2 years;appearedrigh quadrent abdominal signs,thickness of gallbladder wall≥3 mm;and hydrops of gallbladder.Conclusions The risk factors for conversion of LC to OC were attacks of acute cholecystitis,the length of disease,tenderness of upper abdomen,thickening of gallbladder wall and hydrops of gallbladder.A detailed history,clinical examination with suitable imaging test,proper selection of patients and improving the skill of operators,may decrease the occurrence of the LC conversion rate and the complicationafter operation.OC should be selected for the patients with the above risk factors.

Objective To study the expression and significance of CEA in occult micrometastasis ofcolorectal carcinoma. Methods 287 cases without metastatic lymph nodes were observed in 54 cases ofcolorectal carcinoma by immunohistochemical (LSAB) method. Results 15 cases of lymph nodes werefound with occult micrometastasis in 8 patients. All micrometastasis was positive in detection of CEA.Conclusion Detection of CEA was conducive to detect micrometastasis of lymphnode. It is significant forDukes staging,prognostic determination and treatment.

Objective To investigate the prevalence of undernutrition, nutritional risks, and the application of nutrition supports in different hospitals in Shandong province, and to estimate the related complication rate.Methods Totally 2792 patients from different hospitals in Shandong were enrolled, and their nutritional risks were assessed using Nutritional Risk Screening (NRS) 2002. The application of nutritional supports, the length of hospital stay, and the incidences of infectious and non-infectious complications were documented. Results The incidences of undernutrition and nutritional risk among patients in large hospitals were significantly higher than those in middle and small hospitals (5.6%, 1.6%, 2. 7%; 27.3%, 15.4%, 18.3%; P =0. 000). The overall rate of nutritional support was 43. 60%, and there were significant difference among patients in different hospitals (51.5 %, 30. 8 %, 20.9 %, P = 0. 000). Parenteral nutrition was most widely applied. Among the 483 patients in large hospitals, the incidence of complication in patients with nutritional risks was significantly higher than those without nutritional risks (31.3% versus 13.7%, P =0. 000). Of the "with nutritional risk" patients, the infectious complications were significantly lower in the nutritional support group (P = 0. 000). Of the patients without nutritional risks, there was no statistical difference between the nutritional support group and the non-support group. (P ＞ 0. 05). Conclusions NRS 2002 is a useful tool for the assessment of nutritional status among inpatients. Proper nutritional support can reduce the incidence of complications for patients with nutritional risks.

ObjectiveTo observe the effect of comprehensive rehabilitation on chronic schizophrenic inpatients. Methods200 chronic schizophrenics were divided into study group and control group, BPRS and IPROS were used in evaluation before and 3-week after training. ResultsThe scores of both BPRS and IPROS in study group significantly improved (P<0.01) after rehabilitation; only the score of BPRS in control group improved (P<0.05) in control group. ConclusionComprehensive rehabilitation can improve the social function in patients with chronic schizophrenia.

OBJECTIVE:To explore the spasmolytic effect of baked Radix Vladimiriae on in vitro intestinal muscle in rabbits. METHODS:Magnus in vitro intestinal muscle accumulative dose method was adopted to observe the dose-effect relationship of petroleum ether parts of baked Radix Vladimiriae with in vitro intestinal muscle of rabbits and its impact on the spasm of rabbit intestinal muscle induced by acetylcholine, histamine phosphate and Bacl2. RESULTS:There was a certain dose-effect relationship between petroleum ether parts of baked Radix Vladimiriae and spasmolytic mechanism of rabbit in vitro intestine. It showed the effect of acetylcholine, histamine phosphate and Bacl2. CONCLUSION:The inhibition effect of petroleum ether parts of baked Radix Vladimiriae on normal in vitro intestinal muscle increase as long as dose increase. The inhibition mechanism may be associated with acetylcholine competing with histamine to block M receptor and H1 receptor as well as to inhibit excitability of intestinal muscle.

Objective To investigate the dedifferentiation of epidermal cells into their progenitor stem cells induced by basic fibroblasts growth factors(bFGF) in vitro.Methods HEKa cells obtained from Cascade were found flattening and formation of cell-to-cell contacts after 6 to 7 passages,which resembled differentiated epidermal cells in vivo.To examine the effect of growth factors on the cell proliferative alterations,bFGF(100 ng/ml) was added into the culture medium for different periods(6,12,24,48,or 72 h),then the cell proliferation was measured by MTT assay.Phenotypic changes and the cell-fate determination of HEKa cells after bFGF treatment were detected by immunocytochemical assays,flow cytometry and RT-PCR analysis.HEK cells with no intervention treatment were used as a control.Results MTT assay proved that the optimal culture condition to induce the dedifferentiation of epidermal cells into their progenitors was to culture HEKa cells for 36 to 48 h when the addition of bFGF was 100 ng/ml.After treatment with bFGF for 48 h,clusters of round-shaped cells appeared around differentiated epidermal cells,and expanded progressively thereafter.These cells were smaller in shape and with larger nuclear/cytoplasm ratio,and had not only clonogenicity but also ability to form a cutaneous ridge-like structure.Immunohistochemical staining revealed that the expression levels of ?1 integrin,CK19 and CK14 were up-regulated,while the expression of CK10 was significant down-regulated after bFGF treatment.Flow cytometry indicated that there were more CK19-positive and CK14-positive cells in the treatment group than in the control(74.77% vs 15.74%,and 87.14% vs 67.26%respectively),but much lesser CK10-positive cells(4.56% vs 98.56%).Additionally,the mRNA expression levels of ?1 integrin,CK19 and CK14 were up-regulated after bFGF treatment,but that of CK10 was down-regulated.Conclusion bFGF can reverse the differentiated process of epidermal cells and induce them to produce immature,stem-like cells,which can proliferate and be used in the wound repair and regeneration of skin tissues.

Objective To introduce an efficient method to isolate and identify the dedifferentiation derived epidermal stem cells. Methods HEKa cells obtained from Casacade (USA) were induced to reverse their differentiated process and produce immature, stem-like cells-the dedifferentiation derived epidermal stem cells (dHEK cells)-by basic fibroblasts growth factors (bFGF) in vitro. Improved collagen Ⅳ-coated adhesion method was used to isolate and cultivate the dHEK cells. Subsequently, morphological features and phenotypic changes of these immature dHEK cells were immunochemically stained and studied with confocal microscopy and flow FACS array. Results Immunocytochemical analysis proved that dHEK cells and their subunits were positive for ?1 integrin, keratin 19 and 14, yet negative for the expression of keratin 10, which was considered as an established marker of differentiated cells. Double staining immunofluorescence demonstrated that markers such as ?6 integrin and CD71 were co-expressed in dHEK cells, and it was shown that there was important regional differences in the distribution of ?6 integrin and CD71 in dHEK cells and their subpopulations. More importantly, two-color flow cytometric analysis of ?6 integrin and CD71 consistently revealed two phenotypically discrete populations of cells in the isolated dHEK cells, i.e. a major subpopulation exhibiting high levels of both ?6 and CD71 expression (?6+CD71+ representing 66.97%?5.04% of the total cells) and a minor population characterized by high level of ?6 expression and low level of CD71 expression (?6+CD71- representing 24.52%?7.88% of the total cells) (n=3). Conclusions The dHEK cells isolated by collagen Ⅳ-coated adhesion method have some characteristics of native epidermal stem cells, and perhaps it may act as a new vehicle for non-genetic manipulation and therapy for both skin disorders and systemic deficiencies. Additionally, although viewed as an ideal substitute of ESCs, the safety of dHEK cells and their functional difference with native epidermal stem cells are still unclear, which need further research.

AIM:To investigate atrial natriuretic peptide(ANP) circadian in the encapsulated human ANP(hANP) cDNA transfected cells,to alter the ANP circadian by artificial control to achieve the objective of effectively treat hypertension or congestive heart failure(CHF). METHODS:ANP cDNA was transfected into Chinese hamster ovary(CHO) cells,which were encapsulated in polycarprolactone(PCL) tubes.The longterm survival of transfected CHO cells and the levels of ANP secreted were detected.Circadian rhythm of ANP secreted by encapsulated transfected cells was also studied,which was regulated by melatonin. RESULTS:During culturing,the ANP level secreted by transfected CHO cells in 2 mL of culture medium within 24 hours could reach 210.3 ng/L in a 20 mm-long and 2 mm-diameter PCL tube.The section of ANP displayed a circadian variation:higher in daytime,but lower at night.The acrophase of circadian rhythm was 4:15 but could be shifted to 7:55 after melatonin management. CONCLUSION:ANP cDNA transfected CHO cells that encapsulated into PCL tube can secret ANP,which might be suitable for the future implantation into human body.Our research provides a new approach in the treatment of hypertension and CHF by ANP.

OBJECTIVETo investigate the pathogenic and clinical presentation and laboratory tests of bullous rash in hand, foot and mouth disease (HFMD) in Xi'an from January 2013 to December 2014 by retrospective analysis.

METHODA total of 224 specimens were collected from clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions in Xi'an Children's Hospital from January 2013 to December 2014, the identification and subtyping of the isolates were conducted with real-time fluorescent quantitative RT-PCR. A retrospective analysis was performed to analyze the clinical presentation, laboratory tests and late follow-up problems of the HFMD.

RESULTIn the clinically diagnosed HFMD cases who were characterized by widespread mucocutaneous bullous reactions, 207 were caused by coxsackievirus A6 (CA6), accounting for 92. 4% of all cases with bullous, 4 were caused by enterovirus 71 (EV71), accounting for 1.8%, 10 were caused by coxsackievirus A16 (CA16), accounting for 4. 5%; 4 cases were negative for these viruses. In the cases positive for intestinal virus-nucleic acid, 130 were male, 90 were female; male to female ratio was 1. 44: 1, 203 were <5 years old, accounting for 92. 3%. Leukocytosis was found in 75 cases (34. 1%); high-sensitivity C-reactive protein (hsCRP) increased in 200 cases (90. 9%); elevated myocardial enzyme CK-MB was found in 35 cases (15. 9%), alanine aminotransferase increased in 15 cases (6. 8%); 187 cases had fever (85. 0%). None of the cases had serious complications such as encephalitis or myocarditis. In the course of the critical phase bullous rash or large vesicle-like changes, obvious itching, and facial rash appeared. After the fluid in the bullae was absorbed or the bullae ruptured or became ulcerated, scar formation and large areas of exfoliation occurred, with no effusion on the newly formed epithelium in the base, without significant pigmentation on later follow-up. In the late follow up process, 52 cases in CA6-positive patients (25. 1%) developed onychomadesis within 2-4 weeks after onset, 1 to 8 nails, an average of 4. 3 fell off, new nails grew, the nail bed showed no structural abnormalities and hyperplasia after falling off, the surface was smooth, had no hypertrophy, left no sequelae.

CONCLUSIONThe pathogen in HFMD characterized by widespread bullous reactions was mainly the CA6, this kind of HFMD was mainly mild type, with significant itching, later the bullae may have scar formation and skin exfoliation, in some cases onychomadesis may occur.

Child ; Enterovirus A, Human ; Enterovirus Infections ; pathology ; Exanthema ; pathology ; Female ; Fever ; Hand, Foot and Mouth Disease ; pathology ; Humans ; Male ; Pruritus ; Retrospective Studies

Calcitonin gene-related peptide( CGRP) is the strongest vasodilator discovered to date,the synthesis and release of CGRP are regulated by multiple factors.CGRP possesses multiple biological func-tions,such as vasodilator,myocardial strengthener,lung protector,brain protector,immunomodulator.It plays an important role in regulating the function in the body.