Objective To investigate the feasibility of hand-assisted laparoscopic liver resection without hand-port devices. Methods Eight patients were selected into the study, including 5 cases of primary liver cancer located at the segment Ⅳ or Ⅴ or the left lateral lobe, 2 cases of liver spongy hemangioma and 1 case of hepatic focal nodular hyperplasia. After the laparoscopic devices were set up, an oblique incision below the right costal margin was made. The length of the incision was the same as the operator’s wrist. In the absence of hand-port or “blue disc”, the operator’s left hand directly entered the abdominal cavity through the incision. With the assistance of operator’s left hand, the laparoscopic liver resection was conducted, with the ligaments surrounding the liver dissociated, the liver transected and the cut surface properly managed. Results Laparoscopic liver resection was performed successfully in all the 8 patients. The operation time ranged 90～180 min (mean, 118 min), and the blood loss was 50～ 300 ml (mean, 160 ml). There was no uncontrolled bleeding during the operation and no complication happened. Conclusions Hand-assisted laparoscopic liver resection without hand-port devices is a safe and feasible procedure. It may not only reach the purpose of hand assistance but also lower the surgical costs.

Objective To evaluate the arrenotokous toxic action and the related mechanism of MDI in mature male KM mice. Methods The 8-month-old healthy KM mice were intraperitoneally injected with MDI maize oil solution at the dose of 0、62.5、125.0、250.0 mg/kg in normal control group and 3 experiment groups respectively for 14 days.The male mice were killed on day 15 for the measurement of the viscera coefficient of testis and epididymis, the sperm count in epididymis, the activities of enzymes of testis,and concentration of related hormone in testis and blood serum. Results There was no significant difference in body weight between the experiment and the control groups. The viscera coefficient of testis and epididymis in 250.0 mg/kg group decreased significantly compared with the control group(P

As to a nitrite-oxidizing bacterium screened in our laborator y, the effect of pH, nitrogen sources, carbon sources and sodium chloride on its g rowth was studied in order to obtain high cell density. It showed that the cult ure conditions of nitrite- oxidizing bacterium were 4500mg/L sodium nitrite, 1 .5g/L sodium carbonate, 0~0.5% sodium chloride and 0~0.1% glucose at 28℃~30 ℃, 110 r/min and pH 8.0~8.5. After cultivation for 9 days, the bacteria conc entration reached 4.6?109 MPN/mL and all NO-_2-N in the medium w as converted to NO-_3-N. But the transformation of nitrogen sources was inhibited while the sodium chloride concentration exceeded 0.5% or glucose con centration exceeded 0.1%. According to the test of NO-_2-N conversion with nitrite-oxidizing bacteria in a freshwater aquaculture pond, NO-_2 -N began to decrease on the third day of the moculation of this bacterium and t he concentration dropped from 1.47mol/L to 0.49mol/L after 18 days at 25℃ and pH 8.6.

Environmental Microbiology is an important basic course of Environmental Engineering.Its characteristic is content broad,quick development and strong practicality,thus this curriculum's teaching has certain degree of difficulty.Some suggestions and concrete measures about teaching reform,which included curriculum's course content,teaching method,experiment teaching and assessment methods were proposed in this paper.

Adult ; Humans ; Male ; Myocarditis

Objective To explore the effects of adriamycin-loaded immuno-nanoparticles on multidrug resistance (MDR) of hepatoma cell line SMMC-7721/ADM. Methods The cytotoxicity of the adriamycin-loaded immuno-nanoparticles on the bepatoma cell line SMMC-7721/ADM in vitro and the tumor cell-binding ability of adriamycin-loaded immuno-nanoparticles were detected. Results The effect of the cytotoxicity of adriamycin-loaded immuno-nanoparticles on the hepatoma cell line SMMC-7721/ADM was significantly better than that of adriamycin-loaded nanoparticles. Adriamycin-loaded immuno-nanoparticles had the specific binding ability with the hepatoma cell line SMMC-7721/ADM. Conclusions Adriamycin-loaded immuno-nanoparticles can overcome the MDR of the tumor in vitro. The mechanism may be that immuno-nanoparticles could adhere to the tumor cell membrane, and the release of the loaded adriamycin creates a high local concentration in the extracellular medium. The increased concentration gradient improves the diffusion of adriamycin from the extracellular medium to the intracellular medium.

Objective To analyze clinical pathologic characteristics of patients with primary biliary cirrhosis autoimmune hepatitis overlap syndrome (PBC AIH OS),the incidence of extrahepatic autoimmune disease,malignant tumor and the abdominal lymph node enlargement.Methods From January 2000 to January 2012,the clinical data of 49 patients with PBC AIH OS were retrospectively analyzed,which included general information,clinical manifestations,biochemical parameters,immunological parameters,liver histopathological features,the incidence of extrahepatic autoimmune disease and malignant tumor,imaging findings and the efficacy.Results Among 49 PBC-AIH OS patients,the percentage of patients between 51 and 60 years old was 59.2％ (29/49),and the mean age of onset was (57.2±8.9) years old.Female was 83.7％ (41/49).The percentage of jaundice and pruritus in the main symptoms of initial visit was 42.9％ (21/49).The serum level of alanine aminotransferase (ALT),aspartate transaminase (AST),alkaline phosphatase (ALP),γ-glutamyl transpeptadase (GGT) and total bilirubin (TBil) of 49 patients all increased.Among 31 patients who accepted IgA,IgG and IgM level test,the level of IgM increased in 58.1％ (18/31) of patients,and the level of IgG increased in 61.3％ (19/31) of patients.Ninety-eight percent of patients were antinuclear antibody (ANA) positive,6.1 ％ (3/49) were anti-smooth muscle antibody (SMA) positive,89.8％ (44/49) of patients were anti mitochondrial antibody (AMA) and or AMA-M2 positive.All patients had interface hepatitis.Forty-nine percent (24/49) of patients had both histological features of autoimmune hepatitis (AIH) and primary biliray cirrhosis (PBC).After being treated with ursodeoxycholic acid (UDCA) and immunosuppressant,the percentage of remission,incomplete response and failure was 65.3％ (32/49),26.5％ (13/49) and 8.2％ (4/49),respectively.After remission,five of six patients with medicine withdrawal relapsed.Among 49 patients,40.8％ (20/49) with extrahepatic autoimmune disease and the percentage of Sjogren's syndrome,autoimmune thyroid disease,interstitial pneumonia,systemic lupus erythematosus,psoriasis,sarcoidosis and membranous nephropathy was 16.3％ (8/49),12.2％ (6/49),4.1％ (2/49),2.0％ (1/49),2.0％ (1/49),2.0％ (1/49) and 2.0％ (1/49),respectively.Among 49 patients,14.3％ (7/49) with malignant tumor and the percentage of endometrial cancer,breast cancer,thyroid cancer and lymphoma was 4.1％ (2/49),4.1％ (2/49),4.1％ (2/49) and 2.0％ (1/ 49).Among 49 patients,abdominal ultrasound showed abnormality in 93.9％ (46/49) of patients.Abdominal lymph nodes enlargement was found in 91.8％ (45/49) of patients.Conclusions Autoimmune disease and malignant tumor should be screened when patients with PBC-AIH OS were assessed.Abdominal lymph nodes enlargement found by imaging examination may have guiding significance to the diagnosis.

BACKGROUND:Now, domestic total knee arthroplasty surgeries mainly use medial parapatel ar approach, with the disadvantages of large trauma and slower recovery. The quadriceps sparing approach is more accorded with normal anatomy, which can keep the knee extension system intact. The clinical comparison between quadriceps sparing approach and medial parapatel ar approach is rare.
OBJECTIVE:To compare the early effect of total knee arthroplasty through quadriceps sparing approach and medial parapatel ar approach.
METHODS:From January 2009 to January 2010, 55 patients (70 knees) were randomly divided into quadriceps sparing approach group (n=26, 35 knees) and medial parapatel ar approach group (n=29, 35 knees). Patients in two groups received total knee arthroplasty through quadriceps sparing approach and medial parapatel ar
approach respectively. The incision length, operative time, postoperative drainage volume, additional amount of etoricoxib tablets, pain degree, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint, Hospital for Special Surgery Knee Score, radiographic alignment of al components and complications were compared between two groups. Al the prostheses used in this study were the Sigma type prostheses
provided by the rotation platform of Johnson&Johnson Company.
RESULTS AND CONCLUSION:Al the patients were fol owed-up for 12-24 months without infections, deep vein thrombosis, neurovascular injury, prosthesis instability, prosthesis loosening or displacement. Position of al the
prostheses was normal in patients. The operative time in the quadriceps sparing approach group was longer than that in the medial parapatel ar approach group (P=0.00), while the incision length, postoperative drainage volume, additional
amount of etoricoxib tablets, visual analog scale, straight leg raising time, start walking time, hospitalization time, range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score in the quadriceps
sparing approach group were better than those in the medial parapatel ar approach group (P<0.05). There were no
significant differences in range of motion of knee joint at 3 days after replacement and Hospital for Special Surgery Knee Score between two groups. The early effect of total knee arthroplasty through quadriceps sparing approach is better than the medial parapatel ar approach, and there is no significant difference in prosthesis alignment between two methods.

BACKGROUND:Pelvic fractures combined with acetabular fractures are mostly caused by high-energy violence, often accompanied by severe complications and high mortality, and surgical fixation is preferred in most cases. OBJECTIVE:To investigate the internal fixation of pelvic fracture combined with acetabular fracture and to analyze the material biocompatibility. METHODS:A computer-based search of Wanfang, CNKI and PubMed databases was performed for articles related to the internal fixation of pelvic fracture combined with acetabular fracture and material biocompatibility published from 2005 to 2014. The keywords were“pelvis fractures, acetabulum fractures, internal fixators, materials”in Chinese and English, respectively. Articles published in authoritative journals or recently were preferred, and final y 29 articles were enrol ed in result analysis. RESULTS AND CONCLUSION:Steel plate reconstruction or screw internal fixation is often used for clinical treatment of pelvic fracture combined with acetabular fracture. Titanium plate is often chosen with similar elastic modulus to the bone and good biocompatibility. The titanium plate is pre-bended before implantation to match the bone surface of the fracture site. Absorbable screws have good histocompatibility and non-toxic side effects, which can avoid the electrolysis and corrosion of metal screws and maintain certain strength in early period of internal fixation;over time, the fracture is gradual y healed, the material strength gradual y decreases, and the material is final y degraded into water and carbon dioxide to achieve good clinical outcomes. It is difficult and high-risk for treatment of pelvic fracture combined with acetabular fractures, and active treatment and damage control are recommended as soon as possible. A reasonable treatment plan can be developed based on the type of fracture. Plate internal fixation and minimal y invasive fixation developed by the three-dimensional reconstruction techniques show a great progress in fracture treatment, which have broad clinical application prospects.

Objective To explore the role of MMP-9 in blood-brain barrier (BBB) disruption and to promote rMSCs migration.Methods To investigate the effect of MMP-9 on the permeability of BBB,an in vitro model of BBB was established and performed Transwell experiments.To observe the pathologic changes of the cerebral cortex,rat brains from Sham treated group,HIBD group,MMP-9 treated group and TIMP-1 (intervention) treated group at different time points (0.5,1,3,7,14 d) were prepared and stained with Hematoxylin-Eosin and quantified the brain water content.Permeability of BBB examined by EB values measurement.MMP-9 protein level of rat cortex was detected by Western Blot.The number of Brdu labeled rMSCs in the rat cerebral cortex of each group was quantified by Immunohistochemistry (IHC).Results Transwell experiments results showed that migration of rMSCs increased remarkably in hypoxic condition compared to that of normal control (P＜0.01).The number of rMSCs migrated in the MMP-9 treated group was much more than that of negative control group and TIMP-1 group (P＜0.01).The results of pathology showed that compared to HIBD group,brain water content and the permeability of the BBB were increased in MMP-9 treated group but reduced in TIMP-1 treated one.The expression of MMP-9 protein in MMP-9 treated group was reached the peak at 3 d point,which was higher than that of HIBD group and TIMP-1 group (P＜0.05,P＜0.01).The quantity of Brdu labeled rMSCs crossed BBB in MMP-9 treated group was extremely higher than that of HIBD group (P＜0.05,P＜0.01).Conclusions The expression level of MMp-9 protein was improved after hypoxic-ischemic.MMP-9 could facilitate the migration of rMSCs through vitro BBB and control the opening of BBB,which indicate that MMP-9 may facilitate the migration of rMSCs through BBB into brain.