Due to the complexity and risk of liver anatomy and operation, laparoscopic hepatectomy is still a challengeable procedure. In order to acquire the optimal treatment effect, we need to comprehensively analyze the general condition, hepatic reserve function of patients, and the pathway selection before this surgery. Compared with open hepatectomy, the advantage of laparoscopic hepatectomy for hepatocellular carcinoma has been widely recognized. Anatomical hepatectomy, regional resection technology, and precise hepatectomy promote the all-round development of minimal invasive liver surgery. With the navigation of indocyanine green and laparoscopic ultrasound, and the support of associating liver partition and portal vein ligation for staged hepatectomy, controlled low central venous pressure and other technologic revolution, laparoscopic hepatectomy is believed to bring new breakthrough in treatment of HCC. Although the number of HCC patients who underwent laparoscopic resection of is increasing, there are still numbers of problems, referred to technology applied and promoted, at home and abroad. This article aims to discuss the pathway selection, surgical indications and contraindications, transformation of concepts, technology annotation, and the control of complications in HCC treatment.

Objective To study the cardiac function effect of allopurinol for hypemricemia combined with dilated cardiomyopathy patients.Methods One hundred and twenty hypemricemia combined with dilated cardiomyopathy patients were divided into allopurinol group and control group according to the treatment method with 60 cases each.All the patients were given conventional treatment,the control group was added the nitroprusside treatment,and the allopurinol group was added the allopurinol and nitroprusside treatment.The treatment period was 3 months.Results The total effective rate in allopurinol group was significantly higher than that in control group [90.0％ (54/60) vs.75.0％ (45/60)],there was statistical difference (P ＜ 0.05).After treatment,the left ventricular ejection fraction and left ventricular posterior wall thickness at end-systole in allopurinol group were significantly higher than those in control group [(67.85 ± 7.12)％ vs.(30.78 ±7.00)％ and (1.40 ±0.20) mm vs.(1.16 ±0.18) mm[,but the left ventricular internal diameter at end-systole,left ventricular internal diameter at end-diastole and left ventricular posterior wall thickness at end-diastole were significantly lower than those in control group [(4.72 ± 0.41) mm vs.(6.48 ± 0.47) mm,(2.93 ± 0.32) mm vs.(5.56 ± 0.62) mm and (0.77 ± 0.13) mm vs.(0.92 ± 0.18) mm],there were statistical differences (P ＜ 0.05).After treatment,The uric acid,urea nitrogen and creatinine were significantly lower than those in control group [(45.43 ± 11.24) μ mol/L vs.(167.23 ± 19.22) μ mol/L,(10.23 ± 7.12)mmol/L vs.(40.93 ± 8.09)mmol/L and (32.01 ± 8.34) mmol/L vs.(78.09 ±9.11) mmol/L],there were statistical differences (P ＜ 0.05).Conclusion Allopurinol used for treating hyperuricemia combined with dilated cardiomyopathy patients can reduce uric acid,early reversal the atherosclerosis and improve heart function,it should be widely applied research.

Objective To investigate the clinical value of chest low-dose CT (LDCT) combined with computer-aided detection (CAD) system for lung cancer screening in high risk population. Methods Two hundred and nineteen healthy candidates underwent 64-slice LDCT scan. All images were reviewed in consensus by two radiologists with 15 years of thoracic CT diagnosis experience. Then the image data were analyzed with CAD alone. Finally images were reviewed by two radiologists with 5 years of CT diagnosis experience with and without CT Viewer software. The sensitivity, false positive rate of CAD for pulmonary nodule detection were calculated. SPSS 11.5 software and Chi-square test were used for the statistics. Results Of 219 candidates ,104(47.5% )were detected with lung nodules. There were 366 true nodules confirmed by the senior radiologists. The CAD system detected 271 (74.0%)true nodules and 424 false-positive nodules. The false-positive rate was 1.94/per case. The two junior radiologists indenfifid 292(79.8%), 286(78.1%) nodules without CAD and 336 (91.8%), 333 (91.0%) nodules with CAD respectively. There were significant differences for radiologists in indentifying nodules with or without CAD system (P<0.01). Conclusions CAD is more sensitive than radiologists for indentifying the nodules in the central area or in the hilar region of the lung. While radiologists are more sensitive for the peripheral and sub-pleural nodules,or ground glass opacity nodules, or nodules smaller than 4 mm. CAD can not be used alone. The detection rate can be improved with the combination of radiologist and CAD in LDCT screen.

Objective:To study the effect of CsA on CD4+CD25+T cells from DO11.10 mice after immunization with OVA.Methods:The amount of spleen CD4+CD25+T cells and Foxp3+T cells was detected by means of flow cytometry (FCM).Results:After immunization with OVA,the ratios of CD4+CD25+T cells to CD4+T cells and Foxp3+T cells to CD4+CD25+T cells elevated in spleen,but CsA significantly decreased the percentage of CD4+CD25+T cells and CD4+CD25+Foxp3+T cells under either naive state or immune reaction state.Conclusion:CsA inhibits immune responses,while it also suppresses immune tolerance.

Objective To study MR imaging manifestations of the mesorectum and mesorectal fascia. Methods 100 cases were divided into five groups according to the age. All MR images were retrospectively observed and analyzed by two radiologists.The observing contents included: ①exhibition of the mesorectal fascia, ②the signal intensity of the mesorectum and the pelvic fat and ③the thickness ratio of the mesorectum and the subcutaneous fat in different ages. All data were dealed with SPSS 10.0 software. Results The showing rate of the anterior, posterior, left and right mesorectal fascia respectively were 77, 100, 91 and 93 by MR imaging. The signal intensity of the mesorectum(550.8843) was significantly higher than that(469.8693) of pelvic fat in all five groups(P﹤0.05) and the signal difference between the mesorectum and the pelvic fat could be detected by naked eye. The thickness of the mesorectum and the subcutaneous fat had no association with ages.Conclusion MRI can display the mesorectum and mesorectal fascia clearly. The signal intensity of the mesorectum is significantly higher than that of pelvic fat in five groups. The thickness of the mesorectum and the subcutaneous fat have no association with ages.

Objective: To investigate the free radical scavenging properties of six aloe species and study its protective effect on red blood cells. Methods: Free radical scavenging properties were investigated in modified chemical system. The antioxidant was purified by silica column and thin layer chromatography and analyzed by HPLC. Its protection on red blood cells was studied with red blood cells culture system in vitro. Results: The extract from A. berebihoria showed the most effective scavenging activities on O - 2? and ?OH (32.19% and 26.05% respectively) in six aloe species. The fraction A with a Rf value of 0 497 was proved to be a pure antioxidant (Rt=15.956 min). It is an anthraquinone with phenol hydroxyls. Fraction A showed strong inhibitory activity on H 2O 2 induced hemolysis of red blood cells and its IC 50 was 0.856 g/L. Conclusion: Fraction A of the extract from A. berebihoria had strong scavenging activities of O - 2? and ?OH, thereby inhibiting the peroxidation of red blood cells and maintaining their functions.

Objective To investigate the MR manifestations and diagnostic value in patients with choroidal fissure cyst of the brain. Methods Characteristic MR findings in 16 patients with choroidal fissure cyst were retrospectively analyzed, and the correlation between MR imaging and clinical manifestations was reviewed. Results The cysts were situated within the choroidal fissure in all cases, representing as cystic lesion with clear border, no detectable soft tissue mass in the cyst wall or adjacent area, homogenous signal intensity identical to CSF on all sequences, with the average size of 0.9 cm?1.3 cm?1.5 cm, and no associated edema. Gd-DTPA was performed in 6 cases and revealed no evidence of enhancement. Conclusion The choroidal fissure cyst of the brain is a benign and congenital developmental abnormality, and has minor clinical significance. Because of its specific anatomic location, the choroidal fissure cysts simulate intraparenchymal cystic lesions on axial images. Coronal and sagittal MR imaging can be used to delineate its extraaxial location and make the correct diagnosis, and, thus, differentiate with other cystic lesions.

Objective:To observe the hemoclynamic changes caused by adrenaline contained in local anesthetic. Methods:Ninety adult patients undergoing functional endoscopic sinus surgery (FESS) under general anesthesia were randomly allocated into three groups. Group A(n=30) received 2% lidocine 2 ml with adrenaline (1:200000) , group B(n = 30) received saline 2 ml with adrenaline (1:200000) , and group C(n = 30 , control group) received saline 2 ml without adrenaline for local infiltration. Electrocardiogram (ECG) and heart rate (HR) were monitored; systolic blood pressure (SBP) , diastolic blood pressure (DBP) , and mean arterial blood pressure (MAP) were directly measured in radial artery continuously after local infiltration. SBP, DBP, MAP and HR were recorded at 8 time points:before infiltration (baseline) ,0.5, 1,1. 5, 2, 3, 4 and 5 minutes after infiltration. Results:Significant hemody-namic changes, particularly hypotension (P 0 .05). The significant he-modynamic changes lasted no longer than 5 minutes. Conclusion:Lidocaine (2%) or saline with adrenaline (1:200 000) does cause temporary hypotension and other hemodynamic changes during general anesthesia, which last no longer than 5 minutes. The causative mechanism is the effect of adrenaline.

Objective To analyse the CT,MRI features of pleomorphic xanthoastrocytoma and improve the diagnosis.Methods Imaging feature of pleomorphic xanthoastrocytoma of 26 cases confirmed by surgery and pathology were analyzed retrospectively.Distribution,size,shape,signal,dense,peritumor edema and invasion of adjacent structures of lesion were summarized.Results The locations of lesions included:temporosphenoid lobe (19 cases),frontal lobe (2 cases),the lateral and three ventricles in 1 case,occipital lobe (1 case),medulla oblongata (1 case),and cervical cord (1 case).The tumor size:maximum:82 mm × 40 mm × 70 mm,minimum:16 mm × 13 mm × 14 mm.Solid lesions (3 cases),solid lesions with necrosis (7 cases),solid and cystic lesions (16 cases),lesion with calcification (4 cases).The solid lesions of the tumors showed equal signal intensity or slightly low signal intensity on T1WI,and equal signal intensity or slightly high signal intensity on T2WI.The equidensite and high density on CT,peritumor edema degree:mild (2 cases),moderate (5 cases),severe (1 case).Conclusion The characteristic imaging features can help in the understanding and diagnosis of pleomorphic xanthoastrocytoma.

Objective To study the clinical evaluation of the effect of topical application of Periocline ointment in the adjuvant treatment of periodontitis.Methods100 patients with periodontitis as the research object in this study in Xi'an Jiaotong university school hospital from April 2015 to August 2016 were randomly divided into the control group and the experimental group, 50 cases in each group.The control group were treated with the conventional treatment, at this basis, the experimental group were given Periocline ointment topical application as the auxiliary treatment.Eight weeks after treatment, the clinical treatment and related indicators were compared in the two groups.ResultsThe bleeding index, probing depth and attachment level in the experimental group were significantly better than those in the control group (P<0.05).In the experimental group of 50 patients, the total effective number of cases in the treatment of 48 cases, The total effective rate in the experimental group was 94.0%, which was significantly higher than 88.0% in the control group (P<0.05).ConclusionIt can improve the effective rate that Periocline ointment was local applicated in the adjuvant treatment of periodontitis;it is worthy of clinical application.