Objective To investigate the application of middle segment pancreatectomy (MSP) in treating benign pancreatic tumors and the effect on exocrine function.Methods From Jan.2010 to Feb.2013,19 cases with benign pancreatic tumor undergoing MSP were enrolled in our study.Pre-and postoperative pancreatic exocrine function were studied.Results No perioperative death happened.The tumor diameter was 4.2 to 7.0cm,operative time was 80 to 320 mins,and intraoperative blood loss was 200 to 1000 ml.The retained pancreas was＞l.5 cm at pancreatic head side,and＞5 cm at pancreatic caudal side.Three days after surgery,the peritoneal drainage and amylase was 2.5-12.5 ml and 568.4-1013 IU/L,respectively.Seven days after surgery,the peritoneal drainage and amylase was 1.0-19.8 ml and 45.4-76.3 IU/L,respectively.The postoperative hospitalization stay were 10 to 25 days.Three cases (all single anastomosis) had pancreatic fistula after surgery and healed after 3 months without undergoing surgery again.Patients were followed up for 2 months to 3 years.All patients have a good life quality,without new-onset diabetes and cancer recurrence.MSP had no side effects on pancreatic exocrine function.Conclusion MSP is safe and feasible in treatment of benign pancreatic tumors.

The ultrastructure of dissociated brain nerve cells from embryonic chicken cult ivated in vitro was studied both under SEM and TEM. Primitive synaptic junctions among the bipolar and multipolar neuronal cell bodies and its processes forming networks of fibers appeared after 4 days of culture. The presynaptic bags and desmosome-like cell junctions were observed simutaneously. Axo-dendritic, axo-somatic and axo-axonal synapses increased in number after 7 days of incubation onwards. Neuronal degeneration and proliferation of fibrous glial cells were evident in10 and 14 days cultures.

Objective To study the role of gasless laparoscopic techniques in the treatment of abdominal trauma. Methods A retrospective analysis was made on clinical data of 52 cases of abdominal trauma considered unfit for pneumoperitoneum treated by gasless laparoscopic surgery. Results Prompt diagnosis and treatment were achieved in 43 cases. A conversion to laparoscopic exploration under pneumoperitoneum was required in 5 cases. The remaining 4 cases of severe injuries of the spleen and the bowel were cured by a conversion to open surgery after the determination of the incision site under gasless laparoscope. There were no fatal cases in the study. Conclusions Use of gasless laparoscopic techniques for the diagnosis, treatment and determination of incision site in patients with abdominal trauma considered unfit for pneumoperitoneum is feasible. It is a necessarily additional alternative to traditional laparoscopic surgery.

BACKGROUND: At present, the relationship between diabetic nephropathy and osteoprotagerin remains poorly understood. OBJECTIVE: To investigate the correlation between bone mineral density (BMD) and serum osteoprotagerin changes in patients with 2 type diabetic nephropathy. METHODS: Totally 104 patients with 2 type diabetes were divided following 5 groups according to glomerular filtration rate: simple diabetes, mild renal injury, moderate renal injury, severe renal injury, and renal failure groups. Additional 20 healthy people were selected as the control group. The level of serum osteoprotegerin was measured by ELISA. Meantime, levels of serum calcium, phosphonium, alkaline phosphatase, creatinine, urea nitrogen, and glycosylatad hemoglobin were measured by. the automatic biochemistry analyzer. The bone mineral density of entopic L_(2-4) was determined by dual X-ray bone density equipment. The whole data was analyzed by multiple regression correlation analysis. RESULTS AND CONCLUSION: The level of serum osteoprotegerin in patients with diabetic nephropathy was obviously greater than that of the healthy people (P < 0.05), but BMD of the mild renal injury, moderate renal injury, severe renal injury, and renal failure groups was obviously lower than that of the healthy people (P < 0.05). Generally, the worse renal function accompanied by higher osteoprotegerin level, and lower BMD. There was a negative correlation between ostaoprotegerin level and BMD in patients with diabetic nephropathy (r=-0.497, P < 0.01). However, the relationships between osteoprotegedn level and diabetic duration (r=0.566, P < 0.01), serum creatinine level (r=0.772, P < 0.01), serum urea nitrogen level (r=0.708, P < 0.01), serum phosphonium level (r=0.329, P < 0.01), or serum intact parathyroid hormone level (F=0.702, P < 0.01) were positive. Meantime, the serum phosphonium level had negative correlation to serum calcium level (r=-0.505, P < 0.01). it demonstrated that when the renal function got worse in diabetic nephropathy patients, the serum osteoprotegerin level was increasing accompanied by BMD decreasing. The osteoprotegerin level presents a negative correlation to BMD and serum calcium level, but positive to diabetic duration, serum creatinine, serum urea nitrogen, serum phosphonium and serum intact parathyroid hormone levels.

With light and electron microscope, we studied the morphology of the thymus of the neonatal mouse. The results showed: 1.the lobules of the thymus had not well developed and there was no distinct demarcation between the cortex and medulla; 2.a cyst composed of epithelial cells with microvilli or cilia might be frequently seen in the medulla; 3.occasionally small lymphocytes with some glycogen particles in their cytoplasm were observed; 4.only a few small-sized thymic corpusles existed in the medulla, The article also described the ultrastructure of the lymphocytes, epithelial reticular cells, macrophage, interdigitating cell and blood-thymus barrier in the thymus of the neonatal mouse.

Objective To provide evidence for clinical practice by analyzing the factors associated with bloodstream infection in ICU patients through retrospective case-control study. Methods Using self-made data collection form, 133 cases of blood sample record from HIS system during May 2013 to December 2015 at Peking Union Medical College Hospital ICU ward were collected. In this study, 54 patients with positive blood culture results were allocated to the case group while 79 patients with negative results were in the control group. Baseline characteristics, which included sex, age and chronic diseases, were almost the same between both groups. Binary Logistic regression analysis was used to identify factors related to blood infection. Results During May 2013 to December 2015, there were 54 blood infectious cases, among which 19 cases with positive gram bacteria accounted for 35.2%(19/54), 57.4%(31/54) of gram-negative bacilli and 7.4%(4/54) of fungal infection. Logistic regression analysis revealed that blood filtration treatment (OR=7.691), pulmonary infection (OR=7.682), ICU (OR=1.115), Acute Physiology and Chronic Health Evaluation (APACHEⅡ) scores(OR=1.096), procalcitonin (OR=1.065) were risk factors of bloodstream infection for ICU patients, while albumin (OR=0.763) was a protective factor. Conclusions Blood filtration treatment, pulmonary infection, hospital length of stay, APACHEⅡand procalcitonin are factors associated with bloodstream infection in ICU patients. Clinical procedures in ICU should mainly focus on improvement of prevention awareness, strict aseptic technology, professional quality of nursing staff. Besides, guarantee of patients′nutrition, effective treatment of primary diseases, and shortened hospital length of stay are also important to reduce the infection and improve quality of life of these patients.

BACKGROUND: Immunonutrition therapy can increase the synthesis of proteins with shorten half-life, regulate the local and whole body cytokines production, make the intestinal structure and functional integrity, up-regulate the immunity-inhibiting after operation through the improvement of cellular immune function. It has been proved that the appropriate nutritional therapy during perioperative period can improve the patients' immune function; however, enteral immunonutrition (EIN) in patients undergoing liver transplantation is rarely reported. OBJECTIVE: To evaluate the safety and effectiveness of EIN therapy during liver transplantation.METHODS: Eighty-four patients undertaking liver transplantation were randomly divided into two groups, namely EIN group and regular enteral nutrition (EN) group (given EIN and common EN respectively). The liver function, cellular immunity, humoral immunity, infection and the incidence of rejection were monitored in order to compare the therapeutic efficacy of two kinds of nutrition therapies. RESULTS AND CONCLUSION: The serum prealbumin and cholinesterase levels were impressively higher in the EIN group at 1 day before operation than before nutritional therapy. The expressions of CD3+ and CD4+ were significantly higher in the EIN group than the EN group at 1 day before operation (P < 0.05). The recovery of cell immunity was delayed 1 week in the EN group as compared with the EIN group; at 1-28 days after operation, IgA level was higher in the EIN group than in the EN group (P < 0.05). No increase in the incidence of infections occurred in the two groups. The results suggest that the EIN can improve the cell immunity and humoral immunity with a better effect than the EN. The EIN therapy is necessary for the rehabilitation of patients undergoing liver transplantation at the perioperative stage.

Objective To evaluate the potential feasibility of γ-H2AX foci as a biodosimetry after exposure to ionizing radiation by comparing DNA double-strand break repair kinetics in rat blood lymphocytes with that in human lymphocytes.Methods Peripheral blood lymphocytes separated from Sprague-Dawley(SD) male rats and healthy adults were exposed to γ-rays,and some rats were also subjected to total body irradiation.The inductions of DNA repair-related foci of γ-H2AX,pATM (S1981) and pDNA-PKcs (T2609) were detected with immunofluorescence staining technique at different time points post-irradiation,and the status of their co-localization was analyzed.Results The induction kinetics of γ-H2AX foci in rat lymphocytes was similar to that observed in human lymphocytes.The frequencies of γ-H2AX foci peaked at 30 min after γ-ray irradiation (trst =62.64,th =28.52,P ＜ 0.05),then decreased rapidly after 6 h post-irradiation (trat =45.96,th =14.80,P ＜0.05),and the residual foci number remained only about 3％-8％ of its maximal value at 24 h post-irradiation.At 30 min after γ-ray irradiation,the frequencies of pATM (S1981) and pDNA-PKcs (T2609) foci in rat and human lymphocytes significantly higher than those of nonirradiated control (trat =21.05,25.80,th =11.07,29.52,P ＜ 0.05),and the frequencies of co-localization of pATM (S1981) or pDNA-PKcs (T2609) foci with γ-H2AX foci also markedly increased by 26％-32％ in irradiated lymphocytes of rat and human (trat =5.34,9.14,thuman =18.32,51.28,P ＜0.05).Moreover,γ-H2AX foci incidence in rat lymphocytes in vitro was consistent with that induced by total body irradiation of rat.The number of γ-H2AX foci in irradiated rat lymphocytes increased with irradiation dose in a linear dose-dependent manner,its slope was similar to that of irradiated human lymphocytes reported by other laboratory.Conclusions Rat is a useful animal model to evaluate radiation biodosimetry with γ-H2AX foci in lymphocytes.The co-activation of ATM and DNA-PK plays an important role in DSB repair in the irradiated lymphocytes of rat and human.

Objective To investigate the effects of glycogen synthase kinase-3β (GSK-3β) and β-catenin signaling on the human renal proximal tubular epithelial HK-2 cell injury induced by depleted uranium(DU),and provide a new enlightenment for the development of DU antidotes.Methods H K-2 cells were exposed to different concentrations of DU for 3-24 h,then the protein expressions of kidney injury molecule 1 (KIM-1),neutrophil gelatinase-associated lipocalin (NGAL) and nuclear β-catenin were detected by immunofluorescence staining.The protein expressions of p-GSK-3 β(S9),GSK-3β and cmyc were detected by Western blot assay.HK-2 cells were transiently transfected by GSK-3β (KD) plasmid or treated by TDZD-8 to inhibit the activity of GSK-3β specifically.Other HK-2 cells were transiently transfected by β-catenin plasmid to overexpress the β-catenin protein.Results The percentages of KIM-1 and NGAL-positive cells increased with DU exposure time and concentrations from 300 and 600 μmol/L,and they were significantly higher than those of the blank control at 6-24 h of DU exposure (KIM-1-positive cells:t =11.06,18.97,30.49,P ＜0.05;t =6.79,16.02,85.45,P ＜ 0.05;NGAL-positive cells:t =11.78,11.37,34.29,P ＜0.05;t =7.34,21.63,36.84,P ＜0.05).In contrast,the ratio of p-GSK-3β (S9) to GSK-3β and percentage of nuclear β-catenin-positive cells were significantly higher than that of the blank control at 3-24 h of DU exposure (p-GSK-3β(S9)/GSK-3β:t =3.95,4.69,5.40,3.34,P ＜ 0.05;nuclear β-catenin-positive cells:t =4.61,6.52,36.64,14.93,P ＜ 0.05) with a maximum response at 9 h of DU exposure accompanied with corresponding increase of protein level of c-myc,a downstream target gene of β-catenin.Transient transfection of HK-2 cells with GSK-3β (KD) plasmid significantly inhibited the activity of GSK-3β (t =8.07,P ＜ 0.05) and reduced the DU-increased percentage of KIM-1-positive cells (t =24.77,P ＜ 0.05).Treatment cells with TDZD-8 inhibited the activity of GSK-3β and enhanced the percentage of nuclear β-catenin-positive cells,and it also significantly reduced the percentage of KIM-1-positive cells in HK-2 cells exposed to DU (t =6.25,6.73,P ＜ 0.05).Moreover,overexpression of β-catenin significantly reduced DU-induced cell injury (t =7.48,P ＜ 0.05).Conclusions GSK-3β/β-catenin signaling plays a key role in regulating the DU-induced cytotoxicity of HK-2 cells.Inhibition of GSK-3β activity and overexpression of β-catenin can protect the HK-2 cells from DU-induced damage.

Objective:To define the range and classification of adjuvant drugs. Methods:In order to explore the definition meth-od for the range and classification of adjuvant drugs, the information of definition and classification of adjuvant drugs was obtained by searching PubMed, CNKI, Wanfang database and medicine monographs such as Clinical Medication Notice, New Pharmacology and Martindale:The Complete Drug Reference. Results:The preliminary conclusion on definition, range and classification method for ad-juvant drugs was achieved. Adjuvant drugs were classified into ten categories, so that the adjuvant drugs in our hospital were super-vised. Conclusion:In order to promote the standardized management of clinical application of adjuvant drugs, the range and classifica-tion of adjuvant drugs still need further discussion and standardization.