ3-integrin targeted MBt (MBαvβ3) to HUVECs was tested using the parallel plate flow chamber (PPFC) test.Results Bright green fluorescence was observed on the biotinylated microbubbles(MBB) incubated with fluorescein isothiocyanate labeled streptavidin (FITC-SA) and on MBB-SA incubated with FITC labeled biotin.There was no fluorescence seen on non-targeted control microbubbles,MBB incubated with FITC labeled protein A and MBB-SA incubated with FITC labeled protein A. The adherent rate of MBαvβ3 was significantly higher than MBt with non-specific antibody (MBN) in PPFC test,with 9.9±3.1 of MBαvβ3 and 0.8±0.3 of MBN adhered to HUVECs,respectively(P<0.05).Conclusions Avβ3 targeted microbubbles using biotin-avidin bridging method is highly efficient and reliable for HUVECs.

Objective To evaluate the therapeutic efficacy and safety of radiofrequency ablation (RFA) combined with ethanol injection with a multipronged needle under ultrasound guidance for the treatment of hepatocellular carcinoma (HCC) larger than 3 cm in diameter.Methods 65 patients with 67HCC nodules ranging from 3.1 to 7.0 cm in diameter were treated percutaneously under ultrasound guidance.Tumor response and complications after treatment were observed.Results Complete ablation was achieved in 94.0％ (63/67) of HCC nodules.4 residual tumor nodules received complete ablation after additional treatment.Ablation-related major complications was occurred in 3 patients,including liver abscess in 1 case,abdominal bleeding in 1 case and massive ascites in 1 case,all were cured by conservative therapy.After a mean follow-up period of (20.0 ± 7.6) months (6.7-32.6 months),local-tumor progression was observed in 10 (14.9％) of 67 HCC nodules,and distant recurrence was observed in 32 (49.2％) of 65patients.The 1-year and 2-year survival rate were 93.1 ％ and 88.1％,respectively.Conclusions RFA combined with ethanol injetion with a multipronged needle is a safe and effective technique for the treatment of hepatocellular carcinoma larger than 3 cm,especially 3-5 cm in diameter.

Objective To evaluate the ablation zone and temperature changes in the liver caused by laser ablation in vitro and in vivo.Methods Single needle single point laser ablation was performed in vitro with porcine liver using 5 W and 7 W-power and in vivo with rabbit liver using 5 W-power.All energy outputs were 1 800 J.The ablation zone and temperature changes were evaluated.Results Coagulation caused by laser ablation was divided into a black carbonized area and a brown white necrotic area from inside to out,respectively.The mean in vitro ablation range obtained by 5 W and 7 W-power laser ablation was 1.9 cm × 1.2 cm × 1.2 cm and 2.5 cm × 1.5 cm × 1.5 cm,respectively.The mean in vitro black carbonized range obtained by 5 W and 7 W-power laser ablation was 1.1 cm × 0.5 cm × 0.5 cm and 1.4 cm × 0.7 cm ×0.7 cm,respectively.The average maximum temperature using 5 W-power was 243.57 ℃,62.47 ℃ and 34.27 ℃ in the ablation center,5 mm from the center,and 10 mm from the center,respectively.For in vivo liver experimentation,the average maximum temperature using 5 W-power was 62.26 ℃ and 44.35 ℃5 mm and 10 mm from the center,respectively.Conclusion Laser ablation can cause coagulation necrosis of the liver tissue in vitro and in vivo,and the ablation range increased with increasing power.Laser ablation may have potential use in the ablation of tumor localized in critical sites.