Objective To consider the clinical significance of retroperitoneal laparoscopic adrenalectomy for adrenal diseases. Methods We analyzed 33 cases of adrenal diseases treated by retroperitoneal laparoscopic adrenalectomy in this hospital from October 1996 to December 2001. Results Retroperitoneal laparoscopy was successfully applied in 31 cases, whereas conversions to open adrenalectomy were required in the other 2 cases. The mean operation time was 158 min (120 min～200 min). The mean intraoperative blood loss was 150 ml, without blood transfusion needed. The mean length of hospital stay was 6.4 days. Conclusions Compared with open surgery, retroperitoneal laparoscopic adrenalectomy has the advantages of minimal invasion, less blood loss, fewer complications, quicker recovery and shorter hospital stay length. This procedure can be applied to in the absence of contraindications (such as tumor size being more than 10cm, metastatic carcinoma and vital organs or blood vessels being involved).

Objective To investigate age-related changes of serum prolactin(PRL) and testosterone (T) in aging males and to study the correlation between PRL and prostatic hyperplasia. Methods 84 aged males were divided into four groups, the fifties, the sixties, the seventies and the eigh- ties . Serum PRL and T were measured using radioimmunoassay. The volume of prostate was evaluated by ultrasound in 38 and it's correlation with PRL studied. Results Serum T level of the 4 age groups from fifties to eighties was (25.92?2.54),(21.00?1.92),(18.37?2.49) and (14.75? 2.38 ) nmol/L respectively and PRL concentration (1.11?0.16), (0.96?0.20), (0.99?0.18) and (0.91?0.29) nmol/L. Analysis of variance showed that serum T concentration significantly decreased with age ( F =3.44, P 0.05). No association between PRL and volume of prostate has been observed. Conclusions PRL play a physiological role in the development and growth of prostate via androgen. But such effect of androgeno-dependence on prostate is greatly diminished because of the decrease of androgen hormone with age especially in the aged.

During the last decade,tissue engineering techniques,including the preparation of scaffold and cell culture,have undergone significant development and achieved encouraging results in preliminary clinical trails.However,many medical ethical conflicts still lie ahead in the tissue engineering of the bladder for clinical applications.This review focuses on the current status of tissue engineering techniques and proposes some fundamental principles to be followed in the clinical application of tissue engineering of the bladder.

Objective:To establish a rat model of erectile dysfunction caused by the injury of the cavernous nerve. Methods:Rats topographical anatomy were done for identifing the cavernous nerve and major pelvic ganglion and pelvic nerve and hypogastric nerve .Polygraph intracavernous pressure of the models were detected continuously and evaluated. Results:Erectile process was controlled by erectile nerve. Major pelvic ganglion includes two inflows,they are called pelvic nerve and hypogastric nerve. The largest outflow is cavernous nerve. The injury of the cavernous nerve will lead to erectile dysfunction. Conclusion:Rat can be an ideal animal model for studying the erectile dysfunction caused by cavernous nerve injury. The neuvological mechanism of erectile dysfunction can be evaluated with determination of intracavernous pressure.

Objective To explore the clinical significance of early invasive mechanical ventilation for acute respiratory distress syndrome (ARDS) caused by thoracic trauma.Methods We retrospectively analyzed the clinical data of 93 patients of invasive mechanical ventilation in those with ARDS caused by thoracic trauma,and divided them into delayed invasive mechanical ventilation group (n =45) and timely invasive ventilation group (n =48) by the time of invasive mechanical ventilation.We compared the blood gas analysis,oxygen index,heart rate,lactic acid,muscle use score of the two groups before and after invasive mechanical ventilation and the differences of mechanical ventilation time,incidence of complications,mortality and length of hospital stay between the two groups.Results Each index of the delayed invasive mechanical ventilation group and the timely invasive ventilation group was calculated:PaO2 (63.2 ± 12.3,74.2 ± 12.1)mm Hg,PaCO2 (39.4 ±8.7,38.9 +7.6) mm Hg,PaO2/FiO2 (196.2 ± 17.8,231.4 ± 18.2),respiratory rate (27.4 ±3.7,21.1 ± 3.4) beats/min,heart rate (117.2 ± 26.8,96.0 ± 25.1) beats/min,accessory muscle use score (2.69 ± 0.15,1.67 ± 0.10),lactic acid (4.23 ± 1.70,2.12 ± 0.80) mmol/L Except for PaCO2,the differences of each index were statistically significant (t values were respectively 4.346,9.420,3.949,5.436,38.809,7.736; P ＜ 0.05).The duration of mechanical ventilation treatment (10.21 ± 1.50,6.47 ± 1.20) d and the length of hospital stay (21.53 ± 1.90,16.32 ±2.10) d of the delayed group and the timely group were significantly different (t values were respectively 12.518,13.318; P ＜ 0.01).The timely group had significantly lower mortality rate (26.7％ (12/45),14.6％ (7/48)),VAP (46.7％ (21/45),22.9％(11/48)),acute gastric mucosal lesions (33.3％ (15/45),12.5％ (6/48)),MODS (40.0％ (18/45),16.7％ (8/48)) than the delayed group (x2 values were respectively 3.86,5.81,4.49,5.70; P ＜ 0.05).There is no significant difference on the incidence of pneumothorax between the two groups (11.1％ (5/45),8.3％ (4/48)).Conclusion Invasive mechanical ventilation is an effective treatment of ARDS caused by chest trauma.Early invasive mechanical ventilation can reduce the mortality rate and shorten the duration of mechanical ventilation and hospital stay of the patients with ARDS after severe thoracic trauma.

Objective To investigate the effects of Xuebijing on the regulations of tumor necrosis factor-α(TNF-α) 、von Wilebrand factor(vWF)、interleukin-6 (IL-6) and the treatment effectiveness in pulmonary contusion patients.Methods Fifty-one pulmonary contusion patients admitted into the hospital from January 2010 to January 2012 were enrolled in the study and were randomly divided into two groups (treatment group and control group).The levels of the TNF-α、vWF 、IL-6 in the pulmonary contusion patients were measured by enzyme linked immunosorbent assay to investigate the change of the inflammatory cytokines and the treatment effectiveness in treatment group and control group.Results The hospitalization time of treatment group and control group was (19.83 ± 2.35) d,(21.52 ± 2.73) d respectively,the hospitalization time of the treatment group was significantly shorter than the control group,the difference was statistically significant (t =2.38,P ＜0.05) ;The incidence of ARDS was 14.81％ and 41.67％ respectively,the incidence of ARDS of the treatment group was significantly lower,the difference was statistically significant (x2 =4.6,P ＜ 0.05) ;The inflammatory mediators index of the two groups showed as follws:the first day of the TNF-α(181.35 ± 14.25) ng/L,(179.17 ± 16.28) ng/L,the third day of the TNF-α(169.21 ± 16.42) ng/L,(179.18 ± 17.31) ng/L,the fifth day of the TNF-α(131.78 ± 13.02) ng/L,(140.84 ± 14.27) ng/L,the seventh day of the TNF-α (99.45 ± 16.02)ng/L,(110.56 ± 17.09) ng/L;The first day of the vWF (178.73 ± 22.09) ng/L,(177.73 ± 23.02) ng/L,the third day of the vWF (208.46 ± 14.13) ng/L,(220.53 ± 23.02) ng/L,the fifth day of the vWF (252.32 ±15.22) ng/L,(266.40 ±25.79) ng/L,the seventh day of the vWF(201.49 ±9.21) ng/L,(217.27 ±22.68)ng/L;The first day of the IL-6 (172.14 ± 12.41) ng/L,(169.53 ± 13.55) ng/L,the third day of the IL-6 (147.24 ± 16.33) ng/L,(158.41 ±21.04) ng/L,the fifth day of the IL-6(126.36 ± 11.37) ng/L,(137.21 ± 21.23) ng/L,the seventh day of the IL-6 (114.03 ± 10.26) ng/L,(122.16 ± 13.59) ng/L,the differences within the group and between the two groups were significant(within the group:F =206.58,218.57,198.35 respectively,P ＜ 0.01 ;between the groups:F =19.053,17.259,17.235 respectively,P ＜ 0.01).And in the third,fifth and seventh day,3 indicators of treatment groups were lower than the control group (P ＜ 0.01).Conclusion Xuebijing can inhibit inflammatory transmitters,relieve inflammatory reactions,decrease the rate of ARDS incidence,shorten the hospitalization time and help to improve the prognosis of the patients with acute pulmonary contusion.

Objective:To observe the influence of inhaled anesthetic isoflurane in the neuronal protein damage and aggregation in the APP transgenic mouse hippocampus,and to investigate the intervention effect of trehalose. Methods:Sixty APP transgenic mice aged 12 months were divided into control group,isoflurane group (Iso group) and trehalose group (Tre group)(n=20).The rats in control group were not given any drugs and were put into the anesthetic box with continuonsly entering 2 L·min-1 oxygen for 2 h;the rats in Iso group and Tre group were respectively injected intraperitoneally with 2 mL saline or trehalose (400 μg·kg-1 )30 min before anesthesia,and then inhalated 1.4% isoflurane for 2 h.6 h after anesthesia,the hippocampus tissue of the mice was prepared,and DCFH-DA fluorescence was applied to detect the reactive oxygen species (ROS)level; 24 h after anesthesia, immunohistochemical method and Western blotting method were used to detect the contents of carbonyl compounds and nitrotyrosine and the Aβ1-42 protein expression level in hippocampus;TEM was applied to observe the formation of protein aggregates; TUNEL staining was performed to observe the apoptotic rate of hippocampal neurons. Results:Compared with control group, the ROS level, the expression levels of oxidative protein carbonyl compounds and nitrotyrosine,the expression level of Aβ1-42 protein,and the apoptotic rate of hippocampal neurons in Iso group were significantly increased (P < 0.05);compared with Iso group,the ROS level,the expression levels of oxidative protein carbonyl compounds and nitrotyrosine,the Aβ1-42 protein expression level, and the apoptotic rate of hippocampal neurons in Tre group were significantly decreased (P < 0.05).Conclusion:Isoflurane can induce the protein damage and aggregation,the apoptotic rate of hippocampal neurons,aggravate oxidative stress reaction,increase the apoptotic rate of brain hippocampal neurons in the APP transgenic mice;trehalose can intervene the neurotoxicity induced by inhaled anesthetics.

Objective To observe the expression of Her-2/neu protein and androgen receptor (AR) in human prostate cancer and to evaluate their significances in the progression of prostate cancer. Methods The Her-2/neu protein and AR immunohistochemical stain were carried out in human prostate tissue microarray that consisted of prostate cancer (107 cases) and benign prostate tissue (42 cases). The prostate cancer cases were divided into 4 groups: group one (Gleason score 6),group two (Gleasonscore 7), group three (Gleasonscore 8) and group four (Gleasonscore 9) according to the Gleason score. The immunostains immunohistochemical stain were interpreted in two aspects of the staining intensity and the percentage of positive cells. The significance and relationships between the expression of Her-2/neu protein and AR in prostate cancer and benign prostate tissue (BPT) and the grouping of different Gleason scores of prostate cancer were then evaluated. Results The positive expression rate of Her-2/neu protein was significantly higher in prostate cancer tissue than in BPT [43.9%(47/107) vs. 14.3%(6/42), x2=11.562, P=0.009], and the positive expression intensity of Her-2/neu immunoreactivity was also higher (x2= 11.764, P=0.008). There were significant differences in positive expression intensity of Her-2/neu immunoreactivity among the different Gleason scores groups (x2 = 20. 512, P = 0. 015), and the expression intensity was significantly positively correlated with Gleason scores ( r= 0. 269, P = 0. 005). There was significant difference in AR immunoreactivity between in prostate cancer (67 %, 72/107) and in BPT (50 %, 21/42, x2 =3. 843, P=0. 050). Among prostate cancer cases, the positive expression intensity of AR was not significantly different among groups 1 through 4 (x2 = 4. 318, P = 0. 229), and was not significantly correlated with Gleason scores ( r = - 0. 065, P = 0. 505 ). Moreover, the positive expression intensity of Her-2/neu protein was not significantly correlated with that of AR (r = -0. 115, P=0. 237). Conclusions Overexpression of Her-2/neu protein in human prostate cancer tissue suggests that Her-2/neu may have some role in prostate tumorigenesis. Her-2/neu protein expression is positively correlated with Gleason score in prostate cancer, which suggests that Her-2/neu may be a potential prognostic predictor of prostate cancer.

Objective To evaluate intra-operative radiotherapy after breast conservative surgery in early breast cancer patients in terms of postoperative complications,cosmetic outcome and recurrence events.Methods From June 2007 to Dec 2010,115 early breast cancer patients received breast conserving surgery.Fifty-nine patients (study group) received intra-operative radiotherapy,compared with 56 patients (control group) receiving routine postoperative radiotherapy.Postoperative complications were evaluated 1 month after surgery; cosmetic outcome was evaluated 1 year postoperatively; recurrence and death events were followed up.Results The average wound healing time was 13 -22 days in study group and 9 - 14days in control group.In the study group,2 patients developed fat deliquescence,16 patients showed wound edema while no such side effects were found in control group.No infection or hematoma were found in either group.Overall cosmetic outcome was rated 1 year post operation.In the study group (41 cases),36 patients were graded as excellent or good,5 patients were as fair or poor.Meanwhile in the control group (37 cases),wounds in 25 patients were graded as excellent or good,that in 12 patients were as fair or poor (P =0.031).After a follow-up from 3 to 42 months(median:24 months),two patients (3.39％) in study group developed local cancer relapses,one of them( 1.7％ ) died.In control group,one patient ( 1.8％ )developed local relapse,and no one died.Conclusions Intra-operative radiotherapy is safe and reliable with good cosmetic outcome.

BACKGROUND:Establishment of in vitro culture system of human placental microvascular endothelial cel s with high purity is very important. In recent studies, some scholars have successful y obtained a large number of placental microvascular endothelial cel s by three-stepenzyme digestion and magnetic separation method, but the procedures were extremely complex and it had great damage to the cel s. Therefore, how to separate human placental microvascular endothelial cel s easily and obtain high-purified cel s has become a research hotspot.
OBJECTIVE:To investigate an efficient method to isolate and purify human placental microvascular endothelial cel s from early vil us microvessels, observe the cel growth and identify the cel s.
METHODS:The vil i from normal early pregnancies (6-8 weeks) after artificial abortion were col ected aseptical y. Using two-step digestion procedure and discontinuous Percol density gradient centrifugation method, human placental microvascular endothelial cel s were obtained. Then the cel s were identified by trypsin digestion method and repeated adherence method.
RESULTS AND CONCLUSION:Human placental microvascular endothelial cel s were isolated successful y from early vil i. The primary cel s adhered to the wal s after inoculated for 24 hours and entered logarithmic phase at 10 days. 80%of the cel s achieved a confluence at 12-13 days after inoculating. The subculture cel s grew swiftly with the typical cobblestone appearance. Immunofluorescence staining showed that, cultured human placental microvascular endothelial cel s demonstrated a strong positive reaction to von Wil ebrand factor antigen and CD31, accounting for 100%. MTT assay results showed that, human placental microvascular endothelial cel s at passage 5 exhibited an S-shaped growth curve. High-purity human placental microvascular endothelial cel s can be obtained by proteolytic enzymes digestion and discontinuous Percol density gradient centrifugation method, and the purity is detected by trypsin digestion method and repeated adherence method.