By studying the developmental strategy of the revonal medical science and technology and implementation condition from 2001 to 2004 as well as systematically studying the national policy of the scientific and technical field,we proposed the developmental strategy of medical science and technology in Shanghai that the priority for the introduction,the application and the popularization of new or suitable technology should be given,also continuous advancement in technology should be kept.As a result,it is possible to provide the people a safer,more effective,convenient and moderately priced public health and basic medical service.During the past 5 years.we made an experimental work in selected Pudong in Shanghai.It Was proved that the strategy tallies with the actual situation of Pudong and is effectual in practice.

Objective To investigate the effect of rhein on endothelial plasminogen activator inhibitor-1 (PAI-1) mRNA expression and protein synthesis induced by transforming growth factor ?1 (TGF-?1), and explore the protective mechanism of rhein on human endothelial cells. Methods A human umbilical endothelium derived cell line (ECV-304) from ATCC was used in this study. The endothelial PAI-1 mRNA expression and protein synthesis were detected by Northern blot and flowcytometry analysis respectively. The activity of phospho-p44/p42 MAPK induced by TGF-?1 was determined by immunoprecipitation analysis and Western blot. Results TGF-?1 (2?g/L) could increase rapidly endothelial PAI-1 mRNA expression and persist for 24 hours. The PAI-1 mRNA expression induced by TGF-?1 in endothelial cells was inhibited by incubating with rhein. Rhein could also inhibit the endothelial PAI-1 protein synthesis. Further study revealed rhein showed a significantly inhibitory effect on the activity of phospho-p44/p42 MAPK induced by TGF-?1 in human endothelial cells. Conclusions Rhein shows a protective action on endothelial cells by inhibiting PAI-1 overexpression, and this may provide beneficial effects on the treatment of diabetes mellitus and its complications.

Objective Laparoscopy-assisted distal gsstrectomy (LADG) with D1 + β lymph node dissection has become the most popular treatment for early gastric cancer in Asian countries. However, no one has shown the same clinical advantages with this procedure as with LADG with D1 + α lymph node dissection. The aim of this study was to compare the outcome of LADG with D1 + β to that of LADG with D1 + α lymph node dissection. Methods During the period of June 2002 through June 2006, LADG with D1 + α lymph node dissection was performed in 54 patients, and LADG with D1 + β lymph node dissection was performed in 42 patients. Surgical findings, clinicopathologic data, postoperative course, complications, and blood analysis findings were compared between the two groups. Differences were analyzed with Mann-Whitney U test and chi-square test. Results Patients in the two groups were comparable with respect to age, sex, body mass index, and stage and pathologic characteristics of gastric cancer. A significantly greater number of N2 lymph nodes were harvested by D1 + β lymph node dissection than by D1 + α dissection (5.9vs. 2.7, P<0.01). However, no significanees in the total number of retrieved lymph nodes (24.7 vs. 22.2) or perigastric lymph nodes dissected (18.9 vs. 19.4) were identified between the D1 + β and D1 +α groups. There was also no significant difference between the D1 + α and D1 + β groups with respect to operation time, blood loss, complication rate, time to first walking, first flatus, first eating, and first defecation, frequency of analgesics, volume of oral intake on postoperative day 7, weight loss, and postoperative hospital stay. Blood analysis showed there were no significant differences in white blood cell count, levels of C-reactive protein, and serum albumin. Conclusion The short-term outcome of LADG with D1 + β lymph node dissection is comparable to that of LADG with D1 + α lymph node dissection.

Objective To investigate the changes of hepatocyte growth factor (HGF) and vascular endothelial growth factor(VEGF) after partial hepatectomy in patients with liver cirrhosis and their relationship with liver regeneration. Methods Thirty-five patients with partial hepatectomy between June 2007 and August 2009 were enrolled,according to whether cirrhosis were divided into cirrhosis group (16 cases) and non-cirrhosis group (19 cases). Liver size were measured with angiographic computed tomography at 7,30,90 d after operation. Regeneration rate of remnant liver were calculated. The serum concentrations of HGF and VEGF were meaaured. Postoperative hepatic function and complications incidence rate were comparatively analyzed. Results Compared with non-cirrhosis group, the postoperative hepatic function of cirrhosis group suffered serious damage. In non-cirrhosis group, the remnant liver regeneration rate reached (63.6± 15.9)%, (79.4 ± 17.2)%, (97.2 ± 18.3)% at 7,30,90 d after operation,in cirrhosis group,it reached (41.7 ± 10.7)%, (55.7 ± 13.2)%, (76.6 ± 12.5)%, liver in non-cirrhosis group regenerated rapidly (P <0.05). After hepatectomy,the HGF levels in cirrhosis group increased significantly at 1,3,7 d than those in non-cirrhosis group(P ＜ 0.05), but the VEGF levels were lower. Conclusions Liver in the patients with cirrhosis regenerate slowly and it may be due to in part through a decrease in VEGF. Whether it may,when given therapeutically represent a strategy to optimize liver regeneration in problematic patients needs to be clarified.

Objective To investigate the inhibitory effects and the mechanisms of octreotide(OCT) on the growth of hepatocellular carcinoma(HCC).Methods Bel7402 HCC cells were studied for proliferative ability by MTT assay,morphology by light microscopy,adhesive and invasive ability by cell adhesion and "wound strack" experiments.Immunofluorescence flow cytometry was used for study of cMet expression and cell cycle as well. Furthermore,the effects of OCT on tumor growth metastasis were investigated in nude mice with implanted HCC.The expression of cMet in implanted tumor cells was studied by immunohistochemistry.Results With OCT treatment,the proliferative ability of Bel7402 cells and cell morphology didn't change.The adhesive and invasive ability decreased compared with no OCT treatment cells(P

Objective To study the preparation and the in vitro and in vivo release profile of GH-Chitosan-Alginate microcapsules.Methods GH-Chitosan-Alginate microcapsules were prepared through impulsive electrostatic technique.The interrelated factors influencing the diameter and sphericity were studied through orthogonal experiments,and finally the statistic analysis made sure the optimum conditions to prepare microspheres.The morphology and size of the microcapsules were observed,and the content,encapsulation efficiency and recovery efficiency of the microcapsules were measured.Moreover,their in vitro and in vivo release experiments were carried out.Results The results showed that the diameter of needle was the most significant factor to the diameter of microspheres.The optimum conditions for the least diameter of microspheres were 450?m diameter of needle,2cm from needle tips to the gelation surfaee,1.5% alginate concentration,8ml/h speed of flowing-liquid and metal containers.The microcapsules had good sphericity morphology and distribution.The size of the microcapsules was in the range of 10-25?m with an average size of 47.93?m.The encapsulation efficiency and GH-load of the microcapsules were 94% and 11.24% respectively.The release kinetics of microcapsules was studied in false gastric and intestines juice.In false gastric juice,the GH of microcapsules was not released;in false intestines juice,it was released well,and TAM was completely released after about 12h.in vivo release profile made sure that the serum GH level of GH microcapsule group was at the highest value(98.59ng/ml) at 8h.The release profile was fitted well in both in vitro and in vivo conditions.Conclusion GH-Chitosan-Alginate Microcapsules have good morphology and sustained release effect.

[Objective] To investigate the role SPAG5 play in ovarian adenocarcinoma cell mitosis,Taxol sensitivity and ovarian high grade serous carcinoma patients' prognosis.[Methods] Transient knockdown of SPAG5 in SKOV3 cell were performed,and MTT assay and cell cycle flow cytometry assay were carried out.IHC staining of SPAG5 protein in 110 high grade serous carcinoma patients' tumor tissues were performed,and the expression were analyzed with clinical data and prognosis.Finally,SPAG5 were knocked down in OVCAR3 A2780 and SKOV3 cells followed by 0.5μM Taxol treatment,MTT assay were performed to detect cell viability.[Results] SPAG5 knockdown inhibited cell mitosis of ovarian adenocarcinoma cell SKOV3 by G2/M arrest.High grade serous carcinoma patients after neoadjuvant chemotherapy gained the expression of SPAG5.Patients without neoadjuvant chemotherapy with low SPAG5 expression have poor progress free survival,especially in early stage patients.Patients with low SPAG5 expression also have poorer overall survival,but the difference was not statistically significant.Furthermore,SPAG5 knockdown in OVCAR3 A2780 and SKOV3 cells reduced Taxol sensitivity.[Conclusion] SPAG5 regulated cell mitosis and promoted cell proliferation in ovarian adenocarcinoma cell lines.Expression of SPAG5 in patients' tumor tissues predicted patients' prognosis and Taxol sensitivity.As the results,individualized treatment of high grade serous carcinoma patients is necessary.

Objective To assess the clinical application values of HC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture.Methods Retrospective analysis was used to review 60 patients of severe traumatic brain injury with basilar fracture in emergency resuscitation room who needed the hospital emergency tracheal intubation.There were 30 patients operated with visual HC laryngoscope (the observation group), and the other 30 patients underwent common direct laryngoscope (the control group).The index of the degree of exposure,intubation time,success rate of intubation were compared between the two groups.ResultsThere were 28 cases (93.33%) of Cormark-Lehane grading Ⅰ to Ⅱ in observation group,which was significantly higher than 20 cases (66.67%) in the control group(P< 0.05).The average intubation time in observation group was (34.3±6.7) seconds,and it was shorter than (44.5±5.7) seconds in the control group (P<0.05).In observation group,26 cases (86.67%) were of one-time successful intubation,which was higher than 19 cases (63.33%) in the control group,and the difference was statistically significant(P<0.05).ConclusionHC visual laryngoscope in emergency tracheal intubation for severe craniocerebral trauma patients with basilar fracture can improve the success rate of intubation,shorten the intubation time,reduce adverse reactions,and it is worthy of clinical application.

Objective To analyze the risk factors of incision infection and spinal canal hematoma after lumbar spinal posterior surgery.Methods Data of 33 patients with incision infection and 25 patients with spinal canal hematoma after posterior surgery for lumbar spinal disease from January 2010 to December 2014 were retrospectively analyzed.For the patients with incision infection,20 of them were males and 13 were females,with an average age of 58.85±8.76 years (range 38-79 years).Of these patients,5 were diagnosed with lumbar disc herniation,9 with lumbar spondylolisthesis,15 with lumbar spinal stenosis and 4 with lumbar vertebral fracture.For patients with spinal canal hematoma,17 of them were males and 8 were females,with a mean age of 60.96±11.37 (range,38-77).The diagnoses of them were lumbar disc herniation in 18 patients,spondylolisthesis in 3 patients and spinal stenosis in 4 patients.From the same period database,patients who underwent lumbar posterior lumbar surgery with no postoperative complications were selected by 3:1 ratio as the control group according to age,gender and diagnosis.Results For patients with incision infection,it was found that diabetes mellitus,preoperative RBC,hemoglobin,total protein,albumin,serum calcium,operation time,number of segment fusion,intraoperative blood loss,postoperative WBC,RBC,hemoglobin and platelet were significantly different from those with non-infection group.Moreover,multivariate logistic analysis showed that diabetes mellitus (OR=3.716,P=0.032),preoperative serum calcium (OR＜ 0.001,P=0.001),intraoperative blood loss (OR=1.002,P=0.014),postoperative hemoglobin (OR=0.923,P=0.018) and postoperative platelet (OR=1.007,P=0.017) were independent risk factors for postoperative incision infection.For patients with spinal canal hematoma,it was found that patients' preoperative total protein,albumin,serum calcium,platelet,operation time,intraoperative blood loss and postoperative total protein were significantly different from non-hematoma group.Multivariate logistic analysis showed that preoperative serum calcium (OR＜ 0.001,P=0.001),preoperative total protein (OR=1.298,P=0.043),intraoperative blood loss (OR=1.003,P=0.021) and postoperative total protein (OR=1.080,P=0.028) were independent risk factors for postoperative spinal canal hematoma.Conclusion The preoperative diabetes mellitus,serum calcium,intraoperative blood loss,postoperative hemoglobin and platelet were important risk factors for lumbar incision infection.And preoperative serum calcium,total protein,intraoperative blood loss and postoperative total protein were the risk factors for spinal canal hematoma.

Objective To investigate the effects of ω-3 fatty acids on inflammation and coagulation function in hepatocellular carcinoma (HCC) patients after partial hepatectomy.Methods In this prospective randomized controlled trial,80 HCC patients were randomly divided into two groups based on the parenteral nutrition (PN) scheme that was provided 5 days after partial hepatectomy:fish oil group:20％ fish oil and 80％ mediumlong fatty acid; and control group:100％ medium-long fatty acid.The inflammation,liver function,blood coagulation indicators,and prognosis were compared between two groups.Results After 3 days of hepatectomy,the serum C-reactive protein levels in the control and fish oil groups were (119.6 ± 57.3) mg/L and (97.1 ± 46.1) mg/L(P =0.016),respectively; and on day 6 after surgery,C-reactive protein levels of two groups were (54.9 ± 26.1)and (40.7 ±21.8) mg/L,respectively (P =0.018).The plasma fibrinogen level in the fish oil group was significantly lower than that in the control group 3 days [(3.4 ± 1.1) vs.(4.1 ± 1.3) g/L,P ＜ 0.001] and 6 days [(3.3 ± 0.9) vs.(3.8 ± 1.2) g/L,P ＜ 0.001] after surgery.The retention rate of indocyanine green at 15 minutes on the 7th postoperative day were 8.6％ ±4.9％ and 9.2％ ±7.3％ in the control and fish oil groups,respectively (P=0.179).The recurrent rate (40.63％ vs.44.12％,x2 =0.082,P =0.774) and survival rate in the fish oil and control groups (90.62％ vs.88.24％,x2 ＜0.001,P =1.000) also showed no significant difference after 6 months of follow-up.Conclusion ω-3 fish oil emulsion can reduce postoperative inflammatory response and prevent thrombosis.