Objective To investigate the laparoscopic anatomy of the spleen vessels and its clinical application. Methods The data of 47 cases of total laparoscopic splenectomy (TLS) were analyzed. Among the patients, 21 had cirrhotic portal hypertension, 19 had thalassemia, 2 idiopathic thrombocytopenic purpura, 2 hereditary spherocytosis, 1 angioma of the spleen, 1 splenic cyst, and 1 primary hypersplenism. The color of the spleen was observed after the splenic artery near the pancreatic tail was ligated. And then the splenic artery was categorized according to the color. Results Among the 47 cases, 34 (72.3%) were categorized as typeⅠ, 9 were type Ⅱ (19.1%), and 2 were type Ⅲ (4.3%). The arterial anatomy was unclear under a laparoscope in 2 cases (4.3%). The TLS was completed in 46 cases with a success rate of 97.9% (46/47). Among the cases, 14 received extensive esophagogastric devascularization simultaneously,and 3 patients who had thalassemia underwent cholecystecotomy after the TLS because of gallbladder stones. One case was converted to an open surgery because of extensive bleeding owning to coagulation disorder. The spleen artery was ligated in 43 cases, and the hilar vessels were resected by dissecting and ligating in 45 cases. The Operation time averaged at (110?35) min (range 50-240 min), and the mean intraoperative blood loss was (160?87) ml (range, 20-1500 ml). Conclusions In spite of the prominent type Ⅱ of the spleen vessels, the spleen artery can be dissected and ligated at the level of the superior edge of the pancreatic tail to stop the blood supply to the spleen. The hilar vessels can be resected by dissecting and ligating. The spleen artery ligation and hilar vessels resection by dissecting and ligating are effective in controlling intraoperative bleeding and avoiding pancreas injury.

Objective:To explore the effect and mechanism of Xinfuning( recombinant human α-2b interferon capsule for vaginal foams) on the clearance of human papilloma virus (HPV). Methods: The patients with HPV infection were divided into experimental group (Xinfuning group) and control group (Shurunshuan group, a common recombinant human interferon α-2b in suppository form) .The HPV negative conversion rate was compared between the two groups after action on vaginal posterior fomix. The content of cytokines IL-4, IL-10, IFN-γ, TNF-a in the cervical region before or after the application was detected by ELISA. Results:The negative conversion rate in the experimental group was higher than that in the control group ( P<0.05). The content of IL-4, IL-10 was decreased and the cont ent of IFN-γ,TNF-α was increased apparently( P < 0.05). Conclusions: Interferon has the effect on clearance of HPV infection by regulating Th1/Th2 balanced state to boost immunization and the unique preparation of Xinfuning can strengthen such function.

Objective To establish the high-performance liquid chromatography(HPLC)method for measuring concentrations of methotrexate(MTX)in rat lung and some other tissues through internal iliac artery infusion.Methods Fifly female Sprague-Dawley rats were included in this study.The rats were randomly assigned to two groups.Methotrexate was injected to group one through internal iliac artery,and was injected to group two through femoral vein.Blood and tissues were collected in each group at 15,30,60.90 and 120 minutes for detection of the drug concentrations with HPLC.Results The area under the concentration time curve(AUC)in rat lung,ovary and uterus in the artery group were separately(3.77±0.28),(4.40±0.40),(9.97±0.89)μg·h-1·g-1,which were significantly different from those of the vein group[(2.31±0.25),(3.91±0.19),(7.65±1.54)μg·h-1·g-1;P<0.05].The AUC in the rat plasma,heart,kidney,liver and spleen in the artery group were separately(6.13±0.53),(1.90 ±0.11),(5.32±0.89),(14.16±1.96),(0.76±0.20)μg·h-1·g-1.There were no significant differences from the vein group[(5.79±0.71),(1.64±0.29),(5.15±1.69),(14.29 ±3.47),(0.76±0.13)μg·h-1·g-1;P>0.05].Conclusions Through internal iliac artery infusion,there are higher drug concentrations in lung.uterus and ovarian compared to venous injection.The internal-arterial chemotherapy may be used to treat pulmonary metastasis of gynecological tumor.

Objective To study the effects of formaldehyde on the level of microelements in mouse liver and blood and explore the microelements as biomarker in injury induced by formaldehyde.Methods The mice were randomly divided into control,low(1/40LD50),moderate(1/20LD50) and high(1/10LD50) dose groups exposed to formaldehyde by inhalation(n=20),two hours per day for three and six weeks,and than the contents of Cu,Fe,Zn and Mn in mouse liver and blood were measured.Results The contents of Fe,Zn and Mn in liver in high dose group three weeks after exposure and the contents of Fe and Zn in liver in high dose group six weeks after exposure were significantly lower than those in control group(P

Objective To establish a satisfactory lung metastasis model of human choriocarcinoma using severe combined immunedeficient(SCID)mice and explore the appropriate cell concentration for the model.Methods Forty SCID mice aged between 5-6 weeks were randomly difided into four groups.1×107 cells/ml ×0.1 ml.5×106 cells/ml×0.2 ml and 1×106 cells/ml×0.1 ml of human choriocarcinoma cells JEG-3 were respectively injected in SCID mice of experimental groups by lateral tail vein,the remain group was assigned to the control group.The status and weisht of mice were observed every three days.When these mice were being dying.the size and the number of the lesions of lung metastasis in every mouse were inspected with Micro CT.After Micro CT inspection,the SCID mice were executed dissected to note whether there were tumors on all organ surfaces witll naked eyes.then made pathological sections from the metastaticfoci of fresh lung tissues,and cultured primarily cells and purified cells and passaged cells isolated from the same metastastic foci.The pathological sections were observed under the microscope.The special antigen human chorionic gonadotropin-beta subunit(β-hCG)of the choriocareinoma cells was immunohistochemically detected in the pathological sections and the cells out of cultured primarily cells.The chromosomes of the cells out of cultured primarily cells were analysed.Results Of the group inoeutated 1×107 cells/ml×0.1 ml.all mice died when inoculating.In the group of 5×106 cells/ml×0.2 ml,when inoculating, 3 mice died; the remain 7 mice were being dying on ( 18. 0 ±2. 0) days after injection. 5 of them, there were 1 - 3 lesions of lung metastasis after Micro CT inspection in each mice, and the diameter of the tumors lesions reached 1.5 - 3.5 ram, which was choriocarcinoma confirmed by pathological sections.The special antigen β-hCG was detected by immunohistoehemical method in the pathological sections of pulmonary tissue with tumor and in the cells, which were purified and passaged from being cultured primarily cells isolated from metastastic foci of fresh lung tissues from the SCID mice. The chromosome numbers of these cells out of cultured primarily ceils were variety from 19 to 128, and medal numbers were variety from 70 to 79. Conclusions We successfully established the lung metastatic model of human choriocarcinoma in SCID mice by injecting JEG-3 cells into lateral tail vein, of which 5 × 106 cells/ml × 0. 2 ml is the suitable concentration and volume for the model.

Objective To evaluate the feasibility and safety of transabdominal ultrasound-guided suction curettage to treat cesarean scar pregnancy (CSP) and investigate factors affecting prognosis of CSP. Methods This was a retrospective case study of 43 cases who were diagnosed as CSP and treated by suction curettage under transabdominal ultrasound guidance as an initial treatment of CSP in Obstetrics and Gynecology Hospital of Fudan University over past 7 years (from 2007 to 2013);factors affecting prognosis of CSP were investigated. Results 39 of the 43 cases (91%) were successfully treated. There were no statistically significant differences in maternal age, gravidity, abortion frequency, and the time interval between current CSP and last cesarean delivery, the myometrium thickness between the gestational sac and the bladder wall between the success group and the failure group (all P>0.05). Statistically significant difference was found in crown-rump length (CRL) between the two group (median of the two group was 18.5, 2.0 mm) by rank sum test (P=0.047). Univariate logistic regression analysis demonstrated that CRL was strongly associated with the prognosis and the OR for no complications was 18.50, comparing CRL≤6 mm versus CRL>6 mm (P=0.020). Conclusion Transabdominal ultrasound-guided suction curettage is effective and safe in the treatment of CSP with CRL≤6 mm.

The paper covered the self-assessment practices of the hospital in the new round of accreditation.These include principles of Promoting hospital development and reform,and Balancing accreditation and development,Emphasizing Quality,Safety,Service,Management,and Performance,Centering on patients,and Focusing on Quality of Care and Medical Care Performance.The hospital adopted such means as enhancing hospital internal development,building the hospital-department twotier management responsibility system,upgrading quality of care and safety,and promoting sustainable development.The self-assessment has improved and tested the construction of quality control system of the hospital,while a better system further supports the accreditation of the hospital on the other hand.

A safe and effective targeting viral vector is the key factor for successful clinical gene therapy. microRNA, a class of small, single-stranded endogenous RNAs, act as post-transcriptional regulators of gene expression. The discovery of these kind regulatory elements provides a new approach to regulate gene expression more accurately. In this review, we elucidated the principle of microRNA in regulation of targeting viral vector. The applications of microRNA in the fields of elimination contamination from replication competent virus, reduction of transgene-specific immunity, promotion of cancer-targeted gene therapy and development of live attenuated vaccines were also discussed.
Gene Expression Regulation ; Genetic Therapy ; Genetic Vectors ; genetics ; Humans ; MicroRNAs ; genetics ; Viruses ; genetics ; metabolism

Objective To retrospectively analyze the clinical characteristics of acute renal failure ( ARF) induced by crush syndrome after Wenchuan earthquake,and summarize the rational and effective treatment managements of this kind of ARF. Methods The case histories of 12 patients diagnosed as ARF related to the crush syndrome in Wenchuan earthquake were pigeonholed. In order to evaluate the curative effects of the clinical features,laboratorial examination,continuous renal replacement therapy ( CRRT) and cure time were ana- lyzed. Results Anaemia,fever and lung infection were frequently happened in the patients diagnosed as ARF,and the frequency was 91. 67% ,66. 67% and 58. 33% respectively. Pleural effusion and acute respiratory distress syndrome ( ARDS) were noted in 41. 67% of the patients,and the increase of transaminase was noted as 91. 67% . Hypocalcaemia,hypoproteinemia and marked increase of creatine kinase ( CK) appeared in all patients. The patients with CK value exceeded 3 000 IU/L were received CRRT,and there was marked relativity between these 2 variables ( r =0. 845) for the treatment of ARF. Although the proportion of CRRT practiced highly in patients with oliguria,fasciotomies and amputations,there was no significant difference when compared with closed injury and non-oliguria patients ( P = 0. 522 7) . Compared with patients without infections,wound infections were obviously delayed the cure time of ARF ( P = 0. 025 5) . Conclusion As compared with ARF from other causes,ARF related to the crush syndrome has unique characteristics,and easily complicates with multiple organ dysfunction syndrome. Among the treatments, heteropathy and renalreplacement therapy are frequently used. Thorough debridement and infection control are beneficial to renal function recovery.

Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer. Background and purpose: With the development of the means of preoperative diagnosis and treatment of breast cancer, ifne needle puncture no longer seems to be popular with the clinical use. The safety and effectiveness of fine needle aspiration as preoperative diagnosis of breast cancer are controversial. This study was aimed to investigate the application of fine needle aspiration (FNA) of breast cancer and association between FNA and recurrence and metastasis for 30 years in our hospital. Methods:A total number of 1 260 patients with breast cancer treated in Peking Union Medical College Hospital from 1975 to 2006 were reviewed in two groups for clinical characters, recurrence, and survival rate. The two groups were FNA and non-FNA. Results:The positive rate of FNA was 61.4%and the highest rate was inⅣstage (100%). StageⅡandⅢwere the major ones in FNA group (45.2%). The local recurrence (7.0%vs 6.4%), recurrence and metastasis (13.2%vs 14.0%), 5-year (82.0%vs 81.0%) and 10-year disease free survival rates (51.0%vs 64.0%) have no signiifcant difference between FNA and non-FNA groups. Conclusion:FNA is still one of the most important methods for preoperative investigation of breast cancer.