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 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 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 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 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.

Adrenal Gland Neoplasms ; metabolism ; pathology ; surgery ; Adult ; Diagnosis, Differential ; Female ; Hormones, Ectopic ; secretion ; Humans ; Inhibins ; metabolism ; Keratin-8 ; metabolism ; Myelolipoma ; metabolism ; pathology ; surgery ; Ovarian Neoplasms ; metabolism ; pathology ; secretion ; surgery ; Vimentin ; metabolism

Objective Studies show that the abnormal expression of EphB4 plays an important role in the development and progression of colon cancer .The present study aims to provide some experimental evidence for the gene therapy of colon cancer by con -structing a lentiviral expression vector carrying the homo EphB4 gene and further establishing colon cancer cell lines with stable overex-pression of EphB4. Methods A series of oligonucleotides (oligo) encoding the homo EphB4 gene were ligated together by PCR and then cloned into a lentiviral expression vector pLenti 6.3-MCS-IRES2-EGFP.After confirmed by sequencing , the vector pLenti6.3-EphB4-IRES2-EGFP and its helper vectors were mixed and co-transfected into 293 T cells to obtain recombinant virus containing the EphB4 gene.The lentiviral titer was detected and the resulting recombinant lentiviruses carrying EphB4 or control viruses only carrying green fluorescence protein (GFP) were used to infect the human colon cancer cell lines .The expression of GFP was determined under the inverted fluorescence microscope and the level of EphB 4 mRNA in the infected cells detected by qPCR . Results The lentiviral expression vector pLenti6.3-EphB4-IRES2-EGFP carrying correct homo EphB4 gene sequence was successfully constructed .The titer of the recombinant EphB4 lentiviral supernatant Lenti6.3-EphB4 was 1 ×108 TU/mL.The expression of GFP was observed in the trans-duced cells under the fluorescence microscope , and that of EphB4 mRNA in the transfected SW480 and Coca-2 cells was significantly up-regulated as compared with the control and blank groups . Conclusion The homo EphB4 gene was successfully amplified and cloned.A lentiviral expression vector was successfully constructed , and so were colon cancer cell lines stably overexpressing EphB 4, which may shed light on the lentivirus-mediated genetic therapy for colon cancer .

Objective Studies show that the role of EphB 4 in the development and progression of cancer is correlated to its ligand EphrinB2.The present study was to observe the effect of the changes in EphB4 on the expression of EphrinB2 by constructing and identifying microRNA ( miRNA) interference vectors targeting the EphB4 gene in colon cancer cells . Mte hods According to the EphB4 gene sequence , 3 pairs of oligo DNA sequences of miRNA were designed .The single strand of oligo DNA was annealed to form double-strand DNA, and then connected with the plasmid pcDNA 6.2-GW/EmGFP-miRNA.The expression vector pcDNA6.2-GW/EmGFP-miR-EphB4 was linked to pDONR221 and pLenti6/V5-DEST to construct the lentiviral expression vector pLenti 6/V5-DEST-EphB4, which was cotransfected with packaging mix (pLP1, pLP2 and pLP/VSVG) into 293FT cells by lipofectamine 2000 transfec-tion to produce lentivirus , and the lentivirus titer was measured by infection of HEK 293 cells.The stable cell lines were selected and cultured.The expression levels of EphB4 and EphrinB2 were examined by qPCR. Results Three miRNA interference vectors SR-1, SR-2, and SR-3 targeting the EphB4 gene were successfully constructed , with SR-3 exhibiting the most significant interference efficien-cy.The constructed lentiviral vector pLenti 6/V5-DEST-EphB4 was successfully packaged in 293FT cells.The virus titer was 7 ×108 Caco-2 cells. Conclusion The exogenous EphB4 expression could be significantly inhibited by treatment with specific miRNA in co-lon cancer cells .The correlation of EphB4 and EphrinB2 may be effected by many factors and need further studies .

Objective To analyze implementation outcomes of the new health reform policy at a provincial hospital for the past six months.Methods Trend analysis,factor analysis and ratio analysis approaches were used in monthly surveillance,along with comparative study of the data before and after the reform,to probe into impacts of the new policy on hospital operations.Results Medical income increased by 22.09％,mainly contributed by volume growth (22.28％) of medical services; Medical income dropped by 0.16％ due to pricing policy factors; medicine proportion deceased by 4.84％; following the reform,the income per outpatient and inpatient increased by 12.32％ and 5.35％ respectively.Conclusion Following the drug zero profit policy and rise of the charging standards for medical treatment service at the hospital,the growth of total income mainly comes from growing volume of medical services instead of pricing policy factors.The new health reform is conducive to optimizing the hospital's income structure and raising value to doctors' technical service.

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.