Objective To evaluate operative efficacy in regional pancreaticoduodenectomy with mesenteric-portal vein resection and graft reconstruction using iuternal jugular vein for pancreatic head carcinoma.Methods From Jan 2000 to Jan 2003,6 patients with pancreatic head tumors and mesenteric- portal vein involvement underwent regional pancreatieoduodenectomy with mesenteric-portal vein reseetion and vascular reconstruction using internal jugular vein.Results Surgery was successful in all 6 patients. Postoperative pathology revealed that mesenteric vein or portal vein were invaded by tumor in all cases. Survival time ranged from 17 to 49 mouths.The median survival was 23.4 months.Two cases have survived over 3 years and one of them was alive 49 months postoperatively without recurrence.Conclusion The regional pancreaticoduodenectomy with tumor invaded mesenteric-portal vein resection and graft reconstruction by using internal jugular vein renders a longer survival in metastasis-negative patients of pancreatic head adenocarcinoma.

Adjuvants, Immunologic ; therapeutic use ; Adult ; Aged ; B-Lymphocytes ; immunology ; CD4-CD8 Ratio ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Killer Cells, Natural ; immunology ; Liver Neoplasms ; drug therapy ; immunology ; surgery ; Male ; Middle Aged ; Perioperative Care ; Phytotherapy ; T-Lymphocyte Subsets ; immunology

Objective To investigate DJ-1 expression and protective effect against H2O2-induced oxidative stress in primary human melanocytes.Methods The expression and location of DJ-1 in primary melanocytes were identified by immunofluorescence.After cultured melanocytes were exposed to H2O2 for 24 hours,modified MTT assay was used to assess the proliferation of cells and to choose the suitable concentration of H2O2 for the following experiment.Western blot was used to detect D J-1 expression in melanocytes after being treated with 0.5 mmol/L H2O2 for 24 hours.Some melanocytes were divided into 3 groups to be reversely transfected with PBS(mock control group),non-targeting siRNA(negative control group)and DJ-1 targeting siRNA(DJ-1 group).Optical microscopy was utilized to observe the morphologic changes of transfected melanocytes.At 48 hours after the transfection,the melanocytes were stimulated with H2O2 for 24 hours.Subsequently,modified MTT assay,2′,7′-dichlorofluorescein diacetate(DCFH-DA)and annexin Ⅴ-fluorescein isothiocyanate/propidium iodide were used to determine cell viability,intracellular reactive oxygen species (ROS)level and apoptosis rate respectively.Results DJ-1 was expressed in both melanocyte nucleus and cytoplasm,and predominantly in the nucleus.H2O2 inhibited the cell viability in a dose dependent manner.After treatment with H2O2 of 0.5 mmol/L for 24 hours,the cell viability began to decrease in melanocytes with the expression level of DJ-1 being 2.23 times that in the untreated melanocytes(both P ＜ 0.05).Compared with the mock control group,the dendrites of melanocytes in DJ-1 group were obviously shortened with cytoplasm vacuolization.After 24-hour treatment with H2O2 of 0.5 mmol/L,the cell viability in the DJ-1 group dropped to 35％ of that in the mock control group(P ＜ 0.05),while the intracellular ROS fluorescence intensity( FI) and apoptosis rate were higher in the DJ-1 group than in the mock control group (902 ± 40 vs.529± 32,58q％ ± 6.1％ vs.30% ± 3.8％,both P ＜ 0.05).Conclusion DJ-1 can protect melanocytes against H2O2induced oxidative stress likely by decreasing intracellular ROS production and inhibiting ceU apoptosis.

AlM:To investigate the expression of VEGF, CD34, Ki-67 and p21 in pterygium as well as the correlation between their expression and clinical pathological characteristics;explore its pathogenesis.
METHODS: lmmunohistochemical S - P staining method was adopted in detecting the expression of VEGF, CD34, Ki-67 and p21 in 62 cases of pterygia and 20 cases of normal conjunctival tissues. Relationship between these markers and clinical pathological characteristics was analyzed.
RESULTS:(1) The positive expression of VEGF, CD34, Ki-67 and p21 in 62 cases of pterygia was 74. 2% (46/62), 77. 4% ( 48/62 ), 66. 1% ( 41/62 ) and 40. 3% ( 25/62 ) respectively. The differences were statistically significant compared with normal conjunctival tissues (P<0. 05). (2) The expression of VEGF and CD34 in 62 cases of pterygia was correlated with clinical types and stages (P<0. 05), and was not associated with sex, age and occupation ( P>0. 05 ); the expression of Ki-67 was correlated with clinical stages (P<0. 05), and was not associated with other clinical pathological characteristics ( P>0. 05 ); the expression of p21 was correlated with clinical stages and pterygium characters (P<0. 05), and was not associated with other clinical pathological characteristics ( P> 0. 05 ). ( 3 ) Spearman correlation showed that there was a positive correlation between VEGF and Ki - 67 ( r = 0. 279, P < 0. 05 ), a positive correlation between VEGF and CD34 (r=0. 299, P<0. 05), a negative correlation between VEGF and p21 (r=-0. 267, P<0. 05 ); it also showed that there was no correlation between any two of CD34, Ki-67 and p21 (P>0. 05).
CONCLUSlON: ( 1 ) Overexpression of VEGF, Ki-67, CD34 and low expression of p21 suggest that these markers are concerned with the development and progression of pterygium. ( 2 ) Expression of VEGF and CD34 increases along with the increase of clinical types and stages, expression of Ki-67 increases along with the increase of clinical stages, and expression of p21 decreases along with the improvement of clinical types or stages; they suggest that these markers may play important roles in the development and recurrence of pterygium. ( 3 ) There is positive correlation between VEGF and Ki-67, VEGF and CD34 as well as negative correlation between VEGF and p21. They suggest that there may be synergistic action between two factors during the development and progression of pterygium.

Objective:To explore the expressions of Disabled-1 (Dab1 )in human breast epithelial cells and breast cancer cells,and to clarify its role in cell cycle.Methods:Real-time PCR was used to analyze the Dab1 mRNA expressions in breast epithelial cells MCF-10A and breast cancer cells MCF-7,BT-549,and MDA-MB-231. The Dab1 protein expressions in those cells were tested by Western blotting method. The BT-549 cells at logarithmic growth phase were divided into control,pKH3,and pKH3-Dab1 groups;the cell cycle was investigated by flow cytometry.Results:The Real-time PCR results showed that the Dab1 mRNA expression levels in MCF-7 cells (0.504 ± 0.037),BT-549 cells (0.302 ± 0.027),and MDA-MB-231 cells (0.330 ± 0.031 )were reduced compared with MCF-10A cells (0.998±0.020)(P <0.05).The Western blotting results showed that the Dab1 protein expression levels in breast cancer cells MCF-7 (0.134±0.014),BT-549 (0.076±0.01),and MDA-MB-231 (0.074±0.005)were reduced compared with MCF-10A cells (0.227±0.021)(P <0.05).Compared with control group and pKH3 group,the cell cycle in pKH3-Dab1 group was inhibited at G1 phase detected by flow cytometry analysis. Conclusion:The expression of Dab1 is down-regulated in breast cancer cells,and the over-expression of Dab1 can inhibit the cell cycle at G1 phase.

Objective To observe any effect of low intensity pulsed ultrasound (LIPUS) on the expression of integrin-focal adhesion kinase (FAK)-mitogen-activated protein kinase (MAPK) mechanochemical transduction pathway-related proteins in the chondrocytes of rabbits with knee osteoarthritis (OA).Methods Of the 18 New Zealand white rabbits selected for the study,twelve received knee anterior cruciate ligament transection to model OA.The remaining 6 rabbits served as normal controls.At the 4th week after modeling the rabbits were sacrificed and chondrocytes were isolated and cultured in vitro.All the cultured cells were randomly divided into three groups:a normal control group (NC),an OA model group (OA) and an OA model plus LIPUS group (OA + LIPUS).When the cells had been cultured to the 2nd passage,the NC group and OA group cells had received no treatment.The OA + LIPUS group cells were exposed to 40 mW/cm2 of LIPUS for 20 min,once a day for 6 days.The expression of collagen protein type Ⅱ,aggrecan,MMP-13,integrin β1 p-FAK and p-p38,p-ERK1/2 and p-JNK Mapks were detected by Western blotting.Results Compared with the NC group,the expression of collagen type Ⅱ and aggrecan was significantly lower in the OA and OA + LIPUS groups,with more significantly lower expression of collagen type Ⅱ and aggrecan in the OA group than in the OA + LIPUS group.Compared with the NC group,the expression of MMP-13 was significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA group.Compared with the NC group,the expression of integrin β1 and p-FAK was also significantly higher in the OA and OA + LIPUS groups,with a significantly larger increase in the OA + LIPUS group.Compared with the NC group,the expression of p-p38,p-ERK1/2 and p-JNK was also significantly higher in the OA group,but compared with the OA group,the expression of those kinases was,on average,significantly lower in the OA + LIPUS group.Conclusions LIPUS can inhibit the degradation of collagen type Ⅱ and aggrecan,and inhibit the expression of MMP-13,p-p38,p-ERK1/2 and p-JNK in OA chondrocytes,at least in vitro.At the same time,LIPUS can increase the expression of integrin β1 and p-FAK.The results show that LIPUS may activate an integrin-FAK-MAPK mechanochemical transduction pathway to induce changes in the extracellular matrix of chondrocytes.

A total of 209 type 2 diabetic patients were divided into three groups:without,with mild to moderate,or severe diabetic lower extremity arterial disease based on the ankle brachial index value.60 healthy subjects were used as a control group.Retinol binding protein4 (RBP4),cystatin C,and biochemical parameters were determined in all subjects.The results showed that RBP4 and cystatin C levels were progressively raised with the increasing severity of lower extremity arterial disease in various groups,being significantly higher in patients with type 2 diabetes mellitus with mild to moderate and severe arterial disease compared with control group (P＜0.05 or P＜0.01).RBP4 and cystatin C levels in groups with lower extremity arterial disease were significantly higher than those in the group without arterial disease (P＜0.01).Pearson correlation analysis showed that RBP4 level was positively correlated with total cholesterol,triglyceride,low density lipoprotein-cholesterol,fasting serum insulin,body mass index,cystatin C etc while negatively correlated with high density lipoprotein-cholesterol (P＜0.05 or P＜0.01).Logistic regression analysis showed that serum RBP4 and cystatin C were significantly associated with lower extremity arterial disease in type 2 diabetes mellitus.

Objective To explore how to determine the designated hospitals for critical illness scientifically and reasonably.Methods Analyzing the choice of medical providers by inpatients with critical illness,by means of the database of NRCMS in 2009～2010 in one county,Guangxi province.And analyzing the current policies on the basis of general principals used in health policy analysis.Results The choices of medical providers made by inpatients with critical illness are influenced by various factors.Choice of such hospitals should only be dependent on scientific and reasonable determination of patients' reasonable medical needs,instead of on the medical competency of the hospitals only.Conclusion Maximal cost-effectiveness should prevail,be it the class-1 demand of complete healing which is highly dependent on medical technology,or class-2 demand requiring repeated hospitalizations and not highly dependent on medical technology.Reasonable designation of hospitals for critical illness should be based on reasonable medical needs of patients,instead of medical competency of hospitals only.

Objective To evaluate the efficacy of percutaneouse trans-hepatic Cyanoacrylate (TH glue) embolization for gastric varices. Methods TH glue was injected into the gastric varices and its feeder veins in 30 patients. The endoscopy was performed at 1 week and every 3 months after the procedure, while the CT and portal vein angiography were performed at 3 months and every 6 months after the procedure to e-valuate the oblitazation results. Results The effective rate of treatment was 100%. A total of 21 patients were followed up in a mean period of 27.9 months (11-33 months) with a recurrence rate of varices at 14. 29% (3/21). Portal hypertensive gastropathy was observed in 17 patients (80. 95%), and to-bleeding occurred in 2 patients (9. 52%) due to portal hypertensive gastropathy. CT and portal vein angiography dis-played TH glue in fundic peripheral veins, perforating veins in the gastric wall and other feeding veins with-out re-ciroulation or new branches after embolization. Conclusion Peroutaneous trans-hepatic TH glue is a-ble to embolize the gastric varices and its feeding veins, which is feasible and effective in treatment of gastric varices.

Objective To observe the effect of low intensity pulsed ultrasound (LIPUS) on chondrocytes co-cultured with infrapatellar fat pads.Methods Twenty-four infrapatellar fat pads and cartilages from female knee trauma patients aged between 25 and 35 were cut and stained using hematoxylin-eosin staining.Chondrocytes were isolated from part of the integrated surface of the cartilages to be cultured in vitro.They were then randomly divided into a normal chondrocyte group (the control group),a normal chondrocyte+FCM (fat conditioned medium) group (the model group),a normal chondrocyte+ FCM + LIP US group (the treatment group),and a normal chondrocyte+ FCM + LIPUS + GRGDSP (an integrin inhibitor) group (the inhibited group).The treatment group and inhibited group received LIPUS at 40 mW/cm2 for 20 min once a day,while the other groups received sham LIPUS treatment.Five days later,the cells were collected and western blotting was used to examine the expression of type Ⅱ collagen (COL2),aggrecan (Acan),matrixmetalloproteinase (MMP)-13,integrin β1,phosphorylation-focal adhesion kinase (p-FAK) and phosphorylation p38 (p-p38).Results Western blotting showed that compared with the control group,the expression of COL2 and Acan was significantly lower in the model group,but that of MMP-13,integrin β1,p-FAK and p-p38 was significantly higher.As compared with the model group,the expression of COL2,Acan,integrin β1 and p-FAK was significantly higher,and that of MMP-13 and p-p38 was significantly lower in the treatment group.The expression of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 showed no significant difference between the inhibited and model groups,but that of COL2,Acan,MMP-13,integrin β1,p-FAK and p-p38 was significantly different between the control and treatment groups.Conclusions LIPUS provides a protective effect on chondrocytes through inhibiting the expression of MMP-13 induced by adipokines and the degradation of COL2 and Acan through activating the integrin-FAK-p38 MAPK pathway.