Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

0.05)between the images from the two groups.Conclusion When scanning the heart with volume CT(VCT),the application of ECG modulated mA can effectively reduce the exposure dosage without sacrificing the image quality.

Objective This study was performed to assess the clinical feasibility of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer.Methods Between March 2011 and May 2012,we retrospectively analyzed the data from 56 patients who underwent video-assisted mediastinoscopic lymphadenectomy(VAMLA).In patients receiving tumour resection subsequently,radicality of the previous mediastinoscopic dissection was controlled during thoracotomy.Results Mean operative time of video-assisted mediastinoscopic lymphadenectomy was(42.0 ± 13.5) min(range of 26-86 min).Mean number of resected lymph nodes was 12.4 ± 6.7 (range of 5-24).In video-assisted mediastinoscopic lymphadenectomy,the rates of lymph node dissection of stations 2,4,5,7,8 were 54.5％,92.7％,58.2％,100％,61.8％,respectively,there was no operative mortality and morbility.90.9％ patients achieved radical dissection.Conclusion Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure and provides more accurate staging of mediastinal node in lung cancer patients.It also plays an important role in minimal invasive surgery and neoadjuvant therapy.

To demonstrate the current strategies for treating cartilage defects of knees and the related research. Published papers about cartilage defects were searched and reviewed. The current strategies for the treatment were summarized. Based on the research of our study and others, the conclusion how to treat cartilage defects was made. The current ways for treating cartilage defects include micro-fractures, chondrocytes transplantation, mosaicplasty and tissue engineering; Research on functional magnetic resonance imaging in the early diagnosis of cartilage defects, cartilage degeneration is gradually increasing. There is still no effective treatment of cartilage defects and tissue engineering has brought new hopes for the treatment of cartilage defects , functional magnetic resonance imaging has some significance in early diagnosis of cartilage defects, cartilage degeneration.
Animals ; Cartilage Diseases ; surgery ; therapy ; Cartilage, Articular ; surgery ; Humans ; Knee ; surgery ; Tissue Engineering ; Transplantation, Autologous

ObjectiveTo evaluate the therapeutic value of neoadjuvant chemotherapy for patients with stages Ⅱ and ⅢA(Only T3N1M0) breast cancer,and assess the relationship of the tumor size and pathologically complete response.MethodA total of 408 breast cancers patients at stages Ⅱ and ⅢA,were studied,which were divided into neoadjuvant chemotherapy group (group A) and control group (group B).All patients of group A received 2-4 cycles NAC with TE scheme in breast cancer.The impact of neoadjuvant chemotherapy on surgical methods choice,local control rate,5-year overall survival rate and 5-year disease free survival rate were analyzed.ResultsFor patients of stage Ⅱ,the rate of breast conservation significantly increased from 23.6％ to 49.1％ (P =0.000) and there was no significant difference between groups A and B ( P =0.939,0.858 ) in 5-year overall survival rate and disease free survival rate.For patients of stage ⅢA,the 5-year overall survival rate (59.8％ ) and disease free survival rate (51.8％) in group A were greatly higher than that in group B (35.7％ and 27.6％ ) (P =0.000,0.000).The 3-year local relapse and metastasis rate(7.9％ ) was lower than group B (18.4％)(P ＜ 0.05 ).The tumor less than 3.0 cm is easy to achieve pathological complete remission (P =0.001 ).ConclusionsThe neoadjuvant chemotherapy can improve potential rate of breast conservation,reduce the rate of local-regional recurrence rate for the patients with stage Ⅱ and ⅢA breast cancer,and also improve the 5-year survival rate for the patients of stage ⅢA.Patients with clinically complete response or PCR may have higher 5- year overall survival rate and disease free survival rate.Primary tumor size was found to be the significant predictive factor for pathologically complete response to neoadjuvant chemotherapy in patients with breast cancer,particularly,the small tumor is easy to reach pathologically complete response.

Molecular methods and fluoroscopic techniques suggest that rich microbial diversity exist in the marine environment, but less than 1% of these microbes can be cultured in the laboratory conditions, and that the cultivable dominant species were even less. This limitation has long been a barrier to the development of environmental microbiology and the utilization of marine resources. In the past decade, novel methods for culture and detection of these uncultured marine microbes have successfully applied to obtain several conventionally-uncultured microbes including those from extreme environments. Those progresses have inspired researchers greatly. Developments in the research of marine microbial resources are an important basis for the study of the micro-world and deserve increasing scientific attention.

In this paper, GLUT4 vesicles are observed in real-time under TIRF microscopy and a new three-dimensional single particle tracking algorithm according to the unique features of TIRF is put forward. Firstly a fluorescence correction procedure was processed to solve the problem of fluorescence bleaching over time and mobile vesicles were segmented by an adaptive background subtraction method. Kalman filtering was then introduced to track the granules so as to reduce the searching range and to avoid the disturbance of background noise and false targets. In the experiments the algorithm was applied in analyzing the long-distance movement of GLUT4 vesicles. The experimental results indicate that the algorithm has achieved robust tracking of the vesicles in the imaging plane and has effectively calculated the position in the direction orthogonal to the imaging plane.
Glucose Transporter Type 4 ; metabolism ; Imaging, Three-Dimensional ; instrumentation ; methods ; Ion Transport ; Microscopy, Fluorescence ; methods

Objective:The effect of antiviral therapy for hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after radical hepatectomy was assessed. Methods:A total of 478 HBV-HCC patients treated by radical hepatectomy were retrospectively col-lected. Patients in the treatment group (n=141) received postoperative lamivudine therapy (100 mg/d), whereas patients in the control group (n=337) did not. Recurrence-free survival rates, overall survival rates, treatments for recurrent HCC and cause of death were com-pared between the two groups. Propensity score matching was also conducted to reduce confounding bias between the groups. Results:The one-, three-, and five-year recurrence-free survival rates didn't significantly differ between the two groups (P=0.778);however, the one-, three-, and five-year overall survival rates in the treatment group were significantly higher than those in the control group (P=0.002). Similar results were observed in the matched data. Subgroup analysis showed that antiviral treatment conferred a significant sur-vival benefit for Barcelona Clinical Liver Cancer stage A/B patients. Following HCC recurrence, more people in the treatment group were able to choose curative treatments than those in the control group (P=0.031). For cause of death, fewer people in the treatment group died of liver failure than those in the control group (P=0.041). Conclusion:Postoperative antiviral therapy increases chances of receiving curative treatments for recurrent HCC and prevents death because of liver failure, thereby significantly prolonging overall sur-vival, especially in early-or intermedian-stage tumors.

OBJECTIVE: To evaluate the effect of aerobic exercise on genome expression in human skeletal muscle. METHODS: Six healthy sedentary elderly men aged (66+9) years were selected from military cadre retirement centers and after exercise. Testing indices included height, weight, vital capacity, step index and maximal oxygen uptake. Needle biopsies were obtained from the skeletal muscle before and after the last training. Total RNA extracted from the samples was hybridized to Affymetrix U 133A platform, the gene expression datum was analyzed.RESULTS: Aerobic exercise was shown to improve cardiorespiratory function and reduce body fat of elder subjects. It could alter the genome expression in human skeletal muscle, the number of genes that passed filtering criteria was 725. The most differently expressed genes (n=20) were investigated in this study, in which there were 3 upregulated and 17 downregulated. According to gene function annotations, the differential genes were classified into 8 categories which concerned cellular component and biological process, Kyoto Encyclopedia of Genes and Genomes (KEGG) searching showed 4 genes' metabolism pathway. CONCLUSION: Systematic aerobic exercise upregulates expression of enzyme genes concerning tricarboxylic acid cycle, and downregulates expression of genes conceming muscle protein synthesis and sphingolipid. It is suggested that aerobic exercise is good to protect human nerves' integrity, exerts positive action on anti-aging and accelerate the aerobic metabolism of lipid materials in vivo.

Objective To explore the efficacy of postoperative adjuvant transarterial chemoembolization (TACE) on the survival of patients after radical resection for hepatocellular carcinoma (HCC).Methods Between March 2007 and March 2010,229 HCC patients who underwent radical resection were retrospectively studied.Patients who underwent resection alone were used as the control group (138 patients) while those who received post-operative adjuvant TACE was used as the interventional group.In order to balance the covariates between the groups,a matched comparison of the patients was done by selecting patients using the propensity score matching (PSM).Then,the efficacy of adjuvant TACE upon survival was evaluated.Results After PSM,we obtained 67 pairs of patients.The survival time for the interventional and the control groups were 32.1 months and 28.3 months respectively.The survival rates at year 1,2,3 post-resection were 94.0％,84.8％ and 75.3％ in the interventional group versus 83.6％,69.9％ and 61.5％ in the control group respectively.There were no significant differences between the two groups (P =0.062).Univariate analysis showed the serum level of AFP,tumor size,number of tumor,BCLC stage,and adjuvant TACE significantly affected the survival of HCC patients who received radical resection (P ＜0.05).Cox model suggested that AFP≥400 μg/L and tumor diameter ＞ 5 cm were independent risk factors of survival for HCC patients who received radical resection (P ＜ 0.05).Conclusion Postoperative adjuvant TACE had no positive effect on survival,and AFP level ≥ 400 μg/L and tumor size ＞5 cm were independent risk factors of survival of HCC patients who received radical resection.