Objective To analyze the clinical value of laparoscopic ultrasonography (LUS) in laparoscopic hepatobiliary surgeries. Methods A total of 156 cases of laparoscopic hepatectomy, hepatic abscess fenestration, and complicated cholecystectomy were analyzed. LUS was used during all the 156 operations; the anatomy and stage of the tumors were investigated. Results In 19 cases of hepatectomy and 39 cases of hepatic abscess fenestration, the direction of critical intrahepatic and extrahepatic ducts were indicated by using LUS, and the operations were performed under the guidance of LUS. Moreover, in 15 cases of complicated cholecystectomy, the tumor was precisely located and further distinguished by LUS. Conclusions Laparoscopic ultrasonography can precisely locate the tumor, guide the treatment, and resolve the problem of reduced feedback in touching for surgeons during laparoscopic hepatobiliary surgeries. It is of value to improve the operative outcomes.

Objective To investipate the cerebral autosomal dominat arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) through the clinical features , pathology, neuroimage, and molecular genetics as well as the family tree of a case as to exploring the diagnostic method of the disease .Methods Systematic study on the clinical manifestations, genetic site, neurologic and muscular biopsy was performed. Results The main clinical features including poor memory and history of stroke were found. Neuroimaging examination showed multiinfarct lesions and leukoencephalopathy. Biopsy indicated the arteriolar hyalinosis,GOM and osmiophilic granule. A family history was confirmed. A mutation on the fourth exon of notch 3 gene was revealed. And no risk factors of hypertension and arteriosclerosis were found. All these features are in conformity with those of CADASIL.Conclusion CADAIL is not rare and is possible to be defined in vivo by way of dermal biopsy,examination of gene and neuroimage characteristics.

ObjectiveTo investigate changes of sex hormone levels and sexual function in male patients after liver transplantation.MethodsBlood samples were taken from 69 male patients receiving liver transplantation pretransplantation and postoperative 3rd,7th,14th day,1st and 3rd month respectively.Serum estradiol and testosterone were measured by radioimmunoassay.Serum sex hormone binding globulin was measured by ELISA.Sixty-nine discharged adult male liver transplant recipients ( age ranging 24 -45 years) with a normally functioning allograft for at least 6 months were questioned on their pre-and post-operativesexualfunction compared with 23adulthealthy controls.ResultsPretransplantation serum estradiol and sex hormone binding globulin were significantly higher (87.56±31.21 vs.26.00 ±9.12,u=9.30,P＜0.0001,134.50±30.68 vs.51.04 ±12.05,u=12.69,P ＜ 0.0001,respectively),and testosterone was lower than normal controls (2.02 ± 1.28 vs.4.82 ± 1.48,u =-8.73,P ＜0.0001 ) and levels were correlated with MELD scores (r =0.80,P ＜0.0001,r =-0.77,P ＜0.0001,r =0.72,P ＜0.0001,respectively).Sex hormone levels were back to normal on postoperative 2nd week (serum estradiol) or 1st month (serum testosterone and sex hormone binding globulin).Compared with pretransplant status,sexual function improved significantly when evaluated on postoperative 6th month.ConclusionsLevels of serum sex hormone were correlated with MELD scores before liver transplant.After liver transplant,estradiol was back to normal level on postoperative 2nd week,testosterone and sex hormone binding globulin back to normal level on postoperative 1 st month.Sexual function significantly improves after liver transplantation.

ObjectiveTo survey and analyze the changes of dental medical students' concerns before and after their internship in order to provide practical evidences for intern orientation and junior students education.MethodsAnonymous questionnaires were designed with single choice and multiple-choices and were accomplished by 175 dental medical students of different grades to investigate their' concerns before and after the clinical internship and choices for future employment.Results 47％ freshmen,43％ junior,45％ graduates were willing to work in dental restoration field,30％sophomore and 39％ senior were willing to work in orthodontics field.Before the internship,the most concem of 97％ students was the teaching quality of the practice hospital; 67％ students worried that patients may unsatisfy with the treatment.After the internship,the quality of the practice hospital was considered most important by 79％ students; 51％ students worried that internship may influence the postgraduate entrance exam.ConclusionTeachers should strengthen their self-cultivation and cope with the key concerns before the practice based on the investigation and survey after the practice.Meanwhile teacher should provide employment guidance for students based on students' interests and practice skill ability,encourage them to broaden their horizon and pay attention to the long-term interests in an aim to pave the way for future employment.

Objective Chronic diseases are recognized as a major health problem in the 21st century.This project was to assess the effects of self-awareness health management service on optimization of life-style of community residents so as to effectively control the occurrence and development of chronic diseases.Method A survey of health information,an evaluation of health status,health intervention were conducted among 231 people aged between 29-65 years in a community for a half year,and the health management was effectively assessed of them.38 subjects with chronic diseases were subjected to diet friends used and exercise quantitative management model.Results The way of life of the 231 people has been optimized,and in the 38 patients with chronic diseases who had adopted the management mode of friends six months later their average body weight dropped by 1.3 kg,body mass index dropped by 0.5,and waist circumference reduced by 1.8 cm(P<0.05).Conclusion It is feasible to conduct health management in residents of communities,especially in patients with chronic diseases,which COnforms to the basic principles and requirements of prevention and treatment of chronic diseases advocated by WHO.

Objective To explore the diagnostic value of prostate specific antigen (PSA),compound prostate specific antigen(cPSA),and cPSA / tPSA ratio in prostatic cancer(PCa).Methods Two hundred nineteen people,aged 62-68,were divided into three groups according to the clinical diagnosis,including PCa group(n=73),benign prostatic hyperplasia(BPH) group(n=76) and control group(n=70) composed of healthy people.The various indicators,including tPSA,cPSA and cPSA/tPSA were measured by Advia Centaur CP chemiluminescent analyzer.Results tPSA,cPSA and c/t significantly increased in PCa group compared with those in BPH or control group (P<0.05).ROC analysis indicated that if the tPSA cut-off values was19.89 μg/L,the sensitivity,specificity,the area under the curve (AUC) and Youden index would be 94.5%,97.9%,0.96 and 0.924 respectively.If the cut-off value of cPSA was 13.14 μg/L,the sensitivity,specificity,the area under the curve(AUC) and Youden index would be 95.9%,91.8%,0.98 and 0.877 respectively.The chi-square test showed that there is no correlation between tPSA,cPSA and pathology diagnosis(χ2=102.036、151.409,P<0.05).Conclusion PCa or PCa treatment relapse should be highly suspected when the concentration of tPSA or cPSA in patients reached 19.89 μg/L and 13.14 μg/L,the patients should be reminded for treatment timely.

Objective To investigate the effects of glycine on the expression of HSP70 and TNF-α mRNA in the liver tissue of rats with traumatic shock and explore the protective mechanism of glycine a-gainst secondary liver injury after traumatic shock. Methods The traumatic shock model was established and 120 Wistar rats were divided randomly into three groups: treatment group, shock group and control group. At the beginning of resuscitation, the rats in the treatment were injected with 0.5 ml isotonic saline containing 100 mg/kg glycine, those rats in the shock group were injected only with 0.5 ml isotonic saline. The rats in three groups were killed at 3, 6, 12, 24 and 48 hours after resuscitation respectively. The ex-pression of HSP70 and TNF-α mRNA in the liver tissue were detected by RT-PCR, pathological changes were observed and serum ALT and AST were measured. Results The expressions of HSP70 and TNF-α mRNA in the liver tissue of rats in the shock group began to increase at 3 hours and both reached the peak value at 6 hours after resuscitation, but the expression of HSP70 mRNA in the treatment group reached the peak value at 12 hours after resuscitation. Compared with the control group, the expression of HSP70 mR-NA in the treatment group increased significantly and that of TNF-α mRNA decreased siganicantly, serum ALT and AST decreased and pathological damage was relieved significantly (all P < 0.05). Conclusion By enhancing the expression of HSP70 mRNA and decreasing the expression of TNF-α mRNA, glycine may play a protective role against the secondary damage of liver after traumatic shock.

Objective To investigate the dynamic changes of HSP70 mRNA expression in the liver tissue of rats with traumatic shock and the treatment effects of glycine.Methods The expression of HSP70 mRNA in the liver tissue of treatment group,shock group and control group was detected by ELISA.Pathological changes were observed,and serum ALT and AST were measured.Results The expression of HSP70 mRNA in the liver tissue of rats in the shock group and the treatment group reached peak at the 6th and 12th hour after resuscitation respectively.Serum ALT and AST increased and pathological damage aggravated with time prolonging.Compared with control group,the expression of HSPT0 mRNA in treatment group increased significantly,serum ALT and AST decreased significantly and pathologi- cal damage was significantly relieved(all P<0.05).Conclusion Glycine can increase the expression of HSPT0 mRNA and relieve the secondary damage of liver after traumatic shock.

Objective To evaluate the effect of ADV-TK gene in its inhibition of the recurrence and metastasis of hepatocellular carcinoma after curative resection in a nude mouse model. Methods In the two experimental groups, GFP-labelled ADV-TK gene transfection was determined 24 h after injection in one-each mouse. Nude mice with inplanted intrahepatic hepatocellular carcinoma underwent curative tumor resection, in the end of the operation ADV-TK gene was injected in incisional margin (11 mice) or retroperitoneally (11 mice). Ganciclovir at a dosage of 50 μg/10 g bw was given in the next day after resection. Mice in control group did not receive ADV-TK gene injection. After six weeks, mice were sacrificed. Results 1. It was showed that organs were all transfected by ADV-TK gene.2. Compared with the control group in which the recurrent tumor number of (8.7±6.5) ,tumor volume of (2933±597) mm3, and recurrence involved liver lobes of (4.3±2.2), that was (0.0±0.0), (0.0±0.0) mm3, and (0.0±0.0)(X2 = 3.05 all P<0.01) in incisional margin gene injection group, and (2.2±1.3), (265±109) mm3, and (2.1±1.3) (X2= 5.32, all P<0.01 ) respectively in intraperitoneally gene injection group.3. Compared with the control group in which the lung metastasis rate of (10/10)、number of distant organ involved by metastasis of (7.2±5.3 ), and serum AFP level of (1322±702), that was (2/10) , (3.2±1.5) and (322±102), (X2=4.33, all P<0.01) in incisional margin group, and ( 1/10)、( 1.8±1.2 ), and (268±133 ) ( X2=7.15, all P<0.01 ) in retroperitoneal group, respectively. Conclusions ADV-TK gene inhibits recurrence and metastasis of HCC after curative resection in this nude mouse model.

OBJECTIVETo investigate the long-term outcomes of laparoscopic low anterior resection of rectal carcinoma with preservation of the left colic artery(LCA).

METHODSClinicopathological and follow-up data of 322 cases with rectal carcinoma undergoing laparoscopic low anterior resection in Department of General Surgery, Beijing Chaoyang Hospital Affiliated to Capital Medical University from January 2007 to December 2011 were retrospectively analyzed. According to the different surgical methods of inferior mesenteric artery (IMA), cases were divided into the trial group (LCA preservation plus lymph nodes around IMA root dissection, 168 cases) and the control group(origin of IMA ligation, 154 cases). The 5-year rates of disease-free survival(DFS) and overall survival(OS) were compared between two groups.

RESULTSThere were no statistically significant differences in the baseline data between the two groups. The follow-up rate was 91.1%(153/168) during 5-60 months in the trial group, and 90.3%(139/154) during 6-60 months in the control group. The number of patients who developed death, local recurrence and metastasis were 49(32.0%), 9(5.9%) and 62(40.5%) in the trial group, and 44(31.7%), 9(6.5%) and 52(37.4%) in the control group, respectively, without significant differences(all P>0.05). The 5-year DFS and OS rates were 57.2% and 69.5% in the trial group, and 59.7% and 70.1% in the control group, and the differences were not significant between the two groups(all P>0.05). After stratification by TNM stage, the 5-year DFS rates of I( stage, II( stage and III( stage were 80.4%, 62.5% and 45.1% in the trial group, and 82.6%, 66.0% and 48.8% in the control group; the 5-year OS rates of I( stage, II( stage and III( stage were 90.2%, 76.2% and 56.7% in the trial group, and 94.4%, 74.3% and 60.5% in the control group, respectively, and the differences were not significant as well (all P>0.05).

CONCLUSIONThe long-term outcomes after laparoscopic low anterior resection of rectal carcinoma with preservation of LCA and dissection of lymph nodes around root of IMA are comparable with ligation at origin of IMA.