Objective To investigate the clinical value of fast track surgery (FTS) in perioperative management of laparoscopic cholecystectomy in the plateau.Methods The clinical data of 88 patients with gall stone who received laparoscopic cholecystectomy at the No.115 Central Hospital of PLA from March 2011 to July 2012 were retrospectively analyzed.All the patients were randomly divided into the control group (44 patients) and the observation group (44 patients).Patients in the control group received traditional perioperative treatment,while patients in the observation group received FTS treatment.Differences in the operation time,time to out-of-bed activity,time for recovery of bowel function,duration of postoperative hospital stay,medical treatment cost and incidence of complications between the 2 groups were compared.The measurement data were shown in x ± s,and analyzed using the t test,and the count data were analyzed using the chi-square test.Results The operation time of the control group and the observation group were (63 ± 19)minutes and (59 ± 21)minutes,with no significant difference between the 2 groups (t =-1.34,P ＞ 0.05).The time for out-of-bed activity,recovery of bowel function,duration of postoperative hospital stay and medical treatment cost were (25 ± 6) hours,(36 ± 9) hours,(5.6 ± 1.3) days,(10.8 ± 1.1) × 103 yuan in the control group,and (10 ± 4) hours,(23 ± 5) hours,(3.1 ± 1.3) days,(7.9 ± 1.3) × 103 yuan in the observation group,with significant differences between the 2 groups (t =-3.81,-3.67,-6.40,-4.08,P ＜ 0.05).The incidences of complications in the control group and the observation group were 4.5％ (2/44) and 2.3％ (1/44),respectively,with no significant difference between the 2 groups (x2=3.01,P ＞ 0.05).Conclusion FTS can promote the recovery of patients,decrease duration of hospital stay and medical treatment cost without increasing incidence of complication for patients who received laparoscopic cholecystectomy in the plateau.

Objective To investigate the effects of the microbubbles combined with different mechanical index ultrasound irradiation on ultrastmcture and migration of colon cancer cells.Methods The experimental study was conducted.Colon cancer cells inn vitro (Lovo ceils) were cultured and divided into 4 groups,ceils in the A group were not treated and cells in the B,C and D groups were treated by microbubbles combined with different mechanical index ultrasound irradiation (mechanical index were 0.20,0.80 and 1.45).The changes of ultrastructure and migration of cells were observed using laser scanning confocal microscope and MilliceIl-PCF cell culturechamber method,respectively.Measurement data with normal distribution were represented as (x)±s.Comparisons among groups were analyzed by the one-way ANOVA.Pairwise comparisons were done by the t test.Results (1)Effects of the microbubbles combined with different mechanical index ultrasound irradiation on ultrastructure of Lovo cells:Lovo cells in the A group showed big nucleus,less plasma,regular arrangement,jagged-like or more irregular varicosity surrounding nucleus,twisted euchmmatin,expansion of nucleus cisternal space,homogeneous distribution and normal development of granular soil and clear mitochondrial ridge-like structures.Lovo cells in the B group showed big nucleus with regular arrangement,obvious nucleolus margination,endoplasmic reticulum dilatation,normal development of mitochondrion and clear mitochondrial ridge-like structures.Lovo cells in the C group showed broadening nucleus space,abnormal nucleus with karyopycnosis,chromatin condensation,a few remaining or obvious dilatation of rough endoplasmic reticulum,typically consisting of different fragments or bubbles,cytoplasmic vacuoles changes and decreasing mitochondrial ridge-like structures.Lovo cells in the D group showed big and irregular nucleus,nucleolus margination,obvious endoplasmic reticulum dilatation,fewer mitochondrion with extended cell area and swelling shape,rare mitochondrial ridge-like structures with disordered or broken arrangement,even disappearing.(2) Effects of the microbubbles combined with different mechanical index ultrasound irradiation on migration of Lovo cells:Millicell-PCF cell culture chamber method showed that number of migration of Lovo cells were respectively 63±7,61±4,21±3 and 19±5 in the A,B,C and D groups,with a statistically significant difference (F=55.040,P＜0.05).There were no statistically significant difference in migration of Lovo cells between group A and B (t =1.571,P＞0.05) and between group C and D (t =2.013,P＞0.05).There were statistically significant differences in migration of Lovo cells between group A and C or D (t=7.861,10.652,P＜0.05) and between group B and group C or D (t=7.161,10.453,P＜0.05).Conclusion Microbubbles combined with high mechanical index ultrasound irradiation can make the ultrastructural alterations in the cancer cells,resulting in tumor cell degeneration and death,ultimately inhibit tumor cell migration and metastasis.

BACKGROUND:B cell activating factor belonging to tumor necrosis factor family(BAFF)is essential to B cell differentiation,maturation,survival,and antibody secretion via binding to its receptors,and may play a role in the development of T cell response.Whether or not BAFF signal participates in the kidney allograft rejection is worthy of studying.OBJECTIVE:To analyze the expression and potential bioactivity of BAFF in the peripheral lymphocytes of kidney transplant recipients.DESIGN,TIME AND SETTING:A case observation was performed at the Department of Urology,Third Affiliated Hospital of Soochow University from June 2006 to March 2007.PARTICIPANTS:Eighty-six kidney transplant recipients comprising 60 males and 26 females,aged 12-62 years old,who received first-time kidney transplantation,were included.The serum creatinine levels ranged between 65-267 μmol/L.METHODS:Peripheral blood of follow-up recipients was taken for anticoagulation using EDTA-Na2.Renal graft biopsy samples of some patients were collected.MAIN OUTCOME MEASURES:The expression rates of BAFF+,BAFF-R+,CD4+,CD8+,CD4+ CD25+ CD127-/low,CD134+,CD4+ CD 134+ and CD19+ BAFF-R+ in peripheral mononuclear cells were analyzed,and the ratio of CD4/CD8 was calculated.Biopsy tissue was subjected to pathological and immunohistochemical analyses.RESULTS:BAFF expression rate on the peripheral mononuclear cells was between 0.18%-76.97%.15%was used as the cut-off value.In the ≥15%group,the mean value of BAFF expression rate was 36.91%;BAFF+ mononuclear cells were not significantly correlated to the ratio of peripheral CD4+/CD8+ and the CD4+ CD25+ CD127-/low T lymphocytes.However,there were significant correlations between BAFF+ mononuclear cells and CD134+ lymphocytes or CD4+ CD134+ lymphocytes(P ＜0.01,P ＜0.05,respectively).While in the ＜15%group,there were no significant correlations among all indices.Pathological diagnosis confirmed that BAFF was expressed in the renal tubular epithelial cell cytoplasm and cytomembrane staining of some chronic rejection sections.CONCLUSION:Abnormal high expression of BAFF in peripheral mononuclear cells may be related to renal allograft rejection.

Objective To summarize the experience with cadaveric renal transplantation for improving the long-term survival rate of the recipients.Methods The clinical data of 1210 cases(773 men and 437 women;age range,6-75 years) of cadaveric kidney transplantation from 1986 to 2003 were analyzed retrospectively,including the resection of the donor's kidneys,surgical techniques,use of immunosuppressants,and complications.The 1210 patients underwent renal transplantation for most of them(1047 cases) suffered from chronic glomerulonephritis.Lymphocytotoxicity test was performed in 1210 cases with all

Passing the hospital grading evaluation, establishing a tertiary-A specialized hospital for occupational diseases, enhancing hospital's internal quality and sustainable development, and continuously improving medical service quality are important measures to promote the high-quality development of hospitals. The evaluation standards for occupational disease specialized tertiary-A hospital require standardized, scientific, and sustainable management of medical equipment. Guangdong Province Hospital for Occupational Disease Prevention and Treatment is the first tertiary-A hospital for occupational diseases specialized in Guangdong Province. Relative regulation on medical equipment management was systematically reviewed based on the requirement of tertiary-A specialized hospital for occupational diseases during hospital grading evaluation process. Building and completing the medical equipment management system, standardizing and strengthening government procurement management, completing the configuration management and safety management of large-scale medical equipment, strengthening the effectiveness analysis and evaluation of large equipment, enhancing training on medical equipment usage, establishing emergency allocation systems for first-aid and life support medical equipment, and forming a medical equipment quality and safety management team is the measure to systematically improve and implement each item in various regulation for the full lifecycle management of medical equipment. It provides vital support in passing the tertiary-A hospital evaluation for hospitals. During the hospital grading evaluation process, each issue identified in medical equipment management was addressed and improved. This process continuously enhanced the hospital's medical equipment management level, ensured the safe and effective use of medical equipment, and improved the quality of medical services, laying a solid foundation for the hospital to become a high level specialized medical institution for occupational diseases.

OBJECTIVE: To establish a method for detecting human urinary thiocyanate by gas chromatographic and pre-column derivatization with 2,3,4,5,6-pentafluorobenzyl bromide( PFB-Br). METHODS: A total of 20. 0 μL of urine was taken and 1. 0 m L of acetonitrile and 100. 0 μL of PFB-Br were added for derivative reaction. The gas chromatography was directly used for measurement. RESULTS: The urinary thiocyanate concentration showed a good linear range of 1. 000-10. 000 mg/L. The linear correlation coefficient was 0. 999 6. The minimum detection concentration was 0. 112 mg/L,and the minimum quantitative concentration was 0. 411 mg/L( 20. 0 μL urine sample). The standard recovery rate was 97. 22%-102. 04%.The within-run relative standard deviation( RSD) of this method was 1. 56%-5. 35%. The between-run RSD was 1. 46%-5. 10%. Hydrocyanic acid ions interfered with the measurement. Other common inorganic ions such as chloride,sulfate,and nitrate ions did not interfere with the measurement results. The samples can be stored at 4 ℃ for at least 15 days. CONCLUSION: This method is suitable for detecting human urinary thiocyanate.

ObjectiveTo study the effect of Qizhu Kang'ai prescription （QZAP） on the gluconeogenesis enzyme phosphoenolpyruvate carboxykinase 1 （PCK1） in the liver of mouse model of liver cancer induced by diethylnitrosamine （DEN） combined with carbon tetrachloride （CCl₄） and Huh7 cells of human liver cancer， so as to explore the mechanism on regulating metabolic reprogramming and inhibiting cell proliferation of liver cancer cells. MethodDEN combined with CCl₄ was used to construct a mouse model of liver cancer via intraperitoneal injection. A normal group， a model group， and a QZAP group were set up， in which QZAP （3.51 g·kg^-1） or an equal volume of normal saline was administered daily by gavage， respectively. Serum and liver samples were collected after eight weeks of intervention. Serum alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， γ-glutamyltransferase （γ-GT）， and alpha-fetoprotein （AFP） in mice were detected to evaluate liver function changes of mice in each group. Hematoxylin-eosin （HE） staining and Sirius red staining were used to observe pathological changes in liver tissue. In the cell experiment， Huh7 cells were divided into blank group， QZAP low， medium， and high dose groups and/or PCK1 inhibitor （SKF-34288 hydrochloride） group， and Sorafenib group. The corresponding drug-containing serum and drug treatment were given， respectively. Cell counting kit-8 （CCK-8） method， colony formation experiment， Edu fluorescent labeling detection， intracellular adenosine triphosphate （ATP） content detection， and cell cycle flow cytometry detection were used to evaluate the proliferation ability， energy metabolism changes， and change in the cell cycle of Huh7 cells in each group. Western blot was used to detect the protein expression levels of PCK1， serine/threonine kinase （Akt）， phosphorylated Akt （p-Akt）， and cell cycle-dependent protein kinase inhibitor 1A （p21）. ResultCompared with the model group， the pathological changes such as cell atypia， necrosis， and collagen fiber deposition in liver cancer tissue of mice in the QZAP group were alleviated， and the number of liver tumors was reduced （P<0.01）. The serum ALT， AST， γ-GT， and AFP levels were reduced （P<0.01）. At the cell level， compared with the blank group， low， medium， and high-dose groups of QZAP-containing serum and the Sorafenib group could significantly reduce the survival rate of Huh7 cells （P<0.01） and the number of positive cells with Edu labeling （P<0.01） and inhibit clonal proliferation ability （P<0.01）. The QZAP groups could also reduce the intracellular ATP content （P<0.05） and increase the distribution ratio of the G₀/G₁ phase of the cell cycle （P<0.05） in a dose-dependent manner. Compared with the model group and blank group， PCK1 and p21 protein levels of mouse liver cancer tissue and Huh7 cells in the QZAP groups were significantly reduced （P<0.05，P<0.01）， and the p-Akt protein level was significantly increased （P<0.01）. Compared with the blank group， the ATP content and cell survival rate of Huh7 cells in the SKF-34288 hydrochloride group were significantly increased （P<0.05）， but there was no statistical difference in the ratio of Edu-positive cells and the proportion of G₀/G₁ phase distribution. Compared with the SKF-34288 hydrochloride group， the QZAP combined with the SKF-34288 hydrochloride group significantly reduced the ATP content， cell survival rate， and Edu-positive cell ratio of Huh7 cells （P<0.05） and significantly increased the G₀/G₁ phase distribution proportion （P<0.05）. ConclusionQZAP may induce the metabolic reprogramming of liver cancer cells by activating PCK1 to promote Akt/p21-mediated tumor suppression， thereby exerting an anti-hepatocellular carcinoma proliferation mechanism.

OBJECTIVE: To establish a headspace gas chromatography-mass spectrometry method for the determination of 14 chlorinated hydrocarbons in urine. METHODS: The urine sample 4.00 mL and anhydrous sodium sulfate 3.00 g were added into a 10.00 mL headspace bottle, then the headspace bottle was maintained at 70 ℃ for 40.0 min. After headspace pretreatment, 14 chlorinated hydrocarbons in headspace air were separated in the DB-5 MS capillary column of the gas chromatography and detected by mass spectrometer. RESULTS: There was a good linear relationship of 14 chlorinated hydrocarbons in urine in the range of 0.62-1 630.00 μg/L. The linear correlation coefficient was greater than 0.999 0.The minimum detectable concentration was 0.19-0.43 μg/L and the minimum quantitative concentration was 0.62-1.44 μg/L. The average recovery rate was 89.8%-107.1%. The within-run relative standard deviation(RSD) was 4.0%-8.5% and the between-run RSD was 6.3%-9.1%. Urine samples can be stored at 4 ℃ or-8 ℃ for 3 days and below-20 ℃ for 7 days. CONCLUSION: This method is rapid, simple, sensitive, accurate and has little interference,which can be used as a method for detecting 14 kinds of chlorinated hydrocarbons in urine samples of patients with occupational poisoning.