Objective To explore the indications,surgical techniques and clinical effects of laparoscopic splenectomy on patients with portal hypertension. Methods Analysis the clinical data of 32 patients of portal hypertenision with laparoscopic splenectomy and open splenectomy from March 2006 until June 2009. Results The effectiveness of the procedures for portal hypertension was evaluated.Among 16 patients with LS, 2 patients were converted to open surgery. There is no significant difference with operatative time, blood loss and hospital fees between the two groups, the laparoscpy group had the shorter mean hospitalization, fasting and draining time. Conclusions If there are enough preparation preoperation, skillful laparoscopic technique and micromesh manipulation during operation,laparoscopic splenectomy is a minimally invasive and safe technique in the patients with lower-grade to medium varicose veins.

Objective To evaluate the safety and feasibility of total laparoscopic hepatectomy for liver neoplasms.Methods Laparoscopic hepatectomy in 15 patients with liver neoplasms were completed by combined application of ultrasound scalpel,Ligasure and vascular clip without blockage of liver blood flow,including 9 cases of hepatic cavernous hemangioma,whose diameters were from 5.0 cm to 15.0 cm,3 cases of hepatic cyst with fibrosis,located in left lateral hepatic lobe,3 cases of primary hepatic carcinoma,whose diameters were from 1.0 cm to 5.0 cm and the hepatic functions were all Child A.Results Laparoscopic hepatectomy was completed successfully in all 15 cases with no conversion to open laparotomy,including 6 cases of left lateral hepatectomy,9 cases of irregular hepatectomy.The mean operative time was 110 min,blood loss during operation was from 30 ml to 500 ml,the average was 251 ml.The mean postoperative hospital stay was 6.5 d.The mortality rate was 0%.No severe complications occurred except 1 case of small amount bleeding which stopped itself.Conclusion Total laparoscopic hepatectomy is a feasible,safe and minimal invasive approach for patients with liver neoplasms within segment Ⅱ、Ⅲ、Ⅳa、Ⅴ、 and Ⅵ.

[Abstract ] Objective C reactive protein (CRP), an in-flammatory maker, increased significantly among diabetes mellitus and other metabolic diseases.Meanwhile, adiponectin plays a vital role in anti-atherogenic, anti-inflammatory and anti-diabetic poten-tials.Further, it decreased in diabetes mellitus.To investigate the effects of C-reactive protein in the expression of high-molecular-weight adiponectin ( HMWA) and adiponectin multimerization. Methods The fully differentiated 3T3-L1 cells were respectively treated with 50μg/mL CRP for 0 h、6 h、12 h and 24 h , and different doses of CRP with 0μg/mL、5μg/mL、25μg/mL、50μg/mL for 24 h.The expres-sion of HMWA was further detected by Western blot.Additionally,
the mRNA expressions of adiponectin assembly related genes ( Ero1-L、DsbA-L、ERp44 ) were detected by Real time PCR after 50μg/mL CRP treatment for 24 h. Results After 24 h treatment, 25μg/mL CRP and 50μg/mL CRP resulted in a substantial reduction ( [70 ±7]%vs [44 ±7]%, P<0.05) while 5μg/mL CRP revealed no change.With the dose of 50μg/mL CRP treated, the ex-pression of HWMA were both inhibited after the 12 h and 24 h CRP treatment ([71 ±6]%vs [48 ±11]%, P<0.05), but for the 6 h CRP treatment group, HWMA remained unchanged.Additionally, CRP inhibited Ero1-L(86 ±10)%and DsbA-L(72 ±6)%gene expression and upregulated the expression of ERp44(141 ±23)%. Conclusion CRP decreases HMWA expression in a dose and time-dependent manner and inhibits the multimerization of adiponectin, thus weaken the benefits of adiponectin in diabetes.

Objective To compare the effect of naive porto-azygous devascularization and that as a remedy therapy after a failed endoscopy for the treatment of bleeding portal hypertension.Method From June 2005 to June 2010,230 portal hypertension patients were treated with porto-azygous devascularization,among them,202 cases were of portal hypertensive cirrhotics,28 cases of alcoholic cirrhosis.Group A (16 patients)received remedial porto-azygous devascularization after endoscopic treatment failed (esophageal variceal ligation,esophageal variceal selerotherapy).Group B(214 patients)received naive porto-azygous devascularization.Results The average operation time in group A was 198 min(115-335)min,mean bleeding amount was 750 ml(300-2000)ml,average post-operative hospital stay was 11 days (8-15)days.The average operation time in group B was 120 min(90-190)min,mean blood loss was 250 ml(150-500)ml,average post-operative hospital stay was 7 days(6-9)days.The average operation time,bleeding amount and post-operative hospital stay was significantly different between the two groups (P＜ 0.05).212(92.2％)patients were followed up,and the mean follow-up time was 2.5 years (1-6)years,mortality rate was 4.2％,rebleeding rate was 5.7％.Conclusions Surrounding the perioesophageal and gastric tissues were fibrotic and hard after the endoscopic treatment,this significantly increased the difficulty of surgery,therefore,porto-azygous devascularization is the choice of therapy for portal hypertension patients.

The resource of rare and endangered medicinal plant Swertia mussotii Franch. in Tibet, Qinghai and Sichuan province were surveyed by ways of documents, interview, quadrat and market investigation. The results indi-cated that Swertia mussotii Franch. mainly distributed in Zuogong and Mangkang of Tibet, Yushu of Qinghai province, Shiqu, Daofu, Kangding, Maerkang, Jinchuan and Xiaojin of Sichuan province. According to the height above sea level, the distribution altitude was from 2 300 m (Kangding of Sichuan province) to 3 900 m (Mangkang of Tibet). There are distributions of Swertia mussotii Franch. within the scope of 2 600 m. The illumination, water, soil, temperature and altitude had significant influence on the distribution, growth and reserve of Swertia mussotii Franch. from different angles. In recent years, there was huge increase of market requirement in Swertia mussotii Franch. which were used in Tibetan medicine Zangyinc he n. Excess collection was the primary cause of rapid decreasing in resource of Swertia mussotii Franch.. It was suggested to strengthen the management of rational collection, as well as to accelerate the development of cultivation and production.

The fourth time national survey of Chinese materia medica (CMM) was used. The quadrat survey contained recording on species and amounts of plants, collection of specimens and CMM. The weight of main medicinal plant was measured. The quadrat numbers were calculated on regions, plant species and sea level of samples from different regions. There were 703 species of medicinal plants. The 143 species of main medicinal plants, which occupied to 74.5% in main medicinal plants in Chongqing, belonged to 71 families and 132 genera. There were 128 species of wild main medicinal plants. The 30 species of main medicinal plants were cultivated (including 15 species of both wild and cultivated medicinal plants). Among them, 14 species were in large-scale cultivation. This investigation helped the understanding of present situation of medicinal species distribution in Chengkou County, the habitats of wild medicinal plants, and the resources reserves, which provided references for the continuous development of Chinese herbal medicine resources.

ObjectiveTo study the effect of hydrogen peroxide (H2O2) in inducing apoptosis of typeⅡalveolar epithelial cell (AECⅡ) after overexpression by adenoviral transfection of micro RNA-21-5p (miR-21-5p), and to explore the mechanism of its anti-apoptosis.Methods Subculture AECⅡ were randomly divided into four groups: normal control group (normal saline), H2O2 challenge group ( 0.5 mmol/L H2O2), miR-21-5p overexpression group (miR-21-5p adenovirus+ 0.5 mmol/L H2O2), miR-21-5p negative transfection group (adenovirus void+0.5 mmol/L H2O2). Transmission electron microscopy and flow cytometry were used to detect apoptotic morphology and early apoptotic rate. Real-time fluorescence quantitative reverse transcription-polymerase chain reaction (RT-PCR) was used to detect the expression of miR-21-5p in AECⅡ, and Western Blot was used to detect the protein expressions of Bcl-2, Bax, and caspase-3 at the highest transfection efficiency at different time points (6, 12, 24, 48 hours).Results ① AECⅡ identification: fluorescence microscopy showed the presence of characteristic structure of AECⅡ, i.e. microvilli and osmiophilic lamellar bodies.② Apoptotic morphology: transmission electron microscopy showed cytoplasmic retraction, chromatin condensation, margination, lack of cell surface microvilli, and emptying of osmiophilic lamellar bodies in AECⅡ.③ The expression of miR-21-5p in AECⅡ: the highest transfection efficiency was found at 48 hours. The expression of miR-21-5p in miR-21-5p overexpression group was significantly higher than that of the normal control group, H2O2 challenge group and miR-21-5p negative transfection group (A value: 1.54±0.02 vs. 1.02±0.02, 0.56±0.03, 0.58±0.02, allP< 0.05).④ The rate of early apoptosis: compared with normal control group, the early apoptotic rates in H2O2 challenge group, miR-21-5p negative transfection group and miR-21-5p overexpression group were gradually elevated with the prolongation of injury time. The early apoptotic rate in miR-21-5p overexpression group was significantly lower than that of the H2O2 challenge group and miR-21-5p negative transfection group at all time points except 6 hours [12 hours: (10.73±2.80)% vs. (16.26±0.59)%, (16.04±0.70)%; 24 hours:(16.00±3.44)% vs. (23.29±2.78)%, (23.58±2.31)%; 48 hours: (31.30±3.55)% vs. (50.53±2.17)%, (49.41±1.97)%, allP< 0.05]. There was no significant difference in early apoptotic rate between miR-21-5p negative transfection group and H2O2 challenge group at each time point.⑤ Protein expression: the expressions of Bax and caspase-3 in miR-21-5p overexpression group were significantly lower than those of the H2O2 challenge group and miR-21-5p negative transfection group [Bax (A value): 0.07±0.01 vs. 0.18±0.01, 0.13±0.01; caspase-3 (A value): 0.07±0.01 vs. 0.23±0.01, 0.12±0.01, allP< 0.05], and Bcl-2 protein expression was significantly higher than that of the H2O2 challenge group and miR-21-5p negative transfection group (A value: 0.26±0.01 vs. 0.06±0.01, 0.10±0.01, both P< 0.05).Conclusions① miR-21-5p has the function of anti-apoptosis of AECⅡ.② Adenoviral vector is a successful gene transfer vector when transfected with AECⅡ.③ The anti-apoptosis of AECⅡ by miR-21-5p may be associated with reduced Bax and caspase-3 protein levels and raised expression levels of Bcl-2 protein.

Objective To investigate the effects of microRNA-21-5p (miR-21-5p) on hyperoxic acute lung injury (HALI) in rats and provide a theoretical basis for HALI gene therapy. Methods One hundred and sixty Sprague-Dawley (SD) rats were randomly divided into four groups with number table:hyperoxia control group, phosphate buffer saline (PBS) group, blank virus group and miRNA-21-5p group (each, n = 40). The rats in hyperoxia control group were fed directly in the hyperoxia box (oxygen concentration > 90%); in the other three groups, 200 μL PBS, 200μL slow virus and 200μL miRNA-21-5p slow virus were dropped into the nose respectively, and then they were fed in the hyperoxia box. The rats were exposed to hyperoxia in the boxes for 0, 24, 48 and 72 hours in all the groups, and at each time point, 10 rats were taken randomly from each group to perform arterial blood-gas analysis, calculate oxygenation index (OI) and respiratory index (RI). Afterwards the rats were sacrificed by blood-letting from carotid artery under intra-peritoneal anesthesia, and the lung tissues were obtained to measure the left lung wet/dry weight (W/D) ratio, hemotoxylin-eosin (HE) staining was made and the pathological changes of the right lung were observed under light microscope and the pathological score was measured. Results At 0 hour, the OI, RI, lung W/D ratio and the lung tissue pathology score in rats with hyperoxic injury had no statistically significant differences among the four groups (all P>0.05). With the extension of time, the level of OI was gradually reduced, and the levels of RI, pathologic score and W/D ratio of lung tissues were gradually increased. Compared with the hyperoxia control group, in miRNA-21-5p group, the levels of OI were increased significantly at 24, 48 and 72 hours after the exposure to hyperoxia [mmHg (1 mmHg = 0.133 kPa): 24 hours 358.10±29.25 vs. 306.19±37.23, 48 hours 336.67±29.27 vs. 269.70±29.00, 72 hours 323.81±19.05 vs. 203.81±43.40, all P < 0.05], whereas the levels of RI were decreased significantly (24 hours 0.23±0.05 vs. 0.31±0.06, 48 hours 0.28±0.07 vs. 0.38±0.06, 72 hours 0.30±0.04 vs. 0.46±0.07, all P <0.05), the pathologic scores were decreased significantly (24 hours 0.60±0.52 vs. 0.90±0.74, 48 hours 1.30±0.95 vs.2.90±1.20, 72 hours 1.90±0.88 vs. 4.70±1.57, all P < 0.05) and the levels of W/D ratio were decreased obviously (24 hours 3.77±0.38 vs. 4.14±0.46, 48 hours 3.83±0.31 vs. 4.56±0.34, 72 hours 3.89±0.31 vs. 5.32±0.27, all P<0.05). Compared with the hyperoxia control group, the index results of the PBS group and the blank virus group after staying in the box had no statistical significant differences at each time point (all P>0.05). Under the optical microscope, along with the prolongation of exposure to hyperoxia, the structure of alveoli was gradually disturbed, their walls fractured and damaged, alveolar septa widened, edematous, infiltrated with inflammatory cells and in part of the rats a small amount of red blood cell exudates could be seen, but the degree of lung pathological injury in miRNA-21-5p group was much milder than that of the other groups. Conclusion The rat persistently exposed to hyperoxia for 24 hours can establish the rat model of HALI successfully, and the miRNA-21-5p can protect the lung tissue from the damage to some degrees in HALI rats.

Objective To summarize the clinical applications and surgical technique of laparoscopic distal pancreatectomy (LDP). Method The clinical data of 10 cases of pancreatic body and tail tumors undergoing laparoscopic distal pancreatectomy were retrospectively analyzed.Results Laparoscopic distal pancreatectomy (LDP) was successfully undertaken in 8 cases (including spleen preserving distal pancreatectomy in one case ). Intraoperatively two cases were converted to open surgery because of peripancreatic organs involvement by cancer in one case and massive bleeding in another case during laparoscopic procedures. The average operation time of LDP was 141 ± 35 min (95 -195 min),mean blood loss was 263 ± 151 ml( 100 -600 ml), average postoperative hospital stay was 7 ± 1 days (5 -9 days ). There was no major postoperative complications and no mortality. Final pathology was solid psedopapillary tumor in 4 cases, mucinous cystadenoma in 3 cases and islet cell tumor in 1 case, pancreatic ductal adenocarcinoma in 2 cases, hence 80% of tumors were benign. Conclusions LDP is indicated for benign body and tail pancreatic tumors and early malignant tumor of pancreatic body and tail. Being less traumatic, and fewer complications, LDP is a safe, effective and minimally invasive therapy.

Objective To explore a simpler, more economic and reproducible method to reproduce a model of high oxygen induced acute lung injury (HALI) in rats. Methods An animal feeding box equipped with a controllable high oxygen was designed. 100 Sprague-Dawley (SD) rats were divided into normal control group and HALI group by random number table method, with 50 rats in each group. Each group was randomly subdivided into five subgroups according to the duration of exposure to high oxygen, namely 0, 24, 48, 72 and 96-hour subgroups, with 10 rats in each subgroup. The rats in normal control group were kept in cages with ambient air, and the rats in HALI group were kept in an oxygen tank in which the oxygen concentration was higher than 90% volume ratio, with the temperature maintained at 25-27 ℃, humidity of 50%-70%, and CO2 concentration < 0.5% for 23.5 hours every day. The arterial blood of rats was collected for analysis of blood gas at all time points, and the oxygenation index (OI) and respiratory index (RI) were calculated. Then the rats were sacrificed and the right lung was harvested, which was sectioned and stained with hematoxylin and eosin (HE). The changes in histopathology were observed with light microscopy, and pathological score was recorded. The left lung was harvested for the measurement of the wet/dry weight ratio (W/D). Results With the prolongation of high oxygen exposure time, the degree of lung injury in HALI group was gradually increased, and the degree of derangement of alveolar structure appeared in an increasing degree, with destruction of the alveolar wall, widening of alveolar space, and appearance of edema, and inflammatory cell infiltration. A small quantity of red blood cells exudation could be found in some rats. The pathologic changes were most obvious at 48-72 hours after exposure. With the prolongation of high oxygen exposure time (0, 24, 48, 72, 96 hours), the OI (mmHg, 1 mmHg = 0.133 kPa) in HALI group was gradually decreased (446.67±29.93, 306.19±37.23, 269.70±29.00, 253.81±43.40 and 245.58±35.25), RI, pathological score of lung tissue and W/D ratio were gradually increased [RI: 0.25±0.04, 0.31±0.06, 0.38±0.06, 0.46±0.07 and 0.44±0.03; pathological score of lung tissue: 0.00±0.00, 0.90±0.74, 2.90±1.20, 4.70±1.57 and 4.80±1.23; lung W/D ratio: 3.84±0.61, 4.14±0.46, 4.56±0.34, 5.32±0.27 and 5.18±0.25]. Statistically significant differences were found in 72-hour group as compared with that of other groups (all P < 0.05), while no significant difference was found between 96 hours and 72 hours groups (all P > 0.05). There were significant differences in changes between 24, 48, 72, and 96 hours as compared with those of the normal control group: OI (mmHg): 24 h 306.19±37.23 vs. 435.65±25.34 and 96 h 245.58±35.25 vs. 465.42±24.75; RI: 24 h 0.31±0.06 vs. 0.24±0.04 and 96 h 0.44±0.03 vs. 0.24±0.06. The same as true in pathological scores of lung tissue: 24 h 0.90±0.74 vs. 0.00±0.00 and 96 h 4.80±1.23 vs. 0.00±0.00; lung W/D ratio: 24 h 4.14±0.46 vs. 3.79±0.44 and 96 h 5.18±0.25 vs. 4.12±0.91, all P < 0.05. Conclusions A self-designed high oxygen box is simple, easy to operate and reproduction of HALI model can be attained. Sustained exposure to high concentrations of oxygen (≥ 90%) for 24 hours can replicate the HALI model successfully, and the most serious injury appears at 48-72 hours after exposure.