Eighty cases of intrauterine adhesions who received adhesion separation technique were divided into two groups equally. The control group was placed intrauterine device and ballon catheter in intrauterine,and received o-ral female estrogen cycle treatment. The test group with the same treatment was added growth hormone treatment. Three months later,all of the patients were checked the hysteroscopy and intrauterine device was took out, also the uterine cavity form,and follow-up recovery of endometrial and menses were evaluated. Then it showed:①Endome-trial thickness increased by an average of (1.73±0.83) mm in the test group,while the control group average in-creased by (1.10±0.66) mm. The difference was statistically significant (t=3.73,P<0.01).② The re-adhe-sion rate was 45.0% in the control group,while it was 32.5% in the test group,respectively. The difference was not statistically significant. ③ The difference of mensual recovery between both groups was not statistical significant. Therefore growth hormone can promote the growth of endometrium of intrauterine adhesions after resection of adhe-sions.

Objective To investigate the effects and underlying mechanism of calcitriol on ameliorating podocytes impairment in DN rats.Methods SD rats were randomly divided into four groups:normal control (NC) group,calcitriol treatment (VD) group:calcitriol 0.1μg· kg--1 d-1,diabetic nephropathy (DN) group:streptozocin (STZ) 58 mg/kg,DN treated with calcitriol (DN + VD) group:calcitriol 0.1 μg · kg-1 · d-1 + STZ 58 mg/kg.Rats were sacrificed at the end of 18 weeks.Results Compared with the DN group,the DN + VD group exhibited significantly lower proteinuria by 36％,improved renal histology at the end of the experiment (P ＜ 0.05),and similar levels of blood glucose,serum urea nitrogen as well as body weight (P ＞ 0.05).There were no significant differences in the serum concentrations of creatinine,calcium and phosphorus among the four groups (P ＞ 0.05).In DN group,the expressions of nephrin,podocin,VDR,PI3K-p85 and p-Akt were significantly decreased and the expression of desmin was increased compared to NC group.Calcitriol treatment could attenuate the above changes.Additionally,a positive correlation was observed between the expressions of nephrin and VDR (r=0.776,P ＜ 0.05).Likewise,the expression of nephrin was positively correlated with either PI3K -p85 or p-Akt (r=-0.736,r=0.855,all P ＜ 0.05).Conclusion Calcitriol can ameliorate podocytes injury in DN rats,which might be related with the further up-regulation of PI3K/p-Akt signaling pathway.

Objective To investigate the effect of 1,25(OH)2D3 on high glucose induced macrophage activation and its underlying signal transduction mechanism.Methods RAW 264.7 cells were used to perform cell culture,the activity of intracellular iNOS was measured.VDR siRNA and PPARγ antagonist pre-treatment with macrophages were done before using 10-8 mol/L1,25(OH)2D3 to intervene high glucose pre-incubated macrophages.M1 markers including iNOS,TNF-α,IL-12,M2 markers including MR,Arg-1,IL-10 and nuclear receptors VDR and PPARγ were separately examined.Results The iNOS activity was increased in a glucose-dose and time dependent manner.Particularly,25 mmol/L glucose at 24 h gave the maximum response.After being treated with 25 mmol/L glucose for 24 h,not only inflammatory cytokines of TNF-α,IL-12 in the supernatant were increased,but quantitative real-time PCR and Western blotting analysis showed iNOS was also up-regulated (P ＜ 0.05).However,M2 markers,i.e.MR and Arg-l were significantly decreased (P ＜ 0.05).When in the presence of 1,25(OH),D3,the trends were reversed:the markers of M1,including TNF-α,IL-12 and iNOS were obviously reduced (P ＜ 0.05),while M2 markers,IL-10,Arg-1 and MR were increased (P ＜ 0.05).In addition,VDR and PPARγ were also increased (P ＜ 0.05).However,the above effects of 1,25 (OH)2D3 were abolished when further inhibited the expression of VDR and PPARγby VDR siRNA and PPARγ antagonist.Besides,accompanied by VDR,PPARγwas also decreased upon the treatment with VDR siRNA (P ＜ 0.05).Conclusion 1,25(OH)2D3 can promote high glucose induced classically activated macrophages (M1) converting to alternatively activated macrophages (M2) and this is achieved through VDR-PPARγ pathway.

OBJECTIVE To evaluate theefficacy of the pedicled nasoseptal flap for anterior skull base reconstruction after endoscopic resection of sinonasal malignancies involving the skull base.METHODS From September 2008 to May 2016, 31 patients with sinonasal malignancies involving the skull base were treated via transnasal endoscopic surgery and then two type mucoperiosteal flap of contralateral nasal septum were used to repair the anterior skull base defect according to the actual situation, one is a flap supplied by the posterior nasal septal artery and the other is supplied by the anterior and posterior ethmoidal arteries.RESULTS Successful anterior skull base reconstruction was obtained in all 31 cases. Complications included 3 cases of intracranial infection without hemorrhage or hematoma. In addition, cerebrospinal fluid leakage occurred in one case because of tumor recurrence, and leakage was healed by vertebral draining for one week. Another one had occurred as a result of removing the support form nasal cavity.The follow-up lasted from 3 to 66 months, there were no necrosis of the flap or meningoencephalocele occurred and mucoperiosteal flap healed up well.CONCLUSION The vascularized nasoseptal flap is a reliable and preferred repairing material for anterior skull base reconstruction.

Objective To analyze the feasibility and clinical effect of thoracoscopy and laparoscopy minimally invasive surgery in the treatment of esophageal cancer.Methods Eighty-six cases patients with esophageal cancer who were underwent the minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer in the Central Hospital of Hengyang from August 2014 to February 2016 were retrospectively analyzed.Operation time,bleeding volume,indwelling time of thoracic drainage tube,length of stay,number of lymph node dissection,postoperative complications and so on were recorded.Results All patients were successfully completed surgery,no intraoperative death and intraoperative massive hemorrhage.Operation time was 270-380 min,the amount of bleeding during the operation was 50-550 ml.Chest drainage tube was removed from 3 to 10 d after operation.The number of lymph node dissected was 10-19.Lymph node metastasis was found in 13 cases.Postoperative cervical anastomotic fistula in 6(7.0%) cases,hoarseness in 8(9.3%) cases,7(8.1%) cases of pulmonary infection,and 1(1.2%) case of chylothorax,all were cured after conservative treatment.Postoperative hospital stay was 9-20 d.The patients were followed up for 3 to 21 months,1 case had lymph node metastasis in 10 months after surgery,and the other patients had no recurrence,metastasis or death.Conclusion Minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer is safe and feasible,clinical effect is satisfied,it is worthy of further clinical application.

Objective To investigate the effect of 1,25(OH)2D3 on high glucose induced podocyte injury and its signal transduction mechanism.Methods Differentiated mouse podocytes were exposed to normal glucose,high glucose,and different concentrations of 1,25(OH)2D3 or LY294002 (a selective PI3K inhibitor) for 24 h.PCR and immunofluorescent staining were used to detect nephrin,podocin,and desmin.Western blotting was used to detect protein expression of nephrin,podocin,desmin,PI3K,Akt and p-Akt.Results Compared with high glucose group,1,25(OH)2D3 (100 nmol/L and 1000 nmol/L) significantly up-regulated the expression of podocin and nephrin in podocytes induced by high glucose (P ＜ 0.05).Meanwhile,1,25(OH)2D3 (100 nmol/L) significantly reduced the expression of desmin (P ＜ 0.05).PI3K and p-Akt were obviously reduced in high glucose group.In the presence of 1,25(OH)2D3,the trends were reversed.However the above effects of 1,25(OH)2D3 were abolished when p-Akt was blocked by the PI3K inhibitor LY294002.Conclusions 1,25 (OH)2D3 can inhibit high glucose-induced pedocyte injury through PI3K/p-Akt signaling pathway.

Objective To investigate the effect of active vitamin D (VD) on macrophage M1 and M2 phenotype and its role in protecting podocyte impairment in diabetic nephropathy (DN).Methods Diabetes mellitus rats were established by intraperitoneal injection with streptozocin.Rats were randomly divided into four groups:normal-1 (NC-1,n=8),normal-2 (NC-2,n=8,normal rats treated with calcitriol 0.1 μg· kg-1 · d-1 by gavages),DN (n=24) and VD (n=24,DN+calcitriol 0.1 μg· kg-1 · d-1 by gavages).Blood glucose and body weight were assessed,and 24-hour urine was collected regularly.Blood and urine samples were taken for biochemical study,and kidney tissues were used for PAS staining to assess histological changes.Immunohistochemical staining was used to detect number of CD68 + macrophage.Western blotting was used to detect protein expressions of nephrin,podocin,CD68,M1 specific marker of inducible nitric oxide synthase (iNOS),TNF-α and M2 specific marker of CD163,arginase 1 (Arg-1),mannose receptor (MR).Results (1) In DN group,levels of BUN,Scr,urinary protein and glomerular mesangial matrix proliferation were significantly higher (P ＜ 0.05),and the expressions of nephrin,podocin were significantly decreased compared with NC groups (P ＜ 0.05).These above changes were significantly improved in VD group (P ＜ 0.05).(2)Number of CD68 + macrophage infiltration in DN group was increased in a time dependent manner compared with NC groups,which was significantly reduced in VD group (P ＜ 0.05).(3)To further definite M1 and M2 macrophage activation phenotype,the protein expressions of iNOS and TNF-α was increased in DN group at 8th,14th,18th weeks compared with NC groups (P ＜ 0.05),which were significantly decreased in VD group (P ＜ 0.05).Although,there were no significant difference of protein expressions of CD163,Arg-1 and MR between VD and DN group at both 8th and 14th week (P ＞ 0.05),the protein expressions of CD163,Arg-1 and MR were higher in VD group at 18th week than that in DN group (P ＜ 0.05),and the ratio of CD163/CD68 was also enhanced in VD group (P ＜0.05).(4)Moreover,the protein expression of iNOS was negatively correlated with expression of either nephrin or podocin (r =-0.707,P ＜ 0.01; r =-0.712,P ＜ 0.01),whereas the protein expression of CD163 was positively correlated with expression of either nephrin or podocin (r =0.627,P＜ 0.01; r=0.613,P ＜ 0.01).Conclusion Vitamin D can regulate macrophage phenotype,via inhibiting M 1 macrophage activation and enhancing M2 macrophage activation to protect podocyte impairment.

In order to investigate the effects of vector-based hairpin small interference RNA (shRNA) on the reversal of multi-drug resistance (mdr) of A2780/Taxol cells, a novel vector pEGFP-H1/mdr1 containing mdr1-shRNA targeting at position 2943-2963 of mdr1 was designed and synthesized. Subsequently, A2780/Taxol cells were transfected with pEGFP-H1/mdr1, and the expression of mdr1 mRNA and P-gp was detected by using RT-PCR and Western blot respectively. MTT was used to measure the 50% inhibition concentration (IC(50)) of Taxol to A2780/Taxol cells. The results showed that at the 24th and 48th h after transfection, the expression of mdr1 mRNA was decreased to (52.1+/-1.0)% and (0.01+/-1.7)%, and that of P-gp decreased to (88.3+/-2.1)% and 0%, respectively. At the 48th h after transfection, the relative reversal rate of A2780/Taxol cells to Taxol was 69.54%. In vivo, the nude mice xenografts were injected with pEGFP-H1/mdr1, and then administrated Taxol. The tumor volume in pEGFP-H1/mdr1-transfected group was significantly reduced as compared with that in blank control group or pEGFP-H1-transfected group (807.20+/-103.16 vs 1563.78+/-210.54 or 1480.78+/-241.24 mm(3), both P<0.01). These results suggested that transfection of pEGFP-H1/mdr1 could efficiently down-regulate the expression of mdr1 mRNA and P-gp in A2780/Taxol cells, and effectively restore the sensitivity of A2780/Taxol cells to Taxol both in vitro and in vivo.

Objective To evaluate the clinical efficacy of total mesoesophageal excision and sanye lymph node dissection in the radical resection of esophageal carcinoma under thoracoscopy and laparoscopy,and to investigate its safety and feasibility, and to find a more reasonable and effective surgical treatment of esophageal carcinoma. Methods One hundred and twenty-six cases of esophageal cancer who underwent the minimally invasive surgery under thoracoscopy and laparoscopy for esophageal cancer in Central Hospital of Hengyang from October 2015 to September 2017 were retrospectively analyzed. Among them,Sixty-four patients accepted total mesoesophageal excision and sanye lymph node dissection under thoracoscopy and laparoscopy (observation group ), Sixty-two cases accepted with conventional esophagectomy under thoracoscopy and laparoscopy ( control group) . The operation time, blood loss, indwelling time of thoracic drainage tube, postoperative drainage volume,postoperative hospitalization time,number of lymph node dissection,lymph node metastasis degree,perioperative complications of the two groups were analyzed and compared. The number of lymph node dissection and lymph node metastasis degree in different regions were compared between the two groups. The number of recurrence and death were recorded in the two groups. Results Compared with the control group,the operation time was longer in the observation group((264. 9±32. 9) min vs. (233. 5±30. 4) min,t= -5. 56,P<0. 001),but blood loss was less((152. 7±26. 4) ml vs. (235. 5± 30. 6) ml,t = 16. 27,P<0. 001). There was no significant difference in the indwelling time of thoracic drainage tube, postoperative drainage volume or postoperative hospitalization time between the two groups (P>0. 05). The number of lymph nodes in the observation group was significantly higher than that in the control group ((32. 7±15. 5) pieces vs. (20. 9±11. 2) pieces,t = - 4. 93,P< 0. 001),and lymph node metastasis degree in the observation group was smaller than that of the control group ( 6. 7% vs. 9. 3%, χ2 = 7. 22, P < 0. 01) . There were no significant differences in perioperative complications such as pulmonary complications, arrhythmia, anastomotic fistula, chylothorax,hemorrhage,recurrent laryngeal nerve injury,tracheal injury and perioperative death (P>0. 05). Left and right recurrent laryngeal nerve,thoracic esophagus,celiac artery lymph node dissection of the number of observation group was higher than that of the control group ((4. 7 ± 3. 2) pieces vs. (1. 5 ± 1. 4) pieces, t= -7. 25;(6. 0±2. 7) pieces vs. (3. 1±1. 7) pieces,t = -7. 12;(5. 7± 2. 4) pieces vs. (3. 2± 1. 9) pieces,t= -6. 48;P<0. 001). Left and right recurrent laryngeal nerve,thoracic esophagus lymph node metastasis degree in the observation group was smaller than that in the control group (8. 7%(26/ 300) vs. 18. 1%(17/ 94),χ2= 6. 53;8. 9%(34/ 382) vs. 17. 9%(35/ 195),χ2 = 10. 04;P<0. 05) . There were no significant differences in the recurrence rate of tumor recurrence at 1 and 24 months after operation in the observation group and the control group(3 cases(4. 7%) vs. 4 cases(6. 5%),χ2 = 0. 92,P > 0. 05) . There were no deaths in the two groups. Conclusion Total mesoesophageal excision and three-field lymph node dissection in radical resection of esophageal carcinoma under thoracoscopy and laparoscopy is safe and feasible,the recent effect does not increase the surgical complications, but its long-term effect need a lot of long-term follow-up. A relatively thorough cleaning of the esophageal mesentery and its lymph nodes can minimize the tumor in the subendothelial micrometastasis,and is beneficial for the prognosis of patients with esophageal cancer.

In order to investigate the effects of vector-based hairpin small interference RNA (shRNA) on the reversal of multi-drug resistance (mdr) of A2780/Taxol cells, a novel vector pEGFP-H1/mdr1 containing mdr1-shRNA targeting at position 2943-2963 of mdr1 was designed and synthesized.Subsequently, A2780/Taxol cells were transfected with pEGFP-H1/mdrl, and the expression of mdr1 mRNA and P-gp was detected by using RT-PCR and Western blot respectively. MTT was used to measure the 50% inhibition concentration (1C50) of Taxol to A2780/Taxol cells. The results showed that at the 24th and 48th h after transfection, the expression of mdr1 mRNA was decreased to (52.1±1.0)% and (0.01+1.7)%, and that of P-gp decreased to (88.3±2.1)% and 0%, respectively. At the 48th h after transfection, the relative reversal rate of A2780/Taxol cells to Taxol was 69.54%. In vivo, the nude mice xenografts were injected with pEGFP-H1/mdrl, and then administrated Taxol.The tumor volume in pEGFP-H1/mdr1-transfected group was significantly reduced as compared with that in blank control group or pEGFP-H1-transfected group (807.20±103.16 vs 1563.78±210.54 or 1480.78±241.24 mm3, both P<0.01). These results suggested that transfection of pEGFP-H1/mdr1 could efficiently down-regulate the expression of mdr1 mRNA and P-gp in A2780/Taxol cells, and effectively restore the sensitivity of A2780/Taxol cells to Taxol both in vitro and in vivo.