ObjectiveTo study the feasibility,safety and effect of laparoscopic splenectomy and selective pericardial devascularization in the treatment of portal hypertension.MethodsThis study included 7 patients diagnosed as posthepatitie cirrhosis and portal hypertension with a history of up GI bleeding receiving laparoscopic splenectomy and selective pericardial devascularization.ResultsThe operation was successful in all 7 patients without conversion to laparotomy.There were no postoperative severe complications.The average operation time was 4.2 h,mean blood loss was 430 ml.All patients recovered well,and were followed-up for 0.5 ～ 2.0 years,and there was no rebleeding in this period.ConclusionsLaparoscopic selective pericardial devascularization is feasible,safe,minimally invasive.The short to mid term result was satisfactory.

OBJECTIVE:To observe the efficacy and safety of atorvastatin calcium combined with metoprolol in the treatment of chronic congestive heart failure (CHF). METHODS:207 CHF patients were randomly divided into control group (102 cases) and observation group (105 cases). Control group received cardiac,diuretic,vasodilating and oxygen inhalation,Metoprolol tar-trate tablet with initial dose of 6.25 mg,2-3 times a day,then increased 6.25-12.5 mg based on the improvement,2-3 times a day. Observation group additionally received 80 mg Atorvastatin tablet,twice a day. The treatment course for both groups was 16 w. Clinical efficacy,cardiac functions [left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),mi-tral early diastolic and late diastolic peak flow velocity ratio(E/A)],blood lipids [lipoprotein(a)Lp(a),triglyceride(TG),total cholesterol(TC)] levels before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant (P<0.05). Before treatment,there were no significant differences in cardiac functions and blood lipids in 2 groups(P>0.05). Af-ter treatment,the LVEF and E/A in 2 groups were significantly higher than before,and observation group was higher than control group,LVESD,Lp(a),TG and TC were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions (P>0.05). CONCLUSIONS:Based on conventional treatment,the efficacy of atorvastatin calcium combined with metoprolol is su-perior to metoprolol in the treatment of CHF,with better safety.

Peritoneum is one of the common site of colorectal cancer metastasis. Traditionally, peritoneal carcinomatosis is associated with a poor prognosis without effective surgical treatment. Recently, the attitude towards the treatment strategies for colorectal peritoneal metastasis has changed significantly with advances in surgical techniques, hyperthermic intraperitoneal chemotherapy and multi-disciplinary treatment. As to the prognosis, colorectal peritoneal metastasis has an inferior outcome to non-peritoneal metastasis under the palliative systemic treatment. However, the complete peritoneal cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy can achieve a long-term survival in selective patients with colorectal peritoneal metastasas. The prognostic factors include peritoneal carcinomatosis index, completeness of cytoreduction, the presence of extra-peritoneal metastasis (liver etc), peritoneal surface disease severity score and Japanese peritoneal staging. In terms of the treatment, complete peritoneal cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy and systemic treatment (including chemotherapy and targeted therapy) may be the best modality of multi-disciplinary treatment for colorectal peritoneal metastasis.

Objective To investigate the early diagnosis of vitiligo and its differential diagnosis from other depigmentated diseases using polarized light dermoscopy(PD)imaging analysis.Methods Patients with localized depigmented macules were enrolled into this study.PD was used to observe the micromorphology,feature and color of skin lesions.Histopathology was performed to confirm the diagnosis of all cases except for those of pityriasis versicolor which were confirmed by clinical and laboratory examination.Results Of the 176 patients.97 were diagnosed as vitiligo.Residual perifollicular pigmentation Was observed in 91.94%(57/62)of patients with progressing vitiligo and 62.86%(22/35)of those with stable vitiligo,with significant difference between the two groups of patients(P<0.05).However.residual perifollicular pigmentation was absent in the 79 non-vitiligo depigrnented cases.The presence of telangiectasia,early reservoirs of pigmentation and perilesional hyperpigmentation were related to the stage of vitiligo and treatment history of patients.Conclusions PD,which efficiently eliminates the interference of reflected light on skin lesions of vililigo,is an imaging technique that allows for the visualization of minor structures and features of the skin lesions that are indiscernible to naked eyes.In a nutshell,the application of PD has offered references to the early diagnosis of vitiligo and its differential diagnosis from other depigmentation diseases.

Objective To investigate the value of image analysis technology of polari-light dermoscopy (PD) in diagnosing head and face tumors. Methods We randomly collected the head and face tumors from the patients in this hospital, and then diagnosed them with naked eyes and PD, respectively. After making sure the diagnosis by histopathology, we analyzed the results retrospectively. Results We summarized the diagnostic signs of 211 head and face tumors on dermoscopy, which shown a great specificity. Its diagnosis rate reached to 92.89 %, obviously higher than that (69.67 %)with naked eyes. Due to clinical misdiagnosis and erroneous treatment, the recurrence rate of skin lesions was 19.91 %. The top 3 of head and face tumors, in turn, was seborrheic keratosis, melanocytic tumor and basal cell carcinoma. Conclusions PD is a non-invasive image analysis technology, which is especially applicable to the early diagnosis of head and face tumors. It can make sense in decreasing blind biopsy, directing surgical excision areas effectively, and selecting reasonable remedy. It also has great significance in the recovery and beauty of skin lesions.

Objective To study the safety and feasibility of laparoscopic total splenectomy (LTS) and laparoscopic partial splenectomy (LPS) in the diagnosis and treatment of benign splenic tumors by comparing the perioperative and follow-up data between these two operative approaches.Methods We retrospectively analyzed the clinical data of 57 patients who underwent laparoscopic surgery for benign splenic tumors from December 2009 to April 2016.These patients were divided into the LTS and the LPS groups.The clinical data including the preoperative,intraoperative,postoperative and follow-up data were analyzed.Results When compared with the LPS group,the LTS group had shorter operation time [(97.0 ± 22.1)min vs.(135.0 ± 24.6) min,P ＜ 0.05] and less blood loss [(33.3 ± 19.5) min vs.(90.6 ± 55.1)min,P ＜ 0.05],but there were no significant differences between the two groups in the length of hospital stay,the duration of drainage tube placement,the amount of postoperative analgesics as well as the incidences of pulmonary infection,postoperative pancreatic fistula and other complications after surgery.These incidences were low in the two groups.Conclusion Laparoscopic surgery,including LTS and LPS,were safe and feasible in treating benign splenic tumors.

Insect antifreeze protein (AFP) has high antifreeze activity. Antifreeze proteins can be used in cryopreservation of biological tissues and cells. We expressed an antifreeze protein from the desert beetle Microdera punctipennis in yeast and determined the function of the protein at low temperatures. Yeast expression vector, pPIC9K-Mpafp698, was constructed and transformed into Pichia pastoris GS115. The expression of MpAFP698 was induced by methanol, and identified by tricine SDS-PAGE and Western blotting. Mpafp698 gene was inserted into the genome of the host yeast strain GS115, and correctly expressed. Hardly any yeast's own protein was secreted into the media. Cryoprotective experiments showed that MpAFP698 can significantly protect mouse liver as well as other mouse organs from cold damage compared with those in the control of Bovine serum albumin (BSA) addition. Besides, the hemolysis of blood cells protected by MpAFP698 at 4 degrees C was reduced and the survival rate of SF9 cells protected by MpAFP698 after freezing and thawing was increased compared to those of the control with BSA addition. Our results showed that MpAFP698 can be expressed in yeast, which allows a convenient purification of the MpAFP protein that has the cryoprotective effect.
Animals ; Antifreeze Proteins ; biosynthesis ; Blotting, Western ; Cold Temperature ; Coleoptera ; Cryoprotective Agents ; chemistry ; Electrophoresis, Polyacrylamide Gel ; Freezing ; Insect Proteins ; biosynthesis ; Mice ; Pichia ; metabolism ; Sf9 Cells

Studies show that heme oxygenase-1 (HO-1) can promote the tumor neovascularization via interacting with angiogenic factors,such as vascular endothelial growth factor (VEGF) and stromal cell-derived factor-1.On the other hand,HO-1 may suppress angiogenesis in tumors via inhibiting the transcription of NF-кB.In a word,HO-1 may participate in the pathophysiological process of tumor angiogenesis,and may be a new target for cancer treatment.

[Objective To evaluate the teaching effects and advantages of problem-based learning (PBL) teaching mode based on network in the clinical practice of obstetrics and gynecology. Methods 2007 grade intern students in department of obstetrics and gynecology in Beijing Tongren Hospital of Capital Medical University were divided into 2 groups:control group (18 seven-year program and 11 five-year program)and experiment group (17 seven-year program and 10 five-year program). Traditional teaching was conducted in control group:interns and teacher completed teaching ward round several times according to the teaching requirement. PBL based on network was conducted in experiment group:tea-chers asking questions-data collection-learning and discussing-demonstrating and arguing-discussing and summarizing teaching process. Then the effects of different teaching methods were evaluated by clinical practice skill and theoretical test. SSPS13.0 statistical software was used for data analysis and measurement data were expressed as x±s. T test was conducted among groups. Results As for clinical practice skills, scores in PBL group (seven-year program and five-year program )were higher than those of traditional group [seven-year program:(190.47±2.30)vs (87.42±2.93);five-year program:(92.95±2.20)vs (90 . 09 ± 2 . 70 )] . There was no difference between the two groups in scores of theoretical test . In clinical practice skills,scores of general skill and clinic case analysis showed significant differences be-tween PBL group and traditional group. Conclusions PBL tea-ching mode based on network can improve the quality and effectiveness of the clinical practice of obstetrics and gynecology, especially in the social, technical,and knowledge dimension.

Epidermalgrowthfactorreceptor-tyrosinekinaseinhibitor(EGFR-TKI)resistanceinnon-small cell lung cancer(NSCLC)has become more and more common,which includes primary and secondary resistance.The primary resistance is mainly related with EGFR gene mutation,and the secondary resistant is mainly related with T790M,MET and other genes.