Objective To confirm the feasibility and security of the liver hanging maneuver in difficult right hemihepatectomy.Methods Medical records of 40 conseeutive patients considered for difficult right hemihepatectomy were reviewed.The patients were grouped into two groups in pairs:group 1 (using the hanging maneuver) in 20 and group 2 (using the traditional maneuver) in the left 20.Results It was successful in 20 patients and the overall feasibility was 100%.Operative duration,bleeding,transfusion,average stay and complications in group 1 were lower than those of group2.Conclusion The liver hanging maneuver not only has high feasibility but also improves the security in difficult right hemihepatectomy.

Objective To evaluate the the safety and efficiency of precise liver resection for patients with primary liver cancer. Methods 86 patients with primary liver cancer were randomized to receive conventional routine hepatectomy (n=44) or the precise liver resection (n=42). Outcomes were compared between the precise hepatectomy group and the routine group, including, the blood loss, operation time, morbidity and mortality. Results There were significant differences in morbidity rates (7.1% vs. 20.5%; P<0.001), the blood loss [(320±315) ml vs. (613±526) ml;P<0.001) , postoperative alanine aminotransferase (ALT) value (in postoperation 7 d, 82.7 U/L vs.321.7 U/L; P<0.001) and length of hospital stay (12.3 d vs. 18.6 d; P<0.001) between precise hepatectomy and routine groups. The 1 year tumor recurrence rate and 1 year survival rate were 26.2%(11/42) and 78.6% (33/42) in precise liver resection group, 38.6% (17/44) and 65.9%(29/44) in routine liver resection group,with significant difference (P=0.010;P=0.018). Conclusion Precise liver resection is safe and effective in the treatment of liver tumor without much injury to patients.

Endophytic fungi which reside in the tissue of mangrove plants seem to play an important role in the discovery of new biologically active substances. During the course of screening for the antimicrobial metabolites from the endophytic fugus Penicillium sp. FJ-1 of mangrove plant Avicennia marina, a new aurone glycoside (1) was isolated by repeated column chromatography on silica gel and recrystallization methods. The structure of 1 was elucidated as (Z)-7,4'-dimethoxy-6-hydroxy-aurone-4-O-β-glucopyranoside, on the basis of spectroscopic analysis. Compound 1 exhibited antifungal activity against Candida sp., with the potency comparable to amphotericin B and much better than fluconazole. Compound 1 can also inhibit extracellular phospholipase secretion in a concentration-dependent manner.
Antifungal Agents ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Benzofurans ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Candida ; drug effects ; Glycosides ; chemistry ; isolation & purification ; metabolism ; pharmacology ; Molecular Structure ; Penicillium ; chemistry ; genetics ; isolation & purification ; metabolism ; Seawater ; microbiology

Objective To detect the correlations of miR -106 a expression with clinical features of pa-tients with colon cancer ,and to explore the significance of miR -106 a as a prognostic factor .Methods One hun-dred and five patients with primary colon cancer were retrospectively enrolled in this study including their clinical information and slices of FFPE.miR-106a expression was detected by qRT -PCR,and analyzed the correlation between the level of miR -106a and clinical features and survival .Results The level of miR -106a in tumor tissue was higher than adjacent normal tissue (1.142 vs.0.685,P<0.001).miR-106a was correlated with TNM stage and lymphnode metastasis .The higher miR -106a expression,the poorer survival patients were .The hazard risk was increased 3.390 folds(95%CI for HR:1.028 ~11.178)when compared high expression group with the low.Conclusion The aberrant expression of miR -106a may be associated with colon cancer .It will po-tentially be a therapeutic target and prognostic factors .

The possibility of polyoxymethylene (POM) as heart valve leaflet material was investigated by comparing the hemocompatibility with that of 316L stainless steel and low-temperature isotropic pyrolytic carbon (LTIC). Surface hydrophobicity was characterized by water contact angle measurement. Platelet adhesion, APTT/PT/TT and hemolysis rate tests were applied for evaluating hemocompatibility. The results showed that POM was hydrophobic and had a low hemolytic rate, adhesion amount and activation degree of platelets on POM surface were less than 316L stainless steel, and was similar to LTIC. This research pointed out potential application of POM as heart valve leaflets.
Biocompatible Materials ; chemistry ; Blood Platelets ; Carbon ; chemistry ; Heart Valve Prosthesis ; Heart Valves ; Humans ; Platelet Adhesiveness ; Resins, Synthetic ; chemistry ; Stainless Steel ; chemistry

BACKGROUND:Bone marrow derived mesenchymal stem cells (BMMSCs) have multi-differentiation potentials, possessing a repairing capability for the sectional bone defects if combined with degradable porous β-tricalcium phosphate china. This provides a new idea in clinical repair of various bone defects.OBJECTIVE: To explore in radiology the curative effect of implanting porous β-tricalcium phosphate and autogenous BMMSCs compound to treat bone defects.DESIGN: A randomized controlled study with callus growth at various healing periods as subjects for observation. SETTING: Department of Orthopaedics, Renmin Hospital, Wuhan University; Tissue Engineering Center, Research Institute of Basic Medicine,Academy of Military Medical Sciences of Chinese PLAMATERIALS: This experiment was carried out at the Tissue Engineering Center, Research Institute of Basic Medicine, Academy of Military Medical Sciences of Chinese PLA between March and September 2002. Twenty China healthy adult sheep were randomized into the groups of blank control group (4 sheep), simple implantation group (8 sheep) and complex implantation group (8 sheep).METHODS: Under general anesthesia and aseptic condition, 10-15 mL of sheep marrow was extracted; MSCs were separated and cultured before combined with porous β-tricalcium phosphate china for tissue engineering bone construction. Rats in each group were cut off 21mm long metatarsus in the middle section of metatarsus bonestem. Β-tricalcium phosphate china and autogenous MSC compound was implanted into the sheep of the complex implantation group; β-tricalcium phosphate china was implanted into the simple implantation group; and the bone defects in the blank control group remained untouched. Then the incision was sutured.X-ray filming was carried out right after the operation, as well as 1, 3,and 6 months after the operation for radiological appraisal (scored for1 if bone union formed in one surface of bone defect, but scored 0 if no boneunion formed in any surface of bone defect, and scored 4 if bone union formed in front, back, lateral surfaces and the center of bone defect), Xray radiation-resisting density was analyzed to compare the results of bone defect repair.MAIN OUTCOME MEASURES: The postoperative general condition and general observation, as well as the results of the radiological analysis of the bone defects of all sheep.RESULTS: Totally 20 sheep were brought into this xperiment and all entered the stage of result analysis. ① The postoperative general condition:Sheep regained consciousness 2-6 hours after the operation without incision infection and loosing of internal fixation. Their spirit gradually was back to normal 1 week after the operation, at which time the injured legs could touch ground but were incapable of bearing load, and the affected legs could bear load 2 weeks after the operation, walked slightly lamely 3 weeks after the operation, and even moved freely without limp 4 weeks after the operation. ②The general condition 6 months after the operation: In pure implantation group, the surface white hyaline cartilage-like tissues were gradually calcified, with both ends connected with the host bone by bone bridge, but china granules could still be easily observed; while no implantation substance could be observed in compound implantation group,with the boundary between implantation substance and host bone vanished,and bone defect became basically the same as host bone. However there was no bone tissue formed in bone defect at various postoperative time points in the blank control group. ③ Radiological analysis of the bone defects at various postoperative time points: The radiological rating score was obviously higher in complex implantation group at the time poin ts of 3, 6 months after the operation compared with the pure implantation group [(2.3±0.3), (1.8±0.5); (3.3±0.5), (2.6±0.6), P ＜ 0.05]. ④ Radiological analysis of bone callus thickness and the relative value of radiation-resisting density at various postoperative time points: The bone callus thickness in the complex implantation group was obviously lower than that of the pure implantation group at the postoperative time point of 6 months (4.62 vs 7.64, P ＜ 0.05), with relative value of radiation-resisting density obviously higher than that of the pure implantation group (70.4±1.5 vs 61.18±1.2, P ＜ 0.05).CONCLUSION: Radiological appraisal and bone defect density measurement can well reflect the dynamical repairing process of bone defects; the implantation of porous β-tricalcium phosphate china and autogenous BMMSCs compound into sheep can enhance the repair of large sectional bone defect.

BACKGROUND: Urinary incontinence can be divided into stress, urgent and mixed types, they can not be easily distinguished only basing on clinical experience, which often result in misdiagnose or improper treatment OBJECTIVE: To discuss the value of urodynamical inspection, especially stress leak point pressure (SLPP) determination in the diagnose of female stress urinary incontinence.DESIGN: Retrospective paralleled comparison observation.SETTING: Center of General Urology Department, Southern Hospital,Third Military Medical University of Chinese PLA PARTICIPANTS: Totally 120 female patients who received medical treatment in the uropoiesis surgical department of the Southwest hospital due to urinary incontinence between January 1996 and May 2002 were enrolled in this experiment.gle was determined and considered as normal if it was ＜100° and abnormal if ＞ 100°. Urethral tilt angle is judged as normal if ＜ 45° and abnormal if ＞45°; Urethrovesical junction (when static state) was judged as normal if not tion: including fulling urinary bladder pressure measurement, static urethral Cystourethrography classification standard: type Ⅰ refers to posterior urethrovesical angle vanished with urethral tilt angle＜45° and the biggest urethra closure pressure＞20 cmH2O; type Ⅱ: refers to posterior urethrovesical angle vanished with urethral tilt angle＞45° and the biggest urethra closure pressure＜20 cmH2O; type Ⅲ refers to normal posterior urethrovesical angle with urethral tilt angle＜45° and the biggest urethra closure pressure ＞20 cmH2O. SLPP classification standard: typeⅠ: SLPP ＞120 cmH2O; type Ⅱ: SLPP of 90- 120 cmH2O; type Ⅲ: SLPP ＜ 60 cmH2O;type Ⅱ/Ⅲ: SLPP of 60 - 90 cmH2O.compared with that of cystourethrographic classification.RESETS: Totally120 patients all remained in the final result analysis.stress urinary incontinence, 64 cases as symptomatic stress urinary incontinence including 28 cases of unstable bladder and 36 cases of low compliclassification: of the 56 genuine stress urinary incontinence, 20 cases were diagnosed as type Ⅰ; 16 cases as type Ⅱ and 10 cases as type Ⅱ/Ⅲ; 10cases as type Ⅲ. Two classification was proved of 100% consistency in type Ⅰ and Ⅲ, and 94.1% and 90.1% in type Ⅱ and type Ⅱ/Ⅲ respectively, difference was not remarkable (P＞0.05).CONCLUSION: SLPP determination can be used to make accurate classification of female genuine stress urinary incontinence, possessing important instructive significance for the treatment.

Objective To analyze the clinical and CT manifestations of the chest and abdomen lymphangioleiomyomatosis (LAM). Methods The clinical and CT manifestations of 13 patients with LAM proved histopathologically were reviewed retrospectively.Results Twelve patients onset with intrapulmonary manifestations all had progressive dyspnea, other symptoms included pneumothorax of recurrent attacks, chest distress, hemoptysis, cough, chylothorax and so on. During the course of disease, 12 patients had no extrapulmonary symptoms, abdominal great goiter was found unintentionally in the rest one without any intrapulmonary symptoms. Pectoral CT manifestations included sporadic or asystematic cysts in pulmones with size of 2-20 mm, and most had thin and clear capsule wall. The lung parenchyma among cysts was mostly normal. Four patients had pneumatocele, 2 had pleural effusion. Abdominal CT was performed in 10 patients and 7 had abnormal findings: renal angiolipoleiomyoma (ALL) in 3 including one had retroperitoneal multiple lymphangiomyomas and effussion and seroperitoneum, another 2 had multiple liver ALL and spleen accretion. The rest 4 patients included retroperitoneal lymphadenectasis in 2, seroperitoneum in one, as well as retroperitoneal lump and spleen accretion in one patient.Conclusion Pectoral and abdominal symptoms in LAM are not specific, but the CT manifestations somehow specific, which are helpful to the identification and early diagnosis of LAM.

Objective To evaluate the value of monitoring serum cystatin C in assessment of renal function in patients with renal transplantation.Methods Serum cystatin C, creatinine (SCr), β2-microproglobin (β2-MG) and urea nitrogen (BUN) levels were determined at different time points (pre- or post-operation) in 58 renal transplant patients.Glomerular filtrated rate (GFR) was determined by using of 99mTc-DTPA at the seventh day after operation.The correlation between GFR and the four markers was analyzed.Diagnostic characteristics and ROC curve for the four markers were obtained using a GFR cut-off of 1.5 ml/s.Intra-individual coefficients of variation (CV) for cystatin C and SCr according to different time points during post-operation monitoring and the ratio (R) between CVSCr and CVcystatin C were calculated.Results Cystatin C was decreased by 48.1 % at the first day after operation, which was higher than others.The correlation coefficients between GFR and cystatin C, SCr, β2-MG, and BUN were 0.876, 0.691, 0.589, 0.516 respectively.Diagnostic characteristics for GFR and cystatin C, SCr, β2-MG, and BUN were as follows:sensitivity (91.3 %, 87.2 %, 82.6 %, 87.0 %); specificity (80.0 %, 69.2 %, 71.4 %, 42.9 %), positive predictive value (82.0 %, 73.7 %, 74.3 %, 60.4 %); positive likelihood rate (4.81, 2.83, 2.87, 1.53).The area under the curve (AUC) for GFR and cystatin C, SCr, β2-MG, and BUN was 0.914, 0.828, 0.803, and 0.765 respectively.The CVSCr was significantly lower than CVcystatin C (P＜ 0.01).R was less than 1 in most patients with cystatin C＜2 mg/L.In patients with cystatin C＞2 mg/L, R tended value 1 with increasing concentrations of cystatin C.Conclusion Cystatin C showes the best correlation to GFR, and is superior to the other markers in accurate in differentiate mild renal impairment from moderate and severe renal impairment.When renal function has minimal change, the cystatin C level has significant change.When the renal function has mild impairment, great changes in serum cystatin C indicate the unstable renal function.

Objective To explore the correlative factors and management of secondary high intraocular pressure(IOP) after vitreoretinal surgery for proliferative diabetic retinopathy(PDR). Methods The data of 51 patients(54 eyes) with PDR after vitreoretinal surgery were collected.The incidence of secondary high IOP was obtained,and the correlative factors leading to high IOP were analysed.Besides,the therapeutic effects of management were observed. Results Twenty-six patients(26 eyes) experienced postoperative high IOP,with the incidence of 48.15%(26/54).It was revealed that the preoperative retinal detachment,the combined performance of crystal phacoemulsification,the practice of intraocular tamponade and the postoperative posterioruveitis were related to the occurrence of high IOP(P