Objective To evaluate the impact of endoscopic sphincterotomy (EST) and bile duct exploration with open surgery on immune function and inflammatory response.Methods Fifty-one patients with choledocholithiasis were divided into endoscopy group ( EG,n =24) and laparotomy group ( LG,n =27 ) according to the patients' will from June 2010 to February 2012.Procalcitonin( PCT),C-reactive protein (CRP),immunoglobulins (IgA 、lgG 、IgM ) and T lymphocyte (CD4、CD8 ) of peripheral blood were examined preoperatively and on the 1st,3rd and 5th day postoperatively.Results Compared with preoperative levels,postoperative levels of serum PCT and CRP were higher in both groups (P ＜0.01 ),but on the 3rd day after the operation,the changes of PCT and CRP levels in the two groups were not significantly different ( P ＞ 0.05 ).Postoperative levels of serum immunoglobulins of two groups were lower than preoperative levels (P ＜ 0.01 ),but the IgA and IgM levels in EG were significantly higher than those in the LG (P ＜ 0.05),and IgG levels in the two groups were not significantly different after surgery ( P ＞ 0.05 ).Compared with preoperative levels,postoperative levels of CD4,CD8 and CD4/CD8 ratio in EG were only slightly decreased (P ＞ 0.05 ),and returned to the preoperative levels on the 5th day postoperatively,but postoperative levels of these variables in LG were decreased significantly ( P ＜ 0.05).Postoperative levels of CD4,CD8 and CD4/CD8 ration of the two groups were significantly different (P ＜ 0.05).Conclusion Both EST and bile duct exploration with open surgery can inhibit immune function and induce inflammation,but the procedure of EST,which may mainly affect humoral immune function,has impact on immune function less intensely.

Objective To explore the efficacy and safety of terminating biochemical pregnancy (the stage in which intrauterine or ectopic pregnancy cannot be confirmed) with mifepristone and misoprostol. Methods Mifepristone (150 mg) combined with misoprostol (600 ?g) 3 days later were given to 500 biochemical pregnancies (G_1),500 early clinical pregnancies (G_2) and 500 clinical pregnancies (G_3) which were classified according to amenorrhea days,serum human chorionic gonadotropin-beta subunit (?- hCG) and vaginal B-ultrasonic examinations.All were observed for 6 hours after taking misoprostol and returned for assessment per week.Results Expulsion of conceptus was G_1 123 (24.6%,123/500),G_2 438 (87.6%,438/500) and G_3 467 (93.4%,467/500).Failure rate was G_1 6 (1.2%,6/500),G_2 24 (4.8%,24/500) and G_3 79 (15.8%,79/500) for ongoing pregnancies,hospitalizations for suspected ectopic pregnancies and surgical intervention for heavy or long-time bleeding.Bleeding cases during the administration of mifepristone were G_1 272 (54.4%,272/500),G_2 141 (28.2%,141/500) and G_3 87 (17.4%,87/500);the mean bleeding days were G_1 (5.8?1.5),G_2 (9.0?2.9) and G_3 (14.3?5.9) days.Other side effects including abdominal pain,nausea,vomiting and diarrhea were low and light in each group,increasing with advancing gestational age.Menses recovery was 486 (97.2%,486/500),452 (90.4%,452/500) and 433 (86.6%,433/500) for each group on scheduled time.Satisfaction was 499 (99.8%,499/500),485 (97.0%,485/500) and 369 (73.8%,369/500) respectively.Conclusion Mifepristone and misoprostol in combination is as safe,and effective for termination of biochemical pregnancies as ordinary medical abortion.It does not need to wait till ectopie pregnancy is excluded.

Acute Disease ; Administration, Inhalation ; Animals ; Disease Models, Animal ; Hypertension, Pulmonary ; drug therapy ; Male ; Nitric Oxide ; administration & dosage ; therapeutic use ; Nitrites ; administration & dosage ; therapeutic use ; Rats ; Rats, Sprague-Dawley

Animals ; Brain ; metabolism ; physiopathology ; Brain Ischemia ; genetics ; metabolism ; pathology ; Gene Expression ; Male ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase ; genetics ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To investigate the effect of parthenolide ( PTL) and PKC inhibitor on human gastrointestinal stromal tumor (GIST) cell proliferation and apoptosis and the mechanism involved .Methods Human GIST cell lines were cultured in vitro, and the cell proliferation rate of GIST , was determinate by MTT;flow cytometry was used to test the early apoptosis rate of GIST;Western blot assay was applied to detect the expression of endoplasmic reticulum stress-related proteins , GRP78 and GADD153.There were four groups: control group , PTL group, PKC inhibitor group , combine PTL and PKC inhibitor group .Results PTL and PKC inhibitor combination therapy for GIST was sig-nificantly more effective than a single-drug therapy (P<0.05);as for the early apoptosis rate , the combination ther-apy for GIST cells was significantly higher than that medication alone group (P<0.05).the expression of endoplas-mic reticulum stress-associated protein GRP 78 and GADD153 was obviously higher in PTL and PKC inhibitor combi-nation group than that in medication alone group (P<0.05).Conclusions PTL and PKC inhibitor combination therapy for GIST cells can induce apoptosis , which is possibly mediated via endoplasmic reticulum stress pathway .

Objective To explore the differences of memory functions and objective sleep parameters and their correlations in patients with insomnia disorder in different subtypes.Methods Eightynine patients with insomnia disorder,including 11 patients with difficulty initiating sleep(DIS),20 patients with early morning awakening(EMA),20 patients with difficulty maintaining sleep (DMS) and 38 patients with mixed sleep symptoms(MS) were enrolled between August 2012 and February 2014 in the Memory and Sleep Disorders Clinic of the First Affiliated Hospital of Anhui Medical University.Memory functions,including objective memory,spatial memory,working memory and reference memory were detected with nine boxes maze,and objective sleep profiles were assessed using polysomnography.Results The error numbers of spatial(H =15.404,P =0.002) and working (H =10.126,P =0.018) memories were significantly different among the 4 subtypes of patients,with more errors of spatial and working memory in the EMA (6.00 (5.00,8.00),5.00 (4.00,6.00)) and MS (5.00 (3.75,7.25),5.00 (2.75,7.00)) groups compared with the DMS (2.50 (2.00,4.00),2.00 (1.00,4.00)) group (tspstial =3.938,3.428;t =2.803,2.840;all P ＜ 0.05).Sleep efficiency(H =7.929,P =0.048),REM sleep time(F =2.840,P =0.043) and the percentage of REM sleep time on total sleep time (REM％;H =7.913,P =0.048) were also significantly different among the 4 subtypes of patients,with lower sleep efficiency in the MS(69.7％ (50.5％,78.7％)) group compared with the EMA (81.0％ (64.8％,86.4％)) and DMS (80.2％ (62.6％,88.9％)) groups (t =2.242,2.352;all P ＜ 0.05),less REM sleep time (min) and REM％ in the EMA(61.6 ±27.1,16.9％ (13.1％,21.9％)) and MS(56.9 ±31.4,16.9％ (11.5％,21.2％)) groups compared with the DMS (80.9 ± 32.7,22.3％ (18.5％,25.5％)) group (qREM time =3.791,5.397;tREM％ =2.513,2.612;all P ＜0.05).The error numbers of working memory and spatial memory negatively correlated with the REM sleep time (r =-0.387,-0.348;all P ＜ 0.05) and REM％ (r =-0.350,-0.354;all P ＜ 0.05).Conclusions There are discrepancies in the spatial and working memories and subtle differences in the objective sleep parameters among the patients with different subtypes of insomnia disorder.The worse memories in insomnia disorder patients might be associated with the decreased REM sleep.

Objective To evaluate the feasibility,safety and efficacy of laparoscopic appendectomy for acute appendicitis with previous abdominal surgery.Methods The clinical data of 253 patients with acute appendicitis undergoing laparoscopic surgery was retrospectively studied from Feb.2009 to Jun.2012,including 177 patients without previous abdominal surgery (no previous abdominal surgery group,NPAS group),76 patients with previous abdominal surgery (previous abdominal surgery group,PAS group).Parameters studied were conversion rates,operation time,blood loss,complications rate,length of hospital stay and the intestine function recovery time between two groups.Results The conversion rates were no significant difference between NPAS group and PAS group.The operation time of NPAS group and PAS group was (40.5 ± 12.3) minutes and (62.6 ± 14.2) minutes (P ＜0.05).The blood loss,intestine function recovery time,complications rate,and length of hospital stay were no significant minutes between NPAS group and PAS group after operation (P ＞ 0.05).Conclusions Previous abdominal surgery prolongs the operation time of laparoscopic appendectomy,but history of abdominal surgery has no significant effect on laparoscopic surgical outcome,which may indicate that laparoscopic surgery for acute appendicitis with previous abdominal surgery is safe and effective and still has the adventages of less trauma,faster recovery.

Many patients suffering from insomnia,especially chronic insomnia are treated by hypnotics.While taking hypnotics for long time will lead to drug dependence.How to fulfill gradual reduction of hypnotics has become one of the big problems doctor meet clinically.Drug dependence can be classified into two aspects.One is psychological,the other is pathological.Psychological treatment has advantage in the procedure of reducing drug.Thought imprint psychotherapy under lower resistance (TIP) which combines traditional Qigong,relaxation and cognitive-behavioral therapy of modern clinical psychology is a psychotherapy fit for Chinese.TIP techniques used during reduction procedure of hypnotics have been improved.

BackgroundHigh myopia is one of leading causes of blindness,so far the pathogenesis remains unclear.Two single-nucleotide polymorphisms (SNPs) of rs6885224 and rs12716080 in CTNND2 gene were recently found to be associated with high myopia in Singaporean Chinese.But whether these SNPs are related with the pathogenesis of high myopia in Han Chinese is worth studying,Objective This study was to investigate the relationship between the genetic variations of the CTNND2 gene and high myopia in Han Chinese.MethodsA case-controlled association study was designed.Nine hundred and thirty-three individuals with high myopia and 1227age- and gender-matched normal subjects were included in this study.The 5 ml of periphery blood was obtained from all subjects for the extraction of genomic DNA.The target DNA was amplified using PCR and purified by the SNaPshot method.Four SNPs rs12716080,rs917012,rs6885224 and rs16901340 in the CTNND2 gene were genotyped.This study was approved by the Ethic Committee of Sichuan Provincial People Hospital.Written informed consent was obtained from each subject before his/her enrollment.Results The frequencies of the genotypes rs6885224,rs12716080,rs917012,rs16901340 SNPs were in Hardy-Weinberg equilibrium (HWE) ( P=0.181,0.085,0.732,0.313,0.264,0.663,0.084,0.196).There were no significant differences in genotypes frequency distribution ( in turn P =0.654,0.406,0.828,0.403 ) and allele frequency distribution of the CTNND2 gene ( in turn P =0.377,0.209,0.743,0.198) between the high myopia group and normal control group.The haplotypes (TA and GA)frequencies of rs12716080 and rs917012 in the high myopia group were significantly different from those of the normal control group(TA:0.784 vs.0.719;GA:0.087 vs.0.136) (x2 =6.115,P=0.013 ;x2 =6.634,P=0.010),but those of GG were similar between the high myopia group and normal control group ( 0.123 vs.0.143,x2 =0.889,P =0.346). ConclusionsThe SNPs rs12716080,rs917012,rs6885224 and rs16901340 in CTNND2 gene were not responsible for high myopia,however,the haplotypes of rs12716080 and rs917012 are susceptible for high myopia in Han Chinese.

Objective To investigate the antiproliferation and induction differentiation of human gas- tric carcinoma which human gastric lower-differentiation mucinous carcinoma MGC-803 cells transplanted in- to nude mice by using rosiglitazone(ROS),and to preliminarily explore the mechanism of differentiation. Methods The mice were randomly divided into five groups:model,ATRA,ROS 25 mg?kg~(-1),ROS 50 mg/kg, ROS 100 mg/kg.After that the volumes were measured and inhibition rates were calculated.The cell cycle was detected by FCM.The protein expression level of Mucin SAC was detected by immunohistochemistry. Results The volume of tumor decreased significantly in ROS treatment groups,the differences had statistical significance compared with model group(P0.05).The xenograft tumors of ROS groups demonstrated the characteristics of differentiation.Xenograft tumor cells were arrested in G_0/G_1 phase,and the cells in S phase decreased significantly,and up-regulated Mucin SAC gene expression.Conclusion ROS could inhibit the growth of tumor,and the effect were dose-dependent with ROS.ROS could induce the differentiation of Xenograft tumor cells of gastric cancer.Its mechanism might be related to the inhibit of transition from G_1 to S phase,degrade the activity of proliferation,regulate the expres- sion of Mucin 5AC.