ObjectiveTo evaluate the feasibility,effectiveness and safety of laparoscopic splenectomy combined with pericardial devascularization for the treatment of portal hypertension in cirrhotic patients. MethodsIn this study 16 cases underwent initial totally laparoscopic splenectomy and paraesophagogastric devascularization,with 10 cases undergoing upfront open surgery as controls by one treatment group.Clinical data including operative time,intraoperative blood loss,post-operative complications and hospitalization were compared between the two groups.ResultsIn the laparoscopic group the procedure was successfully performed in 12 cases.4 cases were converted to open surgery.The operative time in laparoscopic group and the open group was respectively (315 ± 77 ) min and (291± 31) min (P =0.384).The mean intro-operative blood loss was (409 ±216) ml and (980 ±402) ml (P ＜0.01).The post-operative stay was ( 10 ± 3 ) d and ( 17 ± 8 ) d ( P ＜ 0.01).Differences in post-operative complication rate between the two groups was not statistically significant ( 17％ vs.30％,P =0.525 ).ConclusionsLaparoscopic splenectomy and pericardial devascularization is feasible,effective and safe for cirrhotic patients with portal hypertension,it has the advantage of less intra-operative blood loss,less pain and shorter hospitalization than open surgery.

Objective To investigate the clinical characteristics and efficacy of acute myeloid leukemia (AML) with NPM1 and FLT3 mutations.Methods NPM1 and FLT3 mutations were detected in 67 patients with newly diagnosed AML by PCR-capillary electrophoresis.The relationship was analyzed between the mutations and efficacy.Results The incidence of NPM1 mutation was 10.4％ (7/67) in total AML patients and 26.1％ (6/23) in normal karyotypes AML patients.The incidence of FLT3-ITD mutation was 10.4％ (7/67) in total AML patients and 17.4％ (4/23) in normal karyotypes AML patients.The characteristics of 60 NPM1 wild type patients vs that of 7 NPMl mutation patients was as follow,platelet count (BPC) (54× 109/L vs.27.5 × 109/L,P ＜ 0.01),proportion of AML-M5 (57.1％ vs.27.3％,P ＜ 0.01),incidence of CD34+ (28.6％ vs.63.3％,P＜0.01),normal karyotypes (85.7％ vs.28.3％,P＜0.01),cases with particular fusion gene (0 vs.48.3％,P ＜ 0.01),incidence of FLt3-1TD-mutations positive (28.6％ vs.8.3％,P ＜ 0.01),and the differences were significant (P＜0.01).No statistic difference was found in white blood cell(WBC) counts,percentage of blasts in bone marrow,sex,median age and complete remission rate between the two groups (P ＞0.05).The WBC counts (26.9 × 109/L vs.8.1 × 109/L,P =0.013),percentage of blastsin in bone marrow (90％ vs.76％,P=0.014) in the FLT3-ITD mutationg positive patients were clearly higher than those in the FLT3-ITD negative patients.If not associated with FLT3-ITD mutations,mutant NPM1 appears to identify patients with improved response toward treatment.Conclusion It is necessary to detect NPM1 mutation and FLT3-ITD mutation in newly diagnosed AML patients,especially in patients with normal karyotype,which might help to molecular classification and treatment.

To investigate the relationship between intracellular free Ca2+ concentration ([Ca2+]i) and calcium-activated chloride (Clca) channels of pulmonary artery smooth muscle cells (PASMCs) in rats under acute and chronic hypoxic conditions, acute hypoxia-induced contraction was observed in rat pulmonary artery by using routine blood vascular perfusion in vitro. The fluorescence Ca2+ indicator Fura-2/AM was used to observe [Ca2+]i of rat PASMCs under normal and chronic hypoxic condition. The effect of Clca channels on PASMCs proliferation was assessed by MTT assay. The Clca channel blockers niflumic acid (NFA) and indaryloxyacetic acid (IAA-94) exerted inhibitory effects on acute hypoxia-evoked contractions in the pulmonary artery. Under chronic hypoxic condition, [Ca2+]i was increased. Under normoxic condition, [Ca2+]i was (123.63 +/- 18.98) nmol/L, and in hypoxic condition, [Ca2+]i was (281.75 +/- 16.48) nmol/L (P<0.01). Under normoxic condition, [Ca2+]i showed no significant change and no effect on Clca channels was observed (P> 0.05). Chronic hypoxia increased [Ca2+]i which opened Clca channels. The NFA and IAA-94 blocked the channels and decreased [Ca2+]i from (281.75 +/- 16.48) nmol/L to (117.66 +/- 15.36) nmol/L (P<0.01). MTT assay showed that under chronic hypoxic condition NFA and IAA-94 decreased the value of absorbency (A value) from 0.459 +/- 0.058 to 0.224 +/- 0.025 (P<0.01). Hypoxia increased [Ca2+]i which opened Clca channels and had a positive-feedback in [Ca2+]i. This may play an important role in hypoxic pulmonary hypertension. Under chronic hypoxic condition, Clca channel may play a part in the regulation of proliferation of PASMCs.

Objective To explore the features of the parental rearing behavior in schizophrenics with a brilliant school records.Methods 51 schizophrenics in remission with brilliant records were tested by EMBU.36 healthy volunteers were randomized into the controls group.Result Subjects with schizophrenia had abnormal parental rearing behavior,such as overprotection, predilection over intervention and over punishment of parents.Most of them come from peasant family.Conclusion The factors such as abnormal parental rearing behavior probably influence the development of schizophrenics.

AIM: To investigate the role of intracellular free Ca2+ concentration ([Ca2+]i) in the regulation of calcium-activated chloride (ClCa) channels in pulmonary artery smooth muscle cells (PASMCs) of rats under normoxic, acute and chronic hypoxic conditions. METHODS: Acute hypoxia-induced contraction was observed in rat pulmonary artery by using routine blood vascular perfusion in vitro. The fluorescence Ca2+ indicator Fura-2/AM was used to observe [Ca2+]i of rat PASMCs in normal and chronic hypoxic condition. The influences of ClCa channels on PASMCs proliferation were assessed by MTT assay. RESULTS: (1) The ClCa channel blockers niflumic acid (NFA) and indaryloxyacetic acid (IAA-94) produced inhibitory effects on acute hypoxia-evoked contractions in pulmonary artery. (2) Under chronic hypoxic condition, [Ca2+]i was increased. In normoxic condition, [Ca2+]i was (123.63?18.98) nmol/L, and in hypoxic condition, [Ca2+]i was (281.75?16.48)nmol/L (P0.05). (4) Chronic hypoxic increased [Ca2+]i which opened ClCa channels. The NFA and IAA-94 blocked them and decreased [Ca2+]i from (281.75?16.48)nmol/L to (117.66?15.36)nmol/L (P

OBJECTIVE: To discuss the the control of hyperglycemia in patients with severe acute pancreatitis(SAP).METHODS: Patients were treated with NPH(subcutaneous injection) or continuous subcutaneous insulin injection(CSII) or Insulin glargine(subcutaneous injection).Incidences of hypoglycemia and hyperglycemia and the blood sugar level within 5 days of admission were measured.RESULTS: The incidences of blood glucose level being ≤4.0 mmol?L-1 or ≥11.1 mmol?L-1 were significant different in CSII group and insulin glargine group compared with NPH group respectively(P

Objective:To investigate the effect and mechanism of transcription factor Foxp 3 on the proliferation and cell cycle of human lung adenocarcinoma cell line A 549.Methods:We knocked down the expression of Foxp 3 using siRNA.Foxp3 inhibition was detected by RT-PCR.Cell proliferation was detected by MTT.Cell cycle of A549 cells were detected by flow cytometry after the transfection of siRNA.Cell cycle-related checkpoint genes were filtered by RT-PCR.The regulation of Foxp3 on cell cycle-related checkpoint genes were detected by immunofluorescence and dual -luciferase reporter assay system.Results: The proliferation of A549 cells were inhibited after silencing Foxp3,and A549 cells were arrested in G0/G1 cycle.G1/S cycle checkpoint gene CCND1 was down regulated.Mechanism research show that Foxp 3 can regulate the expression of CCND 1 directly.Conclusion: Foxp3 can promote the proliferation of A549 cell line by up regulating G 1/S cycle checkpoint gene CCND 1.This provides a new target for the therapeutic targets of lung adenocarcinoma.

AIM: To study the effect of cigarette smoke medium(CSM) on the gene expression and activity of gelatinases from alveolar macrophages(AMs) in the rat,and then to explore their role in the pathogenesis of chronic obstructive pulmonary disease(COPD).METHODS: AMs were obtained from BALF of the rats that had smoked for 12 weeks.CSM was produced following the method of Wirtz and colleagues,and the cultured AMs were respectively stimulated for 24 h by 0%,1%,3%,5%,10%, 15% CSM.The mRNA levels of MMP-9 and MMP-2 were detected by semi-quantitative RT-PCR,and the enzyme activity was measured by Zymography.RESULTS: When the concentration of CSM was below 5%,the expression and activity of MMP-9 and MMP-2 signficantly increased with the concentration of CSM in a dose-depended manner(P

Objective To evaluate the efficacy of emergency endoscopic intervention in acute obstructive suppurative cholangitis (AOSC) complicated with septic shock.Methods A total of 54 patients with AOSC and septic shock who underwent therapeutic emergency ERCP were included in this retrospective study,and were evaluated by the shock index (SI).Results ERCP was performed for all patients in 24hours after hospitalization,and the average ERCP operation time was 23.8 ± 12.5 min.All 54 patients underwent EST,46 of whom received ENBD,7 biliary stenting and 1 transferred to surgery due to bleeding.The post-ERCP mortality rate was 0,and the complications included 1 case of pancreatitis and 2 cases of pneumonia.The positive rate ofGram-Negative bacillus before ERCP was 46.9％ (15/32).The SI before ERCP was 1.250 ±0.200,which decreased to 0.950 ±0.119 at 2hr after the procedure (P ＜0.001 ),and decreased further to 0.598 ± 0.099 ( P ＜ 0.001 ) at 24 hours after ERCP.Conclusion Therapeutic emergency ERCP is of great importance in the treatments for AOSC complicated with septic shock.

Objective To investigate the level of insulin and amyloid beta-protein (Aβ) in patients with Alzheimer disease(AD). Methods The levels of fasting plasma glucose, true insulin, C-peptide, Aβ40 and Aβ42 in 70 healthy age-matched adults and 55 patients with AD were measured and analyzed. Results No differences were observed for the levels of fasting plasma glucose between AD groups and normal group (P>0.05). The level of the true insulin and C-peptide of the moderate/severe AD group were significantly higher than that of the normal control group(P<0.05), as well aw that of the Aβ40 (P<0.05). The level of Aβ42 of the mild AD group waw significantly higher than that of the normal control group(P<0.01). Conclusion Plasma insulin and Aβ are abnormal in AD, and they are related to severity of dementia.