Objective Pneumosilicosis is characterized by pulmonary fibrosis and cannot be effectively treated at present. This study was to explore the changes of monocyte subsets in the mouse model of silicon dioxide-induced experimental pneumosilicosis and the correlation of the changes with lung inflammatory injury and pulmonary fibrosis. Methods A total of 100 male C57BL/6J mice weighing 18-22 g were equally randomized into a normal saline (NS) group and a silicon dioxide (quartz) group.The model of experimental pneumosilicosis was established by oropharyngeal aspiration of quartz suspension.At 1, 3, 7, 14, and 28 days after treat-ment, the mice were sacrificed and the proportions of different circulating monocyte subpopulations determined by flow cytometry.Dif-ferent types of inflammatory cells in the bronchoalveolar lavage fluid ( BALF) were routinely counted.The inflammation score and col-lagen volume fraction ( CVF) of the lung tissue were obtained by HE and picrosirius red staining. Results At 7 days after quartz treatment, silicotic nodules were observed in the lung tissue.Compared with the NS controls, the model mice showed significantly in-creased inflammation score and CVF at 7 days (0.920 ±0.049 vs 1.400 ±0.089, P<0.01;0.525 ±0.048 vs 1.950 ±0.065, P<0.01) and 28 days (0.800 ±0.089 vs 1.520 ±0.136, P<0.01;0.850 ±0.050 sv 5.300 ±0.776, P<0.01).In comparison with the NS group, the quartz group also exhibited significant increases in the number of total cells at days 1-28 (P<0.01) and the count of neutrophils at days 1-14 (P<0.01) in the bronchoalveolar lavage fluid (BALF) of the model mice, as well as in the number of macrophages in the BALF at 3 days (0.980 ±0.663 vs 6.821 ±2.627, P<0.01), 7 days (1.225 ±0.601 vs 6.697 ±1.864, P<0.01), 14 days (1.492 ±0.438 vs 2.574 ±0.396, P<0.01), and 28 days (2.035 ±0.456 vs 3.249 ±0.492, P<0.01).The count of neutrophilic granulocytes in the BALF was remarkably higher in the quartz than in the NS group at 1, 3, 7, and 14 days (P<0.01) but not at 28 days (P>0.05).Compared with the NS controls, the quartz-treated mice showed markedly increased proportion of Ly6Chimonocytes at all time points, which peaked at 7 days (58.750 ±2.386 vs 78.300 ±2.517, P<0.01), with a positive corre-lation with the inflammation score (P<0.01) and CVF of the lung tissue (P<0.01) at 7 and 28 day. Conclusion The propor-tions of circulating Ly6Chi and Ly6Clo monocytes changed dynamically in the murine model of quartz-induced experimental pneumosilico-sis.The increased proportion of the Ly6Chi monocyte subpopulation might be closely related with lung inflammatory injury and pulmona-ry fibrosis in pneumosilicosis.

AIM: To establish a cell line of stable silencing of P2X7 receptor (P2X7R) expression through short hairpin RNA ( shRNA)-mediated interference in murine RAW264.7 macrophages, and to investigate the proliferation and apoptosis in the cell line.METHODS:Stable silencing of P2X7 R gene in the RAW264.7 cells was achieved by re-combinant shRNA plasmid targeting murine P2X7 R gene via liposome mediated transfection, followed by G418 selection. The efficacy of plasmid transfection and P2X7 R silencing in G418 resistant cells was verified by immunofluorescent micros-copy and real-time PCR, respectively.The proliferative activity was analyzed by CCK-8 assay and EdU cell proliferation as-say.The cell cycle distribution and apoptosis were evaluated by flow cytometry.RESULTS:The expression of P2X7 R at mRNA and protein levels was down-regulated by 80% in shP2X7 R group compared with negative control ( NC) plasmid transfection.In addition, P2X7 R-silencing cells exhibited higher proliferative activity compared with NC and wild-type RAW264.7 cells (P<0.05).Compared with NC cells, P2X7R silencing resulted in an increase in the phagocytosis of the cells ( P<0.05) .CONCLUSION:A cell line RAW264.7 of stable silencing of P2X7 R expression was successfully es-tablished.P2X7 R gene silencing stimulates the proliferation, and changes phagocytic function in murine RAW264.7 macro-phages.

Objective To compare laparoscopic appendectomy to conventional operation for the treatment of appendicitis.Methods In this study 1558 patients diagnosed as appendicitis were divided into group A(laparoscopic appendectomy)and group B(conventional operation)according to the random numbers.In group A,779 patients were treated with laparoscopic appendectomy.In group B,779 patients were treated with conventional open appendectomy.The inhospital data and that of followed-up were compared.Statistical analysis was carried out using SPSS11.5 for Windows.Comparisons between categorical variables and continuous variables were analyzed using the X~2 test and t test.Results The operation was successfully performed in all 1558 patients.The operating time in group A and B were(30±2.2)min versus(30±1.6)min(t=0.00,P>0.05),the blood loss were(15±2.9)ml versus(29±5.2)ml(t=65.62,P<0.05),the bed off activity time were(26±3.1)h versus(51±2.1)h(t=69.95,P<0.05),the bowels'move time were(29±1.6)h versus(52±4.6)h(t=10.92,P<0.05),the hospital stay were(3±0.9)d versus(7±1.2)d(t=74.42,P<0.05),the inhospital cost was (6591±41)yuan versus(4860±32)yuan(t=-12.19,P<0.05),the incision infection rate was 0 and 2.8%(X~2=25.40,P<0.05).Postoperative analgesics were needed in 3.8% and 31.4% (X~2=30.63,P<0.05).All the patients were followed-up from 4.5 years to 9.8 years(average 6.8 years).The development of incision hernia in group A and B was 0 versus 0.64% (X~2=5.01,P<0.05).Conclusions Laparoscopic appendectomy is a therapy of choice for patients with acute appendicitis with advantages of minimal invasion,early recovery,few complications and short hospital stay.

Objective To study the safety and efficacy of laparoseopic subtotal thyroidectomy for primary hyperthyroidism.Methods From January 2003 to January 2007,seventy-five patients with primary hyperthyroisism underwent subtotal thyroidectomy,among which thirty patients by laparoscopic procedure and forty-five patients by open surgery.The clinical data were retrospectively analyzed.Results All the surgery were Successful.No patient in the endoscopic group was converted to open surgery.The mean operative times of endoscopic group and open surgery group were(110.5±12.3)min vs(98.8±15.5)min(t=3.46,P<0.05),the mean blood loss were(45.5±11.5)ml vs(65.8±12.6)ml(t=7.07,P<0.05),the inhospital fee were(11128.5±358.8)RMB yuan vs(6500.9±231.9)RMB yuan(t=67.92,P<0.05),the amount of drainage were(125.9±10.7)ml vs(46.5±9.4)ml(t=33.90,P<0.05),the days of drainage were(2.98±0.5)d vs(1.75±0.3)d(t=13.31,P<0.05),tlle use of analgeties was in 20.0%(6/30)vs 42.2%(19/45)(χ~2=4.00,P<0.05),the rate of temporary hoarseness wag 6.6%(2/30)vs 8.8%(4/45)(χ~2=0.12,P>0.05).There were 1 hypothyroidism and 1 recurrent hyperthyroidism in endoscopic group while 1 hypothyroidism and 2 recurrent hyperthyroidism in open surgery group after a 47.8 month's follow-up. Conclusions Endoscopic subtotal thyroideetomy for hyperthyroidism patients is safe,effective and presents a significant cosmetic advantage.

Objective To study the efficiency of iaparoscopic inguinal hernia repair without the use of a mesh. Methods We used laparoscopic hernia repair without the use of a mesh in 92 cases of inguinal hernia. Results were compared with that of total extraperitoneal laparoscopic inguinal hernioplasty(TEP) in 91 cases from January 2001 to March 2004. Results The laparoscopic procedures were successfully performed in all the patients. In mesh-free and TEP group respectively the operating time was (21±4) min vs. (70±16) min (t=28. 01, P<0.05), hospital stay was (3.5±1.0) d vs. (4.8±1.2) d (t=7.96, P<0.05), average time off-bed was (1.0±0.5) d vs. (1.8±0.7) d (t=8.90, P<0.05), duration of pain was (1.0±0.5) d vs. (2.5±0.7) d (t=16.69, P<0.05), the expense was (4500±500) RMB yuan vs. (8000±820) RM B yuan(t=34.89, P<0.05), subcutaneous hematoma rate was 0% vs. 8.7% (χ~2=6.48, P<0.05). The 48 hour C-reaction protein level after the operation was (3.9±0.3) mg/dl and (8.8±0.5) mg/dl (t=80.48, P<0.05). All the difference was statistically significant between the two groups. All patients were followed up for 56.9±6.2 months. The recurrence rate was 0 and 2.1% (χ~2=0.51,P>0.05) respectively. Conclusions Mesh-free laparoseopie inguinal hernia repair is safe, cost-effective, as well as of much lower hernia recurrence.

Objective To study the efficacy of laparoscopic hepatectomy combined with Iodine-125 and radiofrequency ablation(RFA)in the treatment of metastatic hepatic carcinoma.Methods There were 124 patients diagnosed as hepatic metastasis detected by CT or MR scan, and were divided into two treatment groups. Group A(combined group of 41 cases)with laparoscopic excision,RFA and iodine-125 treatment and group B(control group of 83 cases)with transhepatic artery chemoembolization(TACE)and systematic chemotherapy.Results Nine new hepatic metastatic foci were found by laparoscopic ulstrasound during the operation in group A,and in this group,18 hepatic metastatic lesions located on the surface in 13 patients were removed,then RAF applied to the hepatic metastases,and iodine-125 planted in place,altogether 59 foci near to the porta hepatis or large vessels were treated by laparoscopic RFA and iodine-125 implantation.All patients were followed-up from 26 to 45 months(average 35.4 months).The total relief rate was 90.2% and 30.1 % in group A and B respectively(x~2=39.68,P＜0.05＝.The median survival time was 19 and 11 months in group A and B respectively(t=-9.74,P＜0.05＝.The survival rate at 1-,2-and 3-years was 80.5%,48.8%,24.4% and 54.2%,28.9%,9.6% in group A and B respectively (x~2=8.11,4.73,4.81,P＜0.05＝.Conclusions Laparoscopic excision,Iodine-125 implantation and radiofrequency ablation in the treatment of metastatic liver carcinoma is safe、effective,and this approach prolongs the patient's survival time.

Objective To evaluate the feasibility and efficacy of laparoscopic thyroidectomy in the treatment of thyroid carcinoma. Methods 12 patients with thyriod carcinoma treated with laparoscopic thyroidectomy from January 2003 to January 2006 in our hospital were analyzed retrospectively. Results All operations were successful and there were no surgical deaths. The postoperative complications included 2 cases of hoarseness, 1 extremity numbness and 1 temporary hypoparathyroidism. The number of dissected lymph nodes was from 0 to 13 with a mean of 7.6 nodes in each patient. Of the 12 patients, there was one patient with bilateral lymph nodes metastasis, 5 patients unilateral positive lymph nodes and 6 patients no lymph nodes involvement. The pathologic result of all 12 cases was papillary thyroid carcinoma. After 30 to 62 months' follow-up (average 50.4 months), all patient were still survive and no local recurrence or distance metastasis happened. Conclusion Laparoscopic thyroidectomy in the treatment of early papillary thyroid carcinoma is safe and feasible.

Objective To investigate the therapeutic effectiveness of residue liver embedding of iodine-125 on recurrence after hepatectomy in hepatocellular carcinoma patients. Methods In this study, 85 cases with resectable hepatocellular carcinoma were collected and divided into two groups randomly: intrahepatic embedding of iodine-125 group and control group. The serum values of T lymphocyte phenotypes (CD3 + CD4 + ,CD8 +), NK cells,TB IL, ALT, AST, AFP and MMP-9 were measured in all patients 1 day before and 7, 30 days after the operation respectively; B ultrasonic and CT were used to detect for intrahepatic dissemination and recurrence of HCC after hepateetomy. All patients were followed-up from 16 to 55 months (average 35.4 months). Results Surgery were successful in all cases. There were no difference in T lymphocyte phenotypes, NK cells, TBIL, ALT and AST between the two groups (P＞0.05). The serum values of AFP and MMP-9 were much lower in the intrahepatic embedding of iodine-125 group than the control group(P<0.05). In iodine-125 embedding group, the 0.5-, 1-year recurrent rates were 2.3%、6.9%, respectively, compared with 14.2% and 26.1%, respectively, in control group (all P<0.05). Conclusions Intrahepatic embedding of iodine-125 in HCC patients after hepatectomy decreases values of AFP, MMP-9 and local cancer recurrence rate in HCC patients after hepatectomy.

BACKGROUND: Meseuchymal stem cells (MSCs) have extremely strong self-duplication ability and multidirectional ifferentiation potential. When bone marrow stromal cells (BMSC) are isolated and cultured in vitro, implanted in vivo, the distribution and colonization are still unclear, which is concerned with whether BMSC can be usedas target cells in clinic.OBJECTIVE: To explore the capacity of colonizing to the liver after allografting of green fluorescent protein (GFP) labeled MSCs of rats by different approaches.DESIGN: Factorial design.SETTING: Department of General Surgery, Second People's Hospital of Guangdong Province, Postdoctoral Workstation of Sun Yat-Sen University;Department of General Surgery, Zhujiang Hospital, Southern Medical University; Department of Organ Transplantation, Third Hospital Affiliated to Sun Yat-Sen University.MATERIALS: The experiment was performed at the Staff Room of Pharmacology, Basic Department, First Military Medical University of Chinese PLA from January 2003 to December 2004. A total of 36 clean adult SD rats were selected and randomly assigned into 5 groups: CCL4 plus portal vein transplantation group (n=6), portal vein transplantation control group (n=6), CCL4 plus caudal vein transplantation group (n=6), caudal vein transplantation control group (n=6) and mixed group (n=12).METHODS: ① MSCs were obtained from rat marrow and labeled with GFP. After amplifying in vitro, MSCs suspension was implanted with thin needle, with the volume of 0.5 mL/100 g. ②CCL4 plus portal vein transplantation group: In 3 days before MSCs transplantation, the rats were administrated with 20 g/L CCL4 2.5 mL/kg by gastric perfusion every day. The dose was double at the first time. Labeled MSCs were implanted from portal vein. Portal vein transplantation control group: Before transplantation the MSCs were bred commonly, and the labeled MSCs were implanted from portal vein. CCL4 plus caudal vein transplantation group: In 3 days before MSCs transplantation, the rats were administrated with 20 g/L CCL42.5 mL/kg by gastric perfusion every day. The dose was double at the first time. Labeled MSCs were implanted from caudal vein. Caudal vein transplantation control group: Before transplantation the MSCs were bred commonly, and the labeled MSCs were implanted from caudal vein. Mixed group: On the basis of the former 4 groups, 2 rats were implanted with non-labeled MSCs; Another 2 rats fed with CCL4 for 3 days and normal feed were established, without MSCs transplantation. ③At days 3 and 7 after transplantation expression of transplanted MSCs in liver of rats of each group were examined with fluorescent quantitative PCR.MAIN OUTCOME MEASURES: ①Results of MSCs isolation, purification, in vitro amplification and phenotype identification, ②result of GFP-labeled MSCs, ③observation of growth of rats following allografting of MSCs, and ④result of quantitative identification of GFP positive DNA amount in hepatic tissues of each group.RESULTS: Totally 36 experimental SD rats were involved in the result analysis. ①Percoll gradient separating medium was applied to isolate bone marrow of rats. The obtained cells were transferred and amplified,and then mostly showed coincident shuttle shape. Cells did not express CD34 and CD45, but CD29, CD44 and CD90 of MSCs, which were noncommitted stem cells in non-differentiating status that were different from hemopoietic stem cells in bone marrow. ②The green fluorescent cells appeared 24 hours after MSCs transfection. From hour 48 to 72 the number of positive cells significantly increased, with strong intensity.The transfection efficiency was 20%-30% under high-power field, and most of the cells were with green fluorescence. But green fluorescent cells did not appear in the MSCs cells as control. ③After allografting of labeled or non-labeled MSCs of rats with different approaches, at day 1 the rats were listless with bad food appetite, less mobilization; At day 2mostly of them had normal diet and mood, but there was no significant difference in rats of each group. ④The rats in each group with the exception of mixed group had green fluorescent protein positive cells in liver at days 3 and 7. The number of green fluorescent protein positive DNA was higher in liver tissues in the CCL4 plus portal vein transplantation group and CCL4 plus caudal vein transplantation group than in the portal vein transplantation control group and caudal vein transplantation control group (P＜0.05).CONCLUSION: Duration and amount of stem cells colonizing in liver may be associated with liver injury, while not related to the implantation approach. In normal animals with uninjured liver the stem cells can colonize in liver, and the amount is associated with transplantation approach and post-transplantation duration.

Objective To evaluate the efficacy and priority of laparoscopy in the diagnosis and treatment of acute peritonitis. Methods Clinical data of 133 cases of acute peritonitis diagnosed and treated under laparoscope between April 2001 and October 2004 were retrospectively reviewed. Results Of the 133 cases, there were 60 cases of gastroduodenal perforation, 15 cases of acute cholecystitis, 8 cases of gallbladder perforation, 2 cases of sigmoid colon perforation, 35 cases of acute perforated appendicitis, 3 cases of jejunal diverticulum perforation, 1 case of foramen of Winslow hernia, 4 cases of acute pancreatitis, and 5 cases of primary peritonitis. The diagnostic accuracy was 100%. All the patients were treated laparoscopically without complications. Conclusions Laparoscopy gives a high diagnostic accuracy for acute peritonitis. The rationale for the use of it lies in the possibility of avoiding time- consuming preoperative B-ultrasonography or CT scans and performing minimally invasive surgical interventions directly.