Objective To improve the diagnostic rate of laparoscopy for malignant peritoneal mesothelioma (MPM) and enhance acquaintance with this disease. Methods The appearance of laparoscopic detection was retrospectively analysed in 25 patients with pathologically proved MPM. Results Hyperemia, edema and faint vascular net in parietal peritoneum were seen in all patients, and the thick or thin callus-like thickened parietal peritoneum was also observed. There were some grey nodes of various size, distribution and number in parietal and visceral peritoneum in all patients. The purplish red masses with hyperemia and edema were seen in abdominal cavity in 21 patients (21/25,84%). Several small masses cold be connected each other to become one big mass. All patients had yellow turbid or bloody ascites. Conclusion MPM had special characteristics under laparoscopy. Laparoscopic detection possesses the advantages of safety, little trauma, less hurt and high diagnostic rate. Laparoscopic detection and biopsy may be the best method for diagnosis of MPM.

Objective To evaluate the preoperative diagnosis and treatment of primary duodenal adenocarcinoma ( PDA). Methods Clinical data of 89 PDA cases undergoing laparotomy from 1985 to 2009 in three hospital in Beijing and Zhengzhou were analyzed retrospectively. Results The prevalence rate of PDA is comparatively low and its clinical manifestations are not specific. The correct diagnostic rate of auxiliary examination were 93% by endoscopy,90% by gastrointestinal X-ray air barium double radiography,82% by MRCP,42% by BUS,70% by CT/MRI. The most common location of the adenocarcinoma(65% ) was at the second portion of the duodenum. Among 67 PDA cases 48 cases underwent pancreatoduodenectomy, 19 cases received segmental deodenectomy. The 5 year's survival rate was 47% and 50% respectively. Conclusions Endoscope and X-ray radiography are mainstays for the diagnosis of PDA. Early diagnosis and radical operation are the key to improve the resection rate and the long term survival.

Case teaching has evident characteristics compared with traditional theory teaching. This article expound the purpose,significance,teaching process and the noticeable problems of case teaching in medicaI ethics teaching.

Objective To investigate the risk factors of central lymph node metastasis and significance of prophylactic central lymph node dissection for clinical N0 (cN0) patients with papillary thyroid carcinoma (PTC).Methods The clinical data of 315 patients with cN0 PTC in Department of General surgery,the Second Affiliated Hospital of Dalian Medical University from Jan.2012 to Jan.2014 were analyzed retrospectively.Results (Iumor size,infiltration of thyroid capsule,and tumor number were associated with central lymph node metastasis in patients with cN0 PTC(P＜0.05),and the high risk factors of central lymph node metastasis were infiltration of thyroid capsule and multiple lesions (P＜0.05);()The overall complication rate was 3.17％ (10/315),the rate of transient recurrent laryngeal nerve paralysis was 0.63％ (2/315),and the rate of transient hypoparathyroidism was 2.54％ (8/315).All patients with complications recovered after treatment.No patient developed permanent recurrent laryngeal nerve paralysis or hypoparathyroidism;()The follow-up time was 6 to 30 months,and 2 cases were lost.No patient developed local tumor recurrence,distant metastasis,or death.Conclusions The high risk factors of central lymph node metastasis in patients with cN0 PTC were infiltration of thyroid capsule and multiple lesions.No patient developed local tumor recurrence,distant metastasis,or death.It is preferable and necessary to perform prophylactic central lymph node dissection in patients with cN0 PTC.

Some questions like the hardship of treatment and lacking of standard on diagnosis are existing in steroid-resistant nephritic syndrome(SRNS).This article make an ethical analysis on these questions and assumes that we should persist in treating the patients carefully with humanism,carry on informed consent principle,implement the optimal treatment and perfect the standard of diagnosis and treatment,carry on clinical ethics education and promote the judgment level of clinical ethics.

Objective To investigate the significance of non-bronchial systemic collaterals (NBSCs) in supplying bronchial hemoptysic lesions,and to study the morphological features of bronchial artery (BA) when NBSCs become the predominant supplying vessels. Methods Multi-slice helical CT angiographic findings in 124 patients with bronchial hemoptysis were retrospectively analyzed. 3D reconstruction of thoracic systemic arteries,including BAs and NBSCs,was performed at the console work station with the help of real-time thin-slice enhanced helical CT scanning. The number of NBSCs and BAs was calculated,and the internal diameter of the arteries and the thickness of pleura in the vicinity of the pulmonary lesion were measured. According to the presence or absence of NBSCs,the patients were divided into NBSCs group and non-NBSCs group. The relevant data was statistically analyzed. Results NBSCs group included 36 cases,the mean internal diameter of BA was (1.850 ? 0.631)mm and the pleura adjacent to the pulmonary lesion was obviously thickened in 22 cases (61%) with a thickness of 2.7-16.0 mm [mean(7.71 ? 4.12) mm]. In the non-NBSCs group (n = 88),the mean internal diameter of BA was (2.200 ? 0.528) mm and the pleura adjacent to the pulmonary lesion was obviously thickened in 7 cases (8%) with a thickness of 1.1-2.4 mm [mean(1.7 ?0.53) mm]. The differences in both internal diameter of BA and the thickness of lesion's adjacent pleura between two groups were statistically significant (P

Objective To develop a new-type animal dental stent for the experiment of canine pulp regeneration.Methods The stent was composed of an upper support frame,an oral limit bracket and a lower support frame,which were aligned from top to bottom.A sleeve joint was made for the connection structure of the bracket,and the height and the width both could be adjusted to adapt to different animals' mouths.The rubber dam could be spread into tension and concave form by rotating the upper and lower support frames' ends.Results By resizing the animal dental stent based on the structure of animal facies maxillaris,medical staffs could proceed the examination and treatment to animals effectively,including the throat examination,oral examination,oral care,dental treatment (such as root canal therapy and dental filling) and other medical behaviors.Conclusion The experimental result shows the feasibility of utilizing the stent in the process of animal experiment or diagnosis and treatment.Moreover,the stent proves the capacity in protecting the soft tissue,widening the vision of operation field,getting rid of the saliva contamination,which is worthy popularizing in animal experiments and animal medical care.

[ ABSTRACT] AIM:To establish an animal model of rheumatoid arthritis ( RA) in DBA/1 mice induced by im-munodominant mixed peptides derived from glucose-6-phosphate isomerase (GPI).METHODS: The DBA/1 mice were immunized with emulsified mixed peptide fragments of hGPI 325-339+hGPI469-483 or single peptide hGPI325-339 in com-plete Freund′s adjuvant by subcutaneous injection to induce the model of RA .Body weight , ankle joint symptom scores , the pathological change of the ankle joint , the levels of CD4 +T cells in the spleen and peripheral blood , the proportion of iNKT cells in the peripheral blood , and the levels of TNF-αand IL-6 in serum were detected to evaluate and analyze the model.RESULTS:The hind paw of the model mice appeared red swelling on the 8th day, and then aggravated gradually to the limbs.The red swelling reached peak on the 14th day, and then relieved gradually .Inflammation response dominated by lymphocytes and monocytes was observed in the ankle joint .The inflammatory effect of mixed peptides was more obvious than that of the single one (P<0.05).Compared with control group and the mice treated with single peptide , the weight gain was slow, the amount of CD4 +T cells in the peripheral blood and spleen were increased , the proportion of peripheral iNKT cells in the inflammatory peak was decreased (P<0.05), and the serum level of TNF-αwas increased significantly ( P<0.05) in the mice treated with mixed peptide fragments .CONCLUSION: The immunological characteristics of RA model induced by mixed GPI peptides in DBA/1 mice is closer to that in RA patients , especially in the immunopathology of iNKT cells.Therefore, this model can be used as a new tool for studying the mechanism and immunological intervention of RA.

Objective To discuss the effect of selenoprotein P (SeP) on occurring and developing of colorectal cancer and its clinical significance by detecting the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues.Methods Tissue microarray was constructed, the expression of SeP in adjacent mucosa of colorectal cancer, and in the cancer, metastatic lymph node and metastasis hepatic tissues were detected by means of immunohistochemistry.Results The positive rate of SeP were 48.4%,69.5%,66.7% and 61.5% in adjacent mucosa, tumor cell, lymph node metastasis and hepatic metastasis. The expression of adjacent mucosa was significantly lower than that in other three sites(?2=16.53,P

The incorporation of site-specific recombination systems can help to overcome bottlenecks in livestock transgenic technology. For evaluating the efficiency of Cre/lox mediated DNA recombination in embryos and somatic cells, a working model was established using rat mammary carcinoma cell line SHZ-88, aimed at creation of and use repeatedly of selected "friendly loci" in transgenic livestock. An integration vector pTE-lox2272-DsRed-loxP-GFP-loxP, which red fluorescence gene DsRed served as the first target gene and green fluorescence gene GFP as marker gene, was constructed for introduction of acceptor loci in genome. At the same time a replacement vector pT-lox2272-neo-loxP in which Neo coding sequence served as the second target gene was also constructed for replacing DsRed gene. Transgenic cell clones were produced by electroporating SHZ-88 cell with the integration vector. Cells from three transgenic clones selected randomly were further amplified and were then co-electroporated with the replacement vector as well as cre gene. Analysis of the expression patterns of DsRed and GFP indicated that among the 1 070 cell colonies the efficiency on marker GFP deletion was 91.1% and the efficiency on gene replacement was 29.3%. Molecular analysis by PCR and Southern blotting confirmed that the color patterns as expressed by cell colonies could represent the actual molecular events. This working model mediated by Cre/lox system should be useful for the improvement of the present animal transgenic technology.