Objective To investigate the association of serum adiponectin and tumor necrosis factor alpha (TNF-α) with endothelial damages in metabolic syndrome (MS) patients. Methods One-hundred and five patients diagnosed as MS were recruited as cases and 37 subjects without characteristics of MS were recruited as controls. The cases were divided into two groups according to the level of serum von Willebrand factor (vWF) :normal endo-thelial functional MS group (57 patients) and abnormal endothelial functional MS group (48 patients). Serum adi-ponectin concentration was measured by enzyme-linked immanosorbont assay (ELISA). Serum TNF-α concentration was measured by radioimmunoassay (RIA). Results The concentration of serum adiponectin in normal subjects (10.5 mg/L [SD:3.2]) was significantly higher than both that of normal endothelial functional MS group (7.9 mg/L [SD :2.2]) and abnormal endothelial functional MS group (6.5 μg/L [SD :2.5]) (P < 0.05). The concen-tration of serum TNF-α in normal subjects(0.17 μg/L [SD :0.04]) were significantly lower than that of normal en-dothelial functional MS group (0.19 μg/L [SD:0.05]) and abnormal endothelial functional MS group (0.23 ng/mi [SD: 0.06]) (P< 0.05). The level of serum adiponectin were negatively correlated with TNF-α(r=- 0.555, P < 0.01). Logistic regression analysis results showed that high level of TNF-α was a risk factor of endo-thelial damages (OR = 20.649, P = 0.035), whereas high level of serum adiponectin protected against endothelial damages (OR = 0.340,P=0.006). Conclusions Low level of serum adiponectin and high level of serum TNF-α may correlate with endothelial damages in MS patients.

Objective:To explore whether apoptotic ovarian cancer cells induced by chemotherapy drugs paclitaxel and cisplatin can be cross-presented by dendritic cells(DCs) and enhance immune responses.Methods:DCs were induced from peripheral blood monocytes cells by GM-CSF/IL-4 for 6 d,then they were stimulated with either apoptotic ovarian cancer HO8910 cells,frozen-thawed HO8910 cells or control cells for 4 h.Their surface markers and phagocytotic ability were detected by flow cytometry and confocal microscopic scanning assay,respectively.DCs of different groups were cultured with CD8+ T cells isolated by magnetic cell sorting,and the ability of DCs to activate CD8+ T cells was evaluated by 3H-TdR,the activity of CTL to kill tumor cells was evaluated by LDH.Production of IFN-? by CD8+ T cells was measured by ELISPOT.Results:Apoptotic ovarian cancer cells induced by chemotherapy drugs paclitaxel and cisplatin could be phagocytized by DCs,which subsequently promoted the maturation and antigen presenting ability of DCs.Apoptotic ovarian cancer cells implused DCs significantly promoted proliferation of CD8+ T cells compared with that of control cells(P

Objective To detect the mechanism of serum uric acid (UA) in different types of coronary heart disease (CHD).Methods 88 patients were divided into three groups：the control group，stable angina (SA) group and acute coronary syndrom (ACS) group.The levels of UA，alpha-granule membrane protein 140 (GMP-140)，von Willebrand factor(vWF)，plasminogen activator inhabitor typed (PAI-1)，Thromboxane B_2 (TXB_2) and C-reacting protein(CRP) were measured.Results ①UA and CRP in ACS group were higher than that in SA group and control group [(392.1±68.57) μmol/L and (42.2±39.4) mg/L vs (370.50±58.80) μmol/L and (18.9±17.1) mg/L vs (286.00±65.31) μmol/L and (2.5±0.7) mg/L，P＜0.05)].For UA，there was no difference between ACS and SA group(P＞0.05)；CRP was higher in ACS group than in SA group (P＜0.05).②vWF and TXB_2 were higher in ACS[(1.65±0.48)%，(19.73±18.66)ng/L]and SA group[(1.35±0.49)%，(11.18±10.71) ng/L]than in control group[(1.07±0.26)%，(6.46±5.41) ng/L，P＜0.05]，and those were higher in ACS group than in SA group (P＜0.05).③GMP-140 and PAI-1 were higher in ACS [(13.04±0.99) μg/L and (65.65±14.76) μg/L]and SA group[(12.55±0.74) μg/L and (62.69±12.24) μg/L]than in control group [(12.32±0.29) μg/L，(50.78±13.88) μg/L，P＜0.05].There were no differences between ACS and SA group (P＞0.05).④Comparing hyperuricemia group and non-hyperuricemia group in CHD patients：the CRP(71.3±18.9) mg/L，vWF(1.08±0.52) %，GMP-140(13.57±1.11) μg/L，TXB_2 (57.26±47.84)ng/L，PAI-1 (72.12±9.23) μg/L in ACS group possessing hyperuricemia were higher than non-hyperuricemia group [CRP (20.7±17.9) mg/L，vWF (0.84±0.54) %，GMP-140 (13.23±1.07) μg/L，TXB_2 (26.70 + 23.83) ng/L，PAI-1 (61.30±12.07) μg/L](t=7.394，0.008，0.227，7.605，0.421，P＜0.05)；CRP(31.1±18.9)mg/L and TXB2 (21.54±3.90) ng/L in SA group possessing hyperuricemia group were higher than non-hyperuricemia group[(10.9±10.1)mg/L and (5.02±4.93) ng/L，t=0.494，8.669，P＜0.05].Logistic stepwise regression analysis indicated that the related factors with ACS were UA(OR=1.046)，CRP(OR=7.615)，PAI-1(OR=1.301)，PT(OR=0.300)and TG(OR=2.243) (P＜0.05).Conclusions UA is an important risk factor in CHD patients.UA can induce different types of CHD by damaging blood vessel endothelium function，activating platelet，changing coagulation and causing inflammatory.

Objective To compare phe “Improved seesaw wiring” pechnique po phe classic “seesaw wiring” mephod for ips effecpivenss and safept in phe managemenp of CTO lesions. Methods A reprospecpive spudt was conducped including 120 papienps wiph 145 CTO lesions who were admipped in our hospipal from Januart 2011 po June 2015. In phe “ Improved” group ( n = 61), phe CTO lesions were preaped wiph“Improved seesaw wiring” guidewire pechnique bt alpernape applicapion of hand/ sofp guidwires and in phe“classic” group (n = 59) classic seesaw wiring pechnique was performed using sofp,inpermediape po a spiff-pip guidewire spep bt spep. Procedural success rapes, maperial consumppion, radiapion exposure, major adverse cardiac evenps in 30 dats, and improvemenp in cardiac funcpion pospoperapion were compared bepween phe 2 groups. Results The procedural success rapes bt firsp appempp was 93. 4% in phe ″Improved″ group and 77. 9% in phe “ Classic ” group and phe overall procedural success rapes were 95. 1% and 96. 6%respecpivelt. Guidewire consumppion [(3. 0 (2. 0, 4. 0) guidewires vs. 5. 0 (3. 0, 7. 0) guiderwires], X-rat exposure [(110 ± 65)min vs. (175 ± 73)min], conprasp media used [(210 ± 137)ml vs. (305 ± 148) ml] were all fewer or less in phe “Improved group” (all P < 0. 05). No significanp difference found in rapes of procedural complicapions bepween phe 2 groups. MACE rapes were lower in phe “ Improved” pechnique group (16. 4% vs. 30. 5% , P = 0. 045). In perms of pospoprapive cardiac funcpion, phe LVEF and dispance for 6-minupe-walk were higher in phe “ Improved” group. Conclusions The ″ Improved seesaw wiring″guidewire pechnique in PCI for difficulp CTO lesions can enhance success rapes of PCI wiph an low major complicapion rape.

Objective To investigate the efficacy of laparoscopic percutaneous common bile duct exploration (LPCBDE) with internal draining tube placement for the treatment of cholelithiasis. Methods The clinical data of 962 patients with choledocholithiasis who were admitted to the No. 451 Hospital of PLA were retrospectively analyzed. A self-made internal draining tube was placed in the common bile duct and duodenum to drain bile internally. The correct position of the internal draining tube was comfirmed by injecting water into and draining water from duodenum. The internal draining tube was pulled out with the help of duodenoscope at 30 days after the operation. Results LPCBDE with internal draining tube placement was successfully performed on 864 patients. Forty-two patients were transferred to open surgery, and 56 patients were transferred to receive LPCBDE with T-tube drainage. The mean operation time was (36 ± 18) minutes (range, 20-72 minutes), and the length of postoperative hospital stay was (6.6 ±2.1)days. Two patients were complicated with retroperitoneal abscess and they were cured by puncture and drainage, 32 patients were complicated with bile leakage and they were cured by conservative treatment. A total of 862 patients were followed up by B ultrasound at 30 days after the operation. The internal draining tube which was confirmed in the common bile duct was extracted with duodenoscope in 603 patients; the internal draining tube which was drawn back in 1 patient was removed with endoscopic sphincterotomy ( EST); the internal draining tube was removed naturally in 258 patients. The follow-up period ranged from 1 to 3 years, 26 patients had recurrent cholelithiasis and they were treated by EST. Conclusions LPCBDE with internal draining tube placement is a safe and minimally invasive method for the treatment of cholelithiasis.

Objective To explore the curative effect and prevention of complications of emergency laparoscopic cholecystectomy(LC) for acute cholecystitis.Methods The clinical data of 1 278 patients with acute cholecystitis who were treated with emergency laparoscopic cholecystectomy from July 2004 to July 2010 in our haspital were collected and analyzed retrospectively.Among these patients,471 cases had mild acute cholecystitis,720 cases had acute suppurative cholecystitis and 87 cases had acute gangrenous cholecystitis.The impaction of stones in the neck of gallbladder was present in 823 cases.The impaction of stones in the cystic duct was present in 157 cases.In 96 cases emergency operation was performed within 48 hours after the synptoms occurred,in 799 cases operation was performed from 48 to 72 hours,and in 383 cases operation was undertaken after 72 hours.Results The mean operation time was 40min(20-90 min) and the mean blood loss was 80ml(20-300 mL).Early postoperative fever(38.0～39.5℃) developed in 375 cases.Temporary jaundice was found in 108 cases.Bile leakage occurred in 17 cases.No LC cases were converted to open cholecystectomy.No cases were complicated with bile duct injury and there was no mortality.Conclusions Emergency laparoscopic cholecystectomy for acute cholecystitis is difficult.The probable complication rate is quite high.Severe complications can be avoided with skillful surgical technique and rich operative experience.Acute cholecystitis is not a contraindication for emergency laparoscopic cholecystectomy.

Objective To investigate the diagnostic significance of thin layer reconstruction with spiral CT on the pulmonary hamartoma. Methods Accepted both routine CT examination and thin layer construction,2 1 pulmonary hamartoma cases confirmed by pathology were analyzed retrospectively.The margin and inner features of the lesions were observed and recorded.Significant analysis was performed by using SPSS17.0 Pearson chi-square test and Fisher exact test,with P<0.05 as the significant difference criterion.Results Comparison of the display rates by routine CT and thin layer reconstruction:①the same display rate of lobulation were 57.1%(12/21);②the same display rate of calcification were 42.9% (9/21);③the display rates of fat density were 14.3%(3/21)by routine CT and 42.9% (9/21)by thin layer reconstruction.The difference was statistically significant (χ2=4.200,P<0.05);④the display rates of blood vessel throughing were 14.3%(3/21)by routine CT and 47.6% (10/21)by thin layer reconstruction.The difference was statistically significant (χ2=5.459,P<0.05).Conclusion Displaying the inner features of pulmonary hamartoma better than routine CT,the thin layer reconstruction can improve the diagnostic accuracy significantly.

Objective: To evaluate the predictive value for baseline levels of high sensitivity C-reactive protein (hs-CRP) in morbidity of pulmonary embolism (PE). Methods: We conducted a prospective cohort study of 101510 subjects in Kailuan Group by regular physical examination from 2006-07 to 2007-10, and 94314 subjects were enrolled by relevant criteria including 75252 male and 19062 female. The baseline levels of hs-CRP were divided by quartile levels as①hs-CRP<0.3l mg/L,n=25592,②hs-CRP (0.3l-0.77) mg/L,n=21746,③hs-CRP (0.78-1.9) mg/L,n=23504 and④hs-CRP≥2.0 mg/L,n=23472. The subjects were followed-up for (81.5 ± 4.76) months, the morbidity of PE was collected and the predictive value of baseline levels of hs-CRP for PE occurrence was evaluate by multivariable Cox proportional hazard regression analysis. Results: The total PE morbidity was 0.15%, the female subjects were similar with male subjects,P>0.05. As the increased baseline level of hs-CRP, PE occurrence was elevated accordingly,P<0.05. Multivariable Cox proportional hazard regression analysis presented that with adjusted age, gender, smoking, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), fasting blood glucose (FBG), neutrophile granulocyte (NEU), white blood cells (WBC) and heart rate (HR), the subjects in the highest quartile group had 2.84 times higher risk for PE occurrence than the subjects in the lowest quartile group. With the elevated baseline level of hs-CRP, the subjects’ mean age, BMI, SBP, FBG and NEU levels increased accordingly, allP<0.05; while DBP, TG and HR were similar between quartile③ and quartile④ groups, allP>0.05. WBC counts had the increasing trend in quartile①,②,③ groups and had the decreasing trend in quartile④ group, while it was similar between quartile③ and quartile④ groups,P>0.05. Conclusion: Baseline hs-CRP level may predict the risk of PE morbidity; the increased hs-CRP level could be used as one of the predictors for PE occurrence.

Objective To investigate the value of multi slice spiral computed tomography (MSCT) reconstruction technique for diagnosis and preoperative evaluation of pancreatic carcinoma.Methods The multi-phase enhanced CT images of thirty-five cases of pancreatic carcinoma proved histologically were analyzed retrospectively.The techniques of volume rendering (VR),multi-planar reconstruction (MPR) and curved planar reformation (CPR) were used to deal with the images,and the relation between the pancreatic tumor and its surrounding structures,vessels,bile duct were observed,then the evaluation of possible surgical resection was performed,then it was compared with operative results.Results Among the 35 patients,27 vessels invasion was showed in 9 patients,common bile duct invasion in 19 patients,pancreatic duct invasion in 12 patients,duodenum invasion in 7 patients,posterior wall of stomach in 2 patients was invaded; one patient had regional portal hypertension with splenomegaly,peri-pancreatic lymph nodes enlargement was detected in 14 patients,para-aortic lymph nodes enlargement was detected in 4 patients,and liver metastasis was found in 3 patients.According to CT evaluation,surgery could be performed in 21 cases,finally 19 patients underwent curative pancreatic cancer resection,and 2 patients underwent palliative surgery.According to CT evaluation,surgery could not be performed in 14 cases,and all of the patients underwent palliative surgery.The coincidence percentage of pre-operative evaluation and post-operative results of curative surgery,palliative surgery was 90％ and 88％.Conclusions MSCT reconstruction technique is useful for diagnosis of pancreatic carcinoma regional invasion and metastasis,and it can increase the accuracy of assessment of tumor resectability.

OBJECTIVE: To investigate the possibility and anatomy landmark of the frontal beak approach of endoscopic frontal sinusotomy to the frontal sinus lesions. METHOD: (1)Twenty cases of frozen cadaveric head underwent spiral computed tomography scans. Then data were transferred into the Mimics image workstation to reorganize CT images in the coronal, sagittal, and axial planes. The anatomic parameters related to surgical approach points were measured, such as the distance between vertical plate of the middle turbinate and lamina papyracea and the thickness of the frontal beak. (2) 3D visual model of the frontal cell and the drainage way of the frontal sinus was produced with the application of Sinuses Trachea I software. (3)The endoscopic frontal sinus surgery were performed on 20 cases of subjects (objects)to find out the anatomy landmarks of the frontal beak approach, measure the parameters such as the distance between middle turbinate and lamina papyracea, and evaluate the potential surgical complications during operation. RESULT: (1)The frontal beak is a white bony arcs located at the attachment point of middle turbinate front inserted to the skull base. Its position was relatively constant, before frontal sinus above. (2)The distance between the middle turbinate vertical plate and lamina papyracea was (7. 61 ± 1. 34) mm. The thickness of the frontal beak in surgical approach was (3. 27 ± 0. 91) mm. (3) 3D visual structure of the frontal sinus and its ventilation pathway: the shape of unilateral frontal sinus looked like the cone, which was transited by the drainage pathway of the frontal sinus. The front part of the frontal sinus ostium is surrounded by the frontal beak. The upper part the frontal beak connected to the floor of the frontal sinus. (4) Frontal beak can be used as an landmark of frontal beak approach in the endoscopic frontal sinus surgery. But the lateral view of frontal sinus still was limited in the operation. CONCLUSION The endoscopic frontal sinus surgery with the approach of the frontal beak is easy to operate and learn. In this area between the double "L", the operation is safe.
Anatomic Landmarks ; Endoscopy ; methods ; Frontal Sinus ; surgery ; Humans ; Skull Base ; Software ; Tomography, Spiral Computed ; Tomography, X-Ray Computed ; Turbinates ; anatomy & histology