Objective To evaluate the efficacy of endoscopic variceal ligation and somatostatin for esophageal varices bleeding.Methods Eighty patients with hepatic cirrhotic esophageal varices bleeding were allocated into two groups,forty in endoscopic variceal ligation(EVL)group and the others in somatostatin(stilamin)group.Results Initial hemostasis rates(including emergency hemostasis and no bleeding for 72 hours)and one-month rebleeding rates in EVL group and somatostatin group were 97.5% vs 80%(P0.05).The hepatic encephalopathy rates were 2.5% vs 15%(P0.05).Conclusion Endoscopic variceal ligation is superior to somatostatin for hepatic cirrhotic esophageal varices bleeding.EVL can lower the rate of hepatic encephalopathy.

Objective Our retrospective study is aimed to discuss the relationship between the curve changes of T lymphocyte subsets before and after the operation and the infectious complications after radical resec -tion of gastric cancer .Methods Clinical data of patients with gastric cancer received treatment at Central Hospi -tal of Panjin City,Liaoning Province from 2012 to 2014 were retrospectively analyzed .The enrolled patients were divided into two groups according to the infectious complications ,observe group ( patients with infectious complica-tions) and control group ( patients without infectious complications ) .The results of T lymphocyte subsets in two groups were compared .Results A total of 70 patients was retrospective analyzed , including 33 pationts in ob-serve group and 37 pationts in control group.At the 4th day after operation,the levels of CD3,CD4 in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points . At the 4th and 9th day after operation,the levels of CD8,CD4/CD8 rate in the observe group were obviously lower than those in control group .There was no statistical difference at the other time points .Conclusion There is re-markable relationship between the curve changes of T lymphocyte subsets before or after the operation and the in -cidence of infectious complications after radical resection of gastric cancer .

Object To establish the process of purification for ?-linolenic acid from the fruit oil of Camptotheca acuminata Decne.. Methods Complexometry by AgNO 3 was applied. Results The optimal conditions: the AgNO 3 concentration was 4 mol/L, the complexometric temperature was lower than 15 ℃, and the complexometric time was 2 h. The purity of ?-linolenic acid was 91.25%. Conclusion The concentration of ?-linolenic acid from the fruit oil of C. acuminata can reach to 45.8%, therefore it is a new abundant resource for ?-linolenic acid. ?-linolenic acid can be well purified in the fruit oil by this process.

Objective To evaluate the therapeutic effect of early fluid resuscitation under the guidance of pulse indicator continuous cardiac output (PiCCO) on patients with severe acute pancreatitis (SAP).Methods Clinical data of 18 SAP patients (research group),who had undergone fluid resuscitation under the guidance of PiCCO in the Department of Critical Care Medicine of the Second Affiliated Hospital of Anhui Medical University from October 2011 to October 2013,were analyzed prospectively.At the same time,clinical data of 25 cases (control group) that had undergone fluid resuscitation without the guidance of PiCCO from January 2009 to September 2011 were collected retrospectively.The volume of fluid and clinical data were compared between two groups.Results During the first 6 hours,0-24 hours,24-48 hours,and 0-72 hours after intensive care unit (ICU) admission,the research group received larger volume of fluid than that of the control group (mL:2 133 ± 1 593 vs.1 024 ± 421,t=3.337,P=0.002; 5 960 ±2 951 vs.3 767 ± 854,t=3.531,P=0.001; 4 709 ± 1 508 vs.3 863 ± 1 122,t=2.112,P=0.031 ; 14 601 ± 5 095 vs.11 409 ± 2 667,t=2.673,P=0.007).Compared with the control group,the incidence of application of blood purification was lowered [5.56％ (1/18) vs.44.00％ (11/25),x2=7.688,P=0.006],the duration of the systemic inflammatory response syndrome (SIRS) was shortened (days:3.54 ± 2.44 vs.5.62 ± 3.62,t=2.113,P=0.041),acute physiology and chronic health Ⅱ (APACHE Ⅱ) score was significantly declined at 24 hours after admission (11±4 vs.14 ± 5,t=2.104,P=0.042),the blood lactic acid was decreased more significantly after 72 hours (mmol/L:3.10 ±0.55 vs.2.40 ± 1.12,t=2.442,P=0.019),and the length of ICU stay was shortened (days:10 ±9 vs.20 ± 10,t=3.371,P=0.002) in research group.But there was no significant difference in the percentage of the use of vasoactive drugs [16.67％ (3/18) vs.24.00％ (6/25),x2 =0.340,P=0.560],the incidence of invasive mechanical ventilation [50.00％ (9/18) vs.52.00％ (13/25),x2 =0.017,P=0.897],72-hour urea nitrogen changes (mmol/L:-0.33 ± 4.71 vs.-0.09 ± 5.37,t=0.152,P=0.880),and the percentage of abdominal infection [16.67％ (3/18) vs.16.00％ (4/25),x2=0.003,P=0.953] between research group and control group.The mortality in research group was lower than that in control group [5.56％ (1/18) vs.20.00％ (5/25)] without statistical difference (x2=1.819,P=0.178).According to the 2012 Atlanta classification,patients were re-evaluated after 48 hours fluid resuscitation.Six patients in research group developed moderately severe acute pancreatitis,and the incidence was significantly higher than that in control group [33.33％ (6/18) vs.8.00％ (2/25),x2=4.435,P=0.034].The time of mean PiCCO installation was 4.5 days in 18 cases of the research group,and no related complications occurred.Conclusions The PiCCO device may be a useful adjunct for fluid resuscitation monitoring in patients with SAP within 72 hours.Early fluid resuscitation under the guidance of PiCCO may be helpful in improving tissue perfusion,reducing the application of blood purification,as well as shortening length of ICU stay.This program did not increase the risk of invasive mechanical ventilation,and no obvious change in mortality rate was observed.

Objective To observe the effect of apolipoprotein E mimetic peptide (ApoE23) on lipopolysaccharide (LPS) levels in plasma and the regulatory role of ApoE23 on low density lipoprotein receptor (LDLR) on liver cells in the septic mice.Methods An ApoE mimetic peptide was designed and referred terminologically as ApoE23 in abbreviation.ApoE23 was synthesized by using solid phase synthesis assay and were refined by using high performance liquid chromatography (HPLC).The peptide was identified and confirmed by using electron spray ionization mass spectrometry and amino acid composition analysis.The C57BL mice infected with Salmonella typhimurium group B were treated with apoE23 injected into tail vein.The plasma LPS levels were measured by using immunoturbidimetry.The LDLR expression and level on liver cells were measured by real time PCR and western blot respectively.Results The plasma LPS levels significantly increased and the liver LDLR expression decreased in the septic mice.ApoE23 treatment markedly reduced the plasma LPS levels and redressed the LDLR down-expressions on liver cells both in mRNA and protein levels compared to the septic mice without ApoE23 treatment.Conclusions The reduction of LPS level after ApoE23 treatment may be associated with the modulation role of ApoE23 in LDLR expression on liver cells,and ApoE23 may be a potential agent against bacterial sepsis as well.One of possible mechanisms was most likely associated with effect of ApoE23 on LDLR expression.

Objective: To clone the Fab gene of a monoclonal antibody (mAb) BDI against human bladder cancer and its expression in E. coli. Methods: Fd and K genes of mAb BDI were cloned by RT-PCR and inserted into an Fab expression vector. Phage displaying Fab and soluble Fab were expressed in E. coli. The N-terminal sequence of VH region was corrected by PCR mediated mutagenesis. The antigen-binding characteristics of the Fab were tested by ELISA and immu-nohistochemistry. Results: Fd and K genes were cloned into the expressing vector p3MH and the phage displaying antibody and soluble Fab were expressed in E. coli, which showed weak binding activity to bladder cancer cells. Correction of the N-terminal sequence of the VHimproved the biding activity dramatically. The feasibility of the application of the Fab in phage antibody library screening was confirmed by a simulated panning procedure. Conclusion: The Fab gene of an anti-human bladder cancer mAb was expressed in E. coli. The importance of the N-terminal sequence on antibody binding activity was suggested.

Objective To evaluate the safety and effectiveness of bedside nasointestinal nutritional tube insertion with specific guiding techniques in critically ill patients.Methods Critically ill patients who could not take oral or gastric feeding were collected from September 1st, 2013 to September 10th, 2015 in Intensive Care Unit of The Second Hospital of Anhui Medical University.In these patients, bedside nasointestinal tube insertion was performed according to the relevant standard operating procedure in our department, and guiding technique was chosen based on patients' clinical characteristics.Operation time, position of tube tip and complications associated with the bedside operations were recorded for retrospective analysis.Results A total of 21 patients were collected in this study, in whom 23 bedside insertions were preformed.In 21 insertions (91.3％), the tip of the tube was successfully inserted across the transpyloric plane;and in 20 insertions (87.0％), 10 cm distal to the ligament of Treitz.The average operation time was (14.10 ± 1.80) min.The average cost was (297.01 ± 35.26) yuan.No severe complications were occurred.Conclusions The bedside nasointestinal feeding tube insertion without visual guiding is simple, safe, low-cost, and of high success rate.It may be a good choice for establishing enteral nutrition channel in order to implement early enteral nutrition in patients unable to take oral or gastric feeding.

BACKGROUND:Cel co-culture can maximize the simulation ofin vivomicroenvironment. Cel scratch test and interleukin-1β can destroy the balance between matrix metaloproteinases (MMPs) and matrix metaloproteinase inhibitors (TIMPs), resulting in extracelular matrix degradation of the articular cartilage, functional disorders of chondrocytes and articular cartilage degeneration. OBJECTIVE:To study the effect of interleukin-1β on migration, MMP and TIMP expression of chondrocytes co-cultured with osteoblast supernatantin vitro. METHODS:There were three groups: chondrocyte monoculture group, osteoblast+chondrocyte group (co-culture group), osteoblast+chondrocyte+interleukin-1β group (interleukin-1β group). Cel scratch test was conducted to observe the migration of chondrocytes within 24 hours. Semi-quantitative PCR test was used to detect the changes in expressions of MMP-1, MMP-2, MMP-3, MMP-9, TIMP-1, TIMP-2, TIMP-3, TIMP-9 in chondrocytes within 24 hours. RESULTS AND CONCLUSION:Compared with the monoculture group, cel migration rate of the other two groups were increased significantly (P< 0.01). Compared with the monoculture group, the gene expressions of MMP-1, MMP-2, MMP-3 and MMP-9 were increased significantly in the coculture group (P < 0. 05); the gene expressions of MMP-1, MMP-3, MMP-9 were increased significantly in the interleukin-1β group (P< 0. 01). Compared with monoculture group, the gene expression of TIMP-1 was increased significantly (P < 0. 01), but the gene expressions of TIMP-3 and TIMP-4 were declined significantly (P < 0. 05) in the other two groups. These findings indicate that co-culture of chondrocytes with osteoblasts can promote chondrocytes migration, enhance gene expression of chondrocytes MMP-1, MMP-2, MMP-3, MMP-9 and regulate gene expression of TIMPs family. Interleukin-1β inhibitsthe migration of chondrocytes co-cultured with osteoblasts and gene expression of TIMPs family.

AIM:To investigate the effects of pioglitazone on the quantity and function-related factors of regu-latory and effector T cells ( Treg and Teff ) of uremic apolipoprotein E knockout mice in vitro with or without the stimulation of atherosclerotic plaque-specific antigen oxidized low-density lipoprotein ( oxLDL) .METHODS:Uremic apolipoprotein E knockout mouse model was established by 2-step surgical procedure.After intervention with different concentrations ( 2μmol/L and 20μmol/L) of pioglitazone and PPARγantagonist GW9662 (5μmol/L) on splenocytes of uremic mice for 12 h in the presence or absence of oxLDL (2 mg/L), the levels of CD4 +CD25 +Foxp3 +Treg and IFNγ+CD4 +Teff were de-termined by flow cytometry.The mRNA expressions of Foxp3 and IFNγwas detected by real-time fluorescent quantitative PCR.RESULTS:In vitro, oxLDL induced a Treg/Teff imbalance in splenocytes from the uremic mice.Pioglitazone up-regulated the level of Treg and mRNA expression of Foxp3 in the presence of oxLDL, which was not antagonized by GW9662.Meanwhile, pioglitazone downregulated the level of Teff and mRNA expression of IFNγin the presence or ab-sence of oxLDL, which was reversed by GW9662.CONCLUSION:oxLDL induces a Treg/Teff imbalance in uremic apo-lipoprotein E knockout mice.Pioglitazone modulates the Treg/Teff imbalance probably through PPARγ-independent and-dependent mechanisms.

Objective To assess the safety and feasibility of CT-guided percutaneous argon-helium cryoablation in the treatment of adrenal tumors.Methods 1 7 patients with adrenal tumors were treated with CT-guided percutaneous argon-helium cryoablation. Three of these patients were retreated second cryoablation three months later due to the lager tumor diameters.Percutaneous tran-scatheter arterial embolization was performed in four patients because of rich blood supply before cryoablation.Continuous arterial blood pressure monitoring was performed in eight pheochromocytoma patients.Results Technical success was achieved in all pa-tients.There were no serious complications.Eight pheochromocytoma patients experienced a significant increase in systolic blood pressure and diastolic pressure when compared with the basic values (P <0.05).There were no enhancement on enhanced CT and/or up-take on FDG PET-CT in the ablated zones during the follow-up period (3-24months).Conclusion It is safety and efficacy of CT-guided percutaneous argon-helium cryoablation for adrenal tumor.It might be initial treatment of choice for the patients who were not suitable for resection.