ObJective To study the effects of flurbiprofen axetil preemptive analgesia on T cell immune functions in postoperative patients with upper abdominal.Methods Seventy-six patients with upper abdominal operation were divided into observation group (40 cases) and control group (36 cases) by random digits table,observation group and control group were given intravenous injection of 100 mg flurbiprofen axetil or 10 ml 0.9％ sodium chloride 10 min before skin incision respectively.Peripheral venous blood samples were collected for the determination of CD4+,CD8+,natural killer cell (NK cell) and CD4+/CD8+ by flow cytometry 1 day preoperative,2 and 48 h postoperative.Results In two groups,the CD8+ and NK cell of 2 h postoperative were lower significantly than those of preoperative (observation group:0.1850 ±0.0550 vs.0.2430 ±0.0856,0.1197 ±0.0673 vs.0.1598 ±0.0775；control group:0.1219 ±0.0571 vs.0.2385 ±0.0847,0.0778 ± 0.0311 vs.0.1621 ± 0.0806,P ＜ 0.05),however,the observation group was significantly higher than the control group (P ＜ 0.05).There was no significant difference in CD4+,CD8+ and NK cell of 48 h postoperative between two groups.Conclusion There are disorders on the T cell immune functions in postoperative patients with upper abdominal,but flurbiprofen axetil preemptive analgesia can improve the T cell immune function.

Objective To evaluate activity alteration of the pancreatic tissue phospholipase A 2 (PLA 2) and the therapeutic effects of verapamil in acute pancreatitis (AP) rats. Methods After the model of AP in the rat was established by the closed duodenal loop technique, the changes of PLA 2 activity were observed, and the pancreatic histology was examined by light and electron microscopy. Results At 16 and 24 hours after induction of AP in rats, significant inhibition of PLA 2 avtivity in pancreatic tissue was shown in the treated group (32.34?3.87, 35.26?4.52) as compared with AP group (44.83?5.31,47.77?5.86). The treated animals also showed decreasing in the severity of pancreatic pathology. Conclusions In AP rats exist high activity of PLA 2. Verapamil, a calcium channel blocker, might have therapeutic effects on AP by inhibiting the activity of PLA 2.

Objective To investigate the diagnosis and treatment of pseudotumorous pancreatitis. Methods A retrospective clinical analysis was made on 20 cases with pseudotumorous pancreatitis in one stage from 1983.7 to 2004.5. Resulds There were 14 males and 6 females. Jaundice and abdominal pain were the major complaints. 17 cases underwent surgery, including cholangiojejunum Roux-en-Y anastomosis in 11cases, pancreatoduodenectomy in 3 cases, laparotomy and biopay in 3 cases . 3 cases underwent US-guided needle biopsy. All the 15 cases who were followed up had no jaundice at all after operation and abdominal pain relief was achieved to various degree. Conclusion It's difficult to diagnose pseudotumorous pancreatitis before operation. Hepatojejunal Roux-en-Y anastomosis was suitable for the patients with obstructive jaundice. When refractory abdominal pain was encountered or intraoperative pathologic diagnose was diffcult, pancreaticoduodenectomy should be recommended.

Objective To analyze the clinical characteristics of hospital acquired mycotic pneumonia in elderly patients (aged≥ 80 years).Methods The clinical data were reviewed on 64 cases of elderly patients aged 80-93 years with hospital-acquired infection of mycotic pneumonia from June 2007 to July 2011.According to the results of sputum culture,therapy plan was made and antibiotic drugs were selected.Results Among these 64 patients,Candida mycoderma (62.5 ％,40 cases) occupied the first place and C.glabrata (20.3％,13 cases) was the second place (x2 =127.50,P＜0.01).Their chest x-ray or CT films were not characteristic,but lamellar shadows (68.8％,44cases) and cotton-like shadows (40.6 ％,26 cases) were found in the majority.60 cases (93.8 ％ ) of these patients had more than 3 complications,and 58 cases (90.6％) of them took over 2 kinds of antibiotics.The improvement rate of these patients was 81.3％ (52 cases)and mortality rate was 18.8％(12 cases).Conclusions Elderly patients (aged≥ 80 years) with hospital acquired infection of mycotic pneumonia have high incidence and mortality rate.The key point to cure is to make an early diagnosis and treat them as early as possible.

ObjectiveTo observe the clinical effect of acupoint application on lipid metabolism in elderly diabetics with hyperlipidemia.Methods60 elder diabetics were divided into two groups.In the drugs group,patients were purely treated with simvastatin or lipanthyl.In the acupoint group, patients received acupoint application.The serum total cholesterol(TC), triglyceride (TG), low-density lipoprotein (LDL-C), high-density lipeprotein (HDL-C), aPoprotein A(ApoA) and apoprotein B(ApoB) ere measured respectively.Adverse events were observed.ResultsThe levels of TC、TG、LDL-C、ApoB were significantly dechned(all P ＜0.01 ～0.05).However,the rates of reduce lipid had no significant difference in two groups(P ＞0.05).The levels of HDL-C and ApoA were increased in the drugs group,but the homologous levels in the acupoint group showed no significantly change(all p ＞ 0.05).The adverse reaction in the acupoint group was significantly lower than that in the drugs group(P ＜0.05).ConclusionAcupoint application could decrease the blood lipid spectrum in the senile diabetics with hyperlipidemia.This therapeutics could reduce adverse drug reactions.

Objective To assess the surgical treatment of iatrogenic biliary strictures. Methods The clinical data of 235 patients with iatrogenic biliary injuries and strictures who had been admitted to our hospital from January 1989 to December 2006 were reviewed retrospectively. Cholangio-jejunal Roux-en-Y anastomosis (n=182), surgical repair with pediele flap of autogenous tissues (n=34), end-to-end choledocho-choledo-chostomy (n= 12), common bile duct incision and figuration +T-tube drainage ( n =6) and liver transplanta-tion ( n = 1 ) were applied to the patients. Results A total of 189 patients were followed up for 1 to 10 years. The total excellent and good rate was 94.7% (179/189). The recurrence rate of the biliary stricture was 5.3% (10/189), and the main cause of which were biliary cirrhosis, selerosing cholangitis and calculus. One patient with severe biliary cirrhosis and portal hypertension died of liver failure postoperatively. Conclusions The cholangio-jejunal Roux-en-Y anastomosis is a reliable and effective method. Surgical repair of the bile duet with pedicle flap of autogenous tissues could preserve the function of the sphincter of Oddi, but the long-term effect needs further investigation. Biliary stent is not usually necessary to install. Liver transplantation is efficient for the patients with end stage of biliary diseases caused by biliary stricture.

Objective To compare the efficacy of urinary type Ⅳ collagen( Ⅳ C), N-acetyl-β-D-glucosaminidase( NAG ), serum cystatin C ( CysC ), β2 microglobulin ( β2-MG ) in early diagnosis of diabetic nephropathy(DN) ,and to develop a multiple regression equation using above mentioned indices. Methods One hundred and eight cases of DM patients were enrolled in the study. All those DM patients were divided into two groups according to 24 hr urinary albumin excretion(UAE): non-DN group( UAE ＜30 mg/24 h)and DN group (UAE ≥30 mg/24 h). Receiver operating characteristics (ROC)curve was developed using urinary IVC, NAG,serum CysC and β2-MG,and the efficiency of the four indices for early diagnosis of diabetic nephropathy were assessed by area under the curve ROC (AUCROC). Furthermore, the regression equation of four indicators was developed. All statistical analyses were performed using SPSS 13.0. Results The levels of urine Ⅳ C, NAG,CysC,β2-MG,were(3.91±1.93)ng/ml, ( 12.20 ±3.46)U/L, ( 1.18 ±0.41 )mg/L , (2. 50 ±0. 74)mg/ml in the non-DN group, respectively; and ( 14.14 ± 11.17 ) ng/ml, ( 23.12 ± 13.57 ) U/L, ( 2.69 ± 1.69 ) mg/L and(5.21 ± 2.78)mg/ml in the DN group, respectively. There were significant differences in the comparison of the four indicators between the two groups ( Ps ＜ 0.01 ). AUCROC of Ⅳ C, NAG, CysC and β2-MG were 0. 747,0.732,0.764 and 0.823 respectively;which meant the diagnostic efficacy for DN decended from β2-MG, CysC,Ⅳ C, to NAG in order. All these indices showed significant efficiency in assisting diagnosis of early DN ( Ps ＜0.01 ). The regression equation of UAE and the four indices was: UAE = - 242.624 + 6.362IVC + 8.662NAG + 64. 622CysC + 29.488β2-MG, and the equation had statisticl significance( P ＜ 0.O1 ). Conclusion Urine Ⅳ C, NAG,serum CysC, and β2-MG showed significant value in assisting diagosis of early DN, and could be sensitive indices for DN.

Objective To study the clinical significance of urinary type Ⅳ collagen(IVC)and UmAlb/UCr ratio in the diagnosis of early diabetic nephropathy. Methods We collected 52 cases of diabetes(group A)without DN(UAE ＜30 mg/24 h),35 cases of diabetes(group B)with early DN(UAE as 30-300 mg/24 h),and 50 cases of healthy controls. The differences of urine IVC,UmAlb/UCr were compared among group A,B and the control group. ROC curve was used for evaluating the use of urine IVC and UmAlb/UCr in the diagnosis of early DN. The correlation of urine IVC and UmAlb/UCr with UAE were investigated,and linear model curve were established. IVC in urine was detected by chemiluminescence,UmAlb was detected by immunoturbidimetric assay,UCr was detected by enzymatic. Statistical analysis were performed with SPSS13.0 statistical software. Results The urine IVC testing of group A,B and the control group were(2. 64 ± 0. 91),(3.91 ± 1.93)and(10. 08 ± 6. 50)μg/L,respectively. The UmAlb/UCr(mg/mmol)testing of group A,B and the control group were(1.50 ± 0. 40),(2. 58 ±2. 10)and(17.95 ± 13. 38)mg/mmol,respectively. Urine IVC and UmAlb/UCr were significant difference between group A,B and the control group(Ps ＜ 0. 01);the ROC area under the curve(AUCROC)of urine IVC and UmAlb/UCr were 0. 724,0. 945,the two indicators for early diagnosis of DN were significant(Ps ＜ 0. 01);The pearson correlation coefficients of the urine IVC and UmAlb/UCr were 0. 529,0. 919 ,respectively. They were positive and significant correlation(Ps ＜ 0. 01),On the basis of the correlation coefficient and linear model fitting curve with the UAE,the relationship of UmAlb/UCr with the UAE was better than that of IVC. Conclusions Urine IVC and UmAlb/UCr ratio,which significantly assists diagnosis in diabetic nephropathy ,can be used as a sensitive diagnostic indicator of diabetic nephropathy. Moreover,the relationship of UmAlb/UCr with the UAE is better than that with IVC.

Objective To reduce the animal component contamination for human embryonic stem cells ( hESCs ) and to simplify hESCs culture process , we develop a new coating substrate which can support the hESCs growth without dif -ferentiation, and is easy to store and use. Methods Mouse embryonic fibroblasts(MEF)were fixed on the surface of plate by methanol.hESCs were cultured on this new substrate and were passaged every 5 to 6 days.After 10 passages, we checked the cell morphology , alkaline phosphatase expression , embryonic specific markers and the differentiation ability in vitro.Results After 10 passages , the hESCs grew well on this new substrate and maintained the typical hESCs morpholo -gy.Alkaline phosphatase staining was positive .Immunofluorescence staining showed that the expressions of Oct 4, SSEA4, Tra-1-60 were positive .The cells formed embryoid body in vitro .Conclusions This methanol-fixed MEF substrate can support the growth of undifferentiated hESCs .The coating material can be produced in large scale and stored for a long time.It provides a new and relatively easy way to amplify hESCs .

Objective To analyze the expression of T lymphocyte activation antigen in peripheral blood of aged patients with non-small cell lung cancer . Methods The lymphocytes from peripheral blood in 45 aged patients with non-small cell lung cancer were immunologically labeled in double fluorescence and CD3-FITC, CD25/HLA-DR and CD69-PE and determined by flow cytometry. Normal aged donors, young patiens with lung cancer and aged benign lesion group were used as controls. Results Peripheral blood CD3 +/CD25 +, CD3 +/HLA -DR + and CD3 +/CD69 + in T lymphocyte with 45 aged lung cancer(7.24?1.85,28.46?5.39 and 7.78?2.63, respectively) were significantly lower than those in normal aged controls(10.35?2.54,37.16?5.51,11.02?2.18, respectively)and aged benign lesion (9.53?3.02, 35.33?5.23, 10.67?2.45, respectively)( P 0.05). Significant differences were found among them in stages Ⅲ, Ⅳ(7.15?1.13, 25.32?5.23, 7.14?2.81, respectively) and stagesⅠ,Ⅱ(8.06?1.21, 30.27?6.05, 8.43?2.67, respectively)( P 0.05). Conclusions Detection of CD3 +/CD25 +, CD3 +/HLA -DR + and CD3 +/CD69 + levels by flow cytometry might be helpful for reflecting the human immune function and the prognosis evaluation in patients with aged non-small cell lung cancer.