Objective To investigate the effect of TGF ? 1 and TGF ? on hepatic apoptosis in hepatocelluler carcinoma (HCC) after transcather arterial chemoembolization (TACE).Methods The specimens were surgically obtained from 36 patients who had been treated by TACE (TACE group) and 19 patients without any treatments (no TACE group). Expression of TGF ? 1 and TGF ? in HCC tissues was detected by immunohistochemical method. Apoptosis was detected by ISEL method.Results Expression rates of TGF ? 1 in HCC tissues of TACE group and no TACE group were 86.11% and 36.84% respectively.expression rates of TGF ? in HCC tissues of TACE group and on TACE group were 0.0088 and 0.1901 respectively.Conclusions After TACE, the expression of TGF ? 1 was enhanced to accelerate the hepatic apoptosis in HCC.TGF ? was mainly related to the cell proliferation in HCC.That the expression of TGF ? was inhibited after TACE might accelerate the hepatic apoptosis of HCC.

In order to investigate the relationship between the VEGF level and the counts of dendritic cells (DCs) in peripheral blood of patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE), the peripheral blood was obtained from 37 patients with HCC who treated by TACE. The blood was obtained on the day before TACE, the first day, the 7th day and the 15th day after TACE respectively. The counts of DCs were quantified by flow cytometry. The plasma VEGF level was measured by ELESA kit. It was shown after TACE, the counts of DCs in peripheral blood were decreased significantly (P<0.05), and the VEGF level in peripheral blood was increased significantly (P<0.05). The counts of DCs in peripheral blood had an inverse correlation with the plasma VEGF level (r=-0.57, P<0.05) after TACE. It was concluded that in patients with HCC after TACE, the increased plasma VEGF level appeared to have the effect to suppress the maturation of DCs, which may contribute to reduction of the body's anti-tumor immunity effect, with a consequence of recur and metastasis of tumor.

Objective To investigate the diagnosis of diffusion-weighted imaging (DWI) in cervical lymph nodes lesions.Methods Twenty patients with metastatic lymph node,10 patients with tuberculosis lymph node and 10 volunteers were underwent both conventional MRI and DWI,and the ADC values of lymph nodes' solid components were measured.The difference of ADC values between three kinds of lymph nodes were analyzed.Results ADC values of metastatic lymph nodes was (0.842 ± 0.156) × 10-3 mm2/s,ADC values of tuberculosis lymph nodes was (1.249 ± 0.142) × 10-3 mm2/s,and ADC values of normal lymph nodes was (1.291 ± 0.176) × 10-3 mm2/s.There was significant difference between ADC values of metastatic lymph nodes and with the two later kinds of lymph nodes (P＜ 0.01),and no difference in the two later kinds of lymph nodes (P ＞ 0.05).Conclusion ADC values with features of conventional MR is helpful for differentiate metastatic lymph node,tuberculosis lymph node and normal lymph nodes.

Objective To investigate the features of multiple pelvic injuries (fracture combined with multiple traumas) and their effects on management and prognosis. Methods A total of 233 cases of hemodynamically unstable pelvic fractures were grouped according to the patterns of violence, fracture and associated injuries. They were assessed with measured indexes in physiological state, anatomic injury and blood requirement. Their possibilities of survival (Ps) were also predicted. All the data were statistically analyzed. Results The pelvic fractures were often combined with multiple traumas and frequently resulted from high energy traffic accidents. The correlations among sources of bleeding, amounts of blood loss and hemodynamical changes were disproportional. In unstable pelvic fractures with extra pelvic bleeding, BP and blood requirement were significantly different, and their AIS and ISS of the pelvis were higher and their Ps was lower than in the other groups. Conclusions Multiple pelvic injuries caused by high energy are often highly risky and combined with multiple traumas and several sources of bleeding. A clear and precise assessment of the total injuries and sources of bleeding will help treat the patients with different managements.

Objective To study the sugical treatment of elderly patients with acute intestinal ob-struction caused by colorectal cancer. Methods The clinical data of 56 elderly patients of acute colonic ob-struction caused by colorectal cancer from Janury 2002 to Janury 2007 were analyzed retrospectively. There were 20 cases with right side coloniclesion,32 cases with left side coloniclesion and 4 cases with rectal lesion. All patients received emergency operation. One stage tumor resection and anastomosis was performed in 20 cases with right side coloniclesion and in 25 cases with left side coloniclesion,Hartmann operation in 4 cases,proximal colostomy in 3 cases were performed with left side coloniclesion. Dixon operation in 2 cases and proximal colostomy in 3 cases were performed with rectum cancer. Results Postoperative complications occurred in 18 cases,including wound infection,intraperitoneal sepsis and intestinal fistula. Fifty-five cases recovered,there was one perioperative death. Conclusions Positive operation should be taken when the diagnosis of acute obstructing colorectal cancer the elderly is made. The operative methods depended on the patient'conditions. The perioperative managment should be emphasized and selection of rational operation procedure is important for decreasing mortality and complications of acute obstructing colorectal cancer in the elderly.

Objective To improve diagnose and therapy of post-traumatic acute renal failure induced by rhabdomyolysis. Methods A total of 20 patients with post-traumatic acute renal failure induced by rhabdomyolysis were analyzed retrospectively in aspects of clinical manifestation, laboratory examination and treatment. Of all, there were 9 patients treated with continuous renal replacement therapy (CRRT), while the other 11 were set as control, receiving no CRRT. Results After treatment with CRRT, 7 patients obtained clinical curing, with 2 deaths. As for control patients, there were 5 patients with secondary chronic renal insufficiency, 1 with clinical curing and 5 deaths. Conclusions Early diagnosis, CRRT, sufficient hydration, hematedialysis and supportive treatment are key points to improve the cure rate. It is important to apply CRRT for patients with renal inadequacy.

Objective To investigate the effect and mechanism of combined therapy using anti-CTLA-4 antibody and doxoru-bicin on mice bearing breast cancer.Methods Balb/c mice inoculated with 4T-1 mouse breast cancer cell were used as tumor mod-els,which were randomly divided into blank group,solvent control group,anti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group.Tumor growth of mice was observed.The ratio of spleen and bone marrow cell subgroup were evaluated.Tumor microenvironment apoptosis and microvessel density (MVD)were evaluated.Results The tumor volume of an-ti-CTLA-4 antibody only group,doxorubicin only group and combined therapy group were lower than those in the rest groups(P <0.05).The tumor volume and mass of combined therapy group was significantly higher than those of anti-CTLA-4 antibody only group,doxorubicin only group (P <0.05).Compared with blank group,solvent control group,CD8 + Tand CD4 + T ratio in anti-CTLA-4 antibody only group,doxorubicin only group,combined therapy group increased with significant difference (P <0.05). The positive cell apoptosis rate of combined therapy group was significantly higher than those of other groups(P < 0.05 ).The MVD of combined therapy group was significantly lower than those of other groups(P <0.05).The positive cell apoptosis rate and MVD of anti-CTLA-4 antibody only group,doxorubicin only group were better than those of blank group,solvent control group. Conclusion Combined therapy using anti-CTLA-4 antibody and doxorubicin could improve the immune,significantly inhibit the growth of tumor,promote cancer cell apoptosis and decrease MVD.

Objective To study the clinical effects and immunological rejection of allogenic bone as autologous bone graft substitute materials in the treatment of developmental dislocation of the hip.Methods Selected 36 chlidren 40 hip joint undergoing Salter innominate osteotomy,shortening and derotational of the femur bone cutting,Allogeneic bone implantation.Results According to the clinical evaluation criteria of Mckay,excellent 32,good 6,satisfaction 87.5％.All 40 cases of hip bone graft healing,complications such as postoperative incisional drainage response,and no obvious immune rejection.Conclusions Allogeneic bone implantion in the treatment of developmental dislocation of the hip is safe.

AIM:Discoid meniscus is named because its width and height are abnormally increased like a disc.In this study,we observed the injury classification and special features of discoid meniscus and natural meniscus,and compare the postoperative outcome of arthroscopy comparatively.METHODS:①360 cases of meniscus injury in knee joint were selected from the First Affiliated Hospital of Anhui Medical University from June 2001 to September 2006.They were divided into natural meniscus injury group(n =300),and discoid lateral meniscus injury(n =60).People with complete clinical data before operation and following data,confirmed by arthroscopy were selected.The written informed consent was obtained from them.②Meniscus injury in 360 cases was examined by arthroscopy,and plasty,or partial excision or incomplete resection or full resection was performed according to the injury types and surgical circumstance.③All subjects were followed for 6 months to 2 years.The knee function was evaluated by the criteria of Ikeuchi.RESULTS:300 cases of natural meniscus injury and 60 of discoid lateral meniscus injury were all included in the result analysis.①Five tear types of natural meniscus were as follows:43.7% longitudinal,30% radial,12.3% horizontal,7.5% transverse,and 6.5% complex.Four tear types of discoid meniscus were as follows:68.3% horizontal,6.7% radial,3.3% longitudinal,and 21.7% complex tear.②The surgical pattern was determined by the injury types,and all patients were followed up.In 300 cases of natural meniscus,there were 62 knees with excellent function,190 with good,34 with fair and 14 with poor.The excellent and good rate was 85%.In 60 cases of discoid meniscus,there were 19 knees with excellent function,34 with good,5 with fair and 2 with poor.The excellent and good rate was 90% approximately.CONCLUSION:Discoid meniscus is different in anatomical feature and histological structure from natural meniscus;therefore the arthroscopic surgery for discoid meniscus is also different.