The progression of liver fibrosis directly affects treatment options and prognosis.Early diagnosis and classification of liver fibrosis and dynamic monitoring are clinically needed.Noninvasive diagnostic techniques can avoid or reduce liver biopsy to enable early identifica-tion of liver fibrosis and to dynamically monitor the progression of fibrosis.But various limitations have restricted its application.Noninvasive diagnostic techniques,such as liver transient elastography using the different probe mode,controlled attenuation parameter,spleen stiffness measurement,ultrasound-based transient elastography for the early prediction of hepatic fibrosis,and risk assessment of hepatitis B virus-related hepatocellular carcinoma,have been applied in clinical studies.In order to better understand and apply these diagnostic models,the progress in clinical studies of noninvasive diagnosis of liver fibrosis,as well as the limitations,is reviewed.

Objective To detect the tbymidine pbospborylnse (TP) expression in metastatic liver cancer tissues from human colorectal cancer by immunohistochemistry, and analyze the correlation between TP ex-pression and the tumor-associated macrophages (TAM), and the prognosis of patients. Methods Twenty-eight metastatic liver cancer specimens resected from patients with colorectsl cancer, were immunohistochem-ically stained by 654-1, an anti-TP monoclonal antibody, IC6-203, another anti-TP monoclonal antibody, PG-M1, anti-macrophage marker CD68 monoclonal antibody. Morphometrical analysis and positive cell counting were performed, and the correlation of TP expression with the patient's prognosis was evaluated. Results In normal liver tissues, the hepatic cells apart from cancer nests were weakly positive for 654-1 as well as for 1C6-203. The most TP-positive cells were distributed mainly along the invasive margin of cancer or around the cancer nests. In the corresponding areas, CD68-positive macrophages were also increased. The distribution patterns of CD68-positive cells were similar to those of TP-pesitive cells. The numbers of the TP-positive cells stained by 654-1 were significantly correlated with numbers of 1C6-203 positive cells (r=0.697, P<0.01), also correlated with the numbors of CD68-positive cells (r=0.703, P<0.01). While the numbers of 1C6-203 positive cells had no significant differences with the numbers of CD68-positive cells (r=0.359, P>0.05). The TP-pesitive cancer cells both for 654-1 and for 1C6-203 were detected only in 2 of 28 specimens. Both the number of TP-pesitive cells for 654-1 and 1C6-203, and the number of CD68-positive cells had no correlation with the survival period of patients. Conclusions In the metastatic liver cancer tissues of human colorectsl cancer, the TP-expreasinn stained by 654-1 was coincidence with 1C6-203, and the most important source of TP-expreasion is the TAM in stromal tissues around cancer nests, while the cancer cells are little expressed. The numbers of TP-positive cells stained by 654-1 are significantly related with CD68-pesitive macrophages, but not with the post-operation survival period of patients.

Objective To explore virtual three-dimensional (3D)model for intravascular interventional devices,the method of preoperative simulation and its value in clinical work.MethodsThe virtual models including catheter,guide wire,stent and coil were established by using the 3D moulding software of 3D Studio MAX R3. The interventional preoperative simulation was performed on personal computer including 21 patients of cerebral aneurysm embolization ( anterior communicating artery 5,posterior communicating artery 10,middle cerebral artery 3,internal carotid artery 2,and vertebral artery 1 ),during interventional procedures,the surgeon relied on the simulation results for plastic micro-guide wire,catheter and the release of micro-coils and stents.Results( 1 ) All the virtual instruments and real instruments had similar shape,the overall tine for constructing virtual model was about 20 hours.The preoperative simulation took 50 to 80 minutes. (2) The simulation result of catheter insertion in the 18 cases had relevant value to guide micro-catheter,molding micro-guide wire tip,and shortened the operating time.For embolization,the simulation results of filling coil and releasing stent were similar to surgical results in 76％ of the patients (16/21).(3)For teaching and training,93％ (38/41) of doctors in training believed that preoperative simulation facilitated the understanding of surgery. ConclusionsThe method of virtual model of intravascular interventional devices was reliable.The preoperative simulation results could be used to guide practical clinical operation with relatively high degree of similarity,and could play a role in promoting researches on interventional virtual operations.

Objective To explore the methods and curative effect of metallic self-expanding stent in inoperable malignant gas-troduodenal obstruction. Methods The data of 15 cases with gastroduodenal obstruction including 9 cases of carcinoma of head of pancreas and 6 cases of carcinoma of stomach were analyzed retrospectively. The operative procedures of the stent implanted and the tors accepted more radiation dose because the manipulation was under the fluoroscopy in a short distance and with a full field of view. sions, the postoperative eating habit and the development turnover of disease. The main death reasons were tumor transfer and sys-tem exhaustion. Conclusion To pay close attention to the details and main points of operative procedure is the key point to implant stent successfully for malignant gastroduodenal obstruction. The determinative factor to influence the curative effect is the develop-ment turnover of tumor.

OBJECTIVETo study the expression of the receptor for advanced glycation end products (RAGE) and the inhibitory effect of advanced glycation end products (AGEs) on testosterone production in rat Leydig cells.

METHODSRat Leydig cells were primarily cultured and the expression of RAGE in the Leydig cells was detected by RT-PCR and immunofluorescence staining. The Leydig cells were treated with AGEs at the concentrations of 25, 50, 100 and 200 microg/ml, respectively, and the testosterone content was determined by ELISA.

RESULTSRT-PCR and immunofluorescence staining exhibited the expression of RAGE in the rat Leydig cells. AGEs remarkably suppressed hCG-induced testosterone production in the Leydig cells in a concentration-dependent manner in the 50, 100 and 200 microg/ml groups as compared with the control (P < 0.01).

CONCLUSIONRAGE exists in rat Leydig cells and AGEs can significantly inhibit the secretion of testosterone in primarily cultured rat Leydig cells.

Animals ; Cells, Cultured ; Enzyme-Linked Immunosorbent Assay ; Glycation End Products, Advanced ; pharmacology ; Leydig Cells ; metabolism ; radiation effects ; Male ; Rats ; Receptor for Advanced Glycation End Products ; Receptors, Immunologic ; biosynthesis ; Reverse Transcriptase Polymerase Chain Reaction ; Testosterone ; biosynthesis

Objective To explore the establishment method of virtual three-dimensional model of the virtual artery and interven-tional devices,and its application value.Methods The virtual models including virtual artery system,catheter,guide wire,stent and coil were established by using the three-dimensional moulding software of 3D Studio MAX R3.The study about interventional preoperative simulation and assistant instruction were run in personal computer.Results ①All the virtual instruments and real in-struments were highly similar shape,the arterial system in the visual display was similar to realistic system.②All arteries branches had own name,could be arbitrarily adjusted curvature,diameter and established the lesion morphology.③The reference value of preoperative simulation results to guide the actual surgery included following aspects:to guide the reasonable shaping of micro-cathe-ter and micro-guide wire tip,to plan the coil and stent deployment location,number and size.④In training and teaching,the preop-erative simulation could assist doctors in learning and remembering the artery branch and establishing the concept of three-dimen-sional space,and enhanceing the intention understanding of surgery.Conclusion The establishment method of virtual model of the virtual artery and interventional devices is reliable.The preoperative simulation results can be used to guide practical operation with relatively high accuracy,and it has an important supporting role for the teaching and training of medical students.

A series of 2-methoxyestradiol (2-MeO-E2) RGD peptide conjugates with coupling RGD peptides to 3- position or 17-position of 2-MeO-E2 through space linker were synthesized. Their antiangiogenic properties were preliminarily evaluated by cell migration scratch assays against HUVECs. Compound 26c binding RGDV peptide showed the best inhibitory effect. In addition, all 2-MeO-E2 RGD peptide conjugates exhibited obvious activity. These results demonstrate that conjugates with RGD peptides represent a promising means for targeting angiogenesis in cancer therapy.

Objective To assess the effectiveness of the clinical pathway for the treatment of advanced schistosomiasis he-patic fibrosis. Methods The duration of hospital stay,gross hospitalization expense,individual-paid expense,interior diame-ter of portal vein,levels of four serum hepatic fibrosis-related parameters(PIIIP,CIV,HA,and LN),and activities of ALT, AST andγ-GT were assessed and compared between the advanced schistosomiasis patients receiving the clinical pathway and ones receiving non-clinical pathway. Results There were 142 advanced schistosomiasis patients with hepatic fibrosis receiving the clinical pathway of anti-hepatic fibrosis. Compared with the patients receiving non-clinical pathway ,the gross hospitalization expenses reduced by 11.2％(t=6.310,P<0.05),and the individual-paid expenses reduced by 16.1％(t=4.326,P<0.05). The mean HA level was twice higher than the normal range,with a positive rising from 70.4％to 83.1％,and the abnormal rates of CIV andγ-GT were 64.1％and 28.9％respectively. Conclusions The clinical pathway can drastically reduce the treatment expenses in advanced schistosomiasis patients with hepatic fibrosis. However,the patients have a trend towards the persistent disease progression. Therefore,the researches of more effective therapeutic methods for advanced schistosomiasis hepatic fibro-sis are urgently needed.

Objective To compare the clinical efficacies of totally laparoscopic and laparoscopy-assisted radical total gastrectomies.Methods The retrospective cohort study was conducted.The clinicopathological data of 373 patients with gastric cancer who underwent totally laparoscopic or laparoscopy-assisted radical total gastrectomies from the 7 medical centers in China (82 patients in the Affiliated Hospital of Qinghai University,80 in the Traditional Chinese Medicine Hospital of Guangdong Province,60 in the First Affiliated Hospital of Xiamen University,51 in the Hangzhou First People's Hospital,46 in the First Affiliated Hospital of Xi'an Jiaotong University,30 in the Second Affiliated Hospital of Jilin University and 24 in the Xijing Hospital of the Fouth Military Medical University) between January 2015 and December 2016 were collected.Of 373 patients,the 183 and 190 patients were respectively divided into the totally laparoscopic group (undergoing totally laparoscopic radical total gastrectomy) and laparoscopy-assisted group (undergoing laparoscopy-assisted radical total gastrectomy),including 63 and 19 in the Affiliated Hospital of Qinghai University,36 and 44 in the Traditional Chinese Medicine Hospital of Guangdong Province,25 and 35 in the First Affiliated Hospital of Xiamen University,20 and 31 in the Hangzhou First People's Hospital,10 and 36 in the First Affiliated Hospital of Xi'an Jiaotong University,17 and 13 in the Second Affiliated Hospital of Jilin University,12 and 12 in the Xijing Hospital of the Fouth Military Medical University.Routine five-port method was applied for laparoscopic radical total gastrectomy and D2 lymphadenectomy.Roux-en-Y anastomosis was applied for digestive tract reconstruction,and digestive tract reconstruction was performed under laparoscopy in the totally laparoscopic group and via upper abdominal median incision in the laparoscopy-assisted group.Observation indicators:(1) operation and postoperative situations;(2) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect the postoperative overall survival and tumor recurrence or metastasis up to March 2017.Measurement data with normal distribution were represented as x±s.Comparison between the groups was analyzed by the t test.Measurement data with skewed distribution were represented as M (range).Comparisons of count data were analyzed using the chi-square test and Fisher exact probability.Results (1)Operation and postoperative situations:all the patients in the 2 groups underwent successful operations,without perioperative death.Esophagojejunostomy methods of 183 patients in totally laparoscopic group:conventional circular stapler method were performed in 28 patients,anti-puncture circular staplar method in 6 patients,OrVilTM method in 5 patients,functional end-to-end esophagojejunostomy method in 65 patients and peristalsis side-to-side esophagojejunostomy method in 79 patients.Conventional circular stapler method was applied to 190 patients in the laparoscopy-assisted group.Operation time,time of esophagojejunostomy,length of assisted incision,using time of analgesics and expenses of digestive tract reconstruction were (238± 55)minutes,(29±9)minutes,(5.1 ± 1.1)cm,(2.2±l.0)days,(18 332±2 141)yuan in the totally laparoscopic group and (217±39)minutes,(26±7)minutes,(7.8 ±2.0)cm,(2.7± 0.9)days,(16 237 ± 1 923)yuan in the laparoscopy-assisted group,respectively,with statistically significant differences between the 2 groups (t =4.324,3.455,-16.835,-5.561,9.949,P＜0.05).The cases with postoperative overall complications,anastomosis leakage,anastomosis stricture,anastomosis bleeding and expenses of esophagojejunostomy were respectively 24,9,7,5,(9 668±2 814)yuan in the totally laparoscopic group and 24,8,9,6,(9 331 ±2 067)yuan in the laparoscopy-assisted group,with no statistically significant difference between the 2 groups (x2 =0.036,0.107,0.189,0.059,t=1.322,P＞0.05).All the patients with postoperative complications were cured by symptomatic treatment.(2) Follow-up and survival situations:of 373 patients,336 were followed up for 4-26 months,with a median time of 13 months,including 166 in the totally laparoscopic group and 170 in the laparoscopy-assisted group.During the follow-up,cases with overall survival,tumor recurrence and tunor metastasis were respectively 150,10,16 in the totally laparoscopic group and 154,9,16 in the laparoscopy-assisted group (10 and 9 patients in the totally laparoscopic and laparoscopy-assisted groups with simutaneous tumor recurrence and metastasis),showing no statistically significant difference between the 2 groups (x2 =0.075,0.010,P＞0.05).Conclusions Total laparoscopic and laparoscopyassisted radical total gastrectomies are safe and feasible,with equivalent overall outcomes and effects of esophagojejunostomy.Compared with laparoscopy-assisted radical total gastrectomy,the postoperative pain time of patients in total laparoscopic radical total gastrectomy is less,but there are longer time of esophagojejunostomy and higher expenses of digestive tract reconstruction.

Objective To investigate the proliferation of rabbit adipose-derived stem cell(ADSCs) transfected by adenoviral vector mediated hTGF-?_1 gene and its chondrocyte differentiation potential.Methods The Ad-hTGF-?_1 plasmid vetor which had the hTGF-?_1 gene was developed and transfected the ADSCs.The experimental group was the hTGF-?_1 transfected group.The cells enclosed by alginate were cultured in com- plete chondrogenie medium(CMM).The morphology of the cells were observed,and RT-PCR was used to measure hTGF-?_1 and collagenⅡexpression,at the same time western blot and immunohistochemistry were applied to detect the expression of collagenⅡin ADSCs before and after transfected with hTGF-?_1 gene. Results The hTGF-?_1 transfected ADSCs became the polygon and it proliferated well.The RT-PCR result of hTGF-?_1 on the transfected group was better than the control after transtected for 7 day and 21 day.The dif- ference between the two groups was significant(P