Objective To assess the clinical application value and advantages of DSCT Angiography on artery injury in Extremities. Methods Seven suspected patients with artery injury in extremities underwent DSCT Angiography, including three cases on artery injury of upper extremity and four cases on artery injury of lower extremity. All the seven patients were performed with DSCT Angiography after the operation. The data of thin slice cross section were reconstructed by MPR, MIP and VR, employing Somatom Definition, German. Contrast-concentration was 350 or 370mg i/ml, total amount was 80-100ml and injection rates was 4.0 ml/s. Results All the images of angiography displayed many clear blood vessels and smooth vessels verge, contrasting with surrounding issues well. They also displayed no ladder artifact or truncation artifact. The image quality was good enough to meet the requirements of clinical diagnosis. Meanwhile the coincidence between preoperative diagnosis and postoperative diagnosis was 100%. Conclusion To suspected patients with artery injury in extremities, DSCT Angiography may be the first choice. Three-dimensional reconstruction angiographys by means of different reconstruction techniques are very helpful in diagnosing and formulating treatment perscription.

AIM: To investigate the antitumor effects of tumor necrosis factor- ? (TNF - ?) and interferon -?(IFN -?) on hepatocellular carcinoma (HCC) . METHODS: Cytotoxicity of the combination of TNF-? and IFN-? on HCC in vitro was measured by using a crystal violet (CV) staining method. Antitumor effects of the combination of TNF- ? and IFN - ? on HCC in vivo were observed by intra - hepatic injection of TNF-? and IFN-? to the tumor in a human HCC nude mice hepatic model. RESULTS: The growth of HCC cells was inhibited by TNF -? alone, which was dose - dependent. The cytotoxicity of TNF -? on HCC was enhanced by incubation with IFN -?. TNF at 107 U/L, or IFN -? at 106 U/L alone killed only 27.1 % or 7.9 of HCC cells, respectively, when combined with IFN -?, it killed 83.7% of HCC cells. A synergistic antitumor effect on HCC in vivo was observed in combination group, as tumor growth inhibition rate was 35.9% compared with 17.2% in TNF-? group and 5.6% in IFN -? group. The survival period of mice bearing tumor was significantly prolonged and serum AFP was significantly decreased in combination group (P

AIM: To investigate the homing effect of immature dendritic cells (iDC) after injection of iDC into the mouse hepatoma treated by microwave ablation and the possibility of stimulating tumor immunity after thermal ablation. METHODS: The model of hepatoma was established with Hepa 1-6 cells injected into the subcutaneous tissue of C57BL/6J mice. The tumors were treated by microwave ablation under different temperatures, and then fluorescent-labeled iDCs (PKH26-DC) were injected into the ablated tumor tissues. The influences of ablation to homing of PKH26-DC, maturation and excitation ability towards T-cell were observed. RESULTS: There were no homing PKH26-DCs and expression of CCR7 in draining lymph nodes in (65?5)℃ and (90?5)℃ ablation groups after intratumoral injection of iDCs. The number of homing PKH26-DCs was 32?8 in (50?5)℃ ablation group vs 21?6 in un-ablated group, and the expression rate of CCR7 was 100% vs 90%. The number of clusters with immunological synapsis was 8-12 in (50?5)℃ ablation group vs 4-6 in un-ablated group under 100-magnification visual field, and the number of lymphocytes in each cluster was 12-25 vs 3-10. CONCLUSION: Thermal ablation of hepatoma under an appropriate temperature level may promote maturing and homing of iDCs and stimulate immunity of lymphocytes.

Objective To compare the treatment effect of laparoscopic appendectomy(LA) and open appendectomy (OA). Methods One hundred and forty-five cases of LA performed from May 2003 to May 2005, and 142 cases of OA performed from June 2001 to March 2003 were studied retrospectively. Results There was no difference in operative time between group LA and group OA. In the procedure of LA, some occult disease could be discovered and treated, while OA was not. The administration of analgesic, activity time, incidence of incision infection and hospital stay in group LA were better than those of OA group. While the cost of hospitalization in LA was higher than that of OA. Conclusion LA has significant advantages in treating appendicitis and it should be promoted.

AIM: To investigate the effect of microwave ablation of liver cancer on the cellular immunity in mice. METHODS: A C57BL/6J mouse model of liver cancer was established by subcutaneous injection of Hepa 1 - 6 cells. The tumors were subjected to microwave ablation under the ablation condition of 45 ℃, 50 ℃, 55 ℃ or 60 ℃ for 180 s. The CD4~+ T cells, CD8~+ T cells and natural killer cells (NK) in peripheral blood were detected by FACS. The cytotoxicity of splenic NK and splenic cytotoxic T lymphocytes (CTL) activated by inactivated Hepa 1-6 cells was assayed by LDH method. RESULTS: The proportions of CD4~+ T cells, CD8~+ T cells and NK cells in peripheral blood in 50 ℃ and 55 ℃ group at 21 d after ablation were significantly increased and that of NK cells in 60 ℃ group was significantly increased. There was no significant difference between those in group 42 d after ablation and control. The cytotoxicities of splenic CTL and NK cells in 50 ℃ and 55 ℃ groups at 21 d or 42 d after ablation were significantly increased, and they were much higher than those in 45 ℃ group at the same time. The cytotoxicities of splenic CTL in 50 ℃ and 55 ℃ groups at 21 d after ablation were much higher than that in 60 ℃ group at the same time. CONCLUSION: Under a certain ablation temperature, microwave ablation of liver cancer promotes the cellular immunity.

Objective To evaluate the accuracy and utility of percutaneous ultrasonic cholangiography in Bismuth staging of hilar cholangiocarcinoma. Methods Thirty patients who underwent surgery and obtained pathologic diagnosis of hilar cholangiocarcincoma were perspectively ruled in this study. All patients with hilar obstruction underwent baseline ultrasound (BUS), percutaneous ultrasonic cholangiography (PUSC) and percutaneous transhepatic cholangiography(PTC) respectively. Taking operative findings as reference standard,the accuracy of the three imaging modalities in staging of hilar cholangiocarcinoma was compared. Results Among 30 patients, the accuracy of classification among BUS, PUSC and PTC was 23.3 % (7/30), 73.3 % ( 22/30 ), 73.3 % (22/30), respectively. There was statistically significant difference between BUS and PUSC, but the difference between PUSC and PTC was not statistically significant.Conclusions As a new technique for cholangiography, PUSC expands the application of ultrasound in evaluating hilar cholangiocarcinoma and is comparable to PTC in classifying hilar cholangiocarcinoma by Bismuth classification.

Objective To evaluate the feasilibility of ultrasonic cholangiography(USC)with contrast agent SonoVue in evaluating the obstructive bile duct diseases.Methods Twenty patients with obstructive jaundice(choledocholithiasis in 4,post-operative biliary strictures in 2 and malignant tumors in 14)underwent uhrasound-guided percutaneous transhepatic cholangiodrainge drainage(PTCD).Afterward,USC with contrast agent SonoVue administrated from the PTCD tube and percutaneous transhepatic cholangiography(PTC)were carried out in each patient.By using the surgical or PTC findings as reference standard,accuracy of USC in determining the obstructive level and cause of bstructive was evaluated.Results ①The visualization of contrast agent SonoVue was successfully obtained in all 20 patients,three order of bile duct was visualized in 19 patients.The visualization of the ultrasound contrast agent persisted more than 6 min.There was no side effect occurred during the procedure and no uncomfortable complaint after the procedure.②USC determined correctly in 18 cases.Compared with surgical or PTC findings,the accuracy of USC in determining obstructive levels was 90.0%(18/20),and the accuracy in determining the obstructive cause was 85.0%(17/20).Conclusions As a new and safe technique for cholangiography,USC is comparable to PTC in displaying the intrahepatic bite duct and determining the obstructive levels in patients with obstructive jaundice.

Objective To prepare phospholipid-based sulfur hexafluoride gas-filled microbubbles, which were designed for targeting microbubbles. Methods The microbubbles composed of DSPC and mPEG2000-PE were produced by film-sonication method,and were compared with SonoVue. In the physical chemistry characteristics studies, the morphology, particle diameter, concentration, pH value and osmotic pressure were investigated. In the echogenicity studies, contrast harmonic imaging technique was used to investigate the enhancement of vitro water sac and normal rabbit kidney parenchyma. Results The lipid microbubbles were well-distributed, round with air holes. The average diameter of self-made microbubbles and SonoVue were 2.25 μm and 2.50μm respectively. The average diameter of self-made microbubbles and SonoVue distributed from 0.4 μm to 10 μm and 0.2 μm to 10 μm,and 90% were under 6 μm and 8 μm respectively,the concentration were 5 x 108～10 x 108/ml and 1 x I08～5 x 108/ml respectively with a stability of 6 hours. In vitro water sac, the gray scale of self-made lipid microbubbles and SonoVue were 121.67±6.76 and 122.33 ± 4.53 respectively( P>0.05). In normal rabbit kidney parenchyma, the peak video intensity of normal rabbit kidney parenchyma of self-made lipid microbubbles and SonoVue were 72.00 ± 7.21 and 74. 65± 10.93 respectively(P>0.05). Conclusions The lipid microbubbles have satisfactory physical chemistry characteristics and echogenicity.

Objective To explore the feasibility of fishing net repairing transverse fascia method for inguinal hernia (type Ⅰ , Ⅱ ) using laparoscopic surgical procedure. Methods A retrospective analysis of clinical data between the method of fishing net repairing transverse fascia surgery for 145 cases of inguinal hernia (typeⅠ,Ⅱ ) using laparoscopic surgical procedure from May 2004 to May 2008 (laparoscopic group) and the method of open repairing surgery 143 cases (open group) at the same period were conducted. The differences in the operative time, rehabilitation activities time, length of stay, cost of hospitalization and 0comphcations, recurrence rate were compared. Results The laparoscopic group was significantly better in the operative time [ ( 14.8 ± 11.5) min ], found hiding oblique hernia ( 15 cases), rehabilitation activities time[ ( 16.5 ± 14.3) h], use of analgesics(5 cases), scrotal edema(1 case), length of stay[ (4.2 ± 1.5) d], than those of the open group [ ( 37.6 ± 25.4) min, 0, (52.7 ± 12.6) h, 13, 14, ( 8.4 ± 2.6 ) d respectively ] ; but the recurrence rate was no significantly different. Conclusion Method of fishing net repairing transverse fascia for inguinal hernia (type Ⅰ , Ⅱ ) using laparoscopie surgical procedure is feasible.

Objective To investigate the expression of transforming growth factor β1,transforming growth factor beta receptor(TBR)Ⅰ,TβR Ⅱ,Smad4 and C-Jun in rats with nonalcoholic fatty liver disease(NAFLD)and to find out the mechanisms of liver fibrosis in patients with NAFLD.Methods A total of 18 male SD rats were randomly divided into normal control group(n=9)and model group(n=9).The rats in control group were fed with normal diet,and those in model group were fed with fat-rich diet(consisted of 10%lard oil+2%cholesterol).An rats were sacrificed at the 20th week.The levels of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were examined by RT-PCR.The expressions of TGFβ1 and Smad4 in liver tissue were detected by immunohistochemistry.The expression of C-Jun protein was detected by Western blotting.Results The NAFLD model was successfully established.The immunohistochemistry examination revealed that TGFβ1 and Smad4 were expressed weekly in control group,but strongly expressed in model group.RT-PCR showed that A values of TGFβ1,TβR Ⅰ and TβR Ⅱ mRNA were 0.46±0.12,5.z4±2.70 and 3.35±1.95,respectively,in model group,which were higher than those in control group(0.21±0.09,1.36±0.77 and 0.52±0.19,all P values＜0.01).The Western blotting results demonstrated that the expression of C-Jun protein in model group(0.93±0.41)was higher than that in control group (0.32±0.25,P=0.001).Conclusion TGFβ1/Smad4 signal pathway might be involved in the development of hepatic fibrosis in NAFLD.Blocking TGFβ1/Smad4 signal pathway will be helpful in treatment of NAFLD.