AIM: To explore the possible role of the vitamin D receptor (VDR) in the effect of 1,25-dihydroxyvitamin D 3 and its novel analogues on a human osteosarcoma cell line (HOS-8603) proliferation. METHODS: Detecting the VDR mRNA and protein expression in HOS-8603 cells by reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemical analysis, respectively. Using the method of transient transfection of a reporter gene (DR3-tk-CAT) for VDR to detect its function. The cell VDRas3 which stably expressed VDR antisense mRNA was used to observe the effect of 1,25(OH) 2 D 3 on the proliferation of HOS-8603 cells and the induction of p21 mRNA, one of the VDR target genes, when the VDR in the cells was blocked. RESULTS: HOS-8603 cells expressed the vitamin D receptor which functioned as a hormone-dependent transcriptional factor. When VDR in the HOS-8603 cells decreased, the cells lost the responsiveness to 1,25(OH) 2 D 3 irrespective of either the induction of p21 gene expression or the cell proliferation. CONCLUSION: The effect of 1,25(OH) 2 D 3 on the proliferation of the human osteosarcoma cell line HOS-8603 was mediated by its nuclear receptor VDR.

AIM: To investigate the effect of glucocorticoid receptor beta(GR?) on the transcriptional activation function of glucocorticoid receptor alpha(GR?) and elucidate the biological significance of glucocorticoid receptor beta. METHODS: GR? (pRSH-GR?) and GR? responsive reporter gene cat (pMMTV-cat) were cotransfected into human osteosarcoma cell line (HOS-8603). Transient transfectants were treated with dexamethasone and the activity of cat was determined by the method of ELISA. The expression p21 messenger RNA was detected by the method of reverse transcription-polymerase chain reaction. RESULTS: GR? repressed the expression of reporter gene-cat in a dose-dependent manner. The expression of messenger RNA of p21, an endogenous target gene of GR?, was also inhibited by GR?. CONCLUSION: GR? can inhibit the transcriptional activation function of GR?. GR? may be an endogenous inhibitor of GR?.

AIM: To explore the possible role of p21 wafl gene in the effect of 1,25-dihydroxyvitamin D 3 on a human osteosarcoma cell line (HOS-8603) proliferation and differentiation. METHODS: The effect of 1,25(OH) 2D 3 on the expression of p21 wafl mRNA was determined by quantitative reverse transcription-polymerase chain reaction. The human osteosarcoma cell line stably expressing the p21 wafl mRNA, which named HOS-p21 wafl , was constructed by lipofectamine transfection, and the expression of p21 wafl protein was detected by Western blot. Then the growth curve of the HOS-p21 wafl cells and the expression of alkaline phosphatase (AKP) in the HOS-p21 wafl cells were investigated. RESULTS: The expression of endogenous p21 wafl mRNA in HOS-8603 cells was induced by 1,25(OH) 2D 3 in a time-dependent manner, reaching the maximum at 4 h, and remaining the inducible action for up to 24 h over basal levels. The HOS-p21 wafl cells grew much slower than the control cells, only reaching 50% of the control ones when cultured for up to 6 days. Histochemical analysis showed that the expression of alkaline phosphatase (AKP) in the HOS-p21 wafl cells increased remarkably.CONCLUSION: These results suggest that the p21 wafl mRNA expression induced by 1,25(OH) 2D 3 is one of important mechanisms responsible for the cellular effects of the hormone on HOS-8603 cells.

Objective To compare the clinical effects of HC video laryngoscope and fiberoptic bronchoscope (FOB)in guidance of endotracheal intubation for patients undergoing cervical surgery.Meth-ods A total of 50 patients (ASA I or II)with cervical vertebra injury,nerve root cervical spondylopathy or cervical spondylotic myelopathy in the first affiliated hospital of Wenzhou medical university were selected, all of whom were undergone selective cervical operations between March 2014 and June 2015.The patients were randomly divided into two groups (n =25):HC video laryngoscope group (group H)and FOB group (group F).After induction of anesthesia,HC video laryngoscope and FOB were used for tracheal intuba-tion.⑴ Intubation time and success rates of intubation were recorded,and visual analogue scale (VAS) was used to evaluate the difficulty of intubation;⑵ Mean arterial pressure (MAP),heart rate (HR),and rate-pressure product (RPP)before incubation (Tb),immediate after intubation (T0),and 1min after in-cubation (T1)were recorded;(3)Intubation-related complications were recorded.Results ⑴ The dura-tion of intubation (19.7 ±7.1 )s in the group H was significantly shorter than that of group F (51.9 ± 19.2)s (P <0.05).The one-time success rate of intubation in group H (92%)was higher than that of group F (64%),with statistically significant differences (P <0.05).Intubation was easier in group H (P <0.05).⑵ MAP,HR and RPP of group H at T0 were higher than those of group F.And at T1,there were no statistical differences between groups in MAP,HR and RPP (P >0.05).⑶ The incidence of complications (sore throat)was lower in group H (P <0.05).Conclusions Compared to FOB,HC vid-eo laryngoscope-guided selective cervical operation has the characteristics of higher success rate of intubat-ion,shorter operation time,and easier operation,more stable hemodynamics and lower incidence of intuba-tion complications.Therefore,HC video laryngoscope is a safe and effective method in the intubation for pa-tients undergoing cervical surgery.

To summarize and explore the etiopathogenisis, clinical 'characteristics, diagnosis and treatment and prognosis of idiopathic adulthood ductopenia. We described a 27-year-old Chinese female initially manifested with jaundice, pruritus, dark urine, and pallor of the stools in October, 2002. Symptoms occurred repetitively and severed progressively, and she received therapy at the General Hospital of Chinese People's Armed Police Forces. B-ultrasound demonstrated that hepatic lesion and slightly swelling spleen. Pathological diagnosis of liver biopsy showed that she affected idiopathic adulthood ductopenia. The outcome of treatment of ursodeoxycholic acid and adrenal cortical hormone was not significant. She received orthotopic liver transplantation on June 24~(th), 2005. After liver transplantation, pruritus and jaundice were promptly disappeared. Each index of hepatic function recovered to a normal level. In March 2007, decreased dose of hormone induced an abnormal hepatic function, with mildly acute rejection. Drug dose was regulated, and hepatic function gradually returned to normal. During follow-up 51 months after the operation, she was doing well and was free of symptoms with normal liver function and no evidence of allograft dysfunction. The pathogenesis of idiopathic adulthood ductopenia is still unknown. There are still no precise and effective drugs for treatment of idiopathic adulthood ductopenia. Liver transplantation offers an effective therapy for end-stage patients with idiopathic adulthood ductopenia.

Objective To investigate the risk factors of electrical storm(ES) in patients with acute myocardial infarction (AMI) during perioperative period of direct percutaneous coronary intervention(PCI).Methods Forty-one AMI patients had been treated with direct PCI.The patients with perioperative ES were included in ES group and those without perioperative ES were included in conntrol group.ES was defined as the occurrence of spontaneous ventricular tachycardia or venicular fibrillation was twice or more within 24 h and unable to stop by itself and emergency treatment was needed.The difference of the clinical data between two groups were compared.Results There were 7 in 41 patients with direct PCI who had ES,the incidence was 17.07％,and 34 cases didn't have ES.Systolic pressure,diastolic pressure,white cell count,blood glucose,international normalized ratio and time duration from chest pain onset to direct PCI between two groups had no significant differences (P ＞0.05).Age,CK-MB,cardiac troponin I,the diameter of infarctrelated arleries(IRA ),incidence of reperfusion arrhythmia and mortality of ES group were all obviously higher than those of control group (P ＜ 0.05 or ＜ 0.01 ).The incidence of ES in patients whose IRA was left main artery or occlusion of middle section of two main coronary arteries,right coronary artery,left anterior descending branch and left circumflex artery was 66.67％(2/3),18.75％(3/16),11.76％(2/17) and O, respectively.Conclusions Perioperative ES during direct PCI most commonly occurrs in AMI patients with left main artery or occlusion of middle section of two main coronary artery.The diameter of IRA,TIMI flow classification after the patency of IRA and recanalization arrhythmia are the main risk factors of the occurrence of perioperative ES.

Objective To retrospectively analyze the anesthesia management of applying minimally invasive percutaneous neplrolithotripsy for treating hepatolithiasis.Methods The anaesthesia method,anesthetic effect,the time of resuscitation after anesthesia and side -effect of anesthesia in 86 patients who were underwent minimally invasive percutaneous neplrolithotripsy for hepatolithiasis were analyzed.Results All 86 patients were satisfied with anesthetic effect and completed surgery successfully.Among them,48 patients underwent operation with epidural anesthesia,31 patients with general anesthesia and 7 patients with the management of anesthesia monitoring(MAC) plus with local anesthesia.The time of resuscitation after anesthesia in general anesthesia patients was longer than those of epidural anesthesia and MAC.6 patients were delayed recovery and hypothermia after general anesthesia, 4 cases of epidural anesthesia and 1 case of MAC appeared cholecyst -heart reflection,and 2 cases of epidural anesthesia vomiting intraoperation.Conclusion The rational anesthesia method for patients underwent minimally invasive percutaneous neplrolithotripsy for treating hepatolithiasis should consider reasonably heart and lung function, maintain hemodynamics and respiratory stably,pay attention to insulation intraoperation,prevent cholecyst -heart reflection and shorten the operation time,which can reduce the side -effect of anesthesia and were favor for recovery after operation.

Objective To study the effect of MRCP for operation difficulty assessment before laparoscopic cholecystectomy. Methods 110 patients with gallbladder stone were randomly selected from March 2011 to July 2012 in our hospital,and all the patients were given LC operation after examined by MRCP. Regarded the average operation time 30 min as a criterion,when the operation time was no more than 30 min,the operation was considered as normal operation;when the operation time was more than 30 min, the operation was considered as op-eration of a certain degree of difficulty. Made a correlation analysis between LC operation difficulty and age,gender,location,volume of gall-bladder,angle of ductus cysticus, thickness of gallbladder wall, circumstances surrounding the cystic duct, length of ductus cysticus, and whether there were calculus in the cervical part of gallbladder. Results The difficulty level of LC operation is related to length of ductus cys-ticus and whether there were calculus in the cervical part of gallbladder,and there is no correlation with age,gender,location,volume of gall-bladder,angle of ductus cysticus,thickness of gallbladder wall,circumstances surrounding the cystic duct. Conclusion Routinely MRCP test in preoperative patients is of important significance to the prediction of LC operation difficulty.

Papers published by 70 public hospitals in Jilin Province from 2011 to 2015 were retrieved from CNKI, China Citations Database, and Wanfang Database. The scientific papers and their research hot spots were analyzed in aspects of the total number of published papers and different institutions-published papers, high output authors, cited papers, journals that published the papers, and foundation-supported papers in order to provide reference for subsequent research and policy-making.

ObjectiveTo analyze the etiologies and diagnosis of jaundice after liver transplantation during mid later stage and summarize the experience of clinical practice.Methods822 liver transplantation patients were collected from the Department of Internal Medicine, Organ Transplantation Institute in General Hospital of Chinese People's Armed Police Forces between June 2005 and Dec.2008.The clinical data of these cases were analyzed retrospectively.ResultsAmongst 822 patients,129 experienced jaundice after liver transplantation and the occurrence of jaundice ranged from 43 days to 39 months postoperation.Total bilirubin levels were from 27.4 to 503 μmol/L.The etiologies of jaundice and its percentage were as follow:59 cases of biliary complications (45.7％),36 of rejection (27.8％ ),11 cases of virus infection (8.5％),5 cases of drug-induced hepatic injury (3.9％),4 cases of tumor recurrence (3.1％),4 cases of Gilbert syndrome (3.1％),3.cases of dysfunction of papillary muscle (2.3％),2 cases of vascellum complication (1.6％),2 cases of radiation hepatitis (1.6％),1 case of hepatapostema (0.8％),2 cases of unknown reasons (1.6％),respectively.The jaundice of most patients (93％) got released while small part of patients (7％)failed to treatment,of whom 5 cases received liver re-transplantation and 4 cases died of disease progression.ConclusionThe etiologies of jaundice after liver transplantation during mid-later stage are diversiform and complex.And the etiological diagnosis is the premise to treat effectively.