Aim A method of coculture of brain capillary endothelial cells (BCECs) and astrocytes of rats was used to evaluate nanoparticle' s blood-brain barrier (BBB) transcytosis and toxicity at the endothelial tight junction. Methods A lipophilic fluorescent probe, 6-coumarin, was incorporated in poly(ethyleneglycol)-poly (lactide) nanoparticle using double emulsion/solvent evaporation method. BCECs and astrocytes were firstly isolated from brain of newborn rats and characterized by their morphology and immunocytochemistry staining, separately. Subsequently, a coculture model with BCECs on the top of micro-porous membrane of cell culture insert and astrocytes on the bottom side was established. The permeability of 14C-labeled sucrose and nanoparticle were determined, separately. Results The meanweight-based diameter of 6-coumarin loaded nanoparticles was ( 102.4 ± 6.8) nm, with zeta potential of ( - 16.81 ± 1.05) mV. BCECs were positive for factor Ⅷ staining and glial fibrillary acidic protein was tight junction between BCECs in the coculture model could be visualized by both scanning electron microscopy and transmission electron microscopy. The unchanged paracellular transport of sucrose proved vivo situation for examination of the permeability of nanoparticle and toxicity evaluation.

Objective To summarize the clinical experience of laparoscopic repair of esophageal hiatal hernia.Methods A total of 15 cases of esophageal hiatal hernia underwent laparoscopic hernia repair and fundoplication from May 2004 to April 2005 in this division.There were 4 cases of type Ⅰ hernia(all of which presented severe gastroesophageal reflux disease),10 cases of type Ⅱ hernia,and 1 case of type Ⅲ.Surgical procedures included laparoscopic Nissen total fundoplication in 9 cases,Toupet partial fundoplicatin in 4 cases,and Dor partial fundoplication in 2.Symptoms of gastroesophageal reflux disease,including heart burn,dysphagia,regurgitation,chest pain,and belching,were evaluated by using the Visual Analogue Scales(VAS) at preoperative period,1 postoperative month,and 6 postoperative months,respectively.Results No conversion to open surgery was required in this study.The operative time ranged 100~187 min(mean,125 min).The postoperative hospital stay was 2~5 days(mean,2.8 days).All the patients were followed for 1~12 months(mean,8.5 months).No hernia recurrence was found.The VAS scores decreased from 5.0?3.9 preoperatively to 0.9?1.3 at 1 month postoperatively(t=3.823,P

Objective: To observe the effects of astragaloside IV on myocardial fibrosis and connective tissue growth factor (CTGF) expression in experimental rats with chronic heart failure (CHF).
Methods: CHF model was established by abdominal aorta constriction (AAC) and the rats were divided into 5 groups:Sham operation group, the rats received normal saline 2 ml/day, n=10, CHF group, the rats received normal saline 2 ml/day, n=12;Astragaloside IV groups, CHF rats received astragaloside IV at (20, 40, 60) mg/kg respectively and n=12 in each group. All animals were treated for 4 weeks. Hemodynamic indexes were monitored, left ventricular mass index (LVMI) was calculated, morphologic changes of myocardial tissue was observed by HE staining, myocardial ifbrosis degree and collagen volume fraction (CVF) were measured by Masson staining. The mRNA and protein expressions of CTGF were detected by RT-PCR and immunohistochemistry, Western-blot analysis respectivety.
Results: Compared with CHF group, 3 Astragaloside IV groups had decreased LVMI and CVF, P<0.05-0.01;Astragaloside IV (40 and 60) mg/kg groups presented decreased LVEDP and LVSP, increased ±dp/dtmax, P<0.01 to P<0.05 and improved pathological morphology. Compared with Sham group, CHF group had increased average CTGF OD value (0.09 ± 0.03) vs (0.45 ± 0.04) and increased expression of myocardial CTGF (0.57 ± 0.06);compared with CHF group, the average CTGF OD values in Astragaloside IV (20, 40, 60) mg/kg groups were all decreased (0.39 ± 0.05), (0.30 ± 0.06), (0.24 ± 0.04) and decreased expressions of myocardial CTGF (0.44 ± 0.05), (0.35 ± 0.02), (0.28 ± 0.03) respectively, all P<0.01.
Conclusion: Astragaloside IV can inhibit myocardial ifbrosis and improve cardiac function in CHF rats, which might be via inhibiting the over expression of myocardial CTGF.

Objective To estimate the value of urinary neutrophil gelatinase-associated lipocalin (NGAL) level for early diagnosis of acute kidney injury (AKI) in patients with sepsis.Methods One hundred and twenty-six sepsis patients admitted to intensive care unit (ICU) in Baoshan Branch Hospital of Shuguang Hospital Affiliated to Shanghai University ofTraditional Chinese Medicine from June 2014 to December 2015 were enrolled, and they were divided into two groups according to whether complication of AKI was present. The levels of urinary NGAL in the two groups of septic patients were evaluated immediately and at 12, 24 and 48 hours after the definite diagnosis, and the levels were compared between the two groups; the receiver operating characteristic curve (ROC curve) was performed and the value of urinary NGAL level in early diagnosis of sepsis AKI was evaluated.Results There were 60 septic cases complicated with AKI (AKI group), with the prolongation of time after definite diagnosis, the urinary NGAL (g/L) levels were gradually increased at 12, 24 and 48 hours, the levels were significantly higher than those at the corresponding time points in the group without AKI [non AKI group (66 cases), 12 hours: 178.2±32.8 vs. 53.8±10.4, 24 hours: 228.4±24.6 vs. 54.1±9.0, 48 hours: 186.1±43.6 vs. 52.5±9.4, allP < 0.05]. The area under ROC curve (AUC) of urinary NGAL level at 24 hours after definite diagnosis and 95% confidence interval (CI) were 0.863 (0.766-0.929) and 0.686 (0.466-0.696), respectively, when the cutoff value of urinary NGAL was 65.9μg/L, the sensitivity was 81.9% and specificity 76.1%; when the cutoff value of urinary NGAL was 57.9μg/L, the sensitivity was 70.2% and the specificity 57.2%.Conclusion Urinary NGAL level can be used as a reference marker for the early diagnosis of sepsis concomitant AKI.

Objective Toinvestigatetheeffectofchronicrecombinantgrowthhormone(rhGH)stimulationonhepaticSTAT5in healthy young mouse and its molecular mechanism .Methods 32 normal young mice were divided into 4 groups :PBS ,PBS+single rhGH ,chronic rhGH ,chronic rhGH+ single rhGH groups .The mice in the treatment groups(chronic rhGH and chronic rhGH +single rhGH )received intraperitoneal injection of rhGH at 1 μg/g body weight once daily for three weeks ;the mice in the control groups(PBS and PBS+single rhGH) were injected with sterile phosphate buffered saline(PBS ,0 .1 mol/L) .At next day 8:00 after 16 h of injection of last rhGH and PBS ,at 30 min before killing mouse ,PBS 0 .1 mol/L was injected in the PBS group and the chro-nic rhGH group ,while the single dose of rhGH 1 μg/g was injected in the PBS+single rhGH and the chronic rhGH+single rhGH group .Results Compared with the control mice(PBS group and PBS+single rhGH group) ,the body mass in the rhGH stimulation mice (chronic rhGH group and the chronic rhGH + single rhGH group) was significantly increased ;compared with the PBS group ,the base p-STAT5 level within the hepatic GH signal pathway in the chronic rhGH was significantly decreased ;the combi-ning capacity of hepatic STAT5 and DNA detected by EMSA in the chronic rhGH group was significantly lower than that in the PBS group ;in the mice injected by single dose of rhGH 1 μg/g at 30 min before killing mouse ,the hepatic p-STAT5 level in the chronic rhGH+single rhGH was significantly decreased compared with the chronic rhGH + single rhGH ;compared with the con-trol group ,the CIS content in the chronic rhGH was obviously increased ,while the SOCS-2 content had no obvious difference .Con-clusion Chronic rhGH stimulation can inhibit the phosphorylation of hepatic STAT 5 in normal young mouse ,which mechanism could be related with the increase of CIS content .

Objective To investigate the medical cost of 72 patients with panic disorder and efficacy of paroxetine(SSRIs)in the treatment.Methods The course,medical cost,types and times of main examination of all 72 patients were reviewed and analyzed.The effect of paroxetine on the patients was studied in terms of anxiety and depression scale.Results The 72 patients had long course,high medical cost and received many unnecessary medical examinations.Paroxerine was effective on patients with panic disorder in light of anxiety and depression scale.Con- clusion Patients with panic disorder had long course and spent much unnecessany money before final diagnosis. Paroxetine was useful and safe in the treatment of panic disorder.

Objective To explore the operative main point and clinical effects of laparoscopic treatment for hepatic cyst. Methods Between August 2006 and April 2009, Forty-eight cases of laparoscopic treatment for hepatic cyst were performed, and the data were analyzed retrospectively. Of these treatments, there were laparoscopic fenestration (46 cases) and laparoscopic anatomical resection of left hepatic lobe (2 cases). Of the patients, there were solitary cyst (41 cases) and multiple cyst (7 cases). Results Fortyeight cases all performed laparoscopic treatment successfully. There were no converting to open operation, no biliary leakage and no bleeding. Except for resection of left hepatic lobe, the operating time was 30 -96 minutes (mean, 45 minutes), the intraoperative blood loss was 10 -90 mL (mean, 26 mL) and the postoperative hospital stay was 3 - 9 days (mean, 5 days). All the 48 patients were followed up for 6 to 36 months (mean, 32 months), 2 cases were found recurrence. Conclusions Affluent experience and proper standard of operation are key points for avoiding recurrence and complication in laparoscopic treatment for hepatic cyst. Laparoscopic treatment for hepatic cyst is safe, characterized by less pain and rapid recovery.

Objective To evaluate the value of MSCT in the diagnosis of extrahepatic cholangiocarcinoma.Methods The MSCT appearances of extrahepatic cholangiocarcinoma confirmed by pathology in 27 cases were analyzed retrospectively.Among them,20 patients underwent plain and four-phase dynamic contrast-enhanced CT scans including early arterial phase,late arterial phase,portal phase and delay phase,7 patients only underwent contrast-enhanced CT scans.Results 15 lesions were located in the hilar and 12 lesions were located in the common bile duct.CT features of cholangiocarcinomas in this group were varied with its position and growth pattern.Besides the direct sign such as delay enhancement,the indirect findings were also specific such as hepatic lobe atrophy,dilated bile duct,etc.Conclusion MSCT is of great value in diagnosis of extrahepatic cholangiocarcinoma.

Objective To discuss the surgery procedure and treatment effect of reconstruction of the soft tissue of the thumb/finger defects by the second toe tibial toe pulp skin flap. Methods Ten patients with the soft tissue of pulp of the thumb/finger defects were treat by the same side of the second toe tibial toe pulp skin flap, all the patients have the soft tissue defect of finger pulp with exposed phalanx. Crush them in 4 cases, the machine cut wound in 6 cases. A fixed 2 cases, delayed operation 3-7d after injury to repair in 8 patients. The side of skin flap varied from 2.0 cm × 2.2 cm to 2.0 cm × 3.5 cm. Results Ten fingers in 10 cases all survived. Necrosis in edge part of the shin graft occurred in 2 cases, which was healed through changing of dressing. All cases were followed form 4 months to 16 months. The blood-supply, texture and elasticity of transferred flaps and the shape of fingers pulp were excellent. Good function recovery of the fingers was achieved. Pain and temperature sence were regained. Two point discrimination of the finger pulp was 5-9 mm.Primary healing occurred in all cases. It did not disturb dressing shoes and walking. Conclusion It is a reliable approach for soft-tissue coverage of the thumb/finger using the second toe tibial toe pulp skin flap based on distal perforators of digital artery or ulnar artery. The advantages include simply procedures, reliable blood supply without sacrificing main aneries and possibilities of sensoly recovery.

Objective:To analyze the clinical and physical tactors associated with acute bone marrow suppression in concurrent chemo-radiotherapy for rectal cancer and to provide a reference standard for the best clinical treatment plan. Methods:Retrospective analy-sis was performed on 62 patients with rectal cancer who received concurrent radiotherapy and chemotherapy in our department. The pelvis was contoured for each patient in the radiotherapy treatment planning system and divided into three subsites: lumbosacral spine, ilium, and lower pelvis. Prognostic clinical and physical factors were analyzed by univariate and multivariate analyses. Evaluated prognostic clinical factors included sex, age, clinical stage, original hemoglobin levels, and chemotherapy, operation, and radiation modes;physical factors included V5, V10, V15, V20, V25, V30, V35, V40, V45, V50, Dmax, and Dmean of lumbosacral spine, ilium, low-er pelvis, and pelvis. Results:The percentage of patients who developed acute bone marrow suppression (≥2 grade) was 61.3%(38/62).Univariate analysis of related factors revealed statistically significant differences were sex, chemotherapy, lumbosacral spine V45, il-ium V20, and ilium V30. Multivariate logistic regression analysis indicated that chemotherapy and ilium V30 are the risk factors for acute bone marrow suppression. The receiver operating curve showed that the threshold of ilium V30 was 44%. Conclusion:Acute bone marrow suppression is influenced by more than one factor;local control rate of the tumor and acute bone marrow suppression are tradeoffs in rectal cancer treatment. An appropriate chemotherapy method should be selected, and ilium V30 must be maintained below 44%to prevent bone marrow suppression in rectal cancer patients.