Objective To investigate the clinical efficacy of laparoscopic hepatectomy.Methods The clinical data of 258 patients who received laparoscopic hepatectomy at the First Affiliated Hospital of Fujian Medical University from March 2010 to January 2013 were retrospectively analyzed.There were 196 patients with primary hepatic cancer,45 with hepatic hemangioma,13 with hepatic focal nodular hyperplasia,2 with hepatic metastatic cancer,1 with carcinoma of gallbladder and 1 with hepatic hamartoma.All patients were followed up via phone call or out-patient examination till March 2013.Results A total of 142 patients received single hepatic segmentectomy,98 received multiple hepatic segmentectomy,18 received multiple lesions resection.Fifty-one patients received hepatic tumorectomy + cholecystectomy.All the operations were successfully done under laparoscope without conversion to the open surgery.The mean tumor diameter and the operation time were (5 ± 3) cm (range,1.0-11.5 cm) and (113 ± 56) minutes (range,50-310 minutes),respectively.Intraoperative hepatic portal occlusion was performed on 122 patients,and the time for hepatic portal occlusion was (15 ± 7)minutes.The volume of intraoperative blood loss was (211 ± 195)mL (range,10-650 mL),and blood transfusion was not needed.The capsule of the tumor was complete.The distance between the resection margin and the malignant tumor was above 1.5 cm,and there was no residual tumor in the resection margin.The hepatic function was back to the normal level in 1 week after the operation,and no patient had hepatic failure.The duration of postoperative hospital stay was (7.2 ± 1.3)days (range,5-10 days).One patient was complicated with bile leakage,6 with slight peritoneal effusion,and other patients had no postoperative complications.The rate of follow-up was 91.47％ (236/258),and the time of follow-up was (16 ± 10) months.A total of 199 patients with malignant hepatic tumors were followed up.During the follow-up,180 patients had tumor-free survival; 18 patients had postoperative tumor recurrence; 1 patient had omental metastasis and received surgical resection.Thirty-seven patients with benign hepatic tumor survived without complication during the follow-up.Conclusion Laparoscopic hepatectomy is effective for the treatment of hepatic tumors.Multiple hepatic inflow occlusion under laparoscope in a short time may improve the safety of surgery,without prolonging the recovery time of patients.

Objective To explore the application and efficacy of one-stage gastric transposition in long-gap esophageal atresia.Methods 11 patients of long-gap esophageal atresia who received one-stage gastric transposition treatment from March 2008 to December 2013 were analyzed.8 male and 3 female babies were included in the study.The diagnosis was made based on esophageal radiography.And there were 2 cases of type Ⅰ and 9 cases of type Ⅲ a.Results All procedures were completed,9 cases were cured,1 case died and 1 case refused further treatment after operation.6 cases developed pneumonia postoperatively,2 cases had signs of stoma leakage.All cases were followed up for 6 months to 5 years.3 cases had anastomotic stricture and they were cured by balloon dilation.6 cases had mild gastroesophageal reflux but no anti-reflux procedure was needed.And gastroesophageal reflux symptoms were improved by smaller meals and appreciate the feeding treatment.Conclusion One-stage gastric transposition is feasible and acceptable in treating long-gap esophageal atresia in neonates,it can avoid staging operation,shorten the treatment period,and help to improve the cure rate.

Objective To explore the differences in maternal and neonatal complications of twin pregnancies in different modes of conception.Methods Retrospective analysis was performed to compare the differences in mother's gestation history,childbirth and neonatal complications among 102 cases of in vitro fertilization-embryo transfer(IVFET) pregnancy twins,16 cases of simple ovulation induction(OI) pregnancy twins and 96 cases of spontaneous conception(SC) pregnancy twins.Results 1.The maternal age[(32.51 ±4.03) years vs (31.25 ±3.38) years vs (30.20 ± 4.13) years,F =8.061,P ＜ 0.05] and birthrate of full-term infants (21.5 ％ vs 0 vs 10.4％,x2 =7.566,P ＜ 0.05) of IVF-ET group were significantly higher than that of OI group and SC group.The body weight at birth of OI group was significantly lower than that of IVF-ET group and SC group [(1 918.1 ±516.4) g vs (2 228.3 ±4542) g vs (2 164.4 ±442.5) g,F =3.293,P ＜0.05].The birthrate of late preterm infant(87.5％ vs 51.0％ vs 64.6％,x2 =9.322,P ＜ 0.05) and the incidence of twin discordance (50.0％ vs 21.6％ vs 18.8％,x2 =7.781,P ＜ 0.05) of OI group were significantly higher than that of IVF-ET group and SC group,while the incidence of monozygotic twins of SC group was significantly higher than that of IVF-ET group and OI group(52.1％ vs 5.9％ vs 0,x2 =58.016,P ＜ 0.05).2.The incidence of pregnancy induced hypertension of OI group was significantly higher than those of IVF-ET group and SC group(50.0％ vs 17.6％ vs 22.9％,x2 =8.344,P ＜ 0.05).The incidence of gestational diabetes mellitus of OI group and spontaneous group was significantly higher than that of IVF-ET group(12.5％ vs 14.6％ vs 3.9％,x2 =6.838,P ＜0.05).3.The incidence of twin transfusion syndrome of SC group was significantly higher than that of the other groups(6.3％ vs 0 vs 0,x2 =7.588,P ＜0.05),but the incidence of apnea of prematurity of OI group was significantly higher than that of IVF-ET group and SC group(43.8％ vs 15.7％ vs 24.0％,x2 =7.081,P ＜0.05).The incidence of asphyxia,transient tachypnea of the newborn,hypoglycemia,intracranial hemorrhage and septicemia of OI group were higher than that of IVF-ET group and SC group,but there was no significantly difference among 3 groups.Conclusions IVF-ET conceived twin pregnancies are not at greater risk for pregnancy complications and adverse perinatal outcome than SC twin pregnancies.But the incidence of some adverse maternal and neonatal complications of simple OI twin pregnancies is higher than that of IVF-ET group and SC group.More attention should be paid to the perinatal health care of OI conception twins,which is important to avoid serious complications.

Objective:To evaluate the changes of urinary and sexual function after pelvic autonomic nerve preservation with total mesorectal excision operation in patients of rectal cancer . Methods:Fifty-two patients of Dukes B stage received The PANP following TME with follow-up was complete in 38 cases while TME in 35 cases of Dukes B from January 2004 to August 2006. The urinary and sexual dysfunctions of patients in case and control group were analyzed retrospectively by case-control study. Urinary and sexual function were evaluated by means of questionnaires before and after operation.Results:The micturation dysfunction rate was 15.7%(6/38) and 40%(14/35) ,the sexual dysfunction rate was 18.4%(7/38) and 51.4%(18/35)in case and control group respectively,with the difference being significant(P=0.013,P=0.002).Conclusion:The PANP following TME for rectal cancer could reduce sexual and micturition disorder rate and improve the quality of life of the patients after operation.

Objective To determine the relationship between brachial-ankle pulse wave velocity(baPWV)and Rho associated coiled coil protein kinase(ROCK)activity with the cardiovascular disease(CVD).Methods 168 patients with CVD were divided in-to the CVD group(123 cases)and the non-CVD group(45 cases)based on the results of coronary angiography.The baPWV value and the ROCK activity were detected.The CVD group were subdivided into the single vessel,double vessels and multiple vessels le-sions groups.Results The baPWV value and ROCK activity in the CVD group were significantly higher than those in the non-CVD group(P<0.05).The more the lesion vessels,the higher the baPWV value(P<0.05).Conclusion The baPWV and ROCK activi-ty are associated with CVD.Therefore,the combined measurement of baPWV and ROCK levels could be used to assess CVD and its risk degree.

Objective To find the frequencies of FcγRIIIA polymorphisms in Chinese people and the potential role of these polymorphisms(SNPs) in systemic lupus erythermatosus(SLE) and lupus nephritis(LN).Methods The investigation covers 324 unrelated Chinese SLE patients and 319 controls.FcγRIIIA F158V polymorphism was genotyped by specific primer-polymerase chain reaction(PCR).Results The frequency of F allele of FcγRIIIA polymorphism is 60.8% in Chinese people.FcγRIIIA polymorphism revealed a significant difference of both genotype and allele distribution in SLE patients and controls.LN patients have a significant increase in carrier frequency of the FF genotype, while the VV genotype reveals a significant decreased risk of early onset of LN.ConclusionsFcγRIIIA polymorphisms is potentially related with SLE in Chinese people.The homozygous FF genotype of FcγRIIIA might be the risk factor for LN, while the homozygous VV genotype might be the protective factor for late onset lupus nephritis.

Objective To observe the role of chronic inflammation in the development of atherosclerosis (AS) by analyzing the expression of TLR4 and NF-κB in artery endothelium. Methods To construct the atherosclerotic animal model, the balloon catheter was used to injure common carotid artery and rabbits were fed the high cholesterol diet. All the rabbits were divided into three groups: control group with the normal diet, high cholesterol diet-fed group and model group (balloon-injured common carotid artery and the high cholesterol diet fed rabbits). The rabbits were sacrificed after 8 weeks and their tissues were collected. Then morphological changes of rabbit common carotid artery were observed by light microscope. The expression of TLR4 and NF-κB in endarterium was displayed using immunochemistry method. Results Both hyperlipidemia and exterior inflammatory stimulation promoted the expression of TLR4 and NF-κB in vascular endothelium (P ＜ 0.01 ). And when both of them were present, the level of TLR4 and NF-κB expression would get higher even than that affected by one of them( P ＜ 0.01 ). Conclusion Both hyperlipidemia and chronic inflammatory process can improve the expression of TLR4 and NF- κB in vascular endothelium in different degree; the inflammatory stimulation would promote the atherosclerosis to some extent; TLR4/ NF-κB would play a role as a bridge between the internal environment changes and the arterial morphological changes.

Objective To investigate the predictive value of serum lactate combined with PIRO (Predisposition,Infection,Response and Organ dysfunction) score in the development of multiple organs dysfunction syndrome (MODS) in septic patients and to study procalcitonin (PCT),in order to provide guidelines for clinical care.Methods From April 2015 to July 2016,a total of 752 sepsis patients were enrolled and divided into MODS group (n =488) and non-MODS group (n =264) according to the criteria of MODS.At 28 d after admission,these patients were divided into survival group (n =477) and death group (n =275).PCT and lactate levels in serum were measured,and PIRO score of these patients was calculated.Then the differences in levels of PCT and lactate in serum were compared among patients at different PIRO score categories.ROC was constructed to observe the clinical values of the biomarkers,PIRO score and lactate combined with PIRO score in predicting prognosis.Result PCT,lactate levels in serum and PIRO score were significantly higher in MODS group and death group,showing significant positive correlation.The areas under ROC curves (AUCs) of serum lactate combined with PIRO score for predicting MODS were 0.906,which was significantly higher than that of serum PCT (0.716),serum lactate (0.851) and PIRO score (0.840) alone (all P ＜ 0.05).Serum PCT,serum lactate and PIRO score were the independent predictors of MODS.Conclusions Serum lactate in combination with PIRO score was a valuable indicator in predicting development of MODS in septic patients.

Objective To study the mechanism of miR-548a-3p targeting MMP-2 inhibits the metastasis and invasion of gastric cancer cells.Methods Bioinformatics were used to search those miRNAs targeting MMP-2.The level of miR-548a-3p in gastric cancer tissues were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.The level of miR-548a-3p in three reconstructed gastric cancer cell lines were detected by qRT-PCR and the expression of MMP-2 were detected by Western blot.miR-548a-3p targeting the 3'-UTR of MMP-2 were detected by Luciferase reporter assay detected.And the changes of ability of metastasis and invasion were examined by Transwell experiment before and after transfection.Results There were high expression of miR217 and low expression of MMP-2 in human poorly differentiated gastric cancer cell line BGC-823.There were low expression of miR-548a-3p and high expression of MMP-2 in human middle and high differentiated gastric cancer cell line MKN-28 and SGC-7901 (P ＜ 0.05).The result of Luciferase reporter assay showed that miR-548a-3p can targeting the 3’-UTR of MMP-2.There were high expression of miR-548a-3p and low expression of MMP-2 in MKN28-miR-548a-3p mimics.There were low expression of miR-548a-3p and high expression of MMP-2 in others reconstructed three cell lines.There were smaller invaded cells in SGC-7901-miR-217 mimics than in others three cell lines (P ＜ 0.05).Conclusions miR-548a-3p can target the 3'-UTR of MMP-2 and down regulate its expression and inhibit the ability of invasion of gastric cancer cells.