The treatment of chronic pain needs multidisciplinary management.Neurosurgical procedures hold an important role.With advancement in stereotactics,microsurgical and electrophysiological techniques,neurosurgical treatment becomes microinvasive,safer and popular.Neurosurgical procedures include anatomic,neuroaugmentative and neuroablative therapies.The procedure should be chosen individually.The pain characters,primary disorders,quality of life and survival time of the patient should be considered.A successful management must be well-indicated.

Objective To discuss the efficacy of photoselective vaporization of the prostate(PVP) for patients with benign prostatic hyperplasia(BPH).Methods From July 2006 to August 2007,110 patients with BPH received PVP in our hospital.The safety of the procedure,Pre- and postoperative Qmax,and IPSS of the cases were recorded and analyzed.Results The mean operation time was(51.2?36.3) minutes(ranged from 15 to 180).In the patients,23 cases had a prostate weighed ≥100 g,9 of them received TURP during the procedure.89 patients underwent bladder irrigation for 15 to 48 hours(mean,36 hours).After the operation,urinary catheter was left indwelling in all the patients except for 6(

Objective To discuss the method of raising the rate of cut healing by first intention with electrized copper needles and removal of the angioma.Methods Analysis of the clinical history of 68 cases of angiomatous therapy by using the method of electrized copper needles and removal, and the investigation of the connection between the therapy method and the cut healing.Results The healing rate of the cut by first intention is 100% in the total resection of tumor, each 33.33% in the partial resection of tumor and the resection under skin flap, 0% in the resection of tumor and the skin grafting on the surface of wound. When the voltage controlled at 6V is compared with others, remarkably there is the difference (P

Objective:To investigate the feasibility of adipose tissue-derived stem cells(ADSCs) as the seeding cells of skin engineering for skin defect repair. Methods :Adipose tissues were isolated from a SD rat groin, the fat was cut and incubated in a collagenase solution, and then the ADSCs were cultivated in culture medium. The amplified cells in vitro were inoculated in collagen gel to form tissue engineered skin. Fifteen SD rats were randomly divided into three groups: experimental group was treated with ADSCs collagen tissue engineered active skin substitute, and single collagen and blank were served as two control groups. The materials were grafted onto total skin defect wounds on the back of rats in the corresponding group respectively. The effect of wound repair was observed histologically. Results:The time of wound healing in the ADSCs and collagen experimental group, the single collagen control group and the blank control group were (14.3?1.7) days,(16.9?2.5)days,and (21.2?4.2)days respectively, and showed significant differences(P

Objective To evaluate the effectiveness and safety of liraglutide for obesity or overweight. Methods Random controlled trials of liraglutide for obesity or overweight were gathered from MEDLINE, EMbase, CENTRAL, CNKI, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analyses with The Cochrane Collaboration's Revman 5. 3. 0 software. Results Twelve randomized controlled trials of liraglutide for obesity or overweight were included, in which 11 trials were written in English and one trial in Chinese. The results of meta-analyses showed that the body weight was significantly reduced in the liraglutide group than in placebo, insulin, exenatide and glimepiride groups [RR=-0. 91,95%CI(-1. 01,-0. 81),P<0. 000 01;RR=-2. 88,95%CI(-3. 37,-2. 39),P<0. 000 01; RR=-1. 12,95%CI(-1. 32,-0. 92),P<0. 000 01; RR=0. 45,95%CI(-0. 62,-0. 27),P<0. 000 01]. Moreover, liraglutide had significant effect in decreasing HbA1c and systolic blood pressure of patients with obesity or overweight. Conclusion Liraglutide is effective for controlling body weight of patients with obesity or overweight. But its long-term efficacy still needs to be confirmed by performing more RCTs with high quality, large sample and long term follow-up.

AIM:To investigate the expression of poly (ADP-ribose) polymerase-1 (PARP-1) in the epithelial ovarian cancer ( EOC) and its relationship with epithelial-mesenchymal transition ( EMT) .METHODS:The expression of PARP-1, E-cadherin, vimentin and Snail was detected in the EOC and benign ovarian tumor tissues by immunohistochemi -cal method and real-time PCR.The expression of PARP-1, E-cadherin, vimentin and Snail proteins in the SKOV3 cells treated with efficient PARP-1 inhibitor PJ34 was determined by Western blotting .RESULTS:The positive expression rates of PARP-1, vimentin and Snail were significantly higher in the EOC than that in the benign ovarian tumor tissues , whereas the positive expression rate of E-cadherin was the opposite (P<0.05).The expression of PARP-1, E-cadherin, vimentin and Snail in the EOC was associated with the histological grade , clinical stage and lymphatic metastasis (P<0.05), but no relationship with age and pathological types was observed .The expression of E-cadherin in the EOC was negatively co-related to that of PARP-1.In contrast, the expression of vimentin and Snail in the EOC was positively co-related to that of PARP-1.The relative mRNA expression of PARP-1, vimentin and Snail in the EOC was significantly higher than that in the benign ovarian tumor tissues ( P<0.05) , while the mRNA expression of E-cadherin in the EOC was remarkably lower than that in the benign ovarian tumor tissues (P<0.05).The protein expression of PARP-1, vimentin and Snail in the SKOV3 cells was significantly decreased (P<0.05), while E-cadherin protein was increased after treated with PJ 34(P<0.05). CONCLUSION:PARP-1 may contribute to the onset of EMT in the EOC by regulating the expression of E -cadherin, vim-entin and Snail.The role of PARP-1, which is relevant to EMT, might be important in the development of ovarian cancer .

Objective To investigate the value of immunophenotypes in pathologic diagnosis of follicular lymphoma (FL) and the differential diagnosis between neoplastic follicle (NF) and reactive hyperplastic follicle (RHF).Methods 50 cases of FL and 10 cases of RHF as control were studied by clinical data, the expressions of CD20, bcl-2, CD3, CD10, bcl-6, CD21 and Ki-67 were detected by EnVision immunohistochemical method for the immunphenotypical pattern of FL and RHF.Results Among 50 FL cases , there were 24 male cases and 26 female cases, with median age of 50 years old (10-80 years old), including 32 cases (64 ％) involved predominantly neck lymph nodes.The histologic grades were 1-2 in 16 cases (32 ％) and ≥3 in 34 cases (68 ％).CD20, CD10 and bcl-6 were positive in NF tissues of FL, with irregular forms of NF and loss of the mantle area without clear demarcation, and infiltrating to NF, irregular shape and no clear perimeter.The bcl-2 was positive in all of grade 1-2 NF, and it was positive in 68 ％ (23/34) cases and was partial or total negative in 32 ％ (11/34) cases in grade≥3 NF.Those were poorly demarcated contours.The Ki-67 proliferative index of NF were ＜30 ％ in grade 1-2, and ＞30 ％ in grade ≥ 3, with the highest to 90 ％.In FL, the CD21 staining result showed follicular dendritic cells (FDC) network were synchronized with NF, and in some cases of grade ≥ 3, the FDC network were ruptured.In RHF, the CD20 was positive for round or oval nodules with clear demarcation.The CD10, bcl-6 and CD21 were positive and bcl-2 was negative in all germinal center without invasive immunophenotype.The Ki-67 index was high in germinal center, and sometimes polarity may be seen.Conclusion The immunophenotypical differences between FL and RHF include invasive characteristics, loss of follicular mantle area and germinal center pattern in the NF, while the normal follicular immunophenotype in the RHF.

Objective To analyze the characteristics ot lymph node metastasis and prognostic factors for carcinoma of papilla of Vater (CPV) after pancreaticoduodenectomy (PD).Methods From January 2005 to December 2010,94 patients with CPV underwent PD and dissection of regional lymph nodes at the Eastern Hepatobiliary Surgery Hospital.We carefully evaluated nodal involvement in the patients to determine the lymphatic spread of CPV and analyzed the clinicopathological variables in relation to prognosis.Results The overall rate of nodal involvement was 46.8％.Using the UICC staging (7th edition),lymphatic invasion in pT1,pT2,pT3 and pT4 were 15.4％ (2/13),62.7％ (32/51),80.0％ (8/10) and 100％ (2/2),respectively.The metastatic rates in the posterior pancreaticoduodenal lymph nodes,the mesopancreatic lymph nodes,the hepatoduodenal ligamental lymph nodes and the proper hepatic periarterial lymph nodes were 30.9％ (29/94),21.3％ (20/94),11.7％(11/94) and 6.4％ (6/94),respectively.Significant prognostic factors were tumor pT stage (P＜0.01),duodenal wall infiltration (P =0.001),liver metastasis (P =0.001),pancreatic paren chymal invasion (P=0.004),nodal involvement (P＜0.01) and different regional lymph nodes invasion (the posterior pancreaticoduodenal,P＜0.01; the mesopancreatic,P＜0.01; the hepatoduodenal ligamental,P＜0.01; the proper hepatic periarterial,P=0.010).Cox regression analysis for overall survival revealed that the posterior pancreaticoduodenal nodal involvement (P＜0.01),the mesopancreatic nodal involvement (P＜0.01) and duodenal wall infiltration (P=0.019) were significant independent prognostic risk factors.Conclusions The mesopancreatic lymph nodes and the posterior pancreaticoduodenal lymph nodes should equally be regarded as the first stop in lymphatic spread of CPV.Therefore,we should pay much attention to these regional lymph node dissections,especially to ensure complete resection of the uncinate process and the mesopancreas.

Objective: To observe the biocompatibility of acellular nerve scaffold (ANS) via three sterilization methods, to provide experimental data for tissue engineering industrialization. Methods: Pig sciatic nerves were cut and treated using the NaOH maceration method. ANSs were sterilized by ethylene oxide, ~(60)Co-irradiation and peracetic acid. Evaluated the biocompatibility by MTT, cellular compatibility test, collagenase susceptibility test in vitro and local implantation test. Results: ANS retained the integrity of structure and major components of the basement membrane. The result of MTT test showed that the ANSs via different sterilization methods had statistical differences. There were no overall significant differences in Collagenase susceptibility test. Scanning electron microscope results showed the skin fibroblasts could attach, proliferate and grow well on the surface and holes of ANS with sterilization of PAA and Co~(60),a small quantity of cells adhered on ANS with sterilization of ETO. Tests for local effects after implantation show that different sterilization methods don't effect the ability of ANS to resist the enzyme degradation. In ETO group, rats showed an acute inflammatory response followed by chronic inflammation. In PAA and ~(60)Co group rats showed an acute inflammatory response that diminished such that the graft ultimately became indistinguishable from native tissue, observations that were consistent with graft acceptance. Conclusion: Peracetic acid sterilization offers a convenient alternative protocol for ANS processing. ANS sterilized with PAA shows good compatibility and biologic safety. It is an ideal sterilization method for ANS.

Objective To investigate the radiosensitizing effects of cyclooxygenase-2 selective inhibitor LM-1685 on A549 cells in vitro.Methods A549 human lung adenocarcinoma cell line was used in this study.Cell growth kinetics Was determined using MTT assay.Cell survival was analyzed by clonogenic assay.The change of cell cycle Was measured by flow cytometry.Results LM-1685 inhibited the growth of A549 cells,showing a dose-dependent and time-dependent manner.LM-1685(50/μmol/L),either with or without IL-1β,showed the radiosensitizing effects on A549 cells,and the sensitizing enhancement ratio(SER)was 1.12 and 1.06,respectively.LM-1685(50 μmol/L)abrogated radiation-induced G2/M arrest of the tested A549 cells.Conclusions Cyclooxygenase-2 selective inhibitor can enhance the radiosensitivity of A549 cell line.Abrogation of radiation-induced G2/M arrest could be part of the mechanism.