Objective To explore the feasibility and clinical effects of rotary cutter in laparoscopic splenectomy in treatment of traumatic spleen rupture.Methods The study retrospectively identified 10 cases with traumatic spleen rupture treated with laparoscopic splenectomy from June 2014 to June 2016.Results Total laparoscopic splenectomy combined with rotary cutter was completed successfully in 9 cases and 1 case was converted to open laparotomy due to intraoperative uncontrollable hemorrhage. The former operative time was 95 ~ 170 min, the estimated intraoperative amount of blood loss was 300 ~ 800 ml and autologous blood transfusion of 400 ~ 1 200 ml was conducted. The postoperative hospital stay was 8 ~ 14 d. No serious complications were found in the cases followed-up for 3 ~ 24 months after operation.Conclusion Laparoscopic splenectomy combined with rotary cutter is not only feasible and safe but also has the merits of minimally invasive surgery. It can be applied in treating those with abdominal trauma and with benign lesions in spleen. So it deserved promotion and application in clinical work.

Objective To construct a rat fixation device for local infra-red irradiation in rats, observe the binding effect of this fixation device, and assess its practical application.Methods Twelve SD rats were held by this home-made simple device.The holding time was recorded at room temperature (24℃ to 26℃), 38℃ to 39℃ and 42℃ to 43℃ by infrared irradiation, respectively, and the maximum observation point was 60 min.Results Most rats (10/12) were held for more than 30 minutes at room temperature, 38℃ to 39℃ and 42℃ to 43℃ infrared irradiation.While 8 rats reached 60 min.There was no statistically significant difference among the holding times at various temperatures (P > 0.05).Conclusion This self-made device is simple, easy to operate and can be used to hold rats for a long time, and is a convenient and reliable holding device in animal experiments.

Objective To explore the role of Toll-like receptor 7 (TLR7) and related signal transduction molecules in mechanisms underlying human papilloma virus (HPV) infection and condyloma acuminatum (CA) recurrence.Methods Peripheral blood was obtained from 30 healthy controls,35 patients with primary CA,32 patiens with recurrent CA and 30 patients with recurrent CA treated by imiquimod and ALA-PDT.Two-color flow cytometric analysis was used to detect TLR7 expression in different peripheral blood T cell subsets,Western blot to determine the expression levels of an adapter protein myeloid differentiation primary response gene 88 (MyD88),and signaling molecules including tumor necrosis factor receptor-associated factor (TRAF6),phosphatidylinositol3-kinase (PI3K),protein kinase B (AKT),p42/44 and nuclear factor-kappa B (NF-κB) in peripheral blood CD3+ T cells,from these subjects.Statistical analysis was carried out by Student's t test using the software SPSS 13.0.Results TLR7 was expressed in peripheral blood CD3+CD4+ T cells and CD3+CD8+ T cells from the healthy controls.Compared with the healthy controls,the patients with primary and recurrent CA showed no significant changes in TLR7 expression in CD3+CD8+ T cells,but a statistical increase in TLR7 expression in CD3+CD4+ T cells (23.3％ ± 8.4％ and 32.8％ ± 8.9％ vs.12.6％ ± 6.3％,t =4.72,10.76,both P ＜ 0.01).Decreased expression of TLR7 in CD3+CD4+ T cells was observed in patients treated with imiquimod and ALAPDT compared with the patients with recurrent CA (20.3％ ± 5.7％ vs.32.8％ ±8.9％,t =5.41,P ＜ 0.01).The protein expressions of MyD88,TRAF6,PI3K,p42/44 and NF-κB were significantly increased in CD3 + T cells,while the AKT protein expression experienced no significant changes in patients with primary or recurrent CA compared with the healthy controls.A significant decrease was observed in the protein expression of MyD88,TRAF6,p42/44 and NF-κB in the treated patients compared with those with recurrent CA.Conclusions TLR7,which is highly expressed in peripheral blood CD3+CD4+ T cells in patients with CA,may take part in the host immune response against HPV and serve as a recognition receptor for HPV infection.

Objective To observe the effects of adiponectin on mRNA and protein expressions of connective tissue growth factor (CTGF) in hepatic stellate cells (HSCs) and the levels of procollagen type Ⅲ (PC Ⅲ) and hyaluronic acid (HA).Methods Cultured rat HSCs were treated with different concentrations of adiponectin.CTGF mRNA and protein expressions were analyzed by reverse transcription polymerase chain reaction (RT-PCR) and Western Blot.The levels of PCⅢ and HA were detected by enzymelinked immunosorbent assay (ELISA).Results Compared with the control group,the result of RT-PCR showed that the four groups had different degrees of inhibitory effect,of which group D exhibited the strongest inhibitory effect.The absorbance ratio was 1.54 ±0.18,1.21 ±0.14,0.96 ±0.10,and 0.79 ± 0.08,respectively (t =2.42,P ＜0.05;t =2.73,P ＜0.05;t =3.28,P ＜0.01;t =4.67,P ＜0.01).Western Blot also indicated that four groups had different degrees of inhibitory effect,of which D group exhibited the strongest inhibitory effect.The ratio of integral absorption was 1.54 ± 0.18,1.21 ±0.14,0.96±0.10,and 0.79 ±0.08,respectively (t =2.84,P ＜0.01;t =4.05,P ＜0.01;t =6.25,P ＜0.01;t =9.72,P ＜0.01).The levels of PCⅢ and HA secreted in culture media were also decreased.It was significantly decreased with the concentration of adiponectin increased.Conclusion Adiponectin can inhibit the levels of PC Ⅲ and HA,which may be achieved through reducing CTGF mRNA and protein expressions.

The expressions of survivin and bcl-2 protiens were examined in 8 specimens from normal pituitary tissues and 38 pituitary adenomas by immunohistochemistry. The results showed that the expression of survivin was strongly associated with bcl-2 expression and abnormal expression of survivin resulted in inhibition of cell apoptosis, which might play a role in the pathogenesis of pituitary adenomas.

Objective To observe the effect of small interfering RNA(siRNA)expression plasmids targeting transforming growth factor p receptor(TαR)Ⅰ gene on the collagen synthesis of hepatic stellate cells(HSCs).Methods Three siRNA expression plasmids were designed and constructed according to TBR Ⅰ sequence.Then the plasmids were transfected into HSC-T6 using 1ipofectamine2000 reagent. The mRNA and protein expressions of TβR Ⅰ were analyzed by reverse transcription polymerase chain reaction(RT-PCR)and Western blot technique, respectively. The cell proliferation was detected using methylthiazo-lyldiphenyl-tetrazolium bromide(MTT)methods. Concentrations of haluronic acid and type Ⅲ pro-collagen in the supernatants were determined by radioimmunoassay. The data were analyzed using least significant difference(LSD).Results Three recombinant plasmids expressing siRNAs were successfully constructed and confirmed by restriction enzyme assay. Compared with the blank control,all the three recombinant plasmids could inhibit the expressions of TβR Ⅰ mRNA,of which plasmid expressing siRNA2 exhibited the strongest inhibitory effect(psiRNA1 group:t=7.354,P＜0.01;psiRNA2 group:t=9.214,P＜0.01;psiRNA3 group:t=5.967,P＜0.01).The expressions of TβR Ⅰ protein were also reduced by all the three recombinant plasmids,of which the plasmid expressing siRNA2 showed the strongest inhibitory effect(psiRNA1 group: t=6.324,P＜0.01;psiRNA2 group:t=8.741,P＜0.01;psiRNA3 group:t=4.128,P＜0.01).The proliferation activity and collagen synthesis of HSCs also decreased in all three HSC groups treated with recombinant plasmids, of which, again, plasmid expressing siRNA2 exhibited the strongest inhibitory effect. However, no significant change was observed in HSCs transfected with non-related siRNA. Conclusion Recombinant plasmids targeting TβR I can inhibit collagen synthesis, which suggests a novel target for gene therapy of liver fibrosis.

Objective To understand the epidemiological characteristics of a healthcare-associated infection(HAI)outbreak due to Norwegian scabies in a hospital,and provide basis for clinical prevention and control of HAI.Methods Through epidemiological investigation,all suspected patients and close contacts were investigated and traced,three dimensional distribution of patients was described,a series of effective comprehensive prevention and control measures were formulated and implemented.Results A total of 16 cases of Norwegian scabies infection occurred in November 3-16,2015,the most frequent cases were in November 11(n=5),the onset time of infection was concentrated in November 9-11(n=10),accounting for 62.50%of total cases.Spatial distribution of 16 cases: 12 cases were in general internal medicine department,2 in nursing department,and 2 were relatives of employees.Population distribution: patients aged 50-59(n=7),female(n=13),and nursing staff(n=9).After taking comprehensive prevention and control measures and medication treatment,16 infected persons were all cured,the cure rate was 100%,there was no new cases occurred in the hospital,epidemic was under control.Conclusion Norwegian scabies is highly contagious,it can cause epidemic in local area.In order to avoid spread of scabies infection in hospital,health care workers should strengthen the diagnosis and precaution level of the disease.

Objective To investigate the advantages and disadvantages of two different approaches (i.e.internal jugular vein and subclavian vein) when used for the implantation of central venus access ports (CVAP).Methods We retrospectively analyzed 620 patients who underwent the implantation of CVAP via the approach of internal jugular vein (n =222) or subclavian vein (n =398) and compared the success rate on first attempt as well as the incidences of peroperative and long-term complications.Results The implantation of CVAP was successfully performed in all the 620 patients,with the success rate on first attempt being 97.24％ (387/398) in the subclavian vein group and 89.19％ (198/222) in the internal jugular vein group (U =0.171,P ＜ 0.01).The incidences of perioperative/long-term complications were 0.90％ (2/222) /1.80％ (4/222) in the internal jugular vein group and 1.26％ (5/398) /2.01％ (8/398) in the subclavian vein group,showing no significant differences (all P ＞ 0.05).Conclusions The implantation of CVAP via either the internal jugular vein approach or subclavian vein approach is safe and reliable.Few complications will occur if performed properly.

Objective To evaluate the plasma levels of adrenomedullin (ADM) and urotensin Ⅱ ( U-Ⅱ ) in children with capillary bronchiolitis, and their clinical significance. Methods One hundred and fifty three children with capillary bronchiolitis and 36 healthy children were recruited. Plasma levels of ADM and U- Ⅱ were measured at acute stage ( <7days) and convalescent stage (>14days) of airway inflammation. The relationship of plasma ADM and U-Ⅱ levels with symptom scores was evaluated. Results Plasma levels of ADM and U-Ⅱ in acute stage of capillary bronchiolitis were significantly higher than those in convalescent stage and healthy controls ( ADM: t = 20. 57 and 26. 26, P < 0. 01; U-Ⅱ: t = 14. 27 and 7. 61, P < 0. 01 ) , and there were significant differences among mild, moderate and severe capillary bronohiolitis (F = 245. 94 and 304. 79, P <0. 01). Plasma level of U-Ⅱ in convalescent stage of capillary bronchiolitis was lower than that of healthy controls (t = 6. 99, P <0. 01 ) , but ADM was still in a higher level ( t = 8. 98, P < 0. 01 ). In the convalescent stage, there was significant difference on U-Ⅱ levels among mild, moderate and severe capillary bronchiolitis ( F = 25.69, P < 0. 01 ) , but no significant difference was observed for ADM levels (F = 2. 25 , P > 0. 05 ) . Plasma levels of ADM and U- Ⅱ in acute stage showed positive correlation with symptom scores, and the regression coefficients were 0.884 (P =0. 000) for ADM and 0. 943 (P = 0. 000) for U-Ⅱ . Conclusion Plasma ADM and U-Ⅱ levels in children with capillary bronchiolitis are increased in acute stage and correlated with the symptom scores, which may serve as laboratory indicators for assessing the severity of the disease.

Objective To observe the effect of sustained release type Ⅰ collagen-vascular endothelial growth factor (VEGF) on healing of bone-tendon junction injuries.Methods Partial patellectomy was conducted in 72 rabbits divided equally into control group,type Ⅰ collagen group,and collagen type Ⅰ-VEGF group.The scaffold was planted into the bone-tendon interface.Animals were sacrificed at 4,8 and 12 weeks.New bone formation into the patella-patella tendon surface was detected using X-ray films and histological observations.Quality of bone healing was assayed using biomechanical testing.Results At postoperative 4,8 and 12 weeks,X-ray films showed bone formation of type Ⅰ collagen group [(4.1 ± 0.4) mm2,(12.1 ± 0.5) mm2,(13.0 ± 1.2) mm2 respectively] and of collagen type Ⅰ-VEGF group [(3.8 ± 0.4) mm2,(11.0 ± 0.5) mm2,(13.1 ± 1.0) mm2 respectively] were more than that of control group [(2.1 ± 0.6) mm2,(4.1 ± 0.3) mm2,(6.6 ± 0.6) mm2 respectively] (P ＜ 0.05).Histology identified few new bone,massive fibrocyte accumulation and disrupted alignment of tendon fiber in control group,massive new bone formation,neat and orderly alignment of collagen fiber tissues and massive aggrecan expression at postoperative 4 and 8 weeks (fibrous cartage repair in largely) in collagen type Ⅰ-VEGF group,and massive new bone formation but worse alignment of tendon collagen fibers and less aggrecan expression (fibrous repair in largely) in type Ⅰ collagen group.Biomechanical test showed the ultimate tensile strength increased over time in all groups,with significantly higher value at 12 weeks than that at 4 and 8 weeks.At the same time point,ultimate tensile strength ranged in an order as follows:collagen type Ⅰ-VEGF group ＞ collagen type Ⅰ group ＞ control group (P ＜ 0.05).Conclusion Sustained release type Ⅰ collagen-VEGF can accelerate early healing of bone-tendon junction injury and improve the histological and mechanical properties.