Objective To evaluate MR Dual echo imaging in the differential diagnosing liver lesions.Methods:MR Dual echo features in 80 patients with different liver lesions,including 40 cases of benign lesions and 40 cases of malignant lesions,were analyzed,and comparison with MR Dual echo imaging was made.Results MR Dual echo sensitivity and specificity were 85% and 95% in the benign lesions,80% and 94% in the malignant lesions respectively.Conclusion MR Dualecho imaging is a useful MR technique,which is helpful in differentiating benign from malignant lesions.

Objective To investigate the expression of Foxp3+ Treg in liver cancer patients receiving liver transplant after immunosuppressive protocols FK506 or Rapamycin and evaluate the rejection prevention.Methods Liver transplant patients were randomly divided into FK506 group (10 cases),and Rapamycin group (10 cases).Real time quantitatve PCR was used to examine Foxp3 mRNA expression of patients' PBMC starting the 2nd month for consecutively 10 months.Foxp3 mRNA and incidences of acute rejection were compared between the two groups.Results Foxp3 mRNA expression was significantly lower in the FK506 group (0.1032 ±0.0943) as compared to that in the Rapamycin group (1.2136 ±0.6738)(t =5.1610,P ＜ 0.01) ;The incidences of acute rejection was significantly lower in the Rapamycin group as compared to that in the FK506 group after operation in the same period (x2 =2.2222,P ＜ 0.05).Conclusions FK506 may suppress the induction of immune tolerance after liver transplantation,while Rapamycin may play an important role in inducing and maintaining graft immune tolerance.Rapamycin is better than FK506 in preventing rejection reaction in liver cancer patients receiving liver transplant.

Objective To evaluate the efficacy of acting κ opioid receptor for prevention of high altitude pulmonary edema (HAPE) in rats.Methods Forty male Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 5 groups (n =8 each) using a random number table:control group (group C),hypobaric hypoxia group (group H),normal saline + hypobaric hypoxia group (group NH),U50488H (a selective kappa-opioid receptor agonist) + hypobaric hypoxia group (group UH),and nor-binaltorphimine (norBNI,a selective kappa-opioid receptor antagonist) + U50488H + hypobaric hypoxia group (group NUH).The rats were put into the hyperbaric chamber and exposed to hypobaric hypoxia (atmospheric pressure 355 mmHg,partial pressure of oxygen 74 mmHg) for 2 days to induce HAPE.At 3 days before HAPE,normal saline 0.5 ml,U50488H 1.25 mg/kg,and nor-BNI 2.0 mg/kg were injected intraperitoneally once a day in NH,UH,and NUH groups,respectively,and in addition U50488H 1.25 mg/kg was injected intraperitoneally 10 min later in NUH group.After 2 h exposure to hypobaric hypoxia,mean pulmonary artery pressure (mPAP) was detected,and arterial blood samples were collected for determination of serum malondialdehyde (MDA) and erythropoietin (EPO) levels.The rats were then sacrificed and lungs were removed for microscopic examination and for determination of the levels of nitric oxide (NO),inducible nitric oxide synthase (iNOS),MDA,superoxide dismutase (SOD),endothelin-1 (ET-1),thromboxane B2 (TXB2),and 6-keto-prostaglandin F1α (6-keto-PGF1α) in lung tissues.Lung water content and TXB2/6-keto-PGF1α ratio was calculated.Results Compared with group C,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio,and serum MDA and EPO levels were significantly increased,and iNOS,NO and SOD levels were decreased in the other four groups (P ＜ 0.05).Compared with group H,mPAP,lung water content,ET-1,MDA,TXB2 and 6-keto-PGF1α levels,TXB2/6-ketoPGF1α ratio and serum MDA and EPO levels were significantly decreased,and iNOS,NO and SOD levels were increased in UH group (P ＜ 0.05),and no significant changes were found in the indexes mentioned above in NH and NUH groups (P ＞ 0.05).The pathological changes of lung tissues were significantly attenuated in group UH as compared with H group.Conclusion Acting κ opioid receptor can produce prevention for HAPE in rats,and inhibition of lipid peroxidation and correction of the imbalance between vasoconstrictive factors and vasodilative factors may be involved in the mechanism.

Objective To establish a modified method to evaluate the protection of the antioxidant of DNA damage induced by hydroxyl radical. Method Reaction mixture at a final volume of 1.0 ml contained 0.8mg/ml DNA,0.2 mmol/L H2O2,1.0 mmol/L ascorbic acid,in 50 mmol/L NaH2PO4-Na2HPO4 buffer (pH 7.4). EDTA(1.0 mmol/L) and FeCl2 (1.0 mmol/L)were premixed and then dispensed into the reaction mixture to trigger the Fenton reaction,and the mixture was incubated at 37℃ for 30 min. The reaction was stopped by dispensing 1ml of 10% (w/v) trichloroacetic acid ,and reaction mixture was mixed with 1ml of 1% (w/v) 2-thiobarbituric acid,then further heated at 80 ℃ for 30 min. The chromogen formed was extracted into n-1-butanol and absorbance was measured at 532 nm. Results Addition of hydroxyl radical scavenger can compete with DNA for the hydroxyl radicals and diminished TBARS formation at a defined time of reaction with dose-dependent effect. The result showed that hydroxyl radical scavenger exerted inhibition effects on hydroxyl radical-mediated DNA damage. Conclusion This method can be used to evaluate the protection of the antioxidant of DNA damage induced by hydroxyl radical.

Objective To investigate the clinical efficacy of liver resection combined intraoperative choledochoscope for intra‐hepatic biliary calculi .Methods A retrospective analysis of clinical data in seventeen patients with intrahepatic biliary calculi ,who have been received liver resection combined intraoperative choledochoscope in the department of hepatobiliary surgery during 2005 to 2014 was conducted .According to the distribution of intrahepatic bile duct stones ,six cases located in left liver lobe ,five cases lo‐cated in left half liver ,three cases located in liver section Ⅵ ,one case located in liver section Ⅶ ,one case located in liver section Ⅷ , one case located in left liver lobe associated with right posterior lobe lower segment .Seventeen cases were treated with hepatolobec‐tomy or segmental liver resection (single clamp method combined first hilar occlusion) ,among which six cases received hepatic left lateral lobectomy ,five cases received left hemihepatectomy ,three cases received partial hepatic resection in paragraph Ⅶ ,one case received partial hepatic resection in paragraph Ⅶ and one in Ⅷ ,one case received the left lateral lobe combined right posterior lower segmental resection ,ten cases at the same time received choledocholithotomy and T tube drainage .Results All patients were cured without serious complications ,no long term stone recurrence .Conclusion Liver resection combined intraoperative choledochoscope is positive and effective treatment for intrahepatic biliary calculi patients .

Objective To explore the expression of cadherin (Cad) genes in patients with chronic myeloid leukemia (CML),and to elucidate the significance of Cad genes in the development of CML.Methods E-Cad and N-Cad gene expression levels in bone marrow mononuclear cells (BM-MNC) from 48 CML patients (29 in chronic phase,19 in progressive phase) were detected by real time quantitative polymerase chain reaction (qRT-PCR).Results Gene expression of E-Cad and N-Cad was detectable in CML BM-MNC.E-Cad gene expression level was lower in progressive CML than that in chronic CML (0.20 ± 0.35 vs 1.19 ± 0.87,P ＜ 0.01),while N-Cad was highly expressed in progressive CML than in chronic CML (0.89 ± 0.45 vs 0.57 ± 0.47,P ＜ 0.05).E-Cad gene expression level was negatively corrclatcd with thc pcrccntagc of peripheral blood progenitor cells (r =-0.705,P ＜ 0.01).Conclusion E-Cad and N-Cad gene expression correlates with the progression of CML,and might be used as an evaluation index for disease development.

Objective To investigate the therapeutic effect and advantage of laparoscopic appendectomy by concealed three-ports technique. Methods The clinical data of 283 patients received concealed three-ports laparoscopic appendectomy were retrospectively reviewed. Results All the patients were cured after appendectomy,including 5 patients required conversion to operation(because of adhesions around the appendix and difficult to dissect). The surgical time ranged from 25 min to 110 min and the mean time was 38 min. After 8 ～ 12h the patients could move and the average length of postoperative stay was 5d (range 4 ～ 6d). 3 cases had postoperative wound infection. None occurred complications such as postoperative bleeding, abdominal abscess, intestinal fistula, adhesion ileus and incision hernia in 6 months on average (range 1 ～ 18 months)after operation. Conclusion Laparoscopic appendectomy by concealed three-ports technique was a safe and available method and had advantages such as convenience and safety,good cosmetic results,less injury,rapid recovery,less complications,cheap and easy.

Objective To evaluate the efficacy of modified arytenoid adduction in the management of patients with unilateral vocal fold paralysis(UVFP).Methods A retrospective review was performed on 22 patients who underwent modified arytenoid adduction for UVFP between February 2001 and December 2007.Pre-,and 3 months postoperative aspiration,perceptual(GRBAS),acoustic data(fundamental frequency,F_0,fundamental frequency perturbation,jitter,amplitude perturbation,shimmer,normalized noise energy,NNE)and aerodynamic(maximal phonatory time,MPT,mean airflow rate,MFR)were analyzed statistically.Results The ratings of postoperative aspiration were significantly decreased than that of the preoperation(P<0.0001).There was a significant decrease in GRBAS scales postoperatively versus preoperatively(P<0.0001).The mean values of voice acoustics parameters (F_0,jitter,shimmer,NNE)were significantly decreased,the maximum phonation time were significantly longer,and the mean airflow rate were significantly decreased after operation than that of the preoperation(P<0.001).Conclusion Modified arytenoid adduction is an effective medialization technique that can restore satisfactory speech and prevent aspiration in patients with UVFP.

Objective To investigate the variations of the spatial position and overlap ratio for gross tumor volume (respiratory phase 50％) (GTV50) and internal gross tumor volume (IGTV) of primary thoracic esophageal cancer during conventional fractionated radiotherapy based on repeated four-dimensional computed tomography (4DCT) scans.Methods Thirty-three patients with thoracic esophageal cancer underwent contrast-enhanced 4DCT scans before radiotherapy and at the 10th and 20th fractions of radiotherapy.Scans were registered to the baseline 4DCT scan using bony landmarks.The GTV50 was delineated by the same radiotherapist on each 4DCT imaging data set,and the IGTV was constructed accordingly.The target volume,degree of inclusion (DI),and matching index (MI) were compared in different phases.Results The volumes of GTV50 and IGTV decreased along with treatment course.No significant changes in the centroid position were observed for the GTV50 and IGTV.The median DIs of the target volumes at the 10th and 20th fractions in the original target volume were 0.75 and 0.63(P =0.000) for GTV50 and were 0.79 and 0.66(P=0.000) for IGTV,while the median MIs were 0.61 and 0.56(P=0.002) for GTV50 and were 0.68 and 0.58 (P =0.005) for IGTV.A positive correlation between the variation of volume ratio and the variation of DI was found for GTV50 and IGTV (r =0.632,r =0.783),and the variation of volume ratio was also positively correlated with the variation of MI (r =0.387,r =0.483) ;the 3D vector was negatively correlated with the MI (r =-0.455,r =-0.438).Conclusions During conventional fractionated radiotherapy,the variation of spatial position is less than 0.8 cm for GTV50 and IGTV of primary thoracic esophageal cancer,and the decline of the target leads to varying degrees of decreases in DI and the MI.

Objective To compare the position,volume and matching index (MI) of esophagus between quiet end-inspiration and end-expiration in three dimensional CT (3D-CT) assisted with active breathing control (ABC) and the corresponding phases in four dimensional CT (4D-CT).Methods Eleven patients with peripheral lung cancer underwent 4D-CT simulation scan and 3D-CT simulation scans in end-inspiratory hold (CTEIH) and end-expiratory hold (CTEEH) in succession.The 0％ phase was defined as end-inspiratory phase (CT0),while the 50％ phase was defined as end-expiratory phase (CT50).The proximal,mid-,and distal thoracic esophagus were delineated separately on CT0,CT50,CTEIH and CTEEH images.The position,volume and MI of each segment esophagus between CT0 and CTEIH,CT50 and CTEEH were compared.Results In the left-right (x) direction,the position differences in the proximal,mid-,and distal thoracic esophagus between CT0and CTEIH were (-0.02 ±0.16)cm,(0.06 ± 0.26)cm and (0.10 ± 0.33) cm respectively,and in the anterior-posterior (y) direction,the position differences were (0.04 ±0.24)cm,(0.04 ±0.12) cm and (0.08 ±0.15) cm respectively,and the position differences in the same direction were not statistically significant.In the x direction,the position differences of the proximal,mid-,or distal thoracic esophagus between CT50 and CTEEH were (-0.02 ±0.24) cm,(0.12 ± 0.37) cm and (0.26 ± 0.33) cm respectively,and in the y direction,the position differences were (0.03 ±0.21)cm,(0.04 ±0.17)cm and (0.14 ±0.18)cm respectively,and the position differences in x and y directions of proximal and mid-thoracic esophagus between CT50 and CTEEH were not statistically significant,while the position differences in x and y directions of distal thoracic esophagus between CT50and CTEEH were both statistically significant (t =0.025,0.024,P ＜ 0.05).The volumes of the proximal,mid-and distal thoracic esophagus were all larger in CT0and CT50 than those in CTEIHand CTEEH,but without statistical differences.The MIs of the volumes of the proximal,mid-and distal thoracic esophagus between CT0 and CTEIH were (0.50 ± 0.17),(0.50 ± 0.19) and (0.56 ± 0.08),respectively,and those between CT50and CTEEH were (0.50 ±0.16),(0.47 ±0.14) and (0.51 ±0.15),respectively.The MI of each segment esophagus between CT0and CTEIHwas larger than that between CT50 and CTEEH,but without statistical differences.Conclusions The influence of breathing modes on the centroid positions of the proximal,mid-thoracic normal esophagus were not significant and there were spatial mismatches for any segment esophagus between 3D-CT assisted with ABC and 4D-CT.