Objective　To investigate the systemic stress responses of laparoscopic cholecystectomy(LC). Methods　Seventy patients with cholecystolithiasis were randomly divided into two groups: LC and open cholecystectomy(OC). Peripheral blood samples were obtained during the preoperative day and 1, 3, 5, 7 day after operation. Serum cytokines levels (TNF-α, IL-1β and IL-6) and C-reactive protein(CRP) were measured. Results　Changes of TNF-α and IL-1β before or after surgery in both groups showed no significant difference(P>0.05). Serum concentrations of IL-6 and CRP after surgery in both groups were significantly higher than those before surgery(P<0.05); but there were no significant difference between the two groups(P>0.05). Conclusions　The systemic stress responses of LC have no significant difference comparing with OC.

0.05). The valve competence recovery rate in severe PDVI group was significantly lower than that of the mild and moderate PDVI groups (both P

Objective To sum up operative experience and prevention of complications while resecting the hepatic hilar tumor. Methods 14 cases with hepatic hilar tumor were analyzed in respect of operative method,complications, experience and prevention of complications. Results Some peri-operative complications happened. such as massive hemorrhage in 2 cases,billiary fistula in 1 case,hepatic failure in 1 case and tumor remained at resection edge in 1 case. No patients died during the operation. Conclusion The resection of hepatic hilar tumor is very difficult and risky,safety of surgery can be improved by paying attention to pre-operative evaluation and preparation,as well as carefulness during operation.

Objective To explore the characteristics of pathogenic bacteria and risk factors for stroke‐associated pneumonia (SAP) in senile patients in order to privide basis for early clinical intervention .Methods A retrospective study was carried out to review the clinical data of 689 SAP patients treated at a university hospital between January 1 ,2011 and December 12 ,2013 . The pathogens from sputum and their antibiotic resistance profiles were analyzed .Multivariate Logistic regression model was used to screen relevant factors for stroke‐associated pneumonia (SAP) in a case‐control analysis at 1∶1 ratio .Results Of the 684 bacterial strains isolated from sputum , 545 (79 .7% ) were gram‐negative bacteria . The top bacterial species were Pseudomonasaeruginosa,Klebsiellapneumoniae,Acinetobacterbaumannii,and Enterobacterspp.Gram‐negativebacteria were highly resistant to most of the antimicrobial agents . About 31 .8% of the Acinetobacter strains were resistant to imipenem .A total of 139 (20 .3% ) gram‐positive strains were isolated . Staphylococcus aureus was the most frequently isolated gram‐positive pathogen (51 .8% ) , of which 63 .9% were resistant to methicillin (MRSA) .Most gram‐positive bacteria were sensitive to vancomycin , teicoplanin and linezolid . Multivariate Logistic regression suggested that age ( OR = 5 .632 ) , NIH stroke scale (NIHSS) score (OR= 4 .126) ,dysphagia (OR= 3 .481) , totally bedridden (OR=3 .431) ,mechanical ventilation (OR=4 .214) ,hyperglycemia (OR=2 .076) ,hypoalbuminemia (OR=2 .008) ,and high serum cortisol (OR=1 .825) were the major risk factors for SAP in senile patients .Conclusions Multiple antibiotic‐resistant pathogens are usually identified in the senile SAP patients .Early intervention to control the risk factors of SAP is important for prevention of SAP in senile patients .

OBJECTIVE: To investigate the role of phosphorylation of glycogen synthase kinase-3beta (GSK-3beta) inducing epithelial mesenchymal transition in human peritoneal mesothelial cells (HPMC). METHODS: Primary HPMC was harvested from human omental tissue and maintained under defined in vitro conditions. The expression of p-GSK-3beta and total GSK-3beta in HMPC was detected by Western blot after incubation with different concentrations (0, 5, 10, 20, and 40 mmol/L)of LiCl at different time points (0, 1, 3, 6, and 12 h). The protein expression of E-cadherin and alpha-SMA was also examined after treatment with 20 mmol/L LiCl according to different time courses. The intracellular distribution and expression of alpha-SMA were determined by indirect immunofluorescence. RESULTS: LiCl stimulated phosphorylation of GSK-3beta and the effect was time-dependent and concentration-dependent to limited extent (P<0.05). The expression of alpha-SMA increased (P<0.05) and the expression of E-cadherin decreased significantly (P<0.05) after 24 h stimulation by 20 mmol/L LiCl. The indirect immunoflurescence showed that the expression of alpha-SMA in HPMC increased significantly after 24 h incubation with 20 mmol/L LiCl. CONCLUSION The phosphorylation of GSK-3beta leads HMPC to epithelial mesenchymal transition and provides new clue for the treatment of peritoneal fibrosis.
Actins ; metabolism ; Cadherins ; metabolism ; Epithelial Cells ; cytology ; drug effects ; Epithelial-Mesenchymal Transition ; drug effects ; Glycogen Synthase Kinase 3 ; metabolism ; Glycogen Synthase Kinase 3 beta ; Humans ; Lithium Chloride ; pharmacology ; Mesoderm ; cytology ; drug effects ; Peritoneum ; cytology ; Phosphorylation