To explore the mechanism of Jianpi(splenic tonic) and Shugan(dispersing the stagnated liver-qi) prescription regulating immunity by testing the expression of the differentiation signaling transduction protein,calcineurin.Methods We prepared the Sijunzitang and Chaihushugansan prescription serum,take the Ova as antigen induction and B cell as presenting cell,intervened culturing the CD 4 +T cells for 24 hours, and then examine the expression of calcineurin by RT-PCR,Western-blotting.Results The expression of calcineurin was increased in the stimulated Th cells, and the Sijunzitang and Chaihushugansan prescription serum can reduce it significantly,the Chaihushugansan also improved the expression deficit of calcineurin.Conclusions Jianpi and Shugan prescription can regulate the balance of immunity through affecting the expression of signaling transduction proteins at the Th activation and differentiation stage,The regulating the flow of qi prescription is superiority to supplementing qi one.in treatment of the Th2-mediated autoimmune disease.

Objective To research the role of matrix metalloproteinase-9(MMP-9), transforming growth factor ?1(TGF-?1) in viral myocarditis(VM) and their relationships with myocardial fibrosis, and to explore the forensic significance on sudden death due to viral myocarditis. MethodsSelected 30 cases of VM as experimental group,there cases were divided into definite VM group(n=18) and borderline VM group (n=12);Non-VM(n=10) were selected as control group. Collagen hyperplasia was observed by Masson staining. The expression and localization of MMP-9 and TGF-?1 in viral myocarditis were quantified by immunohistochemical method. Image analysis systems and statistical methods were used for quantitative analysis. ResultsThe amount of collagen fibre in the viral myocarditis group was more than that in the control group. The expression of MMP-9 and TGF-?1 were increased obviously. MMP-9、TGF-?1 expression were positively correlated with the collagen hyperplasis. ConclusionsThe MMP-9 and TGF-?1 may contributes to myocardial fibrosis, and may act as the assistant diagnostic indexes of sudden death due to viral myocarditis.

Objective To investigate the efficacy and safety of percutaneous microwave ablation in the treatment of hypersplenism.Methods From March 2007 to May 2011,38 patients with hepatitis B virus caused liver cirrhosis and complicated with hypersplenism received percutaneous microwave ablation treatment for several times.Before percutaneous microwave ablation treatment,the volume of spleen was calculated according to 3D computed tomography (CT) scan.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were also tested.For the first time,1/3 volume of spleen was ablated.If no complication were observed in one week after ablation,then another 1/3 volume of spleen was ablated.Blood routine and liver function test were checked on the 1st,3rd and 5th day after microwave ablation.Blood routine,liver function test and ultrasound were examined on 7th and 14th day after microwave ablation.On the 30th day CT examination was conducted.Ultrasound,blood routine,urine routine,liver function test,kidney function test,serum amylase and lipase were detected at one month,three month and every three month after microwave ablation.The follow up duration was over two years.The t-test was performed for clinical data comparison.Results The mean ratio of ablated spleen was (47 ±5)％ (range 41％ to 57％).Preoperative white blood cell count was (2.46±0.78)× 109/L,which gradually increased after operation and peaked on the 3rd day after operation ((5.34 ± 2.10) × 109/L).Then gradually decreased,which was (3.16 ± 1.02) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t=-3.349,P＜0.01).Preoperative platelet count was (46.58 ± 17.30) × 109/L,which gradually decreased after operation and was lowest on the 3rd day after operation.Then gradually increased,which peaked at 30 days after operation ((101.79 ± 25.80) × 109/L) and then gradually decreased,which was (61.97 ± 15.09) × 109/L at 24 month and the difference was statistically significant compared with that of preoperation (t＝-4.135,P＜0.01).The inner diameter of portal vein was (14.66±0.88) mm preoperation,which was (13.22±0.64) mm at three month after operation and the difference was statistically significant compared with that of preoperation (t=8.145,P＜0.01).It was (14.64±0.81) mm at six month after operation and the difference was not statistically significant compared with that of preoperation (P＞ 0.05).The major adverse effects were fever,left upper abdominal pain,left shoulder pain,pleural effusion,intraperitoneal hemorrhage and temporary hemoglobinuria which all recovered after symptomatic treatment.No severe complication such as uncontrollable bleeding,splenic abscess,spleen rupture and the surrounding organ injury and treatment related death were observed.Conclusion Percutaneous microwave ablation for several times could safely destroy suitable volume of spleen,increase platelet and white blood cell count,improve portal hypertension and with rare complications,which might be a minimally invasive techniques with clinical application value in the treatment of the hypersplenism.

Objective To compare the successful ratio, efficacy and complications between ultrasound-guided and X-ray-guided endoscopic biliary drainage (EBD). Methods EBD was performed in 62 patients under ultrasound guidance and 54 patients under X-ray guidance. Serum bilirubin, the bile duct diameter and the changes of clinical symptoms were compared before and after the procedure. Results Tube placement was successfully achieved in 54 of 62 patients under ultrasound guidance and 51 of 54 patients under X-ray guidance. The serum direct bilirubin and the common bile duct diameter in patients with ultrasound guidance before and one week after procedure were (205.41±115.27) μmol/L vs. (106.47±82.16) μmol/L and (12.6±7.1) mm vs. (8.5±3.1) mm, respectively, with significant difference (all P values<0.05). Whereas they were (211.14±106.25) μmol/L vs. (110.89±59.47) μmol/L and (13.1±7.0) mm vs. (8.8± 3.2) mm, respectively, in patients with X-ray guidance (P<0.05). No complications such as abdominal pain, fever and elevated amylase were found in patients with ultrasound guidance, while 3 patients (5.9%) with X-ray guidence had above complications. Conclusions X-ray is a most effective method in guidance of EBD. However, ultrasound guidence, which may avoid unfavorable factors such as X-ray radiation and allergic contrast agent, has some advantages including real-time display, mobile convenience and emergency bedside application. It can instead of X-ray in performance of endoscopic nasobiliary drainage and endoscopic retrograde biliary drainage in patients with bile duct stone and mild narrow ducl caused by tumors.

Objective To investigate the learning curve of laparoscopic totally extraperitoneal (TEP) inguinal hernia repair.Methods The clinical data of 450 cases of patients who received laparoscopic inguinal hernia repair by the same group of surgeons from December 2012 to August 2016 in our hospital were sequentially divided into three groups,with 150 cases in each group.The cases of each group who received TEP inguinal hernia repair were extracted and enrolled into group A,B and C.The preoperative,intraoperative and postoperative indicators were compared among the three groups.Results Before operation,no statistically significant difference was found in age,gender,incidence rates of scrotum hernia,recurrent hernia and bilateral hernia,and types of hernia among the three groups (P＞0.05).And there was no statistically significant difference in incidence rates of postoperative urinary retention,analgesia and seromas,and hospitalization expenses among the three groups (P＞0.05).During operation,differences in conversion rate,operative time and volume of blood loss among the three groups were statistically significant (P＜0.05).Moreover,statistically significant differences in conversion rate,operative time and volume of blood loss were found between group A and group B (P＜0.05),while there was no statistically significant difference between group B and group C (P＞0.05).The regression curves were drawn based on operation time,volume of blood loss and the number of cases,which estimated the inflection point was 150.Conclusion The learning curve of TEP inguinal hernia repair include approximately 150 cases of laparoscopic inguinal hernia repair (including 16 cases of patients received TEP).The TEP inguinal hernia repair operation during the learning curve can be safety on the basis of preoperative evaluation and appropriate case selection.

Objective To investigate influencing factors of the number of lymph node harvest after radical resection of colorectal cancer.Methods The retrospective case-control study was conducted.The clinicopathological data of 227 patients with colorectal cancer who underwent radical resection in People's Hospital of Changshou Chongqing from June 2010 to June 2016 were collected.The surgical method and resection extention were determined depending on the tumor location showed on imaging examinations,and all patients underwent radical resection and sufficient lymph nodes dissection.Observation indicators:(1) intra-and post-operative situations;(2) influencing factors analysis of the number of lymph nodes harvest after radical resection of colorectal cancer;(3) follow-up and survival situations.Follow-up using outpatient examination and telephone interview was performed to detect patients' survival up to October 2016.Measurement data with normal distribution were represented as (x)±s.Univariate analysis was done using the chi-square test or Fisher exact probability method.Multivariate analysis was performed using the binomial Logistic regression analysis.Results (1) Intra-and postoperative situation:all the 227 patients underwent successful radical resection of colorectal cancer,including 67 with radical resection of right colon cancer,16 with radical resection of left colon cancer,26 with radical resection of sigmoid colon cancer and 118 with radical resection of rectal cancer.Of 227 patients,118 received laparoscopic surgery,109 received open surgery including 8 converted to open surgery from laparoscopic surgery.Tumor located in right hernicolon,left hemicolon,sigmoid colon and rectum were respectively detected in 67,16,26 and 118 patients,same as results of imaging examintions.Operation time,volume of intraoperative blood loss and number of lymph nodes harvest in 227 patients were (192 ± 72) minutes,(94± 84) mL and 14 ± 4.Of 8 patients in 227patients with postoperative complications,2 received secondary suture due to wound infection,2 received reoperation due to intestinal obstruction,1 received transverse colostomy due to anastomotic leakage,and 3 received stoma reconstruction due to stoma retraction.Duration of postoperative hospital stay of 227 patients was (22±9) days.Postoperative pathological examininations:35 and 192 patients were respectively diagnosed with rnucinous adenocarcinoma and non-mucinous adenocarcinoma.Moderate-and low-differentiated carcinoma and high-differentiated carcinoma were respectively detected in 47 and 180 patients.(2) The influencing factors analysis of the number of lymph nodes harvest after radical resection of colorectal cancer:univariate analysis showed that tumor location and tumor pathological T stage were related factors affecting the number of lymph node harvest after radical resection of colorectal cancer (x2=10.066,P＜0.05).Multivariate analysis showed the tumor location and tumor pathological T stage were independent factors affecting the number of lymph nodes harvest after radical resection of colorectal caucer (OR=1.283,6.075,95％ confidence interval:1.031-1.597,1.215-30.385,P＜0.05).(3) Follow-up and survival situations:190 of the 227 patients were followed up for 4-72 months,with a median time of 32 months.During the follow-up,21 patients died,23 patients survived with tumor,and 146 patients survived without disease.Conclusion Tumor location and tumor pathological T stage are independent factors affecting the number of lymph node harvest after radical resection of colorectal cancer.

BACKGROUND: In recent years, the immunoregulatory effects of mesenchymal stem cells (MSCs) can be used to induce immune tolerance. OBJECTIVE: To evaluate the safety and feasibility of human umbilical cord-derived MSCs (hUC-MSCs) in liver transplantation patients. METHODS: hUC-MSCs were cultured and identified. After approved by the Medical Ethics Committee, a total of 50 patients were randomly divided into experimental group and control group according to the proportion of 1:1. In the experimental group, hUC-MSCs were perfused by the portal vein during the operation and infused into the jugular vein on the 3rd day after the operation. The injection dose was 1×106/kg (prepared as 50 mL of cell suspension). Both groups received standard immunosuppressive regimens. Blood biochemistry and immune function indicators were detected preoperatively and at postoperative days 3, 7, months 1, 2, 3, 6, 12. Acute and chronic rejection rates, incidence of infection, and incidence of transplantation-related complications were recorded. RESULTS AND CONCLUSION: (1) At 3 and 7 days after the operation, the percentage of peripheral blood CD4+CD25+ cells (regulatory T cells) in the experimental group was significantly higher than that in the control group (P < 0.05). The percentage of CD4+ cells (helper/inducer T cells) and ratio of CD4+/CD8+ T lymphocytes were significantly lower in the experimental group than the control group (P < 0.05). (2) There was no significant difference in postoperative alanine aminotransferase and total bilirubin levels between the two groups (P > 0.05). (3) The incidence of abnormal liver function in the experimental group was significantly lower than that in the control group (P < 0.05). (4) The incidence of transplantation-related complications and the rate of infection showed no significant difference between the two groups (P > 0.05). Overall, the intravenous infusion of hUC-MSCs is safe and feasible in liver transplantation patients, which in early stage can promote the the proliferation and activation of CD4+CD25+ cells (regulatory T cells), reduce the percentage of CD4+ cells (helper/inducer T cells) and lower the ratio of CD4+/CD8+ T cells, thereby improving the immune status in liver transplantation patients.

Objective To observe the clnical effects of influence of tanshinone type ⅡA sulfonate on preventing hepatic artery thrombosis after transplantation.Methods A total of 60 patients after liver transplantation were randomly individed into the treatment group and control group, each 30 patients. The treatment group received tanshinone ⅡA sodium sulfonate treatment (60 mg qd, ivgtt continuous 10d) , while the control group used conventional heparinization. The blood coagulation index and the thrombelastograph variables were detected after 7 days and the hepatic artery resistance index (RI) was detected by using Doppler ultrasonography. The postoperative complications and mortality rates were analyzed.Results Although it had little improvement on the coagulation function after liver transplantation, tanshinone ⅡA sodium sulfonate had significant improvement on the time of thrombelastograph parameters reaction (6.35 ± 1.59 minvs. 5.21 ± 1.37 min,t=2.453) and maximum amplitude (58.07 ± 5.42 mmvs. 61.67 ± 5.63 mm,t=-2.532). It showed that RI have significantly statistical difference between the two groups after treatment (0.73 ± 0.11vs. 0.62 ± 0.10;t=-2.948,P<0.01). During the trial, the control group had 2 cases of postoperative complications, HAT and bleeding.Conclusions The Tanshinone ⅡA sodium after liver transplantation can improve the clotting mechanism, preventing HAT.

Objective To explore the effect of meta-mood ability training for improving job satisfaction of nurses.Methods A total of 120 nurses were randomized into the observation group and the control group (60 cases in each group).The observation group received meta-mood ability training,while the control group was given routine training.The meta-mood ability and job satisfaction degree were investigated.Results After the intervention,job satisfaction degree and the meta-mood ability level of the observation group nurses were improved than that of the control group.Conclusions The meta-mood ability training is effective in improvement of job satisfaction degree of nurses,as well as increase clinical service quality of nurses.

Objective To assess the efficacy of fish oil in the treatment of IgA nephropathy using the method of Meta-analysis. Methods Randomized controlled trials of fish oil in the treatment of IgA nephropathy were searched in the database of Cochrane library,PubMed, EMBASE and CNKI. Data extracted from the literatures were analyzed with Revman software (version 5.0). Results In comparison with the controlled group, proteinuria in the fish oil group was significantly decreased [SMD=-0.27, 95%CI (-0.52 to -0.03), P=0.03], while the renal function deteriorated [SMD=0.30,95%CI(0.05 to 0.55), P=0.02]. Conclusion Fish oil can decrease the proteinuria of IgA nephropathy, but can not prevent renal function from deterioration.