Objective:To investigate the influence of laparoscopic versus open hepatectomy on the stress reaction of patients.MethodsRetrospectively 30 cases who received operation of laparoscopic and open left lateral lobectomy of liver for stones in bile ducts within left lobes of lives were selected form May 2006 to September 2010.The serum level of neutrocytes (N),adrenaline (AD),cortisol (Cor),blood glucose (BG),white blood cell (WBC),Natural killer cell ( NK cell),interleukin-6 (IL-6),C-reactive protein (CRP) were detected preoperatively as well as 24 h,28 h,72 h postoperatively.ResultsAD,Cor reached their peaks after operation,and N,BG,IL-6,CRP reached their peaks in 24 h postoperatively.There were significant difference between O and L groups (P＜0.05).NK cell sank to its lowest level in 24 h postoperatively,and there were no significant difference between the two groups (P＜0.05).ConclusionLaparoscopic and open left lateral lobectomy of liver are two methods curing stones in bile ducts within left lobes of lives,the former process can result in less stress reaction of patients than the latter.

Recent studies reported that thymoquinone (TQ), a component derived from the medicinal spice Nigella sativa (also called black cumin), exhibited inhibitory effects on cell proliferation of many cancer cell lines. This study was performed to investigate the anti-metastatic effect of thymoquinone on the pancreatic cancer in vitro and in vivo. The results showed that thymoquinone suppressed the migration and invasion of Panc-1 cells in a does-dependent manner. To investigate the possible mechanisms involved in these events, Western blotting analysis was performed, and found that thymoquinone significantly down-regulates NF-kappaB and MMP-9 in Panc-1 cells. In addition, metastatic model simulating human pancreatic cancer was established by orthotropic implantation of histologically intact pancreatic tumor tissue into the pancreatic wall of nude mice. And administration of thymoquinone significantly reduced tumor metastasis compared to untreated control. Furthermore, the expression of NF-kappaB and MMP-9 in tumor tissues was also suppressed after treatment with thymoquinone. Taken together, the results indicate that thymoquinone exerts anti-metastatic activity on pancreatic cancer both in vitro and in vivo, which may be related to down-regulation of NF-kappaB and its regulated molecules such as MMP-9 protein. Consequently, these results provide important insights into thymoquinone as an antimetastatic agent for the treatment of human pancreatic cancer.

OBJECTIVEDesign and make triple cannula dual-lumen vacuum extractor to improve effect of decompression in operation of intestinal obstruction.

METHODSTriple cannula dual-lumen vacuum extractor was applied in 32 patients who underwent operation of intestinal obstruction from 2012 to 2015 in our hospital. The effect of intestinal decompression and patient prognosis were observed.

RESULTS32 patients that used triple cannula dual-lumen vacuum extractor had good recovery except for one patient abdominal incision with fatty liquefaction. The other patients had one-stage healed without any complication such as intestinal fistula, abdominal infection etc.

CONCLUSIONApplication of triple cannula dual-lumen vacuum extractor in operation for intestinal decompression could avoid contamination of abdomen and injury of intestinal mucosa, which had satisfied effect of intestinal decompression and promoted the effect of operation for intestinal obstruction.

Objective To evaluate the effects of sevoflurane on β-amyloid (Aβ)-induced cognitive dysfunction and oxidative stress response of hippocampal tissues in rats.Methods Ninety-six male adlut SpragueDawley rats,weighing 250-300 g,were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C) ; group Aβ ; 1.3 ％ sevoflurane group (group S1) and 2.6 ％ sevoflurane group (group S2).The animals were anesthetized with intraperitoneal.10％ chloral hydrate 350 mg/kg.Cognitive dysfunction was induced by injecting Aβ1-40 2 μ1 into the bilateral hippocampi in Aβ,S1 and S2 groups.The equal volume of normal saline was given in group C.At 22 days after injection,C and Aβ groups were exposed to 30％ oxygen for 4 h,and S1 and S2 groups inhaled 1.3 ％ and 2.6 ％ sevoflurane,respectively,for 4 h.Eight rats were chosen at days 1,3 and 7 after exposure and cognitive function was assessed by Morris water maze test.The swimming speed,escape latency and exploration time at the original platform quadrant were recorded.The rats were then sacrificed after the end of the behavioral test and blood samples were taken for determination of serum S100β protein concentration.Hippocampi were immediately isolated and the homogenate was prepared for determination of superoxide dismutase (SOD) activity and malondialdehyde (MDA) content.Results Compared with group C,the escape latency was significantly prolonged and exploration time at the original platform quadrant was shortened,the serum S100β protein concentration and MDA content were increased,and SOD activity was decreased at each time point in group Aβ (P ＜ 0.05).There were no significant differences in the variables mentioned above between Aβ and S1 groups (P ＞ 0.05).The escape latency was significantly prolonged and the exploration time at the original platform quadrant was shortened,the serum S100β protein concentration and MDA content were increased,and SOD activity was decreased at each time point in group S2 as compared with Aβ and S1 groups (P ＜ 0.05).There was no significant difference in the swimining speed among the 4 groups (P ＞ 0.05).Conclusion Inhalation of 2.6 ％ sevoflurane for 4 h can aggravate the cognitive dysfunction induced by Aβ in rats and aggravation of oxidative stress response may be involved in the mechanism.

Objective To evaluate the efficacy and safety of adefovir dipivoxil(ADV)in treating patients with hepatitis B e antigen(HBeAg)positive chronic hepatitis B.Methods In this randomized,double blind,placebo-controlled,multicenter trial,210 eligible patients with HBeAg positive chronic hepatitis B were recruited and randomized(randomization ratio was 2:1)receiving ADV 10 mg/d for 48 weeks(ADV+ADV group,n=142)or placebo for 24 weeks followed by ADV 10 mg/d for 24 weeks(PLB+ADV group,n=68).The primary endpoint was virological response. The secondary endpoint was serologic response(HBeAg loss rate and HBeAg seroconversion rate) and alanine aminotransferase normalization rate.Results After 24 weeks therapy,mean reduction of hepatitis B virus(HBV)DNA level comparing with that of baseline was 3.12 log_(10)copy/mL in ADV +ADV group while it was 0.95 log_(10)copy/mL in PLB+ADV group.The percentages of patients with HBV DNA clearance(HBV DNA level

Aged ; Female ; Histiocytoma, Malignant Fibrous ; metabolism ; pathology ; surgery ; Humans ; Immunohistochemistry ; Spleen ; chemistry ; pathology ; surgery ; Splenectomy ; Splenic Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To evaluate the MRI value in changes of mid-urethral ligament injury offemale stress urinary incontinence (SUI).MethodsComparison of MRI changes of mid-urethral ligament on 30 healthy female volunteers and 20 female SUI patients.Chi-square test was used to compare the form of SUI patient's mid-urethral support ligaments Results The female nid-urethral support ligaments were composed of 4 groups of ligaments,including the periurethral ligament and pubourethral ligaments (1 pair),and at both sides of the urethra's paraurethral ligaments (1 pair) and suburethral ligament lying dorsal urethra,connecting the urethra and pelvic arcus tendinous fasciae.In normal MRI,ligament was a thin strip and showed low signal on both T1WI and T2WI,T2WI sagittal and cross-section scan was the best combination to show the middle urethral support ligaments changes,with tension;6 patients (20％) in the 30 patients normal control group could be seen tortuously and slack like around the urethra ligaments.Twenty SUI patients mid-urethral support ligaments were performance laxity or rupture,rates were 39％ (47/120) and 42％ (50/120) (x2 =43.191,P ＜ 0.05 ).On T2WI,the ligamentous laxity was floating,and losstension,also could performance one side extension and thinner than the other side.The ligament rupture was performance of the signal interruption,ligament contracture and one end of liganent attachment points separation.ConclusionMRIcanobjectiveeffectiveevaluatethemid-urethralsupportligaments' pathological changes in stress urinary incontinence patients.

In recent years, non-viral gene vectors have attracted great attention for efficient gene delivery due to the advantages, including low toxicity, low immunogenicity and simple preparation. Polyethylenimine (PEI) is one of the typical non-viral gene carriers that have been widely utilized for gene delivery owing to its superior capabilities in gene compression and buffering capacity. This article discusses the processes of gene delivery and the barriers of PEI-based carrier during the gene delivery, such as low biocompatibility, cytotoxicity, lack of specific targeting and insufficient gene release, etc. Therefore, we summarize the multiple approaches for the modifications of PEI in terms of improved biocompatibility, degradability, specific targeting and buffering capacity. Furthermore, we also review on the recent impressive progresses of smart stimuli-responsive PEI carriers, including endogenous stimuli (pH, reactive oxygen species, glutathione, biomolecular, etc), exogenous stimuli (light, temperature, magnetic field, etc) and dual-responsive strategies, which might provide guidance for the development of more efficient and safer non-viral gene vectors.

Objective To observe the characteristic changes in cardiac function and to raise diagnostic accuracy and sensibility.Methods 39 silent myocardial ischemia and 58 angina and 46 age-matched healthy subjects and 62 obsolete myocardial infarction underwent myocardial tomography imaging and gated ventricular imaging.Covariance analysis was used to compare difference between SPECT imaging and parameters of function.The age was tested as covariate factor,then SNK-Q test and multiple comparison were carried on.Results The silent myocardial ischemia and angina showed reversible radioactive defect or fixed defect.Most of myocardial SMI showed single peak exempt TPFR.EF,PFR and PER showed remarkably statistical difference (P<0.01).The multiple comparison of PFR and PER was increased according by OMI,AN,SMI and negative control group (P<0.05).Conclusions The myocardial damage and PFR,PER in SMI is lower than that in AN group,which have no remarkably influence on the parameters of diastolic and retractile function in left ventricular.

Objective To explore the risk factors of severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,and antimicrobial drug resistance among these isolates.It may help to prevent and control the disease and promote to rational use of antibiotics.Methods We conducted the case-control study in our PICU.It included 89 patients with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia as case group and 68 patients with severe pneumonia caused by Klebsiella pneumonia as control group during the same period.To compare the two groups on irrationality use of antibiotics (especial for third generation cephalosporin),length of stay,tracheal cannula,time of mechanical ventilation and underlying conditions (malnutrition,congenital heart disease,heredity and metabolic disease).Antimicrobial susceptibilities among 89 multi-drug resistant Klebsiella pneumonia isolates were analyzed.Results There were 63 cases (70.79％) for irrationality use antibiotics in case group,while there were 27 cases (39.70％) in control group (P ＜ 0.01).The cases for length of stay over 7 days in case group (48 cases,53.93％) were more than those cases with the same situation in control group (12 cases,17.65 ％) (P ＜ 0.01).Thirty-eight cases (42.69 ％) needed mechanical ventilation therapy in case group,while 16 cases (23.53％) needed mechanical ventilation therapy in control group (P ＜ 0.01).The cases for duration of mechanical ventilation over 5 days in case group (18 cases,20.22％) were more than those cases in control group (5 cases,7.35％) (P ＜0.05).The cases with underlying disease in case group (13 cases,14.61％) were more than those cases in control group (2 cases,2.94％) (P ＜ 0.05).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to carbapenems.Conclusion Several risk factors are associated with severe pneumonia caused by multi-drug resistant Klebsiella pneumonia,including irrational use of antibiotics (especial for third generation cephalosporin),long term of length of stay,endotracheal intubation,long term of mechanical ventilation,and having underlying disease (malnutrition,congenital heart disease,heredity and metabolic disease).Multi-drug resistant Klebsiella pneumonia isolates demonstrated that high-level resistance for penicillins,cephalosporins,aminoglycosides and quinolones,but still susceptible to Carbapenems.Carbapenems should be used as first-line drugs for severe pneumonia caused by multi-drug resistant Klebsiella pneumonia.