Objective To investigate the effect of CO2 pneumoperitoneum on the cell adhesion capability of cultured endometrium cancer cells.Methods After treated in a pneumoperitoneum model for 4 h,the changes in cell growth and adhesion of the endometrium cancer were detected by MTT.The expression of ?1-integrin and E-cadherin in the cancer cells were compared with the control that were not treated with CO2,by the immunohistochemical method.Results After treated with CO2 for 4 h,the cell growth was enhanced and the cell adhesion capability increased as compared with the control group.At the same time,the expression of ?1-integrin and E-cadherin was lower in treated cells than that in untreated ones.Conclusion The adhesion capability of endometrium cancer cells in CO2 pneumoperitoneum could be enhanced by the reduction of the expression of ?1-integrin and E-cadherin,and thereby influences the metastasis of cancer.

Objective To discuss the effect of CO2 artificial pneumoperitoneum on the invasion of the endometrial cancer in nude mouse resulted from the transplantation of the cancer cells and its mechanism.Methods Thirty nude mice were divided into 3 groups based on the time in the CO2 pneumoperitoneum circumstance.Control group: the small intestine of the nude mouse was exposed in air for 5 min,and the cancer cells were injected into right lower quadrant after suture.The gas was depleted after 40 min.40 min group: CO2 gas was poured into abdominal cavity to form a 4 mmHg artificial pneumoperitoneum for 5 min before cancer cells were injected into right lower quadrant.The gas were depleted after 40 min.80 min group: CO2 gas was poured into abdominal cavity to form a 4 mmHg artificial pneumoperitoneum for 5 min before cancer cells were injected into right lower quadrant.The gas were depleted after 80 min.The time that each group took to form a solid tumor was recorded.Four weeks later,the transplantation tumors were taken out and sliced into frozen sections and paraffin-embedded sections.The expression of ?1-intergrin and E-cadherins was detected by IMF.Results The time taken to form the solid cancer was shorter in the 40 min group and 80 min group than in the control group,with more blood vessel found(P0.05).Conclusion The CO2 pneumoperitoneum could enhance the abilities of invasion and adhesion of endometrial cancer cells,which is associated with the expression changes of ?1-intergrin and E-cadherins in the cancer cells.

ve To investigate the possible role of platelet endothelial cell adhesion molecule-1 (PECAM-1) in the lung injury induced by mechanical ventilation. Methods Twenty-four healthy small pigs of either sex, weighing (17.5?2.5) kg were randomly divided into four groups according to the tida volume of mechanical ventilation: control group without mechanical ventilation; low tidal volume group (A) VT=6 ml?kg-1; normal tidal volume group (B) VT=12ml?kg-1; high tidal volume group (C) VT =25ml?kg-1. The animals were anesthetized with intramuscular ketamine 15-20mg?kg-1 and diazepam 1.5-2.0mg?kg-1 and intubated and mechanically ventilated. Anesthesia was maintained with infusion of ketamine, procaine and succinylcholine. Respiratory rate was set at 18 bpm, I:E=1:2 and FiO2=35% , Femoral artery and vein were cannulated for intra-arterial pressure monitoring, blood sampling and infusion of fluid and anesthetics. ECG, rectal temperature and urine output were monitored. Venous blood samples and lung tissue from right lower lobe were obtained on 1st, 3rd and 7th day of mechanical ventilation for determination of serum and lung myeloperoxidase (MPO) activities, expression of PECAM-1 protein on pulmonary vascular endothelium cells and electron microscopic examination. Results The serum and lung MPO activities were higher in group A, B and C than those in control group (P

Cellular schwannoma is a rare benign tumor of the peripheral nerves.The tumor is consist of spindle cells which arranged in interwoven bundles,and lacking the mesh district and palisading structure.The tumor cells are abundant,with coarse chromatin,deeply stained nuclei and in multiforms.So the tumor may easily be misdiagnosed as various types of spindle cell sarcoma.Intraperitoneal cellular schwannoma may also be mistaken as gastrointestinal stromal tumors.In this article,the clinical characteristics,diagnosis and treatment of cellular schwannoma were analyzed based on the clinical data of a patient with cellular schwannoma in the gastric wall misdiagnosed as gastric stromal tumor.

Objective To investigate the pregnancy opportunity and outcome of patients with sysmetic lupus erythematosus (SLE).Methods We carried out a retrospective analysis of the clinical information of patients who suffered from SLE complicated with pregnancy and were hospitalized to People's Hospital of Peking University from December of 1992 to February of 2012.Chi-square test were used for statistical analysis.Results Forty-nine cases of patients with SLE complicated with pregnancy had 52 pregnancies in total.In 27 cases of planned pregnancies,24 cases(89％ )resulted in live births and 5 cases( 18％ ) had flares during pregnancy.Of the 24 live births,3 cases( 12％)were premature deliveries and 4 cases(17％) had low birth weight infants.In 25 cases of unplanned pregnancies,12 cases (48％) resulted in live births and 20 cases (80％) had flares during pregnancy.Of the 12 live births,6 cases(50％ ) were premature deliveries and 6 cases (50％) were low birth weight infants.The patients in the planned pregnancy group tended to have flares during pregnancy more frequently than those in the unplanned group (P＜0.01),the former were more likely to have live births than the latter (P＜0.01) and were less likely to have premature delivery (P＜0.05).Conclusion Patients with SLE should have planned pregnancy and need collaborative supervision of both rheumatology and immunology department and obstetric department to improve live birth rate,decrease premature delivery and the activity of SLE during pregnancy.

Objective To construct a genetically-stable double auxotrophic,in which the uracil and leucine were mutated,using the Candida parapolymorpha ATCC26012 as materials.Methods Based on the physical and genetic engineering methods,the chromosome of the C.parapolymorpha strain was modified,where the ura3 and leu2 genes were directly mutated,to obtain the uracil and leucine double auxotrophic strain.Then the constructed strain was identified by the analysis of its biological properties,such as genetic stability,the change of the genes,and the physiologic and biochemical characteristics.Results The uracil and leucine double auxotrophic strain is obtained by screening.The biological identification results show that the obtained strain is genetically stable and the targeted genes are directly altered.In addition,the physiologic and biochemical analyses indicate that the auxotrophic can utilize various kinds of carbon and nitrogen nutrient sources,and its growth is good.Conclusion The successful construction of double auxotrophic mutant strains facilitated the genetic studies on C.parapolymorpha to meet various investigational purposes.Moreover,the constructed auxotrophic strains can be applied as advantageous host cells to express multiple proteins/antigens simultaneously,which is of great significance in the development of vaccines.

Objective To evaluate the efficacy of entecavir in lamivudine-refractory patients with chronic hepatitis B.Methods Literature from Medline,Embase and CBM between January 2001 to December 2008 were reviewed.Acccording to the including and excwding criteria,four randomized controlled trials (RCT) were enrolled.The results of the trials were reviewed and analysed in software Revman 4.2.Results Patients in the entecavir group enjoyed significantly higher negative conversion ratios of HBV-DNA and ALT,and positive seroconversion of HBeAg:RR were 13.90(95% CI 6.39～30.24,P＜0.00001),2.49(95% CI 1.40～4.45,P=0.002),and 3.53 (95% CI 2.85～4.38,P＜0.000 01) respectively.There was a trend for the improvement of negative conversion ratio of HBeAg (RR=2.27,95% CI 1.00～5.15,P=0.05),but the incidence of side-effects of the drugs has no difference (RR=1.05,95% CI 0.97～1.14,P=0.21).Conclusions Compared with lamivudine or placebo,entecavir can significantly decrease HBV-DNA,improve liver function and positive seroconversion ratio of HBeAg without raising the incidence of drug side-effects.

Early use of statins after onset of acute ischemic stroke can improve the functional prognosis of patients and reduce in-hospital mortality.This article reviews the preclinical and clinical trials of statins for the treatment of ischemic stroke.

Objective:To investigate the efficacy of three different methods of digestive tract reconstruction after total gastrectomy.Methods:A total of 106 cases underwent the uncutted Roux-en-Y esophagojejunostomy with a jejunal pouch(group A,n=38) ,Roux-en-Y esophagojejunostomy with the J-type jejunal pouch(group B,n=31) ,and Roux-en-Y esophagojejunostomy with the Orr-type jejunal pouch(group C,n=37) respectively.The clinical data were retrospectively studied.The digestive tract reconstruction time,the post-operative complication incidence rate,postprandial symptoms,food-intake quantity,weight,serum nutritional parameters and emptying time of the gastricsubstitute were compared respectively.Results:The reconstruction time was the shortest in group A,which was significantly shorter than that in group B(P0.05) ,Group A was significantly lower than group B and C in the incidence of roux stasis syndrome.The Visick score of group A were superior to those of group B and C in 6 and 12 months after operation.The food intake gain of group A and B were superior to that of group C 6 and 12 months after operation.There were no significant differences among 3 groups in the term of weight,Hb and ALB loss and prognosis nutritional index(PNI) 6 months postoperatively.Weight and ALB loss in group A and B were lower than those in group C 12 months postoperatively,but PNI was higher in group A and B than those in group C.Emptying time of the gastric substitute was prolonged both in group A and B 12 months postoperatively.Conclusion:The uncutted Roux-en-Y esophagojejunostomy may act as an adoptable method of digestive tract reconstruction after total gastrectomy for gastric cancer.

OBJECTIVE:To provide reference for improving the drug price regulation policy in China. METHODS:Literature research,system comparison and other methods were used to summarize the commonalities and characteristics of drug price regula-tion policy in Germany,Japan and Taiwan area of China,and the successful experience was learned. RESULTS & CONCLU-SIONS:Drug price management in Germany,Japan and Taiwan area of China has their own characteristics. Germany conducted reference price system and new drug pricing mechanism,which was the first country to introduce the reference price system. Japan granted price premiums to innovative drugs,decreased pricing for generic drugs and adjusted drug price again. And Taiwan area of China classified and grouped differential pricing to encourage competition negotiation and regularly investigated drug prices and pric-ing. Germany,Japan and Taiwan area regard medicare pay price as core of drug price management,adopt comprehensive means to regulate the drug price,and pay attention to the monitoring and regular adjustment of market price as well. Price negotiation,phar-macoeconomics and multiple pricing methods are broadly used. Value-based drug pricing system is new trend of price policy re-form. It can be used for reference to improve the drug price regulation system in China.