Objective　To summarize the experiences in caudate lobectomy in five cases of hepatic carcinoma.Methods　Five cases of primary liver caudate lobe cancer resected in the last five years were reviewed.Some problems including anatomy,the biological characteristics of the caudate lobe cancer,surgical approach,blocking of the liver blood supply were discussed.Results　One case died on the 11th postoperative day,the other four cases have been followed up for five years,two years and nine months,two years,one year and six months,respectively.They are all survived.Conclusion　Liver cancer located at the caudate lobe can be successfully resected as those located in other regions with a clear anatomy and a full exposure.

With two recipes,i.e.nodule disease treated with revised Maimengdong Decoction and Xiaoluo Pill,sub-acute thyroid inflammation of granuloma treated with Haizao Yuhu Decoction and Xiaoluo Pill,it makes clinical research to discuss the causa morbi,mechanism,differentiation thought and the experiences of removing toxin,stasis,swelling,sputum,and softening mass in treating such refractory diseases.

Objective To study the imaging diagnosis of tumors and tumor-like lesion of fibrous histiocyte origin in the femora.Methods Imaging features of femoral fibrous histiocyte neoplasm and tumor-like lesion were restrospectively analyzed in 17 cases ,including 16 cases proved by surgery and pathology, and one case was follow-up studied in five years.All cases were examined by plain X-ray flim, CT scan in 5 cases. Results There were fibrous dysplasia of bone in 8 cases,non-ossifying fibroma in 5cases ,fibrosarcoma of bone and benign fibrous histiocyte tumor of bone in 1 case respectively ,malignant fibrous histiocyte tumor of bone in 2 cases. They were diagnosed correctly before operation in 13 cases (13/17,76.5%) and misdiagnosed in 4 cases.Conclusion The most of femoral fibrogenic tumor and tumor-like lesion can be dingnosed correctly before operation ,because of they are of specific imaging features, while femoral fibrous histocyte original tumors are not of specific imaging findings, it must combine with clinical and pathologic data in diagnosis.

MOOC is a new online teaching model. Learners complete the course of study through on-line autonomous learning, communication with others, receiving system assessment and evaluation. In medi-cal imaging teaching, the combination of MOOC and traditional classroom teaching is a new way of med-ical imaging teaching reform. It will be beneficial to integration and making full use of high quality teaching resources, which plays an important role in the discipline development and the teaching quality improve-ment.

Objective To investigate the postoperative changes of serum proteins and immune responses in critical patients and the effect of recombinant human growth hormone(rhGH).Method 45 critical patients were divided randomly into rhGH group (15 cases) and control group (30 cases) after operation. Patients in rhGH group were given rhGH 8*!U/d,im for 7 days starting 48 hours post operation. Result The postoperative level of serum transferin,albumin and prealbumin decreased in all patients, and so did the activity of CD 3,CD 4 ,CD 8,NK and the ratio of CD 4/CD 8 .Serum prealbumin level increased significantly in rhGH group at day 4 and after ( P

0.05). Nine HLA-A2-restricted CTL epitopes of CT10 were found. Conclusion CT10 mRNA is expressed with a high percentage and specificity in hepatocellular carcinomas. The CT10 gene product is potential target for antigen-specific immunotherapy of hepatocellular carcinoma.

Objective To explore the possibility of immune therapy for hepatocellular carcinoma (HCC) with MAGE-3 antigen peptide (FLWGPRALV). Methods The expression of HLA-A2 in HCC patients were examined with microcytotoxicity assay .The mRNA of MAGE-3 genes in the tumor tissues were detected by RT-PCR, the CD8 positive T lympocytes were separated as effector cells with immunobeads from peripheral blood mononuclear cells (PBMCs) of those patients. The irradiated autologous CD8 negative PBMC were pulsed with MAGE-3 peptide as APC. Some effector cells were co-cultured with APC, and some not as the control. After 14 days′ culture with IL-2, the frequency of effector cells secreting IFN-? in response to MAGE-3 peptide were monitored by IFN-? secretion assay. The hepatocellular carcinoma cell line HLE was used as the target cells.ResultsNine HCC patients were HLA-A2 positive in 25 HCC patients, and 3 of them were MAGE-3 mRNA positive. After two weeks′ culture, the effector cells increased by 4-6 folds. The frequency of CD8 positive cells secreting IFN-? in response to MAGE-3 peptide was 22.0% in 3 MAGE-3 mRNA positive patients(n=3),and 0.5% in 6 negative patients( n=6) (?

BACKGROUND: Pioglitazone is a common hypoglycemic drug capable of improving proliferation and activation, and inhibiting apoptosis of endothelial progenitor cells (EPCs). We speculated that the combined use of pioglitazone and EPCs transplantation could have significant improving effects on hyperglycemia and kidney function after diabetes mellitus.OBJECTIVE: To investigate the improving effect of EPCs transplantation combined with pioglitazone treatment on the kidney function of diabetic rat models.METHODS: The 15 of 75 Wistar rats were randomly selected and served as normal control group (no treatment). Animal models of type 1 diabetes mellitus were made in the rest 60 rats through the intraperitoneal injection of 40 mg/kg streptozotocin for continuous 5 days. The human EPCs (labeled by CM-Dil) were recovered, cultured and preserved until transplantation. After 4 weeks of modeling, the 60 rat models were randomly divided into model group (PBS injection), pioglitazone group, EPCs transplantation group and combined treatment group, followed by tail vein injection of EPCs suspension and/or intragastric administration of 20 mg/kg pioglitazone for continuous 4 days. After 8 weeks of treatment, the levels of glucose, insulin and creatinine in serum, urea nitrogen and urine protein during 24 hours were determined. The number and distribution of EPCs labeled by CM-Dil were detected by fluorescence microscope, the apoptosis in kidney cells was tested by TUNEL method, and the kidney weight/body weight ratio in rats was calculated.RESULTS AND CONCLUSION: Compared with the model group, the blood glucose and serum creatinine levels and the urea nitrogen and urine protein concentrations during 24 hours were significantly decreased (P < 0.05), and the seruminsulin level was significantly increased (P < 0.05) in the pioglitazone and EPCs transplantation groups. These biochemical indexes in the combined treatment group were more significantly altered compared with the model group (P< 0.01). The kidney weight to the body weight ratio was lowest in the combined treatment group and lower in the pioglitazone and EPCs transplantation groups followed by the model group (P < 0.05). The order of apoptotic kidney cells labeled by TUNEL was as follows: model group > pioglitazone group > EPCs transplantation group > combined treatment group (P < 0.05). To conclude, the EPCs transplantation combined with pioglitazone treatment can decrease the blood glucose and serum creatinine levels and urea nitrogen and urine protein concentrations, improve the serum insulin level, reduce cell apoptosis in the kidney, and remit the kidney dysfunction of diabetic rats to a certain extent.

Objective To evaluate the diagnostic procedures and treatment choice of primary malignant tumor of the duodenum.Methods The clinical data of 170 cases with primary malignant tumor of the duodenum at Peking University People's Hospital from 1996 to 2015 were analyzed retrospectively.Results Tumors located in the first,second,third and fourth parts in 14 cases (8.2％),144 cases (84.7％),9 cases (5.3％),and 3 cases (1.8％) respectively,and among them,tumors within papillary area accounted for 62.4％ (106 cases).The main clinical presentations included jaundice,upper abdominal pain,abdominal distention,nausea and vomiting.Among the 170 cases,125 cases obtained accurate tumor stages,with 34 cases on stage Ⅰ (27.2％),45 cases on stage Ⅱ (36.0％),30 cases on stage Ⅲ (24.0％),16 cases on stage Ⅳ (12.8％).The accuracy rate of ultrasound and CT in preoperative diagnosis was 27.6％,and 72.3％ respectively.The pathological type of 144 cases (84.7％) was adenocarcinoma.The postoperative 1-,3-and 5-year survival rate was 69.1％,48.6％ and 33.9％.Conclusions Most primary malignant duodenal tumors are located in papillary region,necessitating radical pancreaticoduodenecomy,early diagnosis remains the key for longterm survival.

Objective To evaluate the application of helix hydro-jet in laparoscopic hepatectomy (LH).Methods Clinical data of 18 patients who underwent laparoscopic hepatectomy by helix hydro-jet were analyzed retrospectively.Results There were 18 cases including 9 cases of hepatic cavernous hemangioma,5 cases of primary hepatocellular carcinoma,2 cases of hepatic focal nodular hyperplasia,1 case of hepatic metastasis from colon carcinoma and 1 case of biliary cystadenoma in left liver.In 17 out of 18 patients laparoscopic hepatectomy was successfully completed by using helix hydro-jet.Only 1 patient was converted to open hepatectomy during operation due to uncontrollable hemorrhage from the branch of left hepatic vein.Partial hepatectomy was performed in 14 cases and hepatic left lateral hepatectomy was performed in 3 cases.Average intraoperative blood loss was 230 ml and average operation time was 170 minutes.No postoperative hemorrhage and hepatic function failure was observed.Postoperative bile leakage was observed in 1 patient,which was cured by drainage.Asymptomatic pleural effusions was found in 2 patients,necessitating no special intervention.The average hospital stay after the surgery was 5.6 days.5 patients with hepatocellular carcinoma were followed up for an average of 17 months and the patient converted to open hepatectomy suffered from tumor recurrence 13 month postoperatively.No implantation metastasis was observed on the trocar sites.Conclusions Laparoscopic hepatectomy by helix hydro-jet device can provide excellent visualization of vessels and bile ducts,which can assure the safe margin of hepatic neoplasm.No severe complications were observed.Laparoscopic hepatectomy by helix hydro-jet is a safe and feasible technique.