OBJECTIVETo study the effect of Compound Ezhu Powder (CEP) on serum levels of CA125 and CA19-9, and the expression of cyclin D protein in endometriosis patients, thus providing theoretical evidence for clinical application of CEP.

METHODSTotally 69 all endometriosis patients underwent surgical treatment at Department of Gynecology and Obstetrics, Tianjin Nankai Hospital from January 2011 to January 2013 were randomly assigned to group A (35 cases) and group B (34 cases). Meanwhile, 30 patients with uterine fibroids who prepared for surgical treatment during the same period were recruited as the control group. Patients in group A took EZP 3 months before surgery. No treatment was given to patients in group B and the control group. The serum CA125 level and the expression of cyclin D in the ectopic endometrium and the eutopic endometrium were detected in the 3 groups before surgery.

RESULTSThe expression of cyclin D was higher in group A and group B than in the control group (P < 0.05). The serum levels of CA125 and CA19-9 were significantly lower in group A than in group B (P < 0.05). The expression of cyclin D in the ectopic endometrium was lower in group A than in group B, but with no statistical difference (P > 0.05). The expression of cyclin D in the eutopic endometrium was significantly lower in group A than in group B with statistical difference (P < 0.05). Meanwhile, the serum CA125 level was positively correlated with the serum CA19-9 level (r = 0.45, P < 0.05).

CONCLUSIONSThe expression of cyclin D obviously increased in endometriosis patients, which was associated with the occurrence of endometriosis. CEP could lower serum levels of CA125 and CA19-9, and down-regulate the expression level of cyclin D, indicating its roles in inhibiting the cell cycle.

Adult ; Antigens, Tumor-Associated, Carbohydrate ; blood ; CA-125 Antigen ; blood ; CA-19-9 Antigen ; blood ; Cyclin D1 ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Endometriosis ; blood ; drug therapy ; Female ; Humans

Objective To investigate the operative technique and efficacy of PPH for severe hemorrhoids. Methods The clinical data of 153 cases of severe hemorrhoids treated by PPH, individualized according to size and nature of the piles, concomitant morbidities and conditions at the dentate line, and analysis of the relevance between operative technique and clinical efficacy as well as postoperative complications, were revieuled retropectively. Results All of the prolapsed tissue retracted immediately. Bleeding at the anastomotic site occurred in 49 cases, pulsatile bleeding in 12 cases, all of which were sutured under direct vision with cessation of bleeding. The width of excised-tissue was 2.1~4.6cm(average 3.5cm). The main symptoms of patients on the 1st post-operation day were abdominal distention caused by dysuria, pain, and tenesmus and burning sensation. At followup of 1-40 months, there was no stenosis of stoma, anal incontinence or recurrence of prolapse. After operation, a very satistactory result was achieved in 87 cases, satisfactory in 63 cases and mostly satisfactory in 3 cases. Conclusions In order to achieve ideal results with good retraction of tissues, avoidance of complications and improve patient satisfactory rate, the use of PPH for severe hemorrhords must be individualized and technical skill during operation are important.

· AIM: To discuss the cause and management of complications during the manual small incision cataract surgery (MSICS).combined with intraocular lens implant (MSICS-IOL) were done in 160 patietns with cataract. In this paper, we reviewed the clinical data of the intraoperative complications.injury, posterior capsule rupture, iris prolapse and hyphema, were mainly caused by inexpert skill and lacking of experience.techniques, careful operation could decrease the incidence of complications during MSICS operation. By proper management, the intraoperative complications could be solved satisfactorily.

Objective To investigate the best MR technique for detecting small epidermoids in the cerebellopontine angle.Methods 7 patients with pathologically-proved small epidermoids only located in the cerebellopontine angle were collected. The imaging techniques included:conventional T1WI and T2WI, fluid attenuated inversion recovery(FLAIR),diffusion weighted imaging(DWI) and balanced fast field echo(B-FFE) .The findings were retrospectively analyzed.Results 6 of 7 cases of epidermoid tumours localized at the cerebellopontine angle and exhibited the similar signal intensity as the cerebrospinal fluid(CSF) on T1WI and T2WI.The remaining case was slightly isointense on either T1WI or T2WI.On FLAIR images in 6 cases,3 cases showed slightly hyperintensity, 1 case showed doubtful heterogeneous signal intensity and 2 cases did not reveal any abnormal signal intensity.3 cases were hyperintense differenting from CSF on DW images. All of seven cases showed heterogeneous signal characteristics and were quite different from CFS on B-FFE.Meanwhile B-FFE also produced clearly the tissue contrast of trigeminus embedded in epidermoids of the cerebellopontine angle.Conclusion B-FFE is much more useful for the early diagnosis of epidermoids in the cerebellopontine angle and it also can provide precise preoperative information about the trigeminus encasement.

Objective To evaluate the operative treatment of nonunion of humeral shaft fracture with in- ternal plate fixation and autogenous cancellous hone graft.Methods Forty-one cases of nonunion of humeral shaft fracture operatively treated from February 2002 to December 2004 were analyzed retrospectively.There were 32 males and nine females.Their average age was 37.5 years(range,17 to 67 years).Sixteen nonunions were defined as hypertrophic and 25 as atrophic.We followed all the patients and obtained their complete medical information. Results Our average follow-up was 22.6 months(range,8 to 42 months).Forty fractures(97.6%)were united within an average of 5.8 months(range,3 to 12 months).Complications included iatrogenic radial nerve injury in three patients,wound infection in one patient and fracture nonunion in one patient.At the final follow-up,shou]der and elbow functions were found to be satisfactory.Conclusion Open reduction and plate internal fixation sup- plemented with autogenous cancellous bone graft is an effective treatment for nonunion of humeral shaft fracture.

OBJECTIVETo explore the strategy of pediatric intractable epilepsy surgery.

METHODSThe clinical data of 96 pediatric cases with intractable epilepsy and epilepsy syndromes underwent surgical treatment from April 2004 to April 2006 were retrospectively analyzed.

RESULTSThe surgical treatments were performed based on the results of comprehensive data from neurological, neurosurgical and pediatric departments. Among of them, 78 cases were performed with curative procedure, 17 cases with palliative procedure and 1 case with stereotactic damage procedure. The surgical effect was judged with Engel's standard, 58 cases had no seizure during 14 to 26 months follow-up, 26 cases had significantly improved in seizure control and the total efficiency was 87.5%. 81 cases had improvements in neuropsychological tests. 22 cases had postoperative complications such as neuro-dysfunctions and 15 cases were gradually recovered after the period of follow-up ended, 1 case died of CSF over drainage after operation 3 months.

CONCLUSIONSPediatric patients with symptomatic epilepsy and epilepsy syndromes are suitable to surgical treatment, the results are satisfactory in seizure control and neuropsychological function tests.

Adolescent ; Child ; Child, Preschool ; Epilepsy ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Male ; Retrospective Studies ; Treatment Outcome

?-lactamase inhibitor research is popular for its potential on ?-lactam antibiotics resistant strain.A ?-lactamase binding peptide SIPIS04-01 was obtained by the yeast two-hybid system.In vitro assay showed that it can inhibit the ?-lactamase activity.In order to improve the expression level of the recombinant peptide,a two-copy expression plasmid pYG563 was constructed by random orientation tandem repeat method after codon modification,the two-copy plasmid was successfully expressed and the product was increased by 48.4% than that of one-copy plasmid.Purified peptide showed inhibitory activity against TEM-1 ?-lactamase in vitro and the inhhibitory constant Ki was measured.

Objective To evaluate the toxicity and efficacy of induction chemotherapy(ICT)followed by three-dimensional conformal radiotherapy(3 DCRT)plus concurrent weekly paclitaxel for inoperable non-small cell lung cancer(NSCLC). Methods Patients with stage Ⅲ NSCLC in favorable conditions were treated with 2 to 4 cycles of carboplatin(AUC=5-6,d1)combined with paclitaxel(175 mg/m2,d1),then followed by weekly paclitaxel(40 mg/m2)and concurrent 3DCRT within 3-4 weeks.The prescription dose of radiotherapy was given as high as possible while total lung V20≤31% and total dose of the spinal cord ≤50 Gy. Results ICT was well tolerated.During the concurrent chemoradiotherapy,the treatment of 4 patients was ended ahead of the schedule because of severe pulmonary and cardiac toxicities:the treatment of 2 patients was delayed for 7 and 12 days because of fatigue.Leucopenia(33/56)was in grade 1-2 except 1 patient in grade 3.Lymphocytopenia was severe(54/56,42 in grade 3).Three patients developed grade 3 acute radiation-induced esophagitis.and 3 developed grade 3-4 radiation-induced pneumonitis.There was one patients each who developed grade 2,3,and 4 late esophagealdamage,respectively.Nine developed grade 2 pulmonary fibrosis.The overall response rate was 69.7%.The 1-year overall survival rate was 72.3%.The 1-year local progression-free survival rate was 62.7%. Conclusions The schedule of ICT followed by weekly paclitaxel and concurrent 3DCRT can be well tolerated by most of the favorable patients with stageⅢ NSCLC.and the toxicity is tolerable. Results of this study are encouraging, though long-term results should be followed up.

OBJECTIVE To investigate the effect of phosphotyrosine interaction domain containing 1 (PID1, NYGGF4) onpromotion of IR and HCC, and explore its underlying mechanisms. METHODS Lentivirus were used to mediate the knockdown of PID1 in HFD induced IR mouse model as well as ob/ob mice. Intraperitoneal glucose and insulin tolerance were performed 4 weeks after lentivirus injection. Hydrodynamics-based transfection was applied to induce the liver specific overexpression of PID1. Flow cytometry was exerted to detect the proportion and function of immune cells.qRT-PCR and Western blot were used to detect the expression of downstream pathways of PID1. Liquid chromatography-mass spectrometry (LC-MS) and co-immunoprecipitation (Co-IP) were conducted to identify proteins interacting with PID1.Chromatin immunoprecipitation(ChIP)was operated to measure the modification of H3K4me3 of PID1 promoter.RESULTS PID1 restriction improved insulin resistance,hyperglycemia and fatty liver. Conversely, hepatic knockdown of PID1 attenuated liver xenografted tumor growth. Moreover,PID1 liver-specific protooncogenes via hydrodynamics-based transfection established a primary hepatocellular carcinoma mouse model,induced an immunosuppressive environment,with the reduction of CD3+,CD4+,CD8+T cells,retarded maturation of dendritic cells(DCs),pronounced differentiation of regulatory T cells(Tregs),and recruitment of MDSC.In addition,PID1 overexpression activated prolifer-ation related genes, promoted anti-inflammatory genes, suppressed pro-inflammatory genes, induced glycolysis and lipid metabolism genes to facilitate tumorigenesis in liver. Importantly, PID1 exerted its tumor-promoting function through binding to epidermal growth factor receptor(EGFR)and activation of downstream KRAS/ERK pathway.As such,PID1 exist trimethylation of histone H3 at lysine 4(H3K4me3) modification and IR up-regulated the expression of PID1 by activation the H3K4me3 modification. CONCLUSION PID1 is a new gene that exerts both liver cancer-promoting and insulin resistance inducing function.IR accelerates liver cancer development and progression partially dependent on the activation of PID1.

Objective To investigate the hemodynamics of increasing portal venous pressure(PVP) in hepatocellular carcinoma patients complicated with hepatic arterioportal vein fistulas (HAPVF)and the diagnosis and therapy of intractable upper gastrointestinal hemorrhage caused by HAPVF.Methods One hundred and fifteen cases of hepatocellular carcinoma with upper gastrointestinal hemorrhage were checked by hepatic arteriography and were treated through orifices embolization in cases with severe HAPCF by coils and/or ethanol. Results Twenty-six out of 31 patients suffering intractable upper gastrointestinal hemorrhage have severe HAPVF(the main stem of portal veins are visible).However,there are only 15 patients with light HAPVF among the 84 patients who have mild upper gastrointestinal hemorrhage (the main stem of portal veins are invisible).After the embolization,all of the 26 patients who have severe HAPVF stopped bleeding.Among them,the main stem of hepatic arteries are occluded in 2 patients. Conclusion The existence of severe HAPVF should be taken into consideration when intractable upper gastrointestinal hemorrhage occurs in hepatocellular carcinoma patients,and it can be diagnosed through hepatic artery DSA.Orifice embolization is the most effective method for such kind of hemorrhage.