AIM: To study the effect of sesamin on expression of inducible nitric oxide synthase(iNOS)and nitrotyrosine(NT)in rat liver tissue with metabolic syndromic hepatic steatosis. METHODS: The rat model of metabolic syndromic hepatic steatosis was induced by operation of two kidneys with one clip(2K1C)and high-fat. The rats taken from that successful model were randomly divided into model group and sesamin(120, 60, and 30 mg·kg~(-1)·d~(-1))groups. In addition, the sham-operated group was set up. The rats in treated group were given sesamin intragastrically everyday for 8 weeks. The levels of blood lipids(TC, TG and FFA)in serum were detected. The activity of SOD and MDA level in the liver homogenate were determined. The expressions of iNOS and NT proteins were detected by Western blotting analysis. The histopathological changes were observed by HE staining in the liver tissues. RESULTS: Compared to model groups, sesamin(120, 60 mg·kg~(-1))significantly inhibited the elevation of serum TC, TG, FFA, and MDA in liver homogenate(P<0.05), and increased the activity of SOD(P<0.05). It also decreased the protein expression of iNOS and NT(P<0.05), and ameliorated the degree of hepatic steatosis. CONCLUSION: Sesamin prevents and cures the metabolic syndromic hepatic steatosis. The mechanism is probably mediated through decreasing the protein expression of iNOS and NT, and alleviating the oxidative stress in addition to regulating the lipid metabolism.

Objective To study the expression of DDH and VEGF in esophageal carcinoma and their relationship, and their prognostic significance for patients of esophageal carcinoma.Methods The expression of DDH and VEGF in 61 esophageal carcinoma tissues and border areas were detected by immunohistochemistry SABC method.Results The positive rate of DDH and VEGF in esophageal carcinoma tissues are higher than those in border areas,both of their expression were correlated with TNM stages,grades of cell differentiation and lymph node metastasis.Patients expressing DDH and VEGF seemed to have a poor prognosis.The expression of DDH was found in a positive correlation with VEGF. Conclusion DDH and VEGF were correlated with the tumorigenesis and progression of esophageal carcinoma patients.

Objective To investigate the role of GST-? mRNA in the development and pathogenesis of esophageal cancer. Methods Twenty two matched pairs of esophageal cancerous and noncancerous tissues were obtained from 22 patients with esophageal cancer in an endemic region. AP-PCR was used for determining the differential gene fragments and RT-PCR for detecting the expression of GST-? mRNA. Results Differential random amplified fragments were found in 6 cancerous tissues, and none of the noncancerous tissues. The 5T differential gene fragments were of 1.0 kb, and by cloning, sequencing, and sequence homology analysis, no homologous sequence was found in the gene library. The expression rates of GST-? mRNA in cancerous and noncancerous tissues were 54.5%(12/22) and 18.2%(4/22), respectively. Conclusions Whether the 5T differential gene fragment is a new gene candidate or is a marker of oncogene remains to be further studied. The expression of GST-? mRNA in esophageal cancerous tissue was markedly enhanced.

Endourology has developed very quickly during the past decades. For transurethral therapy of diseases of lower urinary tract, it has been gradually accepted by both urologists and patients for plasmatic electrocautery resection, holmium laser and electrochemical enucleation of benign prostatic hyperplasia. Flexible ureteroscope has been widely used for examination of upper urinary tract for unknown urinary bleeding and micronephrostomy has achieved great success for percutaneous nephrolithotripsy. Laparoscope has become very popular and can be used to perform most of the operations in the field of urology.

Objective To investigate the effect and safety of duct-to-mucosa anastomosis technique for pancreaticoduodenectomy(PD).Methods The clinical data,including pancreatic fistula and other complications,of 189 patients underwent PD with end-to-side pancreaticojejunostomy at our institution from Jan 2001 to Jan 2009 were analyzed retrospectively.The definition of pancreatic fistula was threefold increase over the serum amylase level 7 days after operation,and draining volume was more than 50 ml per day.Results Totally 177 Whipple procedures were performed,while 12 pylorus-preserving pancreateduodenectomy procedures were performed.Five patients developed pancreatic fistula with a incidence of 2.65%(5/189).In which 3 were mild Cases,who fully recovered after conservative management,and the other 2 cages were cured by surgical intervention.Other complications included 9 cases of wound infection(4.76%,9/189),11 cases of empty dysfunction(5.82%,11/189),5 Cases of delayed hemorrhage(2.65%,5/189),and 4 cases of intra-abdominal infection(2.12%,4/189),and 2 patients died due to severe intra-abdominal infection and acute pulmonary infarction.Conclusions Duet-to-mucesa anastomosis technique resembles physiological state with low incidence of pancreatic fistula and delayed anastomosis hemorrhage.It may be used for different kinds of anastomosis for pancreatic stump.

Objective To explore the clinical features of adrenocortical oncocytoma for better understanding. Methods A total of 586 patients with adrenal cortical adenoma were retrospectively analyzed in our hospital from January 1993 to November 2009, in which 18 were diagnosed as adrenal cortical oncocytoma pathologically, with 7 male and 11 female, aged ( 45.5 ± 15.9 ) years, and the disease course of( 13.3 ± 13.1 )months. Results 6 patients suffered from Cushing's syndrome, 2 primary hyperaldosteronism, 1 had clinical features of both Cushing's syndrome and primary hyperaldosteronism, and 9 were nonfunctional. 4 cases were misdiagnosed as pheochromocytoma preoperatively. All 18 patients were diagnosed by B-mode ultrasound and operation ( 13 by laparoscopy, 5 by laparotomy). 11 tumors were located in the left adrenal while 7 in the right, with the average tumor size of 5.6 cm in diameter. Histopathologically, 1 was oncocytic adrenocortical carcinoma, while 17 were adrenocortical oncocytoma, in which 5 were potentially malignant and 12 were benign. 11 patients were followed up for 20.5±20.1 months. 2 patients were dead, and 9 were alive with tumor recurrence in 1 case.ConclusionsAdrenocortical oncocytoma is a pathological diagnosis and the clinical manifestations are various. The tumors are usually large in size, and can easily be found by ultrasound, but may be wrongly diagnosed as pheochromocytoma.Being different from previous reports, the majority of these patients present with endocrine dysfunction. Most of these cases are benign, but malignant potential is obvious. Therefore,follow-up is very important.

Aim To investigate the difference of aortic function between renal hypertension rat(2K1C) and renal hypertensive-hyperlipidemia rat(RHHR).Methods Animals were divided into 3 groups: the sham-operated group,RHHR and 2K1C model groups.The vascular function test was performed in vitro.The response of aortic ring to phenylephrine(PE),acetylcholine(ACh) and sodium nitroprusside(SNP) was measured.Then aortic ring was incubated with nitricoxide synthase inhibitor N-nitro-L-arginine-methyl-ester(L-NAME) and its response to Ach was observed.Results The contraction in response to PE was augmented in the two model groups.ACh-induced vasorelaxation was reduced in both model groups,and such relaxation was more depressed in RHHR than that in 2K1C.The ability of relaxation evoked by NO was impaired in two model groups.SNP elicited complete relaxation in three groups,but the sensitivity to SNP was more decreased in RHHR than those in sham-operated and 2K1C groups.Conclusion These findings suggest that the vasodilation function of aorta is more impaired in RHHR than that in 2K1C group.The decrease in utilization of vascular smooth muscle to NO induced by hyperlipidemia may contribute to the main cause.

Objective To summarize the clinical characteristics of adrenal tumors combined with renal carcinoma and to extend the clinical understanding of the situation.Methods To analyze the data of 1 100 patients with adrenal tumors hospitalized in Peking University First Hospital from Jan.1994 to Mar.2012 retrospectively,in the series there were 42 combined with renal carcinoma.Results There were 27 males,15 females,aged 29 to 83 years,mean 60.5 years old.In 42 renal carcinomas,there were 29 (69.0％) clear cell carcinomas,5 (11.9 ％) cystic renal carcinomas,2 (4.8％)clear cell with granulosa cell hybrid carcinomas,1 renal lymphoma,1 (2.4％) spindle cell tumor,1 acidophilic cell adenoma,and 1 undifferentiated type of renal cell carcinoma and pathologically not clear in 2 cases (4.8％).Clinical manifestations were not specific.In 42 adrenal tumors,20 situated in the left,and 17 right,and 5 were bilateral.35 cases were considered primary adrenal tumors,in which 3 were diagnosed primary hyperaldosteronism,32 were non-functional tumors.Other 7 were non-functional matastatic carcinomas.25 patients underwent resection of adrenal tumors,and pathology revealed 22 (88.0％) were primary,in which 12 (54.6％) were cortical adenomas,7 (31.9％) hyperplasia,1 (4.5 ％) pheochromocytoma,1 (4.5 ％) ganglioneuroma,1 (4.5 ％)adenoma with hyperplasia;2 (8.0％)metastatic tumors,and 1 (4.0％) non-Hodgkin' s lymphoma.The mean diameter of primary adrenal tumors was 1.9 cm,while that of metastatic carcinoma was 3.84 cm.25 underwent abdominal ultrasonography,40 underwent computed tomography (CT) scan,6 underwent magnetic resonance imaging (MRI) scan,positive rate was 72.0％,97.5％,and 100.0％ respectively.25 patients who underwent surgery were followed up,17 survived for 8 months-6 years,4 died,in which 1 metastatic carcinoma died of intraoperative bleeding,1 died of adrenal lymphoma,2 died because of other disease,4 were lost to follow-up.Conclusions The most common type of renal carcinoma combined with adrenal tumors was clear cell carcinoma,while majority of the adrenal tumors were primary with non-specific clinical manifestations and function.The adrenal tumors might be located in the same or the opposite side of renal carcinoma,also might be bilateral which were more common in metastatic carcinomas and always bigger than primary ones.CT/MRI scans were important in judging the nature of the tumors and pathology was the gold standard.The non-functioning primary adrenal tumors could be safely followed up,and the isolated metastatic carcinoma should be resected.Prognosis depends mainly on that of renal carcinoma.

Objective To summarize the experience in the diagnosis and treatment of mucinous cystic neoplasms (MCN) of the pancreas. Methods The clinical data of 20 cases who were diagnosed as MCN of the pancreas in the affiliated hospital of Qingdao university from January, 2003 to June, 2008 were collected, data including clinical manifestations, pathological features, treatment and survival were analyzed retrospectively. Results The clinical manifestations mainly included abdominal pain or discomfort, nausea, vomiting; 11 patients had abdominal tenderness, 6 patients had palpable abdominal mass. All the patients underwent ultrasound and CT scan examinations, 13 patients were diagnosed as having benign MCN of the pancreas, 4 were serous cystadenoma, 3 were mucinous cystadenocarcinoma. The tumors were located in the body and tail of the pancreas, with a mean diameter of 4 - 14 cm. All the 20 cases received surgical treatment. The procedures mainly included pancreaticoduodenectomy and resection of pancreatic body and tail. Pathological examinations confirmed there were 10 patients with benign MCN of the pancreas, 3 were borderline mucinous cystadenomas and 7 mucinous cystadenocarcinomas. After a mean follow-up of 26 months, patients with benign MCN of the pancreas or borderline mucinous cystadenomas were still alive without recurrence, the three year survival of patients with mucinous cystadenocarcinomas was 50%. Conclusions MCN of the pancreas mainly occurred in female, and there was no specific clinical features, preoperative ultrasound and CT scan examinations could help to diagnose this disease. Surgical resection was the only effective method to cure MCN with good prognosis.

Objective:To observe modulation of gut functions and intestinal mucosal immune barrier by ShengJiangXieXinTang in rats receiving Irinotecan(CPT-11).Methods:Sprague Dawley male rats(n=18)were randomly assigned to three groups:(1)herb group (using ShengJiangXieXinTang by oral administration once a day from day 1 to day 9 and being injected with 150 mg/kg?d CPT-11 on day 4 and 5 into the tail vein); (2)diarrhea control group: using distilled water instead of ShengJiangXieXinTang,with the same treatment of CPT-11 as the herb group; (3)normal control group: using normal saline instead of CPT-11, distilled water instead of ShengJiangXieXinTang,and with the same treatment of as the CPT-11 herb group.The animals were scored in terms of delayed-onset of diarrhea. Rats were killed on day 10,collecting ileum,cecum and colon for pathological examination.The damages in intestinal mucosa were assessed under light microscope according to the criterion of chiu's score.CD4+,CD8+T-lymphocytes and SIgA were enumerated by immunohistochemical staining and calculated by imaging analyzer.Results:Compared with diarrhea control group,the incidence of diarrhea and the damage in intestinal mucosa of the herb group was milder(P