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The emerging challenges of global health constantly puts forward new requirements for cultivating medical talents. From the perspective of great health, the First Affiliated Hospital of Sun Yat-sen University aims at cultivating top-notch and innovative medical talents for the future. Since 2018, the hospital has been inheriting and innovating the model of training medical elites and has explored and implemented the clinical postdoctoral program. This program relies on the platform of progressive medical training of the relatively mature 'college system' initiated by our hospital. By regrouping the high-quality interdisciplinary faculty team, the platform optimizes the 'outcome-based' advanced training system and builds effective evaluation and the assessment system, to comprehensively strengthen clinical postdoctoral trainees' abilities of clinical and scientific research and teaching. The program provides reference for the cultivation of high-level medical elites.

In recent years,as an important means for the development of the stadium industry supported by Internet technology, building complex commercial complexes with the help of virtual network platforms around the stadium service as the core industry has become a popular trend in some cities in Chine.The academic circle has paid little attention to research on the abovementioned field, but exploring the integration of the online and offline chains of industrial clusters from the perspective of geographical space can be very fruitful, providing a theoretical reference for discussing the construction of virtual clusters of stadiums.The starting point of this research is based on the development status of the comprehensive penetration of Internet technology into the industrial field. Some scholars hypothesize that"cyberspace proximity will replace geospatial proximity,"while others insist that network information technology and platform are the"catalysts"for the transformation and upgradation of offline industries;at the same time, it focuses on the geographical factors affecting the offline entity industry itself and its related industries, which is of great significance to the construction and development of the online virtual platform.Accordingly, this article explains the construction of virtual clusters of stadiums from the perspective of geographic space.It then analyzes the reasons why the geographical clustering effect of stadiums cannot be formed.By summarizing the role of industrial virtual clusters in promoting industrial aggregation, strengthening scale economy effect, improving relationship between division of labor and cooperation, driving cooperation and competition atmosphere, forming flexible innovation mode,etc. it is proposed that the construction of virtual clusters is one of the most important forms of sports stadium industry development in the future.At present, the virtual cluster of sports stadium industry in China is the value chain of cooperation and competition among members in the horizontal direction, and the value chain of production and sales at both ends of supply and demand in the vertical direction, which together constitute the basic structural system of the cluster;according to the main industry scale, geographical location, property right attribute, network degree,etc., virtual stadium industry cluster can be divided into haplotype, chain type, and alliance type, and according to its structural system and functional characteristics, its development process needs to go through three upgrading stages:technology integration, product transformation, and structure optimization.Finally, it is recommended to gain an understanding of the geographical significance of the virtual cluster construction of stadiums, continue to improve the core competitiveness of offline stadium services, fully utilize the government's policy support and lead the role of alliances, establish a supervision mechanism of virtual industry cluster member access, etc., for the innovation and development of virtual industry cluster theory and the practice guidance.

Objective To investigate the effect of health education with a leaflet and demonstration on prevention of falls in elderly lymphoma patients during in-hospital chemotherapy for the first time. Methods Totally 60 elderly lymphoma patients with hospital admission between December 2017 and June 2018 were included as the control group, received a routing health education during in-hospital chemotherapy for the first time. Another 60 patients with hospital admission between July 2018 and Jan 2019 were recruited as the observation group, received health education with a leaflet and demonstration. The patients’ awareness of prevention on falls, incidence of falls and patients’ satisfaction of nursing care were compared between two groups. Results The awareness rate of prevention on falls was 91. 67%(55/60) in the observation group, which was higher than 76. 67%(46/60) in the control group (P＜0. 05). There were three cases of falls reported in the control group. Patients in the observation group were more satisfied with nursing care than those in the control group (98. 33 vs. 88. 33%, P＜0. 05). Conclusion The health education with a leaflet and demonstration is effective to improve the patients’ awareness of prevention on falls, therefore reducing the risk of falls during in-hospital chemotherapy for the first time. (目的 探讨图文式健康教育预防老年淋巴瘤患者首次住院化疗期间跌倒的效果。方法 将2017年12月—2018年6月入院的60例患者设为对照组, 2018年7月—2019年1月入院的60例患者设为观察组。对照组予常规口述式健康教育方法对患者进行预防跌倒相关知识宣教, 观察组在对照组基础上开展图文式健康教育。比较2组对预防跌倒知识掌握率、跌倒事件发生率以及对护理工作满意率。结果 观察组对预防跌倒知识掌握良好率91. 67%(55/60), 优于对照组的76. 67%(46/60), 差异有统计学意义(P＜0. 05)。观察组住院期间未发生跌倒, 对照组患者住院化疗期间发生跌倒为3例。观察组患者对护理工作满意度为98. 33%(59/60), 高于对照组的88. 33%(53/60), 差异有统计学意义(P＜0. 05)。结论 图文式健康教育可以提高老年淋巴瘤患者在首次住院化疗期间对预防跌倒安全知识的掌握率以及对护理工作的满意率, 减少跌倒不良事件的发生。)

This paper reviewed the clinical data of 54 patients with relapsed or refractory classical Hodgkin's lymphoma treated with sintilimab, and summarized the key points of specialized nursing. In the treatment of refractory classical Hodgkin's lymphoma by sintilimab, nursing measures should be carried out, such as standardization of drug preservation, configuration and infusion operation, observation on adverse reactions, implementation of specialized nursing measures timely, and enhancement of psychological care. The comprehensive nursing management is effective to reduce the risk of sintilimab-induced adverse reactions, relieve patients' negative emotions and increase treatment compliance of patients. (本文回顾性分析54例经信迪利单抗治疗的复发或难治性霍奇金淋巴瘤患者的临床资料, 总结专科护理要点。在信迪利单抗治疗复发或难治性霍奇金淋巴瘤过程中, 严格执行药物保存、配置及输注操作规范, 严密观察不良反应并及时采取积极有效的专科护理措施, 做好专科心理护理, 可减少信迪利单抗相关不良反应的发生风险, 减轻不良反应对患者的负面影响, 缓解患者焦虑抑郁情绪, 增加患者治疗依从性, 对患者顺利完成抗肿瘤治疗及提高疗效有积极意义。)

This paper summarized the nursing management of a patient with methicillin-resistant Staphylococcus aureus (MRSA)and edema of the lower limbs after chemotherapy for B-Lymphoblastic lymphoma. Key nursing measures for the patient included: monitoring vital signs and disease progression; monitoring results of bacterial culture; implementation of strictly disinfection and isolation measures; appropriate use of antibiotics and observation on drug adverse reaction; treatment of edema of the lower limbs and skin care; psychological care for patients. (本文总结1例B淋巴母细胞性淋巴瘤化疗后出现耐甲氧西林金黄色葡萄球菌(MRSA)感染合并下肢水肿患者的护理体会。主要护理要点: 密切监测患者生命体征和病情变化; 监测细菌培养结果; 严格落实消毒隔离措施; 合理使用抗生素并注意观察用药不良反应; 积极治疗下肢水肿并做好水肿部位皮肤护理; 做好患者的心理护理。)

Objective To clarify the underlying mechanism of metformin in improvement of glucocorticoid induced osteoporosis (GIOP). Methods Dexamethasone (DEX, 10 μmol/L) alone or combined with metformin (1 mmol/L) was used to treat murine long bone osteocytes, Y4 (MLO-Y4), and the cells without any treatment served as blank control. Oxidant-sensing probe 2′, 7′-dichlorodihydrofluorescein diacetate (DCFH-DA) was used to measure the production of reactive oxygen species (ROS), Western blotting was employed to detect the protein levels of AKT and Caspase-3, CCK-8 assay and TUNEL assay were conducted to study the cell viability and apoptosis, and real-time reverse transcriptase polymerase chain reaction (RT-PCR) was performed to test the mRNA levels of SOD2 and Cat. After the establishment of GIOP model in Sprague Dawley (SD) rats, micro-CT scanning was carried out to evaluate the effect of metformin on bone metabolism. Results CCK-8 assay demonstrated that DEX significantly reduced the proliferation of MLO-Y4 cells when compared with the blank control cells (P < 0.05), while no obvious difference was seen between the DEX+metformin and control cells. DEX group had significantly higher ROS level than the DEX+metformin group and control group, but there was no difference between the latter 2 groups. RT-PCR results showed that the mRNA levels of SOD2 and Cat were notably decreased in the DEX group (P < 0.05), which indicating defects in enzymatic antioxidant defense system. TUNEL assay suggested the apoptosis was increased in the DEX group, but no difference was seen between the metformin group and control group. The results of Western blotting indicated that the DEX group had higher level of Caspase-3 than the other 2 groups, which suggested that metformin inhibits cell apoptosis induced by DEX, while, the AKT level was higher in the metformin group than the DEX group, showing that metformin activates the AKT signaling pathway. Compared with the blank control group, the microstructural parameters, including trabecular thickness (TB. TH), bone and tissue volume ratio (BV/TV), and trabecular number (TB. N) were obviously decreased (P < 0.05), while trabecular spacing (TB.SP) was increased (P < 0.05). But there were no significant differences in these parameters between the DEX+metformin group and control group. Conclusion Metformin reduces the increase of ROS levels induced by glucocorticoids, activates AKT signaling pathway, inhibits the activity of proteolytic enzyme Caspase-3, regulates proliferation and apoptosis of osteocytes, and thus improve bone metabolism of glucocorticoid-induced osteoporosis.

Objective To investigate the effects of ox-LDL/β2GPI/anti-β2GPI antibody complex on apoptosis and inflammatory factors expression in RAW264.7 cells and its mechanism. Methods RAW264.7 cells were treated with medium, ox-LDL, β2GPI/aβ2GPI antibody complex, ox-LDL/β2GPI complex, ox-LDL/aβ2GPI antibody complex, and ox-LDL/β2GPI/aβ2GPI antibody complex separately. The role of signaling pathways was investigated by TLR4 inhibitor TAK-242 and mTOR inhibitor rapamycin. Finally, cells were stimulated with different concentrations of TNF-α. The apoptosis was detected by Annexin V-FITC/PI double labeling. The mRNA expressions of TNF-α and IL-1β were detected by real-time quantitative PCR, and the protein expressions of TNF-α, IL-1β, and apoptosis-related proteins cleaved-caspase-3 (c-caspase-3) and Bcl2 were detected by Western blot. Results Ox-LDL/β2GPI/aβ2GPI antibody complex promoted RAW264.7 cells' apoptosis, with a decrease in protein Bcl2 and an increase in protein cleaved-caspase-3, and enhanced the level of inflammatory factors, while apoptosis and the expression of inflammatory factors were partially reduced when macrophages had been pre-treated with inhibitors. TNF-α up-regulated apoptosis in RAW264.7 cells at 100 ng/mL and 200 ng/mL. Conclusion Ox-LDL/β2GPI/aβ2GPI antibody complex induces apoptosis in RAW264.7 cells by increasing the expression of inflammatory factors. TLR4 and mTOR pathways are involved in the process.

Objective To evaluate the effect of oxidized low-density lipoprotein/β2-glycoprotein I/anti-β2 glycoprotein I antibody (oxLDL/β2GPI/anti-β2GPI) complex on the calcification and inflammatory cytokine expression in A7r5 rat vascular smooth muscle cells, and to find out the role of Toll-like receptor 4 (TLR4) signal in this process. Methods The A7r5 cells were intervened with oxLDL, oxLDL/β2GPI complex, oxLDL/anti-β2GPI complex, β2GPI/anti-β2GPI complex, and oxLDL/β2GPI/anti-β2GPI complex for different time, with or without TLR4 inhibitor (TAK-242). Alizarin red staining was used to observe the calcification. Real-time quantitative PCR was applied to detect the total mRNA levels of actin-associated protein SM22α (trangelin) and Runt-related transcription factor 2 (RUNX2). The protein levels of SM22α and RUNX2 were measured by Western blotting. Tumor necrosis factor α (TNF-α) was detected by ELISA. Different concentrations of TNF-α were adopted to stimulate A7r5 cells, and the above methods were operated to examine the changes of SM22 and RUNX2. Results When A7r5 cells were incubated by oxLDL/β2GPI/anti-β2GPI complex, more calcified nodules were observed, the expression of SM22α was reduced and RUNX2 expression was enhanced at both mRNA and protein levels. And the complex increased the expression of inflammation cytokine TNF-α. TLR4 inhibitor TAK-242 reversed the phenomenon. Different concentrations of TNF-α could reduce mRNA and protein expression of SM22α while raise RUNX2 expression. Conclusion oxLDL/β2GPI/anti-β2GPI complex can increase the expression of cytokine TNF-α, and thus quicken calcification procedure in A7r5 cells, along with the change of the traditional contraction phenotype into the osteogenic phenotype. TLR4 receptor participates in this process.

Objective To investigate the effect of oxidative low-density lipoprotein/β2 glycoprotein I/anti-β2 glycoprotein I antibody (oxLDL/β2GPI/anti-β2GPI antibody) complex on autophagy in mouse macrophages (RAW264.7 cells) and its mechanism. Methods RAW264.7 cells were stimulated with medium, oxLDL, oxLDL/β2GPI complex, oxLDL/β2GPI/anti-β2GPI antibody complex, oxLDL/anti-β2GPI antibody complex and β2GPI/anti-β2GPI antibody complex separately. The protein levels of autophagy-associated proteins including LC3 and P62 were detected by Western blot analysis. The tandem mRFP-GFP-LC3 adernovirus was used to detect the patency of autophagosomes and autophagy flow. The AKT pathway inhibitor LY294002 (50 μmol/L) was used for investigating the role of AKT pathway in the autophagy in RAW264.7 cells treated by oxLDL/β2GPI/anti-β2GPI antibody complex. Results oxLDL/β2GPI/anti-β2GPI antibody complex reduced the level of LC3-II protein and the number of autophagosomes, increased the level of P62 protein and blocked the autophagy flow. In addition, the autophagy in RAW264.7 cells was partially restored by the pre-treatment of LY294002. Conclusion The oxLDL/β2GPI/anti-β2GPI antibody complex can inhibit the autophagy in RAW264.7 cells through activating the AKT pathway.

Objective To investigate the effects of β2 glycoprotein I/anti-β2 glycoprotein I antibody complex (β2GPI/aβ2GPI) on lipid phagocytosis and class B scavenger receptor CD36 expression of macrophages, and the role of Toll-like receptor 4 (TLR4) during the process. Methods THP-1 macrophages were induced from THP-1 cells treated by 100 ng/mL phorbol ester (PMA), and then identified by morphological observation and DiI-oxLDL uptake assay. THP-1 macrophages were treated with RPMI1640 medium, β2GPI, aβ2GPI or β2GPI/aβ2GPI. The protein and mRNA expression of TLR4 were detected by Western blot analysis and real-time fluorescent quantitative PCR (qRT-PCR), respectively. After that, THP-1 macrophages were treated with RPMI1640 medium, oxidized low-density lipoprotein (oxLDL), oxLDL combined with β2GPI/aβ2GPI or oxLDL combined with LPS. Intracellular lipid deposition was observed by oil red O staining; the mRNA and protein expression of CD36 were detected by qRT-PCR, immunofluorescence and Western blot analysis. To unveil the role of TLR4 in this process, THP-1 macrophages were pre-treated with or without TLR4 inhibitor TAK-242 (1 μg/mL). Results After PMA treatment, THP-1 cells showed macrophage-like morphology and were able to engulf DiI-oxLDL. Compared with RPMI1640 medium, β2GPI/aβ2GPI treatment significantly increased TLR4 expression in THP-1 macrophages. Compared with oxLDL alone, oxLDL combined with β2GPI/aβ2GPI inhibited lipid deposition and CD36 expression in THP-1 macrophages, which could be partly reversed by TLR4 blockage. Conclusion The β2GPI/aβ2GPI can inhibit the phagocytosis of oxLDL and CD36 expression in macrophages, which is linked to the function of TLR4.

Trabecular microstructure is an important factor in determining bone strength and physiological function. Normal X-ray and computed tomography (CT) cannot accurately reflect the microstructure of trabecular bone. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a new imaging technique in recent years. It can qualitatively and quantitatively measure the three-dimensional microstructure and volume bone mineral density of trabecular bone in vivo . It has high precision and relative low dose of radiation. This new imaging tool is helpful for us to understand the trabecular microstructure more deeply. The finite element analysis of HR-pQCT data can be used to predict the bone strength accurately. We can assess the risk of osteoporosis and fracture with three-dimensional reconstructed images and trabecular microstructure parameters. In this review, we summarize the technical flow, data parameters and clinical application of HR-pQCT in order to provide some reference for the popularization and extensive application of HR-pQCT.

Objective: By evaluating the hemodynamic parameters such as cardiac output (CO), right ventricular pressure (RVP), pulmonary artery pressure (PAP) and total pulmonary resistance index (TPRI) in pulmonary hypertension rat model, we established a more comprehensive hemodynamic evaluation system, which objectively evaluated the severity of disease and exercise tolerance in rats with pulmonary hypertension. Methods: SD rats were randomly divided into a control group and a model group with 5 rats in each group. The model group was intraperitoneally injected with SU5416 (20 mg/kg) and placed in an oxygen chamber at a 10% oxygen concentration for 21 days and then placed in a normoxic environment for 14 days. After modeling, rats were anesthetized and mechanically ventilated. The operator cut the skin along the right paraxial line, detached and ligated the intercostal artery, and then cut off the 3 and 4 ribs, exposing the heart and freeing aortic root about 0.2 cm. The flowmeter probe was set in the dissected aortic segment, and real-time recording time, blood flow waveforms, cardiac output were calculated accordingly. Then the needle attached to the baroreceptor was inserted into the right ventricle and the system acquired the right ventricular time-pressure waveform. After the waveform stabilized for about 30 seconds, the end of the cannula was sent to the pulmonary artery trunk through the entrance of the pulmonary artery to record the time-pressure curve of the pulmonary artery. Results: RVSP, PASP, PADP and mPAP in the model group were significantly higher than those of the control group [ RVSP(23.4±5.4) mmHg, 1 mmHg=0.133 kPa vs (56.4±13.0) mmHg, PASP (22.8±4.4) mmHg vs (58.5±14.9) mmHg, PADP (9.7±1.9) mmHg vs (30.3±7.0) mmHg, mPAP (14.1±2.7) mmHg vs (41.9±8.0) mmHg, all P <0.05 ]. Compared with the control group, the cardiac index in the model group was significantly lower [ CI (0.54±0.08) ml·min(-1)·g(-1) vs (0.40±0.09) ml·min(-1)·g(-1,) P =0.02 ]. Furthermore, compared with the control group, pulmonary vascular resistance index was significantly increased in the model group[PVRI (0.27±0.03) mmHg·ml(-1)·min(-1)·kg(-1) vs (0.06±0.01) mmHg·ml(-1)·min(-1)·kg(-1,) P <0.05]. The pathological results also showed that the middle part of pulmonary arterioles in the model group had muscular hypertrophy and muscular pulmonary arterioles, and even plexiform lesions. Conclusion: In this study, we established a new method that simultaneously determined several hemodynamic parameters such as RVSP, PASP, PADP, CO, CI and PVRI, which provided a more comprehensive assessment of hemodynamic changes in pulmonary hypertension rat models.

Objective: To establish a standardized method for isolated pulmonary artery and vein rings with different diameter, pressure and length, which could provide a more scientific method for in vitro study of pulmonary vessel diseases. Methods: Male SD rats were anesthetized, and the right ventricular systolic pressure were measured. Small pulmonary artery and vein rings with 200-400 μm in diameter and 2 mm in length were prepared by dissecting pulmonary arteries and veins. The pulmonary vessel rings were mounted in the organ bath by 2 stainless steel wires with diameter of 40 μm. Then the internal circumference of the vessel rings was increased gradually with 100 μm per step. At the same time the vascular tension was recorded by the Myograph System and Acknowledgement data acquisition system, and subsequently the passive length-tension exponential curve was made. The initial tension of the rings was set, equilibrated for another 30 min, and then stimulated with 60 mmol/L KCl 3 times, and the best contractile reactivity was achieved. The contractile reactivity of pulmonary artery rings and endothelial integrity were detected by exposure to 1 μmol/L phenylephrine(PE) and 10 μmol/L acetylcholine(Ach), while the contractile reactivity of pulmonary vein rings was detected by exposure to 1 μmol/L U46619 and 10 μmol/L papaverine. Results: The contraction and relaxation effects of the pulmonary artery rings reached 0.39 mg and 92% when they were stimulated by 1 μmol/L PE and 10 μmol/L Ach. The contraction and relaxation effects of pulmonary vein rings were up to 0.13 mg and 84% when they were exposed to 1 μmol/L U46619 and 10 μmol/L papaverine, respectively. Conclusion: Pulmonary artery and vein rings with appropriate basal tension and optimal vasodilator activity were prepared, and a standardized method of tension experiment for isolated pulmonary artery and vein rings established.

Objective: To evaluate the association between SLC22A1 expression and the outcomes of hepatocellular carcinoma (HCC) patients., Methods: A tissue microarray of 303 HCC and matched adjacent noncancerous liver tissues (ANLTs) were constructed. The expression of SLC22A1 was tested by immunohistochemistry (IHC) and scored by two pathologists according to a 12-score scale (a score>6 was defined as high expression, and a score≤6 as low expression). The correlation of SLC22A1 expression with the clinicopathological features and the patients' outcome was analyzed., Results: All the ANLTs had a IHC score of 12, as compared to only 29 (9.6%) of the HCC tissues. The patients were divided into 2 groups based on the IHC scores: 59% (180/303) in low expression group and 41% (123/303) in high expression group. The disease-free survival (DFS) rates and overall survival (OS) rates were significantly lower in low SLC22A1 expression group than in the high expression group. The 1-, 3-, and 5-year DFS rates were 43%, 31% and 27% in the low expression group, and were 58%, 47% and 43% in the high expression group, respectively. The 1-, 3-, and 5-year OS rates were 66%, 38% and 32% in low expression group, and were 80%, 57% and 50% in the high expression group, respectively. A low expression of SLC22A1 was positively correlated with the tumor diameter, BCLC stage, tumor differentiation, and AFP levels (P<0.05), and was an independent predictor of poor overall survival (HR=1.454; 95% CI, 1.050-2.013)., Conclusions: Down-regulation of SLC22A1 is a malignant feature and a potential prognostic marker of HCC.

Objective: To explore the serum levels of suppressor of cytokine signaling 3 (SOCS3), tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in preeclampsia mothers and determine their clinical values., Methods: A total of 40 preeclampsia mothers at International Peace Maternity and Child Health Hospital of China Welfare Institute Affiliated to Shanghai Jiaotong University from March 2011 to August 2013 were enrolled into observation group. Another 40 cases of mothers without pregnancy complications were selected as control group. Then the serum contents of SOCS3, TNF-α and IL-10 were detected and their correlations analyzed., Results: (1) The mRNA levels of SOCS3 of observation and control groups were 38 ± 6and 100 ± 16while the mRNA levels of TNF-α 226 ± 40 and 100 ± 19 respectively; (2)the proteins levels of SOCS3 of observation group were lower than those of control group (P < 0.05) while the proteins levels of TNF-α of observation group were higher than those of control group (P < 0.05); (3)the mRNA and protein contents of SOCS3 were negatively correlated with mRNA and protein contents of TNF-α and positively correlated with IL-10., Conclusion: The serum content of SOCS3 decreases significantly in preeclampsia so that there is a down-regulation of Th1 type cytokine TNF-α and an up-regulation of Th2 type cytokine IL-10. And it may play an important role in the occurrence of disease.

Objective: To investigate the safety and efficacy of radiofrequency-assisted anterior approach right hepatectomy for hepatocellular carcinoma (HCC)., Methods: The clinic data of 12 HCC patients who underwent radiofrequency-assisted anterior approach right hepatectomy from January 2010 to July 2011 was analyzed retrospectively. Surgical techniques and treatment response were retrospectively reviewed. All the 12 patients were male, aging from 38 to 57 years with a mean of (48 ± 6) years. Ten of the 12 patients were infected with hepatitis B virus. A retrohepatic tunnel anterior to the surface of the inferior vena cava (IVC) was developed. The liver was hanged away from the IVC and radiofrequency was carried out along the Cantline's line. Scalpel was used to cut off the liver parenchyma along the middle of the ablated area until the parenchyma was fully resected. After short hepatic veins and the right hepatic vein were ligated, ligaments of right liver were fully isolated and right liver was resected. The t test was performed between 2 groups., Results: The surgical time was 165 to 295 minutes, with a mean of (230 ± 55) minutes. The bleeding was 150 to 1500 ml, with a mean of (516 ± 378) ml, which was better than those of anterior approach right hepatectomy ((1291 ± 1159) ml) and classical right hepatectomy ((2129 ± 2012) ml; t = 1.236, 3.265; P < 0.05). The postoperative hospital stay was 8 - 19 days, with a mean of (12 ± 4) days. There were no medical complications and no postoperative death. All patients were cured and discharged., Conclusions: Radiofrequency-assisted anterior approach right hepatectomy for HCC is safe and effective and could effectively decrease intra-operative bleeding and shorten surgical time.

Objective: To explore the technical success rate, efficacy, overall survival, recurrence-free survival and prognostic factors of transcatheter arterial chemoembolization (TACE) plus thermal ablations of radiofrequency ablation (RFA) and microwave ablation (MWA) in the patients with large hepatocellular carcinoma (HCC)., Methods: Forty-five cases with Child-pugh class A, B cirrhosis and large HCC with a maximum tumor between 5.0 cm to 10.0 cm underwent TACE and thermal ablation. Twenty-five patients received TACE plus RFA while the other 20 patients underwent TACE plus MWA. Their efficacy, long-term survival and prognostic factors were statistically analyzed., Results: TACE plus thermal ablation were performed in 84 tumors with a successful rate of 100% (86/86) and a complete ablation rate of 94.0% (79/84). The major complication rate was 6.7% (3/45). Local and distant recurrence rates were 66.7% (30/45) and 71.1% (32/45) respectively. The 1 and 2-year recurrence-free survival rates were 26.7% (12/45) and 13.3% (6/45). And the 1, 2 and 3-year survival rates were 80.0% (36/45), 33.3% (15/45) and 6.7% (3/45) respectively. Univariate and Cox regression analyses indicated that tumor size > 7.0 cm, multi-nodularity, incomplete necrosis and pretherapy α-fetoprotein (AFP) ≥ 200 µg/L were 4 unfavorable prognostic factors for the long-term survival., Conclusion: The combined procedures of TACE and percutaneous thermal ablation are both safe and effective for the unresectable large HCC (> 5.0 cm). It represents an alleviate treatment for those patients with tumor size > 7.0 cm. Tumor size, tumor number, completeness of necrosis and AFP level are all significant prognostic factors.

We have designed a sort of multi-functional bone forceps for use as orthopedic surgical instruments to grip, bend and cut the spicula. It is labor-saving and easily installed. Its left and right clamp bodies are connected by a rivet to hold the spicula, and the pressure-regulating shank is connected with the clamp seat body at the right top of the clamp body by a rivet. It is used to curve the spicula. At an appropriate location on the pressure-regulating shank is a pin-cutting chip. On the right body rotating disc-clamp, there is a rectangular open cutting groove to be in use for cutting the specula with the role of pin-cutting chip. Being characterized by the use of mechanical leverage, the manipulations of holding and bending are less arduous. After achieving the 90-degree bend, the operator can cut off the specula successfully. The operation is easy to perform and labor-saving; the forceps can further meet the actual clinical demand.

Objective: To compare the outcomes between anterior versus conventional approach right hepatectomy for large hepatocellular carcinoma (HCC)., Methods: A total of 188 consecutive patients with large HCC ( > or =5 cm) undergoing right hepatectomy were reviewed retrospectively. Among them, 92 patients received anterior approach right hepatectomy (anterior group) while the other conventional right hepatectomy (conventional group). Their clinicopathologic data and survivals were compared., Results: There were five surgical deaths (2.7%), two in the anterior group and three in the conventional group. The biochemical and tumor pathological data (except for tumor size) of these two groups were comparable. The mean intraoperative blood loss, the number of patients with massive hemorrhage ( >3000 ml) and the volume of blood transfusion of the anterior group were markedly less than those of conventional group. The 1-, 3-year disease-free survival rates of the anterior group were significantly better than those of the conventional group (56.2%, 30.9% vs. 39.1%, 13.0%, P = 0.043). The 1- & 3-year cumulative survival rates of the anterior group were also markedly higher than those of conventional group. The Cox regression model indicated that tumor size [P = 0.014, odd ratio (OD) = 1.074] and surgical procedure (P = 0.009, OD = 0. 468) were independent risk factors correlated with disease-free survival. And the surgical procedure (P = 0.003, OD = 0.369) was the only independent risk factor for postoperative cumulative survival., Conclusion: Anterior approach right hepatectomy can significantly decrease intraoperative blood loss. The postoperative survivals of large HCC patients are significantly improved by anterior approach right hepatectomy.

Objective: To investigate the safety and efficacy of hepatic resection combined with intraoperative ablation to treat multifocal hepatocellular carcinoma., Methods: Clinical data of patients diagnosed with multifocal hepatocellular carcinoma and treated with hepatic resection combined with intraoperative ablation from March 1998 to September 2007 were retrospectively reviewed. Treatment response, postoperative complications and survival data were analyzed., Results: Combined treatment modalities were well tolerated except one patient dying of postoperative hepatic functional failure. The postoperative complication rate was 23.5% with a mortality rate of 6.7%. Postoperative complication included wound infection (1 case), bile leakage (1 case), subphrenic and pleural effusion (1 case), ablation-associated liver abscess (1 case), all of which were treated with non-surgical methods. The median survival time was 25.9 months. The 1, 3, 5 year survival rates were 70.6% (12/17), 23.5% (4/17), 17.6% (3/17), respectively. Three patients survived more than 5 years after surgery. Up to April 2008, 4 patients were still alive., Conclusion: Hepatectomy combined with intraoperative thermal ablation provides a treatment modality for patients with multifocal hepatocellular carcinoma and may improve the prognosis.

Objective: To compare the clinical results of surgical resection (SR) and percutaneous thermal ablation (PTA) for early-stage hepatocellular carcinoma (HCC) (single tumor nodule

Objective: To analyse the soluble antigens of different developmental stages of Pagumogonimus skrjabini and develop a specific and sensitive serodiagnostic method for pagumogonimiasis., Methods: The soluble antigens of P. skrjabini of various stages were separated by SDS-PAGE. The specific antigen of the adult fluke was recognized immunologically by immunoblot assay. The protein bands between 10-30 kDa purified by SDS-PAGE and electrophoretic elution were used in dot-ELISA., Results: Using dot-ELISA, the soluble antigens of adult were recognized by sera infected with P. skrjabini. More reactive bands appeared at 10-30 kDa, but major protein bands were at 22, 24 and 26 kDa. However, using sera from patients infected with other trematodes including schistosome and Clonorchis, cross-reaction bands appeared within 60 to 90 kDa. When compared with ELISA of crude adult antigens for detecting 28 suspected patients, there was no significant difference between the two methods. The sera of 38 patients with other diseases were also detected by the two tests. No cross-reaction occurred with the purified adult antigen dot-ELISA while 13.2% (5/38) of the sera cross-reacted in ELISA of crude adult antigens., Conclusion: Dot-ELISA using 10-30 kDa antigen might be a specific and sensitive serodiagnostic method for diagnoing pagumogonimiasis.

Objective: To explore the relationship between the hemolymph phenol oxidase and melanization of oocysts., Methods: Anopheles stephensi-Plasmodium yoelii system was used to determine the activity of monophenol oxidase (MPO) and o-diphenol oxidase (o-DPO) in the hemolymph collected from 4 groups of mosquitoes by polyacrylamide gel electrophoresis (PAGE) followed by density scanning. The 4 groups of mosquitoes were: non-blood-fed (N), normal-blood-fed (B), infected-blood-fed (I) and nitroquine-administrated (D), respectively., Results: No significant difference was found in the activities of MPO and o-DPO between groups N and B. The activities of MPO and o-DPO were not obviously modified in group I, but were significantly increased on day 10 and decreased on day 15 after blood feeding in the group D as compared with those in the groups N and B., Conclusion: The alteration in the mosquito hemolymph PO activity coincided at each time point with the melanization of Plasmodium yoelii oocysts.

Objective: To investigate the efficacy of internal radiation of (32)P-glass microspheres ((32)P-GMS) in unresected hepatocellular carcinoma (HCC) via subcutaneous arterial port., Methods: Hepatic arterial (99)technetium-macroaggregate albumin ((99)Tc-MAA) scanning via subcutaneous arterial port was undertaken to measure lung/liver shunting ratio and tumor/liver ratio. Hepatic arterial infusion of (32)P-GMS was performed in 17 cases of HCC with a dose from 1.11 to 1.30 GBq. Twenty cases of HCC undergoing hepatic arterial chemoembolization (HACE) in the same period served as controls group., Results: There was no treatment-related death in the 17 cases. In 7 of the 17 cases, AFP level and/or tumor size decreased by 50% after treatment, with a response rate of 64.7%. The median survival time was 5.5 months, and the 3-, 6-, 9-, 12-month survival rates were 94.1%, 44.1%, 31.0%, 24.4%, respectively. The therapeutic efficacy was better than that of HACE. The survival time was significantly longer in patients with T/N ratio >or= 2 than in those with T/N < 2 (P < 0.05)., Conclusions: Hepatic arterial infusion of (32)P-GMS is an alternative treatment for unresected HCC.

In order to repair the intraoral defects after extensive resection of oral carcinoma with radical neck lymph nodes dissection, the nasolabial myocutaneous flap was prepared with its pedicle which only contained the facial artery and anterior facial vein. After removal of the tumor, the flap was used to cover the intraoral defect. Altogether 15 cases of oral squamous cell carcinoma were treated by this method. Seven out of 15 cases had their cervical lymph nodes involved. The tumor in all cases were located in one anatomical region, without involvement of accessory nerve or metastasis. All the flaps survived after the operation. There was no recurrence of tumor in any case after being followed up from 0.5-2 years. Removal of tumor and repaire of the defect by pedided naso-labial myocutaneous flap could be done in one stage. The detail of the process was introduced. Its feasibility and application were discussed. It was suggested that preserving the facial vessels be a kind of modified method of radical neck lymph nodes dissection, and the nasolabial myocutaneous flap have some clinical value in repair of the defect after radical operation of oral carcinoma.

In order to study the clinical efficacy of facial artery musculocutaneous flap on repairing the defect of the floor of mouth, 21 patients had received this type of treatment from 1991 to 1997. The size of the flaps ranged from 8.0 x 3.4 cm to 12.1 x 5.4 cm and the average age of these patients was 59.5 years old. The donor site was closed directly. Nineteen flaps survived completely, while necrosis occurred at the apex of the other 2 flaps, which healed by ordinary management. The applied anatomy of the flap and the design and the main points of the operation were reported in details. The advantage of the flap and the prevention of facial malformation following operation were discussed. The conclusion was that this type of flap was ideal for reconstruction of the defects of floor of the mouth.