Objective To explore clinical curative effect of microsurgery of petroclival tumors by transpetrosal presigmoid approach. Methods A series of 23 patients of petroclival tumors resected by microneurosurgery were analyzed retrospectively, including tumors histological types, clinical and preoperative MRI features, operative approaches, surgical technique and common postoperative complications. Results Total resection of the tumor was achieved microsurgically in 16 cases, subtotal resection in 4 cases, partial resection in 3 cases. No patient died in this series. 8 patients presented worsening crainal nerves palsies postoperatively. CSF leaks were uncommon, occuring in 2 patients. Conclusion The tumors in petroclival region can be totally resected by transpetrosal presigmoid approach. The advantages were offered by this approach such as the temporal lobes and cerebellum are minimally retracted; the operative distance of petroclival tumors is shortened with exposure of clivus and juxta-clival region.

Objective To evaluate the clinical value of laparoscopy in adrenal surgery.Methods From December 2000 to May 2006,86 cases of adrenal space-occupying lesion received laparoscopic adrenalectomy via transperitoneal(n=1),retroperitoneal(n=81) and hand-assisted transperitoneal(n=4) approach,respectively.Results All the operations were successful without conversion to open surgery and severe complications.The mean operative time was 72 min(range,50-175 min).The mean blood loss was 54 ml(range,15-120 ml).The postoperative hospital stay was 6.3 d(range,5-8 d).Imaging examinations revealed no tumor recurrence and metastasis during the mean follow-up period of 26.5 months(range,2-65 months)in 86 patients.The symptoms of patients with functional tumor was alleviated or disappeared.Conclusions Laparoscopic adrenalectomy has advantages of minimal invasion,less blood loss,and quicker recovery,and it should be the fist choice for most adrenal space-occupying lesions.

Objective To discuss the value of TAI, TAE and PEI treatments for intermediate and advanced stages of hepatic cancers.Methods Conventional TAE, TAI, PEI perfusion chemotherapy and mulitiple percutaneous transhepatic injection of pure alcohol under guidance of fluoroscopy and CT were used for different cases. Results Follow up 1-3 year. 1,2,3 year survival rates were 60.3%, 28.6%, 17.3% respectively.Conclusions Combination interventional treatment in intermediate and advanced stages of hepatic is very important outcoming with high efficacy.

Objective:To investigate the efficacy of treatment of primary hepatic carcinoma by three different interventional theraputic methods.Methods:121 cases with moderate and advanced stages of HCC were treated with PEI +LP-TAE,chemoembolization,LP,and SLPGSTAE respectively.All cases were divided into two groups according to the tumor’s size:group A(＞8 cm)and group B(≤8 cm).The efficacy and survial incidence of the three different methods were analyzed.Results:62 of the 76 cases(81%)in group A and 16 of the 45 cases(35.5%)in group B were decreased in size after the same theraputic method,two groups had statistically significant (P＜0.01).In group A,9 cases treated with chemoembolization and LP were invalid.16 of the 36 cases became smaller after SLPGSTAE.The 1,2 and 3 year surval incidence of patients in group B were 77.6%、42.1%、18.4% respectively as compared with group A were 68.8%、40.0%、11.1%.Conclusion:PEI can cause small tumors to form nerosis,SLPGSTAE cn play dual embolization role and had no servious damage to liver function.

Objective To investigate the effect of meridian-unblocking and mind-regulating acupuncture pretreatment on neurobehavioral functions and cerebral water content and explore its mechanism for modulating miRNA664 and MMP9 expressions in cerebral ischemia/reperfusion rats.Methods One hundred and thirty Wistar rats were randomized into group A (electroacupuncture pretreatment) of 30 rats, group B (moxibustion pretreatment) of 30 rats, group C (aspirin pretreatment) of 30 rats, group D (model) of 30 rats and group E (blank control) of 10 rats. Group A received electroacupuncture; group B, suspended moxibustion with moxa sticks; group C, an oral gavage of aspirin 10 mg/kg. A model of cerebral ischemia/reperfusion was made in every group after seven days. Rat neurobehavioral functions were observed and cerebral water content and relative miRNA664 and MMP9 expressions in the cortical region were determined at 24 hours after reperfusion.Results There was a statistically significant difference in the neurobehavioral score between group A, B, C or D and group E (P<0.01), between group A or B and group C (P<0.01) and between groups A and B (P<0.01). There were statistically significant differences in cerebral water content and relative miRNA664 and MMP9 expressions between group A, B, C or D and group E (P<0.01,P<0.05), between group A, B or C and group D (P<0.01), between group A or B and group C (P<0.01,P<0.05) and between groups A and B (P<0.01,P<0.05).Conclusions Meridian-unblocking and mind-regulating acupuncture pretreatment can effectively decrease the neurobehavioral score and cerebral water content and reduce relative MMP9 expression through modulating miRNA664 expression in cerebral ischemia/reperfusion rats. One of the mechanisms of Du meridian-unblocking and mind-regulating acupuncture pretreatment for protecting the brain may be reducing relative MMP9 expression, inducing tolerance to cerebral ischemia and relieving cerebral edema by the modulation of miRNA664 expression.

Objective To determine the immunogenic and adhesive abilities of a segment (P1C protein) that located at the carboxy terminal region of P1 protein (1125 to 1395 amino acids).Methods A recombinant prokaryotic vector (pGEX6p-2/p1c) was constructed for P1C protein expression in E.coli BL21DE3.The expressed target recombinant protein (rP1C) was identified using SDS-PAGE and Western blot assay,and then extracted by GST-based affinity chromatography.The purified rP1C was used to immunize BALB/c mice to obtain rP1C-antiserum and titer of the antiserum was determined by ELISA.Immunoreactivity of the rP1C to the sera form M.pneumoniae-infected patients was detected using Western blot assay,while activity of the rP1C adhering to HeLa cells as well as adhesion blockage of the rP1C antiserum were detected using indirect immunofluorescence assays.Results The constructed prokaryotic expression system could efficiently express soluble rP1C with a relative molecular weight of 66×103.The antiserum from rP1Cimmunized mice showed an ELISA titer as high as 1:64 000.Both the M.pneumoniae-infected patients' sera and the mouse antiserum against rP1C could recognize as well as combine with the rP1C.rP1C could adhere to HeLa cells and the adhesion could be blocked by the mouse antiserum with an antiserum concentration-dependent manner.Conclusion P1C,a segment of M.pneumoniae P1 protein,possesses powerful immunogenicity and immunoreactivity and cell-adhered activity,indicating the protein segment can be used as an antigen candidate for developing vaccines and serological diagnostic methods of M.pneumoniae-induced diseases.

To study the diagnosis and treatment of primary testicular neoplasms. Methods:39 cases of primary testicular neoplasms were analysed retrospectively. Results:There were 4,28 and 7 cases in the groups of 1～4 years (10.3％)、15～50 years (71.8％) and over 50 years (17.9％) respectively. 20 patients were semi noma (51.3 ％ ), 18 nonseminoma (46.1％ ), 1 lymphoma (2.6％ ). The cardinal clinical manifestation was painless solid enlargement of the testis. Ultrasonography demonstrated a hypoechoic or heterogeneous echoic mass. CT and MR could provide informations about the retroperitoneal metastasis lymph nodes and malignant changed ab dominal testis. Elevation of AFP and β-HCG noted in 50％ and 40％ of patients with nonseminomatous germ cell tumor? (NSGCT). Combined therapy, including radical orchiectomy、 retroperitoneal lymph node dissection (RPLND) ,radiation therapy and chemotherapy,were taken. 30 patients have been followed up for 2～5 years,2 of them died of distant metastasis. Conclusions: An intratesticular mass must be considered malignant until proved otherwise. Ultrosonography should be included a conventional examination. CT and MR scan is conducive to clinical staging. Tumor marks is helpful to predicting prognosis and monitoring therapeutic response. The choice of treatment is based upon the pathological type and clinical stage.

Objective To investigate the short- and long-term complications after endoscopic Oddi's sphincterotomy (EST) upon endoscopic retrograde cholangiopancreatography (ERCP) procedure and determine whether the size of EST correlates to the occurrence of EST complications.Methods 95 cases receiving EST in the process of ERCP in our hospital were studied and followed up. The patients were divided into large, moderate and small incision groups according to the size of EST and the states of short-term and long-term EST complications were statistically analyzed.Results The incidence of short-term complications of EST was 18. 94% (18/95). They included bleeding in the process of ERCP in 11 cases, delayed bleeding in 3, acute pancreatitis in 1, acute cholangitis in 2 and duodenal perforation in 1. All these patients but 1 with duodenal perforation were discharged after undergoing symptomatic treatments. Eleven out of the 95 patients had long-term complications (11.57 % ). These included biliary system infection in 5 cases, recurrent calculus of bile duct in 3, papilla stricture in 1 and chronic relapsing pancreatitis in 2. All 11 patients recovered after therapeutic ERCP again or symptomatic drug treatments. There was no significant difference in incidence of short-term (χ2 =2.433, P=0.296) or long-term complications (χ2 = 1.151, P=0.562) among the 3 groups. Furthermore, there was no statistical correlation between the incision size of Oddi and complications including operative bleeding (P=0.109), short-term complications (P=0.124) and longterm complications(P=0.402). Conclusion There are many short-term and long-term complications after EST, but there is no correlation between the complications and the incision size of Oddi. The occurring rate of complications might be reduced through accurate direction of papilla incision, avoidance from injury of blood vessel, keeping bile drainage unobstructed and protection of the function of Oddi sphincter as far as possible in the process of ERCP.

Objective To investigate the expression of fibroblast growth factor 4 (FGF4) in serum of active rheumatoid arthritis (RA) and its role in RA synoviocyte proliferation. Methods The serum level of FGF4 were detected by protein arrays in 20 patients with RA, and 20 age and gender matched healthy controls. FLSs were isolated from RA synovium,and were co-cultured with recombinant human FGF4 (rhFGF4). Cell proliferation was quantified by Cell Counting Kit-8 assay and cell cycle distribution was evaluated by flow-cytometry. The protein levels of cyclin D1, phospho-Akt (p-Akt) and phospho-p38 (p-p38) were measured by western blot. Results The serum expression of FGF4 in RA group was higher than that in control group (P=0.041). After being treated with different concentrations of rhFGF4 (12.5, 25, 50, and 100 ng/ml), RA-FLS showed significant increase in cell proliferation, with different rates of [(121 ±8)％], [(126 ±12)％], [(129 ± 12)％], a nd [(134 ±14)％] respectively, comparing with that of the controls [(100 ±0)％, (P12.5=0.049, P25=0.009, P50=0.004, P100=0.001).]. Among them, the percentage of G2/M+S phase cells were [(12.6±3.6)％], [(15.3±4.5)％], [(17.1±5.1)％], [(19.6±4.1)％] respectively, and except the lowest rhFGF4 concentration treatment group of 12.5 ng/ml, G2/M+S phase cells in other groups was significantly increased compared with the controls [(5.4±2.4)％] (P12.5=0.159, P25=0.042, P50=0.018, P100=0.005). And the protein expression of cyclin D1 was up-regulated after being treated with 50 ng/ml and 100 ng/ml rhFGF4 (P50=0.035, P100=0.027). FGF4 transiently increased the expression of p-Akt and p-p38 protein at the concentration of 50 ng/ml. Comparisons of data between groups were performed by independent sample Student's t-test. Statistical significant differences among groups were tested by one-way analysis of variance (ANOVA) or the Kruskal-Wallis test. The Dunnett's t-test was used for multiple comparisons. A P-value of <0.05 was considered statistically significant. Conclusion Our results suggest that FGF4 is highly expressed in the serum of active RA patients. FGF4 may promote the proliferation of RA-FLS via modulating PI3K/Akt and p38-MAPK signaling pathways, which subsequently contributs to synovial hyperplasia.