Objective:To investigate the changes and the adjusting effects of brain-gut peptides (BGP) on immunologic function in the rats before and after relief of biliary obstruction.Methods:One hundred Wistar rats were randomly divided into five groups,including sham common bile duct ligation group (group A),common bile duct ligation group (group B),sham relief of biliary obstruction + normal saline group (group C) ,relief of biliary obstruction + normal saline group (group D) and relief of biliary obstruction + Sandostatin (group E).At 1d,7d after the operation of each group,the changes of plasma vasoactive intestional peptide (VIP),substance P(SP),serum interleukin-2(IL-2) and serum T-lymphocytic subsets (CD4 +,CD8 +)were determinded by radioimmunoassay and flowcytometry .Results:Plasma VIP and SP were increased in group B compared with group A(P

Objective To evaluate laparoscopic radical cholecystectomy for T2 gallbladder cancers.Methods A retrospective analysis was made on 44 patients with pathology confirmed T2 gallbladder cancer undergoing laparoscopic vs open radical cholecystectomy.The clinicopathological and follow-up data were compared.Results Laparoscopic cholecystectomy was performed in 32 patients,the implantation metastasis rate of this approach has no statistical differences compared with the open cholecystectomy (P =1.000).26 patients underwent laparoscopic radical resection and the remaining 18 patients underwent open radical resection.There was no statistical difference in operation time (P =0.953),blood loss (P =0.193)and postoperative complications (P =1.000),but the laparoscopic radical resection group is superior to the open group on postoperative pain grading (P =0.022),ambulation time (P =0.000),nothing per mouth time (P =0.000) and length of hospital stay (P =0.048).The mean number of lymph nodes retrieved was 5 ±4 (range 1-12) in the laparoscopic radical group and 6 ± 3 (range 1-12) in the open group (P =0.983);the 1,3,5 year survival rates was 92.3％,70.3％,61.5％ and 92.3％,76.3％,69.3％,respectively(P =0.473).Conclusions Initial laparoscopic cholecystectomy does not increase the rate of seeding metastasis in the context of intact gallbladder carcinoma.Totall laparoscopic radical resection is feasible in selected T2 gallbladder cancer patients.

SUMMARY To investigate the effect and feasibility of total laparoscopy to treat hepatolithiasis using gall-bladder-hepatic duct subcutaneous tunnel.Retrospective analysis was conducted of the case data of 11 pa-tients with hepatolithiasis who underwent total laparoscopic treatment using gallbladder-hepatic duct sub-cutaneous tunnel from January 2010 to October 2014.The operation time,blood loss,postoperative com-plications and recurrence of stones were recorded.All the cases completed the operation.The average hos-pital-stay was 9.2 days (range:3 -29 d).The average operation time was 298 min (range:225 -480 min).The average blood loss was 253 mL (range:50 -700 mL),and the average blood loss of liver re-section groups was 325 mL (range:200 -700 mL).The average discharge time was 3.3 days (range:3 -5 d).The rate of postoperative residual stones was 36.4% (4 /11).We extracted stones with chole-dochofiberscope via T-tube sinus six weeks after operation.One case developed biliary leakage,and healed through adequate drainage and the T-tube was pulled out after one month.There was no periopera-tive mortality.All the cases were followed up and the mean follow-up was 22 months (range:2 -51 months).The anastomotic stenosis of gallbladder-hepatic duct was found in one case.But we got a good therapeutic result with performed gallbladder chemical ablation with 95% ethanol.No recurrence of hepa-tolithiasis was found.As a choice for minimally invasive method to hepatolithiasis using gallbladder-he-patic duct subcutaneous tunnel,total laparoscopy is a safe and feasible procedure.

Background Congenital blepharoptosis is a common disorder of eyelid movement.Overseas research showed that the most likely mechanism of congenital blepharoptosis is the hypoplasia of levator.But the study on Chinese is still lack.Objective This study was to investigate the pathological features of hypoplasia in levator aponeurosis in Chinese congenital blepharoptosis patients.Methods Twenty-one patients with congenital blepharoptosis were divided into mild group (3 cases),moderate group (14 cases) and severe group (4 cases).Samples of the levator aponeurosis were obtained during the levator palpebrae superioris muscle shortening surgery.Hematoxylin-eosin,special staining and immunohistochemistry were performed to analyze the characteristics of the samples.Normal samples of fresh levator aponeurosis were obtained from the donors in the eye bank of Beijign Tongren Hospital.Results Hematoxylin-eosin staining and special staining showed that with the increase of severity,the cases of levator fibers sparse,fibrous tissue hyperplasia and endomysium defect were gradually increased,showing significant differences among the different groups (Z =-0.702,P =0.002 ; Z =0.738,P ＜ 0.001 ; Z =0.746,P ＜ 0.001).Four samples (19％) presented with adipose in the interstitial tissue.Immunohistochemistry showed that the expression of muscle proteins myosin was weaker in the levator aponeurosis of patients with congenital blepharoptosis than that in the normal samples,and the expression intensity of collagen type Ⅲ in the samples enhanced in comparison with the normal samples.However,there were no significant differences in the expression of actin,myoglobin,fibronection,collagen type Ⅵ and laminin among various groups (all at P＞0.05).Conclusions The levator aponeurosis appears developing abnormality in Chinese patients with congenital blepharoptosis.The histopathological change degree is parallel with the severity of congenital blepharoptosis.

OBJECTIVETo explore the clinical application value of Provider-Initiated HIV Testing and Counseling (PITC) by analyzing the positive rate of HIV tests for people in need of PITC and that of routine HIV tests.

METHODSWe retrospectively analyzed the demographic and epidemiologic data about the patients seeking PITC services or undergoing routine HIV tests in Nanjing Drum Tower Hospital between January and December 2013.

RESULTSThe positive rate of initial HIV screening was 1.98% in the PITC group and 0.24% in the routine test group, while that of confirmed HIV was 0. 40% in the former and 0.07% in the latter, both with statistically significant differences between the two groups (P < 0.01). The positive rate of HIV was markedly higher in males than in females, particularly in the PITC group.

CONCLUSIONPITC has a high clinical value in HIV detection for targeted subjects and therefore deserves general application in dermatology.

Counseling ; Dermatology ; Female ; HIV Seropositivity ; diagnosis ; epidemiology ; Humans ; Male ; Mass Screening ; methods ; Retrospective Studies ; Sex Factors

Objective To explore the expression and its implication of angiogenesis and invasiveness related factor in primary and recurrent glioma. Methods Expressions of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and MMP-9 were detected by immunohistochemical technique. The morphological characteristics of ultrastructure of glioma were observed by transmission electron microscope (TEM). Results The expressions of VEGF, MMP-2 and MMP-9 varied in different grades of primary glioma. With the elevation of the malignant degree of the primary glioma, positive staining rates of VEGF, MMP-2 and MMP-9 increased significantly. The expression of VEGF correlated with both MMP-2 and MMP-9 expression. Compared with the primary glioma, the immunoreactivities of VEGF, MMP-2 and MMP-9 in recurrent glioma increased, especially in those with more severe malignancy. Under transmission electron microscope, endothelial cells markedly proliferated and protruded from the deficiency of basemembrane, concomitantly with edema of the extracapillary gap, plasma extravasation as well as some small worm-eaten caverns in the basemembrane.Conclusion VEGF, MMP-2 and MMP-9 play important roles in glioma angiogenesis and invasiveness.Inhibition of their expressions may be a useful therapy to glioma.

Diagnosis, Differential ; Female ; Humans ; Middle Aged ; Pancreatic Neoplasms ; diagnosis ; Solitary Fibrous Tumors ; diagnosis

OBJECTIVETo investigate the three-dimensional reconstruction methods of the portal vein using 64-slice spiral CT data and the anatomical variation of the portal vein.

METHODSThree-dimensional reconstruction of the portal vein was performed using Mimics software based on the 64-slice spiral CT data of 64 cases. Each model of the portal vein and its branches was evaluated according to the presentation rate, depiction quality and anatomic variation.

RESULTSThe reconstructed model showed a depiction rates of 100% for the 4-grade branches of the portal vein. The stem of the portal vein and the left and right branches of the level III or above were all displayed, but in 2 cases the superior mesenteric vein and in 1 case the spleen vein was displayed only to the level IV. Of the 64 cases, 50 (78.1%) had normal portal vein and 14 (21.9%) showed anatomical variations.

CONCLUSIONThe 3D model vividly mimics the anatomic variations of the portal vein to provide valuable information for surgical plans.

Adult ; Female ; Humans ; Image Processing, Computer-Assisted ; Imaging, Three-Dimensional ; methods ; Male ; Middle Aged ; Portal Vein ; anatomy & histology ; diagnostic imaging ; Tomography, Spiral Computed ; methods ; Young Adult

OBJECTIVETo study the commodity specification and grade standard of Pseudostellaria Radix, for standardizing market order and achieving industrialization, standardization and modernization of Pseudostellariae Radix.

METHODThe different areas and grade medicinal materials of Pseudostellariae Radix were respectively measured in quantitative characteristics of appearance, and the present grade classification of Pseudostellaria Radix was scientifically verified by the content of polysaccharide. Then the determination data were evaluated by spss correlation analysis, principal component analysis and cluster analysis. So combining with the actual production, the commodity grade standard of Pseudostellariae Radix was formulated.

RESULTCorrelation analysis indicated that the present grade classification of Pseudostellaria Radix was reasonable, and the more the grade of Pseudostellariae Radix was high, the more the content of polysaccharide was high. Meanwhile, length as a classification index was not suitable for the commodity grade standard of Pseudostellariae Radix. Using principal component analysis and cluster analysis, combining actual production, the thickest diameter, weight of single root tuber and the number of 50 g root tuber were filtrated and the grade was divided into 5 ranks: big, mid- dle, small selected goods, big ungraded goods and small ungraded goods.

CONCLUSIONthe commodity specification and grade standard of Pseudostellariae Radix that mainly included the thickest diameter, weight of single root tuber and the number of 50 g root tuber was formulated, the standard was divided into 5 grade. Each grade was not only consistent with the present situation of medicinal materials market, it could also reflected the intrinsic quality of Pseudostellariae Radix. In conclusion, the standard could be used as a classifica- tion basis to the commodity specification and grade.

Caryophyllaceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; standards ; Quality Control ; Reference Standards

Objective To investigate the effect of a selective muscarinic receptor antagonist (penehyclidine hydrochloride) in three vessel occlusion model of acute global cerebral ischemia-reperfusion in rats.Method One hundred and forty-four male SD rats were randomly divided into four groups:sham operated group,vehicle treated group (saline 1 ml,i.p.),scopolamine treated group (0.01 mg/kg,i.p.) and penehyclidine hydrochloride treated group (0.01 mg/kg,i.p.) with drugs injected 40 minutes before ischemia respectively.The ischemic duration was 10 minutes.The animals were subjected to motor activity tests (open field activity test,beam-walking test and grip test) at 24 hours or on the 3rd and 7th day after reperfusion.HE staining,TUNEL staining and immunohistochemical reactions of bax and bel-2 were carried out at the time points of 2,12,24 hours,3 and 7 days after reperfusion.TTC staining was carried out in some rats for assessment of infarction volume on the 4th day after reperfusion.Results As compared with the vehicle treated group,both penehyclidine hydrochloride treatment and scopolamine treatment decreased the numbers of apeptotie neurons (P