Objective To investigate surgical treatment for tumor involved inferior vena cava at the upper segment of kidney.Methods The clinical data of 35 patients with tumor involved inferior vena cava at the upper segment of kidney who were admitted to Changhai Hospital affiliated to the Second Military Medical University from January 2007 to May 2015 were retrospectively analyzed.All the patients received preoperative imaging examinations to insure the site and range of inferior vena cava involvement at the upper segment of kidney.Renal cell carcinomas with inferior vena cava involvement were found in 19 cases,leiomyosarcomas of inferior vena cava in 5 cases,leiomyomatosis involving inferior vena cava in 3 cases,adrenocortical carcinoma involving inferior vena cava in 3 cases,liver cancer involving inferior vena cava in 2 cases,right adrenal pheochromocytomas in 2 cases,retroperitoneal fibrosarcoma involving inferior vena cava in 1 case.According to tumor involvement types,the different surgical approaches,planes and method of inferior vena cava exclusion,reconstruction method and prevention of tumor embolus detachment were selected.Patients were followed up by outpatient examination and telephone interview till May 2015.Results Among 19 patients with renal cell carcinomas with inferior vena cava involvement,10 patients were placed inferior vena cava filters through internal jugular vein before surgery,10 patients underwent total hepatic vascular exclusion and 9 patients underwent intrahepatic inferior vena cava exclusion.All the 19 patients received tumor resection and inferior vena cava embolectomy.Of the 5 patients with leiomyosar-comas of inferior vena cava,3 patients underwent total hepatic vascular exclusion and 2 patients underwent intrahepatic inferior vena cava exclusion.The diseased segments of 5 patients were resected,including 4 patients of artificial vascular graft and 1 patient complicated with resection of right kidney receiving simple ligation of inferior vena cava and left renal vein at proximal and distal tumors.Of the 3 patients with leiomyomatosis involving inferior vena cava,2 patients received total hepatic vascular exclusion and 1 was treated surgically under cardiopulmonary bypass.All the 3 patients underwent inferior vena cava embolectomy and hysterectomy.Three patients with adrenocortical carcinoma involving inferior vena cava and 2 patients with liver cancer involving inferior vena cava underwent total hepatic vascular exclusion.Among the 5 patients,4 had direct suture after tumor removal combined with partial inferior vena cava resection,and 1 had patch repair after partial inferior vena cava resection.Two patients with right adrenal pheochromocytomas were exposed proximal and distal lifting devices of inferior vena cava without clamp,and the tumors were peeled off completely.Intraoperative death happened in the patient with retroperitoneal fibrosarcoma involving inferior vena cava who was prepared to undergo intrahepatic inferior vena cava exclusion but encountered intraoperative pulmonary embolism due to tumor thrombus shedding.Thirty-four patients of 35 patients underwent operation successfully without serious perioperative complications and a patient died in the perioperative period.The mean operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were 2.8 hours (range,1.5-5.0 hours),2 000 mL (range,400-5 000 mL) and 9.2 days (range,6.0-16.0 days).Thirty-four patients were followed up for a median time of 12 months (range,1-60 months).During the follow-up period,a patient with leiomyosarcomas of inferior vena cava and 2 patients with adrenocortical carcinoma involving inferior vena cava died of tumor recurrence,a patient with liver cancer had tumor recurrence,other patients were tumor-free survival.Conclusions Inferior vena cava at the upper segment of kidney is not contraindication for tumor resection.The appropriate way to expose,clamp and reconstruct are selected to safely remove the tumor based on extension and method of tumor involving inferior vena cava.

Aggregatibacter actinomycetemcomitans ; physiology ; Bacterial Adhesion ; Biofilms ; Periodontal Diseases ; microbiology ; Porphyromonas endodontalis ; physiology

Bacterial Proteins ; metabolism ; Carbon-Sulfur Lyases ; metabolism ; Mouth ; microbiology ; Quorum Sensing ; Signal Transduction

BACKGROUND:Bladder acellular matrix graft (BAMG) is frequently used for domains of tissue engineering scaffold due to its great biocompatibility and cell adhesion. OBJECTIVE:To verify the biological characteristics of BAMG after frozen and lyophilized processing. DESIGN,TIME AND SETTING:A biocompatibility experiment was performed at Shanghai Tissue Engineering Research and Development Center and Experimental Animal Department of the Sixth People's Hospital of Shanghai between May and November 2008. MATERIALS:Two New Zealand rabbits were used in this study for BAMG preparation. METHODS:After midsection of rabbit bladder,mucous membrane of urinary bladder was isolated and dipped in three-distilled water for 24 hours. Thereafter,the samples were incubated with acellular solution containing 0.1% Triton X-100 and 0.15% aqueous ammonia for 14 days. The culture medium was changed regularly. The samples in the control group were stored in 75% ethanol,while samples in the experimental group were frozen for 24 hours at -80 ℃,vacuum-dried for 24 hours,and stored in 75% ethanol. MAIN OUTCOME MEASURES:Biological characteristics of BAMG were detected using hematoxylin and eosin staining,Masson staining,and scanning electron microscopy; biological characteristics were compared between the two groups using cell adhesion test,MTT assay,and subcutaneously embedding test. RESULTS:Hematoxylin and eosin staining and Masson staining revealed that no residual cells were detected in the BAMG,and collagen was intact. Scanning electron microscopy demonstrated that cells exhibited a slit-shaped structure mainly containing collagen which was beneficial for cell adhesion. Mechanical test revealed that the BAMG after frozen and lyophilized processing not only reserved the mechanical properties of the raw BAMG,but also had a great elongation. MTT assay confirmed that cytotoxicity was grade 0,and BAMG had a good compatibility to smooth muscle cells. After subcutaneously embedding for one month,BAMGs had good adhesions to subcutaneous tissues,and muscular adhesion and vascular proliferation were observed. CONCLUSION:BAMG after frozen and lyophilized processing reserves original biocompatibility and has great elongation; therefore,it will become a useful and ideal biomaterial for tissue engineering scaffold.

AIM: To explore the effect of bone marrow-derived mesenchymal stem cells (BMSCs) combined with vitamin E on the inflammatory reaction in acute kidney injury ( AKI) rats.METHODS:Gentamicin was used to in-duce AKI and the rats were treated with BMSCs combined with vitamin E.After treatment, the rat plasma and kidney tis-sues were collected, and the expression of inflammatory factors at mRNA and protein levels was detected by real-time quan-titative PCR and ELISA.RESULTS:After the treatment with BMSCs combined with vitamin E, the inflammatory proteins were down-regulated in the plasma and the renal tissues.Compared with single treatment group, the decreases in the in-flammatory proteins were more obvious in combined treatment group.CONCLUSION: The method of BMSCs combined with vitamin E takes the anti-inflammatory effect on AKI, indicating a new and potential mode in clinical application for AKI therapy.

Objective To explore the features of transsphenoidal microsurgical treatment of male pro- lactinoma and to evaluate the sexual function before and after transsphenoidal microsurgery.Methods A se- ries of 23 cases male prolactinoma were analysed combined with retrospective and prospective study.9 casese with sexual disfunction had finished the International Index of Erectile Function with 15-item questionnnaire (ⅡEF-15) before and after the surgery.Results 8/10 cases treated with dopaminergic agonist combined with surgery achieved complete remission,while only 4/13 cases achieved complete remission with surgery on- ly(x~2=5.490,P=0.036).Aecoding toⅡEF-15,sexual function improved after surgery in 9 cases(paired- sample) t test,P＜0.05).Conclusion Transsphenoidal microsurgical treatment of prolactinoma may im- prove the male sexual functions.Dopaminergic agonist combined transsphenoidal microsurgery may achieve a better outcome.

Objective To explore the effects of a single bout of aerobic exercise on oxidative stress and total peripheral vascular resistance. Methods 36 prehypertensive patients were divided into aerobic exercise group (n=18) and control group (n=18). The aerobic exercise group performed cycle ergometry at 70% maximal oxygen consumption for 30 min. Total peripheral vascular resistance (TPVR), malondialdehyde (MDA), mean arterial pressure (MAP), vitamin C (VC) and vitamin E (VE) were measured before, immediately, 1 hour and 2 hours after the aerobic exercise. Results There was no significant difference in TPVR, MDA, MAP, VC and VE between two groups before exercise (P>0.05). TPVR was all significantly lower in the aerobic exercise group than in the control group immediately, 1 hour and 2 hours after exercise (P<0.001), and showed a rising trend of recovery. MDA was significantly higher in the aerobic exercise group than in the control group 1 hour and 2 hours after exercise (P<0.05), however there was no significant difference in MDA between two groups immediately after exercise (P>0.05). MAP was significantly lower immediately after exercise in the aerobic exercise group than in the control group (P< 0.001), but there was no significant 1 hour and 2 hours after exercise (P>0.05). There was no significant difference in VC and VE between two groups immediately, 1 hour and 2 hours after exercise (P>0.05). Conclusion The level of oxidative stress increases after a single bout of aerobic exercise, and the TPVR decreases.

Community rehabilitation of cardiovascular disease is of great significance. Exercise therapy of cardiovascular disease in communities is necessary and feasible. At present, the main problems China faced to carry out community exercise therapy of cardiovascular disease include: cardiovascular patients with a weak sense of community exercise therapy, lack of professional rehabilitation personnel, inadequate community-based exercise therapy practice and lack of community rehabilitation funding. To solve above problems, we should strengthen the community exercise therapy practice of cardiovascular disease, and promote the cooperation between community rehabilitation and hospital rehabilitation. In all, comprehensive efforts should be made in order to solve the problems.

Objective To investigate the feasibility of constructing tissue engineering urethral substituted graft using human lingual keratinocytes and natural derived scaffold.Methods From Oct.2009to Jan.2010,ten patients with anterior urethral stricture were enrolled in this study.A 0.5 × 0.8 cm lingual mucosa was harvested during the operation.Lingual keratinocytes were then isolated and cultured from the mucosa.AE1/AE3 antibody was used to identify the lingual keratinocytes.Keratinocytes were collected and seeded onto three types of scaffold including dehydrated BAMG,liquid stored BAMG and 4-layer SIS product,with the density of 1 × 107/ml at passage three.After being cultured for seven days in vitro,H&E staining and Electronic Scan Microscopy were used to evaluate the compound matrixes.Results No complication occurred in the patients after operation.The primary passage of confluence lingual keratinocytes appeared in a typical cobblestone shape after being cultured for 14 days in vitro.The proliferation rate of these cells increased rapidly during the three passages.However,it decreased significantly in the 4th passage.H&E and Electronic Scan Microscopy examinations showed that few cells grew on the surface of the liquid stored BAMG.Nevertheless,multiple keratinocytes layers could be seen in dehydrated BAMG and 4-layer SIS.Meanwhile,cellular infiltration could be observed in SIS sections.Conclusions Human lingual keratinocytes could be the alternative of seeding cells for constructing tissues for engineering the urethra.These cells exhibited good compatibility and are adhesive to the SIS or BAMG.The compound matrix,which used human lingual keratinocytes and natural derived scaffold,may meet the clinical need of urethral disease in the future.

BACKGROUND:Edaravone as an antioxidant protective effect on nerve cells injured by hydrogen peroxide has been confirmed, but its protective effect on oxidative damage to bone marrow stromal cells has not been reported in-depth. OBJECTIVE:To investigate the regulatory effects of edaravone on oxidative injury to bone marrow stromal cells. METHODS:Bone marrow samples were extracted from the long bone of New Zealand rabbits by the method of washing the pulp cavity, then subjected to the density gradient centrifugation and adherent screening to obtain bone marrow stromal stem cells in vitro. The bone marrow stromal cells at 3 passage were divided into five groups:blank group, treated with low-glucose Dulbecco’s modified Eagle’s medium containing 10%fetal bovine serum and 1%double antibody;dexamethasone group, treated with cellculture medium containing 1×10-7 mol/L dexamethasone;50, 100, 300 mg/L edaravone groups, cultured in cellculture medium containing 1×10-7 mol/L dexamethasone and 50, 100, 300 mg/L edaravone, respectively. After culture, MTT method and flow cytometry were used to detect the proliferative level and cellcycle of cells. RESULTS AND CONCLUSION:Compared with the control and dexamethasone groups, edaravone significantly enhanced the cellproliferation. Edaravone played a protective role in bone marrow stromal cells. When the concentration was 50 mg/L, edaravone began to play a regulatory role (P<0.05), and this effect was certainly associated with the concentration of edaravone. When the concentration was up to 100 mg/L, edaravone showed a better protective role (P<0.01). However, with increasing concentration, this protective effect was not further increased, but decreased slightly. Results indicated that high-concentration dexamethasone can induce oxidative injury to bone marrow stromal cells, and edaravone can protect the cells against this oxidative damage by antioxidant role.