monocarboxylate transporter (MCT) are vital transmembran e transporters involved in multiple cellular functions including the regulation of intracellul ar pH and lactate transport. At least eight isoforms of MCT have been cloned and characterized to date, they constitute a new gene family of mammal transporters . These isoforms have the differences in substrate and inhibitor specificities a nd tissue distribution. Thus it may provide a new way of diagonosis and treating for dieases such as cancer by investigating on the structure and function and r egulational mechanism of MCT.

Objective To compare the safety between laparoscopic cholecystectomy (LC) and open cholecystectomy (OC) for benign gallbladder diseases in elderly patients. Methods A total of 120 patients above the age of 60 with indications for cholecystectomy and tolerance to general anesthesia were divided into two groups (LC Group and OC Group), in admission order of odd or even, with 60 patients in each group. Peri-operative parameters including operation time, analgetic consumption, postoperative gastrointestinal recovery time, length of duration with fluid infusion, length of bed rest, postoperative complications, and hospital stay were compared between the two groups. Serum total triiodothyronine (TT3) and thyroid stimulating hormone (TSH) levels, as well as the functional recovery of the abdominal muscles, were also recorded and compared. Results Peri-operative parameters were better in the LC Group than in the OC Group. Serum TT3 levels decreased significantly after surgery in both the LC Group (F=8.26,P=0.000) and the OC Group (F=124.70,P=0.000), with a more significant difference in the OC Group.Postoperatively,serum TSH levels decreased insignificantly in the LC Group (F=1.87,P=0.157) and significantly in the OC Group (F=27.24,P=0.000). Lasegue’s test at 7 days after surgery showed significantly higher leg-raising times in the LC Group than in the OC Group (t=3.640,P=0.000). Conclusions Laparoscopic cholecystectomy is superior to open cholecystectomy in the treatment of benign gallbladder diseases in elderly patients.

Objective To analyze the mierosurgery treatment and prognosis of cavernous hemangioma loca-ted in pons. Methods 12 cases with cavernous hemangioma located in ports underwent mierosurgery. 11 lesions lo-cated in dorsal tons were resected through midline suboccipital trans- rhomboid fnssa approach. 1 lesion located in ventrolateral pous was resected with suboceipital retrosigmoid approach. Results All the 12 cavernous hemangiomns were rosected totally and confirmed by the postoperative pathology. Clinical improvement was gained in 6 cases, no change in 3 ,aggravation of facial palsy in 1 ,death in 1. The mean follow-up time was 3 months,and Mill scan dem-onstrated good restoration of brain stem tissue with no recurrence signs of lesion. The symptoms due to the operation recovered to some extent. Conclusion The cavernous hemangioma located in brain stem can be resected safely and effectively given the selection of surgical indication and optimal surgical approach.

ObjectiveTo discuss the diagnosis and treatment of spontaneous carotid artery dissection (SCAD).Methods Clinical diagnosis and treatment data of 9 patients with SCAD were analyzed retrospectively.ResultsVascular ultrasound showed stenoses or occlusions of carotid artery.Angiography showed “flame-shaped ” sign in totally occluded proximal section and free intimal flap in stenoses section.One patient with total occlusion of bilateral internal carotid artery and 6 patients with total occlusion of unilateral internal carotid artery were treated with antiplatelet therapy.Two patients with incomplete occlusion of the carotid were operated with stent implantation in carotid arteries,and the clinical effect of both operations was satisfactory.ConclusionAngiography remains the gold standard in diagnosing SCAD,and stent implantation is an effective treatment of this disease.

Objective To discuss the relationship of cerebral infarction with hyperhomocysteinemia and the relationship between hyperhomocysteinemia and folic acid and Vitamine B12.Method We measured the concentrations of homocysteine with FIPA(fluorescence polarization immunoassay)and Vitamin B12 and folic acid with chemiluminescent competitive immunoassay in 40 cerebral infarction patients and 30 healthy controls.Results The concentration of homocysteine in study group was higher than the controls' (P< 0.01).Serum folic acid level in study group was lower than that in control group (P< 0.05).There is negative correlation between plasma homocysteine and serum folic acid(P< 0.05). Conclusions Hyperhomocysteinemia is an independent risk factor of atherosclerotic cerebral infarction.One reason of increased level of homocysteine in blood is that the deficiency of cofactors of enzymes involved in metabolism process.

Objective　To study the effect of transfecting anti-sense expression vector of the first subtype of the monocarboxylate transporter (MCT1) gene into human lung adenocarcinoma cells on intracellular pH (pHi) regulation, lactate transportation and cell growth. Methods　MCT1 antisense gene recombinant vector pLXSN-MCT1 was introduced into human lung cancer cells A549 with electroporation. The cell colonies resistant to G418 were selected. Positive clones were examined by PCR to confirm the integration of genomic A549 DNA and antisene MCT1 gene. The changes of pHi and lactate transportation were detected with spectrophotometry. Cell growth was studied with cell growth curve. Results　pHi and lactate transport were remarkably decreased in the transfected cells, and the cell growth was inhibited compared with the cells without transfection（P<0.001）. Conclusion　MCT1 gene may play an important role in pHi regulation, lactate transport and cell growth in lung tumor cells.

Objective To investigate the risk factors for nosoeomial pneumonia in elderly stroke patients(aged 60 years and over). Methods The clinical data of 259 patients with nosoeomial pneumonia from Jan 2002 to June 2007 were collected and the risk factors were retrospectively analyzed. Results The morbility rate of nosocomial pneumonia in elderly stroke patients was 41.3%,and the risk factors were aging,Iong hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine (all P＞0.05). Conclusions The morbility rate of nosoeomial pneumonia in elderly stroke patients was high,and the risk factors are aging,long hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine.

Objective To investigate the effects of intranasal administration of heparin-binding epidermal growth factor-like growth factor (HB-EGF) on expressions of nestin and caspase-3 in the perihematomal tissue after intracerebral hemorrhage in rats. Methods A total 36 adult male Sprague-Dawley rats were randomly divided into 3 groups: an HB-EGF group, a control group, and a sham operation group (n = 12 in each group). Then they were further divided into 4-, 7-, and 10-day subgroups (n = 4 in each subgroup). A model of intracerebral hemorrhage was induced by injecting type Ⅳ colagenase. At 1 to 3 days after modeling, the HB-EGF group was intranasaly administrated HB-EGF. The control group was administrated the same volume of saline. The Bederson score was conducted at the corresponding time points and the rats were sacrificed after the forelimb placing test. Immunohistochemistry was used to detect the expression of nestin and caspase-3 in the perihematomal tissue. Results The sham operation group did not have neurological deficits. The Bederson scores (P < 0. 05) and the result of forelimb placing test (al P < 0. 01) at day 4 and 7 in the HB-EGFgroup were better than those in the control group. There were no significant differences at day 10. At day 4, 7, and 10, the number of nestin positive cels in the perihematomal tissue in the HB-EGF group was significantly more than that in the control group (al P < 0. 05), and the number of caspase-3 positive cels was less than that in the control group (al P < 0. 01). Conclusions Intranasal administration of HB-EGF can improve the early neurological function, upreguate the nestin expression and downregulate the caspase-3 expression in the perihematomal tissue after intracerebral hemorrhage in rats, indicating that intranasal administration of HB-EGF may promote the proliferation of precursor cels and decrease cel apoptosis in the perihematomal tissue.

Objective To study the role and molecular mechanism of forkhead transcription factor O1 (FoxO1) on proliferation of mesangial cells( MCs) in diabetic rats. Methods Empty lentiviral vector( LV-pSC-GFP) and the constitutively active FoxO1 lentiviral vector(LV-CA-FoxO1) were constructed. Diabetic rat model was established and rats were divided into diabetes group(DM group), diabetes with LV-pSC-GFP group(NC group), and diabetes with LV-CA-FoxO1 group(CA group). The normal SD rats of the same age were considered as the normal control group(NG group). The lentiviral vector was injected into the renal cortex of diabetic rats in corresponding groups. Body weight, blood glucose, 24 h urinary protein, urine albumin, serum creatinine, and blood urea nitrogen was detected at the end of 2 weeks, 4 weeks, and 8 weeks. The ratio of kidney weight/ body weight was counted and the renal cortex was reserved for light microscopy, electron microscopy and frozen section after rats were sacrificed in different groups. The mRNA level of FoxO1 and p27Kip1 were detected by real-time PCR. The protein expressions of FoxO1, p-FoxO1, and p27Kip1 were tested by Western blotting. Results The renal pathological changes were obviously ameliorated in CA group. Compared with DM group, the mRNA and protein expression of FoxO1 and p27Kip1 were significantly increased in CA group (P<0. 05), whereas there was no difference in the expression of p-FoxO1 protein(P > 0. 05). The p-FoxO1 / FoxO1 ratio was decreased ( P < 0. 05). All indexes had not reached statistical difference between NC group and DM group(P>0. 05). Conclusion Overexpression of FoxO1 in kidneys of diabetic rats can inhibit the proliferation of mesangial cells, and may through up-regulating the expression of p27Kip1 delay the progression of diabetic nephropathy.

Objective To increase the understanding in protein-losing enteropathy (PLE).Methods Sixty-one PLE patients were enrolled in the study and the clinical characteristics, complicated disease, diagnosis and treatment were analyzed. Results The age of the patients was 16-77 (40±15)years, and the gender ratio was 35:26 (female: male). The main clinical manifestations were bilateral lower limb edema in 51 cases, ascites in 41 cases, bilateral pleural effusion in 23 cases, pericardial effusion in 13cases, abdominal pain in 16 cases and diarrhea in 33 cases. The prominent abnormality in laboratory examinations was hypoalbuminemia. The underlying diseases include systemic lupus erythematosus (SLE) in 28 cases, intestinal lymphangiectasia in 12 cases, hepatic cirrhosis in 5 cases, heart diseases in 5 cases,Crohn's disease in 3 cases, membranous nephropathy in 2 cases, Budd-Chiari syndrome in 1 case. Four cases happened after abdominal operation and 1 case after radiation therapy of gastric cardia cancer. Thirtyseven cases were diagnosed by 99Tcm-labelled human serum albumin scintigraphy and 24 cases were diagnosed clinically. Treatment was focused on underlying diseases. The clinical manifestations in 21 cases of SLE improved after SLE was controlled. In 2 cases of intestinal lymphangiectasia and one with Crohn's disease, the clinical manifestations improved after surgery. The other patients had no improvement.Conclusions PLE was not uncommon in clinical practice. Its predominant characteristics were severe hypoalbuminemia, edema and dropsy of serous cavity. PLE can complicate other diseases such as SLE,intestinal lymphangiectasia. Treatment should be focused on primary disease.