Objective To explore a new surgical method for hypertensive cerebral hemorrhage and its efficacy.Methods A total of 12 patients with hypertensive cerebral hemorrhage in the fundus node at a super early stage(≤6 h)were enrolled in this study.Microsurgery trough the lateral fissure and insula via pterional keyhole approach was employed to treat the patients.Results All but one of the patients survived after the operation.One patient received a second operation because of hemorrhage for twice,one patient developed intracerebral infection.The survivors were followed up for 3 to 6 months.According to GOS scoring system,7 of them achieved excellent outcomes,3 were good,and 1 was moderate.Conclusion Microsurgery trough the lateral fissure and insula via pterional keyhole approach is effective for hypertensive cerebral hemorrhage.

Objective To research the angiographic manifestations of rabbit implanted VX_2 liver carcinoma.Methods 34 New Zealand big white rabbit were implanted VX_2 tumor pieces under orthophoria into liver left middle segment.Angiography of coeliac artery-hepatic artery catheterization via right femoral artery was performed at the third week after inoculation.Results The tumor blood vessel and tumor stain in 6 rabbit could be not showed clearly by digital cinematography mode but which could be showed in 28 rabbit by digital subtraction mode.The tumor angiographic signs included:dilating growth of tumor,the feeding arteria surrounding the tumor surface were resemblance to the clenched fist,embraced globosity and wreath in form;many slender vessels from feeding arteria appeared as small bud form,root form and filose form pushed forward to the center from the surface of tumor.The tumor vascular density in periphery was higher than that in center and formed circular or oval tumor stain which more denser at periphery than center.The tumor node stain was complete with definite margin when tumor size was large or equal to 1 cm in diameter,and the tumor stain appeared as clump with indefinit margin.Conclusion There are abundant vascularity for rabbit implanted liver VX_2 tumor,and more abundant at periphery part than center part, coeliac artery catheterization angiography can show the typical manifestations of tumor clearly.

Objective To research the angiographic anatomy of celiac artery in rabbit.Methods 36 New Zealand big white rabbitswere included in this study,the angiography of celiac artery and hepatic artery via right femoral artery was performed,and the branchand diameter of celiac artery system were analysed.Results 66.7% of the celiac arterial opening localized at the level of T_(12) vertebral body low edge,gastrohepatic arterial truncus could been divided into three types : type Ⅰ(47.22%),tree-like branch;type Ⅱ(38.88%),trifurcate branch and type Ⅲ(13.90%),dichotomy branch.The length of proper hepatic artery was from 22.70 to 33.00 mm(26.64 mm?2.28 mm),the inner diameter of proper hepatic artery,left hepatic artery and right hepatic arteria was 0.60~1.20 mm(0.90 mm?0.16 mm),0.60~1.10 mm(0.72 mm?0.09 mm) and 0.50~1.00 mm(0.67 mm?0.09 mm) respectively.The segmental artery of liver could be displaied clearly by proper hepatic artery angiography.Conclusion To realize the angiographic anatomy of rabbit celiac artery would provide a useful help for transhepatic arterial interventional treatment of the liver VX_2 tumor model of rabbit.

Objective To research tumor cell apoptosis induced by Lp-THAE of rabbit VX2 liver implanted tumor.Methods 27 New Zealand white rabbits implanted with VX2 tumor at left middle lobe of the liver divided into three groups:Group A(n = 9) Lp-THAE:treated through transhepatic artery catheterization;Group B(n = 9) THAI and Group C(n = 9) as control.The rabbits were executed at second to fifth day after treatment.HE dye microscopy was taken for counting the typical apoptosis cells and calculating apoptosis index(ApI).FITC-AnnexinV/PI assay was used for measuring apoptosis by flow cytometry.Results The ApI of tumor central area and marginal area were(17.769 ? 2.417)%,(4.129 ? 1.172)%,P

To observe the expression of CD40/CD40L on peripheral blood mononuclear cells (PBMC) in patients with condyloma acuminatum (CA), flow cytometry was employed to examine the expression of CD40 and CD40L on PMBC in 36 patients with CA and 20 healthy controls. Our results showed that mean level of CD40 expression in CA patients was significantly lower than that in the controls (6.58% +/- 2.74% vs 14.81% +/- 6.12%, t = 5.703, P < 0.05); the average level of CD40L in CA patients was also significantly lower than that in the controls (0.73% +/- 0.54% vs 2.67% +/- 2.43%, t = 3.532, P < 0.05). Our results suggest that the reduced costimulatory interaction of CD40 and CD40L in CA patients may be one of the important factors responsible for the low cellular immunity.

Objective To investigate the early diagnostic value of traditional scoring systems in critical acute pancreatitis.Methods From Jan 2007 to Ju12013,consecutive 184 patients with AP who were admitted to the surgical intensive care unit of the Institute of General Surgery,Nanjing Generai Hospital of Najing Militery Region within 72 h from the onset of the disease were studied.Patients were assigned to four groups,including mild,moderate,severe and critical AP according to the determinant based classification and the receiver operating characteristics(ROC) curve was used to predict the presence of critical AP,and Z test and logistic regression was applied to determine the diagnostic value of traditional scoring systems.Results The area under ROC (AUC) of Sofa,BISAP and CTSI score for early diagnosis of critical AP was 0.896,0.877 and 0.862;the best cut off value was 4.5,9.5 and 2.5.Moreover,the AUC of APACHE Ⅱ and Ranson score was 0.807 and 0.707,and the best cut off value was 8.5 and 3.5,respectively.Z test showed early diagnosis rate of Sofa,BISAP,CTSI score was significantly higher than that in Ranson score,and the difference between the two groups was statistically significant (P ＜ 0.05);though they were higher than APACHE Ⅱ score,the difference between the two groups was not statistically significant (P ＞ O.05).Logistic regression showed that high APACHE Ⅱ,Sofa,BISAP and CTSI score were independent risk factors for the development of critical AP (P ＜ 0.05).Conclusions Sofa,CTSI and BISAP score may be clinically important for early diagnosis of critical AP.

Objective To investigate the risk factors of central lymph node metastasis and significance of prophylactic central lymph node dissection for clinical N0 (cN0) patients with papillary thyroid carcinoma (PTC).Methods The clinical data of 315 patients with cN0 PTC in Department of General surgery,the Second Affiliated Hospital of Dalian Medical University from Jan.2012 to Jan.2014 were analyzed retrospectively.Results (Iumor size,infiltration of thyroid capsule,and tumor number were associated with central lymph node metastasis in patients with cN0 PTC(P＜0.05),and the high risk factors of central lymph node metastasis were infiltration of thyroid capsule and multiple lesions (P＜0.05);()The overall complication rate was 3.17％ (10/315),the rate of transient recurrent laryngeal nerve paralysis was 0.63％ (2/315),and the rate of transient hypoparathyroidism was 2.54％ (8/315).All patients with complications recovered after treatment.No patient developed permanent recurrent laryngeal nerve paralysis or hypoparathyroidism;()The follow-up time was 6 to 30 months,and 2 cases were lost.No patient developed local tumor recurrence,distant metastasis,or death.Conclusions The high risk factors of central lymph node metastasis in patients with cN0 PTC were infiltration of thyroid capsule and multiple lesions.No patient developed local tumor recurrence,distant metastasis,or death.It is preferable and necessary to perform prophylactic central lymph node dissection in patients with cN0 PTC.

Objective To evaluate the hematological toxicity of craniospinal irradiation,and determine the short-term clinical efficacy and prognostic factors in medulloblastoma.Methods Eightseven patients who underwent craniospinal irradiation were retrospectively analyzed with respect to the changes in hematology during craniospinal irradiation.The effect of sex,age,tumor location,interval between surgery and radiation,interval time during radiation and radiation sequence on survival were also studied.Results The 1,2,3-year overall survival (OS) and progress-free survival (PFS) rate were 95.0％,92.4％,84.9％ and 93.7％,89.8％,80.8％,respectively.The incidence of 2-3 grade leucopenia was 90.8％,while the incidence of 1-2 grade thrombocytopenia was 70.1％,and the incidence of 3 grade thrombocytopenia was 1.1％.The incidence of 1-2 grade hemoglobin reduction was 16.1％.No patient had grade 3-4 hemoglobin reduction.Kaplan-Meier analysis shows that more favorable prognoses in terms of 3-year PFS were evident for 0-1 grade thrombocytopenia compared with 2-4 grade thrombocytopenia (x2 =3.936,P ＜ 0.05).And 3-year PFS and 3-year OS were evident for 0 grade hemoglobin reduction compared with 1-4 grade hemoglobin reduction (x2 =10.269,9.336,P ＜ 0.05).The 3-year PFS between interval time during radiation ＜ 3 days and ≥ 3 days was 84.6％ and 68.6％ (x2 =4.413,P ＜ 0.05).Conclusions Hematological toxicity during craniospinal irradiation and the interval time during radiation were prognostic factors.

Objective To evaluate the prognostic factors and treatment results of intracranial ependymomas (EPs).Methods Thirty-one intracranial EPs patients who received postoperative radiotherapy in Beijing Shijitan Hospital between January 2009 and June 2012 were analyzed retrospectively.Twenty-two males and 9 females had an average age of 18 years (range 3-60 years).Seventeen patients received gross total resection (GTR) while fourteen received subtotal resection (STR).Median total radiation dose was 53.9 Gy (48.6-60 Gy).The three-year and five-year progress-free survival (PFS) and overall survival (OS) were estimated with the Kaplan-Meier method.Univariate analysis was performed using eight clinical and dosimetric factors by Log-Rank testing.Cox proportional hazards model was used to identify the independent prognostic factors correlated to EPs.Results The median time of follow-up was 51 months.At the endpoint of the follow-up period,7 patients experienced tumor recurrence:5 had a local recurrence (LR) and 2 had both LR and distant recurrence.Six patients died,4 of which had cases of pediatric infratentorial anaplastic EPs.The three and five-year progress-free survival (PFS) were 80.6％ and 75.9％.Overall survival (OS) at three-year and five-year were 83.9％ and 76.2％,respectively.Univariate analysis showed a more favorable prognoses in terms of three-year PFS,five-year PFS and OS for GTR compared to STR (x2 =4.685,6.311,4.238,P ＜ 0.05).Besides,a more favourable univariate outcome in terms of five-year PFS was evident in patients when the total radiotherapy dose was ＞ 55 Gy compared to ≤55 Gy (x2 =4.210,P ＜ 0.05),and no severe radiotherapy complications occurred.Conclusions Surgery is the major treatment method,while adjuvant radiotherapy is important for subtotal resection and anaplastic EPs patients.Surgical resection and radiotherapy dose were relevant to prognosis.

Objective To detect the expression pattern of microRNA in A549 cells treated by lipopolysaccharide, study the expression of miRNA-1247-3P in A549 cells under LPS treatment and explore the possible mechanism of miRNA-1247-3P in A549 cells under LPS treatment. Methods A549 cells were divided into experimental and control groups. Immunocytochemical method and RT-PCR were used to detect the changes of SP-A and SP-C. The expression of miRNAs were detected using miRNAs array in different groups. The key miR-1247-3P was collected to detect the changes of miR-1247-3P in all groups using quantitative real-time polymerase chain reaction. Results Compared with control group, the expressions of SP-A and SP-C were significantly decreased in the experimental groups (P < 0.05). MiRNA array showed that 31 miRNAs were up-regulated and 3 miRNAs were down-regulated. Compared with control group, the expression of miR-1247-3P was significantly increased in the experimental groups (P < 0.05). Conclusion The increased expression of miR-1247-3P may play an important role in the pathogenesis of ARDS.