Adenosine deaminase (ADA) activity in pleural fluid from 81 patients was measured by colorime-tric method. Of these cases, 55 cases were tuberculous pleural effusion, 22 cases were malignant pleura! effusion and 4 cases were transudate pleural effusion.The mean ADA, activity in pleural fluid of tuberculous group was 188.3?58.2u and that of malignant group was 52. 2?15. 4u. Statistically the difference is highly significant (p0.05). In tuberculous group, pleural fluid ADA levels higher than 110u were found in 53. cases (96.3%), and those above 120u were found in 52 cases (94.5%), while no case in malignat group had the ADA level higher than 90u, and in 20 cases it is lower than 70u (20/22 cases, 90.9%). These data suggest that pleural fluid ADA activity may be a useful index in the differential diagnosis of tuberculous and malignant pleural effusions.

Clinical manifestations thoracoscopy findings,and pathological findings of 54 patients with tuberculous pleural effusion were reported.The gross appearance of pleural lesions under direct vision with thoracoscope can be divided into three types:(A) tuberculous nodules in 34 cases,all of them were proved by pathological examination;(B) Inflammatory reaction type in 14 cases,in whom rate of positive pathology was 78.5% (11/14);(C) pleural hyperplasia and adhesion type in 6 cases,and rate for positive pathology was 66.7% (4/6).Of these 54 patients,the overall rate for positive pathoiogy was 00.75% (49/54).The diagnosis and pathogenesis of tuberculous effusion were discussed.The presence of characteristic tuberculous nodules on the pleura with specific pathological finbings suggets that direct invasion of pleura by tubercle bacilli may play a more important role than pleural allergic reaction in the pathogenesis of tuberculous pleural effusion.

Objective Helicobacter pylori (H. pylori )contains more than 30 genes and many of them in cag pathogenicity island (cag PAI) composed of cag Ⅰ and cag Ⅱ are involved in eliciting the transcription of interleikin 8 (IL 8) and the induction of IL 8 protein secretion in gastric epithelial cells, although some genes are not involved. This study was designed to observe the effect of ORF10 of H. pylori cag Ⅱ on the transcription of IL 8 in gastric epithelial cells and to test the possibility that certain genes in the cag PAI also downregulate (modulate) the transcription and expression of IL 8 in gastric epithelial cells. Methods Three strains of H. pylori mutants with deletion of ORF10 gene (ORF10, namely 28 1, 28 2, 28 3) and L5F11 cells containing IL 8 reporter gene were constructed. The constructed L5F11 cells were co cultured with the above strains and the luciferase activity (IL 8 transcription) was measured in a scintillation counter and the concentration of IL 8 protein was assayed by enzyme linked immunosorbent assay (ELISA). Results The activities of luciferase induced by 3 strains of H. pylori mutants with deletion of ORF10 gene were much higher than that of the mother strain 26695 [ 28 1:(1.49 ? 0.27)?10 6 cpm vs. (0.67 ? 0.08 )? 10 6 cpm, P

Objective To detect the expression of triggering receptor expressed on myeloid cells-1 (TREM-1) in mice with acute necrotizing pancreatitis (ANP). Methods Male kunming mice (n = 50) were randomly divided to control group, ANP 24, 48, 72, 96 h group. ANP model was induced by intraperitoneally injection with 20% L-arginine at a dose of 4 mg/g each, 1 h apart. Mice in control group received intraperitoneally injections of same amount of normal saline. Serum amylase, creatinine, and ALT were examined and pathological evaluation of pancreatic tissues was performed. The expression of TREM-1 mRNA in peripheral blood leucocyte was determined by RT-PCR. The expression of TREM-1 protein in pancreatic tissue was detected by immunohistochemistry. Results Serum amylase, creatinine, and ALT in ANP 24 h were (9439 ± 1273)U/L, (84.8 ±75.9) μmol/L, ( 158.1 ± 122. 1 ) U/L, which were significantly higher than those in control group [ ( 2412 ± 297 ) U/L, (29.2 ± 19. 1 ) μmol/L, (41.4 ± 7.9 ) U/L) ]. The pathological scores of the pancreas in ANP group increased corresponding to time. The expressions of TREM-1 mRNA in ANP 24, 48,72, 96 h group were 15.55, 30.36, 15.77, 28.32, and the expressions of TREM-1 mRNA in ANP 48 h group was significantly higher than that in other groups ( P <0.01 ). The expressions of TREM-1 protein in the pancreas did not significantly change corresponding to time. Conclusions TREM-1 may be involved in the development of ANP by triggering other inflammatory factors.

Triggering receptor expressed on myeloid cells-1(TREM)-1,a recently identified molecule,is involved in monocytic activation and inflammatory responses.TREM-1 is a member of natural killer cell receptor family and is expressed on neutrophils,mature monocytes and macrophages,and it can enhance the inflammatory responses mediated by Toll-like receptor-2 and -4,showing a role of inflammation promotion.Reportedly sTREM-1 was detectable in the body fluids in the presence of bacterial or fungal infection; therefore it might be used as a marker for inflammation.In addition,recombinant sTREM-1 may also be a new method for anti-inflammatory therapy.Recently,it has been found that TREM-1 not only promoted the acute inflammatory responses,but also participated in the development of chronic inflammation.This review summarizes the role of TREM-1 in the inflammation-associated dieases.

Objective To provide the practical experience of association of liver partition and portal vein ligation for staged hepatectomy(ALPPS) procedure in portal vein tumor thrombosis(PVT) cases,and to explore its value in PVTT therapy.Methods Three cases of ALPPS were applied to PVTT in Department of Hepatobiliary Surgery of PLA General Hospital from 2015 to 2016.The patients data were retrieved and analyzed retrospectively,including the basic information,preoperative PVTT classification,preoperative Child-Pugh classification,ICG test results,future liver remnant (FLR),FLR growth rate between 2 phase operation,operation time,bleeding volume,postoperative complications,postoperative survival etc.We discussed the detail technology and discuss the surgical procedure combine our experience and the published papers.Results ALPPS was performed successfully in all 3 patients.According to the Cheng's Classification of PVTT,they were classified as type Ⅱ,1 case and Ⅲ type,2 cases.Preoperative liver function was Child-Pugh A grade,average ICG R15 was 7.3％ (4.2％-11.0％),and average FLR was 387 ml (333-484 ml).The mean time interval between 2 phases surgery was 24.7 days (9-50 days) and the average FLR growth rate was 50.3％ (24.4％-82.3％).Morbidity of Clavien-Dindo Ⅲ or more was recorded in 1 case,but no mortality occurred.During follow-up period,2 patients were treated with TACE for tumor recurrence.All patients survived with acceptable life quality till now.The portal vein tumor thrombosis necrosis was observed in all 3 specimens.Conclusions ALPPS is a valuable surgery for effective control of tumor thrombus and radical resection rate in well selected PVVT type Ⅱ and type Ⅲ patients.It is expected to improve the therapeutic effect in combination with TACE and other treatment methods.

Objective:To study the clinical features of the "migration birds" population in Hainan Province in winter presenting with acute cholecystitis.Methods:Patients who were diagnosed to suffer from acute cholecystitis in the winter months from November to February of the following year of 2017, 2018 and 2019 and admitted in Hainan Hospital of Chinese PLA General Hospital were included in this study. The "migration birds" patients who arrived in Hainan Province in less than 30 days were defined as the short-term group ( n=49), 30-89 days as the mid-term group ( n=24), more than 90 days as the long-term group ( n=48). The general information, associated medical diseases, clinical presentations, interventional strategies and in-hospital outcomes were compared, and further analyze the clinical characteristics of patients with purulent cholecystitis and non-purulent cholecystitis in the short-term group. Results:Of 120 patients, there were 49 patients in the short-term group (29 males and 20 females with an average age of 65.18±15.02 years), 24 patients in the mid-term group (13 males and 11 females with an average age of 66.21±11.93 years), and 48 patients in the long-term group (30 males and 18 females with an average of 60.73±12.54 years). The general information, interventional strategies and in-hospital outcomes were similar among the three groups. When compared with patients in the long-term group, patients in the short-term group had higher incidences of hypertension [20.83% (10/48) vs 48.98% (24/49)] and diabetes [10.42% (5/48) vs 30.61% (15/49)]. The gallbladder wall in the short-term group was significantly thicker than that in the long-term group [0.60(0.40, 0.70) cm vs 0.50(0.30, 0.60) cm, P<0.017]. The proportion of purulent cholecystitis in the short-term group was significantly higher than that in the long-term group [48.15% (13/27) vs 17.24% (5/29) , P<0.017] . In the short-term group, the incidences of silt-like stones of purulent cholecystitis [38.46% (5/13) vs 14.29% (2/14)], gallbladder perforation [30.77% (4/13) vs 0], gallbladder gangrene [53.85% (7/13) vs 7.14% (1/14)], perigallbladder effusion [76.92% (10/13) vs 14.29% (2/14)], abdominal effusion [46.15% (6/13) vs 7.14% (1/14)] were significantly higher than that of patients with non-purulent cholecystitis, (all P<0.05). Conclusion:Patients presenting with acute cholecystitis after arrival in Hainan in the short term had more severe inflammation with complications of suppuration, perforation and gangrene. Patients with hypertension and diabetes were the high risk group of patients presenting with acute cholecystitis after short-term arrival in Hainan.