Objective To evaluate the effects of conscious sedation analgesia during superficial bladder tumor resection for elderly patients. Methods Forty elderly patients who needed 2 μm laser resection for bladder tumors were treated with target controlled infusion (TCI) remifentanil and propofol. The initial target concentration of remifentanil was 2.5 ng/mL and that of propofol was 1 μg/mL. The target concentration of those two agents was adjusted until loss of painfulness to the operative stimulus. The MAP, HR, SpO2, RR and PetCO2, BIS and scores by OAA/S were compared between pre-and post-surgery at different time points (time before anesthesia, T0; time before analgesia, T1; time when the resection began, T2; 5 minutes after the resection began, T3;10 minutes after the resection began, T4; 15 minutes after the resection began, T5; the end of operation, T6;5 minutes after operation). Results All patients lived through the surgery under a conscious sedation. After the anesthesia, blood pressure, heart rate and breathing rate were declined, while oxygen saturation was unchanged. Conclusion TCI with remifentanil and propofol provides better hemodynamic stability, satisfactory sedation analgesia and faster recovery of surgery.

3200 mg?L~(-1)),and could suppress HBeAg and HBsAg secretion and lower the HBV-DNA level cultured in HepG2 2.2.15 cell line in a dose and time-dependent manner.Conclusion Some of the mechanisms of PSP against HSV-1 and HSV-2 may be explained by the considerable inhibition of virus absorption and virus replication in cells.Some of the mechanisms of PSP against HBV may be explained by inhibition of the secretion of HBV-antigen and the replication of HBV-DNA.

Objective To study the efficacy of CPT-11 TACE in the treatment of unresectable HCC.Methods A retrospective review was undertaken on unresectable HCC patients receiving doxorubicin transarterial chemoembolization (59 cases) and irinotecan(CPT-11) in 24 cases from May 2003 to November 2011.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the two groups were assessed for statistical significance with the log-rank test.Results Overall survival time was significantly longer in patients treated with CPT-11 compared with doxorubicin treated group (21.7 vs 14.5 months,P =0.042).There was no significant difference in time to progression between the two groups,but time to progression was longer in CPT-11 group than doxorubicin treated group (11.42 vs 9.46 months,P =0.091).Subgroup analysis showed that for intermediate-stage HCC,CPT-11 resulted in a significantly longer time to progression and overall survival compared with doxorubicin treated group (P =0.029 and P =0.014,respectively).There were no significant differences in adverse events among the two groups (P ＞ 0.05).Conclusions Chemotherapeutic agent CPT-11 in the form of TACE significantly improved overall survival when compared with doxorubicin for the treatment of unresectable HCC.

Objective To evaluate the efficacy of chemoradiotherapy in patients with unresectable pancreatic cancer who were previously treated with PTCD.Methods From September 2005 to December 2012,47 unresectable pancreatic cancer patients with obstructive jaundice were enrolled in this study.They were divided into two groups.21 patients received after PTCD chemotherapy or radiation,or chemoradiotherapy.26 patients in support care group received only nutrition,analgesia and other related support treatment.Survival analysis was performed with Kaplan-Meier statistics.Differences in survival between the groups were assessed for statistical significance with the log-rank test.Results The median overall survival time of patients after PTCD was 7.19 months.The median overall survival time of chemoradiation group was 9.07 months,which was higher than that of support care group (5.52 months),P=0.017.12 patients received single therapy (either chemo or radiation),and 9 patients received chemoradiotherapy.The median overall survival times were 8.31 months and 11.15 months,respectively (P =0.325).Conclusions Post PTCD chemoradiotherapy helps prolong the survival time in unresectable pancreatic cancer patients.

Objective To investigate the association of the major histocompatibility complex class Ⅰ chain-related antigens A (MICA)-129 gene polymorphism and soluble MICA (sMICA) levels with ulcerative colitis (UC) in Hubei Han nationality. Methods The genetic polymorphism of MICA-129 was examined using a polymerase chain reaction-sequence based test (PCR-SBT) in 256 UC patients and 460 healthy controls. From the above subjects, 80 patients and 90 healthy individuals were randomly selected for determining serum sMICA concentrations by ELISA. Results The frequencies of variant allele (G) and genotype (GG) in MICA-129 gene were significantly higher in the UC patients than in the controls(76. 8%vs 72. 2%, P =0. 060; 55.9% vs 46. 3% ,P =0. 016). Serum sMICA levels were significantly elevated in the patients compared to the controls[(576. 47 ±279. 02) ng/L vs( 182. 17 ±73. 11 ) ng/L,P ＜0. 001]. In addition, the sMICA levels were higher in the patients carrying MICA-129 GG genotypes than in those carrying ( GA + AA) genotypes [( 638. 87 ± 347. 15 ) ng/L vs ( 507. 51 ± 152. 87 ) ng/L, P = 0. 035].Conclusions The genetic polymorphism of MICA-129 and sMICA levels are correlated with the UC patients in Hubei Han nationality. Our findings demonstrate that MICA-129 gene may contribute to the pathogenesis of UC.

AIM: To compare the safety and efficacy of conjunctival autograft transplant ( CAT ) and limbal - conjunctival autograft transplant (LCAT) for primary pterygium.
METHODS: In this prospective, randomized and controlled clinical study, 120 patients ( 120 eyes ) diagnosed with primary pterygium were collected in NO. 474 Hospital of Chinese PLA from January 2014 to January 2015. The 120 patients enrolled in the study in turn, and divided into two group by the odd and even number. The odd number underwent CAT and the even number underwent LCAT.
RESULTS:One hundred and seven patients (107 eyes) completed the follow-up of 1a, including 54 patients (54 eyes) from the CAT group and 53 patients (53 eyes) from the LCAT group. Four patients (4 eyes, recurrence rate 7. 4%) in the CAT group and 2 patients ( 2 eyes, recurrence rate 3. 8%) in the LCAT group developed recurrence. However, there were no significant in recurrence rate between CAT group and LCAT group (P =0. 678).
CONCLUSION: CAT and LCAT might be both effective treatment for primary pterygium for reducing the recurrence rate of pterygium. However, LCAT is the optimal surgical method for primary pterygium.

Upper urinary tract calculi with infection is a quite difficult acute urologic emergency.And what is more, upper urinary tract obstruction after radical cystectomy following urinary diversion may be fatal in the vulnerable patients with this kind of situation.Postoperative anatomy and other factors affect the upper urinary tract calculi, and urinary tract infection greatly increased the risk.But it is particularly difficult to handle with patients with poor general condition and septic shock treatment, so how to optimize the selection program is worth further studying.A 65-year-old man was admitted to hospital for combining with renal and ureteral calculi after radical cystectomy (Bricker) in March 2017.The patient underwent transurethral resection of bladder tumor in the outer court because of the discovery of bladder tumor one year before, The postoperative pathology was high-grade papillary urothelial carcinoma and he underwent regular irrigation of the bladder.Because of tumor recurrence, he came to Peking University Third Hospital for further treatment in August 2016, and the examination of urinary tract CT indicated bladder can-cer;for bilateral multiple renal pelvis and renal calices calculi, he was given laparoscopic radical cystecto-my.After four months, due to sudden chill fever, he was hospitalized.After definite diagnosis, anti-inflammatory treatment combined with left nephrostomy was given.The two-stage lithotripsy was performed.After expansion of the original left renal fistula to 24 F(1 F=0.33 mm), 24 F sheath was inducted into the kidney.We introduced a flexible ureteroscopy into the channel down to the ureteral obstruction, where we found a 1 cm oval black brown stone obstructed.A guide wire was inducted through the stones down to ileal conduit in the right lower quadrant.Through the ureteroscopy, we made ureteral calculi broken into powder, and replaced the residual stones into the renal pelvis.Then we used the nephroscopy for lithotropsy in the pelvis, and finally we introduced a flexible cystoscopy for the residual stone.The operation was successful, the operation time was 181 min, and intraoperative bleeding was 10 mL.After operation, no residual stones were found in kidney, ureter, bladder (KUB) plain films.No operation complications were related to the urinary tract.Therefore, multiple endoscopy with combination therapy of upper urinary tract calculi following urinary diversion is safe and effective, and the reasonable choice with the advantages of each instrument can improve the stone clearance rate and shorten the operation time.This can be used as a useful complement to traditional treatment.

OBJECTIVETo establish an animal model of acute blunt scrotal trauma (BST) and evaluate the types of lesion by conventional ultrasonography (CUS) and contrast-enhanced ultrasonography (CEUS).

METHODSWe made acute BST models in 21 healthy male New Zealand rabbits by striking 3 - 12 times the unilateral testes randomly selected with a 0. 5 kg iron ball falling freely from a 30 cm height. Then we evaluated the lesion types in the models by CUS and CEUS and verified our evaluation against pathological results.

RESULTSAcute BST models were successfully established in all the 21 animals, including contusion in 10, hematoma in 6, and rupture in 5, all confirmed by pathology. CUS clearly manifested the morphology, internal echoes, and blood flow of the testes, but had a low rate of accurate diagnosis in testicular contusion for over 6 hours as well as in complex lesions. CEUS revealed an earlier perfusion of the contrast agent and shorter arriving time (AT) and time to peak intensity ( TP) in testicular contusion than in the control testes (P <0.05) , but showed no statistically significant difference between the two groups in the half time of descending peak intensity (P>0.05). For testicular hematoma, contrast agent clearly presented its outline and a delayed low enhancement in the surrounding tissue, with significant differences from the control in AT and TTP. In severe testis rupture, occasional outflow but no perfusion of contrast agent was observed.

CONCLUSIONBST models can be established in rabbits by repeated strikes of the unilateral testes lesion of contrast agent was observed. with a freely falling iron ball. Simple contusion injury can be induced by less than 6 strikes, while complex injuries can be inflicted by more than 10. Combined application of CUS and CEUS can improve the accuracy of diagnosis of different types of lesion.

Acute Disease ; Animals ; Disease Models, Animal ; Male ; Rabbits ; Scrotum ; diagnostic imaging ; injuries ; Ultrasonography ; Wounds, Nonpenetrating ; diagnostic imaging

Objective To develop a three-dimensional porous film of human hair keratin (HHK)-collagen sponge complex for use as a dermal substitute. Methods The three components F, B, and Z derived from healthy human hair were weaved into a meshwork and integrated with purified soluble type Ⅰ collagen extracted from bovine tendons to prepare a highly porous film with vacuum freeze-drying followed by secondary cross-linking with glutaraldehyde. The film was grafted beneath the dorsal skin in 21 SD rats (experimental group), with simple collagen sponge serving as the negative control. The rats receiving surgical operation but without graft served as the blank control. The graft and its surrounding tissue were harvested on days 3, 7 and at weeks 2, 4, 6, 8, 12 after implantation for evaluation of tissue compatibility, vascularization and degradation. Results The prepared collagen sponge film was semitransparent and porous. Three to 7 days after grafting, inflammatory reaction was relieved gradually, and several fibroblasts and blood vessels were found adherent to the gratts in the experimental groups. At week 4, the wounds healed in the experimental groups, and the fibroblasts were actively secreting collagen and the film degraded obviously with the appearance of elastic fibers. At weeks 6 and 8, new collagen fibers thickened and assumed regular arrangement, and the collagen sponge films disappeared completely. In the control groups, the changes were less obvious and total HHK degradation occurred till week 12. Conclusion The degradable and absorbable HHK-collagen sponge film has relatively satisfactory tissue compatibility and can accelerate wound healing by stimulating cell proliferation and vascularization,showing the potential as an optimal dermal substitute.

OBJECTIVETo analyze LC-MS fingerprints of Aristolochia manshuriensis for quality assessment with two different chemical pattern recognition models.

METHODLC-MS fingerprints of A. manshuriensis were established from 24 batches of samples from different habitats. SIMCA and Clustering analysis were used to compare the parameters of the 29 common peaks.

RESULTTwo methods had good consistency, while they reflected the inherent sample information from different perspectives, respectively.

CONCLUSIONModern equipment analysis technology and multivariable chemical pattern recognition would be an efficient way for quality control and variety identification of A. manshuriensis.

Aristolochia ; chemistry ; classification ; Chromatography, Liquid ; Cluster Analysis ; Drugs, Chinese Herbal ; chemistry ; Mass Spectrometry ; Phylogeny ; Quality Control