Objective To observe the effect of cyanin on the expression of L-glutamate/ L-aspartate transporter (GLAST) in high glucose cultured retina Müller cells. Methods The retinal tissue of SpragueDawley (SD) rats was collected at postnatal 10 day, and Müller cells were isolated and cultured according to literature. The Müller ceils (2nd-4th generations) were treated with five different medium as normal group (group A), high glucose control group (group B), high glucose+30 μmol/L cyanin group (group C), high glucose+60 μmol/L cyanin group (group D) and high glucose+100 μmol/L cyanin group (group E). Cell relative survival rates (A value) were measured by MTT assay at 570 nm. The GLAST protein expression in M011er cells was observed by Western blot. Results MTT assay showed that the A value of the five group were 0. 450 8±0. 020 4, 0. 270 1±0. 031 4, 0. 332 0±0. 023 2, 0. 428 3±0. 017 2, 0. 361 9±0. 027 0,the cell relative survival rate were 100. 0%, 59. 9%, 73.6%, 95%, 80.3% respectively. The A value of group C, D, E were significantly higher than that of group B (F=32.25, P<0.05), the A value of group D were significantly higher than that of group C and E (F=21.07, P<0. 05). Western blot showed that the GLAST protein expression of group B was lower than that of group A (t=5.25, P<0. 05) ; there was no obvious changes of GLAST protein expression in group A, C, D and E (F= 2. 979, P>0.05).Conclusion Cyanin can rescue high glucose-induced GLAST reduction.

This study compared the efficacy of non-penetrating trabecular surgery and trabeculectomy for the treatment of open angle glaucoma. We searched the Cochrane Library, PUBMED (1966 to 2009), Embase (1980 to 2009) and CMB-disk (1979 to 2009) for the randomized clinical trials (RCT) concerning the two treatment strategies. The reports, including the papers listed in bibliographies, were evaluated against a set of quality criteria and the RCTs that satisfied the criteria were selected and subjected to Meta analysis by employing the Cochrane Collaboration's RevMan 4.5 software package. A total of nine RCTs were included in the study. The analyses of the reports showed that, 12 months after surgery, there was significant difference in the reduction of interocular pressure (IOP) between non-penetrating trabecular surgery and trabeculectomy (Z=6.05 P<0.00001). There also existed statistically significant difference in the reduction of IOP at the censored time between the two procedures (Z=4.92, P<0.00001). Difference in the success rate was also found between the two surgeries (Z=3.82, P=0.0001). It is concluded that, compared with the non-penetrating trabeculectomy, the traditional trabeculectomy could reduce IOP more and had higher success rate while the non-penetrating trabecular surgery is associated with lower postoperative complications.

Objective To explore the feasibility and efficiency of laparoscopic surgery for the treatment of acute biliary pancreatitis (ABP) at early stage. Methods From January 2003 to June 2006, 18 patients with ABP received laparoscopic surgeries, including laparoscopic cholecystectomy (LC) in 3, LC combined with laparoscopic common bile duct exploration (LCBDE) in 9, LC combined with opening of the pancreatic capsule for drainage in 5, and LC combined with LCBDE and opening of the pancreatic capsule for drainage in 1. Results In all the patients, the laparoscopic operations were completed successfully without conversion to open surgery. The operation time was 100-150 min with a mean of (115.3?15.2) min. The stones in the bile duct were removed completely by LCBDE in 10 patients. No subcutaneous emphysema, hemorrhage, abdominal abscess or stenosis of the bile duct occurred in this series. The 18 patients were followed up for 4-40 months (mean, 28.5 months), during which 2 patients developed pancreatic pseudocyst. One of the patients was cured by internal drainage. In the other patient, the pseudocyst was absorbed spontaneously. No recurrence of pancreatitis or common bile duct stones was found. Conclusions Laparoscopic surgery is minimally invasive and effective for the treatment of ABP at early stage.

Roux-en-Y gastric bypass (RYGB) is the preferred surgical procedure for obesity and type 2 diabetes mellitus (T2DM).Currently,it is controversial how long the roux limb and biliopancreatic limb should be selected during RYGB.Based on the survey of American Society for Bariatric Surgery (ASBS) (2008),the Roux limb ranged from 10 cm to 250 cm and the biliopancreatic limb ranged from 35 cm to 250 cm.The length of small bowel exclusion may affect the postoperative results.Shorter jejunum exclusion may affect the curative effect,while overlong jejunum exclusion may result in nutritional disorders,diarrhea and other complications.Under the condition of fixed jejunal exclusion,it is worth exploring the relationship between the postoperative outcome and different parameters of small bowel exclusion.Lacking of consensus and criteria in this field,authors focused on the related references published recent years to summarize the valuable information.

BACKGROUND: Disuse osteoporosis is bone mass loss caused by muscular inactivity and reduced weight bearing. OBJECTIVE: To observe bone structure and mineral matter content as well as bone biomechanicai performance change at different time points during the development of disuse osteoporosis. DESIGN, TIME AND SETTING: The present randomized, controlled, and self-controlled animal experimental was performed in the General Hospital of Tianjin Medical University between September and November 2003. MATERIALS: A total of 55 male Japanese rabbits, aged 8 months, weighing 2.5-3.0 kg were enrolled for this study. METHODS: The right hind limbs of 50 randomly selected rabbits were immobilized by cast (experimental sides). The corresponding left hind limbs were untouched (control sides). The remaining 5 rabbits were raised for 3 months, and their bilateral hind limbs were used for controls. Ten rabbits were sacrificed by intravenous injection of air at each time point (2, 4, 6, 8, and 12 weeks after immobilization). MAIN OUTCOME MEASURES: Mechanical test was performed on bilateral tibiofibula for determination of calcium content. Hematoxylin-eosin staining and Masson staining of bilateral metatarsal bones were performed for histological observation. RESULTS: There was significant difference in indices of tibiofibula on the experimental sides, including maximum loading, elastic modulus, and calcium content among different time points, while significant difference also existed between the experimental side and the blank controls (P＜0.05). There was no significant difference in above-mentioned indices between the control side and blank controls as well as between control sides (P＞0.05). The experimental side limbs exhibited thinned cortical bone, increased pores, sparse and fine trabecular bone with several fragmentations, expanded medullary cavity, and increased osteoblasts. Masson staining results demonstrated that with disuse time going, collagen was decreasingly formed. The control side and blank control limbs showed thickened metatarsal bone and cortical bone, a few pores, and compactly arranged trabecular bone with normal structure. CONCLUSION: During the development of disuse osteoporosis, calcium content and the entire biomechanical performance are gradually and slowly decreased to accommodate the stress environment and functional status.

Objective To refrain the medical costs from out-of-control increase, and identify a per-disease payment mode suitable for New-CMS.Methods Case studies were conducted on all the data of five diseases in the course of three years, in a field study of the pilot counties for NRCMS in Anhui Province.Results This system of per-disease "pay by segmentation and quota" is composed of five parts: choice of diseases, measurement of payment criteria, method of settlement, method of compensation, and methods of supervision.Conclusion This system is an effective way to keep the medical costs in the NRCMS under control, given an effective play of the five supportive measures including the clinical pathways for individual diseases.

Objective To prepare a novel extravascular human epithelial growth factor receptor 2 (HER2)-targeted polylactic-co-glycolic acid (PLGA)-COOH ultrasound contrast agent with liquid perfluorocarbons(PFH-PLGA-tra),and to observe it's general properties and it's effects on ultrasound imaging in vitro.Methods Polymeric nanocapsules of liquid perfluorocarbons were prepared by the single emulsion technique and conjugated with trastuzumab monoclonal antibody by EDC/NHS.The general characteristics were observed.The conjugation was demonstrated by immunofluorescence and the targeting performance of the agent was checked in human MCF-7 cells line in vitro.The encapsulation of liquid fluorocarbons was detected by heating in vitro.The effects on ultrasound imaging were observed in vitro.Results The mean diameter of agents was (261 ± 28)nm.The targeted nanocapsules were positive in immunofluorescence.In the targeted study,it was shown that a number of targeted nanocapsules conjugated with MCF-7 cells in vitro.Droplet-to-bubble transition experiment in vitro showed that there were no nano/microbubbles formed by heating in control groups at 80℃,while there were a lot of nano/microbubbles appeared in nanocapsules formulations at 80 ℃.The agents presented a good ultrasound imaging in vitro.Conclusions The HER2-targeted polymeric nanocapsules of liquid perfluorocarbons are successfully prepared,which may become a novel extravascular targeted ultrasound contrast agents.

Objective To discuss the treatment of renal or adrenal tumor with cancer thrombus in the inferior vena cava. Methods From Jan 1984 to Apr 2008,29 cases of renal or adrenal malignancy with thrombosis involving the inferior vena cava underwent treatment.The diagnoses were confirmed by Doppler uhrasonography,CT and MRI.In the 29 surgical patiens the tumor thrombus was level I in 7,level Ⅱ in 10,level Ⅲ in 8 and levelⅣin 4.According to TNM classification,23 cases were classified to T2N.M.,1 case was T2Nl Mo,1 case was TzNlMl,1 case was T3NoMo,2 case were T3NlMl and 1 case was T3N2Mo.The mean tumor size was 8.7(4.O-16.O)cm in diameter.The mean tumor thrombosis length was 3.2(2.5-4.0)cm in level I,5.3(4.5-6.0)cm in level Ⅱ,8.2(6.5-9.O)cm in levelⅢand 15.1(12.0-18.5)cm in level IV. Results The operation was performed succesgfullv in 29 patients Patholocieal examination showed that 18 cases of clear cellcarcinoma,3 cases sarcomatoid carcinoma,2 cases renal papillary adenocarcinoma,1 case renal cell carcinoma (undifferentiated),1 case granule carcinoma,3 cases adrenocortical carcinoma and 1 case metastatic malignant melanoma of adrenal gland.Of 29 patients,3 were out of contact.Twenty-six patients were followed up for 35(0-62)months after treatment,3-and 5-year survival rates were 15/26 and 11/26.Three-year survival rates for stage T2 and T3 were 14/22 and 1/4.Five-year survival rates for stage T2 and T3 were 10/22 and 1/4.Three-year survival rates for level I、Ⅱ、Ⅲ andⅣ were 4/6,5/8,5/8 and 1/4.Five-year survival rates for level I,Ⅱ、Ⅲ andⅣ were 3/6,4/8,3/8 and 1/4.Three-year survival rates for a tumor thrombus in the below or above diaphragm were 14/22 versus 1/4,5-year survival rates were 10/22 versus 1/4.Three-year and 5-year survival rates for the patients without distant metastases and lymph node involvement were 12/18 and 9/18.Three-year and 5-year surviral rates for the patients with distant metastases and lymph node involvement were 3/8 and 2/8.The 3 surgical patients with metastatic disease died at 6,10,22 months. Conclusions Surgical treatment could be the preferred approach for the patients of renal or adrenal tumor with cancer thrombus in the inferior vena cava without distant metastases and lymph node involvement.It could improve the quality of life and may prolong survival.

Objective To explore the effects of pelvic nerves denervation (PND) on the expression of transit potential receptor vanilloid 1 (TRPV1) in distal colonic mucosa of rats.Methods The experimental study was conducted.One hundred and eight adult male rats were randomly divided into the control group,sham operation group and PND group:(1) 36 rats in the control group remained untreated and were fed regularly;(2) 36 in the sham operation group received open exclusion for 15 minutes,and then sew up the incision;(3) 36 in the PND group received laparotomy with pelvic nerve transection before abdominal closure.The expression of TRPV1 protein in distal colonic mucosa was respectively detected by Western blot at postoperative day 1,3 and 7.Reverse transcription quantitative real-time polymerase chain reaction (RT-qPCR) was used to detect the mRNA level of TRPV1 in the distal colonic mucosa.Measurement data with normal distribution were represented as (x)±s.Repeated measurement data were analyzed by repeated measures ANOVA.Comparisons at the same time intervals among the 3 groups were analyzed using one-way ANOVA.Pairwise comparison was done by the independent samples t test.Results (1) The results of immunohistochemical staining:the average density of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 was respectively 0.180±0.016,0.179±0.015 and 0.183±0.026 in the control group,with no statistically significant difference (F=0.088,P＞0.05).The average density of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 was respectively 0.132±0.017,0.160±0.023 and 0.173±0.020 in the sham operation group,with a statistically significant difference (F=8.699,P＜0.05).The average density of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 was respectively 0.057± 0.009,0.122±0.016 and 0.180± 0.016 in the PND group,with a statistically significant difference (F =113.315,P ＜ 0.05).There were statistically significant differences in the average density of TRPV1 at postoperative day 1 and 3 among the 3 groups (F =108.960,15.218,P＜ 0.05),while significant differences were respectively detected between the control group and the sham operation group or the PND group at postoperative day 1 (t =5.025,15.979,P＜0.05),and a significant difference was also detected between the sham operation group and the PND group (t =9.590,P＜0.05).There was no statistically significant difference in the average density of TRPV1 between the control group and the sham operation group at postoperative day 3 (t =1.670,P＞0.05),while significant differences were respectively detected between the control group and the PND group and between the sham operation group and the PND group (t=6.543,3.361,P＜0.05).There was no statistically significant difference in the average density of TRPV1 at postoperative day 7 among the 3 groups (F=0.518,P＞0.05).(2) The results of Western blot:the relative expressions of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 were respectively 1.02±0.13,1.00±0.15 and 1.00±0.10 in the control group,with no statistically significant difference (F=0.084,P＞0.05).The relative expressions of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 were respectively 0.51±0.13,0.93±0.14 and 1.01±0.16 in the sham operation group,with a statistically significant difference (F =20.930,P＜0.05).The relative expressions of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 were respectively 0.30±0.10,0.70±0.10 and 1.07±0.16 in the PND group,with a statistically significant difference (F=61.441,P＜0.05).There were statistically significant differences in the relative expressions of TRPV1 at postoperative day 1 and 3 among the 3 group (F=58.014,8.841,P＜0.05),while significant differences were respectively detected between the control group and the sham operation group or the PND group at postoperative day 1 (t =6.677,11.145,P＜0.05),and significant difference was also detected between the sham operation group and the PND group (t =3.287,P＜ 0.05).There was no statistically significant difference in the relative expressions of TRPV1 between the control group and the sham operation group at postoperative day 3 (t =0.798,P＞0.05),while significant differences were respectively detected between the control group and the PND group and between the sham operation group and the PND group (t=4.127,3.398,P＜0.05).There was no statistically significant difference in the relative expressions of TRPV1 at postoperative day 7 among the 3 group (F=0.428,P＞0.05).(3) The results of RTqPCR:the mRNA levels of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 were respectively 1.00±0.15,1.10±0.21 and 1.09±0.18 in the control group,with no statistically significant difference (F=0.489,P＞0.05).The mRNA levels of TRPV1 in distal colonic mueosa at postoperative day 1,3 and 7 were respectively 0.58±0.12,0.99±0.19 and 1.13±0.23 in the shan operation group,with a statistically significant difference (F=13.964,P＜0.05).The mRNA levels of TRPV1 in distal colonic mucosa at postoperative day 1,3 and 7 were respectively 0.31±0.10,0.67±0.12 and 1.09±0.19 in the PND group,with a statistically significant difference (F=44.642,P＜0.05).There were statistically significant differences in the mRNA levels of TRPV1 at postoperative day 1 and 3 among the 3 group (F=44.653,9.700,P＜0.05),while significant differences were respectively detected between the control group and the sham operation group or the PND group at postoperative day 1 (t=5.233,9.264,P＜0.05),and significant difference was also detected between the sham operation group and the PND group (t=4.127,P＜0.05).There was no significant difference in the mRNA levels of TRPV1 between the control group and the sham operation group at postoperative day 3 (t =0.995,P＞0.05),while significant differences were respectively detected between the control group and the PND group and between the sham operation group and the PND group (t =4.411,3.505,P＜0.05).There was no statistically significant difference in the mRNA levels of TRPV1 at postoperative day 7 among the 3 group (F=0.099,P＞0.05).Conclusion The expression of TRPV 1 in distal colonic mucosa of rats is significantly down-regulated after pelvic nerves denervation,however,it is gradually recovered with passage of time,which is consistent with the trend of gradual recovery of colonic transit function after pelvic nerve injury.

Objective To prepare the folate receptor-targeted and paclitaxel-loaded ultrasound contrast agent (folate-poly(lactide-co-glycolide)-paclitaxel,FOL-PLGA-PTX) and to investigate its targeting and imaging performance in vitro.Methods Paclitaxel-loaded PLGA-COOH micmcapsules with a core of liquid perfluorocarbon (PLGA-PTX) were prepared using single emulsion technique and then conjugated with folate by carbodiimide method.The size,surface potential,entrapment efficiency and drug loading efficiency were measured by Malvern laser detector and HPLC.The connectivity condition of PLGA-PTX with folate and the binding rate of fluorescent antibody were detected by immunofluorescence staining and flow cytometry.The targeting performance of FOL-PLGA-PTX was checked after co-incubated with human SKOV3cell lines in vitro and compared with that of non-targeted group and free folic acid intervention group.In vitro experiments were performed to explore the effects of FOL-PLGA-PTX on the enhancement of ultrasound imaging after irradiation by high intensity focused ultrasound (HIFU).Two-sample t test and one-way analysis of variance were used to analyze data.Results The average diameter of FOL-PLGA-PTX was (244.43 ±13.32) nm,with the drug entrapment efficiency of (86.23 ± 1.23)％ and loading amount of (8.62±0.12)％.The binding rate of folate was as high as (98.49± 1.28)％.The connection rate of FOL-PLGAPTX on SKOV3 cells was higher than that of non-targeted group ((84.32±4.25) ％ vs (16.45±2.89) ％; F289.45,t=10.654,P＜0.01) and the free folic acid intervention group ((36.33±3.23)％; t=8.923,P＜0.01).During in vitro ultrasound imaging,the average grey scale of FOL-PLGA-PTX before HIFU irradiation was significantly lower than that after HIFU irradiation (39.32±3.64 vs 126.44±7.15 ; t =4.829,P＜0.01).Conclusion FOL-PLGA-PTX has been prepared successfully,with high entrapment efficiency and much drug loading,which can target to SKOV3 cells specifically and effectively in vitro,and enhance the ultrasound imaging greatly after HIFU irradiation.