Objective To study the immuno-regulatory roles of antibiotics and their implication for pulmonary fibrosis.Methods The regulatory roles of antibiotics on the phenotypes of dendrite cells(DCs) and maturation of B lymphocytes in vitro were detected with flow cytometry.The roles of nystatin on pulmonary fibrosis in vivo were determined with bleomycin-induced acute injury model of mouse.Results Multiple antibiotics including nystatin apparently promoted the maturation of DCs and B cells,as well as subsequently promoted the polarization of Th2 cells through DCs.In addition,nystatin intensified bleomycin-induced pulmonary fibrosis.Conclusion Multiple antibiotics including nystatin induce suppressive immune responses and might aggravate pulmonary fibrosis like nystatin.

Objective To assess the characteristics of abdominal hernia and summarize the therapeutic efficacy of mesh plug tension-free hernioplasty in elderly ventral hernia. Methods All 207 elderly patients with abdominal hernia who were admitted to our hospital during January 1999 to December 2001 and received the mesh plug tension-free hernioplasty were analyzed retrospectively. Results There were 405 patients receiving the mesh plug tension-free hernioplasty from 1999 to 2001, in whom 207 had elderly ventral hermia. Among the 207 elderly patients, 144 had inguinal oblique hernia, 38 direct hernia, 11 direct and indirect hernia, 6 sliding hernia, 6 incisional hernia, 1 femoral hernia, and 1 femoral and inguinal direct hernia. Postoperative complications were urinary retention(8 cases), hypoincisional hematoma(4), scrotal hydroceles(1), and incisional infection (1). One hundred eithty-seven patients were followed-up for 4-40 months and no recurrence was found. Conclusions The mesh plug tension-free hernioplasty is of advantages for elderly abdominal hernia, such as simpleness in performance and a good therapeutic effect. It is especially suitable for the elderly patients due to less trauma and low recurrence rate. It is also important to pay attention to the postoperative complications to the elderly.

Objective To investigate the significance and surgical skill for lymphadenectomy around common hepatic artery in gastric cancer.Methods Two hundred and fifty-seven cases with undergoing lymphadenectomy around common hepatic artery in gastric cancer between January 2001 and December 2006 were retrospectively reviewed.Experiences and understanding of dealing with this procedure in curative gastrectomy for gastric cancer were concluded.Results The number of dissected No.8 lymph node was 2.2?1.7,and the positive rate of No.8 lymph node was 30.35%.There were no lymphadenectomy related complications,such as anastomotic leakage,lymphatic fistula and postoperative hemorrhage in this series.Dissection around common hepatic artery lymph nodes along artery intrathecal space,division and ligation of left gastric vein at its root,and sufficient exposure of anatomic structures were important to dissection lymph nodes around the common hepatic artery.The exposure of anatomic structures included liberation of common hepatic artery by traction with the band,and the exposure of posterior side of pancreas by Kocher incision.Conclusion Being familiar with the anatomy around common hepatic artery,careful dissection,and attention to the surgical skill of lymphadenectomy are very important to improve the effectiveness of lymphadenectomy around common hepatic artery in gastric cancer.

Objective To investigate the effect of Dl-3-n-butylphthalide on acute cerebral infarction.Methods In Department of Neurology in the Fifth Hospital of Wuhan from March 2013 to June 2014,100 cases of patients with first onset of acute cerebral infarction were recruited.The participants were divided into 2 groups (control group and treatment group) randomly,with 50 participants in each group.Besides general treatment,the patients of treatment group received intravenous injection of Dl-3-n-butylphthalide in acute phase and orally took soft capsule of Dl-3-n-butylphthalide in recovery phase.All the patients were followed up for 24 weeks.Neurological function and general cognition were assessed separately by national institute of health stroke scale (NIHSS),and mini mental state examination (MMSE) was applied to assess overall cognitive function.Results NHISS score was gradually decreased and MMSE score was increased in both groups.As compared with the control group,NIHSS score and MMSE score were changed significantly in the treatment group.From first onset to 24 weeks after treatment,NHISS score was decreased by 30％ in the control group and 44％ in the treatment group;MMSE score was increased by 17％ in the control group and 32％ in the treatment group.Conclusion Sequential therapy with Dl-3-n-butylphthalide improves neurological function and general cognition faster and more significant for patients with acute cerebral infarction.

Objective To systematically evaluate the short-term outcomes of Da Vinci robotic surgical system and laparoscopy in pancreaticoduodenectomy.Methods Literatures were researched using PubMed,Embase,Medline,VIP database,Chinese Journal Fulltext Database from January,2013 to October,2016 with the key words including laparoscopic,robotic,Da Vinci,pancreaticoduodenectomy,腹腔锐,达芬奇机器人,胰十二指肠切除术”.The cohort studies about comparison of short-term outcomes of Da Vinci robotic surgical system and laparoscopy in pancreaticoduodenectomy were received and enrolled.Patients undergoing pancreaticoduodenectomy using Da Vinci robotic surgical system and laparoscopy were respectively allocated into the Da Vinci group and laparoscopy group.Two reviewers independently screened literatures,extracted data and assessed the risk of bias.Count data were described as odd ratio (OR) and 95％ confidence interval (CI).Measurement data were represented as weighted mean difference (WMD) and 95％CI.The heterogeneity of the studies was analyzed using the I2 test.Results Five retrospective cohort studies were enrolled in the Meta analysis,and the total sample size was 364 patients,including 159 in the Da Vinci group and 205 in the laparoscopy group.The results of Meta analysis showed that there were statistically significant differences in the rate,of conversion to open surgery,spleen-preserving rate,operation time and duration of postoperative hospital stay between Da Vinci group and laparoscopy group (OR=0.18,3.80,WMD =-37.54,-4.47,95％CI:0.05-0.60,2.01-7.18,-47.46--27.62,-6.70--2.24,P＜0.05).There were no statistically significant difference in the incidence of pancreatic fistula and overall incidence of complications between Da Vinci group and laparoscopy group (OR=0.95,0.55,95％CI:0.59-1.54,0.29-1.03,P＞0.05).Conclusions Da Vinci robotic surgical system and laparoscopy are safe and feasible in pancreaticoduodenectomy,with the same incidence of postoperative complications.Compared with laparoscopy,Da Vinci robotic surgical system can not only reduce the rate of conversion to open surgery,operation time and duration of postoperative hospital stay,but also increase spleen-preserving rate,meanwhile,it does not increase the incidence of postoperative complications.

Objective To evaluate the efficacy of percutaneous CT guided interstitial 125Ⅰ seeds implantation treatment for refractory pelvic malignant tumors and discuss the procedure of technique.Methods Twenty-three patients with refractory pelvic malignant tumors(25 lesions,diameter 3.5-7.0 cm,mean 4.5 cm) showing failure response to full chemotherapy and/or radical radiotherapy after tumors resection were undergone percutaneous CT guided intratumoral 125Ⅰseed implantation.Treatment plan system(TPS)was used to design the distribution and number of 125Ⅰ seeds according to matched peripheral dose(MPD)1-3 days before the procedure.Of which 6 cases received combined internal iliac arterial infusion chemotherapy before or after the 125Ⅰ seed implantation procedure.Results 9 ～ 75(mean 27)125Ⅰ seeds were implanted into a single tumor at first time including 6 patients with intraarterial chemotherapy for 14 cycles(mean 2.3 cycles),showed relief of clinical pain symptoms in 16 of 23 cases,72 h ～ 4 w after the seeds implantation;with the an effective rate of 69.6%.Follow up for 2-34 months(median,21 months),CT or MRI performed 2 months after the seeds implantation showed no CR,but PR in 18 cases,SD in 4 cases,and PD in 1 case,with overall response rate of 78%(18/23),and no serious complication.In addition,20 cases survived,with the longest one of 34 months and the other 3 died.Conclusions Intratumoral 125Ⅰ seeds implantation under CT guidance for pelvic refractory malignant tumors is safe,minimally invasive,and effective.

Objective To investigate the association of tumor necrosis factor (TNF)-α, heat shock protein (HSP)70-2 gene polymorphisms and susceptibility of acute pancreatitis(AP). Methods Using case-control method,The gene polymor?phism of TNF-α and HSP70-2 was detected by PCR-RLFP in 72 patients with AP and 71 healthy controls. Results There were no significant differences in proportion of TNF-αgenotype and alleles between AP and control groups (P>0.05). There were no significant differences in TNF-αgenotype and alleles between severe acute pancreatitis (SAP) and light acute pancreatitis (MAP) of AP group (P>0.05). There were no significant differences in white blood cell count, C-reactive pro?tein (CRP), amylase, three acyl glycerin and glucose between TNF-a and HSP70-2 gene of AA type and GA+GG type pa?tients (P>0.05). The HSP70-2 genotype GA+GG proportion was significantly higher in AP group than that of control group (69.4%vs 49.3%). The ratio of patients with G allele was significantly higher in AP group than that of control group(46.5%vs 31.7%). The ratio of patients with GA+GG type AP was significantly higher in SAP patients than that of MAP patients of AP group(81.0% vs 53.3%). There was no significant difference in G allele between SAP and MAP patients (P>0.05). Conclusion TNF-α polymorphisms is not associated with acute pancreatitis. There is an association between HSP70-2 polymorphisms and acute pancreatitis. Carrying the G allele increases the possibility of a severe acute pancreatitis ,which is one of the genetic susceptibility factors of severe acute pancreatitis.

OBJECTIVE: To figure out the etiological factors and overall mortality of the patients with acute intestinal obstruction, and to explore the rational period of conservative therapy before operation. METHODS: Medical records of all the patients with acute intestinal obstruction admitted to West China Hospital from 1995 to 2002 were retrospectively reviewed. The etiology of the obstruction was categorized, and the correlation of mortality and time interval between conservative therapy and operation was analyzed. RESULTS: There were 705 patients with acute intestinal obstruction included. There were 71.1% of the obstruction lesions located on the small bowel, and 82.6% of the patients experienced simple obstruction. The most frequent cause was adhesions (62.0%), and next was neoplasms (23.7%). There were 57.6% of the patients underwent the surgical treatment. The overall mortality rate was 1.6%, and the mortality rates in conservative therapy and surgical intervention groups were 1.3% and 1.7% respectively. The intestinal necrosis rate was increased gradually with the prolongation of time interval between conservative therapy and operation, and the death might occur 24 hours after strangulation. CONCLUSION: The epidemiological transition to adhesive obstruction still exists in China, and it is similar to that in Western countries. In our experience, near half of the patients with simple obstruction may achieve palliation by conservative therapy. Surgical intervention is indicated for the patients with prolonged and non-palliated simple obstruction, or strangulation disease within the first 24 hours.

Mental, emotional and other psychological factors have a direct effect on human health, and chronic stress produces neurotransmitters to suppress the body"s immune system, after which homeostasis is destroyed, lead to cells losing their normal state and function and cancer cells being produced. As a result, cancer patients will experience chronic emotional stress and consequently, neurotransmitters will promote the occurrence and development of tumors. This review systematically summarizes the research progress of major neurotransmitters from two aspects: the normal physiological functions and the mechanism of action in the tumor occurrence and development,providing some insights into further exploration of new mechanism of neurotransmitters and the development of drugs that block the neurotransmitters.

0.05). Conclusions There is no difference in immune responses to rectal cancer patients undergoing laparoscopic total mesorectal excision with anal sphincter preservation and those having open surgery.