Objective To study the treatment of hepatocellular carcinoma(HCC) complicated with bile duct thrombus.Methods Restrospective study was performed on the treatment of 34 cases of HCC complicated with bile duct tumor thrombus from January 1995 to December 2002 admitted to our hospital.Results Among the 34 cases, one patient had no treatment,6 cases received PTCD and 27 cases received operation.In surgical treatment patients,the postoperative 30 days mortality was 22.2%(6/27),the morbidity was 55.6%(15/27).In 16 patients who received hepatectomy with thrombectomy and biliary duct drainage, the survival time was 1～27 months with a median survival time of 16.5 months.Conclusion The prognosis of HCC complicated with bile duct tumor thrombus is poor. Early diagnosis and aggressive operative are the key points to improving the survival time of patients.

Objective To investigate the effects of rhGH on hypoalbuminemia in cirrhotic rats after partial hepatectomy. Methods Thirty rats were randomly divided into normal control group ( n =6), liver cirrhosis group (LC group, n =6), liver cirrhosis and hepatectomy group (LCH group, n =6), PN (parenteral nutrition) group ( n =6, given PN after hepatectomy) and rhGH+PN group ( n =6,given rhGH and PN after hepatectomy). Liver function and blood glucose were measured. The expression of ALB mRNA was detected by RT PCR. Liver Ki67 immunohistochemistry was studied. Results Compared with PN group, serum ALP was lower; serum ALB and blood glucose were higher in rhGH+PN group. The expression of hepatic ALB mRNA was higher, and hepatic Ki67 labeling index was higher as well in this group. Conclusion rhGH can improve hypoalbuminemia after partial hepatectomy in cirrhotic rats with partial hepatectomy.

BACKGROUND: As a kind of polypeptide, angiotensin-converting enzyme (ACE) inhibitory peptide can lower the blood pressure of human body through restraining the formation of angiotensin Ⅱ.OBJECTIVE: To investigate the influence of AGE inhibitory peptide on endothelial cell proliferation and endothelin expression in cultured human umbilical vein cells based on cellular and molecular levels in order to provide the experimental evidences for ACE inhibitory peptide to be the potential blood pressure-lowering health food.DESIGN: Repeated measures design.SETTING: School of Bioscience and Bioengineering, South China University of Technology; School of Applied Chemistry and Biological Technology,Shenzhen Polytechnic.MATERIALS: The experiment was carried out in the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic from September 2004 to March 2005. The AGE inhibitory peptide was provided by the Institute of Applied Chemistry and Biological Technology, Shenzhen Polytechnic. Under certain circumstance, 15 μ mol/L of the inhibitor was needed to decrease half of the AGE activity. The human umbilical vein endothelial cells of the 4th generation were cultured randomly in 7 groups with different concentrations: medium group, 150, 300 and 600 mg/L ACE inhibitory peptide groups, captopril group, norepinephrine(NE) group, and ACE inhibitory peptide+NE group.METHODS: ①The endothelial cells were cultured as recommended. The medium was M199+FBS(0.15, v/v)+penicillin(10 000 U/mL)+streptomycin (100 mg/L). After cellular fusion, the cells were carried on the passage with the ratio of 1:2. The 4th generation cells were used for experiment. ②M199(0.15, v/v) was contained in each group. ACE inhibitory peptides were added to make the final concentration 150, 300 and 600 mg/L in the 150, 300 and 600 mg/L ACE inhibitory peptide groups respectively. Captopril was added to make the final concentration 10-5 mol/L in the captopril group. NE was added to make the final concentration 100 μg/L in the NE group. ACE inhibitory peptide and NE were added to make the final concentration 300 mg/L and 100 μg/L in the ACE inhibitory peptide+NE group respectively. ③The state of cell growth was determined with cytometry. The contents of endothelial cells in the medium with different culture times were determined with radioimmunoassay. The expression of endothe lin mRNA was determined with reverse transcriptase-polymerase chain reaction. The expression of cellular endothelin protein was determined with immunohistochemical method.MAIN OUTCOME MEASURES: ①The influence of ACE inhibitory peptide on endothelial cell proliferation. ②The influence of ACE inhibitory peptide on the endothelin mRNA and endothelin protein.RESULTS: ①The influence of ACE inhibitory peptide on endothelial cell proliferation and endothelin secretion: Compared with the medium group,in the captopril and 150, 300, 600 mg/L ACE inhibitory peptide groups,the growth of endothelial cells was restrained and the endothelin content in the medium was lowered(P ＜ 0.01 or 0.05). NE could promote the growth of endothelial cells and the secretion of endothelin, but the cell density and endothelin content after treatment with ACE inhibitory peptide were similar to those in the medium group (P ＞ 0.05). ②The influence of ACE inhibitory peptide on the expressions of endothelin mRNA and protein in endothelial cells: Compared with the medium group, the expressions of endothelin mRNA and protein might be lowered in the captopril and 150,300, 600 mg/L ACE inhibitory peptide groups(P ＜ 0.01 or 0.05). The expressions of endothelin mRNA and protein could be up-regulated by NE.The gene expression after treatment with ACE inhibitory peptide was similar to that in the medium group(P ＞ 0.05).CONCLUSION: The ACE inhibitory peptides of different dosages can all restrain the growth of endothelial cells, lower the endothelin content, decrease the expression of endothelin gene and resist NE improved growth and secretion of endothelial cells in umbilical vein cell effectively.

OBJECTIVE:To investigate the cognition,evaluation and demands of medical staff to the clinical pharmacy work in the secondary and tertiary medical and health institutions in Xi’an city,and provide reference for further promoting the develop-ment of the local clinical pharmacy work. METHODS:20 secondary and tertiary medical and health institutions in Xi’an city were randomly selected to conduct a random sampling questionnaire for physicians,nurses (senior nurses),pharmacists (non-clinical pharmacist)and other medical technicians. And the results were statistically analyzed. RESULTS:Totally 1 020 questionnaires were sent out,851 were effectively received with effective recovery of 83.4%. 45.9% respondents knew clinical pharmacy,and“Col-league”was the main channel;34.3% thought clinical pharmacy“only maintained normal operation. 74.7% surveyed medical staff,92.6% surveyed pharmacists and 70.6% surveyed physicians thought clinical pharmacists“should”take round with the doc-tors and nurses;44.3% respondents showed“dissatisfaction”and“general satisfaction”with the clinical pharmacy work in their hospitals. 48.5% respondents would take the initiative to consult the clinical pharmacist for medication;45.5% respondents partial-ly accepted the drug information provided by clinical pharmacists. There were significant differences in the investigation results in aspects of respondents’understanding level and channel for clinical pharmacy,cognition for development situation of clinical phar-macy,evaluation for clinical pharmacists participating round,demand for consulting the medication,acceptance for drug informa-tion provided by clinical pharmacists,and other items(P<0.05). CONCLUSIONS:The cognition and effect of clinical pharmacy work on medical staff need to be further strengthened,clinical pharmacists should also have solid clinical knowledge and the knowl-edge of medicine to meet the demand of medical staff in different positions,the acceptance of medical staff to the pharmaceutical care needs to be further improved. Clinical pharmacists should earnestly fulfill their job functions through various efforts to promote rational drug use.

Objective To investigate the dementia caregivers' awareness of dementia diagnosis for patients aged≥80 years in veterans community in Beijing.Methods Patients aged 80 years and over who were diagnosed as dementia were selected from Dec.2009 to Jul.2011 in the veterans community in Beijing.A face-to-face interview and questionnaire survey were conducted in dementia caregivers individually,including basic social demographic data (gender,age,educational background),awareness rate of dementia,treatment and drug use situation and their attitude to dementia patients.Results A total of 118 caregivers were investigated individually.The caregivers in this study were mainly the spouse of the patients,and most of them were elderly people.46.6％ (55/118) of caregivers were the spouse of the patients,and 52.5％ (62/118) of caregivers were 65 years old and over.The caregivers' awareness rate of dementia was 32.3％ (38/118) when patients were diagnosed as dementia.There was no correlations of gender,age and educational background with the awareness rate of dementia diagnosis (all P＞0.05).50％ of dementia patients received the dementia treatment,and only 17.8％ (21/118) of patients got the first line drug treatment for dementia (acetylcholinesterase inhibitors and / or memantine).98.3 ％ (116 / 118) of caregivers agreed that the dementia patients should be treated kindly.Conclusions The dementia caregivers are mainly patients' spouse in veterans community and most of them are the elderly.The awareness rate of dementia diagnosis is low among the caregivers.Most patients do not take the formal treatment.The social support for the dementia caregivers should be strengthened.

Objective To evaluate the effects of branched-chain amino acids-enriched early parenteral and enteral nutrition on the liver function and serum aminograms in cirrhotic rats after partial hepatectomy. Methods In this prospective randomized controlled study, 24 cirrhotic rats, induced by thioacetamide, were randomized into three groups: enteral nutrition (EN) group, EN + branched-chain amino acid (BCAA) group, and parenteral nutrition (PN) + BCAA group. After receiving partial hepatectomy, rats in all three groups were nutritionally supported with equal amount of calorie and nitrogen contents from the 1st postoperative day ( PO day 1 ) to PO day 5. On PO day 6, parameters including body weight, liver functions, prealbumin, transferring, and serum aminograms were measured or determined, and the level of liver albumin mRNA was detected by reversal transcription-polymerase chain reaction and morphological examinations such as HE staining and immunohistochemical staining, which were assessed by index of Ki67 protein index. Results Body weight was significantly decreased in all three groups on PO day 6 (P ＜0.05 ). Compared with EN + BCAA group, serum aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase after partial hepatectomy were significantly higher in PN + BCAA group (P ＜0.05 ). Serum alkaline phosphatase level was significantly higher in PN + BCAA group than in EN group ( P ＜0. 05). The level of prealbumin was significantly lower in PN + BCAA group when compared with EN group or EN +BCAA group ( both P ＜ 0. 05 ), although no such significant difference was noted in terms of transferrin ( P ＞0. 05 ). The levels of leucine and isoleucine elevated while those of tyrosine, phenylalanine, arginine and tryptophan declined in PN + BCAA group or EN + BCAA group when compared with EN group ( P ＜ 0. 05 ). Aminograms were not significantly different between EN + BCAA group and PN + BCAA group ( P ＞ 0. 05 ). Levels of total amino acid and aromatic amino acid (AAA) were significantly lower while BCAA and ratio between BCAA and AAA (BCAA/AAA) were significantly higher in PN + BCAA group or EN + BCAA group than in EN group (P ＜ 0. 05 ).Significantly lower level of albumin mRNA and index of Ki67 were observed in PN + BCAA group than in EN group or EN + BCAA group (P ＜ 0.05 ) on PO day 6. Conclusions BCAA-enriched EN or PN reverses amino acid disequilibrium and restores BCAA/AAA in cirrhotic rats after partial hepatectomy. Compared with PN, EN is superior in improving postoperative liver function, promoting protein synthesis, and speed up tissue regeneration in the postoperative liver. However, it still can not restore serum albumin in a short term.

Objective To investigate the cell compatibility of polystyrene(PS) plate chemically modified with RGD peptides.Methods PS surfaces were carboxylated by permanganate oxidation in diluted sulfuric acid,and carboxyls were activated with water-soluble carbodiimide to graft with gelatin,collagen and RGD peptides.IR,X-ray photo-electronic spectroscopy (XPS) and dynamic contact angle were used to characterize the surface modification of PS surface.Results XPS results confirmed the existence of nitrogen element from protein molecules and the covalently binding of proteins to PS surfaces.Dynamic contact angle measurement indicated hydrophilicity of PS surfaces was improved obviously after grafting modification.The cell culture results showed that the cell adhesion and proliferation was better on modified surfaces than the initial.Conclusion The cell compatibility of PS surface was great improved after modification with RGD peptides,which would provide a potential strategy to improve the culture of purified endothelial progenitor cells isolated by immunomagnetic beads.

Objective To evaluate the value of T-cell spot of tuberculosis test (T-spot.TB) in differential diagnosis of Crohn's disease and intestinal tuberculosis.Methods From May 2010 to October 2010,in Xijing hospital,Fourth Military Medical University,the peripheral blood samples of 126 patients were collected and peripheral blood mononuclear cells were isolated with density gradient centrifugation.T-spot.TB was conducted according to the kit instructions.The clinical diagnosis of Crohn's disease and intestinal tuberculosis was according to clinical manifestations, imaging,endoscopy,pathology,laboratory tests and on empirical anti-TB treatment response.The sensitivity and specificity of T-spot.TB in diagnosis of Crohn's disease and intestinal tuberculosis was analyzed.Results Fifteen patients were diagnosed as Crohn's disease (11.9％,15/126),14 patients were intestinal tuberculosis (11.1％,14/126) and 40 patients were extraintestinal tuberculosis (31.7％,40/126).The positive rate of T- spot.TB in Crohn's disease,intestinal tuberculosis,extra-intestinal tuberculosis and other diseases was 1/15,12/14,70％ (28/40) and 0％ (0/57),respectively.Thedifference between the groups was statistically significant (P =0.00).There was statistically significant difference of T-spot.TB positive rate between Crohn's disease and intestinal tuberculosis (x2 =70.58,P=0.00).The sensitivity and specificity of T- spot.TB in Crohn's disease detection was 93.3％(14/15) and 87.5％(14/16),in intestinal tuberculosis was 85.7％(12/14) and 93.3％ (14/15).The negatively predictive value of Crohn's disease was higher [87.5％ (14/16)] than that of intestinal tuberculosis [12.5％ (2/16)].Conclusion T-spot.TB is helpful for differential diagnosis of Crohn's disease and intestinal tuberculosis.

OBJECTIVE: To evaluate the expressions of chemokine receptor 6 (CCR6), chemokine receptor 7 (CCR7) and their ligands (CCL20, CCL19/CCL21) in laryngeal squamous cell carcinoma (LSCC), and then explore their correlation with the clinicopathological features of LSCC. METHOD: Blood samples, fresh specimens of LSCC and paired adjacent tissues were collected. The expressions of CCR6, CCR7 and their ligands CCL20, CCL19/ CCL21 mRNA as well as the protein CCR6, CCR7 were detected by real-time qRT-PCR and IHC respectively. Flow cytometry was also used to investigate CCR6, CCR7 expressed on PBMC. RESULT: The relative expression levels of CCR6, CCR7, CCL19 and CCL21 mRNA in tumor tissue was significantly higher than that of adjacent tissues (P < 0.05), while the relative expression level of CCL20 mRNA in tumor tissue were significantly lower than that of adjacent tissues (P < 0.05). IHC confirmed the expression of protein CCR6 and CCR7 in both tumor tissue and metastatic ILN and the expression levels of protein CCR6, CCR7 were higher in the cases with lymphatic metastasis than that of those without lymphatic metastasis (P < 0.05). FCM showed the percentage of CD4+ CCR6+ T cells of LSCC was significantly higher than that of normal control (P < 0.05), while that of CD4+ CCR7+ T cells was significantly lower (P < 0.05). CONCLUSION CCR6 and CCR7 are expressed in tumor situ, metastatic LN and PBMC,and might exert a potential role in LSCC development.
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Chemokine CCL19 ; metabolism ; Chemokine CCL20 ; metabolism ; Chemokine CCL21 ; metabolism ; Female ; Humans ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Middle Aged ; Receptors, CCR6 ; metabolism ; Receptors, CCR7 ; metabolism

Objective To evaluate the impact of chest blast injury on left ventricular function and myocardial strain with speckle tracking imaging (STI).Methods Fifty healthy New Zealand rabbits were randomly divided into 4 groups.Five rabbits without blast injury were used as a normal group,and the other rabbits were placed in specific semi-enclosed blasting environment in accordance with the different distance of the explosion.With instantaneous detonators,slight,medium and heavy chest blast injury animal models were produced and labeled as A,B,and C group (each n=15),respectively.The left ventricular function was measured with conventional echocardiography and STI.The longitudinal strain (LS) of the left ventricle was measured with two-dimensional strain analysis software and statistically analyzed.Results There was no significant difference of ejection fraction (EF) and fractional shortening (FS) in the left ventricle after chest blast injury between group A and normal group (all P＞0.05),while LS of anterior wall,anterior septum wall and lateral wall of group A significantly decreased compared with those of normal group (all P＜0.05).In group B and C,the left ventricular EF,FS and LS of each segment were lower than those of normal group (all P＜0.05).In group C,the left ventricular EF,FS and LS of each segment were lower than those in group A (all P＜0.05).There was no significant difference of EF and FS between group B and group C.In group C,LS of anterior wall and lateral wall of basal segment and middle segment were lower than those of group B (all P＜0.05).Conclusion STI can reflect functional changes of left ventricle in each segment earlier and more sensitively after chest blast injury.