Objective To study the 2244G→A, 2299 A→G single nucleotide polymorphism (SNP) in the 5' regulatory regions of Toll-like receptor 4 (TLR4) in patients with Gram negative bacteria infection in Shenzhen locality, and to discuss the occurrence, course and prognosis of patients with sepsis. Method Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method was used to detect the genotype of TLR4. After the whole blood DNA of patient was extracted and PCR was amplified, the products were 500bp and 599 bp, and were cut by endonuclease Mae Ⅱ and Sph Ⅰ respectively to determine the SNP 2244G→A and 2299 A→G in TLR4. These two kinds of allele frequencies were statistically calculated in all patients. In the meantime, the incidence of septic shock, average hospitalized days, cost and prognosis of all patients were recorded. Statistical analysis was performed with SPSS version 16 software. ANOVA was used for comparison among multiple groups, and t -test and Sighed rank test were used for paired comparison. Results The 2299 and 2244 sites in the 5' regulatory regions of TLR4 gene of patients with Gram negative bacteria infection in Shenzhen locality had various degrees of changes in single nucleotide. Compared with the documented data from Chinese people in general, there was a significant difference in 2299A→G genotype frequency in residents of Shenzhen locality ( P < 0.05). But there were no statistically significant difference in mortality, incidence of septic shock, average days of ICU stay or ICU cost between TLR4 SNP positive and negative groups of patients. Conclusions There is a wide range of genetic variation in the 2299 and 2244 sites in the 5' regulatory regions of TLR4 among citizens of Shenzhen locality with unique distribution. The 2299A→G genotype frequency probably has differences in distribution and population. The pathogenesis and the prognostic factors of sepsis are complicated, whereas the gene polymorphism may be just one of the factors affecting the prognosis of patients with Gram negative bacteria infection.

Objective To investigate the pre-emptive analgesia effects of hydromorphone on stress reaction in patients undergoing gynecological laparoscopic surgery.Methods Forty ASA Ⅰ or Ⅱ patients [age:45-58 years,body mass index:18-24 kg· (m2)-1] undergoing gynecological laparoscopic surgery were randomly divided into 2 groups (n =20 for each group):treatment group and control group.Hydromorphone (1 mg) was intravenously injected before anesthesia in treatment group.In the two groups,after routine induction and incubation,remifentanil (0.2 μg· min-1 · kg-1) and propofol (0.1 mg· min-1· kg-1) were injected with micro perfusion pump,cisatracurium was injected intermittently.Injection of remifentanil and propofol was stopped when skin suture started.The concentrations of epinephrine(E) and norepinephrine(NE) were obtained before induction (t1),pneumoperitoneum (t2),1 h after pneumoperitoneum (t3) and extubation (t4),respectively.The heart rate,blood pressure and the time of operation to extubation of the patients were recorded.Results There were no significant changes in extubation time after operation among the groups.Heart rate and systolic blood pressure were significantly lower in the treatment group than in the control group (P ＜ 0.05).Plasma E and NE levels at t1 were significantly lower than those at t2,t3 and t4.Plasma E and NE were significantly lower in treatment group than that of control group at t2,t3 and t4 (P ＜ 0.05).Conclusion Pre-emptive analgesia of hydromorphone can significantly decrease the release of epinephrine and norepinephrine during and after laparoscopic surgery,restrain the increase of heart rate and systolic blood pressure during extubation,without influence of revival time.

Objective: To study the air removal efficiency of prevacuum sterilizers.Methods: The results of Bowie-Dick(BD) tests were monitored every day using the 3M disposable BD test pack,which was placed horizontally in the bottom section of the sterilizer rack near the exhaust opening.Results: Of the 1370 BD tests conducted with 3 autoclaves,1366 showed negative results and 4 positive.Conclusion: BD tests can be used to precisely assess the efficiency of prevacuum sterilizers.

ObjectiveTo investigate the feasibility of construction of engineered blood vessel using chitosan tube and fibrin gel as scaffold.MethodsVascular endothelial cells and smooth muscle cells were harvested from aortas of a rat, respectively. After expansion in vitro, vascular endothelial cells were seeded onto the inner surface of chitosan tube and smooth muscle cells mixed with fibrin gel seeded onto outer surface of the scaffold to construct engineered blood vessels. Inverted microscope, immunohistochemical staining and scanning electronic microscope were used to evaluate the construct.ResultsVascular endothelial cells formed monolayer and covered the inner surface of chitosan tube. Smooth muscle cells survived in the fibrin gel and grew in a 3-dimensional manner. ConclusionChitosan-fibrin gel may be potentially used as scaffold of engineered blood vessels.

Objective To compare the diagnostic efficacies of narrow-band imaging (NBI) in distinguishing neoplastic from non-neoplastic colorectal lesions with routine endoscopy and with magnifying endoscopy. Methods Patients with colorectal lesions detected by NBI from September 2008 to February 2010 were enrolled in the study. These lesions were classified by pit pattern and capillary pattern, which was then assessed by reference to histopathology. Results A total of 100 patients with colorectal lesions were enrolled, and the lesions were observed by NBI with ordinary endoscopy (n =64) and NBI with magnifying endoscopy (n =36), respectively, and 7 cases (5 in NBI with ordinary endoscopy and 2 in NBI with magnifying endoscopy) which did not meet the diagnostic criteria were excluded. The overall diagnostic accuracy of NBI endoscopy in distinguishing neoplastic from non-neoplastic colorectal lesions was 91.4% ( 85/93 ), in which NBI with ordinary endoscopy and magnifying endoscopy was 89. 8% (53/59) and 94. 1% (32/34),respectively, with both significantly higher than that of conventional colonoscopy reported in the literature (79. 1% ) (P ＜ 0. 05 ). However, no significant difference was detected between 2 methods ( P ＞ 0. 05 ).Conclusion Similar with NBI magnifying endoscopy, NBI endoscopy without high magnification may also be useful to distinguish neoplastic from non-neoplastic colorectal lesions.

Objective To investigate the correlation between invasion ability and cytoskeleton remodeling of hepatocarcinoma cell by atomic force microscopy (AFM) and to explore mechanical properties during genesis,development and invasion of hepatocellular carcinoma (HCC).Methods Four HCC cell lines (MHCC-97H,MHCC-97L,SMMC-7721 ,Huh-7 )with different invasive ability were studied.Mechanical parameter (Young′s modulus)was measured by AFM.The pattern of cytoskeleton remodeling of HCC cell lines with different invasive ability was detected by immunofluorescent staining. The difference of cell invasive ability was tested by cell scratch experiment in other to verify mechanical data.Kruskal-Wallis H test was used to compare the differences between groups.Results The results of AFM indicated that Young′s modulus of cytoplasma area and nucleus area decreased gradually as cell invasion ability increased (χ2 =472.78,622.43,both P <0.01).According to invasive ability from low to high,Young′s modulus of cell cytoplasm area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 1 602.43 (845 .48,3 317.25)Pa,1 055 .28 (367.48,2 280.77)Pa,1 026.78 (369.20,2 019.96)Pa and 503.12 (366.11 ,700.31)Pa,respectively.Young′s modulus of cell nucleus area of Huh-7,SMMC-7721 ,MHCC-97L and MHCC-97H were 2 823.98 (1 262.78,4 440.07 )Pa,1 313.43 (590.71 , 2 678.62)Pa,1 285 .17 (583.29,1 961 .19)Pa and 655 .57 (441 .29,943.39)Pa,respectively.The results of immunofluorescent staining showed that the stronger the cell invasive ability,the worse cytoskeletal integrity and more irregular cell microfilament distribution. In cell scratch assay, the migration rate of MHCC-97H was 46.67% in 24 h and 86.47% in 48 h,that of MHCC-97L was 45 .70%in 24 h and 82.86% in 48 h,that of SMMC-7721 was 39.41 % in 24 h and 79.85 % in 48 h and that of Huh-7 was 34.60% in 24 h and 72.09% in 48 h,which showed that the cell migration orderly in creased as the cell invasion ability increased.Conclusions It seemed that HCC with higher invasive ability had lower Young′s modulus,softer cell,stronger deformability,worse cytoskeleton integrity and more irregular cell structure,and vice versa.

Objective Hospital material management system of sterile supply has its particularity which is in close relation with medical quality.The study was to greatly improve the quality and efficiency of sterile supply department with the application of material management system. Methods The material management system integrated with the hospital net was applied in the man-agement of material distribution, inventory and statistics. Results It provided exact and detailed data for sterile supply department and clinical departments. Conclusion The application of information system in hospital net can provide exact and overall cost ac-counting information for involved departments, greatly improving the efficiency of material management.

Objective To investigate changes in T lymphocyte subsets and NK cells in patients with simple Graves' disease (GD)and Graves' disease combined with type 2 diabetes mellitus (GD/T2DM). Methods Fifteen cases of GD/ T2DM were selected from our hospital from November 2001 to November 2004. Before and after therapy thyroid function, thyroglobulin antibody (TGA), thyroid microsomal antibody (TMA) and blood glucose level were measured, and T lymphocyte subsets (CD3, CD4, CD8, CD4/CD8) and NK cells (CD56) were measured by immunofluorescence double labeling monoclonal antibody and flow cytometry, respectively. At the same time, comparison was made with simple GD (15 cases), T2DM (15 cases) and healthy control (20 cases). Results Before therapy, CD4/CD8, CD4 and NK cells in GD/T2DM were less than normal, and there was no significant difference in comparison with simple GD (P<0.05). In T2DM group, only CD4/CD8 and CD4 were less than those of healthy controls (P<0.05). When thyroid function recovered after 1 to 3 months of methimazole treatment in both GD/T2DM and simple GD groups, various indexes recovered, which were more obvious in simple GD. Conclusion Immune hypofunction of GD may be the key to the immune abnormality of GD/T2DM, which is more significant than that of simple GD or T2DM. The recovery of thyroid function and immune abnormality is not consistent, and the recovery of GD is more significant than that of GD/T2DM.

Objectives:In order to prevent and control hospital infection efficiently, comprehensive management is put into effect on the quality of disinfectant and sterilization. Methods:The management model which spot-supervision, bacteria monitor and scientific modification are integrated has been applied in hospital. Results and Conclusions:The sterilization mind of staffs has been steadily strengthened and the qualified ratios of various monitor items has increased annually.

Objective To obtain the experimental data of vascular tissue engineering.MethodsThe vascular endothelial cells (VEC) and vascular smooth muscle cells (VSMCs) were acquired and cultured, and then seeded on vascular tissue engineering materials. The porous gelatin-chitosan scaffold with VSMCs was subcutaneously implanted, followed by the observation of the cell growth ten days later.ResultsThe two kinds of cells were successfully cultured and their morpholoical and immunohistochemical characteristics were consistent with vascular endothelial and VSMCs respectively. The VSMCs could grow extensively on the scaffold after the in vivo implantation. The scaffold were wrapped by the fibrous tissue ten days later after the in vitro implantation of VSMCs. The seed cells grew in the scaffold, and the vessel cavity seen in the center of the scaffold, was quite different from the normal vessel structure.ConclusionIt is feasible to implant the VSMCs with fibrin gels into the living body. The vessels reconstructed, though different from the normal structure, is similar to the embryo of the vessels.