Objective To explore the therapeutic effects and mechanisms of somatostatin on liver injury in acute hemorrhagic necrotizing pancreatitis(AHNP) in rats.Methods Murine model of AHNP was established by retrograde injection of artificial bile into the biliopancreatic duct.The animals were divided into sham operation group(S group), AHNP saline injection group(AHNP group), and AHNP octreotide treated group. TLR2,4 mRNA expressions and NF-?B expressions in the liver tissue at 3,6 and 12h after operation were measured.Results TLR2,4 mRNA in liver tissue in the AHNP group began to rise at 3h,and peaked at 12 h(P

Objective To evaluate the effect of dexmedetomidine on the expression of inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) during focal cerebral ischemia-reperfusion (I/R) in rats.Methods Thirty pathogen-free male Sprague-Dawley rats,aged 12-16 months,weighing 300-360 g,were randomly divided into 3 groups (n =10 each) using a random number table:sham operation group (group Sham),focal cerebral I/R group (group I/R),and dexmedetomidine group (group D).Focal cerebral I/R was induced by occlusion of the right middle cerebral artery.In group D,dexmedetomidine was given as a loading dose of 1 μg/kg (over 10 min) starting from 1 h of ischemia,followed by an infusion of 0.05 μg · kg-1 · h-1 until 2 h of reperfusion.Neurological deficit was assessed and scored at 24 h of reperfusion,and then the rats were sacrificed.Brains were removed for determination of cerebral infarct size and expression of iNOS and COX-2 in the hippocampus (by Western blot).The percentage of cerebral infarct size was calculated.Results Compared with group Sham,the neurological deficit score,percentage of head swing to the left,percentage of cerebral infarct size,and expression of iNOS and COX-2 in the hippocampus were significantly increased in I/R and D groups (P＜0.05).Compared with group I/R,the neurological deficit score,percentage of head swing to the left,percentage of cerebral infarct size,and expression of iNOS and COX-2 in the hippocampus were significantly decreased in group D (P＜0.05).Conclusion The mechanism by which dexmedetomidine mitigates focal cerebral I/R injury may be related to inhibition of iNOS and COX-2 expression in rats.

Objective To investigate whether the new mechanically-activated (MA) cation channel Piezo 1 protein can cause the apoptosis of human chondrocytes under compressive loading,using a Flexercell unit by activating MAPK/ERK5 signal pathway.Methods Primary human chondrocytes were isolated,cultured,and then subjected to the static compressive loading for 2 h,12 h,24.h and 48 h,respectively.The GsMTx4,which is the special inhibitor of the Piezo1 protein and the BIX02188,which is the inhibitor of the ERK5 served as the inhibitor group.The immunofluorescence was used to locate the expression of the Piezo 1 protein.The expressions of Piezo1 and ERK5 were assessed by reverse transcription-polymerase chain reaction (RT-PCR),as well as the apoptosis gene B cell lymphoma/leukemia-2 (Bcl-2),Bcl-associated X protein (Bax) and Bcl-associated death promoter (BAD).In addition,Piezo1 inhibitor,GsMTx4,was used to block the MA cation channel Piezo1,served as the inhibitor group.AVPI was used to detect the apoptosis of the OA chondrocytes.Results The location of the Piezo1 was expressed in nucleus and cytoplasm of chondrocytes.The expression of the Piezo1,ERK5,BAD,and Bax mRNA in the OA chondrocytes is weak.The 12 h stretch force group was significant increased,and the 24 h stretch force group was the highest expression.However,the expression of the 48 h group was decreasing.The expression of the Bcl-2 in the 12 h group was decreasing,and the 12 h stretch force group was the lowest expression while the 24 h stretch force group was increasing.In the GsMTx4 group,the expression of the Piezo1,ERK5,BAD,Bax was decreasing while the Bcl-2 was increasing.In the BIX02188 group,the expression of the ERKS,BAD,Bax was increasing while the Bcl-2 was decreasing,while the expression of the Piezo1 was not change.The result of AV-PI shown that the 2 h stretch force group increased early stage of apoptosis.The 12 h stretch force group increased late stage of apoptosis,and the 24 h stretch force group's apoptotic rate was the highest.However,the apoptotic rate of the 48 h group was lower than the 24 h stretch force group.The GsMTx4 could inhibit the late stage of apoptosis.Conclusion Piezo 1 plays an important role in the apoptosis of human chondrocyte through the MAPK/ERK5 signal pathway.

Objective To investigate the results of different measuring procedures of hemoglobin A1c (HbA1c) trueness verification scheme in China.Methods Cross sectional survey.The data were collected via the External Quality Assessment (EQA) software from laboratories participated in the First HbA1c trueness verification EQA.Then the collected data were divided into several groups based on laboratory instruments and the data from less than 5 group were excluded.The observed imprecision, bias and sigma (σ) were calculated and the bias％ and CV％ were drew in the sigma chart.The average bias％, CV％ and weighted average σ of each level were also calculated.Results Total 123 laboratories were divided into 9 groups and setting 6％ as the Allowable Total Error, the average bias％, CV％ and weighted average σ of 201411 (target value was 5.4％) were 3.70％, 4.55％ and 0.51 respectively σ, of 201412 (target value was 7.8％)were 2.42％ , 3.56％ and 1.24σ respectively.None of the group achieved the 2σ quality of 201411, and 1 group achieved the 2σ quality of 201412.Conclusions There are obvious biases among the results of many measuring systems and the target value assigned by reference measuring procedures of HbA1c, as well as the imprecision.The Sigma External Quality Assessment Chart is a visual tool, indicating that the quality of measuring systems necessitate improvement therefore to ensure the reliability of results and make better use of HbA1c in clinical application.

Objective To investigate the significance of PI3K/AKT signal transduetion pathway in gastrointestinal stromal tumors(GIST).Methods The expression of PI3K、Akt、PTEN were detected with RT-PCR and Westem-blot of tumor specimens from 124 GIST cases and the corresponding normal gastric mucosa.Results In gastrointestinal stromal tumors,the tumor suppressor gene-PTEN was on low expression as with the inereased expression of PI3K and Akt.The positive expression rate of PTEN,PI3K and Akt was not statistically correlated with patients'demographics and tumor histological type,but they are significantly correlated with lymphatic metastasis and mucosal invasion.The expression of PI3 K and Akt are of significantly positive correlation(r=0.292,P=0.031).The expression of PI3K and PTEN are of significantly negetive correlation(r=-0.412,P=0.036).The expression of PTEN and Akt are of significantly negetive correlation(r=-0.386,P=0.024).Conclusion PI3 K/Akt and P,PTEN may have bean on reciprocally suppressive effect during the development of GIST.

Objective To explore the relationship between the status of the cervical lymphatic metastasis of papillary thyroid carcinoma(PTC)at cNo stage and tumor recurrence and the patient' s prognosis.Methods The clinical data of 498 cNo PTC patients admitted from 1986 to 1990 were retrospectively analyzed.Results All the patients were followed up for more than 10 years.16 patients died of PTC,among them 3 for metastasis,13 for local recurrence.The total cervical lymphatic metastasis rate in these 498 patients was 52.2％,in 260 cases in which detailed data were available: rate was 14.1％ in zone Ⅱ,27.1％ in zone Ⅲ,24.6％ in zone Ⅳ,12.5％ in zone Ⅴ,and 20.1％ in zone Ⅵ respectively.According to the appearances of microscopic pathology,the cervical lymphatic metastasis rates in 498 cases of cNo PTC were collected as following: uncapsuled group was 65.6％,extracapsular group was 64.5％,extralobal group was 56.5％,involved the surrounding tissue and structure group was 52.0％,focal cancerous focus group was 33.3％,latent sclerosis group was 26.9％,encapsuled and introcapsule group was 0.The cervical recurrence rate was only 2％ in the complete function neck dissection group and 9.9％ in the selective center neck dissection group.Conclusions In cNo PTC the most common cause of death was local recurrence.Prophylactic function complete neck dissection should be performed for cNo PTC cases of highly invasive type such as without tumor capsule,extracapsular,extralobal or surrounding tissue invasion.

Objective To establish a biotin-streptavidin ELISA method to measure CTGF,and evaluate the clinical value of CTGF for the diagnosis of liver fibrosis in chronic hepatitis B (CHB) patients.Methods Biotinylated anti-CTGF polyclonal antibody and monoclonal antibodies were prepared for the establishment of this biotin-streptavidin ELISA method.Two hundreds and sixty-four CHB patients were subjected into non-or mild liver fibrosis group (S0-S1,108 cases) and severe liver fibrosis group (S2-S4,156 cases),according to the liver biopsy pathological diagnosis.The CTGF assay's diagnostic capacity for CHB was assessed by comparing the area under ROC (AUC) with that of a panel of hepatic fibrosis markers ( HA,PC Ⅲ,C Ⅳ,LN and APRI).Analysis of variance and rank sum test were performed to carry out comparisons between multiple groups.Student's t-test and Mann-Whitney U test were performed for the pairwise comparison between multiple samples.Spearman rank correlation test was performed to analyze the correlation between different hepatic fibrosis stages.Results The minimum detectable dose and detection rang of the ELISA was 0.2 μg/L and 0-64 μg/L respectively.The intra-assay and inter-assay CV at high and low level were 4.5％,9.8％ and 10.1％,12.8％ respectively.Serum CTGF concentrations in S0-S1 group and S2-S4 group were 6.7(3.1 - 10.1 ) μg/L and 16.1 ( 11.8 -27.2) μg/L,with a statistically significant difference (U =1 217,P ＜0.001 ).There was a significant correlation between the levels of serum CTGF and fibrosis stages ( r =0.689,P ＜ 0.001 ),AUC of CTGF was 0.841 (95％ CI:0.762 - 0.920) in distinguishing mild fibrosis from significant fibrosis.When the cut-off value of CTGF was 10.3 μg/L,the sensitivity and specification was 70.5％ and 82.4％ respectively.The sensitivity of parallel combination test of CTGF and APRI was 96.1％,which was higher than that of HA (75.6％),PC Ⅲ (70.5％ ),C Ⅳ(63.6％),LN(79.5％ ),APRI(86.3％ ).The specificity of the combination test was 65.5％,which was lower than of above liver fibrosis markers [HA ( 72.5％ ),PC Ⅲ ( 76.5％ ),C Ⅳ ( 78.4％ )].The specificity of serial combination test of CTGF and PC Ⅲ was 95.9％,which was higher than that of HA,PC Ⅲ,CⅣ,LN(64.7％ ),APRI(66.1％ ),however,the sensitivity of the combination test was 67.7％,which was lower than that of above HA,PC Ⅲ,and APRI.Conclusions The biotin-streptavidin ELISA method measuring serum CTGF has a high minimu detectable dose sensitivity,and specificity.Serum CTGF level is significantly correlated with fibrosis stage,and CTGF maybe a valuable marker for liver fibrosis assessment.The paralledl combination of CTGF and APRI could be used as screening for significant liver fibrosis markers.The serial combination of CTGF and PC Ⅲ may be considered as a confirmatory diagnostic marker for liver fibrosis.

Routine supervision on hospital infection control was normally fed back on paper-based media,plagued by low efficiency and poor traceability.A feedback process developed with Workflow technology,can loop the entire process ranging from routine supervision to identifying loopholes,to hospital infection and joint development of correctional measures clinically,all the way to implementation of infection control practice and sustained improvement.The closed-loop PDCA cycle management features greater efficiency and traceability in hospital management of its infection control,and builds a quality improvement model featuring close communication between infection control department and clinical departments.

Achalasia is an esophageal motility disorder involving the smooth muscle layer of the esophagus and the lower esophageal sphincter. It is characterized by difficulty swallowing, regurgitation, and sometimes chest pain. Peroral endoscopic myotomy (POEM) was developed by Inoue to provide a less invasive permanent treatment for esophageal achalasia. We applied this method to cure successfully a 47-year-old female with achalasia. The procedure was as follows: after creating submucosal tunnel, endoscopic myotomy of circular muscle bundles was carried out at approximately 16 cm in total length ( 15 cm in distal esophagus and 1 cm in cardia). Smooth passing of endoscope through gastroesophageal junction was confirmed at the end of the procedure. The third day after POEM, the barium meal examination revealed the barium smoothly passed though the cardia. The short-term outcome of POEM for achalasia was excellent, and further studies on long-term efficacy and on comparison of POEM with other interventional therapies are awaited.

Blood Coagulation Tests ; Coagulation Protein Disorders ; blood ; physiopathology ; Female ; Humans ; Young Adult