Objective To explore the damage of intestinal mucosal barrier caused by vinegar retention enema, and compare the degree of injury in intestinal mucosal barrier between isotonic vinegar and traditional hypertonic vinegar treat-ment. Methods Sixteen adult rabbits were randomly divided into two groups. The solution of vinegar mixed with normal so-dium was given to hypertonic group. Isotonic group was administered with isosmotic solution made of vinegar and double dis-tilled water, with the same volume fraction and pH as hypertonic group. Then two different osmosis solutions were given as enema solution to rabbits under the same condition. Finally, damages of intestinal mucosa were observed by light microscope and transmission electron microscope (TEM) in two groups. Results It was observed that injuries of rectum and distal part of colon were more severe in hypertonic group than those of isotonic group through light microscope. Besides, cell structures were morphologically normal, with in-line microvilli and intact tight junction in isotonic group. In hypertonic group, microvil-li of intestinal cells decreased or disappeared, the cell junction is widened, and cell apoptosis and necrosis were found through TEM. Conclusion Results showed that isotonic vinegar had less damage to mucosa. Consequently, isotonic vinegar can be considered as enema solution for hepatic encephalopathy to avoid damage by osmosis in clinic.

The effects of E-cadherin-transfected neural stem cells (NSCs) transplantation for spinal cord injury (SCI) in rats were investigated. Sixty SD rats were randomly divided into model control group, NSCs group, empty plasmid group and E-cadherin overexpression group (n=15 each). The animal SCI model was established by using the modified Allen's method. NSCs were cultured. Rats in NSCs group were subjected to NSCs transplantation. E-cadherin gene eucaryotic expression vector and pcDNA3.1-E-cadherin were respectively transfected into cultured NSCs, serving as empty plasmid group and E-cadherin overexpression group respectively. At 7th day after transplantation, neurological function of all rats was assessed by Tarlov score. After rats were sacrificed in each group, the number of BrdU and Nestin positive cells was counted by immunohistochemistry. Immumofluorescence method was used to detect the expression of neurofilament protein (NF) and glial fibrillary acidic protein (GFAP). As compared with model control group, the Tarlov score and the number of of BrdU and Nestin positive cells, and the expression of NF and GFAP in NSCs group, empty plasmid group, and E-cadherin overexpression group were increased significantly (P<0.05), and those in the E-cadherin overexpression group were increased more significantly than the other transplantation groups (P<0.05). It was suggested that E-cadherin could be conductive to nerve regeneration and repair probably by promoting the proliferation and differentiation of NSCs.

Objective To investigate the efficacy of relaparoscopic common bile duct exploration in choledocholithiasis.Methods 50 patients who underwent LC/OC/LCBDE/OCBDE for biliary surgery with choledocholithiasis were randomized into two groups:Group A (n ＝25) laparoscopic approach and Group B (n =25) open approach.The operation time,hospital stay,cost of hospitalization and postoperative complications were compared.Results There was no significant difference in the operation time,liver functional index,postoperative bile leakage rate and cost of hospitalization between the two groups.The postoperative hospital stay in group A was shorter than that in group B (7.1 ± 1.5 vs 12.4 ±4.3 days,P ＜0.05),as was the volume of intraoperative blood loss (58.3 ± 24.2 ml vs 108.6 ± 35.7 ml,P ＜ 0.05),recovery of gastrointestinal function (26.3 ±3.6 vs 58.2 ±6.3 hours,P ＜0.05),postoperative analgesia (7/25 vs 17/25,P＜0.05) and wound infection rate (1/25 vs 6/25,P＜0.05).Conclusions Relaparoscopic commonbile duct exploration for recurrent choledocholithiasis appeared to be a safe,feasible,and efficacious procedure when carried out by expert laparoscopic surgeons.The procedure is worth promoting.

OBJECTIVE:To improve the drug turnover rate and the work efficiency of drug storehouse,and to reduce the cost of drug storage. METHODS:Based on ABC dynamic classification,original drug procurement management module in HIS was im-proved. Scientific,accurate and reasonable drug procurement plan was generated by the system automatically through setting pro-curement proportion coefficient. Drug procurement by type was achieved through adding classification scanning function,based on distribution mode and drug property classification. Related index were compared before and after improvement to evaluate the ef-fects of the improvement. RESULTS:Compared with before improvement,average monthly inventory amount of drugs in our hos-pital reduced by 6.44%,turnover rate increased by 47.13%(increasing from 4.18% to 6.15%),and the time for developing pro-curement plan decreased by 75.00%(decreasing from 8 h to 2 h). CONCLUSIONS:The improvement of drug procurement man-agement module effectively reduce drug inventory and improve turnover rate of drugs and work efficiency.

BACKGROUND:In recent years, pedicle internal fixation, spinal canal decompression and bone graft fusion have been used in the treatment of degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis and have achieved good results, which increase the fusion rate. However, there is a large difference between the therapeutic effects of different surgical methods. OBJECTIVE:To contrast the repair effect of posterior and transforaminal lumbar interbody fusion on degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis. METHODS:Forty patients with degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis were enroled, including 11 males and 29 females, aged 56-74 years. Al patients received the combined treatment of pedicle internal fixation, spinal canal decompression and bone graft fusion. The 19 of 40 patients received posterior lumbar interbody fusion and the rest 21 patients underwent transforaminal lumbar interbody fusion. Al the patients were folowed up for 6 months after treatment, and the visual analog scores, Oswestry function index, bone fusion rate, lumbar function score and complication occurrence were analyzed and
compared between the two groups. RESULTS AND CONCLUSION:The visual analog scores and Oswestry function index were both improved significantly in the two groups at 6 months after treatment (P < 0.05). No difference was found in the bone fusion rate, visual analog scores and Oswestry function index between the two groups. But compared with the posterior lumbar interbody fusion group, the lumbar functional recovery and incidence of complications were better in the transforaminal lumbar interbody fusion group (P < 0.05). These findings indicate that both posterior and transforaminal lumbar interbody fusions for degenerative lumbar spondylolisthesis complicated by lumbar spinal stenosis can achieve good results in the bone fusion rate, and however, the transforaminal lumbar interbody fusion is better to protect the nerve root and dural sac and to promote lumbar functional recovery.

Objective To investigate the clinical features of patients with brucellosis in Fujian Province and to update the relevant physician's knowledge on brucellosis.Method Retrospective analysis of the epidemiological,clinical,laboratory,imaging,treatment and outcome data of 7 patients with brucellosis were carried out in Fujian Medical University Union Hospital between January 2011 and July 2015.Results Of the 7 patients with brucellosis,6 were males and 1 was female aged between 29 to 61 years old,and 6 cases had a history of contact with goat.The main clinical presentations were repeated limb pain in 6 cases,6 patients got fever,4 cases with hepatomegaly,6 cases splenomegaly,and 7 cases lung inflammation.Hematology examination results indicated that 4 cases were normal,1 case decreased and 2 cases increased in white blood cells.Six cases had a liver dysfunction and 4 cases with low albumin level.All patients were detected positive of Malta Brucella by blood culture or bone marrow culture.In 6 cases and 4 cases out of the 6 cases,splenomegaly and hepatomegaly were found through B ultrasonography,respectively.After treatment of the 7 cases by doxycycline combined with minocycline rifampicin,3 cases were recovered,2 cases were relapsed,and 2 cases were improved.Conclusions The clinical symptoms are typical in these brucellosis patients.What we need to do is focus on improving the clinical and related physician's awareness of brucellosis,collecting a comprehensive history,choosing suitable assistant examinations based on the conditions of patients,strengthening the contact between clinical departments and auxiliary departments,and timely diagnosis.

OBJECTIVE:To guarantee the reliability of cold chain drug storage device and the quality of the drugs in the hospi-tal. METHODS:The establishment and effects of drug cold chain monitoring platform in our hospital were introduced as well as re-lated improvement and measures. RESULTS:The cold chain monitoring platform was established in our hospital through equipping with related equipment, constructing platform network, determining monitoring point, setting early warning condition, etc. All-weather and real-time monitoring of temperature and humidity were realized for different districts of the hospital and different cold chain equipments. The platform could provide the information about operating condition of equipment,and complete drug re-frigeration temperature record;equipment failure could be dissolved in time based on early warning message. Through analyzing rea-sons of early warning message,the unqualified equipment was updated in time,which further improve the system and procedure of cold chain monitoring platform. Within 2 years after the implementation of the platform,53 sets of special refrigerator for drug were updated. Monthly early warning message and the rate of refrigeration equipment early warning decreased from 6869 and 100% in Sept. 2014 at the early stage of short message warning function to 1083 and 40% in Feb. 2016,respectively. CONCLU-SIONS:The establishment of drug cold chain monitoring platform guarantees the reliability of cold drug storage condition so as to ensure the quality of drug in the hospital.

Purpose To investigate the effect of anti-HER-2 engineered antibody chA21 on the angiogenesis in nude mice xenografts of human ovarian cancer SKOV3 cells that overexpresses HER-2.Methods An animal model with SKOV3 cells involved in nude mice was established and the mice were randomized into control group and chA21 group;chA21 was administrated via caudal vein for 5 weeks, meanwhile the same volume of chA21 buffer was injected in control group.The mice were terminated after 5 weeks and the xenografts dislodged,VEGF and DLL4 expression in two groups were quantitatively analyzed by immunohistochemistry on tissue microarray sections combined with a micro-image analyzing system, and microvessel density (MVD) values were compared between the two groups by immunohistochemical staining of CD31.Results The expression of VEGF, DLL4 and MVD values in chA21 group were lower than those in control group (P<0.05).Conclusion chA21 inhibits the angiogenesis of transplantations of human ovarian cancer SKOV3 cells effectively.

Objective To probe the etiology and management of restenosis after artificially grafting bypass for chronic ischemia of the lower extremities. Methods In this study 52 cases suffering from postoperative restenosis and obliteration were compared with 32 cases whose artificial grafts remain patent during the same postoperative follow-up period of 3～62 months.Possible risk factors that lead to restenosis were evaluated.Resuits FIB(4.48±1.68)g/L,CRP(9.5±2.6)mg/L and LDL(4.5±1.7)mmol/L were significantly higher in the restenosis group than FIB(3.50±0.72)g/L,CRP(4.0±3.2)mg/L and LDL(2.8±0.9)mmol/L in the patent group(P＜0.01).There were no significant difference between HDL(1.02±0.32)mmol/L in the restenosis group and HDL(1.12±0.28)mmol/L in the patent group (P＞0.05).Reoperation in these 52 cases found severe intima hyperplasia and secondary thrombosis within anastomosis in 42 cases and the remaining 10 cases were found with artificial vessel primary thrombosis.After reoperation,artificial graft remain patent in 28 cases,limb amputation was performed in 10 cases,the grafted bypass were removed due to infection in 3 cases. Five patients died postoperatively.Conclusion The main reason for restenosis after artificially grafting bypass is intima hyperplasia in vascular anastomosis.Higher levels of FIB,CRP and LDL maybe the major high risk factors that lead to intima hyperplasia and artificial graft obliteration.

ObjectiveTo investigate the effects and mechanism of rosuvastatin on the expression of tissue factor in cultured human monocyte-macrophages cells which was induced by oxidized low density lipoprotein(ox-LDL).MethodsThe human monocyte-macrophages cells were divided into four groups:control group,ox-LDL group,Poly-inosine monophosphate (Poly Ⅰ) group,rosuvastatin group.The expression of LOX-1mRNA and TF mRNA was assayed by RT-PCR.The ELISA was performed to determine the protein concentration of TF.ResultsCompared with control group,the expression of LOX-1 mRNA and TF mRNA was increased in the ox-LDL group[ (3.25156±0.15772) vs (1±0) ; (2.522451±0.138967) vs (1±0) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the expression of LOX-1 mRNA in the Poly-inosine monophosphate group and rosuvastatin group,TF mRNA were decreased in the ox-LDL group[ (2.95139±0.157253) vs(3.25156±0.15772) ; (2.877343±0.156558) vs(3.25156±0.15772) ; (1.811956±0.169699) vs (2.522451±0.138967) ; (1.687701±0.174647) vs (2.522451±0.138967)],and it was in a concentration-dependent manner(P＜0.05).Compared with control group,the expression of TF in the ox-LDL group was increased [(207.7233±1.154701) vs (184.8467±0.871799) ],and it was in a concentration-dependent manner (P＜0.01).Compared with the Poly-inosine monophosphate group and rosuvastatin group [(197.8733±1.505003) vs (207.7233±1.154701) ;(202.9567±2.722744)vs(207.7233±1.154701) ],the expression of TF in the ox-LDL group were decreased,and it was in a concentration-dependent manner (P＜0.05).ConclusionsLOX-1 may be responsible for the expression of TF in human monocyte-macrophages cells induced by ox-LDL.Rosuvastatin is able to down-regulate the expression of LOX-1mRNA in human monocyte-macrophages cells through oxLDL,and TF mRNA and TF expression can be reduced.