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 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 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 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 assess the clinical significance of antibodies against cyclic citrullinated peptide(anti - CCP) in a cohort of patients with juvenile idiopathic arthritis (JIA). Methods The anti - CCP was tested by an enzyme linked immunosorbent assay (ELISA) in serum samples from 22 patients with JIA(9 boys, 13 girls), with a mean age of 9.1 years(range 1.1 - 16). As control groups, anti - CCP were also tested in sera of 20 healthy children, and 30 adult patients with rheumatoid arthritis(RA). Results Positive anti - CCP were found in sera of 2 patients with JIA(9.1 %), both with lower titre comparing with those of adult patients with anti - CCP positive. In the control groups, none of healthy children was positive for anti - CCP, but 16/30(53. 3%) adults with RA showed anti - CCP positivity. Conclusion Anti - CCP can be detected in children with JIA, but are less frequently present than in adults with RA, so anti - CCP has limited diagnostic value to JIA.

Objective To explore the value of dexamethasone(DEX) for neuronal cell injury and death by observing the effect of DEX on excitatory amino acid(EAA) and monoamine neurotransmitter in cerebral tissue of neonatal rat with hypoxia-ischemia.Methods Hypoxic-ischemic neonatal rat models were established,the levels of EAA and monoamine neurotransmitter in cerebral tissue were analyzed by using capillary electrophoresis and fluorospectrophotometry method.The rats were divided into 4 groups: small dose DEX group pre-treated with DEX(0.5 mg/kg) prior to hypoxia-ischemia,large dose DEX group pre-treated with DEX(10 mg/kg) prior to hypoxia-ischemia,HIE group and shamful operation group.Results The levels of EAA and monoamine neurotransmitter contents in HIE group were significantly higher than those in shamful operation group(P0.05).EAA contents of large dose DEX group greatly decreased compared with HIE group (P

Objective To investigate pathogenic factors,clinical characteristics,pathological changes in 6 patients with localized or disseminated intestinal neuronal dysplasia(IND).Methods The clinical retrospective study was performed in 6 cases with localized and disseminated IND.Results In 6 patients,constipation and partial intestinal obstruction were the major symptoms.Preoperatively,dia-gnoses were revaluated as intestinal stenosis in 2 cases,long sigmoid in 2 cases and long-segment aganglionosis and total gastrointestinal IND in the rest 2 cases,respectively.Exploratory laparotomy was performed on all these patients.Pathological study suggested that 4 of them were localized IND,on whom enterectomy and intestinal anastomosis were performed successfully.However,2 cases of disseminated IND died postoperatively.Conclusions Disseminated IND may be caused by congenital factors,while localized IND by the acquired factors which including intestinal obstruction,local ischemia or inflammation.The surgical interventions are effective for localized IND,and intestine transplantation might be prospective treatment for disseminated IND.

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.