Objective To evaluate the curative effect of selective decongestive devascularization shunt of gastrosplenic region(SDDS-GSR) for the treatment of portal hypertension. Methods From September 2000 to June 2008, 44 patients with portal hypertension had received SDDS-GSR in our hospital. Twenty-nine of them had been followed up for 12-85 months (mean=44months). Results Operative mortality was 0 %. Mesenteric area pressure(33.82±5.12 cm H_2O) was higher than splenic area pressure(24.57±4.63 cm H_2O)soon after the operation finished(P<0.01). No re-bleeding ca-ses were found, and the encephalopathy occurred in 2.27% of the patients in the early stage of post-operation. However, the rates of 3.45% for re-bleeding and 3.45% for encephalopathy were noticed in long-term follow-up. The 1-, 3- and 5-year survival were 100%, 95% and 95%, respectively. Dur-ing the long-term follow-up, the platelet counts markedly increased from (49.2±21.8 × 10~9/L) of preoperative value to (77.2±29.5×10~9/L) (P<0.01), while spleen size was significantly reduced.Conclusion SDDS-GSR is a reliable and reasonable surgical procedure for the management of portal hypertension.

Objective To evaluate the changes of splanchnic hemodynamics after selective decongestive devascularization shunt of gustrosplenic region (SDDS-GSR) in the treatment of patients with portal hypertension. Methods All these 41 portal hypertensive patients underwent a combination surgery including partially occlusion of the splenic artery, Warren distal splenorenal shunt and devascularization. Postoperative patients were followed-up by ultrasonography for changes of splanchnic hemodynamics. Results were compared with that of 21 healthy volunteers. Results The thickness of spleen 2 weeks and 1 year after surgery (47±8) mm, (46±8) nun decreased from preoperative (60±9) mm (P<0.01). The diameter of portal vein (1.13±0.19) cm and splenic artery (0.49±0.08) cm 2 weeks after surgery decreased (P<0.05) and that of hepatic artery (0.40±0.07) cm increased (P<0.05). Patients' preoperative portal vein blood flow volume (1716±1262) ml/min and splenic artery (1269±570) ml/min were larger than that of normal group (P<0.05), while that of hepatic artery (321±126) ml/min was significantly less than that of normal group (P<0.05). The portal blood flow (649±294) ml/min and that of splenic artery (446±254) ml/min 2 weeks after surgery decreased significantly (P<0.01). The hepatic artery blood flow (612±295) ml/min increased significantly (P<0.01). When reevaluated at 1 year the hepatic artery blood flow (401±152) ml/min was not significantly different compared with that before surgery and that in normal group (P>0.05). Conclusions There are significant alterations in hepatic and splenic hemodynamics in patients with portal hypertension, and that SDDS-GSR can partially reverse the chaos of the hepatic and splenic hemodynamics in cirrhotic portal hypertensive patients.

Objective To investigate the clinical features and management of hepatolithiasis associated with intrahepatic cholangiocarcinoma. Methods Data of 84 patients of hepatolithiasis associated with intrahepatic cholangiocarcinoma in our hospital from 1990 to 2009 were retrospectively analyzed.Results The incidence of intrahepatic cholangiocarcinoma in patients of hepatolithiasis was 4. 6%(84/1840), among them only 47 patients got a definite diagnosis before operation. All cancer located in the bile duct containing cholelith. In 20 patients intrahepatic cholangiocarcinoma was identified 6 - 16 years after lithotomy. The clinical manifestation of hepatolithiasis associated intrahepatic cholangiocarcinoma included:refractory hepatic abscess, incurable infection of intrahepatic biliary tract, and progressive obstructive jaundice. Only 35 patients received radical excision, 26 patients received palliative excision, 4 patients received radiofrequency ablation therapy, 19 patients received biopsy only. Conclusions There has been a considerable high coincidence between intrahepatic cholangiocarcinoma and hepatolithiasis. Resection of the lobe containing intrahepatic stones may help to prevent the development of intrahepatic cholangiocarcinoma.

Objective To study the effect of aerobic exercise and dietary intervention on lipid metabolism in metabolic syndrome rats, and investigate the possible mechanism mediated by peroxisome proliferator-activated receptorα(PPARα). Methods After one-week feed-ing, Sprague-Dawley rats were randomly divided into blank control group (CC group) and model group which were feed in high-fat-and-salt diet for 18 weeks to establish a metabolic syndrome model. Then, the metabolic syndrome rats were randomly divided into model control group (MC), the model high-fat diet group (MHE) and the model general died exercise group (ME). ME and MHE groups were forced to run on a treadmill for twelve weeks at the same time. The weight of perirenal fat, blood free fat acid (FFA), and blood lipid were determined. The expression of PPARαmRNA in myocardium was detected by RT-PCR. Western blotting was applied to detect the protein expression of PPARαin myocardium. Results Compared with CC group, MC group showed significant increase in body weight, perirenal fat weigh, FFA, and blood lipid (P<0.05), and significant decrease in PPARαmRNA and protein expression (P<0.01) in myocardium. Compared with MC group, ME and MHE groups showed significant decrease in body weight, perirenal fat weight, triglyceride (TG), and showed significant in-crease in high-density lipoprotein (HDL), and the expression of PPARαmRNA and protein in myocardium (P<0.05). Compared with MHE group, ME group showed decrease in low-density lipoprotein (LDL) (P<0.05), and increase in the expression of PPARαmRNA and protein (P<0.01). Conclusion Aerobic exercise may activate the expression of PPARα, enhance the utilization of fatty acid, reduce body mass and visceral fat mass, improve the dyslipidemia and then regulate lipid metabolism in metabolic syndrome rats.

Background and purpose: When patients have positive sentinel lymph node (SLN), axillary lymph node dissection (ALND) is usually performed, but most of them have no metastasis in the non-sentinel lymph node (nSLN). It is of great significance to predict metastasis of nSLN precisely. The aim of the study was to establish a nomogram for the intraoperative prediction of nSLN metastasis in breast cancer patients using one-step nucleic acid amplification (OSNA) techniques and to direct the subsequent therapy for breast cancer effectively. Methods: Of 552 breast cancer patients who underwent SLN biopsy in the 2010 OSNA clinical trial, 103 with SLN metastasis treated with ALND were assessed to establish a nomogram for intraoperative prediction of nSLN based on the molecular diagnosis. A validation cohort of 61 patients who met the similar criteria in the 2015 OSNA clinical trial subsequently validated it. Results: Primary tumor size, total tumor load, the number of positive SLNs and negative SLNs were associated with the presence of nSLN metastasis based on the multivariable logistic regression results, and a nomogram was established with these variables. Its area under the ROC curve was 0.814 for the predictive model and it was 0.842 in the re-validation cohort. The tumor size assessed by the postoperative histological examination was replaced by the size evaluated by the imaging examination, and the area under the ROC curve was 0.838. There was no statistically significant difference in the accuracy compared with the former validation data (P=0.7406). Conclusion: The predictive nomogram based on the molecular diagnosis can predict the nSLN metastases intra/post-operatively. It appears to be obviously superior to other predictive models and may help to guide the axillary management and to make decisions about radiation target region.

Objective To study the effects of decoy strategy targeted to NF-KB on the development of trauma-associated liver inflammation in rats. Methods In this study, 108 Wistar rats were randomized into 3 groups: control group, traumatic inflammation group and traumatic inflammation plus decoy ODN group. Rats were sacrificed on 3,6,12,24,48 and 72hrs in each group respectively. Liver functions and structural changes were examined and compared between the groups. DNA binding activity of NF-KB in liver tissue was measured by EMSA. TNF-α and IL-6 gene expressin in liver tissue was assessed by RT-PCR and TNF-α and IL-6 protein level was determined by ELISA. Results The DNA binding activity of NF-kB in liver rose at 3 hours after induction of liver inflammation following trauma and peaked at 12 hours. Correspondingly, both the mRNA and protein levels of TNF-α and IL-6 elevated significantly, as well as the serum alanine aminotransferase level culminating at 24 hours after surgery. Hepatocytes was edematous, degeneration and necrosis, with dramatic destruction of lobular structures. All these changes were significantly inhibited with NF-KB decoy oligodeoxynucleotides. Conclusions Decoy oligodeoxynucleotides specifically inhibit the activity of NF-kB, and the release of pro-inflammatory cytokines, TNF-α and IL-6 release from the liver in response to traumatic inflammation decrease, hence the injury on liver structures and functions were alleviated.

Objective Radiofrequency ablation (RFA) and endoscopic breast conserving surgery (EBCS) has been developed as a potential means for treating breast tumors with minimal disruption to adjacent soft tissues.The purpose of this study was to evaluate the cosmetic outcomes of RFA assisted by EBCS on patients with early breast carcinoma (T1 -2 N0-1 M0).Methods Twenty-three patients with biopsy proven invasive breast carcinoma ( ≤3 cm in diameter),were treated with ultrasound (US)guided percutaneous-RFA for the local tumors followed by sentinel lymph node biopsy and endoscopic auxiliary node dissection and lumpectomy.The reactions to breast cosmetics were observed and compared to the conventional approaches using the breast asymmetry score for EBCS and a self -assessment questionnaire targeting objective and subjective data about treatment related breast change.Results Twenty-three patients were successfully treated with RFA.Complete coagulation necrosis of the tumor was visualized at US and mammography in 22 of 23 patients (95.6 ％).22 patients being per formed RFA and EBCS presented little scars and the breasts preserved more cosmetically acceptable than the reported results of traditional protocols.Self-assessment acceptable rate was 100 ％,aesthetic outcome as good or excellent rated in 95.5 ％(21/22).Within the follow-up of above 36 months,there were no local recurrence,metastasis,wound infection or necrosis,nerve damage,haematoma,as well as upper limb swelling or lymphoedema,no reduced upper limb mobility and tumor seeding.Conclusions RFA with endoscopic breast conservation therapy for the treatment of early breast carcinoma is more effective and cosmetically acceptable than the traditional approaches.

Background and purpose:Sentinel lymph node biopsy has replaced axillary lymph node dissec-tion as the standard staging procedure in early breast cancer patients with clinically negative axillary lymph nodes. It is a critical step for staging and treatment. This study investigated the localization effect of a novel tracer for breast cancer sentinel lymph node biopsy [indocyanine green (ICG)-rituximab (R)], using the hind limb drainage in mice as an animal model.Methods:For exploring the optimal dose and imaging time, different doses of ICG-R were injected subcutane-ously to the dorsum of the foot in the BALB/c mice. Then the lfuorescence vasculature imaging instrument was used continuously to observe the popliteal fossa lymph node (as sentinel lymph node) from the injection to 3 h after injection. For exploring the sustained localization effect, the optimal dose of ICG-R was injected and the imaging instrument was used from imaging to 24 h after injection.Results:The time from injection to imaging and the time from injection to the optimal imaging were shortened with the increased doses, and the imaging rate of the second or third level node increased accordingly. The best dosage of the novel tracer was 0.12 μg (dosage of indocyanine green) and the time from injection to the optimal imaging was about 34 min. After the observation for 24 h, the imaging rate of sentinel lymphnode was maintained at 100%, and the imaging rate of the second and the third level lymph node increased from 0% to 20% and 10%, respectively.Conclusion:ICG-R could clearly locate the sentinel lymph node. There is no imaging of the second level lymph node within 6 h. The novel tracer has high value in the clinical application.

OBJECTIVETo study DNA damage of three kinds of gasoline oxygenates.

METHODSingle cell gel electrophoresis assay(Comet assay) was used to detect the damage effects of three gasoline oxygenates[methyl tertiary butyl ether(MTBE), ethanol anhydrous(EA) and dimethyl carbonate(DMC)] on DNA in L-929 mice fibroblasts.

RESULTSIn certain concentation(37.500-150.000 mg/ml), MTBE could directly cause DNA damage of L-929 mice fibroblasts. There was obvious dose-effect relationship, i.e. when the concentration of MTBE was increased from 9.375 to 150.000 mg/ml, the comet rate also increased from 4% to 85%, and the length of comet tail changed correspondingly. The results of EA and DMC were negative.

CONCLUSIONUnder the condition of this experiment(150.000 mg/ml), MTBE could directly cause DNA damage while the effect of EA and DMC on DNA damage was not found.

Animals ; Comet Assay ; DNA Damage ; Dose-Response Relationship, Drug ; Ethanol ; toxicity ; Fibroblasts ; drug effects ; Formates ; toxicity ; Methyl Ethers ; toxicity ; Mice

Objective: To explore and evaluate a simple and useful indicator for cardiopulmonary function assessment. Methods: College male students were enrolled and received leg lifting (in 30 s, 40 s, 60 s) test and t rhythm squat test (20 times/30 s, 30 times/30 s, 30 times/30 s). Exercise heart rate variability index (EHVI) and heart function index (HFI) was calculated and explored its association with vital capacity and to determine the validity and reliability of cardiopulmonary function indicators through Kappa-tests. Results: No significant associations were found between Leg lifting and squat with absolute and relative vital capacity. Correlation between HFI in rhythm squat test with VO-2max was below 0.2, with some being non-significant. Low but significant correlation was found between EHVI in leg lifting test, especially for EHVI of 60 s leg lifting(r=0.47, P<0.01). The Kappa test showed good consistency between the two measures(Kappa=0.76, P<0.01). Conclusion Exercise heart rate variability index (EHVI) from 60s leg lifting test can be used as a simple indicator for cardiopulmonary function assessment in male college students.