Objective To investigate the histochemical characteristics of muscle fiber in patients with Becker type muscular dystrophy (BMD) and its clinical significance.Methods Muscular biopsies were performed in 3 patients with BMD. The specimens were stained by HE and nicotinamide-adenine dinucleotid-tetrazole reducase (NADH-TR) methods and observed under light microscope. Normal muscles from healthy people were saved as controls.Results The slice from BMD patients showed varied sizes of muscular fibers, remarkable hypertrophy fibers, splitting fibers, targetoid fibers, lobulated fibers, whorled fibers and ring fibers. Targetoid fibers were also found using NADH-TR staining.Conclusions The degree of fiber necrosis in BMD is mild. Degeneration and proliferation are the main pathological changes, which predict mild clinical symptoms, long course of disease and favourable prognosis.

Hilar cholangiocarcinoma is a rare biliary malignant tumor derived from the biliary epithelial cell. The primary current treat-ments for hilar cholangiocarcinoma include surgery and chemotherapy, as well as radiation and photodynamic therapies (PDT). A com-plete resection with negative margins is the only treatment with the potential for cure and the only way to maximize survival. Howev-er, over half of the patients in the advanced stage of hilar cholangiocarcinoma lost the chance for surgery. Radiotherapy and chemo-therapy can prolong patient survival;however, these lack reliable data. Most patients who cannot be treated surgically undergo biliary stenting to relieve the biliary obstruction. The PDT is a new method to treat various malignant tumors. Several clinical studies have shown its local tumor ablation capability. Thus, PDT has broad application prospects in the treatment of unresectable hilar cholangio-carcinoma.

Objective:Temperature keeping is vital in the long distance transportation of red blood cell suspensions in military affairs and emergency.This study aimed to develop a composite phase change material to be used for preserving blood in long time transporation without electricity.Methods: The n-tetradecane was adsorbed to the pore structure of silica aerogel through the capillarity and hydrophobicity of silica aerogel.The efficiency of the phase change material was detected by differential scanning calorimetry.Results: The specific surface area and the adsorption capacity were 863.59 m2/g and 9.16,respectively.The phase change temperature was 5.47℃ and phase change latent heat was 180J/g.Conclusion: The n-tetradecane /silica aerogel composite phase change material could be used for blood preservation.

The clinical and fundamental research for intrahepatic and extrahepatic biliary stones were still inadequate currently.It was difficult for treat and has the following clinical features:extensive he-patic lesion,complex conditions,more complications,higher recurrence rate,etc.Satisfactory results were hard to gained if just depend on conventional surgery recently.As the methods of diagnosis and treatment are continuously increasing:Ultrasound,CT,MRCP,Choledochoscope,Cholangiography and 3D imaging of hepa-tobiliary system.From the traditional open operation to a variety of minimally invasive treatment.Different examination and treatment methods has its advantages and disadvantages.How to choose the effective,less trauma,appropriate pathway method is the main direction for the current research.

Background and purpose:Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Intrahepatic recurrence is the main factor affecting its medium-term survival rate. Therefore, the search for the markers of metastasis is essential. This study aimed to evaluate the relationship of expression of tyrosine kinase phosphorylation Tyr416 of sarcoma (SRC pY416) in HCC with clinical parameters and prognosis. Methods:Immunohistochemical method and Western blot were used to detect the expression of non-receptor tyrosine kinase (SRC pY416) in 112 cases of HCC tissues and 40 cases of corresponding cancer adjacent normal liver tissues. Hepatitis B virus (HBV) DNA and alpha fetoprotein (AFP) in patients were detected with chemiluminescence. In the 12 months Follow-up of the study,the association between SRC pY416 expression and clinical parameters was analyzed. Results:SRC pY416 expressions in HCC (65.40±15.69) were higher than those in cancer adjacent normal liver tissues (11.25±2.73,P<0.001). The expressions of SRC pY416 were all associated with the age, the liver cirrhosis, the complete capsule, the tumor differentiation, the HBV DNA and the AFP value of the patients (P<0.01). 12 months after operation, single factor analysis showed that the recurrence was associated with the tumor differentiation, the HBV DNA, the AFP value and the expression of SRC pY416 of the patient (P<0.01). Multivariate analysis showed that the expression of SRC pY416 was an independent prognostic factor for recurrence and metastasis in patients with HCC in 12 months. Conclusion:SRC pY416 may play an important role in the metastasis of HCC. The expression of SRC pY416 may be the marker for HCC liver metastasis.

Objective To investigate the risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy,in order to provide a theoretical basis for prevention and treatment of this complication.Methods The term DGE was searched in Pubmed,Medline,EMBASE,Cochrane Library,CNKI,Wanfang,and published literatures were collected to determine the risk factors of DGE after pancreaticoduodenectomy.The Review Manager 5.3 software was used in the analysis.Results A total of 52 articles were included.The results of Meta-analysis showed that age and preoperative bilirubin levels did not significantly influence the incidence of DGE.Preoperative cholangitis (OR =3.39,95％ CI 1.97 ～ 5.82),hypoalbuminemia (OR =2.53,95％ CI 1.59 ～4.02),and intraoperative blood loss of more than 1 L (OR =1.98,95％ CI 1.18 ～ 3.33) significantly increased the incidence of DGE.Pyloric resection (RR =2.06,95％ CI 1.05 ～4.05),antecolic reconstruction (RR =0.74,95％ CI 0.56 ～ 0.99) and Braun enteroenterostomy (OR =0.36,95％ CI 0.17 ～0.77) significantly decreased the risk of DGE.When compared with Roux-enY enteroenterostomy,Billroth Ⅱ enteroenterostomy reduced the incidence of clinically relevant DGE (RR =0.30,95 ％ CI 0.11 ～ 0.79).Postoperative pancreatic fistula (OR =3.84,95 ％ CI 2.71 ～ 5.44) and intraabdominal infection/abscess (OR =3.95,95％ CI 2.87 ～ 5.43) were significantly associated with a high incidence of DGE.Conclusions Hypoalbuminemia,cholangitis,large blood loss,and postoperative abdominal complications were the risk factors of DGE.Pyloric resection,antecolic reconstruction,Billroth Ⅱ enteroenterostomy,and Braun enteroenterostomy significantly reduced the incidence of DGE.Subgroup analysis showed that differences on DGE definition in studies might be an important cause for the heterogeneity in the results of the different studies.

Objective To investigate the expressions of protein kinase B (PKB/Akt) and glycogen synthase kinasc-3β in the hippocampus in mice with vascular dementia (VaD) induced by repetitive bilateral common carotid artery occlusion.Methods Forty-eight healthy adult male C57B1/6 mice were randomly allocated into 3 group:normal group,sham operation group,and model group (n =16 in each group).A mouse VaD model was induced by intermittent blocking the bilateral common carotid artery for 3 times in the model group.The sham group only separated the bilateral common carotid artery,but did not block it.The normal group did not receive any treatment.The behavioral changes of the mice were observed using the water maze and step-down tests at 4 weeks after procedure.HE staining was used to observe the histopathological changes of hippocampal tissue.The Western blotting was used to detect the expressions of Akt,p-Akt (Ser473),GSK3β and p-GSK3β (Ser9) proteins.Results In the water maze test,the time of swimming the entire distance was prolonged at the learning stage and memory stage (learning stage:F =19.389,P ＜0.05; memory stage:F =27.929,P ＜ 0.05),the number of errors increased (learning stage:F =7.228,P ＜ 0.05; memory stage:F =21.189,P＜0.05) in the model group.In the step-down test,the response time was prolonged (F=19.162,P ＜0.05) at learning stage and the number of errors increased (F =6.562,P ＜ 0.05),the latency time was shortened (F=10.634,P＜0.05) and the number of errors increased (F=12.890,P＜0.05) in the model group.At the same time,HE staining showed the reduction of neurons and the proliferation of glial cells in the hippocampal CA1 region in the model group; p-Akt (Ser473) (F=37.849,P＜0.05) and p-GSK3β (Ser9)(F =67.725,P ＜0.05) protein expressions were up-regulated significantly (F =37.849,P ＜0.05; F =67.725,P＜0.05) at 4 weeks after procedure compared to those in the sham operation group,while there were no significant differences in Akt (F =1.004,P ＞0.05) and GSK3β(F =0.329,P ＞0.05) total protein expressions among all groups.Conclusions The repetitive bilateral common carotid artery occlusion may result in learning and memory impairment and severe damage in the hippocampus in mice.The Akt and GSK3β expressions may be involved in the mechanism of VaD.

Objective:To investigate the recognition and injury prevention strategies of hepatic artery variations during hepatic portal lymphadenectomy. Methods:A retrospective analysis was performed, and 12 patients of hepatic arterial variation among 62 pa-tients with hepatic portal lymphadenectomy were the subjects. The study was conducted in the First Affiliated Hospital of Bengbu Medi-cal College between January 2013 and July 2014. The intraoperative treatment and postoperative complications were recorded. Results:Among 12 cases of hepatic artery variation, we found the following cases:3 cases (25.0%) of Michels' Type III, 2 cases (16.7%) of Mi-chels' Type VI, 1 case (8.3%) of Michels' Type IX, 1 case (8.3%) of Hiatt's Type 6, 2 cases (16.7%) of spatial location variation between right hepatic artery and hepatic duct, 2 cases (16.7%) of left and right hepatic artery originating from a common hepatic artery, and 1 case (8.3%) of right hepatic artery originating from the gastroduodenal artery. No injury of hepatic artery occurred. Two cases had post-operative complications, including 1 case of pancreatic leakage and 1 case of incision infection;postoperative hemorrhage, bile leakage, hepatic abscess did not occur in these two cases. Patients recovered well in general. Conclusion:Hepatic arterial injury can be signifi-cantly reduced by the following:increased familiarity with the various types of hepatic artery variations;complete imaging examina-tions for inspection and evaluation before surgery;and careful and meticulous operations in surgery.

Objective:To investigate the clinical efficacy of extended hepatectomy for hilar cholangiocarcinoma (HCCA) of Bismuth-Cor-lette typesⅢandⅣ(the longitudinal invasion degree along the biliary system is the main criteria). Methods:The clinical data of 61 patients with HCCA of Bismuth-Corlette types III and IV admitted in the Department of Hepatobiliary Surgery of the First Affiliated Hos-pital of Bengbu Medical College from January 2008 to May 2015 were analyzed retrospectively. Among the 61 cases, 22 underwent hepatectomy with half or over half of the liver removed or hepatic caudate lobectomy (regarded as the extended hepatectomy group), whereas 39 cases underwent irregular hepatectomy on the hepatic hilar region (regarded as the limited hepatectomy group). Results:Compared with those in the limited hepatectomy group, the patients in the extended hepatectomy group underwent longer duration of operation and experienced more bleeding during the procedure. The complication incidence rate for the extended hepatectomy group was lower than that for the limited hepatectomy group. No patient died during the perioperative period in the extended hepa-tectomy group, whereas two patients died in the limited hepatectomy group. Moreover, R0 resection was performed on 21 cases in the extended hepatectomy group, with a resection rate of (21/22) 95.5%, and on 20 cases in the limited hepatectomy group (P<0.05), with a resection rate of (20/39) 51.3%. Actuarial 1-, 3-, and 5-year survival rates were 77.27%, 36.36%, and 13.64%, respectively, in the extended hepatectomy group, and 69.23%, 20.51%, and 1.64%, respectively, in the limited hepatectomy group (P<0.05). Conclusion:Extended hepatectomy for patients with HCCA of Bismuth-Corlette typesⅢandⅣcould effectively increase the resection rates of R0 and the survival rate. Meanwhile, the prognosis of patients could be improved.

Objective To compare the effectiveness of surgical procedures (devascularization,shunt and combined shunt and devascularization) in treating recurrent variceal bleeding and other complications in patients with portal hypertension.Methods A systematic literature search was carried out on patients with portal hypertension,and a Meta-analysis was conducted using Revman 5.3 software to evaluate the effectiveness of different surgical procedures on recurrent esophageal variceal bleeding,hepatic encephalopathy,operative mortality and survival rates.Results A total of 24 trials were finally selected using predetermined inclusion criteria.Meta-analysis showed there was no significant difference among the three operations on operative mortality (P ＞ 0.05).The rebleeding rate of the combined group was significantly lower than the devascularization group (P ＜ 0.05).The encephalopathy rate of the combined group was significantly lower than the shunt group (P ＜ 0.05),and the 1-year and 3-year survival rates of the combined group were better than the devascularization group (both P ＜ 0.05),but there were no significant difference in the 5-year survival rates between these two groups (P ＞ 0.18).The 1-year and 3-year survival rates were not significantly different between the combined and the shunt groups (both P ＞ 0.05).Conclusions Combined shunt and devascularization had better therapeutic effectiveness than either devascularization alone or shunt alone in patients with portal hypertension with a high rebleeding risk.There were no significant difference among the three surgical procedures in operative mortality.The survival rates of combined surgery were significantly better than devascrlarization alone.