Objective To evaluate the clinical value of laparoscopic,retroperitoneal laparoscopic,and open radical nephrectomy.Methods Clinical data of 32 cases of laparoscopic radical nephrectomy(Laparoscopic Group),18 cases of retroperitoneal laparoscopic radical nephrectomy(Retroperitoneal Group),and 32 cases of open radical nephrectomy(Open Group) were compared in respect of operation time,length of hospitalization after operation,intraoperative hemorrhage volume,and incidence of postoperative complications.Results With exception of 1 case of conversion to open surgery because of ruptured renal vein in the Laparoscopic Group,the operation was successfully completed in all the cases.Of the Laparoscopic Group,Retroperitoneal Group,and Open Group,the operation time was 100.5?19.2 min,90.3?21.4 min,and 127.2?20.5 min,respectively,the intraoperative hemorrhage volume was 40?15 ml,50?15 ml,and 200?30 ml,respectively,and the length of postoperative hospitalization was 5.2?1.3 d,5.6?1.1 d,and 9.1?1.8 d,respectively.Both the Laparoscopic Group and the Retroperitoneal Group were superior to the Open Group(P

BACKGROUND: The lipid peroxide, monoamine oxidase, and superoxide dismutase are the important biochemical pharmacological indexes to test the ability of eliminating the free radicals of organism. The lipid peroxide is also a quantitative index of senility oxidation.OBJECTIVE: To test the effect of taibai yangshen on resisting free radicals through testing the serum lipid peroxide, monoamine oxidase (MAO),and superoxide dismutase (SOD) of the senile rats.DESIGN: A random control experiment.SETTING: Pharmacy Department of Shaanxi College of Traditional Chinese Medicine (TCM).MATERIALS: The experiment was done in March 2002 in the pharmacological Experimental Base of Shaanxi College of TCM. The 40 healthy young rats and 40 old rats were selected. The water extract of ground taibai yangshen was concentrated to 1.5 g/mL. The ginseng decoction was concentrated to 0.3 g/mL.METHODS: The young and old rats were randomized into 8 groups:young normal control group, young ginseng group, young taibai yangshen big dosage group, young taibai yangshen small dosage group, old normal control group, old ginseng group, old taibai yangshen big dosage group, and old taibai yangshen small dosage group. Ten rats were in each group. Seven days for adaptation to the environment. Then the normal control group was gastro-perfused daily with the distilled water 20 g/kg, the ginseng the taibai yangshen big and small dosage groups were gastro-perfused daily spectively. Thirty-five days later, the rats were cut heads in the state of anesthesia. The serum was centrifuged. The sulfuration barbituric acid was adopted to test the concentration of malondialdehyde (MDA), the ultraviolet absorption was adopted to test the activity of MAO, and the xanthine oxidase was adopted to test the activity of SOD.MAIN OUTCOME MEASURES: The concentration of MDA and the activity of MAO and SOD.groups and the taibai yangshen big and small dosage groups, the concentration of MDA and the activity of MAO were lower than that of the normal control groups (P ＜ 0.05-0.01), the activity of SOD was higher than yangshen small dosage group, the concentration of MDA and the activity of MAO were higher than that of the young taibai yangshen small dosage group [(8.23±1.73), (6.73±1.69) μmol/L; (41.7±15.9), (40.9±14.6) nkat/L,P ＜ 0.05]. In the old taibai yangshen big and small dosage groups, the activity of SOD was lower than that of the young taibai yangshen big and small dosage groups [(386.75±26.71), (403.49±21.58) NU/mL; (382.13±20.07),(389.69±24.45) NU/mL, P ＜ 0.05].CONCLUSION: Taibai yangshen functions well to inhibit the MAO, reduce the lipid peroxide, and enhance the activity of SOD, able to resist the free radicals to put off aging.

Objective To study the clinical features and prognostic risk factors of patients with autoimmune hepatitis-related hepatocellular carcinoma (AIH-HCC).Methods We reviewed the clinical data of 40 patients with AIH-HCC who were treated at the 302 Hospital between May 1,2008 and April 30,2013,and analyzed the clinical characteristics and prognostic risk factors of these patients.Results These patients were diagnosed to have HCC at a mean ± SD of 55.1 ± 13.5 years (range 28-76 years).The median duration from the time of confirmed cirrhosis to a diagnosis of HCC was 49.2 ± 44.5 months (range 3-194 months).The median survival of the AIH-HCC patients was 16.0 ±4.0 months (range 1-44 months),and the 1-year survival rate was 54.0％.Univariate analysis showed AFP,tumor size,tumor number were related to prognosis (P ＜ 0.05) ; while gender,age,IAIHG score,category,history of blood transfusion,alcohol-drinking and smoking did not significantly affect the patients' survival (P ＞ 0.05).Multivariate regression analysis showed AFP and tumor number were independent prognostic factors.Most of these patients received transcatheter arterial chemoembolization(TACE),however the survival rate of those patients who received hepatectomy was significantly higher than those who received TACE or accepted conservative treatment.Conclusion Liver cirrhosis in AIH is the sine qua non for HCC development,which subsequently occurs at a rate of 1.65％ per year.Patients who had AFP-negativity or a single tumor had a better prognosis.Surgical treatment prolonged survival.

Objective To compare the efficiencies of enteral nutrition with nasogastric tube with that of enteral nutrition with endoscopic gastrostomy tube in ICU long-term bedridden patients. Methods A total of 6 patients who were admitted in our ICU between January 2008 and September 2009 were enrolled in this study. The expected completion of daily calorie supply, completion of total volume of nutrient fluid feeding, nutrient fluid backstreaming condition, and incidence rate of tube obstruction were compared between those supported with nasogastric tube and endoscopic gastrostomy tube. Results The completion of daily calorie supply and completion of total volume of nutrient fluid feeding were significantly superior in patients who were supported with endoscopic gastrostomy tube than those with nasogastric tube (P = 0. 002 and P = 0. 008, respectively). In addition, nutrient fluid backstreaming condition and incidence rate of tube obstruction were significantly lower than with nasogastric tube (P= 0. 011 and P = 0. 021, respectively). Conclusion Enteral nutrition with endoscopic gastrostomy tube is more efficient in reaching the nutrition support target than with nasogastric tube.

Objective To investigate the effect of airway lavage on patients with inhalation injury.Methods Sixty patients in our department with simple inhalation injury were divided into experimental group(n=30)and control group(n=30).The control group accepted traditional nursing care(aspiration of sputum,aerosol inhalation,backslap and body position adjusting) and the experimental group accepted timed airway lavage and necessary ventilator-assisted breathing in addition to traditional nursing.The arterial blood gas value(PaO2,PaCO2),rate of sputum crab plugging and lung infection were compared.Result The lung function, SpO2 and PaO2 significantly increased and rate of sputum crab plugging and lung infection significantly decreased in experiment group (P<0.05).Conclusion Airway lavage can clear sputum crab in time,improve lung fuction and reduce lung infection of patients with inhalation injury.

The 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) catalyzes the conversion of HMG-CoA to mevalonate in mavalonic acid pathway, which is the first committed step for isoprenoid biosynthesis in plants. However, it still remains unclear whether HGMR gene plays a role in the isoprenoid biosynthesis in Dendrobium officinale, an endangered epiphytic orchid species. In the present study, a HMGR encoding gene, designed as DoHMGR1 (GenBank accession JX272632), was identified from D. officinale using the reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) methods, for the first time. The full length cDNA of DoHMGR1 was 2 071 bp in length and encoded a 562-aa protein with a molecular weight of 59.73 kD and an isoelectric point (pI) of 6.18. The deduced DoHMGR1 protein, like other HMGR proteins, constituted four conserved domains (63-561, 147-551, 268-383 and 124-541) and two transmembrane motifs (42-64 and 85-107). Multiple sequence alignment and phylogenetic analyses demonstrated that DoHMGR1 had high identity (67%-89%) to a number of HMGR genes from various plants and was closely related to Vanda hybrid cultivar, rice and maize monocots. Real time quantitative PCR (qPCR) analysis revealed that DoHMGR1 was expressed in the three included organs. The transcripts were the most abundant in the roots with 2.13 fold over that in the leaves, followed by that in the stems with 1.98 fold. Molecular characterization of DoHMGR1 will be useful for further functional elucidation of the gene involving in isoprenoid biosynthesis pathway in D. officinale.

Objective To investigate the expression of lipoprotein(a)and fibrinogen different genders of patients with coronary heart disease(CHD)and its clinical significance.Methods 1 500 patients with CHD in the hospital from January 2009 to December 2013 were selected as the observation group,including 954 males and 546 females.Contemporaneous 500 healthy people with physi-cal examination were selected as the control group,including 329 males and 171 females.The myocardial enzymes,serum lipid,blood coagulation function and various proteins were detected.Results Whether males or females,CK,CKMB,AST,LDH,α-HBDH, TC,TG,LDL-C,Fib,D-D,TT,FDP,LPa,cTnI,MYO and HCY in the observation group were significantly higher than those in the control group.HDL-C,APTT,INR and PT in the observation group were significantly lower than those in the control group.The differences were statistically significant(P <0.05 ).Conclusion Whether males or females,the different degrees of abnormal ex-pression of myocardial enzyme spectral indexes,blood lipid indexes,coagulation indexes,apolipoprotein,troponin,myoglobin and ho-mocysteine exist in the patients with CHD.Lipoprotein(a)and fibrinogen have high expression in the CHD patients,which can pro-vide the reliable scientific basis for diagnosis and treatment of the disease.

ObjectiveTo investigate the clinical outcome of laparoscopic nephroureterectomy (LUNT) for native upper tract urothelial carcinoma (UC) in renal transplant (RT) recipients.Methods We conducted a retrospective analysis on 1130 RT recipients,and 9 patients (0.8％,9/1130) with native upper tract UC were identified. UC was confirmed pathologically in the 9 patients,including 3 cases of unilateral ureter tumor (2 on the right,and 1 on the left),4 cases of unilateral renal pelvis tumor (2 on the right,2 on the left),1 case of bilateral ureter tumor and 1 case of tumor in the right ureter and left kidney.Females predominated (8/9) in the 9 patients with upper tract UC.The patients with left upper urinary tract cancer underwent LUNT using a retroperitoneal approach with a technique of transurethral circumcision of the ureteral orifice.The patients with right upper urinary tract cancer were subjected to nephroureterctomy with ureterectomy and bladder cuff excision by complete laparascopy through a transperitoneal approach. Immunosuppressive protocol conversion from calcineurin inhibitors to sirolimus was performed on all cases. Results In the 9 patients,11 LUNTs were performed successfully without conversion to open surgery.The follow-up period was from 6 to 48 months. One patient died of lung metastasis at 8th month after tumor excision,and 1 patient displayed ductal cancer of the left breast at 7th month after LNUT.Another seven patients showed no evidence of disease during the follow-up period with normal renal function.ConclusionOur present clinical experience suggested that LNUT for the native upper tract cancer in renal transplant recipients is feasible,safe,and effective.

Objective To evaluate the operative techniques and the methods of the renal function protection in laparoscopic nephron sparing surgery for the treatment of renal tumors.Methods Thirty-six renal tumor patients accepted transperitoneal laparoscopic partial nephrectomy at the 70 degree lateral decubitus position.There were 17 tumors in the upper pole,13 in the lower pole and 6 in the center of kindey.The mean tumor diameter was 2.6 cm(from 0.8 to 4.0 cm).Peke forceps were used to clamp the renal artery and achieve warm ischemia.Cold scissors was used to resect tumors and Hem-o-lok was used to clamp and control the artery bleeding in surgical bed instead of ligature when suturing the kidney parenchyma.Ulinastatin was used to prevent and relieve the ischemical reperfusion injury.The operative time,estimated blood loss,warm ischemia time,intraoperative and postoperative complications and the operative efficacy were recorded.Results All operations were completed successfully,no case was converted to open surgery.The mean operative time was 128 min(95 to 186 min),mean estimated blood loss was 130 ml (40 to 600 ml),mean warm ischemia time was 21 min(16to 28 min).There was no hemorrhage and urinary leakage after surgery.The post-operative renal function was normal in all the cases.The histopathological examination showed that 36 cases were renal cell carcinoma including 31 pT1a,cases and 5 pT1b cases.There was no positive surgical margin.The mean follow-up time was 16 months (from 6 to 30 months).There was no recurrence and metastasis found and renal function was normal in all cases during the follow-up.Conclusions Laparoscopic nephron sparing surgery for renal tumors is a safe and feasible treatment option.This procedure can resect tumor safely and preserve renal function efficiently.The use of Hem-o-lok instead of ligature can significantly reduce the operative time.Ulinastatin can help reducing the ischemical reperfusion injury and thus preserve renal function.

Objective The study of capsaicin (CAP) on the effect and mechanism of indomethacin induced acute gastric mucosal injury in different period.Methods 80 SD rats were randomly divided into 8 groups with 10 rats in each group.The experiment was completed in two phases,and the Ⅰ period was 2 weeks,the Ⅱ period was 4 weeks.The Ⅰ period including group A1 (control group),group B1 (model group),group C1 (CAP group),group D1 (CAP + indomethacin group).The grouping method of the two periods were the same.The rats' gastric mucosa were damaged by indomethacin,and then killed the rats 4 hours later.Last,astric juice was collected to determine the total acidity of gastric acid,counted thegastric mucosal injury index,observed the gastric mucosa pathological injury,detected the expression of TRPV 1、CGRP、MDA、SOD and PGI2.Results The Ⅰ period:the gastric mucosa of group A1 and C1 had no damage.Group D1 compared with group B1,there was no significant difference in gastric mucosa injury (P ＞ 0.05),total acidity decreased significantly (P ＜ 0.05),MDA was no significant difference (P ＞ 0.05),SOD、PGI2 increased significantly (P ＜ 0.05),the expression of TRPV1、CGRP increased significantly (P ＜ 0.05).The Ⅱperiod:the gastric mucosa of group A2 and C2 had no damage.Group D2 compared with group B2,the gastric mucosa injury were significantly reduced (P ＜ 0.05),total acidity decreased significantly (P ＜ 0.05),MDA decreased significantly (P ＜ 0.05),SOD、PGI2 increased significantly (P ＜ 0.05),the expression of TRPV1、CGRP increased significantly (P ＜ 0.05).Conclusion There was no damage to the general morphology and histology of gastricmucosa in rats by intragastric CAP 1 mg/(kg· d) for 2 weeks and 4 weeks.2.It could prevent that indomethacininduced acute gastric mucosal injury in rats by pretreated with CAP 1 mg(kg· d) for 4weeks.