Objective To explore large_circle manipulation(LCM),a kind of massage manipulation for prolapse of lumbar intervertebral disc(PLID)founded by Professor He Zhenhui. Methods LCM is characterized by the large_circle passive movement of the body below the affected intervertebral disc when the patients were in prone position and the affected intervertebral disc was fixed.Twenty_six cases of PLID were half_randomly allocated to LCM group(Group A) and routine traditional manipulation group(Group B).Lasegue's sign was scored before and after treatment. Results The therapeutic effects were satisfactory in both groups. Conclusion LCM is effective for PLID and can be used as a supplement for routine traditional manipulation.

Objectives Pancreatic ischemia is a pathogeny of acute pancreatitis(AP), and systemic blood rheologic changes have close relationship with AP. The aim of this study was to investigate the potential role of the systemic blood rheologic and pancreatic hemodynamic changes in rats with AP, and to reveal their relationship. Methods Acute edematous pancreatitis(AEP, n =20) and acute necrotizing pancreatits(ANP, n =20) models were induced by injection of sodium taurocholate into the pancreatic duct of rats, another 10 normal rats were used as control group. The pancreatic blood flow(PBF) was measured by Doppler ultrasound before and after the operation. At 12 h after the induction of AP, 10 rats in each group were sacrificed, the blood rheologic indexes were detected, and the pathological study of pancreas was performed. The survival rate in 3 days of the rest 10 rats in AEP and ANP group was also observed. Results Compared with the control group, only the hemagglatination index increased in AEP group and all the blood rheologic indexes increased in ANP group distinctly with the elevation of blood viscosity curve. The velocity of PBF was decreased in AEP and ANP groups, reducing to 79% and 30% of theirs levels before the induction of AP. Compared with the control group, the pathological scores of pancreatic edema, inflammation, hemorrhage and necrosis of AEP rats significantly increased, and compared with AEP group, these four indexes increased significantly in ANP rats. The survival rate in 3 days of AEP group was 90%, but that of ANP group was 0. Conclusions Systemic blood rheologic and pancreatic hemodynamic changes happen synchronously in rats with AP. The injury of pancreatic microcirculation due to ischemia is one of the initial pathogeneses of AP. The change of blood rheology is not a contributing factor causing AP, it could aggravate pancreatic ischemia and accelerate the pancreatic injury after onset.

Objective To compare the different expressions of transforming growth factor beta1 (TGFβ1) and its type one receptor(TGFβR1) between primary pancreatic cancer cell line AsPC-1 and metastatic pancreatic cancer cell line BxPC-3. Methods The mRNA expressions of TGFβ1 and TGFβR1 in AsPC-1 and BxPC-3 pancreatic carcer cell lines were quantatitived by real-time RT-PCR. The protein levels of TGFβ1 and TGFβR1 in these two cell lines were measured by Western blot assay. Results Compared with the primary pancreatic cancer cell AsPC-1, the mRNA and protein expressions of TGFβ1 and TGFβR1 were much higher in BxPC-3 pancreatic cancer cells(P<0.05). Conclusions Upregulations of TGFβ1 and TGFβR1 might be a pivotal incidence in the procedure of malignant progressing and metastasis in pancreatic cancer cells.

The cell killing effects and bystander effects of double suicide gene on pulmonary carcinoma cells were explored. Lung adenocarcinoma cells (A549) were transfected with different titers of adenovirus vector and followed with different concentrations of 5-FC after a recombinant adenovirus vector carrying CD/UPRT gene (Ad-CD/UPRT) was constructed. The cell viability was measured by MTT assay 4 days later. The cell viability was dropped to 30.57 %-8.62 % after 10 MOI of Ad-CD/UPRT transfected and 5-FC (10-1000 microg/mL) administration. Furthermore, Ad-CD/UPRT-infected A549 cells showed a profound neighbor cell killing effect in the same methods. These results suggested that Ad-CD/UPRT/5-FC system can effectively suppress growth of lung adenocarcinoma cells, which may provide a novel and powerful candidate for lung cancer gene therapy strategies.

Objective To investigate the predictive values of P-selectin (P-sel),thrombus precursor protein (TpP) and D-dimer (D-D) in the early diagnosis of portal vein thrombosis (PVT) in patients submitted to splenectomy (or to devascularization).Methods The clinical data of 48 patients with portal hypertension (the PVT group,n=26; and the non-PVT group,n=22) who received operation in our hospital from 2009 to 2011 were retrospectively analyzed.Detecting the P-sel,TpP and D-D levels in the two groups of patients were done on preoperative day 1 and postoperative day 1,3,5,7,14.The SPSS software was used for statistic analysis.Results There were no significant differences on the preoperative day 1 levels of P-sel,TpP and D-D in the two groups (P＞0.05).The postoperative day1 levels of the three indicators in the PVT group were significantly higher than the non-PVT group (P＜0.05).Receiver operating characteristic (ROC) curves showed the area under curve (AUC) of P-sel was largest (0.893),followed by D-D,and TpP.The combined detection of the 3 indicators was highest,with the AUC up to 0.977.Conclusions Combined detection of P-sel,D-D and TpP levels were useful in the early diagnosis of PVT after splenectomy in patients with portal hypertension.

Objective To develop a phenylketonuria (PKU) screening method based on a compact disk (CD) type microfluidic chip capable of generating reciprocating flow within the microchannels that facilitate rapid DNA hybridization. Methods This microfluidic device consists of a two-layer structure: a polydimethylsiloxane (PDMS) top layer containing 12 DNA hybridization microchannels, and a bottom glass layer with immobilized hydrogel conjugated DNA arrays. The DNA arrays included R243Q, V245V and the blank control probes. When the CD device was spun, the PCR products were driven into the hybridization channel by centrifugal force. When the rotation of the CD device was stopped, capillary force pulled the PCR products solution to flow back to the channel. After the on-chip hybridization, the hybridization signals were captured on a fluorescence microscope. The specificity, detection limitation and reproducibility of this device were evaluated. Thirty DNA samples from pregnant women with suspected PKU were detected by this device.Then the results were compared with DNA sequencing results. Results With the compact disk type microfluidic chip, the hybridization time could be reduced to 15 min, sample consume could be as low as 1. 5 μl and the detection limitation was 0. 7 ng/μl. With the chip based method, samples of PKU patients and healthy controls were detected and the results were consistent with DNA sequencing results. Five different batches of chips and five micro-channels of each chip were selected to test one PKU patients with V245V mutation. All the results were positive, indicating good reproducibility. Four cases of V245V mutation and 1 case of R243Q mutation were found in 30 suspected PKU carried pregnant women. Conclusion The compact disk microfluidic device has advantages of simple, rapid and highly sensitive, thus is well suited to PKU screening.

In this study, the time-dependent changes on dynamic computed tomograph (CT) of radiation-induced liver injury in gastric cancer patients was examined. The CT images of 52 gastric cancer patients who had received chemoradiotherapies were reviewed on the PACS system. Dynamic CT scan was performed in all the subjects. Our results showed that 18 patients were found to have radiation-induced liver injury. The CT findings of radiation-induced liver injury in gastric cancer patients tend to show up one month after radiation treatment. The damaged area was of low density on all three phases, and then it was enhanced on portal vein phase or delay phase. The focal radiation reaction of liver without basic disease vanished 9-11 months later after treatment. We are led to conclude that dynamic CT is of help in the diagnosis of CRT-induced liver injury, and it may be the method of choice for following up the whole course of the CRT-induced liver injury, i.e., form hepatic damage to healing. The classification of CT findings we recommend can avoid the influence of technological factors, and thereby serve as a better guide for treatment of CRT-induced liver injury.

We developed a microfluidic device to integrate sample introduction, bacteria culturing and results reading. The identification of multiple bacteria was achieved by combining the spatial resolution of the arrayed bacteria culture chambers and the color resolution benefited from the bacteria specific chromogenic media. A set of 4 common pathogenic bacteria responsible for urinary tract infection were used as a model to test the microfluidic assay. Our results showed that the bacteria identification assay can be completed in 15 h, with a limit of detection (LOD) of bacteria density down to 10 cfu / mL. Clinical sample testing using the microchip approach showed a coincidence rate of 96. 3% as compared with the conventional method. The developed microfluidic approach is simple and rapid, thus hold the potential to serve as a powerful tool for detection of multiple bacteria.

Objective:To explore the impact of early postoperative hypocaloric parenteral nutrition on perioperative infectious complications in patients undergoing hepatectomy for primary hepatic carcinoma.Methods:The data of 205 patients who underwent hepatectomy for primary hepatic carcinoma in the Division of Hepatobiliary and Transplantation Surgery at Nanjing Drum Tower Hospital between February 2020 and December 2022 were collected by a single center prospective cohort study. The patients were divided into a hypocaloric group ( n=108) and a normal calorie group ( n=97) based on whether they received hypocaloric parenteral nutrition within 72 hours postoperatively. The influence of early parenteral nutrition caloric on perioperative infectious complications was analyzed. Measurement data with normal distribution were expressed as mean±standard deviation ( ± s) and compared using t-test. Measurement data with skewed distribution were expressed as M( Q1, Q3) and compared using the Wilcoxon rank-sum test. Comparison of categorical data was performed using the chi-square test or Fisher′s exact test. To adjust for confounding factors, patients were grouped for comparison based on whether they experienced infectious complications within the 30-day postoperative follow-up period. Factors that may influence postoperative infectious complications were first analyzed using univariate analysis, and variables with statistical significance were then included in multivariate analysis. Results:A total of 82 patients experiencing infectious complications, resulting in an incidence rate of 40.0%. Patients in the hypocaloric parenteral nutrition group had significantly lower rates of hyperglycemic events (17.6% vs 29.9%, P=0.038) and gastrointestinal reactions (12.0% vs 22.7%, P=0.043) compared to the normal calorie parenteral nutrition group, with no intergroup differences in other nutrition-related complications. Univariate analysis results revealed that hypocaloric parenteral nutrition, hepatocellular carcinoma, malnutrition assessed by the GLIM criteria, open surgery, major hepatectomy, perioperative hyperglycemic events, and the presence of pleural or ascitic fluid were potential influencing factors for the occurrence of infectious complications ( P<0.05). Multivariate analysis results suggested that malnutrition ( OR=2.707, 95% CI: 1.153-6.354, P=0.022), open surgery ( OR=2.103, 95% CI: 1.073-4.122, P=0.030), perioperative hyperglycemic events ( OR=2.630, 95% CI: 1.228-5.631, P=0.013), and the presence of pleural or ascitic fluid ( OR=2.714, 95% CI: 1.388-5.306, P=0.004) were risk factors for perioperative infectious complications in patients undergoing hepatectomy for primary hepatic carcinoma, while early postoperative hypocaloric parenteral nutrition ( OR=0.388, 95% CI: 0.199-0.757, P=0.006) was a protective factor. Conclusion:For patients undergoing hepatectomy for primary hepatic carcinoma, early postoperative hypocaloric parenteral nutrition may reduce the incidence of perioperative infectious complications compared to normal caloric parenteral nutrition, thereby improving patient clinical outcomes.

Objective :To explore influence of ticagrelor on levels of serum high sensitive C reactive protein (hsCRP) and plasma homocysteine (Hcy) in patients with acute coronary syndrome (ACS).Methods :A total of 135 ACS pa‐ tients hospitalized in our department from Jan 2016 to Feb 2017 were selected .Based on routine treatment ,Patients were randomly and equally divided into routine group ,clopidogrel group and ticagrelor group (based on routine treatment respectively received clopidogrel or ticagrelor ) for four weeks .Levels of serum hsCRP and plasma Hcy were measured and compared among all groups before and after treatment .Results :Compared with before treat‐ment ,after four‐week treatment , there were significant reductions in levels of serum hsCRP and plasma Hcy in three groups (P＜0. 05 or ＜0.01).Compared with routine group and clopidogrel group after four‐week treatment , there were significant reductions in levels of serum hsCRP [ (12.95 ± 1.99) mg／L , (8. 56 ± 1. 24) mg／L vs.(4. 47 ± 1. 92) mg／L] and plasma Hcy [ (13.48 ± 2.12) μmol／L , (9.55 ± 0. 94) μmol／L vs.(6. 61 ± 1. 15) μmol／L] in ticagrelor group ( P＜0.05 or ＜0.01).Conclusion :Ticagrelor can significantly reduce levels of serum hsCRP and plasma Hcy while effective antiplatelet therapy ,then significantly inhibit inflammatory response ,improve vascular endothelial function ,contribute to stabilizing atherosclerotic plaques ,improve prognosis in ACS patients .