Objective To explore the effect of preoperative evaluation checklist in the preoperative preparation of laparoscop‐ic cholecystectomy .Methods Based on whether the preoperative evaluation checklist was used or not ,664 cases of patients were di‐vided into control group (n=350) and experimental group (n=314) .Routine preparation was used in the control group ,while the preoperative evaluation checklist made by department of hepatobiliary surgery in the second affiliated hospital of Chongqing medical university was added to the experimental group .The case histories of patients in both groups were retrospectively reviewed ,so as to make comparisons of the defect of preoperative preparation ,influence to operation (delay or cancel) ,comprehension of preoperative knowledge ,and score of degree of satisfaction .Results The incidence rate of the defect of preoperative preparation in the experi‐mental group (1 .59% ) was lower than that in the control group (6 .86% ) with a statistical difference (P<0 .05) .The influence to operation (delay or cancel) in the experimental group was lower than that in the control group with a statistical difference (P<0 .05) .The comprehension of preoperative knowledge and score of degree of satisfaction in the experimental groups were obviously superior to those in the control groups ,which both had a statistical difference (P<0 .05) .Conclusion The application of preopera‐tive evaluation checklist in laparoscopic cholecystectomy could benefit for sufficient preoperative preparation ,conducting surgery as scheduled ,patients′comprehension of preoperative knowledge and patients′satisfaction of medical treatment ,which deserved widely clinical generalization .

OBJECTIVE To investigate the distribution of drug resistance of Pseudomonas aeruginosa(PAE) among neonates and analyze the characteristic of the PAE infection.METHODS API system was used for the identification of 131 PAE clinical isolates and the resistance to 17 kinds antibiotics was determined by K-B method.RESULTS Most of 131 strains were isolated from sputum(42.0%) and gastric juice(32.8%).All strains were mainly isolated from neonate intensive care unit(NICU).The sensitivity to amikacin,levofloxacin,ofloxacin,ciprofloxacin,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem and meropenem was respectively over 70.0%.PAE was inferior sensitivity to piperacillin,mezlocillin,cefoperazone,ceftriaxone,ceftazidime and aztreonam.CONCLUSIONS PAE is one of the most common pathogens causing nosocomial infection especially for neonates.Its susceptibility to antibiotics showed multidrug resistance.In order to reduce or prevent the occurrence of resistant isolate,we should rationally choose and use antibiotics combining with trait of neonate.

Objective To investigate immune changes in patients with chronic obstructive pulmonary disease during exacerbations(ECOPD).Methods A randomized,prospective clinical trial was done in 65 patients with ECOPD from Feb.2004 to Oct.2004.They were divided into two groups:one group with general treatment and another with general treatment plus Pidotimod which was given 800mg orally twice daily for 15 days and then 800mg orally once daily for 15 days.Twenty healthy individuals sevred as the control.Levels of CD_ 14 、CD_ 158b 、CD~+_3、CD~+_4、CD~+_8、CD~+_4/CD~+_8 in peripheral blood were measured by flow cytometry at baseline(D1)and then again at(D15)and at the end of treatments(D30),in the meanwhile clinical picture was observed to evaluate patients' conditions.Results Totally 60 patients completed the trial correctly(30 in pidotimod group and 30 in control group).The two groups were satistically homogeneous.The positive rate of sputum bacteriological examination was 42.67%.On D1,the percentage of CD_ 14 、CD_ 158b in two groups was not different from healthy volunteers.On D15,the above immunologic parameters of the control group was decreased compared with pidotimod group,and CD_ 14 was satistically low(P

Objective To study the correlation between vascular endothelial growth factor(VEGF) and cyclooxygenase-2 (COX-2) in clear renal cell carcinoma (CRCC).Methods In 60 cases of CRCC and 10 cases of normal renal tissue,immunohistochemistry was used to examine the expression of COX-2 and VEGF.Results The positive expression rate of COX-2 in CRCC (76.7％) was significantly higher than that in normal renal tissue (20％) (x2 =10.28,P ＜0.01).The positive expression rate of VEGF in CRCC(73.3％) was significantly higher than that in normal renal tissue (20％) (x2 =8.58,P ＜0.01).The expressions of COX-2 and VEGF in CRCC were correlated with each other (r =0.469,P ＜0.01).Conclusions The expressions of COX-2 and VEGF were involved in the pathophysiolical processes of clear renal cell carcinoma.The expression levels of COX-2 and VEGF might be used to evaluate the development of clear renal cell carcinoma.

Objective To study whether solasodine hydrochloride (SBHL) could enhance the effect of arsenic trioxide in inducing apoptosis and affecting telomerase activity in cervical cancer HeLa cells. Methods Using cell culture methods, cervical cancer HeLa cells were cultured in vitro. The optimal concentration of SBHL was determined by MTT method from 0, 10, 20, 40, 80, 160, to 320 μmol/L. HeLa cells were grown in improved RPMI1640 supplemented respectively with arsenic trioxide(5 μmol/L As2O3), As2O3(5 μmol/L)+ SBHL( 40 μmol/L) and none (control group). The growth morphology of HeLa cells was observed under phase contrast microscopy after culture for 24, 48, and 72 h. Apoptosis of HeLa cells was determined under transmission electronic microscopy. The method of MTT was used to study the cell survival percentage. The technique of flow cytometry was used to measure cell cycle and cell apoptosis percentage. The method of tartrate-resistant acid phosphatase-enzyme linked immunosorbent assay (TRAP-ELISA) was used to determine telomerase activity of HeLa cells. Results Under phase contrast microscopy, in control group HeLa cells were round, densely packed; in As2O3 group the numbers of the cells were less, cell spacing increased; in As2O3 + SBHL group the cells shrinked significantly, nuclear fragmented as a petal-like, gap became larger. Under transmission electronic microscopy, there were rich microvillus on the cell surface in control group, cell intervals clear, immature connections, and the intervals did not close. The structure of the mitochondria in the cytoplasm was integrated. Most of the chromatin in the nucleus were, euchromatin and characteristics of apoptosis with heterochromatin increased and the chromatin condensed into masses, on the boundary of nuclear membrane. The microvillud on the cell surface were ruptured and decreased in As2O3 + SBHL group. The chromatin condensed into masses. The formation of apoptotic bodies was observed. The difference was statistically significant between groups in cell survival percentage at 24, 48, 72h(x2 = 10.39 , 13.88 , 17.21,respectively, all P < 0.05). Cell survival percentage in SBHL + As2O3 group (52.80%) was significantly less than that of As2O3 group(77.51%, x2 = 9.29, P < 0.05) at 72 h. In cell cycles, the difference was statistically significant between groups in C1 phase and S phase(F = 7.46,22.14, all P < 0.05), respectively. Compared with , control group[ (41.57 ± 1.56)%, (50.45 ± 2.37)%], cell percentages in S phase in As2O3 + SBHL group[(20.06 ± 4.98)%] and As2O3 group[(27.10 ± 5.32)%] were decreased(P< 0.05 or < 0.01), while cell percentage in C1 phase was increased[(58.70 ± 5.18)%, (69.67 ± 4.17)%, P< 0.05 or < 0.01]. The difference was statistically significant between groups in apoptotic percentage of HeLa cells (F = 4.01, P < 0.05). Compared with control group[ (1.18 ± 1.40)%], apoptosis percentage was significantly increased in As2O3 + SBHL group and As2O3 group [(21.08± 1.22)%, (6.04±2.53)%, P< 0.05 or < 0.01], respectively, and As2O3 + SBHL group was higher than As2O3 group(P < 0.01). The difference was statistically significant between groups in telomerase activity (F = 21.28, P< 0.05). Telomerase activity was inhibited in As2O3 group(1.214 ± 0.621) and As2O3A + SBHL group(0.865 ± 0.284) compared to control group (2.107 ± 0.057, all P < 0.05), and telomerase activity in As2O3 + SBHL group was lower than that of As2O3 group (P < 0.05). Conclusions SBHL enhances the effect of As2O3 in inducing apoptosis in HeLa cells, which is related to its inhibiting telomerase activity in HeLa cells.

Objective To investigate the adaptive immune responses in elderly patients with chronic obstructive pulmonary disease during acute exacerbations (ECOPD) and effects of the immunostimulating agent Pidotimod in ECOPD patients. Methods A randomized, prospective clinical trial was held, and 103 patients with ECOPD were recruited into the study. Seventy-five patients aged 65 years and over were divided into two groups: 38 patients with general treatment as a control group and 37 patients with general treatment plus pidotimod as an experimental group. Another non-elderly groups comprised 28 patients younger than 65, and 20 healthy individuals served as the healthy elderly control. Levels of CD3+ , CD4+ , CD8+ , CD4+ /CD8+ in peripheral blood were measured by flow cytometry at baseline (the 1st day) and at the 15th and 30th treatment day, meanwhile, the clinical conditions were evaluated. Results Ninety-one patients completed the trial (32 in experimental group,34 in control group and 25 in non-eldely group). The experimental group and control group were statistically homogeneous. The aged COPD intervention group and aged COPD control had a more decreased CD4+ level, CD4+/CD8+ ratio and more increased CD8+ level, while compared with aged health control and non-elderly COPD control (all P

Objective To explore clinical and pathological characteristics of neurological lesions in primary Sj(o)gren's syndrome (pSS).Methods Ten patients diagnosed as pSS with nervous system involvement were analyzed retrospectively with autoimmune antibody test,cerebrespinal fluid examination and Schivmer's test,six pSS patients with peripheral nervous system lesions (PNS-pSS) were examined with electromyography and nerve conduction velocity and four pSS patients with central nervous system lesions (CNS-pSS) were examined with cranial MRI to analyze their clinical and pathological characteristics.Salivary gland biopsy was performed for all the ten patients,sural nerve biopsy for those with PNS-pSS and brain biopsy or spinal autopsy for those with CNS-pSS.Results Clinically,six patients with PNS-pSS presented symmetrical sensory-motor peripheral neuropathy or pure sensory peripheral neuropathy and four patients with CNS-pSS presented multiple sclerosis,subacute transverse myelitis,encephalitis,pituitary stroke and acute meningitis with varied lesions in the myelin sheath and axon by electromyography and motor nerve conduction velocity.Cranial MRI showed lesions in the white matter of the brain,spinal cord and abnormal signals in the pituitary.Pathologically,sural nerve biopsy showed typical vasculitis and nonvasculitis characterized as degeneration of the axon and myelin sheath,salivary acinar gland biopsy showed its atrophy and infiltration with lymphocytes,and brain biopsy showed demyelination of the brain and spinal white matter,as well as infiltration of lymphocytes surrounding the veins,typical vasculitis and bleeding and necrosis of the pituitary.Conclusions Both central and peripheral nervous systems can be involved in pSS,with complicated clinical manifestations.Electrophysiology,cerebrospinal fluid tests and histopathological examinations by biopsy are essential in diagnosis for neurological lesions in patients with pSS.Inflammatory reaction of the blood vessels and tissues mediated by cell immunity may be involved in mechanism of its neurological lesions.

Objective To investigate the lung function testing performing in normal smokers,and urge smokers to stop smoking early. Methods Two hundred and one adult men did the pulmonary function testing by MINATO AS-505 portable spirometer, and analyzed the effect d different smoking degree on the pulmonary function. Results There was no relationship between lung volume index and smoking, smoking degree. Compared with nonsmokers, the indicants such as FEV1, MVV, FEV1/FVC had decreased, and the indexes of the small airway function (PEF, FEF25%-75%)had significantly dropped in the smokers. And the smokers especially long-term smokers, most indexes of the pulmonary functions and all indexes of the small airway function correlated with smoking index. Conclusion Although smokers do not show clinical symptoms, their lung functions have been reduced, especially small airway function.

Objective To investigate the association of single nucleotide polymorphisms(SNP)in p21and p27 genes with the risk of epithelial ovarian cancer(EOC).Methods Genotypes were analyzed by polymerase chain reaction-restrictive fragment length polymorphism(PCR-RFLP)method in 234 patients with EOC and 284 control women in China.Results (1)The frequencies of the p21 in healthy controls were 34.2%.49.6%and 16.2%,while the distribution of the C and T allele was 59.0%and 41.0%,respectively.The p21 C/C(28.2%),C/T(53.0%),T/T(18.8%)distribution in ovarian cancer patients was not significantly different from that in healthy controls(P＞0.05).There was no statistic difference in allele distribution between ovarian cancer patients and healthy controls(P＞0.05)either.The stratification analysis by tumor histological type did show that the genotype distribution in four types of ovarian cancer patients was significantly different from that in healthy controls(P=0.02).The C/C genotype was likely to reduce the risk of epithelial endometrial cancer.and the adjusted odds ratio was 0.56(95%CI:0.32-0.98).(2)The genotype frequencies of the p27 in healthy controls were 88.4%,10.9%and 0.7%.while the distribution of the V and G allele was 93.8%and 6.2%.respectively.The V/V(93.6%),V/G(5.1%)and G/G(1.3%)distribution in ovarian cancer patients was significantly different from that in healthy controls(P=0.04).There was no statistic difference in allele distributionbetween ovarian cancer patients and healthy controls(P＞0.05).Compared with the V/G and G/G genotypes,the V/V genotype increased the risk of EOC,the adjusted odds ratio was 1.92(95%CI:1.02-3.63).Conclusion The C/C genotype of p21 may reduce the risk of epithelial endometrial cancer,and the genotype of p27 V/V may be a potential risk factor for susceptibility to EOC.

Objective To explore the correlation of posttraumatic growth with social support in patients with gastrointestinal neoplasms at the end of life.Methods Cluster random sampling was used to select 280 patients with gastrointestinal neoplasms who were predicted to survive no longer than 6 months in 10 first-class hospitals in Beijing and Tangshan,and they were investigated by Posttraumatic Growth Inventor (PTGI) and Social Support Rate Scale (SSRS).Results The total score of PTGI (61.13 ± 16.78)and the scores of appreciation of life (23.71±7.34),personal strength(10.67±3.55),new possibility(10.07±2.11),relating to others(12.54±5.14),spititual change(10.89±4.35)were higher than median value.The total score of SSRS(41.21±8.48) and objective support(10.27±2.75) were higer than the normal level((39.05±6.35),(8.42±2.27)) (P＜0.05).The appreciation of life was positively correlated with subjective support and the total score of SSRS (r=0.25,r=0.26,P＜0.05),personal strength was positively correlated with objective support,subjective support and the total score of SSRS(r=0.24,r=0.29,r=0.23,P＜0.05),new possibility was positively correlated with subjective support(r=0.21,P＜0.05),relating to others was positively correlated with objective support and the total score of SSRS (r=0.26,r=0.26,P＜0.05),spititual change was positively correlated with objective support and subjective support (r=0.28,r=0.31,P＜0.05).The total score of PTGI was positively correlated with subjective support and the total score of SSRS (r=0.29,r=0.29,P＜0.05).Conclusion Patients with gastrointestinal neoplasms at the end of life experience a certain extent of posttraumatic growth and high level of social support.Posttraumatic growth is positively correlated with social support.