Objective To assess the feasibility and safety of modified laparoscopic totally extraperitoneal(TEP)hernia repair.Methods From January to August 2007,a total of 31 patients with hernia were treated with modified TEP hernia repair under general anesthesia in our hospital.During the operation,the anterior peritoneal space was separated,and then a domestic single balloon catheter was inserted into the extraperitoneal space to expand the latter.The mesh was not fixed during the operation.Results All the operations were successfully completed with a mean operation time of(69.8?21.8)minutes,mean blood loss of(7.6?4.2)ml,and mean postoperative hospital stay of(2.6?1.3)d.Five cases developed laceration of the peritoneum during the operation,and 2 had scrotal hydrocele after the operation.The patients were followed up for 1-7 months [mean,(4.2?2.4)months],no recurrence or chronic pain at operative area were found during this period.Conclusions Modified TEP is feasible for hernia repair.The method is a safe and tension-free technique with a low rate of postoperative chronic pain at the operation region.

Objective To study the relationship of MR diffusion tensor imaging for corpus callosum and cingulate bundles with cognitive impairment in subcortical ischemic vascular dementia (SIVD) patients.Methods Sixty elderly SIVD patients admitted to our hospital from July 2015 to June 2016 served as a SIVD group and 40 age-matched persons undergoing physical examination served as a control group in this study.The mean ADC and FA were calculated according to the MR diffusion tensor imaging parameters in region of interest.Relationship between fiber tract integraty and MMSE Scale score was compared between the two groups.Results The ADC was significantly higher while the FA was significantly lower for the genu of corpus callosum in SIVD group than in control group.However,no significant difference was found in ADC for the spenium of corpus callosum between the two groups (P＞0.05).The ADC was significantly higher while the FA was significantly lower for bilateral cingulate bundles (P＜0.05,P＜0.01).The FA for the genu of corpus callosum and bilateral cingulate bundles was positively related with the MMSE Scale score (r=0.511,r=0.469,r=0.457,P＜0.05).However,the FA for the splenium of corpus callosum was not related with the MMSE Scale score(r=0.364,P＞0.05).Conclusion Changes of MR diffusion tensor imaging parameters in corpus callosum and cingulate bundles contribute to the early prevention and treatment of cognitive impairment in SIVD patients.

OBJECTIVE:To study the effects of rAd-p53 injection on the proliferation,apoptosis and autophagy of nephroblas-toma cells. METHODS:Nephroblastoma cells were respectively cultured 20 h with high,medium,low concentration(1×109,1× 108,1×107 VP/mL)of Recombinant human rAd-p53 injection,cells with no injection were the blank control. Cell proliferation,cy-cle,apoptosis and related gene p21,Bax protein expressions were detected,and autophagy gene LC-3,Atg7,Atg12 expressions and number of autophagosomes were also detected. RESULTS:The proliferation inhibition rates of high,medium,low concentra-tion of Recombinant human rAd-p53 injection to nephroblastoma cells were(42.86±3.18)%,(33.64±7.25)%,(16.26±9.07)%;apoptotic rates were (53.85 ± 9.36)%,(37.35 ± 9.64)%,(23.64 ± 10.65)%,respectively. Compared with blank control,cells at period G0/G1 were increased under high,medium,low concentration Recombinant human rAd-p53 injection,effects were relatively obvious under high,medium concentration (P<0.05 or P<0.01);p21,Bax protein and LC-3,Atg7,Atg12 gene expressions were enhanced under high concentration,the number of autophagosomes was increased(P<0.01);Bax protein expression was en-hanced under medium concentration(P<0.05),the other indicators had no obvious changed(P>0.05). CONCLUSIONS:Recom-binant human rAd-p53 injection can inhibit the cell proliferation of nephroblastoma,and induce its apoptosis and autophagy.

BACKGROUND:Retinoic acid is the most promising inducer for neuroblastoma minimal residual lesion, and it can induce cel differentiationin vivo, accompanied by reducing tumor cel proliferation.
OBJECTIVE:To study the effect of nanoparticle labeling on biological characteristics of neuroblastoma stem cels, and the role of 13-cis retinoic acid to induce differentiation of neuroblastoma stem cels.
METHODS:Neuroblastoma stem cels were isolated and culturedin vitro using serum-free suspension culture method, labeled with polylysine-modified γ-Fe2O3 nanoparticles and induced in culture medium containing 13-cis retinoic acid. RT-PCR was used to detect the expression of Oct-4 before and after labeling as wel as before and after induction. Immunofluorescence method was used to detect the expression of nestin before and after labeling as wel as before and after induction.
RESULTS AND CONCLUSION:Neuroblastoma stem cels were successfuly cultured in the bone marrow samples from 5 of 20 cases. Polylysine-modified γ-Fe2O3 nanoparticle labeling did no influence the viability and proliferation ability of neuroblastoma stem cels, and also had no effect on Oct-4 mRNA and nestin expression. After cultured in the culture medium containing 13-cis retinoic acid, the cel shape changed and the growth rate slowed down. Moreover, the expression of Oct-4 mRNA and nestin was gradualy reduced. These findings indicate that polylysine-modified gamma-Fe2O3 nanoparticles can be used to label neuroblastoma stem cels, and 13-cis retinoic acid can induce the differentiation of neuroblastoma stem cels.

Objective To study the spectrum of upper gastrointestinal diseases and infection rate of Helicobacter pylori(Hp) in our hospital during the past 35 years.Methods Patients who were 16 or older with duodenal ulcer,gastric ulcer,reflux esophagitis,gastric cancer and esophageal cancer diagnosed by gastroscopy and pathology were retrospectively enrolled in our study from January 1980 to December 2014.Patients with chronic superficial gastritis,chronic atrophic gastritis or Hp infection from January 1989to December 2014 were also included in our study according to the same diagnostic criteria.The incidences of diseases and the infection rates of Hp were studied.Results A total of 213 495 patients underwent gastroscopy in our department during the past 35 years.The overall diagnostic rates of duodenal ulcer,gastric ulcer,reflux esophagitis,gastric cancer and esophageal cancer were 9.87％,3.79％,6.66％,1.59％ and 0.66％ respectively.There were 183 426 patients receiving gastroscopy in our department from January 1989to December 2014.The overall endoscopic diagnosis rates of chronic superficial gastritis and chronic atrophic gastritis were 49.83％ and 22.43％ respectively.The overall infection rate of Hp was 36.18％,which had a declining trend consistent with peptic ulcer (all P =0.000).Yet,the prevalence of reflux esophagitis,chronic superficial gastritis and chronic atrophic gastritis were increasing (all P =0.000).The diagnostic rates of gastric cancer and esophageal cancer were persistent (P =0.266,P =0.156).Conclusions The Hp infection during years has been decreasing,consistent with the declining tendency of peptic ulcer.On the other hand,reflux esophagitis,chronic superficial gastritis and chronic atrophic gastritis show an ascendant trend.The proportion of patients with gastric cancer and esophageal cancer is relatively stable.

BACKGROUND:Recently,researches have found that insulin-like growth factor-1(IGF-1)can induce the differentiation of bone marrow-derived mesenchymal stem cells(BMSCs)into chondrocytes,but there are no reports concerning the differentiation of adipose-derived mesenchymal stem cells(ADMSCs)into chondrocytes induced by IGF-1,as well as interaction with transforming growth factor-β1(TGF-β1)during this process.OBJECTIVE:To explore the possibility of inducing ADMSCs chondrogenic differentiation by using IGF-1 and the interaction with TGF-β1 in induction.METHODS:ADMSCs were obtained,and seeded at 2×10~5 cells/cm~2 in culture flask.Insulin-free chondrogenic media containing IGF-1 or(and)TGF-β1 were used to induce ADMSCs.2 weeks later,cells were harvested and stained by using toluidine blue and collagen Ⅱ antibody immunohistochemistry.Intracellular sulfated proteoglycan and collagen Ⅱ coloring were observed.Reverse transcription-polymerase chain reaction(RT-PCR)was used to detect the expression of collagen Ⅱ,aggrecan and Sox9 mRNA.RESULTS AND CONCLUSION:After induced,toluidine blue stain exhibited that the cells in the three induction groups were polygonal,with cytoplasm and cell membrane of blue different dyeing.Immunohistochemistry for type Ⅱ collagen demonstrated that cytoplasm and cell membrane were stained brown in three induction groups.RT-PCR revealed that the expression of collagen Ⅱ,aggrecan,Sox9 mRNA of IGF + TGF group were significantly greater than the IGF and TGF groups,and IGF and TGF groups were significantly stronger than the control group.No significant difference was determined between the IGF and TGF groups.These results indicated that IGF-1 can induce chondrogenic differentiation from ADMSCs,expressing chondrocyte specific cell phenotype.There is synergism of IGF-1 and TGF-01 to induce the differentiation of ADMSCs into chondrocytes.

Objective To retrospective analyze the specimens and wards distribution and the drug resistance changes of clinical i‐solated Pseudomonas aeruginosa .Methods 1 114 strains of Pseudomonas aeruginosa were isolated from a variety of clinical speci‐mens for the identification and susceptibility testing by using Microscan Walkaway40 identification and antibiotic susceptibility anal‐ysis system and manual method from 2002 to 2012 .And the results were analyzed .Results In all of the 1 114 isolated Pseudomonas aeruginosa strains ,there were 64 .18% of them from respiratory specimens .Pseudomonas aeruginosa infection occured mainly in the ICU wards (49 .64% ) .From 2002 to 2012 ,the drug resistance rates of Pseudomonas aeruginosa to 19 kinds of antibacterial drugs increased year by year .Conclusion Pseudomonas aeruginosa often causes respiratory tract infection ,and its mechanism of drug resistance is complex .There are few alternative antimicrobial drugs for the treatment of Pseudomonas aeruginosa infection .

BACKGROUND:At present, the separation and culture technique of chondrocytes has been mature, but the chondrocytes grow slowly which are prone to degenerate using the present technique. It is not conducive to the fol ow-up test.
OBJECTIVE:To investigate and improve the separation and culture method of articular chondrocytes of New Zealand rats at 4 weeks of age.
METHODS:New Zealand rats aged 4 weeks were selected to take cartilage tissues from the bilateral knees that were resected under aseptic condition. Chondrocytes were isolated by type Ⅱ col agenase enzyme digestion and mechanical isolation method. The cells were cultured and passaged, and then identified by morphologic observation, toluidine blue staining and type Ⅱ col agen enzyme immunohistochemical methods. Growth curve was pictured by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide method.
RESULTS AND CONCLUSION:Inverted microscope observation showed that the primary cultured chondrocytes adhered at 6 hours after cultivation. The monolayer formation occurred at 72 hours after cultivation, and the cells were ready to be passaged at 96 hours after cultivation. In the fourth generation, some cells represented a spindle-like appearance. In the fifth generation, most cells turned into irregular shape appearance, and cellproliferation capacity diminished. Toluidine blue staining showed that the nuclei of cultured chondrocytes were blue and cytoplasm was pale blue. Immunofluorescent staining showed that cultured chondrocytes had a positive expression of col agen type Ⅱ and the color was tawny. Proliferative rate of chondrocytes in the first to third generations had no differences (P<0.05), while differences were found compared with the fourth generation in 4-7 days (P<0.05) and the fifth generation in 1-7 days (P<0.05). The results indicate that type Ⅱ col agenase enzyme digestion and mechanical isolation method is successful for isolating, cultivating New Zealand rat articular chondrocytes in vitro, and the first to third generations can be the best choice for the experiments of knee osteoarthritis.

Objective By analysing the clinical features of Indigo Naturalis-associated ischemic lesion of colon mucosa to improve the precautionary and therapeutic level of the disease.Methods Thirteen patients diagnosed as Indigo Naturalis-associated ischemic lesion of colon mucosa in Peking University Third Hospital from 2005 to 2010 were reviewed.The endoscopic and clinical features were analysed.Results The 13 patients with an average age of(60.6±14.1)years old were prescribed Chinese traditional medicine containing Indigo Naturalis for psoriasis or idiopathic thrombocytopenic purpura(ITP).The ratio of males to females was 1:1.6.The typical manifestations were abdominal pain and bloody stool with watering diarrhea before bloody stool in 61.5%patients.Endoscopic and pathological characteristics were coincident with ischemic lesion and more like a chronic index.Vasodilatic medicine was effective and the average hemostatic time was(1.7±0.8)days.The prognosis was well and no recurrence was found during 3 months follow-up.Conclusions Patients having psoriasis or ITP treated with Chinese traditional medicine containing Indigo Naturalis have an inclination to colon mucosa lesions, even ischemic lesion. Careful assessment and observation before prescribing arc necessary in these patients.

Objective To assess the efficiency and methods of the interventional management in acute mesenteric venous thrombosis (AMVT). Methods Fifteen patients with AMVT who diagnosed by imageology were treated by interventional procedures. Eight patients were treated by transcatheter superior mesenteric artery thrombolysis with urokinase, 5 cases by percutaneous transhepatic treatment, 2 cases by transjugular intrahepatic portosystemic shunt approach. Results The technical success was achieved in all the 15 cases without complications. The majority of the thrombus was cleared by interventional procedures and flow restorated on the angiograms. All the patients with follow-up from 10 to 22 months showed no recurrence. Conclusion The minimally invasive interventional techniques are safe and effective in the treatment of mesenteric venous thrombosis without necrosis.