Objective:To investigate the impact on ovarian reserve function with two different homostatic methods during laparoscopic cystectomy in treatment of endometrioma.Methods:Eighty four cases with unilateral ovarian cysts which located outside of hilum of ovary undergoing laparoscopic surgery were enrolled in the study. Based on hemostasis method, all patients were divided into 2 groups. Study group included 40 cases in ultrasonic scalpel hemostasis. Control group included 44 cases with suture after excision of endometrioma. Before surgery and the 1st, 3rd cycle after surgery, serum FSH, LH and AMH, and ultrasound basal AFC and PSV were examined and compared.Results: The level of FSH, LH, AMH, AFC and PSV had significant difference between before surgery and after surgery 1st, 3rd. The level of FSH, LH, AMH, AFC and PSV had significant difference within group comparisons after surgery 1st, 3rd. The level of serum FSH and LH in study group were lower than these in control group after surgery 1st. The level of serum AMH in study group were higher than in control group after surgery 3st. The level of serum PSV in study group were higher than in control group after surgery 3st.Conclusion: Ovarian reserve function was decresed heavier in ultrasonic scalpel hemostasis during laparoscopic excision of ovarian endometrioma than in suture. Electrocoagulation of the ovarian tissue should be avoided.

Objective To discuss two simulation studies on the closed and open peritoneum in abdomenal operations. Meth-ods We selected 120 domestic female rabbits from animal laboratory of Qi Qi Ha’er Medical College at random and divided them into four groups(according to whether the peritoneum was open or not,the degree of peritoneum defect at the right side of incision and the existence of peritoneum hemorrhagic focus ),with 30 cases in each group. Group Ⅰ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision; Group Ⅱ: no peritoneum suture and making a defect of 4cm?3cm at the right side of the incision,with a hemorrhagic focus at peritoneum defect;Group Ⅲ: with peritoneum suture; Group Ⅳ:with dense and compact peritoneum suture.And then we analyzed postoperative peritoneum healing progress. Results Observeations of the incision infection by the naked eye were that one case was identified in group Ⅰ,Ⅲ and Ⅳ;and a significant difference of occurrence rate was identified between the fallowing groups: groupⅠandⅡ(P

AIM: To study the relationship between expression of ? 3 integrin, focal adhesion kinase (FAK) and migration of vascular smooth muscle cells (VSMC) stimulated by osteopontin (OPN) and fibronectin (FN).METHODS: VSMC migration was examined using a model of wounding injury of confluent cultured cells. The expression of ? 3 integrin, FAK and Gax genes in VSMC were detected using Western blotting and RT-PCR. RESULTS: OPN and FN induced the migration activity of VSMC in a time-dependent manner ( P

Objective To investigate the related mechanism of ligamentum flavum (LF) hypertrophy in diabetic pa-tients with lumbar spinal canal stenosis ( LSCS ) .Methods Twenty-four diabetes mellitus patients [ DM (+) ] and twenty normoglycemic patients [ DM (-) ] with LSCS were enrolled in this study .Sorbitol in LF was analyzed using D-Sorbitol/Xylitol test kit .The thickness of LF was measured by CT .The structure of LF was observed after HE and Masson's trichrome staining .The cell cycle and proliferation of fibroblastic cell NIH 3T3 line cultured in high glucose were analyzed .Sorbitol of NIH3T3 was detected under different backgrounds in vitro, normal glucose , high glucose and high glucose burdened with aldose reductase inhibitor ( ARI) , Epalrestat .The expression of inflammatory factors was detected by qPCR and Western blot under above different backgrounds .Results LF of diabetic patients exhibi-ted significantly higher level of sorbitol and pro-inflammatory cytokines , TGF-βand of CD68-positive staining than that of the normoglycemic subjects ( P<0.01 ) .The diabetic LF was significantly thicker than that of the controls , and showed evidence of degeneration .The high glucose-cultured fibroblasts exhibited significantly higher levels of sorbitol , pro-inflammatory factors , and TGF-βcompared to the low glucose-cultured cells , and these levels were dose-dependently reduced by treatment with the aldose reductase inhibitor (P<0.05).Conclusions Sorbitol level of the LF is significantly increased in the DM patients with LSCS .Increased sorbitol recruites inflammatory factors and fibrogenic-related factor TGF-βin LF of DM patients with LSCS which may contributes to the LF hypertrophy .

BACKGROUND: It is necessary to keep a good cervical curvature for improving nerve symptom in patients with cervical spondylotic myelopathy (CSM). It is verified that cervical anterior plate internal fixation implant is effective to restore the physiological curvature of cervical vertebra.OBJECTIVE: To assess the physiological lordosis of cervical vertebra in CSM patients after cervical anterior plate internal fixation implantation.DESIGN: Observational study.SETTING: First Affiliated Hospital of Nanchang University.PARTICIpANTS: Totally 72 CSM patients were enrolled at Department of Orthopaedics, First Affiliated Hospital,Nanchang University from February 2003 to January 2006, including 46 males and 26 females, aged 45-70 years,averagely 54 years, with the history of 2-6 years. Inclusive criteria included ①cervical spinal cord compression shown in MRI, and ②using autogenous iliac bone. The experiment was approved by Hospital Ethics Committee, and all patients signed the informed consent. Cervical anterior plate was Orion locking plate offered by Shufamo Company. There were single segmental discectomy group (n =32) and two-level segmental discectomy group (n =40) according to experimental requirement.METHODS: ①Anterior decompression plus autogenous iliac bone implant plus titanium plate internal fixation were utilized.The patients were in supine position; shoulder and back were blocked up; neck backward, and endotracheal tube was done under general anesthesia. Transverse or oblique incision was made at right anterior neck. Discectomy decompression was performed with Caspar vertebra ecarteur. Three-dimensional autogenous iliac bone was implanted in decompressed intervertebral space. Immediate stability was obtained after Orion locking titanium plate was fixed, with placement drainage, and then the incision was sutured. ②Postoperative daily activities were conducted with cervical gear, which was removed 8 weeks later. ③Lateral cervical vertebrae X-rays were taken before operation, immediately after operation, 6 and 12 months after operation. Lordosis of the fusion segment was measured with Cobb's angle, and lordosis of cervical vertebra was assessed with D value. These data were analysed by statistic software. ④Bone fusion of the patients was followed up for 12 months after operation. Vertebral fusion standards included no abnormity between two spinous processes of the fusion segment, no lucency between implant and vertebra, as well as bone trabecula across the interface between implant bone and vertebra. ⑤Biocompatibility between material and host was observed during follow-up.MAIN OUTCOME MEASURES: ①Changes of Cobb's angle and D value at different time points before and after operation,and ②Bone fusion and rejection were followed up.RESULTS: Totally 72 patients were involved in the result analysis. ①Cobb's angle was larger and D value was higher immediately after operation, 6 and 12 months after operation than those before operation in the single segmental discectomy group and the two-level segmental discectomy group (P＜0.05). ②Findings of 12-month follow-up showed that bone fusion appeared in all patients of the two groups. ③No significant rejection was found after titanium plate internal fixation implantation. It was found that material and host had a good biocompatibility.CONCLUSION: It is satisfactory to restore physiological lordosis of cervical spine by using cervical anterior plate internal fixation plus autogenous iliac bone for CSM.

[Summary] Type 2 diabetic rat model accompanied by insulin resistance was established by high fat/high glucose diet and streptozotocin.Following metformin treatment for 4 weeks,realtime PCR and Western blot were used to detect the expressions of SIRT3 mRNA and protein in skeletal muscle tissue,respectively.The results showed that insulin sensitivity,superoxide dismutase (SOD),and glutathione (GSH) levels were significantly reduced in diabetic group compared with the control group (P＜0.05),while methane dicarboxylic aldehyde (MDA) level was increased (P＜0.05),along with the decreased expressions of SIRT3 mRNA and protein in skeletal muscles (P＜0.01).After metformin treatment,the insulin sensitivity,SOD,GSH,and SIRT3 mRNA and protein levels were significantly increased (P＜ 0.05 or P＜ 0.01),while MDA level was decreased (P ＜ 0.05),suggesting that metformin may ameliorate insulin resistance via upregulating SIRT3 expression in skeletal muscles of diabetic rats.

Objective To study the expressions of progesterone receptor A (PRA) and B (PRB) in breast cancer and adjacent non-malignant tissues and the correlations between their expressions and the clinical characteristics. Methods The expressions of PRA and PRB in 50 specimens of female human breast cancer and adjacent non-malignant tissues were detected by immunohistochemistry. The correlations between the expressions of PRA and PRB and the clinical characteristics were analyzed.Results PRA and PRB expressed in both the nuclei and the cytoplasma of tumor cells and epithelial cells of the acini and ducts.The percentages of PRA and PRB positive cells were 42%,42% and 52%,36% in the cancer and the adjacent non-malignant tissues,respectively,there was no significant difference.The expression of PRA was significantly correlated with the age of patient(r=-0.316 8,P

AIM: To investigate whether the expression of integrin ?_3 and the activation of focal adhesion kinase(FAK) are involved in neointima formation after de-endothelium.METHODS: The model of intima hyperplasia was prepared by balloon injury.The levels of osteopontin(OPN),integrin ?_3 and FAK in vascular tissue were detected by Western blotting and immunohistochemistry.RESULTS: There were similar expression patterns in OPN,integrin ?_3 and FAK following balloon injury.The levels of three proteins were markedly increased 3 days after operation and reached the peak at 7th day.The increased FAK was mainly the phosphorylated form.The migration and proliferation of vascular smooth muscle cells was associated with the increase in the expression of integrin ?_3 and FAK,and was parallel with rapid turnover of extracellular matrix(ECM).CONCLUSION: The interaction of cells with ECM mediated by OPN and integrin ?_3 is essential for migration.The integrin ?_3-FAK pathway is involved in neointima formation.

OBJECTIVE: To develop a method of HPLC/MS/MS to determine phenacetin and paracetamol in rat liver microsomal incubation system. METHODS: Samples were separated on XTerra MS C18 column, different ratios of methanol- 0.1% formic acid were used as the gradient eluent, and the flow rate was 0.2mL?min-1. The electrospray ion-quadrupole mass spectrometry and multiple reaction monitor were adopted to detect the concentration of phenacetin and paracetamol. RESULTS: The calibration curves were linear in the ranges of 45～9 000ng?mL-1(r=0.999 8)and 15.2～1 520ng?mL-1(r=0.999 6) for phenacetin and paracetamol respectively; The lowest limits of assay were 9ng?mL-1 and 10ng?mL-1.The average recoveries at three concentrations of phenacetin were (96.2?2.3)%～(98.3?2.4)% and those of paracetamol were (99.6?2.1)%～(100.2?2.6)%; RSD of the intra-day and inter-day were less than 5%. CONCLUSION: The method is rapid, sensitive and suitable for determination of phenacetin and paracetamol in rat liver microsomal incubation system.

Objective To discuss the design of pedicled thoracodorsal artery perforator flap (TDAP flap),and to evaluate the aesthetic results and donor-site complications for immediate partial breast reconstruction (IPBR) after breast conserving surgery (BCS) for breast cancer patients.Method Clinical data of 13 breast cancer cases treated with BCS + IPBR using TDAP flap from November 2004 to November 2010 were retrospectively analyzed.Perforators were identified with Doppler preoperatively in all patients.Results All perforators originated within a median distance of 8.0 cm ( range,7.5 to 9.5 cm) from axillary plica at the posterior line of axilla.Median area of the flaps was 6.0 × 8.0 cm ( range,5.0 × 7.0 cm to 8.0 × 10.0 cm).One flap was muscle-sparing,while a small muscle strip was left embedding the perforators in other twelve flaps to increase the reliability of the vascular pedicle.Postoperatively patients were followedup from 4 to 71 months.Median follow-up time was 41 months.Flap necrosis and seroma in the donor-site were not found in all patients.Aesthetic results were graded as excellent or good in 9 patients,fair in 3,and poor in one.Conclusions TDAP flap is a good choice for IPBR after BCS for breast cancer patients whether lesions in outer quadrants or inner quadrants,especially for those patients with excisional biopsy.Preoperative mini-Doppler is helpful for determining the precise location of the main perforators,and decreasing the risk of vessels injury.