Images corresponded to the right knee of a 27 years old, healthy, male volunteer, weighing 68 Kg, 175 cm height, with no knee joint disease, were selected. The scanning was performed using 1.5T Twinspeed/Excite magnetic resonance tomography. The image was uninterrupted sagittal planes picture, and the scanning way was from the inside to out. The three-dimensional tibia-femoral joint model was established by the MR1 images after they were handled by correlation analysis software (Mimics10.0, Geomagic Studio 8.0). At last, transformed the model format STL file to IGS file, which can be acceptable by analysis software 11.0. On the base of this way, a highly simulation tibia-femoral model was established. It provides a guarantee for the further finite element analysis concerning checking the surface of femoral condyle cartilage to repair interphalangeal joint injuries. The result demonstrated that 3-D computer model established by using 2-D MRI pictures makes up the CT scanning deficiencies on soft tissue, which confirms the model closer to the real anatomical structure.

Mutation of ras gene family was studied in 206 cases of gastric cancer and precancerous lesions by PCR/RFLP, PCR/SSCP and DNA suquencmg. The results showed: the mutation rates of H-ras 12 codon in metaplasia, atypical dysplasia, early cancer and advanced cancer were 16.7%(6/36), 31.2%(15/48), 50.0% (5/10), 32.2% (20/60), respectively. In the groups of superficial gastritis and normal controls, no mutations were found. Mutations of H-ras 61 codon and N-ras 12 codon in various groups were the same as that of normal controls. Only 2 cases of K-ras 12 codon mutation were detected in gastric cancer group by PCR-SSCP, but it was not identified by DNA sequencing. It might be due to polymorphism. All H-ras 12 codon mutations were of G→T mutation. There were significant differences between groups of metaplasia, dysplasia, gastric carcinoma and normal controls. (P

Objective To compare the anesthetic effect of ropivacaine and bupivacaine in combined spinal-epidural anesthesia(CSEA)for cesarean section,and their influence on the incidence rate of supine hypotension syndrome(SHS).Methods 200 patients with cesarean section surgery in our hospital from February 2016 to July 2016 were randomly divided into observation group and control group,all of cases were given CSEA.100 patients in the observation group(the group L)were given ropivacaine in spinal anesthesia,the other 100 patients in the control group(the group B)were given bupivacane in spinal anesthesia.Recorded the relevant indicators,compared the incidence rate of SHS,the effect of anesthesia and neonatal score.Results The incidence rate of SHS of the group L was lower than the group B(χ2 =9.261,P<0.01).The effect of anesthesia and Apgar score of two groups had no statistically significant differences(all P>0.05).Conclusion The application of ropivacaine in CSEA for cesarean section not only has exact anesthesia effect,but also can effectively prevent SHS without any side effects.

Objective To explore the clinical pathological features of gastric cancer and to provide a basis for research and treatment of gastric cancer.Methods From 2001 to 2004,a total of 694 cases of gastric cancer with radical gastrectomy were collected.Gender,age,tumor location,tumor size,World Health Organization (WHO) histological type and grade,Lauren type,blood/lymphatic vessel invasion,lymph node metastasis,depth of tumor invasion (pT) and pathological TNM staging (pTNM) were retrospectively analyzed.Results Among 694 gastric cancer cases,male to female ratio was 3.96∶ 1; a total of 644 cases (92.8％) were aged from 41 to 70,and cases aged from 51 to 70 had a high incidence of gastric cancer.The predilection site for gastric cancer was cardia (33.43％),antrum (28.96％) and the body (21.76％) accordingly.The common WHO histological types were tubular adenocarcinoma (70.32 ％) and signet ring cell carcinoma (24.50 ％).The common histological grades were Ⅱ,Ⅲ and Ⅰ.The intestinal type was most common in Lauren classification,accounting for 58.93 ％; followed by the diffuse type,accounting for 22.33 ％.Blood/lymphatic vessel invasion was detected in 438 cases (63.11％),lymphnode metastasis in 504 cases (72.62％).A total of 319 cases (45.97％) were pT3 stage,241 cases (34.73％) were on pTNM Ⅲ stage.Conclusions In recent years,cardia and antrum are the predilection sites of gastric cancer.Tubular adenocarcinoma and signet ring cell carcinoma are common which indicate that the mechanism of gastric cancer pathogenesis is varied.

Objective To investigate the risk factors of cerebral microbleeds (CMBs) in patients with acute isch?emic stroke of large-artery atherosclerosis. Methods One hundred twelve patients with acute ischemic stroke of large-ar?tery atherosclerosis admitted from July 2013 to January 2014 in Nanjing First Hospital affiliated to Nanjing Medical Uni?versity were enrolled. According to the results of MRI magnetic sensitive weighted imaging, the patients were divided into CMBs group or non-CMBs group. The history, general clinical data, serum biochemical results and MRI in both groups were enrolled. All the data were analyzed by the univariate and multivariate analysis. Results The results of univariate analysis showed that there were significant differences in age (61.620±11.479 vs. 70.620±11.185), serum uric acid (UA) level (278.920±69.512 vs. 353.460±111.206), serum creatinine (Cr) level (71.360±19.797 vs. 90.450±44.989), serum ho?mocysteine (Hcy) level (12.587±2.664 vs. 21.715±10.437) between the two groups (P<0.05). There were significant differ?ences in constituent ratio of Fazekas' s grade of periventricular hyperintensities and deep white matter hyperintensities between the two groups (P<0.05). The results of multivariate analysis showed that age (OR=0.963, 95%CI:0.905~1.025, P<0.05) and serum Hcy level (OR=1.487, 95%CI:1.219~1.813, P<0.05) were the independent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis. Conclusions Age and serum Hcy level are the inde?pendent risk factors for CMBs in patients with acute ischemic stroke of large-artery atherosclerosis.

Objective To describe the technique, efficacy, and safety of percutaneous interventional therapy for anastomotic biliary strictures after orthotopic liver transplantation (OLT).Methods From May 2004 to December 2009, 25 patients with anastomotic biliary strictures afte OLT were enrolled in our study. The modalities of biliary drainage included external drainage in 22patients, and external-internal drainage in 3 patients who underwent re-transplantation. All patients accepted percutaneous interventional therapy in our hospital, including single PTBD in 4 patients,PTBD combined with balloon dilation in 14 patients, balloon dilation and plastic stent implantation in 5 patients, balloon dilation and metallic stent implantation in 2 patients. The drainage catheters were exchanged every 1 to 3 months. Results The success rate of PTBD was 100%. Of the all 25patients, 15 (60 %) patients were cured, and 10 (40 %) patients were improved. The effective rate was 100 %. The drainage catheters failed to pass through the narrow bile duct when initial PTBD in 7 patients, and success was achieved in 3 patients by operation again after biliary drainage for one week.In the other 4 patients, anastomotic bile ducts were occluded, which was confirmed by cholangiography after biliary drainage for 4 to 8 weeks. The rate of biliary tract infection was 24 % (6/25). No serious procedure-related complications occurred in the all 25 patients. Conclusion PTBD combined with balloon dilation and biliary stenting is a effective and safe therapeutic modality for anastomotic biliary strictures after OLT, which can improve the patients' clinical symptoms and elevate patients' quality of life. To avoid bile duct occlusion, the drainage catheters should be passed through the narrow segments of bile duct when initial PTBD.

OBJECTIVETo investigate the evaluation of lymphatic emboli by D2-40/CKpan dual immunostain and its prognostic significance in advanced primary gastric adenocarcinoma.

METHODSTissue samples of 108 cases of advanced gastric adenocarcinoma with radical gastrectomy were collected from Chinese PLA General Hospital in 2001. Lymphatic emboli were evaluated by D2-40/CKpan dual immunostain on consecutive sections, and compared with routine HE staining. The correlation of lymphatic emboli with lymph node metastasis and overall survival was analyzed by Pearson Chi-squared test and univariate survival analysis, respectively.

RESULTSLymphatic emboli were detected in 73/108 (67.6%) cases by D2-40/CKpan staining, compared to 57/108 (52.8%) by HE staining. There was significant difference (P=0.007). Lymphatic emboli on HE staining revealed false negative in 24/108 cases and false positive in 8/108 cases. A significant correlation was found between lymphatic emboli and lymph node metastasis on HE staining (P=0.024), while it was not found on D2-40/CKpan staining (P=0.422). The overall survival rate was significantly different between lymphatic emboli positive and negative cases on HE staining (P=0.043). The overall survival rate was lower in lymphatic emboli positive cases on HE staining. Lymphatic emboli evaluated on D2-40/CKpan staining had no prognostic value (P=0.402).

CONCLUSIOND2-40/Ckpan dual immunostaining is more sensitive for lymphatic emboli in gastric adenocarcinoma but may not predict lymph node metastasis and survival, while HE staining may.

Objective To investigate the effect of candesartan cilexetil on rotenone-induced Parkinson's disease (PD) in rats.Methods Forty 10-week-old male Lewis rats were chosen in our study and equally randomized into control group,rotenone group,rotenone+candesartan cilexetil group and candesartan cilexetil group (n=10); rotenone (2.5-3.0 mg/[kg· d]) was given for 4 weeks to the rats of rotenone group and rotenone+candesartan cilexetil group by subcutaneous osmotic minipumps implantation under the back; rats in the rotenone+candesartan cilexetil group and candesartan cilexetil group were orally administered candesartan cilexetil.Neurological behavioral measurements were performed to evaluate the motor features; tyrosine hydroxylase (TH) and α-synuclein immunoreactivities in the substantia nigra pars compacta (SNc) were observed.Protein level of α-synuclein was determined by Westem blotting.Results The weight of rats in the rotenone group reduced to (297.3±12.2) g,with significant difference as compared with that of the other three groups (P＜0.05); decreased TH immunoreactivity (377.0±41.6) cells/mm2) and increased α-synuclein immunoreactivity (0.75±0.02) in the SNc of rats in the rotenone group was noted,enjoying significant differences as compared with the other three groups (P＜0.05); these values in the rotenone+candesartan cilexetil group were (337.2±26.3) g,(639.7±46.0) cells/mm2 and 0.57±0.01,respectively (P＜0.05).Western blotting confirmed that rotenone up-regulated the expression ofα-synuclein in the SNc,and candesartan ceilexetil markedly attenuated the increase (P＜0.05).Conclusion Candesartan cilexetil can protect rotenone-induced PD in rats through decreasing TH-positive cell apoptosis and α-synuclein deposition.

Objective To investigate the efficacy and safety of percutanous transhepatic intrahepatic portosystemic shunt(PTIPS)for chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension.Methods The clinical and imaging data of 38 patients with chronic portal vein occlusion and cavernous transformation with symptomatic portal hypertension, who received PTIPS in our hospital from November 2009 to June 2016,were analyzed retrospectively.The differences of the portosystemic pressure gradient(PPG)measured before and after PTIPS procedure was analyzed by a paired samples t-test. All the patients were followed up and the curative effect and operation-correlated complications were observed.Results The PTIPS procedure was technically successful in 36 patients.The other two patients with unsuccessful PTIPS underwent medical treatment,and one of them died of recurrent variceal bleeding 25 months later. Effective portal decompression and free antegrade shunt flow were achieved in 36 patients with successful PTIPS.And the mean PPG was decreased from(25.2±2.9)to(13.2± 1.3) mmHg (1 mmHg=0.133 kPa) before and after PTIPS respectively and the difference was statistically significant(P<0.05).During the procedure,arterial hemorrhage occurred in two patients who subsequently underwent embolization. Biliary injury occurred in one case and percutanous transhepatic biliary drainage (PTBD)was then performed.The mean follow-up period of the 36 patients was(26.7±10.4)months(range from 3.0 to 74.0 months).Hepatic encephalopathy appeared in 4 cases,among which,3 patients recovered after receiving medical treatment, while 1 patient experienced Grade 3 hepatic encephalopathy and recovered after implanting a smaller cover-stent.Shunt dysfunction occurred in 10 cases,of which 8 cases recovered after shunt revision with stent implantation or ballon angioplasty, while 2 cases underwent anticoagulation by warfarin only. During follow-up period, 7 patients died of liver failure(n=4), hepatic cellular carcinoma(n=1), recurrent varicose vein bleeding(n=1), and renal failure(n=1). The other patients remained asymptomatic and shunt patency. Conclusions PTIPS is both safe and effective for the treatment of symptomatic portal hypertension caused by chronic portal vein occlusion and cavernous transformation.The technical success rate is high,and the short-term curative effect is satisfied.

Objective: To analyze the efficacy of branches portal vein embolization (TBPVE) combined with transcatheter arterial chemoembolization (TACE) on liver neoplasms. Methods: From August 2016 to May 2017, there were 13 patients including 11 males and 2 females with primary hepatocellular carcinoma who underwent TBPVE+ TACE , among whom there were 11 cases with a history of HBV infection.Average age of the 13 patients was (60.8±6.2)years. The live function of all patients were Child-Pugh A classification.The CT or MRI images of each patient was reconstructed and the standard liver volume(SLV) before TBPVE+ TACE was (1 181.2±49.3)ml, estimated future liver remnant(FLR) was (326.1±72.1)ml and FLR/SLV was (27.6±6.0)%.The puncture site for TBPVE was determined by the three-dimensional reconstruction of portal vein.CT scan or MRI, AFP and liver function test were repeated after one and two weeks after TBPVE+ TACE.FLR and FLR/SLV were calculated respectively.Hepatectomy would be performed if the patients agreed.The postoperative complications were analyzed. Results: On the 7^thday after TBPVE+ TACE, the FLR/SLV was(42.6±8.0)% and the FLR increasement was(56.0±24.6)%.The level of AFP decreased from(87.9±81.8)μg/L to (29.7±20.9)μg/L.On the 14^thday after TBPVE+ TACE, the FLR/SLV was(45.8±6.2)% and the FLR increasement was(71.8±29.0)%.Four patients underwent surgery which including 2 right hepatectomies and 2 right trisegmentectomies in 2 weeks after TBPVE+ TACE.Nine patients were performed with targeting intratumoral lactic acidosis TACE (TILA-TACE). No severe complication occurred in all patients. Conclusions TBPVE could induce a rapid growth of the liver remnant but still with the concern of inducing the growth of neoplasms at the same time.To combine TACE in TBPVE therapy not also can the growth of neoplasms be prevented but also inducing its shrinking.This method might be a new mode for the treatment of hepatocellular carcinoma.