Total laparoscopic splenectomy combined with pericardial devascularization has become an important surgical treatment for portal hypertension patients. Compared with the traditional open surgery, laparoscopic surgery has multiple advantages including precise operation, small trauma and quick recovery. Accurate preoperative evaluation, precise surgical operation and delicate perioperative management are still important parts in perioperative management of laparoscopic surgery. Preoperative reasonable and accurate individualized assessment, strict control surgical indications and contraindications are the important basis to ensure the perioperative surgery to be safe and rational; standardized and individualized surgical operation is the key for accurate vascular disconnection, reducing intraoperative bleeding and perioperative complications; the concept of fast-track surgery is conducive to the rapid recovery of patients with portal hypertension and reduce the operation related complications. Anticoagulant therapy is a safe and effective treatment to reduce portal vein thrombosis. It is an important task to strengthen the cooperation among different disciplines for the treatment of portal hypertension in the future.

Objective To study the chemical constituents of the fruiting bodies of Hydnum repandum.Methods Separation and purification were performed on silica gel, Sephadex LH-20 and ODS CC. Their sturctures were established by 2D-NMR (1H-1HCOSY, HMQC, HMBC, and NOESY), MS, HR-MS spectra, and ORD data. Results Eleven compounds were obtained and identified as sarcodonin A ( Ⅰ ),scabronine B (Ⅱ), 3β-hydroxy-5α, 8α-epidioxyergosta-6, 22-dien (Ⅲ), (22E, 24R)-ergosta-7, 22-diene3β, 5α, 6β- triol (Ⅳ), (22E, 24R)-ergosta-7, 22-diene-3β-ol (Ⅴ), benzoic acid (Ⅵ), 4-hydroxylbenzaldehyde (Ⅶ), 4-monopropanoylbenzenediol (Ⅷ), ethyl-β-D-glucopyranoside (Ⅸ), thioacetic anhydride ( Ⅹ ), (2S, 2'R, 3S, 4R)-2-(2-hydroxyoctadecanoylamino) docosane-1, 3, 4-triol (Ⅺ). Conclusion All of the compounds are isolated from this fungus for the first time.

Objective To compare the short and long term effect of knee osteoarthritis treatment with two therapeutic methods which are simple high cut of fibula and arthroscopic lavage debridement combined with fibular osteotomy.Methods Data of 45 consecutive patients with knee osteoarthritis were retrospectively observed and selected,and then they were divided into two groups according to the operation method.23 patients with simple high cut of fibula were selected as the control group,and 22 patients with arthroscopic lavage debridement combined with fibular osteotomy were selected as the observation group.Results The VAS and AKS scores of the control group at the time of 3m,6m,1 2m were (4.1 3 ±0.76)points,(1 07.04 ±21 .53)points;(2.70 ±0.64)points,(1 41 .1 7 ±1 2.57)points;(2.43 ±0.79)points,(1 48.26 ±5.81 )points;and the scores of the observation group were (3.45 ± 0.60)points,(1 26.64 ±1 4.24)points,(2.70 ±0.73)points,(1 46.45 ±7.26)points,(2.41 ±0.85)points and (1 48.26 ±5.81 )points.The differences between the two groups were statistically significant at the time of 3 months after surgery(t =3.32,-3.62,all P <0.05),the effect of observation group was better than the control group;but the other indices had no statistically significant differences (t =0.51 ,-1 .72,0.1 1 ,-0.20,all P >0.05 ). Conclusion The simple high cut of fibula with small trauma,less cost,less surgical difficulty,and long -term clini-cal curative effect is not less than the arthroscopic lavage and debridement combined with fibular osteotomy.There-fore,it should be carried out in the primary hospitals widely.

Objective To investigate inhibitory effects of matrine (Ma) combined with vincristine (VCR), cytosine arabinoside (Ara-c), harringtonine (HRT), adriamycin (ADM), and daunorubicin (DNR) on proliferation of K562 cells. Methods MTT colorimetric assay was used to detect the inhibition rate of Ma combined with antineoplastic on K562 cells. Results The proliferation of K562 cells was inhibited by Ma at the concentration of 160 ?g/ml to 400 ?g/ml. The inhibitory rates of Ma combined respectively with VCR, Ara-c, HRT, ADM, and DNR were significantly higher than those of VCR, Ara-c, or HRT alone (P0.05). Conclusion Ma can inhibit the proliferation of K562 cells in a dose-dependent manner. The anti-proliferation effect of VCR, Ara-c, and HRT on K562 cells could be enhanced by Ma.

AIM and METHODS: To examine the relationship of glutathione S-transferase M1( GSTM 1) and T1( GSTT 1) with the occurrence of lung cancer, The case-control study was conducted among 161 lung cancer and 165 healthy controls. The genetic polymorphisms of GSTM1 and GSTT1 were detected with the method of multiplex polymerase chain reaction. Logistic regression analyses were used to assess the interaction of between different genotypes as well as between null genotypes and smoking. RESULTS: The frequences of GSTM 1 and GSTT 1 null genotypes had no obvious difference between lung cancer and healthy controls. In non-smoking subjects, the frequence of GSTM 1 null genotype was significantly different between lung cancer and healthy controls. Furthermore, GSTM 1 null genotype was significantly overrepresented in adenocarcinoma patients aged 60 or over, compared with controls.The results from interaction analyses showed although smoking and GSTM 1 deletion were associated with an increased risk of lung cancer, GSTM1 and GSTT 1 null genotypes combined with smoking did not have interaction effect on the risk of lung cancer. The risk for adnocarcinoma in the individuals at the age of 60 or over and in nonsmokers without GSTM1 gene but with GSTT1 functional genotype decreased by 48.5% and 45.3%, respectively. CONCLUSION: Our results suggest that GSTM1 deletion is an important host risk for lung cancer, and imply that GSTT1 functional genotype protects the old (aged 60 or over) and nonsmokers who are lack of GSTM1 gene from the risk of adenocarcinoma.

Objective To establish a method of inducing dendritic cells(DC)from rat bone marrow cells in vitro,and identify the phenotype and function characteristics.Methods The rat bone malToW cells were collected and cultured in vitro under the condition of recombinant rat GM-CSF(rrGM-CSF)and recombinant rat IL-4(rrIL-4).After 2 weeks,the morphological character of DCs was observed under light microscope and scanning electron microscope.Expression of MHC-Ⅱ,CD80 and CD86 were detected by flow cytometry.The ability to stimulate allogenic T cells of the cultured DCs was detected by mixed lymphocyte reaction.Results DCs showed typical morphology with elongated dendritic processes under inversion microscope and scanning electron microscope.DCs at day 6 revealed immature phenotype,including MHC-Ⅱ(29.03 ±4.39)%,CD80(21.98±7.08)%and CD86(25.94±6.80)%.DCs at day 12 showed higher expression of MHC-Ⅱ(74.05±5.97)%,CD80(79.85±6.53)%and CD86(81.00±7.47)%,and stimulatory capacity of allogenic T cells,compared with that in DCs at day 6.Conclusion Matured DCs could be generated from rat bone marrow cells and attendance with rrGM-CSF and rrIL-4,which present the feasibility for further research on its application to allograft immunorejection.

Objective: To analyze the disease burden of acute gastrointestinal illness (AGI) caused by non-typhoidal Salmonella and Vibrio Parahaemolyticus in Zhejiang Province, so as to provide the reference for the prevention and control of foodborne diseases. Methods: The detection rates of non-typhoidal Salmonella and Vibrio parahaemolyticus in 2022 were collected through the Zhejiang Foodborne Disease Outbreak Surveillance System. The number of cases, incidence and hospitalizations of AGI caused by non-typhoidal Salmonella and Vibrio parahaemolyticus were calculated. Disability-adjusted life years (DALY) were used to analyze the disease burden of AGI caused by non-typhoidal Salmonella and Vibrio parahaemolyticus among different age groups. Results: The number of AGI cases caused by non-typhoidal Salmonella in Zhejiang Province in 2022 was 889 500 person-times, the incidence rate was 1 352.42/105, the number of hospital visits was 328 900 person-times, the DALY was 972.69 (95%CI: 771.68-1 164.16) person-years, and the DALY rate was 1.48 (95%CI: 1.17-1.77) /105. The incidence rate and DALY rate were highest in the children aged under 5 years, reaching 3 989.51/105 and 13.93 (95%CI: 8.67-18.42) /105, respectively. The number of AGI cases caused by Vibrio parahaemolyticus in Zhejiang Province was 639 400 person-times, the incidence rate of 972.16/105,the number of hospital visits was 166 800 person-times, the DALY was 509.30 (95%CI: 411.75-699.62) person-years, and the DALY rate was 0.78 (95%CI: 0.63-1.06)/105. The incidence rate and DALY rate were highest in the residents aged 45 to <65 years, reaching 1 383.55/105 and 1.27 (95%CI: 1.14-1.96)/105, respectively. Conclusions The incidence and DALY of AGI caused by non-typhoidal Salmonella were relatively high in Zhejiang Province. The AGI caused by non-typhoidal Salmonella in the children under 5 years and the AGI caused by Vibrio parahaemolyticus in the residents aged 45 to <65 years need to be monitored with priority.

Objective:To evaluate thrombo-pretreatment in AngioJet mechanical thrombectomy.Methods:68 acute DVT patients were randomized into two groups: thrombo-pretreatment with low-dose urokinase via popliteal vein before operation (experimental group)comparing with those undergoing upfront surgery.Results:After pretreatment, the immediate thrombus clearance grade in the experimental group was higher than that in the control group( Z=2.446, P=0.014), the procedure time was shorter [(289.1±57.9) s vs. (342.3±75.2) s] and less hemoglobin decreased after operation [(7.2±2.4) g/L vs. (11.4±2.1) g/L]. There was no difference in the deep vein patency and the incidence of PTS between the two groups at 3 , 12 and 24 months after operation. Conclusion:Pre-treatment with low dose urokinase before operation can improve the efficiency of PMT, effectively reduce the time of AngioJet activation and the destruction of red blood cells.

Objective:To investigate the effect of CD226 gene knockout (CD226 -/-) on carbon tetrachloride (CCl 4) -induced liver fibrosis in mice. Methods:Eight 6-8 week-old male wild-type and CD226 -/- C57BL/6 mice were used, with weights of (22.16±2.24) g and (21.84±2.50) g, respectively. Four mice each from wild-type and CD226 -/- mice were injected intraperitoneally with CCl 4 to establish a liver fibrosis model, namely, the liver fibrosis group and the CD226 -/- liver fibrosis group, and the remaining four mice each corresponded to the control group and the CD226 -/- control group. The effect of CD226 -/- on liver mass, liver index and Ishak fibrosis score were observed. HE, Masson, and Sirius red staining were performed to observe the liver injury and liver fibrosis. Immunohistochemistry and Western blot were used to detect the protein expression levels of collagen type I (Collagen I) and α-smooth muscle actin (α-SMA) in liver tissues. Flow cytometry was used to analyze the proportion of T lymphocytes and their intracellular IFN-γ secretion levels in the peripheral blood and liver tissues. The mRNA expression level of transforming growth factor-β1 (TGF-β1) in the liver tissues was detected by real-time fluorescence quantitative PCR (qPCR). Results:Compared to the liver fibrosis group, the CD226 -/- liver fibrosis group showed an increase in liver mass [(2.00±0.14) g vs. (1.41±0.16) g] and liver index (7.25±0.59 vs. 5.33±0.30), and a decrease in Ishak's fibrosis score [(6.75±0.96) score vs. (10.00±1.41) score], and the differences were statistically significant (all P<0.05). HE staining showed disorganization of the liver tissue structure, and degeneration and necrosis of the hepatocytes both occurred in the liver fibrosis group and CD226 -/- liver fibrosis group, but the degree of inflammatory cell recruitment was milder in the CD226 -/- liver fibrosis group than the liver fibrosis group. Sirius red and Masson staining revealed reduced collagen fibre deposition in the CD226 -/- liver fibrosis group compared to the liver fibrosis group. Immunohistochemical staining showed that the expression of Collagen I [(4.38±0.51)% vs. (6.55±1.40)%] and α-SMA [(0.77±0.20)% vs. (1.20±0.24)%] were reduced in the CD226 -/- liver fibrosis group compared to the liver fibrosis group, and the differences were statistically significant (both P<0.05). Western blot indicated that the relative expression level of Collagen I was reduced in the CD226 -/- liver fibrosis group compared to the liver fibrosis group (0.35±0.14 vs. 1.66±0.73), and the difference was statistically significant ( P<0.05). Flow cytometry revealed increased intracellular IFN-γ secretion by T lymphocytes in the peripheral blood in the CD226 -/- liver fibrosis group compared to the liver fibrosis group. qPCR result revealed that the relative mRNA expressions of TGF-β1 was reduced in the CD226 -/- liver fibrosis group compared to the liver fibrosis group (0.38±0.18 vs. 0.61±0.28), and the difference was statistically significant ( P<0.05). Conclusion:CD226 -/- attenuates CCl 4-induced hepatic inflammatory infiltration and hepatic fibrosis, which may be related to its affected intrahepatic T lymphocytes and intracellular IFN-γ secretion.