Objective To investigate the safety and feasibility of lapraroscopic Heller myotomy combined with Dor fundoplication surgery. Methods Three cases with achalasia have been treated with laproroscopic Heller-Dor surgery since February, 2005. Before surgery, patients were examined for generally esophageal barium meal and esophageal manometry. Results The operation time ranged from 110 and 120 minutes with the bleeding volumes between 40 to 50 ml, and the hospitalized time for patients post operation was 6 to 7 days. During a month after surgery, the patients showed the normal lower esophageal sphincter pressure and remnant pressure, increased the rate of relaxation,disappeared reversed peristalsis and gastroesophageal reflux, and no recurred symptoms. Conclusions In comparison to conventional surgery, Heller-Dor procedure results in smaller wound, less pain, fewer complications, faster recovery, shorter hospitalized days, and better therapeutic effectiveness. The Heller-Dor procedure is safe and feasible.

Objective To compare the clinical effect of platelet rich plasma and sodium hyaluronate in the treatment of knee osteoarthritis .Methods According to the different treatment methods ,100 patients with knee osteo-arthritis were divided into the control group ( for treatment of platelet rich plasma ) and study group ( for treatment of sodium hyaluronate),each group 50 cases.The treatment effect would be compared between two groups ,and the patients were scored knee joint active function using Lysholms score standard ,using visual analogue score method on patients with knee joint pain .Results The excellent and good rate had no significant difference between the study group(98.0%) and control group(94.0%)(P>0.05);The knee joint activity of study group (76.81 ±9.24) was significantly better than that of the control group (60.46 ±7.41),the difference was statistically significant (t =-9.76,P<0.05);the knee joint pain degree of the study group (1.91 ±0.88) was lower than that of the control group (3.58 ±0.85),the difference was statistically significant (t=9.65,P<0.05).Conclusion Platelet rich plasma and the knee joint injection of sodium hyaluronate in the treatment of osteoarthritis were able to effectively alle -viate knee joint pain ,activity limitation and other clinical symptoms ,improve the curative rate ,but the treatment effect of sodium hyaluronate is more remarkable ,which is worthy of promotion .

Objective To detect the expressions of COX-2 and VEGF-C in breast cancer and to explore the relationship between their expressions and lymphatic metastasis. Methods Immunohistochemical stai- ning (SABC) was used to detect the expressions of COX-2 and VEGF-C proteins in 60 cases of breast canc- er. Results The positive rate of COX-2 and VEGF-C in breast cancer were 66.7% and 60. 0%, and the expression of COX-2 was positively correlated with VEGF-C (r =0.429, P<0.05). COX-2 and VEGF-C expressions were positively correlated with lymphatic metastasis (P<0.05). The lymphatic metastasis rate in the positive group of COX-2 and VEGF-C were higher than that in the negative group of COX-2 and VEGF-C. Conclusion Over expression of COX-2 and VEGF-C were observed in breast cancer, and closely related to lymphatic metastasis. COX-2 has positive correlation with VEGF-C and was correlated with lym- phatic metastasis of breast cancer. COX-2 may promote the over expression of VEGF-C in tumor cells and cause lymphatic metastasis.

Objective To compare clinical efficacy between the situ secondary spleen pedicle amputation in laparoscopic splenectomy and open splenectomy for traumatic spleen rupture.Methods From January 2013 to June 2015 a total of 70 patients with splenic rupture undergoing splenectomy were devided into laparoscopic surgery (35 cases) and open surgery (35 cases) group.Clinical data included total intraoperative blood loss,the time spent on splenic artery ligation,total operation time,postoperative drainage volume,postoperative hemoglobin,platelet and albumin levels,time of anal exsufflation,hospital stay and postoperative complications.Results The average operation time in the OS group was shorter than that in LS group (P ＜ 0.05).However,LS group was better than the OS group in splenic artery ligation time,postoperative drainage volume,anus aerofluxus time,postoperative platelet count,postoperative albumin recovery,hospital stay and postoperative complications (all P ＜ 0.05).Conclusions The laparoscopic splenectomy by the amputation of in situ secondary spleen pedicle for traumatic spleen rupture has the advantages of a rapid recovery and a low postoperative complication.

Objectives Construct a subtractive library of Caski cell line induced by exposing to the space environment by suppression subtractive hybridization and pave the way to explain the molecular mechanisms of the changes at the gene level. Methods Super SMART cDNA synthesis and suppression subtractive hybridization (SSH) were performed to isolate differentially expressed cDNA fragments from strains subclonal 48A9 cell line. cDNA from the 48A9 cell line were used as " tester" , and the other from the control Caski cell line as "driver". Subtractive products were directly inserted into T/A cloning vector, and then transformed into host bacteria to set up a subtractive cDNA library of specially or highly expressed genes in strains subclonal 48A9 cell line. Results mRNA were directly extracted and purified with good quality. Double strand cDNA were reverse transcripted integratedly, and then cut by Rsa I into even length short segments. Liga-tion was identified as high effective. After two hybridizations, a subtractive library of differentially expressed genes in strains subclonal 48A9 cell line was successfully constructed by SSH. Conclusion SSH is an effective approach to isolate differentially expressed genes.

AIM: To study the effect of ligustrazine on pulmonary hypertensive rats induced by hypoxic hy- percapnia. METHODS: Thirty rats were randomly divided into three groups: control group(A), hypoxic hypercapnic group (B), hypoxic hypercapnia+ligustrazine (lig. ) group(C). RESULTS: (1) Mean pulmonary axterial pressure (mPAP)of group B was significantly higher than that of group A and mPAP of group C was significantly lower than that of group B(P0.05); (2)Electron microscopy and immunohistochemistry showed ligustrazing could inhibit the diposition of col- lagenous fiber(collagen type Ⅰ )in pulmonary arterioles induced by hypoxic hypercapnia; (3) Plasma endothelin level of group C was significantly lower than that of group B (P

Objective To analyze the clinical features and pathogenic gene mutation in a Chinese family with cerebro-oculo-facio-skeletal(COFS)syndrome,in order to summarize the relationship between phenotype and genotype.Methods The clinical data of the proband and his family members were collected.Genomic DNA from the proband and his parents were extracted by using standard procedures from the peripheral blood leukocytes.Next-generation sequencing was used to detect gene mutation in the patient with COFS syndrome.Sanger sequencing was applied to confirm the results.Results The proband,male,1 year and 3 months old,presented with microcephaly nystagmus,large ears,prominent nose,high arched palate,overhanging upper lip,micrognathia,widely set nipples,flexion contractures(especially involving the elbows and knees),failure to thrive,developmental retardation and feeding difficulty.His parents were normal phenotype.Two different heterozygous mutations c.1843G>T(P.G615W)and c.1996 C> T(P.R666W)were identified in the ERCC2 gene.The proband's father had the heterozygous mutation c.1843G>T(P.G615W)and his mother had the heterozygous mutation c.1996 C> T(P.R666W).Meanwhile,this heterozygous mutation c.1996 C> T(P.R666W)had been reported as a pathogenic gene mutation.Conclusions COFS syndrome is characterized by microcephaly,prominent nose,arthrogryposis and severe developmental delay.This is the first report on COFS syndrome patient in the mainland of China.The pathogenic gene mutations and gene status were identified through genetic studies.The result has laid the foundation for accurate genetic counseling and further prenatal diagnosis.

Objective To evaluate ultrasound-guided methylene blue dyeing for radical liver segmental resection.Methods Liver segmental resection with uhrasound-guide methylene blue dyeing (UMD-SR) was performed in 16 cases, results were compared with 16 conventional liver segmental resection (CSR) retrospectively.Results All the operations under uhrasound-guided methylene blue dyeing were successfully carried out, among them, reverse dyeing was used in cases with segment Ⅳ, Ⅴ, Ⅷ resection.The blood loss in UMD-SR group was much less than CSR group(t =3.011 ,P =0.009) , at the cost of a longer operation time (t =5.423,P =0.000 07).There was no difference in the mortality and morbidity rates between two groups.Tumor recurrence rate was 6.25％ in UMD-SR group and 18.75％ in CSR group (x2 =0.133,P =0.285).Conclusions Ultrasound-guided methylene blue dyeing liver segmental resection can reduce the blood loss during operation, improve the safety of hepatectomy in case of hepatic carcinoma.

ObjectiveTo explore efficacy and safety of laparoscopic sleeve gastrectomy for the treatment of obesity.MethodsForty patients underwent laparoscopic sleeve gastrectomy as a treatment option for weight reduction between December 2006 and February 2010.Mean preoperative body weight (BW),body mass index (BMI) and exceed body weight (EBW) were(104.2 ±3.3) kg,(36.9 ± 1.0) kg/m2 and (37.8 ±3.0) kg,respectively.Outcome data were collected and assessed prospectively.ResultsLaparoscopic procedures were completed in all patients,with no conversion to open surgery.The operation time averaged (80 ± 18 ) min,and there were no severe postoperative complications.The median postoperative hospital stay was (5.5 ± 1.5 ) days.BMI loss was (4.3 ± 1.7 ) kg/m2,( 7.0 ± 1.9 ) kg/m2,(9.3 ±3.1) kg/m2 and (10.1 ±3.8) kg/m2,respectively,and percentage of EBW loss was 35.0％ ± 13.5％,57.1％ ± 17.7％,74.2％ ±27.2％,and 81.8％ ±29.4％,respectively,at 1,3,6,and 12 months following the procedure.ConclusionLaparoscopic sleeve gastrectomy is an effective and safe surgical option for the treatment of obesity with lower BMI.Additional long-term studies are still needed to accurately compare laparoscopic sleeve gastrectomy with other procedures of weight reduction.

Objective To evaluate the effects of two different dosage of rosuvastatin on endothelial dysfunction in diabetic rats. Methods The 24 diabetic rats were randomly divided into three groups (n=8,each): diabetic control group, 20 mg rosuvastatin daily (RV 20 mg group) and 10mg rosuvastatin daily for 8 weeks (RV 10 mg group) and normal control group (SD group). The levels of blood glucose, lipid, nitric oxide(NO) and endothelin-1 (ET-1) were measured before and 8 weeks after treatment. Results The levels of blood glucose were higher in all diabetic rats groups than in SD group before experiment (P＜0. 01). Compared with diabetic rats control group, blood glucose was slightly lower in RV 10 mg group and RV 20 mg group at 8 weeks (P＞0. 05). The plasma NO level was significantly lower in diabetic rats control group than in SD group (P＜0. 05).After 8 weeks, plasma NO levels were significantly higher in RV 20 mg and RV 10 mg groups than in diabetic rats control group (P＜0. 01 or P＜0. 05). The plasma levels of ET-1 was significantly higher in diabetic rats control group than in SD group (P＜0. 01). After 8 weeks, plasma ET-1 levels were significantly lower in RV 20 mg and RV 10 mg group than in diabetic rats control group (P＜0. 01).Meanwhile, the plasma lipids were lower in RV 20 mg and RV 10 mg group than in diabetic control group (P＜0. 05 or P＜0. 01). Conclusions Rosuvastatin can adjust blood lipids and significantly improve endothelial function in diabetic rats by increasing plasma NO level and decreasing plasma ET-1 level.