ObjectiveTo explore the biological features of colorectal adenoma with chicken-skin mucosa ( CSM ) and its clinical significance.MethodsExpression of cell proliferation markers ( Ki-67 and COX-2) and apoptosis-related factors ( survivin and caspase-3) in normal colorectal mucosa,colorectal adenoma without CSM,colorectal adenoma with CSM and colorectal adenocarcinoma were detected by immunohistochemistry SP method and enzyme-linked immunosorbent assay (ELISA).ResultsImmunohistochemical results revealed a decreased trend in expressions of Ki-67 and COX-2 from colorectal adenocarcinoma through colorectal adenoma with and without CSM to normal colorectal mucosa,while the expressions of survivin and caspase-3 showed an increased trend.By ELISA,the expressions of Ki-67,COX-2,surviving and caspase-3 showed no significant difference (P ＞ 0.05 ) between colorectal adenoma with CSM and coloreetal adenocarcima,while these variables were significantly different (P ＜ 0.05) between coloreetal adenoma with and without CSM,so as well between normal colorectal mucosa and other 3 groups.ConclusionThe biological characteristics of colorectal adenoma with CSM are different from those without,showing an activated cell proliferation and inhibited cell apoptosis with increased carcinogenesis risk.

ObjectiveTo evaluate the factors implicated in the diagnosis and treatment of early gastric caner.Methods Fifty Patients early gastric caner with diagnosed from March 2004 to May 2006,were investigated in the study retrospectively.ResultsAll of the patients were diagnosed accurately by the gastroscopy,among which 2 had atrophic gastritis history for 6 or 10 years,respectively.Twenty-four masses were located in gastric pylorus,12 in gastic angular incisure,14 in gastric body.D2 radical mastectomy was performed in 41 cases,and D1 radical mastectomy in 9 cases.In 10 cases the diameter of tumors was ＜1 cm,17 cases 1 -2 cm,14 cases 2-3 cm,9 cases ＞3 cm.Lymph node involvements were observed in five cases ( 10％ ).Follow data were available in 48 cases.Among them,3 died from local recurrence and metastasis at postoperative 10,12,19 months respectively. Conclusions Although endosopic mucosal resection or limited surgical resection is a reasonable treatment for some early gastric caner patients,D2 radical mastectomy is necessary for most early gastric caner patients.

Objective To provide the anatomic basis of flap which was anatomized to the ankle by Anatomy study of vascular net around ankle joint.Methods 32 lower limbs were infiltrated into red emulsion;4 perfusions of lower limbs,artery;2 cases of radiography;1 lower limb was infiltrated into black ink.Application anatomy was observed the origin,track-way,branches and configuration in ankle and foot.Results The blood provision in ankle includes three parts;All the patients recovered well after treatment by careful flap-design.Conclusion The vascular net around anatomy of the ankle can provide help for the design,the choice and the operation of ankle's,tissue flap,and the function's,recovery after surgery.

Objective To investigate the indications, techniques and results of laparoscopic hepatectomy. Methods The clinical data and follow-up results of 463 patients who received laparoscopic hepatectomy at our institute were retrospectively analyzed. Results From March 1, 2007 to March 31, 2011, 463 cases of laparoscopic hepatectomy were successfully carried out. Of the 463 patients,165 were with primary liver cancer, 29 with metastatic liver cancer, 143 with hepatic hemangioma, 81with hepatolithiasis and 45 with other benign liver diseases (including hepatic angiomyolipoma, hepatocellular adenoma, focal nodular hyperplasia and chronic liver abscess). The surgical approaches included laparoscopic left lateral lobectomy (93 cases), left hepatectomy (71 cases), extended left hepatectomy (4 cases), right hepatectomy (29 cases), right posterior lobectomy (24 cases), hepatectomy of segment Ⅵ (56 cases), extended right hepatectomy (2 cases), central hepatectomy (8 cases) and hepatectomy of segments Ⅶ/Ⅷ, Ⅳa, caudate lobe and the junction of segment Ⅵ and Ⅶ (41 case).Nonanntomic and wedge resection were performed on 121 patients, and combined resection on 14 patients. The mean operation time, blood loss, length of hospital stay and incidence of postoperative complications were (244.71 ± 105. 07) minutes, (460. 26±425.81) ml, (15.51 ±4.36) days and 9.29%, respectively. And no operative death occurred. In the 194 cases with malignant liver lesions,185 cases were followed up for 2 to 50 months. The 1 year and 3 year overall and disease free survival rate were 90. 8% and 87.9% , 84.2% and 73. 7% respectively. Conclusions As a means of minimally invasive surgical approach, laparoscopic hepatectomy can be selectively adopted for the treatment of all kinds of liver diseases which located at different parts of the liver, with the advantages of smaller trauma, quick recovery and cosmetic benefits. The short-term results of laparoscopic hepatectomy is superior to and its long-term results is equal to that of open surgery. Benign liver diseases, small hepatocellular carcinoma and metastatic liver cancer are the good indications for laparoscopic hepatectomy.

ObjectiveTo investigate effects of anisodamine on myocardial caspase-1 and interleukin-18 expression following overtraining-induced acute myocardial injury in rats.Methods Forty-eight male Wistar rats weighing 200-220 g were randomly divided into 3 groups:group control (group C,n =8) ; group exhausting swim (group ES,n =24) and group anisodamine (group AD,n =16).The animal model of overtraining-induced acute myocardial injury was developed by exhausting swim The animals were forced to swim until they were exhausted.The animals sank to the bottom and no righting reflex or escape response was elicited when they were taken out of water in groups ES and AD.In group AD anisodamine 10 mg/kg was given intraperitoneally 20 min before overtraining.Blood samples were taken from inferior vena cava immediately (T1) and at 6 and 24 h after overtraining (T2,T3 ) in group ES and at T2,T3 in group AD for determination of serum cardiac troponin 1 (cTnI) concentration (by ELISA).The animals were sacrificed after blood sampling and myocardial specimens were obtained for microscopic examination and determination of caspase-1 and interleukin-18 expression (by immuno-histochemistry).ResultsOvertraining significantly increased serum cTnI concentration and up-regulated myocardial caspase-1 and interleukin-18 expression in group ES as compared with group C.Anisodamine significantly attenuated overtraining-induced increase in serum cTnI concentration and myocardial caspase-1 and interleukin-18 expression in group AD as compared with group ES.ConclusionAnisodamine can reduce overtraining-induced acute myocardial injury by down-regulating caspase-1 and interleukin-18 expression.

Objective To investigate the clinical efficacy of laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach.Methods The clinical data of 68 patients who underwent laparoscopic anatomical hepatectomy by Glissonean pedicle transection approach at the Southwest Hospital of Third Military Medical University between March 2009 and December 2013 were retrospectively analyzed.All the patients received intravenous-inhalation general anesthesia.The splitting of liver was carried out after Glissonean pedicles were completely dissected and occluded under the laparoscope according to anatomical structure.The patients with hepatolithiasis underwent intraoperative bile duct exploration and stone removal with T-tube placement based on the conditions of extrahepatic biliary lesions.The fragmented specimens from benign lesions of liver were taken out through a Trocar hole with the diameter of 12mm.The complete specimens from malignancy tumors of liver were taken out through an enlarged Trocar hole or transverse incision at the symphysis pubis.According to the recheck results of benign and malignancy lesions,the patients were followed up by outpatient examination and telephone interview till September 2014.The measurement data with normal distribution were presented as (x) ± s.The survival curve was drawn by Kaplan-Meier method.Results Among the 68 patients,laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach was performed on 64 patients and 4 patients were coverted to open surgery.Laparoscopic anatomical left hemihepatectomy was performed on 30 patients,anatomical right hemihepatectomy on 19 patients,anatomical right posterior lobectomy on 10 patients and anatomical right anterior lobectomy on 9 patients.The mean operation time,volume of intraoperative blood loss,rate of perioperative blood transfusion,time of postoperative gastrointestinal function recovery and duration of hospital stay were (224 ± 117)minutes,(413 ± 349) mL,5.9％ (4/68),(3.0 ± 0.5) days and (8.0 ± 3.0) days,respectively.There was no perioperative death,and 6 patients with postoperative complication were cured by symptomatic treatment.The tumor diameter and distance to resection margin in 29 patients with malignancy tumors of liver were (4.4 ± 1.6) cm and (2.0 ± 0.9)cm,respectively.The results of pathological examination showed that hepatolithiasis was detected in 22 patients,cavernous hemangioma of liver in 12 patients,hepatic focal nodular hyperplasia in 1 patient,hepatic adenoma in 1 patient,hepatic angiomyolipoma in 1 patient,hepatic multiple cysts in 1 patient,hepatic tuberculosis in 1 patient,hepatocellular carcinoma in 27 patients and cholangiocarcinoma in 2 patients.All the 68 patients were followed up for 6-60 months with a mean time of 24 months.No recurrence and residual stones or lesions in 39 patients with benign lesions of liver were detected during the follow-up.The 1-,3-,5-year overall survival rates and tumor-free survival rates in 29 patients with malignant tumors of liver were 92％,84％,60％ and 83％,59％,42％,respectively.Conclnsion Laparoscopic anatomical hepatectomy via Glissonean pedicle transection approach is safe and feasible,and is suitable not only for left hemihepatectomy,but also for right hemihepatectomy of high technical specification.

BACKGROUND:Cryotherapy plays a positive role in the treatment of delayed-onset muscle soreness caused by high intense exercise. OBJECTIVE: To investigate the effects of different crypotherapy programs on the levels of interleukin-6 and prostaglandin 2 in long distance race-walkers after 15-day training, and to determine a rational treatment program for delayed-onset muscle soreness. METHODS:Sixteen male race-walkers in Liaoning Province were randomly divided into cryotherapy and cryo/heat therapy groups, and received 10-minute cryotherapy and 2.5-minute cryo/heat therapy (2.5-mintue cryotherapy and 2.5-minute heat therapy alternately for 10 minutes), respectively, after 15-day training. The serum levels of interleukin-6 and prostaglandin 2 were detected at six different time points to compare the efficacy between two methods. RESULTS AND CONCLUSION: Compared with the cryo/heat therapy group, the serum levels of interleukin-6 and prostaglandin 2 in the cryotherapy group were significantly decreased. That is to say, cryotherapy is more available for alleviating delayed-onset muscle soreness after intensive eccentric training or in intensive seasons.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy for the treatment of large hepatocellular carcinoma (HCC).Methods From January 2009 to January 2011,84 patients with large hepatocellular carcinoma received laparoscopic hepatectomy at the Southwest Hospital,and their clinical data were retrospectively analyzed.Lesions were located at the left lobe in 12 cases,left lateral lobe in 9 cases,right lobe in 3 cases,right posterior lobe in 11 cases,right anterior lobe in 11 cases,segment Ⅴ in 8 cases,segment Ⅵ in 6 cases,segment Ⅶ in 6 cases,segment Ⅴ/Ⅵ in 8 cases,segment Ⅶ/Ⅷ in 4 cases,segment Ⅳ in 5 cases and segment Ⅰ in 1 case.According to the results of preoperative ultrasonography,the tumor diameter ranged between 5.1-6.0 cm in46 cases,6.1-7.0 cm in 12 cases,7.1-8.0 cm in9 cases,8.1-9.0 cm in7 cases,9.1-10.0 cm in 10 cases.Anatomical or non-anatomical hepatectomy was performed according to the results of preoperative assessment and operative exploration.Abdominal imaging examination and serologic examination were done once every 3 months at postoperative year 1,once every 4 months at postoperative year 2,once every 6 months at postoperative year 3.The follow-up ended in January 2014.The survival rate was calculated by Kaplan-Meier method.Results Eight patients were converted to laparotomy,and the rate of conversion to laparotomy was 9.5％ (8/84).Seventy-six patients received laparoscopic hepatectomy,including 30 patients received anatomical hepatectomy and 54 received non-anatomical hepatectomy.The operation time,volume of blood loss,perioperative blood transfusion rate,tumor diameter,resection margin,time for gastriontestinal function recovery,duration of postoperative hospital stay,incidence of postoperative complications were (240 ± 132) minutes,(432 ± 340) mL,10.7％ (9/84),(6.5±1.5)cm,(1.6±0.9)cm,(3.0±0.5)days,(11 ±3)days and 19.0％(16/84),respectively.All thepatients were comfirmed with HCC including 18 cases of high differentiated HCC,57 cases of moderate differentiated HCC and 9 cases of low differentiated HCC.One patient died perioperatively.Eighty-three patients were followed up for 2-48 months,the median follow-up time was 24 months,and the overall 1-and 3-year survival rates and the 1-and 3-year tumor-free survival rates were 91％,80％,70％ and 56％,respectively.Conclusion Laparoscopic hcpatcctomy is safe and feasible for selected patients with large hepatocellular carcinoma.

KLD-12 peptide with a sequence of AcN-KLDLKLDLKLDL-CNH(2) was synthesized and its biocompatibility was assessed in animals. Rabbit MSCs were cultured in the hydrogel for 2 weeks. Live cells were counted by using Calcein-AM/PI fluorescence staining. MTT was employed to assess the viability of MSCs cultured in KLD-12 peptide solution of 0.01%, 0.03%, and 0.05%. Hemolysis test, skin irritation test and implantation test were conducted to evaluate its biocompatibility with host tissues. Our results demonstrated that the MSCs in hydrogel grew well and maintained round shape. Cell survival rate was 92.15% (mean: 92.15%+/-1.17%) at the 7th day and there was no difference in survival rate between day 7 and day 14. Cell proliferation test showed that the A value of the KLD-12 solutions was not significantly different from that of control groups (complete culture media) (P>0.05) at the 24th and 48th h. The hemolysis rate of KLD-12 solution was 0.112%. Skin irritation test showed that the skin injected with KLD-12 solution remained normal and the score of skin irritation was 0. The histological examination with HE staining exhibited that the skin layers were clear and there was no infiltration with neutrophilic granulocytes and lymphocytes. It is concluded that KLD-12 peptide hydrogel had a good biocompatibility with host rabbit and MSCs, and KLD-12 peptide hydrogel can provide an appropriate microenvironment for MSCs.

Objective To evaluate the safety and feasibility of laparoscopic left hepatectomy in patients with primary hepatic carcinoma. Methods Retrospective analysis was conducted in clinical data of left hepatectomy from 2007 to 2014,including 47 cases of laparoscopic hepatectomy and 46 cases of open hepatectomy. The intraoperative and postoperative data of the two surgical methods were compared to evalu-ate whether laparoscopic left hepatectomy is safe and feasible. Results The tumor size were bigger in the open hepatectomy [(56. 57 ± 24. 56) mm vs. (64. 11 ± 33. 39) mm,P=0. 218]. The laparoscopic left hepatectomy resulted in shorter operation time [(217. 53 ± 60. 22) min vs.(306.80±119.91)min],andtherewasasignificantlydifference(P<0.05).Theintraoperativebloodlosswerelesserinthelaparo-scopic left hepatectomy [(350. 21 ± 197. 98) mL vs. (556. 74 ± 471. 41) mL],and there was a significantly difference (P<0. 05). The lap-aroscopic left hepatectomy had a smaller intraoperative blood transfusion rate (12. 8% vs. 32. 6%,P<0. 05). The length of ICU stay,time for gastroentestinal function recovery, postopetative hospital stay were shorter than those of open left hepatectomy (P<0. 05). There was no significant difference of postoperative complication rate between them (14. 9% vs. 23. 9%,P=0. 271). The survival rates of 1-and 3-year after operation in patients with laparoscopic left hepatectomy were 91. 5% and 83. 0% respectively,while 84. 8% and 76. 1% in patients un-derwent open hepatectomy. The tumor-free survival rates 1-and 3-year after operation were 74. 5% and 59. 6% in patients with laparoscopic left hepatectomy respectively,while 65. 2% and 54. 3% in patients underwent open hepatectomy. Conclusion Laparoscopic left hepatectomy for primary hepatic carcinoma is safe and feasible. Laparoscopic left hepatectomy could be a consideration as the standard surgical methods for hepatic carcinoma.