Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) is used for patients with advanced hepatocellular carcinoma who cannot tolerate major hepatectomy due to an insufficient future liver remnant,but the morbidity and mortality rate in the perioperative period are still high.Available studies indicate that damage control surgery variations such as laparoscopic procedure and associating radiofrequency/microwave ablation/liver tourniquet and portal vein ligation could improve the morbidity and mortality associated with ALPPS,as could portal vein embolization.However,randomized controlled trials are needed to determine benefits in technical variations.

Precision medicine significantly promotes the diagnosis and treatment of various diseases,which also induces the revolution of evidence-based clinical practice guidelines,as well as multimodality therapy for hepatocellular carcinoma (HCC).In the application of the concept of precision medicine and evidence-based medicine,surgeons will concretize the precise surgery,establish an improved multimodality therapy for HCC,and ultimately achieve the goal of overall benefit.This is also a new task of surgeons in the precision medicine era.

Trypsin was purified from crude material of pig pancreas by AOT/isooctane reversed micellar system.The influence of the main operating parameters such as ethanol concentration in forward and backward extraction,pH,KCl and AOT concentration,temperature were investigated.Forward and backward extraction recovery of trypsin reached almost 90% and neared 100%,respectively.Finally,about 88% of total yield was obtained,and the specific activity of trypsin was increased to over 1800U/mg with purification factor of 5 folds more.In AOT-isooctane reverse micellar extraction system,denaturation or precipitation of proteins always occured due to strong electrostatic interaction between AOT-proteins molecules.It had been resolved by adding ethanol into reverse micellar system,and no denaturation was observed.Otherwise,the phase separation time was shortened significantly because of ethanol added.It was only 10 minutes or less to reach phases separation after forward and backward extraction.If this method can be applied in industry,efficiency will be greatly improved.

BACKGROUND: Phosphorylcholine-containing poly (L-lactide) (PLLA-PC) is a kind of novel amphiphilic copolymer with good biocompatibility and biodegradability. In the previous work, self-assembly micelles of PLLA-PC were prepared with film rehydration method. But it hardly formed micelle with film rehydretion method because the longer chains of LLA existed in the PLLA-PC copolymer. However, the mechanism of phosphotipid choline polymer with long hydrophobic chain forming micelle remains still unclear. OBJECTIVE: To prepare self-assembling nanoparticles of PLLA-PC using solvent evaporation method, and to explore the factors that affected the properties and stability of nanoparticles.METHOD: ① Nanoparticles were prepared with solvent evporation metod.PLLA-PC copolymer was dissolved into acetone, and the copolymer solution was added dropwise to distilled water with stirring to yield nanoparticles. The critical micelle concentration (CMC) was performed on the F-7000FL220-240V. The emission and excitation wavelength were 395 nm and 300 mm, respectively. Transmission electron microscopy (TEM) was carried out on a JEM-100CX electron microscope to observe the morphology of PLLA-PC nanoparticles. Dynamic light scattering measurements on nanoparticle solutions were performed on a NANOSIZE 3600 at room temperatire. ②Gel permeation chromatography(GPC)measurements were perfrmed on a Waters 717 apparatus equipped with an RI detector. THF was used as the mobile phase at a flow rate of 1.0 mlJmin. A 1 g/L solution (50 μL) was injected for each analysis. RESULTS AND CONCLUSION: TEM indicated that the PLLA-PC nanoparticles presented typical shell/core structure. The critical micelle concentration was determined by fluorescent probe method. The results showed that the CMCs were quite low ( 10~(-3) g/L) and were dependent on the LLA units in the copolymer. The size and size distribution of the nanoparticles were detected by dynamic light scattering. The results indicated that the size could be affected by the LLA units, concentration of the organic solution and the concentration of the aqueous solution of the nanoparticles. On the other hand, they hardly changed over the dilution with water, which was of great importance in venous injection. They degraded at 37℃. PLLA-PC nanoparticles with controllable sizes can be prepared with phase separation method and might serve as a novel material for drug delivery.

Objective To analyze the schistosomiasis endemic situation and understand its transmission trend in Jiangling County from 2004 to 2013 so as to improving the schistosomiasis control. Methods The relevant data of schistosomiasis were collected and analyzed statistically in Jiangling county from 2004-2013. Results The human prevalence of schistosomiasis was decreased from 10.22%in 2004 to 0.63%in 2013 with the descend rate of 93.84% and the notable descend rate was 76.92%from 2009-2013. The cattle infection rate was decreased yearly from 7.59%in 2004 to 0 in 2013. The appearance rate of frames with living Oncomelaniahupensissnails and the infection rate of snails reduce by 17.53%and 100%respectively. Conclusions Af?ter 10?year control the endemic situation of schistosomiasis in Jiangling County decreases and is at a low level. However the risk factors of transmission still exist. Therefore the comprehensive control measures still should be enhanced continuously.

Objective To explore the value of free anterolateral thigh flaps in the reconstruction of maxillofacial defects after resection.Methods Patients were recruited from January,2008 to March,2016 in the Department of Oral and Maxillofacial Surgery of Nanjing University.All patients sunder when reconstructive surgery employing anterolateral thigh myocutaneous flaps follow-up of 3 months to 84 months after operation.Results Among 422 cases,survived completely with satisfied configuration,the survival rate was 98.6％.Postoerative vessel thrombosis occurred in flaps,21 patients required operative exploration in the perioperative period including 10 flaps with thrombotic events and 11 flaps with venous thrombosis were complete survival after the salvages,and 6 flaps were failure.The mean follow-up was 36.5 months (range:3 to 84 months).Conclusion The free anterolateral thigh flap is an ideal choice for reconstruction of maxillofacial defects,as it has many advantages such as abundance volume,easily molding and adjusting the thickness,possessing,long vascular pedicle,composition need to be adjusted according to defects,easily concealed donor site,and little donor site complications and malformation.

Objective To investigate the association between mycoplasma infection and pathogenesis of renal cell carcinoma(RCC). Methods There were 95 samples of archived embedded tissues of RCC and 60 samples of archived embedded normal renal tissues around the tumor for comparison.We detected mycoplasma hyorhinis P40 expression in archived embedded renal tissues by immunohistochemistry(IHC) with mycoplasma hyorhinis monoclonal antibody(MAb) PD4. Results Mycoplasma hyorhinis P40 was present in 64.2%(61/95 cases) of RCC and in 21.7%(13/60 cases) of the paratumor normal renal tissues in controls.The mycoplasma hyorhinis P40 expression ratio in RCC was significantly higher than that in the normal renal tissue,around the tumor(P

AIM: To investigate the role of nitric oxide synthase (NOS), soluble guanylyl cyclase (sGC) and protein kinase C (PKC) signaling in tumor necrosis factor-? (TNF-?)-induced cardioprotection against hypoxia/reoxygenation (H/R) injury. METHODS: Neonatal rat ventricular myocytes were pretreated with TNF-? or sodium nitroprusside (SNP) or L-arginine (L-Arg), respectively, for 12 h and then subjected to continuous hypoxia for 12 h, followed by reoxygenation for 6 h. The manganese superoxide dismutase (Mn-SOD) activity of the cells was measured after H/R. Myocyte injury was determined by the release of lactic dehydrogenase (LDH). RESULTS: TNF-? (10~5 (U/L)) significantly increased the Mn-SOD activity and decreased release of LDH from ventricular myocytes. The cardioprotection against H/R injury was induced by the pretreatment with SNP (5 ?mol/L) or L-Arg (5 mmol/L), which was blocked by ODQ (10 ?mol/L), the specific sGC inhibitor, and Chel (5 ?mol/L), the specific PKC inhibitor. Pretreatment with L-NAME (100 ?mol/L), ODQ, Chel, antoxidant 2-MPG (400 ?mol/L) or tyrosine kinase inhibitor genistein (50 ?mol/L) attenuated the increased Mn-SOD activity and reduced LDH level induced by TNF-?. CONCLUSION: The results suggest that NO may play a role in TNF-?-induced cardioprotection, which is mediated by sGC and PKC. [

Objective To evaluate the efficacy of a self-expandable metal stent coated with autologous endothelial progenitor cells(EPCs)for prevention of restenosis in transjugular intrahepatic portosystemic shunt(TIPS)in a swiue model.Methods EPCs were coated on the metal stents using fibrin gel before TIPS procedure.TIPS was performed in 15 young adult pigs,using an autologous EPC-seeded stent(treatment group,n=9)or a conventional bare metal stent(control group,n=6).All pigs were sacrificed at 2 weeks after TIPS procedure.Portography was performed immediately before the euthanasia.Gross and microscopic pathological exams and immunohistochemical exams of the TIPS track specimens were performed.Fisher test and t test were used to analyse the data.Results TIPS was performed successfully in all the 15 swine.On day 14 of follow-up,direct portography and necropsy demonstrated that 5 shunts remained patent,2 shunts stenosed,and the remaining 2 shunts occluded in the treatment group(n=9);while 5 shunts were occluded and one shunt was stenotic in the control group(n=6).The patency rate was 56%vs 0(P=0.03)between the two groups.Histological analyses showed a greater pseudo-intimal hyperplasia in the TIPS track of the control group than that of the treatment group(pseudointimal thickness at hepatic vein,hepatic parenchyma and portal vein site was(1.2±0.4),(1.3±0.5),(1.5±0.4)mmvs(1.0±0.6),(0.9±0.5),(1.0±0.4)mm respectively(P＜0.05).Conclusion The EPC-coated metal stent is feasibly constructed in vitro and improves the patency in TIPS in a porcine model.

Objective To compare the effects of three different training patterns of MOTOmed training on the somatosensory evoked potentials (SEPs) of healthy youths. Methods Ten healthy young volunteers received training in patterned sequences of passive movement, active movement with no resistance and active movement with resistance. Each pattern lasted for 30 minutes and SEPs were examined before and after 90 minutes of training. The amplitude and latency of N9 and P40 were recorded. Results All three training patterns heightened SEP amplitude and lengthened SEP latency, but active training had the most obvious effect on amplitude. The rates of change of am-plitude after each training pattern had significant differences, which was most obvious after training the resistance training pattern. Conclusions MOTOmed motor training can excite the cerebral cortex and up-regulate SEP ampli-tude. Active movement with resistance is the most effective among the three patterns tested.