Aim To investigate the impact of UVA on expression of tumour necrosis factor related apoptosis inducing ligand (TRAIL) and study the role of TRAIL in UVA-induced apoptosis of HaCaT cells as well as the influence of Polypeptide from Chlamys farreri(PCF)on TRAIL apoptotic pathway induced by UVA.Methods Cells were divided into five groups: control group, UVA model group,UVA+5.69 mmol?L-1 PCF group, UVA+2.84 mmol?L-1 PCF group, UVA+1.42 mmol?L-1 PCF group.Expression level of TRAIL mRNA was assayed by Real-Time PCR.Western blot analysis was used to determine the protein level of TRAIL and caspase-8 activation. The effect of TRAIL neutralization antibody on UVA-induced apoptosis was also investigated.Results TRAIL mRNA and protein levels increased after 8 J?cm-2 UVA radiation and the discrepancy was significant compared with control group(P

5 cm in diameter)were enrolled in this study.Aomong the patients,17 underwent RLRN,and 14 patients received open radical nephrectomy(ORN).The outcomes of the two groups were compared.Results In both the groups,the operations were completed.The blood loss in RLRN group was less than that in ORN group [(245.9?75.5)ml vs(640.5?174.8)ml,t=-8.425,P=0.000].No significant difference was found between the two groups in operation time [(164.8?44.6)min vs(182.7?30.3)min,t=-1.277,P=0.212],postoperative hospital stay [(7.1?3.2)d vs(9.6?5.7)d,t=-1.541,P=0.134],and survival rate(Log-rank test,?2=0.243,P=0.622).Conclusion The efficacy of RLRN is similar to that of ORN.RLRN is safe and induce less blood loss.

Objective To evaluate the efficacy of video-assisted mini-thoracoscopy(VAMT) for radical resection of lung cancer.Methods From April 2002 to December 2008,radical resection of lung cancer was performed on 39 patients by VMAT in our hospital.A 1.5-cm and a 7-to 10-cm incision were made during the operation.Both standard surgical instruments and thoracoscopic set were used to treat the pulmonary vessels,perform lobectomy,and remove the lymph nodes in the mediastinum and pulmonary portal.Results The operation was completed in all of the cases.No peri-operative death occurred.The patients received chest drainage for 4 to 7 days after the operation(mean,4.5 days).Post-operative pathological examination showed primary non-small cell lung cancer(NSCLC) in 37 cases,metastatic cancer in 1,and carcinoid in 1.In the 37 patients with NSCLC,9 were stage Ⅰa,13 were Ⅰb,5 were Ⅱa,7 were Ⅱb,2 were Ⅲa,and 1 was Ⅲb.Follow-up was available in 35 patients for up to 2 to 12 months in 4,13 to 24 months in 15,25 to 36 months in 8,37 to 48 months in 6,and 49 to 60 months in 2 cases.Among the 35 cases,totally 4 patients died of tumor recurrence or metastasis,1 patient survived with tumor,and the other 30 survived without tumor.The 1-and 3-year survival rate of stage Ⅰ and Ⅱ were 100%(21/21) and 91%(10/11) respectively.All of the 3 stage Ⅲ patients died of recurrence or metastasis in 19,11,and 14 months respectively after the surgery.Conclusions VAMT is effective for radical resection of lung cancer in a short term.Combination of traditional procedure and VAMT is safe and reliable for the disease.

Objective To investigate the value of transurethral electrocision of the ureteric orifice in total nephroureterectomy. Methods Transurethral electrocision in combination with lumbar incision was employed in total nephroureterectomy for treating 28 cases of transitional cell carcinoma of the renal pelvis or the upper ureter from January 2002 to September 2003 in this hospital. Transurethral electrocision of the ureteric orifice on the diseased side was performed, and then the kidney and the whole ureter were excised through a lumbar incision. A catheter was placed for 7 days postoperatively. Results The operation time was 70~95 min (mean, 81 min). No urinary leakage, severe hematuria or wound infection occurred. The length of postoperative hospitalization was 7~9 days (mean, 7.4 days). Follow-up for 8~15 months (mean, 12 months) in 28 cases found no recurrence. Conclusions Total nephroureterectomy through transurethral electrocision in combination with lumbar incision is proved to be minimally invasive and safe, with a quick recovery.

Objective To discuss a modified laparoscopic pyeloplasty. Methods A total of 32 patients presenting ureteropelvic junction obstruction underwent a modified laparoscopic pyeloplasty which included the dissection of the ureteropelvic junction under laparoscope and the pyeloplasty through an extended trocar-incision 2.5~3 cm in length as open surgery did. Results The operation was successfully completed in all the 32 patients.Intraoperative findings demonstrated renal inferior polar compression by ectopic blood vessels in 1 patient and primary ureteropelvic stricture in 31 patients.The operative time was 40~70 min(mean,52 min) and the intraoperative blood loss was 20~30 ml(mean,23 ml).No surgery-related complications were observed.Follow-up checkups in 27 patients for 7~15 months(mean,9.6 months) showed disappearance of lumbar distending pain.Intravenous pyelography revealed no anastomotic obstruction.In 17 patients presenting the separation of the renal collective system,(B-ultrasonography) revealed a decrease from 2.0~4.2 cm(mean,2.8 cm) preoperatively to 1.0~2.3 cm(mean,1.5 cm) postoperatively.Conclusions The modified laparoscopic pyeloplasty simplifies the operation performance and shortens the operation time.

Objective To select the best condition of preparation process for the water-extraction and alcohol-precipitation method of Radix astragali in “Leifengguan” granules. Methods The effective compound astragaloside IV of Radix astragali was determined with the methods of TLC-scanning. The preparation process was screened with orthogonal design [L9(34)] and single factor analysis. Results The best condition of preparation process for water-extraction of Radix astragali was A3B2C2 that the drug materials were decocted for 3 times with 8 times amount of water, each time for 1 hour. After the solution was concentrated to proportion as 1 g/mL (drug materials/solution), alcohol was added to the solution to 60% alcohol. Conclusions The optimized preparation process was found to be stable with a good reproducibility.

Objective To compare the setup errors of two position fixation, head-neck-shoulders immobilization system and trunk immobilization system in radiotherapy for esophageal cancer, and to provide technical guidance for the fixed modes and determination of plan target volume (PTV) in the intensity modulated radiation therapy (IMRT) of esophageal cancer. Methods 97 thoracic esophageal cancer patients treated with radiotherapy were collected and divided into two groups: head-neck-shoulders group (51 patients immobilized with head-neck-shoulders immobilization system) and trunk group (the other 46 patients immobilized with trunk immobilization system). Before the weekly radiotherapy, all the patients received cone-beam CT (CBCT) scan to get the setup errors of X axis (left and right), Y axis (head and foot) and Z axis (front and back) on line. Results In the head-neck-shoulders group, the errors in X, Y and Z direction were (0.333 ±0.400) cm, (0.333 ±0.291) cm and (0.238 ±0.256) cm, respectively. In trunk group, the errors were (0.327±0.255) cm, (0.582±0.501) cm and (0.189±0.154) cm, respectively. There were statistically significant differences in the setup errors in Y axis and Z axis between the head-neck-shoulders group and the trunk group (P< 0.05). Conclusions In the radiotherapy for thoracic esophageal carcinoma, there is no difference in the X axis setup error between head-neck-shoulders system and trunk immobilization system. The Y axis setup error of head-neck-shoulders group is less than that of the trunk group. The Z axis setup error of trunk group is less than the head-neck-shoulders group.

Objective To analyze the clinical features of adult patients with acute intestinal obstruction secondary to Meckel's diverticulum and the experience in management of the disease.Methods The clinical data and pathological features of 9 patients with acute intestinal obstruction secondary to Meckel' s diverticulum were retrospectively analyzed. Results All patients were diagnosed with acute intestinal obstruction secondary to Meckel's diverticulum via abdominal cavity exploration and underwent surgical treatment. Before surgical treatment, 1 out of 9 patients was correctly diagnosed as acute intestinal obstruction secondary to Meckel's diverticulum, and the other 8patients were diagnosed as acute intestinal obstruction. Diverticulum was resected in 5 cases and the rest 4 cases received partial excision of small intestine including the diverticulum. Pathological examination showed that all patients had inflammatory changes in diverticulum. Some patients were complicated with mucosal erosion, small ulcers, bleeding or perforation. Forty-four percent (4/9) of diverticula contained ectopic tissue. All patients were cured. Conclusion Meckel's diverticulum is a rare cause of acute intestinal obstruction and preoperative diagnosis is difficult. Diverticulum,howere,is likelihood to develop strangulation or contains ectopic tissue, so that the surgical treatment should be performed early.

Objective To observe the effect of body-weight supported treadmill training (BWSTT) on the lower limb motor function of elderly hemiplegia patients with acute cerebral infarction using semi-quantitative analysis of regional cerebral blood flow (rCBF) through single photon emission computed tomography (SPECT). Methods Seven patients with cerebral infarction were given comprehensive rehabilitation therapy for 10 weeks in three stages: a baseline period of 2 weeks ( conventional rehabilitation therapy), an intervention period of 6 weeks ( conventional rehabilitation therapy plus BWSTT) and a withdrawal period of 2 weeks (conventional rehabilitation therapy). During the intervention period the exercise duration increased gradually from 15 to 30 minutes, once a day, 5 times a week,for 6 consecutive weeks. Dynamic changes in rCBF in the cortex were observed with SPECT before and after treat ment. Results During the baseline period there was no significant change in average MWS (maximum walking speed) or BBS ( Berg balance scale) scores. During the intervention period both scores improved significantly. During the withdrawal period there were some changes in MWS and BBS scores, but they were not significant. There was a significant change in average rCBF in the cortex after treatment compared with before. Conclusions BWSTT is effective for improving the walking speed and balance of elderly patients with acute cerebral infarction. There is a positive correlation between the recovery of lower limb motor function and changes in rCBF in the cortex.

Objective To explore the correlation between liver injury,fibrosis and levels of serum interleukin(IL)-18,transforming growth factor(TGF)-β1,and HBV DNA in patients with chronic hepatitis B(CHB).Methods Sixty-seven CHB cases were collected as experimental group and 20 healthy controls were enrolled as healthy control group.Serum levels of IL-18 and TGF-β1 were analyzed using enzyme linked immunosorbent assay(ELISA),and serum HBV DNA level was measured by fluorescent quantitative polymerase chain reaction(PCR).Liver biopsy was performed in 48 cases.Data analysis was done by variance analysis and data with heterogeneity of variance were analyzed by rank sum test.Partial correlation was employed to analyze the correlations between different data.Results The serum levels of IL-18,TGF-β1,alanine aminotransferase(ALT)and total bilirubin(TBil)were all higher in patients with hepatitis B and cirrhosis than those in controls(P<0.01).With the progression of liver injury,the levels of IL-18 and TGF-β1 were correspondingly increased,and the differences of TGF-β1 level between different groups were statistically significant(P<0.01),with the highest level in the patients with liver cirrhosis.There was no significant difference of the levels of ALT and TBil between the high and low viral load groups,but compared with control group,the differences were both significant(F=10.970,F=7.528;F=14.698,F=13.395;all P<0.05).TGF-β1 level gradually increased with fibrosis stage of CHB increasing from SO to S4,and there were significant differences between two stages except S3 and S4(P<0.01 or P<0.05).The difference of IL-18 level was only significant between SO stage and other stages.There was no significant difference of HBV DNA level among all stages. Partial correlation analysis indicated that IL-18 positively correlated with ALT and TBil(r=0.4806 and r=0.5047,respectively,both P<0.01).HBV DNA had no correlation with IL-18,TGF-β1,ALT and TBil.Conclusions Serum IL-18 and TGF-β1 levels play important roles in the progression of liver injury.Serum TGF-β1 level is correlated closely with post-hepatitis cirrhosis. Serum HBV DNA level is not significantly correlated with liver injury and fibrosis.