Objective To observe and explore the value of combined detection of serum BNP and TnI in patients with acute heart failure(AHF). Methods 60 AHF patients from February 2015 to April 2016 were selected as observation group, and divided into Level III group(n=32) and Level IV group(n=28) according to NYHA classification;60 healthy patients at the same period were selected as control group.BNP and TnI levels were detected by chemiluminescence in each group, and were compared.Results BNP and TnI of observation group were(2624.4 ±378.6) ng/mL and(0.87 ± 0.22) ng/mL, while in control group were(72.4 ±20.2) ng/mL and(0.13 ±0.02) ng/mL, the differences were significant(P<0.05);BNP and TnI in level III group before treatment were significantly lower than grade IV group(P<0.05), after treatment, the level of BNP and III in group IV and group TnI were significantly lower(P<0.05), and the levels of BNP and TnI were significantly lower than those in III group after treatment(P<0.05). Conclusion BNP combine with TnI levels monitoring play an important role in AHF diagnosis and prognosis evaluation, can help to guide the treatment of AHF.

Objective To explore the use of rhomboid skin flap in expanded skin flap transfer. Methods A rhomboid skin flap was designed if the top soft part could not be fully utilized after expanded in a rotation skin flap. The flap pedicels were designed near the incision side. It should be ensured that ra-tio of the length to the width of the composite flap, which was composed of the rhomboid skin flap and the rotation skin flap, was 2.5∶1.0. Results Among these 11 patients with re-designed rhomboid skin flaps in the rotation skin flaps, the ratio of the length to the width reached to 3∶1 in some cases, but 2. 5∶1.0 in most cases. All the skin flaps survived, except one patient with disturbance of blood circulation in a small area and one with mild congestion. Conclusion The expanded soft tissue can be fully and rationally utilized to repair the skin defect in this design. Attention should be paid to the ratio of the length to the width of the composited flap, and it is better to select axial flap as the composite flap for safety. This method is safe, and worthy of recommendation.

Objective To investigate the operative methods and merits of nasal reconstruction in terms of the aesthetics. Methods The noses of 12 patients were reconstructed with an expanded triangle-shaped forehead flap with unilateral supratrochlear artery, a skin expander was placed obliquely under galea aponeurotica of forehead. Liquid was injected with conventional expansion method. Using the skin and the scars on nasal dorsum and tip as lining, based on intercanthal distance and aesthetic standard, a triangle-shaped forehead myocutaneous flap was designed over the expanded forehead skin tissue and used for a nasal reconstruction. The triangle-shaped flap was trimmed to different layer and reshaped based on aesthetic subunit.Results In twelve post-operative patients with nasal defect, no flap necrosis was found and the appearance of reconstructed noses were almost normal and satisfactory after follow-up for 6 months to 2 years. Conclusion The modified forehead myocutaneous flap according to aesthetic standard is safe and ideal for major nasal reconstruction. Meticulous moulding of triangle-shaped flap, nose interior with good blood supply, and primary insertion of nose stretcher are the key to a satisfactory appearance.

Objective To investigate the early diagnosis and disease evaluation value in patients with acute pancreatitis by various serum cytokines measurement.Methods Forty-eight acute pancreatitis patients were divided into two groups based on the results of computed tomography (CT) examination:mild acute pancreatitis group (30 cases) and severe acute pancreatitis group (18 cases).The other 30 normal persons were selected as control group.The various serum cytokines were measured by enzyme-linked immunosorbent assay (ELISA).Results The serum concentrations of interleukin(IL)-1,IL-10 and tumor necrosis factor (TNF)-α in mild acute pancreatitis group were significantly higher than those in control group [(25.00 ± 1.92) ng/L vs.(10.08 ± 2.65) ng/L,(59.78 ± 4.51) ng/L vs.(1.80 ± 0.66) ng/L,(55.31 ± 8.54) ng/L vs.(18.72 ± 7.84) ng/L,P ＜ 0.05].The serum concentrations of IL-1,IL-6,IL-8,TNF-α and platelet activating factor (PAF) in severe acute pancreatitis group were significantly higher than those in mild acute pancreatitis group [(93.27 ± 3.98) ng/L vs.(25.00 ± 1.92) ng/L,(397.84 ± 13.05) ng/L vs.(34.12 ± 4.96) ng/L,(93.32 ±3.40) ng/Lvs.(13.06± 1.86) ng/L,(181.94 ±7.54) ng/Lvs.(55.31 ±8.54) ng/L,(284.53 ±7.88) ng/L vs.(175.25 ±30.15) ng/L,P＜0.05].Conclusion The various serum cytokines measurement has great importance on the early diagnosis of acute pancreatitis and discrimination between the mild acute pancreatitis and severe acute pancreatitis.

ObjectiveTo investigate the influence of connective tissue growth factor (CTGF) onthe collagen metabolism in human keloid fibroblasts with RNA interference (RNAi).Methods Human keloid fibroblasts (KFB) in vitro were transfected by 3 pairs of specific small interfering RNA (siRNA) CTGF plasmid synthesized for human CTGF,respectively.Reverse transcriptase-polymerase chain reaction (RT-PCR) contributed to the screening of the best siRNA in interfering of CTGF expression in human keloid fibroblasts to construct the plasmids,with the application of RNAi,to test the changes of expression level and collagen content of CTGF in transfected keloid fibroblasts through RT-PCR and Western blotting compared to its control groups.ResultsThe 3rd pair (C3) siRNA- CTGF expression of genes and proteins was remarkably inhibited after being interfered with human keloid fibroblasts,with inhibitory rates of 86.8 ％ and 65.6 ％.ConclusionsKeloid fibroblasts transfected by plasmid siRNA-CTGF effectively inhibite the expression of CTGF and deposition of collagen,and CTGF promotes the collagen synthesis in keloid development.

Objective To explore the mutation situation of pancreatic cancer cell mitochondria DNA D-loop region. Method PCR and direct sequencing was used to analyze the mutational site of mitochondria DNA D-loop region in two pancreatic cancer cell lines SW1990 and JF-305 and normal primary cultured pancreas cell. Result The point mutations were found in two pancreatic cancer cell lines and normal primary cultured pancreas cell. Eight point mutations were found in SW1990 and 9 point mutations were found in JF-305. Three point mutations (73 site A-G,16223 site C-T, and 16358 site c-T) existed in all two pancreatic cancer cell lines and normal primary cultured pancreas cells, which can be considered as polymorphism. Other two point mutations (16211 site C-T and 16311 site T-C) were only found in two pancreatic cancer cell lines, which can be considered as special mutations. Conclusion The mitochondrial DNA D-loop region of pancreatic cancer cells existed polymorphism and special mutations, and the special mutations might be new molecule marker.

Objective To explore the effects of recombinant plasmids of pGPU6/GFP/NeoshRNA-CTGF (shRNA-CTGF) on the type Ⅰ collagen (COL-Ⅰ) protein expression in keloid,through RNA interference on connective tissue growth factor (CTGF) in vivo and in vitro.Methods Recombinant plasmids were designed and constructed by specific shRNA-CTGF; After transfeced human keloid fibroblast with shRNA-CTGF in vitro,RT-PCR was used to detect the CTGF mRNA level,and Western blot to detect the secretion of COL-Ⅰ.After transfected the keloid of nude mice with shRNA-CTGF in vivo,RT-PCR was used to detect the CTGF and COL-Ⅰ mRNA level,and Western blot was used to detect the protein expression of COL-Ⅰ.Results Recombinant plasmids of CTGF were successfully constructed,and the CTGF gene expression was significantly decreased in vivo and in vitro by 86.8％ and 54.1 ％,respectively; Down-regulation of CTGF in vitro significantly inhibited the mRNA and protein level of COL-Ⅰ by 76.8％ and 65.6％,respectively; Down-regulation of CTGF in vivo significantly reduced the COL-Ⅰ mRNA and protein level by 52.7％ and 48.0％,respectively.Conclusions CTGF gene expression is successfully down-regulated by the recombinant plasmid of shRNA-CTGF in vivo and in vitro.shRNA-CTGF significantly reduces the COL-Ⅰ protein level in keloid.It implies that CTGF gene is a potential target in the therapy of pathological scar.

Objective To study the significance of HSP47 gene in keloid formation after in vivo study with RNAi technology and the recombinant HSP4 7 siRNA against heat shock protein 47 to keloid in a nude mice model.Methods We injected RNAi mixture into the keloid of a nude mice model in experimental group and PBS water(0.25 ml)into control group at the 16th days after establishing the models.After interference we observed the specimens and harvested specimens at 7th days for biochemical and pathological analysis.Results The expression of HSP47 mRNA reduced obviously and the collagen content also reduced in the experimental group.The rusults had statistical significance.Conclusion We can suppress the expression of HSP47 gene and then reduce the production of collagen after in vivo interfering experiment with HSP4 7 siRNA in keloid nude mice models using RNAi technique.This study cornfirms the mechanism that HSP47 promotes the keloid formation,which provides a new target to treat keloid.

Objective To investigate the specific silencing of connective tissue growth factor (CTGF) in a nude mouse keloid model,using RNA interference (RNAi) technique,and to provide the basis for gene therapy of keloid.Methods The nude mouse keloid model was established,and then transfected in vivo with well-amplifiating plasmid.The mRNA expression levels of CTGF mRNA and type Ⅰ collagen mRNA were detected with reverse transcription-polymerase chain reaction (RT-PCR).The distribution and protein expression levels of CTGF and type Ⅰ collagen were determined quantitatively using immunohistochemistry.Results The expression of CTGF at mRNA and protein levels was decreased in the experiment group,and the expression of type Ⅰ collagen at mRNA and protein levels was also decreased after transfection,as compared with negative control group and blank group,with significant difference between groups (P＜0.05).Moreover,the expression of type Ⅰ collagen and CTGF was positively correlated (r=0.979).Conclusions Keloid type Ⅰ collagen can be decreased through in vivo inhibiting CTGF expression.The transfection of CTGF gene in vivo may have effects on type Ⅰ collagen generation,and thus inhibit the keloid growth.

ObjectiveTo summarize the experience of gastric D2 operation and evaluate the feasibility and safety of peripheral vascular choroid of lymph node dissection.Methods A retrospective study was adopted to analyze the redical D2 operation procedure and operation results 24 advanced gastric cancer cases,summarizing the experience of D2 radical gastrectomy operation for gastric cancer.The number of resected lymph nodes,operation bleeding volume,postoperative complications were analyzed to evaluate the feasibility and safety of operation.Results All 24 cases undergoing D2 radical gastrectomy operation of advanced gastric cancer were successful,and got the R0 resection.A total of 634 lymph nodes were excised in all the cases,averaged 26.42.A totle of 206 metastatic lymph nodes were found,metastasis rate being 32.49％.Operation bleeding volume was averaged 264.58 mL.The postoperative complication rate was 25％,anastomotic bleeding in 1 case,input loop jejunum fistula of esophageal jejunum anastomosis in 1 case,hyperamylasemia and 2 cases reflux esophagitis in 2 cases respectively.Conclusions D2 radical gastrectomy operation of gastric cancer is safe and feasible on the basis of mastering perigastric anatomy and master of lymph node excision technology and anatomical hierarchy separation.