Objective To investigate the clinical value of fast track surgery (FTS) in perioperative management of laparoscopic cholecystectomy in the plateau.Methods The clinical data of 88 patients with gall stone who received laparoscopic cholecystectomy at the No.115 Central Hospital of PLA from March 2011 to July 2012 were retrospectively analyzed.All the patients were randomly divided into the control group (44 patients) and the observation group (44 patients).Patients in the control group received traditional perioperative treatment,while patients in the observation group received FTS treatment.Differences in the operation time,time to out-of-bed activity,time for recovery of bowel function,duration of postoperative hospital stay,medical treatment cost and incidence of complications between the 2 groups were compared.The measurement data were shown in x ± s,and analyzed using the t test,and the count data were analyzed using the chi-square test.Results The operation time of the control group and the observation group were (63 ± 19)minutes and (59 ± 21)minutes,with no significant difference between the 2 groups (t =-1.34,P ＞ 0.05).The time for out-of-bed activity,recovery of bowel function,duration of postoperative hospital stay and medical treatment cost were (25 ± 6) hours,(36 ± 9) hours,(5.6 ± 1.3) days,(10.8 ± 1.1) × 103 yuan in the control group,and (10 ± 4) hours,(23 ± 5) hours,(3.1 ± 1.3) days,(7.9 ± 1.3) × 103 yuan in the observation group,with significant differences between the 2 groups (t =-3.81,-3.67,-6.40,-4.08,P ＜ 0.05).The incidences of complications in the control group and the observation group were 4.5％ (2/44) and 2.3％ (1/44),respectively,with no significant difference between the 2 groups (x2=3.01,P ＞ 0.05).Conclusion FTS can promote the recovery of patients,decrease duration of hospital stay and medical treatment cost without increasing incidence of complication for patients who received laparoscopic cholecystectomy in the plateau.

BACKGROUND: Occurrence and development of the glioma are not only related to regulative gene of cell cycle, but also dealt with adjustive genes of cell invasion, cell metastasis and apoptosis.OBJECTIVE: To identify the differentially expressed genes related to cell proliferation and apoptosis in glioma cell of different differentiating degree with cDNA microarray, and provide basic data for further research of mechanisms of cell proliferation and apoptosis in human gliomas.DESIGN: Opening-up experiment.SETTING: Institute of Pathology, Southwest Hospital and Department of Neurobiology, Basic Medicine Faculty as well as Department of Pharmacy,Xinqiao Hospital, Third Military Medical University of Chinese PLA.MATERIALS: Human malignant glioma cell line CHG-5 ( Ⅱ grading according to the WHO standard) was constructed, kept and cultured in this experiment. SHG-44 (Ⅳ grade according to the WHO standard) was provided by Institute of Brain Tumor, Second Hospital Affiliated to Suzhou Medical College. Serum of calf was produced and provided by Hangzhou Sijiqing Biomaterial Institute. In experiment RPMI-1640 medium (Gibco),Trizol test kit (Gibco-BRL), RNAsecureTM solutions (Ambion, Austin,Texas), biophotometer (Eppendorf, Hamburg, Germany) were also applied.Gene chip contained 9 984 human cDNA segment, which was prepared and provided by City University of Hongkong (UniGEMV2 cloneset known gene and ESTs were purchased from Incyte Company), Superscript Ⅱ reverse transcriptase was provided by Gibco-BRL Company. Fluorochrome Cy3 & Cy5 was the products of Amersham Pharmacia Company.METHODS: The experiment was performed at Chongqing Third Military Medical University of Chinese PLA and City University of Hongkong between 2001 and 2003. Total RNA was extracted from Trizol test kit. Reverse transcription polymerase chain reaction (RT-PCR) was conducted in Superscript Ⅱ reverse transcriptase, and cDNA product was marked with fluorochrome Cy3 & CyS. Followed by chip hybridizationto detect the difference of gene expressions between human glioma cell line CHG-5 and SHG-44 tumor cell, especially the difference of related genic expression between cell proliferation and apoptosis, and the chip result was verified with Northern blot hybridization.MAIN OUTCOME MEASURES: The difference of gene expression of human glioma cell in different differentiating degree; Comparison of result between Northern blot and related gene chip.RESULTS: ①Compared with CHG-5, 120 gene expressions were detected obvious up-regulation and 22 gene expressions were significant down regulation in SHG-44 cells, and the variety of these differentially expressed genes was many, in which apoptosis related genes were 6, including 3 up-regulation genes and 3 down-regulation genes; Cell cycle and proliferating related genes were 12, including 5 up-regulation genes and 7 down-regulation genes. ②Chip result was supported by Northern blot result further.CONCLUSION: The differentially expressed genes of glioma are revealed primarily, especially the differentially expressed genes related with cell proliferation and apoptosis.

Objective To establish a rabbit model of lumbar laminectomy and bone grains replantation and provide experimental evidence for the clinical application.Methods Eighteen healthy male New Zealand rabbits were selected and randomly divided into two groups:the control group (n=6) and experimental group (n=12).The rabbits of control group were given general anesthesia, and taking the L5 spinous process as the center to perfom left L5 laminectomy, using a micro lancet forceps to slowly bite the lamina and ligamentum flavum for fenestration and exposed to an approximately 0.8 cm x 0.3 cm sized bone window and then sutured the skin.The rabbits of experimental group were exposed to an approximately 0.8 x 0.3 cm sized bone window as well, and bone fragments were cut into small grains.Then the small bone grains were embedded in medical collagen sponge, to form an arch shape, and replanted them to the site of epidural fenestration.CT scan and histological changes were observed at 4, 8 and 12 weeks after operation.Results At 8 weeks after operation, CT examination showed that in the experimental group, a thin bone plate was formed by the bone grains.At 12 weeks after operation, the bone plate became thicker and was connected with the vertebral bone, and with continuous bone trabeculae.The spinal canal and volume were not obviously changed, and no spinal cord compression was observed. The rabbits of control group showed segment lamina defects, a small scar protruding into the spinal canal, and the vertebral canal was not completely reconstructed. Conclusions The bone grains replantation can effectively promote bone reconstruction in the laminectomized rabbits, and the formed bone plate can prevent epidural scar from intruding into the spinal canal, and can reduce the postlaminectomy adhesion.

Objective To evaluate HCC family history on recurrence and survival of HCC patients after curative hepatectomy. Methods The family history,postoperative recurrence rate,1,2 and 5 year survival rate of 79 HCC patients who received surgical resection were collected.Patients were divided into two groups:34 cases in familial aggregation HCC group (FH group ) and 45 cases in non- familial aggregation HCC group (NH group).All these HCC patients were followed up for 3 months to10 years after surgery,and the median follow-up period was 48.5 months.We analyzed the survival rate of HCC patients by Kaplan -Meier survival curve to compare the postoperative recurrence rate and survival rate between two groups. Results 34 cases of HCC probands came from 33 families,and there were 104 cases of HCC patients in these families,an average of 3.2 cases per family.There were 6 families in which 3 or more cases developed HCC,and there were 13 families in which father or (and) mother had HCC accounting for 39.4％.The six months,1 year,2 year posthepatectomy recurrence rate in FH group was 15.1％,22.3％,40.1％,significantly higher than NH group of 10.3％,17.4％,25.6％ (x2 =5.762,6.434,5.987,P ＜0.05),and 1,2,5 year's survival rate in FH group was 57％,46％,40.3％,much lower than NH group of 85.3％,75.2％ and61.5％ (x2 =8.986,9.765,7.634,P＜0.05). Conclusions Family history of HCC affects the prognosis of HCC patients after surgery. Patients with HCC family history have higher postoperative recurrence rate and worse prognosis than that of patients who do not have HCC family history.

Objective To evaluate the efficacy and safety of oral propranolol versus atenolol in the treatment of infantile hemangioma(IH). Methods A total of 75 infants with IH aged 5-24 weeks were randomly divided into two groups: propranolol group(n = 30)orally administrating propranolol 2 mg · kg?1 · d?1 in 3 divided doses daily for 24 consecutive weeks, atenolol group(n=45)orally administrating atenolol 1 mg · kg?1 · d?1 once a day for 24 consecutive weeks. After 1?, 4?, 12?, 24?week treatment, the infants with IH were followed and adverse reactions were recorded. In addition, the activity of IH was assessed by hemangioma activity score(HAS)before and after 24?week treatment, and changes of HAS were compared between the propranolol group and atenolol group. Results There was no significant difference in the proportion of patients experiencing satisfactory regression of hemangioma between the propranolol group and atenolol group(70%[21/30]vs. 75.6%[34/45], P>0.05). Treatment failure occurred in one patient in the propranolol group because of severe airway hyperreactivity, and in another patient in the atenolol group because of drug resistance. The incidence rates of gastrointestinal reactions, central nervous system adverse effects, chills on the extremities and bronchiolitis complicated by airway hyperreactivity were all significantly higher in the propranolol group than in the atenolol group(all P<0.05). None of hypotension, hypoglycemia and bradycardia occurred in the two groups. Conclusion Compared with propranolol, atenolol shows similar efficacy but less adverse effects in the treatment of IH.

Purpose To explore the feasibility of low radiation dose combined with lowdose contrast agent in thyroid CT enhanced scan and investigate the benefit of reducing radiation hazard and contrast agent damage to thyroid.Materials and Methods 120 patients assigned for thyroid enhanced CT scan were prospectively and randomly divided into four groups (each group was 30 patients).Group A:radiation dose 120 kV,180 mA,contrast agent dose 1.2 ml/kg;group B:radiation dose 120 kV,180 mA,contrast agent dose 1.0 ml/kg;group C:radiation dose 100 kV,100 mA,contrast agent dose 1.2 ml/kg;group D:radiation dose 100 kV,100 mA,contrast agent dose 1.0 ml/kg.CT values,background sign,background noise of thyroid were measured;signal to noise ratio (SNR) and contrast to noise ratio (CNR) were calculated;CT dose index of volume (CTDIvol),dose length product (DLP),and the effective dose (ED) were recorded and calculated.The image quality was evaluated and the data was statistically analyzed by two radiologists.Results CT values,background sign and background noise of thyroid,as well as CTDIvol,DLP,ED among four groups were statistical significant (P＜0.05);there was no significant difference in SNR,CNR and image quality scores among four groups (P＞0.05).Conclusion It is beneficial of reducing radiation hazard and side-effect of contrast agent from low radiation dose combined with low-dose contrast agent under the condition of ensuring diagnostic image quality.

OBJECTIVE: To exlpore the eff ect of depsides salts from Salvia miltiorrhiza on human hepatoma cell line SMMC-7721 xenograft tumors and the possible mechanisms. METHODS: A total of 36 nude mice were divided into 6 groups: A model group, a negative control group, a positive control group, and 3 treatment groups at low, middle or high dose (n=6). The tumor model of nude mice was given depsides salts at a dose of 10, 20 or 50 mg/kg every 3 day for 16 days. Then samples of subcutaneous tumors in nude mice were collected. The morphological changes of tumor samples were observed by HE staining and the expression of vascular endothelial growth factor (VEGF) and the tumor antigen Ki67 was detected by immunohistochemical method. RESULTS: The tumor growth was inhibited by all doses of depsides salts. The morphology of tumors was shrinkage, broken and irregularly arranged compared with the tumors in the model group and the negative control group. Morphological changes were more obvious in tumors with treatment at high dose. Expression of VEGF and Ki67 in treatment groups and the positive control group were lower than that in the model group and the negative control group, with a significant difference (P<0.05). CONCLUSION Depsides salts from Salvia miltiorrhiza can inhibit the growth of human hepatoma cell line SMMC-7721 tumor in nude mice, which is related to the inhibition of Ki67 and VEGF.
Animals ; Carcinoma, Hepatocellular ; pathology ; Cell Line, Tumor ; drug effects ; Depsides ; pharmacology ; Humans ; Ki-67 Antigen ; metabolism ; Liver Neoplasms ; pathology ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; Salts ; Salvia miltiorrhiza ; chemistry ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

Objective To investigate the effect and mechanism of long noncoding RNA (lncRNA) PTEN pseudogene 1 (PTENP1) on the proliferation and migration of hepatocellular carcinoma (HCC) cells. Methods Lentiviral vectors expressing PTENP1 were constructed. HCC cells BEL-7404 were infected with LV003-GFP-PTENP1 and control vectors LV003-GFP. BEL-7404 cells stably expressing PTENP1 were constructed and the experimental and control groups were established. The proliferation and clone formation abilities of HCC cells in two groups were detected by CCK-8 assay and clonogenic assay. The migration ability of HCC cells was detected by wound healing assay. The expression of p44/42 mitogen-activated protein kinase (MAPK) and p38 MAPK proteins were detected by Western blot. Results The absorbance values A450 of the cells at 48 and 72 h in the experimental group were 1.4±0.3 and 2.3±1.1, signiifcantly lower compared with 3.2±1.7 and 3.4±1.1 in the control group (t=-5.78,-4.23;P<0.05). The number of cell clone formation in the experimental group was 55±12, signiifcantly less than 154±45 in the control group (t=-3.98, P<0.05). The percentage of cell migration in the experimental group was (21.7±2.6)%, signiifcantly lower than (57.7±4.9)%in the control group (t=-8.34, P<0.05). Western blot revealed that the expression of p44/42 MAPK and p38 MAPK proteins in the experimental group was significantly down-regulated compared with those in the control group. Conclusion lncRNA PTENP1 can inhibit the proliferation and migration of HCC cells probably through regulating MAPK signaling pathway.

Objective To explore the resistance of neural stem cells (NSCs) in β-amyloid (Aβ) toxicity after being transfected with brain-derived neurotrophic factor (BDNF) and its mechenism.Methods NSCs in the C57 mice were transfected with BDNF gene by using lipofectamine technique; the BDNF gene expression in transfected NSCs and their differentiated cells were detected by immune-fluorescent staining and ELISA.Rat neurons were cultured in vitro and divided into 3 groups:neurons group,neurons co-cultured with NSCs group,neurons co-cultured with BDNF transfected NSCs group; two-parallel group design was adopted.Three d after the group culturing,cells from each parallel group were added Aβ40 protein.Neuron survival of each group was recorded 24 and 48 h after adding Aβ40 by ELISA.The Aβ,tau,and phosphorylating tau (ptau) levels were detected by Western blotting.Results BDNF-transfected NSCs could continuously express BDNF gene products during the first 1.5 weeks.Both transfected NSCs and their progenies expressed BDNF gene products.Using neurons group as reference,the mean survival rates of neurons plus Aβ40 group,neurons co-cultured with NSCs plus Aβ40 group,neurons co-cultured with BDNFtransfected NSCs plus Aβ40 group were 51.86％±0.03％,73.68％±0.04％ and 85.34％±0.01％ at 24 h after adding Aβ40,and 38.76 ％±0.01％,59.65 ％±0.04％,75.61％± 0.07％ at 48 h after adding Aβ40; the survival rate in the neurons plus Aβ40 group and neurons co-cultured with NSCs plus Aβ40 group was significantly lower than the other groups (P＜0.05).High level of Aβ protein was noted in the neurons plus Aβ40 group,neurons co-cultured with NSCs plus Aβ40 group and neurons co-cultured with BDNF transfected NSCs plus Aβ40 group,without significant differences between each two groups (P＞0.05).The tau protein level showed no significant differences between each two groups (P＞0.05),while the p-tau protein level was significantly different (that in the neurons co-cultured with NSCs plus Aβ40 group and neurons co-cultured with BDNF transfected NSCs plus Aβ40 group was significantly higher than that in the other groups,P＜0.05).Conclusion BDNF-transfected NSCs express BDNF gene products during the early time,which alleviate the toxicity of Aβ to NSCs and reduce the p-tau protein level,leading to increased survival rate of neurons.

ObjectiveTo investigate the clinical characteristics and prognosis of cryptogenic hepatocellular carcinoma (HCC).MethodsClinical data of 177 patients who were diagnosed with cryptogenic HCC in the Third Afifliated Hospital of Sun Yat-sen University from January 2001 to December 2012 were analyzed retrospectively. The informed consents of all patients were obtained and the ethical committee approval was received. There were 138 males and 39 females with age ranging from 30 to 82 years old and median age of 56 years old. Data of clinical characteristics were collected and hepatitis B virus (HBV) serological markers were investigated. According to the different treatments, the patients were divided into surgical resection group (n=24), comprehensive treatment group (n=88), and conservative treatment group (n=65). Impacts of these 3 treatments on the survival of patients were compared.ResultsOf the 177 patients, the ratio of male to female was about 4:1. Patients with age over 60 accounted for 48.0% (85/177), liver cirrhosis 90.4% (160/177), non-alcoholic fatty liver disease (NAFLD) 19.2% (34/177), diabetes mellitus (DM) 21.5% (38/177). Patients with positive hepatitis B virus core antibody (HBcAb) accounted for 70.6% (125/177), alpha fetal protein (AFP) >400 μg/L 31.6% (56/177), liver function Child-Pugh grade A 62.7% (111/177), tumor diameter≤5 cm 35.6% (63/177), single tumor 54.2% (96/177), Barcelona Clinic Liver Cancer (BCLC) stage A 9.6% (17/177), stage B-D 90.4% (160/177). The 1-year survival rate was 92% in surgical resection group, 65% in comprehensive treatment group, but only 8% in conservative group.ConclusionsOccult HBV infection may be the main cause of cryptogenic HCC, though NAFLD and DM may also play an important role in its occurrence. Cryptogenic HCC most occurs on the basis of liver cirrhosis and is usually found at an middle or advanced stage during the initial diagnosis. The treatment outcomes and prognosis are poor so regular follow-up, early diagnosis are the key to improve the prognosis.