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Objective To investigate the detection of monocyte chemotactic protein 1 (MCP-1),macrophage stimulating protein (MSP) and carcinoembryonic antigen (CEA) in differential diagnosis of pulmonary tuberculosis and lung cancer.Methods Thirty four patients with pulmonary tuberculosis,45 patients with pathologically confirmed lung cancer admitted in Quzhou People' s Hospital during December 2009 and December 2011,and 30 healthy controls were enrolled in the study.MCP-1 and MSP in serum and pleural effusion were determined by enzyme linked immunosorbent assay (ELISA),and CEA was detected by chemiluminescence method.Receiver operating characteristic method was used to determine the cut-off values of MCP-1,MSP and CEA in diagnosis of pulmonary tuberculosis or lung cancer.Results Serum MCP-1,MSP and CEA levels in pulmonary tuberculosis patients and lung cancer patients were higher than those in healthy controls.Compared with lung cancer patients,patients with pulmonary tuberculosis had higher serum MCP-1 and lower CEA levels (t =2.69 and 0.89,P ＜ 0.05),but there was no significant difference in serum MSP levels between two groups (t =2.89,P ＞ 0.05).While in pleural effusion,patients with pulmonary tuberculosis had higher MCP-1 level (t =3.54,P ＜ 0.05),lower MSP and CEA levels than those with lung cancer (t =3.47 and 3.48,P ＜ 0.05).Serum MCP-1 level was of the highest specificity (95.6％) with the cut-off value of 240 pg/mL in diagnosis of pulmonary tuberculosis,while MSP level in pleural effusion was of the highest specificity (94.1％) with the cut-off value of 1100 pg/mL in diagnosis of lung cancer.Conclusion Detection of MCP-1,MSP and CEA in serum and pleural effusion can be used for the differential diagnosis of pulmonary tuberculosis and lung cancer.

Immobilization conditions of Candida tropicalis to be absorbed in polyurethane foam carrier materials were studied on the xylitol production from corn hemicellulosic hydrolysate. Optimum batch-fermentation conditions were as follows: inoculum amount, 7% (volume ratio); polyurethane foam quantity, 1.0 g/100 mL; 30?C; initial pH, 6.0. Shaking speed was divided into two-phase to accommodate the dissolved oxygen, with 200 r/min at 0~24 h and 150 r/min at 24 h~46 h. The immobilized cells on polyurethane foam carrier have high density and good resistance to inhibitors in the hydrolysates. Average xylitol yield and volumetric productivity of polyurethane foam immobilized fermentation were much higher than the fermentation without immobilization. Corn cob hydrolysates can be directly biotransformed to xylitol without decoloration or ion-exchange treatment. This process can effectively reduce production costs, and it shows broad prospects of applications. Average xylitol yield was 67.6% and xylitol volumetric productivity was 1.92 g/(L?h).

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.

ObjectiveTo investigate the effect of isoflurane anesthesia on plasma cortisol,and brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF) in hippocampus in rots.MethodsThirty-six adult male SD rots,aged 10 weeks,weighing 250-280 g,were randomly assigned into 6 groups:control group (group C,n =6) and O2 group (group O,n =6),isoflurane group (group Ⅰ,n =24).The rats were exposed to 2％ isoflurane for 2 h (FGF 3 L/min) in group Ⅰ.While the rats were only exposed to the pure oxygen in group O.Six rats in each group were chosen to perform Morris water maze test after inhalation of pure oxygen was stopped in group O,and at 2 h,and at 1,7 and 14 days after the end of administration in group Ⅰ.The escape latency and swimming distance in place navigation test,and the number of crossing the platform and swimming distance in spatial probe test were recorded.After water maze test was terminated at each time point,blood samples were taken from the fossa orbitalis to determine the plasma cortisol concentration and the hippocampal tissue was obtained for measurement of the contents of BDNF and NGF.ResultsCompared with group C,the number of crossing the platform was significantly decreased,the swimming distance was significantly shortened,and the plasma cortisol concentration was significantly decreased in spatial probe test in group O,and the escape latency and swimming distance were significantly prolonged at 1 day after the end of administration in plaee navigation test,and the number of crossing the platform and the content of BDNF in the hippocampal tissue were significantly decreased,and the swimming distance was significantly shortened in spatial probe test in group Ⅰ (P ＜ 0.05 or 0.01 ).Conclusion lsoflurane anesthesia exerts a transient inhibitory effect on cognitive function in the short term,and promotion of the cortisol release and synthesis of BDNF is involved in the mechanism,but not the synthesis of NGF in hippocampus in rats.

An ultra-high performance liquid chromatography-tandem mass spectrometry ( UHPLC-MS/MS ) method was developed and validated for the simultaneous determination of 9 kinds of trace endocrine disrupting chemicals in biological samples using ultrasonic-assisted extraction followed by purification with gel permeation chromatography ( GPC) and silica gel columns. The sample extracts were purified by Bio beads S-X3 GPC columns with cyclohexane/ethyl acetate (1:1, V/V) as mobile phase, and the target compounds were eluted in the fraction of 12-28 mL retention volume. Electrospray ionization source operated in positive mode and atmospheric pressure chemical ionization source operated in negative mode were used for mass spectrometric detection. Data acquisition was carried out in multiple reaction monitoring mode. Recoveries were predominately within 65 . 2%-118 . 0%. Method quantification limits were 0 . 1-9 . 7 ng/g dw ( dry weight ) . This method was successfully applied to the analysis of the target endocrine disrupting chemicals in carps collected from the Pearl River. with the exception of carbanilide and triclocarban, the rest analytes were detected in fish tissue samples, with the concentrations varied within the range of 0. 1-22. 6 ng/g dw.

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.

According to the characteristics of postgraduates of clinical medicine and features of radiology and based on traditional teaching, picture archiving and communicating system (PACS), tutorial system, lecture and modernized tests with the help of problem-based learning (PBL) were ap-plied so that the effect of students' rotation internship was improved.

Objective To investigate the effect of emulsified isoflurane anesthesia on the expression of hippocampal amyloid-beta protein (Aβ) and phosphorylation of Tau protein in rats.Methods Seventy-two healthy Sprague-Dawley rats,aged 8 weeks,weighing 250-300 g,were randomly divided into 3 groups:normal control group (group C,n =12),fat emulsion group (group E,n =12),and 8％ emulsified isoflurane group (group EI,n =48).30％ fat emulsion and 8％ emulsified isoflurane 0.15 ml/100 g were slowly injected via the tail vein in groups E and EI,respectively.Morris water maze test was performed 6 days before anesthesia.Twelve animals in each group were chosen at 2 h after administration (T1) in E group,at the corresponding time points in C group,or at T1 and 1,7 and 14 days after administration (T2-4) in EI group and underwent spatial probe tests,and the escape latency was measured.The rats were anesthetized with intraperitoneal 1％ pentobarbital sodium 4 g/100 g after the end of Morris water maze test.Blood samples were taken for determination of the plasma S100 protein concentration.The rats were then sacrificed and brains were removed for determination of the expression of hippocampal Aβ and phosphorylated Tau (p-Tau) protein by immunohistochemistry.Results The escape latency and swimming distance were significantly shorter on 3rd,4th and 5th days than those on 1st day of place navigation test before anethesia (P ＜ 0.01).Compared with group C,the escape latency and swimming distance were significantly prolonged and the time of staying at the original platform quadrant was shortened at T1,and the plasma S100 protein concentration was decreased at T4 in group EI (P ＜ 0.05),and no significant change was found in the each parameter of Morris water maze test,plasma S100 protein concentration,and expression of Aβ and p-Tau protein in group E (P ＞ 0.05).The escape latency and swimming distance were significantly shorter and the time of staying at the original platform quadrant was longer at T2-T4 than at T1 in group EI (P ＜ 0.05).Conclusion Emulsified isoflurane anesthesia exerts no effect on the expression of hippocampal Aβ and phosphorylation of Tau protein,indicating that hippocampal Aβ and Tau protein are not involved in emulsified isoflurane anesthesia-induced cognitive dysfunction in rats.

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.