Objective To investigate the effects of low-pressure carbon dioxide pneumoperitoneum (CLC) and gasless abdominal distension (GLC) on elderly patients during laparoscopic cholecystectomy. Methods The clinical data,including operation time,hospital stay,surgical complications,and changes of other systems,of 36 elderly patients were analyzed. All the patients were older than 65 years when they received laparoscopic cholecystectomy in our hospital from January 2005 to December 2007. Among the cases,CLC (CO2 pressure:8-10 mm Hg) was used in 24,and GLC was employed in 12. The fourth generation artificial rib lifting apparatus was used for GLC. Results All the procedures were completed by laparoscopy,no patient was converted to open surgery. The operation time of the CLC and GLC groups was (46.2?14.8) min and (52.4?18.6) min respectively (t=-1.087,P=0.285). The vital signs of all the cases were stable during the operation,no carbon dioxide retention or cardiovascular affairs occurred. The hospital stay was (10.5?6.8) d in group CLC and (8.9?5.5) d in group GLC (t=0.706,P=0.485). The patients were followed up for 6 to 42 months,no complications occurred during the period. Conclusions GLC is safe for elderly patients with similar efficacy to that of low-pressure CLC.

Objective To investigate the regulation of Sertoli cells on differentiation balance of allogeneic regulatory T cell (Treg)and T helper cell(Th17).Methods Sertoli cells ,bone marrow‐derived dendritic cells(DC) and T lymphocytes were iso‐latedandculturedinvitro.SertolicellsandDCcellswereco‐culturedwithallogeneicTcells,respectively.MorphologyofSertoli cells were verified under the light microscope and electron microscope. The expression of major histocompatibility complex (MHC)‐Ⅱ and B7‐H1 in Sertoli cells was detected by Western blot.Concentration of cytokines[transforming growth factor (TGF)‐β1 and IL‐17A etc. ] in supernatant was determined by enzyme linked immunosorbent assay(ELISA). The frequency of Treg cells differentiated from na?ve T cells was estimated by flow cytometry.Results Sertoli cells were successfully isolated and cultured in vitro.Western blot results showed the expression of MHC‐Ⅱ and B7‐H1 on Sertoli cells surface was increased significantly ,when Sertoli cells were co‐cultured with allogeneic na?ve CD4+ T cells(CD4+ CD62 L+CD25)in vitro.ELISA re‐sults showed the TGF‐β1 concentration in culture supernatant was significantly increased [from (174.89 ± 23.51) pg/mL to (823.10 ± 59.07) pg/mL ,P<0.05] .Flow cytometry results showed Na?ve T cells(CD4+CD62 L+CD25-)were induced to dif‐ferentiate into CD25+ Foxp3+ T cells(from <1.0% up to 27.6% )by co‐cultured with Sertoli cells.And incubation with Sertoli/Treg supernatant(STS)significantly reduced the concentration of IL‐17A in the mixed culture supernatant of DC cells /Na?ve CD4+ T cell[from (361.58 ± 80.27) pg/mL to (137.54 ± 52.19) pg/mL ,P<0.05]. The percentage of IL‐17A+ T cells subset was also significantly decreased(27.2% to 17.9% ,P<0.05).Conclusion The anti‐inflammatory cytokines and immune sup‐
pressive cytokines derived from Sertoli cells can induce allogeneic na?ve T cells to differentiate into CD25+ Foxp3+ Treg cells in vitro.Sertoli cells can regulate the differentiation balance of allogeneic Treg/Th17 to induce the immune tolerance.

Objective To discuss how to improve the current status on clinical therapy for advanced gastric carcinoma. Methods Related literatures searched on Medline were collected and reviewed. Results The 5th edition of UICC/AJCC TNM staging system of gastric carcinoma is useful to evaluate the prognosis of patients with advanced gastric carcinoma followed by extended lymphadenectomy. There are many factors influencing their prognosis including disease stage, extent of lymphadenectomy, assistant therapy and so on. Conclusion It is significant for patients with advanced gastric carcinoma to undergo individualized extended lymphadenectomy and comprehensive therapy to improve their prognosis after radical gastrectomy

OBJECTIVE:To evaluate the application situation of anesthetic sedative agents in our hospital.METHODS:11945prescriptions of anesthetic sedative agents in inpatient department of our hospital during the period of2001～2003were statistically analyzed.RESULTS:There were5kinds of commonly used anesthetic sedative agents in3dosage types alto-gether;the anesthetic sedatives agents were mainly used in patients ranging from40～50years old;the drug use index(DUI)of all the kinds were all less than1,with the DUI of the majority at no more than0.5.CONCLUSION:Anesthetic sedative dosage for the treatment of cancer of late stage is lower than one needed,which suggests that sufficient dosage should be given to the cancer suffering patients by the physician.

Irrational use of medicine has some reasons subjectively and objectively.Under a system of new framework,the key link of achieving rational medical use is that how to strengthen the effeetive regulation.Construeting a scientific surveillance system.innovating monitoring system,intelligent using of modern management techniques,controlling the entire process of the implementation of medicine,to promotion the rational use of medicineprovides a strong institutional guarantee and technical support.

Serum adiponectin concentration in diabetic nephropathy (DN) group was significantly higher than that of simple diabetes mellitus (SDM) group.In clinical diabetic nephropathy group with massive albuminuria it was remarkably higher than those of normal control,SDM,and early DN.Furthermore,serum adiponectin concentration was positively correlated with urinary albumin excretion rate and negatively correlated with waist hip ratio.Why it is markedly increased in patients with overt DN merits further investigation.

AIM　to compare the bioavailability and pharmacokinetics of two acyclovir tablets. METHODS　Concentrations of acyclovir in 10 men serum after po 600 mg of two acyclovir tablets were determined , in random 2-way crossover design. Pharmacokinetic parameters were also estimated. RESULTS　The peak concentrations of test and reference tablets were 1.24±0.49 and 1.17±0.20 μg/ml, the AUC 7.56±1.80 and 7.56±2.10μg*h/ml, respectively. The relative bioavailability was 101.36%±11.62%. The test formulation was found bioequivalent to the reference in AUC and Cmax by two one-side t test. CONCLUSION　Two tablets were bioequivalent.

BACKGROUND:Cartilage is an avascular tissue and has a limited capacity for self-repair after injury. There are various methods for the treatment of articular cartilage injury ranging from conservation therapy to invasive surgery. With the development of tissue engineering technology, it provides a new way for treating articular cartilage injury. OBJECTIVE:To review the new development of tissue engineering technology for repairing articular cartilage injury. METHODS:The PubMed database and CNKI database were retrieved for articles from 2000 to 2013 by the first author with computer in May 2013. The key words were“cartilage tissue engineering, cartilage defect, stem cell, scaffold, growth factor”in English and Chinese. A total of 64 articles were included which related to cartilage regeneration and cartilage tissue engineering. For the articles in the same field, those published recently or in authorized journals were selected. RESULTS AND CONCLUSION:The three elements of cartilage tissue engineering, seed cells, scaffolds and cytokines, must be coordinated and mutual y beneficial development. At present, the research of tissue engineering for repairing articular cartilage injury has made a great progress. But the application in clinic has not enforced yet which is limited in experimental exploration stage. With the continuous development of new materials, the new tissue engineering cartilage repair materials should meet the requirement of material science and biological science, thus making the materials closely meet the biological characteristics of the self tissues. The animal studies wil turn to clinical experiments with the support of new technique, which make a breakthrough in the treatment of articular cartilage injury.

Objective To establish TLC fingerprint of TGP for assessing the quality consistency of batch- by- batch of commercial product. Methods Silica gel 60 precoated plate (Merck) was used. Solvent system included chloroform- ethyl acetate- methanol- formic acid (40 ∶ 5 ∶ 10 ∶ 0.2); ∶ 5 % vanillin- sulfuric acid reagent was used as visualizing reagent and the heating temperature at 80 ℃ . Results Consistency among ten batches of TGP was demonstrated by TLC fingerprint image and the profiles generated by digital scanning. Conclusion TLC fingerprint of different batches of TGP confirms that TLC is also a powerful tool for developing chromatographic fingerprint, it can be used as a complementary technique for HPLC. 

[Objective]To observe the effects of mesenchymal stem cells(MSCs) transplantation on the brain-derived neurotrophic factor(BDNF) and growth associated protein-43(GAP-43) after the spinal cord injury(SCI) of rats, and to investigate the mechanism of repairing the SCI by MSCs transplantation. [Method]Seven days after the operation of SCI,the MSCs were transplanted into the injured site. Then GAP-43 and BDNF were tested by RT-PCR. By means of above,the mechanism of repairing the SCI after the cell transplantation was investigated.[Result]Compared with group B, transplantation of MSCs enhanced the expression of BDNF mRNA and GAP-43 mRNA in the spinal cord of group A, improved the neuron regeneration.[Conclusion] The transplantation of MSCs can repair the injuried site and promote the regeneration of axon by enhanced the expression of BDNF mRNA and GAP-43 mRNA. It is one of the mechanism of repairing the SCI by MSCs transplantation.