Objective: To discuss the procedure and clinical effect of retroperitoneal laparoscopic nephropexy (RLN).Methods: From August 2001 to June 2006, RLN was performed on 28 female patients aged 26-45 years old (mean, 34±2.5) with symptomatic nephroptosis, including 15 with the right kidney, 12 with the left, and 1 with both. The preoperative complaint of patients included subjective symptoms (constant and recurring pain in 28 patients) and objective symptoms (upper urinary infections in 16, hematuria in 12, and upper tract obstruction in 12). One patient underwent nephropexy via the transperitoneal approach and the others underwent nephropexy via the retroperitoneal approach. A retroperitoneoscopic procedure was performed after positioning the patients in the flank position. Digital preparation of the retroperitoneal space was made and standardized trocar was placed. The key step of the surgery was complete exposure of the kidney within Gerota' fascia, which was aimed to separate the potential adhesions between the colon and kidney or between the inferior blood vessels of the kidney. Nephropexy was performed between the fibrous capsule at the lower pole of the kidney and the dissected psoas muscle, using three sutures placed by intracorporeal technique or the percutaneous needle both for introduction and removal of the suture; the sutures were separately tied over the sacrospinalis fascia. Results: The mean operative time was (125±9) min (ranging 115-240 min); the mean postoperative hospital stay was (9±1.2) days, largely owing to the required 5-12 days' bed rest. During a mean follow-up of (24±4.2) months(ranging 3 to 70 months), 3 patients had paresthesia, 5 had constant and recurrent ache, 20 were completely free of pain, and 4 had micro-hematuria. One patient had further episodes of pyelonephritis and upper tract obstruction after operation. Intravenous pyelogram(IVP) revealed that the ptosis incorporated into more than one vertebral body in 2 patients. Postoperative renal function test showed an improvement in renal function. Conclusion: RLN is mini-invasive and has less complication. The procedure should be considered as one of the optimal therapy for nephroptosis.

Objective:Clonidine,by activating peripheral α-sbrenoceptors, produces transient pressor response after i.v.injection in anesthetized animals.Moxonidine, with at least 40-fold higher affinity to I1-imidazoline receptors than to α2-adrenoceptors,produces also a transient pressor response. This work was designed to investigate whether I1-imidazoline receptors are involved in this pressor effect of moxonidine. Methods:Female spontaneously hypertensive rats(SHRs,aged 14-16 weeks)were anesthetized with urethane.To observe the transient pressor responses,moxonidine 0.1,0.3,1.0mg/kg(intravenous,i.v),2.0μg(intracerebroventricular,i.c.v.)and 1.0,10.0mg/kg(intragastric,i.g.)were administrated in different groups of rats.To evaluate the roles of α1-adrenoceptors,α2-adrenoceptors and I1-imidazoline receptors in the transient pressor responses to moxonidine, prazosin(10.0μg/kg),yohimbine(2.0mg/kg),phentolamine(0.2mg/kg),idazoxan(1.0mg/kg)or yohimbine+idazoxan(2.0mg/kg+1.0mg/kg)were intravenously given to the animals before moxonidine 0.3mg/kg (i.v.).Results:It was found that i.v.moxonidine produced a greater pressor response than clonidine when producing a similar reduction of blood pressure.This effect of moxonidine was not influenced by prazosin, but was partly inhibited by yohimbine, phentolamine or idazoxan,and completely blocked by the combination of yohimbine and idzaxon.Neither i.c.v.injection nor i.g. administration of moxonidine induced transient pressor responses.Conclusion:The transient pressor response of i.v. moxonidine is mediated by both peripheral I1-imidazoline receptors and α2-adrenoceptors.

Objective: To investigate the growth inhibition and apoptosis induction effect of vitamin E succinate (VES) on human colon cancer cells and to analyze the modulation of apoptosis-mediator Fas expression in this process. Methods: Human colon cancer cell line LS174T was treated with VES for 12 h, 24 h and 48 h at the concentrations of 5 mg/L, 10 mg/L and 20mg/L. 1-(4,5-dimethylthiazo-2-yl)-3,5-diphenylformazan (MTT) assay was employed to detect the inhibitory effect of VES on the growth of colon cancer cells. Flow cytometry was then used to analyze the cell cycle of the colon cancer cells after being treated with VES and the apoptotic rate was calculated at the same time. To find out whether the Fas protein expression was modulated in this process, Western blotting assay and flow cytometry were used to detect the Fas protein level in whole cell lystates and on cell surface. Results: VES exhibited a significant inhibitory effect on the growth of human colon cancer cells in a doseand time-dependent manner. After being treated with VES at 5 mg/L, 10 mg/L and 20 mg/L for 48 h, the apoptotic rate of LS174T cells rose from 0.90% to 15.9%, 46.7% and 64.5%, respectively. Fas neutralizing antibody can significantly block VES-induced apoptosis. After the administration of VES, total Fas protein in whole-cell extracts increased in a dose-dependent manner. The flow cytometry showed that the mean fluorescence intensity rose from 5.43 to 9.88, 13.21 and 18.0 after being treated with VES. Conclusion: VES can induce significant growth inhibition and apoptosis in human colon cancer cells. The modulation of Fas expression is one of the mechanisms involved in this process and may be related to the upregulation of Fas molecule on the cancer cell surface.

Tuberculosis (TB) is a global burden disease and is being resurrected as a major worldwide public health problem after two decades of neglect.In 1993,the World Health Organization (WHO) declared that TB had been a global emergency because of the scale of the epidemic and the urgent need to improve global tuberculosis control.China is one of the countries with the largest population,and also the top of the 22 TB high-burden countries in the world.In the United States,the longstanding downward trend in TB incidence was interrupted in the mid-to-late 1980s,where the national TB incidence peaked in 1992.Sub-Saharan Africa is one of the three regions to dominate the worldwide distribution of notified TB cases.Of the 15 countries with the highest estimated tuberculosis incidence rates in the world,13 are in sub-Saharan Africa,where HIV is the most important single predictor of tuberculosis incidence.The largest share of the global burden of HIV-related tuberculosis falls on this region.The reasons for the persisting global tuberculosis burden include increased poverty in some regions,immigration from countries with high tuberculosis prevalence,the impact of HIV,and most importantly,the failure to maintain the necessary public health infrastructure under the mistaken belief that tuberculosis was a problem of the past.Relying on currently available methods of diagnosis and treatment,the DOT strategy promoted by the WHO for global tuberculosis control is effective,affordable,and adaptable in different settings.

Objective: To study the application of CT and MRI fusion technique in the diagnosis and treatment of intraocular and orbital tumors. Methods: 2D-images of 13 patients with intraocular and orbital tumors were fused by special-point registration and Iterative Local Closest Point(ILCP) method; 3D-fusion images were reconstructed by Ray Tracing method. Results: A 3D-CT-MRI fusion images of intraocular and orbital tumors were reconstructed and displayed. The CT and MRI data of intraocular and orbital tumors were displayed on the same image as a comprehensive whole,which provided a stereogram of 3D-structure of the normal and abnormal orbital tissues. Anatomical structure of the orbit was clearly visualized by 3D-CT-MRI image. Conclusion: The multi-modality fusion technique can provide more accurate and comprehensive information for clinical diagnosis of intraocular and orbital tumors, which is helpful for doctors' planning of surgical operations,clinical education and doctor-patient communication.

Objective: To evaluate the efficacy of the third-generation instrumentation including TSRH, CD and ISOLA in the treatment of adult scoliosis. Methods:Thirty-five adult patients with idiopathic or degenerative scoliosis who received treatment with third-generation instrumentation (TSRH,CD and ISOLA) between July 1999 to January 2003 were retrospectively reviewed. The mean preoperative cobb angle of major curves of the frontal plane was 58.1°(42°-95°). The patients received a combined anteroposterior approach or a single posterior procedure. The mean follow-up time was 20 months(10-48 months). Preoperative and postoperative Cobb angles of the frontal plane and sagittal plane and the distance between C7 and CVLS were measured. The subjective assessment was judged by questionnaire. Results: Postoperative clinical appearance of all patients improved significantly. Mean correction of major curves of the coronal plane was 53.2%. Mean loss of correction of the coronal plane in the last follow-up was 4.3°. The distance between the midline of C7 and CVSL was corrected from 2.6 cm to 0.24 cm. The results of follow-up showed that 89.3% patients were satisfied with the outcome. Pneumatothorax and haematothorax occurred in 2 patients. Three patients still complained of low back pain one year after operation because of adjacent degeneration in 2 patients and pseudoarthrosis in the remaining 1 patient. Conclusion: Imageologic findings and subjective assessment of the patients showed that the third-generation instrumentation can achieve good correction and trunk balance in the treatment of adult scoliosis with fewer complications.

Objective:To optimize the injection protocol of contrast medium for contrast-enhanced MRA (CEMRA) of pulmonary artery and to evaluate the diagnostic value of CEMRA and pulmonary perfusion imaging (PPI) in an experimental model of acute pulmonary embolism. Methods:CEMRA and PPI were performed in 6 normal pigs with different doses of gadolinium contrast agent (5ml, 10ml, 15ml, 20ml and 25ml) at an injection rate of 3ml/s, and 3 pulmonary embolism models were injected with 20 ml contrast agent at 3 ml/s. DSA was also performed for comparison. Results:The signal intensities and the signal to noise ratios of the pulmonary arteries kept increasing with the dose increase of the contrast agent, but the best angio-pulmonary contrast dose was 10-15ml (0.25-0.375mmol/kg), while the optimal dose for PPI was 15-20ml (0.375-0.5mmol/kg). Although CEMRA demonstrated less obstructed pulmonary arteries than DSA (5/10 vs 8/10)did, it detected all obstructions when combined with PPI. The pulmonary infarction zones showed wedge-shaped perfusion defects on the PPI images, with the signal intensities lower than those of the normal areas (137.86±45.32 vs 330.14±46.52, P<0.001). Conclusion:It is suggested that the optimal dose of the contrast agent is 0.25mmol/kg to 0.375mmol/kg for CEMRA, and 0.375mmol/kg to 0.5mmol/kg for lung perfusion. CEMRA combined with PPI may be better than DSA in demonstrating pulmonary embolism.

Objective: To investigate the function and mechanism of phospholipase Cγ1 (PLCγ1) in cell-matrix adhesion in colorectal cancer. Methods: Highly metastatic colorectal cancer cell line LoVo and lowly metastatic colorectal cancer cell line SW480 were subjected to cell-matrix adhesion assay. U73122 (a specific inhibitor of PLC) and pyrrolidine dithiocarbamate (PDTC) (an inhibitor of NF-κB) were used to study the effect of PLCγ1 and NF-κB on cell-matrix adhesion. Furthermore, Western blot and gel electrophoresis mobility shift assay (EMSA) were performed to detect the mechanism of PLCγ1 in colorectal cancer cell adhesion to matrix. Results: Inhibition of PLCγ1 or NF-κB resulted in reduction of cell-matrix adhesion in a dose-dependent manner in LoVo cells(P<0.05), but had no marked effect on SW480 cells. Western blot analysis showed that epidermal growth factor (EGF) stimulated the phosphorylation of PLCγ1 in LoVo. The results of EMSA indicated that inhibition of PLCγ1 signaling pathway also down-regulated the activity of NF-κB while EGF reversed the function. Conclusion:These data suggest that PLCγ1 plays a pivotal role in the EGF-induced cell-matrix adhesion of highly metastatic colorectal cancer cells and that NF-κB is also functional in this signaling pathway.

Objective: To construct the extracellular region of PCP-2(PCP-2EC) and the immunoglobin IgG Fc fusi on protein expression vector,and then express and purify the soluble PCP-2EC/Fc fusion protein for the study of its function in neuronal adhesion. Methods: PCP-2 extracellular region was amplified and cloned into an expression vector pIGplus containing human IgG Fc; PCP-2EC/Fc fusion protein was expressed by COS-7 and 293 cells transfected by the constructed plasmid and purified by protein A. The purified fusion protein was used as substrate to study its function in neuronal adhesion. Results: PCP2 extracellular region was cloned into IgG Fc expression vector successfully; PCP 2EC/Fc fusion protein was expressed and purified in mammal cells; and the purified fusion protein promoted neuronal adhesion. Conclusion:PCP 2EC/Fc fusion protein expression system is successfully constructed and the purified fusion protein can promote neuronal adhesion. These results lay a foundation for the research on the PCP-2 function in neuronal adhesion and the further functional study in the nervous system and other fields.

Objective: To observe morphological changes of epithelial-mesenchymal transition in the early stage of mice renal interstitial fibrosis. Methods: Renal interstitial fibrosis was induced by unilateral ureteral obstruction(UUO) in mice. Histological and immunohistochemical methods were used to analyze pathological changes and α-SMA expression in renal tissue.Argentum hexamethylenamine staining and transmission electron microscopy were used to observe changes of the renal tubule basement membrane. Gelatin zymographic analysis was used to observe the expression of MMP2 and MMP9 in renal tissue.Results:The mice suffered from renal interstitial fibrosis were identified by histological analysis and α-SMA positive cells in renal tissue. Argentum hexamethylenamine staining and transmission electron-microscopy showed that the renal tubule basement membrane disrupted locally and renal tubule epithelial cells invaded into the renal interstitium in the early stage of renal interstitial fibrosis. Gelatin zymographic analysis showed that the expression of MMP2 and MMP9 was increased transitorily in the early stage of renal interstitial fibrosis. Conclusion: Renal tubule basement membrane disruption, renal tubule epithelial cells invasion into the renal interstitium, and the expression of MMP2 and MMP9 are involved in the development of renal interstitial fibrosis.