Objective To explore the safety and feasibility of endoscopic-assisted inguinal lymphadenectomy via a small incision (3 cm) for vulvar carcinoma . Methods From September 2013 to December 2015, local wide excision and endoscopic-assisted inguinal lymphadenectomy via a 3-cm incision was performed to treat vulvar carcinoma in 6 women.There were 2 cases of unilateral operation and 4 cases of bilateral operations .A small incision (3 cm) was made in the groin.The skin edge was lifted to separate subcutaneous tissue and obtain a surgical exposure .Then endoscopic inguinal lymphadenectomy was conducted . Results The surgeries were successful in all the 6 patients, with no conversion to open surgery or intraoperative secondary injury .The operation time of inguinal lymphadenectomy was 60-90 min (78.3 ±14.7 min), and the blood loss was 20-40 ml (31.6 ±9.8 ml).The number of lymph nodes desected was 3-13 (8.7 ±3.0) in each side.Pathological examinations showed squamous cell carcinoma . The FIGO staging showed 2 cases of stage ⅠB and 4 cases of stage Ⅱ.The postoperative stitches removal time was 7-9 d (7.8 ±0.7 d) .No surgical complications , such as incision disruption , delayed healing , inguinal skin necrosis , or lower extremity lymphedema , were recorded during a 3-12 months (6.5 ±4.4 months) of follow-up.No tumor recurrence or metastasis was found . Conclusions Endoscopic-assisted inguinal lymphadenectomy via mall incision in the treatment of vulvar carcinoma is effect , safe and feasible .It achieves radical effects .

Objective To study transcerebellomedullary fissure approach to the fourth ventricle and the lateral brainstem without splitting vermis and depict its adjacent structure, and provide clinicians with anatomical information.Methods Five cadaveric heads fixed with formaldehyde and perfused with color latex in their arteries and veins were dissected with microsurgical anatomical skills. The composition of cerebellomedullary fissure and the distribution of the tela choroida, the inferior medullary velum and the posterior inferior cerebellar artery, and study anatomic base of this approach.Results Cerebellomedullary fissure is a natural anatomical gap which is located between the cerebellar tonsil, biventral lobule and medulla oblongata. The tela choroida and inferior medullary velum do not contain nerve tissue, and thus can be dissected to expose the fourth ventricle. The tonsil- medulla segment and telovelotonsillar segment of the posterior inferior cerebellar artery are the most important blood vessels of the cerebellomedullary fissure approach.Conclusions The transcerebellomedullary fissure approach can reach the fourth ventricle and dorsal brain stem through normal anatomic spaces without splitting the vermis, thus reducing the post-operative complications.

Purpose To investigate the imaging features of breast phyllodes tumor on mammography(MG),ultrasound(US) and pathology, correlated with its clinical manifestation.Materials and Methods Twelve cases of pathologically confirmed breast phyllodes tumors were examined by US and MG. The imaging findings were retrospectively analyzed. Results Of the 12 cases of breast phyllodes tumors, 6 were benign, 3 were malignant and 3 were borderline. MG predicted 3 breast phyllodes tumors, 3 breast carcinomas and 6 adenomas. US predicted 2 phyllodes tumors, 8 breast masses and 2 adenomas. Conclusion The imaging findings of phyllodes tumors on MG and US are characteristic but not specific. Combined application of both US and MG are helpful for early detection but can not differentiate its malignancy which is determined by pathology.

[Summary] To investigate the effect of gliclazide on the proliferation and differentiation in MC3T3-E1 cells exposed to normal glucose concentration by applying CCK-8 and RT-PCR. Gliclazide improved the proliferation and stimulated COL-I, OPN and Runx2 mRNA expression in MC3T3-E1 cells, the best concentration of gliclazide was 20μmol/ L, the expression of COL-1 and OPN mRNA had a significant positive correlation with Runx2 binding activity.

After MC3T3-E1 cells were treated with 1,10,and 20 μmol/L glibenclamide for 48 h,the proliferation rate of cells was detected by CCK-8 assay.Flow cytometry was used to test cell apoptosis.The mRNA expressions of collagen I (COL-1) and osteopontin (OPN) were tested by realtime fluorescence quantitative PCR.Western blot was used to detect the expression levels of apoptosis-related proteins Bax and Bcl-2.The results showed that compared with the control group,the proliferation rate of MC3T3-E1 cells was gradually increased (P＜0.05),the apoptosis rate decreased (P ＜ 0.05),the expressions of COL-1 mRNA,OPN mRNA,and Bcl-2 protein were progressively raised (P＜0.05),and the expression of Bax protein were gradually decreased (P＜0.05) along with increasing concentration of glyburide.It suggested that glibenclamide could promote the proliferation and differentiation of MC3T3-E1 cells in high glucose and may inhibit apoptosis in a concentration-dependent manner within a certain range.

Objective To observe the effect of Tung’s acupuncture on walk and balance function in patients with Parkinson’s disease (PD). Method Ninety-two eligible PD patients were randomized into a control group and a treatment group, 46 cases in each group. The control group was intervened by Levodopa, while the treatment group was additionally intervened by Tung’s acupuncture. The two groups were both treated for 20 d. Before and after the treatment, the walk and balance function were evaluated by the indices of NeuroCom Balance Master, including Walk Across (WLK), Step/Quick Turn (SNT), and Timed Up & Go Test (TUGT), and the results were compared between the two groups. Result The walk speed, step length, swing in turning, time-consumption in turning, and TUGT were improved after the intervention in both groups (P<0.05), and the improvements in the treatment group were more significant than that in the control group (P<0.05). Conclusion Tung’s acupuncture plus oral administration of Levodopa can markedly improve the walk and balance function in patients with PD.

BACKGROUND: Acellular vascular matrix as vascular scaffold has following advantages: acellular vascular matrix possesses complicated three-dimensional structure of natural blood vessels. Growth factor and structural domain on the surface of acellular matrix helps for cell adhesion and infiltration.OBJECTIVE: To prepare acellular vascular matrix material and to evaluate its biocompatibility in vivo and in vitro.METHODS: Trypsin and Triton X-100 were used to gradually dispose pig carotid artery and to prepare acellular vascular matrix. The biocompstibility of the material was evaluated by implantation in muscle, acute toxicity experiment and cytotoxicity test in vitro.RESULTS AND CONCLUSION: The acallular vascular matrix material possessed good chemical stability and did not release harmful factors that produced destruction and dissolution in erythrocytes, without acute hemolytic reaction or toxic effects on cell growth. The acellular vascular matrix material showed lots of inflammatory cell infiltration in eady stage of implantation, and no significant inflammatory cell infiltration in late stage of observation. Fibroblasts were visible in the acellular matrix. In addition, the acellular matrix material did not exhibit toxic effects on surrounding tissues, showing wound stage I healing. Simultaneously,histological sections demonstrated that there were good compatibility of scaffold material and surrounding tissues, without rejection. These indicated that acellular matrix material presented good biocompatibility in animals.

Objective To investigate the effects of liraglutide on the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1 exposed to higher glucose concentration. Methods MC3T3-E1 cells were cultured and divided into control group and liraglutide group. In liraglutide group, cells were treated with different liraglutide concentrations (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L, respectively) for 48 hours. Cell proliferation was tested with CCK-8. The mRNA expressions of typeⅠcollagen (COL-Ⅰ), osteopontin (OPN), and alkaline phosphase ( ALP) were detected using semi-quantitative RT-PCR. Results ( 1 ) Compared to control group, the proliferation rate of different liraglutide concentration groups (10-9 mol/L, 10-8 mol/L, and 10-7 mol/L) increased significantly (all P<0. 05), the proliferation rate was the highest in 10-8mol/L liraglutide group. (2)The expression of COL-Ⅰ, OPN, and ALP mRNA in liraglutide groups were higher than those in control group (all P<0. 05). The optimal concentration of liraglutide was 10-8 mol/L. Conclusion Liraglutide within a certain concentration range may improve the proliferation and differentiation of mouse pre-osteoblasts MC3T3-E1.

Objective To study the impact of severe idiopathic pulmonary arterial hypertension (IPAH) on pregnancy outcome and to investigate the effect of multidisciplinary approach during pregnancy on the pregnancy outcome in pregnant woman with severe IPAH.Methods Between March 2007 and November 2013,10 pregnant women with severe IPAH undergoing treatment in Beijing Anzhen Hospital were studied retrospectively.Hemodynamic measurements,medical therapy,manner of delivery,anesthetic administration,multidisciplinary management and outcomes were assessed.Results All 10 cases were first diagnosed at the mean of (24 ± 3) weeks during the pregnancy.The systolic pulmonary artery pressure (sPAP) estimated by transthoracic echocardiography was (95.6 ± 1.3) mmHg (1 mmHg =0.133 kPa).Seven cases of class Ⅲ and 3 cases of class Ⅳ were recorded by World Health Organization functional class.One patient underwent pregnancy termination at gestational age of 21 weeks with no maternal death or complications,nine patients continued pregnancy and all the patients underwent cesarean section.The mean pregnancy length was (31 ± 5) weeks.Nine had cesarean deliveries during continuous epidural anesthesia,and one during general anesthesia.There were three maternal deaths in hospital (5,2,3 days postpartum),and seven patients were alive,and the average hospitalization days was (8 ± 4) days.One fetus lost with cesarean section.Two were term delivery,and seven cases were premature delivery.The average weight is (1 948 ± 731) g and nine were alive and no malformation.Conclusions Because of maternal mortality in patients with severe IPAH remains prohibitively high,patients should continue to be counseled to avoid pregnancy.Women with severe IPAH who become pregnancy should be followed by multidisciplinary approach,and cesarean deliveries during continuous epidural anesthesia are a relatively safe way for pregnancy termination in patients with severe IPAH.

Objective To review and summarize the experiences of transcatheter closure of left ventricular-right atrium communication,and discuss the feasibility of interventional therapy for this kind of cardiac abnormalitis.Methods 22 patients who suffered from left ventricular-right atrium communication underwent transcatheter interventional therapy with ventricular septal defect(VSD) occluder.The operating procedures were performed as like as the transcatheter closure of VSD:established the pathway from femoral artery to femoral vein through left ventricle,VSD,right atrium (or from left ventricle to right atrial through the communication) and inferior vena cava,then inserted the polysheath from femoral vein,introduced by the pathway to left ventricle,and implanted VSD occluder through the polysheath to close the shunt.Results The operation succeeded in 21 patients.The cardiac murmur was disappeared in all patients,and there was no residual shunt or aortic regurgitation that conformed by postoperative ventriculography and echocardiography in follow up phase,and the tricuspid regurgitation was lessened than preoperative.The operation abort in 1 patient because of aortic regurgitation after implanting occluder.Conclusions Transcatheter closure of left ventricular-right atrium communication is feasible as the selected occluder is accordant,and atrioventricular block,aortic regurgitation and tricuspid regurgitation can be avoided.