Objective To evaluate laparoscopic hepatectomy for the treatment of primary liver cancer. Methods Nine patients with primary liver cancers at segment Ⅱ, Ⅲ, Ⅴ, Ⅵ and at the edge of the liver underwent laparoscopic partial hepatectomy with hand-assist devices, harmonic scalpel, and Endo-GIA. Results All operations were successful including resection of tumors involving both Ⅱ and Ⅲ segments, and irregular segmentectomy, and 2 cases with additional laparoscopic splenectomy. Surgery lasted for 80～145 min. Intraoperative bleeding was 150～700 ml, with no postoperative complications. Patients were followed-up for 5～25 months with intrahepatic tumor recurrence on 3rd, 4th and 13rd month in one each respectively. Conclusion Hand-assisted laparoscopic partial hepatectomy is a safe and feasible approach for primary liver cancer in clinically selected patients.

Aim To examine the role of antioxidant effect of subhypotensive dose of ACE inhibitor ramipril in its anti hypertrophic effect in rat myocardium. METHODS Model of hypertension induced myocardial hypertrophy of rat was reproduced by coarctation of abdominal aorta. The effects of nitric oxide (NO) synthase inhibitor N L arginine (6 mg?kg -1 ?d -1 ) and Vitamin E(200 U?d -1 ) on cardiac hypertrophy were examined. The change of superoxide dismutase (SOD) and NO production (assayed as NO 2 -) were monitored. RESULTS The myocardial hypertrophy was effectively prevented under hypertensive condition after treatment with ramipril for 8 week, while SOD activity and NO 2 - content were significantly increased and lipid peroxidation was significantly attenuated. Vitamin E enhanced ramipril effect and N L arginine reversed its benficail effects. CONCLUSION These data showed that sub hypotensive dose of ramipril and in combination with vitamin E enhances myocardial antioxidative capability and NO release, which plays an important role in the mechanism of action involved in their antihypertensive cardiac hypertrophic effects.

Objective To establish a rapid and convenient method for determination of genomic DNA methylation in cells.Methods Five standard substances (dC, mdC, dA, dT and dG) were separated by high-performance capillary electrophoresis.Bare fused-silica capillary was used and eletrophoresis buffer was 48 mmol/L NaHCO3 with 60 mmol/L SDS, pH 9.6.The temperature of separation was controlled at 25 ℃ and a voltage of 20 kV was applied.The separation of the mixture was performed at a wavelength of 256 nm with UV-Vis detection and injection time was 5 seconds at 0.7 psi.Under optimal condition,genomic DNA methylation in methotrexate drug-resistant A549 cells was detected.Results The optimal condition was made by adjusting SDS concentration(40, 60, 80 mmol/L), pH value of running buffer(9.4,9.6, 9.8), voltage(15, 17, 19, 20, 22 kV), injection time(5, 10, 15, 20, 30 s) and capillary temperature(15, 20, 25, 30 ℃).The method for determination of genomic DNA methylation in cells was established.Five substances were completely separated by high-performance capillary electrophoresis in 10 mins.Intra-day coefficient of variation was less than 0.2% and inter-day coefficient of variation was less than 2%.The minimal detection limit was 2 μmol/L.Percentage of mdC in A549 parent cells was (4.80 ±0.52) %.Percentage of mdC in 15, 30, 40 μmol/L methotrexate drug-resistant A549 cells were (4.20±0.44) %, ( 3.70 ± 0.36 ) %, (3.10±0.35 ) %, respectively.Conclusions Genomic DNA methylation can be quantificated by high-performance capillary electrophoresis efficiently, rapidly, conveniently and sensitively.Genomic DNA methylation in methotrexate drug resistance cells decreases significantly.

Objective To establish a method for detection folylpolyglutamate syntbetase (FPGS),explore the change of FPGS in the drug-resistant A549 cells induced by methotrexate(MTX) enantiomer,and provide new tools to further investigate drug resistant mechanism. Methods A549 cell lines induced by L-( + )-MTX and D-( - )-MTX (25 μmol/L) were chosen to raise three cell lines as compared with MTX-sensitive cell line. Then FPGS were extracted for the CEIA-LIF and western blot was performed. After validation, FPGS antibodies were labeled by fluoreacein isothiocyanate (FITC) and produced a immune response with former-extracted FPGS. CELA-LIF can separate and detect labeled proteins according ruination time of the protein with different size and detect FPGS in drug resistant cell lines induced with L-(+)-MTX and D-(- )-MTX. The accuracy was evaluated as compared with western blot assay. Results The separation time of CEIA-LIF for labeled FPGS antibody and the immune complexes were7. 1 min and 8.9 min, and the resolving power was 4. 5. The process of protein separation and detection can be accomplished in less than 10 minutes. Western blot analysis showed there was no non-specific bands appears in the extract of these three cell lines after the freeze-thaw in liquid nitrogen. The minimum detection level in sensitive cell strains was 0. 68 mg/μl. The consent of FPGS in L-(+)-MTX and D-( - )-MTX induced cells were 46. 59% and 48. 36% compared with drug sensitive cell strains with CELA-LIF. Conclusions CELA-LIF was established in this experiment. It is efficient and sensitive for detecting of FPGS, which is similar to western blot method. The level of FPGS in L-( + )-MTX and D-( - )-MTX induced drug resistant cell lines is significantly lower, indicating the expression of FPGS is damaged.

Coronavirus disease 2019 (COVID-19) can cause great damage to the elderly patients and lead to high mortality. The clinical presentations and auxiliary examinations of the elderly patients with COVID-19 are atypical, due to the physiological ageing deterioration and basal pathological state. The treatment strategy for the elderly patients has its own characteristics and treatment protocol should be considered accordingly. To improve the diagnosis, treatment, and prevention of COVID-19 in the elderly, the Expert Committee of Geriatric Respiratory and Critical Care Medicine, China Society of Geriatrics established the "Expert consensus for the diagnosis, treatment, and prevention of coronavirus disease 2019 in the elderly" . We focused on the clinical characteristics and key points for better treatment and prevention of COVID-19 in the elderly. (1) For diagnosis, atypical clinical presentation of COVID-19 in the elderly should be emphasized, which may be complicated by underlying disease. (2) For treatment, strategy of multiple disciplinary team (mainly the respiratory and critical care medicine) should be adopted and multiple systemic functions should be considered. (3) For prevention, health care model about integrated management of acute and chronic diseases, in and out of hospital should be applied.

Objective :To analyze correlation among fasting (FBL) and postprandial blood lipids (PBL) ,blood lipid fluctuation (absolute value of PBL‐FBL) and severity of coronary artery disease .Methods :Cross‐sectional study was performed among 264 patients undergoing coronary angiography (CAG) in our hospital .According to percutaneous coronary intervention (PCI) or not based on CAG results ,patients were divided into plaque group (n＝128) and PCI group (n＝136).Gensini score was used to assess severity of coronary artery disease .Blood lipid levels and its fluctu‐ation were compared between two groups .Correlation among blood lipid levels ,blood lipid fluctuation and severity of coronary artery disease were analyzed .Results :Compared with plaque group ,there were significant rise in per‐centages of men and smokers ,waist circumference ,levels of postprandial‐fasting (P‐F ) serum LDL‐C (ΔLDL‐C ) and P‐F plasma apolipoprotein B (ΔApoB ) , and significant reduction in plasma level of P‐F apolipoprotein A1 (ΔApoA1) in PCI group , P＜0. 05 or ＜ 0. 01. Pearson correlation analysis indicated that serum fasting and post‐prandial HDL‐C levels ,plasma fasting and postprandial levels of ApoA1 and ΔApoA1 were significant inversely cor‐related with Gensini score ( r＝ －0. 130～ －0.218 , P＜0. 05 or ＜0. 01) ,and levels of plasma fasting lipoprotein a (Lp (a)) ,serum fasting and postprandial levels of free fatty acid (FFA) ,serum P‐F FFA (Δ FFA) were significant positively correlated with Gensini score ( r＝0. 139－0. 176 , P＜0.05 or ＜0.01).Multifactor linear regression anal‐ysis indicated that postprandial serum HDL‐C was protective factor for Gensini score (B＝ －22.274 , P＝0.002 ) , while postprandial serum FFA ,Δ FFA ,waist circumference and hyperlipidemia history were its influencing factors (B＝0. 388～24. 135 , P＜0. 05 or ＜0.01).Conclusion :Measurements of fasting and postprandial blood lipid levels and their fluctuation contribute to more comprehensively and objectively assessing blood lipid levels and severity of coronary disease in patients with coronary artery disease .