Objective To assess the efficacy of emergency hand-assisted laparoscopic hepatectomy for spontaneous rupture of primary hepatocellular carcinoma.Methods A total of 15 eases who underwent emergency hand-assisted laparoscopic hepatectomy for spontaneous rupture of primary hepatocellular carcinoma were retrospectively reviewed.Results All operations were successful.The postoperative mortality rate was.Thirteen cases were followed-up from 11 months to 56 months.The overall 1-,3-year survival rate was 84.6%(11/13),53.8%(7/13)respectively.Conclusion Emergency hand-assisted laparoscopic hepatectomy is a safe and feasible approach for pontaneous rupture of primary hepatocellular carcinoma in clinically selected patients.If the patients condition permits it,emergency hand-assisted laparoscopic hepatectomy should be the treatment of choice.

OBJECTIVE:To determine the contents of betahistine hydrochloride and the related substances by HPLC.METHODS:The chromatographic separation was performed on Eclipse XDB-C18 column with column temperature at 25 ℃.The mobile phase consisted of water(sodium heptanesulfonate+10 mL triethylamine+810 mL water,with the pH adjusted to 3.0 with phosphoric acid) and methanol(82:18) at a flow rate of 0.8 mL?min-1.The detection wavelength was 261 nm and the sample size was 50 ?L.RESULTS:The linear range of betahistine hydrochloride was 10～80 ?g?mL-1(r=0.999 3).The lowest detection limit was 2.84 ?g?mL-1 and the lowest quantitative limit was 3.01 ?g?mL-1.The average recovery was 99.8%(RSD=0.3%).The average content for the related substances in 3 batches of samples was 0.13%.CONCLUSION:The method is simple,rapid,accurate and reliable,and suitable for the quality control of betahistine hydrochloride.

Objective To investigate the efficacy of bend-assisted laparoseopie fight bemicolectomy for right colon carcinoma in elderly obesity patients. Methods 20 obesity eases undergoing hand-assisted laparoscopic right bemicolectomy were retrospectively reviewed, and compared with 25 obesity cases with transabdominal right hemicolectomy in the same period. The safety, recovery, eradication and stress reaction were compared. Results In hand-assisted laparoscopic group, there were less bleeding loss, rapid recovery to normal temperature and gastrointestinal function,ont of bed activity, short-time hospitalization compared with transabdominal group(P <0.01). There were no differences in operative time, numbers of lymph nodes removed, postoperative complications and length of specimen between two gronps(P > 0.05). CRP, IL-6, adrenocorticotrophic hormone (ACTH) and cortisol were more significantly increased in two groups after operation than before operation (P < 0. 05) , and this increase was moreprominent in transabdominal group than in hand-assisted laparoacopic group (P < 0.05). Conclusion Hand-assis-ted laparoscopic right hemicolectomy is a safe and effective way for elderly obesity patients,especially in postoperative recovery and physical stress reaction.

Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.

BACKGROUND: Since there are only cell axons of neurons in peripheral cells, the study on neural stem cells (NSCs) is almost focused on neuronal cells, for which, the study on repair of peripheral nerve may be based on some experiences in NSCs.OBJECTIVE: To observe the repair of peripheral nerve after graft of autologus bone marrow derived NSCs in the injured area. To observe whether the grafted NSCs were survived and migrated in spinal cord as differentiated neurons in the injured area of peripheral nerve or not.DESIGN: Observed controlled experiment was designed.SETTING: Institute of Neurological Medicine of Zhujiang Hospital affiliated to Southern Medical UniversityMATERIALS: Eight New Zealand big white rabbits were employed, of clean grade, mass weighted varied from 1.5 to 2.5 kg and of either sex.METHODS: The experiment was performed in Institute of Neurological Medicine of Zhujiang Hospital affiliated to Southern Medical University collected from New Zealand big white rabbits for culture and differentiation was prepared. Sciatic neural injured area of one side was randomized as graft side. Physiological saline, collagen matrix and cellular embedding solution were infused up to 0.01 mL (containing stem cells 1×1010L-1). Another side was taken as the control, in which, collagen matrix suspension 0.01 mL was infused. Peffusion and fixation were followed 3 months after graft and auto-graft was performed in the injured peripheral nerve. The materials were collected for observation from graft area, spinal cord area, injured area on the opposite side and normal neural area.MAIN OUTCOME MEASURES: Morphology of nerve fibers and neuronal cells in NSC graft area, spinal cord area and non-graft area on opposite injury side.RESULTS: The density and continuity of nerve fibers grown in graft area were higher remarkably than non-graft area on opposite side and more Schwann cells were seen under optic microscope. With amplified ×400 visual field, Ranvier's node of spinal nerve fiber was visible. In addition,mucous matrix and few fibroblasts were seen also in the space of nerve fibers. The survived neuronal cells were no visible in graft area, spinal cord area and non-graft area of sciatic injury on the opposite side.CONCLUSION: Graft of autologus bone-marrow derived neural stem cells in defect area of peripheral area benefits repair of nerve fibers. But the neural stem cells cannot survive as neurons in graft area of peripheral nerve, spinal cord area and the defect control on the opposite side.

Objective At present, the risk factors for cognitive impairment in epilepsy patients are not quite clear.This study was to explore the impacts of the clinical features, emotional health and quality of life (QOL) on the cognitive function of the adult patients with mild cognitive impairment (MCI).Methods Using the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) scales, we evaluated the cognitive functions of the 109 adult epileptics of the outpatient clinic of neurology in Jinling Hospital.We assessed their emotional health with Hamilton Depression Scale-24 (HAMD-24), estimated their QOL with Quality Of Life in Epilepsy-31 (QOLIE-31), and collected their baseline clinical data by questionnaire survey.Results There were 67 cases of MCI (61.5%) among the 109 patients.The residential area was the strongest predictor of MCI in the adult epileptics (OR=0.226, 95% CI: 0.082-0.627).Among other risk factors of post-epileptic MCI were the total scores of HAMD-24 (OR=0.770, 95% CI: 0.644-0.921) and QOLIE-31 (OR=0.712, 95% CI: 0.575-0.880), QOL (OR=1.070, 95% CI: 1.015-1.128), cognitive function (OR=1.120, 95% CI: 1.043-1.203), and social function (OR=1.103, 95% CI: 1.035-1.175).Conclusion The incidence of MCI is high in adult patients with epilepsy.The development and progression of post-epileptic MCI can be delayed by more emphasis on the evaluation of cognitive function, emotional health, and quality of life.

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AIM: To study the effects of apolipoprotein (apo) A-Ⅰon ATP binding cassette transporter A1 (ABCA1) degradation and cholesterol efflux in THP-1 macrophage-derived foam cells. METHODS: After exposure of the cultured THP-1 macrophage-derived foam cells to apolipoprotein A-Ⅰ for different time, cholesterol efflux, ABCA1 mRNA and protein level were determined by liquid scintillation counting, reverse transcriptase-polymerase chain reaction and Western blotting, respectively. The mean ABCA1 fluorescence intensity on THP-1 macrophage-derived foam cells was detected by flow cytometry. RESULTS: ApoA-Ⅰ markedly increased ABCA1-mediated cholesterol efflux from THP-1 macrophage-derived foam cells. This was accompanied by an increase in the content of ABCA1. ApoA-Ⅰ did not alter ABCA1 mRNA abundance. Thiol protease inhibitors increased the level of ABCA1 protein and slowed its decay in THP-1 macrophage-derived foam cells, whereas none of the proteosome-specific inhibitor lactacystin, other protease inhibitors, or the lysosomal inhibitor NH_4Cl showed such effects. The apoA-Ⅰ mediated cellular cholesterol efflux was enhanced by thiol protease inhibitors. CONCLUSION: Thiol protease inhibitors might provide an alternative way to upregulate ABCA1 protein. This strategy is especially appealing since it may mimic the stabilizing effect of the natural ligands apoA-Ⅰ.

OBJECTIVETo assess the clinical value of contrast-enhanced ultrasonography (CEUS) in early diagnosis of breast cancer.

METHODSCEUS was performed in 107 cases of ultrasound BI-RADS(®) category 3 or category 4 small breast tumors (diameter no greater than 10 mm) before surgery. The range, type and patter of enhancement of the tumor and the surrounding tissues were observed, and the time-intensity curve (TIC) was analyzed for TIC curve type, basic and peak intensity, enhancement intensity, rising slope, and enhancement intensity. The results were analyzed comparatively between benign and malignant tumors.

RESULTSThe peak intensity, enhancement intensity index and peak time in CEUS were statistically significant between benign and malignant breast tumor (t=-2.310, -2.592, -2.127, P=0.021, 0.010, 0.033), and the intensity difference and rising slope also differed significantly (t=-3.422, -3.388, P=0.001, 0.001). TIC curve type, enhancement pattern, enhancement types and enhancement range were statistically significantly between benign and malignant breast tumor (P<0.001).

CONCLUSIONBenign and malignant BI-RADS(®) category 3 or 4 small breast tumors differ in the peak intensity, enhancement intensity index and peak time in CEUS. More nodular hyperplasia showed no enhancement in CEUS, and 97.8% of the lesions without enhancement are benign. In enhanced breast nodules, malignant breast lesions show more quick wash-in and wash-out type and quick wash-in and slow wash-out type, and the latter is more common; benign lesions often show a slow wash-in and slow wash-out type. In CEUS, the range of enhancement in malignant nodules is wider than that in two-dimensional ultrasound.

BACKGROUNDTo investigate the expression level and its clinical significance of the multi-drug resistance (MDR) associated protein in lung cancer specimens.

METHODSThe expression levels of Pgp, MRP, GST-π and TopoII of MDR associated protein were detected in 60 lung cancer samples and 30 paracancerous tissues by S-P immunohistochemistry method.

RESULTSThe positive rate of Pgp, MRP, GST-π and Topo II in the lung cancer tissues was 40.0% (24/60), 61.7% (37/60), 45.0% (27/60) and 81.7% (49/60) respectively, which was significantly higher than those in paracancerous tissues (P < 0.01). No significant correlation was observed among the expression of multi-drug resistance-related protein and TNM staging, pathological type, cell differention and lymph node metastasis status (P > 0.05).

CONCLUSIONSLung cancer has overexpression of multi-drug resistant-related genes during the oncogenesis. Combined detection of these genes may be useful for guiding the lung cancer chemotherapy.