To study the related factors for the outcome of stroke would help to improve the approaches of the treatment, promote the quality of life of patients.

Objective To analyze the features of infant urinary concretion, Methods The clinical and imaging data of 76 cases of infant urinary concretion were analyzed.Results Infant and child patients showed crying, vomiting, fever,abdominal distension and abnormal urination, which can lead to renal failure and uremia. Conclusion The infant urinary concretion disease can occur with obscurity, whose diagnosis and treatment become difficult in patients who are all infant and little children. Therefore it has great harm, which may be related to artificial feeding and should be highly paid attention to.

Objective To study the role of genomic imprinting of IGF2 gene in the development of lung cancer.Methods The IGF2 genomic imprinting was studied among 32 patients with lung cancer and the normal lung tissues by using PCR and RFLP.Results Twelve out of the 32 patients were informative(37.5),among whom 10 exhibited biallelic expression,i.e.,LOI(83.3).The matched normal tissues from 4 of these 10 patients also showed weak biallelic expression of IGF2.Conclusion The findings indicate that the loss of IGF2 imprinting is involved in the development of lung cancer.

Background and purpose:Recent researches have shown that Secreted Protien Acidic and Rich in Cysteine (SPARC) was closely related to tumor genesis, tumor progression and tumor metastasis. SPARC was highly expressed in malignant melanoma, glioma, meningioma, bladder cancer, lung cancer and prostate cancer, etc. In this study we investigated SPARC expression in hepatocellar carcinoma (HCC) and its signifi cance. Methods:RT-PCR was used to detect SPARC mRNA expression in cancer tissue samples and their adjacent liver tissue samples from 62 patients with hepatocellar carcinoma and 30 normal liver tissue samples, respectively. And the differential protein expression of SPARC between these groups was analyzed by immunohistochemistry (IHC). Results:SPARC mRNA was highly expressed in HCC(14.0?3.6) and in the adjacent liver tissue (6.8?1.8); compared with low expression of 2.7?0.9 in normal liver tissue, there were signifi cant differences among the three groups (p=0.000). SPARC positively stained was found in 54 of 62 patients with HCC and 4 of 30 normal liver tissue, there was significant difference between these two groups (P=0.000). SPARC immunohistochemical score was 21.5?4.8 in the carcinoma group; 11.3?3.6 in paracarcinoma group and 5.7?1.8 in the normal group, there were also significant differences among the three groups (P=0.000). The expression of SPARC protein was significantly upregulated with the progress of Enmondson pathological classification. There was obviously differences between Ⅰvs Ⅱ(P=0.029), and Ⅱ vs Ⅲ Ⅳ(P=0.008). There was more SPARC expression in the patients with metastasis of HCC (26/27, 96.3%) than that without metastasis(23/35, 65.7%)(P=0.004). Conclusion:SPARC mRNA expression and its protein were related to HCC histological differentiation and metastatic lymph node; SPARC is helpful to clinical evaluation of HCC.

Objective:To study the feasibility of a new composite mineralized collagen membrane in alveolar ridge preservation.Methods:The third mandibular premolars on both sides were extracted from 12 dogs,the 24 alveolar sockets were randomly assigned into A,B and C groups(n =8).The distal alveolar sockets of group A was immediately implanted with the new composite mineralized collagen membrane and bone graft material,those of group B with bone graft material,group C was the blank control.The healing of sockets was evaluated by gross observation,morphological measurements,X-ray microscope and photographs of spiral CT.Results:The horizontal width of the alveolar process of group A was bigger than that of group B (P ＜ 0.05),that of group B was bigger than that of group C (P ＜ 0.05).The region of extraction interest in spiral CT value was higher in group A than that in group B and C (P ＜ 0.05).The extraction sockets were generated new bone and the degree of reconstruction measurements was higher in group A than that in group B and C (P ＜ 0.05).Conclusion:The new composite mineralized collagen membrane can induce the regeneration of new bone,and preserve the alveolar.

Objective To investigate the clinicopathological features of undifferentiated embryo-nal sarcoma of the liver (UESL). Methods The clinical data of 9 UESL cases treated in our hospital between 1996 and 2007 were retrospectively analyzed. Results The patients were children and young adults. Clinical presentation was typically an abdominal mass that may be accompanied by pain and fe-ver. Tumors were all removed surgically in the 9 patients. Conclusion UESL is an unusual malignan-cy of the liver. Discrepancy of internal architecture between US and CT is one of the important charac-teristic of UESL. Whenever feasible, surgical resection should be attempted as a part of combination modalities. Modern rnultimodal treatment and supportive therapy might promote the survival rate.

Objective To evaluate the approaches and surgical technique for resection of the lesions occupying different parts of the caudate lobe of the liver. Methods The clinical data of cases undergoing resection of lesions originating in the caudate lobe were retrospectively analysed. The operative procedures were chosen according to lesion location. Results A total of 32 patients were operated on. The surgical technique included left, right and anterior transhepatic approach. The mean operative time was (198?73)min (range 60～345 min) and the mean intraoperative blood loss (917?914)ml (range 100～4?500 ml). There was no operative death, with complications occurring in 4 patients (12%). The patients with benign hepatic tumor are all alive after operation and the 1, 2, 3 and 4 year survival rates for the patients with malignant hepatic tumor were 87%, 59%, 43% and 43%, respectively. Conclusion Resection of the caudate lobe lesions different both in sizes and locations varies greatly in operative complexity, with combined hepatectomy being most difficult. Bilateral surgical approaches are suitable for almost all caudate lobectomies.

Objective To investigate the indications and methods of retaining only portal vein for the hilar cholangiocarcinoma radical resection to improve the therapeutic efficacy. Methods Six patients with hilar cholangiocarcinoma underwent left hepatectomy and extrahepatic bile duct excision. Tumor invaded hepatic artery was resected and fight hepatic duct-jejunum anastomosis was made during July 2006 to December 2007. Results There was no mortality. Bile leakage developed in one case and was cured by drainage. No liver failure developed postoperatively. All 6 cases were followed up for 10 - 23 months, and all were still alive. Conclusions Retaining only portal vein for the treatment of hilar cholangiocarcinoma radical resection under definite indications is safe.

Objective To investigate the role of c-Jun N-terminal kinase (JNK) signal transduction pathway on the up-regulation of the expression of acyl-coenzyme A: cholesterol acyltransferasel (ACAT1) induced by Chlamydia pneumoniae (C. pn), and to discuss the mechanism of macrophages-derived foam cell formation induced by C. pn. Methods C. pn was propagated in Hep-2 cells. THP-1 monocytes were induced into macrophages by 160 nmol/L phorbol myristate acetate(PMA) for 48 h, and were randomly allocated into four groups to be incubated continually: control group, C. pn infection group, C. pn and SP600125 (a special JNK inhibitor)group and SP600125 group. Lipid droplets in cytoplasm were observed by oil red O staining. The contents of intracellular cholesterol ester were detected by enzyme fluorescence analysis. The expressions of ACAT1 mRNA and protein were determined by reverse transcriptase polymerase chain reaction(RT-PCR) and Western blot, respectively. Results Compared with the control group, the expressions of ACAT1 mRNA and protein were up-regulated in C. pn infection group [(4.16±0.26) vs. (2.17±0.18), (1.20±0.10)vs. (0.61±0.03), both P<0.05], and C. pn-induced foam cell formation was observed. The expressions of ACAT1 mRNA and protein and the foam cell formation were inhibited by SP600125 in a concentration-dependent manner (r = - 0.92, P<0.05; r= - 0. 96, P<0.05, respectively). Conclusions The up-regulation of ACAT1 expression is induced by C. pn via JNK signal transduction pathway, which is involved in the mechanism of C. pn-induced macrophage-derived foam cell formation.

Objective To report the preliminary result of cylindrical abdominoperineal resection (cylindrical APR) and pelvic reconstruction with human acellular dermal matrix (HADM). Methods Cylindrical APR was performed in 13 consecutive patients with advanced very low rectal cancer between January 2008 and April 2009. The mesorectum was not dissected off the levator muscles at abdominal part of the operation, the perineal part of the operation was done in the prone position. The levator muscles were exposed circumferentiaUy. The coccyx and part of the 5th sacrum were dissected and Waldeyer" s fascia divided. The levator muscles were divided laterally on both sides from posterior to anterior. The remaining pelvic floor muscle fibers were divided just posterior to the transverse perineal muscles and the levator muscles were resected en bloc with the anus and lower rectum. The specimen was cylindrical. The pelvic defects were reconstructed with HADM. Results There was no bowel perforation, and all specimens were proved CMR negative by pathology. Perineal wounds were healed uneventfully. After 8 months" follow-up, no patient developed perineal wound breakdown, bulge or hernia. There was 1 patient developed perineal wound infection; one patient developed seroma and three with perineal pain. Five patients with short-term urinary retention recovered within 10 days. Conclusion Clinical APR and HADM pelvic reconstruction can reduce circumferential margin positive and rectum perforation rate, and made the procedure easier and safer without increasing complications.