Objective To study the diagnosis and treatment of ureteral obstruction caused by endometriosis. Methods Out of 23 patients suffered from endometriosis treated from 1997 to 2000,ureteral obstruction occurred in 2 accompanied by hydronephrosis and dilatation of ureter.Both the 2 underwent sub total hysterectomy, resection of the intumescence in pelvic cavity, and the ureter was freed from the surrounding tissue. Results Ureteral obstruction was relieved in 7～10 days after the procedure. Both the petients were followed up for 2 years without recurrence. Conclusions Attention shoud be called to ureteral obstruction caused by endometriosis.Ultrasonic examination and intravenous pyelogram before operation, close examination of the ureter and adequate freeing of the ureter from it's surrounding tissue during operation, the application of gestrinone for 6 months after the operation, and scheduled following up would yield a satisfactory outcome.

In order to evaluate the pathogenisis, definite the position and mechanism of ovarian dysfunction. Methods Pi-tuitarygonadal hormones ,-.P and prolactin (PRL) were measured in 25 premenopausal hemodialysis women using enzyme im-munoassay (E3A). Results Patients' serum PRL levels significantly elevated, FSFKLH levels also elevated, whereas P levels were obviously lower compared with normal women. Conclusion (1) Hypothalamic-pituitary-ovarian axis was impaired in uremia women as indicated by the prevalence of acydicity and the failure of LH,E2 levels and marked low P levels. (2)In uremia women clomiphenum stimulation test was positive suggested that the pituitary-ovarian axis were normal, whereas hypothalamic was impaired. (3) Hyperprolactinemia, owing to increased pituitary prolactin secretion. Suppression with bromocriptine was unstable. (4) During dialysis, symptom treating is suitable rather than trigger the ovalation. Successful renal transplantation is the best treatment.

Objective To investigate the relationship between the expression changes of p-Akt (Ser473),p-Bad (Ser136) and the cell apoptosis in peri-infarction tissue of permanent middle cerebral artery occlusion (MCAO) in rats.Methods Sixty male Sprague-Dawley rats were randomly allocated into sham operation,MCAO 3 h,MCAO 12 h,LY294002 intervention MCAO 3 h,and LY294002 intervention MCAO 12 h groups (n =12 in each group).A permanent MCAO model was induced by the modified suture method.At 15 minutes before modeling,the rats in the LY294002 intervention MCAO groups were administered via lateral ventricle.The neurological function score was scored by using Zea Longa method.2,3,5-triphenyltetrazolium chloride (TTC) staining was used to detect infarct volume.Immunohistochemical staining was use to detect pAkt (Ser473) and p-Bad (Ser136) expressions in peri-infaretion tissue.TUNEL assay was used to detect apoptotic cells in peri-infarction tissue.Results Three hours after modeling all the experimental rats awoke from anesthesia.The neurological deficit score in the sham operation group was 0,and the scores of the MCAO 3 h,MCAO 12 h,LY294002 intervention MCAO 3 h and LY294002 intervention MCAO 12 h groups were 2.25 ± 0.45,2.92 ± 0.99,3.00 ± 0.95,and 3.02 ± 0.36,respectively.There were significant differences among all groups (F =26.520,P =0.000).The score of the LY294002 intervention MCAO 3 h group was significantly higher than that of the MCAO 3 h group (P =0.009).There was no significant difference between the LY294002 intervention MCAO 12 h group and the MCAO 12 h group (P =0.354).TTC staining showed that no infarct was observed in the sham operation group.The infarct volumes of the MCAO 3 h,MCAO 12 h,LY294002 intervention MCAO 3 h and LY294002 intervention MCAO 12 h groups were 23.4 ± 1.4,40.3 ± 1.1,31.9 ±6.0 and 44.4 ±3.8 mm3,respectively.There were significant differences among the groups (F =30.440,P =0.000).The score of the LY294002 intervention MCAO 3 h group was significantly greater than that of the MCAO 3 h group (P =0.002).There was no significant difference between the LY294002 intervention MCAO 12 h group and the MCAO 12 h group (P=0.113).Compared with the sham operation group,the p-Akt (Ser473) expression in peri-infarction tissue in the MCAO 3 h group was significantly high,and it was significantly decreased in the MCAO 12 h group; the expression level of p-Bad (Ser136) showed a progressive decline with the passage of MCAO time,at the same time,the number of apoptotic cells increased progressively.After the LY294002 intervention,the expression levels of p-Akt (Ser473) and p-Bad (Ser136) in peri-infarction tissue decreased significantly at 3 h after MCAO,and the number of apoptotic cells increased significantly (P ＜0.05),but there was no significant effect on each index at 12 h after MCAO.Conclusions The activation of the PI3K/Akt signal transduction pathway in early cerebral infarction and the stress elevation of the key protein p-Akt (Ser473) of this pathway have brain protection,while the failure of this pathway activity and the drastical decrease of its key protein in the late cerebral infarction are associated with brain injury.

Objective To investigate the influence of pregnancy on graft after renal transplantation. Methods Clinic data from 13 female transplant recipients with pregnant duration more than 5 months from May 1978 to March 2002 were retrospectively analyzed. Results Immunosuppressive programs: 4 patients received CsA plus Pred, 5 CsA, MMF plus Pred, and 4 FK506, MMF plus Pred. Among the 13 cases, 10 had successful pregnancies with stable graft function; one died of pulmonary infection and cardiac insufficiency with functioning graft after delivery (the baby was safe); 2 experienced chronic rejection proven by biopsy, getting graft lost and pregnancy terminated: one returned to hemodialysis till now and one received successful retransplantation after 1 year hemodialysis. 11 offerings are healthy by now.Conclusion Patient/kidney survival in our study was 76.9?% . Our data and literature have demonstrated that pregnancy has no effect on graft long term survival or function. It is advisable in a woman of childbearing age with a well functioning renal graft 2 years after transplantation, but must be considered risk. Chronic rejection is a risk factor for graft loss following pregnancy. FK506,CsA and MMF have no side effect on newborns.

Apoptosis is one of the important forms during cerebral ischemia.Phosphoinositide-3 kinase (PI3K)/serine/threonine kinase (Akt) is the important cell survival signaling pathway,while c-jun N-terminal kinase (JNK) is the important pro-apoptotic signaling pathway.The dynamic equilibrium of the two signal transduction pathways maintains cell survival and apoptosis under the physiological state.Stimulation during cerebral ischemia breaks this physiological balance and results in the apoptosis of massive neurons.A variety of proved neuroprotective factors are associated with the amplification of enhancement of cell survival signal or inhibition of apoptosis signal,and thrus maintain the balance between the two signal pathways.

Objective To investigate any changes in motor functional connectivity in the brains of acute ischemic stroke patients after low frequency electrical stimulation.Methods Twenty-five ischemic stroke patients were given low frequency electrical stimulation in addition to their conventional rehabilitation treatment.Another 20 patients received only conventional treatment as a control group.Resting-state functional magnetic resonance imaging (rs-fMRl)was employed to assess motor function connectivity in the brains of all 45 subjects before and after treatment.Any differences in functional impairment,extremity motor function or ability in the activities of daily living were also recorded before and after treatment.Results In both groups,average scores on the Canadian neurological scale (CNS)and the National Institutes of Health stroke scale (NIHSS) had been reduced significantly after treatment and FuglMeyer assessment (FMA) and modified Barthel index (MBI) scores had significantly increased.The average improvements in terms of FMA and MBI scores were significantly greater in the observation group.Compared with before treatment,the coefficient of functional connectivity of the bilateral motor cortex had decreased significantly after treatment in both groups.In the observation group the changes were significantly correlated with the improvements in FMA scores.Conclusion Neural functional impairment after ischemic stroke can be reduced significantly and extremity motor function and ability in the activities of daily living can be significantly improved by low frequency electrical stimulation.

ObjectiveTo evaluate the pregnancy outcomes in female kidney transplant recipients and the long-term follow-up for the health of the offspring. MethodsClinical data from April 1978 to April 2011 of 15 female renal transplant recipients who were pregnant more than 5 months and their offspring were retrospectively analyzed. ResultsThe 15 recipients were taking CsA or Tac based immunosuppressive regimens.Twelve had successful pregnancies with stable and functioning grafts ; 1 paitent died of pulmonary infection and cardiac failure with functioning graft after the delivery of a healthy male infant; 2 experienced chronic rejection proven by biopsy at week 21 and 23 respectively,the pregnancies were therefore terminated and the grafts were lost even after rescue.All 13 newborns were smoothly delivered by cesarean section,they had an average gestational age of 35.2 ± 4.0 weeks,and a mean birth weight of 2510 ± 68 g,Apgar scale for each infant was 10,respectively.There were no birth defects,structural malformations,nor learning disabilities in 13 newborns,and their mothers all chose to bottle-feed.Thirteen children had normal intelligence,physical and mental development.Seven children experienced repeated respiratory tract infections during 0- 2 years,and 1 was diagnosed with attention deficit hyperactivity disorder.The oldest offspring is 21 years old and the youngest is 3 years old. ConclusionsFemale renal kidney recipients could achieve successful pregnancies and deliveries 3 years post transplantation with strict criteria.Their offspring were healthy during follow-up.

0bjective To investigate the relationships between the peripheral lung cancer and pulmonary vessels or bronchi by 16-row muhislice computed tomography(MSCT)and analyze the related factors.Methods Fifty-four patients with peripheral lung cancer confirmed pathologically underwent contrast-erdaanced MSC TI Multiplanar reformation(MPR)and maximum intensity projection(MIP)in all patients were used to demonstrate the relationships between the peripheral lung cancer and pulmonary vessels,bronchi.The relationships were categorized five types:Type 1,erupted at the edge of nodule. Type 2,erupted at the center of nodule.Type 3,penetrated through the nodule.Type 4,contacting the nodule but stretched or encased.Type 5,contacting the nodule but smoothly compressed.The pathology type,stage,size,density and location of the peripheral lung cancer were recorded and the relationships with five types were evaluated by using Chi-square test and correlation analysis.Results (1)Tumor-bronchi relationship:type 1(33,61.1%)was more often seen in≥2.0 cm and solid lesions with stage Ⅱ-Ⅳ.while Type 2(14,25.9%)was often seen in<2.0 am and part-solid or non-solid lesions with stage Ⅰ.(2)Tumor-PA relationship:Type 1 was more often seen in≥2.0 am and solid lesions with stage Ⅱ-Ⅳ.while Type 2 was often seen in part-solid or non-solid lesions with stage Ⅰ.(3)Tumor-PV relationship:type 4 was the most common type(29,53.7%).Type 2(13,24.1%)was more often seen in part-solid or non-solid lesions.(4)Tumor-bronchi relationship and tumor-PA relationship had a positive correlation(r=0.5265,P<0.01).Conclusions MSCT can demonstrate the relations between the peripheral lung cancer and bronchi.PA and PV.It is useful for the differential diagnosis and prognosis evaluation of the lung csncer.

Objective: To investigate the effect of micro steel plate internal fixation combined with traditional Chinese medicine medicated bath in the treatment of proximal phalanx fractures. Methods: From January 2012 to December 2012, 100 patients with proximal phalanx fracture in Ningbo Mingzhou Hospital were selected and randomly divided into control group and observation group, according to the digital table, with 50 cases in each group.The control group was treated by simple miniature steel plate internal fixation, the observation group was treated by microplate internal fixation combined with traditional Chinese medicine medicated bath.The clinical treatment effect was compared between the two groups. Results: The hospitalization time and fracture healing time in the observation group were (8.35±1.62)d and (49.35±3.85)d, respectively, which were significantly shorter than those in the control group [(8.95±1.48)d, (57.82±6.12)d], the differences were statistically significant (t=5.032, 6.114, all P<0.05). The postoperative total active flexion degree and incidence rate of adverse reactions of the observation group (16.00%) was lower than that in control group (34.00%), the difference was statistically significant (χ²=18.485, P<0.05). Conclusion Microplate internal fixation combined with traditional Chinese medicine medicated bath in the treatment of proximal phalanx fractures has better treatment effect, and it has shorter treatment time and less complications.

Objective To evaluate effects of targeted silencing of growth arrest and DNA damage inducible gene 45α (Gadd45α) by small interference RNA (siRNA) on the invasion and migration of a cutaneous squamous cell carcinoma cell line A431.Methods Real-time fluorescence-based quantitative PCR and Western blot analysis were performed to detect the mRNA and protein expression of A431 and Colon16 cells respectively,and then A431 cells with highly expressed Gadd45α served as a research object.Cultured A431 cells were divided into 3 groups:experimental group transfected with Gadd45α-siRNA-1,negative control group transfected with negative control siRNA,and blank control group receiving no treatment.After the RNA interference,the mRNA and protein expression of Gadd45α in the above 3 groups were measured by real-time fluorescence-based quantitative PCR and Western blot analysis,respectively,and the effect of the RNA interference on the invasion and migration abilities of A431 cells was evaluated by Transwell and wound scratch assays.Results Gadd45α mRNA and protein were highly expressed in the A431 cells.After the RNA interference,the experimental group showed markedly lower mRNA and protein expressions of Gadd45 in the A431 cells (0.286 ± 0.013,0.33 ± 0.007,respectively) compared with the negative control group (1.028 ± 0.183,0.87 ± 0.002,respectively)and blank control group (1.001 ± 0.057,0.86 ± 0.004,respectively),and there were significant differences in the mRNA and protein expressions of Gadd45 among the 3 groups (F =5 893.857,2 763.000,both P ＜ 0.001).The number of A431 cells crossing the polycarbonate membrane was higher in the experimental group (66.33 ± 3.79) than in the negative control group (26.00 ± 4.36) and the blank control group (28.33 ± 4.16),and there was a significant difference among the 3 groups (F =20.084,P =0.002).Moreover,the wound scratch assay showed that the number of migrating A431 cells per high-power field was significantly higher in the experimental group than in the negative control group and the blank control group (315.33 ± 6.66,154.67 ± 2.08,130.67 ± 3.51 respectively;F =1 676.255,P ＜ 0.001).Conclusion Gadd45α is highly expressed in the cutaneous squamous cell carcinoma cell line A431,and targeted silencing of Gadd45α gene can enhance the in vitro invasion and migration abilities of A431 cells.