Objective To discuss the causes and clinical significance of conversion to laparotomy during laparoscopic surgery.Method Three thousand two hundred and three cases who underwent laparoscopic surgery during the past five years were analyzed retrospectively.Results Three thousand one hundred and eighty cases underwent laparoscopic surgery,in which 23 cases were converted to laparotomy due to factors including severe pelvic adhesions(6 cases),complex disease with difficulties in laparoscopy (7 cases),massive haemorrhage(3 cases),bladder trauma(1 case),gastric trauma(1 case),intestinal trauma(1 case),as well as unexpected malignant genitalia neoplasm(4 cases).Conclusion The major causes for the conversion to laparotomy during gynecology laparoscopic surgery are severe pelvic adhesion and complex disease with difficulties in laparoscopy.Careful evaluation before surgery and conversion to laparotomy at the right moment can decrease the complication.

Objective To evaluate the effects of TENS on metatarsus plantar flexion and inversion in stroke patients,and to explore its mechanism.Methods Thirty-two stroke patients with gastrocnemius spasticity were randomly divided into a control group (n=16) and a TENS group (n=16).All patients were treated with foot sup- ports,neurodevelopmental and manipulation therapies.In addition,the TENS group received TENS on the anterior tibialis,peroneus longus and brevis muscles.All patients were assessed in terms of their Chinese stroke scale(CSS) and H reflex scores before and after therapy.Results Compared with those in the control group,the H reflex scores in the TENS group were obviously decreased,while H reflex latency was prolonged and H/M was reduced. Gait in the TENS group was evidently improved.Conclusion TENS is an effective therapy to decrease gastrocnemi- us spasticity and to improve the gait of stroke patients.

BACKGROUNDTo investigate the transcriptional inhibitory role of hepatitis B virus X protein on the expression of p53 tumor suppression gene.

METHODSThe promoter sequence of the p53 tumor suppression gene was identified and amplified by bioinformatics and polymerase chain reaction (PCR). The recombinant reporter gene expression vector pCAT3-p53p was constructed and transfected into the hepatoblastoma cell line HepG2 and cotransfected with pcDNA3.1 (-)-X by Fugene 6 transfection reagents. The chloramphenicol acetyl transferase (CAT) activity was detected by enzyme-linked immunosorbent assay (ELISA). The expression of p53 mRNA was further detected by RT-PCR with or without HBV X protein.

RESULTSThe reporter vector pCAT3-p53p has been successfully constructed and identified and the p53 promoter could cis-activate the transcription of the CAT gene. The relative expression level of CAT gene in HepG2 cells cotransfected with pCAT3-p53p and pcDNA3.1 (-)-X was lower than the control, and the inhibitory rate was approximately 78%, which indicate that HBV X protein could transcriptionally inhibit the activity of p53 promoter. After transfected with pcDNA3.1 (-)-X, the expression of p53 mRNA was lower than the control.

CONCLUSIONHBV X protein could transcriptionally inhibit the expression of p53 tumor suppression gene, which might be a possible molecular mechanism responsible for the development of HBV-associated hepatocellular carcinoma.

Base Sequence ; Cell Line, Tumor ; Gene Expression Regulation, Neoplastic ; Humans ; Molecular Sequence Data ; Promoter Regions, Genetic ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Trans-Activators ; genetics ; Transcription, Genetic ; Transfection ; methods ; Tumor Suppressor Protein p53 ; genetics

The aim of the present study was to examine whether there are changes in systolic and diastolic blood pressure (SBP and DBP) and heart rate (HR) and their spectral indices in conscious free-moving rats after tail-suspension for 28 d. The tail-suspended hindlimb-unloaded (HU) rat model was used to simulate the cardiovascular effect of microgravity and the post-spaceflight cardiovascular dysfunction. The auto- and cross-spectral analysis of SBP variability (SBPV) and HR variability (HRV) were performed by the method based on the autoregressive model (AR), and the auto-spectral results was compared with the results from the classical periodogram method. The baroreceptor-heart rate reflex sensitivity (BRS) was estimated using transfer function analysis from SBP to HR. The results indicated that auto-spectral results based on the two methods were comparable, while smoother power spectral curves with distinguished peaks were trained by the AR method. The means of SBP, DBP, and HR, the main spectral indices of SBPV and HRV, and the mean average gain of transfer functions computed at low- and high-frequency ranges (0.25-0.8 Hz and 0.8-2.4 Hz) did not show significant changes before and after release from suspension. Furthermore, the main spectral indices of SBPV and HRV at different time points did not show significant differences between the control and suspension groups. However, the means of SBP, DBP, and HR at different time points were significantly higher in simulated weightless rats than those in the control rats. The findings of the present study suggest that a mid-term simulated microgravity might induce hypertension and tachycardia upon removal from the suspension which reflects a general sympathetic hyperactivity. We speculated that the sympathetic hyperactivity might be a compensatory mechanism activated in the intact animal to counteract HU-induced hypo-responsiveness of resistance vessels. In addition, lack of clear and distinct changes in HRV and BRS have also been reported in some recent space and ground-based human studies.
Animals ; Baroreflex ; Blood Pressure ; Heart Rate ; Hindlimb Suspension ; Hypertension ; Rats ; Weightlessness Simulation

AIMTo investigate the effects of simulated microgravity on dilatory responsiveness and NOS expression of abdominal aorta in rats.

METHODSTwenty male healthy SD rats, which body weight ranged from 300 g to 330 g, were divided into control group and simulated microgravity group randomly. After 4 weeks, using isolated arterial rings from rats, arterial dilatory responsiveness of abdominal aorta were examined in vitro. And the expression of nitric oxide synthase (NOS), including endothelial NOS (eNOS) and inducible NOS (iNOS), were observed by Western blot.

RESULTSDilatory responses of arterial rings to L-Arginine (10(-8)-10(-3) mol/L), and Acetylcholine mol/L) were decreased in simulated microgravity rats compared with that of controls; but dilatory responses of isolated aortic rings to sodium nitroprusside (mol/L) and 8-bromo-cGMP(mol/L) were similar in both simulated microgravity rats and control rats. The expression of both eNOS and iNOS had not showed significant differences between two groups.

CONCLUSIONThe data indicate that endothelium dependent vasorelaxation in abdominal aortic rings are decreased by 4-week simulated microgravity, and this change may be result from altered NOS activity in endothelium.

Animals ; Aorta, Abdominal ; metabolism ; Arginine ; metabolism ; Cyclic GMP ; metabolism ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type II ; metabolism ; Nitric Oxide Synthase Type III ; metabolism ; Rats ; Rats, Sprague-Dawley ; Weightlessness Simulation

OBJECTIVETo investigate the effects of rapamycin on cholesterol homeostasis and secretory function of 3T3-L1 cells.

METHODSThe in vitro cultured 3T3-L1 cells (preadipocytes) were divided into control group, rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group. Intracellular cholesterol level was measured by oil red O staining and high performance liquid chromatography. The secretion levels of leptin and adiponectin were assayed by enzyme-linked immunosorbent assay. The mRNA and protein expressions of peroxisome proliferator-activated receptor (PPARgamma) were assayed by quantitative real-time polymerase chain reaction and Western blot.

RESULTSOil red O staining showed rapamycin down-regulated 3T3-L1 cells differentiation and lipid accumulation. Quantitative measurement of cholesterol with high performance liquid chromatography showed that the concentrations of free cholesterol in rapamycin treatment groups had a significant reduction. The concentrations of free cholesterol in the control group, rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group were (12.89 +/- 0.16), (9.84 +/- 0.45), (9.39 +/- 0.46), and (8.61 +/- 0.34) mg/ml, respectively (P < 0.05), and the concentrations of total cholesterol were (12.91 +/- 0.50), (9.94 +/- 0.96), (10.45 +/- 2.51), and (9.53 +/- 0.63) mg/ml, respectively. The leptin concentrations in the control group, rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group were (19.02 +/- 0.52), (16.98 +/- 0.11), (15.62 +/- 0.01), and (13.84 +/- 0.66) ng/ml, respectively. The mRNA expressions of PPARgamma in the rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group were significantly lower than that in control group (P < 0.05). The protein expressions of PPARgamma in the rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group were 80%, 74%, and 61% of that in control group (P < 0.05). After the cells were treated with rapamycin 100 nmol/L, PPARgamma blocking agent GW9662 10 micromol/L, and PPARgamma agonist troglitazone 10 micromol/L, respectively, for 96 hours, the mRNA expression of PPARgamma was (0.60 +/- 0.14), (0.67 +/- 0.03), and (1.30 +/- 0.14) of that in control group (P < 0.05). The protein expression showed a similar trend with mRNA expression (P < 0.05). After the cells were treated with rapamycin 100 nmol/L, PPARgamma blocking agent GW9662 10 micromol/L, and PPARgamma agonist troglitazone 10 micromol/L, respectively, for 96 hours, the expression of leptin in the control group, rapamycin 50 nmol/L group, rapamycin 100 nmol/L group, and rapamycin 200 nmol/L group was (19.02 +/- 0.52), (15.62 +/- 0.10), and (14.45 +/- 1.01) and (18.07 +/- 0.66) ng/ml, respectively (P < 0.05 compared with the control group).

CONCLUSIONSBy downregulating the expression of PPARgamma, rapamycin can decrease cholesterol accumulation in 3T3-L1 cells and inhibit its leptin-secreting capability. This finding may provide a possible explanation for rapamycin-induced hyperlipidemia in clinical practice.

3T3-L1 Cells ; Adipocytes ; drug effects ; metabolism ; Animals ; Cholesterol ; metabolism ; Leptin ; metabolism ; Mice ; PPAR gamma ; genetics ; metabolism ; Sirolimus ; pharmacology

Objective To evaluate the efficacy and safety profile of Reduning injection combined with cefoperazone sodium and sulbactam sodium injection in the treatment of pulmonary infection in patients with chronic obstructive pulmonary disease(COPD).Methods A total of 68 patients with COPD were divided into control group (34 cases) and treatment group (34 cases).Both groups were given routine treatment.The control group was given moxifloxacin hydrochloride sodium chloride injection 250 mL,intravenous drip,qd;cefoperazone sodium and sulbactam sodium 1.0 g,intravenous drip,bid.The treatment group received Reduning injection 20 mL,intravenous drip,qd.Both groups were treated for 10 days.The clinical efficacy and adverse drug reactions were compared between the two groups.Results After treatment,the total effective rates of the treatment group and the control group were respectively 94.12％ (32/34 cases),70.59％ (24/32 cases),the difference was statistically significant (P ＜ 0.05).The main adverse drug reactions of treatment group were headache,gastrointestinal reaction and rash,while those of the control group were headache,slight increase of liver enzymes,gastrointestinal reaction and rash,and the incidences of adverse drug reaction were 8.82％ (3/34 cases) and 14.71％ (5/34 cases) respectively,without statistically significant difference (P ＞0.05).Conclusion Reduning injection combined with cefoperazone sodium and sulbactam sodium injection in the treatment of COPD was effective with a favourable safety profile.

OBJECTIVE: To reconstruct the course of vehicle collision, so that to provide the reference for forensic identification and disposal of traffic accidents. METHODS: Through analyzing evidences left both on passengers and vehicles, technique of momentum impulse combined with multi-dynamics was applied to simulate the motion and injury of passengers as well as the track of vehicles. RESULTS: Model of computer stimulation perfectly reconstructed phases of the traffic collision, which coincide with details found by forensic investigation. CONCLUSION Computer stimulation is helpful and feasible for forensic identification in traffic accidents.
Accidents, Traffic ; Automobiles ; Computer Simulation ; Forensic Medicine/methods* ; Humans ; Models, Theoretical ; Software ; Wounds and Injuries/etiology*

OBJECTIVE: To study the characteristics and biomechanical mechanism of riding injuries involving bicycles collided by motor vehicles. METHODS: The real traffic accident cases of bicycles collided by motor vehicles, including the information of scenes, bicycles, motor vehicles, rider wounds and traffic directions, were collected. Retrospective method was used to study these riding injuries. In addition, typical cases were selected to simulate traffic accident courses with computer simulation software, and the dynamic data like acceleration, force, moment were cxtracted to compare with those in the real cases. RESULTS: There were no difference of occurring frequency between cases with or without riding injuries, as well as between one-side-collision and front- or back-collision. The riding injuries seemed less in accidents involving large-scale vehicles. The frequency of riding injuries increased with vehicle speed. The wound location was low on collision side and high on opposite. CONCLUSION Analysis of riding injury characteristic in traffic accidents and their biomechanical mechanism would be helpful for estimation of traffic manner.
Accidents, Traffic ; Area Under Curve ; Bicycling/injuries* ; Biomechanical Phenomena ; Computer Simulation ; Humans ; Leg Injuries/pathology* ; Models, Theoretical ; Motor Vehicles ; Perineum/injuries* ; Retrospective Studies ; Wounds and Injuries/pathology*

Objective To summarize the auxiliary value of CT scanning in differentiating acute glioma stroke from simple cerebral hemorrhage. Methods The CT data of 12 patients with acute glioma stroke diagnosed by operation and pathological examination were analyzed retrospectively.Results CT scan presented high density hematoma with clear borderline in 12 cases, solid tumor mass in 9 cases, no clear tumor foci in 3 cases, and perifocal edema in 10 cases. Conclusion The combination with the clinical history, CT manifestations and enhanced CT scan can facilitate the diagnosis of acute glioma stroke from simple cerebral hemorrhage.