0.05).The recurrence of pterygium was related to the age.If the age increased five years,the risk of recurrence decreased 18.1%. Conclusion The application of MMC(during) the operation could decrease the recurrence rate of pterygium.The recurrence rate of pterygium was not related to the time of application of 0.02% MMC,and detainment for 3 min was enough during the operation.

Laryngeal interarytenoid neurilemmomas (LIN) is a benign encapsulated tumor originating from the schwann cells lining nerve fibers. Even though LINs are extremely rare in incidence, they could present with potential threat to the airway and thus requiring prompt diagnosis and treatment. Here, we report two cases of LINs. Both patients underwent excision of the tumor via microlaryngeal endoscopic procedures and recovered well postoperatively without complications. No recurrence was observed postoperatively on routine follow-up after 14 months.
Endoscopy ; Humans ; Larynx ; pathology ; surgery ; Neurilemmoma ; surgery ; Otorhinolaryngologic Surgical Procedures ; Postoperative Period

Objective To explore biomechanical properties and clinical results of a new type of dynamic Hoffmann external fixator(NDHEF)for tibial shaft fractures.Methods Fifteen specimens of adult tibia were randomly divided into three groups and osteotomized obliquely in the mid part of the tibia.These specimens were fixed with NDHEF,improved Hoffmann external fixator(IHEF)and maltifunctional external fixator(MEF)re- spectively.The axial compression,bending,torsion and stress shielding tests were performed on the specimens in each group for biomechanical comparison.From 1995 to 2004,40 cases of open tibiofihular fractures were treated with NDHEF and 88 cases with IHEF and their clinical results were analyzed and compared.Results The biomechanical tests showed that the compressive rigidity,bending rigidity and torsion rigidity of NDHEF were similar to those of IHEF(P＞0.05)but significantly stronger than those of MEF(P＜0.05).The stress shielding of NDHEF was obviously weaker than that of other external fixators(P＜0.05).All the 128 cases were followed up for 12 to 36 months(average,16.8 months).The mean substantial bone healing time for NDHEF treatment was 22.3 weeks and that for IHEF was 26.8 weeks.The difference was significant(P＜0.05).The rates of delayed union and malunion were all 7.5% for NDHEF,but 15.9% and 4.5% respectively for IHEF.The difference was insignificant (P＞0.05).Conclusions The biomechanical performance of NDHEF is superior to that of IHEF,for it can diminish the stress shielding and accelerate bone healing.It is a good external fixator for tibial fractures.

General practitioner represents the core competency of community health care center and also the key for sustainable discipline development.Talent developing is regard as critical issue for both discipline construction and community health service development.Community health care center,as a platform for internship,practice and continue medical education of medical professionals,plays an important role in career development of general practitioner.We clearly defined the role and responsibility of community health care center in general practicing talent development,and built an excellent career development platform.We integrated project-talent-discipline three-in-one to promote clinical research and talent development;applied two-factor theory to set up effective talent plan and incentive mechanism.This article summarized our approach and experience in talent development as a reference for colleagues in other community centers.

Objective To evaluate the diagnostic value of quantitative analysis parameters of dynamic contrast-enhanced magnetic resonance imaging (MRI) in differential diagnosis of prostatic disease.Methods 12 patients with prostate cancer and 16 patients with benign disease underwent DCE-MRI examination.Region of interest (ROI) were drawn in areas of cancerous foci,normal prostate peripheral zone and normal prostate central gland to measure the values of Ktrans (transport constant),Kep (rate constant),Ve (extravascular extracellular volume fraction).Values of the three parameters were analyzed by ANOVA and the differences were compared between the different tissues.Results The values of Ktrans,Kep and Ve were (0.42±0.10)/min,(0.64±0.11)/min,(0.61±0.14) respectively in the area of cancerous foci,while (0.17 ±0.08)/min,(0.32 ±0.10)/min,(0.59±0.11) respectively in normal prostate peripheral zone,and (0.33±0.12)/min,(0.50± 0.16)/min,(0.62 ±0.07) respectively in normal prostate central gland.The differences in Ktrans,Kep values were statistically significant between cancerous foci,normal prostate peripheral zone and normal prostate central gland (F =31.646,27.196,respectively,all P ＜ 0.05),but no statistically significant difference was found in the Ve value between the three different tissues (F=0.533,P＞ 0.05).Conclusions Quantitative analysis of DCE-MBI can be used to differentiate benign from malignant prostatic diseases,which hasa great application prospect.

Objective To investigates the role of duodenum and bile duct preserving pancreatic head resection (DBPPHR) in treatment of benign or low-grade malignant diseases located in the head of pancreas.Methods The clinical data of 31 patients who underwent DBPPHR between April 2012 to May 2016 in Zhejiang Provincial People's Hospital and Zhangzhou Municipal Hospital of Fujian Province were analyzed retrospectively.Results Of the 31 patients,4 patients underwent laparoscopic DBPPHR.One patient in the open group was converted to pancreaticoduodenectomy.For the open group,the mean operation time was (165.3 ±63.6) min;the mean estimated blood loss was (258.1 ± 156.9) ml;and the mean postoperative stay was (11.7 ± 6.3) days.The postoperative complications included 1 reoperation due to postoperative bleeding,1 bile leakage and 13 patients developed grade A pancreatic fistula (48.2％).For the laparoscopic group,the mean operation time was 350.0 (280.0 ～ 450.0) min;the mean estimated blood loss was 425.0 (250.0 ～600.0) ml;and the mean postoperative stay was 14 days.Three patients developed postoperative pancreatic fistula (grade A).The pathological diagnosis were:12 patients with pancreatolithiasis,8 patients with serous cystadenoma,4 patients with branched intraductal papillary mucinous neoplasm,5 patients with neuroendocrine tumor and 2 patients with mucinous cystadenoma.The follow-up period was 1 ～ 48 month,and there was no patient with diabetes or diarrhea.Conclusions DBPPHR was safe and efficacious.It is less invasive to treat benign or low-grade malignant diseases located in the head of pancreas.

Objective To observe hypoxia-induced pulmonary arterial endothelial-to-mesenchymal transition and investigate the role of transforming growth factor β1 (TGF-β1) in the process. Methods Pulmonary arterial cells improved by adherence method were cultured in normoxia (containing 21%O2,5%CO2 and 74%N2) or hypoxia (containing 1%O2,5%CO2 and 94%N2) for 1,4,or 7 days,respectively. Endothelial-to-mesenchymal transition was confirmed with morphological observation and expression of α-smooth muscle actin (α-SMA) by immunocytochemistry. Expression of TGF-β1 was evaluated by RT-PCR and Western blot,and α-SMA by Western blot. Results Hypoxia-induced paving-stone-like pulmonary arterial endothelial cells transdifferentiating to polygonal cells with high-expression of α-SMA. TGF-β1 expression was increased significantly after 7 days of hypoxia. TGF-β1 stimulating alone increasedα-SMA expression of pulmonary arterial en-dothelial cells;while,SD-208,inhibitor of TGF-β1,abolished the above effect. Conclusion Hypoxia can induce endothelial-to-mesenchymal transition. And TGF-β1 plays an important role in the process.

BACKGROUND:Previous tudies have shown that the anti-aging effects of stem cel s with lycopene are more significant, and can also significantly improve the aging body immune function.
OBJECTIVE:To investigate the anti-aging effects of human umbilical cord mesenchymal stem cel s combined with lycopene on the aging beagles.
METHODS:Sixteen aging beagles (6-7 years old) were randomly divided into two groups:aging control group and aging treatment group;young beagles (3-4 years old) were chosen as young control group. In the aging treatment group, human umbilical cord mesenchymal stem cel s combined with lycopene was given;while in the other two group, an equal amount of DMEM/F12 cel culture medium and sunflower oil was given. Each dog's general conditions were observed regularly during the whole progress. The changes of superoxide dismutase,
malondialdehyde, glutathione peroxidase in the serum were detected at regular time of the whole process, and the structure changes of each organ were observed at 24 weeks of treatment.
RESULTS AND CONCLUSION:(1) Before treatment, the levels of superoxide dismutase and glutathione peroxidase in the aging control and treatment groups were lower than those in the young control group (P<0.05), while the malondialdehyde content was higher than that in the young control group (P<0.05). However, there was no significant statistical difference between aging control and treatment groups (P>0.05). (2) For the aging treatment group at 24 weeks of treatment:the beagle fur became clearer and smoother, motility was strengthened, appetite became better;and the activity of superoxide dismutase in serum at 8 to 24 weeks of treatment increased significantly compared with before treatment (P<0.05), the activity of glutathione peroxidase significantly increased from 6 weeks (compared with treatment before, P<0.05), the malondialdehyde content decreased significantly from 4 weeks of treatment to the completion of the experiment (compared with before treatment, P<0.05). (3) After the experiment, the microscopic observation showed that compared with the aging control group, the tissues and organ structures of the aging treatment group were al clear, had no inflammatory infiltrates, no obvious necrosis and fibrosis lesions. These results were mainly consistent with the observations of young control group. The above results show that umbilical cord mesenchymal stem cel s combined with lycopene therapy on the natural aging beagles may enhance the activities of antioxidant enzymes, reduce malondialdehyde content, and their combination also can repair tissue structures and promote the functions, which has obvious anti-aging effects.

Objective To study the clinicopathologieal features and expression of cyclin D1 and p53 in epithelial ovarian tumors,and to investigate the correlation between pathogenesis of ovarian cancer and epithelial borderline tumors.Methods Fifty four cases of ovarian borderline tumors and 45 cases of ovarian carcinomas from the People's Hospital,Peking University were reviewed retrospectively.The clinical data and pathological findings were analyzed.Immunohistochemical study of cyclin D1 and p53 was performed in all 99 cases.Results(1)In borderline tumors,the age of patients ranged from 14-82 (mean age=42.5)years.International Federation of Gynecology and Obstetrics(FIGO)stage of borderline tumors was stage Ⅰ in 48 cases,stage Ⅱ in 3 cases,and stage Ⅲ in 3 cases.In ovarian carcinomas,the age of patients ranged from 26-80(mean age=53.5)years.FIGO stage of carcinoma was stage Ⅰ in 6 cases, stage Ⅱ in 8 cases,stage Ⅲ in 26 cases,and stage Ⅳ in 5 cases.In follow-up of 54 cases with borderline tumors the 5-year survival rate was 98% and of 45 cases with carcinomas a 5-year survival rate of 51% was noted.(2)In 54 cases of borderline tumors,mucinous types accounted for 56%(30/54)and serous types accounted for 30%(16/54).There were 5 cases with micropapillary pattern,3 cases with peritoneal implants,3 cases with lymph node involvement,6 cases with microinvasion,one case with intraepithelial carcinoma,and one case with mural nodules.In 45 cases of carcinomas,serous carcinoma was the most (49%,22/45).The remainder included 3 cases of mucinous types,8 cases of endometrioid types,6 cases of transitional cell types,3 cases of mixed phenotype and 3 cases of undifferentiated types.(3) Overexpression of cyclin D1 and p53 was observed in 31%(14/45)and 56%(25/45)of ovarian carcinomas, respectively.There was a significant association between p53 overexpression and tumor grade.In the borderline tumor group,69%(37/54)had overexpression of cyelin D1 and 6%(3/54)had overexpression of p53.There were significant differences in expression of cyclin D1 and p53 between conventional serous borderline tumors and high-grade serous carcinomas(cyclin D1:91% vs 26%;p53:0 vs 58%).However, micropapillary serous borderline tumors and low-grade serous carcinomas showed remarkably similar expression of cyelin D1 and p53.Conclusions Epithelial ovarian borderline tumors are distinct from ovarian cancer in clinical progress and prognosis,and histological types.Overexpression of cyclin D1 is common in ovarian borderline tumors and low grade carcinomas.And overexpression of p53 is more common in high grade ovarian carcinomas.Conventional serous borderline tumors are distinct from high-grade serous carcinomas in pathogenesis.Micropapillary serous borderline ovarian tumors may be closely related to low grade serous carcinomas.

Objective To evaluate the indications and intraoperative management of nephron-spar- ing surgery (NSS) for renal cell carcinoma (RCC).Methods A total of 53 patients (32 men and 21 women;age range,21 -76 years) with unilateral RCC and a normal contralateral kidney underwent NSS.The disease course ranged from 1 week to 13 months.The unilateral RCCs were detected by B-uhrasonography. Partial nephrectomy was performed on 38 cases of polar RCC and wedge nephrectomy was performed on 15 cases of central RCC.Both renal vein and artery were blocked for 10 - 15 min,and unclamped for 1 -2 min if necessary.The resections were finished within 7 -21 min (mean,12 min).No inosine and regional hypo- thermia were used during operation.Absorbable hemostatic gauze and terylene flake were used to suture renal wound surface.After operation all patients were treated with interferon hypodermic injection of 5 000 000 U every other day for 3 months.Results The diagnosis of RCC with negative cutting margin was confirmed by pathological examination in all patients.The greatest dimension of the renal cancers were＜4 cm except for one of 6 cm.The clinical stage was T_1N_0M_0 in all patients.During the follow-up of 6 -48 months,all pa- tients were alive without recurrence and had normal renal function.Conclusions NSS can be rapidly per- formed for T_1 stage renal cancer＜4 cm or single clearly localized cancer＞4 cm in diameter.The follow-up results are satisfactory.