0.05).The operation time was longer,volume of bleeding was less,and postoperative time of bowel gas passage and hospital stay were shorter in laparoscopic group compared to those in open group(P0.05).Conclusions This study reveals that totally laparoscopic D2 gastrectomy is safe and feasible for advanced gastric cancer,and it presents the superior character of minimal invasion.

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.

Objective To investigate management strategy of minimally invasive surgery for common bile duct stones. Methods Three hundred and four cases of common bile duct stones were divided into 3 groups receiving respectively endoscopic papillary balloon delation plus laparoscopic cholecystectomy ( EPBD group, 35 cases ), endoscopic sphincterotomy plus LC ( EST group, 138 cases), and Laparoscopic common bile duct exploration plus LC (LCBDE group, 131 cases). Results There was no significant difference in treatment success rate, short-term complications and bile duct retained stones among these three group ( x2 = 1. 930, 0. 038, and 0. 427 respectively, P > 0. 05 ). There was significant difference among these three groups in operation time ( F = 17.941, P = 0. 000 ), and the operation time in LCBDE group was shorter than that in other two groups( EPBD-EST: P = 0. 122, EST-LCBDE:P = 0. 000, EPBD-LCBDE:P = 0. 020 ). There was significant difference among these three groups in postoperative hospital stay (F =24. 016,P =0. 000) ,and the postoperative hospital stay in EPBD group was shorter than that in other two groups ( EPBD-EST: P = 0. 000, EST-LCBDE : P = 0. 198, EPBD-LCBDE : P = 0. 000 ). In EPBD group,bile duct recurrent stones was found in 2 cases(6. 7% ) and cholangitis in 1 case(33% ) and no duodenal papilla stenosis was encountered; In LCBDE group, bile duct recurrent stones were found in 7 cases (6. 0% ), cholangitis in 3 cases ( 2. 6% ), and there was no duodenal papilla stenosis; In EST group, bile duct recurrent stones were complicated in 18 cases ( 15.8% ), duodenal papilla stenosis in 9 cases (7.9%), and cholangitis in 14 cases( 12. 3% ). There were significant differences among these three groups for these three complications( x2 = 6. 482, 9. 160, and 12. 020 respectively,P < 0. 05 ), and the rate of complications in EST group was higher than that in other two groups. Conclusion For common bile duct stones, EPBD is the first choice followed by LCBDE while EST is only indicated for very few cases.

AIM: To explore whether exogenous hydrogen sulfide (H2S) depresses high glucose (HG)-in-duced injury by modulating the Janus kinase/signal transducer and activator of transcription ( JAK/STAT) pathway in hu-man umbilical vein endothelial cells (HUVECs).METHODS:The protein levels of JAK2, STAT3 and cleaved caspase-3 were determined by Western blot.The cell viability was measured by CCK-8 assay.Mitochondrial membrane potential ( MMP) was detected by rhodamine 123 staining followed by photofluorography.The intracellular level of reactive oxygen species (ROS) was analyzed by DCFH-DA staining followed by photofluorography.The activity of superoxide dismutase (SOD) was also measured.RESULTS:Pretreatment of the HUVECs with 400 μmol/L NaHS (a donor of H2S) for 30 min prior to exposure to 40 mmol/L glucose ( HG) markedly attenuated HG-induced upregulation of the phosphorylation of JAK2 and STAT3.Pretreatment with 400μmol/L NaHS for 30 min or with 20μmol/L AG490 (inhibitor of the JAK/STAT pathway) for 30 min attenuated the injury of HUVECs induced by HG, as indicated by the increases in cell viability and SOD activity, and decreases in the protein level of cleaved caspase-3, ROS generation and dissipation of MMP.CONCLU-SION:Exogenous H2 S protects HUVECs against HG-induced injury by inhibiting JAK/STAT pathway.

Objective To study the value of three-dimensional (3D) visualization and virtual surgery system in piggyback liver transplantation. Methods Two patients who suffered from choledocholithiasis were scanned by 64-slice spiral CT and the data were collected. The segmentation of the hepatic CT images was carried out. The 3D model of the liver and the intrahepatic vessels was reconstructed, and was imported to the FreeForm Modeling System in STL format for smoothing and modifying. Piggyback liver transplantation was simulated with the force-feedback equipment (PHANToM). Results The reconstructed 3D model of the liver was vivid, and the process of the virtual piggyback liver transplantation was verisimilar. Conclusions The 3D model of the liver enables the simulation of piggyback liver transplantation. It can reduce the risk and complications of the surgery, and enhance the communication between doctor and patient through designing surgical plan and demonstrating visualized operation before surgery. Virtual liver transplantation is also helpful during the training of medical workers.

Objective To investigate the role of tet methylcytosine dioxygenase 2 (TET2) in the regulation of transforming growth factor-β1 (TGF-β1) expression in human glomerular mesangial cells induced by high glucose.Methods Cultured human glomerular mesangial cells were divided into normal control group (5.5 mmol/L glucose) and high glucose group (30.0 mmol/L glucose) which was cultured for 12 h to 72 h.The gene expression of TET2 in mesangial cells were inhibited by small molecule chemical called SC1,and which were divided into high glucose group (30.0 mmol/L glucose+ DMEM),DMSO group (30.0 mmol/L glucose+0.1％DMSO) and SC1 group (30.0 mmol/L glucose+3 μmol/L SC1).The mRNA and protein expression of TGF-β1,TET1 to 3 and α-smooth muscle actin (α-SMA) was detected by quantitative real-time PCR and Western blotting.Methylation of CpG islands in the regulation region of TGF-β1 was detected by bisulfite sequencing PCR (BSP).The activity of mesangial cell proliferation was assessed by colorimetry of thiazolyl blue (MTT).Results Compared with normal control group,the mRNA and protein expression of TET2 in mesangial cells induced by high glucose was increased significantly in a time-dependent manner (all P ＜ 0.05),but the expression of TET1 and TET3 was not affected.Meanwhile methylation rate of 4 CG sites from 24 h to 72 h were decreased in the first exon of TGF-β1 (P ＜ 0.01),but not in the promoter.Compared with high glucose group,when the expression of TET2 was inhibited by SC1,the methylation rate of TGF-β1 was recovered evidently (P ＜ 0.05),the mRNA and protein expression of TGF-β1 and α-SMA was suppressed,and the proliferation of mesangial cells was decreased (all P ＜ 0.05).Conclusions Demethylation of the CpG island mediated by TET2 may play an important role in the expression of TGF-β1 and mesangial cell phenotype transformation induced by high glucose.

BACKGROUND:Studies have shown that pulsed electromagnetism has a good effect in promoting peripheral nerve regeneration after cerebral infarction and spinal cord injury, and improving memory function in patients with neurological disorders. OBJECTIVE: To investigate the impact of pulsed magnetic field on brain function and endogenous neural stem cell factor in the brain tissue of rats with brain injury. METHODS: Totally 320 adult male Sprague-Dawley rats were randomly divided into model group, pulsed magnetic field 0.1 mT group, pulsed magnetic field 0.3 mT group and pulsed magnetic field 0.5 mT group (n=80 per group). After brain injury models were established using lateral hydraulic strike method, rats in the latter three groups were exposed to pulsed magnetic fields 0.1, 0.3, 0.5 mT, respectively. After electromagnetic radiation 1, 3, 7, 14 days, the motor function of rats was evaluated by beam-walking test and water maze test. Rats were intraperitoneally injected 5-deoxy-uridine (BrdU) at 1 day prior to different radiation time points, and BrdU and nestin expressions in the cerebral cortex were measured by immunohistochemical method. RESULTS AND CONCLUSION: (1) The time of water maze test and the beam-walking test at 1, 3 and 7 days after irradiation was ranked as follows: pulse magnetic field 0.5 mT < pulse magnetic field 0.3 mT < pulse magnetic field 0.1 mT < model group, and there were significant differences between groups (P < 0.05). (2) The expressions of BrdU and nestin at 1, 3 and 7 days after irradiation were highest in the pulse magnetic field 0.5 mT group, successively followed by pulse magnetic field 0.3 mT group, pulse magnetic field 0.1 mT group and model group (P < 0.05). In summary, the pulse magnetic field exhibits remarkable protective effects on the brain function of rats with craniocerebral injury in an intensity-dependent manner. The possible mechanism is related to the activation of neural stem cells and the proliferation of neural stem cells in the brain tissue of rats with craniocerebral injury.

This study was aimed to select the best preparation form of medicinal in camellia cake,based on the optimal antithrombotic agents in oil tea camellia defatted cake to establish the foundation of research.The content of effective index component of the oil tea camellia defatted cake preparation was detected by HPLC-PDA.The quality of medicinal preparation from oil tea camellia defatted cake was characterized based on the content,relative quantity,relative ratio of content,yield rate and antithrombotic effect.The results showed that the effect of antithrombotic of three medicinal preparations from oil tea camellia defatted cake was listed in the following descending order of enrichment,ethanol extract,and water extract.The enrichment was the best preparation form of medicinal in oil tea camellia defatted cake preparation with the highest content of effective index components,the lowest extract rate and the lowest dosage.But it had the best effect of antithrombotic.It was concluded that the significant improvement of efficacy was due to the increase of the content of the components in the preparation and the rationality of the proportion.At the same time,analysis of component quality based on basic composition of drug system through the consideration of effective components of type and quantity,composition and other quality factors can further guide the preparation of drugs.

Liver cirrhosis is a common kind of chronic liver diseases, with the development of diseases; some patients may gradually develop precancerous lesions, or even progress to hepatocellular carcinoma (HCC). Precancerous lesions of the liver mainly include dysplastic foci (DF) and dysplastic nodules (DN), and most of it occurs on the basis of liver cirrhosis. Thus, recognition of precancerous lesions and liver cirrhosis through screening, combined with imaging and pathological features will identity the nature of nodules in early stage cirrhosis and HCC, and thereby will help to improve the diagnosis rate and clinical prognosis.

Objective To investigate the clinical value of 64-slice spiral computed tomography(64-MSCT)triple-phase enhanced scan in diagnosis of lymphatic metastasis of gastric cancer.Methods Thirty patients with gastric cancer underwent plain and triple-phase enhanced scan by using 64-MSCT to analyze the relevant parameters of lymphatic metastasis.Results The four parameters de-termined metastatic perigastric lymph node as follows:①the short diameter ≥6 mm,②the ratio of short-to-long diameter ≥0.6,③the CT value in the portal venous phase≥ 65 HU,④the difference of CT values between portal venous phase and plain scan≥35 HU.The sensitivity and specificity of combining two parameters (①+②)in diagnosing metastatic lymph node were 90.5% and 29.0%,respectively.The sensitivity and specificity of combining three parameters (①+②+③)were 98.2% and 1 9.4%,respec-tively.The sensitivity and specificity of combining four parameters (①+②+③+④)were 99.7% and 13.2%,respectively.In ad-dition,metastatic lymph nodes were considered if they were ring-enhancement,or adhesions of several lymph nodes.Conclusion The use of 64-MSCT triple-phase enhanced scan and synthesis of various parameters of lymph nodes could lead to reliable diagnosis of lymphatic metastasis in gastric cancer with rapid,non-invasive,high sensitive and specific features.