Objective To evaluate the effect of controlled hypotension with nitroglycerin and esmolol in the operation of endoscopic nasal surgery.Methods 60 patients undergoing selective endoscopic nasal surgery were randomly divided into three groups averagely: control group (groupⅠ), controlled hypotension with nitroglycerin group(group Ⅱ), controlled hypotension with nitroglycerin and esmolol group (groupⅢ). Every group has 20 patients.Mean artery pressure (MAP), HR, scores of surgical field quality(SSFQ) were recorded before anaesthesia and 10,20,30,40 minutes after anaesthesia. After the operation, bleeding capacity, operation time and dosage of nitroglycerin were recorded too.Results The bleeding capacity and operation time in groupⅡ and Ⅲ was significantly less than that in groupⅠ(P

Epigenetic modification, which involve DNA methylation, RNA-associated silencing and histone modification, is implicated in cell proliferation, differentiation, survival, apoptosis and malignant transformation. Some leukemogenesis has been shown to be aberrance of epigenetic modification. This paper discussed the potential causes of some of leukemias correlating with the methylation of cell cycle regulation genes, small interference RNA and modification abnormality of histone after translation. The study on epigenetic modification abnormality of leukemia cells provides a new strategy for treatment of leukemia.
DNA Methylation ; Epigenesis, Genetic ; Gene Silencing ; Histones ; Humans ; Leukemia ; genetics ; RNA, Small Interfering ; genetics

Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

Objective: To evaluate the clinical outcome of botulinum A toxin (BTX-A) injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia (DESD) after spinal cord injury (SCI). Methods: A total of 38 urodynamic examination-confirmed DESD patients, male 31 and female 7, with an average age of (36.5 ± 17.8) years old, were included in this study. 200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites (1 ml per site) of the external sphincter via a 5F flexible cystoscopic needle. On the second day, 9 patients (BTX-A + baclofen group) were randomly selected for baclofen oral administration, 3/d for 3 months, the other 26 patients were taken as control. Urodynamic examination was repeated in all patients 4 weeks later; the voiding diary and urodynamic outcomes were compared before and after treatment. The adverse and toxic effects were observed in the patients who were followed up for 2-9 months. Results: One month after treatment the voiding and storing functions of bladder were improved to different degrees, with the mean maximum uroflow rate (Qmax), the mean urine volume, the mean maximal eystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly (all P

Objective: To summarize our experience on 164 cases of retroperitoneoscopic nephrectomy and to analyze the clinical outcomes of retroperitoneoscopic nephrectomies. Methods: From October 1998 to July 2006, a total of 164 patients (91 males and 73 females; age range 2-80 years, mean age [49.5±25.7] years) have undergone retroperitoneoscopic nephrectomies in our department, with 95 undergoing radical renal cancer resection and 69 undergoing simple nephrectomies. Fifteen renal cancer patients visited doctors due to painless hernaturia and the rest 80 were detected during physical examination. The tumors were averagely (4.3 ± 1.2) cm (range 1.0-8.0 cm) in diameter, with 40 at T1N0M0 stage, 47 at T2N0M0 stage, and 8 at T3aN0M0 stage. Among the 69 simple nephrectomy cases, 3 were kidney atrophy, 46 were kidney dropsy, 3 were kidney maldevelopment, and 7 were kidney tuberculosis. All the kidneys were confirmed to have no function by radiological renal pictures. Results: The operative time was 25-180 min (mean, [53.5 ± 27.2] min) and the blood loss was 20-1 500 ml (mean, [150 ± 66] ml). Three cases were converted to open operations. The average hospital stay was (8.0 ± 4.4) days. Three renal cancer patients died of metastasis during a follow-up of 1-90 months and all the other patients survived. Conclusion: Retro entoneoscopic nephrectomy, with shorter operative time and quicker postoperative recovery, is a practical surgical procedure.

Objective: To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease (ADPKD) - Han : SPRD with chronic renal insufficiency. Methods: Twenty 6-month-old male ADPKD heterozygous (Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random (n=10). Rats in experimental group received intragastric administration of sirolimus (0.2 mg · kg-1 · d-1) for 45 days and those in control group were bred routinely. The general state and renal function of rats were monitored throughout the treatment. The rats were sacrificed 45 days later and both kidneys were harvested, weighed; and the 2-kidney/ total body weight (2K/TBW) ratio was determined. Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen (PCNA) were counted. Results: There was no death in the 2 groups and all rats gained weights, with no significant difference between the 2 groups, Blood urea nitrogen (BUN) increased progressively in both groups, with the increase in experimental group lower than that in the control group by 12.5 % on 45 days after administration (P<0.05). The 2-kidney-weight and 2K/TBW ratio in experimental group was lower by 11.8 % (P<0.05) and 7.1 % (P<0.01) than those in the control group, respectively. Renal enlargement and cystogenesis were inhibited by sirolimus, with the number of PCNA-positive cells per cyst being 0.23±0.11 in experimental group and 0.47±0.24 in the control group (P<0.05). Conclusion: Sirolimus can slow down the disease progression in Han: SPRD rats with ADPKD, even though they had been in a condition of renal insufficiency.

Objective: To investigate the differential expression of matrix metalloproteinases-1/tissue inhibitor of metalloproteinase-1 (MMP-1/ TIMP-1) between normal kidney, kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD), and the original kidneys after renal transplantation (OKRT). Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues. Semi-quantitive RT-PCR was performed to verify the differentially expressed genes. Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues. Expression of MMPI/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue (P<0.05), with no significant difference found between the former 2 groups. Results of RT-PCR were consistent with the microarray findings. Conclusion: The pathogenesis of ADPKD may be related with the high expression of MMPs/TIMPs and the inhibitor of MMPs may have therapeutic effect on ADPKD.

Objective To investigate the risk factors for the prognosis of radical resection in elderly patients with colorectal cancer.Methods A total of 416 patients with colorectal cancer aged over 65 years were analyzed retrospectively,who came from Peking University First Hospital and Beijing Hospital from July 2008 to July 2011.Survival analysis was conducted by Kaplan-Meier and the survival rate was compared by Log-rank method.Multivariate analysis was conducted to analyze the prognostic factors by Cox regression.Results In this group of patients,the age was(74.3 ±5.4)years,and the post operative 5-year survival rate were 84.5％,77.3％,48.2％ respectively for staging Ⅰ,Ⅱ,Ⅲ patients.Univariate analysis showed that age,ASA score,co morbidity,preoperative hypohemia,preoperative hypoalbuminemia,postoperative complications,elevated preoperative carcinoembryonic antigen (CEA),intraoperative blood loss,perioperative blood transfusion,vascular cancer embolus,nerve invasion,depth of invasion,lymph node metastasis,tumor TNM stage and adjuvant therapy were correlated with the prognosis.Multivariate analysis showed that age ≥75 years,co morbidity,postoperative complications,preoperative albumin＜30 g/ L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy were the independent risk factors for prognosis.Conclusions The risk factors for prognosis after radical resection in elderly patients with colorectal cancer include age≥75 years,co-morbidity,postoperative complications,preoperative albumin ＜30 g/L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy.

This paper presents a high voltage generator for the defibrillator.Its principle and design method are introduced.The high voltage generator is the core part of the defibrillator which is necessary toany hospital.There is nodomestic-patented defibrillator by now and published paper specialized in the principle and design method of the high voltage generator for the defibrillator.

Objective To study the detectable rate of antineutrophil cytoplasmic antibodies (ANCA) in Chinese patients with clinical suspected small vessel vasculitis,and the target antigens.Methods All 5 604 sera sent to the authors′ laboratory for ANCA screening were tested by indirect immunofluorescence (IIF),anti myeloperoxidase (MPO),and anti proteinase 3 (PR3) ELISA.Then the positive sera with IIF ANCA but negetive with MPO and PR3 ANCA were further tested by antigen sepecific ELISA using other five highly purified known ANCA antigens as solidphase ligands.The known antigens included human leukocyte elastase (HLE),lactoferrin (LF),cathepsin G (CG),bactericidal/permeability increasing protein (BPI) and azurocidin (AZU).Results Of the 5 604 sera,298(5 3%) were IIF ANCA positive,and 390/5 604(7%) were ANA positive.Patients′ANCA presented mainly in summer or winter.Of the IIF ANCA positive patients,213 were anti MPO positive,32 were anti PR3 positive and 5 were positive for both.Of the 48 sera positive by IIF,yet negative by MPO and PR3 ANCA,13 sera(27%) recognized other target antigens,7 sera recognized BPI,5 recognized HLE,one recognized CG and one recognized AZU,and none of the sera recognized LF.One serum recognized both BPI and HLE.There was no difference in gender(M∶F=1∶1 12) in ANCA positive patient with a mean age of 53 1 years.However,the M/F ratio was 1 17∶1 for patients over 60 years,and was 1∶4 for patients less than 20 years.Conclusion ANCA related diseases are not rare in China and the major antigens are MPO and PR3.When IIF technique is used to detect ANCA,ANA should be carefully distinguished.Some sera also recognized other known ANCA antigens,but for a few sera the target ANCA antigens are still unkown.