Sleeve gastrectomy and simultaneous repair of hiatal hernia for prevention of gastroesophageal reflux / 中华普通外科杂志

Objective:To evaluate the laparoscopic sleeve gastrectomy combined with hiatal hernia repair surgery for weight loss and antireflux.Methods:This study included 21 obese patients with gastroesophageal reflux who underwent laparoscopic sleeve gastrectomy at the Weight Loss Metabolism Center of the Department of Hepatobiliary and Pancreatic Surgery of Zhejiang Provincial People's Hospital from Dec 2019 to Dec 2020. Patients were divided into simple bariatric surgery group (9 cases) and simultaneous combined surgery group (12 cases).Results:In the combined surgery group, 1 case had postoperative gastric leakage. The postoperative body weight, waist circumference, and BMI indexes of the two groups showed a downward trend ( F=5.154, P=0.013; F=14.319, P<0.001; F=6.725, P=0.004). There was a statistically significant difference in the excess weight loss in both the two groups at 6 months after the operation compared to 1 month after the operation ( t=8.927, P<0.001; t=8.926, P<0.001). There was no statistically significant difference in postoperative lower esophageal sphincter resting pressure and Gerd symptom score in the bariatric surgery group compared with preoperative ( t=-0.891, P=0.507; t=0.629, P=0.298). The postoperative Gerd symptom score of the patients in the combined surgery group was significantly lower than that before the operation, and the resting pressure of the lower esophageal sphincter was significantly higher than that before the operation, ( t=-10.539, P<0.001; t=5.066, P=0.038). Conclusion:Combined surgery have the same weight loss effect as in simple bariatric surgery in obese patients with gastroesophageal reflux, in addition to stronger anti-reflux effect.

A prospective multicenter randomized controlled clinical trial study of a domestic single-use digital flexible ureteroscope versus a reusable digital flexible ureteroscope for the treatment of upper urinary tract stones / 中华泌尿外科杂志

Objective:To compare the performance and surgical outcomes of domestic single-use digital flexible ureteroscopes with reusable digital flexible ureteroscopes in treatment of upper urinary stones.Methods:A prospective, single-blind, multicenter and randomized controlled study was performed from September 2018 to June 2019. Eligible patients were randomly assigned, in a ratio of 1∶1, to either experimental group or control group. The inclusion criteria for the study were: aged 18-75 years, solitary upper urinary stone with stone size between 0.8 and 2.0 cm and CT value less than 1 400 HU, negative preoperative urine culture and normal renal function. Exclusion criteria included: patients with acute urinary tract infection, intransitable urethral strictures, impassable ureteropelvic junction obstructions, systemic hemorrhagic disease, coagulation function abnormalities or bleeding tendency, severe hypertension or cardiopulmonary insufficiency, severe hip malformation and difficulty in meeting the demand of operation position and pregnant and lactation women. The device used in the experimental group was a domestic single-use digital flexible ureteroscope, and the device used in the control group was an imported Olympus digital flexible ureteroscope. The qualified rate of clinical comprehensive evaluation (including image quality and operational performance), the rate of device failure, the stone-free rate and the occurrence rate of adverse events (including increase in urine red blood cell and white blood cell counts, postoperative hematuria, nausea, vomiting, dizziness, and fever) in the two groups were recorded.Results:A total of 186 eligible study cases were collected from the People's Hospital of Wuhan University, the First Affiliated Hospital of Xiamen University, and the First Affiliated Hospital of Guangzhou Medical University. 90 cases in the final experimental group and 88 cases in the control group completed the trial and were included in the evaluation. There were no statistically significant differences among age [(48.40±11.36) vs. (47.40±12.53)years old, P=0.594], male to female ratio (62/28 vs. 56/32, P =0.874), BMI [(24.8±2.1) kg/m 2 vs. (25.1±2.0)kg/m 2,P =0.331], hydronephrosis (no/slight vs. mild/severe) (62/28 vs. 65/23, P =0.874), stone location and stone size [(12.8±4.7) mm vs. (11.9±5.2) mm, P =0.227]. There were no significant differences in terms of qualified rate of clinical comprehensive evaluation [98.9% (89/90) vs. 100.0% (88/88), P =0.991], lithotripsy success rate [84.4% (76/90) vs. 84.1% (74/88), P =0.888], device failure/defect rate (both 0%), and the incidence of adverse events [50.0% (45/90) vs. 52.0% (51/88), P =0.894]. The highest incidence of adverse events in two groups was the increase of red blood cells and white blood cells of routine urine after operation. There was no serious adverse event in the experimental group and 1 serious adverse event in the control group. Conclusions:There was no significant difference in image quality, device failure/defect rate, lithotripsy success rate, and adverse event rate between single-use digital flexible ureteroscopes and reusable digital flexible ureteroscopes for lithotripsy of upper ureteral and pelvic stones. Domestic single-use digital flexible ureteroscopes have good safety and effectiveness in the treatment and microscopy of upper urinary tract stones.

Clinical efficacy of atezolizumab plus bevacizumab in the first-line treatment of advanced hepatocellular carcinoma / 中华消化外科杂志

Primary hepatic carcinoma has ranked as the sixth most commonly diagnosed cancer and the third leading cause of cancer death. China shares about 50% of new liver cancer cases, including 80% of hepatic carcinoma. Non-surgical therapy continues to make breakthroughs. The authors report a case of hepatic carcinoma with intrahepatic metastasis and tumor thrombus in the left portal vein, which has achieved continious partial response after the treatment of atezoli-zumab combined with bevacizumab, without adverse reactions such as liver and kidney function damage. The life quality of the patient was improved, showing safety and efficacy of the treatment.

Laparoscopic hiatal hernia repair plus fundoplication for gastroesophageal reflux disease: report of 206 cases / 中华普通外科杂志

Objective:To evaluate the effect of laparoscopic hiatal hernia repair plus fundoplication on gastroesophageal reflux disease (GERD).Methods:The clinical data of 206 GERD patients with esophageal hiatal hernia treated by laparoscopic esophageal hiatal hernia repair + fundoplication at the gastroesophageal reflux center of Zhejiang People′s Hospital from Jan 2016 to Jun 2019 was retrospectively analyzed, including basic data, symptom score, auxiliary examination and follow-up.Results:All 206 patients underwent laparoscopic anti-reflux surgery successfully. There was no conversion to open surgery and no death. Preoperative Deemester scores were 46.49±37.42, while Deemester score 6 month after surgery were 6.38±4.69.Mean follow-up time was 15 months and good result were achieved in 98% of follow-up cases.Conclusion:Laparoscopic repair plus fundoplication for GERD is of minimally invasive and satisfactory, while the preoperative evaluation of surgical indications is properly conducted.

The effect of Pterostilbene on endoplasmic reticulum stress and apoptosis in HK-2 cells induced by oxalate / 中华泌尿外科杂志

Objective:To study the effect of Pterostilbene on endoplasmic reticulum stress and apoptosis in human renal tubular epithelial cells (HK-2 cells) induced by oxalate.Methods:From January 2019 to January 2020, HK-2 cells were divided into a control group (cultured with normal medium), an oxalate group (cultured with a medium containing 4 mmol/L of oxalate), and an intervention group of Pterostilbene (containing 4 mmol/L of oxalate + Pterostilbene 5, 10, and 20 μmol/L mixed medium were cultured at the same time), and the following tests were performed after 12 hours of treatment. Pterostilbene (5, 10, and 20 μmol/L) intervention group for cell viability test, lactate dehydrogenase cytotoxicity test, reduced glutathione, superoxide dismutase, malondialdehyde, hydrogen peroxide enzyme, total antioxidant capacity detection experiments to explore the degree of oxidative damage, and Western blotting experiments to explore the protein expression of ATF6, GRP78, DDIT3, caspase12, Clevead caspase 3/9; Pterostilbene (10 μmol/L) intervention group to detect mitochondrial membrane potential, caspase 3 enzyme activity, apoptosis rate, reactive oxygen detection to detect the apoptosis, reactive oxygen level, and qRT-PCR to detect ATF6, GRP78, DDIT3 of cells mRNA expression.Results:CCK-8 and lactate dehydrogenase toxicity test results showed that the cell activity of the oxalate group was significantly lower than that of the control group [(45.6±3.1)% vs. 100.0%, P<0.001]; the lactate dehydrogenase [(330.2±11.1)U/L vs. (2.6±6.7) U/L, P<0.001] of the oxalate group was higher than that of the control group increased obviously; the cell viability[ (57.2±1.7)%, (67.2±3.4)%, (78.9±1.8)%] of Pterostilbene intervention group (5, 10, 20 μmol/L) significantly increased compared with oxalate group ( P<0.05); lactate dehydrogenase [(288.1±4.3)U/L, (260.9±5.5)U, (202.7±10.2)U/L] in Pterostilbene intervention group (5, 10, 20 μmol/L ) was significantly lower than oxalate group ( P<0.05). The results of the five biochemical indexes of malondialdehyde, reduced glutathione, total superoxide dismutase, catalase, and total antioxidant capacity showed that the cell damage state was consistent with the experimental results of CCK-8 and lactate dehydrogenase. The active oxygen test results showed that the oxalate group had a significantly higher active oxygen level (76.3±4.9 vs. 6.2±1.7, P<0.01); the active oxygen level (39.5±5.4) of the Pterostilbene intervention group(10 μmol/L) was significantly lower than oxalate group ( P<0.01). The flow cytometry and caspase3 enzyme activity showed an increase in apoptosis rate and caspase3 activity in line with the trend of reactive oxygen levels. Mitochondrial membrane potential results showed that the oxalate group had a significantly lower mitochondrial membrane potential (0.76±0.15 vs. 7.84±0.26, P<0.01), and the mitochondrial membrane potential (2.26±0.27) of the Pterostilbene intervention group (10 μmol/L) was significantly higher than oxalate group( P<0.01). Western blot analysis showed that the relative expression of ATF6, DDIT3, GRP78, caspase12 and Cleaved caspase3/9 protein in the oxalate group was significantly higher than that in the control group. The relative expression of ATF6, DDIT3, GRP78, caspase12, Cleaved caspase3/9 protein in the Pterostilbene intervention group was significantly lower than that in the oxalate group ( P<0.05). qRT-PCR results showed that the mRNA expression trends of ATF6, DDIT3 and GRP78 in the three groups were consistent with the results of Western blotting. Conclusion:Pterostilbene can effectively inhibit the endoplasmic reticulum stress and apoptosis of HK-2 cells induced by oxalate.

Suggestions and summaries on multi-center management of acute aortic dissection surgery during COVID-19 epidemic in Hubei province / 中华胸心血管外科杂志

Objective:Since December 2019, novel coronavirus infection has occurred in Hubei province and spread throughout the country quickly. This new crown viral pneumonia was named as coronavirus disease of 2019 (COVID-19) by WHO. However, at present, there is a high incidence of acute aortic dissection in winter and spring. How to prevent the spread of the epidemic and choose the appropriate treatment is an important topic for the patients with acute aortic dissection.Methods:From January 16, 2020 to February 26, 2020, a total of 37 of acute aortic dissection operations were carried out in several cardiovascular surgery centers in Hubei Province. There were 18 cases of Stanford type A aortic dissection and 19 cases of Stanford type B aortic dissection. There were 10 cases (55.55%) with ascending aorta replacement and 7 cases (38.89%) with Bentall procedure for aortic root surgery, and total arch replacement with stented elephant trunk implantation were performed in 14 cases (77.8%). In 19 patients with Stanford type B aortic dissection, thoracic endovascular aortic repair was performed, with the left subclavian artery chimney technique in 2 cases.Results:No deaths occurred within 30 days of hospitalization. Preoperative nucleic acid testing excluded 7 cases of novel coronavirus infection, and 3 suspected cases underwent emergency surgery. the three-level protective standard was adopted in the majority of the surgeries(62.2%, 23/37), and 11 patients were negative in the reexamination of viral nucleic acid after the operation.Conclusion:During the epidemic period, patients with acute aortic dissection should be carefully identified with actife COVID-19 before surgery. The treatment principles-" prevention and control of pneumonia epidemic should be emphasized, conservative medical management should be taken in the comfirmed cases, the selective operation should be delayed as far as possible, and the operation should be reasonable performed in critical cases" should be followed, which can save patients' lives to the greatest extent and prevent the spread of the virus.

Antiviral and antifibrotic therapies reduce occurrence of hepatocellular carcinoma in patients with chronic hepatitis B and liver fibrosis: a 144-week prospective cohort study / 南方医科大学学报

OBJECTIVE@#To compare the efficacy and safety of different antiviral and antifibrotic regimens in patients with chronic hepatitis B (CHB) and hepatic fibrosis and the incidence of hepatocellular carcinoma (HCC) associated with these therapies.@*METHODS@#A total of 840 patients with CHB and concurrent hepatic fibrosis, who received antiviral therapy in Nanfang Hospital between June, 2010 and June, 2018, were enrolled in this follow-up cohort study. The patients were assigned to 3 cohorts matched for gender, age (difference≤5 years), HBeAg status and liver stiffness measurement (LSM) for treatment with one of the 3 antiviral drugs, namely entecavir, tenofovir dipivoxil and adefovir dipivoxil; each cohort was divided into 2 groups, with one of the groups having a combined treatment with Fufang Biejiaruangan tablet. The cumulative negative conversion rate of HBV DNA, normalization rate of ALT, hepatic fibrosis regression and the incidence of HCC were compared among the 3 cohorts and across the 6 groups at 144 weeks.@*RESULTS@#A total of 749 patients were available to follow-up at 144 weeks. Compared with the baseline data, the cumulative negative conversion rate of HBV DNA increased gradually and the abnormal rate of ALT decreased significantly over time during the treatment in all the 6 groups (all < 0.001). Compared with the any of the antiviral drugs used alone, the combined treatments all resulted in significantly better antifibrotic effects (χ=11.345, χ=10.160, χ=6.358; all < 0.05). At 144 weeks, the incidence of HCC were 2.2%, 1.7%, 1.7% and 3.3% in enecavir group, enecavir with Biejiaruangan tablet group, adefovir group, and adefovir with Biejiaruangan tablet group, respectively, showing no significant difference between the two cohorts (4 groups; χ=6.813, =0.138). None of the patients in the 2 groups with tenofovir treatment had HCC by the end of the observation.@*CONCLUSIONS@#Antiviral therapy combined with antifibrotic therapy can effectively reverse hepatic fibrosis and reduce the incidence of HCC in patients with CHB; among the 3 antiviral drugs, tenofovir dipivoxil can be a better option for reducing the incidence of HCC in these patients.

Incidence and characteristics of benign liver space-occupying mass in 17 721 patients with chronic hepatitis B: a color Doppler ultrasound-based case-control study / 南方医科大学学报

OBJECTIVE@#To analyze the incidence and risk factors of benign liver space-occupying mass in patients with chronic hepatitis B (CHB) and the ultrasound features that differentiate these masses from small hepatocellular carcinoma.@*METHODS@#We retrospectively analyzed the color Doppler and clinical data of 17 721 patients with CHB treated in the Hepatology Unit of Nanfang Hospital between January, 2016 and December, 2017. The data were compared with those of 21629 healthy control subjects undergoing routine physical examination in the Center of Heath Management of Nanfang Hospital during the same period.@*RESULTS@#Compared with the control subjects, the patients with CHB had significantly higher incidences of hepatic cysts (11.8% 8.7%, 0.05). Sonographically, the benign liver masses commonly showed homogeneous echo within the lesion with clear boundaries and regular shape. Hepatic hemangioma was distinctively hyperechoic in 83.32% (1579/1895) of the patients, while small hepatocellular carcinoma presented with weaker peripheral and internal blood flow signals with a lower flow velocity in the arteries and a higher flow velocity in the portal vein. Liver cirrhosis nodules mostly showed a mixture of strong and weak echoes (79.60%; 7637/9595) without blood flow signal within or around the nodule; an increased volume of the nodule accompanied by heterogeneous echoes within the nodule indicated an increased probability of malignant lesion. Hepatic cysts often displayed no echo within the lesion, but the echo could be enhanced posteriorly.@*CONCLUSIONS@#The patients with CHB are at a significantly higher risk of developing hepatic cysts, hepatic hemangiomas and hepatic cirrhosis nodules than the control population, and an older age and the male gender are associated with a higher incidence of hepatic cysts or cirrhosis. The differences in the sonographic and hemodynamic features can help to differentiate hepatic benign mass from malignant lesions, and kinetic changes in sonography can be used to monitor potential malignant transformation of the cirrhotic lesions.

Analysis on the Implementation Effect of Zero Makeup Policy for Drug and Medical Supplies in a Top Three Hospital in Zhuhai / 中国药师

Objective:To assess the impact of zero makeup policy for drug and medical supplies on hospitals. Methods:Descrip-tive statistics and comparative analysis were used to analyze the related indicators, profit and loss calculation and the cost of patients from April 2014 to March 2017.Results:After the policy was implemented, the number of outpatients and the number of outpatients choosing general doctors decreased. The average length of hospitalization was 8.88 days, and the proportion of drug consumption was 34.10%. The number of outpatients choosing medical experts, the number of inpatients and the proportion of surgical treatment in-creased. Although the policy benefited patients,the average medical expenditure still increased. There was policy loss in the hospital. Conclusion:The reform promotes the implementation of hierarchical medical system, optimizes the hospital income structure and re-duces drug proportion significantly,which achieves the original intentions of the policy to some extent.

Non-epithelial ovarian cancer:CT,MRI findings and corresponding pathological basis / 实用放射学杂志

Objective To study the CT and MRI findings and corresponding pathological basis of non-epithelial ovarian cancer (NEOC).Methods The CT,MRI and clinical data of 74 patients with NEOC proved by surgical pathology were reviewed retrospectively.CT plain scan was performed in 57 cases,and CT enhancement scan was performed in 52 cases;MRI plain scan was performed in 17 cases,and MRI enhancement scan was performed in 11 cases;CT and MRI scans were performed together in 3 cases.Results Among the 74 patients,there were 23 mature teratomas (25 lesions),2 immature teratomas,8 strumas,10 yolk sac tumors,6 dysgerminomas,7 granulosa cell tumors,11 thecomas,5 fibromas and 2 sertoli-leydig cell tumors.97.3% (72/74)of the lesions were unilateral.There were 88.0% (22/25)and 92.0% (23/25)detection rate of calcification and fat in teratomas,respectively.On contrast enhancement,the immature teratoma showed significant enhancement,whereas the mature teratoma showed mild enhancement.On plain CT,strumas presented as multilocular cystic-solid masses,with calcification in 5 cases.After contrast agent administration,the solid portions showed marked enhancement.Tortuous vessels were seen in 7 yolk sac tumors.The linear hypointensity in dysgerminoma on T2WI showed marked enhancement.The granulosa cell tumors were cystic-solid masses,and 4 cases with increased estradiol.Solid mass with mild enhancement were present in thecomas and fibromas,and there were 8 cases with ascites.CT findings of 2 sertoli-leydig cell tumors were cystic-solid masses with significant enhancement of the cystic wall on contrast CT.Conclusion NEOC have some certain CT and MRI characteristics.Teratomas often contain calcification and fat.Strumas:multilocular cystic-solid masses.Yolk sac tumor:tortuous vessels.Dysgerminoma:marked linear enhancement.

MRI findings of superficial siderosis of the central nervous system / 实用放射学杂志

Objective To study the MRI findings of superficial siderosis of the central nervous system(SSCNS)and to improve the understanding of SSCNS imaging features.Methods MRI images of 21 cases were retrospectively reviewed.MRI plain scan (T1WI,T2WI)and diffusion weighted imaging(DWI)were performed in all patients;T2* weighted angiography(SWAN)scan was performed in 8 patients.Results On T1WI of 21 cases,only 4 cases showed infratentorial superficial siderosis which appeared as linear hypointense signal in sulci cerebelli and around brainstem.On T2WI of 21 cases,18 cases presented with linear hypointense signal on cerebral surface.On DWI of 21 cases,20 cases showed linear hypointense signal on cerebral surface,and the other one case showing negative signal on DWI presented hypointense signal on SWAN.On SWAN of 8 cases,more lesions were found in more regions.Conclusion SSCNS has characteristic findings on MRI.SWAN is sensitive to superficial siderosis.MRI is a reliable method for the assessment of SSCNS.

Near-infrared imaging combined with intraoperative ultrasound in laparoscopic liver tumor resection / 中华普通外科杂志

Objective To evaluate intraoperative ultrasound combined with near-infrared imaging in laparoscopic liver tumor resection.Methods 15 cases undergoing laparoscopic hepatectomy at our department from Ju12017 to Sep 2017 were enrolled in this study.We observed the volume of resected liver,ICG test,the ability of detected lesion overlooked by preoperative imaging,operation time,blood loss,hospital stay,postoperative complication,final pathological result,and tumor margin.Results We have done laparoscopic hepatectomy in 15 cases by intraoperative ultrasound and near-infrared imaging.There was no conversion to open surgery,blood loss was (220 ± 159) rnl,operation time was (136 ±6) min,hospital stay was (8.6 ± 2.1) d,tumor margin was (1.6 ± 1.1) cm,all were tumor negative.There was no major complications such as postoperative bleeding,nor perioperative death.There were pleuraleffusion in 3 cases and bile leakage in one,all were cured by drainage.Conclusion Intraoperative ultrasound combined with near-infrared imaging during the process of laparoscopic hepatectomy helps in assuring safe tumor margin and preserving normal liver parenchyma.

Repeat ultrasonography and MRCP after the pain had subsided in patients who presented with acute abdomen caused by a single common bile duct stone / 中华肝胆外科杂志

Objective To analyze the clinical value of repeat ultrasonography and MRCP in patients who presented with acute abdomen caused by a single common bile duct stone after the pain had subsided.Methods The clinical data of 46 patients who were diagnosed to have a single common bile duct stone and presented with acute abdomen admitted to the Department of Hepatobiliary and Pancreatic Surgery and Minimally Invasive Surgery in Zhejiang Provincial People's Hospital were retrospectively studied.The patients were treated with anti-infection,antispasmodic and choleretic drugs with other conservative symptomatic and supportive therapy.Ultrasound and MRCP examinations were carried out before and after conservative treatment of the acute abdominal pain.Results 26 (56.5％) patients with a single stone in the common bile duct passed the stone spontaneously.Of these patients,11 patients were discharged home and were treated conservatively,15 patients underwent LC,and 20 (43.5％) patients still had choledocholithiasis.Of these 20 patients,12 underwent ERCP + EST,followed by LC;while the remaining 8 patients had a history of cholecystectomy,6 and 2 patients underwent ERCP + EST and LCBDE,respectively.Conclusion A single common bile duct stone in patients who presented with acute abdomen may pass the stone spontaneously as shown in this study using ultrasound and MRCP examinations.

Cell cycle arrest and autophagy induced by celecoxib in human HepG2 cells / 中国生化药物杂志

Objective To investigate the effect of celecoxib on the cell cycle and cell autophagy of HepG2 cell line and its possible molecular mechanism. Methods HepG2 cells were treated with celecoxib at different concentrations (0, 50, 100, 200, 500μM), then MTT was used to detect the cell proliferation, cell cycle and apoptosis were detected by flow cytometry, the cell autophagy was observed by transmission electron microscopy, and the expressions of cyclin and autophagy protein were determined using Western blot. Results Celecoxib inhibited the proliferation of HepG2 cells in a concentration dependent manner (0, 50, 100, 200 and 500 μM) and time-dependent manner (24,48h)(P<0.05). There was no significant change in necrocytosis and apoptosis after ttreated by different concentrations of (0, 50, 100, 200 and 500 μM). The celecoxib inhibited cell cycle arrest at G1 phase, the cell rate of G1 phase increased, while the cell rate of S phase decreased in a concentration dependent manner (0, 50, 100, 200 and 500 μM) and time-dependent manner (0, 8, 16, 24h)(P<0.05). The protein expressions of cyclin D1,cyclin D3, cyclin E2, CDK2 and CDK4 significantly decreased by 500 μM celecoxib (P<0.05). The celecoxib induced autophagy in HepG2 cells, and transformed autophagy protein LC3-Ⅰto LC3-Ⅱ in a concentration dependent manner. Conclusion Celecoxib can effectively inhibit the proliferation of human malignant hepatocellular carcinoma cell line HepG2, which provides a new idea for the clinical application of celecoxib.

Analysis of clinical characteristics of 22 906 gravidas with Hepatitis B Virus infection / 实用医学杂志

Objective To analyze the clinical characteristics of gravidas with HBV in Nanfang Hospital from 2008 to 2014. Methods 22 906 gravidas were retrospectively investigated. Results The HBsAg positive rates were 11.64% and 6.16% when the gravidas were divided into Cantonese and non-Cantonese groups (χ2 =193.370, P < 0.005). The ALT abnormal rates in HBeAg positive and HBeAg negative gravidas were 17.96% and 6.68% (χ2=62.594, P<0.005). Conclusion The HBsAg positive rate of gravidas in Guangdong and the ALT abnormal rate of HBeAg positive gravidas are higher.

Continuous growth with undetectable growth hormone level: one case of invisible pituitary stalk and literature review / 中华内分泌代谢杂志

Normal function of growth hormone-insulin-like growth factor Ⅰaxis is essential for linear growth after birth. A case of continuous growth with undetectable growth hormone level even under insulinhypoglycemia stimulation was reported. The growth hormone deficiency was due to pituitary stalk interruption combined with deficiency of multiple pituitary hormones. Taken together with reviewed literature, this so-called nongrowth hormone-dependent linear growth was preconditioned by other hormones, especially gonadotropin deficiency,and the unclosed epiphysis.

The clinical value of MMP-9 and PIIINP in diagnosis of acute myocardial infarction / 中国基层医药

Objective To investigate the clinical value of MMP-9 and PIIINP in diagnosis of acute myocardial infarction.Methods To retrospective analyze MMP-9 and PIIINP In 76 cases patients with acute myocardial infarction ,when prophase and anaphase of treatment in our hospital.Results The MMP-9(191.6 ±38.5)μg/L and PIIINP(8.9 ±1.8)μg/L of observation group treatment prophase were higher than control group[(85.6 ±33.2)μg/ L,(3.5 ±1.5)μg/L],(t = 13.01,14.55,P ＜ 0.05),which were obviously different between treatment anaphase 3d,7d,14d MMP-9[(170.2 ±30.2)μg/L,(123.6 ±32.7)μg/L,(90.2 ±30.2)μg/L]and PIIINPf(6.9 ±1.7)μg/L,(5.2 ±1.6)μg/L、3.7 ±1.8)μg/L]were lower than treatment prophase(t = 12.63,9.58,5.36,5.01 ,18.0,17.8,all P＜0.05);the MMP-9(90.2 ±30.2)μg/L and PIIINP(3.7 ±1.8)μg/L were remove in treatment anaphase 14d,which had no difference between treatment anaphase 14d and treatment prophase(t=0.69,0.54,all P＞ 0.05).Conclusion The MMP-9 and PIIINP were higher diagnostic value in clinical diagnosis acute myocardial infarction,which was worth to be used.

Effects of AG1024 on hepatocellular carcinoma cell lines / 中华普通外科杂志

Objective Tyrphostin AG1024(3-Bromo-5-t-butyl-4-hydroxybenzylidenemalonitrile) is a specific insulin like growth factor type Ⅰ receptor tyrosine kinase blocker,this study is to investigate the effect of AG1024 on the proliferation and apoptosis of hepatocellular carcinoma cell lines.Methods Treated with AG1024 on vailed concentrations(0～40 μmol/L),human hepatocellular carcinoma cel lines HepG2 and SMMC-7721 were observed for morphological and molecular biology changes,the effect of AG1024 on the cell lines proliferation invasion ability as well as apoptosis was evaluated. Results MTT showed that AG1024 dose-dependently inhibited the proliferation of hepatocellular carcinoma cells,flow cytometry suggested that AG1024 significantly promoted cell lines apoptosis,the cell invasion assay indieated that AG1024 significantly inhibited cell's invasion ability.RT-PCR showed over-expression of IGF-IR in liver cancer cells.and AG1024 dose-dependently increasedtheexpressionofcytochreme C. According totheresultsof Western, blotting,the phosphor-ERK and procaspase-3 were down-regulated while the total ERK remained unchanged. Conclusion AG1024 as a specific IGF-IR blocker blocks the downstream signaling cascade and thus inhibits the proliferation of hepatocellular carcinoma cells and induces cell's apoptosis.