The direct anterior approach is an ideal minimally invasive surgical procedure, which exposes the hip joint through an intermuscular and internervous interval. Compared with other approaches, the direct anterior approach for total hip arthroplasty has several advantages, including less postoperative pain, faster functional recovery and higher patient satisfaction. However, the direct anterior approach could be associated with longer learning curve and higher rate of perioperative complications. We converted the operative position from the classic supine to the lateral decubitus position, aiming to inherit the advantages of the direct anterior approach and to overcome the difficulty of exposing the femoral side in the supine position. The degree of extension, external rotation and adduction of the hip joint was significantly increased in the lateral decubitus position compared to those in the supine position, which provided safe reaming of the femoral medullary cavity and precise implantation of the femoral stem. Therefore, the surgeons do not need to change the operating habits of the acetabular side. The reason is that the exposure of acetabulum in the lateral decubitus position is the same as that in familiar posterior approach. Familiarity with the surgical anatomy and understanding the limitations of the anterior hip approach are the key factors for successful execution.

Objective To study the effects of stereotactic technique on hypertensive basal ganglion hemorrhage. Methods 160 patients with hypertensive basal ganglion hemorrhage were divided into 2 groups: surgical group （132 cases）and conservative group （28 cases）. They were assessed with clinical neurologic impairment scale before and 2 weeks and 4 weeks after treatment. The incidence of rehemorrhage was compared. Results The neurologic impairment scores in surgical group and conservative group were (33.90±3.54) and (33.61±3.82) before treatment (P>0.05), (20.89±3.10) and (26.18±3.61) 2 weeks after treatment (P<0.01), (10.28±2.01) and (15.68±3.28) 4 weeks after treatment (P<0.01), respectively. The incidence of rehemorrhage in surgical group and conservative group were 6.1% and 10.7% (P>0.05), respectively. Conclusion The stereotactic technique may recover neurological function much faster.

Objective To explore the function of unfolded protein response(UPR) in the differentiation of neural cells. Methods In this study, all trans retinoic acid was used to induce the mouse embryonic stem (ES) cells to differentate, immunocytochemistry and RT PCR were adopted to detect the expression of neural specific markers. With this differentiation system derived from ES cells, the expression of UPR molecules was assayed by RT PCR and Western blot respectively. Results Large amount of cells expressing neural tissue specific markers were obtained. With the differentiation of the cells, the expressions of Irel ? declined in different degree in both RA treated and untreated cells, the expression level was lower in RA untreated cells than that in RA treated cells. The expression of Grp78 was up regulated in RA induced cells, however, no increase of the expression of Grp78 could be detected in RA untreated cells.Conclusion RA induced differentiation of ES cells could be used as the neural differentiation model. The expressions of UPR molecules were associated with expressions of neural tissue specific marker molecules, which suggested that UPR signaling might play a role in neural cell differentiation. [

Objective: To investigate the characteristics of renal papillary calcareous deposits and their role in the formation of calcium oxalate kidney stone, and to explore the formation mechanism of renal calcareous deposits. Methods: A total of 21 patients with calcium oxalate kidney stones were included in the present study. The components of the calculi were detected by Fourier-transform infrared spectroscopy. The calcific plaques were observed and the renal papilla biopsy specimens were obtained during PCNL. The specimens were then subjected to alizarin bordeaux staining and light microscopic examination. The expression of osteopontin, BMP-2, and type II collagen in the kidneys was examined by immunohistochemistry. Seven resected renal specimens from patients with non-urolithiasis served as control. Results: Renal papillary calcific plaques were found in all the 21 patients with renal calculi. Local calcareous deposits were found in the renal interstitium around tubular basement membrane and extended toward the mucous membrane in the renal papillas. Microscopically, once the calcareous deposits pierced into the collection system, tiny stones could be seen growing on the deposits. Immunohistochemistristry showed the renal tissues of renal stone patients and normal renal tissues both expressed osteopontin, but not BMP-2 or type II collagen. Conclusion: Renal papillary calcareous deposits may be one of the initiating nidi for kidney stone formation and they may not be an osteoblastic reaction resembling arteriosteogenesis.

This study is to investigate inhibitory effects of lidamycin (LDM) on the proliferation of HERG K+ channel highly expressing cancer cells and its synergy with anticancer drugs. MTT assay was used to examine the inhibitory effects of lidamycin combined with various anticancer drugs on the proliferation of human lung cancer A549 cells, human colon cancer HT-29 cells and herg-stably-transfected A549 cells. Using the xenograft model of subcutaneously transplanted HT-29 in nude mice, inhibitory effect was appraised in vivo. The coefficient of drug interaction (CDI) was used to evaluate the synergistic effect of drug combination. LDM significantly inhibited the proliferation ofA549 cells and HT-29 cells with IC50 values of 2.14 and 4.64 ng mL(-1), respectively. The efficacy in HT-29 cells with high HERG potassium expression level is less potent than that in A549 cells with low expression level. In terms of IC50 values, LDM suppressed the growth of herg-stably-transfected A549 cells less potently than pCDNA3.1-stably-transfected A549 cells. There existed synergistic effects in the combinations of fluorouracil (5-FU) and LDM, doxorubicin (DOX) and LDM, or hydroxycamptothecine (HCPT) and LDM. CDI values of the combinations of 5-FU and LDM were more than 0.75. CDI values of LDM and DOX were more than 0.70, but some CDI values of LDM and HCPT were less than 0.70. As for the CDI values, synergistic effects of the combination of LDM and HCPT were the most potent of the three groups. There is no relationship between the inhibitory effect of the growth of cancer cells by 5-FU and HERG potassium expression level. HERG expression level negatively correlated with inhibitory effect on the proliferation of cancer cells by DOX. HERG expression levels and chemosensitivity were positively correlated for HCPT. In the model of subcutaneously xenograft transplanted HT-29 in vivo, LDM and/or HCPT effectively inhibited the growth of HT-29 in nude mice, and the optimum CDI of the combination of LDM and HCPT was less than 1. HERG expression level negatively correlates the chemosensitivity of cancer cells to LDM. There exist synergistic effects in vitro and in vivo in the combination of LDM and HCPT, which inhibitory effects of the proliferation of cancer cells positively modulated by HERG potassium expression level. HERG K+ channel may become a target of combined therapy for choosing anticancer drugs.

Objective To investigate the feasibility of spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy for the treatment of pancreatic cystic tumor of body and tail.Methods The clinical data of a female patient with pancreatic cystic tumor of body and tail who was admitted to the Sun Yat-Sen Memorial Hospital of the Sun Yat-Sen University in March 2013 were retrospectively analyzed.Spleen-and splenic vesselspreserving laparoscopic distal pancreatectomy was determined as the optimal therapeutic method according to the physical examination and the results of computered tomography scan.Laparoscopic or open operation combined with distal pancreatectomy and splenectomy would be carried out as a candidate choice once it is hard to separate the splenic artery and vein from distal pancreas or to control the serious vessels hemorrhage.The patient was followed up by outpatient examination every 1 to 3 months up to March 2015.Results Spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy was finished successfully.The operation time and volume of intraoperative blood loss were 192 minutes and 50 mL,respectively.The patient took out-of-bed for activity at postoperative day 1 without complications.The multiple severe microcystic pancreatic adenoma was confirmed by postoperative pathological examination,with a maximum diameter of 3.5cm.The leakage tube was removed at postoperative day 5.The levels of serum amylase at postoperative day 1,3,5 were normal.The patient was discharged at postoperative day 8 and got regular follow-up without bleeding,pancreatic fistula,infection and a symptom of epigastric pain or discomfort.Conclusion Spleen-and splenic vessels-preserving laparoscopic distal pancreatectomy has advantages of less traumas,faster postoperative recovery and a preservation of normal splenic function,deserving clinical application.

With the technology progress of human genome sequencing and biomedical analysis and the emergence of big data analysis tools,the new concept of precision medicine has been put forward.Clinically,the application of precision medicine becomes more and more widely in personalized medicine,genetic disease analysis and disease prediction,etc,which will be the trend of disease diagnosis and treatment in the future,however,precision medicine is based on the precise detection.The requirement of the precise detection promotes the rapid development of new detection methods.Clinical laboratory is the carrier to achieve accurate detection,we need to strengthen the construction of clinical laboratory and improve the management level of the laboratory,so as to achieve accurate detection,to provide a more effective basis for the diagnosis and treatment of precision medicine.

Objective: To evaluate an innovative surgical approach for submandibular gland resection with minimal invasive incision. Methods:With cutaneous incision of 30 mm in the submandibular area, six patients with chronic sialadenitis of submandibular gland were treated with this approach. Anterior facial vein and facial artery were maintained without ligation. Results:The operation time is ranged from 40 to 80 minutes. There were no facial nerve injuries. Furthermore, the surgical stigmata was minimized. Conclusion:The modified minimal incision for submandibular gland resection has less wound and better cosmesis.

Objective To compare the effect of oxycodone or sufentanil in preventing post-operative hyperalgesia induced by remifentanil.Methods One hundred and twenty patients scheduled for radical operation for carcinoma of stomach undergoing general anesthesia, 62 males and 58 females, aged 18-65 years, ASA physical status Ⅰ or Ⅱ, were randomly divided into 3 groups.Thirty minutes before the end of operation, oxycodone hydrochloride 10 mg was administered intravenously in oxycodone hydrochloride group (group O, n=42) while sufentanil 10 μg was injected in group S (group S, n=40) and equal normal saline was injected in control group (group C, n=38).The VAS score after waking up was recorded.VAS score>3 was defined as hyperalgesia, and sufentanil was injected when VAS score≥6.The BCS scores were recorded immediately after extubation (T1), 30 min (T1), 1 h (T3), 2 h (T4) and 4 h (T5) after extubation.Awakening time and extubation time and the incidence of nausea and vomiting 4 h after extubation were compared.Results At T1-T5, the BCS scores in group O were significantly higher than those in groups S and C (P<0.05).Group S has a higher adverse reaction (P<0.05).There was no significant differences of awakening time and extubation time in 3 groups.Conclusion Prophylactic injection of oxycodone 10 mg can reduce incidence rate of post-operative hyperalgesia, and increase BCS score with little side effects.

Objective To evaluate the clinical efficacy of four different operative patterns of laparoscopic hysterectomy: laparoscopically assisted vaginal hysterectomy (LAVH), laparoscopically introfasial subtotal hysterectomy (LISH), laparoscopically subtotal hysterectomy (LSH) and laparoscopically total hysterectomy (LTH). Methods A retrospective analysis on 2272 cases of laparoscopic hysterectomy was carried out, including operating time, blood loss, complication and postoperative recovery. Results For the two groups which preserved cervix, LISH was performed in 1323 cases. The operating time was (91?21) min, blood loss (93?23) ml, complication rate 4.1%. LSH was conducted in 229 cases, with an operating time (70?18) min, blood loss (69?17) ml, complication rate 0. The difference between the two groups was significant (all P0.05). All patients recovered well postoperatively. Conclusions The four operative patterns are ideal for hysterectomy. Young patients should be operated with laparoscopic hysterectomy with preservation of cervix, old patients or patients with CIN should be operated with excision of cervix.