This article suggests that doctors should keep the principle that patients’interest should be the first and respect the autonomy of pregnant woman during the prenatal diagnosis and intervention,and brings the ethical concept of fetus as a patient.Before prenatal diagnosis and intervention,doctors should tell the pregnant woman about the advantages and disadvantages of the project for her to make decision.For the fetus born with deformity but still having survival ability,fetal ethical principle prohibits against termination unless pregnant woman has diseases not permitting to continue pregnancy,although there is an increasing risk of morbidity and mortality.

In order to evaluate the value of angiographic diagnosis and interventional therapy in the patients with massive hemobilia, 10 patients with massive hemobilia were analyzed retrospectively from Sep. 1990 to Sep. 1999. All of them underwent emergency celiac and selective right or left hepatic artery angiography. The patients were diagnosed rapidly and treated successfully by embolization of the hepatic artery branch proximal to t he bleeding point, and hemorrhage was stopped immediately. Two out of 10 patients were embolized two times for bleeding again. All patients were alive and followed up for 3 months to 5 years. As a safe, reliable and mininally invasion method, selective hepatic artery angiography and embolization was proved to be an important diagnostic and therapeutic means for massive hemobilia, which had obvious advantages of minimally invasive reatment in unstable patient over surgery and should be the first choice for such patients.

Objective To explore the effects of compound lidocaine cream applied to postoperative wound and nasal packing on postoperative sinus pain after endoscopic sinus surgery . Methods From April 2015 to June 2016, 100 cases of endoscopic sinus surgery were carried out in our hospital under general anesthesia .The patients were randomly divided into two groups , with 50 cases in each group .The group A was given compound lidocaine cream 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing;the group B was given saline 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing . The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at the time of extubation (T0), 1 h after extubation (T1), 4 h after extubation (T2), 10 h after extubation (T3), and 12 h after extubation (T4), respectively.The visual analogue scale (VAS) of pain after extubation was recorded . Results The HR, SBP and DBP at T0, T1, T2 and T3 in the group A were significantly lower than those in the group B (P<0.05).The HR and SBP were not significantly different at T4 between the two groups (P>0.05), while the DBP was significantly lower in the group A than that in the group B (t=-2.562, P=0.012).The VAS scores were significantly lower in the group A than those in the group B at T 0, T1, T2 and T3 (P=0.000).No statistical difference was seen in VAS scores at T4 between the two groups (t=-1.199, P=0.233). Conclusions Application of compound lidocaine cream on nasal endoscopic wound and intranasal packing can effectively relieve the pain after endoscopic sinus surgery .The method has good analgesic effects and is worthy of popularization and application .

ObjectiveTo investigate changes of the cellular immune function in the elderly patients with nonsmall-cell lung cancer (NSCLC) after chemotherapy.Methods T-lymphocyte subsets and natural killer cell were detected in 29 elderly patients with NSCLC,20 adults with NSCLC and 22 healthy elderly,and their levels were compared between pre-chemotherapy and at the end of 2 cycles of chemotherapy in the elderly patients with NSCLC.ResultsThe levels of CD3,CD4,CD8,CD4/CD8andNK cell were (58.9±15.8),(32.3±12.7),(22.0±9.8),(1.3±0.7),(21.6± 7.7),respectively in the elderly patients with NSCLC,(65.9 ± 7.2),(38.5 ± 7.6),(23.1 ± 9.2),(1.5±0.7),(16.8±6.2),respectively in adults with NSCLC and (67.3±9.0),(39.0±7.8),(23.9±9.3),(2.0±1.6),(22.5±5.8),respectively in healthy elderly.The levels of CD3 and CD4 were decreased (t=2.109,2.159,P＜0.05) and NK cell was increased (t=2.273,P＜0.05) while CD8 and CD4/CD8 had no difference(t = 0.406,0.736,P＞ 0.05 ) in the elderly patients with NSCLC as compared with adults with NSCLC.The levels of CD3,CD4,and CD4/CD8 were lower (t = 2.234,2.200,2.016,all P＜ 0.05) in elderly patients with NSCLC than in healthy elderly,with no significant change in the levels of CD8 and NK cell(t= 0.700,0.474,P＞0.05) between the two groups.The levels of CD3 (51.6 ±10.3)was reduced(t=2.067,P＜0.05) and CD4 (31.7 ± 11.7),CD8(21.6 ± 6.5),CD4/CD8 (1.3 ± 0.7),NK cell (26.0 ±12.7)had no remarkable difference (t =0.186,0.180,0.289,1.570,all P＞ 0.05)after chemotherapy in elderly patients with NSCLC.ConclusionsThe cellular immune function in the elderly patients with NSCLC is lower than in adults with NSCLC and healthy elderly,and further decreases after chemotherapy.

Objective To study the inhibit effect of survivin short hairpin RNA on the survivin mRNA and protein expression of gallbladder carcinoma cells.Methods Human gallbladder carcinoma cells(GBC-SD) were transfected with recombinant plasmid.RT-PCR and Western blot were used to analyze the changes in(expression) levels of survivinmRNA and protein.Results The size of the PCR product was 350bp.DNA(sequencing) showed that the sequence of recombinant vector pshRNA-survivin was successfully constructed and suppressed the expression of(GBC-SD) survivinmRNA.Conclusions The recombinant plasmid constructed can inhibit the expression of survivinmRNA in transfected cells.This provides a new method and material for the biological therapy of cancer.

Objective To investigate the protective effect and mechanism of warm ischemic preconditioning of on liver cold ischemic-reperfusion injury of donor liver in rats. Methods Male Sprague Dawley rats were used as donors and recipients of orthotopic liver transplantation, the cold ischemia period and anhepatic phase was 120 min and 16～20 min respectively. Rats were randomly divided into 3 groups: sham-operation group, liver transplantation group, and ischemic pre-conditioning(IP) group. IP was performed with 5-min ischemia followed by 5-min reperfusion. Results After operation, the serum levels of ALT and superoxide were significantly higher in the groups of liver transplantation and IP group than in the sham-operation group(P

Objective To observe the expression of small ubiquitin?related modifiers(SUMO)protein in normal cultured human lens epithelial cells(SRA01/04)and discuss regulation effects of SUMO protein on oxidative stress induced by high glucose. Methods The expression and local?ization of SUMO 1,2/3,4 was detected in normal cultured SRA01/04 cells through immunocytochemistry. The mRNA expression levels of SUMO 1?4 were examined by RT?PCR after the SRA01/04 cells treated with high glucose media at different concentrations and time points. Samples were grouped by medium concentrations(glucoses 5.5 mmol/L,12.5 mmol/L,25 mmol/L,50 mmol/L respectively for 24 h)and by treatment time(0 h, 6 h,12 h and 24 h respectively). After highly efficient transfection of GFP?SUMO2 into SRA01/04 cells,the survival and apoptotic rates of transfect?ed and un?transfected cells treated with high glucose was detected by CCK8 method and AV/PI double staining flow cytometry. Results The immu?nocytochemistry results showed that SUMO1,2/3,4 proteins were mainly located in the nucleus of SRA01/04 cells and part of SUMO2/3 was in the cytoplasm. RT?PCR results showed that compared with the low?glucose group,the mRNA expression of SUMO1?4 was increased along the increas?ing glucose concentration in the high?glucose group(P<0.05). Compared with 0 h,the mRNA expression of SUMO1?4 was enhanced at 6 h,12 h and 24 h(P<0.05)in the high?glucose group treated at 50 mmol/L concentration. Compared with the un?transfected cells,the survival rate was in?creased and the apoptotic rate was decreased in GFP?SUMO2 transfected cells in oxidative stress induced by high glucose(P<0.05). Conclusion SUMO protein was positively expressed in SRA01/04 cells and the expression of SUMO mRNA was affected by oxidative stress induced by high glu?cose.

AIM: To investigate the effect of mfn2 on mitochondrial function in steatosis hepatocytes. METHODS: Plasmid pEGFP-mfn2 was transfected into hepatocyte strain L02 by Lipofectamine 2000 in vitro, then the steatosis model of hepatocytes was establish by oleic acid induction. RT-PCR was used to evaluate mRNA expression and Western blotting was use to detect the protein expression. ATP level was determined by firefly luciferase bioluminescent. ROS production was measured by fluorescence probe DCFH-DA. Chondrosome transmembrane potential of L02 was observed by labeling of JC-1 and FCM. RESULTS: The stable expression of ectogenesis mitofusin2 in L02 cells was confirmed by RT-PCR and Western blotting. In the model of oleic acids induced lipid formation, Mfn2 obviously inhibited the descent of chondrosome transmembrane potential and ATP level, and increased ROS production in L02 cells. CONCLUSION: Up-regulated expression of mfn2 attenuates mitochondria dysfunction caused by oleic acids induced lipid formation.

Objective To summarize the clinical experience of hepatectomy with hepatic artery resection and reconstruction using gastroduodenal artery during radical resection of hilar cholangiocarcinoma.Methods From Dec.2004 to Dec.2008,nine cases of hilar cholangiocarcinoma with hepatic artery invasion were subjected to radical resection comhined with tumor invaded hepatic artery resection and reconstruction using gastroduodenal artery.The clinical data of these patients were reviewed.Results Nine cases underwent hilar cholangiocarcinoma radical resection with hepatic artery resection,immediate hepatic artery reconstruction using gastroduodenal artery end to end anastomosis while hepatic artery resection exceeding 1 cm.One patient underwent partial resection of the portal vein and repair using autogenous segment of great saphenous vein.Roux-en-Y hepaticojejunostomy was performed in 9 patients with intrahepatic bile duct stents in 8 patients.All patients suffered from postoperative transient SIRS and recovered within 2-3 days after operation.One patient experienced massive bleeding from the upper alimentary tract 3 day after operation and the bleeding was controlled afterwards.The blood flow in the reconstructed hepatic arteries monitored by Doppler was normal two weeks after operation.There was no inhospital mortality.9 patients were followed up for 1-4 years,the median survival time is 23 months (6 months to 32 months).Conclusion Hepatic artery can be reconstructed using gastroduodenal artery during a radical resection of hilar cholangiocarcinoma,and hepatic artery reconstruction decreases the postoperative complications.

Background Gene encoding optineurin (OPTN) is a causative gene for glaucoma and amyotrophic lateral sclerosis,with a more expression in retina.Our previous study isolated OPTN-interacting proteins and identified that the gene encode the basic leucine zipper (bZIP) transcription factor neural retina leucine (NRL) zipper,a causative gene for retinitis pigmentosa,and further study demonstrated the interaction between OPTN and NRL proteins in nuclei of cultured HeLaS3 cells.Objective This study was to determine the protein binding site of OPTN necessary for NRL binding.Methods A deletion series of OPTN-expression plasmids were constructed and co-expressed with hemagglutinin (HA)-tagged NRL in HeLaS3 cells,respectively.The cytoplasmic and nuclear fractions were used to perform co-immunoprecipitate (CoIP) and Western blot with anti-tag antibodies.Results In the nuclear fractions of cells transfected with the del1 st,del2nd or del3rd plasmid,a band of coimmunoprecipitated HA-labelled NRL (HA-NRL) was detected.However,the del4th plasmid did not produce a band.The NRL band was not found in cytoplasmic fractions from transfected cells with any of the deletion plasmids or with the whole-length OPTN plasmid.Conclusions The protein binding site of OPTN necessary for NRL binding is determined.This result demonstrates the binding of Flag-OPTN and HA-NRL in HeLaS3 cells.A series of partial-deletion OPTN plasmids demonstrated that the tail region (423-577 amino acids) of OPTN was necessary for binding with NRL.