Objective To discuss clinical significance of the neutrophil alkaline phosphatase(NAP) activity in polycythemia pa‐tients .Methods 35 cases of patients with secondary polycythemia(secondary group) and 22 patients with polycythemia vera (poly‐cythemia vera group) were enrolled in the study ,whose peripheral blood smears were stained by using chemical method and the pos‐itive rate and scores of NAP were assessed .In addition to that ,30 cases of healthy people who had underwent physical examination were recruited as control group .Results NAP positive rate and scores of the polycythemia vera group were significantly higher than those of secondary and control group(P<0 .05) ,while no statistical difference was observed between secondary and control group(P>0 .05) .Conclusion NAP score is a good methord to diagnose polycythemia ,which could facilitate rapid ,accurate diagno‐sis and be used as auxiliary indicators in the differential diagnosis of polycythemia .

0.05.Conclusion Using XT-2000i Automated Hematology Analyzer to test the reticulocyte the reproducibility is better,and the linearity can content well with clinic,the rate of carry contamination is low,the stability is better too.Compared XT-2000i with the manual methods,the relativity is better. It can replace the manual methods.

Objective To investigate the correlation between the level of postprandial blood glucose (PBG)and the incidence of coronary artery disease(CAD). Methods Eighty-five patients performed coronary angiography with abnormal blood glucose levels were divided into 3 groups according the blood glucose levels: impaired fasting glucose(IFG)group(28 cases), impaired glucose tolerance(IGT)group(29cases)and diabetes mellitus(DM)group(28 cases). The detection rate and the extent of CAD were observed. The risk factors of CAD in 3 groups such as C-reactive protein(CRP),carotid artery intima-media thickness(CIMT), blood lipids, blood pressure, body mass index(BMI)and the correlation with CAD were analyzed. Results Sixty-two cases were confirmed CAD by coronary angiography. The incidence rate of CAD in IGT group[79.3%(23/29)]and DM group[85.7%(24/28)]was significantly higher than that in IFG group[53.6%(15/28)](P ＜ 0.01). The incidence rate of CAD in DM group was higher than that in IGT group, but there was no significant difference(P ＞ 0.05). The incidence rate of two-lesion and three-lesion in IGT group and DM group were significantly higher than those in IFG group(P＜ 0.01). The incidence rate of two-lesion and three-lesion in DM group were higher than those in IGT group, but there was no significant difference(P＞0.05). The levels of CRP, CIMT, BMI, triacylglycerol(TG)and systolic blood pressure(SBP)were higher and HDL-C was lower in IGT group and DM group than those in IFG group(P ＜ 0.01 or ＜ 0.05).The levels of CRP,TG and SBP were higher in DM group than those in IGT group(P＜0.05). Correlation analysis showed, in IGT group and DM group,2 h PG had significantly positive correlation with CRP, CIMT,B MI, TG(P＜0.05 or＜0.01), and had significantly negative correlation with HDL-C(P＜0.05 or ＜0.01).Conclusions PBG is closely related with the development of CAD.IGT patients should be intervened as early as possible, which can be effective in preventing cardiovascular events.

Aim To optimize extraction of polysaccha-rides from Dendrobium officinale ( DOP ) and investi-gate the effects of DOP on the expression of Bax and Bcl-2 in vascular endothelial cell of human umbilical vein ( HUVEC) by the induction of high sugar. Meth-ods Response surface methodology ( RSM ) was em-ployed to optimize the conditions for extraction of DOP on the basis of single factor experiment. The HUVEC cells were divided into the blank control group, the normal blood sugar group, the high sugar stimulation group and different drug concentration group plus the high sugar stimulation group. The growth condition of cells was examined by methyl thiazolyl tetrazolium ( MTT) , and RT-PCR was used to detect the expres-sion of Bcl-2 Assaciated X protein ( Bax ) and B-cell lymphoma-2 ( Bcl-2 ) in vascular endothelial cells after 24 and 48 hours. Results The optimal extraction time was 2 h and the optimal liquid-solid ratio was 15. 75∶1 ( mL/g ) , and the optimal extraction frequency was 2. 8. Under these optimized conditions, the extraction rate of polysaccharides was 25. 1%, while the experi-mental extraction rate was 24. 9%, which was highly fit with the regression model. Compared with normal sugar group, high sugar group reduced the growth of cells and enhanced the expression of Bax, and inhibi-ted the expression of Bcl-2 . DOP promoted the growth of cells in high sugar induction, inhibited the expres-sion of Bax, and enhanced the expression of Bcl-2. Conclusions The process optimized through RSM has the extraction effect, and has certain practical signifi-cance. Through the down-regulation of the expression of Bax in vascular endothelial cells and the up-regula-tion of the expression of Bcl-2 by the induction of high sugar, DOP can restrain HUVEC, which could prevent and cure diabetic angiopathy to some extent.

0.05). At day 30 after operation,half-pipe blockage occurred,and some yellow-green sediments were observed on the pipe wall in the straight tube group; a few of yellow-green sediments were found at top of wall,and some white floc sediments were observed in lumen but nothing was observed on valve in the venous valve tube group; a few of yellow-green sediments were found on pipe wall near the living valve,and some white floc sediments were observed in bile in the living valve tube group. At day 30 after operation,epithelium of mucous membrane was not intact,and gland proliferated lightly in the straight tube group; epithelium of mucous membrane was generally intact,and proliferation of gland was not found in the venous valve tube group; epithelium of mucous membrane was exactly intact,and glandular epithelial cells were not heteromorphism in the living valve tube group. CONCLUSION:The artificial bile ducts with a valve structure and living value structure has a good patency and plays an effective role of anti-reflux after a short-term observation,suggesting that a valve structure acts as a similar function to Oddis sphincter.

Objective To investigate the impact of enteral nutrition (EN) through jejunal feeding tube on the nutritional status and immunologic function of patients during chemotherapy after total gastrectomy.Methods Totally 86 patients with gastric cancer who had undergone total gastrectomy with radical resection and jejunostomy received adjuvant venous chemotherapy in our department from January 2009 to June 2010.They were divided into EN group ( n =43 ) and control group ( n =43 ) according to the hospitalization number.The EN group maintained the jejunostomy tube until the end of 6 courses of chemotherapy,and was given EN support for 7 days through jejunal tube during each course of chemotherapy; the control group removed the tube before chemotherapy without further dietary restriction or nutrition support.The nutritional and immunologic indicators on the 1 st day before chemotherapy and the 1st day after 6 chemotherapy courses were measured.ResultsThree patients in the EN group withdrew from the study because of catheter blockage or catheter loss and 2 patients in the control group failed to complete the trial because of chemotherapy side effects or economic reasons; 81 patients entered the final analysis.After 6 courses of chemotherapy,both groups experienced body weight loss,but the percentage is significantly lower in EN group than in control group (6.9％ ± 0.95％ vs.11.2％ ± 1.32％,P =0.0000).Compared with the nutritional status before the first chemotherapy,the prognosis nutritional index (PNI) in both groups declined after the 6th chemotherapy.Such decline was not statistically significant in EN group ( P =0.1534) but was significant in control group (P =0.0000).The PNI in EN group after chemotherapy was significantly higher than that in control group (P =0.0040).The levels of IgG,NK,CD4 +,and CD4 +/CD8 + were significantly higher in EN group than in control group ( P =0.0083,0.0143,0.0000,and 0.0000,respectively) after chemotherapy.ConclusionEN during postoperative chemotherapy may improve the nutritional status and immunologic function in gastric cancer patients after total gastrectomy.

Objective To investigate the efficacy of sophocarpine in rats with alcoholic liver disease and its effects on the expression of tumor necrosis factor (TNF)-α,interleukin (IL)-6 and transforming growth factor (TGF)-β1.Methods A total of 48 male Sprague-Dawley adult rats were evenly divided into healthy control group,model group,prevention group and treatment group.The rats in the healthy control group were gavaged with 0.9％NaCl every day for 12 weeks.The rats in the model group,prevention group and treatment group were gavaged with alcohol for 12 weeks to establish the model.The prevention group was injected with 20 mg · kg1 · d1 sophocarpine for 12 weeks.Since the fifth week,the treatment group was continuously injected with 20 mg · kg1 · d-1 sophocarpine for eight weeks.The histological changes were evaluated.The serum levels of alanine aminotransferase (ALT), aspartate aminotransferase ( AST ), alkaline phosphatase (AKP),triglyceride (TG) and total cholesterol (TC) were examined.And the expression of TNF-α,IL-6 and TGF-β1 in liver tissue at mRNA and protein level were detected with immunohistochemistry and real-time polymerase chain reaction (PCR) assay.Comparison among groups was perform with single factor analysis of variance,pairwise comparisons with least significant difference method (LSD method),ranked data with Kruskal-Wallis H-test and multiple pairwise comparison with Nemenyi test.Results Compared with model group,hepatic steatosis and inflammatory cell infiltration were significantly improved in the treatment group and prevention group.The levels of ALT (41.40 U/L± 10.53 U/L and 40.75 U/L±6.94 U/L vs 58.37 U/I±5.35 U/L),AST(121.60 U/L±16.24 U/L and 109.50 U/L±9.23 U/L vs 156.63 U/L±32.47 U/L),AKP(114.88 U/L±40.37 U/L and 112.60 U/L±44.34 U/L vs 161.75 U/L±28.95 U/L),TG (4.19 mmol/L±0.99 mmol/L and 2.69 mmol/L± 1.35 mmol/L vs 4.50 mmol/L±0.99 mmol/L) and TC (1.48 mmol/L±0.28 mmol/L and 1.43 mmol/L±0.19 mmol/L vs 1.67 mmol/L±0.20 mmol/L) significantly decreased and the difference was statistically significant ( all P＜0.05).The expression of TNF-α,IL-6 and TGF-β1 at mRNA and protein level in liver tissue of model group were significantly higher than those of healthy control group,prevention group and treatment group.After treated with sophocarpine,the expression of TNF-α(mRNA:1.36 ± 0.08,1.16 ± 0.05 ; protein:3.38 ％ ± 0.82 ％,1.74 ％ ± 0.65 ％ ),IL-6 (mRNA:1.51 ± 0.05,1.39 ± 0.02; protein:5.89％ ± 0.96％,4.26％ ± 0.53％) and TGF-β1 (mRNA:1.39±0.04,1.37±0.02; protein:4.27％ ±0.97％,2.11％ ±0.83％) of treatment group and prevention group at mRNA and protein level significantly lower than those of model group (mRNA:1.81±0.16,1.95 ±0.13,1.84±0.22; protein:5.82％ ± 1.21％,7.63％ ±1.03％,5.33％± 1.12％) and the difference was statistically significant (all P＜0.01).Conclusion Sophocarpine significantly alleviates alcohol induced liver injury in rats,improves liver steatosis and inflammatory reaction degree,which may be related with the downregulation of TNF-α,TGF-β1 and IL-6 expression in liver tissue of ALD rats.

Objective To investigate the indications and clinical effect of emergency laparoscopic splenectomy for traumatic splenic rupture.Me,ods Clinical data of 30 traumatic splenic rupture patients undergoing emergency laparoscopic splenectomy from Aug 2011 to Mar 2016 in our hospital were analyzed retrospectively.Results.All patients were of simple traumatic spleen rupture without combined injuries.There were 2 cases of grade Ⅱ (6.7％),17 cases of grade Ⅲ (56.7％),10 cases of grade Ⅳ (33.3％),1 case of grade Ⅴ (3.3％).28 cases underwent successful laparoscopic splenectomy and 2 cases were converted to open surgery.22 cases used intraoperative autologous blood transfusion (73.3％),19 cases received blood transfusion (63.3 ％),average perioperative blood loss were (1 791 ± 643) ml,operation time were (135 ± 51) min,postoperative fasting time was (2.7 ± 1.8) d,postoperative hospital stay was (8 ± 5) d.The overall postoperative morbidity rate was 20％ (6/30),including pancreatic leakage in one,pleural effusions in 2,infections in 3.There were no operative mortality and other serious complications.Conclusions Emergency laparoscopic splenectomy is minimally invasive with faster recovery,less complication and shorter hospital stay.

Objective To evaluate the safety and feasibility of total laparoscopic hepatectomy for liver neoplasms.Methods Laparoscopic hepatectomy in 15 patients with liver neoplasms were completed by combined application of ultrasound scalpel,Ligasure and vascular clip without blockage of liver blood flow,including 9 cases of hepatic cavernous hemangioma,whose diameters were from 5.0 cm to 15.0 cm,3 cases of hepatic cyst with fibrosis,located in left lateral hepatic lobe,3 cases of primary hepatic carcinoma,whose diameters were from 1.0 cm to 5.0 cm and the hepatic functions were all Child A.Results Laparoscopic hepatectomy was completed successfully in all 15 cases with no conversion to open laparotomy,including 6 cases of left lateral hepatectomy,9 cases of irregular hepatectomy.The mean operative time was 110 min,blood loss during operation was from 30 ml to 500 ml,the average was 251 ml.The mean postoperative hospital stay was 6.5 d.The mortality rate was 0%.No severe complications occurred except 1 case of small amount bleeding which stopped itself.Conclusion Total laparoscopic hepatectomy is a feasible,safe and minimal invasive approach for patients with liver neoplasms within segment Ⅱ、Ⅲ、Ⅳa、Ⅴ、 and Ⅵ.

sing guidewire through temporary catheter is an alternative strategy, because of avoiding this avoids vein re-puncturation and doesn't increase catheter related complication.