Objective To investigate the diagnosis value of laparosco-pie examination in ascites.Methods The data of twenty-three cases with ascites of unknown origin undergoing laparescopie examination and pathologic examination were retrospectively analyzed from May 2004 to August 2008.Results Twenty-two eases were definitely diagnosed by laparoscopie exploration,the positive rate was 95.6%.One ease re-mained unknown.Among them,18 eases were tuberculous peritonitis; 3 eases were metastatic adenocarcino-ma; one ease was peritoneal mesothelioma.No obvious postoperative complications occurred.Conclusion Laparoscopie examination is a safe method with hige definite diagnostic rate,which has important values in diagnosis of ascites of unknown origin.

Objective To investigate the feasibility and safety of laparoscopic cholecystectomy(LC) in patients with chronic renal dysfunction at azotaemic stage.Methods Clinical data of 7 patients accompanying chronic renal dysfunction at azotaemic stage treated with LC between May 2004 and September 2006 were analyzed retrospectively.The operation was performed under general anesthesia and endotracheal intubation.The CO2 pressure was maintained at 9～12 mm Hg.The LC was conducted with 3-port technique in 5 patients and 4-port technique in 2.Results The LC was completed smoothly in all the 7 patients.Patients' renal dysfunction was not aggravated.There was no significant difference between pre-and post-operative time in levels of blood urea nitrogen(11.92?4.06 mmol/L vs 12.16?3.76 mmol/L;t=0.50,P=0.633) and blood creatinine(208.62?134.37 ?mol/L vs 204.20?125.53 ?mol/L;t= 0.51,P=0.626).As compared with preoperative levels,the creatinine clearance rates were not significantly changed at 2 weeks after operation in 3 patients(40.03 ml/min vs 45.61 ml/min;32.28 ml/min vs 38.93 ml/min;56.72 ml/min vs 51.60 ml/min).Follow-up checkups for 4～20 months(mean,10 months) showed no aggravation of renal dysfunction.Conclusions Laparoscopic cholecystectomy is a feasible and safe procedure for patients with chronic renal dysfunction at azotaemic stage.

Objective To study the feasibility of laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair.Methods Twenty-four adult patients received laparoscopic cholecystectomy accompanied by simultaneous umbilical hernia repair in our hospital from November 2003 to April 2008.An incision was made in navel defect and entered the abdominal cavity under a direct vision.LC was performed by 3-trocar technique.Umbilical hernia was repaired by Mayo' style.Results The operation was successfully completed in all the cases.The operation time ranged from 35 to 65 minutes (mean,48 minutes),the blood loss was 5-30 ml(mean,16 ml),and hospital stay after the operation was 3 -4 days.No patient dereloped wound infection or skin necrosis.No recurreme was found during a 1-to 54-month follow-up(mean,28.6 months).Conclusions Laparoscopie cholecystectomy accompanied by simultaneous umbilical hernia repair is a safe and effective procedure.Mayo repair is simple and effective for umbilical hernia with less fascial defects.

Objective To investigate the feasibility,safety and clinical efficacy of three-port laparoscopic sleeve gastrectomy (TLSG).Methods The retrospective cross-sectional study was conducted.The clinical data of 104 obese patients who were admitted to the Beijing Friendship Hospital of Capital Medical University between September 2016 and March 2017 were collected.TLSG was performed to all the 104 patients by the same surgical team.The surgical situations,conversion situations (port-site increased or conversion to open surgery),operation time,volume of intraoperative blood loss,surgery-related complications,duration of postoperative hospital stay and follow-up situations were observed.Patients were followed up by Wechat,telephone interview and inpatient examination once at month 3,6,9 and 12 postoperatively and once every year after 1 year postoperatively up to April 2017.Follow-up included weight-loss efficacy and postoperative long-term complications.Measurement data with normal distribution were represented as x±s or average (range).Results All the 104 patients underwent successful TLSG,without port-site increased or conversion to open surgery.Operation time and volume of intraoperative blood loss were (121±25)minutes and (9±6)mL,respectively.There was no severe intraoperative collateral damage.All the 104 patients with complications were cured by symptomatic treatment,including 1 with port-site infection,1 with peritoneal effusions causing secondary infection,3 with improper eating-induced acute delayed gastric emptying,6 with fat liquefaction around port-site and 9 with delay healing of port-site.There was no occurrence of severe complications,such as gastrointestinal bleeding,intra-abdominal bleeding and gastrostoma.Duration of postoperative hospital stay was (2.4±0.8)days.Eighty-two patients were followed up for 3 months (range,3-6 months),including 59 with 3-month follow-up,23 with 6-month follow-up and 22 with under 3-month follow-up.During the follow-up,there was no port-site hernia.Excess weight loss (EWL) was 37％± 11％ in 59 patients with 3-month follow-up and 45％± 13％ in 23 patients with 6-month follow-up.Of 59 patients with 3-month follow-up,14 patients with diabetes mellitus stopped taking antidiabetic drugs,10 of 14 patients had complete remission (CR) of hemoglobin Alc (HbAlc) and 4 of 14 patients had partial remission (PR) of HbAlc.Of 23 patients with 6-month follow-up,6 patients with diabetes mellitus had CR of HbAlc.Of 18 patients with obstructive sleep apnea hypopnea syndrome (OSAHS),4 had 3-month follow-up,including 3 with CR and 1 was improved to mild OSAHS.Other 14 patients were not evaluated due to inadequate follow-up time.Conclusion TLSG for obese patients with specific indications cannot increase operation time and risk,meanwhile,it can reduce port-site,with a good cosmetic effect.

Objective To investigate the effect of platelet activating factor on the proliferation of cultured hepatic stellate cells in vitro. Methods LX-2 cell line was chosen as the study model of the activated hepatic stellate cells. MTT colo- rimetric assay was used to evaluate the proliferation of HSCs. Cell cycle was evaluated by ways of flow cytometry with PI staining and BrdU incorporation.Results OD_(492) value of PAF groups at concentration from (1 × 10~(-8)-1 × 10~(-3) mol/L), were higher than that of control group (P < 0.05). OD_(492) value of PAF (1×10~(-6)) + PAF-RA × 1 (10~(-7)-1 × 10~(-4)mol/L) groups was less than that of PAF (1 ×10~(-6)mol/L) group (P<0.05). S% and PrI of PAF groups increased significantly. Conclusion PAF can increase the proliferation of hepatic stellate cells in a dose-dependent manner while PAF receptor antagonist reduces the proliferation of hepatic stellate cells induced by PAF.

Objective To study the clinic-pathological features,diagnosis,treatment,and prognosis of solid-pseudopapillary tumors of pancreas.Methods A retrospective clinical and pathological analysis was made on 10 patients(1 ∶ 4),admitted from January 2003 to December 2011.There were 2 male and 8 female patients,aging from 16 to 65 years with a mean of 32.6 years.Results The main symptom was mild abdominal pain (4/10).B-US,CT,MRI demonstrated that all tumors were located in pancreas (3 cases at the head,1 case at the neck,and the others at the body and tail),and well circumscribed,contained some degree of cystic degeneration.All the 10 patients had curative resections including,3 patients received standard duodenopancreatectomy,1 patients received tumor resection and pancreaticojejunostomy,2 patients received distal pancreatectomy,and 4 patients received distal pancreatectomy plus splenectomy.The specimens appeared as solid (3/10) or solid and cystic(7/10),and the biggest tumor diameter was between 3.3-14.0 cm with an average about 5.91 cm.Immunohistogically,the tumors were positive for Neuron-Specific Enolase (NSE,9/9)、Vimentin (9/9),CD56(7/7),Synaptophysin (Syn,5/8),Progesterone Receptor (PR,5/6),CD10 (4/6),Chromogranin A (1/4).Totally 10 cases were followed up with a average period of 36.6 months without tumor recurrence.Conclusions Solid-pseudopapillary tumor of pancreas is a rare tumor with low grade malignancy.Accurate diagnosis was difficult before operations.Surgical resection is recommended as the main treatment,and the prognosis is good.

Objective To investigate the different effect of exogenous leptin on estrogen receptor α,β mRNA in human breast tumor tissue in nude mice xenograft models. Methods We made nude mice xenograft models of MCF-7 human breast cancer cells cultured in vitro, then divided them into experimental group of]eptin( n = 30)and control group of normal saline( n = 30)randomly. The models of experimental group were injected subcutaneously the recombinant human leptin for 15 consecutive days, the models of control group were injected subcutaneously the same dose of normal saline. A real- time quantitative RT- PCR assay was developed to quantify the expression of estrogen receptor α, β mRNA in tumor tissue, using the relative quantitative analysis. Results The leptin-intervened nude mice xenograft models were safely established. The relative quantitation of estrogen receptor α mRNA was significantly higher in the leptin group than in the normal saline group ( P ＜ 0.01 ), the relative quantitation of estrogen receptor β mRNA was significantly lower in the leptin group than in the normal saline group ( P ＜ 0. 01 ). Conclusion The nude mice xenograft models can be safely intervened with human leptin by subcutaneous injection around tumor.Estrogen receptor is one of the targets of leptin in the progress of breast cancer. Exogenous human leptin can up- regulate the expression of estrogen receptor α and down- regulate the expression of the estrogen receptor βin nude mice xenograft models of human breast tumor.

Objective To investigate the feasibility of buccal mucosa swab method to isolate genomic DNA for au-tism spectrum disorders (ASD)-related genetic screening. Methods Buccal mucosa swabs and blood were collected from 41 children with ASD. Genomic DNA was extracted from either blood by using a commercial genomic DNA kit or buccal mucosa swab by using phenol-chloroform-isoamyl alcohol method. The concentration, total quality and purity of genomic DNA were compared between these two methods. Genotyping of the ASD-related methylenetetra-hydrofolate reductase (MTHFR) gene C677T locus was analyzed using PCR-restriction enzymatic digestion and sanger sequencing was per-formed for validation. Results The total quality [(5.87±2.58)μg vs. (2.00±0.92)μg] and concentration [(143.25±72.78) mg/L vs. (66.68±24.43) mg/L] of genomic DNA extracted from buccal mucosa swab were higher than that form blood (P<0.05), while the purity was not significantly different between these two methods (P>0.05). Genotyping analysis of MTHFR was also consistent between these two methods. Conclusion Buccal mucosa swab is a simple, non-invasive and reliable meth-od to obtain genomic DNA, which can partially replace blood for analysis of ASD-related gene polymorphisms.

Objective To investigate the method for the normal three‐dimensional ultrasound imaging and the characteristics of the fetal hard palate .Methods 210 single fetus free of deformity were examined using three‐dimensional ultrasound(3DUS) .Offline analysis was made after reconstruction ,the hard palate was observed and the width was measured .Results With reconstruction ,the fetal palate was clearly displayed 1.97 cases in 210 cases were successfully displayed (93 8.% ) .The front palate and both frontalis processus of maxillary bone composed similar triangular structure in the coronal plane .The retral part showed sustained linear hyperechoic and the radian increased along with the gestational age .Early palate showed flaky hyperechoic in the cross section and it became horse‐shoe shaped in the second or third trimester pregnancy surrounded by alveolar bone .Linear regression yielded the following formula for the hard palate width (PW) according to gestational age (GA):PW= -0 5.47+0 0.13 × GA( r =0 9.82 ,P <0 0.01) .Conclusions 3DUS acquired palate images fast and easily .The hard palate in the coronal ,sagittal and cross plane showed obvious characteristic images in different gestational stages .With increasing gestational age ,the curvature ,width ,trend and the contrast with the surrounding tissue had the corresponding changes . The successful three‐dimensional image reconstruction of the postnasal triangle and the retral part of fetal hard palate would have an important significance in terms of assessing its continuity and integrity .

Objectives The purpose of this study was to investigate the characteristics of the aged patients with cholelithiasis and summarize the clinical application experiences.Methods A retrospective analysis was performed on aged patients with cholelithiasis treated by laparoscopic operation between Apr.2012 and Apr.2015.Studies which provided outcome data on aged patients, subjected to laparoscopic operation were considered.Mortality, morbidity, cardiac and pulmonary complications were the outcome measures of treatment effect.Results Twenty-seven patients had cholecystolithiasis, of whom laparoscopic cholecystectomy was successfully performed in twenty-six cases and one case was changed to transabdominal operation.Among the fifty-four patients with suspected or confirmed biliary calculi, laparoscopic cholecystectomy + laparoscopic transcystic common bile duct exploration was successfully performed in forty-two cases and one case was changed to transabdominal operation.Six cases changed to cholecystectomy because of the diameter of the bile duct.Five patients who already had laparoscopic cholecystectomy received Ⅰ stage suturing of bile duct after the removal of the stones.Bile leak occurred in one case and pancreatitis occurred in three cases.Pneumonia occurred in three cases and one case was transmitted to the infection ward for further treatment.No severe procedure-related complication occurred.There was no significant difference in mortality, morbidity, cardiac and pulmonary complications.Conclusions Laparoscopic operation was acceptable for aged patients.Proper peri-operative management was essential to reduce the complications.