Objective To study on the metal clip installation to avoid post-operative bleeding in pa- tients accepted papilla sphinctecotomy.Methods One hundred and eighty five patients who accepted ERCP +EST were divided into two groups:Group 1 was given routine regimen alone(N=95),group 2,given routine regimen and metal clip to prevent post-operative bleeding.Results The postoperative bleeding hap- pened in 3(3.2%)cases of Group 1 and none in Group 2,there is significant difference between these two groups(P＜0.05).The breeding cases in group 1 were controlled by metal clip under endoscopy successful- ly.Conclusion Preventive usage of metal clip was significantly decreased the incidence of post-operative bleeding in EST patients.

Objective To investigate the effects of lovastatin,a widely used antilipemic agent,on cell proliferation,migration and apoptosis in human cholangiocarcinoma cell line QBC939 and explore its possible mechanism.Method After QBC939 cells were either incubated with lovastatin alone or without it as a control,the methylthiazolyl tetrazolium assay (MTT) assay was used to detect cell proliferation at the 24 h,48 h and 72 h mark; flow cytometry (FCM) measured apoptosis at 48 h;scratch assay was used to determine cell migration at 48h; RT-PCR and Western blot detected the expression of inflammatory cytokine interleukin-6 (IL-6),protein kinase (PKB/Akt),vascular endothelial growth factor (VEGF),matrix metalloproteinase-9 (MMP-9) mRNA and Akt protein at 48 h.Results Lovastatin significantly inhibited cell proliferation in a dose and time dependent manner (24 h,48 h and 72 h:F=173.05,159.66,577.87 respectively,all P＜0.01).After lovastatin treatment,apoptosis induction increased (t =15.28,P＜ 0.01 ) as did early apoptosis (t =13.24,P＜0.01),while the average migration velocity was reduced (24 h and 48 h:t=6.21,5.95,respectively,all P＜0.01).The Akt protein expression and mRNA expression of IL-6,Akt,VEGF,and MMP-9 were down-regulated after lovastatin treatment.Conclusions Lovastatin can inhibit cell proliferation,migration and promote apoptosis in human cholangiocarcinoma cell line QBC939.The mechanisms of suppression may be associated with down-regulation of IL-6,Akt,VEGF and MMP-9 expression.

Atropa belladonna is a medicinal plant and main commercial source of tropane alkaloids (TAs) including scopolamine and hyoscyamine, which are anticholine drugs widely used clinically. Based on the high throughput transcriptome sequencing results, the digital expression patterns of UniGenes representing 9 structural genes (ODC, ADC, AIH, CPA, SPDS, PMT, CYP80F1, H6H, TRII) involved in TAs biosynthesis were constructed, and simultaneously expression analysis of 4 released genes in NCBI (PMT, CYP80F1, H6H, TRII) for verification was performed using qPCR, as well as the TAs contents detection in 8 different tissues. Digital expression patterns results suggested that the 4 genes including ODC, ADC, AIH and CPA involved in the upstream pathway of TAs, and the 2 branch pathway genes including SPDS and TRII were found to be expressed in all the detected tissues with high expression level in secondary root. While the 3 TAs-pathway-specific genes including PMT, CYP80F1, H6H were only expressed in secondary roots and primary roots, mainly in secondary roots. The qPCR detection results of PMT, CYP80F1 and H6H were consistent with the digital expression patterns, but their expression levels in primary root were too low to be detected. The highest content of hyoscyamine was found in tender stems (3.364 mg x g(-1)), followed by tender leaves (1.526 mg x g(-1)), roots (1.598 mg x g(-1)), young fruits (1.271 mg x g(-1)) and fruit sepals (1.413 mg x g(-1)). The highest content of scopolamine was detected in fruit sepals (1.003 mg x g(-1)), then followed by tender stems (0.600 mg x g(-1)) and tender leaves (0.601 mg x g(-1)). Both old stems and old leaves had the lowest content of hyoscyamine and scopolamine. The gene expression profile and TAs accumulation indicated that TAs in Atropa belladonna were mainly biosynthesized in secondary root, and then transported and deposited in tender aerial parts. Screening Atropa belladonna secondary root transcriptome database will facilitate unveiling the unknown enzymatic reactions and the mechanisms of transcriptional control.
Alkaloids ; biosynthesis ; genetics ; metabolism ; Atropa belladonna ; genetics ; metabolism ; Gene Expression Regulation, Plant ; genetics ; Hyoscyamine ; genetics ; metabolism ; Plants, Medicinal ; genetics ; metabolism ; Scopolamine Hydrobromide ; metabolism ; Tropanes ; metabolism

OBJECTIVETo study and explore the relativity of adults HBV vicinal failure and HLA-DR, T cell subset, trace viruses infection. To accumulate date for formulating preventing adult HBV infection prophylactic-therapeutic measures.

METHODSSelect 20 adults randomly who had vaccinated with 10 microgYDV and produced anti-HBS successfully, and another 20 hadn't produced anti-HBs to form two groups-defeated group and contral group. Blood samples from two groups were taken for detecting the level of DR range gene phenotype: T cell subset, white blood cell HLA-DR, HLA-B27, HLA DRB1 * 07, DRB1* 04, DRB1 * 1001, DQB1 * 0401 and so on.

RESULTSThe level of CD4(-)/CD8(-) is lower in the infection group than in healthy group. But the average level of HLA-DR and HLA-B27 is higher in the infection group. The differences of HLA DRB1 * 07 gene frequency between two groups were significant (P <0.05), but the levels of CD3, CD4, CD8, CD7, CD4/CD8 and HLA DRB1 * 04, DRB1 * 1001, DQB1 * 0401 were not significant.

CONCLUSIONThe failure of HBV vaccination on adults may have relation to HLA-DR, HLA-B27, HLA DRB1 * 07, CD4(-)/CD8(-), etc.

Adult ; HLA-DR Antigens ; genetics ; immunology ; Hepatitis Antibodies ; blood ; Hepatitis B ; genetics ; immunology ; prevention & control ; virology ; Hepatitis B Vaccines ; administration & dosage ; immunology ; Hepatitis B virus ; genetics ; immunology ; Humans ; Phenotype ; T-Lymphocyte Subsets ; immunology

BACKGROUND/AIMS: To evaluate the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for the treatment of symptomatic pancreas divisum (PD) and to discuss whether ERCP procedures and outcomes in younger patients differ from those of adults. METHODS: Symptomatic patients with PD were included in the study and divided into underaged (age ≤17 years) and adult (age ≥18 years) group. The clinical information of each patient was reviewed, and then the patients were contacted by telephone or their medical records were reviewed to determine their long-term follow-up outcomes. RESULTS: A total of 141 procedures were performed in 82 patients (17 underaged and 65 adult patients). The ERCP indications included abdominal pain (39.02%), pancreatitis (12.20%), recurrent pancreatitis (36.59%), and other discomfort (12.20%). The endoscopic interventions included endoscopic pancreatic sphincterotomy in 44.68% of the patients, bouginage in 26.95%, pancreatic ductal stone extraction in 19.15%, endoscopic nasopancreatic drainage in 21.99%, and endoscopic retrograde pancreatic drainage in 56.74%. After a median follow-up of 41 months, the overall response rate was 62.32%. Between the underaged group and the adult group, significant differences were not observed in the ERCP procedures, complications and long-term follow-up results. CONCLUSIONS: ERCP is a safe and effective treatment for symptomatic PD. Based on the details, complications, and follow-up results, the ERCP procedure did not present differences between the underaged and adult groups.
Abdominal Pain ; Adult ; Cholangiopancreatography, Endoscopic Retrograde* ; Drainage ; Follow-Up Studies* ; Humans ; Medical Records ; Pancreas* ; Pancreatic Ducts ; Pancreatitis ; Telephone

To detect chromosome translocation t(11;18) (q21;q21) and the nuclear expression of bcl-10 in gastrointestinal mucosa-associated lymphoid tissue (MALT) lymphoma in Chinese, a possible API2-MALT fusion transcript specific to t(11; 18) (q21; q21) in tumors from 42 cases of primary gastrointestinal lymphoma (29 cases of low grade MALT lymphoma, 13 cases of transformed MALT lymphoma) and 40 cases of diffuse large B cell lymphoma was examined by means of RT-PCR and proved by DNA-sequencing. Bcl-10 expression was examined by immunohistochemical method. The results showed that t(11;18) (q21;q21) was 14% positive in cases of low grade MALT lymphomas and 46% positive in transformed MALT lymphomas, but none in cases of DLBCL. Bcl-10 nuclear expression was seen 61% in low grade MALT and 69% in transformed MALT lymphoma. It was suggested that t(11;18) (q21;q21) was related to the prognosis and development of highly advanced MALT lymphoma but not relevant to DLBCL. Bcl-10 nuclear expressions were not significantly different between these two groups, which remains to be explained.
Adaptor Proteins, Signal Transducing ; B-Cell CLL-Lymphoma 10 Protein ; Carrier Proteins ; analysis ; Cell Nucleus ; chemistry ; Chromosomes, Human, Pair 11 ; Chromosomes, Human, Pair 18 ; Humans ; Immunohistochemistry ; Lymphoma, B-Cell, Marginal Zone ; chemistry ; genetics ; Translocation, Genetic

OBJECTIVETo assess the clinical effects and safety of modified ultrafiltration during pediatric cardiac surgery.

METHODSThe clinical trials were located through electronic searches of the Cochrane Library (Issue 2, 2009), PubMed (1991 to April 2009), EMBASE (1991 to April 2009), China National Knowledge Infrastructure (CNKI, 1994 to April 2009), VIP (1991 to April 2009) and China Biomedicine Database (CBM, 1991 to April 2009), with the languages limited in English and Chinese. In strict accordance with the inclusion and exclusion criteria of the studies, two authors independently evaluated the quality of the included studies. Meta analysis of the studies was conducted using RevMan5.0 software, and the studies that could not be combined was analyzed descriptively.

RESULTSA total of 9 trials involving 587 patients were included. The results showed that compared with the group without ultrafiltration, the modified ultrafiltration group was superior in duration of postoperative mechanical ventilation [MD=-3.66, 95%CI (-6.02, -1.29), P=0.002] and showed no significant differences from the conventional ultrafiltration group [MD=-3.21, 95%CI (-6.90, 0.49), P=0.09]. Compared with balanced ultrafiltration group, the mechanical ventilation time, intensive care unit (ICU) monitoring time and the results of chest drainage in children were similar. Compared with the group receiving conventional or balanced ultrafiltration alone, the combined group of modified ultrafiltration had similar ventilation time [MD=-2.34, 95%CI (-6.74, 2.07), P=0.30] and ICU time [MD=-0.12, 95%CI (-0.31, 0.06), P=0.19]. The included studies reported no ultrafiltration-related complications.

CONCLUSIONModified ultrafiltration improves the clinical outcomes of patients undergoing cardiopulmonary bypass during pediatric cardiac surgery, but the current evidence has not been sufficient to support the notion that the modified ultrafiltration achieves better clinical results than conventional or balanced ultrafiltration.

Cardiac Surgical Procedures ; Cardiopulmonary Bypass ; Child ; Heart Defects, Congenital ; surgery ; Humans ; Information Storage and Retrieval ; Pediatrics ; Randomized Controlled Trials as Topic ; Treatment Outcome ; Ultrafiltration

Objective To analyze the etiologic characteristics of Vibrio cholerae in Guangdong province in 2007.Genetic relationship was observed including among predominated biotype isolates from different areas within the province and among same biotypes isolates from cholera cases and regular surveillance.Methods Isolates from cholera cases and through environmental surveillance were typed by sero-and phage-typings.Similarity of molecular fingerprinting was analyzed through comparing the pulsed field gel electrophoresis(PFGE)pattern of predominated biotype isolates,and those of the same biotype isolates from cholera cases and environment surveillance,respectively.In addition,genetic relationship was determined by clustering analysis,using bionumerics software.Results In total,31 isolates from cholera cases were collected and subtyped for 3 serogroups.V.cholerae O1 El Tor Inaba phage 1d was the predominant biotype which causing most of the cases in Guangdong province in 2007.Data from cluster analysis showed that the similarity among Inaba phage 1d strains from different areas were from 94.5% to 100%.However.16 isolates were collected from environment surveillance programs and the predominated biotype could not be found.Additionally,the biotype distribution of cases isolates was not consistent with those isolates through surveillance.High phylogenetic diversity was observed for the same biotypes isolates from cases and surveillance samples.Conclusion Our data showed that V.cholerae O1 El Tor Inaba phage 1d was the predominated biotype with multi-clone coexisting and circulating in Guangdong province in 2007.It also appeared to be the characteristics of cholera in the non-epidemic period,suggesting that it was necessary to enhance the alert surveillance programs for cholera epidemic based on the molecular typing techniques.

Objective To understand the distribution,molecular characteristics and virulence genes of the O1 and O139 Vibrio cholerae isolates from the Pearl River Estuary water.Methods Vibrio cholerae isolates collected from the Pearl River estuary waters from January 2009 to December 2010,were tested by PCR for eight virulence-related genes,including cholera toxin(ctxA),zonula occludens toxin(zot),accessory cholera enterotoxin(ace),hemolysin(hlyA),toxin-coregulated pilus (tcpA),outer membrane protein(ompU),and the regulatory protein genes(tcpⅠ,toxR).Genetic relation was assessed by pulsed-field gel electrophoresis(PFGE)and the patterns were clustered by BioNumerics.Results From 1152 aquatic samples,69 isolates were identified,including 41 Inaba,18 Ogawa and 10 O139.All the isolates showed ctxA negative,while the hlyA and toxR genes were positive in all the isolates.34.15％(14/41)of the Inaba strains were hlyA + toxR + ompU + ace + zot + tcpI+,while 66.67％(12/18)belonged to Ogawa strains and 70％(7/10)of the O139 strains were hlyA + toxR+.Through PFGE analysis,the O1 isolates formed three clusters in this study.The patterns of O1 isolates differed widely,with the similarity as 72.8％-100.0％,while the patterns of O139 isolates having the similarity of 69.9％-95.5％.Conclusion The non-toxigenic O1 and O139 V.cholerae had a wide distribution in the environment of Pearl River estuary water during the nonepidemic period of cholera.All the aquatic isolates presented diversities on the related virulent genes.

OBJECTIVETo explore the changes of CD(14)(+) monocyte human leucocyte antigen DR (HLA-DR) and their relationship with multiple organ dysfunction syndrome (MODS) in severe sepsis.

METHODSNinety-one patients with a definite diagnosis of severe sepsis in the intensive care unit (ICU) were included. CD(14)(+) monocyte HLA-DR levels were detected by flow cytometry on the first, 4th and 7th days of the study, and Marshall scores and prognosis on day 28 were evaluated.

RESULTSThirty-four patients died within 28 days following the onset with a mortality rate of 37.4%. Persistently lowered levels of HLA-DR were detected and significantly increased Marshall scores were found in the fatal cases at all the time points (P<0.001). In the surviving patients, the levels of HLA-DR were significantly increased (P<0.01) and Marshall scores were gradually decreased (P<0.001). During the observation period, the levels of HLA-DR decreased significantly as the number of dysfunctional organs and Marshall scores increased (P<0.001). The levels of HLA-DR were significantly increased in severe sepsis patients with 2-4 dysfunctional organs and Marshall score of 5-12 (P<0.05 or P<0.001). No changes in HLA-DR levels in severe sepsis patients with 5-6 dysfunctional organs and Marshall scores of 13-22. The levels of HLA-DR showed a significant inverse correlation to Marshall scores (r=-0.368, P<0.001).

CONCLUSIONIn patients with severe sepsis, persistent low CD(14)(+) monocyte HLA-DR levels predicts high mortality. The levels of HLA-DR are significantly correlated to the severity of organ dysfunction.

Adult ; Aged ; Aged, 80 and over ; Female ; HLA-DR Antigens ; metabolism ; Humans ; Lipopolysaccharide Receptors ; Male ; Middle Aged ; Monocytes ; immunology ; metabolism ; Multiple Organ Failure ; pathology ; Sepsis ; immunology ; metabolism