Objective To summarize the anterior trans-sternal approach endoscopic subtotal thyroidectomy. Methods Clinical data of 10 cases of endoscopic subtotal thyroidectomy were reviewed. Results All endoscopic operations in the 10 cases were successfully completed. The operation time was 140～360 min (mean, 164 min), and the postoperative hospital stay ranged 4～8 days (mean, 5 days). No injuries of nerve or parathyroid glands, or other complications occurred. Conclusions The anterior trans-sternal approach endoscopic thyroidectomy is characterized by its safety, reliability, short incision, and good cosmetic results.

Objective To investigate the laparoscopic techniques in the diagnosis and treatment of acute abdominal emergency. Methods The efficacy of laparoscopic checkups and treatment in 122 consecutive patients with surgical acute abdomen admitted from January 2001 to February 2003 were analyzed retrospectively. Results Diagnosis was clarified under laparoscope in all the patients.Operations were completed under laparoscope in 117 patients,while a conversion to open surgery was required in 5 patients because of the limitation of vision scope or dense adhesion leading to difficult exposure.Two patients expired. Conclusions Laparoscopy is valuable for the differential diagnosis of surgical acute abdomen.Laparoscopic treatment can be completed in the majority of the patients,but is not advisable in certain cases.

0.05). The expression of GFP was located around the ventricle and persisted for a long time. Conclusion The fluorescence of GFP is stable and persistent and the GFP has no negative effects on the NSCs-GFP. It is an ideal maker of neural stem cells and could be used for the study of NSCs transplantation.

Objective To observe DAT1 expression in neural stem cells (NSCs) and the effects of DAT1 on the differentiation of NSCs. Methods Eukaryotic expression vectors pEGFP-C1-DAT1 and pcDNA4/hisA-DAT1 were constructed and transfected into NSCs of rat cerebellum by lipofectamine2000. The transfected NSCs were observed by immunohistochemistry under fluorescent microscope. Results The overexpression of DAT1 could increase the number of Mash-1 staining cells and promote the NSCs to differentiate into neuron progenitors, and the high levels of DAT1 in NSCs facilitated the differentiation of neurons. The localizations of DAT1 protein in Mash-1 staining cells and NF 200 staining cells changed. This shift may result from the two distinct inducing factors, FBS and nature differentiation, or distinct stages in differentiation of NSCs. Conclusion DAT1 functions in differentiation of NSCs as a multiprotein combined with distinct transcription factors by virtue of different inducer or varied stage of differentiation.

Objective To study efficacy and safety of cilazapril in treating patients with essential hypertension.Method 115 patients with hypertension were divided randomly into two groups:59 were treated with cilazapril and 56 were treated with enalopril.All the patients were washed out for one week,then took 2.5 mg cilazapril or 10 mg enalapril once a day in each group respectively for 8 weeks.If blood pressure was not reduced 2 weeks later,hydrochlorothiazide was added. Result The effective rate of cilazapril and enalapril was 89.8% and 91.1% respectively.The SBP and DBP reduced from 153±15 mmHg and 104±9 mmHg to 131±11 mmHg and 91±8 mmHg respectively in cilazapril group,and from 155±12 mmHg and 102±10 mmHg to 139±14 mmHg and 90±9 mmHg respectively in enalapril group.There were no significant differences in two groups. No side effects were observed in two groups. Conclusion Cilazapril is an effective and safe agent in treatment of mild and moderate essential hypertesion.

Objective To evaluate the feasibility and efficacy of laparoscopic treatment of hepatic hemangioma. Methods The clinical data of 27 patients who received laparoscopic treatment of hepatic hemangioma from November 2003 to October 2009 were retrospectively analyzed. The hepatic inflow to the liver or to a hemiliver was temporarily blocked using a Pringle manoeuvre with a self-invented laparoscopic blocker at the porta hepatis or at the pedicle to the relevant hemiliver. The Electriccautery and ultracision were used for liver transaction. Results Laparoscopic treatment of hepatic hemangioma was successfully performed in 25 patients. Conversion to laparotomy was required in two (8%) patients for uncontrollable bleeding. There were no major postoperative complications and no mortality. The mean tumor diameter was (6.34±2. 17) cm. The operating time was ( 105.21 ±72.76)min. The time of hepatic inflow block was (10. 17±12. 21)min. The blood loss was (115. 5±212.14)ml. The volume of blood transfusion was (0. 87 ± 1.45)U. The volume of postoperative drainage was (112.60±201.03)ml. The time taken to return to normal activity was (2. 0±0. 8) days.The length of postoperative hospital stay was (5.5±2.4) days. The length of total hospital stay was (12. 5 ±5.3) days. The total cost was RMB10041.6±8678. 7. Conclusion In selected patients, laparoscopic treatment of hepatic hemangioma was safe and feasible.

ObjectiveTo investigate the role of 15-F2t-isoprostane in intestinal injury induced by intestinal ischemia/reperfusion (I/R) in rats.MethodsThirty-two pathogen free adult male SD rats weighing 230-255 g were randomly divided into 4 groups ( n =8 each):group sham operation (group S) ; group intestinal I/R; group SQ-29548 (TXA2 receptor antagonist) (group SQ) and group DMSO (the solvent).Intestinal I/R was induced by 60 min occlusion of superior mesenteric artery (SMA) followed by 120 main reperfusion in groups I/R,SQ and DMSO SQ-29548 2 μmol/kg and DMSO were injected subcutaneusly at abdominal wall at 30 min before SMS in groups SQ and DMSO respectively.Arterial blood samples were taken at 120 min of reperfusion for determination of serum diamine oxidase (DAO) activity and 15-F2t-isoprostane,endothelin-1 (ET-1) and thromboxane B2 (TXB2) concentrations.Intestinal tissues were removed for microscopic examination and determination of myeloperoxidase (MPO) and SOD activities,MDA and lactate contents.Intestinal damage was assessed and scored according to Chiu (0 =normal,5 =disruption of tunica propria,bleeding and ulceration).ResultsIntestinal I/R significantly increased Chiu's score,MDA and lactate contents and MPO activity and decreased SOD activity in intestine in group I/R as compared with group S.SQ-29548 pretreatment significantly decreased Chiu's score,lactate content and MPO activity in intestine and increased intestinal SOD activity and decreased serum DAO activity and ET-1 concentration in group SQ as compared with group I/R.Conclusion15-F2t-isoprostane is involved in the development of intestinal injury induced by intestinal I/R by activating TXA2 receptor,increasing ET-1 production and promoting neutrophil infiltration.

Objective To investigate the effects of intestinal ischemia-reperfusion (I/R) on the brain in rats. Methods Sixty-four healthy male SD rats weighing 250-300 g were randomly allocated to one of 2 groups (n = 32 each): sham operation group (S) and intestinal I/R group (I/R). Intestinal I/R was produced by occlusion of superior mesenteric artery (SMA) for 90 min followed by reperfusion. Eight animals were sacrificed at each of the following time points: 2, 6, 12 and 24 h of reperfusion (T1-4) in each group. After a median sternotomyblood samples were taken from left ventricle for measurement of plasma TNF-α and IL-6 (by ELISA). Intestine and brain tissue was harvested for microscopic examination and detection of apoptosis ( by TUNEL). The cognitive function was tested using Morris water maze at 24 h. Results No abnormality was found in intestine and brain tissue in group S. Intestinal damage and neurodegeneration were detected in group I/R. Intestinal I/R significantly increased cerebral apoptosis in group I/R compared with group S. Plasma TNF-a and IL-6 concentrations were significantly higher at T1-4 in group I/R than in group S. The escape latency and swimming distance were significantly increased, while the number of crossing the platform was decreased in group I/R compared with group S. There was no significant difference in the swimming speed between the 2 groups. Conclusion Intestinal I/R can induce brain injury and lead to cognitive dysfunction. I/R-induced release of inflammatory mediators and neuronal apoptosis are involved in the underlying mechanism.

Objective To investigate the changes of proteins expressions in intestinal mucosa of rats after is chemic postconditioning (IPo) against intestinal ischemic/reperfusion (Ⅱ/R) injury of intestine in order to elucidate its potential mechanisms of protective role. Methods Sixteen SD rats were randomly divided into Ⅱ/R group and IPo group ( n = 8). Rats of both groups received an episode of ischemic/reperfusion insult to intstine that was made by occlusion of the superior mesenteric artery (SMA) for 60 minutes. Rats of IPo group underwent three additional episodes of clamping SMA on for 30 seconds and off for 30 seconds successively after prolonged reperfusion/reperfusion of intestine. The intestinal mucosa was taken by scratching immediately after reperfusion in both groups, and total proteins were separated by immobilized pH gradient (IPG) based two-dimensional gel electrophoresis (2-DE). The differentially expressed proteins were analyzed using Image Master 2D Elite 5.0 image analysis software, and the proteins were cut out from the gel and then identified using MALDI-TOF-MS. The biological information of these proteins was looked for in the database of these peptide mass finger-printing (PMF) .Results Ten differentially expressed proteins were found, of which 6 were up-regulated and 4 were down-regulated in IPo group. Nine proteins were identified and characterized by their bioelements including aldose reductase and aldehyde dehydrogenase that were related to anti-oxidative stress and inhibition of cell apoptosis. Conclusions The well-reproducible 2-DE profiles of intestinal mucosa in II/R and IPo groups were established. The potentially protective effects of IPo may be attributed to up-regulating protein expressions of aldose reductase and aldehyde dehydrogenase, and thereby suppressing oxidative stress and cell apoptosis.

[Objective]This study was aimed to evaluate treatment outcomes and toxicity of continuous-infusion EPOCH regimen for NK/T-cell lymphoma(NK/TCL).[Methods]From June 2003 to June 2008,34 patients including 30 nasal NK/TCL (88.2%)and 4 nasal type NK/TCL(11.8%)received doxorubicin,vincfistine,etoposide over 96 hours infusion with bolus eyelophosphamide and oral predinisone(EPOCH)chemotherapy as first-line treatment.Median cycles of EPOCH administered were 2.5(1-6 cycles).Additional involved field radiation therapy(IFRT)was administered to patients with localized nasal focus after chemotherapy.[Results]Among 34 patients,33 were eligible for response evaluation.The response rate(RR)was 60.6% (20/33)with complete remission(CR)rate of 45.5%(15/33).The RR of patients with nasal NK/TCL was 66.7%(20/30)with CR rate of 50%(15/30).Only one of the 3 nasal type NK/TCL patients achieved stable disease(SD),the other 2 had progressive disease(PD)during chemotherapy.After a median follow-up of 22(2-68)months,the estimated 3-year overall survival rate(OS)was 52.2%.For patients with nasal NK/TCL,the estimated median survival time was not reached,the 3-year OS was 59.4%.For patients with nasal type NK/TCL,the estimated median survival time was only 7 months.The CR rate was 75.0% for localized nasal NK/TCL who received initial EPOCH chemotherapy followed IFRT with the 3-year OS of 75.0%.Major adverse effect was myelosuppression.The incidence of grade Ⅲ～Ⅳ neutropenia was 30.9%.No treatment-related mortality occurred.[Conclusions]EPOCH regiment was effective and well tolerant for nasal NK/TCL.Combined EPOCH chemotherapy followed by IFRT produced promising outcome for patients with localized disease.However,patients with nasal type NK/TCL responded poorly and more efficacious treatment strategies are urgently needed.