Objective To study the effect of capsule deficient strains CAP64 on apoptosis of mice microglia cell line (N9) cell in vitro . Methods N9 cells were co cultured with CAP64, the flow cytometry was employed to detect the N9 cellular apoptosis on different phase. Results The average apoptotic index of N9 after cultured for 2、4、8、16、24 hours with CAP64 were 9 33%、12 93%、15 37%、16 30% and 20 5%, respectively. There were significant differences between experimental group and control group. Conclusion Capsule deficient strains CAP64 can induce microglia cell line (N9) apoptosis

Objective To evaluate the effect of local resection for the tumor of Vater ampulla. Methods seventeen cases of Vater ampullary tumor were subjected to tumor local resection from November 1987 to December 1998, including 3 adenomas and 14 adenocarcinomas confirmed by pathology. Two methods of excision for the tumor were performed, including through duodenum to perform the tumor local resection in 16 cases, and through common bile duct in 1 case. Results Bile duct infection occurred in 3 cases. There was no death in this series. 12 of the 17 cases (70.6%) had been followed up for 4～61 months, median survival time was twelve months. In three benign cases ,one died with another disease 17 months postoperatively, two still alive well 38 and 7 months after operation respectively. In 14 malignancy, 9 cases (64.3%) had been followed up. Of the 9 cases, 6(66.7%) alived ≥ 12 months, 4 (44.4%) 24 months, two(22.2%) 60 months. Conclusions Local resection of the Vater ampulla tumor has advantages, such as small damage ,less bloodlass, quick recovery and less interference of the body, but it must be performed by rich experienced surgeons. It is suitable for patients with a small benign tumor, or in the high risk patients whose carcinoma showed no invasion or metastasis, and it also can be performed in patients such as those with atypical hyperplasia and suspious malignant tumor.

Objective To analyze the drug resistance and homology of Acinetobacter baumannii (Ab) isolated from patients with explosive injury ,so as to explore the characteristics of drug resistance and prevalence of infection .Methods A total of 61 strains of AB isolated from clinical specimens of patients with explosive injury were collected .The antimicrobial susceptibility of these iso‐lates was detected by using K‐B test .All the strains were gene typed by using the pulsed field gel electrophoresis .Results The re‐sults of antimicrobial susceptibility test shown that the 61 isolates of Ab had high resistance rate ,and were multi‐drug resistant to common antibacterial agents ,except for tigecycline (the resistante rate was 11 .5% ) and minocycline (the resistante rate was 48 .0% ) .The 61 isolates of Ab were divided into 8 kinds of genotypes ,among which type A was the most prevalent one (25 strains) .Other genotypes were type B(10 strains) ,type C(6 strains) ,type D(4 strains) ,type E(8 strains) ,type F(3 strains) ,type G(4 strains) and type H(1 strain) .The isolates of Ab were with high homology .Conclusion Multi‐drug resistance is observed in strains of Ab isolates from patients with explosive injury .Clonal strains of AB may be disseminates among regions ,which indicates that high attention should be paid to these strains .

Objective To study the influence factors of the release rate of benorilate from sustained release matrix tablets. Methods The matrix tablets of benorilate were prepared by using hydroxypropylmethylcellulose (HPMC) as the matrix material. The effects of the contents of HPMC, polyvinyl pyrrolidone (PVP), and microcrystaline cellulose (MCC), and the method of preparation on in vitro drug release were studied by evaluating the n value in the Peppas equation. Results The increasing HPMC content led to decrease of benorilate release. However, PVP and MCC used in this experiment accelerated the benorilate release from the tablets. The drug released from the tablet prepared by dry method was faster than that by wet method. Conclusion The contents of HPMC, PVP, and MCC, especially HPMC, have effects on the release rate of benorilate, but the two preparation methods have less effect.

OBJECTIVE To investigate the postoperative morbility of deep fungal infections and the source and composition of the pathogenic fungi.METHODS Clinical data of 816 patients with post-operative deep fungal infections from Jul 2006 to Jun 2008 were reviewed and analyzed retrospectively.RESULTS The detectable rate of post-operative deep fungal infections was 24.82%,among which Candida albicans was the most common(65.69%),followed by C.tropicalis(10.57%);the rate of broad-spectrum antibiotic application in peri-operation was 96.45%;the infection site in the descending order was cardio-thorax,gastrointestinal tract,urinary tract,female reproductive system,blood and skeleton.CONCLUSIONS Operative trauma is an important factor that causes deep fungal infections in hospital,and is closely related to broad-spectrum antibiotic application.Positive prevention,timely diagnosis and effective treatment should be highly emphasized when dealing with post-operative deep fungal infections.

ObjectiveTo evaluate a computer-assisted operation planning system in curative hepatectomy for complex hilar cholangiocarcinoma.MethodsThe clinical data of 15 patients with complex hilar cholangiocarcinoma who were admitted to the Chinese PLA General Hospital from January 2008 to December 2009 were retrospectively analyzed.Based on triple-phase contrast-enhanced computed tomography inages,a computer-assisted operative planning system was used to evaluate the anatomic relationship between the tumor and its adjacent vessels,liver volume,operative feasibility,and the potential surgical approaches.The accuracy of three-dimensional reconstruction was tested by comparison to actual intraoperative findings.The correlation between actual liver resection volumes and predicted liver resection volumes was analyzed by calculating a Pearson correlation coefficient.Differences in liver volumes calculated by two-dimensional techniques versus three-dimensional reconstruction were analyzed using the paired t test,and the error rate was compared using the chi-squarc test. Results Fifteen patients received curative hepatectomy,including extended hemihepatectomy in 8 patients and trisectionectony in 7 patients.Preoperative evaluation of the hepatic anatomy based on three-dimensional reconstruction imaging was confirmed with operative findings.The sensitivity,specificity and accuracy rates were 100.0％,72.7％ and 72.7％ for patients with portal invasion and 100.0％,78.6％ and 78.6％ for patients with hepatic arterial invasion,respectively.The actual liver resection volume was positively correlated with the predicted liver resection volume ( r =0.974,P ＜ 0.05 ).The mean liver volumes calculated by the three-dimensional reconstruction and the two-dimen-sional techniques were (458 ±86)ml and (491 ± 103 )ml,respectively,with no significant difference (t =-1.911,P ＞0.05 ).The error rates of the three-dimensional reconstruction and the two-dimensional techniques were 4.7％ and 7.2％,respectively,with no significant differnece ( x2 =2.381,P ＞ 0.05 ).Five patients had postoperative complications,and each was cured with conservative or interventional management. Conclusion The application of a computer-assisted operation planning system may improve the safety and accuracy of curative resection for complex hilar cholangiocarcinoma.

Objective A retrospective study to evaluate the feasibility of the sequential treatment of extrahepatic bile duct calculus and acute gallstone pancreatitis using the technique of combination of duodenoscope, laparoscope and choledochoscope in one anesthetic session. Methods 112 patients with extrahepatic bile duct calculus (including 23 patients associated with acute gallstone pancreatitis) were treated using this technique. The data were analyzed. Results The technique was successfully carried out in 102 patients but 10 patients had to be treated by conventional open operation.For the patients treated by this technique, 16 patients were treated by endoscopic sphincterotomy (EST) plus choledochotomy. The stones were removed through a choledochoscope, and the bile duct was drained by a T-tube (LCTD). 18 patients were treated by endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy (LC). The choledocholiths were removed by a choledochoscope through the cystic duct. 22 patients were treated by choledochotomy, and the calculus was removed through a choledochoscope and the bile duct was primarily sutured. 46 patients were treated by endoscopic nasobiliary drainage (ENBD) plus LC, choledochotomy. The calculi were through a choledochoscope and followed by primary suture of the bile duct. The mean time of endoscopic treatment, LC and postoperative hospital day were 35 min, 110 min and 6.5 d respectively. None of the 102 patients died after operation. 9 patients developed complications of ERCP or EST including acute pancreatitis (n=6), hemorrhage of papilla duodeni (n=2) and duodenal perforation (n= 1). 11 patients developed biliary fistula after primary suturing of the choledochus and they recovered with drainage; 2 patients developed residual or recurrent biliary fistula after the T tube was removed and they recovered after drainage via a [aparoscope. During follow-up for 1 to 3 years using ultrasonic or MRCP examinations, 3 cases of stones were found and they were removed by EST. There was no stenosis of common bile duct. Conclusions Our results suggested that the three-endoscope-combination in one anesthetic session for the treatment of extrahepatic bile duct calculi and acute gallstone pancreatitis was safe and efficacious. Moreover, this technique reduced the complications of EST. This technique increased the success rate using minimal invasive surgery.

Objective To study the effect of flupentioxl melitracen and pinaverium bromide treatment on the changes of anorectal motility and rectal sensation in the patients of diarrhea-predominant irritable bowel syndrome (IBS-D) accompanying with depression and/or anxiety status. Methods Forty-four patients with IBS-D accompanying with depression and/or anxiety status were divided into group A (flupentioxl melitracen and pinaverium bromide) and group B (pinaverium bromide) by random digits table,and treated for 4 weeks. Twenty-five healthy subjects were included as control group. The anorectal motility and rectal sensation before and after taking medicines were compared. Results When abdominal pressure was increased, the net increased pressure of anal sphincter was (3.0 ± 1.2 ) kPa in group A and (2.9 ± 1.2)kPa in group B. They were lower than that in control group [(3.6 ± 1.6) kPa](P＜ 0.05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were (55 ± 20) ml,( 145 ± 78 ) ml, ( 21.9 ± 12.9 ) ml/kPa in group A, ( 56 ± 38 ) ml, ( 150 ± 50 ) ml, (20.8 ± 11.2) ml/kPa in group B. They were lower than those in control group [(80 ± 38 ) ml, ( 190 ± 50 ) ml, (30.8 ± 15.2 ) ml/kPa](P ＜ 0.01 ). The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance were higher than those before taking medicines. Only the rectal lowest volume of sensory threshold in group B was higher than that before taking medicines. The rectal lowest volume of sensory threshold, the maximal volume of tolerance and maximal compliance in group A after taking medicines were higher than those in group B (P ＜ 0.05 or ＜ 0.01 ). Conclusions Higher sensitivity, lower tolerance,lower compliance of rectum and weakened anal automatic control function in IBS-D may be associated with diarrhea and frequent defecation. Treatment combining flupentioxl melitracen with pinaverium bromide may preferably improve the aperception functions of rectum in the patients of IBS-D accompanying with depression and/or anxiety status.

Objective To study the changes of anorectal motility and rectal sensation in the elderly patients with ulcerative colitis (UC). Methods The anorectal motility and rectal sensation were investigated by Medtronic PC-Polygraf HR made by Sweden in 35 non-elderly patients versus 19 elderly patients with UC, and 20 non-elderly healthy subjects (HS) and 28 elderly HS were as control group. Results (1) The static pressure, pressure of anal sphincter and the maximal squeeze pressure of anal sphincter in non-elderly patients and elderly patients with UC showed no significant differences compared with those in non-elderly HS and elderly HS group (elderly patients with uc vs. ederly HA:t= 1.311,1.298,1.401;nonederly patients with uc vs. nonederly HS: t=1.294,1.299,1.322all P＞0.05). When abdominal pressure was increased, the net increased pressure of anal sphincter was (2.8±1.1) kPa in the elderly patients with UC, (2.9±1.3) kPa in the non-elderly patients with UC. The pressures were lower in two UC groups than in HS groups [elderly HS group:(3.8±1.2) kPa; non-elderly HS group:(3.9±1.2) kPa,elderly patients with uc vs. ederly HS:t=2.238,nonelderly patients with us vs. nonederly HS:t=2.243 all P＜0.05]. (2)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance were (85±30) ml, (180±69) ml, (26. 5±8.8) ml/kpa in elderly patients with UC and (65±15) ml, (170±58) ml, (22.6± 10. 3) ml/kPa in non-elderly patients with UC. They were lower than in each HS group [elderly HS group (95±31) ml, (205±78) ml, (32.9±12.9) ml/kPa; non-elderly HS group:(78±38) ml, (190±50) ml, (30.8± 15.2) ml/kpa, all P＜0. 01]. (3)The rectal lowest volume of sensory threshold, the maximal volume of tolerance and the maximal compliance in elderly patients with UC were higher than in non-elderly patients with UC (elderly patients with uc vs. elderly HS:t=3. 121,3. 135,3.146,nonederly patients with uc vs. non elderly HS: t= 3.162, 3.141, 3.188 elderly patients with uc vs. nonelderly patients with uc: t = 2. 246,2. 239,2. 240 all P＜ 0. 05). The rectal lowest volume of sensory threshold, the maximal volume of tolerance in elderly HS group were higher than in non-elderly HS group (ederly HS vs. t = 2. 328,2. 301 all P＜0. 05). Conclusions There are some anorectal motility disturbances in UC. Higher sensitivity, lower tolerance, lower compliance of rectum and weakened anal automatic control function in UC may be associated with diarrhea and frequent defecation. The rectal sensation threshold to volume stimulus is higher in elderly HS than in non-elderly HS group. The sensibility to volume ectasis of rectum is weakened and the survivability of rectum is increased in elderly patients with UC.

Objective To assess the clinical value of pentraxin-3 (PTX-3) in diagnosis and survey of therapeutic effect for lung cancer.Methods The serum level of PTX-3,carcinoembryonic antigen (CEA),cytokeratin 19 fragment (CYFRA 21-1) were measured in 802 patients with lung cancer,462 with benign lung diseases and 522 healthy controls from multiple research centers,using ELISA and electrochemiluminescent assays.The clinical value of PTX-3 was assessed by comparing the area under receiver characteristic curves (AUC) with CEA and CYFRA21-1.The optimum cutoff value for diagnosis of lung cancer was investigated by maximizing the sum of sensitivity and specificity.By following-up,the serum level of PTX-3 was measured at 3 day,7 day,and 14 day in 61 lung cancer patients after surgical resection of lung cancer.Results In test group and validation,the serum levels of PTX-3 (g/L) are significantly higher in lung cancer group [9.21 (6.13-12.80),10.4(5.54-13.11)] than in benign lung diseases [5.28 (3.42-8.53),6.52 (3.84-7.89)] and in healthy controls [2.18 (0.54-5.44),2.44 (0.67-5.87)],[Z =8.161,14.118,(test group,all P ＜ 0.05) ;Z =9.832,17.595 (validation group,all P ＜0.05)].ROC curve showed the optimal cut-off values for PTX-3 was 8.03 g/L [AUC of 0.831,with a sensitivity of 76.1％ and specificity of 75.2％ in the test cohort; 0.828,71.3％,89.2％ in the validation cohort].Similar results were noted for early-stage lung cancer [0.764,79.1％,and 62.2％ in the test cohort; 0.744,71.3％,and 69.6％ in the validation].In the diagnosis of early-stage lung,the AUC and sensitivity and specificity of PTX-3 were 79.1％,0.764,71.3％ (test group),and 75.2％,89.2％,0.824 (validation group) significantly higher in these patients than CEA and CYFRA21-1.In small cell lung cancer,PTX-3 and NSE shared similar AUC differentiating LC from benign lung diseases and health controls.In following-up 61 lung cancer patients,PTX-3 levels before surgical resection of tumours [11.12(9.12-12.59)] was significant high than following 3 day after surgery(Z =4.32,P ＜0.01),and 14 day (5.12 ±2.54) vs.7 day (7.13 ±3.42) (t =2.143,P =0.023).The correlation between PTX-3 and CRP in LC,benign lung diseases,health control was 0.364,0.592,0.512 (all P ＜ 0.05).Conclusion Serum PTX-3 is a valuable biomarker of lung cancer and early-stage lung cancer with high sensitivity and specificity and improved identification of patients with lung cancer from those with non-malignant chronic lung diseases.