Objective To investigate MRI value in diagnosing and differential diagnosing intrahepatic peripheral cholangiocarcinoma(IHPCC).Methods Twelve cases with IHPCC proved by pathology underwent plain MRI,and contrast-enhanced MR imaging including arterial,portal and delayed phase.MRI features were analyzed.Results All of 17 leisons in 12 cases,12 lesions exhibited hyperintensity at edge and hypointensity at center on T2WI,5 appeared as hyperintensity.2 lesions showed no enhancement and 15 lesions were circular enhancement in arterial phase,all of 17 lesions showed gradual fill in the center of lesions.The diagnostic accuracy was 100%.Conclusion MRI plays an important role in detecting and diagnosing IHPCC.

Objective: To study the treatment method of apoplectic joint contracture. Method: Fifty-two cases were treated with acupuncture plus cupping and thirty cases were treated with acupuncture alone as the control group. Result and conclusion: The effective rate of the former and later were 100% and 93.3% respectively,combined treatment of acupuncture and cupping was superior to acupuncture alone (P＜0.05).

Objective To explore the thoracic and diaphragmatic complications of treating hepatic malignant tumor using thermal ablation techniques.Methods The patients received thermal ablations were involved as subjects from January 2002 to December 2013.The thoracic and diaphragmatic complications of treating hepatic malignant tumor with percutaneous thermal ablation were retrospectively analyzed.Results A total of 1 520 patients with 2 789 hepatic tumors [average largest diameter of tumor (2.30 ± 1 .03)cm] underwent 2 066 thermal ablation treatments.Five hundred and six radiofrequency ablation (RFA)and 1 560 microwave ablation procedures were performed,respectively.The complete ablation rate was 96.8%(2 701/2 789)at 1 month after treatment.The major thoracic and diaphragmatic complication rates were 0.8%(1 7/2 066 ),meanwhile the minor complication rates were 6.5% (134/2 066 ).Conclusions The thoracic and diaphragmatic complication rate of percutaneous thermal ablation is low in the treatment of hepatic malignant tumors.However,the major complications may cause serious consequences.Therefore, the patients of diaphragm-abutting liver tumors are fully assessed before thermal ablation treatments,and relevant prevention measures are completed.Open or laparoscope is used to assist thermal ablation treatment when necessary.

Background:Intestinal metaplasia(IM)and dysplasia in Barrett’s esophagus(BE)can be detected by endoscopic biopsy combined with pathological examination. Aims:To evaluate the efficacy of acetic acid stain-guided biopsies in detection of IM and dysplasia in BE under standard endoscopy. Methods:One hundred patients found to have columnar-lined esophagus by endoscopy from January 2012 to November 2014 at Shanghai Jing’an District Central Hospital were enrolled. Under standard endoscopy,acetic acid was sprayed and multi-point biopsies were performed in visible abnormal regions. This was followed by four-quadrant biopsies at every 1 to 2 cm of the remaining BE segments. Detection rates of columnar epithelium,IM and dysplasia were compared between acetic acid stain-guided biopsies and four-quadrant biopsies. Results:A total of 96 patients were diagnosed as BE. Detection rates of columnar epithelium by acetic acid stain-guided biopsies and four-quadrant biopsies were 96. 9%(93 / 96)and 90. 6% (87 / 96),respectively,no significant difference was found between the two methods(McNemar test,P = 0. 146),however,consistency of the two methods was poor(κ = 0. 340). A total of 32 patients were diagnosed as BE with IM. Detection rates of IM by acetic acid stain-guided biopsies and four-quadrant biopsies were 84. 4%(27 / 32)and 40. 6%(13 / 32),respectively,difference in detection rate between the two methods was significant(McNemar test,P = 0. 007),and consistency of the two methods was poor(κ =0. 266). Five cases of low-grade dysplasia were detected by acetic acid stain-guided biopsies only. Conclusions:Acetic acid stain-guided biopsies can detect BE with IM and dysplasia better than four-quadrant biopsies.

Objective To investigate the reasons of complications after ultrasound-guided PTBD and explore measures for their management. Methods The clinical data of 753 patients with obstructive jaundice treated with ultrasound-guided PTBD in our hospital from January 2001 to June 2008were retrospectively analyzed. Results The 753 patients received a total of 791 treatments of PTBD.The occurring rates of severe, common, and long-term complications were 1.14 % (9/791), 11.88 %(94/791 ) and 4.3% (9/791), respectively. Only 1 patient died of manipulation-related complications.Conclusion Ultrasound-guided PTBD is an effective method for treatment of obstructive jaundice.

Objective Sperparamagnetic material is widely used in tumor localization and treatment , but there are still few studies in bone tissue engineering .This study aims to investigate the osteogenic efficiency of superparamagnetic scaffolds poly lactic acid hydroxy acetic acid (PLGA)/iron-doped hydroxyapatite (Fe-HA) for repairing rabbit mandibular defects , as well as evaluating the biocompatibility of the material . Methods 36 New Zealand rabbits were randomly selected and randomly divided into 6 groups, control without and with static magnetic field ( SMF ) groups ( no material is implanted), PLGA scaffold without and with SMF groups (implanted PLGA), PLGA/Fe-HA scaffold without and with SMF groups ( im-planted PLGA/Fe-HA), each group has 6 rabbits.We created bilat-eral mandibular defect models , executed the rabbits at 4 weeks and 12 weeks post-surgery, marked the mandibular specimens which detected by general observation, Micro-CT and HE staining, and ana-lyzed the results of bone mineral density in defect area .The hematological detection , pathological examination of liver and kidney sam-ples were carried out at 12 weeks pot-surgery.. Results The PLGA/Fe-HA scaffold without and with SMF groups began to appear rough defect area edge , decreased defect diameter , new bone formation from 4 weeks; the defect area formed a smooth , continuous bone repair from 12 weeks.The PLGA scaffold without and with SMF groups appeared rough , irregular callus repair , visible boundary between defect edge and normal bone tissue .There are still have part of unrepaired bone defect in the center of defect area in the control without and with SMF groups.At 12 weeks , the bone mineral density of PLGA/Fe-HA scaffold with SMF group [(572.50±19.09) mgHA/cm3] , respectively, compared with the PLGA scaffold with SMF group [(467.00±6.24)mgHA/cm3], the control with SMF scaffold group [(480.00±2.08) mgHA/cm3], the PLGA/Fe-HA scaffold without SMF group [(461.00±19.79)mgHA/cm3], the PL-GA scaffold without SMF group [(446.00±11.31)mgHA/cm3] and the control without SMF group [(422.00±28.28) mgHA/cm3], all the differences were statistically significant ( P<0.05).The bone mineral density of PLGA/Fe-HA scaffold with SMF group at 4 weeks [(572.50±19.09)mgHA/cm3] was significantly higher than that at 12 weeks [(276.00±28.28)mgHA/cm3] (P<0.05), the differences between 4 weeks and 12 weeks in other groups were statistically significant (P<0.05). Conclusion The superparama-gentic PLGA/Fe-HA scaffolds can promote the repair of bone defect , optimize the osteogenic effect of the material with SMF .Also ,the scaffold showed a good biocompatibility .

BACKGROUND:Isobaric tags for relative and absolute quantitation (iTRAQ) mass spectrometry technology studys the information of relevant protein according to the ion signal shows different mass-to-charge ratio in the tandem mass spectrometry analysis. OBJECTIVE:To establish the protein spectrum of differential proteins in cerebrospinal fluid of acute spinal cord injury rat model, study the secondary injury mechanism and find an effective method of treating acute spinal cord injury from molecular level. METHODS:Acute spinal cord injury was produced in Sprague-Dawley rats and iTRAQ technology was applied to analyze the differential proteins in cerebrospinal fluid of acute spinal cord injury rat model. RESULTS AND CONCLUSION:Total 722 proteins have been identified in this study, including 107 differentialy expressed proteins, 63 downregulated proteins and 44 upregulated proteins. There were 19 proteins related to neurogenesis, including 14 up-regulation proteins and 5 down-regulation proteins. Seven proteins contributed to the regulation of neurogenesis. The differential proteins and growth factor identified in this study can be taken as the biomarkers of acute spinal cord injury or indicators of clinical monitoring of the progression, target treatment and efficacy assessment after acute spinal cord injury.

Objective To investigate the clinical effect of the free fibula composite tissue flap transplantation to repair the first metatarsal bone with soft tissue defect on foot.Methods From August, 2008 to August, 2013, 6 patients with the first metatarsal bone and soft tissue defect on foot were treated with transplantation of free fibula composite tissue flap.The causes: 2 cases in traffic accident injury, 4 cases in machine injury;3 cases with traumatic defect, and septic defect in 3 patients.Of the 6 cases, the fibular length with transplantation was 6 cm to 12 cm, and the flap area was 8 cm × 5 cm-18 cm × 16 cm;All the cases were followed-up in 3, 6, 12 months postoperatively to observe the fracture healing, and to assess injured limb function in 1 year postoperatively.Results All cases were followed up 12-24 months, and average of 14 months;All the flaps survived, and the metatarsal bone and fibula healing was good visibly in half a year, The surgery function were assessed according to Maryland's scale, and the excellent were 2 and the good were 4.Conclusion The transplantation of free fibula composite tissue flap to repair the first metatarsal bone with soft tissue defect on foot is a safe and effective strategy, and it has the advantages such as covering the wound at foot approvingly, one-time rebuild repair foot weight bearing area and the surrounding soft tissue defect, shorten the treatment cycle, for small area damage in donor area, and the function postoperative is good, etc.

Objective To summarize the successful experience of three cases of heart-lung transplantations performed in our institute.Methods From July 2003 to August 2012,three patients,with diagnosis of end-stage heart-lung diseases,received heart-lung transplantation in our institute.One case was diagnosed as congenital atrial septal defect,Eisenmanger syndrome,NYHA class Ⅳ; one was dilated cardiomyopathy with moderate/severe pulmonary arterial hypertension,NYHA class Ⅲ-Ⅳ,one was diagnosed as double outlet left ventricle (DOLV) with ventricle septal defect and stenosis of pulmonary artery and its left and right branches,NYHA class Ⅲ-Ⅳ.Donor hearts were preserved with UW solution,donor lungs were preserved with Euro-Collin solution in case one and with low potassium dextran containing prostaglandin E1 in the others.Extensive disinfection and strict scrutiny were implemented postoperatively.Immunosuppressive therapy included administration of zenapax or basiliximab preoperatively,methylprednisolone during the operation,and cyclosporine a/tacrolimus + prednisone + mycophenolate postoperatively.Surgical hemostasis is of great importance,as the total pleural effusion reaches 14 640 ml within 31 days postoperatively in case two.Strict postoperative disinfection and isolation were implemented,and management of the respiratory tract was intensified.Therapeutic bronchoscopy was performed frequently for sputum suction.In case two,bronchoscopy was used thirteen times within 40 days after transplantation.Broad-spectrum antibiotics and antifungal antibiotics were used for infection control.Results All three patients were discharged after recovery from operation.Case one died of obstructive bronchitis and lung failure caused by chronic rejection four years and ten months postoperatively.Case two died of sudden cerebrovascular accident 68 days after operation.Case three survives more than one year postoperatively so far and is still alive.Conclusion Proper preservation of the donor heart and lung,perfect surgical hemostasis,strict infection control,frequent application of bronchoscopy and appropriate immunosuppressive management are critical to the success of heart-lung transplantation.

BACKGROUND:In mass spectrometry analysis, the same protein in different samples labeled with isobaric tags for relative and absolute quantitation presents the same mass-to-charge ratio, while in the tandem mass spectrometry analysis, the ion signal shows different mass-to-charge ratio (114-121). Thus the quantitative information of the related proteins can be obtained. OBJECTIVE:To establish the protein spectrum of spinal cord tissue differences proteins after acute spinal cord injury, and to explore the spinal differential protein expression on the molecular level using isobaric tags for relative and absolute quantitation combined with LC-MS/MS mass spectrometry technique. METHODS:Eight Sprague Dawley rats were selected to establish the acute spinal cord injury models using Al en’s method. The rats were randomly divided into 0 hour spinal cord injury group and 8 hours spinal cord injury group, four rats in each group. The spinal cord tissues were col ected after injury, and the spinal cord tissue differences proteins were analyzed with isobaric tags for relative and absolute quantitation technique after acute spinal cord injury. RESULTS AND CONCLUSION:Total y 220 differential y expressed proteins were identified in this research, the number of up-regulation proteins was 116 and the number of down-regulation proteins was 104. There were 12 differential proteins related to neural regeneration, and among the 12 proteins, there were seven up-regulation proteins and five down-regulation proteins. The various identified differential proteins and significantly expressed nerve growth factors in this experiment can be used as the biomarkers of acute spinal cord injury or used as the strong evidence for the clinical management and monitoring of the injury process and target therapy of acute spinal cord injury, as wel as the effect evaluation.