Objective To compare the efficacy of open microwave ablation and repeat hepatectomy for recurrent small hepatocellular carcinoma.Methods The clinical data of 75 patients with recurrent small HCC who were admitted to our hospital from January 2007 to December 2010 were retrospectively analyzed.34 received microwave ablation (MWA group) and 41 received repeat hepatectomy (hepatectomy group).The perioperative condition,liver function recovery,the variation of AFP level,mobidities,hospitalization time and overall survival rate and disease-free survival rate were compared.Results The rate of complete elimination to tumor tissue was 100％ and the AFP levels returned to normal within 3 months in both groups.The mean average operation time in MWA group was shorter than that in hepatectomy group [(91 ±33) min vs (156 ±51) min,t =-6.399 5,P =0.000].The blood loss in MWA group was smaller than that in hepatectomy group [(87 ±62) ml vs (254 ± 134) ml,t =-6.691 5,P =0.000].Patients in PFRA group had a shorter hospital stay [(7.5 ± 2.2) d vs (11.3 ± 2.7) d,t =-6.588 8,P =0.000].The mobidities of the MWA group and hepateetomy group were 2.9％ (1/34) and 22.0％ (9/41),respectively (x2 =5.812 7,P =0.016).The overall survive rate of 1,3 and 5-year were 88.1％,68.8％ and 46.1％ in the MWA group,and 86.1％,71.5％ and 50.2％ in the hepatectomy group (x2 =0.16,P =0.692).The disease free survival rate of 1,3 and 5-year were 67.1％,38.2％ and 16.1％ in the MWA group,and 64.4％,45.5％ and 23.6％ in the hepatectomy group (x2 =0.03,P =0.870).Conclusions MWA can achieve survival benefits equivalent to hepatectomy for recurrent small HCC,and it is less traumatic.

ObjectiveTo investigate the effect and related mechanism of triptolide pretreatment to prevent from ischemia/reperfusion (I/R) injury in mice liver. MethodsSixty male C57BL/6 mouse were randomized into four groups (15/group): A:sham group with saline , B: sham group with triptolide, C: saline I/R group, D: triptolide I/R group. The mice were pretreated with either saline or triptolide (0. 1 mg/kg/d) through intraperitoneal (ip) injection for one week. The mouse partial liver model of I/R injury was established, and samples were collected at 24 h after the I/R injury. ResultsSerum ALT and AST levels were significantly decreased and histological damage was significantly alleviated in the triptolide I/R group as compared with the saline I/R group (P＜0.05), the concentration of MDA in the triptolide groups was significantly decreased, while SOD activity was significantly increased compared with that of the saline I/R group (P＜0.05). The percentages of CD4+ CD25+ regulatory T cells (Tregs) cells among CD4+ T cells in groups A, B, C, and D were(7. 55 ± 1.87)%, (12. 59±3. 87)%,(7. 85±1.07)%, and(12. 02±3. 16)% in liver tissue, respectively. The expression levels of Foxp3 mRNA were significantly higher in the triptolide I/R group than those of saline I/R group (P＜0. 05). ELISA showed that triptolide could significantly inhibit the levels of IL-6, IL-Iβ and TNF-αand promoted the level of IL-10 in the serum (P＜0.05). Conclusion Pretreatment with triptolide could effectively prevent from liver I/R injury, which may be related to the induction of Treg cells by triptolide, the increase in the level of IL-10 in serum, and the inhibition of IL-6, IL-1β and TNF-α production in serum.

BACKGROUND:Pathological mechanism of femoral head necrosis is not fuly known, and high-dose corticosteroids are prone to induce femoral head necrosis.
OBJECTIVE:To investigate the clinical effect of bone marrow mesenchymal stem cels combined with theaflavin on steroid-induced avascular necrosis of femoral head in rats.
METHODS: Rat bone marrow mesenchymal stem cels were isolated and culturedin vitro and compounded onto gelatin sponge, and then, divided into four groups: model group, decompression group, cel transplantation group and combined group. Models of steroid-induced avascular necrosis of femoral head were established using liquid nitrogen method. In the combined group, gelatin sponge carrying bone marrow mesenchymal stem cels was transplanted and 250 mg theaflavin was given daily after modeling.
RESULTS AND CONCLUSION:At 4 weeks after modeling, the femoral head samples in the four groups were round with exfoliation of articular cartilage that was pale in color. Then, the exfoliation of articular cartilage was aggravated in the model group, and some specimens appeared to colapse; the femoral head specimens in the combined group were round and pale. Until the 8th week after modeling, bone necrosis was increased in the model group; osteoblasts were found in the decompression group with fibrous calus formation; a few of empty bone lacunae appeared with irregular medulary cavity in the cel transplantation group; a large amount of new bone tissues formed in the combined group, and intramedulary adiocytes were in regular array. At 4 and 8 weeks after modeling, the number of empty bone lacunae was significantly lower in the combined group than the other groups (P < 0.05). These findings indicate that bone marrow mesenchymal stem cels combined with theaflavin is an ideal therapy for steroid-induced avascular necrosis of femoral head.

Objective To investigate the protective effect of triptolide (TPT) pretreatment against liver ischemia/reperfusion (I/R) injury in mice and the possible mechanism. Methods Sixty male C57BL/6 mice were randomly divided into four groups (15/group): ( 1 ) TPT I/R group: The mouse partial liver model of I/R injury was established by the method of Koba-yashi. The portal triad (hepatic artery, portal vein, and bile duct) was occluded with a microvascular clamp for 90 min and 24 h reperfusion; (2) Sham group with TPT: Mice underwent surgical procedures including isolation of the portal triad without occlusion; (3) Saline I/R group: Surgery was performed as the same in the TPT I/R group, (4): Sham group with saline: Surgery was performed as the same in the TPT sham group, and the mice were pretreated with either saline or TPT (0. 1 mg · kg-1 day-1 ) by intraperitoneal injection for one week. The samples were collected at the 24th h after the I/R injury.The serum ALT and AST levels were determined, the histologic changes were observed by HE staining, the percentage of Th17 cells among mononuclear cells in liver tissue was analyzed by flow cytometry, the expression of IL-17 and ROR-γt mRNA was detected by real-time PCR, and the serum IL-6, IL-17 and TGF-β levels were measured by enzyme-linked immunosorbent assay (ELISA).Results Serum ALT and AST levels were significantly decreased and the histological damage was significantly alleviated in the TPT I/R group as compared with saline I/R group (P＜0. 05). The percentage of Th17 cells among mononuclear cells in TPT I/R group, TPT sham group, saline I/R group, TPT saline group was ( 1.77 ± 0. 53)％, (0. 41± 0. 18)％, (4. 26 ± 0. 82)％ and (0. 72 ± 0. 23) ％ in liver tissue, respectively. The expression levels of the IL-17 and ROR-γt mRNA in the liver tissue, and IL-6, IL-17 and TGF-β levels in the serum were significantly lower in TPT I/R group than in saline I/R group (P＜0. 05). Conclusion Pretreatment with low dose of TPT could effectively protect the liver from I/R injury in mice, which may be related to the inhibition of Th17 cells.

Objective To investigate the causes and treatment of encephalopathy occurred after orthotopic liver transplantation(OLT). Methods The clinical data of consecutive 51 patients who undergoing OLT were analyzed retrospectively. Results Encephalopathy occurred in 6 cases within one month after operation.The incidence of encephalopathy after OLT was 11.8%(6/51). All the 6 cases were cured by application of sedative agent and dopamine recipient blocking agent(aloperidin). Conclusions The etiology of encephalopathy following OLT is thought to be multifactors including metabolism desturbance before and after OLT,blood dynamics alternation during opration,application of immuosuppression drug etc. Application of sedative agent and dopamine recipient blocking agent may result in ideal effects in treating the encephalopathy.

This paper introduces such instrumental induced abortions without vacuum aspiration in China as rotary instrument-induced abortion, ultrasound termination pregnancy, acupuncture antiearly pregnancy and microwave radiation induced abortion. This paper can be referred to when new abortion method and apparatus developed.

Objective To investigate the application of abdominal drainage after liver resection.Methods From Jan 2008 to June 2009,210 consecutively admitted patients undergoing liver resection by the same surgical team were chronologically allocated into drainage group(120)and non-drainage group (90).Patient's preoperative characteristics,operation-related factors,postoperative complications and hospital stay were compared between the two groups.Results Postoperative complications were comparable between the two groups,which was not significantly different among preoperative characteristics and operation-related factors(P>0.05).Mortality was 0.8% in drainage group and 1.1% in non-drainage group,again,the difference was not significant(X~2=0.042,P>0.05).Snrgical complications were significantly higher in drainage group than in non-drainage group,especially for abdominal infection and ascites occurrence(P<0.05).The hospital stay was significantly longer in the drainage group(13.1 ±5.2)days than the non-drainage group(11.4±5.6)days.Conclusions Postoperative abdominal drainage is not necessary for patients undergoing liver resection,furthermore,abdominal drainage increases postoperative complications.

This paper introduces the operational principle, structure, components of rotating abortive apparatus. The structure, size, material and design of the rotation ring are presented, and the abortion with rotating abortive apparatus is also mentioned in this paper.

This paper introduces an ECG real time monitoring system based on LabVIEW.With Wavelet transformation,the original ECG signals are processed to increase the accuracy of R peak detection.The feature of real time in this system is ensured by the application of simplified algorithm.The result panel offers various types of HRV information in time domain,including numerical and graphical displays which make the data more intuitional and more convenient to obtain.The system runs well in lab and the result is acceptable.

Objective To investigate the prevention and treatment of acute renal failure (ARF) following orthotopic liver transplantation(OLT).MethodsClinical data of 51 patients who underwent liver transplantion consecutively between October 2001 and April 2003 were analyzed retrospectively. Results Preoperatively 9 out of 51 patients had suffered renal dysfunction (Cr≥132 ?mol/L or BUN≥18 ?mol/L), ARF developed in 7 cases within one week postoperatively. Kidney function recovered to normal in 6 cases in 3 to 6 days after administration of vasoactive drugs (dopamine) and daclizumab (Zenapax). One patient failing to response needed hemodialysis for 11 days before his kidney finally functioned. Conclusions The etiology of ARF following OLT is multifactorial, with preoperative, intraoperative and postoperative factors being involved. Individually applied immunosuppressant, improving renal perfusion, and hemodialysis were important for the recovery of kidney function.