Objective To evaluate the association between cytomegalovirus (HCMV) infection and atherosclerosis (AS) and explore the possible role of endothelin (ET) and serum tumor necrosis factor(TNF ?) in the pathogenesis of AS in diabetic patients and the relationship between HCMV infection and concentrations of ET and TNF ?. Methods Blood samples were collected from 21 patients with AS of type 2 DM, 47 patients with non AS of type 2 DM and 20 controls. Special antibodies to HCMV (IgM,IgG) were measured by enzyme linked immunosorbent assay (ELISA) . The concentrations of serum TNF ? and plasma ET were determined by RIA. Results (1) Type 2 diabetic patients, especially those with established AS, had a higher prevalence of active infection of HCMV. (2) The levels of plasma ET and serum TNF ? in type 2 diabetic patients were higher than those in normal people. In the pathogenesis of AS in diabetic patients, the ET played more important role than the TNF ?.(3) There was a significantly positive correlation between anti IgM to HCMV and the level of plasma ET in type 2 DM patients. It suggested that the injury of endothelium cell was related to the active infection of HCMV. Conclusion The study suggests that HCMV infection may be important in the pathogenesis of AS in type 2 diabetic patients and ET possibly plays an important role on the pathological course of AS.

Objective To study the application of SLINKY technique in MRA of head and neck by comparison of four TOF MRA methods. Methods We obtained images on 21 patients and 5 volunteers with SLINKY on all the 26 cases, MOTSA on 18 cases, single volume on 16 cases, and 2D on 12 cases. Three experienced radiologists evaluated the images, unknowing which method the images were. The evaluations included clearness of vessel branches, smoothness of vascular wall, and vascular continuity. Signal-to-noise (SNR), contrast-to-noise (C/Ns), and scan time were measured. Results SLINKY displayed vessel branches better and had better smoothness of vascular wall and vascular continuity than the other three methods(P

OBJECTIVE To investigate the diagnostic and prognostic value of molecular biological detection of DTC in peripheral blood. METHODS 32 cases of laryngeal or laryngopharyngeal carcinoma were investigated. DTC in peripheral blood was detected by nested reverse transcription polymerase chain reaction,using CK19mRNA as the marker. RESULTS In the RT-PCR study,15 of 32 cases (46.9 %) showed a positive result. Ten of the 25 cases (40 %) of laryngeal carcinoma were positive. Fix of the remaining 7 cases (71.4 %) of laryngopharyngeal carcinoma were positive. All controls were negative. Of the 20 cases without lymph node metastasis,6 were positive; of the 12 cases with lymph node metastasis,9 were positive. The positive rate of the group with lymph node metastasis was higher than that of the group without lymph node involvement(P

Objective To investigate the effect of acellular dermal matrix (ADM) for abdominal closure to prevent abdominal high pressure after intestinal transplantation.Method ADM was used for abdominal closure following intestinal transplantation in a 17-year-old man with ultra-short bowel syndrome.Two ADMs with 12 cm 20 cm were reconstituted intraoperatively with warm sterile normal saline.After flattened under peritoneum,the ADM was pruned and then sewn to the muscular layer of abdominal wall by interrupted transfixing suture with absorbable suture.A negative pressure drainage tube was placed over an area of native fascia in the subcutaneous space.Skin and soft tissues were closed by interrupted suture.Result The intra-abdominal pressure was not higher than 7 cmH2O 90 h post-operation.The ventilator has been withdrawn 18 h after operation.Enternal nutrition was given from postoperative day 6.He required surgical exploration for abdominal abscess on the postoperative day 19.The ADM closely adhered to the abdominal wall and no abscess in abdomen was related to ADM.Conclusion ADM can be safely used for abdominal closure and effectively prevent intraabdominal high pressure in this intestinal transplantation.No infection or graft loss occurred in the early postoperative period.More observations are needed to study the long-term results and complications in the future.

Objective To investigate the clinical efficacy of laparoscopic surgery for pelvic radiation induced enteritis (PRIE).Methods The retrospective cross-sectional study was conducted The clinical data of 66 patients with PRIE who were admitted to the Nanjing General Hospital of Nanjing Military Command from January 2012 to December 2015 were collected.Laparoscopic surgery will be applied to patients based on patients' clinical manifestations after completing relative examinations.Observation indicators:(1) surgical situations:surgical method,conversion to open surgery,reoperation,surgical incision length,grade of abdominal adhesions,surgical time,volume of intraoperative blood loss,duration of postoperative hospital stay;(2) occurrence of surgical complications;(3) follow-up situations.Follow-up using telephone interview was performed to detect patients' survival and recurrence of PRIE up to April 2016.Measurement data with normal distribution were represented as x±s.Results (1) Surgical situations:① of 59 patients with small intestinal obstruction,11underwent laparoscopic small intestinal resection or enterostomy,including 2 with conversion to open surgery due to dense adhesions,1 due to uncertainty of tumor recurrence and 1 due to intestinal canal dilatation affected vision;48 underwent laparoscopic resection of ileocecum,including 1 1 with conversion to open surgery due to dense adhesions,2 due to iliac vessels injury and 4 due to injuries of sigmoid colon,rectum and bladder.Four patients with colonic obstruction and proctitis underwent laparoscopic colostomy,without conversion to open surgery.One patient received conversional open surgery and underwent intestinal resection of internal fistula + exclusion of rectal stump due to intestine-rectum fistula induced dense adhesions.One patient with anal atresia underwent laparoscope-assisted resection of pelvic tissues and rectal stump.One patient with localized peritonitis underwent laparoscope-assisted ileostomy.② Among 66 patients,4 received reoperations,including 2 with cervical cancer and 2 with rectal cancer,reoperations of 4 patients were respectively caused by intestine-rectum fistula,rectovaginal fistula,anastomotic fistula and ostomy + stoma reversion.Of 4 patients with reoperations,1 received conversion to open surgery due to dense adhesions and then underwent intestinal resection of internal fistula+exclusion of rectal stump,1 with rectovaginal fistula underwent laparoscopic colostomy,1 with anastomotic fistula underwent resection and anastomosis of small intestine due to dense adhesions and 1 underwent laparoscopic ileostomy and stoma reversion.③ Sixty-six patients received 70 operations,including 46 laparoscopic surgeries and 24 conversion to open surgeries.Surgical incision length and average length were respectively 3.0-6.0 cm,4.0 cm in 46 laparoscopic surgeries and 8.0-25.0 cm,15.5 cm in 24 conversion to open surgeries.Grade 0,1,2 and 3 of abdominal adhesions were detected respectively in 7,13,13,13 laparoscopic surgeries and in 1,1,12,10 conversion to open surgeries.Operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were respectively (128±50) minutes,(108±56) mL,(30± 15)days in 46 laparoscopic surgeries and (173±44) minutes,(222± 105) mL,(38± 19) days in 24 conversion to open surgeries.(2) Occurrence of surgical complications:1 patient was complicated with bladder injury in 46 laparoscopic surgeries,and 2,4 and 2 patients in 24 conversion to open surgeries were respectively complicated with bladder injury,colorectal injury and injury of right iliac vessels,they received intraoperative symptomatic treatment.Two,3,3,6 and 1 patients were respectively complicated with pleural effusion,wound infection or dehiscence,venous catheter infection,anastomotic fistula and cholestatic cholecystitis after 46 laparoscopic surgeries.One,5,1,4,2 and 1 were respectively complicated with pleural effusion,wound infection or dehiscence,venous catheter infection,anastomotic fistula,cholestatic cholecystitis and abdominal wall hemorrhage after 24 conversion to open surgeries.They were improved by symptomatic treatment.(3) Follow-up situations:all the 66 patients were followed up for 4-50 months,with a median time of 26 months.During the follow-up,3 patients died of intraperitoneal infection,short bowel syndrome and pulmonary infection,and 3 patients had PRIE.Conclusion The appropriate surgical method is selected based on clinical manifestations of patients,and laparoscopic surgery is safe and feasible for PRIE.

Thirteen compounds were isolated from the ethyl acetate fraction of Crepis crocea by column chromatographies on silica gel, Sephadex LH-20 and semi-preparative HPLC. The structures were elucidated on the basis of spectral analysis as tectorone I (1), 8β- (2-methyl- 2-hydroxy-3-oxobutanoyloxy) -glucozaluzanin C (2), tectoroside (3), luteolin-7-O-glucoside (4), cosmosiin (5), esculetin (6), 3,4-dihydroxybenzaldehyde (7), trans-4-hydroxycinnamic acid (8), Caffeic acid (9), methyl p-hydroxyphenyllactate (10), ethylp- hydroxyphenyllactate (11), cis-3,4-dihydroxy-β-ionion (12). All the compounds, except for compounds 4 and 9, were isolated from this plant for the first time, and tectorone I (1) is a new natural product.
Crepis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Mass Spectrometry ; Molecular Structure

Objective To study the changes in the immune function of advanced hepatic carcinoma patients after thermochemoembo-lization via hepatic artery. Methods Forty advanced hepatic carcinoma patients were randomized divided into 2 groups. A group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 37℃ 9% sodium chloride solution via hepatic artery, and B group (n=20) was treated by perfusion with ADM(40mg) + MMC(10mg) in 60℃ 9% sodium chloride solution via hepatic artery, then all were embolized with some quantity of lipiodol. Flow cytometry (FCM) was used to detect the changes in percentages of T-lymphocyte subsets (CD3<'3, CD4<'+, CD8<'+) and NK cells, and the contents of soluble interleukin-2 receptor (sIL-2R) were detected by double sandwich ELISA before and after therapy. LDH enzyme-release assay was used to detect cytotoxic activity of NK cells. Results Compared with pre-therapy group or A group after therapy, the percentage of CD4<'+ cells of B group after therapy significantly increased (P<0.05), the percentages of CD8<'+ cells and the content of sIL-2R of B group after therapy markedly decreased (P<0.05). The percentages of NK cells and cytotoxic activity NK cells of B group after therapy were significantly higher than those from pre-therapy group or A group (P<0.05). Conclusion Intra-arterial thermochemoembolization may activate and improve cell-mediated immune function with a certain degree.

Objective To study the significance of No12 lymphadenectomy in patients of advanced distal gastric cancer undergoing D2 distal or total gastrectomy.Methods Clinical and pathological data of 193 distal gastric cancer cases undergoing D2 gastrectomy and No12 lymphadenectomy during Jan 2012 and Jan 2013 were analyzed retrospectively.Results In Borrmann Ⅲ,Ⅳ No.12a LN metastasis was significantly higher than that in Borrmann Ⅰ,Ⅱ (x2 =4.841,P =0.028).In cases of multiple cancer 12a LN metastasis was significantly higher than that in gastric angle,gastric antrum (11.1％ 、9.7％ 、30.4％).High-differentiated cancer was lower in LN metastasis than that of low differentiated both in No.12a group (x2 =4.292,P =0.038),and in No.12b group (x2 =4.079,P =0.043).In cases with serosal invasion LN metastasis was higher than that without infiltration both in No.12a group (x2 =8.107,P =0.004),and in 12b group (x2 =3.836,P =0.050).In cases of N 0 ～ 1 the LN metastasis was lower than that in N 2 ～ 3 in 12a group (x2 =10.960,P=0.001),12b group (x2 =4.989,P =0.026),and in 12p group (x2 =4.433,P =0.035 respectively).In cases of tumor diameter ＜3 cm,3 ～5 cm and ＞5 cm,the 12a lymph node metastasis rate was 4.2％,10.0％,and 29.2％,respectively.Tumor size ＞ 5 cm has higher metastasis rate in No.12a group (x2 =6.464,P =0.011).Conclusions No.12 lymphadenectomy should be included routinely in D2 gastrectomy in patients of distal gastric carcinoma.

Objective To investigate the expression of the ternary complex factor Net in human pancreatic carcinoma cell line BxPC3 and its effect on cell proliferation and the expression of c-fos.Methods pEGFP-Net prokaryotic expression plasmid and empty vector pEGFP were transfed into BxPC3 cens by using lipofectamine 2000,then monoclonal cell which stably expressing Net was established.Human pancreatic carcinoma cells proliferation was detected by MTT and flow cytometry.The tuRNA and protein expression of Net and c-fos in BxPC3 cells were detected by real.time PCR and Western blot.Results Net was low expressed in BxPC3 cells.After pEGFP-Net transfection,Net wag stably expressed and the expression of c-fos was inhibited,cell proliferation was also inhibited after pEGFP-Net transfection,the inhibitory rates at the 3rd, 5th,7th day was 38.81%,55.34%and 56.92%respectively,which were significantly higher than those in the empty vector group(5.09%,12.42%,8.6%,P<0.05).G_0/G_1 phase cell was(61.79±5.67)%,which were significantly higher than(45.14±3.37)%in the empty vector group(P<0.05).Conclusions The ternary complex factor Net could inhibit pancreatic carcinoma cell line BxPC3 proliferation.Its mechanism was possibly repressing expression of oncogene c-fos.

Objective To evaluate the preliminary outcome of cannulated screw internal fixation in treatment of the tarsometatarsal joint injuries.Methods From January 2005 to October 2010,21 patients(14 males and 7 females)with the tarsometatarsal joint injuries were treated.Their age ranged from 21 to 62 years(average 38.2 years).According to anatomical three-column classification,there were four patients with single medial column injury,four with medial and middle column injuries,three with middle and lateral column injuries,two with single lateral column injury and eight with three column injuries.The injury causes included traffic injury in nine patients,machine injury in eight and fall from height injury in four.The period from injury to admission was 2-15 hours(mean 5 hours).During operation,open reduction was performed,followed by internal fixation with the cannulated screw.X-ray examination was done in the regular follow-up and function was evaluated by using Maryland scoring system.Results Of all,19 patients were followed up for 4-47 months(mean 20 months),which showed no infection,loosing or breakage of the internal fixation.According to the Maryland scoring system,the clinical outcome was rated as excellent in eight patients,good in seven,fair in two and poor in two,with excellence rate of 79％.Conclusions The three-column theory plays an important role in clinical diagnosis and therapy of the tarsometatarsal joint injuries.Open reduction and cannulated screw internal fixation may attain satisfactory clinical results in treatment of the tarsometatarsal joint injuries.