Objective To investigate the effects of low-pressure carbon dioxide pneumoperitoneum (CLC) and gasless abdominal distension (GLC) on elderly patients during laparoscopic cholecystectomy. Methods The clinical data,including operation time,hospital stay,surgical complications,and changes of other systems,of 36 elderly patients were analyzed. All the patients were older than 65 years when they received laparoscopic cholecystectomy in our hospital from January 2005 to December 2007. Among the cases,CLC (CO2 pressure:8-10 mm Hg) was used in 24,and GLC was employed in 12. The fourth generation artificial rib lifting apparatus was used for GLC. Results All the procedures were completed by laparoscopy,no patient was converted to open surgery. The operation time of the CLC and GLC groups was (46.2?14.8) min and (52.4?18.6) min respectively (t=-1.087,P=0.285). The vital signs of all the cases were stable during the operation,no carbon dioxide retention or cardiovascular affairs occurred. The hospital stay was (10.5?6.8) d in group CLC and (8.9?5.5) d in group GLC (t=0.706,P=0.485). The patients were followed up for 6 to 42 months,no complications occurred during the period. Conclusions GLC is safe for elderly patients with similar efficacy to that of low-pressure CLC.

BACKGROUND: Previous research has indicated that both insulin-like growth factor Ⅰ (IGF-Ⅰ) and basic fibroblast growth factor (bFGF) play an important role in cell proliferation and differentiation. However, the effect on biological characteristics of human dental papilla mesenchymal cells (hDPMCs) still remains unclear. OBJECTIVE: To research the effect of IGF-Ⅰ and bFGF on the proliferation and differentiation of hDPMCs.METHODS: hDPMCs were isolated and cultured in DMEM/F12 culture media containing 1% or 10% fetal bovine serum. The fourth-passaged hDPMCs were incubated in culture media containing 0, 0.1, 1, 10 and 100 μg/L bFGF and 0, 25, 50, 75 and 100 μg/L IGF-Ⅰ(0 μg/L as control group), respectively. At 96 hours after culture, proliferative activity was measured with MTT assay. The corresponding growth factor culture media were used in 10 μg/L bFGF group, 100 μg/L IGF-Ⅰgroup, bFGF + IGF-Ⅰ group, and control group, respectively. At days 1, 3, 5, and 7 after culture, the proliferative activity was detected using MTT assay, and alkaline phosphatase (ALP) activity was measured using modified enzyme kinetics method. RESULTS AND CONCLUSION: At the 0-100 μg/L mass concentration scope, both bFGF and IGF-Ⅰcould accelerate proliferation of hDPMCs, and the proliferation ability of bFGF was superior to that of IGF-Ⅰ; moreover, the combination of bFGF and IGF-Ⅰcaused a synergetic action to proliferation of hDPMCs. The maximal valid concentration of bFGF was 10 μg/L, and the maximal action concentration of IGF-Ⅰwas 100 μg/L. At 0-7 days, the effect of bFGF on the ALP activity of hDPMCs was not obvious, but the effect of IGF-Ⅰon ALP activity of hDPMCs became greater with the time passing; furthermore, the combination of bFGF and IGF-Ⅰcould generate a synergetic action on increasing the ALP activity.

The TIPE( tumor necrosis factor-alpha-induced protein 8-like) family has been recently described as regulators of tu-morigenesis and inflammation .The family consists of four highly homologous members: TNFAIP8 ( tumor necrosis factor-α-induced protein 8), TIPE1 (TNFAIP8L1), TIPE2 (TNFAIP8L2) and TIPE3 (TNFAIP8L3).Although TNFAIP8 family share high degrees of sequence homology , the members have different histological expressions , biological functions and molecular targets .TNFAIP8 shows the functions of inhibiting bacterial infection and promoting tumor migration .As a negative regulator of immunity and inflammation , TIPE2 is also an inhibitor of the oncogenic Ras in some neoplastic diseases .TIPE1 can induce cell apoptosis and inhibit tumor .TIPE3 is the transfer protein of phosphoinositide second messengers and can promote cancer .Emerging studies show TIPE family play important regulatory roles in many diseases;however, specific biological activities and exact molecular mechanisms need to be further elucidated .

Objective: To study the role of basic fibroblast growth factor (bFGF) during human tooth germ development.Method: bFGF expression was exmined with immmunohistochemical technique in bud stage,cap stage and bell stage of human tooth germ from aborted embryo of 7,8,10 and 14 weeks.Results: At the bud stage of human tooth development, bFGF was expressed in most dental epithelium cells,and few condensed mesenchymal cells.At the cap stage ,bFGF was weakly expressed.At the bell stage,bFGF was strongly expressed in the inner enamel epithelium layer and dental papillary cells near inner enamel epithelia,weakly in the stellate reticulum.Conclusion:During human tooth development,bFGF plays an important role in the proliferation and differentiation of dental epithelium.

Cancer immunotherapies are recently gaining attention as viable therapeutic options. There are two types of immunotherapy:passive and active. The passive immunotherapies include several treatments such as monoclonal antibodies,either alone or as antibody-drug conjugates. The active immunotherapies include cancer vaccines which utilize the patient′s own cells as antigen presenting cells and target specific cancer antigens,and chimeric antigen receptor T-cell(CAR-T)therapy which engineers a patient′s T-cells to recognize cancer antigens through chimeric antigen receptors. Recent successes include the US FDA approval of a number of cancer immunotherapies such as treatments utilizing monoclonal antibodies against immune checkpoint inhibitors,the Provenge cancer vaccine that targets prostrate cancer,and a CAR-T against relapsed/refractory acute lymphoblastic leukemia that was designated with breakthrough drug status,all of which has had drug companies investigating cancer immunotherapies with intense enthusiasm. In this review we discuss where the field of immune-oncology stands today,highlight the latest findings and hypothesize future directions.

AIM To investigate the possibility of microvolume rodent ventilator in improving the quality of global ischemia-reperfusion injury model in mice. METHDOS Global cerebral ischemia-reperfusion injury was preduced in mice by obstructing and decompressing bilateral common carolid arteries and pressuring and decompressing cervical soft tissue, artificial respiration was performed using rodent ventilator before those procedures. EKG, ECG was detected and pathological examination. RESULTS Rodent ventilator was used to keep essential physiologic ventilative volume befer pressure, EKG change was not been found in observed duration in all animals. The suppressed cephalograph was displayed continuously in various time in ischemic and reperfusion injury. Pathological examination indicated that the damage was worse progressly in cerebral cortex and hippocampus, as times of ischemic and reperfusion prolonged. CONCLUSION Using microvolume rodent ventilator success rate and stability is increased obviously in model of global cerebral ischemia-reperfusion injury in mice and mortality was decreased greatly.

ObjectiveTo investigate the influence of TGF-β receptor subtypes expression and their downstream signaling Smad proteins on rat renal interstitial fibrosis induced by unilateral ureteral obstruction(UUO).MethodsA total of 90 rats were randomly divided into three groups:normal control(CON),sham operation (SOR) and UUO group,and sacrificed 1,3,7,14 and 21 days after operation.Serum creatinine and urea nitrogen were detected to assess renal function.PAS and Masson staining were performed to observe histological damage in the kidneys.Quantitative RT-PCR was used to define expression of mRNA encoding TGF-β receptor subtypes and their downstream signaling Smad proteins in kidney tubular cells.Real-time PCR,Western blotting and immunofluorescence were used to monitor the time-related expression of the TGF-β receptor subtypes and their downstream signaling Smad proteins in kidney.ResultsCompared with the CON group,serum creatinine and urea nitrogen in UUO groups increased at day 3 after operation (P＜0.05) and reached their peak 21 days after operation (P＜0.01).Obvious inflammatory cell infiltration was observed in UUO group 3 days after operation,while renal tubular atrophy and renal interstitial fibrosis were observed in UUO group14 days after operation.The mRNA expressions of ALK-5,ALK-7 and TGF-βR Ⅱ increased significantly in UUO group 3 days after operation (all P＜0.05) and reached their peaks 14 days after operation (all P＜0.01).The mRNA expression of ALK-6 decreased significantly in UUO group 3 days after operation(P＜0.05) and reached its lowest level 14 days after operation (P＜0.01).The changes in the protein level of those receptors were consistent with their mRNA expressions.The protein expressions of Smad2/3 and p-Smad2/3 increased significantly in UUO group at day 3(all P＜0.05) and reached their peak at day 14 after operation(all P＜0.01).ConclusionExpressions of TGF-β receptor subtypes ALK-5,ALK-6,ALK-7,TGF-βR Ⅱ and their downstream signaling Smad2 and Smad3 proteins may influence the progress of renal interstitial fibrosis,tubular atrophy and inflammatory cell infiltration in UUO model rats.

Objective To explore the correlation of CT perfusion imaging with microvessel density (MVD) and vascular endothelial growth factor (VEGF) in hepatic alveolar echinococcosis (HAE).Methods Multi-slice spiral CT perfusion imaging was performed in 27 patients with HAE.Time-density curves(TDC) of the HAE peripheral area was drawn from the region of interest (ROI) with perfusion functional software.CT perfusion parameters including blood flow ( BF ),blood volume ( BV ),mean transit time(MTT) and permeability surface area product (PS) were calculated.MVD and VEGF expression of pathological specimens were examined by immunohistochemical staining with anti-CD34,anti-VEGF monoclonal antibody.The CT perfusion parameters,MVD and VEGF were compared in different types of TDC with t test.The correlation of CT perfusion parameters with MVD and VEGF were analyzed with Spearman test.Results In this group,21 cases which TDC lower than that of the liver were classified as type Ⅰ,the others 6 cases TDC higher than the liver were of type Ⅱ TDC.TDC perfusion parameters of the two types were as follows,BF:( 111.7 + 27.6),( 158.9 + 39.5 ) ml · 100 g- 1 · min - 1,BV:( 15.1 + 6.2),(26.8+8.4) ml/100 g,MTT:(7.0+4.4),(7.7+3.1) s,PS:(51.7 +17.3),(51.0+20.5) ml·100 g-1 · min-1.The significant differences of BF,BV and MVD[ (20.5 +5.4)/HP,(37.2 ±7.5)/HP,respectively ] were found between two types ( t =- 7.897,- 18.783,- 5.223,P ＜ 0.05,respectively).There were no significant differences in MTT,PS and VEGF expression(2.1 ± 1.0,3.2 ± 1.0,respectively)between two types of TDC(P ＞0.05).The correlation was found between the MVD and BF and BV in the type Ⅱ TDC group( r =0.789 and 0.878,respectively) and no correlation was found between MVD and each CT perfusion parameters in the type Ⅰ TDC group ( P ＞ 0.05 ).There was no correlation between the VEGF expression and CT perfusion parameters in two types of TDC ( P ＞ 0.05 ).Conclusion CT perfusion imaging with different type of TDC reflected different situation of angiogenesis in HAE peripheral area,which could be a potential technique to illustrate the microcirculation of this disease.

Objective To investigate the brain magnetic resonance imaging(MRI)findings in 33 patients with neuromyelitis optica(NMO).Methods Patients who fulfilled the latest diagnostic criteria of NMO and whose brain MRI did not satisfied with diagnostic criteria of multiple sclerosis(MS)were enrolled.All the patients underwent brain MRI and spinal cord scannings and subsequent images analysis.Results Thirty-three patients with NMO were included to study.Five out of 33(15.2%)patients did not have brain parenchymal abnormalities,28 out of 33 patients(84.8%)were detected to have brain abnormal findings.Brain parenchymal lesions were well-defined in 22 patients(66.7%),no non-specific or atypical brain parenchymal lesions were found in the supratentorium or infratentorium in the other 6 cases(18.2%).However,brain MRI disclosed macroscopic,symmetrical diffuse FLAIR and T2-visible hyperintensity in deep white matter.Fifteen cases had more than one lesion(≥2 lesions),and the other 7 cases had single lesion.Supratentorial lesions were mostly punctate or small dots in nonspecific hyperintensity in juxtacortical,subcortical and deep white matter regions,a few were atypical patches.In the infratentorium,brainstem was an easily involved region(14/33,42.4%),especially in medulla(7/33,21.2%).Conclusions Brain MRI abnormalities are common in Chinese NMO,and brain lesions do not exclude the diagnosis of NMO.The observations of brain lesions are helpful to improve and revise diagnostic criteria of NMO.

BACKGROUND:It is reported that bone marrow mesenchymal stem cell(BMSC)transplantation might be a promising treatment for liver fibrosis.But the mechanism is still unclear.OBJECTIVE:To observe the hepatic stellate cells apoptosis induced by BMSC transplantation,and to study the mechanism of BMSC in treating hepatic fibrosis in vivo.METHODS:CCl_4 subcutaneous injection was performed to induce rat liver fibrosis.After 8 weeks of CCU injection,20 rats which underwent successful model establishment were randomly divided into experimental group and control group,10 in each group.The experimental group received MSC transplantation via tail vein injection,and the control group were given DMEM instead.The rats were killed and the livers were harvested at three time point,the day of MSC transplantation,3 days after transplantation,and 7 days after transplantation.The hydroxyproline content was detected by HE and Masson staining,and the expression changes of α-smooth muscle actin(α-SMA)proteins were determined using immunohistochemistry.The apoptosis of hepatic stellate cells were determined by α-SMA and TUNEL(terminal dUTP nick-end labeling)dual-staining.RESULTS AND CONCLUSION:After 8 weeks of CCU injection,the hydroxyproline content increased and histology indicated progress of liver fibrosis.At 7 days after MSC transplantation,the hydroxyproline in the liver was decreased,and the liver fibrosis was alleviated in the experimental group but aggravated in the control group.Immunohistochemistry indicated that α-SMA positive cells were increased at 8 weeks after CCU injection.At day 7 after transplantation,α-SMA positive cells in the experimental group were significantly less than control group(P ＜ 0.05).At 3 days after transplantation,the hepatic stellate cells apoptosis in the experimental group was significantly aggravated compared with control group(P ＜ 0.05).This suggested that MSC transplant was an effective treatment for liver fibrosis.MSC inducing hepatic stellate cells apoptosis may be one of the mechanisms.