Objective To describe the technique and characteristics of simple hand-assisted laparoscopic resection of renal and adrenal. Methods A total of 37 patients (22 males and 15 females) underwent simple hand-assisted laparoscopic resection of renal and adrenal from June 1999 to April 2004.Their mean age was 52 years (range,25～65 years).Renal resection group included 29 cases,including 13 of renal carcinoma and 2 of renal pelvic carcinoma.All these 15 cases were staged as T 1N 0M 0.The average tumor volume of the renal resection group was 3 cm?3 cm?2 cm.8 of hydronephrosis,2 of renal tuberculosis,4 of renal atrophied.Adrenal tumor resection group included 8 cases;the average tumor volume was 4 cm?5 cm?6 cm. Results Simple hand-assisted laparoscopic resection of the tumors was performed successfully in 36 cases without any complication such as injury of intestines and other important abdominal viscera except 1 case who underwent open surgery.The mean operative time of nephrectomy was 145 min,and that of adrenal giant tumor resection was 125 min.The mean blood loss was 110 ml.The patients recovered well and were discharged 7 to 8 days after operation.Follow-up lasted 3 months to 5 years after operation.Of the 37 cases,35 survived healthily;2 with renal carcinoma died (1 died of cerebrovascular accident 2 years after operation and the other died of brain and pulmonary metastasis 3 years after operation). Conclusions Simple hand-assisted laparoscopic resection of renal and adrenal giant tumor has the advantages of easier performance,shortened operative time and faster recovery from operation.Thus,this technique is worthy of popularization.

Aim To observe the protective effects of ginkgolide B(GB)on cerebral ischemia-reperfusion injury in rats and explore its mechanism.Methods Cerebral ischemia-reperfusion injury in rats was induced by middle cerebral artery occlusion.The neurological out-come and infarct size were evaluated.SOD and LDH activity,LD and MDA levels of ischemia cerebral tissue were measured.The pathomorphology examination was done.Results GB did not improve neurologic defects in 3 h ischemia rats,but it improved neurologic defects in 21 h reperfusion rats.GB(10,5 mg?kg-1)markedly decreased infarct size in rats.SOD activity in GB(10,5 mg?kg-1)groups was higher,and LDH activity and MDA level in GB(10,5,2.5 mg?kg-1)groups were significantly lower than those in vehicle group.LD level did not chang.The cellular and intercellular edema was reduced markedly in the pathomorphology examination.Conclusions GB has protective effects on cerebral ischemia-reperfusion injury in rats.Its role is probably related to its effect on the activity of SOD and LDH,and the level of MDA.

ObjectiveTo investigate the value of the MSCT liver perfusion imaging parameters inthe evaluation of the chronic hepatic fibrosis and cirrhosis. Methods Liver CT perfusion ( CTP ) was performed in 107 participants,including 31 patients with mild hepatic fibrosis( S1,S2),34 patients with severe hepatic fibrosis ( S3,S4 ) and early stage of hepatic cirrhosis which conformed by liver pathologic biopsy,42 patients with hepatic cirrhosis who had typical clinical and image signs,and 30 healthy subjects as control group.The data of CTP ( HAP,PVP,LTP,HPI and TTP) at different stages were obtained with Body perfect CT-syngo CT2007A and control study with histopathologic stage.Compared the study index by the one-way ANOVA analysis. Used Spearman rank correlation to analysis the relationship between liver perfusion imaging parameters and the degrees of the chronic hepatic fibrosis. Used Logistic regression to analysis the maximum.regression coefficient among the liver perfusion imaging paraneters,which affected the histopathologic stage mostly.ResultsIn the subgroups of the chronic hepatic fibrosis S1,S2,S3,S4 to the hepatic cirrhosis,HAP values was (28.9 ±8.6),(24.6 ±2.4),(29.2 ±2.3) and (38.9 ± 7.0) ml · 100 ml -1 · min-1,respectively.HAP decreased firstly,then increased.Statistic analysis showed the difference of HAP between later-stage cirrhosis and other groups( F =40.26,P ＜ 0.01 ).PVP values of above subgroups was (111.3 ± 18.1),(92.9 ±5.3),(73.0 ±9.0) and (54.1 ± 13.8) ml · 100 ml-1 ·min -1,respectively.TLP values of above subgroups was ( 140.2 ± 25.9 ),( 117.1 ± 4.5 ),( 102.3 ± 8.7 )and (93.0 ± 11.8) ml · 100 ml-1.min-1,respectively.The difference of PVP,TL.P among each subgroup was significant ( F =136.79,67.40,respectively,P ＜ 0.01 ).HPI values of above subgroups was (20.4 ± 2.6)％,(21.0 ±2.1)％,(28.5 ±3.1)％ and (42.6± 11.1)％,respectively.TTP values of above subgroups was (123.7±22.2),(137.1 ±27.1),(145.0 ±28.6) and (166.5 ±25.1)s,respectively.The difference of HPI,TTP among each subgroup was significant( F =93.05,17.37,respectively; P ＜0.01 ).PVP,TLP was significant negative correlation with the degree of the hepatic fibrosis( r =-0.920,-0.846,respectively; P ＜0.01 ).HAP,HPI and TTP was significant positive correlation with the degree of the hepatic fibrosis( r =0.611,0.882 and 0.545,respectively; P ＜ 0.01 ).Logistic regression analysis showed the regression coefficient of PVP( - 8.798) was maximum.With an area under the receiver operating characteristic curve of PVP =84.76 ml · 100 ml- 1 · min- 1 as a diagnose critical point.The sensitivity was 0.890,the specificity was 0.950,and the accuracy was 0.931 in the prediction of the chronic hepatic fibrosis.Conclusions MSCT liver perfusion imaging parameters can reflect the hemodynamic changes of chronic hepatic fibrosis and cirrhosis.CTP may be helpful for differentiation the severe hepatic fibrosis and early stage of hepatic cirrhosis and later-stage cirrhosis.

This study is to investigate the effects of sophoridine on NF-kappaB signaling pathway in kidney tissue of endotoxemia mice and the mechanism involved. BALB/c mice were challenged with lipopolysaccharide (LPS) caudal vein injection, then sophoridine was administered by intraperitoneal injection. Totally 50 mice were divided into 5 groups: control group, LPS model group, sophoridine treatment 12 mg x kg(-1) group, 6 mg x kg(-1) group and 3 mg x kg(-1) group. All animals were sacrificed at 6 hours after treatment. Kidney and blood samples were harvested. IKKbeta mRNA and TNF-alpha mRNA expression of renal tissue was measured by the reverse transcription polymerase chain reaction (RT-PCR), and phosphorylation IKKbeta protein (pIKKbeta) was detected by immunohistochemistry. NF-kappaB P65 protein expression and distribution of renal tissue were observed by Western blotting and immunofluorescence laser confocal microscopy. Serum TNF-alpha level was detected by radioimmunoassay. The results showed that the sophoridine significantly reduced the expression of IKKbeta mRNA and pIKKbeta protein, and inhibited the expression of NF-kappaB P65 protein and decreased the entry nuclear rate of NF-kappaB P65 in the renal tissue of endotoxemia mice. Thereby the renal TNF-alpha mRNA expression and serum TNF-alpha level were significantly reduced. These results suggest that sophoridine could inhibit inflammatory reaction induced by LPS through inhibiting activation of NF-kappaB signaling pathway.

ObjectiveTo investigate the curative effect of recombinant bovine basic fibroblast gnowth factor (rbbFGF)in the treatment of senile diabetic foot ulcer and summarize the nursing methods.Methods 28elderly patients with senile diabetic foot ulcer were divided into the control group and the treatment group with 14 patients in each group.The control group was given medical treatment and local wound dressing change,the treatment group was given rbbFGF based upon the above method.The degree of granulation tissue maturity,wound healing time and therapeutic effects were compared between these two groups.The nursing measures were summarized.ResultsOn the 9th day and 13th day,granulation tissue maturity degree of the treatment group was better than the control group.On the 14th day,21th day and 28th day,endepidermis growth velocity of the treatment group was better than the control group.The wound healing time of the treatment group was (29.87±5.73) d and was significantly shorter than (38.49±6.58) d of thecontrol group.The therapeutic effect of the treatment group was better than that of control group on the 28th day.ConclusionsApplication of rbbFGF has good curative effect on senile diabetic foot ulcer and suitable nursing care methods contributes to recovery of elderly patients.

Objective To study the clinical efficacy of bilateral double Z plasties for correction of the webbed neck defects, and to explore its principle and superiority to other reported methods. Methods We designed a small Z plasty over the mastoid with a rhomboidal skin resection of infra-hairline, and another large Z plasty transposition skin flap in superior-acromion. The tight band of fibrous webbing was separately cut and undermined at infra-mastoid and midclavicular line, wherein the middle part of the band retracted medially.Results It involved narrow tunneled anterolateral skin undermining and minimal skin resections from the nape of the neck, and posterior rhomboidal skin excision avoided the unnatural and noticeable lateral scars with normal skin extended in the middle of the webbing.The resultant scar was hidden and mild with no hypertrophic scars. A total of 5 cases were repaired, in which 1 case was male, 4 others were females. Follow-up for 1 to 11 years showed that the appearance and function in the repaired sites by using the bilateral double Z-plasties for repair of webbed neck deformity were very satisfactory. Conclusion We propose the use of this technique for correction of webbed neck deformities with simplified manipulation and cosmetic effect.

Objective To evaluate the safety and feasibility of Wingspan stent for patients with symptomatic M1 stenosis of middle cerebral artery (MCA). Methods Thirty-two cases with recurrent symptomatic MCA stenosis resistant to medical therapy treated by self-expanding stent were reviewed retrospectively [average (49±19) years old, 13 women]. All patients underwent angioplasty and stenting with the Gateway balloon-Wingspan stent system. After 6 months, all patients were followed up by telephone or clinic, and advised followed up with DSA or TCD. Results Thirty-two patients were successfully stented during the first treatment session. The mean degree of stenosis reduced from (76.5±15.4)% to (19.3±9.2)%. The number of complicating subarachnoid hemorrhage was one, and occlusion occurred on one patients related to balloon angioplasty. During a follow-up of 6 months, there was no recurrence of transient ischemic attack or stroke in 32 available patients. Cerebral hemodynamics using transcranial Doppler monitoring were normal in 19 follow-up patients. Six-month angiographic follow-up was obtained in 5 patients, demonstrating good patency in 5 stenting vessels. The other patients refused to perform TCD or DSA. Conclusions Wingspan stent for symptomatic stenosis of middle cerebral artery appears to be a safe and feasible under strict control of periperformeral project. However further study is needed to evaluate the long-term effect.

Objective To investigate the infection status of Ureaplasma urealyticum (Uu) and its situation of drug resistance . Methods The separation ,identification and drug resistance test plate was used for Uu detection in 3 249 cases of cervical samples . Results The total infection rate of Uu was 47 .18% (1 533/3 249) .The patients with Uu infection mainly distributed in >20-40 years ,with the constituent ratio accounted to 90 .8% .The sensitive rates of Uu to josamycin and doxycycline were both higher than 95 .00% ,however ,the resistant rate of Uu to azithromycin and ofloxacin were both higher than 50 .00% .Conclusion The drug re‐sistant strains of Uu were common .The clinic should choose the sensitive antibiotics for the treatment according to the results of drug sensitivity test .

Objective To explore the variation of insulin like growth factor-I (IGF-I) and glucose and correlation in children with sepsis. Methods Forty-two children with sepsis in pediatric intense care unit were enrolled from January 2009 to January 2010. In the morning (2nd morning) after admission, the blood glucose, serum IGF-I, cortisol, insulin, IL-6, and IGF-binding protein-I (IGFBP-1) were detected. In the 3rd and 5th morning, the serum IGF-1 was detected again. According to the blood glucose level of the 2nd morning, the children with sepsis were divided into hyperglycemia group and normal group. Meanwhile, 60 healthy children were served as control group. The data had been compared among three groups. Results In the 2nd morning, the levels of blood glucose, serum IGF-I, cortisol, insulin, and IL-6 were signiifcantly different among three groups (all P<0.05), but the serum IGFBP-I was not signiifcantly different (P>0.05). Compared with control group, the sepsis children with hyperglycemia and with normal blood glucose all had signiifcantly higher serum levels of cortisol and IL-6, and signiifcantly lower serum level of IGF-I. In the 2nd, 3rd, and 5th morning, the serum levels of IGF-1 were not signiifcantly changed with time in sepsis children with hyperglycemia and with normal blood glucose (all P>0.05). Meanwhile, there were no signiifcant differ-ences in the serum levels of IGF-1 between sepsis children with hyperglycemia and with normal blood glucose in the 2nd, 3rd, and 5th morning (all P>0.05). In children with sepsis, the blood glucose and serum IGF-1 was not correlated in the next morning (r=0.152, P=0.267). Conclusions The serum level of IGF-I decreased but maintain stable in children with sepsis. The change of blood glucose may be not related with IGF-I.

Objective To investigate the pathological types and features of lymph nodes in human immunodeficiency virus(HIV)/acquired immune deficiency syndrome(AIDS)patients with superficial lymphadenectasis.Methods The tissues of lymph nodes were obtained from 151 HIV/AIDS patients with superficial lymphadenectasis for pathological examination.The pathological results were observed by light microscope after Hematoxylin-Eosin(HE),acid-fast,periodic acid-Schiff (PAS),and digested-PAS(D-PAS)staining.The pathological results of lymph nodes were described and the correlation between pathological changes and CD4+T lymphocyte count was analyzed.Chisquare test was used for the statistic analysis.Results The benign lesions were found in 145 patients (96.0%),while the malignant tumors were found in 6 patients(4.0%).The pathological findings in the 151 HIV/AIDS patients included tuberculosis(72 patients),lymph node reactive hyperplasia(34patients),lymphatic fungal infections(23 patients,including penicillium diseases in 19 cases),AIDSrelated lymphadenectasis(14 cases),non-Hodgkin lymphoma(5 cases),benign fibrous histiocytoma (1 case).In addition,there were 83 patients(55.0%)with CD4+T lymphocyte count lower than 100×106/L.The frequency of penicillium diseases was higher in patients with lower CD4+T lymphocyte count(x2=7.757,P=0.021).Conclusions The major reasons for superficial lymphadenectasis in HIV/AIDS patients are infectious diseases,such as tuberculosis and fungal infections,which are common in patients with lower CD4+T lymphocyte counts.Non-Hodgkin lymphoma is the most common malignant tumor in this patient population.