BACKGROUND: Previous studies demonstrated that adventitia fibroblasts exhibit important role in the hyperplasia of newly born endomembrane after blood vessel injury. However, the mechanism regarding phenotypic transition of adventitia fibroblasts in vitro remains unclear. OBJECTIVE: To observe effect of peroxisome proliferators-activated receptor ?agonist (PPAR ?) on phenotypic transition of adventitia fibroblasts induced by transforming growth factor ?1 (TGF-?1) in vitro, as well as the expression of collagen protein Ⅰ. DESIGN, TIME AND SETTING: A randomized grouping control experiment was performed at the Tissue Engineering Laboratory of Ninth Affiliated Hospital of Shanghai Jiao Tong Medical College between July 2007 and October 2008. MATERIALS: The aorta thoracica's adventitial fibroblasts were cultured from Sprague Dawley rats, with 2-month-old, weighing 120 g. The TGF-?1 was supplied by American GenWay Biotech Company. The rosiglitazone power was purchased from Beijing Comens Chemical Co., Ltd. METHODS: The experiment was divided into 3 groups: In the TGF-?1 group, fibroblasts was induced with TGF-?1 with different concentrations (3, 5, 10, 15 ?g/L) for 48 hours; in the rosiglitazone group, fibroblasts was induced with rosiglitazone (5, 10, 30, 50 ?mol/L) for 45 minutes followed by co-culture with 10 ?g/L TGF-?1 for 48 hours. There was no intervention measure in the control group. MAIN OUTCOME MEASURES: The phenotypic transition of fibroblasts was measured by ?-smooth muscle actin, the expression of smooth muscle ? 2-actin, as well as collagen type Ⅰ was determined by protein immunoblotting. RESULTS: Compared with the control group, 5 ?g/L TGF-?1 could significantly stimulate the changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ?2-actin and collagen type Ⅰ, which reach a peak level when treated with 10 ?g/L TGF-?1 (P 0.05). Compared with control group, 30 ?mol/L rosiglitazone could significantly inhibit changes of phenotypic transition of fibroblasts as well as the expression of smooth muscle ? 2-actin and collagen type Ⅰ(P

Objective To investigate the clinical effect of Guizhi Fuling Capsule Combined with activating blood circulation to remove stasis to treat uterine fibroids.Methods 84 patients with uterine fibroids from June 2015 to October 2016 in our hospital were randomly selected and divided into experimental group and control group, 42 cases in each group.The control group was treated with Guizhi Fuling Capsule,and the experimental group was treated with blood activating and Stasis Removing Therapy on this basis of treatment.The patients were followed up for three months, and the clinical treatment effects of the two groups were compared and analyzed.Results The total effective rate of the experimental group was 97.6%,which was significantly better than the control group(76.1%), the difference was statistically significant(P<0.05);through the change of single symptom in two groups, it was found that there was no significant difference between the experimental group and the control group;The improvement rate of anemia, vaginal bleeding, abdominal pain, dysmenorrhea, menorrhagia in the experimental group was significantly higher than the control group, the difference between the two groups was statistically significant(P<0.05);The average volume of uterine fibroids in the experimental group was significantly lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion Guizhi Fuling Capsule Combined with promoting blood circulation and removing blood stasis therapy has obvious effect and less adverse reaction.It can be used and popularized in clinic.

Objective To evaluate the feasibility and clinical efficacy of intraperitoneal laparoscopic partial nephrectomy for T1a peripheral renal neoplasms. Methods Intraperitoneal laparoscopic partial nephrectomy was performed without renal artery occlusion for T1a peripheral peripheral renal neoplasms. The operative time, bleeding volume and complications were observed and the clinical experience was summarized. Results From October 2014 to January 2017 ,there were 10 patients:7 males and 3 females. All patients had T1a peripheral renal tumors. 10 patients underwent operation successfully ,of which 1 case developed temporarily blocked renal artery in the surgery due to hemorrhage. There was no referral during surgeries. The operative duration was 108 to 210 min,with a median of 135 min. The estimated blood loss was 100 to 750 mL,with a median of 320 mL. Followed up duration was 2 to 24 months (median 12 months),there were not postoperative renal secondary bleeding , leakage and other complications. No recurrence of tumor was found. Conclusion It is feasible and safe to exercise intraperitoneal laparoscopic partial nephrectomy without renal artery occlusion in the treatment of T 1a peripheral renal tumors,which can protect renal function to the greatest extent.

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.

Objective To evaluate the efficacy and safety of intradetrusor injection of botulinum toxin type A in the treatment of ketamine-related cystitis.Methods A retrospective analysis of clinical data of 36 ketamine-related cystitis patients with intradetrusor injection of botulinum toxin type A treatment in our hospital during August 2010 to December 2015 was conducted, including 31 males and 5 females with a mean age of 25.5 years.All patients had failed to conventional treatment options including cessation of ketamine, antibiotics, M-blockers.At the time of the first injection, patients were injected with 200 U botulinum toxin type A diluted in 15 ml of 0.9％ saline into the detrusor muscle at 30 sites, sparing the trigone, under cystoscopic guidance.3-d voiding diary, interstitial cystitis symptom index (ICSI),interstitial cystitis problem index (ICPI), pelvic pain and urinary frequency/urgency symptom score (PUF) were recorded to evaluate the efficacy.The treatment-related complications were recorded.When the efficacy of botulinum toxin type A decreased and the patient's symptoms returned to baseline before treatment, the patient received repeated injections of botulinum toxin type A with the same dose and method as the first injection.Results Thirty-six patients with ketamine-related cystitis were treated with intradetrusor injection of botulinum toxin type A.Sixteen patients received two injection treatments and two patients received three injection treatments.During the follow-up, 3-d urinary diaries, ICSI, ICPI, and PUF showed a significant improvement in outcome at 4 weeks after the first injection.The efficacy of the second and third injection treatment was also remarkable.Three patients developed urinary tract infection after the first injection, and two patients developed urinary tract infection after the second injection.Mild hematuria occurred in 15 patients after the first injection, and mild hematuria occurred in 7 patients after the second injection, which was improved in 1 to 2 days.All patients did not appear acute urinary retention and other adverse drug reactions.Conclusions Intradetrusor injection of botulinum toxin type A could be a safe and effective method for the treatment of ketamine-related cystitis.Repeated injection therapy is still safe and effective.

ObjectiveTo establish a new method for preparing synaptosomes.MethodsDensity gradient centrifugation method was used to isolate synaptosomes of mouse, checking by transmission electron microscopy.ResultsSynaptosomes prepared by this method had intact morphological characteristics, surrounding with a continuous oval-shaped membrane structure, moreover, mitochondrion and lots of synaptic vesicle in them.ConclusionThis method is applicable to establish a rapid, convenient and useful method for preparing synaptosomes.

Objective To investigate modified technique of renal transplantation model in rats.Methods Sprague-Dawley rats were selected as donors ( n=21 ) and Wistar rats as recipients ( n=42 ) .Renal allografts of both sides were harvested from the donors for renal transplantation.After resection of left kidney , end-to-end anastomosis of renal arteries between donor and recipient was performed by the assistance of home-made catheter.And end-to-end anastomosis between recipient's renal vein and donor's inferior vena cava was also performed.The donor's ureter with bladder patch was anastomosed to the recipient's bladder.Finally the right kidney was removed , cefminox (10 mg) was injected intraperitoneally , and then the abdominal cavity was closed.The operation data were recorded , including the operation time , artery and vein anastomosis time , cold and warm ischemia time and so on.Living for 3 days after operation was regarded as a success model.The success rate of modeling was calculated and the cause of death was analyzed.Results The operation time of donor was (32.7 ±5.6) min, and repair time for kidney was (4.2 ±1.1) min.The operation time of recipient was (42.3 ±42.3) min, including (10.1 ±3.2) min of the artery anastomosis time , (13.9 ±2.5) min of vein anastomosis time, (6.3 ±1.4) min of urinary tract reconstruction time.Warm ischemia time was (5.4 ± 1.8) s, and cold ischemia time was (56.2 ±7.3) min.In 42 recipient rats, 40 rats were successful modeling and the success rate was 95.2%.Two rats died.One died of artery anastomosis hemorrhage , and the other died of diffuse peritonitis caused by urine leakage.Conclusions Renal transplantation model in rats with modified vascular end-to-end anastomosis has the characters of simple handling , short operation time and high success rate.

Purpose To design PCR combined probes u-sing TaqMan technology to detect the expression of major driver genes in a variety of soft tissue sarcomas at one time,and to dis-cuss whether the combined probes can better assist clinicopatho-logical diagnosis based on histological features and FISH results.Methods Our research group designed 32 pairs of fusion gene probes related to soft tissue sarcoma based on TaqMan tech-nique,involving 10 types of sarcoma.The histopathological specimens of 70 patients with common fusion gene soft tissue sarcoma in our hospital were examined by fusion gene combina-tion,and the histopathological specimens of 30 patients with oth-er soft tissue sarcoma without fusion gene were set as controls.Individual common sarcoma types were analyzed with FISH probe detection.At the same time,the detection performance of the combined probe was evaluated by various methods.Results The soft tissue sarcoma-related fusion gene probe designed by our research group was used to detect the confirmed soft tissue sarcomas,and the results showed that the highest sensitivity was 100％.Among the three types of tumors,protuberant dermatofi-brosarcoma,synovial sarcoma and mucinous liposarcoma were verified by FISH,and the coincidence rate of the two methods was high,with no statistical significance(P＞0.05).The re-sults of interlot and intralot reproducibility of protuberous derma-tofibrosarcoma,mucinous liposarcoma and synovial sarcoma were consistent.Three different concentration limits were used to de-tect the positive plasmid of all the fused gene RNA,and 25 cop-ies/μL was the lowest concentration limit.Conclusion Com-bined with the pathological diagnosis results,TaqMan technology can be used to design PCR combined probes for soft tissue sarco-ma,which have high sensitivity and high specificity and good methodological performance,and meet the needs of primary medical institutions for one-time and rapid auxiliary pathological diagnosis of common soft tissue sarcoma.It provides a rapid and reliable method for the detection of multiple fusion genes in clin-ical soft tissue sarcoma.

Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.