AIM:To explore the effects of endothelial indoleamine 2,3-dioxygenase (IDO) on the migration and the expression of contractile proteins in the pericytes.METHODS: Human pulmonary artery endothelial cells ( HPAECs) and rat cerebral microvascular pericytes were cultured in vitro.Over-expression of IDO in the HPAECs ( IDO-HPAECs) was established.The pericytes were treated with HPAEC-conditioned medium (control group), IDO-HPAEC conditioned medium (treatment group), or IDO-HPAECs-conditioned medium containing 1-methyl-DL-tryptophan (1-mT) ( inhibition group) .The concentrations of nitric oxide ( NO) , tryptophan and kynurenine in the co-culture system were de-termined.The viability, migration and the expression of the contractile proteins in the pericytes were compared.RE-SULTS:No statistical difference of the pericyte viability after treatment with IDO-HPAEC-conditioned medium at 6~48 h was observed (P>0.05).The migratory ability of the pericytes significantly decreased in treatment group compared with control group (P<0.01), and significantly increased in inhibition group compared with treatment group (P<0.01).The concentration of NO in the co-culture system had no significant difference among groups (P>0.05).The concentration of tryptophan was significantly lower in treatment group than that in control group (P<0.01), and significantly higher in in-hibition group than that in treatment group (P<0.01).The concentration of kynurenine was significantly higher in treat-ment group than that in control group (P<0.01), and significantly lower in inhibition group than that in treatment group (P<0.01).The expression ofα-smooth muscle actin and desmin was significantly lower in treatment group than that in control group (P<0.01), and significantly higher in inhibition group than that in treatment group (P<0.01).CON-CLUSION:Endothelial IDO inhibits the migration and the expression of the contractile proteins in the pericytes, and may play essential roles in the regulation of microvasculatures.

Objective To evaluate the efficacy of laparoscopic-assisted resection of the small bowel for stromal tumors.Methods From January 2003 to May 2007,laparoscopic abdominal exploration was carried out under general anesthesia on 10 patients with space occupying lesion and 5 patients with abdominal pain and hemafecia of unknown origin.After an intestinal lesion was found,a small incision was made at the proper site on the abdominal wall according to the location of the lesion.The diseased intestine was resected outside the abdominal cavity,and then end-to-end anastomosis was performed.Pneumoperitoneum was rebuilt after closing the abdominal cavity in order to observe the blood circulation of the small bowel and intra-abdominal hemorrhage.Results The operation was completed in all the 15 cases.The postoperative pathological examination showed stromal tumors with CD117 positive in 14 cases(93%)and CD34 positive in 9(60%).Three(20%)of the patients were at very low risk,5(33%)at low risk,4(27%)at moderate risk,and 3(20%)at high risk.The mean diameter of the tumors was(2.44?0.63)cm(ranged from 1.5 to 3.6).The operation time was 38 to 72 minutes with a mean of(57.8?10.4),and mean blood loss was(20.1?6.5)ml(10 to 30).The patients were discharged 4 to 7 days after the operation [mean,(5.3?1.1)days],and were followed up for 5 to 36 months [mean,(24.3?8.4)months].No patient had postoperative complications or recurrence in this series.Conclusion Laparoscopy is effective for resection of small bowel stromal tumors.

Visitation in ICU patients increases the risk of nosocomial infection, but it can meet the psychological needs of patients and their families and help patients with physical rehabilitation. The use of video visitation system, can realize not to enter the ICU unit can remote video visitation purposes, which can meet the needs of patients in ICU visitation, and can effectively reduce nosocomial infection. Video visitation system can be implemented by different ways. Through the researching and analyzing of the various video visiting ways, this article summarizes the advantages of each and the conditions of construction, and then points out that the hospital should choose the appropriate way based on the construction conditions of ICU, during its construction.

Objective To evaluate the influence of black dots,isolated line above the best correct visual acuity and multiple lines containing the best correct visual acuity in the accuracy of Jackson cross cylinder examination.Methods Forty students were chosen(11 males,29 females,between 24 to 29 years old).Routine examination of phoropter was used to check under the maximum plus to maximum visual acuity(MPMVA) status.The sequence of three fixation targets was chosen randomly.Astigmatism chart was used to judge the best one when the different results were obtained.Results Among the 80 eyes of 40 students,12 eyes were spherical(the cylinder degree below 0.25 DC).The response of three fixation targets was the same in 19 eyes(27.9%),23 eyes(33.8%)were sensitive to the black dots target,14 eyes(20.6%)were sensitive to the isolated line above the best correct visual acuity,12 eyes(17.6%) were sensitive to multiple lines containing the best correct visual acuity.Kruska Wallis Test was used to detect the difference among three groups.No significant difference was found(?2 =4.026,P=0.134).Conclusion According to the efficiency of examination,communication and judgment,black dots target is recommended although no difference is detected among three fixation targets.

Objective To study the clinical effect of microsurgical treatment via lateral fissure approach on hypertensive basal ganglia hemorrhage.Methods Small bone flap via lateral fissure approach were applied to remove basal ganglia hematoma.Thirty two cases were recruited in the retrospective analysis.Results By head CT scan follow-up 24 h post operation,over 80％ percent of hematoma was successfully removed in 28 cases and over 40％ of hematoma was resided in 4 case.Patients were followed up for 3 - 6 months,according to the ADL (ADL)classification,the outcomes were:Grade Ⅰ in 4 cases( 12.5％ ),grade Ⅱ in 13 cases(40.6％ ),grade Ⅲ in 12 cases (37.5％)and grade Ⅳ in 3 cases (9.4％).No death occurred.Conclusion Small window approach on lateral fissure for microsurgical operation of hypertensive basal ganglia hemorrhage is a less invasive procedure with good surgical exposure and homeostasis.Neurological function was well recovered after surgery.

Background and purpose:The incidence of esophageal cancer of Kazakh race is higher than that of Han people. EphA2, as a member of Eph protein family, is related to a variety of malignant tumors. This study used immunohistochemical method and enzyme-linked immunoassay to detect EphA2 in tissues and serums of Kazakh and Han patients. Therefore to analyze the expression differences of EphA2 in esophageal squamous cell carcinoma (ESCC) tissues and serum of Kazakh and Han patients in Xinjiang, and the relationship with pathological features. Methods:The expression of EphA2 protein was detected by immunohistochemistry method in 100 cases of ESCC tissues and adjacent normal esophageal tissues;Then was tested by ELISA in those cases’ serum and 60 healthy persons. Results:The positive expression rate of EphA2 protein in ESCC and corresponding adjacent tissues were 72.0%, 28.0% in Kazakh, and 62.0%, 26.0% in Han people, respectively, and the differences were statistically significant (P=0.000) in the 2 nations. EphA2 protein levels in serum of ESCC and healthy persons, and Kazakh were (58.36±12.60) and (29.39±7.34) pg/mL, Han Chinese were (58.79±13.29) and (29.39±7.34) pg/mL respectively, there were statistical signiifcance (P=0.000). In ESCC of Kazakh and Han people, EphA2 protein expression had relationship with lymph node metastasis, TNM stage and tumor depth of invasion (P<0.05). In the serum of Kazakh and Han ESCC patients, the expression of EphA2 protein was related to TNM stage (P<0.05), while in the Kazakh esophageal cancer, the expression level was also correlated with the depth of tumor invasion (P=0.001). The positive expression rates of EphA2 protein in Kazakh and Han ESCC specimens were 72.0%and 62.0%, respectively;the protein level in the serum of patients in the 2 nations were (58.36±12.60) and (58.79±13.29) pg/mL, respectively. The protein levels in tissues and serum of the 2 different nations has no statistical signiifcance (P>0.05). Conclusion:The high expression of EphA2 protein may contribute to the occurrence, invasion and metastasis of Kazakh and Han ESCC patients. EphA2 protein expression in tissues and serum of patients with ESCC may be related to the primary tumor invasion, lymph node metastasis and TNM stage. The expression of EphA2 protein in peripheral blood of patients with esophageal cancer in Kazakh may be related to depth the of invasion.

Objective To explore the in vitro cytotoxicity of sunitinib in highly metastatic hepatocellular carcinoma cell line MHCC97-H, and the effect of it on the expression level of focal adhesion kinase (FAK). Methods MHCC97-H hepatoma cells were cultured and divided into control group and experimental (sunitinib) group. Experimental groups were added 2.5, 5,10 and 20μmol/L of sunitinib for 24, 48 and 72 hours respectively. The morphological changes were observed before and after sunitinib treatment in MHCC97-H with Giemsa stain. The inhibitory rate of proliferation in MHCC97-H was detected by MTT assay. The expressions of FAK protein before and after sunitinib treatment were detected by Western blot assay. Results Sunitinib showed the inhibitory effect on hepatoma cell line MHCC97-H. Giemsa staining showed that chromatin condensation, nuclear fragmentation, apoptotic bodies and other typical morphological features. The inhibitory rate was the most obvious in 48-h treatment group. The inhibitory rates were (0.433 ± 0.115)%, (32.863 ± 1.471)%, (49.240 ± 2.256)%, (63.797±2.707)%and (58.887±3.409)%for 2.5, 5, 10 and 20μmol/L concentration groups, and there were signifi-cant differences between groups (P<0.05). Results of Western blot assay showed that the expression levels of FAK protein were significantly reduced after different concentrations of sunitinib treatment for 48 h (P<0.05). Conclusion Sunitinib has inhibitory effect on hepatoma cell line MHCC97-H, enhances the apoptosis and decreases the the expression of FAK pro-tein.

Objective To screen and analyze genes differentially expressed within dermal papillae cells(DPC)with aggregative behavior.Methods Total RNA was extracted from DPC with and without ag-gregative behavior,and double-stranded cDNA were synthesized by using SMART cDNA synthesis.The cD-NA fragments of differentially expressed genes in dermal papillae cells with aggregative behavior were isolat-ed by suppression subtractive hybridization,sequencing,and then subtracted library was set up.Positive clones were screened by PCR method and verified by cDNA dot blot and then analyzed through homologous retrieving.Results A subtractive cDNA library of DPC with aggregative behavior was successfully construct-ed.The results of screening and cloning of the library showed that DPC with aggregative behavior could ex-press genes related to homologous aggregation,regnlation of growth,differentiation and development,and sig-nal transduction proliferation and cycle control,which included known genes(capping protein,paladin,vas-cular endothelial growth factor),hematopoietic stem/progenitor cells(HSPC)related genes(HSPC011and HSPC016)and a new gene.Conclusions The construction of subtractive library of DPC lays solid founda-tion for screening and cloning new and specific genes related to aggregative behavior of DPC.Several genes may cooperatively involve in homologous aggregation,and regnlation of growth of DPC.Among these genes,capping protein and palladin may be closely related to aggregative behavior of DPC,and VEGF and HSPC re-lated clones may be responsible for the status of higher proliferation of DPC.

Objective To investigate the effect of geraniin on expression of Wnt3a protein and mRNA in bone marrow stromal cell (BMSC) from osteoporotic rats. Methods The model of osteoporosis (OP) was duplicated by ovariectomy in rats. BMSCs were isolated and cultured. BMSCs from shamed rats were routinly cultured and taken as normal control, and BMSCs from OP rats were divided into model group, 1μmol/L simvastatin positive group, and geraniin group (0.01, 0.1, 1, 10, 100 μmol/L), respectively. The methods of realtime-PCR and western blot were used to assay the protein and mRNA expression of wnt3a, respectively.Results As compared with normal control group, the protein and mRNA expression of wnt3a in model group were significantly suppressed;Compared with model group, 1 μmol/L simvastatin, and 0.1, 1, 10 and 100 μmol/L geraniin significantly increased the expression of wnt3a protein and mRNA. Conclusion It is suggested that geraniin activates wnt/β-catenin pathway though increasing the expression of signaling protein wnt 3a in BMSCs from OP rats. It would be beneficial to osteogenic differentiation of BMSCs and osteogenesis.

Objective To investigate the feasibility and effectiveness of fast track surgery (FTS) in neurosurgery. Methods One hundred fifteen patients who underwent neurosurgery surgery in Henan Province People's Hospital from June 2012 to March 2014 were enrolled in this study. All the patients were divided into FTS group (62 cases) and the tra?ditional operation group (53 cases). The clinical index, postoperative hospital stay and hospitalization cost were compared between the two groups. Results The clinical index were significantly lower in FTS group than in traditional operation group (P<0.05). Length of hospital stay (days) and hospitalization cost of FTS group were significantly shorter and lower in FTS group compared with traditonal operation group (8±1 vs. 11±2 days and RMB 4.58 ±0.75 vs. 5.78 ±0.64 ten thou?sand, respectively) (P<0.05). Conclusion FTS in neurosurgery operation is an all-new concept for surgery which can ef?fectively reduce postoperative complications, shorten length of hospital stay, decrease hospitalization cost and promote postoperative recovery.