Primary liver adenosquamous carcinoma is a rare kind of liver malignant tumor with very poor prognosis. Clinical data of 5 cases were analyzed retrospectively, four male and one female, whose average age was 60.2 years (50-67 years) old. Adenosquamous carcinoma contains both adenocarcinoma and squamous carcinoma histologically, and squamous carcinoma cells are dominant (>80%). Four cases underwent surgical resection and one received liver transplantation. The postoperative follow-up period ranged from 6 to 35 months and the mean survival time of these cases was about 15 months. Three patients died during the follow-up period. The survival rates 1 and 2 years after operation were 60% and 20%, respectively.

Objective To assess the value of multi-slice spiral CT angiography (MSCTA) in diagnosis of posterior nutcracker syndrome (NCS). Methods MSCTA of 15 patients clinically diagnosed as posterior NCS (patient group) and 50 subjects with normal renal vessels (control group) were retrospectively analyzed. The anatomy, course and relationship to the adjacent structure of left renal vein (LRV) and its branches were observed. The anteroposterior diameter (d1) and cross areas (s1) of the angle of control group and posterior abdominal artery (AA), the anteroposterior diameter (d2) and cross areas (s2) at the largest lumen near the renal hilar were measured and the ratio of s2/s1 and d2/ d1 were calculated.Results All LRVs posterior AA of patient group were compressed and narrowing with dilating apparently near the renal hilar. The difference of d2 was not significant (P＞0.05), but of other values were significant (P＜0.05).Conclusion MSCTA can show anatomy and three-dimentional trend clearly of LRV for posterior NCS, and evaluate the extent of narrow and dilating lumen accurately with cross areas measuring.

Objective To investigate the clinical implication of Neoral C 2 in evaluating drug hepatic toxicity following renal transplantation in hepatitis patients. Methods 162 cases receving renal transplantation were divided into two groups: positive group with positive hepatitis B and(or) C viral antigens or de finite hepatitis history before renal transplantation ( n =51) and the remaining 111 cases served as normal control group. One week posttransplantation, the blood concentrations of cyclosporins at 0 (C 0) and 2 (C 2) h after administration were determined. Results In the positive group, C 2, not C 0 one week postoperation was higher than normal control group ( P

Objective To explore the effects of piperine on cell proliferation and migration in angiotensin Ⅱ (Ang Ⅱ)-treated rat airway smooth muscle cells (ASMCs).Methods The primary ASMCs of rats were cultured by improved tissue-piece digestion inoculation and trypsin digestion.MTT assay was used to detect the effects of Ang Ⅱ and Ang Ⅱ receptor antagonist losartan on cell proliferation activity.After treatment with Ang Ⅱ and piperine, the cell proliferation activity, the cell cycle distribution and the cell migration were detected by MTT, flow cytometry and Transwell assay respectively.ERK1/2 inhibitor PD98059 and losartan were then applied to determine the expression of cyclin D1, MMP-9, p-ERK1/2, ERK1/2, and β-actin proteins by Western blot assay.Results After 24 h culture, Ang Ⅱ treatment promoted the cell proliferative activity in rat ASMCs (P<0.05), and the promotive effect of 10-7 mol/L Ang Ⅱ was the most significant.Additionally, losartan blocked the Ang Ⅱ-induced cell proliferative activity in rat ASMCs (P<0.05).10-7 mol/L Ang Ⅱ treatment resulted in the elevated cell proliferative activity, higher S phase fraction, increased migrated cell number, and enhanced expression of cyclin D1, MMP-9and p-ERK1/2 proteins (P<0.05);these effects were dose-dependently reversed by piperine.Both PD98059 and losartan blocked Ang Ⅱ-induced expression of p-ERK1/2, cyclin D1 and MMP-9 proteins in rat ASMCs.Conclusions Piperine may inhibit Ang Ⅱ-induced cell proliferation and cell migration via ERK1/2 signaling pathway in rat ASMCs.

Objective·To investigate the clinicopathologic characteristics and prognosis of adult rhabdomyosarcoma (RMS).Methods·The clinical and pathological data,immunohistochemical test results of 9 RMS were analyzed retrospectively.Results·The information of 6 males and 3 females were collected in this research,whose average age was (46.89+20.09) years old.The tumors had a wide range distribution.The subtypes of histology included 6 cases of embryonal RMS,1 case of alveolar RMS,1 case of spindle cell RMS and 1 case of pleomorphic RMS.Immunohistochemically study showed that 6 cases were myogenin positive,4 cases were MyoDl positive and 8 cases were desmin positive.During the follow-up period of the 7 cases,only 2 patients survived free of tumors,2 patients presented with tumor recurrence and metastasis after the operations,and 3 patients died of tumor.Conclusion·In this study,embryonaI RMS is the most common type,and immunohistochemistry test is helpful to diagnosis of RMS.

Objective:To investigate the effect of 3 HLA matching measures on preventing hyperacute rejection(HAR). Methods:Among 1 152 cases,550 cases received anti donor lymphocytotoxic crossmatch(LXM),335 cases received LXM and HLA serological test,267 cases of the latter again received panel reaction antibody(PRA)test, the change of the HAR rate with different HLA matching measures were analyzed. Results:If LXM value ≤10% or HLA matched loci ≥3,the rate of HAR was unrelated to LXM value or HLA matched loci. HAR rate decreased significantly in patients with LXM and HLA serological test, and decreased more markedly in those with additional PRA test compared with those only with LXM test. Conclusion:HLA test and PRA are necessary and effective to avoid HAR.

Objective To evaluate the usefulness of serum galactemannan(GM) for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients. Methods Study was conducted between February 2007 and July 2008. Included patients on admission ICU who suffer from suspected IPA. GM test and culture were collected 2 weekly. Chnical feature, mycological evidence and optical density index (ODI) were noted. Clinically invasive fungal infection(IFI) were defined proven, probable and possible. The patients were classified into neutropenia, non-neutropenia and treated with immunosuppressive agents, non-neutropenia and non-immunosuppressive agents. To compared of the sensitivity and specificity of GM in different patients. Results 94 patients were included, 4 patients were proven, 29 patients were probable, 34 patients were possible IFI, 27 patients were non-IPA. The positive rate of the GM was 31.9% (30/94). The sensitivity and specificity of GM in proven cases and probable cases are 66.7% and 92.6%. GM assay tended to become positive earlier than the culture 2-10(5.33±2.17)d. We found that differences in patient diagnosis and selection might account for the disparities seen for positive rate for the GM test. There was positive in three of the four patients with proven, the positive rate of GM was 65.5% for probable cases, for possible cases was 17.6%, for non-IPA cases was 7.4% (P=0.001). For patient with neutropenia , treated with immunosuppressive agents and without immunosuppressive agents, the positive rate of GM was 52.9%vs 41.7% vs 34. 6% (P=0.015) ;the sensitivity was 80.0% vs 70. 0% vs 53.8% (P=0.011), the ODI was 1.365 (0.582-6.736) vs 1. 123 (0. 623-6.868) vs 0.554 (0.522-0.823), P=0. 005, respectively. Conclusion These results show that GM test is useful for early diagnosis IPA in critically ill patients. Differences in patient selection and diagnosis might account for the disparities seen for positive rate and sensitivity for the GM test. It has been higher sensitivity and ODI in the patient treated by immunosuppressive agents.

Objective To evaluate the molluscicidal effect of Rongbao in schistosomiasis endemic areas in Mianyang City. Methods Three Oncomelania hupensis snail habitats with the similar snail status were selected and sprayed with Rongbao,ni-closamide,and fresh water,respectively. Then the snail status in the three fields was surveyed before the spraying and 7,15,30 and 60 days after the spraying,and the molluscicidal effects of different molluscicides were compared. Results The reducing rates of densities of living snails in the field sprayed with Rongbao were 94.4%,95.9%,98.2%and 98.8%,7,15,30 and 60 days after the spraying,respectively. The reducing rates of the densities of living snails in the other field sprayed with niclosamide were 94.0%,94.0%,89.9%and 92.2%in above-mentioned days,respectively. In the 30 days and 60 days after the spraying,the reducing rates of densities of living snails in the field sprayed with Rongbao were significantly higher than those sprayed with ni-closamide(χ230 d=8.18,χ260 d=3.97,Both P<0.05). Conclusion The short-term molluscicidal effect of Rongbao is similar to that of niclosamide,but the long-term effect of Rongbao is better than that of niclosamide.

Objective To explore the feasibility of artificial silastic framework(SF)in repair of large area of tracheal wall defects.Methods Twenty healthy adult dogs with tracheal defects for 2.5 cm?6.0 cm-3.0 cm?6.0cm were randomly and equally divided into experimental group(repaired with SF combined with sternohyoid fasciae)and control group(repaired with T-silastie tubule combined with sternohyoid fascial flap).After the operation,the animals were sacrificed at the 4th,8th,16th,24th, and 48th weeks respectively for harvesting the tracheae that were used for tracbeoscopically observing in- flammatory reaction of the repaired defect area and light microscopically observing epithelium healing on the repaired defect area.Results In the experiment group,the repaired trachea was smooth,without proliferation of granulation;and at the 8th week,the repaired defect area was covered with epithelial cells,with good functional recovery of respiration,phonation and deglutition.In the control group,there was obvious proliferation of granulation on the tracheal surface near anterior and posterior ends of T-silas tic tubule.The animals were under asphyxia to die with extraction of T-silastic tubule.Conclusions SF has excellent tracheal skeletal function.In the meantime,SF combined with sternohyoid fasciae is a simple but effective method for repair of large area of tracheal wall defects.

Objective To evaluate the surgical methods and clinical effects of the reconstruction of soft tissue defect in distal thumbwith dorsal thumb neurocutaneous vascular flap.Methods From January,2014 to December,2016,32 patients with soft tissue defects of distal thumb were repaired with dorsal thumb neurocutaneous vascular flaps,including left thumbs in 11 cases and right thumbs in 21 cases.They were including 7 cases of nail bed defects,9 cases of pulp defects under nails,16 cases ofthe defects of tips or stump of fingers;skin and soft tissue defects range of 1.5 cm×1.0 cm-3.5 cm×3.2 cm;Flap cutting areas range of 2.0 cm×l.5 cm-4.0 cm×3.5 cm.If the donor areas could be sutured directly,be sutured;if they could not,be covered with intermediate split thickness skin grafts.All patients were followed up when they were reviewed in outpatient department,and to be evaluated the shape,texture,sensation,flexion and extension function,and donor site of the flaps.Results One case of flaps blood circulation disordereddue to tight suture,and eased after the removal of part of the sutures;One case of flaps atrophied,and the phalangette was exposed after 3 months,so we removed the end part of bone and the wound was closed;other flaps were survived,with primary wound healing.In the total 32 patients,they were followed up range of 3 to 36 months,with an average of 12 months.Eighteen cases were followed up at least 6 months,which were 4 of the 7 cases of nail bed defects,5 of the 9 cases of pulp defects under nail and 9 of the 16 cases of the defects of tip or stump of fingers.The appearances and textures of flaps were good,protective sensations were restored,and skin flap two-point discriminationswere 8-10 mm.According to the Trial Standard for Evaluation of Upper Limb Function of Chinese Society of Hand Surgery,it was excellent in 11 cases,good in 17 cases and moderate in 4 cases,with the excellent and good rate of 87.5％.Conclusion It has advantages of simple operation,low risk,high success rate and satisfactory curative effects of the use of dorsal thumb neurocutaneous vascular flap for repair of distal thumb defect of skin and soft tissue.It is not only suitable for the hospital with good technical and equipment,but also suitable for the primary hospital.