Objective To investigate application of modified abdominal closure technique by an all layer in ventro-pelvic part operation and evaluate its value and significance. Methods 3200 cases with ventre-pelvic part operation between May 2002 and Aug 2007, were subjected to single layer closure with non absorbable suture material. The clinic data and some results of follow-up were retrospectively analyzed. Results Operative incisions of 1780 (55.6%) cases were in epigastric zone and their rate of primary healing was 98.5%, others (44.3%) in hypogastric zone (including pelvic cavity) and rate of primary healing was 98.2% (P>0.05). Rate of primary healing in older age-group was 97.9% and control group 98.8%, and primary healing of group diabetes 97.4%, control group 98.2% (P > 0.05). Average time of abdmenal closure was only 11±4 min. Primary complications included dehiscence of wound (0.5%), infection (1.4%) and incisional hernia (0.2%). Follow-up (66%) was performed at 30 days, 3 and 6 months, and at 1, 2 and 3 years. Conclusion It is concluded that closure of an abdominal incision can be effected by a multifilament interrupted absorbable sutures without an increased risk of wound dehiscence or incisional hernia, meanwhile economic and fast. It is the optimal method of abdominal closure and can be generalized.

In order to clone and express alcohol dehydrogenase II (ADH2) gene from Saccharomyces cerevisiae in E. coli BL21 (DE3) efficiently, we extracted the total RNA as template and obtained ADH2 gene by RT-PCR and connected ADH2 gene to pTAT plasmids to gain recombinant expression plasmid pTAT-ADH2, then transformed this recombinant expression plasmid pTAT-ADH2 into E. coli BL21 (DE3). The recombinant was induced by IPTG to express ADH2. After purification, ADH2 activity was tested in vitro and toxicologic test was done in mouse. Sequence test showed that the acquired fragments exhibited 90% homology to ADH2 gene sequence from GenBank report. The target gene expressed efficiently and took up to approximant 50% of total protein by SDS-PAGE and band scanning analysis. The purified protein exhibited the identified activity through biochemical test and mouse toxicological test. As a result, the acquired ADH2 gene was highly homology to the published sequence and expressed at a high level in E. coli BL21 (DE3), more importantly, ADH2 proved to have ethanol dehydrogenase activity.
Alcohol Dehydrogenase ; genetics ; isolation & purification ; Animals ; Cloning, Molecular ; Escherichia coli ; genetics ; metabolism ; Genetic Vectors ; Mice ; Random Allocation ; Recombinant Proteins ; biosynthesis ; genetics ; isolation & purification ; Saccharomyces cerevisiae ; enzymology ; genetics ; Saccharomyces cerevisiae Proteins ; genetics ; isolation & purification

Objective To observe the relationship between CYP2C19 gene polymorphisms and major adverse cardiovascular events in the patients of acute coronary syndrome (ACS) who accepted percutaneous coronary intervention (PCI) in Han population from Dalian. Methods A total 809 cases with ACS who had undergone PCI in the cardiology department of Dalian Municipal Central Hospital from Janurary 2012 to Janurary 2014 were selected,Among 809 cases of ACS,there were 178 cases of acute ST segment elevation myocardial infarction (STEMI),105 cases of acute non ST segment elevation myocardial infarction (NSTEMI) and 526 cases of unstable angina. The patients were divided into three groups according to their CYP2C19 genotype.CYP2C19 genotype (*1/*1) were classified as extensive metabolizers (EM group), CYP2C19 genotype (*1/*2、*1/*3) were classified as intermediate metabolizers (IM group) and CYP2C19 genotype (*2/*2、*3/*3、*2/*3) were classified as poor metabolizers (PM group). The occurrence of major adverse cardiovascular events at least 24 months was observed. Results Seven hundred and ninety patients finished the follow-up at least 24 months, 19 patients lost in follow-up, 350 cases (43.2%) were CYP2C19 (*1/*1),318 cases (39.3%) were CYP2C19(*1/*2), 42 cases(5.2%) were CYP2C19 (*1/*3),77 cases (9.5%) were CYP2C19 (*2/*2), 21 case(2.2%)were CYP2C19 (*2/*3), and 1 case (0.1%) was CYP2C19(*3/*3), 350 cases (43.2%) were classified as EM group, 360 cases (44.5%) were classified as IM group, and 99 cases(12.2%)were classified as PM group. No significant difference in age, gender, hypertention, diabetes mellitus, smoking was shown among three groups (P > 0.05). The rate of MACE were 3.3% , 8 cases had target lesion revascularization(EM group 3 cases, IM group 3 cases, PM group 2 cases), 2 cases had non-fatal myocardial infarction (IM group 1 case, PM group 1 case), 15 cases were died(EM group 6 cases, IM group 7 cases, PM group 2 cases), 1 case had subacute stent thrombosis in IM group. The rates of MACE were higher in PM group (5.1%) than those in EM group(2.65%) and IM group (3.41%) , but there was no significant difference in three groups (P>0.05). There was no significant difference in the rate of target lesion revascularization , thrombus in stent, non- fatal myocardial infarction and death among three groups(P > 0.05). Conclusions There is no significant correlation between CYP2C19 gene polymorphism and long-term prognosis in patients with ACS who accepte PCI treatment in Han population from Dalian.

Objective To investigate the safety and efficacy of laparoscopic ureteroureterostomy with intraoperative retrograde ureteroscopy-assisted technique in the treatment of ureteral strictures secondary to Holmium laser lithotripsy.Methods The clinical data of 26 cases of ureteral strictures secondary to Holmium laser lithotripsy performed by laparoscopic ureteroureterostomy from December 2013 to January 2016 in our hospital were analyzed retrospectively.The patients included 15 men and 11 women,with an average age of 39.5 years (range 24-71 years).The ureteral strictures secondary to holmium laser lithotripsy were found on average follow-up of 5.2 months (range 1-22 months).There were 12 cases of mild hydronephrosis before surgery,moderate hydronephrosis in 11 cases,severe hydronephrosis in 3 cases.Preoperative serum creatinine was 102.0 μ mol/L on average (range 53.3-201.4 μmol/L),and ureteral stenosis length was 15.0 mm on average (range 8.0-26.0 mm).The upper ureteral strictures in 6 cases,the middle strictures in 13 cases,and the lower strictures in 7 cases.Results All the operations were completed successfully without conversion to open and no intraoperative death.The average operation time was 121.4 min(range 90-155 min);the estimated blood loss was 92.3 ml (range 30-200 ml);the mean recovery time of gastrointestinal function after operation was 1.4 d(range 0.5-2.5 d);the mean hospital stay was 6.2 d(range 4-9 d)with indwelling double J;the Foley catheter was removed 14.5 d(range 12-16 d)postoperatively;the mean time of double J withdrawal was 76.3 d(range 61-86 d).Postoperative fever occurred in two patients and were successfully treated by re-indwelling catheter and antibiotic administration.Urine leakage occurred in 1 patient postoperatively and was successfully treated by conservative management 5 days later.After a period of 11 to 22 months of follow-up,no patient had ureteric re-stenosis.Conclusions Laparoscopic ureteroureterostomy with intraoperative retrograde ureteroscopyassisted technique could accurately locate and cure the ureteral strictures.It might be safe and effective with short operation time,less injury and quick recovery.

To investigate the feasibility and clinical effects of the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique for the treatment of complex ureteral stricture. 
 Methods: The clinical data of 16 patients with complicated ureteral stricture treated by the laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique from February 2016 to June 2018 were retrospectively analyzed. All 16 patients were iatrogenic stenosis. There were 4 cases of severe hydronephrosis in the affected side, 7 cases of moderate hydronephrosis, and 5 cases of mild hydronephrosis. According to the specific location and length of the ureteral stricture, the corresponding surgical method was selected. 
 Results: All patients successfully completed the operation without conversion to open surgery and organ injury. After the operation, the patients were followed up for 8-18 months. The hydronephrosis of all patients was relieved to varying degrees, and no ureteral restenosis occurred. 
 Conclusion: The laparoscopic urinary tract reconstruction with intraoperative retrograde ureteroscopy-assisted technique can accurately locate the stenosis segment, test the anastomosis effect, expand the inflammatory stenosis, and improve the end-to-end anastomosis of the distal ureteral stricture, which is a new and effective technique for the treatment of complex ureteral strictures.
Constriction, Pathologic ; Humans ; Laparoscopy ; Retrospective Studies ; Ureteral Obstruction ; diagnostic imaging ; Ureteroscopy