Background:Lipopolysaccharide( LPS)and(1,3)-β-D glucan( BG)are involved in the process of Crohn’s disease(CD)by activating immune cells in gut to produce inflammatory cytokines. Aims:To investigate the relationship between LPS,BG and disease activity of CD. Methods:Sixty-eight patients with CD from April 2013 to July 2014 at Shanghai Tenth People’s Hospital were enrolled,of them 41 cases were active-CD( A-CD group)and 27 cases were remission-CD(R-CD group). Twenty healthy subjects were served as normal controls. Crohn’s disease activity index (CDAI)and simple endoscopic score for Crohn’s disease(SES-CD)were used to assess the disease activity and severity. Serum levels of LPS,BG,ESR and CRP were determined,and their relationships were analyzed. Results:Serum levels of LPS and BG in A-CD group were significantly higher than those in R-CD and control groups(P all < 0. 05). No significant differences in serum levels of LPS and BG were found between R-CD and control groups(P all > 0. 05). Levels of LPS and BG were positively correlated with CDAI,SES-CD and ESR(P all < 0. 05),but was not correlated with CRP(P all >0. 05). Conclusions:Serum levels of LPS and BG can be used to assess the disease activity and severity of endoscopic mucosal lesions in CD.

Objective To study the standardization of medical records writing by residents in hospitals. Methods With both quantitative and qualitative analysis, medical records made by residents were sampled in groups to study their standardization. Results Recognition rate of such medical records was 82. 55%, and the excellence rate was 24. 50% in the grade evaluation. For senior residents, their rate of writing excellence falls below those of junior ones; whether the evaluators have medical background bears no significant difference for grade evaluation of medical records writing, yet a significant difference was found with the recognition rate. Conclusion Writing of medical records by residents is found with incompliance now and then, and the recognition rate ought to be improved.

Objective To analyze the causes of medical disputes and to find an effective way to reduce medical malpractice and medical dispute.Methods The complete identification files of 251 cases of medical malpractice obtained from corresponding Offices of Technical Identification of Medical Malpractice in three cities at prefecture level in Shandong province were analyzed to compare the cause of medical malpractice identified by patients with that identified by experts.Results The main causes that identified by patients included violation(36.41%),default(35.60%),illegality(13.05%),tort(11.89%),and absence of management(3.05%).Among the litigation claims,58.53%were identified as existed factors causing disputes.Among the identified factors,72.66%should have been prevented and controlled.Conclusion Medical malpractice and medical dispute can be effectively prevented and controlled by putting management site forward,ensuring the implemention of the policies,and strengthening the substantive responsibility of the leadership.

Objective To explore the possible mechanism and protective effect of mesenchymal stem cell (MSC) on rats with paraquat-induced acute lung injury. Method The solution of 20% paraquat (PQ) in dose of 18 mg/kg was injected intra-peritoneally into rats to induce poisoning,and phosphate buffered solution (PBS) was given to rats instead of PQ in rats of control group. Eighty specific pathogen free (SPF) Wistar rats were randomly divided into four group: PQ plus PBS group (n = 20), PQ plus MSCs group (n = 20), MSCs plus PBS group (n=20), normal group (n = 20). The forth generation of MSCs were transfected with Ad5-EGFP virus vector, and then the MSCs-EGFP was delivered to rats through the tail vein of rats 4h after PQ. Five rats of each group were sacrificed 1 d, 3 d, 7 d and 28 days after MSCs administration, and lung tissues of rats were taken to make sections for histological observation of the migration of MSCs under fluorescence inverted microscope. The lung tissues of rats sacrificed on the 28 th day after PQ poisoning were taken for detecting pulmonary coefficient and the content of hydroxyproline (HYP) in the lung tissue homogenate, and at the same time, the levels of serum transforming growth factor-β1(TGF-β1) were assayed. Results The pathological changes of lung tissue showed that the pulmonary fibrosis and consolidation in the MSCs treatment group were milder than those in PQ poisoning model group. In the MSCs treatment group, the levels of serum TGF-β1 and lung tissue HYP, and pulmonary coefficient were lower than those of PQ poisoning model group (P＜0.05). Conclusions The use of MSCs for treatment of paraquat intoxication can protect pulmonary structure by decrease in TGF-B1 and inhibiting the fibroblast migration, suppressing the production of collagenous protein.

Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89％(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.

Objective To compare the surgical effects of laparoscopy and open mini-incision surgery in cholelithotomy with the gallbladder being preserved.MethodsFrom April 2006 to May 2008,63 cases of cholelithiasis received cholelithotomy with the gallbladder being preserved in our hospital by laparoscopy(n=33) or mini-incision open surgery(n=30).The operation time,recovery time of gastrointestinal function,rates of postoperative analgesics use and complications,inpatient charge,and drug expense after the operation were analyzed.ResultsThe mean operation time in laparoscopy group was significantly longer than that in open group [(66.4?10.6) min vs(60.6?9.8) min,t=2.248,P=0.020)].And the inpatient charge in laparoscopy group was significantly higher than that in the open group [(7865?992) yuan vs(6995?825) yuan,t=3.765,P=0.000)].Whereas,the recovery time of the gastrointestinal tract and postoperative hospital stay in the laparoscopy group was significantly shorter than those in the other [(22.7?6.9) h vs(36.9?17.2) h,t=-4.374,P=0.000);(4.8?1.5)d vs(10.0?7.4) d,t=-3.951,P=0.000)].In the laparoscopy group,only one patient showed complication(periumbilical infection) after the treatment,while in the open group,2 patients developed incisional hematoma,2 showed incisional infection,3 had pelvic effusion,and 1 suffered from adhesive intestinal obstruction(?2=5.369,P=0.020).ConclusionsLaparoscopy is a good choice for cholelithotomy with the gallbladder being preserved,for it is minimally invasive,and thus leads to less surgical trauma,quicker recovery,fewer complications,and shorter hospital stay after the procedure.

Objective To analysis the outcome of gastroscopy and B ultrasonography in patients of post hepatitis cirrhosis with portal hypertension, and to evaluate the degree of cirrhosis in clinic and affording suggestions in preventing complication. Methods One hundred and ninety two cirrhosis patients with portal hypertension were divided into three groups : mild, moderate and severe group based on the extent of esophageal varicosis. By estimating the diameter of portal vein, thickness of spleen and width of splenic vein in three groups to investigate their correlation with the extent of cardio-esophageal varicosis. Results The incidences of gastric varices in these three groups have prominent difference,The severer the degree of esophageal varices , the higher the incidence of gastric varices. According to the different degree of esophageal varices, the diameter of portal vein,thickness of spleen,diameter of splenic vein are differed. There is linear relation between thickness of spleen and diameter of splenic vein. Conclusion Diameter of portal and splenic vein, thickness of spleen,can provide valuable suggestion in predicting the presence of portal hypertension,but further confirmation is based on the result of gastroendoscopy.

Objective To investigate the cytotoxic effect of 103 palladium( 103 Pd) particle radiotherapy combined with 41℃ heating on human hepatocarcinoma cell line Bel-7402. Methods Human hepatocarcinoma cells (Bel-7402) were treated by water-heating and/or 103 Pd particle. The cell growth was determined with MTT assay, and the cell apoptosis was detected by the fluorescent stain of Hoechst33258. Results The cytotoxic effect of 103 Pd radiotherapy combinded with 41℃ heating on Bel-7402 cells was stronger than that of only 103 Pd radiotherapy. Conclusion 103 Pd radiotherapy and 41℃ heating had a synergistic effect on hepatocarcinoma cell Bel-7402, and 103 Pd radiotherapy had the cytotoxic effect on the surviving Bel-7402 cells after hot therapy.

Objective To evaluate the application of a new laparoscopic hepatic forceps for laparoscopic liver resection in pigs.Methods A laparoscopic hepatic forceps was designed by using the CAD software,and was manufactured in coordination with the Hangzhou Kangyou Medical Company for pilot tests.An assessment was made on outcomes of the forceps for blocking hepatic blood flow and controlling cut surface hemorrhage in laparoscopic hepatectomy in 12 pigs.Results The experimental group had a significantly lower intraoperative blood loss than control group(47.8 ?6.9 ml vs 86.3?3.9 ml;t=11.898,P=0.000) and a significantly shorter operation time than control(53.2?7.4 vs 97.5?5.8 min;t=11.541,P=0.000).No significant difference was observed in the weight of resected liver between experimental and control groups(34.7?4.2 g vs 35.3?4.2 g;t=0.245,P=0.812).Conclusions This new laparoscopic hepatic forceps can be used for the occlusion of liver blood flow,offering advantages of less blood loss and shorter operation time and facilitating laparoscopic performance in liver resection.

Osteoarthritis (OA) is the main reason of joint pain and dysfunction in the elderly in China, and its incidence is increasing year by year. In addition to the joint peripheral osteophyte formation and degeneration of articular cartilage, in?flammation, as one of the dominant pathological changes in OA, is causing more and more attention. Pro-inflammatory cyto?kines (PIC) are important mediators of inflammation. The increased level of PIC in OA can lead to systemic and local inflam?mation, results in further destruction of many kinds of tissues in joint (such as cartilage), and accelerates the development of OA. Besides, the severity of inflammation is closely related to the clinical symptoms of OA. Therefore, it is important to un?derstand the role of PIC in the pathogenesis of OA. From the perspective of the relationship between pro-inflammatory fac?tors and OA and the molecular mechanism, this article reviews the research progress in this field, which provides new con?cepts for diagnose and treatment of OA.