Objective:To evaluate the feasibility and clinical efficacy of retroperitoneal laparoscopic nephronsparing surgery for renal cell carcinoma of the early stage.Methods:Between June 2003 and June 2008,53 patients (31 males and 22 females) with renal mass were selected to undergo wedge resection of the tumor through retroperitoneal laparoscopy.Spiral computerized tomography (CT) and color Doppler ultrasound were used to provide information for nephron-sparing surgery (NSS).Patients with small (≤3 cm),peripheral,shallow and exophytic tumors,at a distance which exceeded approximately 10 mm between the tumor and renal collecting system,were enrolled into our studies.Surgical resection was performed along a resection line about 0.5 cm from the tumors.Results:All procedures were technically successful.Mean operating time was 96 min (ranging from 75 to 110 min).Mean warm ischemia time was 15 min (ranging from 10 to 21 min).Mean estimated blood loss was 70 m L (ranging from 40 to 120 mL).Mean hospital stay after the surgery was 4.2 days (ranging from 3 to 6 days).No intraoperative or postoperative complications occurred.Of 53 patients,52 had negative surgical margins and a 63-year male patient had a positive surgical margin.Neither local recurrence nor trocar-site metastasis was observed in the 53 patients during followups averaging 39 months (ranging from 11 to 83 months).Conclusion:Under the modified techniques of the surgery and conservative criteria for patient selection,laparoscopic partial nephrectomy can be safely and effectively performed and satisfactory outcomes are achievable.

Objective To explore the expressions of stromal cell derived factor 1 α (SDF-1α) and cysteine-X-cysteine chemokine receptor 4 (CXCR4) in the peripheral blood of patients with systemic lupus erythematosus (SLE).Methods Forty hospitalized SLE patients were recruited and twenty healthy volunteers were enrolled as normal controls.The percentage of CD3+CD4+CXCR4+,CD3+CD8+CXCR4+ and the plasma concentration level of SDF-1α in the control group and SLE patients were detected by flow cytometry and ELISA.The relationship between SDF-1α/CXCR4 and SLEDAI was explored.Kruskal-Wallis H,Pearson's and Mann-Whitney U test were used for statistical analysis.Results the expression of SDF-1α [329 (127,539) pg/ml] and CXCR4 [CD3+CD4+CXCR4+:4.20(2.01,6.35)％,CD3+CD4+CXCR4+:2.70(1.68,4.20)％] were significantly elevated in SLE patients when compared to the normal controls (Z=-6.277,-5.707,-4.885,respectively,all P=0.000),and were significantly increased in highly active SLE patients than less active SLE (Z=-5.414,-5.256,-5.312,P＜0.01).The expression of SDF-1α and CXCR4 in the butterfly erythema group,anemia group and proteinuria group were significantly higher than the normal group (P＜0.05).Both SDF-1αand CXCR4 were positively correlated with SLEDAI (r=0.857,0.830,0.861,respectively,all P＜0.01).Conclusion The expressions of SDF-1α and CXCR4 increase significantly in the peripheral blood of SLE patients and there is close relationship between SDF-1α/CXCR4 and disease activity,organ damage.The results of this study suggestthat SDF-1α/CXCR4 may play an important role in the pathogenesis of SLE.

Objective To explore the clinic value and efficacy of color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation for secondary hyperparathyroidism. Methods Fifty-six cases of secondary hyperparathyroidism who came from nephrology department of Beijing Friendship Hospital in the period of September 2012 to September 2013 were treated by color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation. One hundred and thirty-eight glands underwent this treatment and were evaluated by contrast enhanced ultrasound before, during and after operation. The levels of serum parathyroid hormone (PTH) were measured before and at 1 week, 1 month, 6 months and 1 year after treatment. Results The whole 56 cases achieved 1 month follow-up and 34 cases and 12 cases achieved 6 months and 1 year follow-up, respectively. Two special cases had been excluded. The PTH levels of 54 cases were signiifcantly different between after and before treatment [(369.5±183.4) ng/L vs (1321.6±471.4) ng/L, t=10.727, P=0.000]. The PTH levels continued to fall at the ifrst week after treatment, but there was no statistical signiifcance between the ifrst week and the ifrst day after treatment [(324.6±172.8) ng/L vs (369.5±183.4) ng/L], while there was signiifcantly different between the ifrst week after treatment and before treatment [(324.6±172.8) ng/L vs (1321.6±471.4) ng/L, t=9.364, P=0.000]. The PTH levels increased from (324.6±172.8) ng/L to (332.5±164.9) ng/L at 1 week and 1 month after ablation, while there was no signiifcant difference.But there is signiifcantly different between 1 month after treatment and before treatment (t=11.348, P=0.000). The PTH level at 6 months after treatment [(205.2±136.3) ng/L] and 1 year after treatment [(177.1±171.5) ng/L] had signiifcant difference compared with the value before treatment (t=8.737, P=0.000; t=7.655, P=0.017). Conclusion Color Doppler ultrasound guided percutaneous microwave/radiorequency thermoablation can be considered as a feasible and effective nonsurgical alternative treatment for secondary hyperparathyroidism patients.

Objective To study the effect of modified sensorimotor training (SMT) method on standing ba- lance of the stroke patients during their recovery stage. Methods Sixty stroke patients at recovery stage were ran- domly divided into an intervention group and a control group. The intervention group was trained by modified SMT method which combined Thera-band with partial body weight support (PBWS) system, while the control group was trained only with their standing balance in the parallel bars based on the neurodevelopment therapy (NDT) method. Both groups were given the same medications as well as physical therapy, acupuncture and OT. The patients in the two groups practiced standing balance in front of a mirror daily, 40 minutes every day and 6 days every week for 4 weeks. The balance abilities of patients were evaluated by Berg balance scale (BBS) , and their lower extremity func- tions were assessed by simplification Fugl-Meyer assessment (FMA). Results After training, both groups showed significant improvement in BBS and FMA ( P

Objective To study the relationship between transforming growth factor-β1 (TGF-β1), transforming growth factor-β receptor Ⅰ (TGF-βRⅠ) and high concentration iodine in promoting fibroblast proliferation so as to explore the pathogenesis of the membranous formation in Budd- Chiari syndrome. Methods The experiment included five groups: blank control group, solvent group, KI group, TGF-βRⅠinhibitor group (SD-208) and SD-208 plus KI combination group. ① Fibroblasts were cultured in high content of iodine and treated with TGF-βRI inhibitor then the fibroblast proliferation activity was determined by CCK-8 assy.②The protein expressions of TGF-β1 and TGF-βRⅠof fibroblasts in different concentrations of iodine (0, 250, 500, 1 000, 2 000 and 3 000 ug/L) were determined by Western-blot method. Results ①When the culture solution was of 1 000 ug/L iodine concentration, the cell proliferation rate of the SD-208 plus KI combination group (A:1.29 ± 0.41) was significantly higher than that of the control group (0.52 ± 0.10), but significantly lower than that of the KI group(1.70 ± 0.03) with P < 0.05. ② Fibroblast TGF-β1 protein relative expression levels in the groups with the iodine concentration of 1 000 ug/L and 2 000 ug/L were significantly higher than those of the other groups (P < 0.05). No significant difference in fibroblast TGF-βRⅠ protein relative expressions existed between each other groups (P > 0.05). Conclusion ①High concentration of iodine may promote the proliferation of fibroblasts through raising TGF - β1 protein expression. ② The proliferation of fibroblasts caused by high concentration of iodine may be related to the membranous formation in Budd-Chiari syndrome.

Objective:To evaluate the efficacy and safety of tirofiban,a platelet glycoproteinⅡb/Ⅲa Inhibitor,in percutaneous coronary intervention(PCI)of patients with acute non-ST segment elevation myocardial infarct(NSTEMI).Methods:A total of 114 patients with acute NSTEMI were enrolled in the trial from Sep.2005 to Jan.2007;they were randomly divided into 2 groups:tirofiban group(n=57)and placebo group(n=57).Patients in tirofiban group were given tirofiban for 24 h after PCI.All patients were routinely given heparin,aspirin and clopidogrel before CPI.The composite occurrence of death,myocardial infarction(MI),need for target vessel revascularization(TVR)after PCI,and the adverse effects(hemorrhage and thrombocypenia)were compared between the 2 groups.Results:One(1.8%)patient had angina pectoris and the other(1.8%)developed subacute thrombus in control group within 24 h after PCl;there was no such event in the tirofiban group.Two(3.6%)patients developed angina pectoris and 2(3.6%) developed subacute thrombus within 30 days after PCI in control group;one patient(1.8%)in birofiban group developed angina pectoris and one patient in birofiban group developed subacute thrombus.Each group had one case(1.8%)of upper digestive tract bleeding during hospitalization.No intracranial hemorrhage,skin/ mucosa hemorrhage,thrombocytopenia,or-death occurred in the 2 groups.Intravenous tirofiban treatment reduced the composite occurrence of death of NSTEMI patients after PCI(P

Objective To investigate the protective effect of pretreatment with Shenfu injectio(SFI)on myocardium against ischemia-reperfusion(I/R)injury in diabetic rabbits.Methods Forty healthy adult male rabbits weighing 2.4-3.2 kg were used in this study.Type I diabetes mellitus was induced by intravenous alloxan 120 mg?kg~(-1) and confirmed by fasting blood glucose＞11.1 mmol?L~(-1).The animals were randomly divided into 5 groups(n=8 each):groupⅠsham operation;groupⅡI/R and groupⅢ,Ⅳ,ⅤSFI+I/R.I/R was produced by occlusion of the anterior descending branch of left coronary artery(LAD)for 60 min.The occlusion of LAD was then released for reperfusion.In sham operation group(Ⅰ)LAD was exposed but not occluded.In groupⅢ,ⅣandⅤSFI 5,10 and 15 ml?kg~(-1) was givenⅣrespectively 30 min before myocardial ischemia.MAP,HR,left ventricular developed pressure(LVDP),?dp/dt_(max),left ventricular end-diastolic pressure(LVEDP)and Vmax were recorded immediately before ischemia(T_0,baseline),at 5 min of ischemia(T_1),immediately before reperfusion(T_2)and at 5,15,60,90,120 min of reperfusion(T_(3-7)).The animals were killed and hearts removed for determination of infarct size and microscopic examination of the ultrastructure of LAD using transmission electron microscope.Results MAP,HR,LVDP,?dp/dt_(max) and Vmax were significantly decreased while LVEDP was significantly increased during reperfusion as compared to the baseline values at T_0 in I/R group. I/R produced myocardial infarct and damage to the endothelial cells of LAD.The harmful effect of I/R was attenuated by different doses of SFI.SFI 10 ml?kg~(-1) provided best effect.Conclusion Pretreatment with SFI can protect the myocardium against I/R injury in diabetic rabbits.SFI 10 ml?kg~(-1) produces better effect.

Objective To study the effect of balloon dilatation therapy on dysphagia caused by cricopharyn- geal achalasia.Methods Ten cases of dysphagia were diagnosed as cricopharyngeal achalasia by videofluoroscopic swallowing study(VFSS).A 14~* urethral catheter was inserted into the esophagus and an amount of water was injec- ted into the balloon of the urethral catheter to make it turgid.Then the catheter was pulled upwards and passed through the stricture of esophagus to dilatate the cricopbarygeus muscle.Meanwhile,low frequency electrical stimula- tion was used and combined with functional training of the organs related to deglutition and ingestion.The results be- fore and after the treatment were evaluated.Results After 19.7 times of dilatation therapy,the content of water in- jected into the balloon was increased from 2.65?0.91 ml to 8.20?0.92 ml.Cricopharyngeal achalasia was alle- viated significantly(P

Objective To study the incidence and risk factors of infection caused by methicillinresistant staphylococcus aureus (MRSA) with a targeted surveillance at intensive care unit (ICU) acquired MRSA infection in Tianjin area.Methods A prospective multi-center observational analysis of consecutive patients admitted to 15 adult ICUs from March 1,2012 through March 31,2014 was carried out.The ICUs were divided into four groups according to the type of the ICU.All of the patients were cared for with routine MRSA surveillance.A number of risk markers and prognostic factors were recorded.The risk factors contributing to ICU acquired MRSA were evaluated using a logistic regression model.Comparison of survival between groups was analyzed with Kaplan-Meier method.Results A total of 1 787 patients were enrolled,and 144 cases of them were MRSA infections.The patients with MRSA infection were significantly older than those with non-MRSA infection (P =0.043),length of ICU stay,length of antimicrobial therapy,the history of repeated administration of antibiotics in recent days,history of operation in the past five years,history of MRSA infection or colonization,frequent application of and the overall length of time for mechanical ventilation and central venous catheter and catheter-associated infection were significantly higher than those with non-MRSA infection.The survival rate of patients with non-MRSA infection were higher than those with MRSA infection (x2 =9.23,P =0.004).The rate of MRSA infection and MRSA colonization in 2013 were significantly lower than that in 2012,because the rate of hand hygiene rule execution and bacterial clearance rate were significantly higher in 2013.Multivariate Logistic regression analysis demonstrated that advanced age (OR =1.05,95％ CI:1.009-1.086),length of ICU stay (OR =1.05,95％ CI:1.01-1.08),history of MRSA infection or colonization (OR =1.33,95％ CI:1.82 -3.27),glucocorticoid therapy (OR =2.85,95％ CI:1.18-6.91),antacid medicine (OR =4.92,95％ CI:1.18-20.58),history of recent or repeated application of antibiotics (OR =3.26,95％ CI:1.06-4.59) catheter-associated infections (OR =2.22,95％ CI:1.08-4.59) were associated with ICU acquired MRSA infections.Conclusions Performing the rule of hand hygiene strictly as well as strengthening prevention and control of MRSA infections can effectively reduce the incidence of ICU acquired MRSA infections.The advanced age,length of ICU stay,history of MRSA infection or colonization,glucocorticoid therapy,antacids medicine,history of recent or repeated application of antibiotics,catheterassociated infections were independent risk factors of ICU acquired MRSA infections.

A reverse transcription polymerase chain reaction (RT-PCR) and single-strand conformation polymorphisms (SSCP) assay were applied to rapidly detect the molecular variability in CP and SP genes among seven isolates of Rice stripe virus in China. The PCR results showed that the CP gene of JD isolate and SP gene of PJ isolate could not be amplified. SSCP analysis showed that there were completely different electrophoretic pattern of CP gene among six isolates. To SP gene, SSCP results also discovered polymorphisms. There were five patterns among these isolates, and the pattern of YL and BS isolates were same.