Objective To investigate the clinical efficacy of laparoscopic splenectomy (LS) for immune thrombocytopenic purpura (ITP).Methods The clinical data of 84 patients with ITP who underwent LS at the First Affiliated Hospital of Chongqing Medical University from January 2007 to January 2014 were retrospectively analyzed.The potential prognosing indexes (gender,age,course of diseas,preoperative response to steroid,preoperative PLT,operation time,volume of intraoperative blood loss and postoperative PLT peak within 7 days) were collected and analyzed.The evaluation of surgical efficacy was done according to the American Society of Hematology 2011 evidence-based practice guideline for ITP.The complete response and partial response were defined as effective and no response as void.All of the patients were followed up by outpatient examination and telephone interview till December 2014,the follow-up information included platelet count,bleeding performance,presence of long-term complications and postoperative recurrence,etc.Measurement data with normal distribution were presented as x ± s,and skew distribution data were described as M (range).The postoperative long-term effective rate was analyzed by Kaplan-Meier method.The univariate analysis and multivariate analysis were done using the chi-square test and Logistic regression model,respectively.Results The operation time of 84 patients was (154 ±40)minutes with a median volume of intraoperative blood loss as 200 mL (10-1 000 mL).Lienculus was detected in 11 patients and resected.Seven patients had complications and recovered after symptomatic and supportive treatment.There was no perioperative death.Among the 84 patients who were followed up for an average follow-up time of 51 months (12-96 months),45 patients had complete response,18 patients had partial response and 21 had no response,without serious spontaneous visceral and intracranial hemorrhage.Eighteen partial-response patients underwent symptomatic medical therapy and 21 no-response patients took orally prednisolone,among which 13 had PLT ＞ 30 × 109/L stably.During the follow-up,only one complete-response patient died of lung cancer with systemic metastasis at 2 years after surgery.Four patients had pneumonia,1 noresponse female patient had pyothorax repeatedly for a long time,and they all recovered after symptomatic and supportive treatments.There were no serious complications and overwhelming postsplenectomy infection in other patients.The 1-,3-,5-,7-year effective rates were 82.1％,77.6％,72.5％ and 67.9％,respectively.Univariate analysis showed that preoperative response to steroid,preoperative PLT and postoperative PLT peak within 7 days were related factors affecting long-term effecacy of patients with ITP (x2=5.600,6.006,21.733,P ＜ 0.05),but gender,age,course of disease,operation time and volume of intraoperative blood loss were not related factors affecting long-term effecacy of patients with ITP (x2=0.018,2.684,0.000,0.064,0.397,P ＞ 0.05).Multivariate analysis showed that preoperative response to steroid and postoperative PLT peak within 7 days ≥300 × 109/L were independent protective factors affecting long-term efficacy (OR =5.426,19.454,95％ confidence interval:1.220-24.129,4.704-80.449,P ＜ 0.05).Conclusions LS is safe and feasible for the treatment of ITP with a high long-term effective rate.Preoperative response to steroid and postoperative PLT peak within 7 days may be the predictors of LS for ITP.

Objective:To study the protein expression of maspin in the HCC and its correlation with AFP,and to discuss its clincal significance.Methods:the protein expressions of maspin and AFP in the normal liver tissue(NT),paratumor tissue(PT)and liver tumor tissue(TT)were detected with immunohistoch-emistry and their area densities were measured.A total of30 patients with HCC and 30 patients without HCC in our Department of Hepatobiliary Surgery were as samples from March,2004 to December,2005.Results:(1)The area densities(AD)of maspin protein in the NT,PT and TT were 20 712.48?1 826.28,7 347.40?441.16,85.68?19.81 respectively,but the area densities of AFP protein were 66.00?10.70,7 005.04?335.69,13 094.00?516.32 respectively;the comparion of two was P

Objective:To construct the expression vector maspin /Pcr2.1 in order to provide the evidence for the inhibitory effect of maspin gene on growth,metastasis and invasion of hepatocellular carcinoma(HCC) and to discuss its mechnism.Methods:The full length of maspin gene was cloned,and the expression vector PCR2.1 was digested by Hind111/XbaI,then the maspin gene and the PCR2.1 vector were ligated with T4 DNA ligase to be recombinant vector.The recombinant vector maspin/PCR2.1 was transfected into humman hcc MHCC-97 cell line,and the expressive changes of maspin gene were detected.Results:The recombinant plasmid was amplified in the E.coli.JM109.After the identification of redigesting by HindIII/XbaI and sequencing,the reconstructive plasmid was confirmed to contain the correct and full nucleotide sequence of maspin gene,and the mRNA and protein level of maspin gene were up-regulated in hcc MHCC-97 cell.Conclusion:The expression vector maspin/PCR2.1 is constructed successfully and can be expressed in eukaryotic cells.

Objective:To explore the biological effect of maspin on VEGF(vascular endothelial growth factor,VEGF)in hepatocarcinoma cell MHCC-97 and discuss its significance.Methods:Maspin/pEFIRES-N expressing plasmid was constructed .The changes of maspin and VEGF in the levels of mRNA and protein in hepatocarcinoma cell MHCC-97 before and after the transfection and recombination were detected by RT-PCR and Western blotting.Results:The maspin/pEFIRES-N plasmid was constructed successfully,and was stably transferred into MHCC-97 cell.The expressions of maspin mRNA and protein increased in hepatocarcinoma cell MHCC-97 after the transfection of maspin/pEFIRES-N plasmid,while the expressions of VEGF mRNA and protein decreased ,as compared with those after the transfection of pEFIRES-N plasmid(P

Diabetes mellitus is a common disease of serious harmful to human health,but its pathogenesis is not entirely clear.Mitochondria are the important organelles to generate energy in eukaryocytes,and play a pivotal role in the regulation of reactive oxygen species generation,intracellular calcium homeostasis,and apoptosis signal transduction.The possible causes of mitochondrial dysfunction include oxidative stress,Ca2+ disturbances,reduction of mitochondrial biosynthesis,opening of mitochondrial permeability transition pore,mitochondrial DNA mutations,and etc..Many studies demonstrate that mitochondrial dysfunction is associated with β-cell dysfunction of type 1 diabetes mellitus and insulin resistance of type 2 diabetes mellitus.Moreover,mitochondrial dysfunction plays important roles in the development of diabetic cardiomyopathy.This present article reviewed the current status of studies on the relationship of mitochondrial dysfunction and diabetes mellitus and diabetic cardiomyopathy.It is very important to understand and study mitochondrial dysfunction and its important roles in diabetes mellitus and diabetic cardiomyopathy in order to clarify the pathogenesis of diabetes mellitus and explore new approaches of prevention and treatment for diabetes mellitus.

Objective To study metabolism of glucose and lipidin patients with hyperandrogenism and analyze the risk of their cardiovascular disease.Methods Object of study:firstly,choosed 118 cases of women of reproductive age from April 2013 to July 2014.Then detected their serum Testosterone (T),Estradiol (E2),fasting plasma Glucose (FPG),fasting plasma insu-lin (FINS),triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipopro-tein cholesterol (LDL-C),lipoprotein (a),body mass index (BMI).Finally,divided them into different groups and analyzed the results using SOSS19.0 software and two independent samples t-test statistical method.Results BMI,T,FPG,HOMA-IR and TG were significantly more higher (P <0.05)in the group of hyperandr-ogenism than in the group of normal con-trol.However,E2,TC,HDL-C,LDL-C and LP(a)had no significant difference (P >0.05)in statistics between the group of hyperandrogenism and the group of normal control.Hyperandr-ogenism group was divided into PCOS group and non-PCOS group according to etiology.In those two groups,BMI,T,E2,FPG,HOMA-IR,TG,TC,HDL-C,LDL-C and LP(a)had no significant difference in statistics (P >0.05).According to the definition of obesity adults in china,78 patients with hyperan-drogenism were divided into 2 group,one with BMI normal (BMI<24 kg/m2 )and the other group with overweight and obe-sity (BMI≥24 kg/m2 ).In group with overweight and obesity,BMI,T,FPG,HOMA-IR,TG,TC,LDL-C and LP (a)were significantly higher than the group with BMI normal (P <0.05),moreover,HDL-C was significantly lower than the group normal (P <0.05).E2 had no significant difference in statistics between the two groups (P >0.05).Conclusion Investiga-tion of the relation between hyp-erandrogenism and metabolism of glucose and lipid,can not only practically guide life style and drug therapy,but also prevent cardio-vascular disease.

BACKGROUND:Stem cells under appropriate conditions can be induced to differentiate into neuron-like cells. Chinese herbs can function in cellproliferation and differentiation.
OBJECTIVE:To investigate the interventional effects of traditional Chinese medicine on stem celltransplantation in the treatment of cerebrovascular diseases.
METHODS:Experimental studies concerning traditional Chinese medicine intervention for stem celltransplantation were retrieved and analyzed. Under specific conditions, stem cells can proliferate in vitro in a suspended or monolayer manner, and can be potential y induced to differentiate into neurons, oligodendrocytes and astrocytes, thereby providing basis for stem celltransplantation in the treatment of cerebrovascular diseases. We observed expressions of nestin, glial fibril ary acidic protein, and microtubule-associated protein expression for analysis of stem cellproliferation and differentiation.
RESULTS AND CONCLUSION:Baicalin or Astragalus saponin Ⅳ can stimulate stem cells to differentiate into nerve cells in vitro. Naomaitong or danshen combined with bone marrow mesenchymal stem celltransplantation can promote neurological recovery from cerebrovascular diseases in rats. Buyang Huanwu Decoction can significantly promote the proliferation of neural stem cells in the subventricular zone and neurological recovery after cerebral ischemia. Chinese herbs, such as Zhichan Decoction and Panax notoginseng, can promote survival of transplanted cells and prevent most cellapoptosis in the stem celltherapy for treatment of Parkinson’s disease. Therapy of benefiting qi and elevating yang or ginsenosides Rg1 combined with stem celltherapy can improve memory ability of dementia rats. Traditional Chinese medicine exerts a catalytic role in the stem celltherapy for cerebrovascular diseases.

Objective To study the characteristics of working memory impairment in patients with lacunar cerebral infarctions(LCI).Methods 42 patients proved by clinics were chosen,and divided into two groups:multiple and single LCI groups,versus left,right and double side infarction groups.Their working memory status were evaluated and compared with Digit Ordering Test,Corsi block task,House Visual Span Test and Stroop Digit Counting Test.All scores were analyzed statistically.Results(1)All scores of the four types of Tests in multiple LCI group were significantly lower than those in single group(P0.05).Conclusions Multiple LCI is closely related to working memory impairment.Left brain infarction may induce verbal working memory impairment,and right infarction may induce spatial working memory impairment,but object working memory impairment may related to double side of brain infarction.It suggested that in the physiological structure,different components of working memory regions had dissymmetrical effect in two sides of brain.

Objective To construct the expression vector maspin/pEFIRES-N so as to study maspin gene on the inhibition of the growth,invasion,and metastasis in hepatocellular carcinoma.Methods The full lenth of maspin gene was cloned and ligated to the expression vector pEFIRES-N digested by EcoRⅠ+XbaⅠ by T4 DNA ligase.The recombinant vector maspin/pEFIRES-N was stably transfected into hepatocellular carcinoma MHCC-97 cell line,and the expressive changes of maspin gene were detected.Results The recombinant plasmid was amplified in the E.coli.JM109.After the identification and sequencing,the reconstructive plasmid was confirmed containing the correct and full nucleotide sequence of maspin gene and the mRNA and protein level of maspin gene were up-regulated in hepatocellular carcinoma MHCC-97 cells.The proliferation and invasion of MHCC-97 cells was inhibited.Conclusion The expression vector maspin/pEFIRES-N was constructed successfully and could be expressed in eukaryotic cells.

In view of the increased incidences of cardiac arrest outside hospital year by year and younger tendency of the patients,foreign medical education practice showed that school-age children accepting cardiopulmonary resuscitation (CPR) skill training will benefit most from this survival skill in the future.This article elaborated on the meaning and methods of promoting CPR training in primary and middle school based on the present situation of CPR in order to promote its further development.