Objective To observe the effects of LPS and PMA on proliferation of human len epithelial( HLE )cells and expression of epidermal growth factor receptor(EGFR) in HLE cells.Methods The expressions of EGFR protein of HLE cells from felus,adult lens age-related cataract and cultured HLE cells were detected by immunohistochemical staining.The expression of EGFR mRNA was detected by RT-PCR.The effects of LPS (0.5,1.0,2.0 mg?L-1 ) and PMA(25,50,100 nmol?L-1 )on proliferation of HLE cells were detected by MTT colorimetry method,and the EGFR mRNA expression in HLE cells was determined by RT-PCR. Results The expressions of EGFR protein and mRNA were positive in HLE cells from felus,adult lens age-related cataract and cultured HLE cells.The proliferation rates of HLE cells treated with 0.5,1.0,2.0 mg?L-1 LPS were (3.21?0.42)%,(12.25?1.34)% and (36.67?3.65)%,respectively.The proliferation rate of HLE cells in 2.0 mg?L-1 LPS group was higher than those in 0.5 and 1.0 mg?L-1 LPS groups(F=7.709,P0.05).PMA(25,50,100 nmol?L-1 )could not effect the expression of EGFR mRNA in HLE cells .Conclusion Inflammation stimulant factor such as LPS can promote the proliferation of HLE cells by increasing the expression of EGFR and result in occurrence of posterior capsular opacifition(PCO).

BACKGROUND:The patients receiving total knee arthroplasty are high in average age, and often accompanied with hypertension, diabetes and other basic diseases. Due to the poor physical conditions of the patients,
perioperative hemorrhage becomes the important factor that affecting the safety of replacement.
OBJECTIVE:To analyze perioperative hidden hemorrhage of primary total knee arthroplasty, and to explore the method of evaluating perioperative blood loss by osteoarthritis severity before total knee arthroplasty.
METHODS:A retrospective analysis of 126 knee osteoarthritis patients undergoing total knee arthroplasty was conducted. Al the patients were divided into two groups according to Kel gren and Lawrecne imaging classification:stage Ⅲ group and stage Ⅳ group. The hidden hemorrhage of the patients in two groups was calculated.
RESULTS AND CONCLUSION:The average total blood loss of the patients was 1 560 mL, included hidden hemorrhage 865 mL (55%). The mean blood loss of stage Ⅲ group was 1 290 mL with the mean hidden
hemorrhage of 684 mL (53%). The mean blood loss of stage Ⅳ group was 1 644 mL with the mean hidden
hemorrhage of 921 mL (56%). Statistical analysis showed there were significant differences of total blood loss and hidden hemorrhage between two groups (P<0.05), but there was no significant difference in the percentage of
hidden hemorrhage. The results indicate that higher grade of osteoarthritis imaging classification, the more of total blood loss and hidden hemorrhage, while the change of the percentage of hidden hemorrhage is not significant. Preoperative evaluation of patients’ blood loss by osteoarthritis severity has great significance for blood
management and surgical safety of patients.

Objective To analyze the clinical characteristics and explore the risk predictors on mortality in elderly patients with acute cholecystitis and cholangitis.Methods We conducted a retrospective analysis of elderly patients hospitalized in the Second Medical Center of General Liberation Army Hospital for acute cholecystitis and cholangitis during 2000 to 2018.Clinical data and risk predictors on mortality were assessed.The patients were stratified into three groups based on age:Ⅰ (65-74 years old),Ⅱ (75-84 years old),and Ⅲ (≥85 years old).Logistic regression analysis was used to identify the predictors of mortality.Results A total of 574 patients were finally enrolled with the mean age 87.6 years including 191 in group Ⅰ,167 in group Ⅱ,and 216 in group Ⅲ.The main cause of acute cholecystitis and cholangitis was gallstone (76.3％),and the main symptom was abdominal pain (62.9％),followed by chills(62.5％),fever(59.8％),jaundice (47.2％) and septic shock(26.3％).Cholecystitis was the most common diagnosis in groups Ⅰ and Ⅱ,whereas it was cholangitis in group Ⅲ.Percutaneous transhepatic biliary/gallbladder drainage (PTBD/PTGD) and endoscopic retrograde cholangiopancreatography (ERCP) were administrated more frequently in groups Ⅲ.A total of 35 patients (6.1％) died during follow-up.Senior in age (OR=11.1),the Charlson comorbidity index (OR=19.5),cancers (OR=9.6),blood stream infections (OR=7.4),severity of cholecystitis and cholangitis (OR=4.2)were risk factors associated with mortality.Conclusions Even in the elderly patients with acute cholecystitis and cholangitis,comorbidity is one of the main factors affecting clinical outcomes.Due to the poor performance,this group of population presents more severe disease and undergoes conservative treatment strategies.

Objective To explore the effects evaluation of extended care after “one-day care” for delivery women with gestational diabetes mellitus ( GDM ) . Methods From May to September 2013 in Department of Gynaecology and Obstetrics Peking University First Hospital, a total of 354 GDM pregnant women participated “one-day care” and then they were divided into experimental group (171 cases) and control group (183 cases) according to whether attended the extended care. Using repeated variance analysis measurement, the fasting blood glucose and postprandial 2h blood glucose values were compared whether the values had statistical significance between two groups at different visit time. Results The uterine-incision rates were 48. 55%(83/171) and 49. 7%(91/183) in the experimental group and control group respectively, and the incidence of giant babies were 9. 4%(16/171) and 12. 0%(22/183) respectively in the experimental group and control group (P>0. 05). The time point of before visit, during visit and last visit in the experimental group, the fasting blood glucose and postprandial 2 h blood glucose were lower than that of the control group (P<0. 05). Conclusions “One-day care” for GDM can reduce the blood glucose level of GDM delivery women, but it has not significant effects on the control of gestation′s body weight and to decline the uterine-incision rate and incidence of giant babies.

Objective To explore the feasibility of minimally invasive autopsy by natural orifice transluminal endoscopic surgery.Methods Autopsy was performed on a deceased patient with COVID-19 via transesophageal,transtrachea,and transgastric natural orifice transluminal endoscopic surgery.The white light endoscopic manifestations of the corresponding organs were observed,and organ tissue specimens were obtained for routine pathological examination.Results All four pathways reached the corresponding organs successfully.Diffuse congestion and submucous bleeding were seen in the trachea,bronchus and bronchus of the pulmonary lobes.The bronchus of the left lower lobe was filled with dark red sputum;the surface of the left lung was congested obviously.Four thrombi and plaque rupture were seen on the aortic wall.The gastric mucosa was congested,eroded,and had active ulcers.The surface of heart and liver was smooth.Small lamellar panniculitis was seen in the omentum.Routine pathology showed chronic inflammation with acute inflammation of the bronchial mucosa and inflammatory exudation,and partial squamous metaplasia of the epithelium.In lung tissue,some alveolar epithelial hyperplasia,a little fibrin-like exudation,widened alveolar septa,and infiltration of acute and chronic inflammatory cells were seen.The columnar epithelial mucosa of the gastric mucosa showed chronic inflammation with acute inflammation and exudates and fungal masses.Conclusion Natural orifice transluminal endoscopic surgery is feasible for autopsy,and covid-19 virus can cause multi-system and multi-organ damage.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.

Objective:To investigate the current situation of the use of transjugular intrahepatic portosystemic shunt (TIPS) for portal hypertension, which should aid the development of TIPS in China.Methods:The China Portal Hypertension Alliance (CHESS) initiated this study that comprehensively investigated the basic situation of TIPS for portal hypertension in China through network research. The survey included the following: the number of surgical cases, main indications, the development of Early-TIPS, TIPS for portal vein cavernous transformation, collateral circulation embolization, intraoperative portal pressure gradient measurement, commonly used stent types, conventional anticoagulation and time, postoperative follow-up, obstacles, and the application of domestic instruments.Results:According to the survey, a total of 13 527 TIPS operations were carried out in 545 hospitals participating in the survey in 2021, and 94.1% of the hospital had the habit of routine follow-up after TIPS. Most hospitals believed that the main indications of TIPS were the control of acute bleeding (42.6%) and the prevention of rebleeding (40.7%). 48.1% of the teams carried out early or priority TIPS, 53.0% of the teams carried out TIPS for the cavernous transformation of the portal vein, and 81.0% chose routine embolization of collateral circulation during operation. Most of them used coils and biological glue as embolic materials, and 78.5% of the team routinely performed intraoperative portal pressure gradient measurements. In selecting TIPS stents, 57.1% of the hospitals woulel choose Viator-specific stents, 57.2% woulel choose conventional anticoagulation after TIPS, and the duration of anticoagulation was between 3-6 months (55.4%). The limitation of TIPS surgery was mainly due to cost (72.3%) and insufficient understanding of doctors in related departments (77.4%). Most teams accepted the domestic instruments used in TIPS (92.7%).Conclusions:This survey shows that TIPS treatment is an essential part of treating portal hypertension in China. The total number of TIPS cases is far from that of patients with portal hypertension. In the future, it is still necessary to popularize TIPS technology and further standardize surgical indications, routine operations, and instrument application.

Objective:To investigate the epidemiological characteristics and current status of surgical management for esophageal cancer in China.Methods:A national database was setup through a network platform. The clinical data of esophageal cancer treated by surgery was collected from 70 major hospitals in China between January 2009 and December 2014.Results:Complete data of 8 181 cases of esophageal cancer patients who underwent surgery were recorded in the database and recruited in the analysis. Among them, 6 052 cases were male and 2 129 were female, the average age was 60.5 years.The epidemiological investigation results showed that 148 cases (1.8%) had history of psychological trauma, 7 527 cases (92.0%) were lower social economic status, 5 072 cases (62.0%) were short of fresh vegetables and fruits, 6 544 cases (80.0%) ate rough food frequently, 3 722 cases (45.5%) drank untreated water directly from lake or river or shallow well, 3 436 cases (42.0%) had a unhealthy eating habit, including habits of eating food fast (507 cases, 6.2%), eating hot food or drinking hot tea/soup (998 cases, 12.2%), eating fried food (1 939 cases, 23.7%), 4 410 cases (53.9%) had the habits of smoking cigarettes and 2 822 cases (34.5%) drank white wine frequently.The pathological results showed that 7 813 cases (95.5%) were squamous cell carcinoma, 267 cases were adenocarcinoma (3.3%), 25 cases were adenosquamous cell carcinoma (0.3%) and 50 cases were small cell carcinoma (0.6%). A total of 1 800 cases (22.0%) received preoperative neoadjuvant therapy due to locally advanced disease or difficulty of resection. The esophagectomies were performed through left thoracotomy approach in 5 870 cases (71.8%), through right chest approach in 2 215 cases (27.1%), and the remain 96 cases (1.2%) received surgery though other approaches.A total of 8 001 cases (97.8%) underwent radical resection, the other 180 cases (2.2%) received palliative resection. The 30-day postoperative mortality rate was 0.5%, the overall ≥ grade Ⅱ postoperative complication rate was 11.6% (951 cases). The 1-yr, 3-yr, and 5-yr overall actual survival rates were 82.6%, 61.6%, and 52.9%, respectively.Conclusions:The data analysis of the national database for esophageal cancer shows that bad eating habits or eating rough food without enough nutrients, lower social and economic status, drinking white wine and smoking cigarettes frequently may be correlated with tumorigenesis of esophageal cancer. However, strong evidences produced by prospective observation studies are needed. Overall, the long-term survival of esophageal cancer patients has been improved gradually due to the application of advanced surgical techniques and reasonable multimodality treatment.