Abdominal Wall ; pathology ; surgery ; Hernia, Abdominal ; etiology ; surgery ; Humans ; Models, Anatomic ; Postoperative Complications ; etiology ; surgery

Enterostomy ; adverse effects ; methods ; Hernia, Ventral ; etiology ; surgery ; Humans ; Postoperative Complications ; etiology ; surgery

Anastomosis, Surgical ; adverse effects ; Brachiocephalic Trunk ; pathology ; Hemorrhage ; etiology ; therapy ; Humans ; Larynx ; surgery ; Male ; Middle Aged ; Postoperative Complications ; Trachea ; surgery ; Tracheal Stenosis ; etiology ; surgery ; Tracheotomy ; adverse effects

Objective The study was to investigate the relationship among angiotensin 1-converting enzyme(ACE), plasminogen activator inhibitor-1 (PAI-1)gene polymorphisms and the common carotid artery (CCA-IMT), and the predicting effects of them on CCA-IMT in newly diagnosed type 2 diabetes (T2DM). Methods The polymorphisms of ACE (I/D) gene and PAI-I (4G/5G) gene were deter-mined by polymemse chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele-specific polymerase chain reaction (AS-PCR) method in 308 cases with T2DM. CCA-IMT was compared among the groups with different genotypes of ACE and PAI-1. The in-dependent or synergistic effects of the ACE I/D and PAI-1 40/5G polymorphisms on CCA-IMT in 308 patients with T2DM were analyzed with multivariate linear regression. Then the 156 newly diagnosed type 2 diabetics (durations< I year) without AS received the maltifactorial targeted intervention, including taking aspirin and controlling blood glucose, blood pressure, blood lipid and body weight. The differences of metabolic control, ACE (I/D) and PAId (40/5G) gene polymorphisms were analyzed. Logistic regression analysis was used to analyze the eorrelation among the CCA-IMT, ACE (I/D) and PAI-1 (4G/5G) polymorphisms. Results Patients with ACE DD genotypes had higher CCA-IMT than those with ACE-Ⅱ or ACE ID genotypes. Patients with both ACE DD and PAI-1 404G genotypes had a higher CCA-IMT than those with any other pairs of genotypes. Multivariate linear regression analysis showed that ACE DD and PAI-1 4G4G gene polymorphisms had synergistic effect on the CCA-IMT in T2DM patients. After 2 years multifactorial intervention, the frequencies of PAI-1 4G alleles and 404G genotypas were lower than those in the CCA-IMT non-inereasing group. Conclusions These findings indicate that the ACE-DD geno-type and its synergistic effects with the PAI-1 4G/4G genotype are independent risk factors for the CCA-IMT in T2DM patients. Under multi-factorial intervention for 2 years, PAI-1 4G/4G genotype may be a negative predictor for the progression of CCA-IMT in T2DM patients.

Objective To evaluate the value of neutrophil gelatinase - associated lipocalin (NGAL) for diagnosis of acute kidney injury (AKI) after cardiopulmonary bypass established. Method 120 children undergoing cardiopulmonary bypass were enrolled in this prospectively study. Serial urine samples were analyzed by ELISA for NGAL expression. The primary outcome measure was AKI, which was defined as a 50% or greater increase in serum creatinine from baseline. Result 21 children ( 17.5% ) developed AKI. Urine concentrations of NGAL increased after cardiopulmonary bypass had been established for 2 hours. The concentration of NGAL in urine after cardiopulmonary bypass had been established for 2 hours was used to diagnose AKI. The area under the receiver-operating characteristic curve was 0. 96, the sensitivity was 92%, and the specificity was 91% for the cutoff value of 100ng/mg Cr. Conclusion Concentrations of NGAL in urine might be used as a sensitive and specific biomarker for early prediction of AKI after cardiopulmonary bypass had been established.

Objective To compare the perioperative outcomes and long-term therapeutic response of laparoscopic splenectomy versus open splenectomy for idiopathic thrombocytopenic purpura.Methods A retrospective analysis of 124 patients who under-went splenectomy(68 LS and 56 OS)for ITP between January 2011 and January 2015 was conducted.Results Patients undergoing LS were found to require a longer operative time(P <0.05 )but had reduced hospital stay,lower intra-operative blood loss(P <0.05),less postoperative pain,earlier drain removal,and decreased incidence of complications(P <0.05).Conversion to OS was re-quired in 4 patients for excessive loss of blood(5.8%).Deep venous thrombosis(DVT)was observed in 1 patients after OS.One pa-tient died from pneumonia after LS.Mean follow-up of (33±11.8)months was performed in LS group and of (32±12.9)months in OS group.50 patients(73.5%)in LS group and 43(76.7%)in OS group reached sustained complete haematological response(P >0.05).Kaplan-Meier analysis showed that there was no significant difference in the relapse-free survival rate between the groups (P =0.679).Conclusion Compared with open splenectomy,laparoscopic splenectomy for patients with ITP has similar long-term therapeutic response,but it has advantages of minimally invasiveness.

?ig-h_3 was first identified as a transforming growth factor-beta1-inducible gene in human lung adenocarcinoma cell line. It encodes for a secreted extracellular matrix (ECM) protein, which is thought to act on cell attachment and ECM composition. Previous study showed that ?ig-h_3 were highly expressed in human hepatoma cell lines and lowly expressed in human normal hepatic cells. The present study aimed to transfect ?ig-h_3 into 7721 cells to investigate its effect on secretion of MMPs in the transfected human hepatoma cells. Full-length ?ig-h_3 gene,cloned by reverse transcription polymerase chain reaction (RT-PCR) was inserted into the eukaryotic expression vector pEGFP-C_2. The recombinant plasmid was transfected into 7721 cells with Lipofectamine2000 and Gelatin-Zymography were adopted to detect the production of MMPs in the transfected cells. Results showed that ?ig-h_3/pEGFP-C_2 recombinant expression plasmid was successfully constructed and achieved high transfection efficiency. MMPs expression of the transfected cells was promoted significantly. These results suggest that overexpression of ?ig-h_3 promoted the production of MMPs, indicating that ?ig-h_3 may play roles in the invasive and metastatic processes of hepatoma.

Objective To compare the effect of three methods in diagnosis of plague by detecting of Yersina pestis F1 antigen. Methods In natural foci of plague, wild animal samples, such as blood, liver, spleen,and lymphoid tissue were collected, and the three methods of enzyme linked immunosorbent assay (ELISA),reverse indirect hemagglutination assay(RIHA) and gold-immunochromatography assay(GICA) were employed to detect F1 antigen of Yersina pestis. Results Total of 414 infused organ samples of natural death and captured wild animals in natural foci of plague were determined. Positive samples detected by GICA and ELISA were the same,the positive rates were 5.31%(22/414), both positive and negative coincidence rates were consistently 100%. Only 18 samples were positive by retrial in 186 samples with more than 2 holes aggregation by preliminary examination of RIHA, with nonspecific agglutination rate of 40.6% (168/414) and positive rate of 4.35% (18/414). The positive coincidence rate was 81.82% (18/22) between RIHA with GICA and ELISA, and negative coincidence rate was statistically significant(t = 4.379, P ＜ 0.01). Conclusions ELISA, RIHA and GICA can be used for early diagnosis of plague by detecting F1 antigen. The results of RIHA have quantitative significance, with higher non-specific agglutination rate, and heavy workload of re-examination; GICA and ELISA has the same specificity and sensitivity, but the results of GICA is only qualitative. ELISA excluded the defect of RIHA and GICA, and combines the advantages of both methods.

Objective To investigate the etiology of acute recurrent pancreatitis (ACP) and de-termine how to further enhance its level of treatment.Methods The clinical data of 33 patients with ACP treated in Ruijin Hospital from 2003 to 2007 were retrospectively analyzed.Results Of the 33 patients with an average age of 55 (22-86), 18 (55%) were male and 15 (45%) female.ACP occurred once in 26 patients, twice in 4 and 3 times in 3.The disease appeared whithin 1 year in 29 patients, 1-2 years in 2, 2-3 years in 1 and 3 years in 1 after being dischared from hospital.For its etiology, it was of biliary origin in 29 patients, hyperlipidemia in 1, pancreatic tumor in 1 and unknow reasons in 2.Twenty-four patients were treated with operation or endoscopy.Two patients died and the mortali-ty was 9.1%.Conclusion ACP is mainly due to biliary origin in China.Operative intervention at an appropriate opportunity can effectively reduce the recurrence of biliary-origin pancreatitis.

OBJECTIVETo probe the safe depth and angle of needling the point Yaotu for treatment of prolapse of intervertebral disc.

METHODSCT technique was used for scanning investigation of the depth and angle of needling the point Yaotu.

RESULTSWhen the acupuncture needle was inserted vertically to the external space of intervertebral foramen of human body with arrival of qi, the tip of needle could reach to 73 mm deep, which is the best needling depth and angle.

CONCLUSIONThe needle vertically inserting to the external space of intervertebral foramen at the point Yaotu is proper in treatment of prolapse of intervertebral disc.