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 evaluate the diagnosis, treatment and prognosis of patients with synchronous primary endometrial and fallopian tube cancers. Methods: The clinical records of four cases of synchronous primary endometrial and fallopian tube cancers from Jiangxi Maternal and Child Health Hospital between October 2008 and October 2013 were reviewed. The follow-up was performed in all patients. The date of last contact was June 30, 2014. Results: The preoperative diagnosis for four cases was endometrial cancer. Two of them underwent extensive abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy and para-aortic lymph node biopsy, and the other two cases underwent extrafascial abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy and para-aortic lymph node biopsy. The postoperative diagnosis for four cases was stage IA endometrioid adenocarcinoma and stage IA/IB fallopian tube adenocarcinoma. Three patients received 1-3 cycles of chemotherapy of docetaxel plus platinum, and one patient didn't receive any chemotherapy. The follow-up time was 38-71 months. All patinets remained tumor-free survival by June 30, 2014. Conclusion: The patients with synchronous primary stage I endometrial cancer and stage I fallopian tube cancer has a good prognosis, and the extensive/extrafascial abdominal hysterectomy, bilateral salpingo-oophorectomy, pelvic lymphadenectomy and para-aortic lymph node biopsy are appropriate surgical procedures for these patients. The necessity of postoperative chemotherapy should be further explored.

Objective:To separate and purify the immunoactive polysaccharide RTPS- I from Trichosanthis Radix and study the physicochemical properties and preliminary structure. Methods:The crude polysaccharides were extracted by water, and then precipita-ted by ethanol. After the deproteinization with trichloroacetic acid, the polysaccharide RTPS-I was separated and purified by using DE-AE-Cellulose, DEAE-Sepharose FF and Sephadex G-200 column chromatography. The analysis of properties and structure was per-formed by using GC, HPGPC, IR and NMR. Results:RTPS-I was a white flocculent solid after vacuum freeze-drying, and soluble in water. It contained three elements (carbon, hydrogen and oxygen) with the specific rotation [α]25D (H2O) of +164. 44 and the relative molecular mass of 17555. The glycosyl in RTPS- I was composed of glucose without uronic acid. The sugar ring was pyranoid ring, and each monosaccharide was linked by α-glycosidic bond. Conclusion: A homogeneous immunoactive polysaccharide RTPS- I from Trichosanthis Radix is isolated for the first time.

Objective To observe the effects of the preconditioning of ulinastatin on GES-1 cell injury induced by oxygen and glucose deprivation (OGD). Methods GES-1 cells were cultured in vitro and divided into three groups: normal control group (group N), oxygen and glucose deprivation group (group O), and ulinastatin preconditioning group (group U). The OGD model of GES-1 cells were established by glucose-free medium and three-gas incubator for 6h. Ulinastatin was added to group U 12h before the deprivation of oxygen and glucose. The cell viability and apoptosis were determined by cck-8 and flow cytometry respectively. Western Blot was used to examine the protein expression of Caspase-3 and Cleaved Caspase-3. The TRPV1 mRNA expression was measured by quantitative real-time PCR. Results As compared with group N, the viability of GES-1 was decreased, the apoptotic rate and the expression of Caspase-3 and Cleaved Caspase-3 were increased, and the TRPV1 mRNA expression decreased greatly in group O (P < 0.05). As compared with group O, the aforementioned changes were significantly inhibited in group U. Conclusions Ulinastatin preconditioning could effectively inhibit GES-1 cell injury induced by OGD, which may be related to the inhibition of apoptosis and the upregulation of TRPV1 mRNA expression.

Objective To investigate the renoprotective effect of erythropoietin(EPO) in streptozotocin-induced diabetic rats and to explore the possible mechanism.Methods The SD rats were randomly divided into there groups: normal control rats, diabetic, diabetic treated with EPO(NC, DM, DE groups).The rats were sacrificed after 8 weeks treatment.Renal morphology was observed by light microscopy.The expression of erythropoietin receptor(EPOR) in kidney was detected by immunofluorescence and Western blotting.The expression of p47phox, transforming growthfactor (TGF)β1andfibronectin (FN)proteininkidneywasdetectedby immunohistochemistry and Western blotting.The activity of antioxidants including total antioxidant capacity (T-AOC), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and the level of malondialdehyde(MDA) in kidney were also measured.Results EPO treatment notably attenuated renal pathologic and functional changes.The expression of EPOR was found in kidney,but there was no difference among groups(P＞0.05).Compared with normal rats, diabetic rats showed an elevated expression of p47phox, TGF-β1, FN proteins and MDA levels in kidney as well as reduced activities of SOD, GSH-Px and T-AOC (all P＜0.01).Compared with diabetic rats, EPO could decrease the protein expression of p47phox,TGF-β1and FN in kidney (all P＜0.05).Meanwhile, elevated MDA level in the kidney was decreased as well as decreased SOD, GSH-Px,T-AOC activities were significantly remitted in DE group(all P＜0.01).Conclusion EPO can amelioraterenaldamagevia theinhibition of oxidativestressandTGF-β1andFNprotein expression in streptozotocin-induced diabetic rats.

ObjectiveTo observe the expression of Caspase-3 mRNA in prefrontal cortex and hippocampus of chronic stress-induced depression rats,and to detect the machnisms of antidepression by electro-acupuncture.MethodsSprague-Dawley rats were randomly divided into four groups:control group,model group,model +electro-acupuncture group and model + paroxetine group,12 rats in each group.Open-field test was used to observe the changes of movements,and real-time fluorescence quantitative PCR (RT-PCR) method was used to detect Caspase-3 mRNA levels in prefrontal cortex and hippocampus.Results ①Open-field test:after stress,compared with control group rats,the model group rats' crossing numbers (29 ± 7),rearing times (6 ± 2) were apparently less than those of control group( (66 ± 13),( 10 ±2) ; P＜0.05,P＞0.05).In comparison with model group,the crossing times and rearing times being increasing in degree in electro-acupuncture group( (61 ±9),( 13 ±1 ) ) and paroxetine group( (39 ± 10),(8 ± 1 ),P＜0.01,P＞0.05).② Compared with the control group,Caspase-3 mRNA in prefrontal cortex and hippocampus significantly increased in model group(P ＜0.05 ) ;and compared with model group,Caspase-3 mRNA in prefrontal cortex in electro-acupuncture group and paroxetine group significantly decreased(P ＜ 0.05 ),and both expression of Caspase-3 mRNA in hippocampus in electro-acupuncture group and expression of Caspase-3 mRNA in hippocampus in paroxetine group decreased (P ＞ 0.05 ).ConclusionChronic stress can increase the expression of Caspase-3 mRNA in prefrontal cortex and hippocampus of chronic stress-induced depression rats,while electro-acupuncture can decrease the expression of caspase-3 mRNA,which may be an important way to anti-depression by electro-acupuncture.

Objective To explore the expression of COX-2 and p38MAPK in patients with trauma MODS. Methods Forty MODS patients were evaluated. The levels of peripheral blood mononuclear cells COX-2 and p38MAPK in MODS patients and 40 normal controls was detected by enzyme linked immunosor-bent assay (ELISA). RT-PCR was used to measure the COX-2 mRNA and p38MAPK mRNA expression of in PBMCs. ANOV and correlation analysis were used in statistical analysis. Results The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in MODS group were higher than in control group (all P <0.05). The levels of COX-2 and p38MAPK of PBMCs and the mRNA expression in dead group were higher than in survival group( all P <0.05). The levels of COX-2 and p38MAPK of PBMCs were positively correlated, (r =0.6 147, P<0.01). The expression of COX-2 mRNA, p38MAPK mRNA of PBMCs and APACHE I scoring were positively correlated (r1 =0.5 009, P1 <0.05,r2 =0. 5 316, P2 <0. 05). Conclusions COX-2 and p38MAPK of PBMCs take part in the onset of MODS, and may service as index to judge the prognosis of MODS.

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 study the effects and reasons caused by different sex on the teaching of ligation in fundamental surgery. Methods Students of grade 2005 were chosen,and then sc10.35 statistical software was used to analyze these four different departments’data and independent-samples T test to compare the data of 2 groups. Results It showed a statistical significance(P