The localization and development of substance P (SP) like immunoreactive retinal neurons in the adult, newborn and postnatal New Zealand albino rabbits were studied with immuaocytochemistry ABC method. We found most of the SPlike immunoreactive somas in adult rabbit retina located in inner margin of inner nuclear layer (INL) and ganglion cell layer (GCL). Their processes ramified in the lamina 1,3 and 5 of inner plexiform layer (IPL). Some immunoreaetive fibers in the layer of optic nerve fiber (LON) were occasionally observed. The highest cell density of SP-like somas occured in the visual streak (VS). The cell density gradually decreased from the VS to the ventral and dorsal periphery. In the new born rabbit retina, the labelled cell bodies and their processes appeared. Most of them located in the GCL, and a few of them located in the' INL. Their processes formed discontinuous layer in the lamina 5 and never seen in the lamina 3. The cell density of SP positive somas gradually increased from newborn to postnatal 4 th day. From postnatal 6 th day to 12 th day, the cell density gradually decreased. From postnatal 12 th day the somas mainly located in the INL. On the 20th day after birth the distribution and morphology of SP-like immunoreactive somas and processes had approached that of mature age. These results suggest that rabbit retinal SP-like immunoreactive neurons had appeared at prenatal period and continuously developed after birth.

objective To summarize the clinical experience of pancreatoduodenectomy using Da Vinci surgical system,and to investigate the methods to improve its efficacy.Methods Sixteen patients who received pancreatoduodenectomy from January to December 2009 at the General Hospital of Second Artillery of PLA were divided into robotic group(n=8)and open group(n=8).Data on the surgical procedure,perioperative management and postoperative recovery between the 2 groups were retrospectively analysed using t test and chi-square test.Result The radical resection rates of robotic group and open group were 7/8 and 8/8,respectively,with no significant difference between the 2 groups(χ~2=1.067,P＞0.05).The operation time of robotic group was (718±186)minutes,which was significantly longer than(420±127)minutes of open group(t=3.714,P＜0.05＝.The blood loss of robotic group was(153±43)ml,which was significantly less than(210±53)ml of open group(t=2.318,P＜0.05＝.The postoperative ambulation time and length of hospital stay of robotic group were(28±7)hours and(16±4)days,which were significantly shorter than(96±18)hours and(24±7)days of open group(t=9.939,2.714,P＜0.05＝.The incidences of postoperative complications of robotic group and open group were 2/8 and 6/8,respectively,with significant difference between the 2 groups(χ~2=6.349,P＜0.05＝.The incidences of anastomotic leakage of robotic group and open group were 2/8 and 3/8,respectively,with no significant difference between the 2 groups(χ~2=0.291,P＞0.05).Conclusion Pancreatoduodenectomy performed by Da Vinci surgical system is feasible and safe,and with the advantages of less trauma and rapid recovery of patients.

Objective To analyze the differential expression of microRNA-146a (miR-146a) in monocyte-macrophage cell line (THP-1 cells) after induction by Cryptococcus neoformans (C.neoformans,reference strain WM148) or Cryptococcus gattii (C.gattii,reference strain R265),and investigate the mechanism of miR-146a in regulating the inflammatory response of cryptococcal meningitis.Methods The cultured THP-1 cells were divided into two groups to be induced by C.neoformans or C.gattii,respectively.THP-1 cells were induced with inactivated WN148 (or R265) strains at multiplicity of infection (MOI) of 5 in all experiments.The supematant and the cell pellet were collected separately after incubation.The expression of miR-146a was measured by real-time quantitative PCR (qRT-PCR) technique.The levels of TNF-u and IL-6 release were assayed by ELISA.Results The expression of miR-146a increased significantly in the C.neoformans induction group compared to 0 h.It reached peak at 3 h (P＜0.01),and then declined gradually.The level of TNF-α increased in supematant and reached peak at 12 h.The expression of IL-6 did not change significantly at each time point.The expression of miR-146a and TNF-α increased gradually and reached peak at 12 h in the C.gattii induction group (P ＜0.01),but the change did not reach statistical significance at 3 h,6 h time points.The expression of IL-6 gradually increased,and reached peak at 12 h time point.Conclusions Following stimulation with C.neoformans or C.gattii,the expression ofmiR-146a in THP-1 cells showed different patterns over time.The expression levels of TNF-α and IL-6 showed different patterns.These findings suggest that there may be different regulatory mechanisms in the THP-1 cells-associated inflammatory response after stimulation by inactivated C.neoformans and C.gattii strains.

Objective To summarize the clinical experience of operations with Da Vinci surgical system in 27 patients with previous abdominal surgery.Methods The clinical data of 27 patients with previous abdominal surgery who had received reoperation using Da Vinci surgical system at General Hospital of Second Artillery of PLA from January to December 2009 were retrospectively analysed.The distribution of trocars was designed according to the surgical sites and previous surgical incision sites.The operation was divided into 2 steps:firstly,intraabdominal adhesion was dissected and the robotic arms were set up;secondly,the lesions were resected.Experience in trocars placement,surgical approach and management of complications were summarized.Results Six approaches were designed according to previous incision sites.Of all patients,22 were with severe intraabdominal and hepatic hilar band adhesion,and 5 with strip adhesion.One patient who underwent intraabdominal radiotherapy and chemotherapy abandoned robotic surgery because of the failure in trocar placement and pneumoperitoneum establishment.Twenty-six patients had successfully undergone robotic surgery and the success rate was 96%(26/27).Of the 26 patients,1 was complicated with enterorrhexis intraoperatively and received repairment.No postoperative complication was observed.Conclusions Previous abdominal surgery has little influence on robotic surgery with Da Vinci system. Pneumoperitoneum establishment,insertion point of the first trocar and dissection of the intraabdominal adhesions are key points for success of operation.

Objective To explore the clinical safety and validity of Da Vinci surgical system in distal pancreatic tumor resection.Methods The clinical data of 14 patients with distal pancreatic tumor underwent robotic surgeries by using Da Vinci surgical system from January 2009 to June 2012 were retrospectively analyzed.Results The average operation time was 343.93 (170-575) min,average blood loss was 192.5 (10-700) ml,without blood trahsfusion.Pathologic examination showed:pancreatic ductal adenocarcinoma in 7 patients,pancreatic cystadenoma in 1 patient,mucous cystadenoma in 1 patient,cystadenocarcinoma in 1 patient,high levels of pancreatic ductal intraepithelial neoplasia in 1 patient,insulinoma in 1 patient,solid pseudo-papillary tumor in 2 patients.Two patients with pancreatic leaks after operation and then relieved after conservative medical therapy.Others were discharged from hospital without complications.The average hospital stay was 10.64 d.Conclusions Da Vinci surgical system is safe and effective in treatment for patients with distal pancreatic rumor with minimally invasive advantage.Because lack of surgical experience and small sample,a large sample with long term follow-up of high-quality clinical research is required and then update the system to evaluate the efficacy and safety.

ObjectiveTo explore the value of expanded radical resection for gallbladder cancer located respectively at body and bottom of the gallbladder and at the neck.MethodsIn this study,91 cases of gallbladder cancer were macropathologically divided into two groups, one with the lesion at the body and bottom of the gallbladder and the other at the neck, survival analysis was made accordingly. Three different kinds of resection were performed: the expanded radical resection, the standard radical resection and palliative operation.ResultsThe overall median survival rate of patients undergoing expanded radical operation was significantly longer than that of the cases doing other two procedures, that was 27. 1 ± 2. 4,10. 7 ±2. 2,4. 7 ±2.2 (months) respectively for body and bottom cancer, and 8.5 ±2. 1,6. 7 ± 1.9,3.1 ± 1.1 (months) respectively for neck cancer. For cancer at the body and bottom RO was achieved by expanded radical resection in 16/18(88％ ) cases and by standard radical resection in 7/12(58％ ) cases, while for cancer at the neck it was in 6/16(38％ ) cases, and in 3/13 (23％)cases only.ConclusionsThe median survival time is longer and RO resection rate is higher in patients with the cancer at the body and bottom than these at the neck of the gallbladder.

Objective To summarize the clinical experience in Da Vinci surgical system-assisted hepatopancreatobiliary surgery.Methods From January to December in 2009,94 patients with hepatopancreatobiliary diseases were treated at General Hospital of Second Artillery of PLA.The surgical procedure and postoperative recovery of patients were analysed.Results A total of 90 patients had successfully undergone robotic surgery,and 4 patients were converted to open surgery with the conversion rate of 4%(4/94).Sixteen patients received surgeries for hepatic diseases,and 1 patient with a giant hemangioma in the right posterior hepatic lobe was converted to open surgery,because a very close relationship between the hemangioma and inferior vena cava was observed;27 patients received surgeries for hilar diseases;19 patients underwent surgeries for pancreatic diseases,and 3 patients were converted to open surgery,including 2 with poor exposure of the giant pancreatic head carcinoma and 1 with tumors in the distal common bile duct:32 patients received other surgeries,including 6 with choledochojejunostomy and 11 with laparoscopic common bile duct exploration.Conclusions Almost all kinds of operations for hepatopanereatobiliary diseases could be performed by Da Vinci surgical system.Da Vinci surgical system expands the indications for laparoscopic surgery.

Objective To investigate the effect of clinical classification and operational methods of gallblad-der carcinoma on the prognosis.Methods Clinical data of 88 patients with gallbladder carcinoma treated surgically from January 1994 to December 2004 were retrospectively analyzed.Results 8 cases were in class Ⅰ and Ⅱ , 14 in class Ⅲ ,28 in class Ⅳ,38 in class Ⅴ.The mean survival of these 4 classifications was 36.5,9.3,4.6,3.9 months respectively.There was a remarkable difference(P <0.01,P<0.05) in survival among these 4 classifications ex-cept between class Ⅳ and class Ⅴ (P0.05).The mean survival of radical resection and palliative resection in class Ⅳ and Ⅴ was 4.2 and 3.8 months.There was no remarkable difference( P0.05 ) between them.Conclusion The key to increase the therapeutic effect gallbladder carcinoma is early diagnosis and radical resection.

Objective By investigating the effects of miR-379-5p on the proliferation,invasion and metastasis of mouse breast cancer 4T1 cells,we aimed to provide new therapeutic targets for the clinical inhibition of breast cancer proliferation,invasion,and metastasis.Methods After plasmid transfection,4T1 cells were utilized to detect the expression of miR-379-5p using fluorescence quantitative PCR.While 5-ethynyl-2'doxyuridine(EdU)cell proliferation and Transwell assays were employed to detect changes in the proliferation and invasion ability of 4T1 cells in each group.The migration ability of 4T1 cells after overexpression and knockdown of miR-379-5p was examined by scratch healing assay.A transplanted tumor model of breast cancer was established in BABL/c mice,and the effects of overexpressing miR-379-5p on tumor growth and the number and size of lung metastases were observed.Results EdU result showed that knocking down miR-379-5p enhanced the proliferation ability of the cells compared with the control group cells,and miR-379-5p overexpression reduced the capacity of breast cancer cells to proliferate(P＜0.05).Transwell and wound healing assays showed that miR-379-5p knockdown enhanced,while miR-379-5p overexpression significantly inhibited,the invasion and migratory ability of breast cancer cells(P＜0.01).An in vivo tumorigenesis experiment with BABL/c mice showed that miR-379-5p overexpression significantly slowed the tumor growth rate(P＜0.05)and inhibited lung metastasis(P＜0.01).Conclusions MiR-379-5p plays a role in tumor gene suppression in breast cancer and inhibits the proliferation,invasion,and migration of mouse breast cancer 4T1 cells.

Objective:Exploring the role and mechanism of gremlin-1 in lipotoxicity-mediated pancreatic β-cell dysfunction.Methods:The model of lipid toxicity-mediated pancreatic β-cell dysfunction was constructed using palmitic acid(PA) to treat mouse pancreatic β-cells(MIN6). Initially, to clarify the effects of lipotoxicity on islet β-cells, the cellular lipid deposition and changes in the levels of insulin caused by PA were detected. The effects of PA on gremlin-1 expression and its downstream signaling pathway BMPs/Smads were further investigated using qPCR and Western Blot assay. Subsequently, recombinant mouse gremlin-1 protein and BMP signaling pathway inhibitor LDN193189 were used to intervene the cells to explore the effects of gremlin-1 and its downstream signaling pathway BMPs/Smads on pancreatic islet β-cells.Results:PA could reduce pancreatic β-cell viability and insulin secretion capacity( P<0.05). Meanwhile, PA inhibited the expression and secretion of cell gremlin-1 and upregulated BMP-4 and its downstream Smad-1 and Smad-5( P<0.05). Intervention of cells with recombinant mouse gremlin-1 protein resulted in a significant elevation of insulin secretion and a concomitant decrease in the expression of key molecules in the BMP4/Smads signaling pathway( P<0.05). And inhibition of the BMP4/Smads signaling pathway ameliorated PA-induced pancreatic β-cell dysfunction. Conclusion:Gremlin-1 is involved in the regulation of lipotoxicity-mediated pancreatic islet β-cell dysfunction, and this effect may be associated with activation of BMP4/Smads signaling pathway.