To furtherly reduce the subxiphoid port site pain,improve the cosmetic result and patient satisfaction,and increase the safety for patients underwent laparoscopic cholecystectomy by advanced laparoscopic knotting skill.Methods:Among our 1500 patients underwent laparoscopic cholecystectomy since 1991,120 cases of modified laparoscopic cholecystectomy (MLC) were performed with three 5-mm ports and one 10-mm port(for laparoscope and sepcien withdrawn).There were 25 male and 95 female patients with an average age of 55 years (24～77years).The indications for MLC included polypoid lesions of gallbladder (21),simple cholecystitis(3),cholecystolithiasisi with chronic cholecystitis(84),with acute suppurative cholecystitis(7),with atrophic cholecystitis(5).Results:There were 5 patients underwent combined laparoscopic appendectomy(3),fenestration of hepatic cyst(1),and drainge for liver abscess(1).The average operative time for MLC was 55 minutes(30～150min),blood loss was 10ml(3～50ml),and postoperative stay was 3 days(1～5days).There were no conversion from MLC to either LC or open surgery,without mortality.Complications were limited to two patients(1.7%).One was retained common bile duct stone and another was port site bleeding after operation.They were treated by transduodenal endoscopic stone retrieval and simple suture ligation,respecrtively.Conclusions:The advantages of MLC conducted mainly by advanced laparoscopic knotting techniques were no more laparoscope (either 2-mm or 5-mm)needed,no sacrifice of good illumination and laproscopic image.Most of all,its costeffective and operative safety were all improved furtherly.

Beckwith-Wiedemann Syndrome ; Female ; Humans ; Infant, Newborn

Objective To understand the water quality of centralized water supply in Shanghai and provide the scientific data for further improvement of the health inspection and management of centralized water supply. Methods The management situation of centralized water supply, the water quality of water source, product water and tap water were investigated by using the methods in Analytical Methods for Water and Sanitary Standard for Drinking Water Quality (2001) in Shanghai in 2006. Results The current situation of management of 165 units of centralized water supply including 19 self-supply water plants in Shanghai was satisfactory. The analysis of drinking water showed that COD and total coliform in source water exceeded the standard limit remarkably(the eligible rates were 63.93% and 22.95% respectively), the eligible rates of COD, turbidity and manganese in product water and tap water were 25.45%, 18.18%, 27.88% and 18.06%, 13.89%, 11.81% respectively. Conclusion The results of the present investigation show that in Shanghai the main problems about the water quality are water source contamination by organic pollutants and the undeveloped water treatment.

Objective To investigate the mid-term efficacy of percutaneous laser disc decompression(PLDD) for patients with lumbar disc herniation.Methods Between May 2001 and December 2006,a total of 122 patients with simple lumbar disc herniation underwent PLDD in our hospital.Under local anesthesia,the operaiton was performed using a laser diode with the patients in supine position.A C-arm X-ray system was employed to guide the surgery.Results The patients were followed up for 6 to 60 months(mean 36.5 months).Accroding to the MacNab Criteria,60 patients achieved excellent outcomes,39 were good,15 were fair,and 8 were poor.The rate of exellent and good outcomes was 81.1%(99/122).No patient had postoperative complications.Conclusions PLDD is effective and safe for patients with simple lumbar disc herniation.The cases recover quickly after the operation,because the procedure is minimally invasive.

Objective To explore the effect of recombinant pEGFP-N3-APC vectors carrying various APC functional domains on the expression of β-catenin in human colorectal cancer cells HT-29.Methods The recombinant plasmids were transfected into HT-29 cells mediated by lipofectamine~(TM) 2000, and detected by green fluorescence and RT-PCR. Western blot was applied to detect β-catenin expression level in HT-29 cells after transfection, and gray scales of electrophoresis strips were analyzed by SPSS 13.0.Results Green fluorescence and RT-PCR made clear that all 5 recombinant plasmids were successfully expressed in HT-29 cells. Western blot showed that β-catenin expression level in HT-29 cells was not affected after being transfected with pEGFP-N3-APC1, pEGFP-N3-APC2 and pEGFP-N3-APC3, and was distinctly affected after being transfected with pEGFP-N3-APC4 and pEGFP-N3-APC5, especially the later one. Conclusion The selected APC5 gene fragment with 15-amino acid repeats and SAMP repeats, which is relatively short, can degrade β-catenin level in HT-29 cells and may be applied in the gene therapy.

Objective To observe the effect of resveratrol on arterial remodeling in spontaneous hypertensive rats.Methods Spontaneous hypertensive rats (SHRs, n=20) and Wistar-Kyoto rats (WKYs, n =10) were randomly assigned to three groups: control group, model group and resveratrol group.Systolic blood pressure (SBP) and pulse wave velocity (PWV) of the three groups was observed.Morphological observations were obtained by hematoxylin and eosin or victoria blue and picrosirius red.The content of nitric oxide (NO) and endothelin-1 (ET-1) were determined to assess the endothelial function.Oxidative stress was assessed by malondialdehyde (MDA), hydrogen peroxide (H2O2) , and activities of antioxidant enzymes superoxide dismutase (SOD) and catalase (CAT).Results Compared with control group, SBP, PWV, wall thickness, wall-lumen ratio,vascular cross-sectional area (VCSA), luminal cross-sectional area (LCSA) and collagen-elastic ratio were increased, and the levels of NO, SOD, CAT in rat aortic tissues were decreased, while ET-1,MDA, H2O2 levels in rat aortic tissues were enhanced in model group at the end of 22 weeks.After the treatment of resveratrol, SBP had no significantly difference between model and resveratrol groups, while PWV, aortic wall thickness, wall-lumen ratio, VCSA, LCSA and collagen-elastic ratio were decreased in resveratrol group as compared with model group [(6681.1 ± 2154.9) cm/s vs.(4283.1±946.1) cm/s, (234.7±51.8) μm vs.(123.4±21.5)μm, (10.3±2.3) ％ vs.(5.8±1.4) ％, (6.4±0.4) mm2 vs.(4.8±0.6) mm2, (4.1±0.1) mm2 vs.(3.2±0.4) mm2, (1.1±0.3) vs.(0.4±0.2), P＜0.05 or 0.01].Compared with model group, the expressions of NO, SOD, CAT in rat aortic tissues were increased and levels of ET-1, MDA, H2 O2 in rat aortic tissues were decreased in resveratrol group after treatment of resveratrol (P＜0.01 or P＜0.05).Conclusions Resveratrol has an antioxidant effect, and it could attenuate arterial remodeling by improving oxidative stress.

Objective To investigate the effect of running exercise on cartilage in rats with an unstable knee joint.Methods Twenty 8-week-old Sprague-Dawley rats had their left anterior cruciate ligament cut to model an unstable knee.They were randomly divided into a control group and an experimental group,10 rats in each group.The control group was given no intervention,while the experimental group accepted running exercise training on na animal treadmill at a velocity of 15 m/min for an hour every day.After 3 and 6 weeks of training,5 rats were sacrificed and cartilage from the medial condyle of the femur was sampled,decalcificated,embedded and sliced on the sagittal plane.After hematoxylin-eosin staining,toluidine blue staining and immunohistochemical staining,the cartilage thickness,Mankin' score,the content of matrix collagen and the proteoglycan content of the cartilage matrix were assessed,and the shape and structure of the unstable knee joints were observed under a transmission electron microscope.Results The cartilage thicknesses and Mankin's scores at 6 weeks were significantly different from those at 3 weeks in both groups.In the experimental group the average thickness of cartilage was 154 ± 13 μm at 3 weeks and 131 ± 15 μm at 6 weeks.The corresponding Mankin's scores were 9.93 ± 1.36 and 11.23 ± 1.57,respectively.Both were significantly different from the control group averages at the same time points.There was also a significant difference in the positive rate of toluidine blue and collagen type Ⅱ staining between the experimental group and the control group at both time points,and in the experimental group between 3 and 6 weeks of training.After 3 weeks of training,fewer chondrocytes were observed under the transmission electron microscope in the experimental group,and fissures were seen on the surface of the cartilages.However,3 weeks later,quite a few ruptures and a lot of necrotic cells could be seen.Conclusions Running exercise can damage the cartilage of unstable knee joints and speed up the development of osteoarthritis.Even moderate exercise could aggravate damage to unstable joints and the cartilage matrix,and accelerate chondrocyte degeneration.

Objective To investigate if the single item fatigue question of the Bath Ankylosing Spondylitis Disease Activity Index(BASDAI) is appropriate for measuring fatigue in patients with ankylosing spondylitis(AS), and to identify factors that influence fatigue in these patients. Methods A total of 93 patients with ankylosing spondylitis were recruited. Patients completed questionnaires on disease activity(BASDAI), functional ability[Bath Ankylosing Spondylitis Functional Index(BASFI)], the short form McGill Pain Questionnaire and 10 cm visual analogue scale(VAS) for sleep disturbance. Reliability was assessed with intraclass correlation coefficients. The patients were then dichotomized into a F+group (eg, fatigue is the major symptom) if the BASDAI fatigue scale was ≥5.0 and a F-group(eg, fatigue is the minor symptom) if the fatigue score was

Objective To clarify whether the regulatory effect of all-trans-retinoic acid (atRA) on the antigen presentation function of dendritic cell(DC) is tightly associated with NF-κB signaling pathway.Also to clarify atRA mainly affected differentiated DC or influence the differentiation procedure from bone marrow cell to DC.Methods MOG35-55 immunized C57BL/6J mice received administration of atRA or not,splenic DC and CD4 cells isolated from immunized mice were subjected to in vitro cross-culture,treated with IL-12 and IL-23 respectively.Th1 and Th17 polarization of stimulated CD4 cells were determined by intracellular staining and FACS analysis,while the production of their corresponding cytokines,IFN-γ and IL-17,were measured by ELISA.Bone marrow cells were isolated from the femurs of the na(i)ve mice,treated with IL-4 and GM-CSF with or without synergistic RA treatment.MHC Ⅱ and CD11c molecules on the DC were assayed by immune staining and FACS analysis,their antigen presentation functions were decided by the proliferation and cytokine production of the Th1 effecter cells stimulated by antigen pulsed DC.To investigate the status of the NF-κB signaling pathway,the amount of phospho-Ser536 NF-κB p65 in the whole DC lysate and total NF-κB p65 in the nucleus were detected by Western blot.Finally,selective RA receptor antagonists were studied to figure out which receptor was majorly involved in the regulatory effect of RA on DC.Results Splenic DC from RA treated mice showed significantly decreased function of presenting antigen to stimulate CD4 cell polarization and cytokine production.Compared with untreated control,RA in vitro treated DC showed decreased expression of MHC Ⅱ and CD11c on its cell surface,which was accompanied with depressed function of stimulating Th1 cell proliferation and IFN-γ production.Further study revealed that RA mainly affect the differentiation procedure from BMC to DC,however,has no significant effect on differentiated DC as the aspects of MHC Ⅱ,CD11c expression,responder cell proliferation and cytokine production were evaluated.Decreased amount of phosphor-Ser536 NF-κB p65 in the whole cell lysate and total NF-κB p65 in the nucleus was investigated in RA treated DC,and decreased antigen presentation function of RA treated DC always came together with diminished activation of NF-κB signaling pathway.Finally it was demonstrated that RARβγ antagonist,but not RARα antagonist,could entirely block the RA effect on DC.Conclusion Retinoic acid inhibit the differentiation of DC as well as decrease its antigen presentation function,which might be resulted from the inactivation of NF-κB p65 signaling pathway and mediated by RARβγ.

Objective To evaluate ipsilateral hepatic blood flow exclusion in combination with liver hanging manoeuvre for hepatectomy. Methods From Jul 2007 to Feb 2008, 14 cases underwent hemihepatectomy under ipsilateral hepatic blood inflow and draining hepatic vein exclusion in combination with liver hanging manoeuvre for liver malignancier or ligating ligating vessels, portal vein branch and major hepatic vein to set up a tunnel at the interior vena cava. Results Small laceration on fight hepatic vein was encountered in 2 cases during the operation and managed by suturing. There was no intraoperative injury on inferior vena cava or short hepatic veins. Blood loss ranged from 100 ml to 600 ml with a mean of 280 ml. Postoperative pleural effusion was cured conservatively in 3 cases and paracentes was needed in one case. There was no severe postoperative hepatorenal dysfunction, biliary fistula, infection or other major complications. The operative mortality was nil. Conclusion For regular major hepatectomy, ipsilateral hepatic blood flow exclusion plus liver hanging manoeuvre has the advantage of less blood loss and protecting contralateral hemiliver from reporfusion injuries.