Hepatocellular carcinoma (HCC) is the most common primary malignant tumor of the liver.The incidence and mortality rates were ranked the sixth and three respectively in all kinds of tumors.Liver resection and liver transplantation has achieved remarkable curative effect in the treatment of early of HCC,but the recurrence is still an important problem to be solved.In HCC patients,local resection and liver transplantation after 5 years,the recurrence rate wasere 70％ and 35％,respectively.The invasiveness of tumor is different,and the recurrence rate is also different.Microvascular invasion (MVI) as a marker of tumor invasion has been widely used in the diagnosis of HCC.Some scholars believe that MVI imay bes the first step in the liver or systemic metastasis of liver cancer,if we can predicted the MVI before surgery,it will play a positive role in making treatment programs,because in order to reduce the recurrence rate,anatomic resection of and extended resection range is recommended.Advances in magic radiological technology have made made it possible to diagnose MVI before surgery.In this paper,CT,MRI,PET and ultrasound in the diagnosis of MVI would be introduced.

Objective　To study the changes of quantitative expression,adhering activity and genomic density polymorphism of complement type 1 in erythrocytes (CR1) of patients with liver cancer (104 patients) and their clinical significance.Methods　Polymerase chain reaction (PCR),HindIII restriction enzyme digestion,the quantitative assay of ECR1 and the adhering activity assay of CR1 in erythrocytes were used.Results　No difference was observed between the patients with liver cancer (29.8%) and healthy individuals (25.3%) in the spot mutation rate of CR1 density gene (χ2 =0.537,P>0.05).The number and the adhering activity of CR1 in patients with liver cancer (0.83±0.22 and 47.1±6.5) were significantly lower than those in healthy individuals (1.26±0.33 and 62.4±7.6; t=10.5,P<0.0001).The number and the adhering activity of ECR1 in high expression genomic type (HH) liver cancer were obviously lower than those of healthy individuals,expecially those of the patients with advanced liver cancer.There was a good relationship between quantitative expression,adhering activity of ECR1 and liver cancer development.Conclusion　Defective expression of CR1 in liver cancer is mostly acquired through central peripheral mechanisms.The changes of CR1 quantitative expression and adhering activity are consanguineously related to the severity and the activity of the development in patients with liver cancer.

Objective To investigate the feasibility of osteoarthritis (OA) model in rabbits by injuring medial meniscus so as to understand the role of interleukin-1 beta (IL-1β) and matrix metalloproteinase-13 (MMP-13) in pathological mechanism of articular cartilage and synovial fluid of OA model in rabbits.Methods We randomly divided 40 New Zealand white rabbits into experimental group (n =30) and control group (n =10).Pathological changes in articular cartilage of the femoral condyle were scored at weeks 2,6 and 12 after surgery.We detected the expressions of IL-1β and MMP-13 by immunohistochemistry.The cell fractions of IL-1β and MMP-13 were recorded by ELISA.Results The articular cartilage score and HE staining significantly differed at various time points of gross and pathological observation between control group and experimental group (P＜ 0.05).Immunohistochemistry showed that IL-1β was expressed in both groups and that the cell fraction differed significantly at weeks 6 and 12 (P＜0.05),but not at week 2 between the two groups.MMP-13 protein expression was not detected in articular condrocytes in control group,but was detected in experiment group with a significant difference (P＜0.05).IL-1β expression was consistent in articular cartilage and synovial fluid.Conclusion The reasonable rabbit animal OA model could be established by knee meniscus injury caused by surgical method.Expressions of IL-1β and MMP-13 change obviously in the pathomechanism of OA.Further clinical studies are needed to determine whether they can be used as markers in early diagnosis of OA.

Objective To evaluate the effect of early intracoronary injection of tirofiban via aspiration catheter on myocardial no-reflow in elderly patients with acute ST-segment elevation myocardial infarction (STEMI).Methods 120 consecutive patients over 65 years old with AMI undergoing primary percutaneous coronary intervention (PCI) were randomized into two groups.In tirofiban group (n=60),thrombus aspiration and intracoronary tirofiban bolus (10 μg/kg prior to the first balloon inflation) via aspiration catheter were performed.In control group (n=60),thrombus aspiration was followed by primary PCI.The incidence of no-reflow and bleeding were assessed in the two groups.Results The moderate to severe bleeding (TIMI bleeding criteria) did not occur in the two groups,there's no significant difference between two groups in the incidence of minor bleeding [26.7％(16 cases) vs.21.7％ (13 cases),x2 =0.19,P=0.522].The incidence of myocardial noreflow was significantly lower in tirofiban group than in the control group [10.0％ (6/60) vs.25.0％ (15/60),x2 =4.68,P=0.031].Conclusions The intracoronary injection of tirofiban via aspiration catheter may significantly reduce the incidence of myocardial no-reflow in patients with STEMI without increasing bleeding complications.

Objective To identify the waves of abnormal myocardial Doppler tissue imaging (DTI) spectra and their alterations.Methods In 13 open chest dogs left ventricular (LV) wall motion velocity patterns at the mid wall portion of the middle of the LV posterior walls in the short axis direction were recorded with DTI before and after arteries infarct.Simultaneously the LV pressure (P) curves,their first derivative (dP/dt) curves,electrocardiography (ECG) and phonocardiogram (PCG) were recorded.Compared with ECG,PCG,P curves,and dP/dt curves the waves of abnormal myocardial DTI spectra and their alterations could be identified.Nineteen patients with myocardial infarction and six cardiac allograft recipients entered the clinical study.The motions of LV walls and mitral annuli were studied with DTI spectra and tissue velocity imaging (TVI) curves.Basing on ECG the velocity waves of DTI spectra and TVI curves were identified.Results In dogs the acutely ischemic walls motioned negatively(IVC 2) while the normal LV wall motions were mainly positive (IVC 1) during isovolumic contraction and these negative motions could prolong into injecting phase.Before and after coronary arteries occlusion,acute ischemia resulted in significant reduction of peak IVC 1S,and A [( 16.60 ? 4.11 )cm/s vs ( 4.60 ? 5.38 )cm/s,( 11.30 ? 1.58 )cm/s vs ( 7.16 ? 1.80 )cm/s,( 11.08 ? 3.35 )cm/s vs ( 6.71 ? 4.81 )cm/s,respectively,P

Serum Cardiac troponin Ⅰ (cTn Ⅰ) and lactic acid were measured in 128 neonatal patients with hypoxic-ischemic encephalopathy and 38 healthy neonates (control group). Serum cTn Ⅰ and lactic acid levels were higher in neonates with hypoxic-ischemic encephalopathy than those in healthy neonates (P < 0. 05 ); and the differences of these values were also statistically significant between the serious patients and the mild patients (P<0.05). Serum cTn Ⅰ and lactic acid are two sensitive markers for degree of myocardial injury and hypoxia in neonatal patients with hypoxic-ischemic encephalopathy.

Objective To assess the effectiveness of the Chinese herbal formula Tongxie Yaofang(TY) or its modified prescriptions in the management of irritable bowl syndrome(IBS).Methods A systematic review was carried out according to the Cochrane standards.A computerized literature search was carried out in main Chinese and English databases including CNKI,CBMdisc,Database of Chinese Doctorate Dissertation,Database of excellent Chinese Master Dissertation,MEDLINE and Cochrane Library.Studies were retrieved when they were randomized controlled trials(RCTs) whose interventions for IBS patients were TY or modified prescriptions of TY with placebos or conventional medicine as controls.Outcome measurement included the alleviation of main symptoms such as abdominal pain,diarrhea frequency,and(or) comprehensive effectiveness and quality of life(QOL).Meta-analysis was performed after evaluating the quality of included studies.Subgroup analysis was done between subgroups of diarrhea-predominant IBS and subtype-regardless IBS,and was also done between diarrhea-predominant IBS treated with TCM syndrome differentiation and that without TCM syndrome differentiation.Funnel plot analysis was used to analyze the publication bias.Results Forty-six studies met the inclusion criteria,and 4155 participants were included in the meta-analysis.The results showed that the effectiveness of TY or modified prescriptions of TY was better than that of conventional medicine or placebos[OR= 5.30,95%CI(4.38,6.41)].Subgroup analysis showed that the OR of TY or modified prescriptions of TY in the diarrhea-predominant groups[OR=5.61,95%CI(4.33,7.25)]was higher than that of subtype-regardless groups[OR=4.95,95%CI(3.74,6.55)],and OR of TY or modified prescriptions of TY in the studies of diarrhea-predominant IBS treated based on TCM syndrome differentiation [OR=6.50,95%CI(3.78,11.20)] was higher than that of the studies without TCM syndrome differentiation[OR=5.37,95%CI(4.01,7.19)],but the difference was insignificant.Funnel plot showed certain publication bias.Conclusion The effectiveness of TY or modified prescriptions of TY for IBS patients is better than that of western medicine and placebo.But their effectiveness for diarrhea-predominant IBS or with TCM syndrome differentiation was not proved to be better than those for other subtypes or without TCM syndrome differentiation.Biases may exist for overall quality of the studies is low;negative results in some high quality studies need further discussion.

ABSTRACT:Objective To evaluate the expressions of cell adhesion molecules CD146 and transferrin receptor 1 (TfR1)in ovarian epithelial cancer and investigate their relationship with clinical pathological features of patients with ovarian epithelial cancer (OEC ) so as to further explore the pathogenesis of OEC. Methods Immunohistochemistry was employed to determine the expressions of CD146 and TfR1 in normal,benign and ovarian cancer tissues.Results The immunohistochemical results showed that the positive expressions of CD146 and TfR1 gradually increased with the changes of normal,benign and malignant tissues in OEC.There were significant differences between all the groups (P<0.05).The advanced the clinical stage,the higher the expression rate (P<0 .0 5 ).The lower the histopathological differentiation,the higher the expression rate (P<0 .0 5 ).The expressions of CD146 and TfR1 were not correlated with age or pathological patterns (P>0.05).There was a significant correlation between expressions of CD146 and TfR1 in OEC (P<0.05,rs=0.532).Combined detection sensitivity and specificity were 82.4% and 75.0%.Conclusion The high expressions of CD146 and TfR1 may play a key role in the occurrance,progression and metastasis of OEC.They may be used as potential markers for diagnosis,postoperative follow-up and targeted therapy.

Objective To investigate the value of CEUS quantitative analysis in diagnosis of different pathological stages of small hepatocellular carcinoma (HCC).Methods Data of 112 patients with HCC confirmed by surgical or biopsy were analyzed retrospectively.All the diameter of single tumor or the sum of the largest two lesions in multiple tumors were within 3 cm.Three groups were classified based on the Edmonson stage:High differentiation group (n=50,stage Ⅰ or Ⅱ),median differentiation group (n=30,stage Ⅲ),low differentiation group (n=32,stage Ⅳ).Qontraxt ultrasound imaging analysis software was utilized to measure CEUS parameters,including the maximum intensity of tumor (TMAX),nontumor's intensity (NT),maximum intensity of nontumor (NTMAX),appear time,time to peak,washout time,and the ratio of TMAX/NT and TMAX/NTMAX were calculated.The differences among the three groups was compared by statistics test.Results The values of TMAX,TMAX/NTMAX and washout time were statistically different among the three groups (all P＜0.05).The maximum values of TMAX,TMAX/NTMAX and the shortest washout time were found in the low differentiation group.And the minimum values of TMAX,TMAX/NTMAX and the longest washout time were found in the high differentiation group.There were no statistical differences of NT,NTMAX,TMAX/NT,appear time and time to peak among the three groups (all P＞0.05).Conclusion The quantitative parameters of CEUS is helpful in distinguishing different Edmonson stage of small HCC.

Objective To explore metabolic characteristics of and risk factors for newly diagnosed type 2 diabetes mellitus(T2DM) combined with non-alcoholic fatty liver disease (NAFLD).Methods One hundred and forty-two cases of newly diagnosed T2DM were divided into two groups according to whether they have comorbid NAFLD:group A (without NAFLD,n =79) and group B (combined with NAFLD,n =63).Data collected included body height,body weight,blood pressure,fasting plasma glucose (FPG),blood lipid,serum uric acid (UA),HbA1c and fasting insulin,body mass index and insulin resistance index with homeostasis model(HOMA-IR) were calculated to compare the clinical and biochemical parameters between groups A and B.Results (1) The difference of age and blood pressure between groups A and B were not statistical different (P ＞ 0.05).Compared with group A,BMI ((26.79 ± 1.93) kg/m2 vs (24.61 ± 2.46) kg/m2,t =5.76),FINS((15.49±2.44) mU/L vs (13.20±2.17) mU/L),t =5.91),HOMA-IR((6.74± 1.32) vs (5.65 ±1.10),t =5.37),glycerin trimyristate (TG) ((2.94 ± 0.65) mmol/L vs (1.74 ± 0.46) mmol/L),t =12.86),low density lipoprotein cholesterin (LDL-C) ((3.46 ±0.73) mmol/L vs (2.78 ±0.86) mmol/L,t =5.07) and UA((342.41 ±71.49) mmol/L vs (312.98 ±66.24) mmol/L,t =2.54) were significantly higherand hight density lipoprotein cholesterin (HDL-C) ((0.99 ± 0.17) mmol/L vs (1.21 ± 0.29) mmol/L,t =5.33) was significantly lower in group B (P ＜ 0.05).(2) Using whether to combined with NAFLD as dependent variable,and BMI,FINS,HOMA-IR,TG,LDL-C,HDL-C and UA as independent variable,logistics regression analysis showed that BMI,HOMA-IR and TG were risk factors for NAFLD(OR =2.838,19.241,and 2.019 respectively,P ＜ 0.05).Conclusion Newly diagnosed type 2 diabetes mellitus combined with NAFLD have more obvious dyslipidemia and insulin resistance.Obesity,insulin resistance,hyper-triglyceridemia are risk factors for newly diagnosed type 2 diabetes mellitus combined with NAFLD.