Objective To investigate the characteristics of laparoscopic cholecystectomy(LC) in the elderly. Methods A retrospective analysis was made on clinical data of 118 elderly patients treated with LC in this hospital between January 2000 and January 2005. Results The LC was successfully completed in 116 patients,while conversions to open surgery were required in 2 patients due to low level of insertion of the cystic duct(1 patient) and common bile duct injury(1 patient).The operation time was(30~120 min)(mean,50 min).The postoperative recovery was uneventful in all the patients.The length of hospital stay after operation was 3~7 d(mean,4.5 d).The patient with common bile duct injury was followed for 2 years and 6 months.Transient onsets of abdominal pain and fever were noted and cured with antibiotics for 2~5 days.No biliary tract stenosis or bile duct calculus was seen.Follow-up observations in the remaining 117 patients for 6~12 months(mean,10.5 months) revealed no abdominal pain,fever,or jaundice. Conclusions Laparoscopic cholecystectomy is acceptable and safe for elderly patients.Proper peri-operative management and careful surgical performance are essential to the success of surgery.

Cytokine-Induced Killer Cells ; immunology ; Cytotoxicity, Immunologic ; Dendritic Cells ; immunology ; Fetal Blood ; immunology ; HL-60 Cells ; Humans ; K562 Cells ; Killer Cells, Natural ; immunology

Objective To evaluate the safety and feasibility of totally thoracoscopic anatomic pulmonary segmentectomy (TTAS) for the treatment of the peripheral stage ⅠA non small cell lung cancer(NSCLC).Methods The study involved 50 consecutive patients undergoing totally thoracoscopic anatomic segmentectomy (TTAS) from September 2010 to November 2012 in the First People's Hospital affiliatied to Nanjing Medical University.The diameter of the tumors were less than 2 cm [(mean diameter(1.35 ±0.48) cm].All lymph node sampling of N1 and N2 were neglive,All patients received symtematic lymph node dissection.The pulmonary vessels were individually ligated,and the bronchi were closed using an endoscopic stapler.The intersegmental plane was identified using the demarcation between the resected(inflated) and preserved(collapsed) lungs.Staplers were used for intersegmental dissection.Results The mean operative time and intraoperative bleeding were (191.5 ± 50.4) min and (49.2 ± 54.6) ml respectively.The chest tube drainage duration was (3 ± 1) days.The number of stapler cartridges used for intersegmental division was 3.9 ±0.8.The mean number of lymph nodes and nodal stations dissected were 12.6 ± 2.8 and 6.0 ± 1.5 respectively.No mortality and complications were observed 30 days after the surgery.Further,no local recurrence or metastases were observed during follow-up.Conclusion Totally thoracoscopic anatomic segmentectomy(TTAS) is a feasible and safe technique.With systematic lymph node dissection,TTAS can be a reasonable therapeutic option for stage ⅠA NSCLC.

AIM: To study the effect of garlicin on protecting nonalcoholic fat liver in rats induced by high fat diet and explore the pathogenesis involved. METHODS: According to the dosage of garlicin and diet, fifty SD rats were randomly divided into five equal groups: normal control group, model control group and garlicin (10, 20, 30 mg/kg) groups. Apart from the rats in normal control group, the rats were all fed with high fat and high cholesterol diet. After 12 weeks, the levels of serum endotoxin (ETX), total cholesterols (TC), triglyceride (TG), superoxide dismutase (SOD), malondialdehyde (MDA), transaminase and free fatty acids (FFA) were detected. The levels of MDA, SOD, glutathione hormone (GSH) in hepatic tissue were also detected. Then the features of live pathology were observed. RESULTS: The levels of ETX, TC and TG in garlicin groups were significantly lower than those in model control group (P

[Summary] The aim of this study was to detect the levels of serum miR-130b expression in patients with type 2 diabetes mellitus and to analyze their correlation with diabetic renal damage. 243 patients with type 2 diabetes mellitus were divided into three groups according to urinary albumin/creatinine ratio ( UACR ): normoalbuminuria group (UACR<30 mg/g, n=103), microalbuminuria group (UACR 30-300 mg/g, n=86), and macroalbuminuria group(UACR>300 mg/g, n=54). The levels of serum miR-130b were validated by realtime polymerase chain reaction. Serum transforming growth factor-β1 (TGF-β1) and tumor necrosis factor-α(TNF-α) were determined by enzyme-linked immunosorbent assay ( ELISA) in all patients and 59 healthy volunteers. Compared with control group, the level of serum miR-130b in the type 2 diabetes mellitus group were significantly decreased, gradually with the increases of UACR. The level of serum miR-130b was inversely correlated with blood urea nitrogen ( r=-0. 295, P<0.05), serum creatinine(r=-0. 316, P<0. 05), UACR(r=-0. 463, P<0. 05), but positively related to the estimated glomerular filtration rate(r=0. 367, P<0. 01). The level of serum miR-130b was also negatively correlated to homeostasis model assessment for insulin resistance, triglyceride, low density lipoprotein-cholesterol, TNF-α, and TGF-β1 (r=-0. 257,-0. 345,-0. 242,-0. 562,-0. 622, all P<0. 01). The present study indicates that serum miR-130b might be a potential new biomarker for early diagnosis of diabetic nephropathy. Serum miR-130b might be involved in the pathogenesis of diabetic nephropathy.

OBJECTIVETo study the efficacy of Xiaoyao Powder (XYP) combined with interferon alpha (IFN-alpha) in treating HBeAg positive chronic hepatitis B (CHB) patients and the effect on their quality of life (QOL).

METHODSTotally 193 patients with HBeAg-positive CHB confirmed by liver biopsy were randomly assigned to 2 groups, Group A (94 cases) and Group B (99 cases). IFN-alpha1b was subcutaneously injected to patients in Group A at the dose of 50 microg, thrice per week. Those in Group B additionally took XYP. The therapeutic course for all was 24 weeks. Clinical efficacy was observed by assessing ALT restoration rate, HBeAg negative rate, HBeAg conversion rate, HBV DNA negative rate, complete response rate, partial response rate, and symptoms integral. The evaluation of QOL was performed by using chronic liver disease questionnaire (CLDQ) score. Adverse reaction occurrence rate was observed in the two groups.

RESULTSBetter effects were obtained in Group A on ALT restoration rate, HBeAg negative rate, HBV DNA negative rate, complete response rate, partial response rate, TCM symptoms integral, the total effective rate of TCM sysmptoms, CLDQ score, and adverse reaction rates, showing statistical difference when compared with Group B (P < 0.05, P < 0.01).

CONCLUSIONXYP could elevate the efficacy of TCM symptoms of HBeAg-positive CHB patients and anti-viral effect, improve their QOL, and reduce adverse reaction of IFN-alpha.

Adult ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Hepatitis B e Antigens ; Hepatitis B, Chronic ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Male ; Quality of Life ; Treatment Outcome

Obje:ctive To establish an optimized method to isolate, culture and identify human umbilical cord mesenchymal stem cells (hUCMSCs) in vitro and induce their osteogenic and adipogenic differentiation. Methods The hUCMSCs were isolated from human umbilical cord by digestion with collagenase. After serial subcultivation in vitro, the stem cells were passaged. Morphologic appearance of hUCMSCs was observed under an optical microscope and atomic force microscope. The proliferation rate was measured by MTT assay. Cell cycle and surface antigens were measured by flow cytometry. The osteogenic and adipogenic differentiation was tested and evaluated by specific staining methods. Results The isolation of hUCMSCs by digestion with collagenase was efficient. After seeded for 24 hours, the adherent cells showed spindle shape and fibroblast cell-like shape and the size of hUCMSCs was homogeneous. The similar growth curves of passage 3 and 7 exhibited a great potential for proliferation. Flow cytometry analysis revealed that CD29, CD44 and CD105 were highly expressed on the surface of passages 3 cells, but the expression was negative for CD34, CD45 and HLA-DR. After culture in inducing medium, the cells were successfully induced into osteogenic and adipogenic lineages. These cells were highly positive for alkaline phosphate staining and also showed mineralization presented with von kossa staining after 4 weeks' culture induction of osteogenic differentiation. Furthermore, liquid vacuoles were detected by oil red O staining after 3 weeks' culture induction of adipogenic differentiation. Conclusion An in vitro method for isolation and purification of hUCMSCs from human umbilical cord has been established. The cultured cells were composed of only undifferentiated cells and their biological properties were stable. The hUCMSCs are expected to be a new type of stem cells of tissue engineering.

Objectiv e:To investigate the effect of different culture conditions on the differentiation of Treg and Th17 to lay a foundation for exploring the methods to reverse the immune tolerance induced by tumor microenvironment.Methods:The IL-6 gene was cloned and stablely transferred into the tumor cell line expressing TGF-β.The conditioned mediums ( CM) were prepared by collecting the culture supernatants of tumor cell lines with or without IL-6 expression and used in the in vitro culture of peripheral blood mononuclear cells ( PBMC ) .The changes of Treg and Th17 in PBMC treated with different CM were detected with flow cytometry ( FCM) .Results:The expression of TGF-βin BEL-7402 was higher than that in HepG2.Thus the BEL-7402 was selected for preparation of cell line stablely transfected with IL -6 gene.ELISA detection confirmed the effective expression of IL -6 by the identified cell lines.It was showed that the Treg increased in PBMC treated with culture supernatants of tumor cells .However,the presence of IL-6 reversed the increase of Treg and promoted the differentiation of Th 17.Conclusion: The culture supernatants of tumor cells increases the proportion of Treg.However,the presence of IL-6 in this CM can reverse the increase of Treg and raise the proportion of Th 17.

Antibodies, Monoclonal ; metabolism ; CD79 Antigens ; metabolism ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunoglobulin G ; metabolism ; Male ; Middle Aged ; Nose Neoplasms ; metabolism ; pathology ; therapy ; virology ; Paranasal Sinus Neoplasms ; metabolism ; pathology ; therapy ; virology ; Plasmacytoma ; metabolism ; pathology ; therapy ; virology

Objective To observe the imaging features of primary lymphoma of bone (PLB) on MRI and PET, and to assess the value of MRI combined with PET for PLB. Methods Sixteen patients with pathologically confirmed PLB were collected, and the MRI and PET appearances were analyzed retrospectively. Results Single bone infiltration was detected in 15 patients (5 in femurs, 3 in vertebro, 3 in right iliums, 2 in tibias, 1 in radius and 1 in maxillae), while multiple bones infiltration were noticed in 1 patient (lesion located in manubrium sterni and the 7th right rib). MRI demonstrated heterogeneous focal-lamellar or diffuse signal intensity within marrow, isointense or hypointense on T1WI and slightly hyperintense on T2WI with homogeneous or heterogeneous enhancement. Severe soft tissue mass was seen in all 16 patients, the range of soft tissue mass was larger than osseous lesion in 15 patients and equal to osseous lesion in 1. Most PLB were homogeneous isointense or slightly hypointense on T1WI and homogeneous or heterogeneous slight-hyperintense on T2WI with slightly or moderately homogeneous or heterogeneous enhancement, while in 3 patients showed single vertebral compression fracture with local epidural- and/or paravertebral-soft tissue, and the range of soft tissue larger than the pathologic vertebrae. PET was performed before operation in 13 patients, showing local increasement of glycometabolism and uptake of radioactive nuclide without abnormality for other sites. For three patients of primary lymphoma of vertebrae underwent PET after operation, and recurrence was detected in 1 patient after 2 months. Conclusion Large soft mass with small osseous destruction and relatively hypointensity on T2WI is somehow characteristic for PLB. PET features of PLB are not specific, but has some advantages in determining the nature of lesion, differentiating lesions and follow-up after operation. MRI combined with PET is an appropriate imaging method for PLB.