Minimally invasive surgery has been one of the main trend of surgical practice in 21 century,while the laparoscopic technique,as one of the product of high-tech,shows the minimally invasive surgery a more lactiferous prospect.However,with the popularity of laparoscopic technique,its high complications rate is gradually being highly regarded.By analyzing various causes comprehensively,we found that the complications rate had direct correlation with the operant level of the operator.Combining the successful experience of twice laparoscopic technique training courses,which were conducted by our department,this article will give rise to a discussion about the training of the general surgery doctor.

Objective To explore the expression of DKK-1 and its clinical value in patients with e-sophageal cancer. Methods The levels of serum DKK-1 were measured by sandwich enzyme linked immu-nosorbent assay(ELISA) in 80 patients with esophageal squamous cell cancer and in 35 healthy subjects. The sensitivities of serum DKK-1, CEA and CYFRA21-1 in the patients with esophageal squamous cell cancer were calculated and analyzed to compare their values in diagnosis of esophageal cancer. Results The serum DKK- 1 levels in patients with esophageal squamous cell cancer were significantly higher than those of healthy subjects(P<0.05). According to the highest value of medicine reference of DKK- 1 (14. 54 ng/ml), its sensitivity and specificity were 66. 25% and 82. 86% respectively; There was a significant difference between the sensitivity of DKK-1 in patients with esophageal squamons cell cancer(66. 25%) and that in healthy subjects(17.14%) (P<0.05). The sensitivitis of serum DKK- 1 in patients with esophageal squamous cell cancer were associated with tumor size, TNM stage and lymph node metastasis(P <0.05),but not associated with gender,age and differentiation grade(P>0.05). And the sensitivity of DKK-1 (66. 25%) was significantly higher than that of CEA, CYFRA21-1 (39. 44% ,25. 35%, P <0. 01). Conclusion DKK-1 played a very important role in the growth and metastasis of esophageal cancer and may be a new tumor marker or an important index in the diagno-sis of esophageal cancer.

BACKGROUND: Following peripheral nerve transplantation, the time phases and law of growth associated protein 43 (GAP-43) expression in sensory neuron soma of the corresponding dorsal root ganglia remain unclear.OBJECTIVE: To investigate the expression of GAP-43 at the corresponding dorsal root ganglia following sciatic nerve transplantation in rats.METHODS: Adult male Wistar rats were randomly divided into 2 groups: control group (sham-operated group) and experimental group (nerve transplantation group). The rats were killed at 3 days, 1, 2, 4, 6, and 8 weeks after operation and the dorsal root ganglia U-s of every rat was taken for observation. The expression of GAP-43 mRNA and protein in the corresponding segments of spinal cord were detected by RT-PCR and Western-blot techniques.RESULTS AND CONCLUSION: GAP-43 mRNA showed a low level of expression in the control group, which had no obvious changes in different phases. In the experimental group, GAP-43 mRNA expression was observed remarkably in the dorsal root ganglia at the first week, reached a peak at the second week and gradually descended from the sixth week. The GAP-43 protein expression showed the same laws as that of GAP-43 mRNA. The results demonstrated that there exists damage reactivity change in the regeneration ability of neurons.

Objective To approach the effects of MMP-9 antisensc oligonucleotide(ASODN)on human lung adcnocarcinoma(A549) cell apoptosis and proliferation capability.Methods MTT.was used to analyze the effect that MMP-9 transfection on A549 cell growth.Flow cytometry was used to analyze the ratio of cell proliferation and apoptosis.RT-PCR WaS used to detect the expression of MMP-9mRNA and Western blot was used to detect the changes of MMP-9 protein.Results In some degree,MMP-9 ASODN that inhibited the survival rate of the A549 cell presented concentration and time dependence manner.The best dependence concentration of ASODN was 600nmol/L for 24 hour.After trasnfection of MMP-9ASODN to A549 cell.the perceive of A549 apoptosis cell was significandy higher than that in control group(P＜0.01).When the antisense oligonucleotides concentration is 600nmol/L and the action time is 48 hours,the relative expression level of MMP-9mRNA and MMP-9 protein are obviously less than that in control group(P＜0.01).Conclusion MMP-9ASODN may down regulate the expression of MMP-9mRNA and MMP-9 protein,effectively inhibit the proliferation of A549 cell and promote the apoptosis of A549 cell.

It has been widely accepted that Faecalibacterium prausnitzii (Fp) induces the differentiation of Treg cells.Lymphocyte function-associated antigen-1 (LFA-1) is also involved in the differentiation of Treg cells.Aims: To investigate the effect of Fp on Treg cells and cytokines in colitis mice with LFA-1 knockout (LFA-1-/-).Methods: Twenty wild type mice and twenty LFA-1-/-mice with same genetic background were randomly divided into wild type control group, wild type treatment group, LFA-1-/-control group and LFA-1-/-treatment group.Colitis model was induced by drinking DSS solution.Mice in the two treatment groups were intragastrically administrated with Fp.General status and histopathological score were assessed.Percentages of Treg cells in spleen and mesenteric lymph nodes were measured by flow cytometry.Serum levels of IL-10 and TGF-β1 were measured by ELISA.mRNA expressions of IL-10 and TGF-β1 in colonic tissue were detected by real time PCR.Results: Compared with corresponding control groups, histopathological score was significantly decreased in wild type treatment group (P<0.05);percentages of Treg cells in spleen and mesenteric lymph nodes were significantly increased (P<0.05), serum levels of IL-10 and TGF-β1 were significantly increased (P<0.01), expression of TGF-β1 mRNA was significantly increased in wild type treatment group and LFA-1-/-treatment group (P<0.05);expression of IL-10 mRNA was significantly decreased in LFA-1-/-treatment group (P<0.01).Compared with wild type treatment group, serum level of TGF-β1 was significantly decreased (P<0.05), and mRNA expressions of IL-10 and TGF-β1 were significantly decreased in LFA-1-/-treatment group (P<0.05).Conclusions: Fp can up-regulate the percentages of Treg cells and enhance the secretion of anti-inflammatory cytokines IL-10 and TGF-β1 in LFA-1-/-mice.The therapeutic efficacy for colitis in wild type mice is superior to that in LFA-1-/-mice, which may be related to the inhibition of function of Treg cells and secretion of cytokines due to LFA-1 knockout.

Objective To compare the clinical efficacy of different doses of ultrafine extracted granule preparation (EGP) and traditional herbal decoction (THD) of Li Zhong Tang in treatment of epigastric pain. Methods Sixty cases of epigastric pain patients in accordance with the diagnostic criteria of deficiency and cold pattern of spleen and stomach in TCM were randomly divided into THD group, 1/3 dose group and 1/5 dose group, and were given THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP, respectively. The clinical efficacy of the three groups after one course of medication was comparatively analyzed. Results There were no significant differences in age, course of disease, symptom score before treatment, epigastric pain efficacy and syndrome curative effect among the three groups, the differences had no statistical significance (P>0.05). The severity, frequency and duration of epigastric pain were all reduced in the three groups, with significant differences between before and after treatment (P<0.05). Conclusion There are no significant differences in the clinical efficacy on epigastric pain among THD, 1/3 dose of ultrafine EGP and 1/5 dose of ultrafine EGP. In addition, the effect of 1/3 dose group is very close to the THD group.

Objective To explore the effect of chronic low lead exposure on molecular pathological mechanisms of learning and memory of rats at the developmental stage Methods The changes of N methyl D aspartate receptor 1 (NMDAR 1) mRNA expression in rat hippocampus were observed by using digoxigenin labled anti sense oligonucleotide probes in situ hybridization technique Results The changes in NMDAR 1 mRNA levels in Pb exposed rat hippocampus were found to be dependent upon the developmental period of exposure and the region of the hippocampus analyzed Hippocampal NMDAR 1 mRNA levels increased significantly in the CA1 (18 75%) and CA3 (13 2%) ( P

Objective To study the application of ultrasonically activated scalpel in laparoscopic intestinal adhesion release.Methods Intestinal adhesion release with ultrasonically activated scalpel under laparoscope was performed in 29 patients suffered from intestinal adhesive obstruction after gynecological operation. Results All operations were successfully performed, and none of them converted into open surgery. Intestinal disruption occurred durring operation in 2 patients with extensive intestinal denseadhesion which were mended successfully under laparoscope. The operative duration was 30-150 min (mean 45 min). Postoperative complications such as bowel leak age, bleeding, abdominal infection were not experienced. Postoperative hospital stay was 3-7 days (mean 4 days). No case had relapse symptom such as abdominal distention or pain after 1-24 months of follow up. Conclusion Compared with electric scalpel, ultrasonically activated scalpel can improve the operative safety, lessen tissue damage, shorten operative time, and reduce the chance of relapse in laparoscopic operation in gynecology.

Objectives: To study the changes of blood levels of soluble semaphorin 4D (sSema4D) and matrix metalloproteinases-14 (MMP-14);to explore the correlation between sSema4D and ventricular remodeling in patients of dilated cardiomyopathy with chronic heart failure.
Methods: Our research included in 2 groups:Dilated cardiomyopathy group, n=86 patients and Control group, n=32 healthy subjects. Blood levels of sSema4D, MMP14, Pro-BNP and hs-CRP were examined by ELISA. Left atrial diameter (LAD), right ventricular diameter (RVD), ejection fraction (EF), left ventricular end diastolic diameter (LVEDD), left ventricular fractional shortening (LVFS) were measured by echocardiography. Correlation analysis between blood levels of sSema4D, MMP-14 and the parameters for left ventricular remodeling was conducted.
Results: Blood levels of sSema4D and MMP14 were different between 2 groups, P<0.005. In Dilated cardiomyopathy group, sSema4D level was positively related to MMP-14 and LVEDD (r=0.462, P=0.001 and r=0.643, P<0.001) respectively.
Conclusion: Serum level of sSema4D might be related to ventricular remodeling in patients with dilated cardiomyopathy which could be used as risk factor for predicting the prognosis of heart failure in relevant patients.