Adolescent ; Alkaline Phosphatase ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; therapeutic use ; Cisplatin ; therapeutic use ; Diagnosis, Differential ; Dysgerminoma ; pathology ; Etoposide ; therapeutic use ; Female ; Gonadoblastoma ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Hysterectomy ; methods ; Inhibins ; metabolism ; Isoenzymes ; metabolism ; Ovarian Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Young Adult

OBJECTIVETo explore the scientificity of Yunqi theory based on incidence of disease related recognitions such as year evolutive phase, host climatic qi, six climatic factors, celestial manager qi, qi in the earth by analyzing data of hypertension incidence.

METHODSA total of 1,265 inpatients with confirmed first diagnosis as hypertension were recruited at Dongzhimen Hospital, Beijing University of Chinese Medicine from February 4, 1999 to February 4, 2011. Each period (including year evolutive phase, host climatic qi, guest climatic qi) was deducted based on Yun-qi theory. Their ratios of different phases and qi in the total number of hypertension inpatients number were calculated and statistically tested.

RESULTSThere was statistical difference in ratios at year evolutive phase, celestial manager qi, and qi in the earth (P < 0.05).

CONCLUSIONThe incidence of hypertension has certain difference in each period, which is consistent with Yun-qi theory.

Objective To observe the effects of ursolic acid (UA) on the activation of nicotinamide adenine dinucleotide phosphate oxidase (NOX) and the downstream signaling pathways in platelet derived growth factor (PDGF) activated rat hepatic stellate cell (HSC-T6).Methods Rat HSC-T6 cells were divided into blank control group (no treatment),UA control group (50 μmol/L UA),PDGF group (10 μg/L PDGF),UA intervention group (50 μmol/L UA + 10 μg/L PDGF),diphenyleneiodonium intervention(DPI) group (20 μmol/L DPI+ 10 μg/L PDGF),SB203580 (p38 mitogen-activated protein kirase(p38MAPK) inhibitor) intervention group (10 μmol/L SB203580 + 10 μg/LPDGF),LY294002 (phosphatidylinositop 3 kinase(PI3K) inhibitor) intervention group (10 μmol/L LY294002 + 10 μg/L PDGF) and rosup positive control group (5 μg/mL rosup).Except rosup positive control group,the expression of type Ⅰ collagen at mRNA level of each group was detected by fluorescence quantitavepolymerase chain reaction (RT-PCR).The expression of membrane protein p47phox (except rosup positive control group),PI3K(except rosup positive control group and SB203580 intervention group),p-protein kinase B (p-AKT,except rosup positive control group and SB203580 intervention group) and phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK,except rosup positive control group and LY294002 intervention group) were tested by Western blot.Except SB203580 intervention group and LY294002 intervention group,the fluorescence intensity in the cells of each group was analyzed with active oxygen detection kit and fluorescence microplate reader.Single factor analysis of variance and LSD test were performed for comparison between groups.Results Type Ⅰ collagen at the mRNA level of PDGF group (3.74±0.32) was higher than that of blank control group (1.00±0.00) ; Type Ⅰ collagen at the mRNA level of UA group (0.21 ±0.02) was lower than that of blank control group,UA intervention group (1.02 ± 0.12),DPI intervention group (1.09±0.21),SB203580 intervention group (1.18± 0.27),and LY294002 intervention group (1.15 ± 0.26) were all lower than PDGF group,and the differences were statistically significant (t =15.667,-4.501,-15.553,-15.154,-14.642 and -14.813,all P＜0.05).p47phox at the protein expression level of PDGF group (1.98±0.53) was higher than that of blank control group (1.00±0.00) ; that of UA group (0.48±0.10) was lower than blank control group; those of UA intervention group (0.95 ± 0.26),DPI intervention group (0.99 ± 0.28),SB203580 intervention group (0.93±0.31),and LY294002 intervention group (1.07±0.19) were all lower than PDGF group (t=4.209,-2.234,4.424,-4.252,-4.510 and-3.909,all P＜0.05).The protein expression level of PI3K of PDGF group (2.27±0.46) was higher than that of blank control group (1.00±0.00); that of UA intervention group (0.14 ± 0.07) was lower than PDGF group and blank control group; that of UA group (0.14±0.07) was lower than blank control group; those of DPI intervention group (0.53±0.25) and LY294002 intervention group (0.35±0.14) were all lower than PDGFgroup (t 6.205,8.208,-2.003,4.202,-8.502 and-9.831,all P＜0.05).The protein expression level of p-Akt of PDGF group (2.54±0.49) was higher than that of blank control group (1.00± 0.00); those of UA intervention group (0.74± 0.20),DPI intervention group (0.94 ± 0.37) and LY294002 intervention group (1.17±0.41) were all lower than PDGF group; that of UA group (0.59± 0.15) was lower than blank control group (t=5.927,-6.928,-6.158,-5.273 and-1.578,all P＜ 0.05).The protein expression level of p-p38MAPK of PDGF group (1.98±0.35) was higher than that of blank control group (1.00±0.00); those of UA intervention group (0.68±0.28),DPI intervention group (0.63±0.27) and SB203580 intervention group (0.67 ± 0.29) was all lower than PDGF group; that of UAgroup (0.28±0.13) was lower than blank control group (t=4.897,-6.479,-6.727,-6.529 and-3.561,all P＜0.05).The level of active oxygen of PDGF group (105.57±7.51) was higher than that of blank control group (69.60±8.63) ; those of UA intervention group (64.56±9.11),DPI intervention group (65.75 ± 6.62) was lower than PDGF group,UA group (29.84 ±3.19) was lower than blank control group (t=6.368,-7.288,-7.071 and-7.255,all P＜0.05).Conclusion UA could inhibit membrane displacement of NOX subunit p47phox and reduce active oxygen production in PDGF induced rat HSC-T6 cells,and then block phosphorylation of PI3K Akt,p 38MAPK signal pathways and inhibited the expression of type Ⅰ collagen at mRNA level.

Objective To investigate effectiveness of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome in the elderly. Method A cross-sectional study of 763 (406 men and 357 women) elderly people who participated in the annual health check-up was conducted. Clinical data of all participants were obtained including anthropometric parameters, body composition, lipid profiles, fasting blood glucose, and high sensitivity C-reactive protein. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff points for waist circumference, waist-to-hip ratio, waist-to-height ratio, percent body fat and fat mass index in relation to the area under the curve (AUC), sensitivity and specificity in the screening and prediction of metabolic syndrome. Result In total subjects, compared with non-metabolic syndrome group,the ROC curve analysis showed that parameters including waist circumference, waist-to-height ratio, waist-to-hip ratio, percent body fat and fat mass index had a significant potential for predicting metabolic syndrome (P<0.001). It was determined that waist circumference of 87.5 cm and 77.5 cm, waist-to-hip ratio of 0.89 and 0.87, waist-to-height ratio of 0.51 and 0.52, percent body fat of 24.1%and 31.7%and fat mass index of 5.00 kg/m2 and 7.80 kg/m2 were the optimal cutoff points for screening and predicting the presence of metabolic syndrome among men and women with a sensitivity of 81.3%,78.8%,87.5%, 51.3%and 83.8%(in men) and 85.1%,79.8%,71.3%, 70.2%and 80.9%(in women) and a specificity of 57.7%,62.6%,50.0%, 75.5%and 51.8%(in men) and 38.0%,53.2%,55.1%, 50.6%and 52.5% (in women),respectively. The area under the ROC curve (AUC) was 0.728, 0.755, 0.716, 0.671 and 0.725 in men and 0.652, 0.707, 0.658, 0.619 and 0.675 in women,respectively. Waist-to-hip ratio showed the highest AUC in all the parameters in men and women. Conclusion Anthropometric parameters and body composition analysis play important roles in the screening and prediction of metabolic syndrome, and waist-to-hip ratio seems to be the best parameter in the screening and prediction of metabolic syndrome in the elderly.

Laparoscopic curative gastrectomy has been widely adopted because it is minimal invasiveness.The efficacy of laparoscopic gastrectomy is comparable to that of open gastrectomy for patients with early or advanced gastric cancer,but few studies of laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy for patients with advanced gastric cancer have been reported.Seven patients with advanced gastric cancer received laparoscopic total gastrectomy combined with distal pancreatectomy and splenectomy at the First Hospital of Jilin University from September 2010 to September 2011.The mean operation time,blood loss,postoperative hospital stay and the nunber of lymph nodes resected were (218 ± 24) minutes,(366 ± 174) ml,( 14.6 ± 2.8 ) days and 32 ± 15,respectively.Two patients were complicated by pancreatic juice leakage and were cured with drainage. No anastomotic leakage,abdominal bleeding or mortality was observed. With the development of techniques and equipments,laparoscopic total gastrectony combined with distal pancreatectomy and splenectomy is safe and feasible in selected patients.

Objective To explore the clinical effect of laparoscopic radical nephrectomy by retroperitoneal in 65 cases.Methods 65 patients who received retroperitoneal laparoscopic radical nephrectomy were selected as the observation group,and their clinical data were analyzed.At the same period,S0 patients treated by open operation were selected as the control group.The clinical effect was compared between the two groups.Results The operation time,intraoperative blood loss,hospital stay,incision infection,pulmonary infection,hypercapnia,intestinal injury of observation group were lower than those of control group (t =7.60,8.38,8.83,x2 =8.33,6.19,4.08,4.08,all P ＜0.05).The positive margin rate,local recurrence rate,distant metastasis rate of two groups were not significantly different (P ＞ 0.05).Conclusion Laparoscopic radical nephrectomy by retroperitoneal has advantages of small wound,quicker recovery,less complications and good prognosis,which is worthy of clinical application.

Objective To approach the clinical curative effect of retroperitoneal laparoscopic adrenalectomy.Methods 120 adrenal tumors patients clinical data of urinary surgery in our hospital were analyzed,who was divided into detection group(80 cases) and control group(40 cases).Results The operation time,bleeding volume,postoperative exhaust time,hospitalization time,incision infection,pulmonary infection,intestinal injury of detection group were lower than those of control group (t =5.59,21.17,26.32,6.01,x2 =7.79,7.79,5.13,all P ＜ 0.05).Conclusion Retroperitoneal laparoscopic adrenalectomy has some advantages:the small incision,less trauma,faster postoperative recovery,less complication,,which was worth of applying.

Objective The palliation of dysphagia in metastatic esophageal cancer remains a challenge ,and the optimal approach for this difficult clinical scenario is not clear .We therefore sought to define and determine the efficacy of various treatment options used at our institution for this condition .Methods Methods We reviewed a prospective database for all patients managed in an e-sophageal cancer referral centre over a 5-year period .All patients receiving palliation of malignant dysphagia were reviewed for de-mographics ,palliative treatment modalities ,complications ,and dysphagia scores (0= none to 4= complete) .The Wilcoxon signed rank test was used to determine significance (P<0 .05) .Results During 2005~2010 ,80 patients with inoperable esophageal cancer were treated for palliation of dysphagia .The primary treatment was radiotherapy in 66% ,metal stenting in 21% and radiotherapy combined with stent in 13% .Mean duration of treatment was 1 day in he stent group and 40 days in the radiotherapy group(P=0 . 001) .In patients treated initially by stenting ,dysphagia improved within 2 weeks of treatment in 82% of patients(dysphagia score of 0 or 1) .However ,18% of patients presented with recurrence of dysphagia at 10 weeks of treatment .In the radiotherapy group , the onset of palliation was slower ,with only 50% of patients palliated at 2 weeks(dysphagia score of 0 or 1) .However ,long-term palliation was more satisfactory ,with 90% of patients remaining palliated after 10 weeks of treatment .Conclusion In inoperable e-sophageal cancer at our centre ,radiation treatment provided durable long-term relief ,but came at a high price of a long wait time for initiation of treatment and a long lag time between initiation of treatment and relief of symptoms .On the other hand ,stenting pro-vided more rapid and effective early relief from symptoms ,but was affected by recurrence of dysphagia in the long-term .

Objective To evaluate clinical efficacy of retroperitoneal laparoscopic adrenalectomy in patients with adrenal disease.Methods 21 cases of adrenal disease undergoing retroperitoneal laparoscopic adrenalectomy from Jun.2006 to Oct.2010 were retrospectively reviewed.Results All operations were performed successfully except 2 cases were converted to open surgery due to peritoneal rupture,which resulted in difficult exposure of retroperitoneal cavity.The operation time ranged from 55 to 300 minutes,with 90 minutes as the medium.Blood loss volume ranged from 10 to 100 ml during operation (30 ml as the medium ).No blood transfusion was given.No complication such as massive hemorrhage,infection,abdominal visceral injury etc.occurred.19 patients were treated successfully and followed up from 3 to 55 months with 12.3 months as the medium.No tumor recurrence and metastasis was found in the 19 cases.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of high safety,less complications and satisfactory efficacy in patients with adrenal diseases.

Objective To retrospectively determine the features of stones and calcifications in hepatobiliary system on virtual nonenhanced (VNE) dual-energy computed tomography (CT), and to evaluate the possibility of VNE images in diagnosis for those lesions.Methods A total of 128 gall stones and calcifications of the liver found in 110 patients were examined with triple phase abdominal CT scan from July 2007 to December 2011, in which true nonenhanced (TNE) phase and arterial phase were performed with single-energy CT (120 kVp) and portal venous phase was performed with dual-energy CT (100 kVp and 140 kVp). VNE images were generated from the portal venous phase dual-energy CT data sets by using commercially VNC software. The mean CT values for the stone, liver, bile and paraspinal muscle, mean lesion density and size in area dimension, contrast-to-noise ratio (CNR) of lesion to the liver or bile, and image noise were assessed and compared between VNE and TNE images. The effective dose and size-specific dose estimate (SSDE) were also calculated.Results The mean CT values of the lesions measured on VNE images declined significantly compared with those measured on TNE images (164.51±102.13 vs. 290.72±197.80 HU, P<0.001), so did the lesion-to-liver CNR (10.80±11.82 vs.18.81±17.06, P<0.001) and the lesion-to-bile CNR (17.24±14.41 vs. 21.32±17.31, P<0.001). There was no significant difference in size of lesions area between VNE and TNE images (0.69±0.88 vs. 0.72±0.85 cm, P=0.062). Compared to the 128 lesions found in TNE images, VNE images showed the same density in 30 (23.4%) lesions, lighter density in 88 (68.8%) lesions, while failed to show 10 (7.8%) lesions, and showed the same size in 61 (47.7%) lesions and smaller size in 57 (44.5%) lesions. The CT cutoff values of lesion and size were 229.21 HU and 0.15 cm, respectively. The total effective dose for triple phase scan protocol with TNE images was 19.51±7.03 mSv, and the SSDE was 39.84±11.10 mGy. The effective dose for dual phase scan protocol with VNE images instead of TNE images was 13.29±4.89 mSv, and the SSDE was 27.83±9.99 mGy. Compared with TNE images, the effective dose and SSDE of VNE images were down by 32.05%±3.69 % and 30.63%±2.34 %, respectively.Conclusions Although the CT values and CNR of the lesions decreased in VNE images, the lesions of which attenuation greater than 229.21 HU and size larger than 0.15 cmcould be detected with good reliability and obvious dose reduction. There was good consistency in the size of stones and calcifications in hepatobiliary system between VNE images and TNE images, which ensured the possibility of the clinical application of VNE images.