0.05). It shows that mushroom broth culture, which is processed conveniently and cheaply, has good practical value.

Objective To explore the value of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) in diagnosing adult multiple atrial septal defect (MASD). Methods Thirty adult patients with MASD were examined with TTE, 25 patients were examined also with TEE, 26 patients were examined with cardiac catheterization as well. Transcatheter closure of MASD was performed in 20 patients and succeeded in 18, while open-chest operation was performed in 4 patients. Results Foramen secundum atrial septal defect was diagnosed with both TTE and TEE with an accuracy rate of 60.00% (18/30) and 96.00% (24/25), respectively. The main color Doppler flow imaging (CDFI) feature of adult MASD was multiple colorful left-to-right shunt signals through the atrial septal designated, i.e. colander sign of CDFI. Conclusion TTE has some difficulties and TEE has specific value in diagnosing adult MASD. TTE can be used before open-chest operation. TEE is necessary before transcatheter occlusion to make sure of the amount and location of atrial septal defect.

Objective:To detect the expression of tumor necrosis factor alpha in (TNF alpha) breast cacner and its relationship with imaging features.Methods:Using immunofluorescence and flow cytometry to detect the expression of TNF-α in MDA-MB-231 and MCF-7.Collect 82 patients with mammary gland disease,which was confirmed by pathological tissue,its pathological data,imaging data,and by immunohistochemistry to detect the expression of TNF-α in breast tissues,and analyze and the relationship between its expression and the pathological features and imaging characteristics.Results:TNF-α high expression in MDA-MB-231,the expression of TNF-oα in malignant breast tumor tissue significantly higher than that in benign tumor,the expression quantity associated with lymph node metastasis,TNM stages,strengthen uniform in MRI,the boundary and the shape of the X-ray Mammography (P=0.01),and color flow signal strength in ultrasound (P＜0.05).Conclusions:TNF alpha in breast tumor tissue was unusually high expression,and is closely related to some of the imaging features of breast tumor.

Objective To observe the effect of acute normovolemic hemodilution(ANH)combined with enhanced recovery after surgery(ERAS)on immune function in patients undergoing hepatic lobectomy. Methods 80 patients were divided into two groups:ERAS group(group E),ANH combined with ERAS group(group AE). bleeding volume,blood transfusion,infused fluid volume,urine output during operation and clinical index after surgery were recorded. Exhaust and defecation time ,fluid intake time and hospitalization duration were also record-ed. Blood samples were obtained from the patients at 30 min before anesthesia induction(T1),immediately(T2), 24 h(T3),3 d(T4)and 7 d(T5)after the end of operation for determination of the expression of CD3+,CD4+, CD8+ on T cells and natural killer cell. Results In group E ,CD3+,CD4+ T-lymphocytes and NK cells at T2-3 decreased as compared with T0. Compared with group E ,no allogeneic blood transfusion cases were found and clinical index duration was shorter in group AE. CD3+,CD4+T-lymphocytes and NK cells at T2-3 increased in group AE as compared with those in Group E. The difference is significant (P < 0.05). Conclusion ANH combined with ERAS can decrease allogenic blood transfusion and increase post-operation immunologic function ,shorten the postoperative hospitalization time.

OBJECTIVETo study postoperative anorectal dynamic change in ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection.

METHODSClinical and follow-up data of 26 ultra-low rectal cancer patients undergoing laparoscopic intersphincteric resection in our department from January 2007 to January 2013 were retrospectively analyzed (observation group). Thirty rectal cancer patients undergoing laparoscopic low anterior resection by the same surgical team in the same period from the Medical Record Room were randomly extracted as control group. The observation indexes included preoperative and postoperative anal resting pressure(ARP), anal maximum squeeze pressure (AMSP), rectal maximum tolerable volume (RMTV), rectal anal inhibition reflex (RAIR) and Wexner anal function scores (0 means normal).

RESULTSThere were no significant differences in clinical baseline data between the two groups(all P>0.05), except the distance from lower edge of tumor to dentate line [(2.9±0.4) cm in observation group vs. (5.0±0.5) cm in control group, P=0.000]. There were no differences in preoperative anorectal manometry and Wexner anal function score between two groups (all P>0.05). The average follow-up time in observation group and control group was 14.5 months and 14.0 months respectively. Three months after operation, significant differences between observation group and control group (all P=0.000) were as follows: defecation frequency [(6.0±1.5) times/day vs. (2.5±1.0) times/day], Wexner anal function score(5.0±0.9 vs. 2.9±1.2), ARP [(32.0±6.7) mmHg vs. (45.0±8.2) mmHg], AMSP [(90.1±6.9) mmHg vs. (110.0±7.5) mmHg], RMTV [(61.0±7.2) ml vs. (91.1±7.5) ml] and positive rate of RAIR [11.5%(3/26) vs. 66.7%(20/30)]. One year after surgery, there were no significant differences in defecation frequency, Wexner anal function scores, ARP, AMSP and RMTV between the two groups (all P>0.05), however the difference in positive rate of RAIR was still significant[38.5%(10/26) vs. 93.3%(28/30), P=0.000].

CONCLUSIONLaparoscopic intersphincteric resection for ultra- low rectal cancer can achieve satisfactory anorectal dynamic effect.

Aged ; Anal Canal ; physiopathology ; Female ; Humans ; Laparoscopy ; Male ; Middle Aged ; Postoperative Period ; Pressure ; Rectal Neoplasms ; surgery ; Rectum ; physiopathology ; Retrospective Studies

Objective:To investigate the effects of Cordyceps sinensis (CS) on cellular apoptosis and Sirt1 expression in HK2 cells followed by ischemia-reperfusion (I/R).Methods:HK2 cells were incubated with different concentrations of CS (10,20,40,80,160,320 mg/L) for 24 hours,and the optimal concentration of CS was selected by measuring cell proliferation.The confluent HK2 cells were incubated with 0.01 μmol/L antimycin A for 2 hours to induce ischemia in vitro,and then the reperfusion was achieved by incubating cells with glucose-replete complete growth medium for 24 hours.HK2 cells were divided into 4 groups:a control group,an I/R group,an I/R+CS (160 mg/L) group,and an I/R+CS (160 mg/L)+Sirtinol (25 μtmol/L) group.Twenty-four hours later,total RNA and protein were collected.The cell proliferation was evaluated by MTT assay;the mRNA and protein expression of Sirtl and the cleaved caspase-3 were measured by qRT-PCR and Western blot,respectively.The cellular apoptosis rate was determined by Annexin V-FITC/PI double staining and flow cytometry.Results:Certain concentrations (10-160 mg/L) of CS did not show effect on the proliferation of HK2 cells (P＞0.05),while 320 mg/L of CS inhibited cell proliferation significantly (P＜0.01);compared with the control group,the mRNA and protein expressions of Sirtl and the cleaved caspase-3 in the I/R group were up-regulated (P＜0.01) and the apoptosis rate was extremely high;compared with the I/R group,CS significantly up-regulated Sirt1 mRNA and protein expression (P＜0.01) while down-regulated cleaved caspase-3 mRNA and protein levels (P＜0.01),and reduced apoptosis rate (P＜0.05).The effects of CS were blocked in the presence of sirtinol,an inhibitor of CS.Conclusion:CS protects HK2 cells from I/R injury through activation of Sirt 1 pathway.

Purpose: Accumulating evidence has suggested that toll-like receptor 4 (TLR4) is critically involved in the pathogenesis of asthma. The aim of this study was to investigate the role of TLR4 in toluene diisocyanate (TDI)-induced allergic airway inflammation. Methods: TLR4−/− and wild-type (WT) C57BL/10J mice were sensitized and challenged with TDI to generate a TDI-induced asthma model. B-cell lymphoma 2 (Bcl-2) inhibitors, ABT-199 (4 mg/kg) and ABT-737 (4 mg/kg), were intranasally given to TDI-exposed TLR4−/− mice after each challenge. Results: TDI exposure led to increased airway hyperresponsiveness (AHR), granulocyte flux, bronchial epithelial shedding and extensive submucosal collagen deposition, which were unexpectedly aggravated by TLR4 deficiency. Following TDI challenge, TLR4−/− mice exhibited down-regulated interleukin-17A and increased colony-stimulating factor 3 in bronchoalveolar lavage fluid (BALF), while WT mice did not. In addition, TLR4 deficiency robustly suppressed the expression of NOD-like receptor family pyrin domain containing 3 and NLR family CARD domain containing 4, decreased caspase-1 activity in TDI-exposed mice, but had no effect on the level of high mobility group box 1 in BALF. Flow cytometry revealed that TDI hampered both neutrophil and eosinophil apoptosis, of which neutrophil apoptosis was further inhibited in TDI-exposed TLR4−/− mice, with marked up-regulation of Bcl-2. Moreover, inhibition of Bcl-2 with either ABT-199 or ABT-737 significantly alleviated neutrophil recruitment by promoting apoptosis. Conclusions These data indicated that TLR4 deficiency promoted neutrophil infiltration by impairing its apoptosis via up-regulation of Bcl-2, thereby resulting in deteriorated AHR and airway inflammation, which suggests that TLR4 could be a negative regulator of TDI-induced neutrophilic inflammation.

Purpose: Accumulating evidence has suggested that toll-like receptor 4 (TLR4) is critically involved in the pathogenesis of asthma. The aim of this study was to investigate the role of TLR4 in toluene diisocyanate (TDI)-induced allergic airway inflammation. Methods: TLR4−/− and wild-type (WT) C57BL/10J mice were sensitized and challenged with TDI to generate a TDI-induced asthma model. B-cell lymphoma 2 (Bcl-2) inhibitors, ABT-199 (4 mg/kg) and ABT-737 (4 mg/kg), were intranasally given to TDI-exposed TLR4−/− mice after each challenge. Results: TDI exposure led to increased airway hyperresponsiveness (AHR), granulocyte flux, bronchial epithelial shedding and extensive submucosal collagen deposition, which were unexpectedly aggravated by TLR4 deficiency. Following TDI challenge, TLR4−/− mice exhibited down-regulated interleukin-17A and increased colony-stimulating factor 3 in bronchoalveolar lavage fluid (BALF), while WT mice did not. In addition, TLR4 deficiency robustly suppressed the expression of NOD-like receptor family pyrin domain containing 3 and NLR family CARD domain containing 4, decreased caspase-1 activity in TDI-exposed mice, but had no effect on the level of high mobility group box 1 in BALF. Flow cytometry revealed that TDI hampered both neutrophil and eosinophil apoptosis, of which neutrophil apoptosis was further inhibited in TDI-exposed TLR4−/− mice, with marked up-regulation of Bcl-2. Moreover, inhibition of Bcl-2 with either ABT-199 or ABT-737 significantly alleviated neutrophil recruitment by promoting apoptosis. Conclusions These data indicated that TLR4 deficiency promoted neutrophil infiltration by impairing its apoptosis via up-regulation of Bcl-2, thereby resulting in deteriorated AHR and airway inflammation, which suggests that TLR4 could be a negative regulator of TDI-induced neutrophilic inflammation.