Objective To explore the effects of anatomical and nonanatomical hepatectomy on the prognosis of patients with hepatocellular carcinoma(HCC).Methods A total of 62 HCC patients were enrolled,including 33 cases of anatomical hepatectomy(Group AH)and 29 cases of nonanatomical hepa-tectomy(Group IH).The operation situation and hematocrystallin(HB)loss were record.Fasting venous blood of HCC patients were extracted for detection of circulating AFP mRNA expression.The recurrence, mortality and complication rate were recorded at the same time.Results The operative time of Group AH was significantly higher than that of Group IH,while the bleeding volume and HB loss were lower(P<0.05).There were no significant differences in AFP mRNA expression and recurrence rate.The short-term mortality rate of Group AH was lower than Group IH(P<0.05 ),but their long-term mortality rates were similar(P>0.05 ).There was no significant difference in complication rate between groups.Patients of Group AH got more hepatosis due to liver cirrhosis or fibrosis,while patients of Group IH got more bleeding or infection due to the central tumor.Conclusion Anatomical hepatectomy has advantages in protecting artery and improving prognosis for HCC patients,but it has surgical risks for patients with serious patholog-ical damage in hepatic lobes,and nonanatomical hepatectomy may be considered.

Hepatic satellite cell (HSC) is a kind of nonparenchymal cells in the liver,which releases various collagenous fibers and cytoskeletal proteins,playing an important role in the pathophysiological changes of the liver.In normal,HSCs maintain normal tissue architecture via regulating the synthesis and degradation of extracellular matrix (ECM) proteins.During liver injury,HSCs were activated.Activated HSCs are the main cells that lead to the accumulation of extracellular matrix,which is the main reason of hepatic fibrosis,cirrhosis and liver failure.Therefore,lucubrating the role and mechanism of HSC in the progress of hepatic disease and investiating the HSC-related therapeutic strategies have practical significances for the prevention and treatment of liver injury and raise of patients' survival rates in clinical practice.

With the improvement of endoscopic retrograde eholangiopancreatography (ERCP) technology, endoscopy is not only applied to diagnosis, but also utilized to therapy for cholangiopancreatic neoplasm. This article is to summarize the application of endoscopic technology on cholangiopancreatic neoplasm.

With the development of molecular mechanisms of hepatocelluar carcinoma,targeted therapy has been a research hotspot in recent years.Some target agents of hepatocellular carcinoma have been approved.We summarize the progress of targeted therapy for hepatocellular carcinoma in this paper.

Objective:To evaluate the expression of EGFR and gene nm23H1 and their relation to the tumor oncogenesis and progress of cholangiocarcinoma.Methods:SABC immunohistochemistry was used to detect the expression of EGFR and nm23H1 in cholangiocarcinoma and cholangitis tissue.Results:The positive rate of nm23H1 in cholangiocarcinoma was lower than cholangitis(P

Objective To analyse the imaging characteristics of pulmonary tuberculosis(TB) in elder in order to improve its diagnostic accuracy.Methods Radiological and CT fndings of pulmonary tuberculosis in 200 old patients were analysed retrospectively.Results The types of TB in 200 patients were:type Ⅱin 13 cases(6.5%),type Ⅲ in 163 cases (81.5%),accompanied with the pleuritis in 44 cases(22%) and type Ⅳ in 24 cases (12%).The mainly imaging findings included:old lesions in 85 cases(42.5%),exudative and/or multiplicative lesions in 81 cases (40.5%),caseous pneumonia in 47 cases(23.5%),cavitive lesions in 127 cases(63.5%),tuberculoma in 12 cases(6%),miliary nodules in 13 cases(6.5%),TB pleuritis in 68 cases(34%) and enlargement of lymph nodes in 57 cases (28.5%).Conclusion TB in elder is of characteristics of atypical location and unstable morphology.

Objective To evaluate the diagnostic value of the combined detection of serum Fer,AFP and AFP-L3 in patients with primary hepatic cancer (PHC).Methods The serum levels of Fer,AFP and AFP-L3 were determined in 92 patients with PHC,84 patients with benign liver disease,and 45 control subjects.Results The PHC group serum Fer was (819.4±616.8) μg/L,AFP was (556.9±451.5) μg/L,AFP-L3 was (109.0±62.5) μg/L.The benign liver disease group Fer was (229.3±155.5) μg/L,AFP was (6.0±4.2) μg/L,AFP-L3 was (26.0±49.4) μg/L.The healthy control group Fer was (125.6±110.5) μg/L,AFP was (2.8±0.8) μg/L,AFP-L was (7.0±1.8) μg/L,there was significant difference between the three groups (all P ＜ 0.01).The sensitivity of PHC group alone in detection of serum Fer was 85.9 ％,the sensitivity of AFP was 71.0 ％,the sensitivity of AFP-L3 was 83.7 ％,the combined detection of Fer and AFP or AFP-L3 improved the sensitivity of the test to 90.2 ％ and 95.7 ％,the three combined detection sensitivity was 98.9 ％.Conclusion Combined detection of serum Fer,AFP and AFP-L3 is essential in the diagnosis of PHC.

Objective To observe the correlation between postmenopausal estrogen levels and diabetic retinopathy (DR) in women.Methods Thirty-nine menopause female patients with type 2 diabetes mellitus and 17 menopause subjects (control group) were enrolled in this study.Control subjects aged from 53 to 82 years,with the mean age of (69.80± 8.32) years.Diabetes mellitus patients aged from 56 to 84 years,with the mean age of (70.50±8.27) years;diabetes duration ranged from 3 to 23 years,with the average course of diabetes (11.40± 7.97) years.DR diagnosis was according to the results of fundus fluorescein angiography,and thus the 39 patients were divided into DR group (19 patients) and non-DR (NDR) group (20 patients).There was no significant difference in age and menopause duration between the three groups (t=0.347,0.485;P＞0.05).There was significant difference in diabetes course (t=2.748,P＜0.05).Compared with NDR group,fasting blood glucose (FBG),glycosylated hemoglobin (HbAlc),total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C) were significantly increased (t=6.130,5.322,4.574,2.426,4.033),high density lipoprotein cholesterol (HDL-C) was significantly lower (t=3.917),the difference was statistically significant (P＜0.05).The level of estradiol (E2) was measured by radioimmunoassay.The differences of E2 levels between the three groups were compared.Logistic regression analysis was used to analyze the influencing factors of DR.Results The levels of E2 in control group,DR group and NDR group were (42.38 ±8.64),(21.49 ± 9.81) and (32.72 ± 10.51) pg/ml,respectively.The level of E2 in DR group was significantly lower than that in NDR group and control group (t=3.443,10.110;P＜0.05).Logistic regression analysis showed that the duration of diabetes mellitus [coefficients =0.166,odds ratio (OR)=1.181,P=0.016],FBG (coefficients=1.162,OR=4.014,P=0.001),TC (coefficients=3.212,OR=10.820,P=0.002),TG (coefficients=1.649,OR=5.203,P=0.030) and LDL-C(coefficients=1.605,OR=4.976,P=0.003) were the risk factors for DR;E2 (coefficients=-0.100,OR=0.904,P=0.004) and HDL-C (coefficients=-4.460,OR=0.012,P=0.002) were the protective factors for DR.Conclusion The estrogen level of postmenopausal women have a certain correlation with the development of DR,it may be one of the protective factor of DR.

Exposure of gerbils 120 min to a high concentration oxygen (HCO)atmosphere after 60 min cerebral ischemia resulted in a marked increase in cerebral malondialdehyde (MDA, 4.39?0.26 nmol/mg protein). Much less cerebral MDA was among the other groups (2.63?0.50 nmol/mg protein in sham-operated controls; 3.07?0.52 nmol/mg protein in gerbils exposed to HCO without ischemia; 2.96?0.41nmol/mg protein in ger. bils subjected to 60 min ischemia; 2.79?0.59nmol/mg protein in gerbils subjected to 60 min ischemia and 120 min reperfusion). The contents of cerebral water, sodium, increassd after 60 mln cerebral ischemia. The contents of TXB_2 increased, 6-Keto-PGF_(1?) decreased, the elevation of cerebral water and sodium were more obvious after 120 min repefusion following ischemia. There was no difference in these items except for MDA between the reperfusion groups within air and within HCO.The authors proposed the mechanism that HCO elevates the contents of cerebral MDH might be due to abnormal function of election transport chain of mitochondria.

Objective Gastrointestinal tract is commonly affected in amyloidosis.The deposition of amyloid protein may cause a variety of endoscopic changes in the gastrointestinal tract.The aim of this study was to investigate the endoscopic manifestations and evaluate the biopsy results in amyloidosis of the gastrointestinal tract.Methods The gastroscopy or colonoscopy records of ten patients with amyloidosis of gastrointestinal tract(five males,five females) were reviewed.The definitive diagnosis of amyloidosis was made by tissue biopsy.The endoscopic changes in the gastrointestinal tract were characterized. Results The frequent clinical symptoms related to amyloidosis of the gastrointestinal tract presented as:abdominal pain,hematochezia or melena,abdominal distension and chronic diarrhea.Five patients underwent gastroscopy and three of them were established the diagnosis.Gastroscopic examinations revealed ulcerations,granular appearance,mucosal denudations and scars except one patient in whom the mucosa appeared normal.Eight patients underwent colonoscopy or sigmoscopy and all of them got positive results.The endoscopy revealed polyps,ulcerations,mucosal denudations,granular appearance,mucosal hyperemia and edema.Two patients who suffered from abdominal pain and hematochezia were diagnosed as colonic ischemia clinically.The histopathological examination of one of the patients showed that there was amyloid deposits in the blood vessels.In another patient,amyloid was found in the stroma.This suggests that there are some relationship between amyloidosis and colonic ischemia. The amyloid deposition in the small vessels may decrease the blood flow of the colon,on the other hand,chronic ischemia may cause inflammation which may lead to amyloidosis.The relationship between amyloidosis and colonic ischemia needs to be further investigated.Conclusion Gastrointestinal tract is one of the predisposed organs in amyloidosis.Endoscopic examination may discover the lesion.Biopsy of gastrointestinal tract may greatly help the diagnosis of this disease.