Primary hepatic carcinoma is one of the common digestive tract tumors.Surgical operation in clinic is still the most effective way to treat it so far.The caudate lobe has often been considered the forbidden zone of hepatic operation in the past due to complicated anatomy.In resent years,with the deepening of knowledge of anatomy and advanced radiological technology,many new operative approachs and operation methods have been explored to improve the situation of caudate lobectomy which is already not rare in clinic now.This article summarized the anatomy of caudate lobe and reviewed the therapy progress of the hepatic carcinomas located caudate lobe.

A benzyl functionalized ionic liquid, 1-benzyl-3-methylimidazolium bis [( trifluoromethyl ) sulfonyl]imide ([BeMIM][Tf2 N]), was synthesized and characterized as an extraction solvent of dispersive liquid-liquid microextraction ( DLLME) for enrichment and determination of 5 organophosphorus pesticides (phoxim, fenitrothion, chlorpyrifos, phorate and parathion) and 2 aromatic compounds (chloronaphthalene and anthracene) from environmental water samples by high-performance liquid chromatography ( HPLC). [BeMIM] [ Tf2 N] had higher extraction efficiency than 1-octyl-3-methylimidazolium bis [( trifluoromethyl) sulfonyl]imide and common organic solvents such as CCl4 and C2 Cl4 . The extraction was performed using 40 μL of [BeMIM][Tf2N] and 1 mL of methanol as extraction solvent and dispersive solvent respectively with centrifugal time of 5 min. Under the optimal conditions, the method proposed here provided a good linearity for all analytes with correlation coefficients between 0. 9994 and 0. 9998. The repeatability values, described as intra-day and inter-day relative standard deviations (RSDs) of five replicate experiments at three different concentrations of 10, 40 and 100 μg / L, were 1. 1% -4. 3% and 0. 8% -4. 8% , respectively. The limits of detection (LOD) were 0. 01 μg / L-1. 0 μg / L at a signal-to-noise ratio (S / N) of 3. This developed method was convenient and speedy, and could be employed to detect the analytes in three real environmental water samples with satisfactory relative recovery of 82. 7% -118. 3% and RSD of 0. 7% -5. 6% . Introduction of benzyl group into the imidazolium could obviously enhance the extraction efficiecny for analytes due to the π-πinteraction between [BeMIM] [ Tf2 N] and analytes. [ BeMIM] [ Tf2 N] was a satisfactory extraction solvent with a high enrichment factor of 339 and extraction efficiency of 81. 4% . Partition coefficients of all analytes in [BeMIM][Tf2 N]-DLLME system were determined and the extraction mechanism was discussed.

microRNAs combined with specific mRNAs are 19-25 nucleotide-long small-molecule RNA that mediate sequence-dependent post-transcriptional gene expression.Accumulating evidences indicate that microRNAs target critical signal transduction molecules of immune system,and involve in regulation of immune tolerance.Recently,microRNAs have been a potential biomarker,and are widely useded in diagnosis and prognosis of cancer,infectious disease,autoimmune disease,and transplantation.If we can further identify regulatory mechanism of microRNAs and their target genes,which makes possible the successful induction of immune tolerance and exert a huge push on organ transplantation.

Objective To investigate the methods and effects of multimodal and phased protective training for medical staff against Ebola.Methods The 4 stages of the protective training include the theoretical teaching,track type simulative process train-ing,simulative ward training,on-site training.We combined the 4 protective training stages and made 4 protective skills assessments in sequence.Results The average scores and qualified rates of the medical staff in the second,third,fourth assessment increased significantly comparing with that in the first assessment.The qualified rate reached 100% in the fourth assessment and we realized zero infection during the mission.Conclusion Multimodal phased protective training reinforced the protective skills of medical staff.Zero infection of medical staff needed seamless supervision in work time eventually.

ObjectiveToinvestigatetheriskfactorsforunfavorableoutcomeinpatientswithminor ischemic stroke. Methods Patients with minor ischemic stroke were enroled prospectively. The modified Rankin Scale ( mRS ) w as used to assess the clinical outcome at day 90 after onset, and mRS 0-2 w as defined as favorable outcome. The demographic data, vascular risk factors, clinical data, imaging data, stroke etiologic subtypes, laboratory test results, and treatment methods in the favorable outcome group and unfavorable outcome group w ere compared. Multivariate logistic regression analysis w as used to identify the independent risk factors for early poor outcome in patients w ith minor ischemic stroke. Results A total of 516 patients with minor ischemic stroke were enroled. At day 90 after onset, 90 patients (17.44%) had unfavorable outcome and 426 (82.56%) had favorable outcome. Multivariate logistic regression analysis showed that age (odds ratio [OR] 1.045, 95% confidence interval [CI] 1.017-1.074; P=0.002), heart diseases (OR 2.021, 95%CI 1.063-3.841; P=0.032), baseline National Institutes of Health Stroke Scale (NIHSS) score (OR 1.662, 95%CI 1.177-2.347; P=0.004), limb movement disorder ( OR 2.430, 95%CI 1.010-5.850; P=0.048), ataxia (OR 2.929, 95%CI 1.188-7.221;P=0.020), early neurological deterioration ( OR 50.994, 95%CI 17.659-147.258; P<0.001), infarct diameter ( OR 1.279, 95%CI 1.075-1.521; P=0.005), non-responsible vascular stenosis ( OR 2.518, 95%CI 1.145-5.536;P=0.022), and large artery atherosclerotic stroke ( OR 2.010, 95%CI 1.009-4.003; P=0.047) w ere the independent risk factors for unfavorable outcome in minor ischemic stroke. Conclusions The early poor outcome of minor ischemic stroke is closely associated w ith age, heart diseases, baseline NIHSS score, limb movement disorder, ataxia, early neurological deterioration, infarct diameter, non-responsible vascular stenosis, and large artery atherosclerotic stroke. The relevant examinations need to be improved early, the etiologic subtype should be identified, and the correct clinical treatment should be guided.

AIM: To observe the changes of interleukin1 receptor associated kinase-4(IRAK-4) in ischemia/reperfusion(I/R) liver pretreated with lipopolysaccharide(LPS) and to explore the protective mechanisms of LPS pretreatment against hepatic I/R injury.METHODS: Male Sprague-Dawley rats,weighing 240-280 g,were divided into three groups: control,ischemia/reperfusion group(I/R group) and LPS-pretreated group(LPS group).On the first day,LPS group received 0.1 mg/kg LPS via the tail vein,followed by 0.5 mg/kg on the 2nd,3rd,4th and 5th day.I/R group received the equivalent volumes(0.5 mL) of sterile PBS.Experiments of I/R injury was induced by temporary ischemia of the left lateral liver lobe for 90 min followed by 3 h reperfusion on 2 days after the last LPS treatment.At 0 min,60 min and 180 min after reperfusion,the expression of IRAK-4 gene and protein level were determined by RT-PCR and Western blotting.The activity of NF-?B and the serum TNF-? level were also detected by ELISA.RESULTS: Although the level of IRAK-4 gene and protein were higher in the LPS group than that in I/R group and control group(P0.05) at 0 min after reperfusion.However,all those indexes were evidently lower in the LPS group than those in I/R group(P

Objective To investigate the morphological changes in the sciatic nerve and the dorsal root ganglions (DRGs) and also gene expression in DRGs after non-freezing cold injury, and to explore the molecular mechanism of peripheral nerve cold injury and regeneration. Methods Twenty-four male Wistar rats were used. The sciatic nerve on one side was cooled to 4℃ for 2 h, and the sciatic nerve on the opposite side was exposed, but without cooling. Sciatic nerves and L4, L5 and L6 DRGs from both sides were harvested at the 1st, 2nd and 3rd week after cooling. Any pathological changes were observed using light and electron microscopy. Laser capture microdissection (LCM) was used to investigate the DRG neurons' gene expression. The array result was verified with RT-PCR for eight genes. Results Large fiber degeneration was obvious by the 7th day after cooling. Myelinated fiber regeneration had begun by the 14th day, so this time was chosen to explore the neurons' gene expression. Ninety-six genes and expressed sequence tags (ESTs) were up-regulated greater than 2 fold. Their proteins' functions were classified as adaptive response to external stimulus, apoptosis regulation, cell adhesion, immune and inflammation response,nerve regeneration, pain associated molecules, microtubule cytoskeleton, ion-channels, neurotransmitters and receptors, and neuropeptides. Conclusions A complex molecular mechanism is involved in cold injury and regeneration of the sciatic nerve, and many genes are involved. Large scale microarray analysis is a potent means to screen out related genes, thus suggesting future repair strategies.

Objective To investigate the correlation between dose volume histogram(DVH)of tumor targets and organs at risk(OAR)at CT-image based 192Ir brachytherapy and effects and complications for patients with locally advanced cervical cancer. Methods Ten patients with FIGO stage ⅢB cervical cancer received CT image-based 192Ir intracavitary brachytherapy after 54 Gy of three-dimentional four-field pelvic external beam radiotherapy and concurrent weekly cisplatin chemotherapy. Before each brachytherapy,CT images were acquired with applicators in place. Gross tumor volume(GTV), clinical target volume (CTV)and OAR were contoured and inverse treatment planning was designed and optimized by using PLATO treatment planning system. Conventional two-dimensional plans were also designed for comparison.The total intracavitary brachytherapy dose was 30 -42 Gy in 5 -7 fractions. The patients were followed, and the local control and complications were analyzed. The biologically equivalent dose(BED)and biologically equivalent dose in 2 Gy fractions(BED2)for GTV, CTV and OAR were calculated. The minimum dose in the most irradiated tissue volume 2 cm3(D2 cm3)adjacent to the applicator of the sigmoid colon, rectum,bladder and small bowel was determined from the DVH. Results The 1-year local pelvic control rate was 90% and grade 1-2 late complication of sigmoid colon and rectum was 50%. No grade 3 or more complications developed. On CT-image based planning, the BED and BED2 to 90% of the CTV(D90)were 95.50 Gy ± 7. 81 Gy and 79. 73 Gy ± 6. 57 Gy. The BED and BED2 to 90% of the GTV(D90)were 101.86 Gy ± 7.27 Gy and 84. 95 Gy ± 6. 1 Gy. The volume enclosed by 90% of prescribed dose(V90)for GTV and CTV were 92% ±4% and 87% ±7% respectively. The D2cm3 for rectum and sigmoid colon were 74. 97 Gy ±1.64 Gy and 67. 93 Gy ± 4. 30 Gy(EQD2, α/β = 3). Comparing with 2D brachytherapy plans , CT - image based planning has improved D90 and V90 for GTV and CTV with similar dose at point A and rectum reference point. Conclusions Computer tomography-image based 192Ir brachytherapy has resulted in the better dose distribution to the tumor targets with excellent tumor control and acceptable toxicity.

The medical contingent of Chinese PLA to libera operated the China Ebola treatment center(ETC) with 100 beds,and employed 80 Liberian health workers according to the task requirements and the normal operation demand.Under consideration of current health education situation and epidemic prevention requirements,combined with experiences in the fight against SARS,the training content includes the Ebola prevention and control knowledge,isolation of patients and safe burial,malaria prevention and control knowledge,hospital disinfection technology,psychological intervention.Training methods diversified,with theoretical teaching,site visit,on-site demonstration and training and video guide.With the pass of the simulation training evaluation model in all staff,the expected goals of pre-service training have been achieved.

The normal range of oral mucosal cell apoptosis and proliferation rate through a larger sample of non-malnourished crowd was investigated, and the nutritional status of clinical patients was assessed. Of 194 clinical patients selected according to "NRS2002" guidance, there were 167 non-malnourished patients and 27 malnourished cases, respectively. Twelve patients with toxic reactions of grade III after postoperative chemotherapy (POC) were chosen. The oral mucosal epithelial apoptosis and proliferation rate were measured by using flow cytometry. The statistical significance was processed by using unpaired t-test. The results showed that there was no significant difference in gender, age and body weight between malnourished and non-malnourished groups. The normal range of oral mucosal epithelial apoptosis and the proliferation rate was (27.50±1.50)% and (15.12±1.68)% in non-malnourished patients, and that was (19.90±4.14)% and (6.66±5.83)% in the malnourished patients, respectively. It is concluded that the normal range of oral mucosa cell apoptosis and proliferation rate is achieved, which can not be influenced by gender, age, weight and other factors, and could be used as a sensitive and accurate index to assess the nutritional status of clinical patients.