Intrahepatic cholangiocarcinoma (ICC) has the significant characteristics of regional spread and lymphatic metastasis. Radical resection provides the only chance for long-term survival of patients with ICC. Anatomic or extended hepatectomy is the most optimal treatment. The value of hepatic resection with lymph node dissection and the area of lymph node dissection are controversial. Palliative resection improves prognosis of some patients. Secondary hepatectomy also benefits some patients with late (＞1 year) intrahepatic recurrence. Liver transplantation is only performed for highly selected prophase-patients or prudent clinical trials, and a combination with adjuvant treatment such as chemo-radiotherapy after operation is suggested.

Orbscan-II anterior system was used for early diagnosis of keratoconus. 48 Eyes of 24 patients with suspicious keratoconus were examined by Orbscan-II anterior system from Dec. 1999 to Dec. 2000 and followed up. The values of Diff and anterior chamber depth (ACD) were recorded. Results indicated that values of Diff and ACD were increased in 4 eyes of 2 patients with keratoconus trend during follow-up. Taking advantage of Orbscan-II anterior system to observe the values of Diff and ACD can early diagnose the sub-clinical keratoconus. The values of Diff and ACD can sensitively report the progression of keratoconus.
Anterior Chamber/pathology ; Cornea/pathology ; Corneal Topography/*instrumentation ; Corneal Topography/methods ; Evaluation Studies ; Keratoconus/*diagnosis ; Keratoconus/ultrasonography

To describe and evaluate a refraction-derived method and a clinically derived method to calculate the correct corneal power for intraocular lens (IOL) power calculations after laser in situ keratomileusis (LASIK) and to compare the results to the commonly used history-derived method. Retrospective analysis were conducted in consecutive case from clinical practice. For each patient, we established the pre-LASIK and post-LASIK spectacle refraction, the pre-LASIK (K(pre)) and post-LASIK K readings (K(post)). We then calculated the pre- and post-LASIK refraction at the cornmeal plane and the amount of correction obtained by the refraction surgery (deltaSEQco). The cases were divided into two groups. Group I was used to derive two formulas. The values obtained with the two methods were compared with the K by history-derived method (K(c.hd) in group II to validate the results. The K values calculated by using the refraction-derived method (K(c.rd)) and the K values calculated using the clinically derived method (K(c.cd)) correlated highly with K(c.hd). The correct corneal power for intraocular lens (IOL) power calculations after LASIK can use refraction-derived method and clinically derived method instead of history-derived method when some refractive parameters are not available.

Boosting spatial resolution of visual prostheses is an effective method to improve implant subjects' visual perception. However, power consumption of visual implants greatly rises with the increasing number of implanted electrodes. In respond to this trend, visual prostheses need to develop high-efficiency wireless power transmission and high-speed data transmission. This paper presents a review of current research progress on wireless power and data transmission for visual prostheses, analyzes relative principles and requirement, and introduces design methods of power and data transmission.
Electric Power Supplies ; Prosthesis Design ; Visual Prosthesis ; Wireless Technology

Changes of corneal properties induced by laser in situ keratomileusis (LASIK) results in low inaccurate intraocular pressure (IOP) readings by Goldmann applanation tonometry (GAT). Before and after LASIK, the applied value of IOP, measured by dynamic contour tonometry (DCT) in comparison to GAT, was evaluated. Before and 1, 4 weeks after LASIK, the IOP in 30 cases (60 eyes) was measured by GAT and DCT respectively. The obtained results were statistically processed by SPSS11.5 statistical software. The results showed that central corneal thickness (CCT) could affect GAT measurements but not DCT measurements. The comparison of IOP one and 4 weeks after LASIK revealed that the readings from GAT was separately decreased by 5.00 +/- 1.12 and 5.45 +/- 1.13 mmHg as compared with those before LASIK, while those from DCT had no significant difference. It was concluded that LASIK-induced changes of CCT could influence the accuracy of GAT measurements, but had no influence on those from DCT. DCT was more beneficial to the measurements of IOP in normal eyes and those subject to LASIK surgery.

Objective To investigate the differential diagnosis and management of IgG4 associated biliary pancreatic diseases.Methods A total of 18 patients with jaundice and abdominal pain were retrospectively studied.The final diagnosis was 7 cases of type Ⅰ autoimmune pancreatitis (Ⅰ-ALP),4 cases of IgG4-associated sclerosing cholangitis (IgG4-SC),and 7 cases of I-AIP combined IgG4-SC.Results (1)Imaging features:I-AIP patients showed pancreatic head mass,with relatively poor blood supply when under dynamic contrast-enhanced scan,in delay image,enhanced amplitude more than the normal pancreas.IgG4-SC can be seen in patients with symmetrical bile duct wall stenosis and (or) soft tissue mass,the thickened bile duct wall and intraluminal soft tissue mass can be enhanced with bile duct wall thickening.(2) Serological characteristics:Serum IgG4 fluctuated between 59.3 and 1 120.0 mg/dl,CA19-9 fluctuated between 12.2 and 230.8 U/ml.(3) Histopathology:Plasma cells lymphocyte infiltration and fibrosis,immunohistochemical staining showed IgG4 positive cells ＞ 10/hpf,and obliterative phlebitis.(4) Combined with other organ lesions in 6 cases including renal injury,retroperitoneal fibrosis,mesenteric inflammatory nodules,omental inflammatory nodules,submandibular gland enlargementin,and pituitary inflammation.(5)Response to hormone therapy:4 out of 6 operated patients were none resected and we re given hormonotherapy.In twelve non-surgical patients,2 cases abandoned therapy,10 cases were treated with hormone therapy,and improved.Conclusion IgG4 associated biliary pancreatic disease characterized by localized pancreatic or bile duct disease,can be distinguished from malignancy by special imaging,IgG4 elevation,histopathology and positive response to experimental hormonotherapy.

Objective To study the therapeutic effects and mechanisms of Astragaloside-Ⅳ (ASG-Ⅳ) on diabetic cardiomyopathy (DCM) in the rat diabetic model. Methods Forty SD(Sprague-Dawley)healthy rats were used. The diabetic retinopathy rats model were induced by STZ, 45 mg/kg, 3d. Another 10 were injected the same amount of citrate buffer as a control group. Fasting blood glucose was measured with SureStep Plus detector 72 h later. The blood glucose of the diabetes model was ≥16.7 mmol/L. And 12 weeks later, DCM rats were divided into 4 groups randomly in the experiment, includes: DCM, ASG-Ⅳ-L (10 mg/kg), ASG-Ⅳ-M (30 mg/kg), ASG-Ⅳ-H (60 mg/kg)groups. After give dugs 4 weeks, the phosphokinase isoenzyme (CK-MB) and LDH level were tested, the cardiac hypertrophy was evaluated by HW/BW and LVW/BW. Activity of Na+-K+-ATPase and Ca2+-ATPase were determined in left ventricular tissues by ATPase ELISA Assay Kit. The content of FFA was measured and myocardial pathological examination was performed. Results Compared with the control group, blood and urine glucose were higher than experimental animal in diabetic model group, were significantly increased (P<0.05). LDH and Phosphokinase isoenzyme (CK-MB) level were significantly increased, the HWI and LVWI ratio were enhanced in DCM group (P<0.05). ASG-Ⅳ could reduce the ratio of HWI and LVWI, decrease the level of CK-MB and LDH, improve the pathomorphological changing of DCM rat model (P<0.05). Moreover, compared with DCM group, ASG-Ⅳ could restore the Na+-K+-ATPase and Ca2+-ATPase activity, reduced the content of FFA (P<0.05). Conclusion ASG-Ⅳ plays therapeutic effect on diabetic cardiomyopathy might via restore the Na+-K+-ATPase and Ca2+-ATPase activity, reduce the content of FFA, protect the myocardial energy metabolism in DCM.

Objective To evaluate the efficacy of applying problem based learning (PBL) combined with traditional teaching in clinical internship in department of gastroenterology.Methods Totally 60 full-time medical undergraduates of clinical medicine in clinical internship in department of gastroenterology of the Second Hospital of Baoding were randomly divided into PBL group (n=30) and traditional group (n=30).Practical effect of the different modes was evaluated by questionnaire and examination resuits.Data were analyzed by SPSS 15.0.Enumeration data were compared between groups using x2 test and measurement data were manifested (x-) ± s with P ＜ 0.05 signifying significant difference.Results PBL group was superior to traditional group in comprehensive analysis capabilities,motivation to learn and learning outcomes with statistically significant differences between the two groups (P values were 0.001,0.007 and 0.005).Concerning stimulating students' interest and satisfaction of the teaching mode,the difference between the two groups was not statistically significant (P ＞ 0.05).PBL group was superior to traditional group in the pre-class preparation,full and accurate expression of views in classroom and clinical logic,with statistically significant differences between the two groups (P values were 0.002,0.000 and 0.002).There was no difference in communicative abilities with patients between the two groups (P=0.118).PBL group had higher scores than traditional group in the quiz,case analysis and overall performance,with statistically significant differences between the two groups (P values were 0.005,0.045 and 0.013).Concerning score of glossary and multiple-choice questions,differences between two group were not statistically significant (P＞0.05).Conclusions PBL combined with traditional teaching method is suitable for internship teaching in the department of gastroenterology for full-time undergraduates of clinical medicine.PBL can improve students' clinical comprehensive analysis capabilities and helps to develop the ability to take the initiative to solve practical problems.

Objective To investigate the expression of LKB1 and p53 in human gastric tissues and their correlation with clinical pathological factors.Methods The expression of LKB1 and p53 in 115 cases of gastric carcinoma and 20 cases of normal gastric tissues were detected by immunohistochemistry method,and the relation between the expression and the clinicopathological parameter of gastric carcinoma was analyzed.Results The positive rates of LKB1 in gastric carcinoma and normal tissues were 20.9 ％ (24/115) and 95.0 ％ (19/20),respectively (P ＜ 0.01).The positive rates of p53 in gastric carcinoma and normal tissues were 45.2 ％ (52/115) and 5.00 ％ (1/20),respectively (P ＜ 0.05).The analysis revealed that the high expression of LBK1 was associated with tumor lymph node metastasis,stage,Lauren classification and worse survival (P ＜ 0.05).The expression of p53 was associated with tumor lymph node metastasis,stage,distant metastasis and worse survival (P ＜ 0.05).Conclusions LKB1 protein expression may play an important role in the development and progression of gastric cancer.LKB1 may be used to assess the malignant biological behavior and prognosis of gastric cancer.

Objective To evaluate the treatment experience on primary retroperitoneal neoplasms involving large blood vessels.Methods In this study 82 patients with primary retropetropeal neoplasms were treated surgically from 1990 to 2010 and the clinical data of these patients including preoperative radiological examinations and surgery were retrospectively analyzed.Result The sensitivity and specificity of preoperative imaging examination for identifing large blood vessel involvement was 70％ and 73％respectively.Compared with those of no large blood vessel involvement,patients with large blood vessels involvement had a lower rate of tumor complete removal,more intraoperative blood loss and longer operation time( P ＜ 0.05).In group of large vascular involvement,patients undergoing complete tumor resection were all alive after 12 months,and none of those undergoing palliative resection survived more than 9 months.Conclusions Preoperative imaging allows precise evaluation on the status of large blood vessel involvement in patients of retroperitoneal tumors.Involving large vessels often predicts inability in total resection of retroperitoneal tumors.