Objective To explore the clinical value of using heparin in DIC caused by Tsutsugamushi.Methods 27 cases of Tsutsugamushi with DIC were divided into two groups. The heparin treatment group(n = 15) and non-heparin treatment group(n = 12). The two groups were compared and analyzed. All the cases were diagnosed definitely depended on the "Tsutsugamushi-Disease-Diagnosis Standard".Results The group which use heparin improved in rectifying shock,terminating heorrhage,restoring the time of lab index of DIC,rating of MOF and death. Compared with the control group, the difference had statistical significance(P

Objective To investigate the safety and feasibility of laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis.Methods Between September 2015 and May 2016,patients with hepatic cystic echinococcosis indicated for surgery were evaluate.Selective hemihepatic inflow inclusion or non-selective hepatic inflow inclusion was adopted to control the bleeding.Laparoscopic multifuctional operative dissector (LPMOD) was applied for liver parenchymal transection.Laparoscopic hepatectomy and cystectomy was applied for hepatic cystic echinococcosis in eight cases,including one case of mesohepatectomy,two cases of right posterior sectionectomy,two cases of right partial hepatectomy,one case of left hepatectomy,one case of left lateral sectionectomy and one case of cystectomy in the left hepatic lobe.Results 8 patients received laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis.Seven cases were performed totally laparoscopically and one case required a conversion.The maximum size of the lesion was 10 cm.Operating time was 150-260 min (mean,200 ± 35);Blood loss was 100-1 000 ml (313 ±290).One patient received intraoperative transfusion.Postoperative hospital stay was 6-9 days (mean,7.6 ± 1.3).One patient developed postoperative pleural effusion that resolved after medical treatment.One patient developed biliary leak in postoperative five days and recovered after drainage for twelve days.No remaining cavity infection,postoperative abdominal bleeding,liver failure occurred.No hospital death occurred.Conclusions Laparoscopic hepatectomy and cystectomy for hepatic cystic echinococcosis is technically safe and feasible.

The clinical data of 147 patients with carcinoma of ampulla of Vatar at our hospital from January 1998 to December 2012 were retrospectively analyzed.The neutrophil-to-lymphocyte ratio ( NLR) was calculated from pre-operative complete blood count.They were divided into low NLR group (NLR<5,n=121) and high NLR group (NLR≥5,n=26).The 5-year survival rates of two groups were compared and the prognostic risk factors examined by univariate analysis and Cox model.The 5-year free survival rates of low and high NLR groups were 57.9%and 27.6%respectively ( P=0.005 ).Univariate analysis revealed that depth of invasion (P=0.006),pancreatic invasion (P=0.002),lymph nodal metastasis (P=0.008), poor differentiation ( P =0.008 ) , tumor stage ( P =0.003 ) and per-operative NLR ( P =0.005 ) were significant prognostic factors.Multivariate analysis showed that per-operative NLR significantly increased the risk of recurrence (P<0.05).Pre-operative NLR represents a significant independent prognostic indicator for patients with carcinoma of ampulla of Vatar.

10.3969/j.issn.1000-8179.2013.12.012

Objective To investigate the effects of exercise on memory impairment in demented mice and possible molecular mechanisms.Methods Thirty Kunming nice were divided into a normal control group,a dementia group and a dementia plus exercise training group (exercise training group),10 mice/group. Dementia models were established by intraperitoneal injection of scopolamine.Exercise training was begun 30 min after the injection and lasted for a 6-week period. A water maze test was performed after the exercise training. Brain-derived neurotrophic factor (BDNF) expression and protein kinase (Akt) phosphorylation in the hippocampus were detected by Western blot analysis.Nitric oxide (NO) content and superoxide dismutase (SOD) activity in the hippocampus were also measured.ResultsDementia models were successfully induced as indicated by prolonged escape latency in the water maze test.After exercise training the escape latency had shortened significantly and hippocanpal BDNF expression and Akt phosphorylation had increased.NO content increased and SOD activity decreased after the injections,but these effects were partially reversed after exercise training.Conclusions Exercise can improve spatial memory significantly after scopolanine-induced dementia in mice.The increased hippocampal BDNF expression and Akt phosphorylation,increased SOD activity and decreased NO content may partially explain the behavior improvement induced by exercise.

Objective To observe the efficacy of CTLA4Ig and CD40Ig gene local cotransfection on the survival of renal allografts.Methods The kidneys of guinea pig were transfected with PcDNA 3.1+-CTLA4Ig and/or PcDNA 3.1+ -CD40Ig gene by Lipo2000,and the transfected kidneys were transplanted to SD rats.The recipients were divided into group 1 (transfected with PcDNA 3.1 +,mock group),group 2 (transfected with PcDNA 3.1 + -CD40Ig,CD40Ig group),group 3 (transfected with PcDNA3.1+ -CTLA4Ig,CTLA4Ig group) and group 4 (co-transfected with PcDNA 3.1+-CD40Ig and CTLA4Ig,CTLA4Ig+ CD40Ig group).The effects of CTLA4Ig and CD40Ig transfection were determined by Western blotting.The serum creatinine (Scr) in the recipients,the pathological changes of the allografts and the survival of renal allografts were observed.Results Significantly prolonged allografts survival time was observed in group 2 (40.7 ± 10.9 days),group 3 (49.3 ± 9.5 days) and group 4 (75.7 ± 8.0 days) as compared with group 1 (6.8 ± 1.9days),especially allografts got the longest survival time in group 4 (75.7± 8.0 days).The serum creatinine level was reduced in group 4 at 30th day as compared with that in group 2 and group 3.The lymphocytes infiltrating rate in the grafts was lowest in group 4 after transplantation.Conclusion Local co-transfection of CTLA4Ig and CD40Ig genes can prolong the survival time of renal allografts significantly.

Objective To study the clinical feature,diagnosis,treatment and prognosis of hepatocellular adenoma(HA).Methods The clinical data of 10 patients confirmed pathologically with HA,were retrospectively analyzed.Results There were four females and six males,aging from 25 to 71 years(mean:42.6 years).Among these 10 patients,6 cases were discovered to have no clinical symptom.Tumors were located in the right lobe of the liver in 4 cases,and in the left lobe in 6 cases.Uhrasonography was performed in all cases.Six cases underwent CT examination and three cases experienced MRI as well as angiography was conducted in one case.All cases were confirmed by complete excision and pathology.All of them were followed up for 5 months to 9 years without tumor recurrence.Conclusion The combination of imaging data is helpful in the diagnosis of HA.Surgery is the best treatment with satisfactory results,and its prognosis is fairly good.

Objective To study the diagnosis and treatment of pancreatic cystadenoma and cystadenocarcinoma.Methods The clinical data of 21 surgically treated patients of the cystic neoplasms of pancreas(CNP),confirmed by pathology,in recent 8 years were retrospectively analyzed.Results CNP was more frequently seen in young to middle-aged women.Upper abdominal mass and abdominal distention and pain were the main clinical presentations.The CNP resection rate was 95%(100%and 80%in benign and malignant CNP respectively).Of the 21cases,pancreaticoduodenectomy and distal pancreatectomy were performed in 2 and 16 respectively;and middle segment pancreatectomy in 2 patients.Postoperative pancreatic fistula was the leading complication.Conclusion CNP have no clinical characteristics.Ultrasonography and CT could be helpful to the diagnosis of CNP.The resection of the whole tumor with part paratumor pancreas tissue is advocated.

Objective To investigate the effectiveness of surgical resection for metastatic liver cancer in patients of gastric carcinoma, and evaluate the prognosis. Methods Clinical data of 24 gastric cancer cases undergoing hepatectomy for hepatic metastatic tumor were collected retrospectively. There were 18 cases of synchronous resection and 6 cases of heterochronous resection. The prognostic values of clinicopathological factors were assessed by univariate and multivariate analyses. Results Postoperatively all cases were followed up until the death of the patietns. Counting from the time of liver resection the 1-,3- and 5-year survival rate was 67%, 21% and 13% respectively. Univariate analysis showed lymph node involved, tumor size of hepatic metastases, vascular invasion and R0 margin as significant prognostic factors;Multivariate analysis indicated that tumor size of hepatic metastases and vascular invasion were independent prognostic factors influencing the survival. Conclusion These results suggest that for patients with liver metastasia from gastric cancer, better prognosis can be obtained by surgical treatment.

Objective To detect the expression changes and location of the mouse developmental regulation brain protein(Dbn1)in the developmental mouse brain.Methods Monoclonal antibodies against drebrin protein were used to assess Dbn1 by immunohistochemistry and Western blot.The paternal expression of Dbn1 in developmental mouse brain(E14,P1,P7 and adult)was initially investigated by Western blot.Dbn1 was shown at various developmental stages(E14,P1 and P7)as well as in adult in different brain area of developmental mouse brain by immunohistochemical.Results Dbn1 protein was detected in developmental brain but a little in adult brain by Western blot,high at E14,decreased at P1,gradually increased at P7 and lowest in adult.Immunohistochemistry confirmed as follows:Dbn1 expressed mostly in cortex,hippocampus and ependyma areas at E14,and the positive signal was distributed at cells border;The expression of Dbn1 was decreased at P1,mainly distributed at the verge of cells or dendrites;The peak expression of Dbn1 appeared at P7,Dbn1 located at nucleus of hippocampus and cortex,and the positive signal located within cytoplasm and dendrites;Only a little positive Dbn1 cells were found in adult mouse brain.Conclusion Dnb1 may be involved in regulating the differentiation and migration of neurons during the development of mouse brain.