Objective To investigate the possibility of transplantation of adrenocortical cells to treat insufficiency of adrenocortical function using poly-?-hybroxybutyric acid (PHB) as cell carrier.Methods Adrenocortical cells were seeded to PHB and then implanted into rats bearing bilateral adrenalectomy, while adenocortical cells implanted into the similar rats as a contrast. The changes of blood corticosterone and aldostenone and local histological changes in these rats were observed.Results The blood corticosterone and aldostenone were elevated after transplantation. The levels of blood corticosterone and aldostenone in PHB group were higher than that of control group. Histological study showed that adenocortical cells in PHB grew well.Conclusion The implanted adrenocortical cells within PHB can not only survive in rat body but also secrete corticostenone and aldostenrone which can satisfy the need of adrenalectomized rats. It is more effective to use PHB in adrenocortical cell transplantation than that cell implanted singly.

Objective To investigate the angiogenesis,apoptosis and their mechanisms in septic mice with myocardial injury.Methods Forty male C57BL/6 mice aged 8 weeks were randomly ( random number) divided into two groups:the sepsis group and the control group.The mice of sepsis group were treated with lipopolysaccharide (LPS) ( 10 mg/kg Intraperitoneal injection) while the mice of control group were treated with saline solution instead (10 mg/kg Intraperitoneal injection).Cardiac function of mice (n =40) was evaluated with ultrasound 6 hours after LPS administration.Subsequently,the tissues of heart,lung and kidney of mice (n =6) were taken and treated with Haematoxylin -Eosin staining (H&E) in order to observe the pathological changes and verify the successfulness of modeling.Immunohistochemistry staining with PECAM - 1 and α - SMA was used to identify the angiogenesis in the heart ( n =3 ),while the TUNEL apoptosis assay was applied for detecting the myocardial cell apoptosis ( n =3 ).The mRNA was extracted from heart tissue (n =6) to observe the expression of HIF-1 ot which was proved to be an angiogenesis factor.All the results were analyzed by independent sample t - test.Results Compared to the control group,mice in the sepsis group showed increased in thickness of left ventricular diastolic anterior wall ( t =- 4.60,P ＜ 0.05 ) and thickness of left ventricular systolic anterior wall (t =-3.24,P ＜0.05 ) along with decrease in left ventricular end diastolic diameter ( t =3.57,P ＜ 0.01 ) and stroke volume ( t =5.51,P ＜ 0.01 ).Immunohistochemistry staining with alpha - SAM antibody revealed increase in cardiac angiogenesis in the sepsis group (t =- 11.00,P ＜ 0.01 ).TUNEL apoptosis assay demonstrated apoptosis of the cardiomyocytes [ sepsis group versus control group:( 191.31 ±5.41 ) vs ( 52.24 ±4.32) ] and RT - PCR showed an increase in the expression of HIF - 1 alpha in the mice of the sepsis group ( t =- 8.12,P ＜0.05) Conclusions There were apparent myocardial angiogenesis,apoptosis and cardiac dysfunction in septic animal models.HIF-1α might play a role in the angiogenesis pathway.

Objective To explore the effects of different initial treatment protocols on the prognosis of pneumonia in the kidney transplant recipients. Methods Sixty-seven cases of pneumonia following kidney transplantation were divided into case group (34 cases) and control group (33 cases).The patients in case group were treated with Imipenem and Cilastatin, SMX/TMP and ganciclovir,and those in control group received routine treatments. Mortality and length of stay in hospital (LOS)were analyzed. Results Mortality (5.9 % ) and LOS (15 days) in case group were reduced as compared with those in control group ( 18. 2 %, 23 days, respectively) (P＜ 0. 05). Among the patients without severe pneumonia, the mortality and incidence of LOS beyond 21 days in case group (3. 4 %, 1/29; 3. 4 %, 1/29) were lower than those in control group (17. 2 %, 5/29; 37. 9 %, 11/29, respectively) (P＜0. 05). Whether the patients were admitted to hospital sooner or later, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05).Whether the etiologies were determined or undetermined, the incidence of LOS beyond 21 days in case group was lower than that in control group (P＜0. 05). The incidence of LOS beyond 21 days in case group was lower than that in control group among the patients with cardiopulmonary disease (P＜0. 05). Conclusion The initial appropriate treatment would improve the prognosis of pneumonia in the kidney transplant recipients.

Objective To investigate the characteristics and risk factors of abdominal lymph node metastasis in thoracic esophageal squamous cell cancer.Methods The clinical data of 586 patients with thoracic esophageal cancer who underwent surgery via transabdominal and transthoracic approaches between June 2009 and June 2014 at the Sichuan Cancer Hospital were retrospectively analyzed.All the patients received resection of esophageal cancer and lymph node dissection, and the transabdominal right thoracic approach or cervico-thoracicabdominal triple incision was selected according to the condition of patients.No.18, 19, 20 lymph nodes were dissected seperately and No.16, 17 and lesser curvature lymph nodes were separated.All the specimens of lymph nodes were detected by regular pathological examination.Measurement data with normal distribution were presented as x ± s and count data were described as rate.Comparisons of rate between 2 specimens and among the multiple specimens were respectively analyzed using the chi-square test and partition of chi-squared.The multivariate analysis was done using the logistic regression.Results The number of lymph node dissected in 586 patients was 12 524 with an average number of 20 ± 11 per case, and the rate of lymph node metastasis was 55.63％ (326/586).The number of mediastinal lymph node dissected was 7 012 with an average number of 12 ± 5 per case, and a rate of mediastinal lymph node metastasis was 40.96％ (240/586).The number of abdominal lymph node dissected was 5 512 with an average number of 9 ± 8 per case, and a metastasis rate was 31.74％ (186/586).The abdominal lymph node metastasis rate of the upper, middle and lower thoracic esophageal cancer were 13.73％ (14/102), 31.51％ (92/292) and 41.67％ (80/192), respectively, showing a significant difference among the above 3 indexes (x2 =25.91, P ＜ 0.05).The lymph node metastasis rate in No.16, 17, 18,19, 20 and lesser curvature lymph nodes were 12.80％ (75/586), 16.89％ (99/586), 1.71％ (10/586),0.68％ (4/586), 1.71％ (10/586) and 2.05％ (12/586), respectively, with a significant difference among the above 6 indexes (x2 =287.95, P ＜ 0.05).The results of univariate analysis showed that the tumor location,surgical procedure, T stage, N stage, G stage, pathological stage and mediastinal lymph node metastasis were risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer (x2 =24.02, 23.97, 37.87,136.85, 38.79, 7.70, 154.27, P ＜ 0.05).The tumor in the lower thoracic portion, N3 stage and stage Ⅳ were independent risk factors affecting abdominal lymph node metastasis of thoracic esophageal cancer in the multivariate analysis (RR =5.80, 2.36, 2.76, 95％ confidence interval: 1.022-1.813, 1.317-3.950, 1.652-12.351, P ＜ 0.05).Conclusions Abdominal lymph node metastasis is common in thoracic esophageal cancer in which No.16 and 17 lymph nodes predominate, and it is easy to occur in patients with lower thoracic esophageal cancer, and advanced N stage and pathological type.

Objective To study the change of serum diamine oxidase (DAO) level in patients with severely acute pancreatitis (SAP) in order to explore the role of DAO in assessing the severity of SAP and the magnitude of gastrointestinal dysfunction.Methods From January 2012 through December 2013,56 SAP patients with 33 male and 23 female and average age (45-± 14) years admitted within 3 days after onset were enrolled for this study.At admission,serum diamine oxidase (DAO) was detected,and APACHE Ⅱ score,computed tomography severity index (CTSI) score and Balthazar grading and gastrointestinal dysfunction score were calculated.And at the corresponding time,serum procalcitonin (PCT) was detected.The correlations between serum DAO level and 4 other markers were analyzed.Results The high level of serum DAO was found at admission in SAP patients correlating positively with serum PCT concentrations (r =0.516,P＜ 0.01),APACHE Ⅱ score (r =0.631,P＜ 0.01),CTIS score (r=0.640,P ＜ 0.01),and the degree of gastrointestinal dysfunction (r =0.730,P ＜ 0.01).Conclusions The role of serum DAO in assessing the severity of SAP and magnitude of gastrointestinal dysfunction in SAP patients is really valid.

Objective This study was performed to assess the clinical feasibility of video-assisted mediastinoscopic lymphadenectomy in the treatment of resectable lung cancer.Methods Between March 2011 and May 2012,we retrospectively analyzed the data from 56 patients who underwent video-assisted mediastinoscopic lymphadenectomy(VAMLA).In patients receiving tumour resection subsequently,radicality of the previous mediastinoscopic dissection was controlled during thoracotomy.Results Mean operative time of video-assisted mediastinoscopic lymphadenectomy was(42.0 ± 13.5) min(range of 26-86 min).Mean number of resected lymph nodes was 12.4 ± 6.7 (range of 5-24).In video-assisted mediastinoscopic lymphadenectomy,the rates of lymph node dissection of stations 2,4,5,7,8 were 54.5％,92.7％,58.2％,100％,61.8％,respectively,there was no operative mortality and morbility.90.9％ patients achieved radical dissection.Conclusion Video-assisted mediastinoscopic lymphadenectomy is a clinically feasible procedure and provides more accurate staging of mediastinal node in lung cancer patients.It also plays an important role in minimal invasive surgery and neoadjuvant therapy.

Objective To investigate the curative effect of the preoperative intervention transcatheter arterial chemoembolization and preoperative intravenous systemic simple chemotherapy for gastric cancer.Methods Retrospective analysis of 55 patients diag-nosed with gastric cancer.These patients were divided into two groups:treatment group and control group (simple chemotherapy group),with treatment group of 35 cases and control group of 20 cases,and cases of two groups all received surgical radical surgery for gastric carcinoma treatment.Preoperative and postoperative clinical symptoms were observed.Data of tumor sizes and tumor vessel changes were analyzed and compared.The difference of curative effect between two groups was observed.Results Compared with control group,degeneration and necrosis of tumor cells in gastric cancer tissue of treatment group were obvious,and tumor ves-sels significantly reduced,with nonuniformed,and became thinner.Number of tumor vessels of treatment group was obviously low-er than that of control group (P <0.05).Conclusion The interventional therapy of gastric cancer has obvious short-term therapeutic effects,and can reduce tumor vessels effectively and improve surgical resection rate.

Objective To investigate the clinical characteristics of hemodialysis (HD) patients complicated with arteriosclerosis obliterans (ASO) of lower extremity,and to discuss the factors that influence the curative prognosis of percutaneous transluminal angioplasty (PTA).Methods The clinical data of 211 patients with ASO of lower extremity receiving HD or not receiving HD,who were admitted to authors' hospital during the period from January 2008 to October 2015,were retrospectively analyzed.PTA was successfully accomplished in all patients.Results The median follow-up time was 2.24 years.Theamputation-free survival of HD group was significantly lower than that of non-HD group (P＜0.000 1),and the postoperative artery patency rate of HD group was also obviously lower than that of non-HD group (P＜0.000 4).The factors influencing the survival rate without amputation of the two groups were different.The independent influence factor in HD group was diabetes mellitus,while in non-HD group the independent influence factors were Fontaine stage and hyperlipidemia.The infection mortality of HD group was 55.5％ (10/18),which was higher than 22.2％(6/26) of non-HD group,the difference was statistically significant (P＜0.05).Conclusion In treating ASO of lower extremity,the curative effect of PTA is poorer in HD patients than in non-HD patients,and the presence of diabetes mellitus may be an independent factor influencing prognosis.

Objective To evaluate the curative effect,safety,and medium-term effect of intracranial artery stenosis stent (ICASS) for the treatment of the symptomatic intracranial artery stenosis.Methods ICASS was performed in 21 cases with the symptomatic intracranial artery stenosis.The stenting success rate,the improvement rate of stenosis post-stenting and the incidence of complications were observed.The change of the scores of the Modified Rankin Scale (MRS)and National Institutes of Health Stroke Scale (NIHSS)between pre-and post-stenting (1 month,3 months,6 months,12 months and 2 years)and the occurrence of ischemic cerebrovascular events after stenting were compared and analyzed respectively.Results Except one case failed because of intracranial hemorrhage during the operation,other 20 patients were treated with endovascular stent plasty successfully,the total technical achievement ratio was 95.2%.The aver-age stenosis ratio decreased from (73.4±7.9)% to (13.7±9.2)%.The complications incidence was 4.8% within the peroperative. 9 patients were reviewed with DSA in 6 months,the average ratio of stenosis was (29.5 ±12.2)%,no patient was found with the restenosis.Compared with pre-stenting,the score of MRS and NIHSS at the follow-up duration of 3 months,6 months,12 months and 2 years post-stenting of patients were significant improved (all P < 0.05 ).During the follow-up period,2 patients were found with new transient ischemia attack (TIA),1 patient had non-targeted vascular CI without other target vascular therapy-related com-plications.Univariate analysis indicated that patients with elderly (≥ 75 years old),or hypertension,or diabetes,or dyslipidemia,or in the set of events to endovascular treatment for longer than 1 month,or with more than two independent risk factors for patients with underlying diseases treatment,or without systemic therapy,whom would be much more easily to reoccur the cerebrovascular events in post-operation(all P <0.05 ).Conclusion ICASS should be an effective and safe therapeutic method to the symptomatic intracra-nial arterial stenosis.The medium-term efficacy is significant.Serious complications might still be emerge with endovascular stent plasty,so close attention must be paid with.

Objective To evaluate the safety and effectiveness of different anesthesia methods in performing percutaneous radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC). Methods The clinical data of 102 HCC patients, who were admitted to authors’ hospital during the period from January 2010 to October 2014 to receive percutaneous RFA, were retrospective analyzed. According to the anesthesia method used for RFA, the patients were divided into 3 groups. Group A: control of breathing and general intravenous anesthesia; group B: general intravenous anesthesia with spontaneous breathing; group C: local anesthesia with monitoring. The vital signs, perioperative adverse reactions and procedure-related complications were analyzed. Results The operation time of group A and B was longer than that of group C (P<0.02); the time of waking up after the operation in group A was longer than that in group B (P<0.03). During the performance of RFA the patient’s vital signs in group A and B were more stable than those in group C (P<0.01);during the performance of RFA the blood oxygen saturation in patients of both group A and B remained above 95%(from the placement of oxygen masks to the end of operation), although the blood oxygen saturation of group B was lower than that of group A (P<0.05), and the blood oxygen saturation of group C was lower than that of both group A and B (P<0.01). The incidences of adverse reactions such as involuntary limb activity, tears, need of anesthesia machine-assisted respiration, etc. in group A were significantly lower than those in group B and C (P<0.01). The postoperative complications such as subcutaneous emphysema, pneumothorax or need of thoracic drainage in group B and C were significantly higher than those in group A (P<0.05). Conclusion General intravenous anesthesia can reduce the operation time of RFA for HCC, which can create a safe and comfortable surgical environment for patients. The use of general intravenous anesthesia together with the control of breathing is the safest method with lower incidence of perioperative adverse reactions and procedure-related complications; it might be a relatively optimal anesthesia method for RFA of HCC.