There are many kinds of diseases in hepatic surgery department including hepatitis,hepatic cirrhosis, liver cancer etl. Most of them are very ditficult to diagnose and treat, so it's necessary to change our traditional clinical practice teaching mode.Role-playing mode increases the interaction between students and teachers, which can achieve the desired effect with entertainment. So role-playing is a new model of clinical teaching as a meaningful innovation.

Objective To investigate the correlation between lipoprotein-associated phospholipase A2 (Lp-PLA2) gene R92H polymorphism and ischemic stroke and its subtype in a Chinese Han population of Shandong province. Methods A total of 386 patients w ith first-ever ischemic stroke and 368 healthy controls in China Shandong region w ere enrol ed. According to the TOAST criteria, the patients w ere further divided into large artery atherosclerosis (LAA) and smal artery occlusion (SAO). Enzyme linked immunosorbent assay w as used to detect the serum Lp-PLA2 level. Polymerase chain reaction and directly sequencing w ere used to detect R92H gene polymorphism. Results The serum Lp-PLA2 levels in the ischemic stroke group, LAA group and SAO group w ere higher than that in the control group, and there w ere significant differences (al P<0.01). The distribution frequencies of GA (P=0.006), AA (P=0.020), AA+AG (P=0.009), and A al ele (P=0.001) in the ischemic stroke group w ere significant higher than those in the control group. There w ere also significant differences in distribution frequencies of GA+AA genotype (P=0.007) and A al ele (P<0.001) betw een the LAA group and the control group, w hile the SAO group w as not the case. Multivariate logistic regression analysis showed that GA+ AA genotype (odds ratio [OR] 1.43, 95%confidence interval [CI] 1.02-2.00; P=0.029), GA genotype (OR 1.42, 95%CI 1.01-2.00; P=0.037), and A alele (OR 1.44, 95%CI 1.11-2.18; P=0.028) were the independent risk factors for ischemic stroke. GA+AA genotype (OR 1.73, 95%CI 1.18-2.55; P<0.001) and GA genotype (OR 1.67, 95%CI 1.13-2.48; P<0.001) w ere the independent risk factors for LAA, and they w ere not significantly independent correlated w ith SAO. Conclusions The serum Lp-PLA2 levels increased in patients w ith ischemic stroke, and they increased most significantly in the LAA group. The R92H gene polymorphism might be associated w ith the susceptibility of ischemic stroke in a Chinese Han population of Shandong province.

Objective To explore the angiogensis in epithelial ovarian neoplasms and the relationship among angiogenesis and clinical stage, the histological type and pathological grade of epithelial ovarian carcinomas. Methods The microvessel density (MVD) was examined in 74 cases of epithelial ovarian neoplasm and 20 nomal samples by using immunohistochemical SP method. Results MVD increased gradually from benign to borderline malignancy and ovarian carcinomas, and MVD there was a significant difference in between the borderline malignancies and benign tumors or normal tissues(P

Objective To study the pathologenesis and to evaluate an operative method of blepharochalasis. Methods A double eyelid-fold incision was made. The lacrimal glands were found and repositioned into lacrimal glands fossa behind superolateral orbital rim. Then redundant skin and muscles as well as hernia septal fat were removed. Results Twenty-three patients were successfully treated by the mentioned methods from 1998 to 2002. A good clinical results in both function and appearance were achieved. Conclusion It is convenient and effective to treat blepharochalasis through a double eyelid fold incision.

Objective To investigate the therapeutic effects of botulinum toxin type A injection and acupuncture on periorbital wrinkles.Methods From May to September in 2015,24 patents were randomly divided into experimental and control group according to random number table:the patients in experimental group were treated with disposable acupuncture needles,20 min for each treatment,once a day,five times each course for courses,2 days interval between the two courses;the patients in control group were treated with 20 units of hotulinum toxin type A injection.The therapeutic results were observed 2 weeks after the treatment by the third-party doctor according to skin wrinkles grading.Results The periorbital wrinkles in both groups improved remarkably,and the wrinkle grading in control group was significantly lower than that in the experimental group (0.67±0.67 vs 1.33±0.61,P＜0.05).The skin quality and facial expression sensation in the experimental group improved significantly when compared with those in the control group.Conclusions Acupuncture can be used as a complementary treatment of periorbital wrinkles,and it improves the skin quality in terms of elasticity and color and keeps the natural facial expression sensation.

Objective To investigate the memory monitoring ability in patients with hepatolenticular degeneration(HLD) and explore the mechanism of their memory impairment.Methods The feeling-of-knowing (FOK) paradigm of episodic memory(EM) and semantic memory(SM)were established and subsequently applied to 30 HLD patients and 30 healthy control(HC) participants who were matched in age and educational level.Results Compared with healthy control group (FOK-EM recall (64.17 ± 29.21) ％ ; FOK-SM recall (84.72 ± 11.44)％),the FOK-EM recall((26.55±20.92)％) and FOK-SM recall((53.93±28.42)％) in HLD patients were significantly lower(t=-5.140,P＜0.01 ; t=-5.123,P＜0.01).The positive judgment and correct recognition of FOK-EM ((50.64±29.43) ％) and the negative judgment and correct recognition of FOK-EM((12.80± 18.32) ％) in the HLD group were significantly different from the HC group (the positive judgment and correct recognition of FOK-EM:(75.15±31.73)％ and the false judgment and correct recognition of FOK-EM:(1.81±5.41)％; t=-2.693,P＜0.05 ; t=3.026,P＜0.01).Most importantly,the stroop effect was positively correlated with the negative judgment and correct recognition of FOK-EM in HLD group(r=0.601,P＜0.01).Conclusion The results show that the HLD group underestimate their memory performance on episodic FOK,and the impairment of memory monitoring is positively correlated with the deficit of executive function,indicating that the prefrontal impairment can be an influential factor of memory disorder in HLD,whereas the unimpaired semantic metamemory FOK indicates the episodic and semantic metamemory monitoring may depend on different neural network.

OBJECTIVE:To observe clinical efficacy and safety of capecitabine and tegafur gimeracil and oteracil potassium synchronous radiotherapy in the treatment of recurrence after radical resection of colon cancer. METHODS:A total of 150 patients with recurrent after radical resection of colon cancer in our hospital during Jan. 2012-Dec. 2012 were divided into group A and B ac-cording to random number table,with 75 cases in each group. Both groups received three-dimensional conformal radiotherapy. Group A was additionally given capecitabine 2.5 g. Group B was additionally given tegafur gimeracil and oteracil potassium,40 mg,bid for body surface area <1.25 m2,50 mg,bid for body surface area ranged 1.25-1.50 m2 and60mg,bid for body surface ar-ea<1.50 m2. Clinical efficacies of 2 groups were compared;1-year,2-year,3-year survival andⅢ-Ⅳdegree toxic effect were fol-lowed up. RESULTS:The total response rate of group B was 86.67％,which was significantly higher than 66.67％ of group A, with statistical significance(P<0.05). 1-year,2-year,3-year survival rates of group B were 93.335,72.00％,58.67％,which was significantly higher than 74.67％,53.33％,41.33％,with statistical significance(P<0.05). The median disease progression time of group A was 8.0 months,which was significantly shorter than 9.5 months of group B,with statistical significance (P<0.05). There was no statistical significance in Ⅲ-Ⅳ degree toxic effect between 2 groups (P<0.05). CONCLUSIONS:Compared with capecitabine,tegafur gimeracil and oteracil potassium combined with three-dimensional conformal radiotherapy show significant therapeutic efficacy for recurrence after radical resection of colon cancer,can control disease progression,prolong the survival time and don't increase the risk of toxic effects.

Objective To investegate the effect of phosphorylated-P38 MAPK(mitogen-activated protein kinase) on the expression of caspase-3 in the substania nigra (SN) of MPTP-induced mouse model of(PD). Methods Mice were randomly divided into MPTP model group, which were treated with MPTP and inhibitor group. Once a day for 5 days; control group was treated with saline and DMSO as much as the model group received per day for 5 days. The behavioral were observed, immunohistochemistry and Western blot for TH, caspase-3 and phosphorylation of P38 MAPK were used to observe the change of positive cell number and the expression level in the SN of midbrain. Results Compared with the mice in control group, the model group showed typical symtoms of PD with decreased numbers of TH-positive neurons and the protein level of TH in SN of the midbrain by about 60% and 65% respec-tively(P<0.01) , the numbers of caspase-3 and phosphorylation of P38 MAPK immunoreactive cells and their protein level in the SN of the midbrain increased markedly (P<0.01). After giving SB203580, the above changes were reduced obviously (P <0. 01). Conclusion In the mouse model of subacute Parkinson's disease induced by MPTP, phosphorylated-P38 MAPK regulated caspase-3 in the SN of midbrain, the specific P38 MAPK inhibitor SB203580 is neurologically oprotective to the mouse model.

Objective To investigate the expressions of extracellular matrix protein 1 (ECM1)and matrix metalloproteinase-9 (MMP-9) in hepatocellular carcinoma (HCC) and to explore their correlations with metastasis and recurrence.Methods Immunohistochemisty was employed to determine the expressions of ECM1 and MMP-9 in 120 HCC and 17 normal liver tissues.Results The positive rates of ECM1 and MMP-9 expression in HCC tissues were 73.3％ (88/120) and 65.0％ (78/120),respectively.They were significantly higher than that in normal liver tissues.The expression of ECM1 in HCC tissues was significantly correlated with vascular invasion and TNM stage.The expression of MMP-9 in HCC tissues was significantly correlated with tumor size,number of tumor nodules,differentiation of tumor and degree of cirrhosis.They were not correlated with age,gender,serum AFP level,HBsAg,Child-Pugh class and capsulated tumor.Patients with ECM1 and MMP-9 positivity had significantly poorer overall and disease-free survival rates.There was a significant positive correlation between ECM1 and MMP-9 (r=0.585,P＜0.001).Conclusion Both ECM1 and MMP-9 were significantly related to invasion and metastasis.Over-expression of both ECM1 and MMP-9 had predictive values for prognosis and recurrence of HCC after surgery.

Objective To observe vasculogenic mimicry formation difference in human hepatocellular carcinoma cell lines MHCC97-H/L with different metastatic potentials under three-dimensional culture condition,and to study extracellular matrix and adhesion molecules-related mechanism of vasculogenic mimicry.Methods Three-dimensional cell culture system of MHCC97-H/L was established to observe tubelike structures by inverted microscope.Human umbilical vein endothelial cell(HUVEC),human hepatocellular carcinoma cell line Hep3B with non-metastatic potentials and normal human hepatic cell line HL-7702 were taken as control.Gene expression profiles of MHCC97-H and MHCC97-L were detected by Oligo extracellular matrix and adhesion molecules microarray analysis.Two differentially expressed genes were verified with semi-quantitative reverse transcriptionpolymerase chain reaction(RT-PCR)and Western blot.All data were analyzed using two sample t test.Results After a 24-hour three-dimensional culture,the length of tubelike structures was(474 ± 16)mm/cm2 in MHCC97-H,which were significantly longer than(320 ±41)mm/cm2 in MHCC97-L(t =6.119,P ＜0.05).Hep3B and HL-7702 could not form tubelike structures.Compared with MHCC97-L,the expression of 7 genes were up-regulated and the expression of 3 genes were down-regulated among a total of 113 angiogenesis genes in MHCC97-H.Two of the genes with differential expressions including tenascin C and extracellular matrix protein 1 were further validated by RT-PCR and Western blot.Conclusion MHCC97-H has stronger ability to form vasculogenic mimicry than MHCC97-L,and this perhaps correlates with the differential expression of certain extracellular matrix and adhesion molecules-related genes in MHCC97-H.