Hepatorenal syndrome (HRS) is one of the most serious complications of end-stage liver disease. Type Ⅰ/Ⅱ HRS has a high short-term mortality rate and poor prognosis. The diagnostic criteria for HRS based on serum creatinine cannot keep up with the world, and early diagnosis is of great importance to the treatment and prognosis of HRS. This article introduces the value and clinical significance of seven biomarkers for renal injury in the early diagnosis, differential diagnosis, and prognostic evaluation of HRS. It is pointed out that neutrophil gelatinase-associated lipocalin, interleukin-18, and kidney injury molecule-1 may be the biomarkers for early identification of renal injury in patients with liver cirrhosis. A combination of multiple biological indicators, imaging examination, and interventional techniques might be a feasible method for early diagnosis of HRS in future.

Objective:To study the effects of dexamethasone,cyclophosphamide,cyclosporin A and mycophenolate mofetil on the expression of Dectin-1 and TLR2 receptor in RAW264.7 cell line.Methods:In vitro culturing RAW264.7 macrophages ,the cells were given different doses of dexamethasone and cyclophosphamide ,cyclosporin A and mycophenolate mofetilfor 24 h.The influence of different immunosuppresants on cell proliferation was detected by CCK-8 assay.Dectin-1,TLR2 mRNA and protein levels of change were detected with RT-PCR technique and flow cytometry .Results:CCK-8 cell proliferation toxicity experiment results showed that with the increase of the dose of dexamethasone ,cyclophosphamide ,Cyclosporin A and mycophenolate mofetil ,the different degree of inhibi-tion of RAW264.7 cell proliferation in mice can be saw after the intervention of 24 h (P<0.05).After 24 h of dexamethasone stimula-tion,Dectin-1 mRNA and protein level decreased,TLR2 mRNA and protein levels elevated (P<0.05).However cyclophosphamide had no obvious influence on Dectin-1 and TLR2 ( P>0.05 ) .Mycophenolate mofetil and cyclosporin A could both inhibit the expression of Dectin-1 and TLR2 (P<0.05).Conclusion:There are significant differences among the regulatory functions of various immunosupres -sants on the expression of pattern recognition receptors .Different immunosuppressive agents exert their inhibitory effects on immune rec-ognition process of fungal pathogens not only by selectively regulating their target PRRs expression ,but also by inhibiting the growth and proliferation of macrophages .

Background and purpose:Esophageal cancer is one of the common malignant tumors in our country. Anastomotic stenosis is a common complication after resection of esophageal cancer, seriously affecting the quality of life of patients after operation. By changing anastomosis, this study explored the methods for prevention of anastomotic stenosis after esophageal cancer surgery.Methods:Patients were randomly divided into groups. Patients admitted on odd dates were placed in the control group whereas patients admitted on even dates were placed in the experimental group. Patients in the control group were treated with gastroesophageal anastomosis using anastomat for gastroesophageal anastomosis. Anastomotic stomach was contracted by purse string suture at first, and then treated with stapler gastroesophageal anastomosis, before the gastroesophageal anastomosis was carried out on patients in the experimental group. After 6 months’ follow-up, the incidences of anastomotic stenosis between the two groups were compared.Results:The postoperative anastomotic stenosis rate in the control group was 19.2%, while that in the exper-imental group was 0%. There were statistically signiifcant differences between them (χ2=22.8,P<0.005). The incidence of anastomotic stenosis in the control group was signiifcantly higher than that in the experimental group.Conclusion:Anastomotic stomach contracted by purse string suture before stapler gastroesophageal anastomosis can effectively reduce the occurrence of anastomotic stenosis after esophageal cancer surgery.

Objective To determine the effect of bacille Calmette-Guerin-polysaccharide nucleic acid (BCG/PSN)on 2,4-dinitrochlorobenzene(DNCB)-induced atopic dermatitis-like skin lesions in Nc/Nga mice.Methods Fifteen mice were randomly and equally classified into 3 groups,i.e.,control group receiving topical acetone on foot pad and abdomen and intraperitoneal injection of physiological saline,model group receiving topical 5% DNCB solution and intraperitoneal injection of physiological saline,treatment group receiving 5% DNCB solution and intraperitoneal iniection of BCG/PSN,and all drugs were used every other day for 7 weeks.Further more,0.1% DNCB was topically applied on the ear and neck of Nc/Nga mice once a week from week 2 to week 7.The effects of BCG/PSN were evaluated by ear thickness,skin histopathology and immunological parameters.Results Repeated application of DNCB caused the development of eczematous dermatitis in mice.Mice in model group chnieally manifested skin dryness,erythema,edema and erosion with histopathological changes including dermal and epidermal thickening,hyperkeratosis,and inflammatory infiltration.The serum levels of IL-4 and IrE in model group were significantly higher than those in control group[(174.72±12.64)μg/L vs (17.32±3.56)μg/L,(91.49±6.32)ng/L vs (83.95±6.63)ng/L,both P<0.05].Increased serum IL-12 and IFN-γ and decreased serum IgE were observed in treatment group compared with the model group[(122.10±4.64)ng/L vs (20.14±6.15)ng/L(73.89±2.39)ng/L vs (51.53±3.45)ng/L, (84.27±9.35)μg/L vs (174.72±12.64)μg/L, all P<0.05].Conclusion BCG/PSN might be beneficial for the treatment of atopie dermatitis-like skin lesions in Nc/Nga mice by enhancing the secretion of IL-12 and IFN-γ and suppressing the synthesis of IgE.

Objectives To evaluate the efficacy and safety of single-incision versus conventional laparoscopic cholecystectomy.Methods We searched electronic databases (PubMed,EMBASE,Cochrane Library,Chinese Biomedicine databases) from January 2000 to April 2012.Personal contact with experts in the field of laparoscopic cholecystectomy was performed to identify further potentially relevant clinical trials.Randomized controlled trials conducted on single-incision versus conventional laparoscopic cholecystectomy were analysed to compare conversion rates,blood loss,operation time,postoperative complications,wound satisfaction score,postoperative pain score and postoperative duration of hospitalization.Data were extracted by two reviewers independently.Statistical analysis was performed by using the RevMan 5.1 software.Results Twelve studies involving 915 patients met the inclusion criteria.When compared with conventional laparoscopic cholecystectomy (LC),the singleincision laparoscopic cholecystectomy (SILC) group showed no significant difference in conversion rate (OR=0.70,95％CI: 0.13～3.77,P=0.68),postoperative complications (OR=1.13,95％CI:0.72～1.78,P＝0.59) and postoperative pain scores (WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57) . There was a significant increase in operative blood loss (WMD ＝ 1.43,95 ％ CI: 0.09 ～2.78,P＜0.05),increase in operative time (WMD=16.79,95％CI: 9.05～24.52,P＜0.01),but an increase in wound satisfaction score (WMD=1.28,95％CI..1.09～1.47,P＜0.01).The postoperative duration of hospitalization was significantly shorter (WMD =-0.30,95％ CI:-0.58 ～-0.02,P＜0.05).Conclusions Current evidence suggests that there is no significant difference in conversion rate or postoperative complications between SILC and LC.Although SILC requires a longer operative time and there is more blood loss when compared with LC,the SILC is superior in wound satisfaction score and in duration of hospitalization.

Objective To construct plvx-cyclooxygenase-2(COX-2)-DsRed and establish breast cancer cell line MCF7 which overexpressed COX-2, to explore the effect of COX-2 on breast cancer cell.Methods The full-length COX-2 PCR product was obtained by total COX-2 PCR primers and COX-2 cDNA vector.After the PCR product and lentiviral vector plvx-DsRed-Monomer-N1 were cut simultaneously by restriction enzyme BamH1 and Xholl, they were connected and sequenced, to get lentiviral vector plvx-COX-2-DsRed.After selected by puromycin, overexpressed COX-2 breast cancer cell line MCF7-plvx-COX-2-DsRed was obtained.The stable cell line was verified by real time PCR and Western blot.The differences of proliferation ability between stable cell line and normal one were compared by colony formation test and Western blot.Results The lentiviral vector plvx-COX-2-DsRed and stable cell line MCF7-plvx-COX-2-DsRed after selecting were obtained.COX-2 expression level of the stable cell line was 75.29 times as high as that of MCF7, and 64.91 times as high as that of cell line MCF7-plvx-DsRed-Monomer-N1 by PCR assay (P ＜ 0.05), which was consistent with the results of Western blot and microscope photo.MTT results showed that cell line MCF7-plvx-COX-2-DsRed had grown faster than cell line MCF7 and MCF7-plvx-DsRed-Monomer-N1 from the 2nd day (P ＜ 0.05), which was accordant with colony formation assay.MCF7-plvx-COX-2-DsRed cell line had higher c-myc expression and lower β-catenin expression than MCF7 cell and cell line MCF7-plvx-DsRed-Monomer-N1 detected by Western blot relative quantification (P ＜ 0.05).Conclusion The plvx-COX-2-DsRed lentiviral vector and cell line MCF7-plvx-COX-2-DsRed are successfully constructed.COX-2 can increase proliferation of MCF7 cells through up-regulating the expression of c-myc.

Objective To evaluate the protective effect of polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) against atopic dermatitis (AD) in Nc/Nga mice,and to explore its possible mechanism.Methods Sixteen Nc/Nga mice were classified into normal control group (n =4),low-concentration BCG-PSN group (n=5) and high-concentration BCG-PSN group (n =7) to be subcutaneously injected with sodium chloride physiological solution,BCG-PSN of 0.1 mg/kg and 0.5 mg/kg respectively,at 1,8,15 and 22 days of age.Dinitrochlorobenzene (DNCB) was repeatedly and topically applied to these Nc/Nga mice to induce AD-like lesions at 49 days of age.The preventive effect of BCG-PSN against AD was evaluated by dermatitis scores,scratching frequency,histopathological manifestations and immunological parameters (including IgE,i nterleukin (IL)-4 and-12,and interferon (IFN)-γ).Results Repeated injection of BCG-PSN within 4 weeks after birth significantly decreased the severity of DNCB-induced AD-like lesions,dermatitis scores and scratching behavior in Nc/Nga mice.There was no statistical difference in scratching frequency between the high-and low-concentration BCG-PSN groups.BCG-PSN treatment reduced the plasma level of IgE in Nc/Nga mice in a dose-dependent manner.BCG-PSN at 0.5 mg/kg increased the number of cells secreting IFN-γ in skin lesions of mice.Both doses of BCG-PSN down-regulated IL-4 level,but up-regulated IL-12 level in the culture supernatant of spleen mononuclear cells from mice.Conclusion Early injection of BCG-PSN could protect Nc/Nga mice against dermatitis by promoting the proliferation of IFN-γ-secreting cells,increasing the synthesis of IL-12,and reducing the levels of IL-4 and IgE.

Objective To explore the health education model of cerebral palsy rehabilitation.Methods Forty children with spastic cerebral palsy were screened and randomly divided into the therapy group and the control group.All the children received common health education,but parents of the therapy group were offered new standardized systematic health education whenever their children were in hospital or discharged from hospital by primary nurses.The Improved Ashworth Spasm Evaluation,GMFM evaluation and ADL evaluation were respectively performed in both the therapy and the control groups before the treatment and after six-month rehabilitation.Results There was no significant difference in the index score between both groups before the treatment.After six months,all the above indicators increased in both groups.And notably,significandy more increment was observed compared with the control group.Conclusions The new health education can further improve gross motor function and ADL of cerebral palsy children,which can be popularized and used as a new health education model for cerebral palsy rehabilitation.

Objective To investigate the effect of gradient heat stress on phagocytosis of hepatic Kupffer cells (KCs) in vitro in rats. Methods Rat Kupffer cells were isolated in vitro and the temperature for gradient heat stress was set at 37, 39, 41 and 43℃. After thermal stimulation, cell injury was detected by PI and Hochest33342 staining. CCK-8 assay was used to investigate difference in cellular proliferation rate over 24h between the groups. Flow cytometry was used to investigate the influence of heat stress on the phagocytosis of KCs. Results Compared to the normal control group, cells in each heat stress group exhibited varying degrees of damage, especially cells in 43℃ group. The ratio of damage cells increased with the increase of heat stress severity (P<0.05). Proliferation assay indicated that the proliferation rate of cells in each heat stress group was significantly decreased in comparison with normal control group 6h after heat stress (P<0.05). After 12h recovery, decrease in proliferation rate was observed only in 43℃ group (P<0.001), and no difference in the rate of proliferation could be observed between the heat stress groups and normal control group after 24h recovery. Flow cytometry showed, that the phagocytosis of KCs decreased in heat stress groups compared with control group, especially in 43℃ group (P<0.05). This phenomenon disappeared after 24h recovery. Conclusion Heat stress can inhibit the phagocytosis of rat liver KCs through its cytotoxic effect on KCs, and subsequently inhibits its proliferative ability. Further investigation of the effect of heat stress on KCs may help understand the pathogenesis of heat stress.

OBJECTIVE To investigate the rescue and treatment of critical children with tracheobronchial foreign body. METHODS From June 2011 to June 2015,there were 2489 children with tracheobronchial foreign bodies treated in Children's Hospital of HeBei Province, among which 11critical children who were rescued as soon as they came to the hospital. The clinical data of the 11critical children were analyzed. RESULTS All the 11 critical cases endured dyspnea of third degree or more severe and presented severe hypoxia, in which 2 children had been performed tracheal intubation before they came to the hospital and 1 child even showed the symptom of respiratory and cardiac arrest. Among these critical cases, the foreign body was removed directly without anesthesia in 1 child. The other 2 children with severe pneumothorax, mediastinal emphysema and subcutaneous emphysema in neck and chest area were treated by excision and drainage of emphysema firstly, and then the foreign bodies were extracted through bronchoscope after general anesthesia. The another 8 children were performed operations of extraction of bronchial foreign body and then the foreign bodies were taken out. All the 11 critical children were rescued successfully and no death cases happened. CONCLUSION Rapid diagnosis and rapid removal of foreign bodies is the key to save the lives of critical children with tracheobronchial foreign bodies.