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 .

Objective To explore the effects of repetitive transcranial magnetic stimulation (rTMS) and fluoxetine on depression and cognition in the treatment of post-stroke depression (PSD).Methods A total of 82 PSD patients were divided into a treatment group and a control group using a random number table.Besides conventional neurological therapy,the treatment group was treated with rTMS combined with fluoxetine,while the control group was treated only with fluoxetine.Forty healthy persons acted as normal controls.The Hamilton depression rating scale (HAMD) was used to evaluate depressed emotions,and event-related potential (ERP) P300 and exploratory eye movement (EEM) were used to evaluate cognitive function.The three groups were tested before treatment and after 8 weeks of treatment.Results After 8 weeks of treatment the HAMD scores in both the treatment and control groups had decreased significantly compared with before treatment.The HAMD scores decreased significantly more in the treatment group than in the control group.Before treatment,the N2 and P3 iatencies of P300 in the treatment and control groups were significant longer than those in the normal group,and the average amplitude of P3 in the treatment and control groups was significantly lower than among the normal controls.Before treatment,the number of eye fixations (NEF) and the average responsive search score (RSS) in the treatment group and control groups were significantly lower than in the normal group.After 8 weeks after treatment,the N2 and P3 latencies were significantly shorter and the amplitude of P3 was significantly higher in the treatment and control groups than before treatment.The NEF and the average RSS in the treatment and control groups had increased significantly compared with before treatment.All of these indexes improved significantly more in the treatment group than in the control group.Conclusion rTMS combined with fluoxetine can improve depression and cognitive function among PSD patients better than antidepressant treatment alone.

BACKGROUND:Currently, bone marrow mesenchymal stem cel s can differentiate into nerve cel s via many approaches. Different methods for inducing bone marrow mesenchymal stem cel s differentiating into nerve cel s have different ratios. OBJECTIVE:To investigate the difference between chemical method and co-culture method to induce the differentiation of rat bone marrow mesenchymal stem cel s into nerve cel s. METHODS:Rat bone marrow mesenchymal stem cel s were isolated and purified using whole bone marrow culture method, and then randomly divided into two groups:chemical group,β-mercaptoethanol was added;co-culture group, co-cultured in a Transwel chamber. RESULTS AND CONCLUSION:Visible protrusions from induced cel s showed radiation growth at 1 week of induced culture, and neuron-specific enolase staining was positive at 2 weeks of culture. Star-like structure of nerve cel s was visible in the co-culture group within 4-5 days of culture, and then more protrusions formed. Meanwhile, the positive rate of neuron-specific enolase was (70.82±2.46)%. After 6-7 days of culture, neuron-like cel s formed and were interconnected in the chemical group;while, the positive rate of neuron-specific enolase was (52.37±1.83)%. These findings suggest that cel microenvironment plays a leading role in the differentiation of bone marrow mesenchymal stem cel s into nerve cel s, and chemical induction method is inferior to the co-culture method.

Objective To investigate etiologies,treatment approaches and prophylaxis for delayed thoracostomach emptying in esophageal or gastric cardiac cancer patients treated with esophagogastrostomy.Methods We performed a retrospective review of the clinical data of 24 patients suffering delayed thoracostomach emptying among 1985 post-surgical patients with esophageal or gastric cardiac cancer from January 2000 to June 2011.Results Eighteen patients in the 24 patients were cured by conservative managements including endoscopic dilatation procedures.The remaining 6 patients were treated with surgery.Conclusion The main etiology of delayed thoracostomach emptying is gastroparesis,which can be treated with nonsurgical conservative approaches; whereas mechanical emptying disturbance requires surgery.Endoscopic examination appears to be the most important diagnostic approach in identifying and differentiating the etiologies of delayed thoracostomach emptying in post-surgical patients.Endoscopic dilatation procedure is proved to be effective for the treatment of delayed thoracostomach emptying in post-surgical patients in this study.

Objective To investigate the mRNA expression of survivin, livin and XIAP gene in peripheral blood of patients with gastric cancer and its relationship with clinico-pathological features.Methods This study included 50 patients with gastric cancer and 20 healthy donors. The expression of survivin, livin and XIAP gene was detected by reverse transcription-quantitative polymerase chain reaction (RT-QPCR) using a molecular beacon probe, while recombination plasmid containing the sequence of survivin, livin and XIAP was standard. The relationship between copies of survivin, livin and XIAP gene expression in peripheral blood with gastric cancer and clinical data was analyzed. Results A linear standard curve was obtained between 103 ～ 1010 copies. The copies of survivin, livin and XIAP mRNA in peripheral blood of patients with gastric cancer did not correlate with gender, age, and histological types ( P ＞ 0.05). There were positive relationships between copies of survivin, livin and XIAP gene with lymph node metastasis and TNM stage (P ＜0.05 ). The expression of survivine, livin and XIAP was all negative in peripheral blood of healthy people. 52% (17/33) of patients suffered from recurrence or metastasis who had positive expression of survivin and/or livin and/or XIAP mRNA, while it was 18% (3/17)among the negative survivin and/or livin and/or XIAP mRNA caces ( P ＜ 0.05). Conclusions The expression of survivin, livin and XIAP mRNA can be used to detecte micro-metastasis in peripheral blood circulation of gastric cancer.

Objective To investigate the efficacy and prognostic factors of transcatheter arterial chemoembolization (TACE),and radiofrequency ablation (RFA) combined with intensity modulated radiotherapy (IMRT) for hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT).Methods Sixtythree cases of HCC with PVTT were retrospectively analyzed.All of them received 1-3 time(s) of TACE therapy followed by RFA.IMRT was finally performed to PVTT.Both the therapeutic effects of HCC and PVTT were observed in 6 to 8 weeks after IMRT therapy.The long-run efficacy was observed by analyzing the 1-3 year(s) survival rate,and the hazards to prognosis were analyzed.Results The CR,PR,SD,PD numbers and rates in PVTT were 9 cases (15.0％),36 cases (60.0％),10 cases (16.6％),and 5 cases (8.3％).The effective rate in PVTT was 75.0％.Meanwhile the CR,PR,SD,PD numbers and rates in HCC were 19 cases (31.6％),30 cases (50.0％),6 cases (10.0％),and 5 cases (8.3％).The effective rate in HCC was 81.6％.The 1,2 and 3 year survival rates were 73.3％,45.0％ and 27.0％,respectively.ECOG score (x2 =53.046,P =0.000),history of hepatitis (x2 =6.472,P =0.030),tumor size (x2 =7.293,P =0.026),the number of tumor(x2 =24.382,P =0.000),the types of tumor thrombus (x2 =28.085,P =0.000) and Child-Pugh class (x2 =6.184,P =0.040) were independent hazardous factors for survivals.Conclusion TACE combined with RFA is effective treatment for HCC with PVTT patients with low frequency of severe complications and high rate of tumor response.ECOG score,history of hepatitis,the size and number of tumor,the types of tumor thrombus,Child-Pugh class are the factors that influence the long curative effect.

Objective To investigate the predictive value of dose?volume histograms ( DVHs ) of organs at risk ( OARs ) including the bladder, rectum, and small intestine in volumetric modulated arc therapy ( VMAT) plans for cervical cancer. Methods A total of 100 VMAT plans for cervical cancer were assigned into the learning group. The correlation of the anatomical information with the V30 , V40 , and V50 values of the bladder, rectum, and small intestine was evaluated in the group. The support vector regression ( SVR) algorithm was used to establish the correspondence between the anatomical information and the DVHs of OARs. The DVHs of OARs in the verification group containing 20 VMAT plans were predicted based on the anatomical information. Results The DVHs of the bladder, rectum, and small intestine were likely to be influenced mainly by the spatial relationship between these OARs and target volume. In the verification group, the prediction errors of V30,V40 and V50 by SVR algorithm were-2.4%±3. 5%,-2.5%±3. 8%, and-1.5%±4. 9% for the bladder, 0.5%±2. 6%,-1.5%±5. 1%, and-2.0%±7. 4% for the rectum, and-2.9%± 5. 3%, 2.7%±7. 7%, and 5.3%±11. 1% for the small intestine, respectively. Conclusions After learning the correlation between the anatomical information and the DVHs of OARs from prior VMAT plans for cervical cancer, SVR algorithm can precisely predict the DVHs of the bladder, rectum, and small intestine based on the anatomical information.