Objective To study the relationship between serum macrophage migration inhibitory factor (MIF) levels and clinical features in the patients with colorectal cancer. Methods Enzyme-linked immunosorbent assays was used to detect the concentration of MIF in sera of 75 patients with colorectal cancer (35 case with primary colorectal cancer and 40 cases with lymphnode metastasis of colorectal cancer) and 40 healthy controls. The relationship between serum MIF levels and clinical features was analyzed. Results Serum MIF was found to be significantly elevated in the patients with colorectal cancer(mean value 31.2ng/ml) compared with healthy subjects (mean value 13.6ng/ml) (P <0. 001). The levels of MIF in colorectal cancer were significantly correlated with advanced clinical progression pathology stages (P <0. 05) and lymph node metastasis (P < 0. 05). Conclusions Increased expression level of MIF in serum may promote the pathogenesis of colorectal cancer and M1F is closely associated with the stages and lymph node metastasis of colorectal cancer.

MicroRNAs (miRNAs)are closely associated with the development,invasion,metastasis and prognosis of cholangiocarcinoma (CCA).The abnormal expressions of miRNA play important roles in regulating the genetic variation,cell cycle,invasion and metastasisability and apoptosis of CCA.MiRNAs are hopeful for being used as the biological markers of early diagnosis,prognosis and treatment target.

Objective To establish a animal model for diffusion mesangioproliferation complicating focal segmentally glomerulosclerosis.Methods The models were established in the seventieth day by repetitive injection of 4mg/kg and 3mg/kg adriamycin to the SD rats in the 7th and 30th day after removal of their right kidneys.Results Serious edema, profuse albuminuria, hypoalbuminemia, hyperlipemia and renal failure were presented. Simultaneously, diffuse medium- or serious-grade proliferation of mesangial matrix, slight-grade proliferation of mesangial cells, segmental sclerosis of 22% of glomeruli, and overexpression of PDGF-B and bFGF in glomeruli were showed by pathologic examination, computerized image analysis and immunohistochemistry staining.Conclusions The models established in the transition stage from mesangioproliferation to glomerulosclerosis are helpful to study mechanisms and take measures for prevention and cure of chronic glomerulonephritis.

Objective To evaluate the value of vascular intervention in the diagnosis and management of hemobilia. Methods With Seldinger's technique ,digital subtraction angiography of superior mesenteric artery and hepatic arteriography were performed on 3 patients with hemobilia, two of whom manifested hemobilia after the operation of liver trauma and one of whom did after the operation of command bile duct stones . Arteriography showed the bleeding vascular branch, the false aneurysm and the arteriovenous fistula. And then a small catheter was put into the bleeding focus. The bleeding branch arteries were selectively embolized with embolus of n-butyl cyanoacrylate (NBCA),PVA granule,spring wire loop and gelatin sponge. Results Two cases showed diffuse bleeding focus and another showed a local bleeding focus. Two cases had expression of false aneurysm and one showed expression of ateriovenous fistula. The artery branches of the bleeding focus were successfully embolizated and the hemobilia stopped immediately. Conclusions Vascular intervention is an effective method for the diagnosis and management of hemobilia.

Objective To characterize the electroanatomical mapping and to assess the value of radiofrequency ablation of atrial tachycardia (AT) in left atria. Methods Nine patients with AT in left atria were studied. Three-dimensional electroanatomical maps were constructed in left atrium using electroanatomical mapping system (Carto). The type of AT (focal or macroreentrant) was identified by the electroanatomical maps, and the ablation targets were at the earliest activation sites or the isthmus of circuit. Results There were ten ATs in 9 cases. The relatively early A waves were recorded in middle, distal or proximal parts of coronary sinus catheter. Nine focal ATs were diagnosed. The activation maps demonstrated that the earliest activation sites were at the ostium of pulmonary veins ( n =5), posterior area of left atrium ( n =2), ostia of left atria appendage ( n =1) or left atria appendage ( n =1) respectively. One macroreeentrant AT was diagnosed, whose circuit propagated through the isthmus, formed by the right superior pulmonary vein and fossa ovalis. Eight focal ATs were all ablated successfully at the earliest activation sites, and one AT from left atria appendage was ablated unsuccessfully. Line of ablation was performed at the isthmus of the macroreentrant AT. During a period of 6-30 months follow-up, one patient with focal AT recurred and underwent another ablation with successful result. No complication occurred. The procedure time and the fluoroscopic time were 90-140 min, 8-16 min respectively in successful cases. Conclusion These results suggest that electroanatomical mapping of AT in left atria may facilitate rapid and accurate identification of the type of AT and guide ablation safely or effectively with less fluoroscopic time and higher success rate, especially in unsuccessful cases with conventional technique.

Objective To investigate the efficacy of interferon alpha (IFNα) plus adefovir dipivoxil (ADV) and tebivudine (LdT) monotherapy for patients with HBeAg positive chronic hepatitis B (CHB) who have poor response to IFNα treatment.Methods A total of 86 HBeAg positive CHB patients admitted to the Sixth People' s Hospital of Shaoxing during February 2010 and April 2013 were enrolled in the study.All the patients received IFNα monotherapy for 24 weeks and had poor responses.The patients were voluntarily divided into three groups:IFNα monotherapy group (n =21),IFNα plus ADV group (n =30) and LdT monotherapy group (n =35).Chi-square test was used to compare ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates among three groups.Results After 48 weeks of treatment,the ALT normalization rate in IFNα monotherapy group was 52.6％ (10/19),which was lower than those in IFNα plus ADV group (86.7％,26/30) and LdT monotherapy group (84.8％,28/33) (x2 =6.913 and 6.361,P ＜ 0.05).The rate of HBV DNA load ＜500 copies/mL in IFNα monotherapy group was 26.3％ (5/19),which was lower than those in IFNα plus ADV group (60.0％,18/30) and LdT monotherapy group (54.5％,18/33) (x2 =11.33 and 3.895,P ＜0.05).No HBeAg negative conversion or seroconversion was observed in IFNα monotherapy group,but it was observed in 6 (20.0％,6/30) patients in IFNαt plus ADV group and 7 (21.2％,7/33) patients in LdT monotherapy group (x2 =4.330 and 4.657,P ＜ 0.05).No HBsAg seroconversion was observed in three groups.There were no statistical significant differences in ALT normalization rates,rate of HBV DNA load ＜ 500 copies/mL,HBeAg seroconversion and HBsAg seroconversion rates between IFNαt plus ADV group and LdT monotherapy (x2 =0.042,0019 and 0.064,P ＞ 0.05).Conclusion For patients with HBeAg positive CHB who had poor response to IFNα treatment,IFNα plus ADV therapy and LdT monotherapy have the same efficacy in improvement of both liver function and virological response.

OBJECTIVE To survey the varieties of microorganism on nurse hands and probe into its controlling measure in general hospital.METHODS We sampled microorganism of nurse hands during intravenous fluids infusion in the Respiratory Department,the Cardiovascular Department,the Department of Digestion,Gynecology and Obstetrics Department,the Department of Thoracic Surgery and the Department of Organ Transplantation in our hospital.All samples carried out co-cultures of fungi and bacteria.RESULTS The varieties of microorganism included not only opportunistic pathogens such as Acinetobacter,Corynebacterium,Pantoea agglomerans(Enterobacter agglomerans) former,and Escherichia coli,but also strong pathogenic microorganisms such as Staphylococcus aureus,and it is so common that finding meticillin-resistant coagulase-negative staphylococci.CONCLUSIONS Nursing staff's hands contamination is serious in the process of manipulating operation in general hospital,emphasis should be placed on prophylaxis and control for nosocomial infection.

Objective To assess the operation time of laparoscopic operation for acute cholecystitis by Meta analysis.Methods The methods of computer literature retrieval and manual search were used to collect the research on the timing of laparoscopic surgery for acute cholecystitis in recent years,and the random effects model was used to conduct the Meta analyze.The quality of the literature was evaluated,and then the RevMan5.0.21 software was used to calculate the RR value and 95%CI of the operation time,bleeding volume and postoperative complications.Results A total of 13 articles were included in the Meta analysis,9 in Chinese,4 in English,2535 for a total number of cases,1401 in the early operation group,1134 in the delayed operation group,and 10 papers for low risk of bias,3 papers for bias risk.Meta analysis of the random effects model showed that the operation time of the early operation group was significantly shorter than that of the delayed operation group(P=0.00,RR=-20.25,95%CI=-24.97~15.33),and the intraoperative blood loss was also significantly reduced(P=0.00,RR=-12.58,95%CI=-29.36~5.78),then the postoperative complications were also significantly reduced(P=0.00,RR=0.63,95%CI=0.47~0.84).Conclusion The use of laparoscopic operation in the treatment of acute cholecystitis in patients with 72h could not only shorten the operation time and reduce the amount of bleeding,but also had a significant effect on reducing postoperative complications.

OBJECTIVE:To explore the effects of dual-phase insulin aspart with different dosing regimens on the related indica-tors of type 2 diabetic (T2DM) patients with poor glycemic control. METHODS:70 T2DM patients with poor glycemic control were randomly divided into group A and group B. All patients were given metformin and stopped other antidiabetic drugs;based on it,group A was additionally given Dual-phase insulin aspart injection,0.5 U/(kg·d),in the morning and evening before a meal by subcutaneous injection;group B was given Dual-phase insulin aspart injection,0.5 U/(kg·d),once before lunch time for 6-10 U and other twice in the morning and evening before a meal by subcutaneous injection. Both groups were treated for 12 weeks. Glu-cose control rate,glucose control time,and glucose indicators,daily fluctuations of glucose before and after treatment and incidenc-es of hypoglycemia and adverse reactions in 2 groups were observed. RESULTS:Glucose control rate in group B was significantly higher than group A,glucose control time was significantly shorter than group A,incidence of hypoglycemia was significantly low-er than group A(P<0.05). After treatment,glucose indicators and daily fluctuations of glucose in 2 groups were significantly lower than before,and group B was lower than group A(P<0.05). There were no obvious adverse reactions during treatment. CONCLU-SIONS:Conpared with 2 times a day,Dual-phase insulin aspart with 3 times a day for administration can effectively improve the glucose control rate and glucose levels in the treatment of T2DM patients with poor glycemic control,with good safety.

Objective To screen specific mutations on extracellular regions of membrane proteins ( extracellular membrane protein mutations ) in tumor cells and provide the reference information for target searching in cancer precision medicine .Methods Somatic mutations on extracellular regions of membrane proteins of 7042 tumor samples were collected to screen all specific extracellular membrane protein mutations, and the overall distribution of these mutations were obtained by statistical analysis.Genes, gene site and cancer types occured high frequency of extracellular membrane protein mutations were identified.Results 97193 specific extracellular membrane protein mutations were obtained from 4938362 somatic mutations in 7042 tumor samples (30 cancer types), the statistical analysis showed that 4347 genes and 65532 sites were involved in these specific mutations.The study further analyzed five genes (MUC16、LRP1B、CSMD3、RYR2、USH2A), one site (17:37868208) and six cancer types (including colorectal cancer, melanoma, uterine cancer, brain lower grade glioma, lung adenocarcinoma and stomach adenocarcinoma) which occured high frequency of extracellular membrane protein mutations.Conclusion An information library of specific mutations on extracellular regions of membrane proteins was established and the distribution of these specific mutations was obtained which can provide reference information for target detection in targeted cancer therapy and immunological therapy.