Hepatic surgery has got fast development during recent years. Hepatic anatomic complexity is not the fence of hepatic surgery development. The limit of liver function reserve controls hepatic operation and makes surgeons confused. The investigation of hepatic function reserve has made great prograsses recently. This article reviewed domestic and overseas documents to explain the contrilmtion of liww functional reselwe examination for hepatic surgery on the basis of hepateetomy quantity, tumor postoperative relapse, liver transplantation , liver function failure and liver function reserve detection.

Objective:To observe the e ects Of Jianpitongmai soup in regulating blood fat.Methods:120 cases of hyperlipidemia patients were randomly divided into two groups:Jianpitongmai group with 60 cases and simvastatin control group with 60 cases.To compare the treatment e cacy after 8 weeks.Results:Jianpitongmai soup can signi cantly improve indicators of blood fat(P0.05).Conclusions:Jianpitongmai soup can control blood fats comprehensively,and the e ect will be cumulative with the continuation of treatment.

Objective To isolate hepatic stem cells from adult rats,and to examine the process and morphologic changes of isolated hepatic stem cells differentiated into hepatic cells and bile duct epithelial cells under in vitro culturing conditions.Methods AAF/PH was used to stimulate the oval cells.Selective enzymatic digestion and density gradient centrifugation were employed to isolate and purify these cells from heterogeneous liver cell population.The hepatic stem cells were induced to proliferate and differentiate into hepatic parenchymal cells by the addition of dexamethasone,DMSO and several growth factors.The morphologic changes of hepatic oval cells to that of hepatic cells and bile duct epithelial cells were examined.Immunofluorescence method was used to detect the hepatic stem cells c-kit and the expression of OV6 antigen.The albumin of hepatic stem cells and the CK19 expression were identified by RT-PCR analysis.Results The activity of freshly isolated oval cells were over 90%,with different colors and size.The diameter of oval cells was about 1/4~1/6 that of hepatocytes.Large and round hepatocytes appeared first during differentiation,and the cell morphology changed when the oval cells differentiated to hepatocytes.Freshly isolated oval cells was positive for c-kit and OV6 with immunofluorescence staining,and RT-PCR analysis indicated that the albumin and CK19 mRNA were expressed in the new isolated cells.Conclusion The oval cells could be induced to differentiate into a variety of cell lineages including hepatocytes and bile duct epithelial cells in the presence of DMSO and several growth factors.Several antigens such as c-kit,OV6,CK19 and albumin may be expressed in the freshly isolated hepatic stem cells,and the course of morphologic changes may be observed under in vitro conditions of induction and differentiation.

Objective To study the expression and cellular distribution of?-catenin in hepatocellular carcinoma and in HepG2 and SMCC-7721 cells.Methods Immunohistochemistry,immunocytochemistry techniques and Western blotting analysis were used to examine the expression and distribution of?-catenin in the cell membrane,cytoplasm and nucleus of bepatocellular carcinoma tissues,HepG2 and SMCC-7721 cells.Results Immunohistochemical staining showed that the?-catenin poorly,unevenly,even not distributed on the mem- brane of hepatocellular carcinoma cells.The expression of?-catenin on the membranes of low differentiated liver cancer cells was lower than that in the highly differentiated liver cancer cells,but it was strongly expressed in the cytoplasm of hepatocellular carcinoma cells,The ex- pression of?-catenin in the membranes of hepatocellular carcinoma cells was found to be reduced obviously in 18 out of 20 patients(90%).?-catenin was found to be poorly,unevenly,even not distributed in the membrane cells in 10 patients(50%).An obvious accumulation, but with poor-distribution,of?-catenin was observed in the cytoplasm of 17 cases(85%).Significant differences in the?-catenin expres- sion in both membrane and cytoplasm were found among differently differentiated stages of liver cancer cells.In 7 of 9 cases(77.8%)with highly differentiated liver cancer cells,?-catenin was continuously and evenly distributed in both the membrane and cytoplasm,while in 4 of 5(80%)cases with poorly differentiated liver cancer cells the expression of?-catenin in the membrane was found to be significantly poor and showed a uneven distribution in the cytoplasm.The?-catenin expression was positive in the cytoplasm of 5 of 6(83.3%)cases with moderatdy differentiated liver cancer cells.No expression of?-catenin was found in the membrane of HepG2 and SMCC-7721 cells,while it was highly expressed in both cytoplasm and nucleus.Western blotting showed that the?-catenin expressed in both cytoplasm and nucleus of all the liver cancer tissue,and also in HepG2 and SM(3C-7721 cells.Conclusions The expression of?-catenin was down-regulated in the membrane of hepatocellular carcinoma cells and HepG2 and SMCC-7721 cells,while?-catenin was strongly expressed in cytoplasm,and it was obviously accumulated in the nucleus.The distribution of?-catenin was related to the stage of differentiation of cancer cells.

Tissue engineering may allow obtaining patient’s own cells, seeding them on biodegradable scaffolds, thus achieving formation of a particular tissue or organs, such as bone, cartilage, muscle, or heart. These tissues or organs can be used to repair tissue or organs defects caused by disease or trauma. Many animal studies have demonstrated the efficacy of using bone marrow mesenchymal stem cells in treatment of diseases such as nervous system diseases, liver disease, respiratory diseases and kidney disease. The main ways of the stem cells therapy are local implantation and systemic transplantation of bone marrow mesenchymal stem cells, and the effect of such treatments is notable. The use of gene-modified stem cells in gene therapy is an fantastic option due to theoretical advantage of stem cells compared to somatic cells with respect to higher proliferative capacity. Bone marrow mesenchymal stem cells can deliver genes and proteins into organs or tissues with specific need for gene therapy.

Seventeen patients with femoral intertrochanteric fracture admitted to Department of Orthopedics, First Hospital of Tianjin University of Traditional Chinese Medicine between December 2005 and October 2008, including 6 males, 11 females, aged 81 to 97 years, were retrospectively analyzed. All fractures were caused by acute falling, including left side in 8 patients, right side in 9. According to Evans-Jensen classification, there were 2 cases of ⅡA, 10 of Ⅱ B, and 5 of Ⅲ. All patients underwent artificial femoral head replacement using S-ROM hip joint system (Depuy). The time of the operations, bleeding volumes and the days of hospitalization were recorded, and the complications and the motion of the hip joint were observed. All the operations were accomplished successfully, with the average surgery time of 61 minutes and the bleeding volume 435 mL. Two of them were away from bed in 3 days, 13 in 7 days and others were in 2 weeks. The average hospitalization was 19 days. The patients were followed-up for 13.7 months (ranging 4.5-36.0 months), postoperatively. No death or severe complications were found during hospitalization; 15 patients were recovered basically in doing daily as before injury; 1 patient had tow-grade fever for long period of time and been considered to get urinary system infection, but no severe complication developed. However, 1 patient died of myocardial infarction at 4.5 months post-replacement. The range of motion of the hip joints was 90°-110°. All patients became life-independent postoperatively except 3 patients hospitalized because of cerebral infarction and 2 moved assisted by the walker. The prosthetic appliance significantly reduced operation time and decreased bleeding; it is of clinical significance for elderly patients.

Objective To assess the value of tomographic ultrasound imaging (TUI) for prenatal analysis of the relative orientation of fetal heart and great arteries. Methods Volume datasets acquired from 12 patients of transposition of the great arteries (TGA) and 13 normal fetal heart were evaluated offline with TUI. The aortic valves (AV) and pulmonary valves (PV) were respectively showed on the two parallel slices. According to the pivot point in the middle of the PV in one slice, the relative orientation of the AV on another slices were analyzed. Results In the 12 patients of TGA confirmed postnatally, 7 were concomitant with single ventricle anomaly, AV was on the anterior-right orientation of the PV in 5, and was relatively on the anterior and anterior-left orientation in other 2 of them.In the remained 5 with seeming normal 4 chamber view, AV was found on the anterior-right of the PV in 3, and was relatively on the anterior and upright orientation.in other 2 patients. In 13 normal fetuses, TUI showed that all AV located on the posterior-right orientation to the PV. Conclusion TUI can provide detailed spatial information of the great arteries both in normal and abnormal fetal heart. It may be a convenient and veracious tool for prenatal exploring the morphology of the great arteries.

BACKGROUND:It has been demonstrated that shortening of femoral eccentricity would lead to decreased abductor muscle strength,and overlengthening eccentricity would increase the risk of femoral neck prosthesis fracture and the compressive stress of cemented femoral stem prosthesis after artificial hip replacement,which easily causes prosthetic loosening and subsidence.OBJECTIVE:To investigate the importance of eccentricity adjustment in the artificial hip replacement for treatment of femoral neck fracture in elderly patients.DESIGN,TIME AND SETTING:An observational study was performed at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine between January 2004 and December 2005.PARTICIPANTS:A total of 30 patients with femoral neck fracture,12 males and 18 females,averaging 73.8 years of age (range 62-90 years old),received treatment at the Department of Orthopedics,First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and were recruited into this study.METHODS:All patients underwent artificial hip replacement operated by the same team of surgeons.Prior to surgery,some indices on the uninjured side were determined through the anteroposterior radiographs of pelvis using X-Caliper measurement tool,including rotation center of femoral head,rotation center of hip joint,collodiaphyseal angle,femoral transverse eccentricity,abduction moment arm,and moment arm of gravity.These indices were precisely calculated using trigonometric function.The angle of osteotomy plane was determined.Proper prosthesis was selected and eccentricity was adjusted.Following artificial hip placement,a comparison was made between uninjured and injured sides.MAIN OUTCOME MEASURES:Eccentricity and hip joint function.RESULTS:The eccentricity on uninjured side of 30 patients averaged 38.7 mm (range 22-57 mm) prior to surgery and that on the injured side averaged 39.2 mm (range 21-59 mm) after surgery.Limb discrepancy ranged 1.8-8.7 mm,with a mean of 3.4 mm,after surgery.There were 26 patients (86.7%) presenting long limbs and 4 patients (13.3%) showing short limbs after surgery.All patients were followed-up 0.5-2.5 years old.Harris hip score results were excellent in 10 patients,good in 19 patients,and fair in 1 patient,with an excellent and good rate of 97%.CONCLUSION:In treatment of femoral neck fracture,eccentricity adjustment during artificial hip replacement is closely associated with hip joint function after surgery.

BACKGROUND: The decrease of activity level of choline acetyltransferase (ChAT) and reduction of membrane protein of synaptic vesicles are the main biochemical indexes in Alzheimer disease. Traditional Chinese bushen yizhi formula is of the effects of strengthening the kidney, replenishing qi, generating marrow and nourishing the brain, its medicine-containing serum can effectively protect these changes resulting from amyloid protein.OBJECTIVE: To investigate whether the medicine-containing serum of bushen yizhi formula can improve the pathological injury of neurons induced by amyloid protein metabolites in Alzheimer disease, thus to estimate the therapeutic effect of bushen yizhi formula on Alzheimer disease.DESIGN:A randomized and controlled trial. SETTING:Institute of Neuroscience, Second Affiliated Hospital, Guangxi College of Traditional Chinese Medicine, Nanning 530011, Guangxi Zhuang Nationality Autonomous Region, China; Encephalopathic Institute of Guangzhou University of Traditional Chinese Medicine.MATERIALS:The experiment was conducted from September 2003 to March 2004 at the Research and Development Center of New Drugs of Guangxi College of TCM. Totally 60 healthy Wistar rats of clean grade,three months, were at random divided as blank control and bushen yizhi groups, with 30 in each group. The bushen yizhi formula consisted of Fructus Lycii, Fructus Cnidii, Radix Gingeng, Radix Polygoni Multiflori,Cortex Moutan Radicis, Borneolum, etc. The medicine was prepared before use as 0.176 g/Ml liquid(including 1.13 g/Ml rude drugs).METHODS:① Each of the rats in bushen yizhi group was by garage given 1.0-1.5 Ml prepared liquid per day for consecutive 30 days. Within 4hours after the last administration the serum was isolated at 5 000 r/min for 5 minutes, filtered aseptically, the compliment was inactivated at 56 ℃,then the medicine-containing serum was obtained. The rats in blank control group were given saline of the same volume, and the serum was prepared with the same method. ② For NG108-15 cells, the concentration of amyloid protein 25-35 segments in the culture liquid was 5 μ mol/L, or 1-42 segments, 200 nmol/L, was suitable. ③ NG108-15 cells was first in cubated for a day in CO2 incubator with Dulbecco-improved Eagle medium of 0.1 molarity at 37 ℃, then 5 μmol/L amyloid protein 25-35 segment or 200 nmol/L segment 1-42 was added to continuously incubate for a day, after that the cell models of Alzheimer disease was ready. Then 50 g/L medicine-containing serum or Dulbecco-improved Eagle medium of blank control group serum was taken to replace the original culture liquid, and the amyloid protein segments of the above-mentioned concentration was still added for maintaining the cell models of Alzheimer disease, after 5 days'differentiation incubation, the indexes were detected with those in non-amyloid protein as control. ④ Western blotting, radioimmunoassay and electrophysiological examination were used to investigate the ChAT activity,synapsin protein level and rate of functional synapse formation of NG108-15cells in Alzheimer disease after treatment with the medicine-containing serum of bushen yizhi formula.MAIN OUTCOME MEASURES :The effects of the medicine-containing serum of bushen yizhi formula on ChAT activity, synapsin protein level,rate of functional synapse formation of NG108-15 cells and frequency of miniature plate potential in NG108-15 cells.RESULTS:Totally 60 rats involved all entered the final result analysis.① The effect of the medicine-containing serum of bushen yizhi formula on ChAT activity: In the conditions when there was no amyloid protein or the final concentration of amyloid protein 1- 42 was 200 nmol/L, the ChAT activity in bushen yizhi group was obviously higher than that in blank control group [(1651.2±134.5), (1336.1±268.2), ( 586.1±223.4),(1290.7±381.5)μmol/(g·h); P ＜ 0.05] . ② The effect of the medicinecontaining serum of bushen yizhi formula on synapsin protein level: The absorbance values of synapsin Ⅰa and Ⅰb, in the conditions when there was no amyloid protein, amyloid protein 25-35 and 1-42, were respectively 5.02, 1.36 and 2.46 in bushen yizhi group; and 3.18, 0.57 and 0.71 in blank control group. The values in bushen yizhi group were respectively 1.6,2.4 and 3.5times those in blank control group. ③ The effect of the medicine-containing serum of bushen yizhi formula on functional synapse formation of NG108-15 cells: In the conditions when there was no amyloid protein or amyloid protein 1-42, the levels of functional synapse formation in bushen yizhi group wereall higher than those in blank control group [(90.6±6.0)%, (63.2±17.0)%, (58.0±13.1)%, (34.2±13.0)% ;P＜0.05].④ The effect of the medicine-containing serum of bushen yizhi formula on frequency of miniature plate potential in NG108-15 cells: In the conditions when there was no amyloid protein or amyloid protein 1-42, the frequencies of miniature plate potential in bushen yizhi group were all higher than those in blank control group [(9.28±4.1), (5.48 ±5.14), (5.55±5.85),(3.05±4.46)/min; P ＜ 0.01, P＜ 0.05].CONCLUSION:In the conditions when there existed no amyloid protein or amyloid protein, the medicine-containing serum of bushen yizhi formula can raise ChAT activity, not only correct the decrease of cellular synapsin caused by amyloid protein, but also raise the expression of synapsin protein, the rate of functional synapse formation and neurotransmitter release under the condition of no amyloid protein. It was shown that the prescription can antagonize the pathological development of Alzheimer disease, and play the therapeutic effect through enhancing the release power of neurotransmitter.

Objective To introduce our experience in embolizing cerebral ruptured-aneurysms of elderly patients in our hospital. Methods Totally 76 elderly patients were referred to our hospital due to ruptured-aneurysms.81 aneurysms were confirmed by DSA,all of them were sac aneurysms,among which 75 cases (body/neck≥ 1) were treated with balloon-assisted coiling,29 narrow-necked (body/neck≥2) aneurysms and 30 wide-necked (1 ≤ body/neck＜ 2) aneurysms were treated with balloon-assisted coiling successfully,but 6 narrow-necked (body/neck≥2) were treated with balloonassisted coiling in emergency,followed by a stent-assisted coiling in secondary embolization,4 cases with body/neck＜1 were treated with stent-assisted coiling technique in emergency,2 non ruptured aneurysms could not be treated.The times of balloon dilation were (2.1 ± 1.3),single expansion of filling was (33.4±14.1)s. Results The arterial thrombosis happened in two patients (2.7 ％),two aneurysms ruptured (5.3％) during the procedure. No stent-related thrombosis happened. 86were elevated as good,8 as serious according to the Glasgow outcome scale,neither died after operation or delayed thrombosis or infarction lesion during following up. Conclusions Balloonassisted coiling is a safe and effective method in elderly patients during acute stage of rupturedaneurysms.