Objective To investigate the effect of obesity on the early complications after esophageal cancer operation.Methods Clinical data of 327 patients who had esophageal cancer operation in our hospital from August 2012 to September 2015 were retrospectively analyzed.The patients were divided into 4 groups:lean group(n =75), normal group(n =120),overweight group(n =103)and obesity group(n =29)by body mass index(BMI).The impact of obesity on early complications of esophageal carcinoma after surgery was analyzed.Results The operation time of the lean group,normal group,overweight group and obesity group were (257.8 ±52.6 )min,(289.3 ± 48.7)min,(321.5 ±55.9)min,(367.9 ±50.2)min respectively.The operation time was increased with the increase of BMI (F =13.397,P =0.000).The incidence rates of incision infection,empyema,hoarseness,diaphragmatic hernia,postoperative bleeding,chylous fistula,pulmonary complication were 5.3%,1.3%,1.3%,1.3%,2.7%, 2.7%,16.0% in the lean group,5.0%,1.6%,1.6%,1.3%,1.6%,1.6%,17.5% in the normal group,5.8%, 1.9%,0.9%,1.9%,1.9%,1.9%,1.9% in the overweight group,10.3%,3.4%,0.0%,3.4%,3.4%,0.0%, 13.8% in the obesity group.No significant differences were found about the hospital days,wound infection,empyema, hoarseness,diaphragmatic hernia,operation hemorrhage,chylous fistula,pulmonary complications among the 4 groups (all P >0.05 ).The incidence rates of cardiovascular complications and anastomotic leakage after operation were 0.0%,4.0% in the lean group,1.9%,5.0% in the normal group,6.8%,9.7% in the overweight group,13.8%, 17.2% in the obesity group.The incidence of cardiovascular complications,postoperative anastomotic leakage increased with the increase of BMI.The differences of the four groups were statistically significant(F =1.675,1.054, all P <0.05).Conclusion Obesity can increase the incidence of early postoperative complications in patients with esophageal cancer.But obesity is not a contraindication of surgery for esophageal cancer,but obese patients should be more carefully treated in the perioperative period.

Objective: This study aimed to observe the long-term effect of Pseudomonas aeruginosa preparation used in peritoneal injection of advanced colorectal cancer patients during surgery. Methods: A total of 83 colorectal cancer patients who received surgery between September 2006 and March 2008 were enrolled in this study. The patients were divided into two groups. Palliative resection and a 10 ml P. aeruginosa peritoneal injection were performed in 30 of 83 patients in the treatment group. Simple palliative resection was conducted in the other 53 patients, which comprised the control group. Both groups were then treated by regular chemotherapy and radiotherapy. Results:The follow-up visit was completed in 79 of 83 patients, with a high follow-up rate of 95.2%. No significant difference was found in the five-year overall survival time between the two groups (P=0.403). However, the five-year median survival time in the control group was only 13.9 ± 2.14 months, whereas that in the treatment group was 17.2 ± 2.12 months. Conclusion: Within a short period, peritoneal injection of P. aeruginosa during surgery could confer certain survival advantages for advanced colorectal cancer patients. However, the long-term effect of this therapy remains unknown.

Purpose:To study the effectiveness of inserting central venous catheter was inserted into pericardial cavity for the drainage and treatment of lung cancer hydropericardium. Methods:A central venous catheter into pericardial cavity by pericardial puncture and continuous drainage, then chemotherapeutic agents were administered. Results:Among twelve patients, complete response was seen in 4 cases and partial response in 7, no cardiostenosis and sinus appeared. Conclusions:This method is convenient, effective, safe for the treatment of lung cancer hydropericardium and without apparent complications.

Through setting up the elective course Protein Abnormity and Diseases for the undergraduates,we combine basic courses and clinic courses to enhance the students' enthusiasm in biochemistry.And at the same time modern molecule biology knowledge is organically combined with clinic lessons.

Objective To introduce the donor heart preservation techniques and study the clini- cal results in 26 patients undergoing orthotopic heart transplantations with long donor ischemia time (DIT) in our center.Methods From Sept.2004 to Aug.2006,26 patients underwent orthotopic heart transplantation at our center with DIT longer than 360 min.Crystalloid cardioplegia was infused through aortic root after aorta was cross clamped.UW solution was used when donor heart was removed.All patients underwent bicaval anastomotic cardiac transplantation.NO was inhaled through ventilator during and after operation in patients with pulmonary hypertension.Results DIT was 360- 560 (mean 401?43) min.There was no operative death in this group.Echocardiography and X-ray examinations in one month were normal.One case of abnormal coronary orifice was subjected to re- anastomosis of aorta.One case of renal failure post-operation was subjected to blood dialysis.Conclu- sion With proper donor heart procurement and preservation,recipient selection,anastomotic technique,efficient postoperative surveillance and pulmonary hypertension treatment,transplanted patients with long DIT can obtain the satisfactory short-term outcome.

Objective To observe the clinical outcome of closed reduction and percutaneous screw fixation for talar neck fractures,and explore the minimally invasive treatment for talar neck fractures.Methods From June 2009 to December 2012,12 cases with talar neck fracture were treated by closed reduction and percutaneous screw fixation,including 10 males and 2 females with an average age of 34 years (range,21-52).All cases are unilateral side,including five cases of left foot and seven cases of right foot.All cases are evaluated the displacement,shape and number of fracture fragments by CT before fixing the fracture.According to Hawkins classification:type Ⅰ 7 cases,type Ⅱ 5 cases.Seven patients with type Ⅰ were used direct percutaneous screw fixation,five patients with type Ⅱ were treated with closed reduction and subsequent percutaneous screw fixation.The Computed Tomography was used to evaluate the quality of close reduction.The AOFAS (ankle-hindfoot scale) scores was used to evaluation clinical outcome in follow-up,and Computed Tomography was used to evaluate the result of reduction and fixation after operation.Recording Hawkins sign according to X-ray film,recording infection,talar body necrosis,traumatic arthritis and other complications.Results Twelve patients were followed up for an average of 34 months (range,22-40).At the end of followup,the AOFAS scores was average 90 points (range,84-95).Nine patients showed Hawkins sign 6 to 10 weeks after operation,2 patients did not find Hawkins sign,but in the follow-up period didn't appear talar body necrosis.One case did not appear Hawkins sign,and who's talar body necrosis was diagnosed by MRI,but no collapse,no pain and did not need further treatment.There patients with postoperative subtalar traumatic arthritis,patients are asymptomatic,at end no further treatment.All patients with no wound complications and no neurovascular injury.Conclusion Closed reduction and percutaneous screw fixation for talar neck fractures can obtain excellent clinical results,but should be selecting the appropriate patients,and Computed Tomography must be used to ensure satisfactory reduction.

BACKGROUND:It is hopeful that skeletal muscle satellite cells(SMSCs)can be served as seed cells for hematopoietic reconstitution.Angelica polysaccharides(APS)can not only promote hematopoietic stem cells and hematopoietic progenitor cells proliferation and differentiation,but also change the growth characteristics of SMSCs.OBJECTIVE:To investigate the effects of APS on the proliferation of mouse SMSCs in different culture environments.METHODS:SMSCs were procured by a modified method from new born mouse.The α-actin protein of the SMSCs was examined by immunohistochemistry at 5 days after culture.SMSCs were cultured and synchronized for 24 hours in the 96-well plate.After that,SMSCs were assigned into the blank control group,marrow stroma cell supernatant group,APS DMEM/F12 groups(contained 50,100,200,300,400 mg/L APS)and the marrow stroma cell conditioned medium(disposed by 50,100,200,300,400 mg/L APS in DMEM/F12).The proliferation of SMSCs was determined by MTT.RESULTS AND CONCLUSION:The α-actin was positive in the cultured SMSCs.MTT results demonstrated that,SMSCs showed a proliferative property in the marrow stroma cell conditioned medium groups.Additionally,the marrow stroma cell conditioned medium can effectively alter growth characteristics of SMSCs in a dose-dependent manner.

Objective To examine the levels of serum tissue inhibitor of metalloproteinase in severe sepsis patients with disseminated intra-vascular coagulation (DIC) and evaluate its diagnostic value in severe sepsis with DIC.Methods Sixty patients were divided into 3 groups,namely severe sepsis group (SS group,n =28),severe sepsis with DIC group (SSD group,n =12) and normal group (n =20).Clinical data including APACHE Ⅱ score and DIC score of these patients were collected.Serum levels of TIMP-1 and TIMP-2 of these patients were measured by using ELISA.Results The patients of SS group had higher levels of TIMP-1 (723.74 ± 96.27) and lower levels of TIMP-2 (68.08 ± 14.87) than healthy control subjects (TIMP-1:574.24 ± 79.99,TIMP-2:89.99 ± 18.45) (P ＜ 0.05).The patients of SSD group had higher levels of TIMP-1 (907.56 ± 200.20) and lower levels of TIMP-2 (44.84 ± 22.13) than patients of SS group (P ＜ 0.05).An association was found between TIMP-1 and fibrinogen (FIB) (r =-0.392,P ＜ 0.05),TIMP-1 and D-dimer (r =0.407,P ＜ 0.05),TIMP-2 and PLT (r =0.484,P ＜0.01),TIMP-2 and PCT (r=-0.523,P＜0.01),TIMP-2 and DIC score (r=-0.579,P＜0.01).The areas under the curves (AUC) for TIMP-1/TIMP-2 was 0.896 (95％ CI:0.843 ～ 0.950 (P ＜ 0.05).Conclusions Serum levels of TIMP-1 in patients with severe sepsis complicated with DIC increased and TIMP-2 decreased,suggesting they were valuable in diagnosis of severe sepsis complicated with DIC.

BACKGROUND: Bone marrow mesenchymal stem cells (BMSCs) can be induced to differentiate into neuron-like cells in new environment after transplantation, and then to replace damaged cells for reconstructing neural circuit. OBJECTIVE: To establish the co-culture system between rat BMSCs and neural cells in vitro, and to study the influence of neural cells on the differentiation of BMSCs into neuron-like cells in the co-culture system. METHODS: The neural cells obtained from Wistar rat fetal brain tissue and BMSCs gained from rat thighbone were co-cultured in Transwell culture plate. The morphological changes of BMSCs were observed and the special markers of neural cells in BMSCs were examined by immunofluorescence on the fifth day of the co-culture. The results were compared with control group which where BMSCs were alone cultured. RESULTS AND CONCLUSION: BMSCs in the neural cells co-culture system extended, were radial, connected each other. Neuron specific enolase immunoreactions showed positive results, showing neuron-like cells. The positive ratio of neuron specific enolase-positive cells was (33.0±10.5)%. However, BMSCs in the control group did not express neuron morphological character. Immunofluorescence exhibited that cells were negative for neuron specific enolase. These indicate that microenvironment provided by neurons improves the differentiation of BMSCs into neuron-like cells.

Objective To investigate the expression of Foxo3a and p27kip1 in lumbar dorsal root ganglia (DRG) after injury of sciatic nerve in rats. Methods Adult rats were randomly divided into control group and experimental group. The rats in experimental group were subjected to sciatic nerve clamp.Expression and distribution of Foxo3a and p27kip1 and cellular proliferation and axon regeneration in DRG was detected by western blot and immunohistochemistry. Results Foxo3a protein levels begined to reduce at 1 day (7.0 ± 3.5), reached valley at 2 day (6.0 ± 3.8) after injury, and following Foxo3a downregulation, p27kip1 protein levels begined to decrease at 2 day (29.0 ± 3.5), reached valley at 7 day (21.0± 3.0) after injury. Down-regulation of Foxo3a and p27kip1 was expressed predominantly in neurons and glial cells by double immunolabelling. Foxo3a and p27kip1 were expressed in neurons [(37.8 ± 5.7)%, (43.3 ±4.3)%] and glial [(22.4 ± 3.9)%, (13.8 ± 3.2)%] cells in sections of DRG at 2 day after injury less than neurons [(73.6 ± 2.5)%, (84.1 ± 3.7)%] and glial [(61.3 ± 4.4)%, (68.7 ± 5.6)%] cells in sections of normal DRG. Proliferating cell nuclear antigen (PCNA) and GAP-43 were up-regulation from 2 day, and PCNA reached peak at 7 day after injury.The glial cells were the main type of cellular proliferation.Conclusion Down-regulation of Foxo3a and p27kip1 in lumbar DRG is correlated with the proliferation of glial cells and axonal regeneration after sciatic nerve injury.