Objective To compare the effects of different surgical methods for the recovery of elderly patients with acute cholecystitis and provide reference for its clinical treatment. Methods 60 Patients aged 65 years or older undergoing laparoscopic cholecystectomy for acute cholecystitis between January 2010 and December 2013 were selected from the database. The comparison group comprised 76 patients from the same age-group who underwent open cholecystectomy for acute cholecystitis. Then the curative effects of two groups were compared and analyzed. Results 76 patients underwent laparoscopic surgery and 60 had open surgery. The demographic data and co-morbidities were compared between the two groups. The postoperative hospital stay was significantly shorter for patients undergoing laparoscopy (P < 0.05). The overall complication rate was significantly lower for patients undergoing laparoscopy (P < 0.05). There was no statistical significant difference in the operating time and the bleeding among the operation. Conclusions Laparoscopic cholecystectomy is a safe procedure for acute cholecystitis in elderly patients , resulting in fewer complications and shorter hospital stay than open cholecystectomy. Laparoscopic cholecystectomy is worth in the clinical application.

Objective To investigate the clinical outcomes of interbody fusion with transpedicular screw fixation in the reoperation for lumbar spinal instability secondary to lumbar discectomy.Methods From May 1997 to Aug 2002, 23 patients underwent reoperation with posterior lumbar spinal decompression, removal of residual disc, transpedicular screw instrumentation and interbody fusion because of lumbar spinal instability after previous lumbar discectomy. There were 14 males and 9 females. The age of patients ranged from 28 to 64 years with an average age of 48.5 years. The time between the onset of the symptoms and the diagnosis was 18 months on average (range, 6 months to 36 years). The mean interval between the primary and revision surgery was 68 months (range, 24 months to 10 years). Lumbar discectomy had been performed in all patients as the primary surgery. All patients were evaluated by the conventional radiography, and CT or MRI if necessary. The low back pain was predominant in 8, and associated with radicular leg pain in 15. The instability of one segment was found in 17, and two segments in 6. The average follow-up was 3.6 years (range, 1 to 6.4 years). Results The lateral, AP, flexion and extension X-ray films were taken at 1, 3, 6 months and 1 year to evaluate the fusion, sliding between two vertebral bodies and internal fixation, and McGill pain questionnaire was adopted to determine the satisfaction of the patients. The intraoperative blood loss ranged from 550 to 800 ml (mean, 650 ml), and the total operative time ranged from 120 to 210 min (mean, 180 min). Based on Oswestry low back pain and disability scores, the clinical successful rate was 86.9%. The rate of patient satisfaction was 82.6%. 20 patients showed radiographic bony fusion. Pedicle screw breakage and loosening were found in 3 out of the 102 screws. 5 patients had nerve root irritation and recovered within 2 to 3 weeks. 5 patients had dural laceration. Bony nonunion was found in 3 patients. Conclusion Transpedicular screw instrumentation and interbody fusion is proved helpful in management of spinal instability secondary to decompression surgery, providing successful interbody fusion and restoration of the intervertebral stability.

Objective:To investigate the frequency and severity of systemic adverse reactions in children with allergic rhinitis (AR) undergoing subcutaneous immunotherapy (SCIT).Methods:The clinical data of 321 children with allergic rhinitis receiving SCIT at Department of Otorhinolaryngology, Changzhou Third People′s Hospital from January 2016 to January 2020 were retrospectively analyzed. There were 180 boys and 141 girls aged 5 to 14 years. Patients were injected subcutaneously with standardized dust mites allergen extract. The onset time, symptoms and signs and treatment of adverse reactions were documented. The relationship of adverse reactions with gender, age, treatment course and dosage of allergen injection were analyzed.Results:Patients received total 13 053 injections, and 115 adverse reactions (0.88%) occurred in 56 cases (17.45%). The incidence of adverse reactions in children aged 5-9 years was higher than in those aged 10-14 years, for both the number of cases and injections (χ2=4.41, P=0.04; χ2=9.13, P<0.01), but no significant differences were observed in gender of patients. The incidence of adverse reactions in the age group 2-3 years was lower than that in age groups<1 year and 1-<2 years in both of cases and injections (χ2=22.86, P<0.01; χ2=6.43, P=0.01; χ2=12.14, P<0.01; χ2=13.74, P<0.01). The incidence of adverse reactions in the high-dosage phase (100 000 SQ-U) was higher than that in the low-dosage phase (<100 000 SQ-U) (χ2=4.35, P=0.04). Conclusions:The study shows that the incidence of adverse reactions in children with allergic rhinitis receiving subcutaneous immunotherapy is less than 1% in the number of injections and most of them are grade Ⅰ adverse reactions. The study also shows that younger age, the early course of treatment and the high dosage of allergens are risk factors for adverse reactions.

Objective To introduce the advantages of the endoscopic assistance in primary and secondary face-lift in the frontal and temporal areas.Methods 67 cases were involved in the study,22 of them were secondary facelift cases.The follow-up period ranged from 1 month to 2 years.The patients and doctors satisfactory rate were recorded and the complications were also reported.Results All 67 cases had complete recovery without serious complications.The patient's satisfactory rate was 85％ (57/67),and the doctor's satisfactory rate was 89％ (60/67).Some early minor complications included dimpling at the suture site,asymmetry,overcorrection,transitory paralysis,late edema,scar and fall-off of hair among 80％ or so of patients.4 cases experienced hematoma on the frontal areas.The hematoma disappeared after early aspiration and later fomentation.2 cases had wound ulceration in the temporal 3 months after operation.The anchoring materials were removed and the ulceration tissues were excised 6 months after operation.The wound healed completely.2 patients experienced skin necrosis and depression due to careless electric cauterization on the frontal area.The depression gradually became smooth and inconspicuous after 6 months.All these complications were resolved and became negligible about 6 months after operation.Conclusions Endoscopic assistance is valuable in primary and secondary face-lift in the frontal and temporal areas.It is reliable and worthwhile to introduce the technique for patients aged less than 50-year-old.

Objective: To investigate the targeting and anti-tumor ability of the tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library, and to discuss the application of the antibody in clinical diagnosis and therapy of cancer. Methods: The ScFvH1 gene was inserted into pET-28a(+)/EGFP vector containing green fluorescent protein(GFP) gene and pTIG-Trx vector containing thioredoxin gene; the products were then expressed in E.coli and purified by using Ni-NTA. Tumor-bearing mice model was established by subcutanuous injection of cervical cancer cell line HeLa. The mice were injected with purified ScFv-EGFP fusion protein through vena caudalis and the GFP signals were observed by fluorescent microscope to evaluate the targeting ability of the antibody. Meanwhile, the mice model also received intratumoral injection of purified ScFv-EGFP fusion protein to evaluate the anti-tumor effect of the antibody. Results: Soluble ScFvH1 gene and ScFvH1-EGFP protein were successfully expressed in E.coli; a single band was showed in SDS-PAGE after the purification by Ni-NTA. We found that ScFvH1-EGFP fusion protein was enriched to tumor tissues, but there was only weak fluorescent signal when EGFP protein was injected. No EGFP signal was observed in the lung of tumor-bearing mice. Tumor inhibition experiment showed that the tumor growth in the antibody treatment group was similar to that of the PBS control group. Conclusion: The tumor vessel-specific antibody ScFvH1 selected from phage-ScFv library can specifically target tumor vessels, but it has no obvious inhibitory effect on tumor growth. Our findings pave a way for antibody in cancer diagnosis and treatment.

Objectives To explore a comprehensive approach for the functional and aesthetic correction of septal deviation. Methods From Jan. 2007 to Dec. 2009, 48 patients with deviation of the frontier and ceiling border of the septal cartilage, 6 males, 42 females, average age of 26.5 years, were surgically treated with a comprehensive use of several techniques, such as septoplasty, reconstruction of septal support, precise osteotomies and nasal tip plasty. Results Functional improvement achieved in all the patients, contour satisfaction achieved in 91.7 % patients; 30 patients were very satisfied, and 14 satisfied with the outcome. Conclusions With the thorough understanding of surgical anatomy of the nose and the use of comprehensive surgical approach, satisfactory outcomes can be achieved both functionally and aesthetically in patients with septal deviation.

Objective To investigate the effects of Ulinastatin(UTI)on the function of splenic lymphocytes from rats with severe acute pancreatitis(SAP).Method Twenty-eight Wister rats(clean grade)were randomly divided into control,sham operation,SAP,and ulinastatin group.No operation was performed in control group.And rats with sham-operation received laparotomy and catheterization into choledocho-pancreatic duct without injection of sodium deoxycholic.Rats in ulinastatin group received ulinastatin injection(50000 U/kg)via tail vein 30 minutes after pancreatitis induced with DCA injected into pancreatic duct.Rats ofother groups were given equal volume of saline.At 2,4 hours after operation,all animals were killed by neck dislocation,and splenocytes were isolated and cultured in RPMI 1640 medium containing 10%fetal calf serum.Proliferation of splenecytes was determined with MIT cellular proliferation assay.Levels of Th1 cytokines(IL-2,IFN-γ)and Th2 cytokine(IL-10)in supematants of splenoeytesweremeasured by ELISA.Quantitative data were expressed as mean±SE.Statistical analyses were performed by Student's t test with SPSS software(version 10.0 for Windows).A P value less than 0.05 Was considered statistically significant. Results The concentration of IL-2, IL-10 and IFN-γ and proliferative activity of splenocytes in SAP group were significantly lower than that in sham operation group.In contrast,the proliferative as well as the eytokine-releasing capacities of the solenecms from rats treated with UTI were significantly increased compared with those from rats with SAP.Conclusions The deficiencies in proliferation and cytokine release in response to antigen stimulation inaplys an anergic state of splenocytes during SAP.Treatment with UTI contributed to the recovery of the immune function by improving proliferative responses and cytokine release of splenocytes.

BACKGROUND: Apoptosis in the skeletal muscle leads to a variety of skeletal muscle diseases, but there are ideal no therapies so far. OBJECTIVE: To analyze the effects of different intensities of exercises on the morphology and apoptosis of the skeletal muscle in rats. METHODS: Thirty healthy male 3-month-old Sprague-Dawley rats were randomly allocated into three groups (n=10 per group): control group (no swimming), aerobic exercise and high-intensity exercise groups. The rats in the exercise groups underwent swimming for consecutive 10 weeks. Then, the gastrocnemius muscle was isolated from all rats under anesthesia. The morphology and cell apoptosis were detected by hematoxylin-eosin staining and TUNEL test. At the same time, the levels of superoxide dismutase and malondialdehyde in skeletal muscle tissue were tested and the correlation of malondialdehyde with integrated optical density (IOD) was analyzed. RESULTS AND CONCLUSION: The results of hematoxylin-eosin staining showed that the muscle fibers were in disorder arrangement with obscure structure in the high-intensity exercise group. Compared with the control group, the content of malondialdehyde was increased in the exercise groups, especially in the aerobic exercise group (P < 0.05). The level of superoxide dismutase in the high-intensity exercise group was significantly lower than that in the aerobic exercise group (P < 0.05). The results of TUNEL test showed that the IOD values in the high-intensity exercise group were significantly higher than those in the aerobic exercise and control groups (P < 0.05). There was a positive correlation of malondialdehyde with IOD. These results indicate that the long-term and high-intensity exercise can increase the content of malondialdehyde in the skeletal muscle, resulting in an aggravation of fatigue. Aerobic exercise can obtain the adaptation of the skeletal muscle, but damage the morphology and structure of the skeletal muscle because of excessive exercise load, thus accelarating the cell apoptosis. With the exercise intensity increasing, the balance between malondialdehyde production and clearance is broken, and the IOD value is increased.

Objective: To understand the survival status and influencing factors of HIV/AIDS patients with highly active antiretroviral therapy ( HAART ) among drug users in Yili Prefecture, Xinjiang from 2005 to 2019, so as to provide references for reducing AIDS mortality. Methods : The demographic information, clinical stage, baseline CD4+T lymphocyte ( CD4 ) level and treatment status of HIV/AIDS patients with HAART in Yili Prefecture from 2005 to 2019 were collected through AIDS Antiretroviral Therapy Information System. The survival rate was calculated by the life table method. The influencing factors for survival time were analyzed by Cox proportional hazard regression model. Results: Totally 1 935 patients were recruited, the median age receiving HAART was 37 years old and the median CD4 counts was 293/μL. The cumulative survival rates at 1, 5, 7 and 10 years were 97%, 78%, 73%, and 66%, respectively. The multivariate Cox proportional hazards regression analysis showed that the patients with body mass index of 18.5-<28.0 kg/m2 ( HR: 0.391-0.656, 95%CI: 0.234-0.958 ), baseline CD4>200/μL ( HR: 0.354-0.667, 95%CI: 0.232-0.841 ) , or missed medication in the last 7 days ( HR=0.009, 95%CI: 0.001-0.061 ) had lower risk of death; the patients with WHO clinical stage of Ⅱ-Ⅳ ( HR: 1.479-2.311, 95%CI: 1.004-3.288 ) or treatment delay ≥1 years ( HR: 1.287-1.388, 95%CI: 1.029-1.826 ) had higher risk of death. Conclusions The 5-year cumulative survival rate of HIV/AIDS patients with HAART in Yili Prefecture is 78%. Body mass index, baseline CD4 level, WHO clinical stage, treatment delay and missed medication in last 7 days were the influencing factors for survival time.

Human nerve growth factor (NGF) is a nerve cell growth regulation factor, which can provide nutrition for the neurons and promote the neurites outgrowth. In order to produce large-scale recombinant human nerve growth factor (rh-beta-NGF), we constructed a plasmid vector, which can stably express the rh-beta-NGF in the HEK293 cell lines. First, the plasmid of pCMV-beta-NGF-IRES-dhfr was constructed and transformed into HEK293 cells. Then MTX pressurized filter and limiting dilution methods were used to obtain monoclonal HEK293 cell lines. After stepwise reducing serum in culture media, the cells eventually adapted to serum-free medium and secreted rh-beta-NGF. SDS-PAGE analysis revealed that the expression product owned a molecular weight of about 13 kDa and a purity of more than 50%. The peptide mapping sequencing analysis demonstrated the sequences of rh-beta-NGF matched with the theoretical ones. Later we purified this protein by ion exchange and molecular sieve chromatograph. Finally, our experimental results exhibited that the recombinant cell lines can stably express rh-beta-NGF with a high efficiency of more than 20 pg/cell x day. In addition, this protein could successfully induce differentiation of PC12 cells. In summary, our recombinant HEK293 cells can express bio-active rh-beta-NGF with great efficiency and stability, which supply a valid basis to large-scale production of rh-beta-NGF.
Cell Differentiation ; Genetic Vectors ; HEK293 Cells ; Humans ; Nerve Growth Factor ; biosynthesis ; Plasmids ; Recombinant Proteins ; biosynthesis