Objective To evaluate the effects of different optional time leading to complication and prognosis by laparoscopic cholecystectomy.Methods Search all of clinical randomized trials on early and delay laparoscopic cholecystectomy in CNKI database.The RevMan 5.0 software was used to conduct the Meta-analysis,which was carried out by collecting information based on inclusion and exclusion criteria from all trails' information available,and the pubhcation bias analysis and the susceptivity analysis was also evaluated to make sure the results stable.Results There was significant statistical difference in conversion,surgery time,complication and postoperative hospitahzation time between the ＜ 72 h group and ＞ 72 h group (P ＜ 0.05).Conclusions Meta-analysis shows that in the laparoscopic cholecystectomy progress,the surgical outcome is best with 72h,which can short the surgery and postoperative hospitalization time,reduce the complication and decline the conversion.

ObjectiveTo evaluate partial inferior vena cava (IVC) interruption and filter placement in the prevention of pulmonary embolism caused by lower extremity deep vein thrombosis (LEDVT).MethodsAmong 44 cases of LEDVT, 10 cases underwent partial IVC interruption, 34 cases received IVC filter placement.Results7 out of 10 cases undergoing IVC occlusion experienced post operative relief of non-fatal pulmonary embolism symptoms with no perioperative mortality or severe complications.On follow-up of 8 months, 3 cases experienced non-lethal pulmonary embolism. 24 out of 34 filter placement cases had postoperative relief of pulmonary embolism symptoms with no perioperative mortality. 2 cases suffered from inhospital pulmonary embolism with one death. 20 cases were followed up for an average of 10 months without recurrence of pulmonary embolism. Conclusion Both partial IVC interruption and filter placement are safe and effective surgical procedures for the prevention of recurrence of pulmonary embolism. The result of filter placement is more favourable.

Objective To evaluate our early results of a combined minimally invasive surgery with surgical procedures for critical extremity ischemia. Methods From July 1999 to October 2000 intraluminal iliac minimally invasive surgery combined with simultaneous conventional surgery were performed on 20 lower extremities of 15 pa- tients suffering from critical multilevel atherosclerotic occlusive disease. There were 11 men and 4 women with an aver- age age of 73 years. The indications for surgery included disabling claudication in 6, rest pain in 9(included tissue gan- grenes in 3)patients. Mean preoperative ankle - brachial index(ABI)was 0. 35 ? 0. 18. Results 17 iliac mini mal- ly invasive approaches combined with simultaneous 11 femoro - popliteal bypass and 3 femoro - femoral popliteal by- pass as well as 5 profundaplasty were performed in 20 limbs of 15 patients. minimally invasive surgery were technically successful in all patients. One femoral - popopliteal bypass was failure. There were no additional instances of procedural or postoperative morbidity or mortality, and no wound - related complications. Postoperative ABI of femoral - popliteal bypass was 0.74 ? 0. 16(p

Objective To investigate the expression and clinical significance of RegⅣand EGFR,PI3K proteins in gastric adenocarcinoma .Methods S-P immunohistochemistry was used to detect the expression of RegⅣand EGFR,PI3K proteins in pathological tissues of 73 cases with gastric adenocarcinoma and tumor -adja-cent normal gastric tissues .Results The positive expression rates of RegⅣand EGFR,PI3K proteins in 73 cases with gastric adenocarcinoma tissue were 50.7%(37/73),56.2%(41/73) and 69.9%(51/73) respectively, which were significantly different from the positive expression rates of tumor -adjacent normal gastric tissues ,be-ing 20.5%(15/73),19.2%(14/73),and 21.9%(16/73),respectively(P<0.05).The expression of RegⅣprotein was significantly correlated to differentiation degree ( P<0.05 ) and the expression of EGFR protein was significantly correlated to infiltrative depth,TNM stage,and lymph node metastasis(P<0.05).The expression of PI3K protein was significantly correlated to differentiation degree ,infiltrative depth,TNM stage and lymph node metastasis(P<0.05).There was positive correlation between the expressions of RegⅣ/EGFR,RegⅣ/PI3K and EGFR/PI3K proteins in gastric adenocarcinoma and the values of Spearman coefficient correlation were 0.325, 0.403 and 0.384,respectively(P<0.05).Conclusion RegⅣmay play an important role in gastric adenocarci-noma genesis and progression by activating EGFR /PI3K/Akt signaling pathway .

BACKGROUND:Bone marrow mesenchymal stem cel transplantation for myocardial infarction becomes popularized in recent years, but transplanted cels cannot survive and proliferate under early inflammatory reaction or local ischemia/hypoxia microenvironment, eventualy hampering the therapeutic outcomes.
OBJECTIVE:To investigate the therapeutic effect of PTEN-silenced bone marrow mesenchymal stem cels on acute myocardial infarction.
METHODS:(1) Bone marrow mesenchymal stem cels from Sprague-Dawley rats were randomly assigned to receive no treatment, NCsiRNA transfection using Lipofectamin2000orPTEN siRNA transfection using Lipofectamin2000. Cel growth curves were described using MTT method to detect cel cycle using flow cytometry. (2) Thirty Sprague-Dawley rats were selected to prepare myocardial infarction models that were randomized into three groups (n=10 per group): blank control, negative control and RNAi group. Six hours after modeling, bone marrow mesenchymal stem cels transfected with nothing, NCsiRNA and PTEN siRNA were respectively injected into the infarcted center of the left ventricular anterior wal in these three rat groups. After 4 weeks, al rats were subjected to cardiac function detection using echocardiography, and the survival and proliferation of bone marrow mesenchymal stem cels in the rats were observed by fluorescence microscopy.
RESULTS AND CONCLUSION:Compared with the other two groups, a significant increase in the absorbance values at different culture time, the proportion of cels in S+G2phase, and the number ofbone marrow mesenchymal stem cels in the myocardial tissue was found in the RNAi group (alP< 0.05). Additionaly, the left ventricular ejection fraction and left ventricular shortening fraction were significantly reduced in the RNAi group than the blank control and negative control groups at 4 weeks after cel transplantation (P< 0.05). Bothin vivoandin vitroexperimental findings showed that PTEN silencing could effectively improve cel survival and proliferation in the infarcted myocardium. Moreover, in thein vivoexperiment, an overt improvement in rat’s cardiac function was achieved.

BACKGROUND:Although there are many studies addressing osteoarthritis in China, population-based epidemiological studies of knee osteoarthritis have been rarely reported. OBJECTIVE:To explore and analyze the clinical efficacy of early ladder-like treatment in knee osteoarthritis patients from Zoucheng city in the southwest of Shandong province based on an epidemiological investigation. METHODS: A total of 3 427 people randomly enroled from Zoucheng city located in the southwest of Shandong province in 2008 were taken as research objects. A self-designed epidemiological survey on knee osteoarthritis was carried out to analyze the sex, age, urban and rural distribution, and incidence of knee osteoarthritis. According to Kelgren Lawrence Grading, 208 patients with levels 0, I, II of knee osteoarthritis were randomly selected and divided into two groups: surgical treatment group was given intraarticular injection, intraarticular rinsing, arthroscopic treatment and functional exercise; oral drug group was only given oral administration of non-steroidal anti-inflammatory drugs and blood circulation drugs. Ninety-eight patients in the surgical treatment group and 87 in the oral drug group were folowed-up for over 1 year. RESULTS AND CONCLUSION:The incidence of knee osteoarthritis showed an increasing trend with aging in Zoucheng city. There were 33.2% patients who did not receive treatment, 53.2% patients who received irregular treatment, and only 13.6 patients who could folow the doctor’s advice. The excelent rate and total effective rate were higher in the surgical treatment group (81% and 99%) than the control group (34% and 87%;P < 0.01). This epidemiological investigation exerts a certain protective role in the occurrence and development of knee osteoarthritis, and active early ladder-like treatment has achieved good outcomes in patients with knee osteoarthritis.

Objective To investigate the feasibility, safety and efficiency of endovascular treatment for patients with aorto-bilateral-iliac artery total occlusive disease.Methods A total of 35 patients with aorto-bi-iliac artery total occlusive disease treated with endovascular therapy in Peking Union Medical College Hospital and the First Hospital of Shijiazhuang between Jan 2012 and Dec 2013 were retrospectively analyzed.Results There were 33 males and 2 females, mean age (67 ± 6) years treated during the study period.Technical success rate was 100％.129 bare stents and 4 covered stents were implanted.There were no peri-operative death.Postoperative leg ankle brachial index (ABI) improved significantly (0.86 vs.0.28, P ＜ 0.28).Postoperative complications occurred in 2 patients (5.7％), including brachial artery thrombosis and rupture of external iliac artery post-dilation.The mean follow-up period was 16.5 months (2-28 months).Two patients (5.7％) were lost to follow up.Re-intervention was performed in 3 patients (8.6％) due to reocclusion of the stents.Primary patency was 91％ (30/33) Conclusions Endovascular treatment is effective for aorto-bi-iliac artery total occlusive disease with low complications and acceptable mid-term patent rate.

Objective To evaluate therapeutic effects of endovascular therapy for in-stent restenosis of superficial femoral artery,and the risk factors of restenosis of re-intervention therapy.Methods We retrospectively summarized the clinical data of 35 patients(38limbs)who suffered from in-stent restenosis of superficial femoral artery(SFA)stent from 2010 to 2012.Results 35 patients (38 limbs)were enrolled in this study,there were 24 males and 11 females.Mean age was (68 ±8)years.The success rate of endovascular therapy was 89.5％ (34/38),including in-stent angioplasty in 14 limbs,in-stent and beyond-stent angioplasty in 5 limbs,in-stent angioplasty and beyond-stent re-stenting in 15 cases.The primary patency and sencondary patency rate for 6,12 and 24 months was 65.2％,46.5％,46.5％,and 87.5％,80.2％,55.8％ respectively.The independent risk factors for re-obliteration were age ＞ 70 years (P ＜ 0.05) and diabetes mellitus (P ＜ 0.05).Conclusions Endovascular therapy is effective and safe in treatment in-stent restenosis of superficial femoral artery.The long-term in-stent patency is not satisfactory,with age ＞ 70 years and diabetes mellitus as independent risk factors.

Objective To investigate the clinical roles of lysine methyltransferase 5A(KMT5A)in human hepatocellular carcinoma(HCC)and its functions in cell migration and invasion. Methods The expression levels of KMT5A of 60 cases were detected by immunohistochemistry(IHC). KMT5A siRNA was used to down-regulate the expression of KMT5A in SMMC-7721 cells. Cell migration and invasion were measured by wound healing assays and transwell assays,respectively. Immunoblotting was used to detect the expression of MMP-2 after siRNA trans-fection. miR-186 mimics were transfected into SMMC-7721 cells and the mRNA levels of KMT5A was detected by qRT-PCR after transfection. Results High expression of KMT5A was associated with large tumor diameter (>5 cm,P=0.047)and advanced TNM stage(Ⅲ+Ⅳ,P=0.035). The expression of KMT5A was knocked down by siRNA in SMMC-7721 cells. Down-regulation of KMT5A suppressed cell migration(P=0.031,P=0.006)and invasion(P=0.010),and impaired MMP-2 expression(P=0.040). Overexpression of miR-186 could significantly inhibit the expression of KMT5A(P = 0.007). Conclusions Over-expression of KMT5A in HCC tissues associ-ates with poor clinical features. KMT5A knockdown inhibits the migration and invasion on HCC cells.

Objective To study the differential expression of cell adhesion molecule(CAM) genes in the pathegenesis of AAA. Methods Microarray technique was applied to screen for the differential expression of CAM genes between AAA and normal aortic tissues. Results Three differentially expressed CAM genes were found in AAAs by microarray technique and molecular biology investigation, including VCAM 1, PECAM 1, TSP,with up regulating ratio of 5 683,3 601,57 406,respectively.Conclusion These abnormally up regulated CAM genes found in AAA might participate in the development of abdominal aortic aneurysms.