Objective To study the influence of defection of Fragile X mental retardation-1 gene (FMR1) on cyclic adenosine monophosphate (cAMP) and to discuss its mechanism. Methods FMR1 gene of peripheral blood mononuclear cell was silenced in vitro by sodium nitrointroprusside. The effect of gene-silencing was detected using reverse transcript polymerase chain reaction (RT-PCR). The specific activity of adenylate cyclase and phosphodiesterase was showed by the activity ratio of yield or consumption of cAMP during a unit time. Spectrophotometry was used to measure the two key enzymes (adenylate cyclase and phosphodiesterase), as to determining the level of intracellular cyclic adenosine monophosphate in the process of cAMP metabolism. Results FMR1 gene was fully silenced by sodium nitrointroprusside at 12th, 24th and 48th hour separately, re-expressed at 72th hour. If the cultivated fluild was replaced with new sodium nitrointroprusside at 48th hour, FMR1 gene would be silenced continuously. The intracellular cAMP level in the gene silenced group was lower, and significant depression of adenylate cyclase specific activity was found in the FMR1 gene silenced group (P=0.000). No significant difference was found on phosphodiesterase specific activity (P=0.983). Conclusions The results suggest that the yield of cAMP could be influenced by defection of FMR1. The depression of adenylate cyclase activity might be one of the causes of the decrease of intracellular cAMP production.

Objective To summarize the causes and the prevention of bile duct injuries during laparoscopic cholecystectomy (LC). Methods Clinical records of 1 000 cases of LC were analyzed retrospectively. Results Conversions to open cholecystectomy were required in 15 cases(1.5%). Complications took place in 6 cases(0.6%), involving 3 cases of common bile duct injury, 1 case of stomach puncture, 1 case of port hemorrhage, and 1 case of bile leakage. No long-term complications were seen. Conclusions The most frequent cause leading to bile duct injuries is pulling the bile duct to be angulated.

Objective:To investigate the knowledge level on AIDS among medical staff in Xianyang city and provide evidence for performing health education and training on occupational protection.Method:Medical staffs including doctors,nurses,laboratory workers and administrators from 17 different rank hospitals in Xianyang city were enrolled in the investigation.Result:1046 questionnaires were collected back.The average accurate response rates about basic knowledge,transmission,diagnosis and treatment were 52.5%,36.3% and 30.1%,respectively.Sex,age,education level,professional title,nature of work and the grades of units have showed correlation with the knowledge levels of AIDS(P

OBJECTIVE:To study the influence of calcineurin gene polymorphism on the efficacy of cyclosporine A (CsA). METHODS:The blood samples of patients treated with CsA were collected. The trough blood concentration of CsA was detected by EMIT. The genotype of PPP3CA and PPP3CB was assayed by RFLP-PCR method. The expression of NFAT-regulated gene IL-2, IFN-γand GM-CSF were measured by RT-qPCR,which were used to define the index of indirect efficacy of CsA. The relationship of gene polymorphism with CsA efficacy was study by relationship analysis and multiple factor regression method,etc. RESULTS:A to-tal of 100 blood samples were collected. There was no significant correlation between the expression of CsA efficacy-related NFAT-reg-ulated gene GM-CSF and trough concentration of CsA(rGM-CSF=-0.04,P=0.238);the expression of IL-2 and IFN-γ were negatively correlated with trough concentration of CsA significantly(rIL-2=-0.384 3,P<0.001;rIFN-γ=-0.335 4,P<0.001). Using the average value of mRNA expression of IL-2 and IFN-γas indirect efficacy index,the polymorphism of PPP3CB rs3763679 site significantly in-fluenced the efficacy of CsA(P<0.05),but PPP3CA rs3804358 had no any effect on it(P>0.05). Stratified analysis showed that among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 genovariation(TC+TT) were better than those with wild-type gene (CC)(P<0.05). After the efficacy was normalized by CsA trough concentration, multivariate analysis showed that normalized efficacy of CsA was negatively correlated with gender,PPP3CB rs3763679,lactate dehy-drogenase and creatinine significantly,but positively correlated with PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate,etc. CONCLUSIONS:PPP3CB rs3763679 gene polymorphism influence the efficacy of CsA;among patients with immune disease underwent renal transplantation,efficacy of patients with PPP3CB rs3763679 TT+TC is better than that of CC type. At the same time,gender,PPP3CA rs3804358,leucocyte count,usea nitrogen,glycerin trilaurate and other factors all can influence the nor-malized efficacy of CsA to different extent. Multiple factors should be considered when using CsA.

Objective:To explore the effect of humanistic care on the quality of life and the negative emotion of patients with liver cancer operation. Methods: A total of 577 patients with liver cancer surgery were selected to participate in this study from January 2014 to December 2015 . From January 2014 to December 2014 , 288 cases of liver cancer patients were given routine nursing care as the control group. From January 2015 to December 2015, 289 patients were given humanistic care nursing as experimental group. The emotion of depression and anxiety were evaluated using Self-rating Depression Scale and Self-rating Anxiety Scale, the quality of life was evaluated with the core scale of life quality measurement system for cancer patients, while sleep quality with the Pittsburgh Sleep Quality Index. Results:Both depression and anxiety score of the subjects in experimental group were lower than those in the control group(P<0. 05). Physical function, cognitive function, social function, emotional function, role function, and overall health status of the subjects in the experimental group were higher than those in the con-trol group (P<0. 05), while pain, tiredness, nausea, vomiting, shortness of breath, insomnia, diarrhea, loss of appetite, constipation, economic difficulties and other score were statistically lower than those in the control group (P<0. 05). The subjects′quality of life of in the experimental group was better than those in the control group(P<0 . 05 ) , but the sleep index score was lower in the experimental group ( P<0 . 05 ) . Conclusion: Humanistic care nursing can effectively reduce the negative emotions of patients with liver cancer surgery, and thus to improve the quality of life.

Objective To investigate the efficacy of concomitant precise hemihepateetomy for the treatment of hilar cholangiocarcinoma.Methods The clinical data of 38 patients with hilar cholangiocarcinoma who received concomitant precise hemihepatectomy at the First Affiliated Hospital of Xi'an Jiaotong University from January 2009 to October 2012 were retrospectively analyzed.All patients were examined by B ultrasonography,computed tomography (CT),magnetic resonance cholangiopancreatography (MRCP) and CT angiography (CTA)preoperatively.The hepatic function was tested before operation.Of the 7 patients with obstructive jaundice,5 received percutaneous transhepatic cholangial drainage,and 2 received endoscopic nosalbiliary drainage.Surgical procedures were determined according to the results of imaging examination.The resection of hilar cholangiocarcinoma,postoperative histopathological examination,pre-and postoperative hepatic function and prognostic indicators were analyzed.The count data and measurement data were analyzed using the chi-square test and t test,respectively; the survival curve was drawn by Kaplan-Meier method,and the survival rate was analyzed using the Log-rank test.COX proportion hazards model was used for multivariate analysis.Results The positive rates of B ultrasonography,CT and MRCP were 65.8％ (25/38),71.1％ (27/38) and 89.5％ (34/38),respectively.The results of 5 patients who received CTA were positive.Concomitant left hemihepatectomy was performed on 28 patients,concomitant right hemihepatectomy on 10 patients; concomitant caudate lobectomy on 22 patients,concomitant resection and reconstruction of portal vein on 4 patients (including 1 patient who received left hepatic vein repair),concomitant hepatic artery resection on 12 patients (including 3 patients who received hepatic artery reconstruction).Of the 38 patients,R0 resection was performed on 32 patients,R1 resection on 4 patients,R2 resection on 2 patients.Hepatic function indicators including total bilirubin,direct bilirubin,alkaline phosphatase,gamma-glutamyl-transferase,alanine aminotransferase and aspartate aminotransferase were significantly decreased after operation (t =7.799,8.445,5.697,6.633,4.469,4.140,P ＜ 0.05).Two patients died perioperatively,with the mortality rate of 5.3％ (2/38).The main postoperative complications included bile leakage and hepatic function insufficiency,with the incidences of 28.9％ (11/38) and 21.1％ (8/38),respectively.Postoperative histopathological findings included 31 patients with invasive adenocarcinoma,5 patients with nodular adenocarcinoma,1 patient with mucinous adenocarcinoma and 1 patient with adenosquamous carcinoma.The overall 1-,2-,3-year survival rates were 66％,37％ and 21％,and the median survival time was 22.0 months.There were significant differences in the survival rates between patients who received R0 resection and those with R1/R2 resection,and between patients with N0 and N1/N2 stage (x2 =4.516,10.397,P ＜ 0.05).The results of multivariate analysis showed that positive margin and lymph node metastasis were prognostic indicators.Conclusions Concomitant precise hemihepatectomy has significantly improved the radical resection rate and the efficacy of treatment for hilar cholangiocarcinoma.Comprehensive preoperative imaging examination and hepatic function test are important for the assessment for resectability of hilar cholangiocarcinoma.Selective preoperative biliary drainage are key points to decrease postoperative morbidity and morality.

This study explored the double lethal effects of pEGFP-C1-wtp53/junB fusion gene on hepatocellular carcinoma (HCC) cells. wtp53/junB fusion gene was constructed and transformed into HepG2 cell line. Expression of KAI1 was detected by quantitative real-time PCR and Western blotting, cells apoptosis rate was detected by flow cytometry, proliferation of cells was detected byMTT chromometry, cell transmigration was detected by using transwell systems. The results showed that after transformation with pEGFP-C1-wtp53/JunB, the expression level of KAI1 protein was up-regulated, being 8.13 times the blank control group in HepG2 cells and significantly higher than 2.87 times which transformed with pEGFP-C1-JunB, 3.11 times which transformed with pEGFP-C1-wtp53 (P<0.001). Apoptosis rate of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly higher than that of other groups (P<0.001), and invasive ability of HepG2 cells transformed with pEGFP-C1-wtp53/JunB was significantly lower than other groups(P<0.001). It was concluded that the fusion gene of wtp53 and JunB could not only inhibit the growth of hepatoma cells and promote tumor cell apoptosis, but also suppress the invasive ability of tumor cells by up-regulating the expression of KAI1.

Objective To construct wtp53/junB fusion gene and its eukaryotic expression vector in order to provide the basis for further application of polygene union therapy in hepatocellular carcinoma. Methods Polymerase chain reaction (PCR), reverse transcription-PCR (RT-PCR) and gene recombination techniques were used to construct the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the enhanced green fluorescent protein (EGFP). The transfection of pEGFP-C1-wtp53/junB in hepatoma HepG2 cells was detected by the location of green fluorescence. Results The DNA sequence of wtp53/junB fusion gene was successfully cloned into the pEGFP-C1 plasmid and the sequence was the same as what we expected. Green fluorescence located on cell nucleus proved that pEGFP-C1-wtp53/junB was transfected into HepG2 cell line successfully. Conclusion We successfully constructed the eukaryotic vector of pEGFP-C1-wtp53/junB fusion gene, which carries the EGFP, and transfects it into human hepatoma cell nucleus. It may lay the basis for studying the synergetic effect of wtp53 and junB in hepatocellular carcinoma.

Objective To investigate the possibility of liver lesion and its relationship with the rela tive factors in young children with rotavirus(RV) diarrhea. Methods The values of ALT and AST in sera of young children with RV diarrhea were measured to be compared with those of common diarrhea and were analyzed with the multifactors about diarrhea. The genomes of RV from blood serum were tested with reverse-nest polymerase chain reaction. Results Of the 41 young children with RV diarrhea, 15 (36.6 % ) and 32 cases (75.6%) were abnormally higher in the level of ALT and AST respectively and both the ratio and degree of increase were significant in comparison with that in control group. There was no significant relation between the changes of the values of ALT and AST and the clinical manifestation of diarrhea. 4 out of 41 cases were found to be positive of viremia. Conclusion RV infection might spread from intestine to blood and to other organs resulting in viremia, and the liver may be one of the organs involved.

Objective We report a case of neonatal thyrotoxicosis with concurrent respiratory failure in an infant born to a mother with Graves' disease and review the published literature describing neonatal hyperthyroidism. The male infant who was born by spontaneous delivery at 35 weeks of gestational age presented with fever, tachycardia and tachypnea at rest on day 11 after birth, and developed severe apnea on day 14. Thyroid function studies revealed hyperthyroidism in the infant, and his mother was confirmed to have Grave's disease during pregnancy. Literature review showed that among the 33 infants with similar conditions, tachycardia, tachypnea and poor weight gain were the most distinct clinical features of congenital hyperthyroidism. Accurate diagnosis of Graves' disease in the mother during pregnancy and awareness of the clinical presentations of neonatal hyperthyroidism are key to reducing missed diagnosis or misdiagnosis of neonatal hyperthyroidism.