Objective To investigate the relation of a lipopolysaccharide receptor CD14C-159T gene polymorphism to severe sepsis susceptibility and outcome in postoperation.Methods A prospective,consecutive entry study WSS made among 42 postoperative severe sepsis admitted in neurosurgeon,and 50 health volunteers.The genomic DNA of peripheral blood nucleated was extracted.Typing of each patient for the CD14-159C/T gene polymorphism was performed by restrictive fragment length polymorphism(RFLP).Genotypes were then related to the susceptibility and mortality rate of severe sepsis.Results Development of postoperative severe sepsis increased in patients homozygous for the allele T(78.4%)than that of the allele C(21.6%)(P＜0.05).The mortalitv of sepsis were significantly higher in patients with CD14 homozygous for the T allete(TT)(84.6%)than those with genotype TC (15.4%)and C ailetc(CC)(O).Conclusion The single base pair polymorphism at position-159 in the CD14 gene promoter might influence the development of severe sepsis as well as outcome in postopration.

Objective To investigate the relation of a lipopolysaecharide receptor CDl4C-159T gene polymorphism to severe sepsis outcome and cytokines in postoperative severe sepsis.Methods A prospective,consecutive entry study was made among 42 postoperative sevel'e sepsis admitted in neurosurgeon department,Second People～Hospital ShenZhen between Feb.2007 to Jul.2007.The genomie DNA of peripheral blood nucleated cells WaS extracted.CDl4-159C/T gene polymorphism patients was detected by restrictive fragment length polymorphism(RFLP)analysis.The relationship between genotypes and the production of eytokines TNF-α,IL-6,IL-10 and mortality rate of severe sepsis were evaluated.Results The mortality of sepsis in patients with CDl4 homozygous for the T allete(Tr)(69.2％)was significanfly higher than those with genotype CT(23.1％)and C allete(CC)(7.7％).In addition,TNF-a and IL-6 production ofTI'homozygore were markedly higher than those of the TC and CC genetypes.while IL-10 production were the lowest of the three(P<0.05).Conclusion The single base pair pelymorphism at position-159 in the CD14 gene promoter might influence the outcome of severe sepsis and may be related to production of pro-inflammatory cytokines TNF-α,IL-6,and decrease the anti-inflanunatiry factor IL-10.

Objective:To perform trans-peritoneal laparoscopic adrenalectomy via a single incision in treatment of adrenal tumors,and to discuss its clinical outcome and safety.Methods:Single incision trans-peritoneal laparoscopic adrenalectomy was used in treatment of three patients with adrenal tumors.The incision was made 3 cm below the costal margin of anterior axillary line; three Tocars were placed in the cut.The instruments used included single port access,CUSA,Hem-o-lok,etc..Results:The three operations were all successful,and there were no conversion to open procedure or a need for extra Ttrocars.The operating time periods were 75,116,and 135 min,with a mean of (108.7?30.7)min.The perioperative blood losses were 10,20,and 30 ml,with a mean of (20?10)ml.The gastric canal and ureteral catheter were withdrew one day after operation,and the drainage tube was withdrew 3 d after operation.The mean postoperative hospital stay was 4 d.Conclusion:Single incision trans-peritoneal laparoscopic adrenalectomy has the advantage of little trauma,less blood loss,satisfactory safety,and prompt postoperative recovery,but is difficult to manage.