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.

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

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.

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.

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(?

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 observe the effects of infrasound on the expression of inducible nitric oxide synthase(iNOS)and endothelial nitric oxide synthase(eNOS)in gastric tissues in rats.Methods The study consisted of a total of 210 SD rats.Of them,140 rats were randomly divided into 8 Hz-90 dB,8 Hz-130 dB and 16 Hz-130 dB experimental groups and a control group A.The experimental groups were exposed to infrasound with different frequencies and intensities,2h/d.After exposure for 1,7,14,21 and 28 days,7 rats randomly selected from each group underwent an examination of the expression of iNOS and eNOS in gastric tissues.The other 70 rats were randomly divided into a control group B and an exposure group continuously stimulated by infrasound with 8 Hz-130 dB for 14 days,2 h/d,and after stopping exposure for 1,7,14,21 and 28 days;the same indexes were detected in 7 rats randomly selected from each group.Results ① Compared with that in the control group A,the expression of iNOS in gastric tissues significantly increased in 8 Hz-90 dB group after exposure for 14 and 21 days,in 8 Hz-130 dB group after exposure for 7,14,21 and 28 days and in 16 Hz-130 dB group after exposure for 7 and 14 days(P

Objective To discuss the clinical value of transposition of the pedicled anterolateral femoral periosteal flap. Methods The blood supply of anterolateral femoral periosteum were dissected on 38 adult cadaveric lower limber specimens injected with red dye. The origins, distributions and anastomosis of periosteal breanches were observed and measured. Based on these anatomic investigations, the transposition of pedicled anterolateral femoral periosteal flap was designed to repair the bone nonunion and lesion of femur. Results Twenty-two cases were treated in the satisfactory results, and followed-up from 1 to 5 years. The size of the periosteal flap ranged from 8cm?4cm to 10cm?5cm. Conclusions The periosteal flap could be operated so conveniently and safely as to be spread easily, treatment of lesion and incision of periosteal flap can be finished in the same operative approach. The periosteal flap have been proved to be powerfully clinical value.

Objective To explore the effects of infrasound frequency and intensity on gastric emptying in rats. Methods One hundred and forty rats were randomly divided into a control group, and groups receiving 8 Hz-90 dB, 8 Hz-130 dB and 16 Hz-130 dB infrasound. Another 70 rats were randomly divided into a control group and an exposure group continuously stimulated with infrasound at 8 Hz and 130 dB. The control group again was not exposed. The gastric emptying rate of the rats in all the groups was tested at different time points. Results ①Compared with the control group, gastric emptying rate decreased significantly after exposure to infrasound for 7 or 14 days. After exposure for 1 day, no significant difference was found. After exposure for 7 , 14, 21 or 28 days, gastric emptying decreased significantly more in the 8 Hz-130 dB group than in the 8 Hz-90 dB group or the control group. ②Compared with the controls, gastric emptying decreased in the 16 Hz-130 dB group after exposure for 1 , 7 and 14 days, but there was no significant difference between these two groups after 21 or 28 days. Gastric emptying decreased significantly more at 8 Hz-130 dB than at 16 Hz-130 dB after exposure for 14 or 28 days.③Gastric emptying tended to recover after exposure of 14 days to 8 Hz-130 dB infrasound, but compared with the controls, gastric emptying was still reduced after exposure had been stopped for 1 , 7 , 14, 21 and 28 days. Conclusion Infrasound at 8 Hz-90 dB, 8 Hz-130 dB or 16 Hz-130 dB can restrain stomach emptying. The extent of the reduction is closely related to the frequency, intensity and exposure time. Gastric emptying tends to recover after infra-sound exposure is stopped.

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.