Objective To compare the primary treatment efficacy of radiofrequency ablation and surgical resection in patients with solitary hepatocellular carcinoma (HCC) which the diameter is ≤5 cm.Methods Databases were searched for comparative studies on radiofrequency ablatiom vs surgical resection published from 2005 to 2012.A Meta-analysis was performed using a randomized or fixed effect model to compare the treatment efficacy between radiofrequency ablatiom and surgical resection.Results Five studies fulfilled the criteria and were included.For HCC patients whose single tumors' diameter is ≤5 cm,radiofrequency ablation was equivalent to surgical resection for 1-,3-and 5-year overall survivals (P ＞ 0.05).However,surgical resection was superior to radiofrequency ablation in 1-,3-and 5-year disease-free survivals and there' s significant difference (P ＜ 0.05).Higher local recurrence rate was associated with radiofrequency ablation than surgical resection.Conclusions For HCC patients whose single tumors' diameter is ≤5 cm,radiofrequency ablation can achieve comparable overall survival as surgical resection,though with higher recurrence rate and lower disease-free survival.

Objective To investigate how SDF-1α and c-MYC protein regulates TACRl-Tr expression. Methods c-myc shRNA vector was constructed, small interfering RNA was employed for silencing c-myc gene in MCF-7 breast cancer cell. SDF-1α neutralized antibody was used in c-myc+ cell group and c-myc- cell group, while other c-myc+ cell group and c-myc- cells group were cultured under normal condition. The mRNA level of TACRl-Tr was determined by real-time PCR. Results c-myc shRNA vector was constructed successfully, in the normal presence of SDF-la, the level of TACRl-Tr mRNA in c-myc- cell group were lower than that in c-myc+ cell group( P < 0.05). But in the presence of SDF-la neutralized antibody, TACRl-Tr mRNA level of c-myc- cell group was higher than that of c-myc+ cell group(P < 0.05). Conclusion In the normal culture condition, c-MYC protein may transactivate TACRl-Tr transcription in MCF-7 cell, in the presence of SDF-1α neutral antibody, c-MYC protein lost the activity of transactivating for TACRl-Tr transciption.

AIM To investigate the inhibitory effect of paeonol on hydrogen peroxide(H2O2)-induced apoptosis in PC12 cells. METHODS The injury model in PC12 cells was generated by H2O2 treatment. The cell viability was determined using methylthiazolyl tetrazolium reduction assay. Apoptotic cells and reactive oxygen species (ROS) were measured by flow cytometry. Lactate dehydrogenase (LDH) activity and malonyldialdehyde (MDA) content were measured by spectroscope respectively. RESULTS After PC12 cells were treated with H2O2 (100 μmol*L-1) for 10 h,its viability obviously decreased, and apoptotic cells, LDH release into the culture media, ROS and MDA contents in PC12 cells significantly increased. When the cells were pretreated with paeonol (12, 25 and 50 μmol*L-1)for 1 h prior to incubation with H2O2, its viability was greatly increased, and apoptotic cells, LDH release, ROS and MDA contents significantly decreased. CONCLUSION Paeonol protects PC12 cells from H2O2-induced apoptosis and this effect is probably achieved through its antioxidative action.

Radiofrequency ablation (RFA) has been playing an important role in the treatment of hepatocellular carcinoma (HCC). It is minimally invasive, easily repeatable and potentially curative. Many centers now accept it to be the best therapeutic choice for patients with early-stage HCC when liver transplantation or surgical resection is not suitable. In this article, we reviewed the indications, techniques , and clinical results of RFA in the treatment of HCC.Suitable patient selection, good pre-treatment planning,complete ablation, and careful post-treatment follow up are important. Techniques, such as artificial pleural effusion and ascites, contrast-enhanced ultrasonography-guided RFA,laparoscopic or open surgical approaches have reduced complications and expanded the indications for RFA.

Objective To investigate the expression of soluble triggering receptors expressed on myeloid cells-1 ( sTREM-1 ) in intraperitoneal drainage fluid of patients with abdorminal trauma and its predictive value for post-traumatic sepsis. Methods A total of 80 abdominal trauma patients were served as the trauma group and 25 patients treated with subtotal gastrectomy as the control group.Intraperitoneal drainage fluid sTREM-1,serum sTREM-1,procalcitonin (PCT) and C-reactive protein (CRP)at 0,24,48,72 hours after admission were determined in two groups for assessing their value in early prediction of post-traumatic sepsis. Results The levels of drainage fluid sTREM-1,serum sTREM-1,PCT and CRP in the trauma group were significantly higher than those in the control group (P ＜ 0.05 ).Drainage fluid sTREM-1 showed the area under the receiver operating characteristic (ROC) curve,sensitivity and specificity for 0.84,77％,and 83％ in the prediction of post-traumatic sepsis,which was superior to the serum sTREM-1,PCT and CRP. Conclusion Intraperitoneal drainage fluid sTREM-1 has high accuracy in predicting the sepsis in abdominal trauma patients.

Objective To evaluate the clinical efficacy of 1 aparoscopic anatomical hepatectomy (LaHt)in the treatment of liver cancer by comparing with Open precise hepatectomy (OHt).Methods Forty-six cases of liver tumor hepatectomy were collected by the none randomized controlled trails (non-RCTs) from January 2011 to December 2013 in Department of Hepato-Biliary-Pancreatic Surgery,Nanjing Drum Tower Hospital.According to the operation method,they were divided into two groups,including 19 cases of LaHt group and 27 cases of OHt group.Compare differences of their operation time,intraoperative blood loss,time of Pringle maneuver,and postoperative hospital stay,time of postoperative gastrointestinal function recovery,Serum liver function index,pathological tumor margin,postoperative complications,total hospitalization expenditures.Results (1) No perioperative mortality was observed in the 2 groups.(2) Compared with OHt group,LaHt group had shorter Pringle maneuver time with statistical significance (P ＜ 0.05,F =8.662) ; while,LaHt group also had less hemorrhage and shorter operation time than OHt group,although statistical significance did not existed (P ＞ 0.05,F =1.481,F =0.539).(3) Compare with OHt group,postoperative gastrointestinal function recovery of LaHt group was faster while postoperative length of hospital stay of LaHt group was shorter with obviously statistical significances existed (P ＜ 0.01,F =7.691,F =11.408).(4) The liver function index serum ALT,AST of LaHt group is lower compared to that of OHtgroup postoperative dayl and 3,however,only the day 3 AST had statistical significance (P ＜ 0.05,F =4.226).LaHt group had lower CRP level than OHt group on both day 1 and 3 after surgery,but there was no statistical significance(P ＞ 0.05,F =0.792,F =0.007).Serum TB and DB varied little between LaHt and OHt group on both day 1 and 3 after surgery without statistical significance (P ＞ 0.05,F =2.002,F =0.021,F =0.442,F =1.392).(5) The average hospital charges for the patients in LaHt group is higher than that in OH group,but there was still no statistical significance (P ＞ 0.05,F =0.046).(6) Although there was no significant difference between LaHt and OH in positive/negative excision margin ratio (P ＞0.05,x2 =1.453),there was 1 case of excision margin residues in LaHt group which would have negative effects on the prognoses.Conclusions Laparoscopic hepatectomy is a safe and feasible surgical approach,with minimally invasive advantage for treatment of liver cancer.However,compared with open precise hepatectomy,there are still some deficiencies in terms of radical curative aspect.

Objective To investigate the effect of high volume hemofiltration (HVHF) on expression of miRNA-146 in peripheral blood mononuclear cells in posttraumatic sepsis patients and its therapeutic mechanism.Methods Twenty-five cases of posttraumatic sepsis were included as HVHF group.Another 25 age-and gender-matched traumatic sepsis patients with similar APACHE-Ⅱ who received no HVHF treatment for some reasons were used as controls.Therapeutic measurements were the same of the two groups except for HVHF.At 0-,6-,12-,24-and 48-hour time points,the peripheral blood mononuclear cells were isolated from patients of both groups to detect level of miRNA-146.Peripheral blood mononuclear cells isolated at 24 hours were incubated with lipopolysaccharide (LPS) in vitro.At hours 4,8,12,24 and 48 after incubation,level of miRNA-146 in mononuclear cells was determined and levels of TNF-α,IL-6,and IL-10 in the substrate was detected by ELISA.Results (1) Level of miRNA-146 in HVHF group was decreased significantly over time as compared with that in sepsis group;(2) Before incubation and at 4-and 8-hour after incubation,miRNA-146 level was lowered significantly in HVHF group as compared with that in sepsis group.After LPS stimulation,mononuclear cell also presented a stronger inflammatory response in HVHF group than in sepsis group.Conclusions HVHF provides a definite effect on immune function recovery and a significant improvement in prognosis.Moreover,HVHF may attenuate the impact of miRNA-146 on mononuclear cell inflammatory factor release and enhance the cell ability to respond to external stimuli again via down-regulating miRNA-146,as may be one of the therapeutic mechanisms of HVHF for posttraumatic sepsis.

Objective To investigate the correlation between immediate postoperative platelet count with liver failure after partial hepatectomy in patients with hepatocellular carcinoma.Methods The clinical data of 71 patients with hepatocellular carcinoma who underwent liver resection at the Hepatopancreatobiliary Surgery Department of Nanjing Drum Tower Hospital from July 2013 to August 2015 were retrospectively analyzed.The clinical diagnosis was confirmed by pathology of the resected specimens.Based on postoperative platelet count within 2 h,the patients were divided into the low platelet count (PLT ＜ 100 × 109/L) group (n =24,33.8％) and the normal platelet count (PLT ≥ 100 × 109/L) group (n =47,66.2％).The correlations between immediate postoperative platelet count with serum indexes including serum alanine aminotransferase (ALT),aspartate aminotransferase (AST),total bilirubin (TBil) and direct bilirubin (DBil) were analyzed,and the incidences of posthepatectomy liver failure was also evaluated in these two groups.Results There was no re-operation and perioperative death in this study.Among the 71 patients,25 patients (35.2％) developed postoperative complications (grade Ⅰ to Ⅲ),and 8 patients (11.3％) suffered from postoperative liver failure (grade A).When compared with the normal platelet count group,the low platelet count group had significantly increased risks of postoperative liver failure (29.2％ vs 2.1％,X2 =11.618,P ＜ 0.05),increased postoperative peaks of ALT,AST,TBil and DBil levels [(462.5 ±135.7)U/L vs (307.9 ± 192.6) U/L,(440.0 ± 163.3) U/L vs (265.8 ± 155.8) U/L,(29.5 ±9.1) μmol/L vs (17.9 ±8.8) μ mol/L,t =3.507,4.385,5.129,P ＜0.05,respectively] and longer normalization time of liver function.Multiple Logistic regression analyses revealed that an immediate postoperative low platelet count was an independent risk factor of posthepatectomy liver failure.Conclusions The platelet count was associated with the incidence of postoperative liver failure after partial liver resection in patients with hepatocellular carcinoma.Patients with an immediate postoperative low platelet count suffered from a high incidence of posthepatectomy liver failure and delayed liver function recovery.

AIM:To study the chemical constituents of Fissistigma oldhamii(Hemsl.)Merr.METHODS:Silica gel column chromatography was used in the isolation procedure,the structures of the isolated compounds were elucidated by spectral data.Meanwhile cytotoxic activity of compound Ⅰ was made according to the cell experiment in vitro.RESULTS:Five compounds were isolated from Radix of Fissistigma oldhamii(Hemsl.)Merr..On the basis of physical-chemical constants and spectral data(EI-MS,1H-NMR,13C-NMR),these compounds were identified as:Aristolactam A Ⅱ(Ⅰ),Aristolactam B(Ⅱ),Physcion(Ⅲ),?-sitosterol(Ⅳ),Stigmastan-7-one(Ⅴ).Compound Ⅰ showed cytotoxic activities on GLC-82 and HL_ 60 cell strains.CONCLUSION:Compounds Ⅲ,Ⅳ and Ⅴ are firstly isolated from Fissistigma oldhamii(Hemsl.)Merr..The IC_ 50 of compound Ⅰ on GLC-82 and HL_ 60 cell strain are:234.45,101.17 ?M.

Objective To invcstigate the value of preoperative imaging morphologic classification in solitary small hepatocellular carcinoma treated by RFA.Methods The clinical data of 73 patients with small hepatocellular carcinoma who rcccivcd radiofrequency ablation at the Affiliated Drum Tower Hospital of Medical School of Nanjing University from January 2008 to December 2012 were analyzed retrospectively.The lesions were classified into three types according to gross appearance in preoperative contrast-enhanced computed tomography (CT):single nodular type (type 1);single nodular with extranodular growth type or confluent multinodular type (type 2);infiltrating type (type 3).Thc clinicopathological features of patients with 3 types of tumors were compared by statistical methods.Patients were followed up via outpatient examination and telephone interview up to August 2014 or death.Results There were 24 cases of type 1,35 cases of type 2,14 cases of type 3,and the proportion were 20.2％,32.9％,47.9％,19.2％,respectively.The preoperative alpha-fetoprotein of type 3 was significantly higher than othcr types.The disease-free survival time of the three types were (37.2 ± 3.3) months,(20.9 ± 4.0) months,(14.4 ±4.9) months.The prognosis of the irregular types (type 2,type 3) is poor than the regular types (type 1).The overall survival time were (72.5 ± 4.7) months,(66.2 ± 7.3) months,(31.2 ± 5.3) months.The type 3 was the worst.The results of univariate analysis showed that morphologic classification,preoperative AFP,tumor size were related factors affecting the prognosis of patients (P ＜ 0.05).The results of multivariate analysis showed that morphologic classification was the independent risk factors affecting the prognosis of patients (P ＜ 0.05).Conclusion The preoperative imaging morphologic classification is the independent risk factors affecting the prognoses of patients with small HCC,which is help to choose the best treatment for patients with small hepatocellular.