Objective To evaluate the value of retroperitoneal laparoscopic adrenalectomy for benign adrenal tumors.Methods From March 2003 to May 2008,78 patients with adrenal tumors received retroperitoneal laparoscopic adrenalectomy in our hospital. During the operation,three trocars were introduced into the lumbar region to establish retroperitoneal space by blunt dissection with the camera. Afterwards,the tumor was removed by using a harmonic scalpel. Results The procedures were successfully completed in all the 78 cases without blood transfusion,the operation time ranged from 45 to 180 min (mean,90 min). Drainage tubes were removed 24 hours after the operation. And the patients were discharged from hospital in 3 to 5 days postoperation. One patient showed regional subcutaneous emphysema after the surgery and was cured spontaneously. The patients were followed up for 3 to 24 months with a mean of 10 months,during which 36 patients achieved normal blood pressure in 3 months,while in the other 7 patients,oral antihypertension drugs were still needed. No patients had recurrent tumor during the follow-up. Conclusions Retroperitoneal laparoscopic can be the first choice for adrenal tumors,as it is safe and effective with minimal invasion,quick recovery,and short postoperative hospital stay.

Objective To investigate the efficacy and toxicity of etoposide combined with prednisone (EtoP regimen) for elderly patients with unspecific peripheral T-cell lymphoma (PTCL-U) compared with the CHOP regimen.Methods 23 elderly PTCL-U patients were randomly assigned to EtoP group (n =12) or CHOP group (n =11).The curative effects and the adverse reactions were analyzed and compared between the two groups by Log-rank test and x2 test.Results The overall response (OR) rate was 66.67 ％ (8/12) in EtoP group and 63.64 ％ (7/11) in CHOP group.There was no statistically significant difference between the two groups(x2 =0.023,P =0.879).The progression-free survival (PFS) was 7.55 months in EtoP group and 4.38 months in CHOP group,statistically significant difference were observed between the two groups (x2 =23.000,P =0.011).The overall survival (OS) was 15.02 months in EtoP group and 12.26 months in CHOP group,no statistically significant difference was observed between the two groups (x 2 =14.985,P =0.597).The main side effects were bone marrow depression and digestive tract toxicity,no hematology toxicity and digestive tract toxicity of grade Ⅲ-Ⅳ occurred in EtoP group.Of those in CHOP group were 36.36 ％ and 27.27 ％.Conclusion For elderly PTCL-U patients,EtoP regimen is an effective and well tolerated therapeutic schedule.

Aim To test the strength of Kraekow bilateral locking stitchfor tendon or ligament free end fixation and evaluate the stitch which wasused in reconstruction of cruciate ligament or secure fixation of soft tissue tobone. Methods Twenty-four specimens of patellar tendon free end, whichwere divided into 3 groups according 2 or 3 stitches and 6 subgroups ac-cording No1 Ethilon or 0.4 mm diameter stainless steel wire different suturematerials, fixed with Krackow locking stitch, were undertaken the tensiletest respectively, so as to find out the least stitches and efficient suture pat-tern. Results 2 Krackow locking stitches had more strength than that of0.4 mm diameter stainless steel wire, the fixation strength of 2 stitcheswhich used No1 Ethilon was more than 80 N, superior to the failure strengthof material itself, it still maintained the same strength if the first stitch wasacross the tendon tissuetransversely. There was no significant differencebetween 2 and 3 Krackow locking stitches in suture strength statistically, thefixation strength was superior to the suture material, it could reduce the'suture exposure when the first stitch is across the tendon tissue while main-tains a comparable strength to other suture. Conclusion If attempt to makea higher strength of suture, we should focus on selecting a stronger materialsor adding the suture materials in number rather than the stitch number.

Interleukin-17 (IL-17) is a newly discovered proinflammatory cytokine in recent years. It has wide biological activities; therefore it may be one of the important factors in the occurrence and development of certain diseases. The article mainly reviews the current situation of the study on the related roles of IL-17 in nervous system diseases.

Babesia parasites are obligate intracellular apicomplexan protozoa and important pathogens causing babesiosis of humans and animals. They have conserved subcellular structures and invasion mechanism. Rhoptry⁃associated proteins，which are released into the host cell，are considered to be the key molecules of invasion and replication of parasites in the host cell and are immunosuppressive factors of the host cell mediated immunity in the stage of parasitophorous vacuole（PV）formation. The knowledge about rhoptry⁃associated proteins has made a great progress with the development of genomics and proteomics，so we review the research progress in rhoptry⁃associated proteins of different Babesia including Babesia bovis，B. ovine，B. gibsoni，B. bigemina and B. orientalis，etc.

Objective To study the role of phosphorylation at Serine 129 in regulating the neurotoxicity of ?-synuclein. Methods Wild type and phosphomimic mutant ?-synuclein genes were over-expressed in mouse dopaminergic cells MN9D using retrovirus. The cell viability was examined using CCK-8 assay and cell morphology was observed by immunofluorescence microscopy. Results The result of real time PCR showed that WT/?-SYN and S129D/?-SYN genes were overexpressed in MN9D as compared to uninfected MN9D and vector control group(P

Objective To evaluate the efficacy and safety of percutaneous micro-channel approach in treatment of pelvis side cyst and ureteropelvic junction obstruction simultaneously. Methods 32 patients with unilateral solitary parapelvic cyst complicated with UPJO, including 25 cases with ipsilateral kidney stones. After percutaneous holmium laser lithotripsy for patients complicated with calculi, then performed incision and drainage through the channels for parapelvic cyst by holmium laser, and antegrade high pressure balloon dilatation for UPJO, drainage by hippocampal tube in 3 ~ 6 months postoperatively. The operation time of fenestration drainage of cyst, narrow hypertensive dilatation and postoperative hospital stay were analyzed. Results Compared with 1 month (46.17 ± 6.33), 3 months (40.47 ± 6.06), 6 months (33.81 ± 7.05), 9 months (28.95 ± 7.92) after surgery, there was a marked improvement of the separation coefficient of renal convergence, the difference was statistically significant (P < 0.05). And compared with 6 months after surgery, the data of 9 months after surgery has statistical significant differences (P < 0.05). The separation coefficient of renal convergence decreases as time goes on. Conclusions Percutaneous micro-channel approach in treatment of pelvis side cyst and ureteropelvic junction obstruction by the same time can effectively relieve symptoms and decrease the separation coefficient of renal convergence. It is safe and effective.

Objective To discuss the influence of different ways of low-dose corticosteroids infusion on hemodynamics, changes in blood glucose level and prognosis in patients with refractory septic shock. Methods A prospective single-blind randomized controlled trial was conducted. Refractory septic shock patients admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from April 1st, 2013 to October 31st, 2014 were enrolled for the study. The patients were divided into control group and research group by random number table. Besides conventional treatment for septic shock, patients in control group were given 200 mg/d hydrocortisone intravenous infusion lasting for 2 hours, while those of research group were given 8.33 mg/h hydrocortisone per hour with an intravenous pump. Treatment lasted for 5 continuous days for both groups. The changes in heart rate ( HR ), mean arterial pressure ( MAP ), central venous pressure ( CVP ) and arterial blood lactic acid in both groups were observed at the time of enroldment and 6 hours, 24 hours, 48 hours, and 5 days after the treatment. With a dynamic blood glucose monitor, mean blood glucose ( MBG ) level, largest amplitude of glycemic excursions ( LAGE ), glucose variability ( GV ), and the ratio of hyperglycaemia time were recorded. The duration of shock, length of intensive care unit ( ICU ) stay, total length of hospital stay, and 28-day mortality of both groups were recorded. Results Seventy-nine septic shock patients were assigned to the treatment, with 41 in control group, and 38 in research group. Compared with control group, 6-hour MAP in research group was obviously lowered [ mmHg ( 1 mmHg=0.133 kPa ):66.31±4.38 vs. 68.58±4.86, t=1.062, P=0.033 ], but there were no significant differences in HR, MAP, CVP, lactic acid clearance and norepinephrine ( NE ) utilization rates at other time points between two groups. No significant difference in MBG was found between research group and control group ( mmol/L:8.69±2.14 vs. 9.95±3.87, t=1.771, P=0.080 ), but LAGE, GV, the ratio of hyperglycemia time in research group were significantly lower than those of the control group [ LAGE ( mmol/L ): 17.18±8.97 vs. 22.71±11.80, t = 2.331, P = 0.022; GV ( mmol/L ): 2.57±1.05 vs. 3.16±1.37, t=2.136, P=0.036;the ratio of hyperglycemia time:( 43.1±11.7 )%vs. ( 49.4±15.3 )%, t=2.044, P=0.044 ]. There was no statistical difference in the following features between research group and control group, such as the duration of shock ( days:3.47±0.98 vs. 3.61±1.07, t=0.605, P=0.547 ), length of ICU stay ( days:8.74±3.12 vs. 9.97±3.37, t = 1.543, P = 0.120 ), total length of hospital stay ( days: 18.34±9.27 vs. 19.58±9.83, t = 0.576, P = 0.566 ) and 28-day mortality rate ( 23.68%vs. 26.83%,χ2=0.103, P=0.748 ). Conclusions Compared with slow intravenous infusion, a continuous intravenous supplementation of small amount of hydrocortisone to patients with refractory septic shock could stabilize blood glucose levels and maintain metabolic balance efficiently. However, in both groups there was no significant difference in the efficiency in stabilizing hemodynamics, shortening shock duration, reducing ICU or hospital days and decreasing 28-day mortality.

This study aimed at verifying a previous patented fraud detection method of propolis.In accordance with the patented process,the chromatographic separation was achieved on a Kromasil 100-5C18 column (250 mm × 4.6 mm,5 tm) as mobile phrase A was methanol and mobile phrase B was water (0.5％ phosphoric acid) at the flow rate of 1 mL· min-1 for gradient elution.The detection wave length was 296 nm.Fraudpropolin A was taken as the reference,while the known sources of natural propolis were determined by HPLC.As a result,no fraudpropolin A was detected in the 134 sources of natural propolis at different types or from various origins.It was concluded that the patented process was sound in the fraud detection method of propolis.

Objective To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock.Methods A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled. The patients satisfied ARDS Berlin diagnostic criteria, over 15 years old, needing vasopressor after fluid resuscitation were enrolled. The patients were divided into norepinephrine group (NE group) and terlipressin group (TP group) by randomise number table derived by computer. Patients in TP group were given terlipressin (0.01-0.04 U/min) with an intravenous pump, while those of NE group were given norepinephrine (> 1μg/min) with an intravenous pump, and the target mean arterial pressure (MAP) was maintained at 65-75 mmHg (1 mmHg = 0.133 kPa). Hemodynamics and extravascular lung water index (EVLWI) were monitored by pulse indicator continuous cardiac output (PiCCO). The volume responsiveness of patient was evaluated by passive leg raising (PLR) test, and cardiac index (CI) change (ΔCI ≥ 10%) served as positive volume responsiveness. The differences in hemodynamics, EVLWI, oxygenation index (OI), lactate clearance rate (LCR), rate of positive volume responsiveness, urinary output, fluid volume balance, renal function, and prognostic indicators were compared between the two groups.Results Fifty-seven patients with ARDS complicated with septic shock were enrolled, with 26 patients in NE group, and 31 patients in TP group, thebaseline data in both groups was balanced with comparability. Compare with NE group, 48-hour and 72-hour heart rate (HR) in TP group was significantly slowed (bpm: 82.1±6.8 vs. 87.6±7.4, 81.3±6.1 vs. 85.6±8.3, bothP < 0.05), 72-hour central venous pressure (CVP) was significantly decreased (mmHg: 9.4±2.6 vs. 10.9±3.0,P < 0.05), but no significant difference was found in HR, MAP, CVP, CI, EVLWI, OI and LCR at other time points between the two groups. 48-hour and 72-hour positive volume responsiveness rate in TP group were significantly increased as compared with those of NE group (74.2% vs. 46.2%, 64.5% vs. 38.5%, both P < 0.05), urinary output on the 2nd day (mL/24 h: 2342.8±704.1 vs. 1944.6±684.3) and fluid volume balance (mL: -319.7±54.8 vs. -169.6±27.2) were significantly decreased (bothP < 0.05). There was no significant difference in positive volume responsiveness rate, urine output, fluid volume balance, and the level of serum creatinine at other time points between the two groups. There was no statistically significant difference in the following features between TP group and NE group: duration of mechanical ventilation (days: 8.41±2.97 vs. 9.67±3.56), length of intensive care unit (ICU) stay (days: 12.84±4.47 vs. 14.77±5.01), total length of hospital stay (days: 19.34±7.37 vs. 21.07±8.41), and 28-day mortality (29.0% vs. 30.8%, allP > 0.05).Conclusions Compared with norepinephrine, terlipressin for ARDS patients with septic shock is more conducive to restrict fluid load, improve the renal perfusion and increase urine output. However, in both groups therewas no significant difference in the efficiency of stabilizing hemodynamics, shortening the duration of mechanical ventilation, reducing ICU or hospital days and decreasing 28-day mortality.