Objective To construct the suppression subtracted cDNA library of deltamethrin-resistant Aedes albopictus. Methods Total RNA was extracted from the deltamethrin-resistant (R-lab) and -sensitive (S-lab) isolates, mRNA was obtained after purification. Double stranded cDNAs were synthesized after reverse transcription. Two subtractions were performed by suppression subtractive hybridization with S-lab as tester and R-lab as driver or S-lab as driver and R-lab as tester. Enriched different expressed cDNA was cloned into pMD18-T vector to construct subtractive libraries. Results The subtracted cDNA libraries contained 580 and 477 positive clones respectively. The PCR results of 150 clones picked randomly from each library showed that the positive ratio of constructed cDNA libraries was 93%, with a length of cDNA fragments ranged from 150 bp to 750 bp. Conclusion The suppression subtracted cDNA library of deltamethrin-resistant Ae. albopictus is constructed.

Objective　To study the effect of portal vein blocking on the permeability of the intestinal mucosa in pigs. Methods　Healthy Rongchang pigs were divided into 3 groups: ① sham operation group(SO), ② portal vein clamping for 45 min group (PVC-45'), ③ portal vein clamping for 60 min group (PVC-60'). Urine lactulose/mannitol(L/M) ratio was measured after portal vein blocking. Results　The L/M ratio was increased significantly (P<0.05) in PVC-45' and 60' groups than in SO group, with that of PVC-60' higher than that of PVC-45' group, but not significantly. Conclusion　The increase of intestinal mucosal permeability after portal vein blocking is an early and important index for the damage of the intestinal mucosa barrier.

Objective To study microsatellite instability(MSI) in multiple primary colorectal carcinoma(MPCC) and solitary colorectal tumor(SCT), and to explore the relationship between the expression of mismatch repair(MMR)、p53、Bax、PCNA and MSI. Methods The expression of MMR、p53、Bax、 PCNAwere detected by immunohistochemical staining, and MSI at five microsatellite loci were examined by PCR-SSLP in 51 tumors from 38 MPCC patients and 35 SCT cases. Results The replication errors positive phenotype was observed in 27 of 51(53%) tumor foci from MPCC cases, and in 6 of 35(17%) SCT cases. There was an inverse correlation between replication errors (RER) positive and expression of p53; the PCNA labeling index of RER positive tumors were significantly lower than of RER negative tumors; RER positive related strongly with poor differentiation, the proclivity for proximal colon. Conclusions MSI may play an important role in the development of MPCC and may be used as a tumor marker of MPCC.

Myasthenia gravis (MG) is an immune-mediated disorder of the neuromuscular junction that is characterized by fluctuating muscle weakness.Acetylcholine receptor antibody (AchR-Ab) is the first MG specific antibody being elucidated,however,the discovery of many other MG specific or related antibodies enriches its immunopathogenesis greatly.The detection of antibodies is very important for the diagnosis and classification of MG.It can be used to guide the clinical management and evaluate the response to treatment as well.With the development of laboratory medicine,the methods of antibody detection are also being optimized.In this paper,we will review the serum antibodies closely associated with MG and their mechanisms,detection methods and clinical significance.

Objective To evaluate Western blot analysis in diagnosing limb-girdle muscular dystrophy type 2A (LGMD2A). Methods The clinical records including their pathological and biochemical results of 4 patients with LGMD type 2 were reviewed. Histochemical and immunohistochemical staining were performed on muscle biopsy specimens from the four patients. The expressions of dysferlin and calpain-3 in muscles were analyzed by Western biol. Results All 4 LGMD patients shared some common clinical features, such as dorsal muscular atrophy of lower limbs and remarkably elevated CK. The immunohistochemical results showed partial or complete deficiency of dysferlin staining in all 4 LGMD patients. However, Western blot revealed that the calpain-3 protein in the muscle of patient 1 was completely absent, who was later diagnosed with LGMD2A. The other 3 patients had complete dysferlin deficiency with reduced calpain-3 expression and they were confirmed to be LGMD2B. Conclusions Western blot analysis of calpain-3 and dysfcrlin can be used to differentiate LGMD2A which shows absence of calpain-3 from other LGMD types which show dysferlin deficiency. Western blot is an invaluable method in clinical diagnosis of LGMD2A.

Ex-vivo liver resection and liver autotransplantation offers a chance to cure extensive regional liver diseases which are otherwise deemed untreatable in selected cases. A 33-year-old male patient with advanced alveolar echinococcosis (AE) which invaded the right lobes and adjacent retrohepatic inferior vena cava, while the left lobes were free from lesion and had proliferated to over 1200 ml in size except for a 1 cm × 1 cm solid lesion in the segment Ⅳ. No extrahepatic metastases were found in this patient. A lesion with a size of 4300 ml and other small lesions in the right lobes were removed extracorporeally,and the retrohepatic vena cava was repaired, then the remaining AE-free left lobes (more than 700 ml in size) and the retrohepatic inferior vena cava were re-implanted in situ. A temporary end-to-end cavo-caval shunt with interposition of a blood vessel prosthesis and end-to-side portocaval shunt were established to keep the blood flow during the four-hour anhepatic phase. The patient was followed up for six months, and he had no signs of residual liver disease with good hepatic function.

Objective To summarze our experience and evaluate the therapeutic effect of hepatectomy for intrahepatic bile duct stones. Methods The clinical data of 316 patients suffering from intrahepatic lithiasis who underwent hepatectomy from Feb. 1985 to Dec. 2004 were retrospectively analyzed. Stones distribution, operation modality, postoperative complications, and therapeutic effect were evaluated. Among the 316 patients, 192 cases(60.76%) were treated with left lateral hepatectomy, 58 cases(18.35%) with left hemihepatectomy, 12 cases(3.80%)with quadarate lobectomy, 54 cases(17.09%) with right hemihepatectomy or segmentectomy, and 14 cases(4.43%)with left and right segmentectomy. Additional biliary procedures including common bile duct exporation and cholangio-enterostomy were performed in 184 patients(58.23%). Results Postoperative complications occurred in 56(17.72%)cases, including biliary fistula, hemobilia, and subdiaphragmatic infections. Three patients(0.95%)died. The follow-up study conducted in 258 patients(81.65%)for an average of 10.3 years showed that excellent results were achieved in 90.31% of the patients. Conclusions Regular hepatic lobectomy/segmentectomy is the most effective treatment for intrahepatic lithiasis.

Objective To study the clinicopathological features of chronic inflammatory mass lesion of the pancreas.Methods The clinical data of 37 patients with focal chronic inflammatory mass lesion of the pancreas were retrospectively studied.Seventeen cases congruent with the standard clinical diagnostic of chronic pancreatitis were separated into group A;and Whipple procedure was carried out in two cases,resection of the body and tail of the pancreas in 2 cases,local resection in one case,and choledochojejunostomy in 12 cases.Those without the stander clnical features of Group A but with the features of pancreatic tumor were separated into Group B;and Whipple procedure was carried out in 4 cases,choledochojejunostomy in 16 cases.Results In group A,except for the local mass lesion,sclerosis of the whole pancreas was found in 88.2% of cases.Pathological examination showed proliferation of fibrous tissue with associated inflammation,as well as acinar atrophy,remnant islet cells,and ductular dilatation and focal calcification.While in Group B,only a local mass lesion of the pancreas was found in 19 cases.The pathological features were characterized histologically by proliferation of fibrous tissue with associated moderate or marked inflammation.No pancreatic carcinoma was found during 1 to 12 years follow-up of 33 cases.Conclusions Chronic inflammatory mass lesion of the pancreas showed the clinicopathological features of pseudotumoral pancreatitis.Internal drainage by choledochojejunostomy is suggested as its effective management.

Objective To investigate the clinical and immune pathological features of Ullrich congenital muscular dystrophy (UCMD) with sarcolemma-specific collagen Ⅵ deficiency (SSCD). Methods The clinical aspects of 2 patients with SSCD were analyzed and the muscle specimens from them were studied by immunofluorescence. Results SSCD patients were clinically characterized by neonatal hypotonia with proximal contractures and distal hyperlaxity at birth or early infancy. Immunofluorescence staining revealed partial deficiency of collagen Ⅵ. Double immunofluorescence staining revealed sarcolemma-specific deficiency of collagen Ⅵ, while collagen Ⅳ intact in thesarcolemma. Conclusions The clinical picture and severity of UCMD with SSCD are similar to the cases with collagen Ⅵ complete deficiency. The proximal contractures and distal hyperlaxity are the clinical hallmarks of both types. Sarcolemma-specific collagen Ⅵ deficiency can be better demonstrated by double immunofluorescence staining.

Objective To assess the feasibility,safety and advantages of robotic-assisted precise hepatectomy.Methods Between April and July 2009,13 consecutive patients underwent robotic-assisted hepatectomy for hepatic diseases.The clinical data were analyzed retrospectively.Results All 13 Da Vinci surgical systemassisted precise hepatectomies were successfully performed without conversion to laparotomy.Major hepatectomies were performed in 9 patients,left lateral segmentectomies in 4 patients.All the Da Vinci surgical system-assisted hepatectomies were performed anatomically with hilum dissection.Prior to the parenchymal transaction,vascular control of the portal vessels was carried out whenever possible.The mean operative time was 338 minutes(range,150-720 minutes).The mean blood loss was 208 ml(range,50-800 ml).No patient required blood transfusion,and no mortality,transient bile leakage was observed in patients with hilar cholangiocarcinoma.The mean postoperative stay was 7 days(range,2-13 days).Conclusions These preliminary results show that Da Vinci surgical system-assisted precise hepatectomy is safe and feasible with potential benefits of a minimally invasive approach.Da Vinci surgical system may broaden the indications for laparoscopic hepatactomy,and it enables surgeons to perform precise laparoscopic hepatectomy which required hilum dissection,hepatocaval dissection,endoscopic suturing and microanastamosis.