Objective To investigate the effect of the teaching modes based on problem-based learning (PBL) and lecture-based learning (LBL) in clinical practice of hepatobiliary surgery.Methods 166 5-year program students were divided into 2 groups:PBL group (n=83)and LBL group (n=83).The performance in interrogation,physical examination,medical records and theoretical tests were analyzed.Results PBL group had better performance in all the above aspects compared to LBL group (P<0.05).Conclusions The teaching mode based on PBL is a good method,which Can inspire the students and improve their ability to solve problems in clinical practice of hepatobiliary surgery.

Objective To study the role of bone marrow mesenchymalstem cells in recovery process of hepatocyteinjury and to explore the possible mechanism. Methods BMSCs and primary generation of hepatocytes were cultured and identified. A model of hepatocyte injure was established. Liver cell proliferation at different conditionswas detected by MTT method. Hepatocytes were added with BMSCs,baxinhibitor and mixture of BMSCs and baxinhibitor for co?cultured.Expressions of TGF?β1,bcl?2,and baxwere detected by Westernblot and real?time PCR. Results BMSCs and primary generation of hepatocyte were successfully cultured and identified, and a model of hepatocyte injury was successfully established. MTT tests revealed that the OD value of the mixture wassignificant higher in BMSCs and HGF co?culture group than in BMSCs co?culture group or HGF co?culture group;there was no significant difference between BMSCs co?culture group and HGF co?culture group,while both groups were significant higher than control group. The MTT tests also revealed that the OD value of the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while the OD value was significant higher in both groups than in the control group. Westernb lot and real?time PCR results revealed that the value of TGF?β1 and bax in the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while both groups had a significant higher value than the control group. The value of Bcl?2 in the mixture of BMSCs and Baxinhibitor co?culture group had no significant difference as compared with BMSCs co?culture group or Baxinhibitor co?culture group. There was no significant difference between BMSCs co?culture group and Baxinhibitor co?culture group,while both groups had a significant lower value than the control group. Conclusions BMSCs can promote hepatocyte proliferation during the recovery process of hepatocyte injury,BMSCs and HGF promote liver cell proliferation have synergy effect,the effect of BMSCs probably through regulate TGF?β1/bcl?2(bax)correlation pathway.

Objective To investigate the diagnosis and treatment of functional pancreatic endocrine tumors (PETs). Methods The clinical data of 45 patients with functional PETs who were admitted to the Southwest Hospital from January 1998 to December 2008 were retrospectively analyzed. Etiologic and localization diagnosis were made preoperatively according to the manifestation and the results of color doppler ultrasound and computed tomography, respectively. Eight patients received resection of the body and tail of the pancreas and spleen, 32 received tumor enucleation, one received resection of the pancreaticobiliary junction and four received pancreaticoduodenectomy. All patients received chemotherapy after the operation. Results Thirty-four cases of the PETs were benign and the rest eleven cases were malignant. Eight cases of the PETs were in the head of the pancreas,26 in the tail of the pancreas, seven in the body of the pancreas and four cases were with multiple PETs. The diameters of the PETs were 0. 3-5.0 cm, and the diameters of the PETs in 19 cases were above 2.0 cm. Eight patients were complicated with pancreatic leakage, two with incision infection and one with abdominal infection. Of the 33 patients with insulinoma, the blood glucose of five patients with multiple PETs was still abnormal after the operation, three patients underwent reoperation and the other two were treated by diazoxide to control the blood glucose in the normal range. The clinical symptoms of the seven patients with gastrinoma disappeared after the operation, and the gastric ulcer was healed, the 12-hour gastric juice volume and the level of the gastric acid were in the normal range after a continuous treatment with proton pump inhibition agents for 6 months. Necrotizing or migratory rash and diabetes of the four patients with glucagonoma were cured three weeks later, and the level of the amino acid was back to normal. Diarrhea and electronic disturbance of one patient with vasoactive intestinal peptide tumor were alleviated after the operation. Thirty-nine patients were followed up for 20-120 months. Of the 32 patients with benign PETs, two patients had tumor recurrence, and three patients died of other diseases. Of the seven patients with malignant PETs, two patients survived, and three patients died of hepatic metastasis or tumor recurrence, two patients died of other diseases. Conclusions Surgical treatment is effective for the treatment of functional PETs. Palliative resection of the tumor also can obviously improve the life quality of patients with fuctional PETs.