Objective: To investigate the role of intraoperative ultrasound(IOUS) and appropriate approach in local resection for the central small hepatocellular carcinoma(sHCC) which is deeply situated within the parenchyma and adjacent to the hepatic veins. Methods: under IOUS guidance, local resection was carried out for 8 cirrhotic patients with central sHCC which was deeply located and adjacent to hepatic veins by approach of splitting or unroofing superficial hepatic parenchyma. Results: All tumors were precisely localized by IOUS and excised successfully. Except for injury to central hepatic vein in 1 case, no other injury occurred to the hepatic veins in the remaining 7 cases. There was no postoperative mortality, and the liver function recovered well in all cases postoperatively. Conclusion: Local resection by using IOUS and appropriate approach is applicable for the cirrhotic patients with deeply located central sHCC. IOUS plays an important role in avoidance of injuries to the hepatic veins.

[Objective]To investigate the effects of two different densities of bone marrow mesenchymal stem cells (BMSCs) combined with ?-TCP on spinal fusion in rabbits.[Method]Spinal fusion surgery of lumber intertransverse process were performed using MSCs/?-TCP as a graft in two groups of rabbits (low density group versus high density group),and rate of lumbar fusion,image characteristics,bone mineralization content,bone mineralization density,bone mineralization tissue volume and rate of new bone formation were observed.[Result]Compared with the low intensity group,the rate of lumbar fusion was greatly improved in the high density group(P

Objective To investigate the role of modified Seldinger technique combined with vascular ultrasonography in the placement of peripherally inserted central catheters (PICC) in patients with breast cancer undergoing postoperative chemotherapy.Methods Totally 120 patients with breast cancer undergoing postoperative chemotherapy were equally divided into the observation group and the control group using the table of random number.In the observation group,PICC were placed using the modified Seldinger technique combined with vascular ultrasonography; in the control group,the PICC were placed using the traditional blind puncture technique.The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis and thrombosis were compared between two groups.Results The success rate of first puncture,success rate of first placement,and the incidences of mechanical phlebitis were 91.67％,100％,and 3.33％,respectively,in the observation group and 76.67％,86.67％,and 45％,respectively,in the control group (P =0.0061,P =0.0434,and P ＜ 0.0001).However,no significant difference was found on the incidence of thrombosis between the two groups (P =0.1187).Conclusion Modified Seldinger technique combined with vascular ultrasonography is efficient and safe for PICC placement for patients with breast cancer undergoing postoperative chemotherapy.

Objective To research the expression and biological significance of methallothionein(MT) in different thyroid diseases(TDs).Methods The expression of MT was observed by immunohistochemical stain and the difference among TDs was compared.Results MT was completely expressed in all TDs. Expression of MT was 87.60?9.20 in thyroid carcinoma,significantly higher than that(62.20?12.40) in thyroid adenoma, that(61.10?13.20) in Graves′ disease and that(58.50?10.60) in Hashimoto′ thyroiditis (P

Objective To investigate the distribution of occupations and traditional Chinese medical syndromes of the patients with hypokalemic periodic paralysis in Foshan area. Methods A multicenter retrospective investigation was carried out to analyze the characteristics of occupations and syndrome types of hypokalemic periodic paralysis in Foshan area, and the correlation of occupations with syndrome types was also explored. Results (1) The workers engaged in agriculture, forestry, animal-breeding and fishing, and the workers engaged in production & transportation were most likely to suffering from hypokalemic periodic paralysis, with the incidence being 36.8%, 34.7% respectively. (2) The damp-heat syndrome was the most commonly-seen syndrome type, accounting for 53.1%, and then followed by Qi deficiency syndrome (20.3%) and Qi-Yin deficiency syndrome(15.7%).(3) The syndromes of heavy manual labor workers such as agriculture, forestry, animal-breeding and fishing workers, production & transportation workers, and soldiers were characterized by damp-heat type, accounting for 62.5%, 69.4%, 47.0% respectively. Professionals & technicians were most likely to suffering from Qi-Yin deficiency syndrome, accounting for 44.4%; business service personnel were most likely to suffering from Qi-Yin deficiency syndrome (32.5%) and Qi deficiency syndrome (31.3%). The syndrome distribution of heavy manual labor workers differed from that of light manual labor workers and brain workers(P < 0.001). Conclusion The high-risk groups of hypokalemic periodic paralysis in Foshan area are the heavy manual labor workers who are manifested with the damp-heat syndrome. The dominated syndrome types of light manual labor workers and brain workers are Qi deficiency and Qi-Yin deficiency.

Objective To compare the clinical effects of closed reduction and intramedullary nailing versus open reduction and plate fixation in the treatment of displaced midshaft clavicular fractures.Methods A prospective,randomized,controlled trial was performed between July 2012 and May 2014 in 194 patients with acute displaced midshaft clavicular fracture.They were 136 males and 58 females,from 16 to 65 years of age.They were randomly divided into 2 groups to received either closed reduction and intramedullary nailing (n =98) or open reduction and plate fixation (n =96).We recorded operation time,intraoperative blood loss,hospitalization expenses,fracture healing time and complication rate.Functional assessments were conducted at 3,6 and 12 months using the Disabilities of the Arm,Shoulder and Hand (DASH) and Constant-Murley scores.The preoperative general data showed no statistical significance between the 2 groups (P ＞ O.05).Results All the 194 patients were followed up for 12 to 27 months (average,15.6 ±3.1 months).The operation time (27.7 ± 16.3 min),intraoperative blood loss (18.6 ± 14.4 mL),hospitalization expenses (12,462.0 ±3,263.4 yuan),and fracture healing time (12.1 ± 3.0 weeks) in the intramedullary nailing group were significantly better than those(62.3 ± 19.4 min,40.3 ± 17.4 mL,24,760.0 ± 3,320.4 yuan,and 16.9 ± 2.8 weeks) in the plate fixation group (P ＜ 0.05).At 3 months after surgery,the DASH (13.4 ± 3.5) and Constant-Murley (88.5 ±5.9) scores in the plate fixation group were significantly better than those (24.8 ± 6.7 and 69.1 ± 6.2,respectively) in the intramedullary nailing group (P ＜ 0.05).At 6 and 12 months after surgery,there were no significant differences in the Constant-Murley scores or DASH scores between the 2 groups (P ＞ 0.05).The complication rate in the intramedullary nailing group (25.5％,25/98) was significantly higher than in the plate fixation group (9.4％,9/96) (P ＜ 0.05).Conclusions In the treatment of displaced midshaft clavicular fractures,compared with open reduction and plate fixation,closed reduction and intramedullary nailing has advantages of less invasion,lower cost and faster fracture healing,but a disadvantage of higher complication rate.The 2 treatments may lead to similar functional recovery of the shoulder.

Objective To explore the key points of diagnosis and treatment of Behcet's disease with venous sinus thrombosis.Methods The diagnosis and treatment of a 25 year-old female patient with recurrent headaches was analyzed and discussed.Results Her headache was due to Behcet's disease with venous sinus thrombosis and her symptoms were gradually relieved.Conclusion Physician should be asked about the history in patients with persistent headache and the correct diagnosis can be made by MRI.

Objective To evaluate the clinical value of eversion carotid endarterectomy in patients with carotid atherosclerosis stenosis. Method Summarized the clinical data of 20 patients who accepted eversiou carotid endarterectomy from March 2009 to August 2009, compared the outcomes with preoperative and postoperative image learnt materials and clinical symptoms. Results All cases finished successfully. All clinical symptoms were improved after operation. The stenosis were all improved completely on the image after operation. Conclusions Eversion carotid endarterectomy is safe, effective, and shortening operative time and hospitalization time. It has low restenosis rate, thicken endometrium and plaque can be stripped completely.

Objective To construct and purify the recombinant protein of platelet-activating factor acetylhydrolase (PAF-AH) isoform I , and study the enzyme activity by different substrates. Methods The (3 subunit of PAF-AH isoform I was cloned and expressed in E. coli. Exogenously expressed recombinant protein was purified to SDS-PAGE homogeneity, and its activity was identified by arylesterase detection. Phenylacetate, 1-O-hexadecyl-2-deoxy-2-thioacetyl-sn-glycero-3-phosphocholine ( 2-Thio PAF) and l-myristoy1-2-( 4-nitrophenylsuccinyl) phosphatidylcholine (the latter two were commercial plasma PAF-AH substrates) were used for the substrate identification. The plasma type PAF-AH was served as positive control. Results Recombinant protein of β subunit of PAF-AH isoform I was successfully constructed and expressed in E. coli after purification. Compared with positive control, the recombinant protein could hydrolyze phenylacetate and 2-Thio PAF, but could not hydrolyze l-myristoyl-2-( 4-nitrophenylsuccinyl) phosphatidylcholine. Conclusion Recombinant protein of β subunit of PAF-AH isoform I can be successfully constructed. There are differences in the substrate specification to the two commercial PAF substrates for PAF-AH isoform I and plasma type PAF-AH, which provides a quick method to differentiate PAF-AH isoform I from plasma type PAF-AH.

Objective To observe the clinical outcome of closed reduction and percutaneous screw fixation for talar neck fractures,and explore the minimally invasive treatment for talar neck fractures.Methods From June 2009 to December 2012,12 cases with talar neck fracture were treated by closed reduction and percutaneous screw fixation,including 10 males and 2 females with an average age of 34 years (range,21-52).All cases are unilateral side,including five cases of left foot and seven cases of right foot.All cases are evaluated the displacement,shape and number of fracture fragments by CT before fixing the fracture.According to Hawkins classification:type Ⅰ 7 cases,type Ⅱ 5 cases.Seven patients with type Ⅰ were used direct percutaneous screw fixation,five patients with type Ⅱ were treated with closed reduction and subsequent percutaneous screw fixation.The Computed Tomography was used to evaluate the quality of close reduction.The AOFAS (ankle-hindfoot scale) scores was used to evaluation clinical outcome in follow-up,and Computed Tomography was used to evaluate the result of reduction and fixation after operation.Recording Hawkins sign according to X-ray film,recording infection,talar body necrosis,traumatic arthritis and other complications.Results Twelve patients were followed up for an average of 34 months (range,22-40).At the end of followup,the AOFAS scores was average 90 points (range,84-95).Nine patients showed Hawkins sign 6 to 10 weeks after operation,2 patients did not find Hawkins sign,but in the follow-up period didn't appear talar body necrosis.One case did not appear Hawkins sign,and who's talar body necrosis was diagnosed by MRI,but no collapse,no pain and did not need further treatment.There patients with postoperative subtalar traumatic arthritis,patients are asymptomatic,at end no further treatment.All patients with no wound complications and no neurovascular injury.Conclusion Closed reduction and percutaneous screw fixation for talar neck fractures can obtain excellent clinical results,but should be selecting the appropriate patients,and Computed Tomography must be used to ensure satisfactory reduction.