ObjectiveTo explore the practicability of combined surgical treatment for the patients with Hepatocellular Carcinoma(HCC) complicated with Portal Hypertension(PH).MethodsThe clinical data of 43 patients withHCCcomplicatedwithsignificantesophagealvaricesandhyperspleniawereanalyzed retrospectively.All patients were diagnosed with esophageal varices and hypersplenia of different degrees, 14 of them had severe esophageal varices, the other 29 patients had moderate esophageal varices.Firstly all patients underwent splenectomy, 18 of them had selective portoazygous devascularization in addition.After that the patients received hepatectomys ,with local excision or segmentectomy as the major operation methods.Results All patients received hepatectomy combined with splenectomy treatment.There was no perioperative mortality, but 12 patients had complications after the surgery.Over seventy percents patients(33/43)accepted regular followup.Among these 33 patients,the 1-year and 3-year survival rates were 90.9％ (30/33) and 63.6％ (21/33)respectively.Eleven patients died of tumor recurrence.Four patients had upper postoperatively gastrointestinal hemorrhage.ConclusionHepatectomy combined with splenectomy didn't increase the mortality in the patients with HCC complicated with PH.The combined surgery might reduce the incidence of severe complications, such as postoperative bleeding.We believe the combined surgical treatment is feasible for this group of the patients.

Objective To explore the expression of DKK-1 and its clinical value in patients with e-sophageal cancer. Methods The levels of serum DKK-1 were measured by sandwich enzyme linked immu-nosorbent assay(ELISA) in 80 patients with esophageal squamous cell cancer and in 35 healthy subjects. The sensitivities of serum DKK-1, CEA and CYFRA21-1 in the patients with esophageal squamous cell cancer were calculated and analyzed to compare their values in diagnosis of esophageal cancer. Results The serum DKK- 1 levels in patients with esophageal squamous cell cancer were significantly higher than those of healthy subjects(P<0.05). According to the highest value of medicine reference of DKK- 1 (14. 54 ng/ml), its sensitivity and specificity were 66. 25% and 82. 86% respectively; There was a significant difference between the sensitivity of DKK-1 in patients with esophageal squamons cell cancer(66. 25%) and that in healthy subjects(17.14%) (P<0.05). The sensitivitis of serum DKK- 1 in patients with esophageal squamous cell cancer were associated with tumor size, TNM stage and lymph node metastasis(P <0.05),but not associated with gender,age and differentiation grade(P>0.05). And the sensitivity of DKK-1 (66. 25%) was significantly higher than that of CEA, CYFRA21-1 (39. 44% ,25. 35%, P <0. 01). Conclusion DKK-1 played a very important role in the growth and metastasis of esophageal cancer and may be a new tumor marker or an important index in the diagno-sis of esophageal cancer.

BACKGROUND: Existing research shows that in situ regeneration of skin deep within the second degree bum wound and donor site wound healed without physical scarring, can promote three-degree burn wounds liquefied necrotic tissue removement, the growth of transplanted skin, reduce scar; scar-shift using the in situ regeneration is expected to reach significantly reduce scar symptoms, and to reduce the effect of scar, which have not be reported.OBJECTIVE: To observe effects of skin regeneration in situ method to remove scar in the treatment of hypertrophic scar. METHODS: A total of 32 patients with many hyperplastic scars, including 25 males and 7 females, aged 16-52 years, disease course of 1-11 years. Two similar scar regions were selected from each patient for self control. In the experimental group, scar removal, scar skin replantation after the application of in situ regeneration of the skin treatment using burn cream coated yarn. In the control group, scar removal, scar skin replantation after the application of traditional Vaseline covered by treatment. Curative effects were observed and compared. Scar hyperplasia was assessed using Vancouver Scar Assessment Scale assessment. RESULTS AND CONCLUSION: Replanted scar skin explants were survived in both groups. In the experimental group, healing speed and quality of wound surface were better than the control group (P< 0.05). After 6 months, the Vancouver Scar Assessment Scale assessment in the experimental group was better than control group (P < 0.05, P < 0.01). Scar caused by pain, itching and other symptoms disappeared, skin formation and color back to pre-implantation were significantly improved compared with the surrounding skin almost. Results indicated that with regarding to the lack of autologous skin source, large area of scar in patients with hypertrophic scars or unwilling to add a new donor site wounds in patients, in situ replantation method is an ideal approach.

BACKGROUND: Following peripheral nerve transplantation, the time phases and law of growth associated protein 43 (GAP-43) expression in sensory neuron soma of the corresponding dorsal root ganglia remain unclear.OBJECTIVE: To investigate the expression of GAP-43 at the corresponding dorsal root ganglia following sciatic nerve transplantation in rats.METHODS: Adult male Wistar rats were randomly divided into 2 groups: control group (sham-operated group) and experimental group (nerve transplantation group). The rats were killed at 3 days, 1, 2, 4, 6, and 8 weeks after operation and the dorsal root ganglia U-s of every rat was taken for observation. The expression of GAP-43 mRNA and protein in the corresponding segments of spinal cord were detected by RT-PCR and Western-blot techniques.RESULTS AND CONCLUSION: GAP-43 mRNA showed a low level of expression in the control group, which had no obvious changes in different phases. In the experimental group, GAP-43 mRNA expression was observed remarkably in the dorsal root ganglia at the first week, reached a peak at the second week and gradually descended from the sixth week. The GAP-43 protein expression showed the same laws as that of GAP-43 mRNA. The results demonstrated that there exists damage reactivity change in the regeneration ability of neurons.

Objective: To observe the efficacy of skin regenerative medical technique in treating proliferative scars. Method: Select 32 patients (age16-52) with proliferative scars after burns or wound for 1-11 years,which include 25(male) and 7(female). 2 scar similar spots are chosen in each patient for self-comparison.After the experimental group uses the scar detachment, scar Pi Huizhi applies the beautiful valuable moist burn medicinal plaster gauze cover the cooperation of Chinese and Western medicine home position skin regenerative method treatment; After the control group uses the scar detachment, scar Pi Huizhi applies the petroleum jelly cover the traditional method treatment.The observation comparison curative effect, applies the Vancouver scar appraisal meter appraisal scar proliferation situation. Results: Two groups return to the scar skin which plants to survive.The experimental group regenerates the skin to be good, the cicatrization speed and the quality surpass the control group (P

Objective To explore the reason of colon cancer with appendicitis and reduce the rate of misdiagnosis. Methods We car-ried out analysis retrospectively to analyze 1 094 hospitalized patients with colon cancer in the First Affiliated Hospital of Harbin Medical Uni-versity from January 2006 to March 2013. Results Among 1 094 colon cancer patients,31 patients who firstly diagnosed with acute appendi-citis received appendectomy,1 patient with appendiceal abscess received non-surgical treatment. Among 31 patients with acute appendicitis,6 patients were found to be with ileocecal tumors during surgeries;24 patients were diagnosed with colon cancer within one year;incision of 1 patient did not heal, with continuous drainage of brown liquid;the appendicitis of 1 patient who received non-surgical treatment was recur-rent. Conclusion As lack of typical symptoms,colon cancer is prone to misdiagnose and diagnose incorrectly when the cancer co-exists with appendicitis and symptoms of appendicitis were showed firstly. Therefore,clinicians should be vigilant for patients with appendicitis. In order to induce the rate of misdiagnosis,it is essential that requesting disease history carefully,timely and relevant inspection and appropriate ex-ploratory surgery for the patients with appendicitis.

Objective To investigate the association with death for serum parameters at the time of diagnosis and its value in predicting the death in infants with hemophagocytic syndrome (HPS).Methods A retrospective case-control study was conducted on 108 children with HPS who were admitted to our center between July 2005 and July 2012.For each patient,demographic,laboratory data and outcome information were collected.The patients were divided into death and surviving groups based on the follow-up results.The relation between serum markers and death was examined using the COX proportional hazards model and decision tree.Results Of 108 infants with HPS,33 died corresponding to a fatality rate of 30.6％ and 90.3％ of deaths occurred within 8 weeks after diagnosis.Following features were significantly associated with death:white blood cells (WBC) ＜5 x 109/L (HR =9.08,95％ CI 3.07 ～ 26.87),hemoglobin ＜80 g/L (HR =6.15,95％ CI 1.68 ～ 22.49),albumin ＜ 28 g/L (HR =4.63,95％ CI 1.12 ～ 7.39),serum ferritin ＞ 1 100 μg/L (HR =3.05,95％ CI 1.28 ～ 16.75),trigeminal ganglion ≥4 mmol/L (HR =2.88,95％ CI 1.51 ～ 8.60),and prothromin time ≥ 16 s (HR =3.60,95 ％ CI 1.28 ～ 7.24),and fever for more than 2 weeks (HR =5.39,95％ CI 1.97 ～ 14.66).Decision tree demonstrated that the probability of death was as high as 100％ for infants with WBC ＜5 x 109/L and hemoglobin ＜ 80 g/L.The odds of dying was still 66.7％ for infants who had WBC≥5 × 109/L but reported trigeminal ganglion ≥4 mmol/L after having fever for more than 2 weeks.Conclusion The first 8 weeks after the onset of HPS is the critical period of treatment.There are several easily available serum predictors of early mortality in HPS infants,particularly the WBC and hemoglobin level,which may help guide treatment decisions.

Objective To observe the influence of human umbilical cord wharton′s jelly‐mesenchymal stem cells(WJ‐MHCs) on the tumor necrosis factorα (TNF‐α) and N‐terminal pro‐brain natriuretic peptide(NT‐proBNP) in rats with heart failure of a‐cute myocardial infarction .Methods Totally 80 male rat models of heart failure of acute myocardial infarction were made by isopre‐naline(ISO) 200 mg/kg injected subcutaneously twice at an interval of 24 hours .After one week ,24 survival rats were randomly di‐vided into WJ‐M HCs transplantation group and normal control group .Sham group was made of 12 health rats ,and then each of the three groups was subdivided into pre‐transplantation group and post‐transplantation group 4 weeks later .WJ‐MHCs transplantation group was transplanted with WJ‐MHCs with DAPI labeled after ISO injected one week .Sham group and normal group were un‐treated and normally bred .The left ventricular ejection fraction(LVEF) measured by before transplantation and post‐transplantation 4 weeks later .The injected cells and the expression of TNF‐αwas measured .Results Compared to pre‐transplantation group ,WJ‐M HCs transplantation group increased the LVEF(P<0 .05);compared to pre‐transplantation and normal control ,WJ‐M HCs trans‐plantation group reduced the TNF‐αand NT‐proBNP in the serum(P<0 .05)and the expression of TNF‐α from the heart tissue (P<0 .05);compared to normal transplantation ,WJ‐M HCs transplantation group reduced the mortality from 33 .3% to 16 .7% ;immunofluorescence demonstrated that transplanted cells were still found alive in the heart after transplantation 4 weeks later .Con‐clusion Transplantation of WJ‐MHCS down‐regulates TNF‐α and NT‐proBNP in the serum in the serum and the expression of TNF‐αfrom the heart tissue and up‐regulates the LVEF in rats with heart failure of acute myocardial infarction .

Objective To observe the therapeutic effect of the new plan of concurrent capecitabine (CAP) and radiation therapy for hu-man cervical adenocarcinoma in nude mice. Methods The nude mice were injected with CAC-1 cells for the modelization of cervical ade-nocarcinoma. Before treatment,all mice with tumors were randomly divided into control group,CAP group,5-FU group,radiation group,CAP+ radiation group,5-FU+radiation group. According to the tumor size,mice were furtherly divided into large-size and small-size groups in the control group,CAP group,radiation group, CAP+radiation group. The change of tumor size,tumor growth percentage and the delay time of tu-mor growth were evaluated. Results The therapeutic effect of combining 2/3MTD CAP with 6 Gy radiation or fractionation 2 Gy × 8 times radiation was better than that of the control group,chemotherapy group and the radiation group. The difference was significant (P < 0.05). The restraint effect of the combining 2/3MTD CAP with 6 Gy radiotherapy was better than that of the combining 2/3MTD 5-FU with 6 Gy radiotherapy. Combining 2/3MTD CAP with fractionation 2 Gyx8 times radiation therapy was more efficient than Combining 2/3MTD CAP with fractionation 6 Gy radiation therapy. In combining therapy groups,the response of large-size tumors was more significant than that of the small-size tumors (P < 0.05),which had almost no obvious response. Conclusion Concurrent CAP and radiation therapy has obvious restraint effect on CAC-1 cervix adenocarcinoma in nude mice. The CAP and radiation therapy can promote the therapeutic effect to each oth-er. The therapeautic effect of the concurrent CAP and radiation therapy is affected by the radiation dose, radiation method and the tumor size.

Objective To improve the level of diagnosis and treatment of the sharp injury in the back. Methods 47 cases which were treated from Jan 1991 to May 2000 were reviewed. ResultsAmong 37 cases who underwent the exploration, 5 cases died. Among 10 cases who underwent conservative treatment, 2 cases died. ConclusionThe condition of sharp injury in the back is very complicated,it is easy to be misdiagnosed, the mortality is high. Saving should be equalled with the diagnosis and treatment. The application of wound exploration, abdominal puncture, ultrasound examination and X-ray checking is valuable to the diagnosis. The patients with operation indications should be operated at once,while the others should be observed for some time to prevent the delayed clinical manifestation.