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The present study aimed to investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) in the preoperative prediction of the histologic differentiation of hepatocellular carcinoma (HCC). Seventy HCC patients were scanned with a 3.0 T magnetic resonance scanner. The values of apparent diffusion coefficient (ADC), slow apparent diffusion coefficient (D), fast apparent diffusion coefficient (D*), and the fraction of the fast apparent diffusion coefficient (f) were measured. Analysis of variance was used to compare the differences in parameters between groups with different degrees of histologic differentiation. p −3 mm2/s, 1.16 ± 0.17 × 10−3 mm2/s, 0.98 ± 0.21 × 10−3 mm2/s, and 1.06 ± 0.15 × 10−3 mm2/s, 0.88 ± 0.16 × 10−3 mm2/s, 0.76 ± 0.18 × 10−3 mm2/s, respectively, and all differences were significant. The D* and f values of the three groups were 32.87 ± 14.70 × 10−3 mm2/s, 41.68 ± 17.90 × 10−3 mm2/s, 34.54 ± 18.60 × 10−3 mm2/s and 0.22 ± 0.07, 0.23 ± 0.08, 0.18 ± 0.07, respectively, with no significant difference. When the cut-off values of ADC and D were 1.25 × 10−3 mm2/s and 0.97 × 10−3 mm2/s, respectively, their diagnostic sensitivities and specificities for distinguishing well differentiated HCC from moderately differentiated and poorly differentiated HCC were 73.3%, 85.5%, 86.7%, and 78.2%, and their areas under the ROC curve were 0.821 and 0.841, respectively. ADC and D values can be used preoperatively to predict the degree of histologic differentiation in HCC, and the D value has better diagnostic value.

To investigate the effect of alpha-lipoic acid (α-LA) combined with tamoxifen citrate (TC) in the treatment of oligoasthenospermia.From June to November 2016, we treated 60 patients with oligoasthenospermia in our Department of Andrology, 30 (the trial group) with oral α-LA (0.6 g, qd) + TC (20 mg, qd) and the other 30 (the control group) with oral L-carnitine (1g, bid) + TC (20 mg, qd). Before and after 3 months of medication, we examined the semen parameters of the patients and the levels of their seminal oxidative stress biomarkers, including methylenedioxyamphetamine (MDA) and total antioxidant capacity (TAC) in the seminal plasma. We also compared the pregnancy rate and adverse reactions between the two groups.Totally, 57 of the patients completed the treatment, 28 in the trial group and 29 in the control. Compared with the baseline, the patients of the trial group showed significant improvement after 3 months of medication in the semen volume (［2.50 ± 0.71］ vs ［3.37 ± 0.70］ ml, P0.05), sperm concentration (［12.00 ± 1.65］ vs ［19.34 ± 2.04］ ×10⁶/ml, P0.05), percentage of progressively motile sperm (PMS) (［18.01 ± 3.01］% vs ［35.41 ± 6.49］%, P0.05), MDA level (［14.96 ± 2.76］ vs ［10.04 ± 1.04］ nmol/ml, P0.05), and TAC in the seminal plasma (［9.83 ± 1.02］ vs ［12.25 ± 1.11］ U/ml, P0.05), and so did the controls in the semen volume (［2.76 ± 0.67］ vs ［3.36 ± 0.93］ ml, P0.05), sperm concentration (［11.47 ± 1.10］ vs ［17.77 ± 3.56］ ×10⁶/ml, P0.05), percentage of PMS (［19.22 ± 1.41］ vs ［36.01 ± 5.22］ %, P0.05), MDA level (［14.66 ± 2.75］ vs ［10.14 ± 1.01］ nmol/ml, P0.05), and TAC in the seminal plasma (［9.84 ± 0.90］ vs ［11.14 ± 0.84］ U/ml, P0.05). There were no statistically significant differences in the above post-medication parameters between the trial and control groups (P0.05) except in TAC, which was markedly more improved in the former than in the latter (P0.05), nor in the percentage of morphologically normal sperm before and after treatment in either of the two groups (P0.05). After 3 months of treatment, 3 pregnancies were achieved in the trial group and 1 in the control (10.7% vs 3.45%, P0.05). No obvious adverse events occurred during the treatment.Alpha-lipoic acid combined with tamoxifen citrate can evidently improve semen parameters in oligoasthenospermia patients by relieving oxidative stress injury.目的： 观察α-硫辛酸胶囊联合枸橼酸他莫昔芬片对少弱精子症患者的疗效。方法： 选择2016年6~11月就诊的60例少弱精子症患者，将其随机分为2组，每组30例。治疗组给予α-硫辛酸胶囊（0.6 g， 1次/d）联合枸橼酸他莫昔芬片（20 mg，1次/d）口服治疗，对照组给予左卡尼汀口服液(1 g， 2次/d)联合枸橼酸他莫昔芬片（20 mg， 1次/d）口服治疗，治疗前及治疗后3个月检测所有病例精液参数及精液氧化应激生物标志物，包括丙二醛（MDA），总抗氧能力（TAC）水平，同时了解配偶妊娠率及不良反应发生情况。结果： 57例患者完成了全部治疗，包括治疗组28例，对照组29例。治疗组治疗前、后精液量分别为(2.50±0.71) ml、 (3.37±0.70) ml，精子浓度 (12.00±1.65) ×10⁶/ml、 (19.34±2.04) ×10⁶/ml，前向运动精子百分率 (18.01±3.01) %、 (35.41±6.49)%，精浆TAC (9.83±1.02) U/ml、 (12.25±1.11)U/ml，MDA (14.96±2.76) nmol/ml、 (10.04±1.04) nmol/ml；对照组治疗前、后精液量分别为(2.76±0.67) ml、(3.36±0.93) ml，精子浓度(11.47±1.10) ×10⁶/ml、(17.77±3.56)×10⁶/ml，前向运动精子百分率(19.22±1.41)%、 (36.01±5.22)%、精浆TAC (9.84±0.90) U/ml、 (11.14±0.84)U/ml，MDA (14.66±2.75) nmol/ml、(10.14±1.01) nmol/ml，上述各指标两组治疗后均较治疗前有显著改善(P0.05)，精浆TAC改善方面治疗组优于对照组（P0. 05），其余指标两组之间差异无统计学意义（P0.05），两组正常形态精子百分率治疗前后无统计学差异（P0.05）。治疗3个月后配偶妊娠，治疗组3例(10.7%)，对照组1例(3.45%)，两组比较差异无统计学意义（P0.05），治疗期间所有患者均未见明显不良反应。结论： α-硫辛酸胶囊联合枸橼酸他莫昔芬片可明显改善精浆氧化应激损伤，进而改善少弱精子症患者的精液质量。.

To investigate prognostic factors related to early and late intrahepatic recurrences after curative hepatectomy for patients with hepatocellular carcinoma (HCC).A retrospective review was conducted on medical records of patients with HCC treated by curative hepatectomy from January 2002 to January 2009. Clinicopathologic data were evaluated for their possible association with postoperative intrahepatic recurrence in univariate and multivariate analysis using Cox proportional hazard model. Recurrence time calculated by Kaplan-Meier method was compared using Log-rank test. Receiver operator characteristic curve (ROC) analysis with calculation of the area under the curve (AUC), sensitivity, and specificity where appropriated and risk stratification were applied to assess predictive ability of prognostic factors.All 101 patients underwent curative hepatectomy. During follow-up period, 75 patients developed postoperative intrahepatic recurrence, among whom, 63 experienced early recurrence (84.0%) and the remaining had late recurrence (16.0%). The 1-, 2-, 3-and 5-year cumulative recurrent rates were 48.5% (49/101), 62.4% (63/101), 70.3% (71/101) and 74.3% (75/101), respectively. Multivariate analysis identified that tumor residual resectional margin, increased BCLC staging and severity of concomitant liver cirrhosis as independent prognostic factors predicting early recurrence while age ≥ 60 years and presence of tumor capsule predicting late recurrence. Cutoff point values (PI ≥ 2.798) predicted early recurrence with AUC 0.897 (95%CI = 0.829 - 0.965), sensitivity 76.6%and specificity 88.9% calculated from ROC. Median recurrent time of early recurrence and late recurrence reached statistically difference after risk stratification, 20.2 months vs. 4.4 months (χ(2) = 29.198, P = 0.000), 46.6 months vs. 28.6 months (Log-rank test, χ(2) = 8.479, P = 0.004), respectively.Postoperative recurrence for HCC after curative hepatectomy should be differentiated as early recurrence and late recurrence, since each is associated with different risk factors, indicating possible different mechanism responsible for postoperative recurrence. Risk stratification can be used for prediction of different type of recurrence.

To summarize the experience and lessons of the using of antibiotic-loaded cement articulating spacer made by a self-made mold system for the treatment of the infected hip replacement, and to evaluate its efficiency and role in the two-stage revision of infected total hip arthroplasty (THA).The patients with infected THA treated with two-stage revision protocol from August 2005 to December 2009 were reviewed. All of the 127 patients were debridement thoroughly and followed by implantation of an antibiotic-loaded cement articulated spacer made by a self-made mold system; Two-stage revisions were not followed until the infection were controlled. Among of them, 106 patients, 107 hips were gotten fully followed up. Evaluations were made for the efficiency of infection control, convenience of making, implanting and removing of the spacers, occurrence of complications, the deal of the special circumstances, the function and satisfaction of the patients.The 107 hips were gotten an average of 34.3 months' (3 - 55 months) follow-up. The infection control rate was 96.3% after the first-stage surgery, the infection control rate was 94.4% at last follow-up after two-stage revisions. The breakage rate of the spacer was 4.7%, dislocation rate was 2.8%, removal of the spacers with difficulty were seen in 15 patients (14.0%). The satisfactory rate of the patients was 93.5%.Antibiotic-loaded cement articulating spacer made by a self-made mold system is an effective methods for the two-stage revision of the infected hip replacement, characterized by simple, good reproducible, high rates of infection control, better joint function after surgeries, high rate of patients satisfaction and other advantages. And it can decrease the complications, such as the breakage, spacer dislocation of hip joint and difficulty in removal of spacer at the second stage revision. Using of metallic internal fixation or allograft bone combined with spacer does not affect the results of infection controlling.

One of the important reasons for male infertility is asthenozoospermia, for which there is no specific cure for the time being. The authors explored the clinical effect of L-carnitine for infertile males with asthenozoospermia.A total of 135 patients with asthenozoospermia were randomly divided into Groups A (n = 68) and B (n = 67), the former treated with L-carnitine (2 g/d) and vitamin E, while the latter with vitamin E only, both for 3 months. All the patients received semen analyses before and after the treatment, and were observed for adverse effects. The pregnancy rates of their wives were recorded.Group A showed a significantly increased percentage of forward motile sperm after the treatment (45.4% +/- 11.1%) as compared with pretreatment (28.6% +/- 9.2%) (P0.01), but no statistically significant differences were found in sperm density and the percentage of the sperm of normal morphology (P0.05). The rate of pregnancy was significantly higher in Group A (31.1%) than in B (3.8%) after the treatment (P0.01). No adverse events were found during the treatment.L-carnitine, capable of significantly improving sperm motility and raising the rate of pregnancy, is a safe and effective therapeutic option for asthenozoospermia.

To compare the metastatic characteristics of HCCLM3 cells and SMCC-7721 cells in nude mice model.Nude mice were divided into two groups (n = 8, each), mice were transplanted with HCCLM3 cells (group A) and SMMC-7721 cells (group B). Tumor size, metastasis rate and other clinical parameters were compared between the two groups. Statistical analysis was performed with the help of SPSS 16.0 for Windows computer software (SPSS, Inc., Chicago, IL). P values of less than 0.05 were considered statistically significant.Intrahepatic metastases rate was 100% (8 / 8), mean intrahepatic primary tumor volume was (6954+/-1945) mm(3) in group A, Intrahepatic metastases rate was 62.5% (5/8), and mean intrahepatic primary tumor volume was (6034+/-2035) mm(3) in the group B. There was no statistical difference in the primary liver tumor size and intrahepatic metastases rate (P = 0.20; t = 6.38, P = 0.37, respectively). The numbers of intrahepatic metastases and the involved lobes, and the volume of tumor were 4.5 (median), 3, and 975 mm(3) (median) respectively, in group A, and these were 1 (median), 1 and 274 mm(3) (median) respectively in group B. The difference between two groups was statistically significant (Z values, -2.818, -2.289, and -1.975, respectively).The rate of lung metastasis and other organ metastasis in the A group was significantly higher than that in group B (P less than 0.001, P less than 0.041, respectively).HCCLM3 cells have higher metastatic potential than SMMC-7721 cells in nude mice.

The aim of this study was to explore the effect of recombinant human interleukin 11 (rhIL-11) on platelet recovery after peripheral blood hematopoietic stem cell transplantation and its side-effects. 20 patients with hematologic malignancies treated by allogeneic peripheral blood stem cell transplantation (PBSCT) were randomly divided into test and control groups. The patients in test group were treated with rhIL-11 since the day 6 after PBSCT, while the patients in control group were given supporting treatment. The results showed that the average time of the platelet to recover to 20 x 10(9)/L was 22.8 days in test group and 27.3 days in control group (p0.01). The average time for platelet to recover to 50 x 10(9)/L was 25.7 days in test group, and 32.3 days in control group (p0.01). The average number of megakaryocytes was 15.6 in test group, and 7.8 in control group on day 30 after PBSCT (p0.01). In conclusion, the rhIL-11 is able to accelerate platelet recovery after peripheral blood hematopoietic stem cell transplantation.

To compare proximal femoral resection with transverse subtrochanteric osteotomy in the treatment of Crowe's IV congenital dislocated hip (CDH) with total hip arthroplasty (THA).Thirty-six primary hip arthroplasties were performed in patients with Crowe grade IV CDH from April 2003 to October 2007. These patients were divided into two groups, one for proximal femoral resection (n = 20) and another for subtrochanteric osteotomy (n = 16). The leg length discrepancy, rotation center height and Harris score were measured pre- and post-operation to compare the two methods of osteotomy.All surgeries were successfully performed. The average leg discrepancy was 0.6 cm (range from 0 to 1.5 cm) for subtrochanteric osteotomy group and 0.3 cm (range from -1.0 to 1.5 cm) for proximal femoral resection group, there was no significant difference between them (P0.05). There were also no statistically significant difference between the two groups in other index. The complication rates were much higher in the proximal femoral resection group. At the latest follow up, the Harris score of subtrochanteric osteotomy group was 90 +/- 6, and the proximal femoral resection group was 83 +/- 8. There was statistical difference between the two groups (P0.05).Although both the femoral shortening techniques can restore the leg length of Crowe IV CDH, the subtrochanteric osteotomy technique has advantage of avoiding the potential complications in the high riding patients (high dislocation4 cm).

Inflammation promotes acute coronary syndromes (ACS) and ensuing clinical complications. It is well known that statins decrease the risk of coronary events and may benefit the stabilization of atherosclerotic plaque with their anti-inflammatory effects. We investigated the effects of different doses of fluvastatin on serum concentrations of high-sensitive C-reaction protein (hs-CRP) and tumor necrosis factor-alpha (TNF-alpha) in the early phase of ACS.We prospectively randomized 60 patients with ACS to 3 groups: (1) group A (n=20): were given routine therapy; (2) group B (n=20): were administrated routine therapy with 40 mg/d oral fluvastatin; (3) group C (n=20): received routine therapy with 80 mg/d oral fluvastatin. Twenty patients with stable coronary heart disease served as controls. The following-up period was 7 days. By immunoturbidimetric assay and ELISA methods the serum concentrations of hs-CRP and TNF-alpha were measured before and after therapy.(1) The serum concentrations of hs-CRP and TNF-alpha in patients with ACS was significantly higher than those in the control group (P0.05). (2) After 1 week of therapy, the serum concentrations of hs-CRP and TNF-alpha were significantly lower in group B and group C (all P0.01), especially in group C. (3) The serum concentrations of hs-CRP and TNF-alpha did not correlate to the concentrations of TC, TG, LDL-C, or HDL-C.Early fluvastatin intervention decreases dose-dependently the serum concentrations of hs-CRP and TNF-alpha of patients with ACS. The high-dose fluvastatin invention may play a stronger anti-inflammatory effect in ACS patients. The anti-inflammatory effect of fluvastatin may be beyond the lipid lowering.

To study the effect of the -455G--A substitution on influencing fibrinogen levels and morbidity in patients with Budd-Chiari syndrome (BCS).53 patients with BCS diagnosed by color Doppler-ultrasound and venography and 105 healthy persons as control were observed. Assay of plasma fibrinogen was performed by the method of enzymatic reaction. DNA was extracted from white cells using the phenol/chloroform method. beta fibrinogen gene was detected by polymerase chain reaction- restriction fragment length polymorphism techniques using thermostable Taq polymerase under conditions recommended by the manufacturer.The frequencies of -455GA+AA genotype were significantly increased in patients with BCS compared with normal controls (P0.05, OR=2.04, 95% CI: 1.03-4.02). There was a significant difference in plasma fibrinogen levels between BCS subjects and control subjects (P0.01). Either in patients with BCS or in healthy controls, the plasma fibrinogen levels was significantly increased seen in the subjects with -455A alleles (0.01P0.05).beta fibrinogen gene -455G/A polymorphism is associated with increased plasma fibrinogen levels and may be an important risk factor in the pathogenesis of BCS.

Hyperhomocysteinemia (HH) is a factor that predisposes individuals to thrombosis, and the C677T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) is known to give increased plasma homocysteine. However, little is known about their roles in Budd-Chiari syndrome (BCS). This study evaluated the roles of HH and the MTHFR C677T mutation in patients with BCS. We compared 41 BCS patients with 80 sex- and age-matched healthy controls. The mean plasma homocysteine level was significantly higher in patients with BCS (20.15 +/- 5.78 micromol/L) compared with normal controls (15.80 +/- 6.58 micromol/L), P0.01. HH (19.5 micromol/L in men and15.0 micromol/L in women) was detected in 15 (36.59%) patients and in 14 (17.5%) controls (odds ratio [OR], 2.72; 95% confidence internal [CI], 1.17-6.32). The prevalence of the mutated MTHFR 677TT genotype and the 677T allele in normal controls was 10.0% and 31.3%, respectively. The mutant 677T homozygotes and alleles were more frequent in patients with BCS than in controls (22.0% vs. 10.0%, 0.025P0.05; 45.1% vs. 31.3%, 0.025P0.05). The relative risk of BCS among the carriers of 677TT was significantly increased (OR, 3.3; 95% CI, 1.1-10.0). The mutant MTHFR heterozygous 677C/T carriers were not significantly increased in patients with BCS compared with controls (46.3% vs.2.5%, P0.05). The relative risk OR of BCS among carriers of 677C/T was 1.6 (95% CI, 0.7-3.6). This study suggests that both HH and the homozygous C677T mutation in the MTHFR gene are important risk factors of BCS.