Objective To investigate the feasibility,safety and clinical efficacy of three-port laparoscopic sleeve gastrectomy (TLSG).Methods The retrospective cross-sectional study was conducted.The clinical data of 104 obese patients who were admitted to the Beijing Friendship Hospital of Capital Medical University between September 2016 and March 2017 were collected.TLSG was performed to all the 104 patients by the same surgical team.The surgical situations,conversion situations (port-site increased or conversion to open surgery),operation time,volume of intraoperative blood loss,surgery-related complications,duration of postoperative hospital stay and follow-up situations were observed.Patients were followed up by Wechat,telephone interview and inpatient examination once at month 3,6,9 and 12 postoperatively and once every year after 1 year postoperatively up to April 2017.Follow-up included weight-loss efficacy and postoperative long-term complications.Measurement data with normal distribution were represented as x±s or average (range).Results All the 104 patients underwent successful TLSG,without port-site increased or conversion to open surgery.Operation time and volume of intraoperative blood loss were (121±25)minutes and (9±6)mL,respectively.There was no severe intraoperative collateral damage.All the 104 patients with complications were cured by symptomatic treatment,including 1 with port-site infection,1 with peritoneal effusions causing secondary infection,3 with improper eating-induced acute delayed gastric emptying,6 with fat liquefaction around port-site and 9 with delay healing of port-site.There was no occurrence of severe complications,such as gastrointestinal bleeding,intra-abdominal bleeding and gastrostoma.Duration of postoperative hospital stay was (2.4±0.8)days.Eighty-two patients were followed up for 3 months (range,3-6 months),including 59 with 3-month follow-up,23 with 6-month follow-up and 22 with under 3-month follow-up.During the follow-up,there was no port-site hernia.Excess weight loss (EWL) was 37％± 11％ in 59 patients with 3-month follow-up and 45％± 13％ in 23 patients with 6-month follow-up.Of 59 patients with 3-month follow-up,14 patients with diabetes mellitus stopped taking antidiabetic drugs,10 of 14 patients had complete remission (CR) of hemoglobin Alc (HbAlc) and 4 of 14 patients had partial remission (PR) of HbAlc.Of 23 patients with 6-month follow-up,6 patients with diabetes mellitus had CR of HbAlc.Of 18 patients with obstructive sleep apnea hypopnea syndrome (OSAHS),4 had 3-month follow-up,including 3 with CR and 1 was improved to mild OSAHS.Other 14 patients were not evaluated due to inadequate follow-up time.Conclusion TLSG for obese patients with specific indications cannot increase operation time and risk,meanwhile,it can reduce port-site,with a good cosmetic effect.

Objective To establish a method for determining the dissolution oftorasemide sustained-release tablet in vitro and study the methodology of the determination.The consistency of the in vitro release behavior between self-prepared torasemide sustained-release tablet and original preparation were evaluated by constructed method.Methods HPLC method was applied to detect the cumulative release percentage of self-prepared torasemide sustained-release tablet and original preparation in five kinds of release media (water,0.1 mol/L hydrochloric acid solution,pH 4.5 acetate buffer,pH 6.8 phosphate buffer,and 0.1 mol/L hydrochloric acid solution turn to pH 6.8 phosphate buffer).Similarity factor (f2) was used to evaluate the similarity of release curves.Results There was a good linear relationship between the quality concentration of torasemide and peak area in the range of 1.0-12.0 μg/mL (r =0.9995).Results of precision and stability tests were good,and the RSDs for probational liquid were all lower than 2.0％.The average recovery of accuracy test was 100.04％,and RSD was 0.54％ (n =12).The homogeneity of within group of self-prepared preparation met the technical requirement,RSDs of each sampling points in six Dissolution Vessels were lower than 10.0％.The f2 factors of self-prepared torasemide sustained-release tablet and original preparation were 72,60,77,66,and 60 in five kinds of release media.Conclusion The method in the paper is suitable for the release test of torasemide,meanwhile,the self-prepared tablet shows consistent in vitro release behavior with that of the original preparation.

Objective To investigate whether exogenic brain derived neurotrophic factor (BDNF) can permeate placental barrier into fetus and further through fetal blood brain barrier(BBB) after transient ischemia. Methods Seventeen day pregnant rats were selected. The uterine arteries of the rats were clamped for 30 minutes in experimental group. BDNF labeled with 125 I was injected into the rats through caudal veins. The radioactivity of BDNF in different fetal organs was measured at 24 h, 48 h and 72 h. Results 125 I BDNF was detected in amniotic fluid, placenta and fetal organs including brain, heart, lung, liver and kidney. This indicated that BDNF partly permeated placental barrier. The permeability of BDNF through placenta barrier and fetal BBB increased with the increased dose injected. BDNF reached the fetal brain through BBB under hypoxia eschemia condition. The rates of penetration of BDNF through placental barrier and BBB increased under the condition of fetal ischemia and hypoxia. Conclusions Exogenic BDNF may partly go through placental barrier and BBB into fetal brain, which makes it possible for BDNF to be a treatment for fetus suffered from ischemia and hypoxia.

AIM:To investigate the autophagy induced by sepsis and acute kidney injury , and the regulation of phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in this process.METHODS: The rats were subjected to cecal ligation and puncture ( CLP) or sham operation .Histopathologic changes of the renal tissues were examined by HE staining .Blood urea nitrogen ( BUN) and serum creatinine ( SCr) were measured by chemical colorime-try.The protein expression of microtubule-associated protein light chain 3 I/II (LC3 I/II), beclin-1 and p-Akt at different time points after CLP was detected by Western blotting .In vitro, human proximal tubular epithelial cell line HK-2 were treated with LPS to induce autophagy .The protein expression of LC 3 I/II and p-Akt in the HK-2 cells after LPS treatment at different time points and different concentrations was detected by Western blotting .These molecules in HK-2 cells and apoptosis of HK-2 cells treated with LPS plus PI3K inhibitor or Akt inhibitor were also detected .RESULTS: Compared with sham group , the severe changes of renal histopathological injuries in CLP groups were observed , the levels of BUN and SCr in CLP groups were significantly increased .LC3 I/II, beclin-1 and phosphorylation of Akt gradually increased after CLP.After treatment with LPS, the expression of p-Akt (308) in the HK-2 cells gradually increased in a dose-and time-dependent fashion.The expression of beclin-1 and p-Akt (472) reached a peak at 8 h or 10 mg/L LPS treatment.Treat-ment with PI3K or Akt inhibitor down-regulated the expression of LC3 and promoted the apoptosis of HK-2 cells.CON-CLUSION:Autophagy in the kidney is induced by sepsis and acute kidney injury .PI3/Akt signaling pathway may be in-volved in this process .

Freshwater crabs and snails were collected from Ninghai County in Zhejiang Province, and examined respectively for Paragonimus metacercariae and cercariae. Among 97 freshwater crabs found, the prevalence was 11.3% (11/97) with a mean intensity of 1 metacercariae per crab. It was 10.2% (5/49) and 20.2% (4/20) in the groups weighted 5-15 g and 15-25 g respectively, with an average intensity of 1, and no metacercariae were found in weight group of 25-35 g. Two positive crabs were found from 20 crabs with a low weight (

Objective To investigate the value of contrast-enhanced ultrasonography (CEUS) in the diagnosis of tuberculous mesenteric lymphadenitis by analyzing its enhancement pattern. Methods The conventional ultrasound and contrast-enhanced ultrasound images of 62 patients with tuberculous mesenteric lymphadenitis confirmed by needle core biopsy or surgery were retrospectively analyzed. The location, size, shape, internal echo and posterior enhancement of mesenteric lymph nodes were recorded. All cases were divided into two groups:the maximum diameter of the lymph node≤20 mm and the maximum diameter of the lymph node >20 mm, and the patterns of enhancement in two groups were analyzed. Results The conventional ultrasound of 62 cases with tuberculous mesenteric lymph nodes showed enlargement. And the echogenicity was hypoechoic or heterogeneity, containing punctate or clusters of calcification in 19 cases (30.6%). After CEUS, there were three forms of enhancements:rim enhancement in 29 cases (46.8%);inhomogeneous enhancement in 21cases (33.9%);non-enhancement in 12 cases (19.3%). Rim enhancement was more common in the≤20 mm group, while inhomogeneous enhancement was more common in the lymph nodes>20 mm. There was statistically significant difference of the enhancement type between the≤20 mm group and the>20 mm group (χ2=6.782, P=0.034). Conclusions Most of tuberculous mesenteric lymph nodes showed rim and inhomogeneous enhancement in CEUS, and the sizes of mesenteric lymph node tuberculosis influenced the CEUS enhancement patterns. CEUS may provide useful information for the diagnosis of the tuberculous mesenteric lymph node.

Objective To improve the knowledge of the diagnosis and treatment of functional insulinoma. Methods The clinical data of 12 cases of functional insulinoma in China-Japan Union Hospital of Jilin University from 2000 to 2009 were analyzed retrospectively. Results For the 12 cases of functional insulinoma, preoperative fasting blood glucose and the positive rate of insulin were 92% and 89% respectively. The positive rate of IRI/G and C-Peptide reached 100%. The accuracy of the niveau diagnosis of preoperative abdomen ultrasound, CT and of MRI were 75%, 36% and 0% respectively; whereas the accuracy of localization of intraoperative palpation combined with ultrasonography reached 100%. The result of glucose increased by one time within one hour after excision and the rest excision. In the 7 follow-up cases, the symptom of hypoglycemia was not found. There were 3 cases of pancreatic fistula after operation. Conclusions For the suspected cases of functional insulinoma, the measurement of IRI/G and C-Peptide are needed besides measuring blood glucose and insulin. Intraoperative palpation and ultrasonography are effective methods of the localization of functional insulinoma. The complete resection of the insulinoma can be assessed by monitoring the change of the blood glucose after excision as well as the rapid intraoperative pathological examination.

Objective To investigate the effects of a novel synthetic immunostimulator CH2b containing thiazolidin-4-one on the function of invariant nature killer T (iNKT) cells isolated from patients with active rheumatoid arthritis (RA).Methods Peripheral blood mononuclear cells (PBMCs) isolated from patients with active RA were in vitro cultured with α-Galcer and IL-2.The iNKT cells were separated by using magnetic activated cell sorting (MACS) method.The effects of CH2b on the proliferation of iNKT cells were analyzed by using MTT assay.MILLIPLEX MAP Human Cytokine/Chemokine kit was used to measure the levels of IFN-γ and IL-4 in the supernatants of iNKT cell culture.The expressions of IFN-γand IL-4 at mRNA level in iNKT cells were analyzed by RT-PCR.Western blot assay was used to detect the levels of T-bet and GATA-3 in iNKT cells.Results CH2b significantly enhanced the proliferation of IL-2 activated iNKT cells isolated from the patients with active RA.CH2b promoted the secretion of IL-4,resulting in a decrease in the ratio of IFN-γ/IL-4.Moreover,CH2b promoted the expressions of GATA-3 and IL-4 at mRNA level in iNKT cells.Conclusion The novel immunostimulator,CH2b,might enhance the immunoregulatory effects of iNKT cells by promoting the GATA-3 pathway-mediated secretion of Th2-1ike cytokines and inducing the differentiation of Th0 to Th2 cells.

OBJECTIVETo study the effects of antisense Bmi-1 (B cell-specific moloney murine leukemia virus insertion site 1) RNA on the growth, cell cycle and apoptosis of lung cancer cell line A549.

METHODSRecombinant plasmids carrying antisense Bmi-1 RNA were transfected into A549 cells, which expressed a high level of endogenous Bmi-1. The mRNA level of A549 cell was analyzed by real time quantitative RT-PCR and the protein level was determined using Western blot. MTT growth curve and plate colony forming assay were used to measure the effect of antisense Bmi-1 RNA expression on the growth of A549. Flow cytometry was used to analyze cell cycle and apoptosis.

RESULTSAntisense Bmi-1 RNA reduced the Bmi-1 expression at the protein level, but did not alter the mRNA level in A549 cells. Compared with the control cells, A549 cells transfected with antisense Bmi-1 RNA showed a strong inhibition of the cell growth. The number of plate colony formation of the antisense Bmi-1 transfected cells (0.67 +/- 0.50) was less than those of the control (73.0 +/- 4.1) and cells transfected with empty vector (67.0 +/- 4.0, P < 0.01). Transfection of antisense Bmi-1 RNA arrested the A549 cells at G₀/G₁ phase of the cell cycle and did not increase the apoptosis.

CONCLUSIONAntisense Bmi-1 RNA expression inhibits A549 cells proliferation, likely through the interference of Bmi-1 leading to an arrest of the proliferating cells at the G₀/G₁ phase.

Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Down-Regulation ; Gene Expression Regulation, Neoplastic ; Humans ; Lung Neoplasms ; genetics ; metabolism ; pathology ; Nuclear Proteins ; biosynthesis ; genetics ; Polycomb Repressive Complex 1 ; Proto-Oncogene Proteins ; biosynthesis ; genetics ; RNA, Antisense ; pharmacology ; RNA, Messenger ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Repressor Proteins ; biosynthesis ; genetics ; Transfection

AIM To observe the oxidant stress and opoptotic effects of anisodine hydromide (AH) on chronic cerebral hypoperfusion (CCH) rats.METHODS In vivo CCH models were established in adult male SpragueDawley rats by permanent ligation of bilateral common carotid arteries [two-vessel occlusion (2-VO)] surgery.Rats were randomly divided into six groups,sham group,model group,positive group of n-butylphthalide and sodium chloride injection,and AH groups (1.2 mg/kg high-dose group,0.6 mg/kg medium-dose group,and 0.3 mg/kg low-dose group).Antioxidant indices including the activity of SOD,CAT,LDH and iNOS and the content of GSH and NO were measured.In the in vitro trial,PC12 cells were divided into control group,model group,positive group of n-butylphthalide,and AH groups (100 μmol/L high-dose group,50 μmol/L mediumdose group,and 25 μmol/L low-dose group),and the hypoxic models were established by treating PC12 cells with CoCl2.The cells had their release of NO and LDH detected,their cellular apoptosis determined by Hochest 33342 fluorescence staining,and the expression of P53 protein identified by IF (immunofluorescence) and Western blotting method.RESULTS The in vivo trial revealed AH's enhancement in serum SOD activity and inhibition in serum iNOS activityof the CCH rats,and its power in the cerebral GSH and LDH release reduction.The in vitro trial showed the resultant lower LDH and NO release,decreased number of neuro-apoptosis,and inhibited P53 pro tein expression after AH intervention.CONCLUSION The antioxidant and antiapoptotic effects of AH on CCH rats may be associated with down regulation of P53 protein.