Objective To study the survivin expression in mononuclear cells of both bone marrow and peripheral blood in childhood acute leukemia(AL).Methods Twenty-one children with AL were divided into newly diagnosed group(n=12) and complete remission(CR) group(n=9).The control group was consisted of 15 children without tumor.Mononuclear cells were separated from bone marrow and peripheral blood (PBL) by gradient density centrifugation and RNA was extracted,and RT-PCR was performed to detect survivin mRNA.Results In newly diagnosed AL group,6 out of 12 patients had positive survivin expression in bone marrow(50%) and 4 out of 11 patients in the PBL(36.37%),both of which were higher than the control group(P0.05).In 9 CR patients,all the patients had the negative expression in the PBL,but 1 positive expression in bone marrow(11.11%).The positive expression in CR group was significantly lower than the newly diagnosed AL group.The only one patient with positive survivin expression in CR group had relapse 7 weeks later.In newly diagnosed patients,the average immature leukocytes were(76.43?43.28)?10~(9)/L in the patients with positive survivin expression and(13.85?5.86)?10~(9)/L in those with negative survivin expression(P

The key to performing spreading moxibustion on the Du meridian and the characteristics of its application are investigated. Summer is the time suitable for spreading moxibustion on Du meridian. The performance on Du meridian points has special requirements for every procedure: selecting moxibustion materials, spreading medication, igniting moxa and cleaning moxibustion sores. There are five large characteristics in the clinical application. The first is accumulating heat and focusing on warm-unblocking; the second is regulating both the whole body and local parts; the third is timing the treatment and making adaptations;the fourth is selecting high-quality materials and guarantee the performance;the fifth is focusing on health maintenance and strengthening nursing. Spreading moxibustion on the Du meridian has a wide area of performance, large moxa cones, a long time, sufficient fire power, strong warm-unblocking force, quick and convenient treatment and a remarkable effect. Mastering the key to the performance and the characteristics of the clinical application can further rich acupuncture and moxibustion treatments and give full play to the role of old and traditional moxibustion.

Objective To explore the therapeutic modalities and clinical characters of acute pancreatitis (AP) in the middle or late stage of pregnancy.Methods There were 26 cases of AP in the middle or late stage of pregnancy, among which 18 cases (69.2 %) received conservative therapy, and 8 cases (30.8 %) underwent operation for removal of necrotic tissue and termination of pregnancy.Results Two cases of both fetus and mother death occurred, whereas 24 mothers were cured. 15 (57.7 %) fetuses were healthy but 11(42.3 %) died.Conclusions The women in middle and late stage of pregnancy are inclined to pancreatitis because of hormonal changes, especially in those with history of cholecystitis and cholelithiasis. The main method of management is active non-operative therapy and surgical intervention when necessary, so as to decrease the tragedy of both maternal and fetal death.

Objective To review the experience in perioperalive management of 324 consecutive cases of pancreatico-duodenectomy(PD).Methods The clinical data of 324 cases of PD were analyzed retrospectively.All underwent PD successfully,275 cases received the standard PD,while,49 cases had pylorus preserving PD.Digestive tract reconstruction was done by Child method.Pancreatointestinal anastomosis was performed by pancreas stump intussussception in 303 cases,and end-to-side anastomosis in 21 cases.Results The 30 day mortality rate was 0.3%(1/324).Complicalion rate was 8.0%,included one case of liver dysfunction,7 cases with pancreatic fistula and intraabdomind bleeding,1 case of stenosis of pancreaticoenteral anastomosis,3 cases with pancreatic dysfunction,4 cases with gastroenteral anastomosis ulcer,6 cases with delayed gastric emptying,1 with reflux of bile and 3 with lymphatic fistula.Conclusions Perioperative managemen for pancreaticoduodenectomy is crucial for patient prognosis.Carful perioperative management can decrease postoperative complications and ensure smooth recover of these patients.

Objective To summarize the experiences of middle pancreatectomy. Methods Eleven female and 4 male with a mean age of 49.4 years (23.8-73.1 years) who underwent middle pancreatectomy from January 2001 to October 2005 were collected. Eight patients with neuroendocrine tumor (non-function of 5 cases), 5 with serous cystadenomas and 2 with mucinous cystadenomas were included. The proximal apical end of pancreas was sutured, while distal end of pancreas was anastomosed to a Roux-en-Y jejunal loop. Results Mean operative time was 275 min (179-370 min), mean length of resected pancreas was 45 mm (30-60 mm) and max diameter of tumor was 23 mm (15-40 mm). Complication after operation was pancreatic fistula 4 cases (26.7%), in which 3 cases (20.0%) had intraabdominal blood. The mean time of follow-up was 23 months (3 months-5 years). one patient was died of multiple organs failure for pulmonary infections in month 3 after operation, and the others were alive without novo-diabetes. Conclusion Middle pancreatectomy is an effective operation for benign and borderline tumors of neck and body of pancreas without a significant increase of postoperative morbidity.

Objective To establish a method to induce dendritic cells (DC) from peripheral blood mononuclear cells of healthy people in normal human AB serum in vitro and to identify the phenotype and the function of DC. Methods Peripheral blood mononuclear cells (PBMNC) of healthy people were cultured in RPMI 1640 media including human AB serum, GM-CSF, rhIL-4, and/no rhCD40 for 7 days to generate DC,which were identified by morphological features, surface antigen expression and the ability to stimulate T cells.Results After cultured and induced, DC displayed typical morphology with elongated dendritic process viewed by inverse light microscope as well as Wright-Gimsa stain. Mature DC express CD83 and the costimulatory molecules CD40 CD80, and CD86 to effectively activate T cells. In the five time points of 0 day, 1st day, 3rd day, 5th day and 7th day, the expression of CD83, CD40, CD80, CD86 and CD14 were significantly different (F= 50.253, 243.769, 248.181, 191.267 and 226.339, respectively, P＜ 0.05). The ability to stimulate T cells in GM-CSF, rhIL-4, and rhCD40L group was also stronger than that in GM-CSF and rhIL-4 group. DC started to secrete IL-12 from 5th day, the values were (42.92±1.54) pg/ml and (136.18±5.27) pg/ml in group of plus CD40L and of non plus CD40L, respectively. The secretion of the two groups of IL-12 were (60.09±2.27) pg/ml and (322.30±30.60) pg/ml (t = -44.941, -22.611, bath P ＜ 0.05). There are significant differences between the two groups. Conclusion DCs can be cultured from the peripheral blood of healthy people in normal human AB and rhCD40L serum.

AIM To investigate if inhibiting neutrophil infiltration and adhesion molecules expression is a part of the mechanisms of ginsenoside Rg1 protecting from cerebral injury after cerebral ischemia-reperfusion. METHODS Rats were pretreated with ginsenoside Rg1 25, 50 and 100 mg·kg-1·d-1, ig, for 7 d, respectively, then subjected to cerebral ischemia (middle cerebral artery occlusion) for 2 h and reperfusion for 22 h. The infarct volume and the neurological deficit were determined by TTC staining and Longa's scoring, respectively. The infiltration of neutrophils was evaluated by measuring the activity of myeloperoxidase (MPO). The expressions of intercellular adhesion molecule-1 (ICAM-1) and E-selectin were analyzed by Western blot. The permeability of the blood-brain barrier was evaluated by measurement of Evans blue content in brain tissue with spectrophotometer at 4 h after reperfusion. RESULTSCompared with vehicle-treated group, ginsenoside Rg1 (50 and 100 mg·kg-1·d-1) treatment significantly reduced infarct volume and elevated permeability of blood-brain barrier, alleviated the neurological deficit, and inhibited protein expressions of ICAM-1 and E-selectin in brain tissue. CONCLUSION Ginsenoside Rg1 has protective effects on cerebral injury induced by ischemia-reperfusion through inhibiting neutrophil infiltration and expression of the adhesion molecules.

BACKGROUND:Destroying posterior stable structure of cervical vertebra may facilitate the ligamentum flavum regeneration. Whether anterior cervical instability can induce the regeneration in posterior and adjacent ligamentum flavum remains unclear.
OBJECTIVE:To observe the changes of transforming growth factor-β1 expression and histopathology in the ligamentum flavum of cervical instability animal models.
METHODS:Thirty-six New Zealand white rabbits were randomly divided into control group and experimental group, with 18 rabbits in each group. In the experimental group, cervical instability animal models were established made through destroying annulus fibrosus by anterior puncture and absorbing nucleus pulposus in C4/5 . And no intervention was given to the control group.
RESULTS AND CONCLUSION:Compared with the control group, fibers in the C 3/4, 4/5, 5/6 ligamentum flavum arranged disorderly and the glass like degeneration was found in the experimental group. The expression of transforming growth factor-β1 in ligamentum flavum was increased, especial y in C 4/5 , in the experimental group. At 4, 8, 12 weeks, transforming growth factor-β1 expression in the C 3/4, 4/5, 5/6 ligamentum flavum segments was similar between the two groups. Experimental findings indicate that, anterior cervical instability can induce the regeneration in posterior ligamentum flavum, especial y in the injured segment.

Objective The purpose of this study was to discuss the therapies for hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.Methods After three cases of pancreatoduodenectomy,the disruptions of pancreatojejunal stoma resulted in serious pancreatic leakage and the hemorrage in abdominal cavity.During all the second operations,the drainage-tube insertions into the main pancreatic ducts were used to lead the pancreatic juice into the neighboring loop of jejunum.Results Afer the operations,the supportive treatment,continuous irrigation of peritoneal cavity and pancreatic enzyme inhabition were given to the patients of these cases and all of the patients were successfully cured.Conclusions The bridge-crossing internal drainage which inserts drainage-tube into the main pancreatic duct was a convenient and effective therapy and method to rescue the hemorrage caused by the fissuration of pancreatojejunal stoma and pancreatic leakage after pancreatoduodenectomy.While the patients' lives were saved,their functions of pancreas were preserved and the qualities of life were improved after the operations.

Objective To explore the relationship between flood ing and the prevalence of schistosomiasis in the river beach area. Met hods The subjects were investigated on the ways of exposure, frequency and duratio n of water conta cted from May to November in 1999, and eggs of Schistosoma were examined bef ore and after flooding. Results Exposure to infested water for human being s in the area comprised productive, living and recreational contacts including 11 kinds of activities, and 53.55% of the subjects contacted infested w ater. The number of person, frequency and duration of water contacted in floodin g strongly increased; the infection rate and density among population stron gly increased after flooding. There was significant difference between the infec tion rate in exposure group and that in non-exposure group. Conclusions It can be inferred that flooding has increased water contacted and i nfection, therefore, health education should be strengthened to avoid or dec rease water contact.