Objective To summarize the clinical experience of the diagnosis and treatment for 23 cases with malignant peritoneal mesothelioma.Methods The clinical data of 23 cases of malignant peritoneal mesothelioma was analysed retrospectively.Results All of the 23 cases were finally diagnosed with pathology.The pertinacious abdominal pain and distension, bloody ascites,multiple abdominal masses were clinical manifestation chiefly.The examination of B type ultrasonography and CT displaied the obvious irregular thickening of peritoneum and mesenterium, multiple nodes in abdomen and pelvic masses.Conclusions The vigilance to the disease ought to be aroused when possesing the above-mentioned clinical manifestation. The diagnosis chiefly depends on the peritoneal biopsy with abdominal cavity puncture,peritoneoscopy and exploratory.

Objective Objective To analysis the clinical curative effect on elderly patients with choledocholithiasis by endoscopic retro-grade cholangiopancreatography ( ERCP) and endoscopic sphincterotomy ( EST) and discuss its clinical significance. Methods 256 patients with choledocholithiasis were collected for diagnosis and treatment by ERCP. The stone characteristics was mastered by ERCP and the pa-tients were treated with EST. Results Patients with choledocholithiasis were successful in 249 cases (97. 27%) for ERCP intubation and 239 cases (93. 36%) for stone remove. After EST,the stones were removed successfully at one time in 199 cases (83. 26%),2 times in 40 cases (16. 74%). 7 patients (2. 73%) with multiple diverticulum and papillary position poor by intubation failure were changed over to op-eration treatment. After ERCP,patients were performed endoscopic nasobiliary drainage (ENBD) 64. 44% (154/239). Pull out the drain-age tube of 90. 91% (140/154) of the patients after stones disappeared which was proved by angiography for 3~5 days. 14 cases (9. 09%) were performed second times to remove the stones due to the presence of residual stones. Postoperative complications occured in 15 cases (6. 02%) including 9 cases of acute pancreatitis and 6 cases of infection of biliary tract, and they were cured after 1 week of corresponding treatment. Transient increase of serum amylase occurred in 39 cases, and all of them recoveried after 3 days without special treatment. Con-clusion The results showed that ERCP ( or EST) were well tolerated by elderly patients with choledocholithiasis,and they were of obvious curative effect and quick recovery,which is worthy of promotion and application.

Object To study the effect of puerarin on the expression of inflammatory factors and miR-155-3p in human umbilical vein endothelial cells ( HUVEC) induced by visfatin.Methods The HUVEC cell injury model was es-tablished with visfatin.Cell proliferation was measured by MTT assay.Cell apoptosis was detected by flow cytometry.The level of CRP and NF-κB was detected by ELISA, and the expression of miR-155-3p was detected by RT-PCR.The expres-sion of myeloid differentiation factor 88 ( MyD88) was identified by western blotting.Results Visfatin induced cell prolif-eration and inhibited apoptosis in HUVEC, meanwhile the expressions of both CRP and NF-κB were significantly increased, compared with that of the control group (P<0.01).Puerarin at moderate and high concentrations obviously reduced the HUVEC injury induced by visfatin, mainly through down-regulating the expression of CRP and NF-κB, as well as up-regu-lating the level of miR-155-3p in the HUVEC.MiR-155-3p mimic markedly decreased the level of MyD88, CRP and NF-κB in the HUVEC induced by visfatin (P<0.05).Conclusions Pueprarin obviously alleviates HUVEC injury induced by visfatin, probably related to down-regulating the level of MyD88, CRP, NF-κB, and up-regulating the expression of miR-155-3p in HUVEC.

Objective To evaluate the technique of finger palpation in thoracoscopic localization in patients with pulmonary nodules,and to summarize its technical details,especially with exploit of chest computed tomography (CT) facilitating it.Methods 95 patients with total amount of 109 pulmonary nodes 20 mm or smaller in size shown with lung window of CT,were reviewed.They were located subpleurally,with a median depth of 8.2 mm and a median size of 10.0 mm.The value of their depth over their size (D/d value) could be used as the extent of localizing difficulty.Each node had its own radiographic fealures for being localized,which was built preoperatively.Under thoracoscopic vision,nodules were finger-palpated by index finger via the 4th or 5th intercostal space on anterior axillary line,followed by wedgectomy or lobectomy for instant histopathological diagnosis to further decide the final surgical type.The distance between the nodule and the origin of segmental bronchus (L value) were also calculated out,as it might be relevant to the way the nodule could be biopsied.Results All nodules were successfully localized and resected for biopsy goal,105 by wedgectomy,4 by lobectomy.After intraoperative diagnosis was made by the pathologist,VATS lobectomy and lymph node dissection were further performed in 55 patients.L value of 4 cases being biopsied by lobectomy ranged from 18.3 to 30.3 mm,averaging 26.1 mm.Conclusion Finger palpation is viable in any cases of pulmonary nodules.Detailed reference of CT digital information,and enough detachment of mediastinal pleura,can greatly facilitate thoracoscopic localization by finger palpation.Lobectomy or segementectomy is preferable when L value is less than 30 mm.

A novel antimicrobial peptide, named as perinerin (GenBank accession No. P84117), was isolated and characterized from Asian marine clamworms, Perinereis aibuhitensis Grube. Perinerin showes powerful and broad activity against both grampositive and gramnegtive bacteria in vitro, especially on Pseudemonas aeruginosa. To obtain large amounts of active perinerin and characterize its main physiochemical features, The perinerin weve expressed in Pichia pastoris. Intact perinerin gene amplified by the modified gene SOEing method(Gene splicing by overlap extension)was cloned into expression vector pPICZ?A and obtained recombinant vector pPICZ?APEN, then pPICZ?APEN was expressed in the Pichia pastoris GS115. The expressed sample was analyzed by TricineSDSPAGE. The results showed that Pichia pastoris was a suitable system producing the secreted form of perinerin. Bioactivity assay showed that the recombinant perinerin had marked antimicrobial effects.

Objective To compare the efficacy and side-effects of preoperative neoadjuvant uterine arterial chemoembolization and venous chemotherapy in treating cervical cancer in young female patients. Methods A total of 241 young females(≤35 years old) with cervical cancer were enrolled in this study. The clinical data were retrospectively analyzed. The patients were divided into group A (n=63) and group B (n=57). Patients in group A received preoperative neoadjuvant uterine arterial chemoembolization with subsequent surgery, while patients in group B were treated with preoperative neoadjuvant intravenous chemotherapy followed by surgery. The chemotherapy scheme included carboplatin (50 mg/m2) and gemcitabine (1 000 mg/m2). The short-term effect, the amount of blood loss during the surgery, pathological findings and the side-effects of the two groups were compared. The Kaplan-Meier method was used to calculate survival rate, and the log-rank test was used for survival difference analysis. Results The short-term response rate of group A was 90.5%, which was significantly higher than that of group B (71.9%), the difference between the two groups was statistically significant (χ2=7.5, P<0.05). The resection rate of group A was 95.2%, which was higher than that of group B (84.2%). The amount of intra-operative blood loss of group A and group B was (443±263) ml and (695±312) ml respectively, the difference was statistically significant (t=4.802, P<0.05). The pathological complete remission of group A and group B was 9.5%(6/63) and 5.3%(3/57)respectively; the differences in postoperative pathological results between the two groups were statistically significant (χ2=12.3, P<0.05). The side effect of group A was milder than that of group B (P<0.05). The 5-year progression-free survival (PFS) rate of group A and group B was 73.0% and 54.4% respectively (χ2=4.471, P<0.05);and the overall survival (OS) rate of group A and group B was 77.8%and 63.2%respectively (χ2=3.022, P>0.05). In both groups, the clinical stage, the pathological grade and the size (≥ 4 cm) of the tumor were the main factors that could influence the prognosis in young females with cervical cancer (P<0.05). Conclusion The short-term efficacy of preoperative uterine artery chemoembolization is better than that of preoperative intravenous chemotherapy for the treatment of cervical cancer in young female patients. Besides, this therapy carries mild side effect, and it can improve the 5-year progression-free survival rate, although the long-term survival rate has not been obviously improved.

Objective To investigate the clinical therapeutic effect of comprehensive treatment in young women with cervical car-cinoma.Methods A total of 52 young women with cervical carcinoma were treated with uterine artery chemoembolization.50 cases underwent radical hysterectomy and pelvic lymphadenectomy after interventional therapy.The patients with pathological risk factors were given supplementary radiotherapy.Results The clinical overall response rate was 88.5%.96.2% of patients underwent sur-gery and lymph node metastasis rate was 26.9%.The 2,5 year overall survival rates of patients were 91.5%,71.2% respectively. Conclusion The comprehensive treatment can improve overall survival rate and quality of life for young woman with cervical carci-noma.Postoperative patients with pathologically related risk factors should be treated with supplement chemoradiotherapy.

Objective To investigate the effect of silk fibroin scaffolds seeded with adipose mesenchymal stem cells (ADMSCs) in remodeling fiber for tunica albuginea defect in rabbits.Methods Fifty-six New Zealand rabbits were divided into 4 groups according to the random number table after a defect was created in the tunica albuginea:Group A (the defect was repaired with silk fibroin),Group B (with silk fibroin seeded with ADMSCs),Group C (with autologous tunica vaginalis) and Group D (left unrepaired),with 14 rabbits per group.Tunica albuginea sections were obtained for HE staining,Sirius red staining,Hart staining and immunofluorescence staining of macrophages at 6 and 12 weeks after surgery.Results At 12 weeks after surgery,HE staining revealed chaotically distributed new fiber ingrowth in Group D and orderly ingrowth in Groups A,B,and C.At 12 weeks after surgery,Sirius red staining revealed mean area of type Ⅰ collagen fibers was greater than that of type Ⅲ in Groups A (98 780 ±4 190 vs 51 177 ±5 464),B(94 855 ±9 010 vs 50 815 ±3 895),and C(99 860 ±6 015 vs 50 948 ± 6 595),but the difference in area of collagen fiber of the same type was insignificant among the three Groups.Moreover,less type Ⅰ collagen fibers (79 386 ±2 237) and more type Ⅲ collagen fibers (85 278 ± 2 645) were observed in Group D compared with other three Groups (P ＜ 0.01).At 12 weeks after surgery,Hart staining showed the mean area of elastic fibers in Groups A,B,C,and D was 2 805 ± 90,2 849 ±84,3 068 ±485,and 1 961 ±96 respectively.There was no statistical difference between Groups B and C,but less amount of fibers was observed in Group A (P ＜ 0.01) and least amount was observed in Group D (P ＜0.01).At 6 weeks after surgery,the number of infiltrating macrophages in Groups A,B,C and D was 4.10 ± 0.87,3.80 ± 0.78,3.70 ± 0.94,and 6.80 ± 1.63 respectively.There was no statistical difference in the number of macrophage infiltration among Groups A,B and C,but all were lower than that in Group D (P ＜ 0.01).Conclusion Silk fibroin seeded with ADMSCs is comparable to autologous grafts for repair of tunica albuginea defect in rabbits.

Objective To confirm whether the open-ended coaxial line is effective in detection of the differences in dielectric properties between colorectal cancer tissues and surrounding normal tissues and evaluation of the depth of tumor invasion. Methods The open-ended coaxial line system at frequencies ranging from 50 to 500 MHz in 98 freshly excised colorectal cancerous specimens obtained from the operating theatre of Zhujiang Hospital, was used to detect both the relative permittivity and conductivity on the serosal surface of the carcinoma nidus, the mucosa of the carcinoma nidus, and the mucosa of the surgical resection margin. Pathological examinations were conducted on each specimen after surgery. Results The values for relative permittivity and conductivity of the colorectal cancerous mucosa were significantly higher than those of the normal mucosa (P < 0.01). For the tumor which had invaded or penetrated the serosa (stage ≥ T3), the dielectric properties of both the cancerous serosa and mucosa were higher than the one restricted to muscularis propria or less intestine wall (stage < T3) over the measured frequency range, and there existed statistical differences at the common frequencies of 213 MHz and 426 MHz. Conclusion The open-ended coaxial line system may result in fast and effective diagnostic differentiation between cancerous and normal colorectal tissues as well as reasonable assessment of the tumor infiltration depth.

Objective To investigate the efficacy of transjugular intrahepatic portosystemic shunt (TIPS) with covered stent in the treatment of portal hypertension in patients with hepatocellular carcinoma.Methods The clinical data of 46 patients with primary hepatocellular carcinoma and portal hypertension who received TIPS with stent treatment were retrospectively analyzed.After treatment,liver function,shunt patency,re-bleeding rate,hepatic encephalopathy,ascites,gastric intestinal symptoms, lifetime and causes of death were analyzed. Compare t test was performed for measurement data comparison among groups.The survival curves were used to analyse the cumulative stent shunt patency rate,the incidence of hepatic encephalopathy and the survival rate.Results After the operation,portal vein pressure significantly decreased compared with that before operation [(16.2 ± 4.6 )mmHg vs (28.3±5 .1)mmHg,1 mmHg=0.133 kPa],and the difference was statistically significant (t =21 .30, P <0.05).There was no significant difference in liver function before and after operation [(6.8 ±1 .8) score vs (6.9±1 .5)score,P >0.05].Cumulative stent shunt patency at 3,6,12,24,36 month after operation was 100.0%,95 .6%,93.5 %,91 .3% and 91 .3%,respectively.The cumulative incidence of hepatic encephalopathy was 6.5 %,8.7%,13.0%,17.4% and 26.1 %,respectively;cumulative survival rate was 95 .7%,82.6%,67.4%,43.5 % and 32.6%,respectively.In 10 cases of refractory ascites, ascites of all the patients reduced with different degree after operation and gastrointestinal uncomfortable symptoms were relieved.Conclusion In patients with primary hepatocellular carcinoma and portal hypertension,who have gastrointestinal bleeding or refractory ascites,treatment of TIPS with covered stents could effectively lower portal pressure,prevent re-bleeding and reduce the volume of ascites.