With ever-increasing knowledge of biomechanics and anatomy of pelvis,more and more findings have been made on the integrated sacroiliac joint system.The sacroiliac complex plays a very important role i n the functions of pelvis due to its specia l biomechanical features.The sacro iliac screw internal fixation is bio mechanically superior to other fixation methods.[

Objective:To research the number and function of monocyte-macrophages in patients with chronic active hepatitis B. Methods:The 51 chronic viral hepatitis B( CHB) patients were selected randomly,which consisted of 20 cases of mild-moderate,31 cases of severe group and 13 cases of healthy controls. PBMCs were separated by percoll. Monocytes were tagged by CD14,the molecules CD80,CD86,HLA-DR and CD163 were detected by flow cytometry which expressed on the surface of PBMCs. Serum cytokine were detected for IL-10, IL-12 and IL-23 by ELISA. The distribution of CD68 was detected in the liver by immunohistochemical staining. Results:The expressions of CD80 for all chronic hepatitis B patients were lower than the controls respectively,no matter mild-moderate or even severe group. Similarly,the HBV patients expressed lower level of CD86 in the peripheral blood mononuclear cells when compared with the control group. Furthermore, there was statistically difference between the levels of CD86 in severe group compared with control group (P<0. 01). As the expression of CD80 and CD86,the levels of HLA-DR in the patents had also declined when compared with controls. While the HLA-DR levels in both the mild-moderate HBV hepatitis groups were statistically significant higher than the severe group (P<0. 01). Different from the above all,the expression of CD163 in all chronic HBV hepatitis was higher than the control group. The CD68 positive cells in chronic HBV patients were observed and infiltrated increasingly in portal area and hepatic lobules (P<0. 05). There were statistically significant differences of IL-10 levels between the mild-moderate group,severe group and the control group,respectively (P<0. 01). Conclusion:Macrophages have participated in the pathological lesions of liver in CHB patients,among peripheral blood mononuclear cells,the phenomena of imbalance between type M1/M2 and polarization to type M2 have been observed,which participated in the development of the chronicity of CHB.

With the maturation of laparoscopic surgical technology and the development of surgical instruments,the scope of application for laparoscopie surgery has expanded constantly in recent years.It is now possible to perform total laparoscopic distal pancreatectomy (TLDP).Cuschieri succeeded in performing laparoscopic distal pancreatectomy and slpenectomy in 1996,and in the same year,Kimura successfully performed spleen-preserving laparoscopic distal pancreatectomy.However,few successful spleen-preserving TLDP cases have been reported domestically or abroad.We made a success in a case of spleenpreserving TLDP with preservation of the splenic artery and vein in 2011,and the experiences of this surgical approach were introduced.

Objective To investigate the inhibitory effect of dauricine on the growth of human bladder cancer T-24 cell and its mechanism.Methods The T-24 cells were treated with dauricine(Dau) at different concentrations.The proliferation of T-24 cells was assayed with MTT colorimetric method.The apoptosis of T-24 cells induced by Dau was studied by fluorescent staining,flow cytometry(FCM) and DNA agarose gel electrophoresis.Results Dau effectively inhibited the proliferation of T-24 cells in a concentration dependent manner.A characteristic DNA ladder was observed in Dau treated groups.Dau at the concentration of 5-30 ?g/ml induced the apoptosis of T-24 cells and the apoptosis rate increased in a time-dependeut manner.Cell cycle was arrested at G_0/G_1 phase.The expression of bcl-2 was inhibited and the expression of bax was up-regulated.Conclusion Dauricine significantly inhibits the growth of bladder cancer cells.Cell cycle arrest and apoptosis might be the functional mechanisms.

Objective To investigate the value of timely duodenal papilla fenestration for reducing the incidence of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP).Methods The clinical data of 181 patients with difficult biliary cannulatian during ERCP at the Xinhua Hospital of Shanghai Jiaotong University from July 2006 to December 2009 were retrospectively analyzed.Of the 181 patients,98 patients who received traditional incubation were in the control group,and the other 83 patients who received early duodenal papilla fenestration were in the test group.The success rate of selective incubation and incidence of pancreatitis were compared between the 2 groups.All data were analyzed using the t test,chi-square test or Wilcoxon rank sum test.Results The success rate of incubation,incidences of hyperamylasemia and pancreatitis were 85.7％ ( 84/98 ),7.1％ (7/98) and 10.2％ ( 10/98 ) in the control group,and 94.0％ ( 78/83 ),18.1％ ( 15/83 ) and 2.4％ (2/83) in the test group,respectively,and there were significant differences between the 2 groups (x2 =10.12,5.03,4.41,P＜0.05).The numbers of patients with mild,moderate and severe pancreatitis were 3,5 and 2 in the control group,and 1,1,0 in the test group,respectively,and there was a significant difference between the 2 groups ( Z =- 2.11,P ＜ 0.05 ).Conclusion Timely duodenal papilla fenestration is safe and effective in reducing the incidence of pancreatitis for patients with difficult biliary cannulation during ERCP.

Objective To evaluate the success rate, safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) after Billroth Ⅱ gastrectomy. Methods Data of 75 patients with biliary disease after Billroth Ⅱ gastrectomy, who underwent ERCP from January 2007 to November 2009, were retrospectively analyzed. Results In 75 patients, afferent loop intubation was achieved in 69 (92%) and selective cannulation of bile duct were successful in 68 (68/69, 98. 5%). Diagnostic procedures were carried out in 3 patients, and therapeutic in 65 others, which included EST plus stone removal and ENBD in 16, ERBD in 19, EMBE in 18 and EBD plus stone removal and ENBD in 12. Afferent loop perforation occurred in 1 patient (1.3%) and was treated surgically, and 2 acute pancreatitis (2. 6%) were treated conservatively.There was no complication of bleeding. Conclusion ERCP after Billroth Ⅱ gastrectomy is safe and efficiency for biliary disease.

AIM: To evaluate the growth-inhibitory effects of NS-398, a selective cyclooxygenase-2 inhibitor, in human colon cancer HT-29 cells and its possible mechanisms. METHODS: MTT assay was applied to detect the cell proliferation. Flow cytometry was performed to detect apoptosis rate and cell cycle. RT-PCR was used to detect the expression of bcl-2 mRNA and bax mRNA. Alteration of cytoskeleton component F-actin was observed by confocal laser scanning microscope. RESULTS: NS-398 could inhibit growth of HT-29 cells in dose-and time-dependent manners. Flow cytometry revealed that NS-398 could induce apoptosis and cause G0/G1 arrest of HT-29 cells in a dose-dependent manner. After 72 h incubation with NS-398 at different concentrations, the expression level of bcl-2 mRNA was lowered and the ratio of bcl-2 to bax was decreased in HT-29 cells. F-actin was mainly distributed around nuclei forming annular structure in HT-29 cells. After exposure to NS-398, the annular structure around nuclei disappeared and fluorescence intensity of F-actin decreased obviously. CONCLUSION: NS-398 can inhibit the growth effectively and induce apoptosis in HT-29 cells in vitro, which is associated with the down-regulation of bcl-2 to bax ratio and the disruption of cytoskeleton.

Objective To detect the expression levels of adipose-specific phospholipase A2 (AdPLA) mRNA in orbital adipose tissue of thepatients with thyroid associated ophthalmopathy and the normals.Methods Sixteen patients with TAO of m level and stationary phase underwent orbital decompression,and 29 normals underwent ocular plastic surgery in Shenzhen Eye Hospital between August,2015 and October,2016.Orbital fat samples were collected from one eyes of these patients during surgery.The age,gender,height,weight,body mass index (BMI),exophthalmos degree,orbital fat of the patients with TAO and the normals were recorded and calculated.Using real time PCR,the AdPLA mRNA were detected from these orbital fat samples.Results There was no significant difference between the patients with TAO and the normals in age,gender,and BMI (all P ＞ 0.05).TAO group had more exophthalmos degree (20.406 ± 1.369)mm than the normals (14.207 ± 1.146) mm.TAO group had more orbital fat (32.162 ± 1.923) mL than the normals (24.279 ± 1.070) mL.The average expression level of AdPLA in patients with TAO was 0.039 42 ± 0.009 85,and 0.004 42 ± 0.001 36 in the normal.There was significant difference between two groups (P ＜ 0.05).Conclusion The patients with TAO of Ⅲ level and stationary phase have more exophthalmos degree and orbital fat than the normals.AdPLA mRNA is higher expressed in orbital adipose tissue of the patients with TAO of Ⅲ level and stationary phase than the normals.The high expression of AdPLA may reduce lipolysis in the orbital adipose tissue,lead to fat accumulation in orbits,and aggravate exophthalmos of patients with TAO.

Objective To evaluate the curative effect and safety of emergency therapeutic endoscopic retrograde cholangiopancreatography (ERCP) and treatment strategy of mobidity and combined diseases for patients aged over 90.Methods The clinical and follow-up data of 116 cases treated by ERCP from January 2002 to December 2006 were analyzed retrospectively.Results The success rate was 97.41% for biliary drainage.The occurrence rate of mobidity was 21.24%(24/113),of which 6 cases of acute pancreatitis (25.00%),2 cases of upper gastrointestinal bleeding (8.33%),12 cases of electrolyte disorders (50.00%),acid-base balance disorders in 4 cases (16.67%).Except the higher incidence of hypokalemia disorders of emergency group than out-patient group (P=0.003),the rest of the mobidity rates were similar in the two groups.The mortality rate and deterioration rate of combined disease between the two groups were also similar.Conclusion Simplify operations,rapid drainage,positive preoperative preparation can effectively reduce the incidence of mobidity and avoid the aggravation of combined diseases.Emergency ERCP for treatment of patients aged over 90 is safe and effective.

Objective To investigate the effect and mechanism of sphingosine 1-phosphate(S1P)on action potential(AP)and voltage-dependent potassium current(KV)in isolated guinea pig ventricular myocytes.Methods The ventricular myocytes were isolated by using Langendorff perfusion method.The AP and KV were recorded by whole cell patch-clamp recording technique.Results S1P prolonged the 50% and 90% action potential duration(APD50 and APD90)and decreased KV which were blocked by pertussis toxin(PTX)or Calphostin C.Conclusion S1P decreased KV in a PKC pathway and prolonged action potential duration in guinea-pig ventricular myocytes.