Objective To assess the safety and effectiveness of robotic-assisted laparoscopic radical cystcctomy and urinary diversion in the treatment of bladder cancer.Methods We collected the clinical data of one patient with bladder cancer who underwent RCRA with ileal neobladder from the Second Artillery General Hospital in Beijing on March,2010.Literature on this topic was analyzed.Results ( 1 ) Tbc operation duration of this procedure was 540 mins.The intra-operative blood loss was 200 ml,and no blood transfusion was needed.Postoperative pathologic examination indicated low-grade infiltrative urothelial carcinoma.The patient exhausted on the 3th post-operative day,had off-bed activities on the 4th post-operative day,and was discharged on the 28th post-operative day.(2) There were more than 400 patients underwent RARC worldwide.The RARC group had marginally lower complications rate (31％ vs.28％ ) and numbers of lymph node dissection ( 18.2 vs.13.0) than the LCR group.There were significant differences in the duration of operation (285.7 mins vs.372.0 mins),intraoperatie blood loss ( 286 ml vs.556.0 ml) and mean days of hospitalization ( 8.6 d vs.13.0 d) between the RARCA and the LCR groups.Conclusion RARC is a novel and effective procedure for the treatment of bladder cancer.As there is only a relatively small sample around the world and little experience on this procedure can be referred,more clinical practice with RARC and high quality research with long-term follow-up are needed to update the database and evaluate its effectiveness and safety.

Objective:To evaluate the efficacy of paroxetine on functional low fever. Methods:Using a randomized and placebo controlled trail, a total of 54 with functional low fever were randomized into paroxetine group and placebo group. In paroxetine group, 28 patients received oral paroxetine 1 tablet (20mg/tablet), one times a day for 8 weeks. There were 26 patients in the placebo. The criteria of assessing the therapeutic efficacy on functional low fever and Hamilton Depression Scale (HAMD; 17 items) were used to assess the therapeutic efficacy at the 4th and 8th weekend respectively.Results:After 8 weeks of treatment, the efficacy rate on functional low fever and antidepression were 78.6%, 82.1% in paroxetine group and 26.9%, 23.1% in the placebo group respectively. There was a significant difference between the two groups (P

Purpose:To detect the abnormalities of WWOX(WW domain containing oxidoreductase) gene in human lung adenocarcinoma cell line A549. Methods:Deletion of WWOX exons 6-8 transcript was analyzed by reverse transcriptase-PCR technology; loss of heterozygosity (LOH) of WWOX gene was analyzed by PCR-based assays for dinucleotide repeat polymorphisms technology. Aberrant expression of WWOX protein was analyzed by western blot. Results:A549 cells samples showed loss of WWOX exons 6-8 transcript.This deletion was not detected in normal primary cultured human bronchial epithelial cells samples.Three microsatellites(D16S3029、D16S3096、D16S504)did not have LOH in the normal primary cultured human bronchial epithelial cells samples, but D16S2029 and D16S3096 were all found to have LOH in A549 Cells samples. We further observed that expression of WWOX protein was significantly lower in A549 cell samples compared to the normal primary cultured human bronchial epithelial cells samples. Conclusions:WWOX gene may be important during tumorigenesis in lung adenocarcinoma cancer.Deletion of exons 6-8,LOH and aberrant expression of protein are all modes of WWOX gene inactivity in lung adenocarcinoma cancer.

Objective To examine the influence of serum on pulmonary surfactant (PS) function.Methods Caesarean section was performed on 26-day pregnant Japanese white rabbits (full term=31 days). The pre-term rabbits weighing 20-34g were anesthetized with intraperitoneal(ip) pentobarbital sodium 0.5mg. Tracheotomy was performed. Test liquids were prepared by suspending PS in rabbit serum or acetate Ringer solution at concentration of 2.0,4.0,6.0,8.0,10,12,24 mg/ml. The surface tension of test liquids was measured by pulsating bubble technique. Test liquid 10ml/kg was instilled in the lungs of PS-deficient pre-term rabbits via tracheotomy cannula.Animals were ramdomly divided into 4 groups according to the test liquid used: group A: 24mg/ml PS suspended in acetate Ringer solution; group B: 24mg/ml PS suspended in serum; group C: 4.0mg/ml PS suspended in acetate Ringer solution; group D: nothing was instilled. Rabbits were placed in plethysmograph. Siemens-Elema ventilator was used for mechanical ventilation. PIP was set at 22.5cmH 2O, PEEP=0,respiratory rate=40 frequency/min, I:E=1:1,FiO 2=100%. Tidal volume was measured at 5,10,15,20 min after the start of mechanical ventilation.Results When concentration of PS suspended in acetate Ringer solution was 2.0 mg/ml, the minimum surface tension (?min) was less than 3.0 mN/m; when suspended in serum, ?min was significantly higher than 30 mN/m (P15 ml/kg, but in group B the mean tidal volume was

Objective To examine the effects of exogenous pulmonary surfactant (PS)on lung function in rats with meconium aspiration.Methods Twenty Wistar rats of both sexes were anesthetized with intraperitoneal pentobarbital 30 mg?kg-1 , tracheotomized and mechanically ventilated (PIP= 16 cm H2O,RR =40 bpm,I:E= 1 : 1, FiO2 = 1.0) . 3-4 ml? kg -1 of saline suspension of human meconium ( 200 mg ? ml-1 ) was introduced into trachea. Respiratory failure was induced when PaCO2

Objective The reconstituted pulmonary surfactant (SP) is composed of synthetic lipid(SL) and surfactant- associated protein C (SP-C) . The purpose of this study was to determine the surface tension reducing activity of the reconstituted surfactant containing different concentrations of SP-C.Methods Pulmonary surfactant (SP) was isolated from alveolar lavage fluid of fresh porcine lungs by centrifugation, extraction and precipitateon. SP-C was extracted from PS and SL was prepared by mixing dipalmitoyl-phosphatidyl choline (DPPC), dioleoyl-phosphatidyl choline (DOPC) and palmitoyl-oleoyl-phosphatidyl glycerol (POPG) in the weight ratio of 60: 20: 20. Three synthetically reconstituted surfactants RS-1, RS-2, RS-3, were prepared by adding different concentrations of SP-C to SL. The end concentration of SP-C was 1% , 2% and 3% respectively. Five test liquids (PS, SL. RS-1, RS-2, RS-3) were prepared by suspending the materials mentioned above in nonnal saline. The dynamic surface tension of the five test liquids were measured by a pulsating bubble technique. Thirty-six PS-deficient premature rabbits were studied. The premature rabbits were delivered by cesarean section on the 26 th day of pregnancy. The animals were tracheostomized and mechanically ventilated. 0.1 ml of test liquid PS (group Ⅱ) , SL(group Ⅲ) or RS-3(group Ⅳ) was instilled into the lungs via the tracheostomy cannula. In control group (group Ⅰ) no test liquid was instill. The animals were placed in a body plethysmograph and mechanically ventilated (the maximum inspiratory pressure = 25 cm H2 O, RR = 40 bpm, I: E = 1:1, FiO2 = 100 % made of ventilation IPPV) . Tidal volume was measured at 5, 10, 15 and 20 min after onset of IPPV. Results The minimum surface tension (?min) of PS was 0.9?0.3 mN?m-1 , and of SL was 22.6 ?1.3 mN?m-1 . The ? min of RS-3 was 0.7?0.1 mN ?m-1. The mean tidal volume after 20 min of mechanical ventilation in group Ⅱ(PS) and groupⅢ(RS-3 ) was 25 ?7 ml?kg-1 and 25 ? 4 ml?kg-1 respectively, significantly larger than that in control group (Ⅰ ) and group Ⅲ (SL) . Conclusion The surface tension-reducing activity of SL alone is low. Adding SP-C to SL greatly enhances the surface tension-reducing activity of reconstituted surfactant (RS).

To examine the deletion and point mutation of WWOX (WW domain containing oxidoreductase) exons 6-8 in human non-small cell lung cancer and their possible relationship with pathological stages, tumor tissues and the corresponding normal tissues were obtained from 44 Chinese patients who had undergone surgery for non-small cell lung cancer. RNA was extracted from each sample and deletion and mutation of WWOX exons 6-8 were analyzed by RT-PCR and DNA sequencing. Our results showed that 28 of 44 (63.6%) lung cancer samples showed loss of WWOX exons 6-8 transcript and the deletion was detected in only 3 of 44 (6.8%) corresponding adjacent normal tissues (P < 0.05). The transcript sequencing analyses of the 16 lung cancer samples without transcript loss of WWOX exons 6-8 revealed no difference from the sequence of GenBank. Moreover, the deletion of WWOX exons 6-8 was significantly higher in the smokers when compared with the non-smokers. It is also higher in the men and squamous carcinomas than in women and adenocarcinomas (P < 0. 05). The deletion, however, was not found to be associated with pathological stages of the tumors. Our study documented a high incidence of deletion of WWOX exons 6-8 in non-small cell lung cancer in Chinese patients and suggested that the frequent loss of WWOX exons 6-8 might play an important role in the tumorigenesis of non-small cell lung cancer in Chinese. WWOX exons 6-8 may serves as a candidate molecular target of smoking carcinogenesis, and point mutation is not a predominant way of alteration of WWOX exons 6-8.
Carcinoma, Non-Small-Cell Lung/*genetics ; Exons/genetics ; Gene Deletion ; Loss of Heterozygosity ; Lung Neoplasms/*genetics ; Oxidoreductases/*genetics ; Point Mutation ; Sequence Analysis, DNA ; Tumor Suppressor Proteins

The ideal scaffold material can reconstruct the morphology, structure and function of tissues and organs. Thus, it has received extensive attention in the field of tissue engineering. With the rapid development of the theories and technologies of naturally-derived biomaterials, it has gradually become a research hotspot in the field of regenerative medicine. Natural biomaterials have high bionics, good biocompatibility and a wide range of sources. Thus, they are very suitable to be used as scaffolds for tissue engineering. According to ingredients and source of raw materials, they can be roughly divided into protein-based biomaterials (collagen, gelatin, silk and fibrin), carbohydrate-based biomaterials (cellulose, chitin/chitosan, alginate and agarose), glycosaminoglycans (hyaluronic acid, chondroitin sulfate) and decellularized extracellular matrix (amniotic membrane, small intestinal submucosa, tendons). Different scaffold materials have unique natural structures and properties. Protein-based biomaterials can affect cell migration and differentiation through polymerization to form a network structure. They can be made into stents alone or used with other synthetic materials based on certain mechanical properties. Carbohydrate biomaterials can carry a large amount of liquid due to their high specific surface area. However, their mechanical properties are poor. Therefore, it is often used in the form of gel with other materials to control the release of cells and growth factors in tendon tissue engineering. Regularly, the anti-inflammatory, viscoelastic, lubricating and highly hydrating properties of glycosaminoglycan biomaterials can be combined with synthetic materials to increase their biocompatibility and hydrophilicity. Compared with the above materials, the decellularized extracellular matrix not only has a more similar extracellular structure and nutrients, but also has certain mechanical properties. Therefore, it can better reconstruct the morphology, structure and function of tissue and organ lesions. Ultimately, the above materials have been paid more and more attention in tissue engineering. The ingenious combination of different materials makes the repair of tendons show better results. In future, naturally-derived biomaterials could have broader clinical prospects and application value.

Objective To make a summary of radiation-induced changes in ocular lens and retinal lesions based on dynamic follow-up of a patient exposed to a radiation exposure from 192 Ir source accident,in order to provide the information and experience for the clinical diagnosis and treatment of such injury in emergency of a nuclear or radiation accident.Methods The examination methods included eye lens and visual acuity,slit-lamp examination,fundus examination,automated perimetry,optical coherence tomography (OCT) examination,fundus photography,and fundus fluorescein angiography (FFA).The patient was followed-up for 20 months.Comparative analyses were made of the follow-up results.Results One month after 192Ir radiation exposure,the visual acuities in both eyes were 1.0.Mild age-related opacities were observed in peripheral cortex,but the fundus looked normal.Twenty months later,the patient was followed-up.The visual acuities reduced to about 0.6,evident powder-and punctuate-like opacities could be observed in the cortex of the right lens,and mild turbid foci in the posterior polar and capsule.Multiple scotomata appeared in the superior temporal and inferior nasal in the right eye.The macular fovea thickness was not changed significantly in the right eye.Examination with fundus photography demonstrated mild optical nerve atrophy,drusens,and pale optic discs,while FFA examination showed punctuate or flocculent leakages in both eyes.Conclusions The lens opacity could be induced or accelerated by radiation exposure.In addition to the posterior capsule and pole cataracts,punctuate opacity within cortical layer may also occur.It also suggests that cataract and fundus injuries may occur later during long-term follow-up,even though the eyes may look normal during early examination after the patient exposed to the radiation.

Objective To analyze the effect of clinical pathways on single disease management.Methods Clinical controlled trials on tumors of uterine,benign biliary tract diseases and benign thyroid neoplasm were collected and related literatures were screened according to the criteria of inclusion.The literature so collected underwent a Meta analysis.Results A total of 21 literatures were included.Meta analysis indicated that statistical difference existed in the total cost of hospitalization(WMD=1046.06,95％CI:- 1281.15 ～ - 810.96,P＜0.00001) and length of hospital stay (WMD=- 2.18,95％CI:-2.59～- 1.76,P＜0.00001)between non-clinical pathways group and clinical pathways group.Conclusion Implementation of clinical pathways can further reduce hospital costs and shorten hospital days of the single disease management.