Objective To investigate three strains of vaginal Lactobacillus for their regulative effects on macrophage and murine uterocervical carcinoma number 14(U14).Methods Mice were transplanted with U14,then ramdomly divided them into 5 groups.Model group and DDP group respectively were regarded as nagative and positive comparison;Lactobacillus groups were injected with 1010 each with Lactobacillus into peritoneum for 10 days successively.The TNF-? and NO content secreted by KM mice and the inhibitory rate of U14 cells were detected.Results The production of TNF-? and NO secreted by the peritoneal macrophages activated by Lactobacillus was greatly increased.The three strains of Lactobacillus all had significantly antitumor effects on KM mice bearing U14.Conclusion Lactobacillus showed a marked inhibition effects on the U14 cells and can activate macrophages to produce TNF-?and NO which may be involved in the antitumor mechanism.

Objective To investigate the effect of liver function with portal vein occlusion (PVO) in various phases and the following restoration portal vein flow on intestinal mucosal cells. Methods Twenty-four healthy adults white Japanese rabbits were randomized into 1 control group and 2 experimental groups (according to portal vein clamping for 30 min and 45 min). Each experimental group's blood samples were collected from caval vein 1 h before operation, by the end of portal vein oc-cluded, 30 min, 60 rain after relief of portal vein blocking, then with restoration of portal vein flow for 2 h and rabbit guts were continuously cut to sections for HE, TUNEL staining and Bcl-2, Bax protein immunohistochemical staining to observe the injury of intestinal mucosa cell apoptosis and the relation-ship between the expressions of Bcl-2 and Bax. The levels of blood glutamate-pyruvate transaminase (ALT), glutamic oxalacetic transaminase (AST) were measured and compared. Results The levels of ALT, AST in the control group did not significantly change. Compared with control group, group B did not change significantly with PVO 30 rnin in liver enzyme and they were significantly increased after portal vein occlusion relief. The levels of ALT and AST were increased obviously at 45 min with PVO, then raised again. Down-regulation of Bcl-2 expression, up-regulation of Bax expression and the increased index of apoptotic cell were found in each experimental group. Conclusion It may be more safe with PVO for 30 min. But the following restoration portal vein flow will bring about ischemia-reperfusion injury that is mainly apoptosis in the small intestine. The index of apoptosis will be raised with time prolongation of PVO.

The pathogenesis of icteric hepatitis is that pathogenic dampness blocks the middle energizer or blood stasis blocks the bile duct,so that the bile is not excreted normally and moves to the skin surface,which makes the skin yellow.Traditior al Chinese medicine (TCM) has unique advantages in the prevention and treatment of icteric hepatitis.This article systematically introduces the etiology and pathogenesis of icteric hepatitis and the TCM syndrome differentiation therapy for icteric hepatitis,in order to provide a reference for the clinical treatment of icteric hepatitis and the improvement in its prognosis.

Objective To evaluate the safety of percutaneous radiofrequency ablation (RFA ) in hepatic malignant tumors under the guidance of ultrasonography .Methods The clinical data and the follow‐up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA between January 2012 and February 2014 were retrospectively reviewed ,and the major or minor complications of RFA were both calculated .Results 1 568 lesions were ablated by 1 080 percutaneous RFA procedures in 900 patients with hepatic malignant tumors under the guidance of the sonography .The average size of the tumors was (2 6.± 1 2.)cm .The total complications rate of 1 080 RFA procedures was 5 9.3% (64/1 080) , which including intra‐abdominal bleeding 2 7.8% (30/1 080) ,hepatic abscess 0 7.4% (8/1 080) ,biliary tract damage 0 6.4% (7/1 080 ) ,vascular damage 0 5.6% (6/1 080 ) ,tract seeding 0 4.6% (5/1 080 ) ,pleural hemorrhage 0 3.7% (4/1 080) ,gastrointestinal damage 0 1.8% (2/1 080) ,hepatic encephalopathy 0 0.9% (1/1 080) ,and death 0 0.9% (1/1 080) .While major complications was 1 9.4% (21/1 080) vs minor 3 9.8% (43/1 080) .Sixty three patients with complications recovered after treatments including blood transfusion , ablation ,surgery ,interventional drainage procedure and liver transplantation ,only one patient died for irreversible liver failure .Conclusions RFA for hepatic malignant tumors under the guidance of sonography is a safe method with lower complications rate ,however ,the potential major complications and the indications of RFA liver malignant tumors should be carefully focused on .

Objective To evaluate the diagnostic value of contrast enhanced ultrasonogrphy(CEUS) and quantitative analysis in differentiating between thyroid solid malignant masses and solid benign masses.Methods 40 patients with thyroid solid mass were enrolled into this prospective study between March 2012 and June 2012.A total of 45 thyroid solid masses were evaluated by CEUS,and the final pathology diagnosis was confirmed by core biopsy or thyroidectomy.The diagnostic yield of enhancement patterns and quantitative parameters were assessed for differentiating between the solid malignant and benign masses.Results Enhancement patterns were classified into five types (nonenhancement,early hypo enhancement,hypo enhancement,isoenhancement,hyperenhancement).Two malignant masses had nonenhancement pattern,and 6 malignant masses had early hypoenhancement pattern,and 14 malignant and 4 benign masses had the hypo enhancement pattern,and 5 malignant and 7 benign masses had the isoenhancement pattern,and 1 malignant and 6 benign masses had the hyperenhancement pattern.There was a significant difference between malignant and benign enhancement patterns of thyroid solid masses (x2 =12.184,P =0.016).Nonenhancement,early hypoenhancement and whole phase hypoenhancement pattern predict thyroid solid malignant masses with sensitivity of 78.5 ％ and specificity of 76.5 ％.Among seven quantitative parameters used to predict thyroid malignant mass,the relative maximum intensity (IMAX％) of lesions had highest value in differentiating between the malignant and benign masses with sensitivity of 80.8 ％ and specificity of 82.6％,and area under receiver operating curve (AUC) of the IMAX％ was 0.878.RT (rising time),TTP (time to peak intensity),mTT (mean transit time) had almost non differentiation value with AUC of 0.619,0.601,0.656 separately.And mTT-Ratio (mTT of lesion/mTT of parametric area),RT-Ratio (RT of lesion/RT of parametric area),TTP-Ratio (TTP of lesion/TTP of parametric area) had less differential diagnostic value with AUC of 0.749,0.744,0.704 comparing with IMAX％.Conclusions Nonenhancement and early or whole phase hypoenhancement could be characteristic enhancement pattern of malignant thyroid solid masses,and IMAX％ had good diagnostic value in differentiating between malignant and benign masses among the quantitative parameters.

Objective To evaluate the short-term efficiency and risk factors for effects after percutaneous radiofrequency ablation (RFA) for hepatic malignant tumors under the guidance of sonography.Methods The clinical data and the follow-up radiographic images of the patients with hepatic malignant tumors treated by percutaneous RFA were reviewed between June 2011 and May 2012,and the short-term incomplete ablation rate,recurrance rate and tumor progression rate were calculated,and the factors affecting the incomplete ablation rate,recurrence rate and progression rate were analyzed.Results 610 lesions were ablated in the total of 462 RFA procedures for 405 patients under the guidance of sonography with percutaneous method.The average size of the tumor was (2.5 ± 1.1)cm.During at least 3-month follow-up,complete and incomplete ablation rate was 89.2％ (544/610) and 10.8％ (66/610)separately,and recurrance rate and progression rate of tumor was 17.5％ (81/462) and 23.8％ (110/462).The numbers (≥3) and the size (≥3 cm) and the location (close to vessels) of the lesions reduced the complete ablation rate.The numbers (≥3) of lesions affected the recurrence rate and progression rate of lesions as only risk factor.Recurrent hepatocellular carcinoma (HCC) and metstasis from gastrointestine or non-gastrointestine had higher recurrence rate and progression rate comparing with primary HCC.Conclusions RFA can effectively control local progression of hepatic maglinant tumors,and the tumor's size,number and location close to velssels could effect complete ablation rate,the number of tumors could effect the recurrence and porgression rate.Recurrent HCC and metstasis from gastrointestine or nongastrointestine had higher recurrence and progression rate comparing with primary HCC.

Objective To compare the difference between bone marrow stomal cell (BMSC) and adipose-derived stem cell (ADSC) of liver fibrosis in rats.Methods BMSC and ADSC of Sprague-Dawley (SD) rats were isolated and purified.The stem cell markers were detected with flow cytometry.The coculture system was set up with 0.4 μm Transwell insert semipermeable membrane.ADSC or BMSC were co-cultured with hepatic stellate cells (HSC).Normal hepatocyte cell line of rat (BRL) was co-cultured with HSC as negative control group and HSC cultured alone was blank control group.After cultured for 72 hours,the proliferation of HSC was determined by cell counting kit-8 (CCK-8) method.The expression of α-smooth muscle actin (α-SMA) of HSC was detected by Western blotting.The apoptosis of HSC was examined by flow cytometry.After BMSC,ADSC and BRL cultured alone for 72 hours,expression level vascular endothelial growth factor (VEGF),interleukin-10 (IL-10),nerve growth factor (NGF) and transforming growth factor-β1 (TGF-β1) in the culture medium were detected by enzymelinked immunosorbent assay (ELISA) method.The rats model of liver fibrosis were established.The rats were divided into BMSC treatment group,ADSC treatment group,BRL group and culture medium group,six rats in each group,which were injected with 1.5 mL BMSC,ADSC and BRL cells suspension (5 × 106) through portal vein,respectively,and same volume of culture medium was injected to the rate of culture medium group,once every two weeks for four weeks.The pathological changes of liver tissue sections were observed and liver fibrosis markers were tested.T test was performed for comparison between two samples and analysis of variance was used for comparison among multiple groups.Results BMSC and ADSC were successfully isolated and cultured.The phenotype of BMSC and ADSC was similar.Compared with blank control group and negative control group,both ADSC and BMSC could inhibit the proliferation of HSC and promote apoptosis (proliferation,2.43±0.27,2.39±0.33,1.92±0.38 and 2.18±0.31,FBMSC =25.61,FADSC =38.63,both P＜0.05 ;apoptosis rate,(5.59 ± 0.40)％,(6.82±0.57)％,(8.31± 1.03) ％ and (9.36 ± 0.54) ％,FBMSC =73.69,FADSC =97.41,both P＜ 0.05).The effects of ADSC were more significant than those of BMSC (t=5.76 and 5.18,both P＜0.05).There was difference in the cytokine levels secreted by ADSC and BMSC (NGF,(7.46 ± 0.54) pg/mL vs (3.95 ± 0.71) pg/mL,t =10.92,P＜0.05; TGF-β1,(8.79 ±0.93) pg/mL vs (6.36±0.85) pg/mL,t=7.58,P＜0.05).The cell transplantation experiment indicated that both BMSC and ADSC had significant inhibitory effect on liver fibrosis.The activity index of inflammation and degree of fibrosis in BMSC treatment group and ADSCs treatment group were 9.87±2.07,4.17 ± 0.94 and 10.13 ± 1.81,3.98 ± 0.82,which were significantly lower than those in blank control group (13.78±2.53 and 5.09±1.15)and negative control group (13.34± 1.89 and 4.95± 1.22,FBMSC=51.26 and 32.29,P＜0.05; FADSC =46.73 and 40.94,P＜0.05).The level of hyaluronic acid ((191.5±33.2) μg/L and (178.8±28.2) μg/L),type Ⅲ collagen ((19.9±5.1) μg/L and (21.7± 3.3) μg/L) and hydroxyproline ((312.6±38.8) μg/g and (325.8±28.2) μg/g) of BMSC treatment group and ADSC treatment group were significantly lower than those of negative control group and blank control group (hyaluronic acid,(282.3 ± 18.7) μg/L and (287.5 ± 26.7) μg/L),F =73.51 ; type Ⅲ collagen,(35.3± 3.3) μg/L and (32.5±4.3) μg/L,F=76.19; hydroxyproline,(458.4 ± 38.1) μg/g and (473.9 ± 63.7) μg/g,F=60.37,all P＜0.05).However,there was no difference between BMSC treatment group and ADSC treatment (all P＜0.05).Conclusions ADSC and BMSC had similar stem cell characteristics.There was difference in inhibiting the activation of HSC between ADSC and BMSC.But there was no significant difference in inhibiting liver fibrosis of rats in vivo.

Objecltive To intensify the coordination and nursing in the operation room in order to prevent surgical site infection after gastrointestinal operation. Methods 337 medical history of patients received gastrointestinal operation and third rate healing from 1999 to 2006 were collected. A series of intensified measures were applied to surgical site infection from 2003 gradually, including invocation of new surgical handwashing method, modified skin disinfection manner, adoption of degreasing with ethanol first before disinfection with iodophor, placement of incision protector and clean bag for incision protection after entering abdomen, changing to use new gastrointestinal anastomofic thimerosal,standardization of operation order and clean manage-ment in operation room. The incidence rate of surgical site infection after gastrointestinal operation of patients from 1999 to 2002 and from 2003 to 2006 underwent χ2 test. Results The incidence rate of surgical site in-fection after gastrointestinal operation greatly decreased after adoption of intensified nursing intervention, Signifi-cant difference existed in rate of patients with third rate healing between the year 1999 to 2002 and 2003 to 2006. Conclusions Modified nursing intervention for surgical incision after gastrointestinal operation can de-crease incision infection rate evidently.

Objective To discuss the epidural cavity surgical anatomical physiology under fiber optic epidural catheter, and to analyze the technological advantages compared to the the agent under blind. Methods 60 cases who need to epidural abdominal surgery from Jan. to Nov. 2013 were collected. Common duct (30 cases) and fiber optical epidural catheter (30 cases) were respectively used at anesthesia, and the epidural cavity surgical anatomy physiology were observed. Results Compared with indexs before anesthesia, before induction and before intubation, the HR, SPB, and MAP in 5 min after intubation and at the moment of skin incision were of statistically significant differ-ences (P<0. 05). There is a cavity between epidural space and vertebral canal periosteum which is not linked to cranial cavity, but there were a certain amount of connective tissue and venous plexus. The volume of the cavity was about 100 mL, the front and side were narrow and the back was wide, and it began to gradually expand from the neck, and reached its peak at the waist, and then gradually narrowed, un-til the sacral hiatus. Conclusion Fiber optic epidural catheter could make the patient’ s anatomy physiology structure more clear, and it also make it possible to cathetering visually for the anesthesiologist.