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 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 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 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 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.

Antitumor effects of erythromycin and the related mechanism were investigated in the present study. Neuroblastoma cells (SH-SY5Y) were exposed to erythromycin at different concentrations for different durations. Cell proliferation was measured by cell counting, and cell viability was examined by MTT assay. Cell cycle phase distribution and the cytosolic calcium level were detected by flow cytometry. Mitochondrial membrane potential was measured by the JC-1 probe staining and fluorescent microscopy. The expression of an oncogene (c-Myc) and a tumor suppressor [p21 (WAF1/Cip1)] proteins was analyzed by using Western blotting. Erythromycin could inhibit the proliferation of SH-SY5Y cells in a concentration- and time-dependent manner. The cell cycle was arrested at S phase. Mitochondrial membrane potential collapsed and the cytosolic calcium was overloaded in SH-SY5Y cells when treated with erythromycin. The expression of c-Myc protein was down-regulated, while that of p21 (WAF1/Cip1) protein was up-regulated. It was concluded that erythromycin could restrain the proliferation of SH-SY5Y cells. The antitumor mechanism of erythromycin might involve regulating the expression of c-Myc and p21 (WAF1/Cip1) proteins.

Objective To evaluate the value of T2WI scores for diagnosis and differential diagnosis of transition zone prostate cancer(PCa).Methods T2WI of 43 cases of transition zone PCa and 91 cases of benign prostatic hyperplasia(BPH) were analyzed retrospectively.Transition zone T2WI signs were divided into the main signs and the secondary signs, which were given different scores and were evaluated separately by receiver operating characteristic (ROC) curve for their diagnostic value.Results In a total of 11 scores sections (-1-10), as the increase of scores, the sensitivity of transition zone PCa was decreased while the specificity and positive predictive value were both increased.According to the ROC curve, when the critical value of scores≥4.5, the sensitivity, specificity, negative predictive value, and the accuracy were 81%,73.3%,90.9%,70.4% respectively.When the scores ≥8.5,the specificity and positive predictive value were both 100%.When the scores ≥0.5 and ≥1.5,the negative predictive value were 100%.Conclusion T2WI scores can quantitatively analyze the transition zone PCa,which has an important value to improve the clinical diagnosis and guide treatment.

Objective To explore the way and the effect of surgical treatment of primary hepatic carcinoma with diaphragmatic invasion.Method Clinical data of 37 primary hepatic carcinoma patients with diaphragmatic muscle invasion undergoing enbloc liver resection in Anhui Provincial Hospital between January 2008 and January 2014 were retrospectively analyzed.Control group comprised 54 liver cancer patients without diaphragm involvement.Results All cases underwent surgery successfully,no significant statistical differences were found between pre-operation clinical data of two groups.The operation time of the group with diaphragmatic invasion is slightly longer than that of the group without (149.4 ± 23.4 min vs 137.9 ±24.6 min,t =2.228,P =0.028);meanwhile,there was no obvious difference between blood loss of the two groups (449.5 ±304.1 ml vs 304.1 ±222.3 ml,t =0.678,P =0.499).There were no significantly statistical differences in other aspects between the two groups such as postoperative pulmonary infection,pleural effusion,infection of the incision,mortality and hospitalization time.Based on Kaplan Meier-log-rank test analysis,it is found that the two groups had no significant differences in disease-free survival and overall survival (P1 =0.982,P2 =0.906).Conclusions Hepatic carcinoma patients with diaphragmatic invasion are still indicated for liver resection with a favorable prognosis.