Objective To improve the recognition of intrahepatic biliary cystadenoma.Methods The clinical manifestations,radiologic features,diagnosis and surgical treatment of 18 patients with intrahepatic biliary cystadenomaadmitted in our hospital during the recent 8 years were retrospectively analyzed.Results Four cases were discovered by general medical examination,while the other 14 patients had varying symptoms that included right upper abdominal discomfort or pain in 11 cases,abdominal mass in 3 cases,and jaundice accompaniedby fever in 2 cases.B ultrasound and CT scan showed intrahepatic cystic occupying lesions consistingof multilocular or single cyst,and usually with papillary structures in the cyst wall.All of 18 cases received surgical resection.The patholgic dingnosis was intrahepatic biliary cystadenoma in all the 18 cases,and 6 of them showed malignant change.The average survival time of maligmant patients was 35(27-58)months.Conclusions Preoperative diagnosis of intrahepatic biliary cystadenoma is difficult.Intrahepatic biliarycystadenoma is easy to develop into cystadenocarcinoma.Early surgical resection is necessary,and can effectively prevent recurrence or malignant transformation.

Tumor markers can reflect tumor existence,and open an entrance to diagnose tumor at early stage.Recent researches reveal that gastric cancer related tumor markers such as microRNAs,enzymes,cytokines and antibodies-antigens are significant for the diagnosis,treatment,relapse surveillance,prognosis evaluation of gastric cancer.

A new target in cancer treatment involves tumor-associated macrophages (TAMs) which are infiltrated in microenvi-ronment. By secreting a wide range of cancer-promoting cytokines, such as vascular endothelial growth factor, interleukins, and matrix metalloproteinase, TAMs can promote the proliferation, invasion, and metastasis of cancer cells. Cyclooxygenase-2 (COX-2), an inflam-matory factor that is significant for angiogenesis and immunoregulation within the local microenvironment, may also contribute to can-cer progression and act as a novel target for breast cancer therapy. Several COX-2 inhibitors, such as celecoxib, have shown potential as suppressors of TAMs and the microenvironment. Hence, the current study discusses the crosstalk between TAMs-delivered important cytokines and COX-2 in the breast cancer microenvironment, and then analyzes the value of homologous antagonists alone or in combi-nation with COX-2 inhibitors. This paper aims to provide the theoretical principle of multi-target selection in TAMs blockage, and offer a new direction for biological targeted therapy in breast cancer treatment.

Objective To provide applied anatomic bases for the transplantation of scapular spine bone flap pedicled with supraspinous branch of suprascapular artery Methods The origin,course,branches and distribution were observed on 30 adult cadaver specimens;the operative designs were imitated on 6 specimens Results The supraspinous branch originated from suprascapular artery,went between supraspinatus muscle and scapular bone medially,and divided into 3～4 periosteal branches to scapular spine with a diameter of 0 5～0 8mm The length of stem of supraspinous branch was (4 8?0 6)cm Conclusions The transplantation of scapular spine bone flap pedicled with supraspinous branch of suprascapular artery is feasible

Objective To investigate the effect of acute physiology and chronic health evaluationⅡ ( APACHEⅡ) scoring system on evaluating the severity and prognosis in severe acute pancreatitis(SAP). Methods The APACHEⅡ scores were analyzed in 52 patients with SAP. Results The mean APACHEⅡ score of SAP was 16.60?9.07(8～40), and there were significant differences between the scores not only in Grade SAPⅠand Grade SAPⅡ(?

OBJECTIVETo analyze the risk factors of liver metastasis in patients after radical resection of pancreatic cancer.

METHODSOne hundred and twenty-four patients with non-metastatic, resectable pancreatic cancer treated in our department between 2006 and 2012 were included in this study. All of these patients underwent resection of the primary tumor combined with extensive lymph node dissection. The development of postoperative liver metastases was carefully followed up, and the clinicopathological factors and molecular characteristics were evaluated by univariate analysis and multivariate logistic regression using SPSS 16.0 software.

RESULTSForty-eight cases of liver metastases were found among the 124 cases of pancreatic cancer after radical surgery (38.7%). The rate of liver metastasis of pancreatic cancer after radical surgery in the age groups < 40, 40-60, and > 60 were 68.8%, 33.3% and 35.1%, respectively. The rate of liver metastasis in the body mass index (BMI) group < 20 kg/m2, 20-25 kg/m2, and > 25 kg/m2 were 21.6%, 44.1% and 52.6%, and the rate of liver metastasis in the time between the onset and diagnosis groups ≥ 3 months and < 3 months were 59.4% and 31.5%, respectively. The rate of liver metastasis in patients with preoperative fatty liver was 14.3% and it was 43.7% in patients without preoperative fatty liver. The rate of liver metastasis in patients of histological high, medium and low grade was 10.0%, 35.4% and 49.0%, respectively. The rate of liver metastasis in patients with venous tumor thrombus was 68.8% and it was 34.3% in patients without venous tumor embolus. The rate of liver metastasis in patients with postoperative chemotherapy was 31.2% and it was 51.1% in patients without postoperative chemotherapy. All those differences had statistical significance (P < 0.05). Univariate analysis revealed that age, body mass index (BMI), time between the onset and diagnosis, preoperative fatty liver, histological grading, tumor invasion depth, venous tumor embolus, and postoperative chemotherapy were significantly related to postoperative liver metastasis. Multivariate analysis revealed five statistically independent risk factors for postoperative liver metastasis: BMI, time between onset and diagnosis, preoperative fatty liver, histological grading, and venous tumor embolus.

CONCLUSIONSOur data suggest that patient's BMI, time between onset and diagnosis, histological grade, and venous tumor embolus are significantly correlated with postoperative liver metastases in patients with pancreatic cancer. Pancreatic cancer patients with preoperative fatty liver have less postoperative liver metastasis.

Adult ; Aged ; Body Mass Index ; Humans ; Liver Neoplasms ; secondary ; Lymph Node Excision ; Middle Aged ; Pancreatic Neoplasms ; pathology ; surgery ; Regression Analysis ; Risk Factors

Objective To analyse tratment strategies and to evaluate the relation between different therapies and survival rate of patients of with asynchronous liver metastases after pancreatic cancer surgery (PCLM).Methods From January 2006 to January 2012,48 patients with PCLM were included in this study,and their medical records were retrospectively analyzed.Results Among the 48 patients,27 cases of liver metastases were found within six months after surgery,and the survival rate for 1,3 and 5 years was 22.2％,3.7％ and 0％,respectively,with the median survival of 6 months,and 21 cases of liver metastases were found after six months,and the survival rate for 1,3 and 5 years was 85.7％,30.6％ and 9.2％,with the median survival of 15 months,and the difference between the two groups was statistically significant (P ＜ 0.01).After pancreatic cancer surgery and adjuvant gemcitabine chemotherapy,the probability of liver metastases was 33.3％ (8/24) within six months,the median disease-free survival time was 8 months and the disease-free survival rate for 1,3 and 5 years was 20.8％,4.3％ and 0％.For patients without adjuvant gemcitabine chemotherapy,the probability of liver metastases was 79.2％ (19/24),the median disease-free survival time was 3 months and the disease-free survival rate for 1,3 and 5 years was 4.2％,0％ and 0％,and the difference between the two groups was statistically significant (P ＜ 0.01).The overall survival for patients undergoing resection of liver metastases combined with gemcitabine treatment was better than the other groups (P ＜ 0.01).And the overall survival for patients undergoing transhepatic arterial embolization (TACE) combined with gemcitabine treatment was better than TACE group,gemcitabine group or the observation group (P ＜0.05).There were no difference in overall survival between TACE group,gemcitabine group and observation group.Conclusions Pancreatic cancer patients who develop liver metastasis within six months after surgery have poor prognosis,but postoperative chemotherapy can delay the development of liver metastasis.For patients with resectable lesion,resection of asynchronous liver metastasis is the treatment of choice,and TACE combined with gemcitabine has better efficacy than that of single treatment.

Objective To investigate the effects of pretreatment with remifentanil on hemorrhagic shock (HS)-induced acute liver injury in rabbits.Methods Thirty-two New Zealand white rabbits,weighing 2.0-2.5 kg,were randomly divided into 4 groups (n=8 each): sham operation group (group S) ; group HS,low-dose remifentanil group (group RL) ; high-dose remifentanil group (group RH).Remifentanil was infused at 0.66 and 1.32 μg· kg-1 · min-1 for 145 min in groups RL and RH respectively,while the equal volume of normal saline was infused in group C.HS was induced by withdrawing blood from the left femoral artery at 15 min after continuous infusion of normal saline or remifentanil and mean arterial pressure (MAP) was reduced to 40 mm Hg.MAP was reduced to 35-45 mm Hg and maintained at this level for 120 min in groups HS,RL and RH.Blood samples were taken for determination of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities before administration (T0),immediately before blood letting (T1),and at 10,30,60 and 90 min after blood letting (T3-6).The animals were then sacrificed and the livers were immediately removed for microscopic examination.Results Compared with group S,the serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in the other three groups (P ＜ 0.05).Compared with group HS,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH,and no significant change was found in group RL (P ＞ 0.05).Compared with group RL,the serum ALT activity at T5 and T6,and serum AST activity at T4-T6 were significantly decreased in group RH (P ＜ 0.05).The serum ALT activity at T5 and T6 and serum AST activity at T4-T6 were significantly increased in groups HS,R and RH than those at T0 (P ＜ 0.05 or 0.01).The patho1ogical injury was attenuated in group RH compared with groups HS and RL.Conclusion Remifentanil pretreatment can attenuate HS-induced acute liver injury in rabbits,and the effect is related to the dose.

Objective: To establish the determination method of ester alkaloids in Shiwuweirupeng Capsules. Methods:The chromatographic method was carried out on Aichrom TM C 18 column using CH 3OH 0.05 mol?L -1 KH 2PO 4 CH 3COOH-(CH 3) 2CHOH(67∶173∶4∶4) as a mobile phase. The detection wavelength was set at 230nm. The flow rate was 1mL?min -1 . The column temperature was 35?C. Results: The benzoic acid calibration curves were linear at the ranges of 0.0152～0.076?g( r =0.9998). The average recoveries of aconitine was 93.3% with RSD =1.9%.Conclusion: This method is simple, reliable and provides a reference standard for the quality control of Shiwuweirupeng Capsules.

Objective: To determine tannins in Ershiwuweidatang Capsules (Flos Carthami, Fructus Chebulae, Fructus Terminaliae Billericae, Fructus Phyllanthi, etc.). Methods:Tannins were determined by casein method.Results: The contents of tannins in Ershiwuweidatang Capsules were 0.96%, 0.90%, and 0.85%, respectively. The gallic acid calibration curves were linear at the ranges of 0.8 ～4.0 ?g?mL -1 ( r = 0.999 ). The average recovery of tannic acid was 96.2% with RSD =1.4%( n =5).Conclusion: The method was simple and reliable.