Glucocorticoid receptor (GR),a member of the steroid receptor superfamily,can mediate the signal pathway of ligands like glucocorticoids,regulate the transcription of target genes,and exert biological activity.GR is expressed in different degrees in three major kinds of urological malignant tumors including renal cancer,bladder cancer and prostate cancer.It also affects the metabolism of tumor cells,and is closely related to the occurrence,development and prognosis of tumors.GR provides an important clue for targeted therapy and endocrine therapy of urological malignant tumors.

OBJECTIVETo study the influence of estradiol on histomorphology of skin flaps with ischemia reperfusion injury.

METHODS48 adult male Wistar rats aged 12-14 weeks old, were randomly divided into control group (group I), ischemia-reperfusion group (group II), saline group (group III), estradiol group (group IV). Superficial epigastric artery axial flap, 3 cm x 6 cm in size, was made in the left lower quadrant abdominal of each rat. Flap model with ischemia-reperfusion injury was established by using the nondestructive micro vascular clamp to clamp the superficial epigastric artery. The general condition of the flap was observed after operation. At 7 days after operation, the survival rate of the flap was detected, the flaps were harvested to receive histology and ultrastructural observation. The neutrophils level of the superficial epigastric vein were tested.

RESULTS7 days after operation, the survival rate of the flap in group IV was significantly higher than that in group II, III (P < 0.05). The neutrophils level in group IV was lower than that in group II, III (P < 0.05). The histological observation showed that the degree of tissue swelling and inflammatory exudation in group IV was more slight than that in group II, III. Presence of high neutrophils density were observed in group II, III, while slight inflammation and necrosis were observed in group IV. In group I, collagen fibers in flap are regularly arranged with no significant necrosis. Oganelles structure disappeared and apoptotic bodies were shown in group II and group III, even the lysosome could be seen in the cell. Collagen fibers in flap are regularly arranged with slight swelling and no obvious ultrastructural necrocytosis was seen in the cell of group IV.

CONCLUSIONThe estradiol can significantly increase flap survival rate by inhibiting neutrophils infiltration and improving the pathological changes of organization structure in flap.

Animals ; Epigastric Arteries ; Estradiol ; Leukocyte Count ; Male ; Necrosis ; Neutrophil Infiltration ; drug effects ; Neutrophils ; cytology ; drug effects ; Random Allocation ; Rats ; Rats, Wistar ; Reperfusion Injury ; etiology ; pathology ; Sodium Chloride ; Surgical Flaps ; blood supply ; pathology

Objective To develop a gut-brain interaction animal model of IBS which combines multiple factors including behavior, visceral sensation and motility. Methods Setting up a multifactor interactional animal model (chronic acute combining stress model, CACS) based on a chronic unpredictable mild stress model of depression (CUMS) while combined with wrap restraint stress (WRS) , changes of some indexes were recorded including motility (granules of defecating, time of defecating), visceral sensitivity ( spontaneous contraction of abdominal striated muscles ) and behavior/mind ( sucrose consumption, body weight). G protein subunits were measured by Western blot in both hippocampus and prefrontal cortex simultaneously. Results ( 1 ) Compared with the state before stress given, defecating granules increased, defecating time of glassie from rectum shorten, number of abdominal contraction increased, and sucrose consumption decreased in CACS, however, neither significant change was found on defecating behavior in CUMS nor on sucrose consumption in WRS; (2) Compared with the control group, some G protein submits expression decreased in both CACS and CUMS( P < 0. 05 ) , while no significant changes of any G protein subunits were found in WRS. Conclusion The CACS animal model was a new, brain-gut interaction model, which can mimic part of human symptoms of IBS very well.

Objective: To explore the effects of multiple free homologous superficial peroneal artery perforator flaps of crus for repair of multiple hand wounds. Methods: From November 2017 to December 2018, eight cases with eighteen hand wounds were hospitalized in our unit. Among them, wounds were distributed in the forefinger and middle finger in four cases, wounds were distributed in the middle finger and ring finger in two cases, wounds were distributed in the forefinger, middle finger, and ring finger in one case, and wounds were distributed in the middle finger, ring finger, and little finger in one case. The area of skin defect ranged from 1.5 cm×0.8 cm to 4.0 cm×3.0 cm. There were 4 males and 4 females, aged 34-62 years. Wounds of six cases were repaired by two free superficial peroneal artery perforator flaps from homolateral crus, and those of two cases were repaired by three free superficial peroneal artery perforator flaps from homolateral crus. Superficial peroneal artery and its accompanying vein of flap were anastomosed by end to end with digital artery and palmar or dorsal subcutaneous vein of recipient site during the operation. The area of flap ranged from 2.5 cm×1.2 cm to 5.0 cm×4.0 cm. No nerve was harvested during the operation, and donor site was sutured directly. The survival of the flaps and the healing of donor sites were recorded. During follow-up, the recovery of donor and recipient sites was observed. Results: All flaps survived well, donor site healed well. No vascular crisis occurred. Follow-up for 4 to 12 months showed that the appearance of flap was satisfactory with good color, texture, elasticity, and function. Protective sensation of recipient site was recovered. Five months after operation, flap of finger pulp in one case was swollen slightly with two-points discrimination of 10 mm, which received the thinning surgery. Obvious scar formation was not observed in donor site of crus. The appearance of the donor site was good without functional damage. Conclusions The application of multiple free homologous superficial peroneal artery perforator flaps of crus to repair the multiple hand wounds has advantages of easy acquisition, easy operation, little effect on donor sites, and satisfactory clinical effects.

Objective To investigate the expressions of TF mRNA and TFPI mRNA of liver in rats with Vibrio vulnificus sepsis and to assess the interventional effects of cefoperazone sodium along with levofloxacin lac-tate. Method One hundred and ten male SD rats were divided (random number) into normal control group (NC group, n = 10), Vibrio vulnificus sepsis group (VV group, five subgroups n = 10 in each), drug intervention model (AA group, five subgroups n = 10 in each). The Vibrio vulnificus sepsis models and drug intervention models of rat were made. The reverse transcription polymerase chain reaction (RT-PCR) assay was employed for the measurement of TF mRNA and TFPI mRNA. ANOVA and t-test performed with SPSS version 12.0 software. Results Compared with NC, the expressions of TF mRNA in liver increased markedly 2 h,6 h, 12 h and 16 h af-termodeling in VV groups (P<0.05), and reached peak 6 hours after modeling. The expressions of TF mRNA in liver of rats in AA groups were much higher than those in NC group 9 h and 12 h after modeling (P<0.05). The expressions of TFPI mRNA in liver of rats in VV groups and AA groups were not significantly different to those in NC group (P>0.05). Compared with VV groups, the expressions of TF mRNA in liver of rats in AA groups were greatly lowered 9 hours after administration of bactericide (P<0.05), and the expressions of TFPI mRNA in liver of rats in AA groups were significantly higher 12h and 16 h after intervention (P<0.05). Conclusions There is a obvious imbalance between coagulation and anticoagulation functions of circulation system during Vibrio vulnificus sepsis, and the imbalance can be corrected gradually after treatment with antibacterial agents.

Objective To investigate the potential role and changes of CD14, TNF-ct and IL-10 in liver in Vibrio vulnificus septic rats, and detect the intervention effects of eefoperazone sodium combined with levofloxacin. Methods To make Vibrio vulnificus sepsis model (VV group) and drug intervention model (AA group) in rats, the expression of CD14, TNF-α, IL-10 in liver were detected by RT-PCR. Results Compared with normal control (NC) group,CD14 mRNA and TNF-α mRNA expression increased markedly at 2, 6, 9, 12, 16 h in VV group (P<0.05), IL-10 mRNA raised greatly at 9, 12, 16 in VV group (P<0.05). CD14 mRNA expression was also rised in AA group at 9 h(P<0.05). TNF-α mRNA at 9, 12 h and IL-10 mRNA at 9, 12, 16 h in the AA group increased (P<0.05). Compared with VV groups, CD14 mRNA expression diminished greatly at 9, 12, 16 h in AA group (P <0.05), TNF-α mRNA and IL-10 mRNA diminished in the AA group at 16 h(P<0.05). Conclusion The treatment with cefoperazone sodium and levofloxacin may reduce expression of CD14, TNF-α and IL-10 in liver of rats with VV sepsis, it may inhibit the level of pro-inflammatory/anti-inflammatory cytokines, thereby regulating the balance of the inflammatory response in VV sepsis.

Objective To explore the surgical methods and clinical application effects of repairing hand soft tissue defect with free vascularized flaps based on the distal perforator of ulnar artery.Methods From March, 2001 to December, 2012 in our hospital, 90 patients with hand soft tissue defects were repaired by free vascularized flaps based on the distal perforator of ulnar artery, including 74 patients cases were repaired by Phase Ⅰ emergency surgery, 16 patients cases with scar contracture were repaired by Phase Ⅱ surgery.There were 34 cases were rebuild the sensory by repaired the continuity between the dorsal branch of the ulnar nerve and dorsal digital nerve or palmar digital nerve.The free vascularized flaps that used the emerging point of perforator of the ulnar artery as center of the flap was designed, which based on the distal perforator to repairing the hand soft tissue defect.Results All 89 patients postoperative flaps were survived.Necrosis was seen in 1 flap which was repaired by skin grafting.Follow-up ranged from 3 to 36 months with an average of 12 months.The appearance of flap was not clumsy, the quality was good.The sensation was S3-S3+ in 34 cases after nerve reconstruction surgery.The active and passive activity of 16 cases with scar contracture were improved significantly.The incision in 72 cases for direct suture were healed without scar contracture, 18 cases of skin grafts were all survived without contracture.Conclusion The free vascularized flaps based on the distal perforator of ulnar artery has constant perforating point, which can carry sensory nerves and leads to little donor site damage without major vascular injury.The flap serves as a simple approach to repair hand defects, and get satisfied skin flap appearance and texture, the fingers feel and function recovered well.

Objective To investigate the factors affecting Fly-Thru (FT) and the best reconstruction conditions in a bile duct model.Methods The bile duct model was made with corn powder and rubber pipes.FT data of bile duct in vitro were acquired with a 3-dimensional probe of Toshiba Aplio 500,and the data were reconstructed offline in Fly-Thru workstation.Two US doctors assessed the FT images in three degrees.Results The images were divided into good,moderate and poor groups with corresponding score 3,2,1.Of 162 images,72 were rated as grade 1,57 as grade 2 and 33 as grade 3.According to x2 analysis,the diameter,scanning way,and Filter were brought into multinomial regression,then the scanning way was found to be correlated to FT images quality as well as filter (likelihood ratio =87.598,294.290,x2 =9.492,313.722,respectively,P ＜0.01).Best images of FT can be acquired by transverse scanning,reconstructing in Filter =3,gain =5(0,dynamic range (DR) =50 and threshold ranging 40-90.Conclusions Best FT images in the model could be achieved by scanning in short-axis,and reconstructing the data in Filter =3,gain =50,DR =5(0 and threshold ranging 40-90,which would be basic information for advanced clinic study.

Objective To summarize the first experience with ultrasound-guided percutaneous ab lation treatment (PAT) for recurrent hepatoblastoma (HB) after liver resection in children.Methods From August 2013 to April 2015,PAT was used to treat 6 children with a total of 9 recurrent HB,including 5 patients with 8 tumors in the liver and 1 patient with 1 tumor in the lung.The mean size of ablated tumors was (1.5 ± 0.8) cm,and the tumor size range was 0.7 cm to 3.1 cm.Results Four patients were performed percutaneous radiofrequency ablation (RFA) for recurrent HB;and 2 patients were performed percutaneous ethanol injection (PEI).Ablation success was achieved in all patients (6/6,100％).The complete ablation rate after the first ablation session was 88.9％ (8/9) on a tumor-by-tumor basis.Only 1 patient developed a fever with temperature ＞ 39 ℃;it was resolved by conservative therapy.During the follow-up period of 5-30 months,3 patients died to tumor progression.The 1-and 2-year overall survival rates after ablation were 83.3％ and 41.7％,respectively.Conclusions PAT is a safe and promising therapy for children with recurrent HB after liver resection,and further investigation in large-scale randomized clinical trials is required to determine its role in the treatment of this disease.

BACKGROUNDTo analyze the perioperative respiratory and circulatory features of overweighted patients with lung cancer.

METHODSThe perioperative respiratory and circulatory features of 221 overweighted lung cancer patients were compared with those of 715 normal-weighted patients, by means of Chi-square analysis and t analysis.

RESULTSThe abnormal incidence of MBB, Raw, SGaw, PEF, FEV₁, V₇₅ , and EEG, blood presure, serum cholesterol and glucose, was significantly higher in overweighted group than that in the normal weighted group ( P < 0.05), and FRC was significantly lower than that of the normal weighted group (3.46±0.87 vs 3.63±1.17, P < 0.01). There was no difference in D LCO, MMEF, V₅₀ , V₂₅ between the two groups. The odds of postoperative complication in respiratory or circulatory system was significantly increased in overweighted group than that in the normal weighted group.

CONCLUSIONSThe obstruction of main airway, partial alveolar collapse and impotency of respiratory muscle may result in respiratory complication in overweighted patients, and increased cardiac burden and some pre-existing diseases in overweighted patients might be the cause of increased incidence of circulatory complication.