ObjectiveTo study the clinical feature, diagnosis, treatment and prognosis of hepatic angiomyolipoma.Methods The clinical materials of eight surgically treated patients with hepatic AML were retrospectively analyzed.ResultsThere were five females and three males, with age ranging from 25 to 59 years (mean 39 6 years). Tumors were located in the right lobe of the liver in 5 cases, and in the left lobe in 3 cases. Ultrasonography and computed tomography were performed in all cases. Magnetic resonance imaging and angiography were done in two each cases. The myoid cells in all tumors showed over expression of HMB 45. One patient died of postoperative heart failure, seven were followed up for 9 mos to 12 years without tumor recurrence. Conclusions Comprehensive imaging features can reveal the characteristic components of hepatic angiomyolipoma. HMB 45 immunostaining can be used to confirm the diagnosis. Surgical resection is an effective treatment of hepatic AML.

Objective To improve the diagnostic rate of laparoscopy for malignant peritoneal mesothelioma (MPM) and enhance acquaintance with this disease. Methods The appearance of laparoscopic detection was retrospectively analysed in 25 patients with pathologically proved MPM. Results Hyperemia, edema and faint vascular net in parietal peritoneum were seen in all patients, and the thick or thin callus-like thickened parietal peritoneum was also observed. There were some grey nodes of various size, distribution and number in parietal and visceral peritoneum in all patients. The purplish red masses with hyperemia and edema were seen in abdominal cavity in 21 patients (21/25,84%). Several small masses cold be connected each other to become one big mass. All patients had yellow turbid or bloody ascites. Conclusion MPM had special characteristics under laparoscopy. Laparoscopic detection possesses the advantages of safety, little trauma, less hurt and high diagnostic rate. Laparoscopic detection and biopsy may be the best method for diagnosis of MPM.

OBJECTIVE: In recent years, in the field of neurosurgery, people have tried to study the mesenchymal stem cells(MSCs) transplantation for treatment of spinal cord injury and review its related studies.DATA SOURCES: We did a computer-search of Medline for spinal cord injury related articles published in English from January 1990 to November 2004, with the key words of "mesenchymal stem cells, transplantation,spinal cord injury". Meanwhile, We also searched Chinese Biomedical Literature Database (CBM) for bone marrow-derived mesenchymal stem cells for transplantation of spinal cord injury related articles published from January 1990 to November 2004, with the key words of "mesenchymal stem cells, transplantation, spinal cord injury" in Chinese.STUDY SELECTION: All articles were selected firstly, and those relevant to progression of mesenchymal stem cells transplantation in spinal cord injury therapy were collected. The full texts of the rest literatures were looked up and the latest evolutional articles were enrolled.DATA EXTRACTION: A total of 32 articles about the mesenchymal stem cells transplantation in spinal cord injury therapy were collected. After the exclusion of repetitive or similar studies, 19 articles met our criteria.DATA SYNTHESIS: Aiming at the spinal cord injury therapy by means of mesenchymal stem cells transplantation, the viewpoints of collected articles were summarized. We found bone marrow derived mesenchymal stem cells could supply lesioned part as filler. Directional regeneration accomplishes the construction of the function that transfers up and down for the nerve cell anchor through surrounding structure. The microenvironment which can inhibit the regeneration of the glial cell, protect the survival of nerve cell body, promote the regeneration of autogenic nerve cells shall be created in transplant. The international successful experience was introduced emphatically, and the most hopeful outlook was suggested.CONCLUSION: The transplanted MSCs survive, migrate to the injury site and differentiate into neurons and astrocytes. Transplantation of MSCs following spinal cord injury may improve the recovery of spinal function and may be an effect way in treating spinal cord injury.

Objective To evaluate the clinical effect of immediate implant restoration in lower posterior teeth . Methods 31 XIVE implants were placed in lower posterior teeth of 31 patients.The temporary fixed resin crowns were fabricated immediately and final restorations were finished in 3~4 months.The control group used nonsub-merged implants and were restored with final crowns in 3~4 months.The tracking survey was taken from 12 to 24 months after final restoration .The patient satisfaction , papilla index score ( PIS ) and implant survival rate were eval-uated between the two groups .Results PIS of patients with immediate restoration reached (2.35 ±0.70) in aver-age compared(1.84 ±0.74) in control group.The patient satisfaction reached (91.5 ±7.5) with immediate resto-ration, compared with VAS score in average of(85.8 ±8.1) in control group.All implants in both groups achieved osseointegration and received 100% survival rate .Conclusion With proper technique in surgical and restoration procedure , immediate restoration after implant insertion in posterior madible has similar clinical success compared with delayed restoration .

Objective:To observe the effect of CD40 siRNA on expression of IFN-γ,IL-17,IL-4 and anti-dsDNA antibody of systemic lupus erythematosus (SLE)animal model MRL/Lpr mice and to discuss its therapy on MRL/Lpr mice.Methods:In the study,16 female MRL/Lpr mice were randomly divided into control group (n =4),empty vector group (n =4),CD40-siRNA1 group (n =4)and CD40-siR-NA2 group (n =4).The vectors expressing siRNA against CD40 were injected by tail veil into MRL/Lpr mice,while MRL/Lpr mice in control group and empty vector group were injected with the same dose of PBS and pGFP-V-RS vector respectively.The injection was given six times and every one day.The mice were sacrificed 14 d after injection,and the spleen tissue was weighed.The pGFP-V-RS was labeled by green fluorescent protein(GFP)and the tissue sections were observed whether siRNA expressed in the spleen.The expression levels of IFN-γ,IL-17,IL-4 and anti-dsDNA antibody in the sera were detected by ELISA method on the 1st day before the first time and the 2nd,5th,8th,11th,and 14th days after last injection,and the expression levels of CD40 mRNA in spleen tissue of MRL/Lpr mice were detected by RT-PCR and the expression levels of CD40 protein in spleen tissue of MRL/Lpr mice were detected by immunohistochemistry method.Results:The expression vector of CD40-siRNA could express in the spleen of MRL/Lpr.The spleens in CD40-siRNA1 group [(78.85 ±5.61 )mg]and CD40-siRNA2 group [(80.25 ±4.07)mg]were lower than those in control [(141.88 ±7.81)mg]and empty vector group [(153.10 ±7.60)mg].The levels of IL-17,IFN-γand anti-dsDNA antibody were lower and the levels of IL-4 was higher in CD40-siRNA1 group and CD40-siRNA2 group on the 2nd,5th and 8th days after last injection than on the 1st day before the first time (P <0.05).The levels of IFN-γin CD40-siRNA1 group were (118.74 ±10.32)ng/L,(115.24 ±8.26)ng/L and (113.71 ±5.02)ng/L in turn,the levels of IFN-γin CD40-siRNA2 group were (117.83 ±6.83)ng/L,(114.07 ±0.97)ng/L and (112.67 ±9.66)ng/L in turn.The levels of IL-17 in CD40-siRNA1 group were (7.05 ±0.41 ) ng/L,(6.34 ±0.76)ng/L and (5.83 ±0.43)ng/L in turn,the levels of IL-17 in CD40-siRNA2 group were (7.07 ±0.22)ng/L,(6.35 ±0.49)ng/L and (6.12 ±0.80)ng/L in turn.The levels of anti-dsDNA antibody in CD40-siRNA1 group were (7.51 ±0.29 )ng/L,(6.74 ±0.45 )ng/L and (6.32 ±0.39)ng/L in turn,the levels of anti-dsDNA antibody in CD40-siRNA2 group were (8.19 ± 0.38)ng/L,(7.14 ±0.50)ng/L and (6.48 ±0.29)ng/L in turn.The levels of IL-4 in CD40-siRNA1 group were (26.51 ±1.81)ng/L (27.80 ±1.72)ng/L and (28.08 ±2.21)ng/L in turn,the level of IL-4 in CD40-siRNA2 group were (26.28 ±2.03)ng/L,(28.15 ±2.95)ng/L and (28.37 ± 1.71)ng/L in turn.The expression levels of IL-17 and IFN-γantibody increased gradually and the levels of IL-4 decreased gradually in CD40-siRNA1 group and CD40-siRNA2 group on the 11th and 14th days after last injection,then reached to the levels of control group and empty vector group (P >0.05). Though the levels of anti-dsDNA antibody in CD40-siRNA1 group and CD40-siRNA2 group on the 11th day was higher than on the 8th day,there was more significance than those in control group and empty vector group (P <0.05).There was no significance between the 4 groups on the 14th day.The levels of CD40 mRNA and protein were lower in CD40-siRNA1 group and CD40-siRNA2 group than in control group and empty vector group on the 14th day after last injection (P <0.05).Conclusion:CD-40 si-RNA can reduce the concentration of IL-17,IFN-γand of anti-dsDNA antibody in serum,and at the same time,it can elevate the concentration of IL-4 and suppress CD40 mRNA and protein of spleen in MRL/Lpr.Meanwhile after suppressing CD40 mRNA and protein,it can reduce inflammatory response of the mice and the disease activity of MRL/Lpr,suggesting that CD-40 siRNA has therapy effect on SLE.

OBJECTIVE:To study the rationality of multiple-unit containers of oral drugs.METHODS:The condition of whether the oral western medicines currently used in our hospital were packaged in single-dose container or not were inves?tigated;the information on packaging and distribution of multiple-unit containers was analyzed as well.RESULT:Of the460kinds of oral western medicines investigated,220were in single-dose containers,and138were in multiple-unit containers,of the multiple-unit containers87involved problems in packaging.CONCLUSION:It is suggested that single-dose container should be used and the multiple-unit containers should be improved reasonably.

Objective To evaluate the preoperative diagnosis and treatment of primary duodenal adenocarcinoma ( PDA). Methods Clinical data of 89 PDA cases undergoing laparotomy from 1985 to 2009 in three hospital in Beijing and Zhengzhou were analyzed retrospectively. Results The prevalence rate of PDA is comparatively low and its clinical manifestations are not specific. The correct diagnostic rate of auxiliary examination were 93% by endoscopy,90% by gastrointestinal X-ray air barium double radiography,82% by MRCP,42% by BUS,70% by CT/MRI. The most common location of the adenocarcinoma(65% ) was at the second portion of the duodenum. Among 67 PDA cases 48 cases underwent pancreatoduodenectomy, 19 cases received segmental deodenectomy. The 5 year's survival rate was 47% and 50% respectively. Conclusions Endoscope and X-ray radiography are mainstays for the diagnosis of PDA. Early diagnosis and radical operation are the key to improve the resection rate and the long term survival.

Objective To study the methods for diagnosis and treatment of insulinoma.Methods The clinical data of 120 patients with insulinoma who had been admitted to our hospital in the last 40 years were retrospectively reviewed.Results Fasting blood glucose values were less than 2.75 mmol/L in all the patients.Fasting serum insulin values in 75 patients were higher than 25 ?U/mL,and the average was (65 ?6.0)?U/mL.Before operation,tumor was detected in 2 of 60 patients by ultrasound scan,and in 10 of 50 by CT. Among 18 patients who had intra-operative B-ultrasound examination, 16 positive cases were verified by intraoperative exploration; and one case the tumor was not palpable but was found by intraoperative B-ultrasound examination.The operations included enucleation of insulinoma(70 patients),insulinoma resection and distal resection of the pancreas(44),distal resection of the pancreas(4),and biopsy(2).The low blood glucose symptoms disappeared after the first operation in 111 of the 112 patients who had benign tumor.One case with benign tumor was cured by a second operation.Twenty patients developed pancreatic fistula after tumor enacleation, of them,14 healed uneventfully after drainage,5 were cured by operation,and 1 died of peritoneal infection.Conclusions Preoperative localization of insulinomas is difficult. Intraoperative exploration and ultrasound scan are the chief methods for the localization of insulinoma.Enucleation of insulinoma should be selected for benign tumor. Resections of the pancreatic body and tail is required for large,deep or multiple tumors.

Objective: Combined detection of anti-mutated citrullinated vimentin ( anti-MCV ) antibodies, anti-cyclic citrullinated peptide ( anti-CCP) antibodies and rheumatoid factor ( RF-IgM) levels to investigate the diagnostic value of anti-mutated citrullinated vimentin (anti-MCV) antibodies for rheumatoid arthritis(RA).Methods: A total of 359 patients with RA,128 patients with other rheumatic diseases and 90 healthy controls were involved.Enzyme linked immunosorbent assay ( ELISA) was used to detect anti-MCV and anti-CCP, and dynamic immune nephelometry was applied to detect RF-IgM .The sensitivity and specificity were obtained from the experimental data.Results:The sensitivities of anti-MCV,anti-CCP and RF-IgM were 85.1%,76.7% and 82.7%in RA respectively.The specificities were 93.2%,95.1%and 80.1%respectively.Combined detection of anti-MCV and anti-CCP,the sensitivity decreased to 70.2%; but the specificity increased to 98.7%.The sensitivity reached to 89.5% with specificity 97.6%when the union of anti-MCV and anti-CCP positivity was used as criterion.Conclusion:Anti-MCV and anti-CCP are novel makers for RA diagnosis with high sensitivity and high specificity.Combination of anti-MCV and anti-CCP is more helpful for RA diagnosis.

Objective To investigate the expression of human leukocyte antigen F (HLA-F) in hepatocellular carcinoma (HCC) tissues and to evaluate its relation to clinicopathological features and prognosis of HCC.Methods HLA-F expression of tumor lesions and their adjacent normal liver tissues from 115 HCC patients were analyzed by immunohistochemistry,and its relationship between HLA-F expression and the clinicopathological features and prognosis of HCC patients was also analyzed.Results HLA-F expression was positive in 47.0％ (54/115) of the HCC lesions and in 10.6％ (7/66) of the normal liver tissues (x2 =24.799,P ＜ 0.05).HLA-F expression in HCC lesions was significantly correlated with portal vein invasions (x2 =7.644,P =0.006),tumor number (x2 =4.210,P =0.040) and patient sex (x2 =6.759,P =0.009).The mean survival time of the HLA-F positive HCC patients was 34.0 months(95％ CI:27.5-40.5 months),which was significantly shorter than that of HLA-F negative HCC patients(44.6 months,95％ CI:38.3-50.9months) (x2 =5.148,P =0.023).HLA-F expression was an independent predictor of overall survival of HCC patients.Conclusions Positive HLA-F expression is negatively correlated with the prognosis of HCC patients.