Objective To evaluate the role of myosin light chain kinase(MLCK)in the increase in the permeability of human pulmonary microvascular endothelial cells(HPMVECs)induced by mechanical stretch.Methods HPMVECs were cultured in vitro and then randomly divided into 3 groups(n = 4 each): mechanical stretch group(group S),ML9 treatment group(group M)and control group(group C).In group S,the monolayer cells and magnetic beads coated with an RGD peptide were incubated in serum-free MCDB131 medium for 2 h,the unbound beads were washed out,and then the cells were exposed to magnetic twisting stimulation(MTS)for 2 h(frequency 3 Hz,intensity 4.2 mT).In group M,the monolayer cells and magnetic beads coated with an RGD peptide were incubated for 2 h in serum-free MCDB131 medium in which MLCK inhibitor ML9(50μmol/L)was added,and the other procedures were the same as in group S.In group C,the cells after washing as in group S were incubated for 2 h without exposing to MTS.Monolayer permeability was detected with FITC-dextran flux in transwell model.The distribution of integrin αVβ3 and actin was detected using the immunofluorescence assay.Results Compared with group C,the permeability of HPMVECs was significantly increased in group S,while no significant change was found in group M.Compared with group S,the permeability of HPMVECs was significantly decreased in group M.In addition,actin polymerized to form stress fiber,and integrin αVβ3 clustered at the end of stress fiber in group S,while actin mainly distributed in the surrounding area of the cell membrane and integrin αVβ3 evenly distributed on the cell surface in group C and M.Conclusion The mechanism by which mechanical stretch induces the increase in the permeability of HPMVECs is related to MLCK activation-mediated stress fiber formation and integrin αVβ3 clustering.

Objective To explore the efficacy of laparoscopy in acute abdominal pain. Methods From March 2002 to March 2007,306 patients with acute abdominal pain were explored and treated by laparoscopy in our hospital. The patients were diagnosed with acute appendicitis in 105 cases,unidentified abdominal pain in 34,acute cholecystitis complicated with cholecystolithiasis in 64,gastrointestinal tract perforation in 51,common bile duct stones complicated with acute cholangitis in 5,intestinal obstruction in 33,and severe acute pancreatitis in 5; 9 patients were confirmed as having trauma. Results All the 306 patients were unequivocally diagnosed during the operation. Laparoscopy was successfully completed in 275 cases,including 123 cases of appendectomy,57 cases of cholecystectomy,48 cases of gastrointestinal tract perforation neoplasty,13 cases of enterodialysis,4 cases of intestinal replacement combined with indirect hernia repair,4 cases of radical resection of the sigmoid colon with precolon anastomosis,1 case of small-incision segmental resection of the small bowel,3 cases of common bile duct resection and calculus removal,2 cases of neoplasty for right-lobe hepatorrhexis,3 cases of haemostasis for splenic rupture,5 cases of debridement and clysis and drainage for severe acute pancreatitis ,and 12 cases of laparoscopic abdominal exploration (2 cases of mesentery contusion and laceration,1 case of abdominal wall punctured wound with contusion of the greater omentum,8 case of primary peritonitis,and 1 case of abdomen-type allergic purpura). The remaining 31 patients were converted to open surgery because of difficulties in laparoscopy. The patients were followed up for 1 to 18 months,during which no one showed intra-or post-operative complications.Conclusions Emergency laparoscopic exploration can not only clarify a diagnosis for acute abdominal pain with unknown causes,but also treat the cases simultaneously. Moreover,it is of great help in guiding abdominal resection and making a suitable operative incision,even if the patients can not be treated by laparoscopy alone.

Objective To explore advantages of combined laparoscopic surgery(CLS).Methods The clinical data of 728 cases of CLS from July 1992 to March 2006 were analyzed retrospectively,including 586 cases of laparoscopic cholecystectomy(LC) combined with fenestration drainage of hepatic cysts,80 cases of LC combined with appendectomy,46 cases of LC combined with oophorocystectomy,16 cases of LC combined with unroofing and drainage of renal cysts.Results 726 cases of CLS were successfully performed,and 2 cases were converted to open surgery for abdominal adherence,with no complications such as bile duct injury,hemorrhea,infection and death occurred.During a mean follow-up period of 16 months(range,2-60 months) in 512 cases,no biliary calculi,recurrence of liver,kidney and ovarian cysts occurred.Conclusions CLS for two kinds or more abdominal diseases in one operation is safe and effective,with advantages of minimal invasion,less pain,and quicker recovery and so on.

Objective To investigate the risk factors of hypoparathyroidism after total thyroidectomy and bilateral central lymph node dissection in patients with papillary thyroid carcinoma.Methods Data of patients with PTC who accepted total thyroidectomy and bilateral central lymph node dissection in the Department of Thyroid Surgery from Jan.2013 to Jun.2016 were collected and analyzed retrospectively.The patients were divided into normal group,transient hypoparathyroidism group and permanent hypoparathyroidism group according to the level of serum parathyroid hormone within 6 months after surgery.Clinical data were collected for comparison between the three groups.The risk factors of hypoparathyroidism were indentified with univariate analysis and multivariate analysis.Results A total of 468 patients,241 in the normal group and 227 in the hypoparathyroidism group (220 in the transient hypoparathyroidism group and 7 in the permanent hypoparathyroidism group),were included in the study.Univariate analysis showed that without application of carbon nanoparticles (P=0.04) and autotransplantation of more than one parathyroid gland (P＜0.001) were risk factors of hypoparathyroidism,and without application of carbon nanoparticles (P=0.047),incidental parathyroidectomy of one parathyroid gland (P=0.04),gross extrathyroidal extension (P=0.006) and c N1a were risk factors of permanent hypoparathyroidism.Multivariate analysis showed that without application of carbon nanoparticles (OR,0.437;95％ CI,0.243-0.789;P=0.006) and autotransplantation of more than one parathyroid gland (OR,3.025;95％ CI,1999-4579;,P=0.000) were independent risk fact ors of hypoparathyroidism,and without application of carbon nanoparticles (OR,0.197;95％ CI,0.039-0.982;P=0.048) and gross extrathyroidal extension (OR,12.381;95％ CI,1.432-107.036;P=0.022) were independent risk factors of permanent hypoparathyroidism.Conclusion When total thyroidectomy and bilateral central lymph nodes dissection were performed,carbon nanoparticles were routinely applied.Although autotransplantation of more than one parathyroid gland can increase the incidence of transient hypoparathyroidism,it can reduce the incidence of permanent hypoparathyroidism.If extrathyroidal extension is suspected,hypoparathyroidism should be emphasized to patient,and accurate operation should be done to reduce the incidence of hypoparathyroidism.

Objective To assess the influence of different methods of blood sampling on the results detected by instant glucose monitor.Methods We searched the following electronic databases CNKI and VIP(from 1995 to 2007).Five quasi-RCTs involving 305 participants were included,RevMan 4.2.10 was used for statistical analysis.Results There was significance in results between instant glucose monitor and auto-analyzer by finger massage and extrusion(WMD=-1.32,95%CI:-2.05 to-0.59,WMD-2.11,95%CI:-2.95 to-1.27,respectively),but no difference by natural outflow(WMD=-0.17,95%CI:-0.53 to 0.19).Conclusion There are influence on the blood glucose results by different methods of blood sampling,the natural blood outflow of fingers is the better way.

8 000 mg group was lower than the normal control's(P

Objective To explore the clinical significance of T lymphocyte subsets and NK cells' detection in peripheral blood of patients with non-Hodgkin' s lymphoma (NHL).Methods 62 newly diagnosed NHL and 30 healthy adults were enrolled for analyzing.T lymphocyte subsets and NK cells were deteced by flow cytometry and compared between different groups according to age,sex and pathology.Multiple linear regression was used to analyze the correlation among the levels of T lymphocyte subsets and NK cells and several clinical factors,such as clinical stage,IPI and B symptoms.Results The proportions of CD3,CD4 and NK cells in peripheral blood of NHL group [(64.13±19.83) ％,(27.10±8.20) ％,(13.51± 10.59) ％] were significantly lower than those of normal control [(65.78±10.69) ％,(31.95±12.74) ％,(18.76± 7.36) ％] (P ＜ 0.05),while the proportions of CD8 and Treg cells in peripheral blood of NHL [(32.15±13.83) ％,(10.44±3.00) ％] were significantly higher than those of normal control [(29.25±12.35) ％,(7.51±4.36) ％] (P ＜ 0.05).In NHL,the proportions of CD3 and NKT cells [(67.06±19.24) ％,(4.91±3.69) ％] in ≤60 years old group were significantly higher than those in ＞ 60 years old group [(59.18±20.33) ％,(4.89±3.05) ％] (P ＜ 0.05).The proportions of Treg cells in T-NHL was significantly higher than that in B-NHL [(8.17±6.41) ％ vs (7.11±2.53) ％] (P ＜ 0.05).The proportions of CD3,CD4,NK and NKT cells in peripheral blood of NHL were significantly correlated with clinical stage (P ＜ 0.05),that of CD8 cells were significantly correlated with IPI (P =0.000),that of Treg cells were significantly correlated with IPI and B symptoms (P ＜ 0.05).Conclusion The cellular immune is suppressed in NHL patients.The proportions of T lymphocyte subsets and NK cells in peripheral blood of patients with NHL are different between different groups according to age,sex and pathology.The correlations among that and clinical factors need to be further explored.

Objective:The clinical factors of single-port video-assisted thoracoscopic surgery (SP-VATS) were compared with those of multi-port video-assisted thoracoscopic surgery (MP-VATS). The differences between the two surgical methods and their respective postoperative recoveries were also discussed. Methods:A total of 522 patients who underwent surgical treatment for lung cancer in Tianjin Medical University Cancer Institate and Hospital from January, 2014 to December, 2015 were retrospectively reviewed. Of these cases, 83 underwent SP-VATS and 439 underwent MP-VATS. The two surgical methods were then compared in terms of opera-tive time, operative bleeding, number of lymph node and lymph node cleaning station, pain degree, 24 h postoperative chest drain-age, and in-hospital time after operation. Results:The differences between the patients who underwent SP-VATs and those who under-went MP-VATS in term of gender, age, smoking, tumor diameter, TNM stage, pathological type, and tumor location were not statistical-ly significant. The operative time in SP-VATS group was longer than that in the MP-VATS group (P<0.01), whereas in-hospital time after operation in the former group was shorter than that in the latter (P=0.011). Furthermore, pain degree in the SP-VATS group is lower than that in the MP-VATS group (P=0.041). The differences between the two groups in terms of operative bleeding, number of lymph node and lymph node cleaning station, and 24 h postoperative chest drainage were not statistically significant. Conclusion:SP-VATS can achieve a surgical effect similar to that of MP-VATS but has a prolonged operation time. SP-VATS is beneficial to postoperative re-covery and reduces the degree of pain. Thus, it has great potential for development.

Objective To investigate the clinicopathological significance of the expression of annexin A2 (ANXA2) in liver fibrosis and hepatocellular carcinoma (HCC).Methods The expression level of ANXA2 in normal liver,liver cirrhosis and HCC were examined by Western blot.The correlation between ANXA2 expression and clinicopathological parameters in liver fibrosis and HCC were analyzed by immunohistochemistry.Results Compared with the normal liver tissue,ANXA2 protein expression level increased significantly in HCC and liver cirrhosis,with the highest expression in HCC (P =0.000).There was significantly positive relationship between ANXA2 protein expression and stages for liver fibrosis (P ＜ 0.01).The expression of ANXA2 protein in HCC was closely associated with HBV infection,differentiation degree and the recurrence (P ＜ 0.05).In some cases,ANXA2-positive cancer cells were often dispersed in the periphery of cancer nodules and were adjacent to stromal cells.Conclusion Overexpression of ANXA2 may be involved in liver fibrosis and play a role in the development of HCC,indicating ANXA2 may serve as a diagnostic biomarker for liver fibrosis and tumor differentiation in HCC.

OBJECTIVETo compare the clinical efficacy difference between encircling needling combined with physical factor therapy and simple physical factor therapy for severe pressure sore, and to explore the optimal method for severe pressure sores.

METHODSThirty-four patients with IV-grade pressure sore were randomly divided into an observation group and a control group, 17 cases in each one. Patients in the control group were treated with conventional nursing, ultrasonic wave and short-wave ultraviolet therapy; additionally, the encircling needling was applied in the observation group. All the treatment was given once a day, 5 times a week, and 4-week treatment constituted one session. Totally, two sessions of treatment were performed. Three indices, including the area of pressure sore, 24-h volume of exudates and wound-bed tissue type, were compared between the two groups before and after treatment; the clinical efficacy was evaluated in the two groups.

RESULTSAfter treatment of one session and two sessions, the area of pressure sore, 24-h volume of exudates and wound-bed tissue type were significantly reduced in the two groups (P < 0.01, P < 0.05), which was more obvious in the observation group (all P < 0.05). The total effective rate in the observation group was 76.5% (13/17) after 1 session and 94.1% (16/17) after 2 sessions, which were superior to 35.3% (6/17) after 1 session and 64.7% (11/17) after 2 sessions in the control group (both P < 0.05).

CONCLUSIONEncircling needling combined with physical factor therapy can obviously reduce the pressure sore area and 24-h volume of exudates and improve wound-bed tissue type, which is superior to simple physical factor therapy.

Acupuncture Therapy ; Adult ; Aged ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pressure Ulcer ; therapy ; Short-Wave Therapy ; Ultrasonic Therapy ; Ultrasonic Waves