Objective To explore the effects of TNF alpha on the expression of sterol-regulatory element binding protein-1c, SREBP-1c mRNA and the content of triglyceride (TG) in the models of cultured steatosis hepatocytes. Methods Steatosis models of hepatocytes were established by adding oleic acid to the growing L-02 cells, and then cultured in present with TNF alpha or its antibody. The expressions of SREBP-1c and fatty acid synthetase (FAS) mRNA were measured with RT-PCR, lipid droplets in the hepatocytes were observed with oil red staining and the TG contents in hepatocytes were measured with analyzed kit. Results SREBP-1c mRNA was upregulated in the TNF alpha treatment group in comparison with the normal control group(P

Objective To investigate the treatment of common bile duct or common hepatic duct transverse injures(CBDTI) in cholecystectomy.Methods From January 1993 to March 2008,3362 patients received cholecystectomy in our hospital,among them 5 developed CBDTI.We reviewed the clinic feature,management,and outcomes of these patients. Results Of the 5 patients,2 had common hepatic duct transverse injuries and 3 showed common bile transverse injuries.One of the five received postenterobiliary drainage and the other four underwent choledoch end-to-end anastomosis.No biliary leakage was found after the operation.One patient developed biliary stenosis and cholangitis after the end-to-end anastomosis and thus received postenterobiliary drainage.This case was followed up for 15 years,during which no abdominal pain,fever or jaundice occurred.The patient who underwent postenterobiliary drainage showed symptoms of cholangitis for 3 times whithin 2 months after the treatment;therefore,conservative therapy was carried out.Afterwards,the patient was cured and showed no abdominal pain,fever or jaundice during a 5-year follow-up.The other 3 patients who received end-to-end anastomosis were followed up for 1,2,or 4 years,no complications were noticed during the period.Conclusions Based on personal experience and the type of injury,surgeons may chose choledoch end-to-end anastomosis or postenterobiliary drainage to treat CBDTI.

Objective To investigate the effect of evidence-based nursing on the clinical curative effect and prognosis of patients with hypertensive cerebral hemorrhage.Methods 120 patients with hypertensive cerebral hemorrhage were selected,and they were randomly divided into observation group(60 cases) and control group(60 cases) according to the digital table.The control group was treated with routine nursing,the observation group was treated with routine nursing and evidence-based nursing.Before and after nursing,the SDS,self rating anxiety scale (SAS),neurological deficit score NIHSS,Barthel score,the incidence of sequelae,hospitalization time,nursing quality score and patients’ satisfaction with nursing were compared between the two groups.Results There were no statistically significant differences in SDS,SAS,NIHSS and Barthel scores between the two groups before nursing intervention(all P ＞ 0.05).After nursing intervention,the SDS,SAS,NIHSS and Barthel scores of the observation group were (38.74 ± 6.21) points,(35.83 ± 8.17) points,(11.24 ± 3.08) points,(92.58 ± 6.46) points,respectively,which in the control group were (44.58 ± 7.10) points,(43.66 ± 8.06) points,(15.34 ± 3.29) points,(84.27 ± 5.82) points,there were significant differences between the two groups (t =4.796,5.285,7.047,7.403,all P ＜0.05).,The incidence rate of venous thrombosis,muscle atrophy and joint ankylosis sequelae of the observation group was 8.33％,which was lower than 40.00％ of the control group,there was significant difference between the two groups(x2 =16.415,P ＜ 0.05).The hospitalization time of the observation group was (9.55 ± 2.43)d,which was shorter than (15.97 ± 4.68) d of the control group (t =9.430,P ＜ 0.05).The health education nursing quality score,ward management score,basic nursing score,nursing care of critical patients score,nursing document writing score of the observation group were (97.66 ± 2.45) points,(98.23 ± 3.46) points,(97.54 ± 3.18) points,(96.88 ± 3.49) points,(98.76 ± 1.31)points,respectively,which were higher than those of the control group [(88.79 ± 2.37) points,(90.72 ±3.52) points,(91.05 ±3.16) points,(91.67 ± 5.34) points,(93.04 ± 1.12) points],there were significant differences between the two groups(t =20.156,11.786,11.214,6.326,25.707,all P ＜ 0.05).The patients’ nursing satisfaction of the observation group (96.67％) was higher than that of the control group (85.00％),there was significant difference between the two groups (x2 =4.904,P ＜ 0.05).Conclusion Evidence -based nursing can effectively relieve patients’ anxiety and depression of patients with hypertensive cerebral hemorrhage,improve the quality of life of patients,reduce the incidence of complications,shorten the hospitalization time,improve patients'satisfaction.

To investigate effects of l% l-acetylforskoin (l-aF) suspension eye-drops administeredtopically on intraocular pressure (IOP) in rabbits and men, and observe the loca l irritation of the drug． l% l-aF suspension eye-drops was prepared and was instilled into one of e yes while the corresponding vehicle into the contralateral eye as control． IOP was measured b y pneumatonometer before and after administration． l%1-aF suspension eye-drops s ig nificantly reduced IOP in rabbits reaching the maximum reduction of 2.2 mmHg and lasting a t least 3 hours． But it didnt show significant effects in men． There was little local irritati on neither in rabbits nor in men． l% l-aF suspension eye-drops significantly reduced IOP in normal rabbit s, but not in men． No local irritation was observed in rabbits and in men．

Objective To investigate the relationship between cytochrome P450 1A2 (CYP1A2) gene polymorphism and susceptibility to chronic obstructive pulmonary disease (COPD). Methods CYP1A2 gene polymorphisms in 100 COPD cases and 100 healthy controls were tested with polymerase chain reaction- restriction fragment length polymorphism (PCR- RELP). Results Genotype frequencies of 4 SNPs in both the COPD and control groups were in accordance with Hardy-Weinberg equilibrium (P>0.05). There was significant difference between the COPD and control groups in genotype and allele frequencies of 1D and 1F (P<0.05), but not of 1C and 1E (P>0.05). Conclusion CYP1A2*1D and CYP1A2*1F polymorphisms may play an important role in the development of COPD.

Objective To explore the relationship between stone formation and histopathological characters of renal papilla in patients with infectious renal calculi. Methods A total of 43 patients with infectious renal calculi undergoing percutaneous nephrolithotomy (PCNL) were included in this study. Renal papilla biopsy specimens were obtained under a nephroscope during the operation, fol-lowed by staining with hematoxylin-eosin or alizarin bordeaux for light microscopy and electron mi-croscopy. The extracted stones were analyzed and proved to be composed of magnesium ammonium phosphate or carbonate apatite with a transform-infrared spectrometer. Results Renal papilla calci-um plaques were found in 24 of the 43 patients (56 % ) during PCNL. Local calcium salt deposits could be found localized in the renal tubular basement membrane and spread to the interstitial tissue. Tiny stone adherence was observed in the renal papillae where calcium salts grew into the collection system. Conclusion Calcium salt deposits exist on the renal papilla in some patients with infectious renal calculi, which may be correlated with the formation of infectious stones.

Objective To evaluate the toxic effects of oxalic acid and calcium oxalate monohydrate crystals on human renal tubular epithelial cells (HK-2) as well as the influence on cell protein expression. Methods Normal HK-2 cells were cultured in vitro and the culture medium was changed to serum-free medium after cell growth to confluence. Oxalic acid with different concentration wasthen added and the formation of crystals and their adherence to cells were observed microscopically. A Fourier infrared spectrometer (FT-IR) was used to analyze the crystal composition. The toxic effects of 1, 2, 5 and 10 mmol/L oxalic acid on HK-2 cells after incubation for 4, 12 and 24 h were detected with a CCK-8 kit. Changes of protein express of HK-2 cells were determined using the Bradford method. Results Crystal formation and adherence to cell surface could be microscopically observed in a few minutes after oxalic acid was added to the DMED medium containing Caz+. The composition of the crystals was revealed to be calcium oxalate monohydrate by FT-IR. Oxalic acid and calcium oxalate monohydrate presented a concentration-dependent toxic effect on HK-2 cells which was, however, not merely increased with time lasting. The quantity of protein expressed by HK-2 cells incubated with 1,2, 5 mmol/L oxalic acid for 12 h and that of control was 358±51, 365±43, 328±52 and 329±60 mg/L, respectively (all P>0. 05), while the quantity of protein was significantly smaller than that of control after the incubation of 10 mmol/L oxalic acid for 12 h (264±76 vs 329±60 mg/L,P<0. 05).Conclusion Oxalic acid and calcium oxalate monohydrate crystals have toxic effects on normal human HK-2 cells and cause changes in protein expression,which may play an important role in the formation of renal calculi.

Objective To evaluate the efficacy of percutaneous nephrolithotomy (PCNL) forupper ureterie calculi or renal calculi without keeping nephrostomy drainage. Methods A total of240 patients with upper ureteric calculi or renal calculi undergoing PCNL were selected and randomizedto receive no nephrostomy drainage (Group A,120 patients) or a standard (14 F) nephrostomy drain age (Group B,120 patients) after lithotripsy was finished. Inclusion criteria included no urinary infec tion history,one stage operation,single percutaneona tract,no operative bleeding and no need for see ond percutaneous operation. The pain score,the number of patients requiring postoperative analgesiaand the incidence of urine leakage as well as postoperative hospital stay time of the 2 groups were not ed and compared. Results Compared with Group B,patients in Group A got lower pain scores at6 h,1 d and 2 d after the operation (4.2±1.5,2.1±1.6 and 1.2±1.0 vs 5.5±2.4,3.9±1.5 and2.5±1.5,respectively,P<0.01),with fewer patients requiring postoperative analgesia (15.0% vs26.7%,P<0.05),lower incidence of urine leakage (2.5% vs 23.3%,P<0.01) and shorter postop erative hospital stay (1.7±0.6 dvs 3.1±1.1d,P<0.01). Conclusion For selected patients,takeaway nephrostomy drainage right after PCNL could be considered as an effective method to get lesspostoperative pain,lighter economic burden and shorter recovery time.

Objective: To investigate the effect of sevolfurane (SEVO) post-conditioning on protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway for protecting ischemia/reperfusion (I/R) injury in isolated rat’s heart. Methods: A total of 84 isolated rat’s heart prepared by Langendorff method were randomly divided into 7 groups andn=12 in each group.①Sham group,②I/R group,③SEVO post- conditioning (SPC) group,④NVP-BEZ235 solvent dimenthyl sulfoxide (DMSO) group,⑤Phosphatidyl inositol 3-kinase (PI3K)/mTOR dual inhibitor NVP-BEZ235 (BEZ) group,⑥BEZ+SPC group and⑦SEVO alone group. The hearts received 30 min ischemia followed by 120 min reperfusion with relevant treatment except for Sham group and SEVO group in which the hearts were without ischemia process. Myocardial infarct (MI) size and tissue pathological changes were observed, protein expressions of phosphor-AKT (P-AKT)/total-AKT, P-mTOR/total-mTOR, Beclin1, Bax/Bcl-2 and cleaved Caspase-3 were examined at the end of reperfusion respectively. Results: Compared with I/R group, SPC group presented decreased MI size (26.28±4.00) % vs (49.22±3.66) % and reduced tissue pathological changes; up-regulated protein expressions of P-AKT/total-AKT and P-mTOR/total-mTOR by 79.85% and 67.02%, while down-regulated protein expressions of Beclin1, Bax/Bcl-2 and cleaved Caspase-3 by 33.77%, 69.26% and 48.84%respectively, allP<0.05. Compared with SPC group, BEZ+SPC group sowed increased MI size (53.85±4.06) % vs (26.28±4.00) %and elevated tissue pathological changes; down-regulated proteins expressions of P-AKT/total-AKT and P-mTOR/total-mTOR by 46.06% and 42.95%, while up-regulated protein expressions of Beclin1, Bax/Bcl-2 and cleaved Caspase-3 by 29.90%, 206.85% and 114.65% respectively, allP<0.05. Conclusion: SPC may activate AKT/mTOR pathway and inhibit cardiomyocyte autophagy and apoptosis, thereby attenuate I/R injury in isolated rats’ heart.

Objective To evaluate the practicability of CHROMagar orientation medium combined with simple biochemical tests for identification of common oxidase-negtive gram-negative bacilli.Methods The CHROMagar orientation medium was used together with biochemical tests including indole test , ornithine decarboxylase test and lysine decarboxylase test for identification of common oxidase -negtive gram-negative bacilli.The sensitivity, specificity, likelihood ratio, Youden index and Kappa value of the diagnostic assays were evaluated .McNemar test was performed to evaluate facticity, accuracy and cost of the method in com-parison with the Vitek-2 system as reference method .Results The identification of oxidase-negtive gram-negative bacilli from 318 bacterial strains showed that the sensitivities and specificities of CHROMagar orien-tation mediumm in combination with simple biochemical tests to Serratia marcescens, Stenotrophomonas mal-tophilia and Acinetobacter baumannii reached 100%, and for Escherichia coli, Enterobacter aerogenes and Klebsiella pneumoiae were above 90%.The specificities for identification of Enterobacter cloacae, Klebsiella oxytoca, Citrobacter freundii and Proteus mirabilis were all above 90%, but the sensitivities were around 75%-90%.Kappa values of the assays were above 0.85, howerer, which was only 0.5947 for Citrobacter freundii.McNemar test showed that all P values were above 0.05, and cost of the assays was reduced by 90%.Conclusion CHROMagar orientation medium in combination with simple biochemical tests is a cost-effective assay for identification of common oxidase-negtive gram-negative bacilli .