Objective To discuss the clinical significance of anomalous origination of right gastric artery in interventional treatment for hepatocellular carcinoma(HCC).Methods The dynamic enhanced CT scanning of the liver with a 64-slice spiral CT unit was performed in 72 HCC patients.In arterial phase,maximum intensity projection(MIP) and volume reconstruction technique(VRT) were used to observe the origin of the right gastric artery and its relationship with the hepatic artery.The findings were compared with the angiographic results.Results Of the total 72 cases,the anomalous origin of the right gastric artery was found in 43(59.8%).The anomalous origins of the right gastric artery included proper hepatic artery(n=19),left hepatic artery(n=17),gastroduodenal artery(n=4),right hepatic artery(n=2) and common hepatic artery(n=1).The results obtained from three-dimensional reconstruction were in good accordance with angiographic findings.Conclusion The anomalously originated right gastric artery most commonly originates from the left hepatic artery.Three-dimensional reconstruction obtained from the 64-slice spiral CT scans can provide the clear and reliable images of the right gastric artery,which is very helpful for the interventional procedure.

Objective To discuss the feasibility of displaying the extrahepatic feeding arteries in hepatocellular carcinoma with the help of multi-slice spiral CT 3D reconstruction and to assess the clinical value of this technique. Methods Triple-phase enhanced CT scanning with a 64-slice spiral CT scanner was performed in 89 patients with advanced primary hepatocellular carcinoma (HCC). Three-dimensional reconstruction techniques,including maximum intensity projection (MIP) and volume rendering (VR),with arterial phase images,were used to display the origination and course of both the intrahepatic and extrahepatic supplying arteries of HCC. The results were compared with the angiographic findings. Results Of 59 cases with massive type HCC,extrahepatic supplying arteries were found in 33. In 21 cases of diffuse type HCC four showed extrahepatic supplying arteries,and in nine cases of nodular type HCC only one had extra-hepatic supplying arteries. The HCC could get their extrahepatic blood supply via eight pathways. A total of 44 extrahepatic supplying arteries were detected,and 19 anomalously originated hepatic arteries were found. Conclusion The extrahepatic supplying arteries in hepatocellular carcinoma are common findings and their supplying pattern are extremely varied,which may be associated with the type and location of the tumors. Three-dimensional reconstruction technique with the help of triple-phase enhanced CT scanning on a 64-slice spiral CT scanner can provide excellent images as vivid and ideal as angiography can afford. Therefore,the times of angiography examination,the use of contrast media as well as the dose of radiation to both the patients and the physicians can be reduced as far as possible. The detailed information about extrahepatic blood supply is very useful for improving the therapeutic result of HCC.

0.05), but the symptom of fever and character of respiratory tract's secretion of the patients in experiment group took turns for better obviously than the control group's ( P

Objective To study the correlation between liver fibroindex and prognosis of hepatocellular carcinoma after hepatectomy.Methods The clinical data of 77 patients with hepatocellular carcinoma who underwent hepatectomy at the 5th Hospital Affiliated to Sun Yat-sen University from 2009 October to 2014 December were analyzed retrospectively.Using data from preoperative Fibroindex,these patients were divided into 2 groups,Group 1:Fibroindex ≤5.4,and Group 2:Fibroindex ＞5.4.The clinical pathological parameters and postoperative disease free survival rates in these groups were analyzed.The Cox ratio risk pattern analysis was used for factors correlating recurrence.Results The parameters in the 2 groups which included sex (35/0 vs 29/13),type of cirrhosis (23/12 vs 14/28),numbers of tumor (35/0 vs 26/16),maximal diameter of tumor (31/4 vs 23/19),vascular invasion status (32/3 vs 26/16),resection margin status (35/0 vs 36/6),hepatic vein/portal vein tumor thrombus status (35/0 vs 29/13),perioperative change of HBV DNA levels (23/12 vs 15/27)were correlated with postoperative recurrence,and they all showed significant differences (P ＜ 0.05).Disease free survival rate in Group 2 was lower than Group 1 (71.4％,33.7％,22.4％ vs 94.3％,46.2％,46.2％,P ＜ 0.05).The Cox regression analysis showed Fibroindex ＞ 5.4,AFP-L3％ ≥ 10％,and number of tumor ＞ 3 to be independent predictors of poor disease-free survival after hepatectomy for hepatocellular carcinoma (P ＜ 0.05).Conclusions Preoperative Fibroindex ＞ 5.4 was an independent adverse predictor of poor disease-free survival.It was valuable to predict postoperative recurrence in hepatocellular carcinoma patients.

Objective To explore the matrix effect on cyclosporine A (CsA) test by fluorescence polarization immunoassay (FPIA) and enzyme-multiplied immunoassay technique (EMIT), explain the discrepancy of external quality control results between these two methods and find the corrective action.Methods One hundred whole blood samples with various concentrations were adopted and CsA levels were detected by FPIA and EMIT.The results were compared with each other.Moreover, the influence of residual metal ions upon immunoreactions was assessed by adding Cu2+ and Zn2+.The effect of non-whole blood matrix on extraction efficiency for quality control materials and CsA calibrator was evaluated by adding identical volume of Hb-rich reagents followed with re-extraction.Results There is good correlation between results measured with FPIA(X) and EMIT(Y) methods ( Y=0.926 8X -8.115,R2 =0.996 9).Neither FPIA nor EMIT was affected by residual metal ions ( P ＞ 0.05 ). Non-whole blood matrix decreased the extraction efficiency of two methods, but it could be corrected by supplementation of the Hb-rich reagents (≥30 g/L).Conclusions Non-whole blood matrix may be the main reason for the inconsistent results measured by FPIA and EMIT methods.It could be corrected by using Hb-rich reagents.In addition,we should consider the influence of low lib on CsA test,espocially for organ transplant patients with lower Hb ( ＜30 g/L).

Objective To summarize the etiologic factors and evaluate the clinical outcome of reoperations on 119 limbs of recurrent varicose veins.Methods Retrospective analysis was made on etiologic factors of 119 limbs (113 patients) of recurrent varicose veins admitted to our hospital from January 2007 to June 2013.All patients underwent color duplex ultrasonography and anterograde venography of the lower extremity and were treated by reoperations.Results In the 119 limbs,102 limbs (85.7％) had residual main great saphenous veins or tributaries,97 limbs (81.5％) had incompetent perforator veins,23 limbs (19.3％) had neovascularization,9 limbs (7.6％) had incompetent small saphenous veins,21 limbs (17.6％) had incompetent femoral veins,6 limbs (5.0％) had iliac vein compression syndrome,and Budd Chiari syndrome was found as the cause of recurrence in 1 limb (0.8％).Postoperative patients were followed-up for 6-72 m (32-± 7 m).The cure rate of varicose veins were 100％.There was not recurrence of varicose veins,postoperative VCSS was 0-5 (1.2 ±0.5) vs preoperative 1-17 (6.2 ±2.5)(P ＜ 0.01).Conclusions Residual and incompetent great saphenous veins or tributaries and incompetent perforator veins were the main etiologic factors of postoperative recurrent varicose veins.Therapeutic principle for recurrent varicose veins is to eliminating the reverse flow of superficial vein system and ligate incompetent perforator veins.

Objective To clone the full-length CDS sequence of LOC 401296 , an undefined gene that we found recently, and to obtain both its expression in eukaryotic cells or E.coli and antiserum to LOC401296 protein.Methods The full-length CDS sequence of LOC401296 was amplified by polymerase chain reaction (PCR).Then we established the expression vectors pET28B-LOC401296 and pCMV-Myc-LOC401296 by cloning the full-length CDS sequence into vector PET28B and vector pCMV-Myc respectively.Isopropyl Thiogalactoside (IPTG) was used to induce LOC401296 expression in E.coli.Furthermore,the protein purified and refolded was used to immunize BALB /c mice.The titer of the antiserum collected from immunized mice was identified by ELISA assay and Western blot .Results We cloned the full-length CDS sequence of LOC401296 was successfully .Protein LOC401296 was expressed as was expected and the mouse anti-human LOC401296 antiserum was obtained .The antiserum titer reaching 1∶64 000 was identified by ELISA .Besides, Western blot analysis showed that the antiserum could be used to detect protein LOC 401296 .Conclusion The full-length sequence of LOC401296 is obtained and the mouse anti-human LOC401296 antiserum becomes available .This study can contribut to further research on the undefined gene LOC 401296 .

Preoperative diagnosis of biliary obstruction mainly depends on imaging examination.Percutaneous transhepatic cholangiography (PTC) is a common method in detecting biliary obstruction.PTC combined with computed tomography (CT) could enhance the diagnostic rate.From April 2009 to April 2011,8 patients with biliary obstruction were admitted to the Shenzhen Hospital of Peking University.Contrast solution (30 ml of iodine solution at a concentration of 1.5％ -2.0％)was injected through a PTC tube,and then CT scan was performed.An iohexol contrast solution at a concentration of 300 mgl/ml was injected at a dosage of 1.5 ml/kg and at 3-5 ml/s,then the arterial phase,venous phase and delayed phase were scanned.The original data were uploaded to Vitrea 2 workstation for multiplane reconstruction,maximum intensity projection and volume rendering.The procedure was successfully performed on all patients,and the position of the biliary obstruction was identified in 7 patients.Five patients were diagnosed as with hilar cholangiocarcinoma,1 with sclerosing cholangitis and 2 with adenoma of the distal common bile duct.The patients' symptoms were alleviated after percutaneous transhepatic biliary drainage.

Objective To compare the clinical results of endovenous laser treatment(EVLT),radiofrequency endovenous occlusion(RFO)and conventional stripping combined with transilluminated powered phlebectomy(TIPP)for lower extremity varicose vein.Methods From Jun 2004 to Jan 2007,200 cases(232 limbs)were treated by EVLT with TIPP,80 cases(88 limbs)by RFO with TIPP,and 180 cases(202 limbs)by conventional stripping with TIPP.Operation time,number of the incision made,intraoperative bleeding,postoperative hospital stay,complications,and one-year recurrence rate were compared with each other. Results Operation time was longer(41±8)min in RFO group than that in other two groups.Postoperative hospital stay was shorter in EVLT group(1.2±0.4 d)and RFO group (2.1±0.8 d)than that in stripping and TIPP group(P＜0.05).Patients in stripping group also suffered from more intra-operative bleeding more often incidental nervus saphenus injury and more incision numbers when compared with other two groups(P＜0.05).There was no significant difierence in one-year recurrence rate among patients in the three groups. Conclusions The clinical efficacy is almost the same among the three groups in terms of eradication of the varicose veins.EVLT and RFO are safe and minimal invasive for the treatment of lower extremity varicose vein.