Objective To investigate risky factors,and predictability of portal vein thrombsis in patients with portal hypertension caused by hepatic cirrhosis after spleenectomy and portaazygous devascularization. Methods Between Jan 2004 to Nov 2009,clinical data of 27 patients suffering from postoperative PVT were compared with 37 patients admitted during the same period without postoperative PVT. Results There were 4 factors proved to be risk factors for PVT.Perioperative peripheral platelet count (postoperative to preoperative) 、D-dimer、the whole blood viscosity and the blood flow of portal vein postoperatively.The right predictive rate of PVT was 87.3%. Conclusion The risk factors of PVT are the ratio of platelets、D-dimer、the whole blood viscosity and the blood flow of portal vein postoperatively.By this method it is probable that postoperative PVT is predictable.

Objective To investigate the changes in the proportion of regulatory T (Treg) cells and in the levels of cytokines secreted by these cells in the peripheral blood in the patients with chronic myeloid leukemia (CML). Methods The enrolled subjects consisted of 30 CML patients who were newly diagnosed , 20 CML patients who were under the effective treatment of tyrosine kinase inhibitors (BCR-ABL 210 transcript ratio is below 10%) and 20 healthy donors whose age and sex were matched .Flow cytometry was used to detect CD4+CD25 high CD127 low /-Treg cells and CD4+ T cells.The enzyme linked immunosorbent assay was used to determine the plasma concentra -tions of interleukin-10(IL-10), transforming growth factor-β1(TGF-β1) and IL-35.Results The proportions of Treg cells in CD4+ T cells were similar among the three groups .As concerns the three kinds of Treg-associated cy-tokines, there were no significant differences in the plasma concentrations of IL -10 among the three groups.Howev-er, compared with the treatment group and the control group , the plasma concentrations of TGF -β1 and IL-35 in the newly diagnosed patients significantly increased (P <0.001), with no significant difference between the treat -ment group and the control group.Conclusion Though the proportion of Treg cells did not significantly change in the newly diagnosed patients, the plasma concentrations of TGF-β1 and IL-35 indeed significantly enhanced , sug-gesting the dysfunction of Treg cells in the newly diagnosed patients might be associated with the progression of dis -ease.Effective treatment of tyrosine kinase inhibitors could down -regulate the plasma levels of these cytokines to baseline, suggesting that monitoring these cytokines might evaluate the efficacy of therapy .

OBJECTIVE:To study the effects of Thymalfasin for injection on the apoptosis of human lung cancer A549 cells. METHODS:After treated with 0(blank control),25,50,100,200 and 400 mg/L Thymalfasin for injection for 24,48 and 72 h, the cell proliferation inhibitory rate was analyzed with MTT and calculated. After treated with 0(blank control),50 and 100 mg/L Thymalfasin for injection for 48 h,cell apoptosis was detected by flow cytometry,and the expression of Caspase-3,Bcl-2 and Bax and the phosphorylation level of Akt were deteced by Western blot. RESULTS:Compared with blank control group,proliferation in-hibitory rate of A549 cells increased after treated with Thymalfasin for injection,in concentration and time-dependent manner(P<0.05). The apoptotic rate of A549 cells increased after treated with Thymalfasin for injection 50,100 mg/L for 48 h (P<0.05). The expression of Caspase-3 increased while the Bcl-2/Bax and phosphorylation level of Akt decreased in A549 cells after treated with Thymalfasin for injection 100 mg/L (P<0.05). CONCLUSIONS:Thymalfasin for injection can inhibit the proliferation of A549 cells by activating Caspase-3,decreasing Bcl-2/Bax ratio,inhibiting Akt signal pathway and induce the apoptosis of A549 cells.

Objective　To study the distribution of insulin-like Growth Factors (IGFs) in liver、 spleen、kidney、thymus and supraadrenal glands of fetus from 16 to 24 weeks.Method　Using ABC immunohistochemistry. Results　 IGF-I positive cells were found in these organs during this period of fetal life, but the differences of number and reaction intensity of IGF-I positive cells appeared in different organs and individuals.Conclusion　These organs tissues can express IGF-I during fetal development and play paracrine and/or autocrine role in cellular proliferation and differentiation of these fetal tissue.

Objective To study the risk factors for spontaneous rupture of primary hepatic carcinoma.Methods The clinical data of 31 patients with spontaneous rupture of primary hepatic cancer admitted to our hospital from Jan 1999 to Dec.2008 were retrospectively analyzed,and compared with 31 randomly selected concurrent patients without rapture of HCC.Results Three factors were shown to be the risk factors for spontaneous rupture of primary hepatic carcinoma.Those were APTT,HBeAg and the greatest height of tumor protrusion above the surface of liver.Conclusions APTT,HBeAg and the greatest height of tumor protrusion above the surface of liver are risk factors for spontaneous rupture of primary hepatic carcinoma.

Objective To explore the causes and management of postoperative complications of laparoscopic Roux-en-Y gastric bypass (LRYGB).Methods The retrospective cross-sectional study was conducted.The clinical data of 450 patients with metabolic diseases who underwent LRYGB between June 2004 and November 2016 were collected,including 283 (58 in hospital consultation) in the First Affiliated Hospital of Jinan University,140 in the Jihua Hospital Affiliated to Jinan University and 27 in the Zhengzhou Hospital of Jinan University.Observation indicators:situations of surgical completion,follow-up situations,occurrence,treatment and prognosis of complications.Follow-up using outpatient examination and telephone interview was performed to detect postoperative complications once at month 1,3,6 and 12 within 1 year postoperatively and once every year after 1 year postoperatively up to March 2017.Measurement data with skewed distribution were described as M (range).Count data were evaluated by the ratio,and comparison between groups was analyzed using the chi-square test.Results All the 450 patients with metabolic diseases underwent successful LRYGB,including 50 receiving LRYGB during surgical internship period and 400 receiving LRYGB after surgical internship period,without conversion to open surgery.All the 450 patients were followed up for 70 months (range,1-153 months).Twenty-seven patients had postoperative complications,with an incidence of 6.00％ (27/450).The incidence of postoperative complications was 20.00％(10/50) in 50 patients receiving LRYGB during surgical internship period and 4.25％ (17/400) in 400 patients receiving LRYGB after surgical internship period,with a statistically significant difference (x2 =16.86,P＜ 0.05).Of 27 patients with postoperative complications,1 was complicated with fulminant acute pancreatitis and died from multiple organ failure at day 15 postoperatively,5 with intra-abdominal bleeding,2 with anastomotic leakage,3 with gastrojejunal anastomosis stenosis,2 with gastrojejunal anastomosis ulcer,1 with improper anastomosis,1 with respiratory failure,1 with umbilicus infection,3 with internal hernia,2 with dumping syndrome,6 with weight-loss failure (1 refused to undergo revision surgery),and patients with postoperative complications were improved or cured by surgery or conservative treatment except one death.Conclusions The incidence of complications in patients receiving LRYGB after surgical internship period is significantly reduced,and complications needs to make the individualized treatment plan.

Objective To study the effects of ginkgo biloba extract(GBE)on c-reactive protein(CRP) and tumor necrosis factor-α(TNF-α)in serum and alveolar lavage fluid(BALF)from rats with chronic obstructive pulmonary disease(COPD). Methods 90 rats were randomly divided into groups A,B,C,D,E and F. There were 15 rats in each group. The rat model of COPD were established in groups B,C,D,E and F. Groups C and D were given intraperitoneal injections with GBE from day l to day l4 and day 29 to day 42. Groups E and F weregiven intraperitoneal injections with erythromycin from day l to day l4 and day 29 to day 42. After the end of experi-ment ,the contents of CRP and TNF-α in serum and BALF were detected in all groups. Results The contents of CRP and TNF-α in the serum and the BALF were markedly lower in groups C,D,E and F than in group B (P<0.05);and the contents of CRP in the serum and the BALF and TNF-αin the BALF were lower in groups C, E and F than in group D(P<0.05). Conclusions GBE can inhibit the airway and systemic inflammatory response in COPD rats. Early intervention is more effective.

Objective To study the concentration of anti-cyclic citrullinated peptide antibody (CCP),rheumatoid factor (RF),immunoglobulin (Ig) in synovial fluid and serum of patients with rheumatoid arthritis (RA),and the positive rate of anti-keratin antibodies (AKA) and anti-perinuclear factor (APF) were also measured.The aim was to explore the diagnostic value of these antibodies in synovial fluid for RA.Methods Thirty RA patients were collected,synovial fluid were withdrawn from the inflamed joints and peripheral blood were collected at the same time.Anti-CCP antibody,AKA,APF and RF were measured.The cut-off value of CCP in synovial fluid was determined through operating characteristic curve (ROC curves) analysis.The antibody levels in serum and synovial fluid were compared.Statistical analyses were performed using t test,and Pearson's correlation test.Results The cutoff value of CCP in RA synovial was higher,which was 29.00 U/ml,with the sensitivity of 87.00％ and specificity of 94.10％.There were significant differences in the concentration among anti-CCP antibody [(326±313) U/ml,(496±454) U/ml,t=-2.399,P＜0.05],IgG [(57±39) mg/L,(173±86) mg/L,t=-7.4792,P＜0.05),RF [(53±36) U/ml,(149±104) U/ml,t=-2.402,P＜0.05] in synovial and blood serum respectively in RA patients.Conchsion The diagnosis of RA is enhanced if anti-CCP antibodies,RF and IgG in synovial fluid are examined.They are supplementary to RA diagnosis and are helpful for clinical practice,especially for patient with very recent-onset RA.

Objective To analyze the clinical characteristics and prognostic factors in patients with primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL),and to improve the diagnosis and treatment of PGI-DLBCL.Methods Retrospective analysis was conducted in 51 cases of PGI-DLBCL between January 2009 and August 2013.The data included clinical manifestations,pathological features,treatment regimens and prognosis.Results 51 patients included 31 males and 20 females,the range of ages was from 16 to 80 years old,median age was 48 years old.The major clinical presentation were abdominal pain,abdominal distension,abdominal mass,nausea and vomiting,abdominal mass.The occurrences in stomach,small intestine,colon,rectum and multiple involvement were 56.86 ％,29.41％,7.84 ％,1.90 ％ and 3.92 ％ respectively.The mass bigger than 10 cm was found in 13 cases (25.49 ％).47.06 ％ (24/51) of the cases belonged to the GCB subtype and 52.94 ％ (27/51) belonged to the non-GCB subtype.There was no significant impact of lymphoma cell origin,disease distribution (stomach or intestinal) and mass on prognosis of lymphoma treatment.The univariate analysis revealed that the patients with Lugano stage Ⅳ,increased level of serum lactate dehydrogenase (LDH),modified-international prognosis index (modified IPI) 3-5 and increased level of CA125 had poor prognosis (all P ＜ 0.05).There was no difference of survival rate between patients treated with rituximab plus chemotherapy and single CHOP like therapy.Surgery plus postoperative chemotherapy significantly improved survival of patients treated with simple chemotherapy (P ＞ 0.05).Conclusion The clinical Lugano stage,IPI score,increased LDH and CA125 are important prognostic factors of PGI-DLBCL.

Objective To investigate the correlation of methylation status in DA T1 and DRD4 genes and severity of clinical manifestations in ADHD patients.Methods One hundrd eleven DSM-Ⅳ defined ADHD patients were enrolled in this study and the demographic data were collected.Clinical symptoms were also assessed by Attention Deficit Hyperactivity Disorder Rating Scale-Ⅳ Home Version (ADHD-RS-Ⅳ) and self-developed Oppositional Defiant Disorder (ODD) rating scale.Bisulfite genomic sequencing (BGS) was used to detect the methylation status of every CpG site in DA T1 and DRD4 promoter CpG island in peripheral venous blood.Results The DNA methylation level in total CpG island for DA T1 was higher in individuals without depression,anxiety or ADHD family history compared to individuals with above family histories (P＜0.05).The differences on methylation levels for DA T1 and DRD4 were not significant between high and low ADHD-RS-Ⅳ total score (≤30 vs.＞30),ADHD-RS-Ⅳ inattention score (≤ 17 vs.＞17),and ADHD-RS-Ⅳ hyperactivity/impulsivity score (≤13 vs.＞13) subgroups (all P＜0.05).The methylation levels in total CpG island in DA T1 was higher in individuals whose ODD score were ＜9 compared to those whose ODD score were ≥9 (P＜0.05).Conclusions Methylation status of CpG island in DAT1 may influence the severity of oppositional defiant symptom in ADHD patients,which is correlated with depression,anxiety and ADHD family histories.