Objective To explore the molecular mechanism of S100A9-induced secretion of vascular endothelial growth factor-A (VEGF-A)by monocytes.Methods Peripheral blood specimen were collected from healthy individuals undergoing physical exami-nation and the CD14 + monocytes were purified by using immunomagnetic beads and the expression of the receptor for advanced gly-cation endproducts (RAGE)was detected by flow cytomertry.In vitro CD14 + monocytes were stimulated by S100A9,and anti-RAGE antibody or NK-κB signal pathway inhibitor were pre-incubated for 1 hour and then stimulated by S100A9,the levels of VEGF-A were detected by using enzyme-linked immunosorbent assay.Results The high level of RAGE was expressed by isolated CD14 + monocytes,after S100A9 stimulation,the secretion of VEGF-A by CD14 + monocytes was significantly increased in a dose and time dependent manner.However,the inducing VEGF-A was significantly decreased(P <0.01 ),while pre-treated with anti-RAGE antibody or NK-κB inhibitor (P <0.01).Conclusion S100A9 inducing the secretion of VEGF-A by monocytes and is de-pended on RAGE-NK-κB signal pathway,suggesting that S100A9 might promote angiogenesis.

Objective To compare the effectiveness and the influence on life quality of endovenous laser obliteration with those of traditional surgical ligation in treating varicosis of lower extremity.Methods By using numerical random grouping method,40 patients with varicosis of lower extremity were divided into traditional surgical ligation group (high ligation plus stripping,traditional group,n=20) and endovenous laser obliteration group (laser group,n=20).The curative effect and complications were compared between the two groups.According to the brief health survey (SF-36) scale,the influences of the two treatments on the life quality were evaluated.Results During the follow-up period,the differences in the curative effect and complications between two groups were not significant (P＞0.05).The life quality assessed by SF-36 scores in the laser group was better than that in the traditional group,the difference between the two groups was statistically significant (P＜0.05).Conclusion For the treatment of varicosis of lower extremity,endovenous laser obliteration is safe and effective,it carries less influence on the patient's life quality when compared with traditional surgical ligation therapy.

Hepatocellular carcinoma (HCC) combined with inferior vena cava (IVC) tumor thrombosis is regarded unresectable.Most of the patients received non-surgical treatment or gave up treatment,and the prognosis of these patients is poor.As the development of surgical treatment,the success rate of surgical treatment for HCC combined with IVC tumor thrombosis is increasing yearly.In May of 2012,one patient with HCC combined with IVC tumor thrombosis received hepatic Ⅴ,Ⅶ and Ⅷ segmentectomy + tumor thrombosis removal from the IVC at the Second Affiliated Hospital of Harbin Medical University.Preoperative computed tomography showed space-occupying lesions in the segments Ⅴ,Ⅶ and Ⅷ,and the IVC was filled with tumor thrombi.The volume of the left liver was 489 cm3,which was under the limit for survival.In order to preserve the remnant liver,right hepatectomy with reservation of hepatic segment Ⅵ,and the tumor thrombi in the IVC were removed with total hepatic vascular exclusion.The patient was recovered with no tumor recurrence or metastasis at postoperative month 18.

Objective To summarize the surgical skills of the pancreaticoduodenectomy via mesenteric approach for the treatment of duodenal gastrointestinal stromal tumors (GISTs).Methods The clinical data of 1 patient with huge duodenal GIST combined with gastrointestinal hemorrhage and liver metastasis who was admitted to the Second Affiliated Hospital of Harbin Medical University in June 2014 were retrospectively analyzed.The patient had continuous bleeding before the operation.The results of computed tomography (CT) showed that there was a solid tumor below the liver and in front of the right kidney,with the size of 12.2 cm × 8.1 cm,inferior vena cava was squeezed by the tumor,a solid tumor was detected in the right lobe of liver,and the colon was suspiciously invaded by the tumor.The patient received pancreaticoduodenectomy,right hemicolectomy and right lobectomy of liver metastases.The patient was followed up by out patient examination and telephone interview up to August 2014.Results The operation time,volume of blood loss and volume of red blood cell (RBC) transfusion were 420 minutes,800 mL and 2 U,respectively,with a full recovery of patients.The duodenal GIST with metastasis tumor and necrosis located at the colon,pancreatis,liver and renal hilum was confirmed by pathological diagnosis.The life quality of the patient was good by follow-up at postoperative month 3.Conclusion In the pancreaticoduodenectomy via mesenteric approach,surgeons perform vigorously the method of mesenteric approach at the first stage of operation,it could maximally reduce the risk of operation and the volume of blood loss.

Objective To investigate and compare the applications of white blood cell count (WBC),neutrophil percentage (N%),C reactive protein (CRP)and procalcitonin (PCT)in the detection of bacterial infections.Methods Patients were randomly recruited in the study,70 patients with bacterial infection disease were recruited in the study as bacterial infection group,81 patients without bacterial infection were enrolled as no infection group.WBC,N%,CRP and PCT were detected,then comparative analysis of test results performed.Results Compared with no bacterial infection group,WBC,N%,CRP and PCT were increased in bacterial infection group(P <0.05),CRP and PCT increased obviously.The positive rate of WBC,N%,CRP and PCT in bacterial infection group was significantly higher than that of no bacterial infection group(P <0.05).In the bacterial infection group,the positive rate of N%,CRP and PCT was significantly higher than that of WBC(P <0.05),the positive rate of CRP was higher than PCT(P <0.05).But the positive rate of CRP was relatively high,and PCT was low in no bacterial infection group,suggesting that the false positive rate of CRP was higher,while that of PCT was lower,which had higher specificity.Conclusion WBC,N%,CRP and PCT all have clinical value for bacterial infections diagnosis.For the diagnosis of bacterial infections,N%,CRP and PCT is superior to WBC.CRP is more sensitive,but less specific,therefore,PCT with higher specificity was more suitable in the diagnosis of bacterial infections.

Objective To study the clinicopathologic features,effective therapeutic regimen and prognosis of human immunodeficiency virus (HIV) infection with acute promyelocytic leukemia (APL) and chronic myeloid leukemia (CML).Methods Two cases of HIV infection concurrent with leukemia,one with APL,one with CML,were studied and relevant literatures were reviewed.Results Case 1 was HIV infection concurrent with APL,ATO was used to induce remission,in the eight day of therapy,the patient died of brain disorder.Case 2 was HIV infection concurrent with CML,hydroxycarbamide and interferon were used to induce remission,three month later,state of an illness progressed to acute phase,after combination chemotherapy,concurrent with lung multiple infection (fungus and pneumocystis carinii),at last,the patient died of respiratory failure.Conclusion HIV infection concurrent with acute and chronic leukemia has poor therapeutic effect,and is easy to infect seriously.

Objective Controversies remain as to the recovery time, recovery quality, and incidence of peri-recovery adverse reactions of the patient receiving general anesthesia with remifentanil and sufentanil.This study aimed to systematically assess the qual-ity of recovery from general anesthesia with remifentanil and sufentanil. Methods Randomized controlled trials ( RCTs) were re-trieved from The Cochrane Library, PubMed, MEDLINE, EMbase, Ovid, Springer, Web of Science, CNKI, CBM, VIP, and Wan-Fang Data.According to the modified Jadad quality scale, the literature retrieved was screened and subjected to quality evaluation and meta-analysis was performed on the included studies using the RevMan 5.1 software. Results Thirty-three RCTs involving 2175 pa-tients were finally included.The results of meta-analysis showed no significant differences between the remifentanil and sufentanil groups undergoing thyroid surgery either in the recovery time to spontaneous breathing ( T1) and eye-opening ( T2) and endortracheal extubation time ( T3 ) ( P >0.05 ) or in the incidence rate of postoperative nausea and vomiting (PONV) (P>0.05).T1, T2 and T3 were significantly shorter in the sufentanil than in the remifentanil group in other types of surgery (P<0.05).The patients with level-1 Ramsay score were remarkably more in the remifentanil than in the sufentanil group ( MD =13.67, 95% CI 2.67 -69.91 ) ( P <0.05), and the VAS scores were markedly higher in the former than in the latter group at 30 minutes (MD=3.37, 95% CI 3.28-3.46) and 1 hour after extubation (MD=2.53, 95% CI 2.43 -2.63) (P<0.05). Conclusion Compared with sufentanil, remifentanil provides a quicker recovery but a weaker analgesia effect and a higher rate of post-operative agitation.However, sufentanil produces a better pain relief and a higher quality of recovery after operation.

Objective To compare the contents of astragaloside Ⅳ and polysaccharides in radix astragali with different growth years, providing reference for the better harvest time of radix astragali. Methods HPLC-ELSD was used to determine the content of astragaloside Ⅳ. A Hypersil-Keystone C18 column was used with the mobile phase consisting of acetonitrile-water (33∶67). The flow rate was set at 1.0 mL/min. The parameters of drift tube and gas flow rate of the detector were set at 105 ℃ and 2.7 L/min respectively. Phenol-sulfuric method was employed to determine the content of polysaccharides, and the detection wavelength was set at 490 nm. Results The linear range of astragaloside Ⅳ was within 1.25-6.28 μg. The average recovery was 97.28%, with RSD=1.42%. The linear range of polysaccharides was 10-100 μg. The average recovery was 99.02%, with RSD=0.94%. The content of astragaloside Ⅳ in radix astragali cultivated for more than 1 year was higher than the standard in Chinese Pharmacopoeia, and radix astragali cultivated for 3 years showed the highest content. The content of polysaccharides in radix astragali cultivated for more than 3 years was the highest, and radix astragali cultivated for 2 years was slightly lower. Conclusion The better harvest time for radix astragali is at least two years of growth, which is judged from the content of astragaloside Ⅳ and polysaccharides.

Objective:To establish the identification method for Aucklandia Lappa and Picrorhiza kurrooa Royle ex Benth and the content determination of hydroxysaffor yellow A in Liangxue Shiwei San. Methods:The identification was carried out by TLC. The con-tent of hydroxysaffor yellow A was determined by HPLC. The column was Kormasil C18 (250 mm × 4. 6 mm, 5 μm) and the flow rate was 1. 0 ml·min-1. The mobile phase was methanol-0. 5% acetic acid (30∶70). The detection wavelength was 403 nm and the col-umn temperature was 25℃,and the sample size was 10 μl. Results:The TLC spots were clear with high resolution without interference from the negative sample. A good linearity of hydroxysaffor yellow A was within the range of 1.212-48.480μg·ml-1(r=0.999 8). The average recovery was 98. 13%(RSD=1. 6%,n=6). Conclusion:The established TLC and HPLC methods are simple and accu-rate with good reproducibility, which can be used in the quality control of Liangxue Shiwei San.