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 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.

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.

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 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.

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 investigate the mechanisms underlying the protection by punicalagin against ultraviolet B (UVB)-induced damage to keratinocytes.Methods Cultured human HaCaT keratinocytes were divided into several groups:blank control group receiving no treatment,punicalagin groups treated with various concentrations of punicalagin,UVB group irradiated with UVB at 30 mJ/cm2,combination groups pretreated with different concentrations of punicalagin followed by UVB radiation at 30 mJ/cm2.The concentrations of punicalagin were 5,10,20,40 and 80 μmol/L in the cell proliferation assay,10,20 and 40 μmol/L in the other assays.After additional culture for different durations,methyl thiazolyl tetrazolium (MTT) assay was performed to evaluate the proliferation of HaCaT cells,Hoechst and propidium iodide (PI) staining as well as flow cytometry to detect the apoptosis in cells,reverse transcription-PCR to quantify the mRNA expressions of matrix metalloproteinase-1 (MMP1) and tissue inhibitor of metalloproteinase-1 (TIMP1) in HaCaT cells,Western blot to determine the phosphorylation levels of the mitogen-activated protein kinase (MAPK) pathway-related proteins including P38,JNK and ERK.Statistical analysis was carried out by t test,one-way analysis of variance,and Dunnett's t-test.Results As the MTT assay showed,punicalagin at 10-40 μmol/L showed stronger pre-protective effects against UVB-induced damage to HaCaT cells compared with punicalagin at the other concentrations.The number of cells highly positive for both Hoechst and PI staining was larger in the UVB group than that in the blank control group,but smaller in the combination groups than in the UVB group.The percentage of apoptotic cells increased significantly in the UVB group compared with the blank control group (9.82％ ± 0.11％ vs.1.24％ ± 0.91％,P ＜ 0.01),but decreased significantly in the three combination groups (punicalagin (10,20 and 40 μmol/L) + UVB) compared with the UVB group (6.38％ ± 0.14％,5.24％ ± 0.17％ and 3.77％ ± 0.11％ vs.9.82％ ± 0.11％,all P＜ 0.01).Theexpression of MMP1 mRNA was significantly higher,but that of TIMP1 mRNA was significantly lower in the UVB group than in the blank control group (both P ＜ 0.01),whereas no statistically significant difference was observed in the expression of MMP1 or TIMP1 mRNA between the punicalagin groups and blank control group (all P ＞ 0.05).The pretreatment with punicalagin significantly reduced the expression level of MMP1 mRNA (P ＜ 0.01),but elevated that of TIMP1 mRNA (P ＜ 0.01) in the combination groups compared with the UVB group.As Western blot showed,the phosphorylation levels of P38,JNK and ERK were markedly increased in the UVB group (all P ＜0.01),but experienced no significant changes in the punicalagin groups (all P ＞ 0.05) compared with the blank control group,and decreased to different degrees in the combination groups compared with the UVB group (all P ＜0.01).Conclusion Punicalagin has a pre-protective effect on UVB-induced damage to HaCaT cells.

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 investigate the clinical value of lasting methylene blue staining in precise hepatectomy.Methods The clinical data of 21 patients with liver cancer who received precise hepatectomy after methylene blue staining at General Hospital of PLA from February to August in 2009 were retrospectively analyzed.After the hepatic pedicle Was dissected,methylene blue WaS injected into the portal vein,and then the hepatic pedicle was ligated.Parenchymal division is initiated along the line of devascularization demarcated on Glisson capsule.Results The success rate of methylene blue staining Was 100%.Methylene blue retained in the parenchyma for(80±23)minutes.Right hepatectomy was performed on 2 patients,left hepatectomy on 1,right posterior lobectomy on 2,right anterior lobectomy on 3,left lateral lobectomy on 1,segmentectomy of segment Ⅷon 2,segmentectomy of segment Ⅶ on 3,segmentectomy of segment Ⅵ on 1,segmentectomy of segment Ⅳ on 2 and combined segmentectomy on 4.The mean volume of blood loss,incidence of postoperative complications and postoperative hospital stay were(236±6)ml,14%(3/21)and(12±3)days.Conclusions Ligation of hepatic pedicle after methylene blue injection has the advantages of high success rate and lasting staining of parenchyma of liver.Especially,this staining method contributes to improve the precision of hepatectomy by guiding the segment selection during parenchyma transection.