Objective To investigate the diagnostic value and clinical significance of phosphorylated signal transducer and activa-tor of transcription 3(pSTAT3)in malignant pleural effusion(MPE)caused by lung adenocarcinoma.Methods 47 pleural effusion samples were collected and detected by using liquid-based cytologic test (LCT).Furthermore,the expression of pSTAT3 was detec-ted by using the method of immunocytochemistry in all of the specimens.Results Among the 47 cases of pleural effusion,40 cases of MPE were caused by lung adenocarcinoma and 7 cases were benign pleural effusion,which were confirmed by clinical manifesta-tion,biopsy and imaging data.The positive expression rate of pSTAT3 was 80.0%(32/40)in MPE caused by lung adenocarcino-ma,significantly higher than benign group(P <0.05).13 cases of MPE caused by lung adenocarcinoma and 7 cases of benign pleural effusion were diagnosed with liquid-based cytologic test alone.The other 27 cases were undetermined and needed to be differentiate between adenocarcinoma and atypical mesothelial cells.However,32 cases of lung adenocarcinoma and 7 cases could be clearly diag-nosed if liquid-based cytologic test was used combined with immunocytochemistry detection of pSTAT3 expression.Only 8 cases were undetermined.Diagnosis of grey area was significantly narrowed.There was significant statistical significance between the two methods(P <0.05).Conclusion High expression of pSTAT3 is related to the MPE caused by lung adenocarcinoma.Detection of pSTAT3 expression can be used as a new method in the diagnosis of MPE caused by lung adenocarcinoma.pSTAT3 may play an important role in the development of the MPE.

Objective To determine an early and noninvasive predictor of chronic kidney diseaase(CKD),by detecting the correlation between the urinary Col-Ⅳ concentration,the renal tissue and renal lesions in patients with CKD Col-Ⅳ expression.Methods 98 CKD patients proved by renal biopsy were selected and 76 healthy people were enrolled as control.Urinary and serum Col-Ⅳ concentration were examined by enzyme-linked immunosorbent assay(ELISA).Renal Col-Ⅳ expression was detected by immunohistochemistry.Renal injury grade was semiquantitative by CMIAS image analysis system.The association between urinary Col-Ⅳ level and renal Col-Ⅳexpression,as well as renal lesion was analyzed,meanwhile the proteinuria and glomerular filtration rate(GFR)were analysed simultaneously.Results Urinary Col-Ⅳ level in patients with CKD was significantly higher than that in control,however,there was no difference in blood Col-Ⅳ level.Expression of Col-Ⅳ could be found in the sclerosing glomeruli and tubulointerstitial tissue,and Col-Ⅳ expression degree was consistent with lesion degree.Urinary Col-Ⅳ level was correlated positively with renal Col-Ⅳ expression,as well as with density of glomerular basement membrane and interstitial damage.Elevated urinary Col-Ⅳ concentration was observed in patients with mild renal sclerosis prior to the change of GFR.No correlation between urinary Col-Ⅳ concentration and proteinuria was observed.Conclusions These results suggested urinary Col-Ⅳ concentration reflected renal Col-Ⅳ expression and renal sclerosis,and could predict the progression of CKD.

Objective To investigate the expression of integrin avβ3 in both of hepatic stellate cell (HSC)and fibrotic liver tissue,and to demonstrate whether integrin avβ3 is a phenotypical receptor of activated HSC.Methods HSC were isolated from Sprague-Dawley rats and activated by prolonged cultural.The rats were injected with 175 mg of thioacetamide twice a week for 12 weeks to induce liver fibosis.The expressions of avβ3 and a-SMA were identified by immunocytochemical staining.The expression of avβ3 in HSC,normal and fibrotic tissues were examined by real-time PCR and Western blot.Results The expression of avβ3 in activated HSC were up regulated and levels of mRNA and protein were increased to 18 and 5.2 folds on day 14 compared with day 1 and were also higher than control(t=2.39,P＜0.05;t=2.74,P＜0.05).The immunochemistry staining showed that integrin avβ3 was expressed on membrane of activated HSCs.The avβ3 and a-SMA were expressed in portal vein in normal liver,but were also expressed in portal and fibrotic.Conclusions The integrin avβ3 is up-regulated in activated HSC both in vitro and in vivo.It is a phenotypical receptor of activated HSC which involved in liver fibrosis.

OBJECTIVE: To study the curative effect of Sodium Ferulate( SF) on rheumatoid arthritis( RA) and its effects on the levels of serum vascular endothelial growth factor( VEGF) and tumor necrosis factor- ? ( TNF- ? ) . METHODS: A total of 43 patients with RA were randomly divided into trial group and the control group: conventional treatment was adopted in both groups, but the trial group was treated additionally with SF injection for 4 consecutive weeks. Serum levels of VEGF and TNF- ? before and after treatment were determined by the enzyme linked immunosorbent assay( ELISA) . RESULTS: The total effective rate in the trial group the control group were 91. 30% vs. 75. 00% ( P

Objective To investigate the relationship between various clinicopatholngic factors and prognosis of early gastric cancer. Methods The clinical data of 459 patients with early gastric cancer who had undergone gastrectomy combined with extended (D2) lymphadenectomy at Zhongshan Hospital from January 2002 to October 2007 were retrospectively analyzed. Survival was calculated using the Kaplan-Meier method, and clinicopathologic factors such as age, sex, tumor size, gross morphology, tumor differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis were analyzed using the Cox regression model. Univariate analysis was done by Log-rank test. Results Univariate analysis demonstrated that tumor size and differentiation, depth of invasion, lymphatic vessels involvement and lymph node metastasis significantly affected survival in patients with early gastric cancer (χ~2 = 8.476, 6.210, 4.014, 14. 197, 55.027, P < 0.05). The status of lymph node metastasis was an independent predictor of survival in patients with early gastric cancer, and the more metastatic lymph nodes detected, the greater the influence on the prognosis. Conclusions Lymph node metastasis is the most important factor influencing the prognosis of early gastric cancer. Appropriate lymph node dissection is necessary, especially for patients with risk factors associated with lymph node metastasis.

Objective To assess the efficacy of urethroplasty by using the mucosa of diverticulum as the distal urethral for the recurrence of urethral stricture.Methods We reviewed our experience about 6 cases from Jan.2007 to Oct.2012,including 5 hypospadias and 1 epispadias.The mean age of the patients was 28 ± 16 (12-45)month,range 12 to 45 months.The patients presenting urethral diverticulum should last for 6 months after urethroplasty,which should last for 6 months.The preoperative mean urinary flow rate was 5.1 ± 1.4 (range 3.1 to 7.3) ml/s.All the patients took the retrograde urethrography and cystoscopy to confirm the position and length of urethrostenosis.The positions of urethrostenosis were at the penis coronary in 5 cases and glans penis in 1 case.The mean length of stricture was 13.3 ±4.2(range 8.8 to 20.5) mm.The mean length of diverticulum was 37.5 ± 15.3 (range 21.8 to 55.2) mm.All patients received the urethral reconstruction by using the pedicel diverticulum mucosa.After resecting the stenosis urethra and exposed the whole diverticulum,we opened the diverticulum laterally and halved it.One was used for tabularized urethroplasty in situ,the other was flipped to the distal urethral as pedicel flap to remedy the defect of the urethral.Results Totally 6 cases received the procedure.The mean operating time was 133 ± 48 (range 84 to 192) min.Postoperatively,urethral catheter was remained 2 weeks.All the patients can urinate smoothly after removing the catheter.The postoperative mean urinary flow rate was 10o 9 ± 3.3 (range 6.3 to 15.9) ml/s.The mean follow-up time was 2.2 yrs(range 1 to 4 years).At the end point of follow-up,all patients had not experienced a recurrent diverticulum or stricture at the anastomotic site.Urethrocutaneous fistula in the coronary glan was reported in 2 patients,which were finally cured after 2nd repair.No complication was found in other 4 patients.Conclusions Urethroplasty by flipping the mucosa of diverticulum takes full advantage of urinary mucosa that already existing,which can be very useful in those patients who are lack of foreskin.This approach can also reduce the patient's pain by completing the urethroplasty in situ and avoiding staging operation.But up till now,it can only be applied to the urethral diverticulum secondary to urethrostenosis.It also demands flip flap skilled.And the long-term effects and complications still remain to be seen.

Objective To evaluate the effect of staged repair for tetralogy of Fallot (TOF) associated with pulmonary artery hy- poplasty.Methods From June 1996 to June 2006,37 patients with TOF were operated on.There were 26 males and 11 females. Their age was 5 months to 17 years(mean 3.6 years) and weight was 4.6～38.0 kg.All patients were diagnosed as TOF with pulmo- nary artery hypoplasty by cardiac catheterization.The mean pre-operative arterial saturation of the patients was (68.2?6.5) %,Mc- Coon ratio was 0.95?0.26 (0.81～1.17) and Nakata index was 82.7?21.6(71.6～97.5) mm~3/m~2.At the time of the first surgi- cal procedure,17 patients underwent central aortopulmonary shunt,13 patients received modified Blalock-Taussig shunt in the left side and 7 patients had modified Blalock-Taussig shunt in the right side.Results There were no easly operative deaths and no late deaths after the first stage repair.Pleural effusion after shunt occurred in 5 patients.The mean arterial saturation was significantly increased to (91.3?10.4) %,P

Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Objective To evaluate the feasibility and outcomes of robotic-assisted laparoscopic pyeloplasty in children .Methods A retrospective study was performed in patients who underwent robotic-assisted laparoscopic pyeloplasty ( Anderson-Hynes ) at our institution between January 2014 to August 2014.Totally 6 boys were diagnosed as left ureteropelvic junction obstruction depending on the symptoms and radiographic studies .The mean age was 9 years ( range 4 -12 years ) .Results The procedure was performed successfully without conversion to open surgery in all of the cases .Mean operative time was 216 min (range 175-269 min), with a mean robotic anastomosis time of 45 min (range 30-60 min).Mean estimated blood loss was less than 15 ml.The mean hospitalization was 4.5 days.Mean follow-up period was 10 months ( range 7 -14 months ) .There were no perioperative complications , and recovery was uncomplicated (without recurrence, pyelonephritis, nephrarctia) in all of the patients.Conclusion Robotic-assisted laparoscopic pyeloplasty can be safely performed in children older than 4-year-old with ureteropelvic junction obstruction .

OBJECTIVE: To explore the reasons and treatments of recurrent or residual cholesteatoma in middle ears after operations. METHOD: The clinical data of 102 cases (105 ears) with recurrent or residual cholesteatoma was retrospectively analyzed. RESULT: The main reason of recurrent or residual cholesteatoma is incomplete removal of cholesteatoma in the former operations or obstructive drainage of middle ears after operations. Twenty ears healed through cleaning with otoendoscope. Eighty-five ears underwent the second operations of radical mastoidectomy including 23 tympanoplasty meanwhile. The air-conductive auditory threshold of them all decreased more than 15 dBHL. CONCLUSION For the ears with low facial ridges and non-obstructive drainage of mastoid, tympanic antrum and tympanic cavity, its possible to be cured through cleaning with otoendoscope. For those with high facial ridges and obstructive drainage , it's essential to perform the second operations of radical mastoidectomy and some of them are suitable for tympanoplasty meanwhile.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Cholesteatoma, Middle Ear ; surgery ; Female ; Humans ; Male ; Middle Aged ; Postoperative Period ; Recurrence ; Retrospective Studies ; Treatment Outcome ; Young Adult