Objective To analyze the clinical effects, as well as its advantages and disadvantages, of laparoscopic surgery for appendicitis in obese patients. Methods Clinical data of 80 obese patients receiving appendectomy, including 38 cases of open appendectomy and 42 cases of laparoscopic appendectomy, were analyzed retrospectively.The operative time, blood loss, analgesic and antibiotic use, postoperative fever, postoperative complications, length of hospital stay, and hospitalization cost were compared between the two operative methods. Results Conversions to open surgery were required in 2 patients in the laparoscopic group. There was no significant difference in operative time between the 2 groups (P >0.05).Compared with the open group, the laparoscopic group had less blood loss [(14.98 ±12.77) ml vs.(31.58 ±19.00) ml, t=-4.550, P=0.000], shorter time of postoperative antibiotic use [(2.7 ±1.0) d vs.(4.1 ±1.2) d, t=-5.470, P=0.000], less postoperative analgesics needed [5.0%(2/40) vs.26.3%(10/38),χ2 =6.802, P=0.009], less drainage [2.5% (1/40) vs.18.4% (7/38), χ2 =5.367, P=0.021], less postoperative fever [5.0%(2/40) vs.23.7%(9/38),χ2 =5.616, P=0.018], less postoperative wound healing [5.0%(2/40) vs.21.1%(8/38),χ2 =4.493, P=0.034], and shorter hospital stay [(5.9 ±3.2) d vs.(8.7 ±4.1) d, t=-3.345, P=0.001], but the higher cost of hospitalization [(7800 ±396) yuan vs.(4914 ±434) yuan, t=30.716, P=0.000]. Conclusion For obese patients with appendicitis, laparoscopic appendectomy has less surgical trauma, faster recovery, less postoperative pain, fewer complications,and shorter hospital stay, being a preferred method of treatment.

In addition to the common complications involving hepatic artery, hepatic vein and biliary tract, which have already been mentioned and discussed in the preceding parts of this article, there are some uncommon complications which have been reported in the medical literature as the case report or as the case- series analysis. This paper sums up these uncommon complications. Part of these uncommon complications can be treated with interventional therapy. It is very important for interventional radiologists to make a further understanding of the different etiology of these uncommon complications occurred after liver transplantation so as to get a comprehensive knowledge about the complications after liver transplantation.

BACKGROUND: There are many studies on the effect of different experimental parameters on the tetragonal phase of zirconia, but it is unclear whether pH values have effects on the tetragonal phase in hydrothermal reactionOBJECTIVE: To prepare two zirconia systems via hydrothermal method and to regulate the tetragonal phase purity and control the grain size of zirconia (ZrO2) crystal by pH values.METHODS: Analytical reagents Zr(NO3)4?5H2O and Y(NO3)3?6H2O were adopted as reactors, and nano-sized neat ZrO2 and yttria-stabilized tetragonal ZrO2 polycrystal (Y-TZP) powders were synthesized using the hydrothermal method. X-ray diffraction was adopted to characterize the influence of pH values and pH regulators (NaOH solution and ammonium hydroxide/NaOH solution) on phase purity and grain size of tetragonal zirconia.RESULTS AND CONCLUSION: Pure zirconia samples with a grain size lower than 20 nm were obtained through the hydrothermal method, and samples with higher tetragonal phase content compared to monoclinic phase could be derived when the pH value was higher than 10. The optimal pH values for neat zirconia and Y-TZP were 13 and 12,respectively. Furthermore, the ammonium hydroxide/NaOH solution was more favorable to enhance the content of tetragonal zircona. Therefore, the control of pH values and rational choice of pH regulators can improve the tetragonal phase purity and grain size of zirconia.

BACKGROUND: There are some reports about the relationship between atherosclerotic cerebral infarction and apolipoprotein E and B, but the results are still controversial. The relationship between apolipoprotein E and B and young adult atherosclerotic cerebral infarction has not been reported yet in China.OBJECTIVE: To investigate the relationship between the polymorphism of apolipoprotein E and B gene and young adults atherosclerotic cerebral infarction (ACI).DESIGN: A controlled case analysis of young adult atherosclerotic cerebral infarction patients.SETTING: Department of Neurology, Shengjing Hospital of Chinese Medical University.PARTICIPANTS: This study was conducted in the Department of Neurology, Shengjing Hospital of Chinese Medical University from January of 1998 to December of 2000. Thirty-six young adult patients with atherosclerotic cerebral infarction, including 30 males and 6 females, with the meaage of (41.6±6.54) years, and 100 healthy young adults, including 66 males and 34 females, with the mea age of (36.16±6.12) years were included in this study.METHODS: 8 Ml venous blood was collected after fasting for 12 hours to assay serum lipid and apolipoprotein. The gene polymorphism of apolipoprotein E and B were detected with PCR method. Enzymic method was used to detect total cholesterol, total triglycerides and high density lipoprotein-cholesterol (HDL-C). Apolipoprotein AI.B was measured with immunoturbidimetry method and lipoprotein (a) with ELISA method.Lipids, lipoprotein and apolipoprotein of six control blood samples couldn't be measured because of hematolysis.MAIN OUTCOME MEASURES: ① The distribution characteristics of genotypic frequency of apolipoprtein E and B in the two groups. ② The relationship between gene polymorphism of aoplipoprotein E and B and the level of blood lipids, lipoprotein and apolipoprotein. ③ The correlation intensity between genotypes of apolipoprotein E and B and onset of young adult atherosclerotic infarction.RESULTS: ① In ACI group, ε3/4 counted for 36.1% and ε2/4 for 27.7%, but was 12% and 7% in control group respectively. The gene frequency of ε4 was 0.320. All these values were higher than that in control group 0.95 (P ＜ 0.05). ② The levels of TG, TC, and LP (a) in ACI group were higher than that in control group. The level of HDL-C was much lower than the control group's (P ＜ 0.05-0.01). ③ ε4 allele caused the increase of the content of TG, TC, and LP (a) so as to induce the relative risk rates of decrease of HDL-C which were 8.23, 4.85, 29.9,4.39 (P ＜ 0.01-0.001) respectively. ④ AI content of the gene frequency of ApoB XbaⅠ X+X- was (1.01±0.30) g/L in ACI group, which was lower than (1.33±0.15) g/L in X-X- subgroup (t=2.55, P ＜ 0.05). The level of ApoA I in X+X group (244.3 mg/L) was remarkably different from that (183.0 mg/L)in control group (t=4.50, P ＜ 0.01). ⑤ Three cases had both ε3 and X+X-in ACI group, 10 had both ε3 and X-X-, 2 had both ε4 and X+X-, and 19 had both ε4 and X-X-. The risk of ACI was 2.85 with the linkage of allele ε4 and allele X-X- in ACI patients (x2=1.52, P ＞ 0.05).CONCLUSION: Allele ε4 is a genetic facilitated factor of young adults ACI. Xba Ⅰ X+X- is another probable genetic symbol. The correlation between atherosclerotic cerebral infarction of young patients during the combination of apolipoprotein E and B should be researched further.

Adult ; Aged ; Aged, 80 and over ; Breast Neoplasms ; metabolism ; pathology ; Carcinoma, Ductal, Breast ; metabolism ; pathology ; Female ; Homeodomain Proteins ; biosynthesis ; genetics ; Humans ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; RNA, Messenger ; biosynthesis ; genetics ; Receptors, Estrogen ; metabolism ; Transcription Factors ; biosynthesis ; genetics

BACKGROUND:There are myoblasts in human embryonic skeletal muscle. It remains poorly understand whether myoblasts in vitro can form myotube and what are the corresponding markers for identifying myoblasts and myotubes. OBJECTIVE:To investigate whether in vitro cultured myoblasts from human embryonic skeletal muscle can form myotube and whether they can express neural markers. METHODS:Human embryonic muscle-derived myoblasts were cultured in serum-containing medium. When the primary culture was established, cultured cel s were identified with immunocytochemistry for neural markers, such asβ-tubulin markers (desmin, myogenin, smooth muscle actin and myosin). RESULTS AND CONCLUSION:A population of myoblasts could migrate from human embryonic muscle tissues. They could express the markers for skeletal muscle such as desmin and myogenin, and they could express neuron specific enolase, nestin and neurofilament 200. They could form myotubes in vitro, and myotubes expressedβⅢ-tubulin, neurofilament 200 and glial fibril ary acidic protein. The data support the hypothesis that myoblasts from human embryonic muscle express neural markers and muscle markers, and cultured myoblasts and myotubes expressed neuron specific enolase,β-tubulin Ⅲ, nestin, neurofilament 200 and glial fibrillary acidic protein. This indicates that these markers could not be used for cel identification of trans-differentiation study from muscle origin to nervous system.

Objective To compare the efficacy of valsartan,benazepril and felodipine on reversal of left ventricular hypertrophy(LVH)in patients with hypertension and the relevant "aldosterone escape phenomena".Methods One hundred eleven patients with hypertension-related LVH were randomly to receive valsartan(80-160 mg/d,n=36),benazepril(10-20 mg/d,n=39)and felodipine(5 mg/d,n=36).Plasma angiotensin Ⅱ(Ang Ⅱ)and aldosterone(Ald)were determined before and 10-14 weeks 20-26 weeks after treatment.Echocardiographic examinations and blood routine,urine routine,blood glucose,blood lipid,liver function and renal function were conducted in all subjects before and after treatment.Results Blood pressure was significantly decreased in all three groups(P0.05).Valsartan increased plasma Ang Ⅱ at 10-14 weeks and furthermore at 20-26 weeks;benazepril decreased plasma Ang Ⅱ initiatively with trend of rebound at 20-26 weeks;however,plasma Ang Ⅱ was kept constantly in felodipine group.Valsartan decreased Ald and sustained during the all treatment period.On contrary,benazepril initiatively decreased Ald which was rebound to baseline level at 20-26 weeks.No change in Ald by felodipine was found during the treatment.After treatment plasma Ald level was significantly related to the reduction of LVH in both valsartan and benazepril groups.36% patients in benazepril group was found to have "aldosterone escape".Conclusion The antihypertensive effect was similar between valsartan,benazepril and felodipine.Although three medications all reversed LVH,but valsartan,benazepril was more effective than felodipine.There was no evidence of aldosterone escape in the long-term treatment with valsartan.Valsartan might have more advantages in reversal of LVH than benazepril.Felodipine had no effect on the plasma level of aldosterone.

Objective To observe the level of autophagy induced by TRAIL in TT cell line and identify the role of autophagy in TRAIL-inducing apoptosis of TT cell line.Methods The growth inhibition of TT cells was measured by MTT assay.MDC staining was used to identify the happening of autophagy.Annexin V/PI double staining was used to analyze the apoptosis rate of TT cells by flowcytometry.The protein expression of caspase-8 and Beclin1 was detected by Western blot.Results ① The growth inhibition ratio of TT cells induced by TRAIL at the concentration of 250,500,1000 and 2000 ng/ml was (3.02 ± 1.82)％,(4.87 ± 1.45)％,(7.51 ± 1.57) ％,(12.76 ± 3.23) ％ respectively,which suggested significant resistance of TT cells to TRAIL.② MDC-labeled green light vesicles was significantly increased after the treatment of TRAIL for 48 h.③ The apoptosis rate of TT cells induced by TRAIL at the concentration of 500 ng/ml and 1000 ng/ml after the pretreat ment of 3-MA for 4 h was(17.83 ± 1.54) ％ and(27.81 ± 1.79) ％ respectively,which was significantly higher than the apoptosis rate induced by TRAIL(3.70 ± 0.34) ％,(6.55 ± 0.59) ％ alone and that induced by 3-MA(7.71 ± 0.64) ％ (t =3.282,P ＜ 0.05 ; t =7.830,P ＜ 0.01).④ The combination treatment of TRAIL and 3-MA increased the cleavage of caspase-8 and down-regulated the expression of Beclin 1.Conclusion Autophagy induced by TRAIL may contributes to the resistance of TT cells to TRAIL,which can be reversed by the inhibition of autophagy.

Objective To compare the prognosis and life quality of patients with early-stage breast cancer(stage I or II)undergoing breast-conserving surgery or modified radical mastectomy.Methods 180 cases with early-stage breast cancer were divided into 2 groups:breast-conserving surgery group(BCS)and modified radical mastcctomy group(MRM),with 90 cases in each group.The 2 groups were all given radiotherapy,chemotherapy and endocrine therapy according to indications.The prognosis and life quality in the 2 groups were compared.Results The 5-year-postoperative follow-up showed there was no significant difference in duration of disease-free survival(DFS)of the 2 groups.However,life quality of BCS patients was significantly better than that of MRM patients in terms of general health,physical function,pain,vitality,social functioning,emotion and mental health.Conclusion Breast-conserving surgery is highly recommended for patients with early-stage breast cancer.

Objective Using zebrafish to analyze the effect of water temperature on the recovery of spinal cord in-jury. To detect the cell proliferation and changes of gene expression at the injury site during the process of recovery. Meth-ods Surgical operation was performed to induce spinal cord injury ( SCI) on adult fish. Water at a series of temperature was applied to culture the fish. Swimming ability was adopted to observe the recovery of spinal cord injury following surger?y. Vibration sections and immunohistochemistry were performed to observe the cell number post SCI at different stages. The changes of gdnf and nos gene expression were determined by real?time PCR. Results The water temperature changes from 28℃ to 32℃ did not affect the swimming ability of non?injured and sham?injured fish ( P>0. 05 ) . The swimming ability recovered mostly in 8 weeks post spinal cord injury. At 32℃, the swimming ability recovered faster than at 28℃ or at 30℃(P<0. 05). The cell proliferation increased obviously following spinal cord injury (P<0. 05). The proliferation of cells surrounding the spinal cord in jury was more extensive in SCI fishes incubated in 32℃ water than in 28℃ or 30℃ water ( P<0. 05). Real?time PCR assay showed that gdnf was up?regulated in all groups post SCI at 24 h, and 7 and 14 days (P<0. 05). The nos expression was up?regulated in all groups following SCI in 24 h (P<0. 05) and 7 days. There was no sig?nificant difference between the SCI group and sham?injury group (P<0. 05), while after 14 days, the expression of nos was reduced in the SCI group compared with the sham?injury group (P<0. 05). Conclusions A slight increase of incu?bating water temperature can accelerate the recovery of spinal cord injury in zebrafish.