Objective To investigate the pathologic basis of intrahepatic biloma formed in the patients with hepatocellulr carcinoma (HCC) after interventional treatment and to assess its clinical significance. Methods Three hundreds and fifty cases of HCC were followed up with CT examination after TAE/PEI, 11 cases received percutaneous bilomography, 10 cases received percutaneous biopsy, and 1 case had surgical resection. All cases of biloma underwent external drainage of bile or ethanol ablation. Results 11 cases of biloma were found (11/350), and all of them displayed a cystic dilation (11/11), 4 cases showed a columnar dilation with indefinite border (4/11), and 3 cases accompanied with a “soft rattan sign” of intrahepatic bile ducts (3/11). The pathologic findings included necrosis on the wall of the biliary tract, extravasation of bile, and infiltration with inflammatory cells. After the external drainage or the ethanol ablation, jaundice had been decreased and symptoms relieved (9/11). Conclusions Biloma is one of the complications of the patients with HCC after TAE/PEI caused by the necrosis of the wall of biliary tract, the correct diagnosis depends on the imaging procedures and biopsy. It is helpful to the further treatment to distinguish biloma from residual nidus of carcinoma. External drainage, stent placement, and ethanol ablation may be the choice of management.

To investigate the protective effects and possible mechanism of Mycelium of Hirsutella hepiali Chen et Shen (MHCS) on metabolic syndromes, free fatty acid and MHCS-treated hepatocytes were used for detecting autophagy-related LC3, p62 and lipid accumulation. Moreover, high fat diet fed mice were used to establish metabolic syndromes model. 50-weeks age mice were randomly divided into: control group, model group and MHCS group. At 80-weeks age, 15 mice were randomly chosen from each group separately for examining oral glucose tolerance, serum insulin, insulin-like growth factor 1 (IGF-1), hepatic LC3, p62, p-NF-kappaB p65, NF-kappaB p65, IL-6 and CXCL-8. Moreover, insulin resistance index (IRI) was calculated. Hepatic pathological changes, including vacuoles, lipids accumulation and fibrosis were observed. Remaining mice were fed with diet separately to 110 weeks-age for statistics of mortality. MHCS promoted autophagy of free fatty acid treated hepatocytes. Mice fed with high fat plus MHCS diet exhibited improved oral glucose tolerance, insulin resistance, hepatic pathology, inflammation, mortality and activated autophagy. The protective effects of MHCS against metabolic syndroms might be through the activation of hepatic autophagy.

This study analyzes the reason and situation of the educational inspection for colleges and universities.The author suggests the five points to solve these problems and provide countermeasures for improving the educational inspection.

BACKGROUND: Total isoflavones of pueraria (TIP) possesses estradiol-like structures and has inhibition effect on bone loss or osteopenia in ovariectomized rats. However, studies have demonstrated that the prevention and treatment effect of TIP on osteoporosis in ovariectomized rats is poor, especially in single utilization. OBJECTIVE: To investigate the combination effect of TIP and vitamin D on the treatment of osteoporosis in ovariectomized rats. METHODS: Totally 81 female sprague-drawly (SD) rats of 3-month-old were randomly assigned into 9 groups. Exception those in the sham-surgery group, all rats were prepared for ovariectomized models. Vitamin D or low-, middle- and high-dose TIP or low-, middle- and high-dose TIP combined with vitamin D were intragastric administrated in the vitamin D, TIP or combination groups, respectively. There was no drug medication in the model and sham-surgery groups. The uterus coefficient was calculated at 3 months after medication. The serum alkaline phosphatase (ALP) activity, calcium, phosphonium, bone gla protein, estradiol levels, as well as bone mineral density of femur was determined. RESULTS AND CONCLUSION: Compared with the model group, the uterus coefficient and estradiol level was obviously increased in the middle- and high-dose TIP groups and all combination groups (P < 0.05); the ALP and bone gla protein levels significant decreased (P < 0.05); and the bone mineral density of central and distal femur were notably increased (P < 0.05); in particular, the result was more manifest in the high-dose combination group. TIP and vitamin D presented with synergism in uterus coefficient, estradiol, ALP, bone gla protein levels and bone mineral density of distal femur, but the effect was not significant in the calcium and phosphonium levels in the TIP and/or vitamin D groups. The findings demonstrated that Tip combined with vitamin D can induce synergism on prevention and cure of osteporosis in ovariectomized rat.

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

Objective To investigate the risk factors related to persistent unconsciousness in patients with severe traumatic brain injury (sTBI) by way of building a prognosis model.Methods The clinical data of 165 sTBI patients admitted from July 2011 to November 2013 were retrospectively analyzed.The eligible patients were randomly assigned to derivation cohort (n =115) and verification cohort (n =50) by treatment order.Inclusion criteria:(1) age ＞ 15 years; (2) definitive history of head injury; (3) traumatic brain injury confirmed by head computerized tomography or brain MRI; (4) initial Glasgow coma score (GCS) was less than 8; (5) patient's light come or consciousness impairment gradually deteriorating to profound coma on the day of admission.The exclusion criteria were as follows:(1) only a brief loss of consciousness or coma after trauma (coma time ＜ 6 hours) ; (2) post-injury hysteria or dementia causes appearance like coma ; (3) unconsciousness results of status epilepticus which was induced by emotion after injury.Univariate and muhivariable logistic regression were employed to determine the independent predictors of persistent unconsciousness in the derivation cohort,and then prognosis model was established.The Hosmer-Lemeshow goodness-of-fit test and the area under the receiver operating characteristic curve were used to assess the capacity of model for discrimination and calibration.Results Logistic regression analysis was used to identify GCS score,neurological complications,diffuse axonal injury (DAI),electrolytes disturbance as the most important predictors of persistent unconsciousness.The model was well calibrated in the derivation cohort (Hosmer-Lemeshow test,x2 =4.380,P =0.496).The model showed good discrimination (area under the receiver operating characteristic curve) in the derivation cohort (0.87; 95％ CI:0.798-0.942) and in the versification cohort (0.90; 95％ CI:0.803-0.997).Conclusions The prognosis model could accurately predict the persistent unconsciousness lasting in sTBI patients despite its certain limitations,and therefore,it has significantly clinical and societal value.

Objective To investigate the expression of CyelinD1 protein in nephroblastoma.Methods The tissue microarray were made in 28 cases of nephroblastoma and 19 cases of renal tissue adjacent to tumor.The expression of CyclinD1 and p53 proteins were detected by immunohistochemistry.Results The positive rate of the expression of CyclinD1 and p53 protein was significantly different between nephroblastoma and renal tissue adjacent to tumor (P < 0.05).The positive rate of the expression of CyclinD1 and p53 protein was significantly different in different degree of differentiation of nephroblastoma (P < 0.05).The expression of CyclinD1 and p53 protein was positively correlated (P < 0.05).Conclusions The CyclinD1 and p53 might be used as the marks for estimating the degree of differentiation of nephroblastoma.The over-expression of CyclinD1 and the mutation of p53 might play the vital role in nephroblastoma.

Objective To investigate the clinical effects and safety of urethral anastomoses and ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure. Methods Ninety patients with urethral straddle injury and catheter placement failure were chosen and divided into A group (45 patients, choosing urethral anastomoses) and B group (45 patients, choosing ureteroscopy urethral realignment). The operation time, intraoperative blood loss, hospital staying time and peri-operation complications in both groups were compared. Results The operation time, intraoperative blood loss, hospital staying time in B group were significantly lower than those in A group: (26.15 ± 10.41) min vs. (71.93 ± 14.50) min, (22.37 ± 7.41) ml vs. (50.70 ± 13.25) ml, (3.22 ± 0.97) d vs. (5.19 ± 1.43) d, P<0.05. After 6 months′follow-up, the clinical indicators in peri-operation period of B group were significantly better than those in A group (P<0.05). The complications incidence in B group was significantly lower than that in A group: 2.22%(1/45) vs. 13.33%(6/45), P <0.05. Conclusions The technology of ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure can efficiently shorten the operation time, reduce the degree of trauma and accelerate the rehabilitation process, and it is helpful to reduce the risk of complications in peri-operation period.

Objective To explore the relationship between HPV infection ,the expression of PCNA ,Ki-67,p53 in cervical carcinoma and clinicopathologic data .Methods Seventy-six cases of cervical cancer tissues with complete clinical data were collected from the third affiliated hospital of harbin medical university from march 2012 to September 2012 .Tissue microarray technology ,immunohistochemical technique and statistic method were adopted to make comparative analysis among HPV ,PCNA,Ki-67,and p53 expression in patrents with cervical cancer.Results The expression rate of HPV in cervical carcinoma was 68.4%,which was related to the lym-phatic metastasis(P<0.05).Expression of PCNA in cervical cancer tissue was 90.1%and 100%in female pa-tionts women under the age of 35.The expression rate of Ki -67 and p53 were 48.9%and 38.2%respectively, both were correlated to lymphatic metastasis(P<0.05)and preoperative chemotherapy(P<0.01).Conclusion HPV infection with Ki -67,and p53 expression in cervicalcancer tissues are associated with the presence of lymph node metastasis .HPV promotes cervical epithelial cell proliferation ,inactivates tumor suppressor gene p 53 function ,and promotes the invasion and metastasis of cervical cancer .Preoperative chemotherapy of cervical canc-er can reduce the expression of p53,PCNA and Ki-67.

Objective To explore the clinical features of very long chain acyl-CoA dehydrogenase deifciency (VLCADD). Methods The clinical manifestation and the biochemical data of one baby girl with VLCADD were summarized and related literatures were reviewed. Results Female patient, aged 7 months, presented with recurrent vomit, haematemesis, stare, nodal tachycardia, hypoglycemia, abnormal liver function and myocardial enzyme. She died after one month due to frequent relapse together with withdrawing treatment. Conclusion VLCADD as a rare disease that cause sudden unexpected death in infant, the early diagnosis and treatment are important to patients.