Objective To evaluate imaging diagnosis, differential diagnosis, surgery and interventional therapy of hepatic angiomyolipoma associated with tuberous sclerosis.Methods Clinical features, imaging appearances and interventional therapy for 2 cases of HAML in TS were retrospectrively analyzed. Results The features of HAML in TS are as following:(1) Two cases were female with no history of hepatitis and hepatocirrhosis, liver function test and alpha feto protein were normal. (2) the tumor was shown as a multiple hyperechoic mass with sharp margin on ultrasonography; well defined, fat density and intensity mass on computerized tomography (CT); hypervascular mass with early drainage of hepatic vein and tumor staining on angiography. (3) One case underwent interventional therapy. After 42 month follow up, the tumor was found to be diminished in size. Another case was under monitored with only the enucleating of left renal mass. The hepatic tumor showed no change after 10 months.Conclusions The imaging appearances of HAML in TS are relatively characteristic. Superselective arterial embolization is an effective treatment for HAML in TS.

Objective To investigate the effects of rapamycin which is an autophagy inducer and 3-adenine (3-MA) which is an autophagy inhibitor on motor behavior and autophagy related protein LC3 in C57BL/6 mice of Parkinson's disease(PD).Methods 40 C57BL/6 male mice were randomly divided into control group and experimental groups which consist of MPTP model group,rapamycin group and 3-MA group,with 10 in each group.Mice in experimental groups received intraperitoneal injection with MPTP to establish PD models,and mice in control group received intraperitoneal injection with the same amount of saline solution for 1 week.Mice in rapamycin group received intraperitoneal injection with rapamycin and mice in 3-MA group received intraperitoneal injection with 3-MA at the same time when MPTP was injected.Animal behavior detections were carried out on the 1 th,7th and 14th day after the last injection.After the last injection,mice were sacrificed and sections of midbrain nigra were gained for the detection of expression of autophagy specificity protein LC3 by Western Blot.Results Compared with MPTP model group,rapamycin could improve the general condition and behavioral manifestation of mice in pole test((14.89± 1.14) s vs (16.24±1.39) s,P＜0.05;(15.18±1.36) s vs(17.93±1.11s),P＜0.01),traction test((1.7±0.5) vs (1.2±0.4),P＜ 0.05;(1.5±0.5)vs (1.1±0.3),P＜0.05) and open field test which contained total activity distance((5 875.3 ± 1148.9) cm vs (5 061.5±773.1) cm,P＜0.05;(5 753.2± 1 106.7) cm vs (4 669.3±969.1) cm,P＜0.01) and average speed((19.29±2.35) cm/s vs (16.47±3.01) cm/s,P＜0.05;(18.71±2.71)cm/s vs (15.80±2.50) cm/s,P＜0.01),while 3-MA aggravated behavioral deficits of mice in pole test(19.92± 1.61s vs 17.93± 1.11 s,P＜0.05),and both total activity distance((3 879.7±575.0) cm vs (4 669.3±969.1) cm,P＜0.05) and average speed((13.34± 1.87) cm/s vs (15.80±2.50) cm/s,P＜0.05) in open field test were decreased.The results of Western Blot confirmed that rapamycin could increase the expression of LC3-Ⅱ,however 3-MA could re duce the expression of LC3-Ⅱ.Conclusion This study confirmed that rapamycin could alleviate behavioral symptoms of PD model mice and increase the level of LC3 in midbrain nigra,while 3-MA could exacerbate behavioral symptoms in PD model mice and decrease the level of LC3 in midbrain nigra.Thus it can be speculated that drugs which can regulate autophagy may be potential treatment protocols for PD.

Objective To study the conditions and methods of hydrodynamics-based transgene into rat regenerating liver in vivo. Methods The solution with concentration 30mg/L gene-containing plasmid was injected into rat tail veins at a speed of 2ml/s, then partial hepatectomy (PH) was performed at different times before/after injection, finally the rat (g) and regenerating liver (g) were weighed, and the liver coefficient (Lc) was calculated. Out of 15 groups which are Lc±Lc*0%, *5%, *10%, *15%, *20%, *25%, *30%, *35%, the most suitable group was chosen as correction coefficient to calculate the most appropriate volume of plasmid solution which was injected into the regenerating liver at different recovery times, and at the same time, right lobe of liver was gathered to make frozen section, then observe and quantify the positive green fluorescent protein (GFP) rate at 488 nm excitation wavelength. Results Injection of either physiological saline or empty plasmid has no significant difference compared with control (only PH performance). The appropriate time of hydrodynamics-based transgene is more than 12 hours before PH or anytime after PH. The solution volume of hydrodynamics-based transgene into liver regenerating rat after PH is rat weight (g) ×9%×1/3×corresponding correction coefficient (Trc). Both vector and target gene have effect on the time and abundance of gene expression. Conclusion Hydrodynamics-based transgene can effectively be applied to gene transfection in rat regenerating liver.

Objective To evaluate the feasibility and outcome of laparoscopic cholecystectomy as a overnight procedure in China.Methods The data of 59 consecutive patients who had undergone outpatient laparoscopic cholecystectomy between Januaiy 2013 and January 2015.All the patients were operated in the morning hours and discharged during 24 hours after operation.They were contacted by telephone 3 days subsequent to surgery and were seen in the outpatient unit 7 days after.Results Fifty-nine laparoscopic cholecystectomies were performed.No Conversion to open surgery case.The average operation time was 25 minutes,and restore semi-liquid diet 6 hours after the operation All the 59 patients were discharged during 24 hours after operations.None of the patients had an emergency readmission.None of the patients had complications 7 days after discharged.The average payment was 8 240 yuan.Conclusion These results suggest that laparoscopic cholecystectomy can be routinely performed as a overnight procedure.

From June 2007 to June 2009, 133 patients underwent esophageal resection, among them 64 cases received esophageal reconstruction with narrow gastric tube (NGT) and 69 received esophageal reconstruction with whole stomach (WS).The postoperative quality of life (QOL) in 6 months of both groups was investigated.The study found that there were 3 cases in WS group having leakage, while no one in NGT group, the weight loss, regurgitation and chest-stomach syndrome in NGT group were superior to those in WS group, there were no statistical differences in activities of daily life, emotional functions, food intake, dysphagia between two groups.The study indicates that the quality of life in NGT group is superior to that in WS group.

Objective To observe the effect of small doses of dexmedetomidine on postoperative analgesia and comfort after colorectal cancer radical operation in elderly patients .Methods 60 cases of elderly patients for elective colorectal cancer resection ,ASAⅠ~Ⅱgrade anesthesia were selected .According to randomly digital table , they were divided into the dexmedetomidine given group ( group D) and control group ( group C),30 cases in each group.The patients of group D was given to 0.5μg/kg dexmedetomidine for induction of anesthesia infusion , 15minutes bolus injection was completed ,intraoperative maintain 0.2μg· kg-1 · h-1 dexmedetomidine fixed to the front end of surgery 10 min.And group C was given to infusion of 0.9%sodium chloride injection in the same capacity . The operation time, amount of fentanyl using , comfort and VAS scores were recorded within 24h, maintain VAS score≤3 points.When VAS score>3 points,the pressing PCA was given ,and the number of times of pressing the PCIA was recorded.The adverse reactions occurred within 24h such as nausea and vomiting were also recorded . Results In the two groups,the results of postoperative analgesia were good ,but the VAS score of group D at each time of PCA point were less than those of group C (tend of surgery =5.99,tafter operation 2h =4.76,tafter operation 4h =4.08,all P<0.01).The Bruggrmann comfort score of group D were greater than those of group C (tend of surgery =9.86,tafter operation 2h =4.91,tafter operation 4h =6.84,all P<0.01).The incidence of adverse reactions of group D was 13.30%,which was less than 26.67%of group C(χ2 =4.32,P<0.05).Conclusion Small doses of dexmedetomidine given to improve the analgesic effect in elderly patients with colorectal cancer cure can improve comfort and reduce the incidence of adverse reactions ,and has a role in reducing postoperative nausea and vomiting .

Objective To evaluate the effect of preoperative sleep disturbance on efficacy of postoperative analgesia and comfort in patients undergoing colorectal cancer resection surgery.Methods 60 colorectal cancer patients with elective anesthesia laparoscopic radical resection were selected.According to the presence or absence of preoperative sleep disorders,they were divided into the sleep disorder group (group A) and non-sleep disorders group (group B),30 patients in each group.Two groups of patients used the same method to maintain anesthesia induction.Intraoperative intravenous nicardipine controlled hypotension in parallel to maintain MAP 60-75mmHg,HR 65-95times/min.The patients received PCIA pump at the end of surgery.Postoperative 24h VAS scores were maintained VAS score ≤3 points,when VAS score ＞ 3 points,given the pressing PCA analgesia remedy.The remedy situation within 24 hours after surgery and comfort analgesic score were recorded.Results Compared with group B,postoperative PCIA pressing number of group A significantly increased [A group:(11 ± 5),group B:(6 ± 5),t =2.44,P ＜ 0.05].At the end of surgery,postoperative 2h,4h,8h pain scores of group A were (2.8 ± 0.4),(2.5 ± 0.7),(3.2 ± 0.6),(3.5 ± 0.5),respectively,which were significantly higher than those of group B [(1.8 ± 0.5) points,(1.8 ± 0.4) points,(1.9 ± 0.3) points,(2.9 ± 0.3) points; at the end of surgery t =5.78,postoperative 2h t =4.56,postoperative 4h t =4.17,postoperative 8h t =2.09,all P ＜ 0.05],but postoperative 12h,24h had no significant change in pain scores (P ＞ 0.05).Compared with group B,the comfort scores of A group at the end of surgery,postoperative 2h,4h,8h,12h[group A:(2.8 ±0.3) points,(2.5 ±0.9)points,(2.6 ±0.9) points,(2.5 ±0.5) points,(2.9 ± 0.6) points ; group B:(3.8 ± 0.4) points,(3.3 ± 0.5) points,(3.6 ± 0.8) points,(3.3 ± 0.3) points,(3.3 ± 0.6) points] were significantly lower (at the end of surgery t =9.87 ; postoperative 2h t =4.94 ; postoperative 4h t =6.87 ; postoperative 8h t =7.61 ; postoperative 12h t--2.79,all P ＜ 0.05),after 24h comfort score had no significant change (P ＞ 0.05).Conclusion Preoperative sleep disorders can affect laparoscopic colorectal cancer after radical surgery analgesia and comfort of patients.

Objective To compare dose-volume parameters for local failure in esophageal cancers treated by there-dimensional conformal radiotherapy (3 D-CRT) or intensity modulated radiotherapy (IMRT) with different target regions.Methods A total of 244 patients with esophageal cancer (including 127 patients with local recurrence and 117 without recurrence) underwent radical 3D-CRT and IMRT were enrolled in this study.Data including dose-volume parameters and clinical features were analyzed retrospectively.Results No statistically significant differences were found in the dose-volume parameters of different planning target regions between groups with local tumor recurrence and without recurrence (P ＞ 0.05).In the elective nodal irradiation(ENI) group, neither the recurrence and the non-recurrence groups showed statistical differences in the dose-volume parameters (P ＞ 0.05).While for the involved-field iradiation(IFI) group, the GTV-V60, CTV-V60, PTV-V60 of local recurrent group were significantly lower than those in the non-recurrent group (t =-2.08,-2.19,-2.08, P ＜ 0.05).In the ENI group, radiated doses of GTV, CTV and PTV as well as dose-volume of PTV were significantly higher than the IFI group (t =1.97-3.12, P ＜ 0.05).For patients with a esophageal GTV less than 30 cm3 but without concurrent chemotherapy, radiated dose of CTV-D98％ , CTV-D95％ in the recurrent group were significantly lower than in non-recurrent group (t =-2.24--2.07, P ＜ 0.05).Conclusions Elective nodal prophylactic radiation of esophageal carcinoma could provide greater volume and doses of GTV, CTV and PTV to prescribed target regions, which may decrease local recurrence.Greater efficiency can be obtained when the primary lesion of the esophageal cancer is smaller or at an early stage, and concurrent chemotherapy is not given.

One hundred and seventeen patients with esophageal squamous cell carcinoma were treated with radical esophagectomy from January 2011 to June 2011,among whom 63 cases received early enteral nutrition (study group) and 54 received parenteral nutrition (control group).There were no differences in serum levels of albumin (ALB),prealbumin (PAB) and transferrin (TRF) before surgery between two groups.Serum PAB and TRF levels in study group were significant higher than those in control at d8 after surgery(P ＜ 0.05),and also higher than those at d1 after surgery (P ＜ 0.05).There were no differences in immune indexes in two groups before surgery,the IgA and IgM levels were rising at d8 compared those at d1 after surgery.The total lymphocytes,CD3,CD4,CD8 and CD4/CD8 in study group at d8 were significant higher than those in control group and those at d1 after surgery.The study shows that early enteral nutrition can improve nutritional index and immune function,and to promote rapid rehabilitation in esophageal cancer patients after surgery.

Adult ; Delivery of Health Care ; Female ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Male ; Occupational Health