Objective To investigate the effect of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus.Methods Eighty-seven patients with hepatobiliary calculus who underwent hepatectomy from December,1998 to December,2008 were reviewed retrospectively.Forty-six patients underwent the section of common bile duct to remove calculus combined with left lateral segmentectomy and fiber choledochoscope( Group A),41 patients underwent left hepatectomy and section of common bile duct to remove calculus( Group B).The postoperative stone residual rate,complications and long-term outcome were compared between the two groups.Results The postoperative stone residual rate of either group was zero.Intraoperative bleeding ( 401.1 ± 180.4ml) ,operative times ( 202.5 ±36.6 rmin) of group A were significantly lower than those of the group B (515.9 ± 200.6ml and 257.3 ± 42.9min) ( P ＜ 0.001 and 0.01,respectively) .Hospital stays of group A was lower than that of group B,but this is no statistical significance ( P ＞ 0.05 ) .The incidence of postoperative complications were similar in the two groups( 15.2% v.s.24.4% ,P ＞ 0.05 ).The effective rates of the two groups were similar (91.3 % VS 92.7 %,P ＞ 0.05 ).Conclusions The long-term and short-term outcome of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus is similar to that of left hepatectomy ,and can successfully shorten the hospital stay and reduce the hospital fee.

Objective To evaluate the feasibility and efficacy of Separate stent placement in the palliative treatment of inoperable malignant gastroduodenal obstruction.Methods Thirty four consecutive patients with inoperable malignant gastroduoenal obstruction were treated with peroral placement of Separate stent. Gastroduodenal obstruction was caused by gastric ( n =11), pancreatic ( n =12), matastatic ( n =3), biliary duct ( n =6) or duodenal ( n =2) cancers. Separate outer partial covered stent overlapping with inner bare stent were placed coaxially under fluoroscopic guidance.Results The technical successful rate reached 97% (33 of 34) with no major complication. Symptoms of gastroduodenal obstruction relieved in 33 patients. The average score of food intake capacity improved from 3.8 to 1.2 after Separate stent placment. Stent migration and tumor ingrowth were not detected during the follow up period. Tumor overgrowth was confirmed in one patient and a second stent was placed to solve the problem.Conclusions Peroral placement of Separate stent is a feasible and effective treatment for patients with inoperable malignant gastroduodenal obstruction.

Objective To investigate the effect of IVIG on pre-existing anti-HLA-A2 Ab levels and graft skin survival.Methods C57BL/6 wild type mice were sensitized to HLA-A2 by intraperitoneal injec-tion (IP) of HLA-A2 TgN mouse spleen cells (C57BL/6-TgN [HLA-2.1]1Enge SC) expressing human HLA-A2 at day 0, week 3 and 4.Sensitized mice were respectively treated with human IVIG , albumin, gly-cine, or PBS for 5 days during week 7.Skin transplantation from TgN mice to C57BL/6 wild type mice was performed at week 10 .Efficacy of IVIG DES was assessed by measuring anti-HLA Ab levels by ELISA pre-/post-Rx and graft skin survival was monitored daily post-Tx.Results Changes of HLA-A2-IgG levels:IgG HLA-A2 class I Ab levels in all groups predictably increased from baseline following spleen cell IP and peaked at week 4 ( P <0.01 ) , indicating sensitization .IVIG-treated mice showed significantly lower IgG Ab levels vs.albumin, glycine and PBS-treated at week 9 post-desensitization ( P <0.01).IgG quickly increased to extremely high levels in all groups following skin transplantation ( P <0.01 ) .Graft skin sur-vival between Rx-groups were similar with all rejecting at about 7 days post-transplantation ( P >0.05 ) . Conclusion However, IVIG alone does not inhibit anti-HLA class I Ab production after skin transplanta-tion or prolong SG survival , indicating combination of IVIG with other immunosuppressant or more optimal protocol for desensitization might show more efficacy and should be under explored .

Objective To understand the infection situation of human T lymphocyte virus(HTLV) among blood donors in Zhongshan area.Methods Blood samples from 40 874 blood donors in Zhongshan from March to December 2016 were screened for HTLV antibody by using,enzyme linked immunosorbent assay(ELISA).The positive samples were reexamined two times,and specimens with positive results of reexamination were detected by using immunohistochemical method(CLIA).Then the positive samples were confirmed by Western blot(WB),and confirmed positive samples were judged as infection.Results Of all 40 874 cases of voluntary blood donors,21 cases were positive with HTLV antibody detected by ELISA,the positive rate of ELISA was 0.05%.Five cases were positive detected by CLIA method.One case was confirmed by WB,and the infection rate was 0.002 4%.Conclusion In order to ensure the safety of blood transfusion and reduce blood transfusion infection of HTLV,it might be necessary to perform HTLV screening in first-time blood donors in Zhongshan area.

Objective To report effects of microsurgical treatment for tumors in cervical spinal canal. Methods A total of 32 cases of tumors in cervical spinal canal had received microneurosurgery through a posternmedial approach. 22 cases had received reconstruction of cervical spinal canal stability. Results A total tumor resection was performed in 26 cases (81.25%),a subtotal tumor resection was conducted in 6 cases(18.75%). A cemplete recovery was achieved in 23 cases(71.88%), an improvement of symptoms was achieved in 6 cases(18.75%), and no improvement in 3 cases(9.38%), no death was encountered. Follow up observations were carded out in 30 cases for 3 months to 3 years. MRI examinatious 3 months after operation in 26 cases found no residual or recurrent tumor,recurrence was seen in 3cases of astrocytoma, 1 case was invariable. X-ray radiography in 26 cases showed good vertebral stability ,spinal deformation was found in 4 eases. Conclusion Microsurgery in early period play a key role in treatment of cervical spinal tumors. Reconstruction of spinal canal stability is important to patients.

Objective:To investigate the effect of human growth hormone releasing hormone receptor splice variant type 1 (GHRHR SV1) on the proliferation of human liver cancer HepG2 cells,and to clarify the proliferation effect of GHRHR SV1 on the human cancer cells.Methods:The GHRHR SV1 plasmids were transfected into the human HepG2 cells to construct the HepG2-SV1 cell line.HepG2 group(HepG2 cells),HepG2-empty group(HepG2-pcDNA3.0 cell line) and HepG2-SV1 group(HepG2-SV1 cells) were set up.PCR and Western blotting methods were used to identify the HepG2-SV1 cell line;CCK-8 method was used to detect prolifernation rate of cells;colony formation assay was used to detect the colony formation rate of cells;cell wound healing assay was used to evaluate the migration rate of cells.Results:The PCR and Western blotting results showed the HepG2-SV1 cell line expressed GHRHR SV1 steadily.The CCK-8 results showed that the proliferation rate of the HepG2-SV1 cells in HepG2-SV1 group was higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).The colony formation assay results showed that the colony formation rate of HepG2-SV1 cells in HepG2-SV1 group was 3.5 times higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).The cell wound scratch assay results showed that the migration rate of the HepG2-SV1 cells in HepG2-SV1 group was higher than that of the HepG2-pcDNA3.0 cells in HepG2-empty group(P<0.05).Conclusion:GHRHR SV1 could increase the proliferation of HepG2 cells.

Objective To evaluate the value of CT virtual endoscopy(CTVE)for microsurgery of pituitary microadenomas via transsphenoidal approach.Methods In 18 patients with pituitary micmadenomas underwent microsurgery via transsphenoidal approach,the presurgical CT data was transfered to work station,the anatomies of the sphenoid sinus were then reconstructed by CTVE.The CTVE images were used to make the preoperative planning and indentify sphenoid sinus, sellar floor,and the position of the tumor during surgery.The CTVE images and the views from intraoperative microscope were compared. Results CTVE could display the anotomoties of sphenoid sinus in a three-dimentional mode.The display rates of superfical antomies such as sphenoid septa,sellar floor,carotid prominence,optic prominence and opticocarotid recess were 344.4%,100%,41.7%,36.1%and 58.3%respectively and the visual fields of these anatomic landmarks were larger than the views from the intraoperative microscope. CTVE could depcit the anatomies of the enhanced carotid ateries and pituitary tissue and some optic canals underlying the sellae by transparent function or heighten the threshold.The sites of the tumor could be marked correctly on CTVE images.CTVE could simulate the operative approach and some operating procedures properatively. Conclusion CTVE can display the anatomies of sphenoid sinus in a three-dimensional mode. In transsphenoidal treatment of pituitary microadenoma,CTVE can help to make preoperative planning,locate the intraoperative structures and make a precise bone window during surgery.

Objective To summary the microsurgery clinical experience of 21 patients with cerebellopontine angle tumor by the help of three dimensional individual digital anatomy. And to evaluate the value of three dimensional individual anatomy in the treatment of tumors in cerebellopontine angle. Methods Between January 2011 and November 2011,21 patients with various cerebellopontine angle tumor,managed at the Third Affiliated Hospital of Sun Yat-Sen University, underwent CTA scan, and reconstruct the local anatomy by 3D view software. According to the individual anatomical model, the microsurgery program by restrosig moid approach was developed. Results All patients had reposition of the bone flap at original site after craniectomy during the same operative setting mentioned above with retrosigmoid approach. No complication was noted.Patients did not have any delayed postcraniectomy pain at operation site.Postoperative computed tomography of the skull showed good healing and shaping of the suboccipital bone at the surgical region. Conclusion With the help of three dimensional individual anatomy, the microsurgery of cerebellopontine angle tumor underwent less postoperative complications.This study provides a safe and effective individualized microsurgical methods by restrosig moid approach.

ObjectiveTo investigate prospectively the feasibility and clinical value of catheterization via the ipsilateral great saphenous vein in catheter-directed thrombolysis (CDT) for acute iliofemoral deep vein thrombosis (IFVT) by a comparative study.MethodsThe prospective study included 93 cases of IFVT proved by venography.All patients were divided into three groups randomly.In group A,31 patients received CDT via the ipsilateral great saphenous vein.In group B,27 patients received CDT via the ipsilateral popliteal vein.In group C,35 patients received anterograde thrombolysis via an ipsilateral dorsalis pedis vein.Urokinase was adopted as the thrombolytic agent in all cases.The assessment of the curative effect include therapeutic effective rate,rate of edema reduction and venous patency which were observed according to the clinical symptoms and the follow-up venograms obtained 5 days after thrombolysis.The time and comfort scores of procedures was recorded and compared between group A and B using two independent samples t test.The rate of edema reduction and venous patency were assessed using analysis of variance (LSD method).Therapeutic effective rate and complication rate were assessed using Chi-square test.Results The total effective rate of the three groups were 90.3％ (28/31),92.6％ (25/27) and 68.6％ (24/35) respectively.The limbs edema reduction rate were (83.5 ±21.1)％,(82.4 ±20.1)％,and(67.0±23.3)％ respectively(F=6.059,P = 0.003 ).The venous patency rate after thrombolysis were (61.2 ± 20.2) ％,(55.7 ± 20.5 ) ％,and (44.2 ±23.6)％ respectively.There was no significant difference between group A and B in therapeutic effective rate( x2 =0.09,P =0.759),rate of edema reduction( P =0.822 ) and venous patency ( P =0.343 ).There was a significant difference statistically in therapeutic effective rate(x2 =4.65,P =0.031 ),rate of edema reduction (P = 0.002) and venous patency (P = 0.002) between group A and C.Compared with group A and B,the procedure time [group A (8.3 ±3.1) min,group B (16.3 ±3.5) min,t =9.379,P ＜0.05],comfort scores during treatment [ group A (2.2 ± 1.2),group B (5.0 ± 1.4 ),t = 8.129,P ＜ 0.05 ] had statistical significant difference.The CDT-asscciated complications in group A were less than group B significantly(3 cases in group A,11 cases in group B,x2 =7.60 P ＜0.05).ConclusionsCatheterizationvia the great saphenous vein in CDT therapy for acute IFVT is feasible and effective.It is easily operable with less complications.

Ohjective To observe the inhibition effect of total glucosides of Picrorhiza on hepatitis B virus covalently closed circular DNA (HBV cccDNA) in HepG 2.2.15 cell line. Methods HepG 2.2.15 cells were incubated with culture medium containing 50 mg/L of picrosides or 5 mg/L of adefovir dipivoxil for 2 or 5 days. HBV DNA in the supernatant, intracellular cccDNA, relaxed circular DNA (rcDNA) and pregenomic RNA (pgRNA) were quantified by specific real-time polymerase chain reaction (RT-PCR) and inhibition rates were calculated. The means were compared by t test. Results After treated with picrosides for 2 and 5 days, the inhibition rates of HBV DNA in thesupernatant were 49. 74% (t=4.723, P<0.05) and 79.48% (t = 7.512, P<0.05), respectively. The inhibition rates of intracellular cccDNA were 43.55% (t = 5.216, P<0.05) and 56.43% (t=7.262, P<0.05), respectively, while those of intracellular rcDNA were 43.39% (t=4.137, P<0.05) and 63.86% (t=7.861, P<0.05), respectively, and those of intracellular pgRNA were 54.72% (t=4.532, P<0.05) and 56.08% (t=4.833, P<0.05), respectively. Comparatively, after treatment with adefovir dipivoxil for 2 and 5 days, the inhibition rates of HBV DNA in the supernatant were 25.56% (t=2.874, P<0.05) and 92.44% (t =10.276, P<0.05), respectively. Those of cccDNA were 18.54% (t=2.736, P<0.05) and 47.19% (t=6.852, P<0.05), respectively. Those of rcDNA were 21. 20% (t=3.206, P<0.05) and 71.47% (t=8.332, P<0.05), respectively, pgRNA were 11.14% (t=1.761, P>0.05) and 37.61%(t=3.632, P<0.05) respectively in HepG2.2.15 cells. Conclusions Pierosides may inhibit the replication cycle of HBV, including the formation of cccDNA in HepG 2.2.15 cells. The mechanism of pierosides on cccDNA may differ from adefovir dipivoxil's due to its earlier inhibition time phase.