Objective:To explore the effect of ICE regimen (ifosfamide, carboplatin, VP16) combined with methotrexate on the clinical efficacy and expression of miR-451a and miR-15a in patients with diffuse large B cell lymphoma (DLBCL).Methods:A total of 56 patients with DLBCL in the Third Hospital of Changsha from March 2013 to may 2018 were prospectively selected and randomly divided into observation group and control group, 28 cases in each group. The control group was treated with ICE regimen, and the observation group was treated with ICE regimen combined with methotrexate. The tumor control rate, toxic and side effects, the expression of miR-451a and miR-15a, immune function (CD3 +, CD4 +, CD8 +, CD4 +/CD8 +), serum tumor markers [β 2 microglobulin (β 2-MG), carbohydrate antigen 125 (CA125), and lactate dehydrogenase (LDH)] levels were compared before and after treatment between the two groups, follow-up for 6 to 12 months was used to calculate the survival rate of the two groups. Results:The tumor control rate in the observation group (92.86%) was higher than that in the control group (71.43%) ( P<0.05); After treatment, the miR-15a decreased and miR-451a increased in the two groups, and the miR-15a in the observation group was lower than that in the control group, while miR-451a was higher than that in the control group ( P<0.05); After treatment, the CD3 +, CD4 +, CD4 +/CD8 + of the two groups were lower than before treatment, and CD8 + was higher than before treatment ( P<0.05), but there was no significant difference between the two groups ( P>0.05); After treatment, the serum CA125, LDH, and β 2-MG in the two groups were lower than before treatment, and the above indexes in the observation group were lower than those in the control group ( P<0.05); There was no significant difference between the two groups in the incidence of side effects and the survival rates of 6, 9 and 12 months after treatment ( P>0.05). Conclusions:ICE regimen combined with methotrexate in the treatment of DLBCL can further improve the therapeutic effect and reduce the serum tumor marker levels by regulating the expression of miR-451a and miR-15a, with less toxic side effects and less immune damage, and high safety.

In recent years, the emergence of single-port laparoscopic technology promoted the development of the technology of laparoscopy, but deficiencies like equipment conflict or lack of triangulation severely hampered the clinical application of this technology. The appearance of single-port laparoscopic flexible instruments makes up for those deficiencies to a great extent. The element is to add a wrist joint to the tip of the instrument to form triangulation and reduce equipment conflict. But this technique is still in an early stage of development. The purpose of this article is to summarize the characteristics and problems of existing flexible single-port laparoscopic instruments, and to provide information for the further improvement, finally the future development was expected.
Equipment Design ; Humans ; Laparoscopy ; instrumentation

Inflammation is one of the key pathological process of atherosclerosis (AS),and multiple risk factors of AS have consanguineous relationships with the regulation of inflammatory signal pathway.So it could be effective approach to control inflammation,even the pathological process of AS if we do the deep research on AS inflammatory signal pathway and make out the potential medicine.

Atherosclerosis(AS),the major cause of ischemic cerebrovascular disorder(CVD)destroying human health,the damage-reaction theory and inflammation theory proposed by professor Ross were popular because those theories were explainning the beginning and developing of AS well.The key point is anti-inflammatory.Through the intervention of some key factors in inflammatory response network,the theory provide a great significance and value on the treatment of AS.We considered that AS pathogenesis of "Endogenous Heat Toxin,Phlegm and Blood Stasis" in Chinese medicine has substantial relationship with current mainstream theory of AS-"injury-response theory,inflammatory reaction theory",which is a good integrating point for AS pathogenesis in both theoretical systems of Chinese and Western Medicine.With the entry point of intervention of "Endogenous Heat Toxin" or "inflammatory response",on the basis of activating blood circulation to dissipate blood stasis and heat-clearing and detoxicating,it is a beneficial attempt with theoretical and practical significance to discuss the role of Chinese medicine on prevention and treatment of AS.With the mainline of AS anti-inflammatory theory,this article analyzed and discussed the research ideas of Chinese Herbs intervene AS inflammatory reaction combined with our work of the research group.

Objective To investigate the clinical effect of dysmenorrhea in patients with adenomyosis treated by high intensity focused ultrasound (HIFU) ablation combined with gonadotropin-releasing hormone agonist (GnRH-a) and levonorgestrel-releasing intrauterine system (LNG-IUS). Methods From April 2012 to December 2015, 477 cases of adenomyosis patients with dysmenorrhea were treated by HIFU in the Third Xiangya Hospital. Among them, some patients were treated with HIFU alone, some of them were treated with HIFU combined with GnRH-a and (or) LNG-IUS, thus were classified as H group, H+G group, H+M group and H+G+M group. The improvements of clinical results were compared among the four groups and the influencing factors of HIFU treatment for adenomyosis were also analyzed. Results During the follow-up period, the overall effective rates of the treatment decreased with time, 3 months 89.4% (345/386), 12 months 84.0%(221/263), 24 months 74.2%(98/132), and the overall recurrence rate was 12.9%(39/303). The significant difference in the curative at 3 months [H group 83.7%(170/203), H+M group 95.0%(95/100), H+G group 100.0%(43/43), H+G+M group 96.8%(30/31)], 12 months [H group 79.4%(123/155), H+M group 93.2%(69/74), H+G group 11/12, H+G+M group 15/17], and 24 months [H group 68.0%(51/75), H+M group 96.4% (27/28), H+G group 6/12, H+G+M group 15/15] after HIFU treatment and recurrence rate [H group 19.0%(29/153), H+M group 3.3%(3/90), H+G group 19.4%(6/31), H+G+M group 4.5%(1/22)] were observed among the four groups (P<0.05). Pairwise comparison further showed that, in 3 months after the treatment, the effect of H group was significantly lower than those of H+M group and H+G group (P=0.003, P=0.005);in 12 months after the treatment, the effect of H group was significantly lower than that of H+M group (P=0.006);while in 24 months after treatment, the effect of H group was significantly lower than that of H+G+M group (P=0.005), and the effect of H+G group was lower than that of H+G+M group (P=0.001); and the recurrence rate of H group was significantly higher than that of H+M group (P<0.008). In patients of group H, the effect of HIFU was related to uterine size, the effect of patients with large uterine volume was significantly higher than that of small volume of uterine of patients (P=0.017, OR=2.739, 95%CI:1.200-6.251); with increasing of age, the improvement of dysmenorrhea had a increasing trend (P<0.05). Conclusions HIFU combined with GnRH-a and (or) LNG-IUS could improve the treatment effect in relief of dysmenorrhea. Based on our results, individual treatment protocol should be selected for different patients.

Objective To investigate the changes in metabolic indexes and anesthesia administration during perioperation in patients undergoing orthotopic liver transplantation. Methods Eleven patients who underwent orthotopic liver transplantation were selected. Their pH, BE, HCO 3 -, K +, Ca 2+, blood glucose, PT, APTT and FIB were assessed at 60 min of pretransplantation, 20 min and 40 min of liver transplantation, 20 min and 40 min of new liver reperfusion. Results The pH, BE, HCO 3 -, K +, Ca 2+ during 20 min and 40 min of liver transplantation decreased more significantly than those during pretransplantation 60 min, PT and APTT extended markedly, the level of blood glucose did not change markedly; pH, BE, HCO 3-, K +, Ca 2+ and the level of blood glucose during new liver reperfusion 20 min and 40 min increased significantly compared to those during liver transplantation 20 min and 40 min; PT, APTT and FIB did not change markedly. Conclusion Metabolic indexes during liver transplantation change more markedly than those during pretransplantation or new liver reperfusion.

Objective To investigate acquired carbapenemases and prevalence of carbapenem- resistant gram-negative bacill.Methods The antimicrobial susceptibility was determined by agar dilution method.Metallo-B-lactamase(MBLs)were screened by EDTA-disk synergy tesL The encoding genes of MBLs were amplified by PCR followed by sequencing.Strain homology Was investigated by pulsed-field gel electronphoresis(PFGE).Results In 141 carbapenem-resistant Pseudomonas aeruginosa(P.aeruginosa), there were three resistant patterns which were imipenem(IMP)-resistant+meropenem(MEM)-resistant (66.7%),IMP-resistant+MEM-sensitive(32.6%),and IMP-resistant+MEM-sensitive(0.7%).AⅡthe carbapenem-resistan Acinetobacter baumannii(A.baumannii),Acinetobacter lwoffi(A.lwoffi),Citrobactor freundii(C.freundii),Klebsielta pneumoniac(K.pneumoniac)and Serratia were resistant to imipenem and meropenem.Four strains of 141 P.aeruginosa were positive by EDTA-disk synergy test,and they produced VIM-2-type Metallo-B-1actamase.Of 34 carbapenem-resistan A.baumannii,30 strains produced OXA-tllrpe.Among them, OXA23, OXA24 and OXA66 accounted for 79.4%,38.2% and 67.6%,respectively.And 22 of 34 strains(64.7%)produced multiple OXA-carbapenemases.All 7 strains A.lwoffi produced OXA-23-type carbapenemases.A11 11 strains C.freundii,5 strains k pneumoniac and 1 strains Serratia produced KPC-2-type carbapencmases.And 6 of 11 strains C.freundii produced new subtype IMP-8.Of 15 PFGE type in 34 strains A.baumannii,14 strains belonged to A-type,7 strains belonged to B-type.Seven A.lwoffi strains distilbuted in difierent PFGE type.Four strains of P.aeruginosa producing VIM-2.type Metallo-8-lactamase did not have the same PFGE type.Eleven C.freundii strains had the same PFGE type.Five k pneumoniae strains had the sanle PFGE type.Conclusions Drug resistance to 12 common antibiotics in carbapenem-resistant gram-negative bacill was higher than non-carbapenem-resistant gram-negative.The former produced many kinds of carbaponemases and the strains prducing carbapenemases were prevalent in the C.freundii, A.baumanii, and k pneumoniae.

Objective To evaluate the effect of propofol on liver injury in mice with acute liver failure (ALF).Methods Eighty adult male ICR mice,aged 1 months,weighing 20-25 g,were randomly divided into 3 groups (n =20 each) using a random number table:control group (group Ⅰ),ALF group (group Ⅱ),and ALF + propofol group (group Ⅲ).ALF model was established with intra-peritoneal D-galactosamine (D-GaIN) and lipopolysaccharide (LPS).Propofol 5 mg/kg was injected via the tail vein every 1 h within 6 h after injection of DGaIN and LPS in group Ⅲ,while the equal volume of normal saline was given instead in the other groups.Venous blood samples were taken from the tail vein at 1,3 and 6 h after injection of D-GaIN and LPS (T1-3) to detect the activities of serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) and serum tumor necrosis factor-alpha (TNF-α),interleukin-1β (IL-1β) and IL-10 concentrations (by ILISA).The survival within 12 h after injection of D-GaIN and LPS was observed and the survival rates were calculated.The mice were sacrificed and livers were removed for microscopic examination of pathologic changes.Results Compared with group Ⅰ,the activities of AST and ALT were significantly increased at each time point in Ⅱ and Ⅲ groups and the serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at each time point were significantly increased in group Ⅱ,and the serum TNF-α concentrations at T1,and IL-1β and IL-10 concentrations at T2,3 were significantly increased in group Ⅲ (P ＜ 0.05).Compared with group Ⅱ,the activities of AST and ALT at each time point,serum TNF-α concentrations at T1,2 and IL-1β and IL-10 concentrations at T2,3 were significantly decreased and the survival rate within 12 h after injection of D-GaIN and LPS was increased in group Ⅲll (P ＜ 0.05).The pathologic changes of liver tissues were gradually attenuated in Ⅱ and Ⅲ groups.Conclusion Propofol can reduce the liver injury in mice with ALF through inhibiting inflammatory responses.

Objective To analyze the 23S rRNA gene partial sequences of common bacteria, and establish molecular biologic techniques to identify bacteria by the difference of gene sequences. Methods Analyzing the sequences of variable region of bacterial 23S rRNA genes, primers and oligonucleotide probes were designed accordingly. Thereafter, bacteria were identified by PCR gel electrophoresis and PCR reverse hybridization. Results There exists significant sequence difference between Gram negative bacteria and Gram positive bacteria and it could be used to differentiate these 2 kinds of bacteria quickly with PCR gel electrophoresis. Meanwhile, sequence variety in different species of bacteria was also observed and PCR reverse hybridization could be used to identify different bacterial species further.Conclusions There exist significant sequence differences among 23S rRNA genes in different common bacteria. By the sequence differences, a specific, sensitive and rapid molecular biologic techniques could be established to quickly identify the pathogens of bacterial infections.

Objective:To investigate the changes of plasma prothrombin fragment 1+ 2 (F 1+2), tissue factor positive microparticle (TF+ MP) and thrombin antithrombin complex (TAT) level before and after the treatment of low molecular weight heparin combined with reteplase in patients with malignant tumor and lower extremity venous thrombosis. Methods:From July 2016 to October 2019, 64 patients with malignant tumors and lower extremity venous thrombosis in the Third Hospital of Changsha were selected, they were divided into observation group ( n=32) and control group ( n=32) by simple randomization. The control group was treated with low molecular heparin, and the observation group was treated with low molecular heparin combined with reteplase. The efficacy, clinical symptom improvement time, incidence of adverse reactions, difference in lower limb circumference, blood flow velocity, activated partial thromboplastin time (APTT), prothrombin time (PT), plasma F 1+2, TF+ MP, TAT level before and after treatment were compared between the two groups; the correlations of plasma F 1+2, TF+ MP, and TAT level with clinical symptom improvement time, peripheral diameter difference of lower extremity, blood flow velocity, APTT, and PT were analyzed. Results:The total effective rate of the observation group (87.50%) was higher than that of the control group (65.63%) ( P<0.05); The improvement time of clinical symptoms in the observation group was shorter than that in the control group ( P<0.05); After treatment, the peripheral limb diameter difference of the observation group was lower than that of the control group, and the blood flow velocity was higher than that of the control group ( P<0.05); The APTT and PT in the observation group were higher than those in the control group after treatment ( P<0.05); The plasma F 1+2, TF+ MP, and TAT level in the observation group were lower than those in the control group after treatment ( P<0.05); The levels of plasma F 1+2, TF+ MP, and TAT were positively correlated with symptom improvement time and lower limb circumference difference, and negatively correlated with blood flow velocity, APTT, and PT ( P<0.05); There was no significant difference in the incidence of adverse reactions (18.75%) between the observation group and the control group (12.50%) during the treatment period ( P>0.05). Conclusions:Plasma F 1+2, TF+ MP, and TAT expression in patients with malignant tumors and venous thrombosis of the lower extremity can be used as biological indicators to evaluate the patient's condition and treatment effect. Low molecular weight heparin combined with reteplase can significantly reduce the plasma F 1+2, TF+ MP and TAT level, promote the improvement of symptoms, effectively reduce the peripheral diameter difference of lower extremity, improve blood flow velocity and coagulation function, and has a significant effect.