Objective To investigate the indications, techniques and results of laparoscopic hepatectomy. Methods The clinical data and follow-up results of 463 patients who received laparoscopic hepatectomy at our institute were retrospectively analyzed. Results From March 1, 2007 to March 31, 2011, 463 cases of laparoscopic hepatectomy were successfully carried out. Of the 463 patients,165 were with primary liver cancer, 29 with metastatic liver cancer, 143 with hepatic hemangioma, 81with hepatolithiasis and 45 with other benign liver diseases (including hepatic angiomyolipoma, hepatocellular adenoma, focal nodular hyperplasia and chronic liver abscess). The surgical approaches included laparoscopic left lateral lobectomy (93 cases), left hepatectomy (71 cases), extended left hepatectomy (4 cases), right hepatectomy (29 cases), right posterior lobectomy (24 cases), hepatectomy of segment Ⅵ (56 cases), extended right hepatectomy (2 cases), central hepatectomy (8 cases) and hepatectomy of segments Ⅶ/Ⅷ, Ⅳa, caudate lobe and the junction of segment Ⅵ and Ⅶ (41 case).Nonanntomic and wedge resection were performed on 121 patients, and combined resection on 14 patients. The mean operation time, blood loss, length of hospital stay and incidence of postoperative complications were (244.71 ± 105. 07) minutes, (460. 26±425.81) ml, (15.51 ±4.36) days and 9.29%, respectively. And no operative death occurred. In the 194 cases with malignant liver lesions,185 cases were followed up for 2 to 50 months. The 1 year and 3 year overall and disease free survival rate were 90. 8% and 87.9% , 84.2% and 73. 7% respectively. Conclusions As a means of minimally invasive surgical approach, laparoscopic hepatectomy can be selectively adopted for the treatment of all kinds of liver diseases which located at different parts of the liver, with the advantages of smaller trauma, quick recovery and cosmetic benefits. The short-term results of laparoscopic hepatectomy is superior to and its long-term results is equal to that of open surgery. Benign liver diseases, small hepatocellular carcinoma and metastatic liver cancer are the good indications for laparoscopic hepatectomy.

AIM: To observe the efficacy and safety of intravitreal injection of Conbercept for the treatment of wet age-related macular degeneration( AMD) .
METHODS:Retrospective analysis. A total of 20 patients involving 22 eyes were diagnosed of wet AMD and confirmed by routine ophthalmic examination, fundus fluorescein angiography ( FFA ) and optical coherence tomography. All these affected eyes received intravitreal injection of 10 mg/ml of 0. 5mg Conbercept, once monthly, for 3 successive times during the initial treatment. The need for repeated treatment was determined according to patients'disease conditions. The patients were followed up once monthly for ≥6mo. The changes in best corrected visual acuity ( BCVA ) , central retinal thickness ( CRT ) and choroidal neovascularization ( CNV) lesion leakage of the affected eyes before and after treatment were compared and analyzed.
RESULTS:Within 1, 3 and 6mo after treatment, the mean BCVA ( logMAR ) of the affected eyes increased when compared with before treatment;the difference was statistically significant(P<0. 01). In 1, 3 and 6mo after treatment, the mean CRT of the affected eyes decreased when compared with before treatment;the difference was statistically significant(P<0. 01). During the last follow-up, FFA showed that macular CNV lesion leakage disappeared in 20 eyes(90%) while leakage mitigated in 2 eyes ( 9%) . During the follow - up, there were no treatment - related serious ocular complications and systemic serious adverse reactions.
CONCLUSION: Clinically, intravitreal injection of Conbercept for the treatment of wet AMD can increase visual acuity of the affected eyes. It also can decrease CRT of the affected eyes, and inhibit neovascular leakage. There are no treatment-related adverse reactions.

Objective To investigate the changes and significance of concentration of soluble intercellular adhesion molecule-1(sICAM-1) in cerebrospinal fluid (CSF) of bacterial meningitis(BM) in rabbits. Methods A total of 36 rabbits were randomly divided into m eningitis group, meningitis cefotaxime-treated group and control group. BM indu ced by escherichia coli(Ec) via cerebellomedullary cistern inoculated. Normal sa line was injected in control group. CSF was sampled in different time. The conce ntration of CSF sICAM-1 was detected by ELISA.Results 1.There was a low concentration of sICAM-1 in CSF in 85 percent of normal rabbi ts.2.In meningitis group, there was a sharp rise in the concentration of CSF sIC AM-1 at 6 hours after Ec was inoculated, reached a peak level at 12 hours, and t here was higher concentration of CSF sICAM-1 between 6 and 24 hour than that at 0 hour.3.In meningitis cefotaxime-treated group, the concentration of CSF sICAM -1 at 6 hour and 12 hours was similar to meningitis group, the time that get pe ak level was at 24 hours that at 12 hours after making use of antimicrobial agen t.The peak level was higher than meningitis group. The concentration of CSF sICA M-1 decreased markedly at 48 hours that made use of antimicrobial agent 36 hour s later,but the concentration was still higher than the peak level of meningitis group.Afterwards, with the time of making use of antimicrobial agent lengthened ,the concentration of CSF sICAM-1 decreased gradually.4.Experimental results in dicated by correlating analysis to these data that there was positive correlatio n in the concentration of CSF sICAM-1 with the brain water content.Conclusions sICAM-1 participates in the pathological process of BM, and contributes to the damage of blood brain barrier and the formation of brain edema.There is importan t significance that drugs which can resist the discharge of sICAM-1 will be impl ied. J Appl Clin Pediatr,2005,20(2):163-165

The brown slime inside pipeline of the polluted mineral waters well was analyzed. It was confirmed that the brown slime was a biofilm formed mainly by growth of bacteria contaminant, using microscope analysis. After treated with HCl, the brown crystals and mycelioid matter presented in slimes disappeared. It was verified these were metal deposits. The samples produced Prussia blue deposits by dropping K 4Fe(CN) 6 and HCl, which proved that the metal deposits were iron compound. Also it was believed the biofilm was produced by growth of iron bacteria, mixed with deposits of iron compound. The iron bacteria have been isolated from the slimes and cultured in the laboratory. The colony on agar plate also produced Prussia blue deposits after treated with K 4Fe(CN) 6 and HCl. The cells form of pure culture was the same as that in the samples by electronmicroscope analysis. Therefore, It indicated that the bacteria on biofilm inside pipeline were iron bacteria mainly.

Ataxia telangiectasia mutated (ATM) kinase plays an essential role in the maintenance of genomic stability. ATM-deficient (ATM(-/-)) mice exhibit hematopoietic stem cell (HSC) dysfunction and a high incidence of lymphoma. Gadd45a controls cell cycle arrest, apoptosis and DNA repair, and is involved in the ATM-p53 mediated DNA damage response. However, the role of Gadd45a in regulating the functionality of ATM(-/-) HSCs is unknown. Here we report that Gadd45a deletion did not rescue the defects of T-cells and B-cells development in ATM(-/-) mice. Instead, ATM and Gadd45a double knockout (ATM(-/-) Gadd45a(-/-)) HSCs exhibited an aggravated defect in long-term self-renewal capacity compared to ATM(-/-) HSCs in HSC transplantation experiments. Further experiments revealed that the aggravated defect of ATM(-/-) Gadd45a(-/-) HSCs was due to a reduction of cell proliferation, associated with an accumulation of DNA damage and subsequent activation of DNA damage response including an up-regulation of p53-p21 signaling pathway. Additionally, ATM(-/-) Gadd45a(-/-) mice showed an increased incidence of hematopoietic malignancies, as well as an increased rate of metastasis than ATM(-/-) mice. In conclusion, Gadd45a deletion aggravated the DNA damage accumulation, which subsequently resulted in a further impaired self-renewal capacity and an increased malignant transformation in ATM(-/-) HSCs.
Animals ; Ataxia Telangiectasia Mutated Proteins ; genetics ; B-Lymphocytes ; pathology ; Cell Cycle Proteins ; genetics ; Cell Proliferation ; Cyclin-Dependent Kinase Inhibitor p21 ; metabolism ; DNA Damage ; Hematopoietic Stem Cell Transplantation ; Hematopoietic Stem Cells ; metabolism ; pathology ; Leukemia ; genetics ; pathology ; Lymphoma ; genetics ; pathology ; Mice, Knockout ; Neoplasm Metastasis ; Nuclear Proteins ; genetics ; T-Lymphocytes ; pathology ; Tumor Suppressor Protein p53 ; metabolism

OBJECTIVETo evaluate the feeding behavior of infants and young children aged from 6 to 24-month-old in Chengdu by feeding index.

METHODS608 infants and young children were randomly selected from Chengdu and divided into 6-, 9-, 12 - 24 month-old groups. Data including basic information, breastfeeding, and complementary feeding were collected through questionnaire. The feeding status of subjects was evaluated by feeding index system (the total score was 19) established by infant feeding principle of WHO.

RESULTSThe total feeding index score (FIS) of 608 subjects was 11.0 ± 2.4. The FIS of 6-(192), in 9-(174) and 12 - 24 month-old (242) groups were 9.6 ± 2.8, 11.1 ± 2.1, 11.9 ± 1.6, respectively. The FIS was increased with month of children (F = 61.311, P < 0.05). The ratios above 60% (the score of 11.4) and 80% (the score of 15.2) of FIS were 46.4% (282/608) and 0.7% (4/608) respectively. The ratios above 60% of FIS were 26.5% (51/192), 45.4% (79/174), 66.9% (162/242) in 6-, 9-, 12 - 24 month-old groups respectively. The percentages of bottle feeding and breastfeeding were 94.2% (573/608) and 25.2% (153/608) respectively.45.1% (274/608) of them were fed by recommended feeding frequency, and 73.0% (444/608) were given enough types of food. With the month-old increasing, the foods of higher intake frequency were vegetables/fruits, cereals, milk and diary product, eggs. The intake frequency of meat was higher in 9 to 24 month-old group, but intake frequency of fish and beans was low in all groups.

CONCLUSIONThe feeding behavior of infants and young children in Chengdu is not optimistic, especially for the lower month infants.

Bottle Feeding ; Breast Feeding ; China ; Feeding Behavior ; Feeding Methods ; Female ; Humans ; Infant ; Male ; Nutritional Status ; Surveys and Questionnaires

OBJECTIVETo repair cartilage defects at non-weight-bearing area of the femoral condyle in rabbits with invitro amplified cartilage cell using calcium alginate column scaffold combined with calcium alginate gel injection, and to study repair effects of combination with different form of the same material.

METHODSTwenty-four New Zealand rabbits were divided into 4 groups randomly. The wounds of rabbits in the Group 1 were repaired with injection of calcium alginate gel; the wounds of rabbits in the Group 2 were repaired with in planting of calcium alginate column scaffold; the wounds of rabbits in the Group 3 were repaired with in planting of calcium alginate column supporter firstly, and then injection of calcium alginate gel at the surrounding; and Group 4 is control group, the rabbits in the group were repair and without any support. The repair effects were demonstrated with Xij, and the effects of all animals were studied with statistical analysis.

RESULTSThe Xij scores of each rabbits were calculated, and the scores in four groups were compared. The statistical results showed that combination therapy was better than other methods (F = 69.0, P < 0.05).

CONCLUSIONThe calcium alginate with column shape has better shaping effects and certain mechanical strength. The calcium alginate gel has better stick nature and can be used to integrate artifical material with normal structure. They can be used together, which meeting the desire of repair and integration in cartilaginous tissue engineering.

Alginates ; administration & dosage ; Animals ; Cartilage, Articular ; pathology ; surgery ; Collagen Type II ; analysis ; Female ; Gels ; Glucuronic Acid ; administration & dosage ; Hexuronic Acids ; administration & dosage ; Immunohistochemistry ; Knee Joint ; pathology ; surgery ; Male ; Rabbits ; Tissue Engineering

The purpose of this study was to determine the combined effect of transmyocardial laser revascularization (TMLR) and the implantation of endothelial progenitor cells (EPCs) on cardiac function of ischemic hearts in canines. The left anterior descending artery (LAD) was occluded to establish the canine model of acute myocardial infarct (AMI). Four weeks later, the animals were randomly divided into four groups: TMLR group, in which transmyocardial laser-induced channels were established at the ischemic region; EPCs+TMLR group, in which EPCs were locally transplanted into laser-induced channels at the ischemic region; EPCs group, in which the EPCs were injected into the ischemic region; control group, in which the AMI animals received neither TMLR nor EPCs. The peripheral blood (50 mL) was sampled in all groups. Mononuclear cells from the peripheral blood were separated and cultured to obtain spindle-shaped attaching (AT) cells in vitro. AT cells were labeled with 1, 1'-dioctadecyl-1 to 3,3, 3',3'-tetramethyl-indocarbocyanine perchlorate (DiI) before injecting into the laser-induced channels or ischemic region. Four weeks after the first operation, TMLR was performed in the TMLR group and EPCs+TMLR group, and at the same time, the EPCs originating from the AT cells were mixed with calcium alginate (CA). Then the EPCs-CA composites were implanted into myocardial channels induced by laser in the EPCs+TMLR group, and into the myocardial infarct area in the EPCs group. All dogs underwent echocardiography at second month after LAD occlusion. Finally the samples of myocardium around the LAD were subjected to histochemical and immunohistologic examinations. The results showed there was no significant difference in the diameter of left atrium and ventricle before treatment among all groups (P>0.05). Eight weeks after modeling, the regional contractility in the LAD territory in the EPCs+TMLR group was increased as compared with control group and TMLR group, but there was no significant difference between control group and TMLR group. Neoangiogenesis was observed in the EPCs+TMLR group, and the fibrosis was seen in the TMLR group. There was no significant difference in neoangiogenesis around the channels induced by laser among EPCs+TMLR, EPCs and TMLR groups. It was concluded that TMLR combined with EPCs could improve the regional and global cardiac function in AMI, and augment neovascularizaiton in channels of ischemic myocardium induced by laser.

Objective To evaluate the accuracy of respiratory variations of internal jugular vein (IJV) in monitoring fluid responsiveness in patients undergoing radical gastrectomy for gastric cancer.Methods Fifty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 40-64 yr,scheduled for elective radical gastrectomy for gastric cancer,were enrolled in this study.Before induction of anesthesia,the hemodynamic parameters such as heart rate,central venous pressure,cardiac index,stroke volume index (SVI),stroke volume variation and respiratory variation of IJV were recorded after haemodynamics was stable and were recorded again at 10 min after endotracheal intubation,and a loading dose of 6％ 130/0.4 hydroxyethyl starch 7 ml/kg was infused over 15 min.The parameters mentioned above were recorded within 5 min after loading dose.Patients were divided into 2 groups according to the percentage of increase in SVI (△SVI) after volume expansion:△SVI≥ 15％ was considered to be a positive response (responder group) and △SVI＜15％ was considered to be a negative response after volume expansion (non-responder group).Results The area under the receiver operating characteristic curve of respiratory variations of IJV in monitoring fluid responsiveness and 95％ confidence interval were 0.852 (0.744-0.961).Respiratory variation of IJV 24.6％ was considered as the cut-off value and used to monitor fluid responsiveness,and the sensitivity and specificity were 67.6％ and 92.3％,respectively.Conclusion Respiratory variation of IJV can be considered as an effective index in monitoring fluid responsiveness in the patients undergoing radical gastrectomy for gastric cancer.

Objective To evaluate the effect of early mechanical ventilation on the clinical outcome of the patients with severe brain injury. Methods In 251 patients sustaining severe brain injuries with Glasgow Coma Scores(GCS)of 5 to 8,early mechanical ventilation was administered in 128 patients,with the other 123 patients serving as the control group.The oxygen saturation(SaO2),oxygen pressure(PaO2),carbon dioxide pressure(PaCO2),GCS score,heart rate(HR),andblood pressure (BP)were measured before and after the ventilation in the two groups,and the prognosis of the patients were evaluated.Results Before the treatment,the two groups showed comparable SaO2,PaO2,PaCO2,BP,HR and GCS scores(P>0.05).Compared with the control group,early mechanical ventilation significantly improved the blood gas parameters 24 h and 7 and 14 days after the treatment. SaO2 and PaO2 showed significant increases(P<0.05)and PaCO2 decreased significantly(P<0.05)after early ventilation,which resulted in no significant changes in the HR and BP(P>0.05). Conclusion Early mechanical ventilation can significantly improve the blood gas parameters and the clinical outcome of the patients with severe brain injury.