Objective To look for a method of LC with minimal invasion and better exposure. Methods During laparoscopic cholecystectomy with three holes, a needle with a No.7 thread was pierced to the abdominal cavity at the right eighth intercostal space and the fundus of the gallbladder was sutured. The gallbladder traction was performed by the thread to help exposure of the operative filed. LC of 90 cases were operated on by the method. Results All of the 90 cases were cured without any complication. Conclusions External abdominal gallbladder traction is more effective with minimal invision and better exposure as compared with the routine LC.

Ojective To study the method of laparoscopic fenestration and its effect for the treatment of hepatic and renal cysts and polycystic livers and kidneys. Methods Laparoscopic fenestration of the cysts was performed Results All of the 15 cases were operated on successfully and recovered smoothly. Conclusions laparoscopic fenestration of hepatic and renal cysts and polycystic livers and kidneys has all the advantages of minimally invasive surgery. Relapsed cysts can be also treated by laparoscopic fenestration.

Objective To study the causes and prevention of complications during LC. Methods The clinical data of 1200 patients treated by LC in the latest 10 years were reviewed retrospectively. Results All of the 1200 cases recovered smoothly without severe complications. 18 cases were converted to open-cholecystectomy. Conclutions Complications of LC can be prevented by strict training, serious operative procedures, and mastery of causes and prevention of complications.

Aim To develop a simple and rapid method to monitor insulin receptor kinase activity and provide a novel cell-based model for screening anti-diabetes drugs.Methods CHO cells were co-transfected by plasmids which respectively contained insulin receptor gene,STAT5b gene and luciferase gene driven by STAT5 response elements.The expression of exogenous gene in transfected cells was examined by RT-PCR.The transfected cells were treated by insulin,and then the concentration and time-dependent response of luciferase expression to insulin induction was examined.Moreover,the specificity was identified by AG1024 treatment and PTP1B gene transfection.Results Expressions of insulin receptor and STAT5b were detected in the transfected CHO cells.The expression of luciferase in transfected cells was induced by insulin in concentration and time-dependent way.The maximal induction fold was 6.25.Moreover,the inducible expression of luciferase by insulin could be specifically blocked by tyrphostin AG1024,an inhibitor of insulin receptor kinase,or co-transfected PTP1B gene.Conclusions The insulin receptor kinase activity can be detected by expression of reporter gene with high sensitivity and specificity in this cell model,and with potential value in high throughput screening for insulin receptor activators and sensitizers.

The process of intervertebral disc degeneration,which could result in intervertebral disc structural and functional change,is a chronic one with multiple factors.The pathophysiologic process is still not completely find out.More and more research reports manifest that certain gene polymorphism also lead to increased risk of intervertebral disc degeneration except environmental factors.Discussions about related genetic factors and their pathophysiological role in the process of degeneration could have a further understanding to disease development.Elucidating genetic components which are associated with degeneration could not only provide insights into the mechanism of the process,but also have clinical significance for early diagnosis and prevention.In order to have a thorough understanding of functional role played by different genes,this paper summarize polymorphism and disease correlation by selecting 15 genes after reviewed the related literature published in recent years.Genetic polymorphisms in 15 genes have been analyzed in association with intervertebral disc degeneration,including aggrecan,collagen Types Ⅰ,Ⅸ and Ⅺ,fibronectin,HAPLN 1,CILP,MMP-1,2 and 3,PARK2,IL-1,6 and VDR.Each genetic polymorphism codes for a protein which has a functional role in the pathogenesis of disease.Among the 15 genes analyzed,polymorphisms in aggrecan,Type Ⅸ collagen,MMP3,IL1,IL6 and VDR show the most promise as functional variants.Genetic studies are necessary for understanding the mechanism of the degeneration.Relevant genetic information could be used as a predictive model for determining individuals' risk for intervertebral disc degeneration eventually.

Objectives: To explore the role of liver in the process of severe acute pancreatitis. Methods:Comparing the survival time, the endotoxin level of plasma and ascites , the IL-6 level of serum and ascites, the platelet granule membrane protein-140 (GMP-140) level of plasma and the histology change of lung between control group, portocaval shunting group(PC), acute necrotic pancreatitis (ANP) group and acute necrotic pancreatitis immediately after portocaval shunt(PC+ANP) group of rats. Measuring the serum IL-6 of control group, portocaval shunt control group (injecting normal saline through caval vein, PCJ), ascites injecting group (AJ) and ascites injecting portocaval shunt group (PC+AJ). Results: The survival time of PC+ANP group was much shorter than those of the other groups, and its plasma endotoxin , serum IL-6 and plasma GMP-140 levels were higher than those of the other groups (P

ObjectiveTo explore the pharmacodynamic ingredients of Zhenqi Fuzheng granules （ZFG） for immunomodulatory through spectrum-effect relationship analysis， which provides experimental basis for improving the quality standard of ZFG. MethodEighteen batches of ZFG from six manufacturers were collected for analysis. The fingerprints were established by high performance liquid chromatography （HPLC）. Acetonitrile （A）-0.1% formic acid aqueous solution （B） were adopted as the mobile phase with gradient elution （0-15 min， 5%A； 15-23 min， 5%-8%A； 23-30 min， 8%-11%A； 30-45 min， 11%-18%A； 45-60 min， 18%-21%A； 60-67 min， 21%-23%A； 67-90 min， 23%-37%A）， the detection wavelength was 220 nm. Chemometric analysis such as similarity analysis and hierarchical cluster analysis （HCA） were subsequently used to analyze the similarities and chemical differences among these samples. A cyclophosphamide-induced immunodeficiency mouse model was used to evaluate the immune-enhancing effects of the products from different manufacturers. The spectrum-effect relationship between HPLC fingerprints and the immunomodulatory effects was examined using Spearman bivariate correlation analysis. HPLC coupled with mass spectrometry （HPLC-MSⁿ） was used to identify the spectrum-effect related peaks with electrospray ionization， positive and negative ion modes， and scanning range of m/z 100-1 500. ResultThe HPLC fingerprint of ZFG was established， and twenty peaks with good resolution were selected as common peaks. The results of quality analysis and pharmacodynamic test showed there were significant differences in both ingredients content and immune-enhancing effects of ZFG from different manufacturers. Through spectrum-effect relationship study， twelve peaks were screened as bioactive ingredients peaks. Thereafter， eight peaks among them were subsequently identified by HPLC-MSⁿ. They were salidroside （peak 2）， echinacoside （peak 5）， calycosin-7-glucoside （peak 6）， isomer of specnuezhenide （peak 7）， isonuezhenide （peak 9）， calycosin （peak 11）， nuezhenide G₁₃ or oleonuezhenide （peak 14）， and formononetin （peak 18）， respectively. ConclusionThere are differences in quality and efficacy of ZFG produced by different manufacturers. Through spectrum-effect relationship analysis， the medicinal ingredients of ZFG for immune-enhancing effects are screened， which can provide reference for the improvement of its quality standard.

【Objective】 To investigate the effects of CSF-1 transport from dorsal root ganglion to spinal cord on activation of microglia in rats with neuropathic pain induced by vincristine. 【Methods】 A total of 54 male 10-12-week old SD rats with successful intrathecal catheterization, weighing 200-230 g, were divided into three groups according to the random number table method(n=18) : Control group(Control), Chemotherapy-induced Neuropathic Pain+intrathecal injection of IgG group(CINP), Chemotherapy-induced neuropathic pain+intrathecal injection of CSF-1 neutralizing antibody(CINP+anti). The animal model of CINP was established by intraperitoneal injection of vincristine 125 μg/kg on four alternate days. Mechanical allodynia and heat hyperalgesia were evaluated by MWT and TWL, respectively. The expression of CSF-1 and microglial marker Iba1 were detected by immunofluorescence chemistry and Western blotting. The mRNA expression of CSF-1 and Iba1 was measured by RT-PCR. The expression TNF-α, IL-6 and IL-1β were determined by ELISA. 【Results】 Compared with Control group, MWT and TWL in CINP group decreased significantly on the 3rd, 5th and 7th day after the first injection of vincristine(P<0.01), MWT and TWL in CINP+anti group increased significantly on the 5th and 7th day compared with CINP group(P<0.01). Compared with Control group, the protein and mRNA expression of CSF-1 in DRG, the mRNA expression of Iba1 in spinal cord, the protein expression of CSF-1 and Iba1 in spinal cord, the immunofluorescence intensity of CSF-1 in DRG and Iba1 in spinal cord , and the expression of TNF-α, IL-6 and IL-1β in spinal cord were significantly up-regulated in CINP group(P<0.01, P<0.001). Compared with CINP group, the protein expression of CSF-1 in DRG and spinal cord, the protein and mRNA expression of Iba1 in spinal cord, the immunofluorescence intensity of spinal Iba1 and CSF-1 in DRG, and the expression of TNF-α, IL-6 and IL-1β were obviously downregulated in CINP+anti group(P<0.05, P<0.01, P<0.001) . 【Conclusion】 The transport of CSF-1 from dorsal root ganglion to spinal cord is involved in the process of neuropathic pain induced by vincristine, and its mechanism may be related to the activation of microglia and inflammatory reaction in rat spinal cord.

BACKGROUND: The maximal problem of patient with serious hepatitis and surgical doctor is whether they can get donator and rational therapy timely. Looking for the suitable preoperative therapy method to enhance the success rate of operation and improve patient's prognosis is the focus of this domain.OBJECTIVE: To investigate the therapeutic effect of artificial liver support system (ALSS) combining with allotransplantation of the liver on patients with serious hepatitis.DESIGN: Retrospective case analysis. SETTING: Organ Transplantation Center, the Third Affiliated Hospital of Anhui Medical University.PARTICIPANTS: Five male patients with serious hepatitis who underwent allograft liver transplantation were selected from Organ Transplantation Center, the Third Affiliated Hospital of Anhui Medical University form June 2004 to May 2005. Their age ranged from 25 to 48 years. Inclusion criteria: The diagnosis was in accordance with phase standard established at the National Infectious Disease and Parasitology Academic Meeting in September 2000; all patients had signs of routine liver transplantation; their patients fiercely requested the operation.METHODS: Plasma exchange (PE) combined with continuous veno-venous hemofiltration (CVVH) technique was used in this study. Donor who supplied lives was from 20-38-year patients. All of them and their family agreed to donate their organ and signed the donate file before operation. All of 5 patients were used classical no-by-pass orthotopic liver transplantation (OLT). MAIN OUTCOME MEASURES: They were follow-up visited for 21-32 months for rechecking liver and kidney function,RESULTS: All of 5 patients' operation was succeeded. One continued coma postoperative and his serum creatinine and urea nitrogen raised up progressively and complicated by pulmonary infection 1 week after operation and died 2 weeks after operation although given medical treatment hemodialysis positively. The rest recovered well. All of them discharged one month after operation smoothly.CONCLUSION: Allotransplantation of the liver is an utilizable method to treat serious hepatitis. ALSS can be used as an effective method of supportive treatment preoperatively.

Objective: To observe whether an Xingnaojing 醒脑静 injection could improve the prognosis of patients, by increasing rifampicin penetration through the blood-brain barrier. Methods: Patients with severe tuberculous meningitis were enrolled in this study. The concentrations of Xingnaojing in cerebrospinal fluid and blood in patients treated with Xingnaojing and control were determined by high performance liquid chromatography. The changes in cerebrospinal fluid and the improvement of clinical symptoms and signs, were evaluated two weeks after admission. The long-term prognosis of the patients in the two groups were evaluated by the Glasgow Outcome Scale (GOS). Results: The concentration of rifampicin in cerebrospinal fluid was significantly higher in the Xingnaojing group (1.77±0.17 μg/mL), than in the control group (1.27±0.16 μg/mL, p<0.05). The difference in concentration of rifampicin in the blood was not significant (P>0.05). The short-term effective rate of the Xingnaojing group was 92.5% (37/40), which was significantly higher than that of the control group (80%, 32/40, p<0.05). After 6 months, 75% (30/40) of the Xingnaojing group had good prognosis according to the GOS score, whereas that of the control group was 50% (20/40) showing significantly better long-term treatment effect of the Xingnaojing group compared to the control group (P<0.05). Conclusion: Xingnaojing injection improved rifampicin penetration into the central nervous system. The increase in rifampicin concentration in cerebrospinal fluid improved outcomes in patients with severe tuberculous meningitis.