Objective　To investigate the operation treatment of gallbladder carcinoma(GBC). Methods The clinical data of 132 patients with GBC from 1980 to 1999 were analysed. Results　The mean age was 55 years and the occurrence sex ratio in female/male was 1.5∶1. Gallstone was found in 80% of the patients, and 87.1% of the GBC were adenocarcinoma. Before December 1990(forward group), simple cholecystectomy were performed on 11 cases, radical cholecystectomy on 9 cases, extended radical cholecystectomy on 5 cases, palliative extra- or intra- drainge on 15 cases, surgical biopsy on 30% cases. Hospital death occurred in 4 cases, the postoperative complications occurred in 20 cases including biliary fistula in 4 cases, pancreatic fistula in 2 cases. Since January 1991(latter group), radical simple cholecystectomy were performed on 2 cases, radical cholecystectomy on 16 cases, extended radical cholecystectomy on 24 cases; palliative extra- or intra- drainge in 9 cases, surgical biopsy on 8 cases. Hospital death occurred in 1 cases; postoperative complications in 12 cases, including biliary fistula in 1 cases, pancreatic fistula in 1 cases. Radical resection rate was 35.7% in forword group, 72.6% in latter group. Conclusions　Surgical tech-nique progress and application with Peng's Multifunctional Operative Dissector can improve the resection rate of GBC. Extended redical resection is an effective and active method to treat middle or late stage GBC.

Kenaf has a high content of gum that is difficult to remove. Traditional chemical degumming process causes serious environmental pollution. To solve the problem, we developed a new method to degum kenaf. We pretreated the kenaf with steam explosion followed by ultrasonic treatment. We chose the single factor tests to select the ultrasonic frequency, sodium hydroxide concentration and processing time. Combined with orthogonal tests, we found that the optimum conditions were as follows: ultrasonic frequency was 28 kHz, sodium hydroxide concentration was 2%, and processing time was 60 min. Under these conditions, the residual gum of kenaf fiber was 9.72% and the fineness was 139.45 N(m). Steam explosion combined with ultrasonic method is effective in degumming of kenaf.
Hibiscus ; Plant Gums ; isolation & purification ; Sodium Hydroxide ; chemistry ; Steam ; Ultrasonics

Objective To investigate the effect of radiation on the expressions of RANKL and OPG in osteoblasts in order to disclose the molecular mechanism of bone injury induced by ionizing radiation.Methods The osteoblasts were differentiated from MC3T3-E1 cells.After 2 or 4 Gy137 Cs γ-irradiation,the mRNA and protein expression levels of RANKL and OPG of osteoblast precursor and osteoblast were detected by real-time PCR and Western blot.Results The expressions of RANKL mRNA (t=5.41,P＜0.05)and protein(t=68.37,P＜0.01)were up-regulated after 4 Gy irradiation,while the expressions of OPG mRNA(t=5.20,7.02,P＜0.05)and protein(t=7.78,9.45,P＜0.05)were down-regulated after 2 and 4 Gy irradiation.Conclusions 2 and 4 Gy ionizing radiation alters RANKL/RANK/OPG pathway in osteoblasts,which may promote the osteoclast differentiation and maturation and hence promote bone resorption of osteoclasts.

Background and purpose:Anastomotic leakage and low anterior resection syndrome(LARS) are both common complications in dual-anastomosis for patients with low rectal cancer. The aim of this study was to observe and explore the signiifcance and role of vertical cutting of the closed distal rectum in dual-anastomosis for patients with low rectal cancer.Methods:A total number of 120 patients with mid-low rectal cancer who admitted to and completed laparoscopic rectal cancer resection in the Department of General Surgery, the First Afifliated Hospital of Soochow University from Feb. 2010 to Jun. 2014 were pair-matched into Groups A and B based on their gender,age, tumor size, the distance of lower edge to the dentate line and tumor staging, etc. For the 55 patients in Group A (observation group), the rectum distal end was closed vertically instead of horizontally while disposing “the ifrst intestinal anastomosis”, intestine-intestine anastomosis was conducted in an “end-corner” approach when dealing with “the second intestinal anastomosis”, upper corner (“dog ear”) of the closed line in the distal end of the rectum was removed, the lower corner (“dog ear”) of the closed line in the distal end of the rectum was removed using vascular occlusion clamp method, and the T-shaped interchanges (“dangerous triangle”) of stapled sutures formed after anastomosis were strengthened with absorbable suture. For the 65 patients in Group B (control group), laparoscopic dual anastomosis was conducted using conventional method, and the two “dog-ears” and “dangerous triangles” were kept without any treatment. The clinical outcomes of the two groups of patients were analyzed retrospectively. Results:In group A, It was convenient to complete the operation when the “dog ears” and “dangerous triangle” on the vertical line after cutting the closed distal rectum vertically by “end-corner” anastomosis. The axis of intestine formed a certain angle making the closed distal rectum into “ampulla” sample without “dog ears”. the “dangerous triangle” were strengthened with absorbable suture. In group B, The distal and proximal intestine located on the same axis after intestine-intestine anastomosis leaving two “dog ears” and a “dangerous triangle”. The general clinical data of patients in the two groups were comparable and not signiifcantly different (P>0.05). The two groups of patients showed no signiifcant differences in blood loss, postoperative drainage, postoperative anastomotic bleeding, anal exhaust time, and length of hospital stay (P>0.05). However, the operation time as well as the numbers of anastomotic ifstula occurrence, defecation, tenesmus and post-operation re-ostomy differed significantly (P<0.05).Conclusion:Vertical cutting of the closed distal rectum with dual anastomosis made the “new” intestine closer to the physiological bending and morphology of the rectum, meanwhile, it simpliifed the approach of removing “dog ear” and strengthening “dangerous triangle”, ifnally it signiifcantly reduced the incidence of post-surgical complications.

Objective To investigate the relationship between thyroid hormone and uric acid (UA) and body mass index (BMI) in patients with type Ⅱ diabetes and normal thyroid function.Methods Total of 313 patients with type Ⅱ diabetes and normal thyroid function were selected.BMI,fasting blood glucose (FBG),the metabolism of blood lipid,thyroid hormones and UA indicators were examined and the correlations of thyroid hormone,BMI and UA were analyzed.Results (1) The patients were divided into two groups according to gender,and FT3,FT4,and UA of male were found to be significantly higher than those in female (P＜0.01).TSH,SBP,HDL-C in female were significantly higher than those in male (P＜0.01);(2) The patients were divided into three groups according to BMI Level.Thyroid-stimulating hormone (TSH),three iodine armour gland original glycine (TT3),free three iodine thyroid glycine (FT3),UA,and FBG in overweight and obesity groups were found to be higher than those in normal weight group (P ＜ 0.05);(3) The patients were divided into two groups according to the TSH level.Serum uric acid,TT3,FT3,fasting insulin in the group with TSH above 2.5 uIU/L were found to be higher than those in the group with TSH under 2.5 uIU/L (P ＜ 0.05);(4) Patients were divided into two groups according to the UA level.TSH,FT3 in male with high uric acid were found to be higher than those in male with normal uric acid (P ＜ 0.05);TSH was in female with high uric acid was found to be higher than that in female with normal uric acid (P ＜ 0.05).Conclusion Thyroid hormone in patients with type Ⅱ diabetes can be used to assess the body weight and uric acid,which is of great clinical importance.

Objective To observe clinical efficacy and explore clinical value of a modified procedure of double-stapling technique for mid-low rectal cancer.Methods Clinical data of patients undergoing laparoscopic anterior resection at the Department of General Surgery,the First Affiliated Hospital of Soochow University from February 2011 to February 2015 was analyzed retrospectively.According to the different ways in doing double-stapling technique,we divided patients into modified group (51 cases) and conventional group (74 cases).Parameters were compared between the two groups as general considerations,oncologic outcomes.Data were analyzed by SPSS 17.0 software packet,using t and x2 inspection.Results The difference of the general data of two groups was not statistically significant (P ＞ 0.05).Operation time in the modified group was longer than that of the conventional group [(169 ± 23) vs.(150 ±42)min,t =-3.150,P ＜0.05],but it had shorter drainage tube indwelling days [(7.9 ±2.9)d vs.(10.8±11.6)d,t=1.999,P＜0.05] and length of hospital stay after surgery [(10.0±3.6)d vs.(13.3 ± 13.7) d,t =1.025,P ＜ 0.05].The incidence of anastomotic leakage (2.0％ vs.18.9％,x2 =4.402,P ＜ 0.05) and tenesmus(3.9％ vs.17.6％,x2 =4.110,P ＜ 0.05) in the modified group was less than that of the conventional group.The difference in those areas was not statistically significant (P ＞ 0.05),such as intraopretive blood loss,per-anal exhaust time,consumption of liquid diet time,anastomotic bleeding,intestinal obstruction,reoperation for neostomy and infections.Conclusions Compared with traditional laparoscopic anterior resection,End-Corner anastomosis has the benefits of less postoperative anastomotic leakage and fewer low anterior resection syndrome.

Objective Cancer radio-therapy may induce bone damage of the patients.collagen type I gene expressions in osteoblast after radiation indicates the influence of radiation on the function of early and late osteoblast.Methods Bone marrow stromal cells were differentiated into osteoblasts in vitro.and the characteristics was indentified.The collagen type I expressions in early and late stage osteoblasts exposed to 1～4Gy radiation were examined by RT-PCR.Results Compared to control group,collagen type I gene expressions increased in early osteoblast after 1～3 Gy radiation (P＜0.05),while the gene expressions in late osteoblast that cultured 10 days decreased.Collagen type I gene expression in late stage ostoblast after 4 Gy irradiation was greatly higher than that in early stage osteoblast (P＜0.01).Conclusion After 1～3 Gy irradiation,the collagen type I expression in early osteoblast was enhanced,indicating the increased ability of bone formation.The exposure to 1～3 Gy decreased collagen type I expression in late osteoblast and weakened the ability of bone formation.The result of high expression of collagen type I in late osteoblast after 4 Gy irradiation may be the manifestation of compensatory function.

Magnetic chitosan (CS) nano-spheres were prepared by the modified suspension cross-linking technique. The results demonstrated that the magnetic drug nano-spheres are mainly spherical in form with a size of 200 to 800 nm, and show good magnetic responsivity. Here, Doxorubicin was used as exam drug. Glutaraldehyde connects Doxorubicin to CS by the chemical bond (-N = C-), and the drug content is in range of 1% to 15% (w/w). The chemical bond is broken depending on pH, so pH is the important factor for the release of doxorubicin. The doxorubicin release was 22.0%, 13.4%, and 4.1% in the space of 7d, when pH was 1, 2, 4. So the nano-spheres are pH-sensitive magnetic targeting drug micro-spheres.
Chitosan ; chemistry ; Doxorubicin ; administration & dosage ; Drug Carriers ; chemical synthesis ; Drug Delivery Systems ; methods ; Magnetics ; Nanospheres ; chemistry

ObjectiveNotch signaling is highly conservative in evolution and plays an important role in cell's proliferation and differentiation.Construction of tentiviral vector containing Notch intracellular domain (NICD) would lay the foundation for the study of Notch signaling.MethodsTotal RNA was extracted from the myeloid tissue of C57BL/6 mice.cDNA was composed via reverse transcription.NICD sequence was obtained by PCR and recombined into lentiviral vector.Lentiviral vector with NICD was infected into target HEK293T cell.Real-time PCR and Western blot were used to examine NICD expression in HEK293T cell.ResultsNICD expression increased in HEK293T cells.ConclusionThe successful construction of lentiviral vector involving mice NICD expression provides the foundation for the future study.

Objective: To understand the readiness for hospital discharge of the day surgery patients of obstructive sleep apnea-hypopnea syndrome and analyze its influencing factors. Methods: A total of 129 children with obstructive sleep apnea-hypopnea syndrome during the day surgery were investigated with a general data questionnaire and an adapted discharge preparation metric. Results: The total score of the readiness for hospital discharge was 166.38±30.93. The scores of discharge in all dimensions from high to low were adaptive ability 8.35±1.80, expected support 8.17±1.70, knowledge status 7.35±2.10, and personal status 7.10±1.43. Multiple linear regression results showed that the difficulty of caring for children from parents had a significant effect on the readiness of children with obstructive sleep apnea hypopnea syndrome during day surgery (P<0.01). Conclusions The discharge readiness of children with obstructive sleep apnea-hypopnea syndrome during day surgery was at the upper-middle level, but their personal status was not good. Medical and nursing staff should pay attention to health guidance for parents of children with disease-related knowledge, do a good job of interpretation before discharge, help parents increase their confidence in caring for children after discharge, improve the level of preparation for discharge, and ensure the safety of children after discharge.