In recent years,the incidence of hepatocellular carcinoma (HCC) has increased with a higher mortality rate.Early detection and early treatment are essential to improving the patients' survival rate. Imaging is widely used HCC and is advantageous because it is non-invasive. The rapid development of imaging calls for higher standards in order to diagnosis hepatocarcinoma at an earlier stage so as to achieve complete treatment.This review describes the scientific progress on imaging differential diagnosis and application on pre-cancerous nodules (dysplastic nodule,DN) and small hepatocellular carcinoma (sHCC) related to hepatocarcinogenesis in cirrhotic livers.

Cholangiocarcinoma is a malignant tumor that occurs in the bile duct epithelium,it is the second most common malignant tumor of the liver and bile duct after hepatocellular carcinoma.Imaging examination is an important method to detect bile duct cancer;the purpose of imaging is to determine the location of the tumor,and the extent of invasion and distant metastasis.Different imaging methods have their advantages and disadvantages,so they should be chosen based on the condition of patients,or be optimized as the combined detection.

Hypoxia exists in a wide range of advanced solid tumors and is often associated with poor prognosis.Hypoxia can enhance tumor invasion, promote tumor angiogenesis, impact genomic stability and change the tumor microenvironment by activating expression of relevant genes through hypoxia-induced factors (HIFs).Hypoxia provides favorable conditions for tumor metastasis and relapse, and it is involved in all aspects of tumor development.The study of hypoxia in tumors may provide useful information for pre-clinical evaluation, individualized treatment and clinical prognosis.Positron emission tomography (PET) is a non-invasive imaging method, which can be used for assessing and quantifying tumor hypoxic microenvironment.This article reviews the mechanisms of hypoxia-induced tumor biological behavior changes and the research progress of the application of radiotracers for PET imaging of tumor hypoxia.

Objective To evaluate the teaching effectiveness of applying article structure analysis to improve medical graduate students' ability to read research articles.Methods 48 medical graduate students from basic medicine school of the Fourth Military Medical University were randomly and equally divided into the experimental group and control group.In the reading ability training of scientific research papers,the experimental group used the teaching of the structure analysis,while the control group used the collective self study.Before and after the training,the two groups of students were implemented a unified reading ability test and self reading ability evaluation survey,and after the training,the teaching satisfaction survey was conducted among the experimental group only.SPSS 16 was used to analyze the correlation data and Wilcoxon for signed-rank t est.Results After training the reading ability test results showed that reading ability score (P=0.013),consumed reading time score (P=0.003) and reading efficiency (P=0.004) of the experimental group were significantly higher than those of control group.The two groups of students' self-evaluation of the reading ability showed that after training,the scores of the students in the experimental group were higher than those in the control group,and the differences were statistically significant (P values were less than 0.05).The experimental group students' teaching satisfaction survey to article structure analysis showed students' score in 6 survey contents were greater than 3,namely degree of evaluation was more than general,among which,the score of four survey contents was more than 4,that is to achieve satisfied or very satisfied.Conclttsion Applying article structure analysis can significantly improve medical graduate students' ability to read research articles.

Objective To summarize the diagnosis and surgical treatment of hepatic focal nodular hyperplasia (FNH). Methods The clinical data of 63 patients with FNH proved by pathology were analyzed retrospectively. Results The disease mainly affected young to middle aged, 50 cases (79. 4% )were of 31-50 years old. Male and female ratio was 2.94: 1. Fifty-six patients (89%) were asymptomatic, 3 cases were HBsAg positive (4.8%). Liver function was basically normal (92. 1%),5 cases (7.9%) were with elevated level of total bilirubin and rGT. AFP, CEA and CA19-9 was all negative. FNH occured as a single node in 95.2% cases, ranging from 1.5 cm to 17 cm in diameter ( average 4. 5 cm). Of these patients, 25 lesions were present in the left lobe, 29 in the right lobe, 6 in the mid lobe, and 3 in the caudate lobe. A big central artery was found in 2 cases (3. 2% ) as found by color Doppler ultrasound. CT scan showed transient immediate enhancement in 96. 8% (61/63) of patients, with central scar in 6 cases. MRI demonstrated early vigorous enhancement in 93. 7% (59/63) of patients, with central scar in 5 cases. All patients underwent surgical resection; including local resection in 34 cases;segmentectomy or hepatectomy in 13 cases; hemihepatectomy in 13 cases. There was no postoperative mortality and major complications. Conclusions FNH is a kind of hepatic benign disease and characteristic of high preoperative misdiagnosis rate (25. 4% ).

BACKGROUND:Coronary stent implantation can cause blood vessel damage and wal reconstruction, leading to vascular stent restenosis. Studies have found that visfatin is associated with inflammatory reaction, and exhibits an increased expression at the site of plaque rupture in acute myocardial infarction. OBJECTIVE:To investigate the influence of percutaneous coronary intervention on the levels of visfatin in patients with coronary heart disease. METHODS:Thirty patients with acute myocardial infarction within 12 hours after the onset of the chest pain, 30 patients with unstable pectoris and 30 patients with stable angina pectoris were included. Al patients were successfuly treated by percutaneous coronary intervention. Meanwhile, 30 patients only undergoing coronary angiography but not stenting treatment were selected, and another 30 patients without any treatment served as normal control group. RESULTS AND CONCLUSION:According to enzyme-linked immunosorbent method, the visfatin levels of acute myocardial infarction, unstable angina, stable angina and coronary angiography groups continue to rise at pre-operation, 30 minutes, 6 hours, 12 hours, 24 hours after operation, al of which were higher than that in the normal control group (P < 0.05). The results confirmed that within 24 hours after coronary stent implantation the visfatin levels continue to rise.

Objective To evaluate the diagnostic value of 64-slice VCT reconstruction techniques in the diseases of joints of foot and hand.Methods 50 patients with diseases of joints of foot and hand underwent MSCT scans,the data were reconstructed,including multiplanar reconstruction(MPR),maximum intensity projection(MIP),shaded surface display(SSD)and volume rendering(VR),the results were analysed.Results 33 patients with fractures,40 and 51 fractures were found by X-ray and MPR,VR,respectively.The joint surface involved in 7 fractures,which was best with VR and MPR to show the whole fractures.SSD was better to demonstrate the soft tissue and the vessels of the skin.3D bone reconstruction with MIP was better than plain film in showing the fractures in 4 patients with plaster external fixation.Conclusion 64-slice VCT reconstruction techniques are effective in diagnosis of the diseases of joints of foot and hand.

Cardiovascular System ; Forkhead Transcription Factors ; Humans

Objective To evaluate the intraoperative advantage and short-term outcomes of three-dimensional laparoscopic surgery for rectal cancer.Methods The clinical data of patients who underwent radical resection for rectal cancer at Department of Colorectal Surgery,China-Japan Union Hospital of Jilin University from November 2013 to February 2014 were retrospectively analyzed.There were 20 patients undergoing three-dimensional laparoscopic surgery and 26 patients undergoing two-dimensional laparoscopic surgery.The following parameters were compared between the two groups:intraoperative factors,oncologic outcomes,and short-term surgical outcomes.Data were analyzed by SPSS 17.0 software packet,using t and x2 inspection.Results All the operations were perfomed successfully without conversion.Compared with the two-dimensional laparoscopic surgery group,the three-dimensional laparoscopic surgery group had shorter operative time [(97.2 ± 19.3) vs.(114.1 ± 22.6) min,t =2.680,P =0.010],less intraoperative blood loss [(13.5 ± 6.7) vs.(20.1 ± 12.7) ml,t =2.288,P =0.028],less stapler docking times [(1.4 ± 0.6) vs.(2.3 ± 0.8) number of times,t =4.962,P =0.000],earlier removal of urethral catheter [(2.2± 0.6) vs.(2.7 ± 0.8) d,t =2.401,P =0.021].There were no significant differences in the postoperative ventilation time,postoperative hospital stay,number of lymph node dissection (all P ＞ 0.05).Conclusions Three-dimensional laparoscopic compared with two-dimensional laparoscopic radical resection for rectal cancer has many advantages,such as shorter operative time,less intraopretive blood loss,high accuracy operation and earlier postoperative urine voiding.

Objective To summarize surgical experience for the treatment of substernal goiter.Methods 102 cases of substernal goiter underwent surgical resection,in 74 by low collar incision,12 cases by larger low collar incision and pillowing the shoulder pad about 20 degrees for neck hyperextension,8 cases by unilateral or bilateral infrahyoid muscles transection,8 cases by low collar and up-mid-sternal incision plus horizontal sawing in 2 and 3 ribs.Results Resection was performed successfully in all cases.Hoarseness occurred in 7 cases,4 cases recovered after one month,3 cases did not improve because of tumor invasion of laryngeal recurrent nerve.Postoperative transient hypocalcemia in 9 cases recovered after 2 to 3 months.102 patients were followed up for 1 to 3 years without recurrence.Conclusions Substernal goiter can be resected successfully through a transcervical approach or mid-sternal incision.CT scanning and chest X radiograph are decisive for the surgical approach.