ObjectiveTo study the clinical value of minimally invasive treatment of the doppler-guided hemorrhoid artery ligation with lauromacrogal sclerosis injection in treatment of hemorrhoids.MethodsA retrospective analysis was made on treatment of 32 cases with hemorrhoids using doppler-guided hemorrhoid artery ligation combined with lauromacrogal sclerosis injection.ResultsAccording to the branch of the Chinese Medical Association by the Surgery the clinical diagnosis and Treatment Guidelines of Hemorrhoids (draft),the Ⅰ degree hemorrhoid was found in 1 case,Ⅱ degree hemorrhoids in 18 cases,Ⅲ degree hemorrhoids in 13 cases.Recovery was found in 32 cases.The longest follow-up time was 30 weeks.No relapse was found. ConclusionsDoppler-guided hemorrhoid artery ligation combined with lauromacrogal case sclerosis injection is a low aggressive minimally invasive method to treat hemorrhoid and has small trauma,definite effect,less pain,fewer complications,and short course and other advantages,but the longterm outcome needs further observation.

The key of individualized therapy is that using molecular markers to select more suitable drug.At present,some studies have confirmed that certain molecular markers can predict the efficacy of the drugs.For example,cetuximab is beneficial in patients with K-ras wild-type colorectal cancer,gefitinib and erlotinib are beneficial in patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer( NSCLC),imatinib is beneficial in patients with C-KIT gene-positive gastrointestinal stromal tumor.In terms of safety,the promoter polymorphism of UDP glucuronosyltransferase 1 polypeptide A1 ( UGT1 A1 ) can predict the toxicity of irinotecan.

The combination of chemotherapy, radiotherapy and targeted therapies are considered to be major treatments for metastatic pancreatic cancer. At present, the target therapy-related medications include mainly antagonist of epidermal growth factor receptor, monoclonal antibody of vascular endothelial growth factor and so on. Erlotinib combined with gemcitabine has been demonstrated to prolong the survival of patients with pancreatic cancer.

Objective:To establish a method for the determination of residual 5 heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles, including Cd, Cr, Cu, Sn and Pb. Methods:After the pre-preparation,the sample was dissolved in 1% nitrate. The 5 heavy metal elements in the sample solution were determined by inductively coupled plasma mass spec-trometry (ICP-MS). Results:Under the ICP-MS assay conditions, each element showed good linearity within the range of 0-50 ng· ml-1(r>0. 999 0). The average recoveries were within the range of 92%-116% and 1. 6%-2. 9%, respectively (RSD<3,n=9). Conclusion:The operation is simple and can meet the demand for the analysis of heavy metal elements in single use and gravity feed infusion sets and intravenous infusion needles.

OBJECTIVE To find standard for the management of the medical waste through the plan,do,check and action(PDCA) loop method. METHODS Four steps of PDCA were done to treat the medical wastes. RESULTS Establishment of the effective management of organization and the feasible rules and regulations was an important pledge.Training,propaganda and education for enhancing every-one′s management consciousness were a considerable element.Matching institutions for treating medical waste was the most important basis.Examinations according to the formulated quality specification were the artifice. CONCLUSIONS PDCA loop method is one of the scientific management for treating the medical wastes.

Objective To investigate the clinical characteristics between elderly and non-elderly patients with ulcerative colitis (UC) in Shanghai, so as to improve the diagnosis and management of the disease. Methods The clinical and endoscopic data from 214 patients with UC,who were admitted to Shanghai Ruijin Hospital between 1998 and 2009,were retrospectively analyzed. The database was established and according to onset age,the patients were divided into elderly group (n= 28, ≥60 years of age) and non-elderly group (n = 128, ＜60 years of age), The comparisons between two groups were performed using Chi square test for non-quantitative variables, and student's t test and nonparametric tests for quantitative variables. Logistic regression was used to analyze the risk factor.Results Onset peak of UC was found in patients ranged from 40 to 49 years of age, and elderly patients were accounted for 13.08 % in Shanghai. There was no significant difference between two groups with respect to clinical manifestation, complications, Truelove and Witts criteria index, or endoscopic score. In active phase, elevated peripheral platelet counts were seen in more elderly patients than those in non-elderly patients (75% vs 29%, F= 4. 4, P= 0. 043). However, high level of peripheral platelet was found in non-elderly patients (Z= -2.6, P=0. 008). Endoscopic examination revealed that the colonic lesion in elderly patients was limited and was more common in left-sided colon and protosigmoid (F=5. 8, P = 0. 012). More non-elderly patients were treated with steroid in comparison to elderly patients with mild or severe UC (28. 6% vs 55.7%, F=7.7,P=0. 007). In addition, the high mortality was found in elderly patients when compared with non-elderly patients (20.8 % vs 2.84%, F= 12. 8, P = 0. 008). Conclusion The differences existed between elderly and non-elderly UC patients with respect to clinical manifestation, lab investigation, involved extent of colon, medication and prognosis.

Objective To observe the selective regulation of peroxisome proliferator-activated receptors (PPAR) on fatty acid binding protein-4 (FABP4) in human syncytiotrophoblasts.Methods Cultivate normal human syncytiotrophoblast cells,and put in the specific antagonists and agonists of PPAR each subtypes receptors,then observe the different expression of FABP4 mRNA and protein.Results Pretreated the human syncytiotrophoblast cells with the agonists (GW7647,GW0742) and antagonists (GW6471,GSK0660) of PPARα and PPARβ receptors,the expression of the FABP4 was not significantly change (P＞0.05).However pretreated with PPARγ agonists (rosiglitazone,1 × 10-9,1 × 10-8,1 × 10-7 and 1 × 10-6 mol/L),the expression of FABP4 mRNA and protein could be dose dependent-promoted significantly (mRNA:1.27 ±0.12,1.45 ±0.14,1.57±0.14,1.72 ±0.12,protein:1.10 ±0.08,1.37 ±0.09,1.60 ±0.13,1.79 ± 0.14 ; P ＜ 0.05),furthermore,the promotion can be dose dependent-reversed by specific antagonists GW9662 (mRNA:0.92 ± 0.06,0.77 ± 0.06,0.64 ± 0.05,0.55 ± 0.05,protein:0.91 ±0.03,0.78 ±0.06,0.70±0.07,0.55 ±0.06; P ＜ 0.05).Conclusions In normal human syncytiotrophoblast cells,FABP4 is a target factor of PPARγ.PPARγ regulated the expression of FABP4 mRNA and protein selectively.And the regulation will not be influenced by the other two PPAR subtypes.

Objective To investigate the expression of DNA methyltransferase 1,3a,3b (DNMT1,DNMT3a,DNMT3b) in human hepatocellular carcinoma (HCC) and to determine their clinical significance.Methods The expression of DNMT1,3a,3b proteins was detected in 47 HCC tumor specimens and 42 HCC paracarcinoma liver tissues by immunohistochemistry.12 normal liver tissues were used as control.The results and clinicopathological parameters were analyzed.Results The positive expression rates of DNMT1,3a and 3b in HCC tissues were 80.9％,68.1％ and 78.7％ respectively.The positive expression rates of DNMT1,DNMT3a and DNMT3b in paracarcinoma tissues were 50.0％,52.4％ and 57.1％ respectively.The expression rates of DNMT1,3a and 3b in both HCC tissues and paracarcinoma tissues were significantly higher than normal liver tissues.The expression of DNMT1,DNMT3a,DNMT3b was correlated with tumor differentiation (P＜0.05) and hepatitis B surface antigen (HBsAg) positivity.Conclusions DNMT1,3a and 3b play important roles in carcinog(c)n(c)sis and development of HCC.

Objective To determine the median effective concentration (EC50) of remifentanil inhibiting responses to tracheal extubation in patients of Uygur nationality.Methods The patients of Uygur nationality,aged 18-60 yr,of ASA physical status Ⅰ or [Ⅱ,scheduled for elective surgery,were enrolled in this study.After the end of surgery,remifentanil was given by target-controlled infusion until tracheal extubation.The initial target plasma concentration (Cp) of remifentanil was 2.0 ng/ml.The response was defined as positive when MAP and/or HR increased by ＞ 15％ of the level at the end of operation and the duration ＞ 15 s during extubation.Each time the target Cp increased/decreased if the cardiovascular response was positive or negative.The ratio between the two successive concentrations was 1.1.The EC50 and 95 ％ confidence interval of remifentanil blunting responses to extubation was calculated by Probit method.Results Twenty-eight patients completed the study.The EC50 and 95 ％ confidence interval of remifentanil required for inhibiting the responses to extubation was 1.75 ng/ml and 1.45-2.01 ng/ml.Conclusion The EC50 of remifentanil inhibiting the responses to tracheal extubation is 1.75 ng/ ml in patients of Uygur nationality.

Objective To explore whether phenylalanine affect Cdc42, Racl, and RhoA expression and disturb dendritic development. To determine the effects of brain-derived neurotrophic factor (BDNF) on this process. Methods Neurons were cultivated up to 3 days and then treated with 0.9 mmol/L phenylalanine or 100 ng/ml BDNF. Dendritic number were determined by morphologic analysis. Cdc42, Racl, and RhoA protein expression were examined by Western blotting analysis. ResultsThe number of dendrites in cultured neurons reduced two days after being treated with phenylalanine,while BDNF could rescue this change(P < 0.01), furthermore, BDNF was found to inhibit phenylalanineinduced down-regulation of Cdc42, Racl, and RhoA protein expression(P < 0.01). Conclusions Our study indicated that the protective effect of BDNF against phenylalanine-induced neuronal injury is probably mediated by expression of Cdc42, Racl,and RhoA. It suggested a potential neuroprotective action of BDNF in prevention and treatment of brain injury in the patients with phenylketonuria.