OBJECTIVETo compare the perioperative, functional and oncologic outcomes of patients with prostate cancer receiving laparoscopic radical prostatectomy (LRP) using three-dimensional (3D) versus two-dimensional (2D) imaging systems.

METHODSFrom February, 2014 to January 2016, 72 consecutive patients with clinically localized prostate cancer underwent LRP with 2D or 3D imaging systems performed by a single experienced surgeon. The baseline characteristics, perioperative data, and functional and oncologic outcomes of the patients were collected and analyzed.

RESULTSThirty-six patients underwent 3D LRP and the other 36 patients underwent 2D LRP. Compared with 2D LRP group, 3D LRP group had a significantly shorter operative time (167 vs 218 min, P<0.001), a smaller volume of intraoperative blood loss (86.11 vs 177.78 mL, P<0.001) and a better early urinary continence outcome (88.89% vs 63.89%, P=0.026). No significant differences were found between the two groups in terms of complications, potency outcome or biochemical recurrence-free rate.

CONCLUSIONCompared with 2D LRP, 3D LRP shortens the operative time, reduces intraoperative blood loss and is associated with a better early urinary continence outcome in patients with clinically localized prostate cancer.

OBJECTIVETo compare the short-term outcomes in patients with esophageal cancer after subtotal esophagectomy via thoracoscopy in prone position and in left lateral position.

METHODSBetween September 2008 and September 2010, thoraco-laparoscopic esophagectomy (TLE) with thoracoscopic mobilization of the esophagus and mediastinal esophagectomy was performed in 41 patients in prone position (group A) and other 41 patients (group B) performed by the same surgeon in left lateral position.

RESULTSPreoperatively, the endoscopic location of the tumor was in the upper third in 5 cases (2 vs. 3), the middle third in 21 cases (12 vs. 9), and the lower third in 56 cases (27 vs. 29). The median operative time was 230 (range 170-310) min in group A and 280 (range 190-380) min in group B (P=0.04). The median intraoperative blood loss was 275 (range 100-320) ml in group A and 360 (range 120-670) ml in group B (P=0.09). The median number of lymph nodes dissected was 8.4 (range 4-23) in group A and 6.9 (range 6-21) in group B (P=0.03). The postoperative complications totaled 6 (14.6%) in group A and 8 (17.1%) in group B (P=0.44). After a median follow-up period of 15.7 (range 2-28) months for group A and 16.3 (range 3-31) months for group B, 19 patients in group A died and 21 patients in group B.

CONCLUSIONSFor esophageal cancer under T3N1M0, surgical outcomes are similar between prone thoracoscopic esophageal mobilization and left lateral position. Prone position may be associated with better lymph node dissection.

Esophageal Neoplasms ; surgery ; Esophagectomy ; methods ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prone Position ; Retrospective Studies ; Thoracoscopy ; methods ; Treatment Outcome

OBJECTIVETo identify protein markers for the early diagnosis of pancreatic cancer by a comparative proteomic method.

METHODSComparative analysis on the pancreatic peripheral blood protein profiling from 20 pancreatic cancer patients, 10 chronic pancreatitis patients and 20 cancer-free controls from May 2007 to September 2008 was carried out by two-dimensional fluorescence electrophoresis (2D-DIGE). Differentially expressed proteins were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS). The significance difference proteins were confirmed by Western-blot.

RESULTSA differentially expressed proteins: complement 3 (C3) was identified. The gray level of C3 in pancreatic cancer tissue, chronic pancreatitis, and normal control group were 1.63 ± 0.28, 0.65 ± 0.13 (t = 11.81, P = 0.00) and 0.88 ± 0.19 (t = 9.93, P = 0.00), respectively. C3 was high expression in pancreatic cancer group compared with normal control group. The expression of C3 was higher in pancreatic cancer group than in chronic pancreatitis group. The high expression of C3 in pancreatic carcinoma was confirmed by Western blot.

CONCLUSIONS2D-DIGE and MALDI-TOF-MS technology is a quick, easy and practical method to screen for specific biomarkers in serum of patients with pancreatic carcinoma. The identified protein C3 in this study may be as specific serum biomarkers of pancreatic carcinoma.

Adult ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; blood ; Case-Control Studies ; Complement C3 ; analysis ; Early Diagnosis ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms ; blood ; diagnosis ; Pancreatitis, Chronic ; blood ; Proteomics ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ; Two-Dimensional Difference Gel Electrophoresis

OBJECTIVETo study changes in T lymphocyte subsets in preterm infants with intrauterine growth retardation (IUGR).

METHODSThe study enrolled 29 IUGR preterm infants, 38 preterm infants born appropriate for gestational age (AGA), and 20 healthy full-term infants. Peripheral blood was sampled during the first 24 hours of life, and again at a corrected age of 38 weeks of the preterm infants. T lymphocyte subsets were analyzed by flow cytometry, and absolute counts of leukocytes, total lymphocytes, and T lymphocytes were determined with an automated hematology analyzer.

RESULTSWithin the first 24 hours of life, percentages of CD3(+) and CD4(+) were lower in IUGR preterm infants than in AGA preterm infants and full-term infants (P<0.05), percentages of CD8(+) and CD4(+)/CD8(+) ratio were lower in IUGR preterm infants than in full-term infants (P<0.05), and percentages of CD3(+), CD4(+) and CD4(+)/CD8(+) ratio were lower in AGA preterm infants than in full-term infants (P<0.05). Moreover, the absolute counts of total lymphocytes were lower in IUGR preterm infants than in full-term infants (P<0.05); the absolute counts of T lymphocytes were lower in preterm infants, regardless of IUGR, than in full-term infants (P<0.05), and lower in IUGR infants than in AGA infants (P<0.05). At the corrected age of 38 weeks, percentages of CD3(+), CD4(+) and CD4(+)/CD8(+) ratio were increased in both IUGR and AGA infants as compared to the measurements within the first 24 hours of life (P<0.05), and percentages of CD3(+), CD4(+), CD8(+) and CD4(+)/CD8(+) ratio were lower in IUGR infants than in AGA infants (P<0.05), whereas there were no significant differences in counts of leukocytes, total lymphocytes and T lymphocytes between IUGR and AGA infants (P>0.05).

CONCLUSIONSThere may be a certain degree of compromise in cell-mediated immunity in preterm infants with IUGR and this compromise may last to 38 weeks after birth.

Female ; Fetal Growth Retardation ; immunology ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Male ; T-Lymphocyte Subsets ; immunology

AIMStudies on synthesis and antibacterial activity of new heterocycles.

METHODSThe cyclocondensation of [(3-pyridyl)-1,3,4-oxadiazol-2-yl] thio acetic acid with various aroyl hydrazines in the presence of POCl3 and xylene gave the corresponding titled compounds, and the in vitro antibacterial activity was primarily evaluated by the method of cupplate diffusion solution.

RESULTSSixteen novel titled compounds were synthesized, their structures were confirmed by IR, 1HNMR, MS and elemental analysis. Biological screening results demonstrated that most of the compounds prepared displayed potential antibacterial activity.

CONCLUSIONOxadiazoles incorporting pyridyl oxadiazole ring may be usefully antibacterial candidate drugs.

Anti-Bacterial Agents ; chemical synthesis ; chemistry ; pharmacology ; Escherichia coli ; drug effects ; Oxadiazoles ; chemical synthesis ; chemistry ; pharmacology ; Proteus vulgaris ; drug effects ; Staphylococcus aureus ; drug effects

BACKGROUNDSyncope is common in children and adolescents, with 15% estimated to have had at least one syncopal episode by age 18. In recent years, an increasing number of children, especially girls at their school age, have developed unexplained syncope. The mechanism of an unexplained syncope exhibited by children is incompletely studied; the association between different hemodynamic patterns and clinical features is also not clear. The aim of the study was to investigate the hemodynamic patterns of children with unexplained syncope and to examine the clinical relevance.

METHODSTwo hundred and eight children [87 boys, 121 girls, aged 3 - 19 years, mean (11.66 +/- 2.72) years] were selectively recruited from May 2000 to April 2006 when they presented syncope as their main complaint at the Multi-center Network for Childhood Syncope in Beijing, Hunan Province, Hubei Province, and Shanghai of China. All of the patients underwent head-up tilt tests; data were analyzed using SPSS version 10.0 for Windows. Continuous variables were expressed as the mean +/- standard deviation. Dichotomous variables were compared through a chi(2) test. A value of P < 0.05 (two sided) was regarded as statistically significant.

RESULTSThe age distribution of children with syncope was approximately normal. Head-up tilt tests was positive in 155 children, and the incidence of positive response of the baseline head-up tilt test for diagnosing unexplained syncope was 50.48%. The sensitivity value and diagnostic value of sublingual nitroglycerin head-up tilt test were both 74.52%. The hemodynamic pattern was normal in 53 children. The 155 children, who were positive in head-up tilt tests, showed signs of postural orthostatic tachycardia syndrome (60, 28.8%), the vasoinhibitory pattern (72, 34.6%), the cardioinhibitory pattern (5, 2.4%), and the mixed pattern (18, 8.7%). The gender distribution between the two age groups (age < 12 years vs age > or = 12 years) was not different (P > 0.05). The distribution of hemodynamic patterns between the children of the two age groups (age < 12 years vs age > or = 12 years), and the children with different complaints (dizziness vs syncope) was significantly different (P < 0.05), while the distribution between the children of different sexes and different lasting time of syncope (< or = 5 minutes vs > 5 minutes) was not significantly different (P > 0.05). Different hemodynamic patterns were differentiated by differing syncope inducements, presymptoms, and complicated symptoms during and after syncope.

CONCLUSIONThe tested girls were more prone when compared with the boys to have unexplained syncope, and the peak age was around twelve years old. The incidence of positive response of head-up tilt tests was also relatively higher for the girls. The distribution of hemodynamic patterns for different ages was different. For children with unexplained syncope, we should use head-up tilttests to distinguish the hemodynamic patterns in order to adopt rational therapeutic measures.

Adolescent ; Adult ; Blood Pressure ; Child ; Child, Preschool ; Female ; Humans ; Male ; Reflex ; Sex Characteristics ; Syncope ; diagnosis ; physiopathology ; Tilt-Table Test

OBJECTIVETo construct a RNA interference vector for human tissue factor (TF) gene.

METHODSHuman TF short hairpin RNA (shRNA) sequence was designed using online design software (Invitrogen) and synthesized into double-strand oligonucleotide (ds oligo), which was cloned into the pENTRTM/U6 plasmid, followed by transformation of the product into competent Top10 E. coli cells. After expansion of the transformed bacteria, the plasmid was extracted and sequenced, which was subsequently transfected into human umbilical vein endothelial cells (HUVECs). The interference effect of the vector on the target gene expression was detected by RT-PCR and immunofluorescence assay.

RESULTSThe sequencing result indicated that the plasmid pENTRTM/U6-RelB-shRNA was constructed correctly, which resulted in effective inhibition of TF expression in HUVECs after transfection.

CONCLUSIONThe RNA interference vector against human TF gene has been constructed successfully, which may provide a stable transfection vector for potential treatment of blood coagulation abnormalities.

Base Sequence ; Cell Line ; Genetic Engineering ; methods ; Genetic Vectors ; genetics ; Humans ; Molecular Sequence Data ; Oligonucleotides, Antisense ; genetics ; RNA Interference ; RNA, Small Interfering ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Thromboplastin ; deficiency ; genetics ; Transfection

OBJECTIVETo study the anatomy of peroneal tendofascial flap combined with adipofascial flap for the repair of heel tissue defects.

METHODSThe lower extremities of five cadavers (10 sides) were perfused with red latex, the blood supply of peroneal tendofascial flap and vicinity adipofascial flap were observed. The diameter, course, branches and location of the blood vessels were measured. Eight fresh cadavers (16 sides) were perfused with lead oxide-gelatine mixture. The covering fascia tissues of the lower extremities was obtained and photographed by X-ray. The vascular anastomosis and association of nutrient vessel of peroneal tendofascial flap and vicinity adipofascial flap were observed. Two adult lower extremities specimens (4 sides) were used to construct vessel diagrams for observation of the course, distribution and anastomosis of the vessels. Eight cases were treated successfully with theses flaps.

RESULTSThe blood supply of the combined fascial flap is multi-originated. For the area within 4 cm below and above the lateral malleolus cusp, the blood supply includes 2-5 branches from heel lateral artery with an average diameter of (0.5 +/- 0.2) mm, 1-2 branches from posterior lateral malleolus artery with an average diameter of (0.6 +/- 0.2) mm and 2-3 branches from the descending part of perforating branches of peroneal artery with an average diameter of (0.5 +/- 0.2) mm. The blood supply of area 4 cm above lateral malleolus cusp is 1-3 branches from intermuscular septum perforating branches of peroneal artery with an average diameter of (1.0 +/- 0.2) mm. These above branches are anastomosed each other and also send off many smaller branches to form vascular net around tendon. The fascial flaps and free skin grafts in eight patients were completely survived. All patients were followed up for 3-24 months, the donor and recipient sites were healed very well. The functional and cosmetic results were satisfactory.

CONCLUSIONSPeroneal tendofascial flap combined with adipofascial flap, with proximal pedicle or reverse distal pedicle, can be used to repair the defect at the lower leg and refractory small- and medium-sized defects at the heel.

Adipose Tissue ; anatomy & histology ; transplantation ; Adult ; Aged ; Fascia ; anatomy & histology ; transplantation ; Female ; Fibula ; Heel ; injuries ; surgery ; Humans ; Male ; Middle Aged ; Muscle, Skeletal ; anatomy & histology ; transplantation ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; Surgical Flaps

BACKGROUND:Internal and external fixation combined with autologous bone graft for treating atrophic nonunion has a long treatment cycle,and moreover,it cannot achieve a 100％ cure rate.Platelet-rich plasma contains a variety of growth factors and a large number of white blood cells,and contributes to tissue healing.However,there is no clinical study on the effectiveness of platelet-rich plasma combined with conventional surgery in the treatment of atrophic nonunion.OBJECTIVE:To investigate the effectiveness of platelet-rich plasma in the treatment of atrophic nonunion of femoral shaft fractures.METHODS:We conducted a prospective,open-label,randomized,controlled clinical trial at the Affiliated Hospital of Qinghai University,China.Ninety-two patients with atrophic nonunion of femoral shaft fractures were equally and randomly divided into control group and experimental group.Patients in the control group received conventional surgery.Patients in the experimental group were injected with autologous platelet-rich plasma on the basis of conventional surgery.The primary outcome was fracture healing rate at postoperative 9 months.The secondary outcomes were visual analogue scale scores in resting state and during passive motion,healing time,treatment costs,and adverse reactions.The study protocol was approved by the Ethics Committee of Affiliated Hospital of Qinghai University of China (approval number:QHG0223A) on May 20,2014.Written informed consent was provided by each patient and their family members after they fully understood the treatment plan.RESULTS AND CONCLUSION:Our partial results demonstrated that visual analogue scale scores and complications were similar between the two groups at postoperative 1-3 days.The healing rate was significantly higher in the experimental group than in the control group.The healing time was significantly shorter in the experimental group than in the control group.This trial will provide objective data for the clinical use of platelet-rich plasma combined with conventional surgery for the treatment of atrophic nonunion.

OBJECTIVETo evaluate the safety and outcome of patients with acute myocardial infarction (AMI) transferred for primary percutaneous coronary intervention (PCI).

METHODSData from patients with ST elevation AMI urgently transferred from first admitted hospitals to our cath-lab to receive primary PCI were analyzed. According to time intervals from symptom onset to transfer, the patients were divided into early transfer (< 6 h, n = 26), delayed transfer (6 - 24 h, n = 39) and late transfer (24 h to 1 week, n = 18) group. The major cardiac events during transfer periods and one month after PCI were obtained and echocardiogram and left ventricular systolic functions were compared among groups.

RESULTSThere was no serious cardiac event during transfer period and all 83 patients received primary PCI with a mean transfer-to-balloon time about 180 minutes. Success rate of PCI was 92.3% in early transfer group, 89.7% in delayed transfer group, and 94.4% in late transfer group (P > 0.05). At one month follow-up after PCI, 0, 10.3% and 16.7% of patients developed heart failure in early, delayed transfer and late transfer group respectively (P > 0.05 vs. early), the LVEF of early transfer group (53.2% +/- 9.7%) was also significantly higher than delayed transfer group (48.6% +/- 8.2%, P < 0.05) and late transfer group (43.1% +/- 10.3%, P < 0.01).

CONCLUSIONSTransfer patients with AMI for primary PCI is safe in the observed time intervals during acute phase. Early transferred patients are associated with better outcome at 1 month post PCI compared to delayed and late transferred AMI patients.

Aged ; Aged, 80 and over ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; physiopathology ; therapy ; Patient Transfer ; Safety ; Treatment Outcome