Objective To compare the efficacies of mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy and routine retroperitoneal laparoscopic dismembered pyeloplasty for ureteropelvic junction(UPJ) obstruction.MethodsThe clinical data of 47 patients with UPJ obstruction,who underwent dismembered pyeloplasty from January 2004 to November 2006 in our hospital,were retrospectively analyzed.Of the patients,22 were treated by mini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy(group A),in whom a 4-cm incision was made under the costal margin at the posterior axillary line;and the other 25 cases underwent retroperitoneal laparoscopic dismembered pyeloplasty(group B).The clinical data of the two groups,including the operation time,blood loss,average airway resistance and partial pressure of carbon dioxide,recovery of intestinal function,length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR,were statistical analyzed by SPSS 13.0.ResultsNo intra-operative complications occurred in either group.Compared with Group B,Group A had shorter operation time [(92.9?16.3) min vs(155.8?18.6) min,t=-12.251,P=0.000],more blood loss [(18.9?6.3) ml vs(13.6?6.7)ml,t=2.782,P=0.008],lower average airway resistance [(15.6?2.6) cm H2O vs(26.9?4.3) cm H2O,t=-10.715,P=0.000] and partial pressure of carbon dioxide [(36.0?6.9) cm H2O vs(51.6?6.7) cm H2O,t=-7.855,P=0.000].No statistical differences were detected in the recovery of intestinal function,postoperative length of drainage and hospital stay,incidence of urinary leakage,and remission rate of hydronephrosis and improvement of GFR.ConclusionMini-incision dismembered pyeloplasty assisted by retroperitoneal laparoscopy is a safe,effective,and minimally invasive therapy for UPJ obstruction.

Objective Castleman′s disease ( CD) is a rare lymphoproliferative disorder, which has a very high misdiagnosis rate according to its lack of clinical and imaging specificity.The study was to improve the recognition, diagnosis and management of this disease by analyzing the clinicopathological characteristics and concluding diagnosis and treatment as well as literature review. Methods Retrospective analysis was conducted on clinical data of 31 CD patients (13 males and 18 females) who were hospitalized in the Affiliated Drum Tower Hosipital to Medical college of Nanjing University from January 2006 to Feburary 2014.Their mean age was (47.4 ±13.3) years.There were 24 cases with unicentric Castleman′s disease (UCD) and 7 cases with multicentric Castleman′s disease ( MCD) .UCD tended to be present in the form of an enlarged and painless mass which generally remained asymptomatic by accidental touch or regular physical examination.MCD was usually associated with constitutional symptoms.All the 24 patients with UCD underwent complete surgical resection.7 patients with MCD received different treatment methods, such as surgical resection, ste-riod and rituximab in combination with chemotherapy ( CHOP) . Results Postoperative pathology confirmed 23 cases were hyaline vascular type while 8 were plasma cell type.25 cases had been followed up (46.3 ±32.3) months after operation, among which 1 UCD case died of pancreatic head carcinoma 13 months after operation, 1 case with MCD plus pemphigus died 2 months after surgical resection of retroperitoneal lymphadenectasis, another MCD case died in 1 month without any treatment.The remaining 22 cases were alive. Conclusion CD is lack of clinical specificity and its diagnosis should be made by pathology.Each subtype differ greatly in prognosis, therefore different treatments should be taken after definitive subtype diagnosis.

Objective To determine the expression and distribution of Disabled-2(Dab2) in normal human adrenal glands, and further to study the expression of Dab2 in tissues of different adrenocortical adenomas, and to elucidate whether Dab2 can be a specific molecular marker in the pathology of primary aldosteronism. Methods Real-time PCR and immunohistochemical staining were used to detect Dab2 expression in 10 aldosterone-producing adenoma (APA) samples, 8 cortisol-producing adenoma ( CPA) samples, 8 non-functioning adenoma ( NFA) samples and 6 normal adrenal samples. Results Immunohistochemical staining showed that Dab2 was significantly highly expressed in zona glomerulosa of normal human adrenal glands. Sporadical cluster of ZG cells with moderate Dab2 staining were demonstrated in APAs. In all CPA and NFA tumors, weak dab2 staining was detected. According to the results of real-time PCR, Dab2 mRNA expression was increased significantly in APAs compared with normal adrenal glands. There was no significant difference between normal adrenal glands, CPAs, and NFAs in regard to Dab2 mRNA expression. Compared to nontumor portions, APAs also showed higher Dab2 mRNA expression in the tumor( P<0. 05). Conclusion Dab2 was predominantly localized in zona glomerulosa in normal adrenal gland. Increased Dab2 mRNA expression was detected in APAs compared with normal adrenal glands. Whereas, Dab2 protein expression was just moderate increased in APAs. Weather Dab2 can be a specific molecular marker in the pathology of primary aldosteronism has to be further studied.

BACKGROUND: Mesenchymal stem cells (MSCs), with low immunogenicity, can regulate cellular immunity and mitigate graft rejection, which has a good prospect in tissue engineering. However, it is rarely present in bone marrow. OBJECTIVE: To explore an isolation and culture method of the rabbit bone marrow-derived MSCs, to observe the biological characteristics and differentiation potential of bone marrow-derived MSCs.METHODS: MSCs were isolated from rabbit tibia bone marrow by combination of gradient centrifugation and different adherent method, then proliferation in vitro. Morphology was examined by phase contrast microscopy, and the growth curve of cultured MSCs was drawn via MTT results. MSCs were treated with osteogenetic inductor (L-DMEM/F12, 10% fetal bovine serum, 0.1 μmol/L dexamethasone, 200 μmol/L vitamin C, 10 mmol/L β-phosphoglycerol), adipose inductor (L-DMEM/F12, 10% FBS, 1 μmol/L dexamethasone, 200 μmol/L antifani, 0.5 mmol/L IBMX, 10 μg/mL insulin), and chondrocytes inductor (L-DMEM/F12, 10% FBS, 10 μg/L TGF-β1, 0.1 μmol/L dexamethasone, 50 μmol/L vitamin C, 6.25 mg/L insulin) to differentiated into osteoblast, dipocytes and chondrocytes. And the differentiated cells were identified by alkaline phosphatase staining, oil red O staining, and toluidine blue staining, respectively.RESULTS AND CONCLUSION: Bone marrow-derived MSCs can be isolated and cultured by the combination of gradient centrifugation and different adherent method in vitro, which have the better potentiality of proliferation and multi-directional differentiation. Mostly of the primary and passaged cells were spindle-shaped. After osteogenetic induction, cells were positive to alkaline phosphatase staining. Oil red O staining showed that red lipid droplet existed in adipose cells, and toluidine blue staining showed that toluidine blue was positive after chondrocytes induction.

OBJECTIVETo observe the effects of adipose-derived mesenchymal stem cells (ADSCs) with continous over-expression of glial cell line-derived neurotrophic factor (GDNF) on the motor function recovery and nerve regeneration of sciatic nerve of rats after electrical injury.

METHODSFive SD rats were collected to prepare ADSCs with over-expression of GDNF. One hundred and fifty SD rats were divided into normal control group (N), GDNF-ADSCs group (GA), ADSCs group (A), GDNF group (G), and physiological saline group (P) according to the random number table, with 30 rats in each group. Rats in group N were routinely fed without treatment, and rats in the other 4 groups were inflicted with electrical injury on sciatic nerve of thigh of the right hind leg. Rats in groups GA, A, G, and P were respectively injected with 100 µL suspension of ADSCs with over-expression of GDNF (1 x 10(7) cells per mL), 100 [µL ADSCs suspension (1 x 10(7) cells per mL), 100 µL GDNF solution (100 mg/L) , and 100 µL physiological saline to the surface of the injured nerves immediately after injury. Six rats of each group were collected for measuring hind limb stride from post injury week (PIW) 1 to 8, and morphology of the sciatic nerves was observed in PIW 8. In PIW 4, the protein expression of GDNF of sciatic nerves of the rest rats in each group was determined with Western blotting. Data were processed with one-way analysis of variance, analysis of variance of repeated measurement, and SNK test.

RESULTSCompared with that of group N, the hind limb stride values in groups GA, A, G, and P were significantly lower at each time point (with P values below 0.05). Compared with those of group P, the hind limb stride values in group GA from PIW 3 to 8, in group A in PIW 3, 5, and 7, and in group G in PIW 3, 5, 7, and 8 were significantly longer (with P values below 0.05). The hind limb stride values in group GA from PIW 4 to 8 were respectively (10.83 ± 0.97), (13.25 ± 1.40), (12.86 ± 1.42), (14.06 ± 1.50), and (15.09 ± 1.17) cm, which were significantly longer than those in group A [(8.90 ± 0.82), (9.03 ± 0.57), (9.27 ± 0.36), (9.86 ± 0.36), and (9.52 ± 0.58) cm] and group G [(8.87 ± 0.69), (8.51 ± 1.18), (9.34 ± 0.87), (9.76 ± 0.67), and (9.50 ± 1.22) cm], with P values below 0.05. Compared with that of group N, the number of myelinated nerve fibers of sciatic nerves was obviously decreased in group P but obviously increased in groups GA, A, and G; the diameter of axons was obviously shorter, and the myelin thickness was obviously increased in groups GA, A, G, and P in PIW 8 (with P values below 0.05). The number of myelinated nerve fibers in group GA was 31.2 ± 0.8, which was significantly higher than that in group A (23.7 ± 2.7), group G (22.3 ± 2.7), or group P (9.3 ± 2.8), with P values below 0.05. The diameter values of axons among groups P, A, G, and GA were similar (with P values above 0.05). The myelin thickness of rats in group GA was (3.41 ± 0.34) µm, which was significantly thicker than that in group A [(2.64 ± 0.37) µm] or group G [(2.41 ± 0.34) µm], with P values below 0.05. In PIW 4, the protein expression of GDNF of sciatic nerves was significantly higher in groups P, A, G, and GA than in group N (with P values below 0.05), and the protein expression of GDNF in group GA was significantly higher than that in group P, A, or G (with P values below 0.05).

CONCLUSIONSADSCs over-expressing GDNF protein can obviously promote the motor function recovery and nerve regeneration of sciatic nerve of rats after electrical injury.

Adipose Tissue ; Animals ; Electrophysiology ; Glial Cell Line-Derived Neurotrophic Factor ; genetics ; metabolism ; Mesenchymal Stem Cell Transplantation ; methods ; Mesenchymal Stromal Cells ; metabolism ; Nerve Crush ; Nerve Regeneration ; physiology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve ; pathology ; physiology

Objective To assess the intraoperative efficacy of contrast-enhanced ultrasonography (CEUS) in the radiofrequency ablation (RFA) of renal tumors.Methods RFA was performed on 110 renal tumors (size range:1.5-8.6 cm,49 located in the left,55 right and 3 bilateral) in 107 selected patients.Conventional tumor biopsy was conducted for pathological diagnosis using 18G biopsy needle after RFA.CEUS was performed in all patients before,during and after RFA to assess the necrotic area.Once suspicious residual lession was discovered by CEUS,another round of RFA was taken immediately.Initial follow-up enhanced CT and CEUS was performed seven days after the procedure,with subsequent CEUS and enhanced CT after one month,three months,and six months to assess the necrotic area.Technical success was defined as elimination of areas that enhanced at imaging within the entire tumor.Results With CEUS performed during RFA,110 tumors (100％) were successfully ablated during one operation.Of these,five tumors was subjected to additional RFA treatment for the suspicious residual lesion detected by CEUS right after initial RFA.Elimination of areas covered the entire tumor after the second RFA.No residual or recurrence tumors was confirmed by both enhanced CT and CEUS during follow-up.All patients survived in the follow-up phase which ranged from 3 to 18 months(mean 11 months).Conclusions With the application of intraoperative CEUS,there were less residual tumors after RFA.

Objective To assess the contribution of transrectal realtime tissue elastography (TRTE) on the differential diagnosis of prostatic diseases. Methods A total of 88 prostatic disease patients with 95 lesions proved by pathology from May 2012 to January 2013 in the Afifliated Drum Tower Hospital of Medical College of Nanjing University were included. The elasticity grade and strain ratio were calculated by using TRTE. According to the gold standard of pathological results, the sensitivity, speciifcity, accuracy rate were calculated to evaluate the effectiveness of elasticity grade and strain ratio in distinguishing benign and malignant prostatic diseases;and the receiver operating characteristic (ROC) curves were made respectively. The accuracy of elasticity grade and strain ratio in diagnosing prostatic diseases was also compared using chi-square test. Results Forty-seven benign lesions were found in the 95 prostatic lesions and the other 48 lesions were malignant. The elasticity grades of the 95 prostatic lesions were as follows:GradeⅠ26, GradeⅡ19, GradeⅢ16, GradeⅣ21, and GradeⅤ13. Elasticity grade ≤Ⅱwas considered to be benign, while grade ≥Ⅲwas malignant. The sensitivity, speciifcity, accuracy rate of elasticity grade in diagnosis of prostatic malignant lesions was 79.17%(38/48), 74.47%(35/47) and 76.84%(73/95), respectively. According the ROC curve analysis, the cutoff point of strain ratio was 4.67, and Youden′s index was 0.622. The sensitivity, speciifcity, accuracy rate of strain ratio was 83.33%, 78.72%and 81.05%, respectively. The area under ROC curves of strain ratio was superior to that of elasticity grade. But the diagnosis accuracy of the two approaches was almost the same in statistics (χ2=0.51, P>0.05). Conclusions TRTE is valuable in the differential diagnosis of the prostatic benign and malignant lesions. Both strain ratio and elasticity grade are useful approaches, and have similar diagnostic accuracy.

Objective To summarize the operational experience and explore the best surgery strategy in cicatricial alopecia.Methods Clinical date of 80 cases of cicatricial alopecia during January 2012 to December 2016 were analyzed retrospectively.The operation methods and related adverse events were recorded.Patients were followed-up on the postoperative 1 week,1 month,3 months,6 months and 1-2 years.The outcomes were evaluated by a 4-levels questionnaire:very satisfied,satisfied,not satisfied,and no effect.Results Forty cases were operated with expanded skin flap + Follicular unit extraction (FUE) transplantation,10 cases with scar resection + FUE repair,and 30 cases only with FUE.Twenty cases were completed treatment with single-stage surgical operation,and 60 cases with two-stage surgical operation.A percentage (70％) of patients was very satisfied and 30％ were satisfied after one-stage surgical operation.A percentage (85％) of patients was very satisfied and 15％ were satisfied after two-stage surgical operation.Conclusions The cicatricial alopecia needs comprehensive surgical treatment.FUE is a best additional operation technology.The effect of combined treatment is better than single therapy method in large area cicatricial alopecia.

With the development of bio-technological drugs, drug immunogenicity evaluation has become key factor of clarifying safety and efficacy of these drugs. It has become the focus to establish a stable and reliable evaluation system. Due to the advantages such as continuous real-time monitoring, surface plasmon resonance (SPR) technology has been widely used in bio-technological drugs immunogenicity assessments. Our study applied this technology to detect anti-drug antibody (ADA) of a recombinant human anti-rabies monoclonal antibody NM57 in the sera of 48 volunteers admitted in phase I clinical trials. This method could satisfy the basic requirements of detection of ADA.

Purpose To study the clinicopathological characteristics of primary pancreatic neuroendocrine neoplasms. Method 60 cases of resected pancreatic neuroendocrine neoplasms according to the WHO (2010) classification of the digestive system of neuroen-docrine tumor to evaluate morphological standard, and combining with the literature to discuss the clinicopathological characteristics. Results Among the 60 cases, 23 cases were male patients, the rest were females, with male and female ratio of 1 ∶ 1. 61. The age of the patients were ranged from 19 to 69 years, with mean age of 49. 38 ± 11. 60 years. Tumor maximum diameter ranged from 0. 5 to 16 cm, and the mean diameter was 3. 29 ± 3. 53 cm. 30 cases located in the pancreatic head, 27 cases in the body and end of the pancre-as and 3 cases in the neck. Pathological examination showed the G1 (24 cases), G2 (25 cases), G3 (9 cases), and mixed adenon-euroendocrine carcinoma ( MANEC) in 2 cases. Immunohistochemical staining showed that NSE, CgA, Syn, and CD56 were diffusely positive expression. 45 patients were followed up for 4~80 months, 7 cases died, of which 1 case was G2, 4 cases were G3, and 2 ca-ses were MANEC. Conclusion Primary pancreatic neuroendocrine neoplasms is a relatively rare pancreatic malignant tumor, and the diagnosis is based primarily on histologic features and immunohistochemical examination. Accurate pathological assessment has impor-tant value to guide clinical treatment and prognosis.