Objective To evaluate the feasibility and safety of laparoscopic surgery in the treatment of acute pyogenic cholecystitis. Methods From January 2005 to May 2008,laparoscopic surgery was performed on 156 cases with acute pyogenic cholecystitis in our hospital. The clinical data of the patients were retrospectively reviewed. Four trocars were used for cholecystotomy. Major resection of the gallbladder or cholecystostomy was carried out if the anatomy of the Calot triangle was complex. Results Among the 156 operations,laparoscopic cholecystectomy was succeeded in 139 cases (89.1%); cholecystostomy was performed on 6 cases (3.8%); and 11 patients (7.1%) received laparoscopic subtotal cholecystectomy (LSC). None of the patients were converted to open surgery. The operation time ranged from 35 to 180 minutes with a mean of 75. Thirteen patients showed increased level of direct bilirubin and/or stones in the common bile duct (revealed by cholangiography during the bile duct dilation),and were cured by removing the stones under laparoscope and T tube drainage. The T tube was withdrawn in 2 months after cholangiography. Follow-up was available in all of the patients for 3 to 6 months. No jaundice,abdominal pain,fever or other complications occurred during the period. Conclusion Laparoscopic surgery is feasible,effective,and safe for acute pyogenic cholecystitis.

Objective:To investigate the prognostic values of tumor–stroma ratio and tumor-infiltrating lymphocytes in colorec-tal cancer. Methods:A total of 218 stageⅡorⅢprimary colorectal cancer patients were analyzed for the tumor–stroma ratio (TSR) and tumor-infiltrating lymphocytes (TIL) by using HE stained histological sections. The relationship between TSR and clinicopatholog-ic variables and the difference in clinical outcomes of different groups were also analyzed. Results:Overall survival rates for the stro-ma-low group were significantly higher than the stroma-high group in stagesⅡandⅢcolorectal cancer (P＜0.05). However, the differ-ences in TSR were not correlated with clinicopathologic features such as gender and age (P>0.05). Overall survival rates of patients with high TIL were significantly higher than patients with low TIL (P＜0.05). Patients with high TIL had notable better prognosis than patients with low TIL (P＜0.05) in the stroma-low group. Conclusion:TSR and TIL are independent prognostic factors for stagesⅡandⅢcolorectal cancer. The combined estimates of TSR and TIL in routine pathology diagnoses may provide more evidence to predict the prognosis of stagesⅡandⅢcolorectal cancer.

Objective To make sure the psychological condition of patients with liver transplantation,and then make out certain effective nursing methods. Methods Investigated 94 patients with liver transplantation by MSSNS,analyzed the datum. Results The average score of the patients with liver transplantation was higher than the in-patients expected those in the department of psychology,P

OBJECTIVE To investigate the risk factors for nosocomial pneumonia(NP) caused by imipenem-resistant Acinetobacter baumannii(IRAB) and its antimicrobial susceptibility in vitro. METHODS The data of 34 cases of IRAB-NP were analyzed and 68 cases of NP caused by imipenem-susceptible A.baumannii(ISAB) were randomized as control.Antimicrobial susceptibility(MIC) was determined with the method of agar dilution. RESULTS The two independent factors associated with the development of IRAB-NP: previous fluoroquinolone(OR=5.738) and imipenem/meropenem(OR=7.129) use.The drug sensitivity test in vitro showed that these strains were multiresistant to commonly used antibiotics,and only ampicillin/sulbactam and cefoperazone/sulbactam whose resistance rate was less than 30%. CONCLUSIONS Previous imipenem/meropenem and fluoroquinolone use is independent risk factors for IRAB-NP.These strains are high drug resistant.

Pulmonary fibrosis is a common pathological change in many chronic lung diseases, and its pathogenesis and characteristics are mainly caused by repeated lung alveolar injury leading to abnormal activation of fibroblasts and the accumulation of large amounts of extracellular matrix (ECM) deposition. Fibroblasts are not only responsible for constituting the interstitial structure of the lung but are also involved in the post-injury repairment in healthy lung tissue. In contrast, fibroblasts show a typical pro-fibrotic metabolic phenotype after differentiation into myofibroblasts during the development of pulmonary fibrosis. To synthesis large amount of collagen, the myofibroblasts have a strong metabolism characteristic of serine/glycine, glutamine, proline, and arginine. At the same time, the myofibroblast get the ability to resist cell apoptosis. As an important cell type for collagen degradation, fibroblasts reuse the amino acids of collagen to maintain cell metabolism. However, the myofibroblasts cannot degrade the ECM due to the suppression of autophagy activity, thus accelerating the progression of pulmonary fibrosis. This review attempts to summarize how amino acid metabolism of fibroblasts influence the pulmonary fibrosis.

Objective To evaluate the early diagnosis value of MRI combined with DSA in cirrhotic nodules (regenerative nodules, dysplastic nodules) becoming small hepatocellular carcinoma. Methods 40 patients diagnosed as cirrhosis and whose liver nodules detected by ultrasound were followed up as MR dynamic study. All patients were followed up by three dynamic contrast-enhanced MR scanning once every 3 months,and the changes of cirrhotic nodules were observed and analyzed in the signal. If MRI suggested cancerous nodules cirrhosis, hepatic artery DSA would be carried out. Results 40 patients were followed up for 1.5 to 3 years,all patients MR nodules were found in liver regeneration. Follow-up process, the dysplastic nodules were founded in 28 cases and the small hepatocellular carcinoma were founded in 18 patients. 16 cases of 18 patients with small hepatocellular carcinoma carried out routine DSA all had typical of hepatic arterial blood supply and angiogenesis, and were given to Integrated Traditional and Western intervention simultaneously. Conclusion Combined use of MRI-DSA in the evaluation of cirrhotic nodules had a definite value, and could find smaller hepatocellular carcinoma,provide the basis for smaller hepatocellular carcinoma therapy.

Objective To analyse the operation technique and therapeutic effect of "inserting" uretero-intestinal anastomosis in orthotopic bladder substitution.Methods Thirty-eight patients undergoing orthotopic bladder substitution operations were followed up,and the way of uretero-intestinal anastomosis in all Datients was the "inserting"uretero-intestinal anastomosis.The therapeutic effect was observed by radiation,cystoscopy,pathologic biopsy and blood test.Results The average follow-up time was(3 1.65±14.14)montll8.and the stricture rate was 4%(3/75),but no vesicoureteric reflux was found.The rate of leakage was 0.Nipples were formed at the site of anastomosis under the view of cystoscope,and among the 7 patients whose nipples were taken to be examined by histology,2 cases were intestinal epithelium which were taken at the base of nipple8.while the others were transitional epithelium which were taken at the top of nipples.The renal function of all patients was normal (Cr 54-135 μmol/L,BUN 3.2-9.4 mmol/L).Conclusion "Inserting"uretem-intestinal anastomosis is an ideal antireflux uretero-intestinal anastomosis method.

Aim To investigate the method of establishing the atopic dermatitis mice model induced by calcipotriol ( MC903 ) . Methods Induction dose exploratory experiment: since d 0, 0.33,1,3 nmol MC903 was smeared on the right ear of BALB/c mice in each dose group respectively , for 7 consecutive days . The ear swelling degree of the mice was observed every day and the bilateral ears thicknesses were measured .The materials were drawn and analyzed in d 3 and d 7.Induction days exploratory experiment: 2 nmol MC903 was smeared on the right ear of BALB/c mice, for 14 consecutive days .The ear swelling degree of mice was observed every day and the bilateral ears thicknesses were measured .The histopathological examination of the right ear was conducted in 3 d, 7 d, 11 d and 15 d respectively .The tissue homogenate of the mice right ear was prepared .The ex-pressions of thymic stromal lymphopoietin (TSLP),IL-33, IL-4 and IFN-γin the homogenate , CD40 +,CD86 +,the DC surface markers and ILC2 contents in the peripheral lymph nodes were detected.Results ①1,3 nmol MC903 induced ear swelling in mice was significantly increased in d 3, the levels of TSLP and IL-4 were significantly increased .The level of IL-33 in 3 nmol dose group was increased significantly in d 7.② The right ear swelling of 2 nmol MC903 induced atopic dermatitis mice was significant , the ear thickness was increased gradually and reached the peak in d 14.The histopathological examination of the mice ear tissue showed in d 7, the right ear tissue of the mice was swelling and red , the capillary vessels were dilated and the infiltration of inflammatory cells was obvious .The ear in-flammatory symptoms maintained and gradually aggravated for 15 days.Compared with the normal mice , MC903 increased the TSLP level in the right ear tissue homogenate significantly in d 3 and then decreased gradually .The levels of IL-4 and IL-33 were increased significantly in d 7 and then decreased gradually .The levels of ILC2, CD40 +, CD86 + in the peripheral lymph nodes were increased in d 7 and d 15.Conclusion The atopic derma-titis mice model can be successfully established using 2 nmol MC903 induced mice for 7 days.Appropriate testing point of TSLP is d 3.Appropriate testing point of IL-33 and IL-4 is d 7.

Objective To research the possible influence of operation and human chorionic gonadotropin(HCG) therapy on the development of antisperm antibody (AsAb) and serum levels of estradiol (E_2) and testosterone (T) of cryptorchidism boys after orchiopexy. Methods Forty cryptorchidism boys were studied who were divided into HCG treatment group and without HCG treatment group. Twenty boys who underwent inguinal operation were studied as the operation control group and 20 normal boys as the control group. The serum were collected for detection AsAb, E_2,and T. Results There were no significant difference in serum levels of E_2 and T among the three groups(P 0.05 ). Conclusions The level of AsAb is associated with the destroy of blood barrier and the disorder of immune modulation and endocrine. Treatment with HCG has no effect on AsAb level.

OBJECTIVETo explore the protective effect of electroacupuncture (EA) pretreatment on ovarian function in rats with ovulation induction.

METHODSThirty SD female rats were numbered according to random number table. According to vaginal smear method, rats of estrus were divided into a normal group (10 rats) and cohabitated with male SD rats with the proportion of 1:1. With computer-generated random number, the remaining rats were divided into a model group and an EA group, 10 rats in each one. The model of superovulation was established with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (HCG) in the model group and EA group. Before model establishment and cohabitation, rats in the EA group were treated with EA at "Guanyuan (CV 4)" and "Sanyinjiao (SP 6)", once for 15 min, for consecutive 7 days. Rats in the normal group and model group received no further treatment. The third day 23:00 pm after cohabitation, blood samples in three groups were collected to test the level of estradiol (E₂) and progesterone (P). After the rats were sacrificed, the HE staining method was applied to observe the morphological changes of ovarian tissue; the immunohistochemical method was applied to measure the expression of vascular endothelial growth factor (VEGF) and its receptor VEGFR-2; the real-time quantitative PCR technique was applied to measure the gene expression of VEGF and VEGFR-2.

RESULTSThe number of ovarian follicle in the EA group was higher than that in the model group and normal group (all P < 0.05); the ratio of corpus luteum size to ovarian size in the EA group was lower than that in the model group (P < 0.01). The ratio of plasma estradiol to progesterone in the EA group tended to be normal group (P < 0.05) and lower than that in the model group (P < 0.01). The protein expression of VEGF and VEGFR-2 in lutein granulosa cell and follicular fluid in the EA group was lower than that in the model group (P < 0.05); gene level of VEGF and VEGFR-2 in ovarian tissue in the EA group was lower than that in the model group (P < 0.05, P < 0.01).

CONCLUSIONEA pretreatment has certain protective effect on ovarian function in rats with ovulation induction, which is likely to be related to regulation of VEGF and its receptor.

Acupuncture Points ; Animals ; Chorionic Gonadotropin ; blood ; Electroacupuncture ; Estradiol ; blood ; Female ; Male ; Ovary ; physiology ; Ovulation Induction ; Pregnancy ; Progesterone ; blood ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; genetics ; metabolism