Objective To analyse and summarise of the clinical effect and operative opportunity laparoscopic cholecystectomy for acute mild unobstructed gallstone pancreatitis.Methods Fify-four gallstone pancreatitis patients were treated as observation group in the first people's hospital of yangzhou from December 2012 to September 2015,which were treated with laparoscopic cholecystectomy after two weeks,while 53 patients which were treated with laparoscopic cholecystectomy after three months were treated as control group.The treatment effect,operation time,hospitalization time and total cost.Results There were no deaths,no bile duct injury and biliary fistula,the total hospitalization time [(19.8 ±2.6)d vs (26.5 ±3.5) d],the total cost [(2.6282 ± 0.2451) vs (3.2892 ± 0.3982)],recurrent pancreatitis rate (0) were lower than the control group(9.4％),the recovery rate of liver function were higher than the control group,there was significant difference between two groups(P ＜ 0.05),however,there was no significant difference between two groups for postoperative complications and operation time (P ＞ 0.05).Conclusions For acute mild unobstructed gallstone pancreatitis patients,the safe and feasible operative opportunity was recommended two weeks after the symptoms were completely improved,Laparoscopic cholecystectomy in the treatment of acute gallstone pancreatitis can promote recovery,shorten the hospitalization time.

Objective:To investigate the significance of regulatory T cells in peripheral blood of chronic renal insufficientce.Methods:The peripheral blood samples were collected from 40 patients with chronic renal insufficient.The ratios ot CD4+T cell in lymphocyte and CD4+CD127-Treg and CD4+CD25+CD127-Treg in CD4+T were detected by flow cytometry.Results:The number of CD4+T in lymphocyte of chronic renal insufficient was higher than in healthy control group and there wasn’t significantly difference of the CD4+CD25+CD127-Treg ratios in CD4+T between chronic renal insufficience and healthy central.The ratio of CD4+T cells in lymphocytes of chronic renal insufficience was lower than in healthy control group except compensatory stage.There was no correlation between CD4+T cell ratios in lymphocytes,CD4+CD127-Treg or CD4+CD25+CD127-Treg ratios in CD4+T cells and the values of BUN,Cr among the hypertension patients.Conclusion:The number of CD4+T cells increases,and CD4+CD127-Treg decreases in the patients with chronic renal insufficience and their immune functions are shown in disoroler .

Objective To detect the prevalence of hyperuricemia and its relationship to chronic kidney disease(CKD) in the residents of Guangxi, and to discuss the risk factors for the hyperuricemia associated renal damage. Methods The residents aged 18-75 years old(n=6 273) in Xiangshan community,Guilin, were screened by means of cross-sectional study. Blood pressure was measured at 8:00-9:00.Fasting blood and urine samples were collected to determine blood glucose, lipid, insulin, creatinine, and urine albumin. Results The prevalence of hyperuricemia in the community residents was 23.5% in all cohort, being significantly higher in male residents than in female(28.4% vs 19.7%,P＜0.01). The prevalence of CKD was 21.6% in all cohort, and was 24.9% in males and 19.0% in females(P＜0.01). The prevalence of CKD was 30.4% and 18.9% respectively in residents with and without hyperuricemia(P＜0.01).The prevalence of CKD in males with hyperuricemia(34.3%) was significantly higher than in males without hyperuricemia(21.2%) and females with hyperuricemia(25.9%, all P＜0.01). CKD was only positively related to low-density lipoprotein cholesterol, blood glucose, and systolic blood pressure shown by logistic regression analysis. Conclusions The prevalence of hyperuricemia markedly increases in the urban residents, which contribute to the raised prevalence of CKD. Slightly elevated blood uric acid level is associated with raised prevalence of CKD.

Objective To compare the serum peptidome spectrum between nephrotic syndrome patients and normal controls, and to search for their variations. Methods The serum peptide profiling was determined by ClinProt magnetic bead enrichment and matrix assisted laser desorption ionisation time-of-flight mass spectrometry (MALDI-TOF MS) in 17 mesangial proliferative glomerulonephritis (MsPGN) patients, 12 minimal change nephrotic syndrome (MCNS) patients, 10 membranous nephropathy (MN) patients, 10 focal segmental glomerulosclerosis (FSGS) patients, and 10 healthy volunteers. Results 5 differentially expressed polypeptides were screened out between MsPGN and normal controls (15.28±7.61, P＜0.01). 7 differentially expressed polypeptides were screened out between MCNS and normal controls (2.16±1.59, P＜0.01). 6 differential expressed polypeptides were screened out between MN and normal controls (35.48±13.71, P＜0.01). 5 differential expressed polypeptides were screened out between FSGS and normal controls (18.06±8.07, P＜0.05). The statistical significance was set at P＜0.05. A Genetic Algorithm was used to set up the classification model between patients and normal controls. The model separated MsPGN, MCNS, MN and FSGS group from normal controls with a cross validation of 96.18%, 100%, 98.53% and 94.12%, respectively. The recognition capabilities were 100%. Conclusions The study established the serum peptidome spectrum for nephrotic syndrome by proteomic technology, and provided a new viewpoint to better understand the pathogenesis of nephrotic syndrome.

Objective To investigate the changes of the immunological factors in subcutaneous exudate and blood components of the rats receiving cutaneous scraping method,and to compare the changes of skin histopathological features before and after cutaneous scraping under microscope.Methods SD rats were randomly divided into two groups,cutaneous-scraping group and non-cutaneous-scraping group.And then each group was divided into three subgroups.The observation indexes included the levels of interleukin (IL)-1β,IL-6 and interferon gamma (IFN-γ) in the blood and the skin,routine blood examination,and skin histopathological features.Results In cutaneous-scraping group,the number of white blood cells in the blood and the levels of IL-1 β and IFN-γ in skin tissues were increased (P ＜ 0.05),the hemolysis rate was increased (P ＜ 0.05).However,the levels of IL-1β,IL-6 and IFN-γin the blood showed no obvious changes.Under the microscope,severe skin edema,vascular congestion and dilatation,and infiltration of inflammatory cells were found in the skin after cutaneous scraping.Conclusion The cutaneous scraping method can activate the immune response rapidly,and the immunological components of the subcutaneous exudate after cutaneous scraping are helpful to the disease treatment.

Objective To investigate the role of the 5-hydroxymethylcytosine (5-hmC) DNA modification in the onset of systemic lupus erythemosus (SLE),we compared tihe levels 5-hmC between SLE patients and normal controls.Methods With informed consent,whole blood was obtained from patients,and genomic DNA was extracted.Using hMeDIP-seq analysis and validation by quantitative real-time quantitative polymerase chain reaction (RT-PCR),we identified the differentially hydroxymethylated regions that were associated with SLE.Results There were 1 701 genes with significantly different 5-hmC levels at the promoter region in the SLE patients compared with the normal controls.The CpG islands of 3 826 genes showed significant difference at 5-hmC levels in SLE patients compared with the normal controls.Out of the differentially hydroxymethylated genes,three were selected for validation,including TREX1,CDKN1A,and CDKN1B.The hydroxymethylation levels of these three genes were confirmed by quantitative RT-PCR.Conclusion Our studies indicate that there are significant alterations of 5-hmC in SLE patients;these differentially hydroxymethylated genes may contribute to the pathogenesis of SLE.Such novel findings show the significance of 5-hmC as a potential biomarker or promising target for epigenetic-based SLE therapies.

Objective To investigate the expression of BRAF-activated long non-coding RNA (BANCR) in colorectal cancer,and the influence of BANCR on the biological function of HCT116 cells.Methods Fifty-six samples of colorectal cancer specimen (including the cancer tissues and precancerous tissues) were obtained at the First Affiliated Hospital of Nanjing Medical University from March 2012 to June 2013.The expressions of BANCR in all the specimens were detected by qRT-PCR (28 cases in the BANCR-high expression group and 28 cases in the BANCR-low expression group).The relationship between the expressions of BANCR and the clinicopathological factors of colorectal cancer was analyzed.The HCT116 cells were divided into 4 groups after interfering BANCR with lentiviral-mediated shRNA-1 and shRNA-2:interference group 1 (HCT116 cells transfected with LV-shRNA-1),interference group 2 (HCT116 cells transfected with LV-shRNA-2),negative control group (HCT116 cells transfected with lentivirus vector with nonsense sequence) and blank control group (HCT116 cells cultured in RPMI 1640 medium).The proliferation,apoptosis and migration of HCT116 cells in the 4 groups were detected by CCK-8 assay,flow cytometry and Transwell assay,respectively.The comparison between the 2 groups was analyzed by u test,and multiple groups were compared by one-way analysis of variance,repeated measurement analysis of variance and LSD-t test.Multivariate analysis was done by Logistic regression model.The difference between categorical data was compared by chi-square test.Results The relative expression of BANCR in the cancer tissues was 1.6 ± 0.4,which was significantly higher than 0.9 ± 0.7 of the precancerous tissues (u =1 020.000,P ＜ 0.05).The result of univariate analysis showed that the high expression of BANCR was correlated with the lymph node metastasis and tumor stage (x2 =4.595,7.487,P ＜ 0.05).The result of multivariate analysis showed that lymph node metastasis and tumor stage (stage Ⅲ-Ⅳ) were the independent risk factors influencing the high expression of BANCR(OR =4.000,5.914,95％ CI:1.230-12.900,1.685-20.760,P ＜ 0.05).The relative expressions of BANCR of the interference group 1,interference group 2,negative control group and the blank control group were 0.25 ±0.04,0.20±0.06,0.96 ±0.04,0.98 ±0.03,with significant difference among the 4 groups (F =271.610,P ＜ 0.05).The cell proliferation rates at day 6 of the interference group 1,interference group 2 and the negative control group were 80.6％ ± 7.6％,81.2％ ± 5.1％ and 87.9％ ± 13.6％,with no significant difference among the 3 groups (F =0.559,P ＞ 0.05).The apoptotic rates of the interference group 1,interference group 2,negative control group and the blank control group were 4.7％ ± 1.7％,5.1％ ± 1.1％,3.1％ ± 0.6％ and 2.8％ ± 0.9％,with no significant difference among the 4 groups (F =2.881,P ＞ 0.05).The numbers of transmembrane cells of the interference group 1,interference group 2,negative control group and the blank control group were 135 ± 29,107 ± 18,240 ± 24 and 245 ± 22,with significant difference among the 4 groups (F =45.194,P ＜ 0.05).Conclusions BANCR was overexpressed in the HCT116 cells,and the BANCR overexpression was correlated with lymph node metastasis and tumor stage.BANCR can promote the migration of HCT116 cells.BANCR could be an important biomarker for the diagnosis and prognosis of colorectal cancer.

Objective To investigate the effect of the multimodal analgesia on postoperative pain after renal transplantation and the cytokines .Methods 40 cases of allogaft renal transplantation due to chronic renal failure were randomly divided into two groups (n=20) .The group D received the multimodal analgesia :preemptive analgesia plus patient controlled epidural analgesia(PCEA) and the group C(control) received analgesic drugs by intermittent intramuscular injection .The visual analogue scale(VAS) scores , the Ramsay sedation scores ,HR ,MAP and SPO2 at postoperative 2 ,6 ,12 ,24 ,48 h were recorded .Blood interleukin-2(IL-2) ,in-terleukin-6(IL-6) and interleukin-10(IL-10) levels were measured before anesthesia ,at the end of operation and postoperative 6 , 24 ,48 h .Results Postoperative MAP and SPO2 had no obvious change in the two groups ,no statistical differences in the various time points existed between the two groups (P>0 .05) .HR was significantly increased at 6 ,24 h after operation in the group C , which had statistical difference compared with that at the same time points in the group D (P<0 .05) .The VAS scores at postoper-ative 6 ,12 ,24 h in the group D were significantly lower than those in the group C ,the difference showed statistical significance (P<0 .05) .The sedation scores at various time points had no statistical difference between the two groups (P>0 .05) .The levels of IL-2 and IL-10 at postoperative 6 ,24 ,48 h in the two groups were significantly higher than those before anesthesia and at the end of operation (P<0 .05) .The levels of IL-2 and IL-6 at postoperative 6 ,24 ,48 h in the group D were significantly lower than those in the group C(P<0 .05) .Conclusion Multimodal analgesia can reach the effective analgesic effect ,down-regulate the pro-inflam-matory cytokines and up-regulate anti-inflammatory cytokines for maintaining postaperative serum cytokines balance .

Objective To investigate the expression of T cell immunoglobulin-and mucin-domaincontaining molecule-3 (Tim-3) in peripheral CD8 +T cells and its significance in patients with chronic hepatitis B (CHB).Methods Fifty-eight CHB patients and 16 healthy controls were enrolled.Tim-3 expression in CDs + T cells was detected by flow cytometry,and quantities of IFNγ-producing HBV-specific cytotoxic T lymphocytes (CTLs) in HLA-A2 positive subjects were detected by enzyme-linked immunosorbent spot (ELISPOT) test before and after the blockade of Tim-3/Tim-3L pathway.Paired t test was performed to compare the quantities of CTLs before and after the blockade,and nonparametric Spearman correlation analysis was performed to explore the correlation in quantitive data.Results Tim-3 expression in CHB patients was (14.2 ± 8.98 )％,which was higher than that of healthy controls (4.80 ± 2.92)％,and the difference was of statistical significance (x2 =92.48,P ＜ 0.05 ) Tim-3 expressions in 16 severe CHB patients and 42 mild CHB patients were ( 19.54 ± 10.95) ％ and (9.58 ± 7.30) ％,respectively,and the difference was statistically significant (x2 =77.24,P ＜ 0.05 ). Before the blockade of Tim-3/Tim-3L pathway,IFNγ-producing HBV-specific CTLs were 7.27 ± 3.14,and it increased to 19.62 ± 4.97 after the blockade ( t =2.95,P ＜ 0.05 ).Conclusion The upregulation of Tim-3 on peripheral CD8 + T cells may inhibit HBV-specific CTLs,and the blockade of Tim-3 pathway can enhance the proliferation of IFNγ-producing HBV-specific CTLs,thus can enhance antiviral effect.

BACKGROUND:Multimodal analgesia provides sufficient analgesia in renal recipients and appears to be associated with the recovery of renal function after transplantation. OBJECTIVE:To investigate the effect of multimodal analgesia with dezocine on postoperative immunity after renal transplantation, and discuss the appropriate analgesic drugs and methods for patients with renal transplantation. METHODS:Forty patients undergoing renal transplantation were randomly divided into two groups. They al received general anesthesia combined with epidural blockage. Control group received intramuscular injection of analgesic drugs when needed, while dezocine group received multimodal analgesia:preemptive anaIgesia with dezocine+patient-control ed epidural analgesia. The heart rate, mean arterial pressure, and saturation of blood oxygen were detected before anesthesia, 12, 24, 48 hours after transplantation. T lymphocyte subsets, interleukin-2, interleukin-6 and interleukin-10 levels in venous blood were measured before anesthesia, 12, 24, 48 hours after transplantation. RESULTS AND CONCLUSION:Compared with before anesthesia, the CD4+, CD8+cellsubset counts, CD4+/CD8+ratio, the levels of interleukin-2 and interleukin-6 were decreased significantly (P<0.05), and the levels of interleukin were significantly increased after transplantation in the control group (P<0.05). The postoperative CD4+cellsubset counts, the levels of interleukin-2 and interleukin-6 were significantly lower at 12 hours after transplantation than that before anesthesia (P<0.05), then recovered to normal levels at 24 hours in dezocine group. The postoperative CD8+cellsubset counts, CD8+and CD4+/CD8+ratio were not changed before and after transplantation in the dezocine group. The levels of interleukin-10 in the dezocine group were significantly increased at 48 hours after transplantation compared with before anesthesia (P<0.05), which was stil lower than that in control group (P<0.05). Multimodal analgesia with dezocine can effectively protect the immune system, promote short-term turnover of renal function, and prolong graft survival for patients with renal transplantation.