Objective To evaluate the role of computer-assisted surgical planning system in liver resection for patients with hepatocellular carcinoma (HCC).Methods Between January 2010 and January 2012,21 patients with HCC who underwent liver resection were included in this study.Computer assisted operative planning was performed before surgery.Results Computer-assisted surgical planning was performed successfully in all the 21 patients.The three dimensional anatomic evaluation was precise and quantitative.The predicted liver resection volume showed a significant correlation with the actual volume,with a mean difference of 3.5％.The types of liver resection included anatomic liver resection (15 patients) and local resection (6 patients).There was a 0％ mortality and a 14.3％ morbidity (3/21).Conclusions The computer-assisted surgical planning system reliably analyzed the 3D vascular structures and predicted accurately liver resection volumes.It can help to promote precise and safe liver resection.

Congenital bile duct dilatation may occur in any part of the biliary tree,and the diagnosis and treatment of lesions involving the intrahepatic bile duct is the most challenging issue.Surgical operation plays a dominant role in the management of congenital bile duct dilatation,with the purposes of relieving symptoms and preventing disease progression and malignant transformation.Surgical principles are radical resection of lesions and reconstruction of unobstructed bile drainage.Hepatectomy is the main surgical procedure for congenital bile duct dilatation with involvement of the intrahepatic bile duct,and liver transplantation can be used for diffuse lesions.Therefore,we believe that hepatectomy and early intervention will maximize patients' benefits.

Objective To reproduce the inflammatory bowel disease(IBD) models induced by 2,4,6-trinitrobenzene sulfonic acid(TNBS),and to investigate the effect of Changkangyin(CKY) on it.Methods Total 60 rats were divided into 6 groups by random:alcohol control group,model group,salicylazosulfapyridine(SASP)group,low,middle and high dosages CKY groups.IBD model was induced by TNBS.The changes of macroscopic morphous and pathohistology of colon were observed after intervened with drug for 21 d.Results The body weight in model group was obviously lower than that in alcohol control group(P0.05).Conclusion Colitis can be induced by TNBS in rats.The change of it is the same as human's.It is a ideal model to study pathogenesis of IBD and investigate the effect of medicine.CKY has a batter therapeutic effect on IBD model.

Objective To investigate the effect of remifentanil combined with dezocine or fentanyl on analgesia in patients with cholecystectomy. Methods A total of 98 patients with cholecystectomy from our hospital were collected, patients were randomly divided into the experimental group and control group with 49 cases in each group.Patients in the control group were treated by remifentanyl combined with fentanyl intravenous injection and patients in the experimental group were treated by remifentanyl combined with dezocine intravenous injection.The analgesia and sedation score and vital signs changes at recovery time (T1), after recovery 1h (T2), 2 h (T3), and the revival time, extubation time and adverse reactions were compared between two groups.Results The visual analogue scale score in experimental group at T1 , T2 , T3 and Ramsay sedation scale ( RSS) at T2 , T3 were lower than control group, the revival time and extubation time in experimental group were lower than control group, with significant difference (P<0.05). There was no significant difference at T0 ,T1 ,T2 and T3 between two groups.There was no respiratory depression happened in two groups, and there was no significant difference in adverse drug reaction between control group and experimental group (16.33% vs.10.20%).Conclusion The remifentanil combined with dezocine has a good inhibitory effect on postoperative hyperpathia with less adverse reactions.

Objective To investigate the effects of 1% ropivacaine injected epineurally or intraneurally on the recovery of sciatic nerve from acute injury in rats. Methods Seventy-two healthy male Wistar rats weighing 220-250 g were xandomly assigned into 4 groups ( n = 18 each): group Ⅰ epineural injection of normal saline(NS)(group C1); group Ⅱ intraneural injection of NS (group C2); group Ⅲ epineural injection of 1% ropivacaine (group Epi-R) and group Ⅳ intraneural injection of 1% ropivacaine (group Intra-R). The animals were anesthetized with intraperitoneal 3% pentobarbital 60 mg/kg. The sciatic nerve was exposed and crushed with blood vessel clamp for 2 min. NS or 1% ropivacaine 0.2 ml was injected epineurally or intraneurally after release of the clamp.Sciatic nerve function was measured and sciatic nerve function index (SFI) was calculated at day 1, 3, 7, 14, 21and 28 after operation. Six animals in each group were anesthetized on the 14th and 28th day after operation and the nerve conduction velocity (NCV) of the sciatic nerve was measured. The sciatic nerve was then removed for histologic examination. Results There was no significant difference in SFI and NCV at all time points among group C1 , C2 and Epi-R. SFI was almost normal on the 28th day after operation in the 3 groups. The NCV was significantly slower at day 14 and 28 after operation in intra-R group than in the other 3 groups. Conclusion Intra-neural injection of ropivacaine can significantly delay the recovery of sciatic nerve from acute injury.

For unresectable advanced hepatocellular carcinoma (HCC),besides sorafenib,alternative drugs and treatment modalities are required.Clinical studies of hepatic arterial infusion chemotherapy (HAIC),transcatheter arterial chemoembolization (TACE),and system chemotherapy have shown favorable efficacy and tolerance in advanced HCC patients.In addition,the potential efficacy of sorafenib combined with focal treatment is also an interesting issue.As more therapies become available,decision-making for treating advanced HCC becomes increasingly complex.In our opinion,diverse treatment modalities should be utilized for the best interest of patients.Based on predictive biomarkers,we should develop a precise patient stratification system to select suitable candidates for each treatment modality in future studies,as is useful for improving prognosis of patients with advanced HCC.

Objective To observe the effect of fasudil on cytoskeleton reconstruction in mouse podocytes induced by angiotensin Ⅱ (Ang Ⅱ),as well as to study the protective mechanism of fasudil in the pathological changes of podocytes.Methods Conditionally immortalized mouse podocytes were treated with Ang Ⅱ (10-7 mol/L).The podocytes were pre-incubated for 30 min or 60 min with various concentrations of fasudil (10-8,10-7,10-5 mol/L),then Ang Ⅱ (10-7 mol/L) were added and furtherincubated for 24 hours.The cytoskeleton distribution of podocyte as indicated by F-actin and synaptopodin was observed by fluorescence microscopy and Western blotting.At the same time,the activity of Rho signal pathway that mediates actin filament polymerization was analyzed by measuring the extent of Rho-associated coiled-coil-containing protein kinase 1 (ROCK-1) and myosin phosphatase-1 (MYPT1).Results Compared to the control group,AngⅡ disrupted the podocyte actin cytoskeleton and significantly decreased the expression of synaptopodin (P ＜ 0.05),while fasudil stabilized the actin filaments,and improved the synaptopodin expression (P ＜ 0.05).The expression enhancement of ROCK-1 and MYPT1 by Ang Ⅱ were reduced significantly by fasudil (P＜0.05).Conclusion The cytoskeleton reconstruction of podocytes can be induced by Ang Ⅱ and inhibited by fasudil,which suggests that the protective effect of fasudil may be partially contributed to the Rho/ROCK signaling pathway.

AIM:To investigate the effects of gonadotropin-releasing hormone ( GnRH) analogue on the growth of breast cancer cell lines MCF-7 and MDA-MB-231 in vitro and to explore the related mechanisms with PI 3K/Akt or ERK/MAPK pathways .METHODS: The proliferation of human breast cancer cell lines MCF-7 and MDA-MB-231 treatment with triptorelin was detected by MTT assay and the distribution of the cell cycle was determined by flow cytometry .The phosphorylation of the ERK 1/2 and Akt was evaluated by Western blotting .RESULTS:Triptorelin inhibited the prolifera-tion of MCF-7 cells at concentration of 10-5 mol/L after treated for 192 h or at concentration of 10 -4 mol/L after treated for 168 h and 192 h.Triptorelin inhibited the proliferation of MDA-MB-231 cells at concentration of 10 -4 mol/L after treated for 192 h (P<0.05).Treatment with triptorelin for 192 h at concentration of 10 -4 mol/L had no statistical significance effect on phosphorylation of ERK1/2 and Akt(P>0.05).CONCLUSION:Inhibitory effect of GnRH analogue triptorelin on human breast cancer cells is not just the connection with the down-regulation of pituitary hormone , but also a direct in-hibitory effect.The role may not be involved in the activation of ERK /MAPK and PI3K/Akt signaling pathways .

Objective To study the effect of preemptive analgesia with tramadol on ovarian cancer patients with stress reaction.Methods 80 cases with ovarian cancer undergoing elective surgery under general anesthesia were divided into the observation group and the control group according to the computer randomly generated control table,40 cases in each group.Patients in the observation group with PECA were pumped into tramadol after anesthesia induction,while the control group was in the same conditions of pumping tramadol after operation.Patients were all treated with intravenous patient -controlled analgesia with sufentanil after waking up.The blood concentrations of cortisol (COR),adrenal cortical hormone (ACTH),angiotensin Ⅱ (AT Ⅱ)were determined by radioimmunoassay, and the blood concentrations C reactive protein (CRP)was determined by immune turbidity method.The adverse reactions and the VAS score of patients after 2h,6h,12h,24h,48h were recorded.Results The COR,ACTH,AT Ⅱ, CRP concentrations of the two groups had no significant differences (all P >0.05)before operation.After each time point,COR[(208.5 ±31.6)ng/mL vs (446.3 ±19.8)ng/mL],ACTH[(35.7 ±8.2)pg/mL vs (63.5 ±9.1)pg/mL],AT Ⅱ[(46.8 ±10.9)pg/mL vs (75.9 ±12.5)pg/mL],CRP[(3.9 ±0.7)mg/mL vs (40.5 ±2.9)mg/mL] concentrations were significantly higher than those of pre -operation (all P <0.05 );The concentration of COR [(446.3 ±19.8)ng/mL vs (570.8 ±67.2)ng/mL],ACTH (63.5 ±9.1)pg/mL vs (85.2 ±12.5)pg/mL),AT Ⅱ[(75.9 ±12.5)pg/mL vs (108.5 ±18.1)pg/mL]and CRP[(40.5 ±2.9)mg/mL vs (51.8 ±8.5)mg/mL]in the observation group was significantly lower than those in the control group (all P <0.05);After operation,the VAS scores of rest (2.4 ±0.7)and cough (3.4 ±1.0)in the observation group were significantly lower than those in the control group in 2h (t =5.812,P =0.017;t =14.606,P =0.044);At rest,the other time point of the two groups of VAS scores had no significant difference (P >0.05);At the time of coughing,the two groups were significantly differ-ent only at the 6h[(2.5 ±0.6)vs (3.1 ±0.8)]and 12h[(2.1 ±0.6)vs (2.9 ±0.4)]time point (t =13.406, P =0.012;t =12.625,P =0.025).Conclusion Preemptive analgesia with tramadol and sufentanil for postoperative analgesia can effectively reduce the radical resection of postoperative pain and the stress reaction after surgery.It is a safe and effective analgesic method.

Objective To study the effect of chronic poisoning of ketamine on brain cell apoptosis in adult mouse under different duration and doses. Methods The mouse model of chronic poisoning of ketamine was established on adult mouse by tail vein injection of ketamine twice every week with different doses (4, 10, 20 and 30 m g/kg). The mice were sacrificed after continuous injection of ketamine of 1, 2, 4, 8 and 12 weeks. The qualitative assessment of apoptosis was made by transmission electron microscope and the quantitative assessment was made by Caspase-3 im m umofluorescence staining method and terminal deoxynucleotidyl transferase-mediated dU TP nick end labeling (TUNEL ) to estimate the time point of apoptosis. All the experimental results were statistically analyzed. Results The neuron apoptosis was ob-served in hippocam pus and corpus striatum by transmission electron microscope one week after adminis-tration, and continued for eight weeks. High level of Caspase-3 expression was observed one week after administration, but with a lowlevel expression after 4 weeks. The num ber of TUNEL positive cells ob-viously increased one week after administration and maintained in ahigh num ber at 4 weeks. Conclu-sion Ketamine by tail vein injection could induce neuron apoptosis in adult mouse.