Objective To investigate the safety and efficacy of transvaginal hydrolaparoscopic pelvic adhesiolysis (THLPA) treatment in the infertile women.Methods From May 2007 to Sep.2008,30 infertile patients underwent THLPA.The dye-test,hysteroscopy,and dye-test using catheterization of tubal ostium by hysteroscopy were performed at the same time.Pelvic adhesions were scored according to the revised American Fertility Society classification of endometriosis (1985).The adhesions were graded as mild (score 1-9),moderate (10-19),and severe (≥20).Twenty-four cases were in mild adhesions,5 moderate adhesions,and 1 severe adhesion.The duration of the operation and discharge,pelvic adhesions score,tubal patency,complications,and pregnancy rate were investigated.Results (1) THPLA:the majority of pelvic adhesions in all patients were successfully performed adhesiolysis.Only a little filmy adhesions of proximal peritube of 7 tubes and proper ligament of 5 ovaries and cohesive adhesions of 4 ovaries did not underwent surgical lysis.(2) Tubal patency:35 tubes were of proximal occlusion by dye-test,of which 21 (60%,21/35) were unobstructed and 4 (11%,4/35) were partly unobstructed after the dye-test using catheterization of the tubal ostium by hysteroscopy.(3) The duration of operation:the overall operative time were (32±6) minutes in mild adhesion,(52± 6) minutes in moderate adhesion,and 83 minutes in severe adhesion.Of which the time of THLPA were (11±5) minutes in mild adhesion,(35±7)minutes in moderate adhesion,and 62 minutes in severe adhesion,respectively.(4)The duration of discharge:the postoperative discharge time was 120-175 minutes.No complications occurred.(5)The rate of pregnancy:in the (15.8±4.3) months' follow-up,the rate of pregnancy was 45% (13/29),which one patient lost follow-up.Conclusions THLPA is safe,efficacious and not being hospitalized management.When compared with laparoscopy,it is simpler,more economic,and less minimally invasive approach.The appropriate indication of THLPA is to treat filmy,especially mild pelvic adhesions.It could partly avoid transabdominal operative laparoscopy for the infertile women.

In view of the spread of hepatitis C virus(HCV),it still lacks an efficient anti-HCV drug or treatment until now.HCV non-structural proteins 3(NS3) protease is an important drug target in the research of the antiHCV drugs in recent years.This article reviews the active mechanism and peculiarity of HCV NS3 protease inhibitor.

AIM　To study whether KB-R7943 has selective inhibitory effect on the inward and outward Na+-Ca2+ exchange current (INa-Ca) in guinea pig ventricular myocytes. METHODS　Through setting up the model of intracellular Na+-overload during myocardial ischemia and reperfusion, the current-voltage relationship of INa-Ca was recorded using whole-cell patch clamp technique under bi-directional ionic conditions. RESULTS Currents were elicited by a declining ramp pulse depolarized immediately from holding potential of -40 mV to +60 mV, then repolarized to -100 mV at a speed of 80 mV*s-1 and returned to the holding potential under bi-directional ionic conditions, while the ［Na+］ was 25 mmol*L-1 in the pipette solution. The currents increased time-dependently and voltage-dependently which reached from (2.51±0.15) pA*pF-1 to (5.94±0.13) pA*pF-1 at +50 mV and from (-1.92±0.13) pA*pF-1 to (-3.17±0.16) pA*pF-1 at -80 mV (n=12) after 3 min and there is no significant run-down of the current. KB-R7943 10-6 mol*L-1 was found to decrease the current to (4.62±0.05) pA*pF-1 by 29.4% at +50 mV and to (-2.30±0.18) pA*pF-1 by 22.1% at -80 mV (n=5) after 5 min. While 10-5 mol*L-1 KB-R7943 was shown to decrease the current to (3.13±0.03) pA*pF-1 by 61.7% at +50 mV and to (-1.62±0.03) pA*pF-1 by 56.9% at -80 mV (n=7). CONCLUSION　KB-R7943 can block INa-Ca in guinea pig ventricular myocytes. But, it did not show selective inhibition effect on inward and outward currents.

Objective To investigate the expression and relationship between hepatocyte cell adhesion molecule (hepaCAM) protein and some multidrug resistance proteins in renal carcinoma tissue.Methods Expressions of hepaCAM,multidrug resistance associated protein (MRP),P-glycoprotein (P-gp),lung resistance protein (LRP),and topoisomerase Ⅱ (TOPO Ⅱ) protein were detected by immunohistochemistry in different areas of human renal cell carcinoma tissues and their relationships were analyzed.Results In the peripheral zone of renal tumor,hepaCAM,MRP,P-gp and LRP protein were showed positive expression.In the central region of the renal tumor,the expressions of hepaCAM,P-gp and LRP were negative or weakly positive,while the expressions of MRP and TOPO Ⅱ protein were positive.The expressions of MRP and TOPO Ⅱ protein in the central region of tumor were stronger than those in the peripheral zone of tunor (31.23 ±5.67 vs.23.89 ±4.56;45.66 ±2.34 vs.5.23 ±0.66),with statistically significant differences (t =-6.20,P =0.00;t =-100.16,P =0.00).While the expressions of other proteins (hepaCAM,P-gp and LRP) in the central region of tumor were weaker than those in the peripheral zone of tumor (3.21 ±1.12 vs.27.25±2.23;2.34±0.33 vs.51.23±3.45;4.22±1.78 vs.44.23 ± 1.45),with statistically significant differences (t =60.87,P =0.00;t =90.35,P =0.00;t =107.18,P =0.00).Correlation analysis showed that the expression of hepaCAM protein in the central region of renal carcinoma was related with the expression of MRP protein (r =0.94,P =0.01),but it was not related with the expressions of P-gp,LRP and TOPO Ⅱ protein (r=0.22,P=0.44;r=0.14,P=0.80;r=0.34,P=0.07).Conclusion The expression of hepaCAM protein in renal carcinoma may be related to tumor drug-resistance.

Objective Tc explore the value of application of Sevoflurane anesthesia induction in anesthesia management of foreign matter removal from trachea in children.Methods Sixty five cases of children with tracheal foreign matter related in our hospital from January 2015 to December 2016 were selected as the study objects,and were divided into two groups according to random number table method.The control group of 32 cases was given 2.5 mg/kg propofol to induce anaesthesia,and the observation group of 33 cases was given 8％ Sevoflurane inhalation to induce ancsthesia.One shot success rate,deoxygenation time,operation time,recovery time and the relative parameters (systolic pressure,diastolic pressure,respiratory rate and pulse oxygen saturation) at entrance time,before and after setting the mirror were contrasted and analyzed,and the intraoperative and postoperative adverse reactions were recorded in the two groups.Results There were no significant differences in respiratory rate,blood oxygen saturation,systolic blood pressure and diastolic blood pressure between two groups at entrance time and before setting the mirror (P ＞ 0.05).The respiratory rate and blood oxygen saturation of the observation group were higher than those of control group after setting the mirror and at withdrawing mirror time,with statistically significant differences (P ＜ 0.05).No statistically significant differences in other indexes (P ＞ 0.05).Deoxygenation time,operation time and recovery time of the observation group were significantly lower than those in the control group (P ＜ 0.05).The total incidence of adverse reactions in the observation group was significantly lower than that in the control group (P ＜ 0.05).Conclusions Sevoflurane anesthesia induction can obviously shorten operation time and recovery time in foreign matter removal from trachea in children,and reduce the incidence of intraoperative and postoperative adverse reactions.It has good clinical effect.

Objective To evaluate effectiveness of bone marrow derived mesenchymal stem cells(BMSCs) transduced by adenovirus mediated human bone morphogenetic protein-2 (Adv-hBMP-2) gene in the repair of diaphysic segmental bone defects of goats. Methods The tibial bone defects (2.1 cm) of 22 goats, who weighted from 18.1 kg to 29.5 kg, were established and divided into 4 groups: groupⅠ, Adv-hBMP-2 transduced BMSCs group (n=8); groupⅡ, adenovirus mediated ?-galactosidase(Adv-?gal)gene transduced BMSCs group (n=6); groupⅢ, non-transduced BMSCs group (n=6); groupⅣ, untreated group (n=2). Roentgenography, histomorphometrical analysis and biomechanical measurement were studied at various times. Results Roentgenography showed more callus in the bone defect site of group Ⅰ. At 24th week after implantation, the healing rates of group Ⅰ,Ⅱ,Ⅲ, and Ⅳ were 6/7, 1/5, 2/5, and 0/1 respectively. There was statistic significant difference of X-ray grading between groupⅠand groupⅡor Ⅲ. Histomorphometrical analysis showed much more total new trabecular bone area (TBA) of groupⅠthan that of other groups. Biomechanical strength of groupⅠwas superior to that of groupⅡand Ⅲ. Conclusion Adenovirus mediated BMP-2 gene transferred BMSCs can repair segmental bone defect in goat without osteoconductive scaffold.

The two pore domain K + Channel is a new superfamily of potassium channel subunits expressing the background potassium current on the cell membrane. Its functions are closely related with the physiological and pathological changes. This article reviews five groups of the two pore domain K + Channel on the gene and protein structure, current characteristics and pharmacological properties.

It is generally agreed that the central cholinergic system plays an important role in learning and memory processes. Alzheimers disease (AD), the most common cause of dementia, is a devastating illness characterized by progressive cognitive deterioration. The learning and cognitive deficits observed in AD patients are hypothesized to be partly caused by central cholinergic system dysfunction. There exists a malicious cycle in the pathologic course of AD, that is, the impairment of central cholinergic transmission could increase the amount of A? in the brain, and the increase of A? could also impair the efficacy of the cholinergic transmission.

Objective To assess the safety and the efficacy of endoscopic ultrasound (EUS)-guided transmural drainage of pancreatic pseudocysts (PPC).Methods A total of 17 patients with PPC who underwent EUS to detect the optimal site and depth of puncture.The needle was punctured into the PPC cavity through endoscopic biopsy hole,cyst fluid was drained with a syringe.The guide wire was inserted along the pinhole under X-ray,and then the needle-knife was sent along the guide wire to cut the gastric wall and pseudocysts wall,followed by balloon dilation.The way of drainage was selected according to the cyst fluid properties.The technical success rate,treatment success rate,complication occurring rate and the skills were evaluated.Results Four patients were with nasalcystic catheter drainage,9 patients with double pigtail stents internal drainage,and 4 patients with nasal-cystic catheter and double pigtail stents combination drainage.The treatment success rates were 3/4,7/9,and 4/4 respectively.Only 1 patient subsequently developed bleeding from puncture site after stent successively placed,and was turned to surgery because of ineffective endoscopic treatment.Infection occurred in 4 patients during drainage,two of those were switched to surgical resection due to poor medical treatment response,and the other 2 were cured with intravenous infusion of antibiotics sensitive to cyst fluid bacteria and metronidazole rinse PPC.The median follow-up duration was 28.5months,and there was none of recurrence.Conclusions EUS-guided transmural drainage of PPC is safe.Stent placement and nasal-cystic catheter play an important role in PPC treatment.

Objective To investigate effect of transforming growth factor β3(TGFβ3)on expression of MMP-9,MMP-2,TIMP-1 and collagen I in rats with liver fibrosis through transduction by recombinant adeno-associated virus 2(rAAV2).Methods Rats were randomly divided into 4 groups:normal control group,model group,negative control group and TGFβ3 group.Liver fibrosis model was induced by hypodermic injection of 40% CCl4.rAAV2-TGFβ3,was injected via vena caudalis of the rats one week before CCl4 Was given.All rats were sacrificed and the liver tissues were taken 8 weeks afler injection of CCl4.The histopathological changes were observed on HE sections;the expressions of MMP-9,MMP-2,TIMP-1 and collagen I were examined by histochemistry and the positive area rates were semi-quantitatively analyzed.Results Compared with the model group and negative control group,the decreases of inflammatory infiltration and collagen fibers hyperplasia were observed in the TGFβ3 group,and the expression of MMP-9 increased(q=23.664,27.746,P<0.01),the expression of collagen I(q=5.503,5.251,P<0.01)and TIMP-1(q=5.800,8.608,P<0.01)decreased,but that of MMP-2 was not changed(q=2.1 08,0.996,P>0.05).Conclusion rAAV2-TGFβ3 can reduce the histological damage and degree of liver fibrosis in rats by inhibiting expression of TIMP-1 and collagen I,and upregulating expression of MMP-9.