Objective To compare the prevent effect of biliary retrograde infection in the uncut and cut Roux-en-Y cholecystojejunostomy. Methods Sixteen Begle dogs were divided into two groups randomly. One group was performed with the uncut Roux-en-Y cholecystojejunostomy(the uncut group) and the other was performed with the cut Roux-en-Y cholecystojejunostomy (the cut group). The categories of bacterium in the the Roux limb before and twelve weeks after operation, and the biliary duct pressure of the anastomotic stoma were detected. The changes of the categories of bacterium before and after operation, the categories of bacterium and the biliary duct pressure after operation in two groups were analyzed. Results The isolating rate of G-aerobic bacteria and anaerobic bacteria was 37.50% and 6.25% before operation; in the uncut group, the isolating rate was 62.50%, 12.50%,with no significance difference comparing to preoperation(p＝0.390、1.000). In the uncut group the isolating rate was 87.50%, 75.00%after operation, with significance difference comparing to preoperation (p＝0.033、0.001).The isolating rate of anaerobic bacteria after operation in the cut group is higher than the uncut group,the difference is significance (p＝0.041). And the biliary duct pressure in the cut group is higher than the uncut group(p<0.001).Conclusion The uncut Roux-en-Y cholecystojejunostomy was more effective in prevent biliary retrograde infection.

AIM:To investigate the in vitro killing effect of adenovirus-mediated herpes simplex virus thymidine kinase gene(HSV-TK) driven by hypoxic response element(HRE) on hepatoma cell line HepG2.METHODS:Recombinant adenoviral vector Ad-HRE-TK was constructed with HSV-TK under the control of HRE using AdEasy system.Then Ad-HRE-TK was transfected into hepatoma cell line HepG2 and the cells were cultured under normoxic or hypoxic conditions.After treated with GCV for 3 d,the sensitivity to GCV of HepG2 was measured by MTT method.RESULTS:Over 95% HepG2 cells infected with Ad-HRE-TK cultured under hypoxic condition were killed when the MOI was 100 and the concentration of GCV was 50 mg/L.On the contrary,no killing effect of GCV was observed in cells cultured under normoxic condition.CONCLUSION:HRE promotes the expression of HSV-TK specifically under hypoxic condition and induces the specific killing effect of GCV.

Objective To investigate the correlation between red cell volume distribution width (RDW) and the mortality rate of acute respiratory distress syndrome (ARDS) patients after renal transplantation. Methods Clinical data of 106 ARDS patients undergoing renal transplantation were retrospectively analyzed. According to RDW, all patients were assigned into the normal (≤15.0%, n=68) and increasing RDW groups (>15.0%, n=38). Baseline data and the incidence of adverse events were statistically compared between two groups. Kaplan-Meier survival curve was adopted to compare the 50 d-mortality rate between two groups. Cox's proportional hazards regression model was utilized to identify the risk factors of the mortality of ARDS patients. Results Among 106 patients, the 50 d-mortality rate was calculated as 43.4% (46/106). The sequential organ failure assessment (SOFA) score, serum creatinine, hemoglobin and platelet count significantly differed between two groups (all P<0.05). In the increasing RDW group, the 50 d-mortality rate and the incidence of infectious shock were significantly higher than those in the normal RDW group (both P<0.05). Kaplan-Meier survival curve demonstrated that the 50 d-mortality rate significantly differed between two groups (P<0.01). Cox's proportional hazards regression model univariate analysis revealed that hemoglobin level<100 g/L, serum creatinine>133 μmol/L, platelet count<100×109/L, severe ARDS and RDW>15.0% were the potential risk factors of the 50 d-mortality rate in ARDS patients (all P<0.05). Multivariate analysis demonstrated that severe ARDS [odd ratio (OR)=12.77, 95%confidence interval (CI) 11.63-15.39, P<0.001] and RDW>15.0% (OR=2.01, 95%CI 1.02-3.94, P<0.043) were the independent risk factors of the 50 d-mortality rate in ARDS patients. Conclusions RDW elevation is correlated with the severity of disease and 50 d-mortality rate in ARDS patients following renal transplantation. RDW can serve as a clinical parameter to predict the prognosis of ARDS patients after renal transplantation.