Objective To analyze the causes and the scheme of diagnosis and treatment of intra abdominal hernia. Methods Clinical data from 31 cases of intra abdominal hernia from 1977 to 2001 were analyzed retrospectively. Among the patients were 26 male and 5 female, and 4, 6, 19, and 2 patients were at the age range of 16 25, 26 40, 41 55, and over 56 years old, respectively. Results The causes of congenital intra abdominal hernia were related to malrotation of intestine and abnormality of intestine fixation during embryogenesis, to erroneous juncture of visceral layer peritoneum with parietal peritoneum, and to partial degeneration and weakness of mesentery. The causes of acquired intra abdominal hernia were related to operation or trauma. Conclusion As to patients with intermittence or episode of stomachache, touched painful sausage like mass, intestinal obstruction by X ray, and displacement of aortic arch of small intestines shown by selective arteriography, diagnosis of intra abdominal hernia and immediate operation should be considered. When reduction of the twisted intestines and repair of the hernial neck or hiatus are performed, important blood vessels such as the superior mesenteric arteries should not be injured.

This study was aimed to confirm animal model and evaluating indicators of the chronic obstructive pulmonary disease combined with pulmonary interstitial fibrosis (PIF-COPD). PIF-COPD rats were induced by intratracheal administration of Bleomycin(BLM, 6 mg·kg-1) and cigarette smoke stimulation for 47 days. After that, the lung function and index were measured. Changes of pathomorphism of lung were observed with hematoxylin-eosin staining. Collagen protein I and III were determined by Sirius red staining. The protein antibody microarray chip was employed for serum cytokine expression pattern measurement. The results showed that in the lung function testing, the central airway resistance, tissue damping, dynamic elasticity of model rats increased significantly and the dynamic compliance reduced significantly. The lung index of model rats increased significantly (compared with the control group, P < 0.01). The pathological tests showed that lung tissues of model rats showed emphysema and fibration with inflammatory infiltration, and content of collagen type I and III increasing significantly. The contents of MMP-8, TIMP-1, IL-10, IL-13, PDGF-AA, Beta-NGF of model rats serum increased obviously compared with the control group and RAGE reduced compared with the normal control. It was concluded that rats which were induced by intratracheal administration of BLM (6 mg·kg-1) and cigarette smoke stimulation for 47 days can be used as animal model establishment of PIF-COPD. The respiratory function and serum levels of MMP-8, TIMP-1, IL-13, PDGF and NGF can be used as evaluating indicators of PIF-COPD model.

This article was aimed to study effect of D-ribose on the high-energy phosphate metabolism of skeletal muscle tissues of tired mice. The model was made by burden swimming. And then, the mice were divided into four groups, which were the model group, D-ribose group, caffeine group, and D-ribose with caffeine group). Intragastric administrations of drugs were given to all mice in four groups, three times per day. And all mice continued to swim for three days. The time of swimming was recorded. Gastrocnemius of mice were removed after swimming or 3 days later to measure the concentration of ATP, ADP, AMP and IMP with the HPLC. The results showed that compared with the control group, the time of burden s wimming was significantly prolonged for mice in the D-ribose group and the D-ribose with caffeine group. After three-day recovery, the concentration of ATP, AMP and IMP of gastrocnemius in the D-ribose group and the D-ribose with caffeine group mice was significantly increased. There was no significant difference in the caffeine group mice. It was concluded that D-ribose is involved in the high-energy phosphate metabolism of skeletal muscle tissues of tired mice . D-ribose promotes the recovery of ATP concentration in the gastrocnemius of tired mice, and prolongs the time of burden swimming. Therefore, it has a certain anti-fatigue effect .

Objective To investigate the effect of genistein (gen) on the secretion of vascular endo-thelial growth factor (VEGF) and matrix metalloproteinases (MMPs-1, 2, 3, 9) by fibroblast-like synoviocytes (FLS) from rats with collagen Ⅱ induced arthritis (CIA). Methods The CIA was induced by collagen Ⅱ and complete Freund's adjuvant (CFA) into rats. The rats were scored based on the arthritis index(AI) once a week. At the sixth week, the X-ray of joints was taken. The synovial tissues from knee joints were examined pathologically. The primary fibroblast-like synowocytes were separated from the synovial tissue by collagenase digestion and cultured. Then the expression of VCAM-1 was estimated by flow cytometry. After adding gen (100, 200, 400 μmol/L) at different concentrations into the FLS, VEGF and MMP-1, 2, 3, and 9 of the supernatants were tested by indirect ELISA. Results After 3 days of type Ⅱ collagen and CFA injec-tion, the rats started to catch arthrocele and their arthritis index increased gradually. The arthrocele was most remarkable at the 3rd week. The AI, X-ray and pathological examination indicated that the model group were significantly different from the control group. After the synoviocytes were cultured to the 4th generation, the expression of VCAM-1 was as high as about 85.5%. It showed that most synoviocytes were changed to fibro-blast-like synoviocytes. Different concentrations of gen (100, 200, 400 μmol/L) added to FLS were compared and revealed that the VEGF and MMP-1, 2, 3, and 9 in the supematants were suppressed evidently and in a dose-dependent manner. Conclusion The CIA model can be successfully constructed by collagen type Ⅱ and CFA. Tthe primary FLS of rats' joint can be separated and cultured well by collagenase digestion. Certain levels of gen can suppress the secretion of VEGF and MMP-1, 2, 3 and 9 hy FLS. The affect is dose-depen-dent.

Objective To explore the operation indication feasibility,operation technique and clinical effect of complex tibial plateau fractures with semilateral position through combined approaches.Methods From April 2011 to June 2013,data of 25 patients with complex tibial plateau fractures who were treated by open reduction and interal fixation with semilateral position through anterior lateral incision and an inverse L shaped incision were retrospectively analyzed.There were 15 males and 10 females,with an average age of 49.7 years old (range,30 to 70 years old).21 cases were traffic accident injuris and 4 cases were hurt by falling injuries from bicycle.All of the fracture patterns were three pillars of closed fracture of type Ⅵ according to Schatzker classification.The time at surgery was 5-21 days (mean,9.5 days) after injuries.The posterior condylar and medial condylar fractures were dealt with inverse L shaped incision,and fixated with anatomical locking plate and T shaped plate.The lateral condyle fractures were dealt with anterior lateral incision,and fixated with anatomical locking plate.Results Operating time was 150-250 min with an average time of 197.6 min.Intraoperative blood loss was 150-300 ml with an average of 232 ml.25 patients were followed-up,and the average duration of follow-up was 17.8 months (range,12-24 months).Fracture healing time was 16-24 weeks with an average of 19 weeks.At the time of the latest follow-up,X-ray showed all the knee joint had smooth surface,and there was no obvious varus or valgus deformity.One year later,the flexion of the knees achieved 115.2° (range,100°-130°),and the straighten reached 0°.The mean Rasmussen's score of all the patients were 14-18 (average,16.6),and there were excellent in 11 cases and good in 14.Bassed on the KSS score,the mean score was 88.6 (range,66-96) one year after operation.The excellent and good rate was 96％ (24/25).2 patients had fat liquefaction of anterolateral incision wound dehiscence,local skin necrosis,and they got good outcomes after debridement dressing and secondary suture.Conclusion Multi plate fixation is more effective and safty treatment for complex tibial plateau fractures which can be operated completely through fixed half lateral position,and the knee joint is allowed to do early functional exercise,achieving good clinical efficacy and good knee function.

For the treatment of liver tumors,interventional therapy is becoming more and more important.The development of interventional therapy relies on the development and application of new materials,new equipment and new drugs,and the preclinical animal testing of these applications is an important part of assessing the safety and effectiveness of interventional procedures.The animal HCC model plays an important leading role in exploring the new approach of interventional therapy.However,the animal HCC models which are suitable for experimental researches are limited,at present,the animal HCC models are mainly confined to rats and rabbits.Due to the limitation of animal body shape,routine interventional instruments and equipment are not suitable to perform interventional procedures for some small animals.Nowadays,there is still a shortage of devices for interventional hepatic artery surgery in mice,and interventional instruments for rats are also limited.This paper aims to make a summary about the types of HCC model in rats and rabbits which are often used in the experimental researches,the modeling methods,the interventional procedures,the anesthesia and imaging examinations,etc.

Objective:To observe the G protein-coupled receptor 48 (GPCR48) expression in hepatocellular carcinoma (HCC) cell lines with different metastatic potential and its characteristics effect on the invasion and metastasis of Huh7 hepatoma cells via epithelial-mesenchymal transition (EMT).Methods:Western blot was used to detect the protein expression level of GPCR48 in HCC cells with different metastatic potential. The lentivirus vector expressing GPCR48 gene was constructed. GPCR48 was overexpressed in Huh7 hepatoma cells. The GPCR48 overexpression level was detected by real-time PCR and Western blot. Transwell invasion and migration assay was used to detect the Huh7 hepatoma cells invasion and migration ability in the Control, Mock and GPCR48 overexpression group. Real-time PCR and Western blot were used to detect Huh7 hepatoma cells mRNA and protein expression levels of the EMT related markers (E-cadherin, N-cadherin, vimentin, and γ catenin) in the Control, Mock and GPCR48 overexpression groups, respectively. Analysis of variance was used to compare the differences between data sets.Results:GPCR48 protein expression level in metastatic HCC cell lines was significantly higher than non-metastatic HCC cell lines ( P < 0.05). The lentivirus vector expressing the GPCR48 gene had effectively transfected the Huh7 hepatoma cells and stably expressed the GPCR48mRNA and protein. Compared with the Mock and the Control group, Huh7 hepatoma cells invasion and migration ability in the GPCR48 overexpression group was significantly enhanced ( F≥5.54, P < 0.05), and the mRNA and protein expression levels of epithelial phenotypic markers E-cadherin and γ-catenin were decreased ( P < 0.05). The mRNA and protein expression levels of the mesenchymal phenotypic markers N-cadherin and Vimentin were increased ( P < 0.05), indicating that EMT changes occurred in Huh7 hepatoma cells had overexpressed GPCR48. Conclusion:GPCR48 expression level is positively correlated with the metastatic potential of HCC cells. GPCR48 overexpression can down-regulate the expression of epithelial phenotypic markers and up-regulate the expression of mesenchymal phenotypic markers, and induce EMT changes in HCC cells, thus promoting HCC cells invasion and migration.

Objective To investigate the application value of closed single-port thoracoscopic and laparoscopic radical esophagectomy for esophageal cancer.Methods The retrospective and descriptive study was conducted.The clinical data of a 49-year-old male patient with esophageal cancer who was admitted to the Fujian Medical University Union Hospital in November 2018 were collected.The patient underwent closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.In the thoracic part,esophageal separation and thoracic lymph node dissection were performed with closed pneumothorax,semi-lateral position and multi suspension methods.In the abdominal part,gastric separation and lymph node dissection were accomplished with lifting of liver lobe and respective separation of greater curvature and lesser curvature of stomach.The operation time,volume of intraoperative blood loss,time for out-of-bed activities,time of postoperative drainage tube removal,volume of thoracic drainage fluid,postoperative complications,postoperative pathological examination results,time for discharge from hospital and results of follow-up were observed.Follow-up using outpatient examination and telephone interview was performed to detect tumor recurrence and metastasis of patients after operation up to February 2019.Count data were described as absolute number.Results The patient underwent successfully closed single-port thoracoscopic and laparoscopic radical esophagectomy and three-field lymph node dissection.The operation time and volume of intraoperative blood loss was 310 minutes and 120 mL.The patient resumed out-of-bed activities at 2 days after operation.The abdominal drainage tube,thoracic closed drainage tube and right cervical drainage tube were removed at 2 days after operation with fasting,acid suppression,nutritional support.The thoracic Abel drainage tube and the left cervical drainage tube were removed at 5 days after operation.The volume of thoracic drainage fluid was 550 mL.No obvious sign of anastomotic leakage was found on esophageal angiography at 5 days after operation.The patient recovered well after operation without hoarseness,pulmonary infection and chylothorax.The postoperative examination result of the patient showed midthoracic esophageal squamous cell carcinoma (pT3N1M0G3 ⅢB stage).The patient was discharged at 8 days after operation.The patient was followed up for 3 months,and was able to engage in light physical activity.CT reexamination showed no sign of local recurrence or distant metastasis of the tumor.Conclusion Closed singleport thoracoscopic and laparoscopic radical esopahgectomy for esophageal cancer is safe and feasible,with good short-term efficacy.

Objective:To analyze the cognitive dysfunction and its influencing factors in patients with multisystem atrophy(MSA).Methods:A total of 143 hospitalized patients with MSA in our hospital from January 2015 to January 2020 were selected as the research objects.The cognitive function was evaluated by Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment(MoCA)scales, meanwhile, the influencing factors of cognitive function were analyzed.Results:The average score of MMSE scale of 143 MSA patients ranged from 9 to 30 points, and the MMSE test identified 86 patients(60.1%)with cognitive impairment, including 58 cases(40.6%)with mild cognitive impairment, 27 cases(18.9%)with moderate cognitive impairment and 1 case(0.7%)with severe cognitive impairment.The average score of MoCA scale of 143 MSA patients ranged from 5 to 30 points, among which 111 cases(77.6%)had cognitive impairment, including 69 cases with mild cognitive impairment(48.3%), 35 cases with moderate cognitive impairment(24.5%)and 7 cases with severe cognitive impairment(4.9%). Both the total scores of MMSE and MoCA scores of MSA patients were not correlated with age of onset, old age, gender, disease duration, type of MSA(MSA-C), orthostatic hypotension(OH), urinary retention, positivity of anal sphincter electromyography(ASEMG), triglyceride(TG), total cholesterol(TC), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), fasting blood glucose and glycosylated hemoglobin, serum uric acid and residual urine volume(all P>0.05). Logistic regression analysis showed that fasting blood glucose was a risk factor for cognitive impairment identified by MMSE( OR=2.224, 95% CI: 1.108-4.462, P=0.024); MSA-C( OR=3.905, 95% CI: 1.302-11.713, P=0.015)and TG( OR=3.494, 95% CI: 1.061-11.501, P=0.040)were risk factors for cognitive impairment identified by MoCA.There were no significant differences in above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients identified by MMSE scale( P>0.05). Similarly, there were no significant differences in the above clinical characteristics between moderate to severe cognitive impairment patients and mild cognitive impairment patients by MoCA scale( P>0.05). Logistic regression analysis showed that TG was a risk factor for moderate to severe cognitive impairment identified by MMSE( OR=17.624, 95% CI: 2.596-119.669, P=0.003), while TC was a protective factor( OR=0.006, 95% CI: 0.000-0.714, P=0.036). Logistic regression analysis did not find the influencing factors of moderate to severe cognitive impairment as suggested by MoCA score. Conclusions:There is a high incidence of cognitive impairment in MSA patients.The type of MSA(MSA-C), blood glucose and blood lipid may be influence factors of cognitive impairment in MSA patients.Age of onset, old age, gender, disease duration, autonomic dysfunction, and uric acid have no significant correlation with cognitive impairment of MSA.

OBJECTIVETo investigate the relationship between polymorphisms of the growth arrest specific 6 (GAS6) gene and severe preeclampsia in a South West Han Chinese population.

METHODSBlood samples from 167 patients with severe preeclampsia and 312 normal pregnant women as controls from Han Chinese in Chengdu area were analyzed by polymerase chain reaction-restriction fragment length polymorphisms.

RESULTSC and T allele frequencies for +1332C/T site were 85.63% and 14.37% in the patient group, respectively, and 78.04% and 21.96% in control group, respectively. The TT genotype and variant T allelic frequencies of the +1332C/T polymorphism were significantly lower in patients with severe preeclampsia than in the control group (both P<0.05), and the odds ratio for the risk of severe preeclampsia was 0.602 (95%CI: 0.401-0.904) in carriers for the variant T allele (χ=6.045, P=0.014). G and A allele frequencies for 834+7G/A site were 72.75% and 27.25% in case group, respectively, and 74.36% and 25.64% in control group, respectively. The genotype and allele frequencies of the 834+7G/A polymorphism in patients with severe preeclampsia and controls showed no significant differences (both P>0.05). In addition, there was no significant association between the polymorphisms and blood pressure levels in the patient or control groups.

CONCLUSIONThe variant GAS6+1332 T allele is associated with a decreased risk for severe preeclampsia in a South West Han Chinese population. On the other hand, the 834+7G/A polymorphism has no effect on the severe preeclampsia.

Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; ethnology ; genetics ; Genotype ; Humans ; Intercellular Signaling Peptides and Proteins ; genetics ; Polymerase Chain Reaction ; Polymorphism, Single Nucleotide ; Pre-Eclampsia ; ethnology ; genetics ; pathology ; Pregnancy ; Risk Factors ; Severity of Illness Index ; Young Adult