Objective To study the effect of capsule deficient strains CAP64 on apoptosis of mice microglia cell line (N9) cell in vitro . Methods N9 cells were co cultured with CAP64, the flow cytometry was employed to detect the N9 cellular apoptosis on different phase. Results The average apoptotic index of N9 after cultured for 2、4、8、16、24 hours with CAP64 were 9 33%、12 93%、15 37%、16 30% and 20 5%, respectively. There were significant differences between experimental group and control group. Conclusion Capsule deficient strains CAP64 can induce microglia cell line (N9) apoptosis

Objective To evaluate the effect of local resection for the tumor of Vater ampulla. Methods seventeen cases of Vater ampullary tumor were subjected to tumor local resection from November 1987 to December 1998, including 3 adenomas and 14 adenocarcinomas confirmed by pathology. Two methods of excision for the tumor were performed, including through duodenum to perform the tumor local resection in 16 cases, and through common bile duct in 1 case. Results Bile duct infection occurred in 3 cases. There was no death in this series. 12 of the 17 cases (70.6%) had been followed up for 4～61 months, median survival time was twelve months. In three benign cases ,one died with another disease 17 months postoperatively, two still alive well 38 and 7 months after operation respectively. In 14 malignancy, 9 cases (64.3%) had been followed up. Of the 9 cases, 6(66.7%) alived ≥ 12 months, 4 (44.4%) 24 months, two(22.2%) 60 months. Conclusions Local resection of the Vater ampulla tumor has advantages, such as small damage ,less bloodlass, quick recovery and less interference of the body, but it must be performed by rich experienced surgeons. It is suitable for patients with a small benign tumor, or in the high risk patients whose carcinoma showed no invasion or metastasis, and it also can be performed in patients such as those with atypical hyperplasia and suspious malignant tumor.

Objective To study the influence factors of the release rate of benorilate from sustained release matrix tablets. Methods The matrix tablets of benorilate were prepared by using hydroxypropylmethylcellulose (HPMC) as the matrix material. The effects of the contents of HPMC, polyvinyl pyrrolidone (PVP), and microcrystaline cellulose (MCC), and the method of preparation on in vitro drug release were studied by evaluating the n value in the Peppas equation. Results The increasing HPMC content led to decrease of benorilate release. However, PVP and MCC used in this experiment accelerated the benorilate release from the tablets. The drug released from the tablet prepared by dry method was faster than that by wet method. Conclusion The contents of HPMC, PVP, and MCC, especially HPMC, have effects on the release rate of benorilate, but the two preparation methods have less effect.

OBJECTIVE To investigate the postoperative morbility of deep fungal infections and the source and composition of the pathogenic fungi.METHODS Clinical data of 816 patients with post-operative deep fungal infections from Jul 2006 to Jun 2008 were reviewed and analyzed retrospectively.RESULTS The detectable rate of post-operative deep fungal infections was 24.82%,among which Candida albicans was the most common(65.69%),followed by C.tropicalis(10.57%);the rate of broad-spectrum antibiotic application in peri-operation was 96.45%;the infection site in the descending order was cardio-thorax,gastrointestinal tract,urinary tract,female reproductive system,blood and skeleton.CONCLUSIONS Operative trauma is an important factor that causes deep fungal infections in hospital,and is closely related to broad-spectrum antibiotic application.Positive prevention,timely diagnosis and effective treatment should be highly emphasized when dealing with post-operative deep fungal infections.

Objective To analyze the drug resistance and homology of Acinetobacter baumannii (Ab) isolated from patients with explosive injury ,so as to explore the characteristics of drug resistance and prevalence of infection .Methods A total of 61 strains of AB isolated from clinical specimens of patients with explosive injury were collected .The antimicrobial susceptibility of these iso‐lates was detected by using K‐B test .All the strains were gene typed by using the pulsed field gel electrophoresis .Results The re‐sults of antimicrobial susceptibility test shown that the 61 isolates of Ab had high resistance rate ,and were multi‐drug resistant to common antibacterial agents ,except for tigecycline (the resistante rate was 11 .5% ) and minocycline (the resistante rate was 48 .0% ) .The 61 isolates of Ab were divided into 8 kinds of genotypes ,among which type A was the most prevalent one (25 strains) .Other genotypes were type B(10 strains) ,type C(6 strains) ,type D(4 strains) ,type E(8 strains) ,type F(3 strains) ,type G(4 strains) and type H(1 strain) .The isolates of Ab were with high homology .Conclusion Multi‐drug resistance is observed in strains of Ab isolates from patients with explosive injury .Clonal strains of AB may be disseminates among regions ,which indicates that high attention should be paid to these strains .

ObjectiveTo evaluate a computer-assisted operation planning system in curative hepatectomy for complex hilar cholangiocarcinoma.MethodsThe clinical data of 15 patients with complex hilar cholangiocarcinoma who were admitted to the Chinese PLA General Hospital from January 2008 to December 2009 were retrospectively analyzed.Based on triple-phase contrast-enhanced computed tomography inages,a computer-assisted operative planning system was used to evaluate the anatomic relationship between the tumor and its adjacent vessels,liver volume,operative feasibility,and the potential surgical approaches.The accuracy of three-dimensional reconstruction was tested by comparison to actual intraoperative findings.The correlation between actual liver resection volumes and predicted liver resection volumes was analyzed by calculating a Pearson correlation coefficient.Differences in liver volumes calculated by two-dimensional techniques versus three-dimensional reconstruction were analyzed using the paired t test,and the error rate was compared using the chi-squarc test. Results Fifteen patients received curative hepatectomy,including extended hemihepatectomy in 8 patients and trisectionectony in 7 patients.Preoperative evaluation of the hepatic anatomy based on three-dimensional reconstruction imaging was confirmed with operative findings.The sensitivity,specificity and accuracy rates were 100.0％,72.7％ and 72.7％ for patients with portal invasion and 100.0％,78.6％ and 78.6％ for patients with hepatic arterial invasion,respectively.The actual liver resection volume was positively correlated with the predicted liver resection volume ( r =0.974,P ＜ 0.05 ).The mean liver volumes calculated by the three-dimensional reconstruction and the two-dimen-sional techniques were (458 ±86)ml and (491 ± 103 )ml,respectively,with no significant difference (t =-1.911,P ＞0.05 ).The error rates of the three-dimensional reconstruction and the two-dimensional techniques were 4.7％ and 7.2％,respectively,with no significant differnece ( x2 =2.381,P ＞ 0.05 ).Five patients had postoperative complications,and each was cured with conservative or interventional management. Conclusion The application of a computer-assisted operation planning system may improve the safety and accuracy of curative resection for complex hilar cholangiocarcinoma.

Objective To evaluate three-dimentional (3D) reconstruction technique and methylene blue staining in precise anatomic hepatectomy.Methods The clinical data of 12 patients with hepatocellular carcinoma who were admitted to the Chinese PLA General Hospital from February 2009 to August 2011 were retrospectively analyzed.The 3D reconstruction of the liver tumor and intrahepatic vessels were done based on the computed tomography data and magnetic resonance imaging data.The portal vein supplying the tumor and its anatomic relationship with adjacent vessels were evaluated.Precise anatomic hepatectomy was performed guided by sustained methylene blue staining.Results The accurate rate of 3D model of the portal triad was 12/12.The shape of target segments observed after methylene blue staining was consistent with the results of 3D evaluation.Two patients received hemihepatectomy,3 received lobectomy,5 received monosegmentectomy or subsegmentectomy,2 received multisegmentectomy.The mean tumor diameter,operation time,blood loss,postoperative hospital stay and complication rate were 5.6cm (2.5-16.0 cm),(150±24)minutes,(236±25)ml,(10±3)days and 2/12,respectively.After a median follow-up of 14 months,tumor recurrence was found in 2 patients,and 1 of them died of tumor progression.Conclusions The 3D reconstruction may contribute to precise evaluation of the anatomic relationship between the tumor and its adjacent vessels.The 3D technique combined with sustained methylene blue staining may significantly improve the accuracy of anatomic hepatectomy.

Objective A retrospective study to evaluate the feasibility of the sequential treatment of extrahepatic bile duct calculus and acute gallstone pancreatitis using the technique of combination of duodenoscope, laparoscope and choledochoscope in one anesthetic session. Methods 112 patients with extrahepatic bile duct calculus (including 23 patients associated with acute gallstone pancreatitis) were treated using this technique. The data were analyzed. Results The technique was successfully carried out in 102 patients but 10 patients had to be treated by conventional open operation.For the patients treated by this technique, 16 patients were treated by endoscopic sphincterotomy (EST) plus choledochotomy. The stones were removed through a choledochoscope, and the bile duct was drained by a T-tube (LCTD). 18 patients were treated by endoscopic retrograde cholangiopancreatography plus laparoscopic cholecystectomy (LC). The choledocholiths were removed by a choledochoscope through the cystic duct. 22 patients were treated by choledochotomy, and the calculus was removed through a choledochoscope and the bile duct was primarily sutured. 46 patients were treated by endoscopic nasobiliary drainage (ENBD) plus LC, choledochotomy. The calculi were through a choledochoscope and followed by primary suture of the bile duct. The mean time of endoscopic treatment, LC and postoperative hospital day were 35 min, 110 min and 6.5 d respectively. None of the 102 patients died after operation. 9 patients developed complications of ERCP or EST including acute pancreatitis (n=6), hemorrhage of papilla duodeni (n=2) and duodenal perforation (n= 1). 11 patients developed biliary fistula after primary suturing of the choledochus and they recovered with drainage; 2 patients developed residual or recurrent biliary fistula after the T tube was removed and they recovered after drainage via a [aparoscope. During follow-up for 1 to 3 years using ultrasonic or MRCP examinations, 3 cases of stones were found and they were removed by EST. There was no stenosis of common bile duct. Conclusions Our results suggested that the three-endoscope-combination in one anesthetic session for the treatment of extrahepatic bile duct calculi and acute gallstone pancreatitis was safe and efficacious. Moreover, this technique reduced the complications of EST. This technique increased the success rate using minimal invasive surgery.

BACKGROUND: Numerous studies have shown that the increase of reproductive activity and self-repair capacity of brain endogenous neural cells might be a valuable method to treat ischemia-hypoxia brain damage. OBJECTIVE: To study the effects of He-Ne laser irradiation on the proliferation and differentiation of endogenous neural stem cells and brain functional reconstruction in newborn rats with hypoxia-ischemia brain damage.METHODS: Newborn rats aged 7 days were prepared for hypoxia-ischemia brain damage models. From the second day of model induction, rats in the laser treatment group were subjected to He-Ne laser irradiation. Acupuncture point included Baihui (DU20) on the median parietal bone, and Dazhui (GV14) between the C7 and T1 and the median back. After the second course, the learning and memory ability of rats were tested by Y-type maze test. Then brain hippocampal sections were made and underwent immunohistochemistry for nestin and microtubule-associated protein-2.RESULTS AND CONCLUSION: In the laser treatment group, the ability of learning and memory were obviously higher than those in the model group (P < 0.05), however, compared with the sham-operated group, the difference was not obviously (P > 0.05). Compared with the sham-operated group, nestin expression in the dentate gyrus was significantly increased in the model and laser treatment groups (P < 0.05), and the increased range was greater in the laser treatment group compared with the model group (P < 0.05). Microtubule-associated protein-2 expression was widely distributed in the cerebral cortex, and darkly stained brown dendrite presented with radiation-shape. Neurons in the hippocampal pyramid and dentate gyrus granular cell layer arranged regularly. Positively stained dendrite presented branch-shape and distributed in the molecular layer. No significant difference was determined between the sham-operated and laser treatment groups. But the microtubule-associated protein-2 expression was significantly weakened in the model group. He-Ne laser irradiation can promote proliferation of endogenous neural stem cells in neonatal rats with hypoxia-ischemia brain damage, induce its differentiation into neurons, thus, achieves reconstruction of learning and memory functions.

Objective To analyze the species classification and chracteristics of drug resistance and virulence in CTX-M producing Escherichia coli isolated from urine culture.Methods Escherichia coli cultured by urine were collected from our hospital during 2014,the ring disk diffusion test was implemented to determine the bacterial susceptibility,the EBLs determination test was used to analyze the bacterial EBLs producing situation;the enterobactoer duplicated gene spacer consensus sequency PCR(ERIC-PCR) was adopted to perform the genetic relation analysis;PCR was used to amplify the CTX-M encoding genes and multiple virulence genes iutA,ompT,fyuA,fdeC,fimH,traT,cvaC,pap,kpsMT,pAI,usp,aer,hlyA,cnf and chuA;the multiple PCR was used to analyze the species calssification of CTX-M-producing Escherichia coli;these strains of bacteria were classified as the CTX-M-producing group and non-CTX-M-producing group according to the results of CTX-M coding gene detection,the differences in the antibacterial drug resistance and virulence genes between the two gorups were performed the contrastive analysis.Results One hundred and sixty-two strains of E.coli by urine culture had no genetic correlation,among 126 EBLs positive strains,91 strains produced CT-M,in which 57 strains of CT-M producing Escherichia coli belonged to type D,and 116 strains belong to Type B2.The statistical analysis found that the drug resistance rate in the CTX-M-producing group was significantly higher than that in the non-CT-M producing group (except for imipenem),the prevalence of virulence genes including iutA,chuA and traT in the CT-M producing bacteria group was significantly higher than that in the non-CTX-M-producing group(P=0.001,0.006,0.000)Conclusion CTX-M-producing E.coli is main pathogenic bacterium of urinary infection in our hospital,its majority belong to type D with increased drug resistance,moreover has close correlation with virulence genes iutA,chuA and traA and is a pertential threat in clinical treatment of urinary infection.