Objective To explore the fibrosis mechanism of patients with fibrosing cholestatic hepatitis(FCH) in the way of degradation of collagen.Methods The expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of metalloproteinase 1(TIMP1),and contents of type I,III collagen proteins were detected by immunohistochemical staining in the liver tissues of 9 cases with FCH associated with HBV developed following renal transplantation and 5 cases without liver disease as controls.Results The expressions of MMP1 and TIMP1,and type I,III collagen proteins in the patients with FCH were significantly higher than those in the control group.There was a positive correlation between the expressions of type I,III collagen proteins and TIMP1/ MMP1 ratio.Conclusion Hepatic fibrosis in the patients with FCH associated with HBV developed following renal transplantation may be relative to the increase of TIMP1 expression which inhibit the degradation of collagen.

Objective To observe the expressions of matrix metalloproteinase 1(MMP1) and tissue inhibitor of matrix metalloproteinase1(TIMP1) and the collagen type Ⅰ,Ⅲ deposition in the liver tissues,and evaluate the possible fibrosis mechanism of patients with chronic hepatitis B(CHB) in the way of degradation of collagen. Methods The specimens of the biopsy liver in 50 cases with CHB were detected for the expressions of type Ⅰ,Ⅲ collagen proteins,MMP1 and TIMP1 by immunohistochemical staining. Results The expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1,were significantly increased along with the advancing of hepatic fibrosis.There was a positive correlation between the expressions of type Ⅰ,Ⅲ collagen proteins and TIMP1. Conclusions Hepatic fibrosis in the patients with CHB may be related to increase of TIMP1 expression that inhibit the degradation of collagen.

Objective To study the clinical significance of the serum angiopoietin-2(Ang-2) in the diagnosis,recurrence,invasion and metastasis of gastric cancer.Methods The serum Ang-2 and carcino-embryonic antigen (CEA) levels in 158 patients with gastric cancer (gastric cancer group) and 30 normal controls(control group) were measured by enzyme linked immunosorbent assay(ELISA) technique respectively.The serum Ang-2 and CEA levels were also measured 2 weeks after operation in gastric cancer group and reexamined in the recurred gastric cancer patients in 2 years after operation (recurred and metastasis group).The correlation between the serum Ang-2 level and pathologic c haracterization of gastric cancer was evaluated.Results The serum Ang-2 and CEA levels in gastric cancer group [ (331.8 ±64.3),(42.6 ±37.3)μg/L] and recurred and metastasis group [(318.7 ±72.9),(40.5 ±36.7)μg/L] were significantly higher than those in control group [ (187.4 ± 32.7),(4.2 ± 3.1 )μ g/L] (P ＜ 0.01 ),and the serum Ang-2 level 2 weeks after operation [ (211.6 ± 75.1 ) μ g/L ] was significantly decreased to the control group (P ＞ 0.05 ),while the serum CEA level [ (33.4 ± 30.6) μ g/L ] was still significantly higher than the control group (P ＜ 0.01 ).The sensitivity of the serum Ang-2 for diagnosis of gastric cancer was markedly higher than that of the serum CEA (P ＜ 0.01 ).There was correlation between serum Ang-2 and degree of tumor differentiation,TNM pathological staging,lymphatic metastasis,invasion depth and tumor size (p ＜0.01 ),but there was no correlation between serum Ang-2 and tissue classification and location of gastric cancer (P＞ 0.05).Conclusion The serum Ang-2 level is suggested to be a valuable gastric cancer marker and conduce to the diagnosis of gastric cancer,the monitoring of recurrence after operation and evaluation of prognosis.

Objective To study the characteristics of perioperative care for patients with Mitral Valve Repair (MVP) received totally robotic surgery without opening chest and provide scientific data for the clinic work. Methods The first 13 cases who received MVP with totally robotic was collected on their individual information and nursing data from their admission to discharge. Results All cases were accomplished successfully without complications. After operation 1 patient occurred Cerbral Infarction and recovery activity of extremity prior to discharge. One patient occurred thrombus of right femoral artery and take the right femoral arteriotomy embolectomy. Conclusions Totally robotic surgery with MVP is a new minimally-invasive procedure. Preoperative education is important to alleviate the patient's misgivings care. In early postoperative course, the amount of drainage should be observed and the pulmonary nursing should be carried out, especially the right lung must be stressed. The early postoperative exercise can reduce the recovery time.

Objective To investigate the preoperative psychological requirement of patients undergoing da Viric S Robotic Cardiac Surgery in order to provide scientific data for the effectively nursing interventions.Methods One hundred and six cardiac patients scheduled for Total Robotic operation were selected.They were surveyed on the first day in hospital and 2 hours before operation by self-designed questionnaire.Results Total score of the psychological requirement of patients undergoing total robotic cardiac surgery was 96 to 171 ( 137.52 ±18.54).The amount of items which necessary rate was more than 50％ was 20,they occupied 48 percent of all items.The psychological requirements of patients undergoing total robotic cardiac surgery were various,which mainly embodied in the following:wanting to know the success rate of total robotic cardiac surgery(3.70 ±0.54),wanting to understand the progress and changes of disease(3.68 ±0.51 ),wanting to understand the effect of total robotic operation(3.64 ±0.59),wanting to communicate with the patients underwent total robotic cardiac surgery (3.63 ±0.62).Conclusions The patients have many psychological requirements before to receive total robotic cardiac operation,we should take corresponding nursing countermeasures based on different psychological needs,pay attention to the patient' s health guidance and the preoperative interview in order to promote recovery.

Objective To observe expressions of ?-smooth muscle actin(?-SMA) and collagen type Ⅰ,Ⅲ deposition in the liver tissues, and to evaluate potential mechanism of fibrosis in patients with fibrosing cholestatic hepatitis (FCH) by collagen synthesis. Method Immunohistochemical staining was used to detect the expressions of ?-SMA and contents of type Ⅰ,Ⅲ collagen proteins, which were from the specimens of the biopsy liver in 9 cases with FCH associated with hepatitis virus B (HBV) developed following renal transplantation and in 5 cases without liver disease(control group), respectively. Results The expressions of ?-SMA and type Ⅰ,Ⅲ collagen proteins in the patients with FCH were significantly higher than those in the control group. The expression and distribution pattern of ?-SMA and type Ⅰ,Ⅲ collagen proteins were almost identical, and quantitative analysis showed a positive correlation (P

Objective To evaluate the clinical significance of bone scintigraphy in the preoperative diagnosis of sacral tumor. Methods Preoperative 99Tcm-methylene diphosphonate (MDP) whole body bone scintigraphy was performed in total of 103 patients with sacral tumor for whole body survey and radionuclide uptake in the sacral tumor. Of these 103 patients,39 had SPECT. According to the osteoblastic reaction in bone SPECT studies,patterns of tumor with a "hot" lesion was defined as type Ⅰ,a "cold" lesion accompanied with partial uptake was defined as type Ⅱ,a purely "cold" lesion was defined as type Ⅲ,and a "cold" lesion with marginal uptake which produced "doughnut sign" was defined as type Ⅳ. Imaging interpretation was correlated with the final pathologic diagnosis. Results Of the 103 patients,18 ( 17.5% ) had polyostotic involvement. About 46.6% (48/103 ) in planar and 84.6% ( 33/39 ) in SPECT showed decreased uptake at sacrum. Of the bone metastatic patients (n =21 ) ,12 (51.7%) had sole metastasis to sacrum. Tumor with type Ⅰ (6/6) or type Ⅱ (16/19) uptake was likely to be a malignancy,whereas type Ⅲ uptake tended to occur in the benign disease in those patients without polyostotic involvement( 5/7 ),and type Ⅳ was all appeared in giant cell tumors( n = 5 ). Conclusions Preoperative bone scintigraphy is useful in examination of polyostotic involvement for the patients with sacral tumor,but it is limited for diagnosing isolated sacral metastatic disease. Tumor uptake on bone scintigraphy can be helpful in differential diagnosis of sacral tumor.

Objective To observe the effect of Tangmaikang particles on insulin sensitivity in the treatment of type 2 diabetes.Methods A total of 120 patients with type 2 diabetes were selected, randomly divided into control group ( n=60) and treatment group ( n=60).Patients in control group received routine hypoglycemic, hypotensive and lipid adjusting treatment, while patients in treatment group were given Tangmaikang par-ticles 15 g? d-1 on the basis of conventional treatment.The treatment lasted for 3 months.The data of postprandial plasma sugar ( PPG) , gly-cosylated hemoglobin ( HbA1 c ) , fasting insulin ( FINS ) , insulin sensi-tivity ( HOMA-IS ) , low density lipoprotein ( LDL -C ) , triglyceride (TG), endothelin -1( ET-1) and the change of clinical symptoms in two groups before and after treatment were observed as well as the inci-dence of adverse reactions in 2 groups.Results The total effective rate was 88.33% in treatment group, better than control group (75.00%) .After treatment, the data of FINS, HOMA -IS, PPG, HbA1c were all significantly improved in two groups( P<0.05 ) , and treatment group improved more obviously than control group ( P<0.05 ) .Symptoms in two groups were both improved compared with before treatment( P<0.05) , and the treatment group was better than control group( P<0.05).But the TG level wasn′t significantly decreased in two groups( P>0.05).After treatment, LDL-C and ET-1 level in treatment group were significantly decreased ( P<0.05 ) , and the control group was not obvious (P>0.05).After the treatment for early diabetic nephropathy, ET -1 in treatment group was significantly lower (P<0.05), and the control group was not obvious (P>0.05).There was no adverse reactions found during treat-ment.Conclusion Tangmaikang particles are safe and effective for type 2 diabetes, which also can improve insulin sensibility, reduce insulin resistance and ET-1 level, especially can reduce the ET-1 level of patients with diabetic nephropathy.

OBJECTIVETo explore the interaction between SerpinB5 and MAFbx in gastric cancer cell and to identify the interaction sites.

METHODSThe interaction between SerpinB5 and MAFbx was screened and validated by yeast two-hybrid screening and co-immunoprecipitation. The expression of MAFbx was analyzed after SerpinB5 expression being modified by RNA interference and pGBKT7-SerpinB5 transfection. The impact of SerpinB5 on the expression of MAFbx was studied in gastric cancer cell line SUN-16. A model of MAFbx was constructed by homology modeling. The related residues for interaction were analyzed by Autodock4.0.

RESULTSThe interaction between SerpinB5 and MAFbx was validated. The expression of MAFbx changed along with SerpinB5 expression. Amino acids including PRO261, ASN361, and LYS362 were key residue in the interaction of SerpinB5 and MAFbx.

CONCLUSIONSerpinB5 interacts with MAFbx in gastric cancer cell. Amino acids including PRO261, ASN361, and LYS362 are potential binding sites.

Cell Line, Tumor ; Humans ; Immunoprecipitation ; Muscle Proteins ; genetics ; metabolism ; RNA Interference ; SKP Cullin F-Box Protein Ligases ; genetics ; metabolism ; Serpins ; genetics ; metabolism ; Stomach Neoplasms ; genetics ; metabolism ; Two-Hybrid System Techniques

OBJECTIVETo introduce the clinical experience in transplantation of the anterolateral femoral skin flap.

METHODSA total of 625 anterolateral femoral skin flaps in 600 patients were transplanted from 1988 to 2003. The retrospective analysis was carried out in all the cases as to the flap pedicle, the vascular variations, the surgical procedures and modifications, and the adaptation for a cutaneous-branch-absent flap.

RESULTSThe 625 flaps were transferred except 7 cancelled in the operation. Postoperatively, 17 cases encountered vascular complications, 10 of which survived completely with successful vessel exploration, 3 cases had partial necrosis, and 4 cases had complete necrosis. The survival rate was 97.8%. 545 flaps were pedicled with the descending branch or lateral branches; 45 flaps with the transverse branch or the high-site anterolateral cutaneous artery, 10 cases with the descending-transverse branch, 18 cases with other vessels. 7 cases were found cutaneous-branch-absent. The vessel variation rate of the flap was 4.06%.

CONCLUSIONSThe anterolateral femoral skin flap has less variation of its pedicle and high success rate of operation. It is an ideal choice for repair of soft tissue defects in the extremities.

Adolescent ; Adult ; Child ; Female ; Femur ; Humans ; Male ; Microsurgery ; Middle Aged ; Retrospective Studies ; Skin Transplantation ; Surgical Flaps ; Young Adult