Objective:To analyze influence of vaginal hysteroscopy and laparoscopic surgery on tubal pregnancy patients’ surgical outcome and inflammatory stress response.Methods: Chosen 86 cases of tubal pregnancy patients between July 2012 to July 2013 in our hospital undergoing surgery as study object, according to a random number table divided into hysteroscopy group (43 cases) and laparoscopic group (43 cases), compared surgical outcomes, perioperative differences in the level of inflammation and stress level.Results: No significant difference between hysteroscopy group and laparoscopic group on surgical success rate and ipsilateral tubal patency statistically(x2=0.241,x2=0.193;P>0.05), postoperative intrauterine pregnancy rate was higher than laparoscopic group, again ectopic pregnancy rate was less than laparoscopic patients(x2=7.294,x2=8.283;P<0.05); hysteroscopic surgery group E, Cor, IL-2, IL-6, IL-8, CRP levels were lower than laparoscopic group(t=6.842,t=6.283,t=8.536,t=6.106,t=6.283,t=6.376;P<0.05),TSH levels was higher than laparoscopic group(t=6.823,P<0.05).Conclusion:Vaginal hysteroscopy and laparoscopy can be used for the treatment of tubal pregnancy, hysteroscopy has an advantage in improving patient again intrauterine pregnancy, reduce postoperative systemic stress and inflammation levels, and promote the recovery of patients after surgery respect.

Objective: To analyze the effect of single-hole thoracoscopic surgical treatment on elderly spontaneous pneumothorax patients’ postoperative assessment and serological markers and explore single-hole thoracoscopic surgery application. Methods:78 cases of elderly patients with spontaneous pneumothorax were retrospectively analyzed, and divided into single-hole thoracoscopy group with 35 patients and conventional thoracoscopic group with 43 patients. Then the surgery indicators, postoperative pain scores and perioperative serum target level differences were compared between the two groups. Results: The operative time, postoperative drainage time and total hospital stays of single-hole thoracoscopic surgery patients were shorter than that of conventional thoracoscopic group. The differences were statistically significant (t=7.183, t=5.294, t=6.938;P<0.05). The blood loss and postoperative drainage were less. The differences were statistically significant (t=6.883, t=8.735; P<0.05). The postoperative pain scores within one week was less than conventional thoracoscopic group. The differences were also statistically significant (t=6.882, t=5.724, t=5.284;P<0.05). The serological indicators, CRP, IL-1, TNF-α,α1-AT levels of patients in the single-hole thoracoscopy group were lower than the conventional group (t=8.293, t=7.274, t=9.284, t=7.183;P<0.05). Conclusion:VATS and conventional hole thoracoscopic surgery can be used for treatment of spontaneous pneumothorax in elderly, but single-hole thoracoscopy has more advantages in reducing surgical trauma and postoperative pain and optimize systemic inflammation associated factors.

Objective To study the pathogenic molecular mechanism of H.pylori through analyzing its effect of on MMP-9 expression. Methods BGC-823 cells were cocultured with ATCC49503(CagA +)and HP 030811 (CagA -) H.pylori strains respectively, then the total cellelar RNA was extracted. The MMP-9 mRNA expression in BGC-823 cells, 9 cases of H.pylori-positive and 9 cases of H.pylori-negative gastric ulcer biopsy tissues was detected by RT-PCR. The MMP-9 protein expression on the paraffin-imbedded tissue sections of 17 cases of H.pylori-positive and 14 cases of H.pylori-negative gastric ulcer tissues was detected with immunohistochemical technique, and was quantified by image quantitative analysis. Results H.pylori induced MMP-9 expression in BGC-823, and the level of MMP-9 expression induced by CagA -postive H.pylori strain was higher than that by CagA -negative one. MMP-9 expression level was higher in the H.pylori-positive gastric ulcer tissues than that in the H.pylori-negative ones. Conclusion H.pylori-induced MMP-9 expression may play an important role in gastric ulcer formation and gastric carcinogenesis.

Tachycardia induced cardiomyopathy is a kind of cardiomyopathy caused by sustained or recurrent tachycardia.Various types of tachyarrhythmias can cause TIC, and the main clinical manifestations of it are cardiac dilatation and cardiac dysfunction.TIC can occur at all ages and is a reversible and acquired cardiomyopathy with a generally benign prognosis.After early diagnosis and reasonable treatment to relive the tachycardia, the function of the heart can partially or completely recover.In clinical practice, pediatricians do not fully understand the disease, as a result, it is easily missed, misdiagnosed, then the proper diagnosis and treatment will be delayed.This article provides a systematic overview of the pathogenesis, clinical characteristics, diagnosis, differential diagnosis, treatment and prognosis of TIC in children, and aims to provide a basis for clinical pediatricians to recognize it early and treat it promptly.

The expression of transforming growth factor-beta1 (TGF-beta1) in placental tissue of pregnancy-induced hypertension (PIH) and the relationship between the level of expression of TGF-beta1 and the amount of vascular cell adhesion molecule-1 (VCAM-1) in serum was studied. Immunohistochemistry ABC was used to detect the expression and distribution of TGF-beta1 in placental tissues in 40 PIH women and 20 normal pregnancy women. High resolution pathological image analysis system was used to determine the quality of TGF-beta1. The VCAM-1 in serum was examined by enzyme linked immunoabsorbent assay (ELISA). The results showed that TGF-beta1 could be express in syncytiotrophoblast. The levels of TGF-beta1 expression in placental tissues of the patients with moderate and severe PIH were significantly higher (P < 0.05), while the serum VCAM-1 was significantly lower than in normal group (P < 0.01). There was a significant positive correlation between the expression of TGF-beta1 in placental tissues and the serum VCAM-1 (r = 0.969, P < 0.01). It was concluded that the level of TGF-beta1 expression in PIH was increased and was positively correlated with the amount of serum VCAM-1, indicating that they might be involved in the pathogenesis of PIH.
Hypertension, Pregnancy-Induced/*metabolism ; Placenta/metabolism ; Transforming Growth Factor beta/*metabolism ; Transforming Growth Factor beta1 ; Vascular Cell Adhesion Molecule-1/*blood

Objective To establish a cell level-based negative enrichmen technique to detect circulating tumor cells (CTCs) in the peripheral blood of patients with epithelial ovarian cancer.Methods The colon cancer SKOV-3 cells were mixed with 2 ml whole blood from healthy donors at different ratio.Quantification of CTCs was performed using immunomagnetic bead based negative enrichment combined with immunofluorescence antibody method.The method was evaluated the recovery rate of target cells,Samples of 32 patients with ovarian cancer and 10 controls were assayed for CTCs detection by above method.Results ①The recovery rate was ranging from 64％ ～80％ by spiking varying numbers of SKOV-3 into 2 ml blood samples of healthy volunteers.Regression analysis of number of recovered SKOV-3 cells yielded a regression equation of Y=0.782X-1.408 and a coefficient of determination of R2 =0.998.②Did not detect CK8/18-+ circulating tumor cells in 10 controls,and CK8/18+ circulating tumor cells in 18 cases of 32 Patients with ovarian cancer.The positive rate of CK 8/18 + circulating tumor cells was significantly differences between the two groups (x2 =7.681,P＜0.01).③The presence ofCTCs was significantly correlated with distant metastasis (x2 =5.776,P＜0.05).Conclusion The method of immunomagnetic bead based negative enrichment combined with immunofluorescence antibody technique for CTCs detection in peripheral blood of patients with ovarian cancer has a clinical value of application and extension.

The expression of endothelial nitric oxide synthase traffic inducer (NOSTRIN) was examined in the umbilical vessels of the patients with pre-eclampsia (PE) to explore its possible role in the pathogenesis of PE. The NOSTRIN mRNA in umbilical tissues was determined by RT-PCR. The eNOS activity in umbilical vessels was spectrophotometrically detected. NO2-/NO3-, the stable metabolic end products of NO, was measured by using nitrate reductase. RT-PCR showed that the expression level of NOSTRIN was significantly higher in women with PE than in the normal group (P<0.01). The activity of eNOS was significantly decreased in PE group [(12.83+/-3.61) U/mg] than in normal group [(21.72+/-3.83) U/mg] (P<0.01). The level of NO2-/NO3- in PE patients (27.53+/-7.48) micromol/mg was significantly lower than that of normal group (54.27+/-9.53) micromol/mg (P<0.01). The significant negative correlation existed between the expression of NOSTRIN and the activity of eNOS in umbilical vessels of women with PE (r=-0.58, P<0.01). It was concluded that the level of NOSTRIN expression was increased in umbilical vessel of women with PE, indicating that it may be involved in the pathogenesis of PE.
Intracellular Signaling Peptides and Proteins/genetics ; Intracellular Signaling Peptides and Proteins/*metabolism ; Pre-Eclampsia/*enzymology ; Pre-Eclampsia/etiology ; RNA, Messenger/genetics ; RNA, Messenger/metabolism ; Umbilical Arteries/cytology ; Umbilical Arteries/*enzymology ; Umbilical Veins/cytology ; Umbilical Veins/*enzymology

Objective To observe the feasibility and safety of self-made extended endobronchial tube applicated in one-lung ventilation for radical resection of esophageal cancer.Methods 80 patients were randomly divided into two groups:self-made extended endobronchial tube group (group A) and double-lumen endobronchial tube group (group B).The degree of lung collapse,systolic blood pressure,diastolic blood pressure,heart rate,airway pressure (Paw),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),arterial oxygen saturation (SaO2) were monitored.The time for insertion,rate of successfully intubation for single time,incidence of postoperative hoarseness and sore throat were recorded.Results There were no significant differences in degree of lung collapse,systolic blood pressure,diastolic blood pressure and heart rate,SaO2 in the two groups(all P＞0.05).The comparison of the time for insertion between the two groups:(1.5±0.4)min vs.(2.6±0.8)min(t=4.78,P＜0.05);rates of successfully intubation for single time:95.0％ vs.80.0％(χ2=5.19,P＜0.05).The comparison of Paw between the two groups:T1:(17.3±1.1)cmH2O vs.(22.5±0.9)cmH2O,t=4.613,P＜0.05;T2:(17.9±0.5)cmH2O vs.(23.6±1.4)cmH2O(t=5.438,P＜0.05);T3:(18.1±0.8)cmH2O vs.(24.6±1.2)cmH2O(t=3.741,P＜0.05).The comparison of blood gas during one-lung ventilation between the two groups:PaO2(281.5±53.4)mmHg vs.(187.6±48.8)mmHg(t=5.28,P＜0.05);SaO2(98.1±6.3)％ vs.(94.5±5.7)％(t=3.46,P＜0.05);PaCO2(31.2±3.6)mmHg vs.(37.6±4.1)mmHg(t=6.32,P＜0.05).The comparison of incidence of postoperative hoarseness:1case vs.6cases(χ2=5.91,P＜0.05);The comparison of incidence of sore throat:4cases vs.13cases(χ2=6.13,P＜0.05).Conclusion Single-lung ventilation has achieved via either the double lumen tube or the self-made extended endobronchial tube.However,the self-made extended endobronchial tube is recommended for single-lung ventilation because of the advantages of its easy intubation and position,full oxygenation,low Paw,less incidence of postoperative hoarseness and sore throat.Self-made extended endobronchial tube can be used as a one-lung ventilation method in its indications.

Objective To observe the effect of apigenin on the recovery of neurological function following cerebral ischemia-reperfusion and investigate its mechanism. Methods Ninety male Sprague-Dawley rats were randomized into a sham-operated group, a model group and an apigenin-treated group. A transient ( 1.5 h) focal cerebral ischemia-reperfu-sion model was established in the rats of the model and apigenin-treated groups. In the sham-operated rats the middle cere-bral artery was not occluded. The rats in the apigenin-treated group received an intra-abdominal injection of apigenin, and the rats in the other two groups received injections of normal saline solution. Neurological behavior scores were assessed in accordance with the Zea Longa method at the 24th, 48th and 72nd hour and the 7th day after reperfusion. Cellular and sub-cellular morphology were observed with an optical microscope and an electron microscope, and the levels of TNF-α and IL-1β were measured using ELISA. Results Neurological function improved by the 7th day after reperfusion in the model group, but improved significantly by the 72nd hour after reperfusion in the apigenin-treated group. Average TNF-α and IL-1β levels in the model group and the apigenin-treated group were significantly higher than in the sham-operated group. Av-erage TNF-α and IL-1β levels in the apigenin-treated group were significantly lower than in the model group at the 48th and 72nd hour after reperfusion. Neurological behavior scores had a positive correlation with the IL-1β and TNF-α levels. In the model group, obvious intracellular and intercellular edema and vacuolization were observed in the ischemic cortices and hippocampuses, with remarkable karyopycnosis and organelle broadening and dissolution and vacuolization in glial cells and neurons. In the apigenin-treated group, similar but significantly milder morphological changes were observed. Conclusion Apigenin can promote the recovery of neurological function in rats by downregulating the expression of TNF-α and IL-1βfollowing focal cerebral ischemia-reperfusion.

Background:Medical treatment and surgery are the two main therapeutic approaches for esophageal variceal bleeding ( EVB),but studies showed that the efficacy of medical treatment was poor,and surgery was invasive and could lead to serious complications. Aims:To investigate the efficacy and safety of endoscopic variceal ligation combined with sclerotherapy for treatment of EVB. Methods:A total of 150 cirrhotic patients with EVB admitted from May 2011 to May 2012 at Wenling Oriental Hospital were enrolled and assigned into observation group and control group by random digital table. Patients in observation group were treated with endoscopic variceal ligation combined with sclerotherapy,and patients in control group were treated with somatostatin and pantoprazole. Overall clinical efficacy,recurrence and adverse effect were compared between the two groups. Results:In observation group,the overall clinical efficacy was 94. 7%(72/76), the recurrence rate was 3. 9%(3/76),and the adverse effect rate was 13. 2%(10/76);in control group,the overall clinical efficacy was 79. 7%(59/74),the recurrence rate was 14. 9%(11/74),and the adverse effect rate was 28. 4%(21/74). Overall clinical efficacy in observation group was significantly higher than that in control group(P<0. 05), while recurrence rate and adverse effect rate were significantly lower than those in control group( P all < 0. 05 ). Conclusions:Compared with medical treatment,endoscopic variceal ligation combined with sclerotherapy is effective in improving the clinical efficacy and reducing the recurrence and adverse effect for treatment of EVB. It is worthy of being used in clinical practice.