Objective To study on serum variation of liver cirrhosis patients with spontaneous peritonitis and cytokines in ascites caused by gram-positive bacteria or by gram-negative bacteria,so as to instruct clinical usage of antibiotics.Methods 60 cases of liver cirrhosis were carried out routine test to distinguish between exudative aseites and transudative ascites.At the same time,notric oxide(NO),tumor necrosi factor-?(TNF-?),LPS were tested in the serum and ascites of all patients with liver cirrhosis ascites.Results NO,TNF-?,LPS levels in the serum and as- cites of the exudative ascites patients with liver cirrhosis were obviously higher than those in the serum and ascites of transudate ascitcs patients with river cirrhosis.NO,TNF-?,LPS levels in ascites infected by gram-positive bacteria were obviously higher than those by gram-negative bacteria.Conclusion Test of NO,TNF-?,LPS in the serum and ascites of the patients with liver cirrhosis ascites can help to distinguish between exudative ascites and transudate as- cites,and distinguish between spontaneity peritonitis infected by gram-positive bacteria and by gram-negative bacteria so as to instruct clinical usage of drugs.

Twenty-one biochemically symbolized genetic sites on 11 chro mosomes of closed colony Kunming mice were located with electrophoresis.The genetic picture of the mouse was established and it was confirmed that the mouse showed definite features of genetic polymorphism and hereditary stability.

10.3969/j.issn.1000-3606.2013.06.001

Anti-angiogenesis therapies have emerged as new treatment strategies for several types of tumors. To date, the most studied programs are to find out effective medicines to block the vascular endothelial growth factor (VEGF) signaling pathway. However, VEGF inhibitors are not effective to all kinds of tumors.Thus there is a need to explore other angiogenesis signaling pathways. Recently, the Dll4-Notch pathway was identified as a new target in tumor angiogenesis. Moreover, an important feature in angiogenesis is the manifold ways in which the VEGF and Dll4-Notch pathways interact each other, which play critical roles in tumor angiogenesis. Therefore, the further exploration of these two pathways will provide more therapies for clinic to treat tumors.

Objective To investigate the feasibility of hand-assisted laparoscopic liver resection without hand-port devices. Methods Eight patients were selected into the study, including 5 cases of primary liver cancer located at the segment Ⅳ or Ⅴ or the left lateral lobe, 2 cases of liver spongy hemangioma and 1 case of hepatic focal nodular hyperplasia. After the laparoscopic devices were set up, an oblique incision below the right costal margin was made. The length of the incision was the same as the operator’s wrist. In the absence of hand-port or “blue disc”, the operator’s left hand directly entered the abdominal cavity through the incision. With the assistance of operator’s left hand, the laparoscopic liver resection was conducted, with the ligaments surrounding the liver dissociated, the liver transected and the cut surface properly managed. Results Laparoscopic liver resection was performed successfully in all the 8 patients. The operation time ranged 90～180 min (mean, 118 min), and the blood loss was 50～ 300 ml (mean, 160 ml). There was no uncontrolled bleeding during the operation and no complication happened. Conclusions Hand-assisted laparoscopic liver resection without hand-port devices is a safe and feasible procedure. It may not only reach the purpose of hand assistance but also lower the surgical costs.

Objective: To investigate the effects of hepatitis B virus (HBV) X protein (HBx) on the expression of tumor necrosis factor-α (TNF-α) in glomerular mesangial cells (GMCs) and the underlying intracellular signal pathways. Methods: The plasmid pCI-neo-X that carries the X gene of hepatitis B virus was transfected into cultured GMCs. HBx expression in the transfected GMCs was assessed by Western-blot. TNF-α protein and mRNA were assessed by ELISA and semi-quantitative RT-PCR, respectively. Three kinase inhibitors-U0126, an inhibitor of extracellular signal-regulated kinases (ERKs);lactacystin, an inhibitor of nuclear factor-κB (NF-κB);and SB203580, a selective inhibitor of p38 MAP kinase (p38 MAPK) were used to determine which intracellular signal pathways may underlie the action of HBx on TNF-αexpression in transfected GMCs. Results:A significant increase in HBx expression in pCI-neo-X transfected GMCs was detected at 36 h and 48 h, which was not affected by any of those kinase inhibitors mentioned above. A similar increase in the expression of both TNF-αprotein and mRNA was also observed at 36 h and 48 h, which was significantly decreased in the presence of U0126 or lactacytin, but not SB203580. Conclusions:HBx upregulates TNF-αexpression in cultured GMCs, possibly through ERKs and NF-κB pathway, but not p38 MAPK pathway.

Objective:To study therapeutic effect of cilazapril and amlodipine on QT interval dispersion and arrhyth-mia in patients with essential hypertension (EH) .Methods:A total of 120 EH patients complicated with ventricular arrhythmia in our hospital from Mar 2011 to Mar 2014 were enrolled ,randomly and equally divided into cilazapril group and amlodipine group ,the two groups all received routine antihypertensive therapy .Blood pressure ,QT in-terval and arrhythmias were compared between two groups .Results:Compared with amlodipine group ,there were significant reductions in 24h mean systolic blood pressure [24hSBP ,(123.81 ± 17.95) mmHg vs .(104.92 ± 14.25) mmHg] ,24h mean diastolic blood pressure [24hDBP ,(88.31 ± 10.28) mmHg vs .(72.24 ± 8.45) mmHg] ,24hSBP variability [ (11.62 ± 1.34) mmHg vs .(7.34 ± 0.97) mmHg] ,24hDBP variability [ (9.47 ± 1.18) mmHg vs .(5.13 ± 0.72) mmHg] ,QT interval [ (385.1 ± 50.4) ms vs .(342.7 ± 48.5) ms] ,corrected QT interval [ (362.7 ± 50.2) ms vs .(321.8 ± 45.1) ms] and QT interval dispersion [ (34.1 ± 5.1) ms vs .(22.5 ± 3.7) ms] in cilazapril group , P<0.05 or <0.01;ventricular arrhythmia class in cilazapril group was significantly better than that of amlodipine group , P<0. 05. Conclusion:Therapeutic effect of cilazapril is more helpful to reduce blood pressure ,QT interval dispersion and improve ventricular arrhythmia than amlodipine in EH patients complicated with arrhythmia .

Objective To establish the measuring methods and relevant influencing factors of liver zone speed index (ZSI) by sound velocity tissue quantification (SVQ) technology in healthy subjects.Methods Liver ZSI were obtained in 49 healthy volunteers using SVQ technique with Zonare Z.one Ultra system.In the first 15 subjects,ZSI were acquired at four positions (superficial and deep parts of right lobe,superficial and deep parts of left lobe).Then the achievement rate in different position of liver was calculated to select the suitable measuring position.The reproducibility was analyzed with intra-group correlation coefficient(ICC).The last 34 healthy subjects received ZSI measurements in the appropriate position only.The reference value of ZSI was calculated using x-± 1.96 s.Results It was stable to measure values of ZSI with SVQ technique.The achievement rate was higher in right lobe with being 1 cm below the liver capsule for the optimal measuring point.There was no significant difference of ZSI value between male and female groups.There was no significant correlation between age and values of ZSI while a significant negative correlation was found between body mass index (BMI) and values of ZSI (r =-0.63,P =0.000).The reference value of body mass index between 18.5-23.9 kg/m2 was 5.67-36.29 m/s.Conclusions ZSI values of liver measured with SVQ technique shows a good stability and may be a new promising method for assessment of liver elasticity quantitatively.

Interventional radiology has lot of advantages in dealing with various emergencies. The technique is minimally-invasive,highly-effective and immediately-efficient,moreover,it integrates the diagnosis with the therapy perfectly. Besides,the interventional techniques applied in emergency medicine include not only the vascular interventions,such as embolization,embolectomy,etc,but also the nonvascular interventions,such as tracheal stent implantation,percutaneous vertebroplasty and so forth. However,importance has not been attached to the clinical use of interventional therapy in emergency medicine so far. It is imperative for us to promote the acceptance of interventional therapy in emergency medicine as well as to popularize the technique in clinical practice.

Objective:To investigate the clinical value of electrocardiogram in risk stratification of patients with non-ST segment elevation acute coronary syndrome(ACS).Methods: According to the change of electrocardiogram, 260 patients with non-ST segment elevation ACS were divided into four groups: ECG-undiagnosed group (n=22), T-wave inversion group (ST-segment depression group), ST-segment depression group (n=118) and normal electrocardiogram group(n=80). All patients were treated with conventional 18-lead electrocardiogram and troponin I(TnI)detection in the four groups. The incidence of cardiovascular events during and after hospitalization was observed. Results: The complex cardiovascular events and recurrent angina attacks in ST segment depression group increased significantly than that in normal ECG group. The difference was statistically significant (x2=5.723,x2=15.680;P<0.05). Multivariate logistic regression analysis showed that TnI positive factors predict the independent value of composite cardiovascular events higher.Conclusion:The patients with ST segment elevation acute coronary syndrome can effectively carry out risk stratification by ECG ST-segment changes and TnI levels, and predict the cardiovascular events. It has higher clinical application value and independent predictive value of TnI positive.