Objective This study was to detect protein expression of ERK 1,ERK 2,JNK 1,p38 and MEK 1 ,MEK 2 in human hepatocellular carcinoma and adjacent non neoplastic liver tissues.Method Western blot was used to detect the expression of ERK 1,ERK 2, JNK 1,p38 and MEK 1,MEK 2 in the surgically resected hepatocellular carcinoma and para carcinoma tissues in 16 HCC patients.[WT5”HZ] Result The expression of ERK 1,ERK 2,p38 expressed by integral optic density (IOD) in hepatocellular carcinoma was significantly higher than that in para carcinoma respectively: as for ERK 1 it was 300?98 in carcinoma and 98?48 in para carcinoma tissues ( P

Objective To evaluate the effect of omega-3 polyunsaturaed fatty acid on liver function, donor's T lymphocytes and acute rejection following orthotopic liver transplantation in rats. Methods Orthotopie liver transplantation from BN (RT1 n) to Lewis was performed. Normal saline (NS, n = 6), parenteral nutrition (PN, n = 6) or parenteral nutrition and Omega-3 fatty acid (OM, n = 6) was given through internal jugular vein catheter respectively beginning the first day for consecutive 6 days. At 7thday, the liver function and pathological changes of the transplant liver were observed. The percentage of CD4+ , CD8+, CD4+ CD25+ and CD8+ CD28- T lymphocytes were analyzed by flow-cytometry. Results In OM group the CD4+, CD8+ , CD4+ CD25+ and CD8+ CD28- T lymphocytes significantly decreased, compared with NS (t = 4.28, P < 0.01 ; t = 2.63, P < 0.05 ; t = 2.59, P < 0.05 ; t = 8.86, P <0.01)or PN group(t =8.06, P<0.01; t =3.57, P<0.01; t =5.35, P<0.01; t =7.98, P<0.01). The ratio of CD4+ to CD8+ significantly decreased in OM group compared with NS group and PN group(t = 6.25, P<0.01; t=4.92, P<0.01). RAI (rejection activity index) in NS group, PN group and OM group was 7.17 +0.98, 6.17±0.75 and 4.33±0.52, respectively. The rejection grade in OM group was siguificanfly alleviated than that in NS group and PN group(t =6.25, P <0.01;t =4.92, P <0.01). Conclusion Omega-3 fatty acid inhibits T lymphocytes, especially help T lymphocytes, alleviates acute rejection. The suppressor T cell and the regulatory T cell were not responsible for the alleviation of the rejection.

Objective To compare different dose of remifentanil combined with propofol for painless abortion and approach to an appropriate dose of remifentanil.Methods Ninety pregnant women with ASA 1 were randomly divided into three groups(n=30)before administrating remifetanil,a bolus midazolam 1 mg was injected inminutes later.These two drugs did not stop administration until three minutes before the end of negative suction.MAP,HR,SpO2,BIS,RR,VT,PET CO2 were monitored.The onset,operation and recovery time,sedation score and adverse reaction were recorded.Results Sedation scores were significantly different between group A and C [(3.90±0.97)and(4.90±0.85),t=4.24,P＜0.01].Three cases in group A were found moving.MAP,HR,BIS decreased as compared witll baseline.HR reduced significantly in group C(P＜0.05,P＜0.01).Respiratory movement was lower and shallower.RR,VT decreased compared to preoperative one.PET C02 increased gradually (P＜0.05,P＜0.01).There were two cases of respiratory depressing in group A,four cases in group B and ten cases in group C(five cases apnea more than three minutes).All patients used oxygen mask to maintain SpO2＞95%.Incidence of adverse reactions such as chest titanic,nausea and vomiting,itching were of no difference among three groups(P＞0.05).All patients were satisfied with anesthesia.Conclusion The appropriate infusing dose of remifetory devices such as oxygen mask and monitoring life signs are very important to prevent respiratory depress and bradycardia during operation.

Objective To investigate the expression of doublecortin-like kinase 1 (DCLK1) in colorectal cancer and colorectal adenomas,and it's role in the development and progression of colorectal carcinoma,and explore the relationship of the DCLK1 expression and prognosis in colorectal cancer patients with diabetes medical history.Methods Expression of DCLK1 in 70 cases of colorectal cancers,70 cases of para-carcinoma tissues,and 35 cases of tubulovillous adenomas were detected by immunohistochemical method.Results (1) The DCLK1 high expression rate in colorectal cancers was 41.4％ (29/70),and 45.7％ (16/35) in tubular villous adenomas,both significantly higher than the para-carcinoma tissues (4.3％;3/70) (P ＜0.01).(2) DCLK1 high positive expression had statistical significance with pathological grading (P ＜ 0.01),infiltration depth (P ＜ 0.05),lymph node metastasis (P＜ 0.05),vascular invasion (P ＜0.05),and distant metastasis (P ＜0.01).(3) There was no obvious correlation between the Diabetes medical history,expression of DCLK1,and prognosis of patients.Conclusions DCLK1 has high positive expression in colorectal carcinomas,and may have certain significance for the early clinical diagnosis and prognostic judgment of colorectal cancers.The expression of DCLK1 and prognosis of colorectal cancers has no obvious correlation with diabetes medical history.

Objective To study the sedation and amnesia of midazolam in patients with different ages of lumbar epidural anesthesia . Methods From January to July 2015, 235 patients in the first affiliated of xian jiaotong unniversity,who were implemented abdominal surgery under combined spinal epidural anesthesia and American Society of anesthesiologists (ASA) grade was I-II , were divided into three groups:young group (n=70); middle-aged group (n =82); elderly group (n =83).Intraoperative continuous monitoring of respiratory and circulatory function index,and recorded MAP,SpO2, HR before and 5, 15, 30 min after injection.ResuIts MAP, HR and SpO2 of three groups were compared with the same time points pre-and post used of midazolam, there was no significant difference among indicators.; Compared with the same group at different time points, MAP(FYG =9.2547,FMG =12.8181,FOG =17.77)和 SpO2 (FYG =190.3835,FMG =196.2393,FOG =270.5609),there were significant difference.The difference was not statistically significant between HR group and the same group at different time points and forgetting degree and sedation score , but compared with OG,there were significant difference(P<0.05).The total number of adverse reactions in YG group and MG group was less than that of OG group(X2 =11.2516,X2 =10.4491, P<0.05).ConcIusion The effect of the same dose of midazolam on sedation and amnesia in patients with different ages of lumbar epidural anesthesia is different, and the degree of the effect of the elderly patients is significant,but will produce more adverse reactions.Therefore, in the combined spinal epidural anesthesia,it is necessary to consider the patient's individual differences, rational use of sedative and narcotic drugs.

ObjectiveTo study the feasibility and technique in liver transplantation (LT) in an adult with situs inversus (SI) and reviewed the medical literature on this subject.MethodsA 45-year-old male with complete SI,suffered from progressive hepatic failure secondary to hepatolithiasis,obstructive jaundice,portal hypertension and liver cirrhosis.He underwent liver transplantation in July 2004.His anatomy was studied by preoperative CT scan and three-dimensional liver reconstruction imaging and angiography.LT was performed using the modified piggyback technique.The donor right liver was rotated 45 degree to the left,making the donor left liver pointing to the left paracolic sulcus and the donor right liver was in the recipient hepatic fossa.The donor suprahepatic vena cava was anastomosed end-to-side to the recipient vena cava,and the infrahepatic vena cava was closed by oversewing.ResultThe patient recovered uneventfully.His liver function was stable during a follow-up of 75 months.ConclusionLT in patients with SI is safe and feasible.Exact determination of the anatomy,comprehensive preoperative planning,and good technique in liver transplantation play important roles in LT for patients with SI.

OBJECTIVETo detect protein expression of ERK(1), ERK(2), JNK(1), p38 and MEK(1), MEK(2) in human hepatocellular carcinoma and adjacent non-neoplastic liver.

METHODSIn 16 surgically resected hepatocellular carcinoma and para-carcinoma tissues, Western blotting was used to detect expression of ERK(1), ERK(2), JNK(1), p38 and MEK(1), MEK(2).

RESULTSIn all cases, ERK(1), ERK(2), p38 expression in hepatocellular carcinoma was significantly higher than that in para-carcinoma: integral optic density (IOD) of ERK(1) was 300 +/- 98 in carcinoma and 98 +/- 48 in para-carcinoma tissues (t = 2.519, P < 0.01); IOD of ERK(2) was 587 +/- 83 in carcinoma and 232 +/- 96 in para-carcinoma tissues (t = 2.745, P < 0.01); IOD of p38 was 270 +/- 85 in carcinoma and 107 +/- 88 in para-carcinoma tissues (t = 2.491, P < 0.01). JNK(1) expression in hepatocellular carcinoma was significantly lower than that in para-carcinoma; IOD of JNK(1) was 111 +/- 93 in carcinoma and 292 +/- 109 in para-carcinoma tissues (t = 2.473, P < 0.01). Protein levels of MEK(1) and MEK(2) in carcinoma were significantly higher than in para-carcinoma. IOD of MEK(1) was 1 418 +/- 244 in carcinoma and 806 +/- 90 in para-carcinoma tissues (t = 2.546, P < 0.01). IOD of MEK(2) was 1 041 +/- 122 in carcinoma and 468 +/- 40 in para-carcinoma tissues (t = 2.861, P < 0.01).

CONCLUSIONSERK(1), ERK(2), MEK(1) and MEK(2) in the signal transduction pathway for cell proliferation are significantly overexpressed and the expression of JNK(1) is lower in hepatocellular carcinoma. Their unbalance is one of the important reasons for the over growth and infinite proliferation of the hepatocellular carcinoma cell. The p38 and JNK(1) may be activated by different pathway.

Adult ; Aged ; Carcinoma, Hepatocellular ; enzymology ; Enzyme Activation ; Female ; Humans ; JNK Mitogen-Activated Protein Kinases ; Liver Neoplasms ; enzymology ; MAP Kinase Kinase 1 ; Male ; Middle Aged ; Mitogen-Activated Protein Kinase Kinases ; analysis ; Mitogen-Activated Protein Kinases ; metabolism ; Protein-Serine-Threonine Kinases ; analysis

Objective To evaluate the hemostatic effect of hemocoagulase agkistrodon in elderly patients undergoing laparoscopic cholecystectomy and to analyze its influence on coagulation function and its safety.Methods A prospective,randomized,double blind and controlled research was conducted in 60 patients aged over 65 years.Patients were divided into 2 groups:the study group and the control group (n =30 each group).Patients in the study group were injected with 2 U hemocoagulase agkistrodon intravenously 20 minutes before operation and with 1 U hemocoagulase agkistrodon 4 hours after operation.Patients in the control group were injected with physiological saline instead of hemocoagulase agkistrodon.The intraoperative intraperitoneal hemorrhage and intraperitoneal drainage at 24 hours after operation were recorded.The changes in bemagglutination and safety were observed.Results 59 cases were finished in this study and 1 case was eliminated.The volume of intraoperative hemorrhage was less in the study group than in the control group [(53.6±68.1) g vs.(88.1±79.7) g,t =2.08,P=0.038].There was no significant difference in the volume of intraperitoneal drainage at 24 hours after operation between the study group and the control group [(71.7±113.3) g vs.(89.0±104.7) g,t =1.69,P=0.075].The hemoagglutinationindexes were similar between two groups and no thrombosis occurred.There was no significant difference in the time of hospital stay between the study group and the control group [(5.2±1.4) days vs.(5.3±1.7) days,t=0.52,P=0.61].No adverse event was reported.Conclusions Hemocoagulase agkistrodon has relatively good hemostatic effects and safety for the elderly patients undergoing laparoscopic cholecystectomy.

Objective　To study the clinicopathologic features of hepatic angiomyolipoma (AML) and to investigate the feasibility of a new antibody-A103 as a diagnostic aid for AML. Methods　Ten cases of AML were retrieved from hospital records and analyzed morphologically. Immunohistochemistry was performed on paraffin-embedded tissues with a panel of antibodies, including antibody-A103. Results　There were eight women and two men, with ages ranging from 38-58 years (median 45.7). Clinically, nine cases were asymptomatic and found by imaging techniques. None of the patients had associated tuberous sclerosis. All tumors were sharply demarcated from the surrounding liver parenchyma. Histologically they were composed of a heterogeneous mixture of three components: thick-walled blood vessels, spindle or epithelioid smooth muscle cells and adipose tissue. All tumors showed a strong immunoreactivity to A103, HMB-45 and smooth muscle actins. Follow-up information on all 10 cases showed a benign course with no signs of recurrence. Conclusions　Hepatic AML is a rare mesenchymal tumor of the liver. A103 is a promising marker for a pathologic diagnosis of hepatic AML.

Objective:To investigate the application effect of case-based collaborative learning (CBCL) based on data-information-knowledge-wisdom (DKIW) model in the training of the informatization teaching ability of clinical teachers.Methods:From March to August in 2022, 71 clinical teachers from four grade A tertiary hospitals in Tianjin, China, were selected as subjects and were randomly divided into control group with 35 patients and experimental group with 36 patients using a random number table. The teachers in the control group received blended teaching online and offline, and those in the experimental group received CBCL teaching based on DIKW model. The two groups were compared in terms of theoretical assessment score, informatization teaching demonstration score, and informatization teaching ability score before and after intervention. SPSS 27.0 was used for the t-test and the Mann-Whitney U rank sum test. Results:Compared with the control group after intervention, the experimental group had significantly higher scores of theoretical assessment (83.50±3.11) and informatization teaching demonstration (84.19±1.89) ( P<0.05). After intervention, the control group had significant increases in the total score of informatization teaching ability (74.34±4.08) and the scores of each dimension (15.40±1.19, 19.29±1.62, 28.54±1.67, and 11.11±1.79), and the experimental group also had significant increases in the total score of informatization teaching ability (83.64±5.25) and the scores of each dimension (16.53±1.21, 20.94±1.98, 33.03±2.10, and 13.14±1.48); the experimental group had significantly higher scores than the control group ( P<0.05). Conclusions:The CBCL teaching model based on DIKW model can help to improve the comprehensive informatization teaching ability of clinical teachers.