Objective To investigate the predictive factors and prognosis of early intrahepatic recurrence after curative resection of hepatocellular carcinoma(HCC).Methods Clinicopathological dats of 184 HCC patients with intrahepatic recurrence after curative resection were collected.Thirteen clinicopathological factors and prognosis after recurrence were retrospectively analyzed. Results Univariate analysis showed that preoperative scrota alpha-fetoprotein(AFP)>100 ng/ml,tumour size>5 cm,venous invasion and intra-operative blood transfusion were predictive factors of early intrahepatic recurrence,and selum albumin<35 g/L was marginally predictive factor.Multivariate analysis showed that serum AFP>100 ng/ml,tumour size>5 cm and venous invasion were independent predictive factots of early intrahepatic recurrence.The survival of patients suffering from early recurrence was significantly shorter than those with late recurrence.with median survival period of 12 mos vs 18 mos(P=0.012).Conclusion Serum AFP,tumour size and venous invasion were independent predictive factors of early intrahepatic recurrence in HCC patients after radical resection of the primary tumor.Early intrahepatic recurrence implies poor prognosis.

Objective To investigate the feasibility and safety of designed perioperative surgical treatment for advanced gastric cancer.Method From March 2006 to Sep.2009,24 patients with advanced gastric cancer were enrolled for this study,of which 14 cases were graded as Ⅳ M0,10 as Ⅳ M1,including liver metastasis in 5 cases,peritoneal seeding in 4 and lung metastasis in 1.All patients received 2-4 cycles of chemotherapy of PCF or ECF regimen,followed by intended surgical resection and postoperative 2-3 cycles of adjuvant chemotherapy of the same regimen as used during the preoperative course.Result Seven Cases abandoned surgical therapy,a total of 17 cases completed preoperative chemotherapy,surgical resection and postoperative chemotherapy.R0 resection was achieved in 16 cases(94%).There was no perioperative mortality,and total clinical response rate was 75%,overall pathological response rate was 82%.In 59% surgical cases (10 cases) serum CEA and CA199 has returned to normal;In 71%patients tumor pathological stage degraded at the cost of Ⅲ-Ⅳ grade of neutropenia,thrombocytopenia,anemia,severe nausea and vomiting in 79%,8%,13%,and 54% cases respectively.Fever was encountered in 2 cases with grade Ⅲ-Ⅳ neutropenia.Conclusion Designed perioperative chemotherapy regimen renders advanced gastric carcinoma patients operable at the cost of acceptable complications.

Purpose To compare the mammography and ultrasound imaging features of triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (NTNBC), and to improve TNBC diagnosis. Materials and Methods Using immunohistochemical staining technique, 387 patients with pathologically conifrmed breast cancer were divided into TNBC group (n=54) and NTNBC group (n=333). Mammography and ultrasound ifndings as well as pathological data were retrospectively reviewed. Results TNBC was associated with higher tumor grades. There were signiifcantly more grade III inifltrating ductal carcinomas and axillary lymph node involvement in TNBC group than in NTNBC group (χ2=47.009, P<0.001;χ2=4.658, P<0.05). On mammography, TNBC most frequently presented with a mass (n=37, 69.8%) and was less associated with microcalciifcations (n=10, 18.9%). TNBC masses were mostly round or oval (n=28, 62.2%) with circumscribed margin (n=16, 35.6%). Spiculated margins were rare (n=5, 11.1%). NTNBC most frequently presented as a mass with calciifcations (n=138, 42.1%), and was more irregular in shape (n=119, 46.5%). Spiculated margins were common (n=77, 30.1%). There was statistically signiifcant difference between these two groups in mass, microcalcification, shape and margin (χ2=24.618, 19.889, 32.605 and 21.102, P<0.001). On ultrasonograhy, TNBC most frequently presented as a mass (n=52, 96.3%) with less microcalciifcations (n=5, 9.3%). TNBC masses were more frequently round or oval (n=27, 51.9%) with circumscribed margins (n=25, 48.1%). Spiculated margins were rare (n=3, 5.8%). TNBC was less likely to show attenuating posterior echoes (n=5, 9.6%);NTNBC most frequently presented as a mass (n=318, 96.1%) with microcalcifications (n=135, 40.8%). NTNBC masses were more frequently irregular in shape (n=243, 76.4%) with spiculated margins (n=76, 23.9%). NTNBC was more likely to show attenuating posterior echoes (n=78, 24.5%). There was statistically signiifcant difference between these two groups in microcalciifcation, shape, margin and posterior echo (χ2=19.006 and 18.339, P<0.001;χ2=16.170 and 8.429, P<0.05). Conclusion TNBC demonstrates round or oval mass with circumscribed margin and is less likely to show attenuating posterior echoes on mammography and ultrasound with benign imaging features. NTNBC frequently presents as irregular mass with spiculated margin, and is more associated with microcalciifcations. These imaging ifndings are useful in early diagnosis of TNBC.

Objective To introduce the application of double liver hanging maneuver in anatomical right hemihepatectomy and share our own experience. Methods Twenty-four patients underwent right hemihepatectomy using double liver hanging maneuver, and the data were collected prospectively after operation. Another 49 patients underwent right hemihepatectomy using the traditional methods,serving as the control group. Results Retrohepatic tunnel was constructed in 27 patients, double liver hanging maneuver was successfully performed in 24 anatomical right hemihepatomy and failed in 3 patients due to the near proximity between the tumor and the middle line. Compared with the control group, blood loss was much less (t=3. 191 ,P＜0.05), ALT and liver function recovered more quickly postoperatively and the difference in operative duration between the 2 groups was not significant (t=-1. 695,P＞0. 05). There was about 1-2 cm wide space located between retrohepatic IVC and dorsal liver when the 2 tapes were tracted, and no injury in hepatic short veins and retrohepatic IVC occurred during the operation. Conclusion The double liver hanging maneuver can make anatomical right hemihepatectomy more accessible and safe.

OBJECTIVETo study the arbuscular mycorrhiza and arbuscular mycorrhizal fungi associated with cultivated and wild Pinellia ternata in Guizhou province.

METHODWild and cultivated P. ternata roots were observed through staining and microscopic examination, the arbuscular mycorrhizal fungi spores were isolated through wet thieving according to Gerdemann & Nicolson (1963), the spores were identified following the description of Schenck & Pérez (1988), and some previous publications.

RESULTThe typical arbuscular mycorrhiza (AM) structure was showed according to a research of wild and cultivated P. ternata. In the survey of AM fungi species in the rhizosphere of wild and cultivated P. ternata, 3 genera and 21 species were found, 3 genera and 7 species were identified. 5 species of them belong to Glomus, 1 species belongs to Scutellospora, 1 species belongs to Gigaspora, including Glomus mosseae, G. intraradices, G. melanosporum, G. deserticola, G. aggregatum, Scutellospora castanea, Gigaspora albida, and one of them was a new record, i.e., Scutellospora castanea which was the dominant species in Bijie.

CONCLUSIONThe diversity of AM fungi between wild and cultivated Pinellia ternata was showed on this survey, the fungi associated with wild ones are different form the cultivated ones, such as Gigaspora albida only occurs in cultivated ones, Glomus melanosporum only occurs in wild ones, while Glomus mosseae and Glomus intraradices occur in both wild and cultivated ones, and there were specialization species in Bijie, all these can provide new though for solving degradation problem of cultivated Pinellia ternata.

Biodiversity ; Fungi ; classification ; cytology ; isolation & purification ; Mycorrhizae ; classification ; cytology ; isolation & purification ; Pinellia ; microbiology ; Plant Roots ; microbiology ; Soil Microbiology ; Spores, Fungal ; classification ; cytology ; isolation & purification

Objective To investigate the relationship between the prevalence of isolated systolic hypertension (ISH) and the stages of chronic kidney disease (CKD) in chronic kidney disease outpatient clinic.Methods CKD patients of stages 1,2,3,4 and 5 were recruited (n=626).Based on office systolic pressure (SBP) and diastolic pressure (DBP),they were classified into four subtypes:normotension (＜ 140/90 mmHg),isolated diastolic hypertension (IDH,SBP ＜ 140 mmHg and DBP ≥ 90 mmHg),ISH (SBP≥ 140 mmHg and DBP ＜ 90 mmHg) and systolic-diastolic hypertension (SDH,SBP≥140 mmHg and DBP≥90 mmHg).Results The control rate of blood pressure was 86.4％,75.6％,65.3％,51.0％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively,which decreased with the advancement of CKD.There was a stepwise increase in the prevalence of ISH (0,9.2％,23.9％,28.6％ and 37.0％ at CKD stage 1,2,3,4 and 5,respectively) and SDH (4.5％,8.4％,8.0％,17.3％,21.9％ at CKD stage 1,2,3,4 and 5,respectively).Logistic regression analysis showed that age,diabetes and CKD stages were independent predictors of ISH.Compared with CKD stage 1-2,CKD stage 3,4 and 5 showed 2.388,2.697 and 5.980 folds risk in developing ISH.Conclusion The prevalence of ISH increases correspondingly with the advancement of stages of CKD,which may partially contribute to the increased cardiovascular mortality during the progress of CKD.

Objective To investigate whether there is any difference in aortic stiffness among different hypertension subtypes in patients with chronic kidney disease.Methods Six hundred and twenty-six patients with chronic kidney disease were included in the present analysis.They were classified into four groups:normotension (n =391) with systolic blood pressure (SBP) ＜ 140 mmHg and diastolic blood pressure (DBP) ＜ 90 mmHg; isolated systolic hypertension (ISH,n =141) with SBP≥ 140mmHg and DBP ＜ 90 mmHg; isolated diastolic hypertension (IDH,n =25) with SBP ＜ 140 mmHg and DBP≥ 90 mmHg; systolic-diastolic hypertension (SDH,n =69) with SBP≥ 140 mmHg and DBP≥ 90mmHg.Aortic stiffness was assessed by pulse pressure and pulse wave velocity.Results The IDH group had lower mean age than the other groups(P ＜ 0.01).The percentage of diabetes in the ISH group was higher than that in the other groups.The comparison of aortic stiffness showed that the ISH and SDH groups had higher aortic stiffness than the normotension and IDH groups (P ＜ 0.01),but no significant difference in aortic stiffness was observed neither between the normotension and IDH groups nor between ISH and SDH groups.Conclusion Aortic stiffness is significantly different among different hypertension subtypes,which may be an underlying cause for the different cardiovascular mortality among the hypertension subtypes.

OBJECTIVETo study the influence of arbuscular mycorrhizal fungi to Pinellia ternata leaf index, propagation coefficient, tuber yield and chemical composition.

METHODThe Pinellia ternata leaf length, width, plant height and leafstalk diameter were measured during growing time till P. ternata loded. The leaf index was calculated and the tuber yield were measured after harvest. The contents of guanosine was determined by HPLC method, and the alkaloid contents were determined by spectrophotometric method.

RESULT AND CONCLUSIONInoculated AM fungi could increase P. ternata propagation coefficient and the yield of tuber. Inoculated AM fungi could increase P. ternata leaf index, made leaf tends to be more like bamboo leaf type. Inoculated AM fungi could delayed P. ternata lodging time; G. mosseae + G. intraradices treatment (early inolulation time) proved better influence on increasing fresh weight and dry weight of P. ternata tuber and the propagation coefficient. Inoculated AM fungi could increase guanosine and alkaloid contents of Pinellia ternata tuber, and the contents of guanosine and alkaloid in inoculated treatments were higher than those in cultivated P. ternata from Hezhang; G. mosseae + G. intraradices treatment (later inolulation time) proved good effect on increasing the contents of guanosine and alkaloid.

Alkaloids ; chemistry ; Chromatography, High Pressure Liquid ; Guanosine ; chemistry ; Mycorrhizae ; growth & development ; physiology ; Pinellia ; chemistry ; growth & development ; microbiology ; Plant Leaves ; chemistry ; growth & development ; microbiology

Objective:To investigate feasibility, efficiency and safety of kissing pancreatojejunostomy after pancreatoduodenectomy.Methods:From Jan 2006 to Sep 2020, the clinical data of 267 patients undergoing pancreatoduodenectomy and kissing pancreatojejunostomy were retrospectively analyzed.Results:Grade B postoperative pancreatic fistula (POPF) occurred in 6.37%, Grade C POPF in 2.25% of patients. There was no mortality within 30 days postoperatively as to pancreatic fistula, by cut-off of pancreatic duct diameter at 3mm, there was no significant difference between two subgroups (15/140 vs. 8/127, P=0.20). also, when grouped by texture of the pancreas, no there was significant difference (20/194 vs. 3/73, P=0.11). Conclusions:Kissing pancreatojejunostomy is feasible and easy to perform. It also does not increase the POPF rate when applied to the pancreatojejunostomy with thin pancreatic duct and soft texture.