Objective We summarized the clinical experience of modified ileal ureter substitution for treating long segment ureteral defection.Methods We retrospectively analyze the clinical data of 2 patients with long segment ureteral defect who treated with Yang-Monti ileal ureter substitution between March 2015 and November 2015.One 75 years old male patient was diagnosed as upper ureteral malignance and solitary kidney.The length of defection from renal pelvis to bladder was 22 em.His serum creatinine was 100 μmol/L,blood urea nitrogen was 5.7 mmol/L,serum chloride was 98 mmol/L.Another one 41 years old female patient was diagnosed as middle and lower ureteral iatrogenic injury.The traumatic length was 15 cm.Her serum creatinine was 70 μmol/L,blood urea nitrogen was 5.1 mmol/L,serum chloride was 100 mmol/L.they were both treated by Yang-Monti ileal ureter substitution.The ileal intestinal segment was used for the ureteral replacement,which were more than 15 cm to the ilealcecum.The length of intestine was 10.0 cm and 7.5 cm,respectively.The ileal mesentery was preserved.After closing the mesangial hiatus,the ileal segment was pull into the retroperitoneal space and pulling out via descending colonic mesangial window.The ileal segment was divided into three parts,which was 2.5 to 3.0 cm in each part.Each part was opened via long axis and then rotated 90 degree.The 4-0 absorable suture was used to suture the edge of each intestinal part continuously.The sutured intestine was re-tubularized,using 4-0 absorable suture and the F16 catheter was used as the tube model.The length of reconstructed ureter was 22 cm and 18 cm,respectively.The neo-ureter was re-anastomosed with renal pelvis and bladder wall.Two F6 double J stents were placed in the neo-ureter.Results The operative time was 160 min and blood loss was 200 ml in the first case.In the second case,the operative time was 180 min and blood loss was 220 ml.No significant complications were noticed intra-operation and post-operation.Six months after operation,the male patient's serum creatinine was 112 pmol/L,blood urea nitrogen was 6.1 mmol/L,serum chloride was 106.0 mmol/L and electrolytes were normal.In another patient,serum creatinine was 79 μmol/L,blood urea nitrogen was 5.9 mmol/L and serum chloride was 103.0 mmol/L.The GFR was 24.9 ml/min and 22.1 m]/min 3 and 6 months after operation,respectively.Ureteral obstruction wasn't detected on IVU images 3 months after operation.Conclusions For patient with long ureteral defect,which cannot be replaced by other urinary tissue,YangMonti ileal ureter substitution is one of the optional modalities.As a new technique of ureteral substitution,Yang-Monti ileal ureter substitution is simple and fewer complications and can improve the quality of life in patient compared with traditional ureteral substitution.

OBJECTIVETo observe the effect of Yijing Recipe (YR) on the apoptosis of testis spermatogenic cells and the protein expression of Bcl-2/Bax in rats with adenine induced infertility.

METHODSTotally 75 Wistar rats were randomly divided into 5 groups, i.e., the blank control group, the model group, the high dose YR group, the middle dose YR group, and the low dose YR group, 15 in each group. Except those in the blank control group, rats in the rest groups were intragastrically administered with adenine for 10 successive days. From the 11th day, rats in the blank control group and the model group were fed with equal volume of normal saline. Rats in the YR groups were intragastrically administered with YR at different doses (3.38 g/100 g; 1.69 g/100 g; 0.85 g/100 g), once daily for 20 consecutive days. All rats were killed by the end of the experiment and their testes extracted. The apoptosis of spermatogenic cells and the expression of Bcl-2/Bax proteins were detected by terminal deoxynucleotidyl transferase-mediated biotinylated UTP nick end labeling (TUNEL) and SABC method.

RESULTSCompared with the blank control group, the Bcl-2 protein expression decreased, the Bax protein expression increased, and the apoptosis index increased in the model group, showing statistical difference (P <0.01). Compared with the model group, the Bcl-2 protein expression increased in the three YR treated groups (P <0.01, P <0.05). The Bax protein expression level decreased in the high and middle dose YR groups (P <0. 01, P <0. 05). The apoptosis index decreased in the middle dose YR group (P <0.01).

CONCLUSIONYR could inhibit the apoptosis of spermatogenic cells through regulating the expression of Bcl-2 and Bax protein in the testis.

Animals ; Apoptosis ; drug effects ; Drugs, Chinese Herbal ; pharmacology ; Infertility ; metabolism ; Male ; Rats ; Spermatogenesis ; drug effects ; Testis ; metabolism ; bcl-2-Associated X Protein ; metabolism

Objective To explore the characteristics of defense mechanism in patients with obsessive-compulsive disorder(OCD).Methods Outpatients diagnosed as OCD were tested by Yale-Brown obsessive Compulsive Scale. Among them, 40 patients with score beyond or equal to 16 were selected as research group. 33 healthy individuals were selected as normal group. They were tested with Defense Style Questionnaire.Results ①The factor score of immature defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01); the factor score of mature defense mechanisms in the OCD group is lower than that in the normal group (P<0.05); the factor score of middle defense mechanisms in the OCD group is much higher than that in the normal group (P<0.01). ②Passive aggression, acting out, splitting, regression, somatization in the immature defense mechanisms and relief, false altruism, isolation in the middle defense mechanisms are much more used by the OCD group than that in the normal group; but suppression and humor in the mature defense mechanisms are less used by the OCD group than that of the normal group(P<0.05 or P<0.01). ③Sublimation, suppression and consuming tendency are much more used in male patients than female ones in OCD group(P<0.05).Conclusion The patients with OCD tend to use the immature defense mechanisms and middle defense mechanisms, and there is some difference between male and female patients in using defense mechanisms.

Objective To observe the renal lesion caused by aristolochia manshuriensis kom(AMK) through 2 infants who had used AMK before hospitalization.Method Retrospecting the 2 cases of infants caused by AMK from 2002 to 2003,and evaluating their pathogenesis,treatment,and prognosis.Result Two infants both presented with symptoms of acute renal failure(ARF),and poor outcome.Conclusions Renal lesion in infant caused by AMK is serious.Some medcines,such as glucocorticosteroid,may be useful for its treatment and prognosis.

Objective To explore the pathogenesis and prognosis of acute renal insufficiency in children.Method The pathogensis,clinical manifestation,treatment and prognosis retrospected and discussed by analysis of the clinical features of 34 children with acute renal insufficiency hospitalized in 2002-2005.Results Of 34 children,there were 15 females and 19 males,the age range from 16 days to 15.5 years old.Among pathogenesis of acute renal insufficiency,primary glomerular diseases occupied 35.3% and drug-induced acute renal insufficiency occupied about 29.4%.The mortality of drug-induced acute renal insufficiency was 20% of and about 30%(deve-)loped chronic renal insufficiency was 30%.Conclusions Primary glomerular diseases rank the dominant causes of acute renal insufficiency,while drug-induced acute renal insufficiency has poor prognosis.So it is important to treat primary glomerular diseases in early stage and emphasize the side effect of drugs to kidney.

Background Bevacizumab is primarily aimed at pathologic angiogenesis for off-label uses such as the treatment of ocular neovascular disorders.However,as a new anti-fibrotic and anti-angiogenic agent following trabeculectomy,the safety and efficacy of bevacizumab by multiple-time and high-dose subconjunctival injection are still under study.Objective This study was to assess the safety and efficacy of bevacizumab after multiple-time and high-dose subconjunctival injections.Methods Regular trabeculectomy filtration surgery was performed on both eyes of 18 clean New Zealand White rabbits 0.1ml of bevacizumab(25g/L) was subconjunctivally injected intraoperatively and 3,5,7 days postoperatively in the left eyes of rabbits,and no any intervene in the right eyes were as normal controls.Bleb morphology was examined every 2 days and graded based on Moorefield's criteria and compared between the bevacizumab-treated eyes and normal saline(NS) eyes.The animals were sacrificed at 10,20 and 30 days after surgery respectively.The histopathological changes of the blebs were detected by hematoxylin and eosin stain to evaluate the cellular element around the bleb,and Masson stain was used to assess the degree of fibroblast proliferation.The degree of vascularity of bleb was identified by anti-vWf stain.Approval of this protocol was obtained and permitted from People's Hospital Institutional Animal Care and Use Committee of Peking University.The use of experimental animals complied with the Regulation for the Administration of Affair Concerning Experimental Animals by State Science and Technology Commission.Results Compared to the NS-treated eyes,bevacizumab-treated eyes showed the larger and more diffusely elevated blebs with the significant difference(2.48±0.22cm2 versus 1.73±0.27cm2,t=5.194,P＜0.05).The survival time of the filtration bleb in bevacizumab panel was longer in bevacizumab-treated eyes compared to control eyes,showing a significantly difference between them(21.0±1.56 days versus 12.5±1.97 days,t=3.830,P=0.005).Histological and immunohistochemical analysis confirmed that bleb and adjacent conjunctiva vascularity(A value) was significantly less in bevacizumab-treated eyes than that in control eyes at 20 days after surgery with the difference value 14320.7±4134.9(t=12.275,P＜0.05),and fibroblast deposition value was evidently diminished after bevacizumab treatment at 30 days following surgery in comparison with control eyes with the mean difference 0.27±0.03(t=15.980,P＜0.05＝.Conclusion Repeated subconjunctival injection of bevacizumab can effectively prolong the survival time of bleb in a rabbit model of trabeculectomy and limit the degree and area of vascularization in 30 days following surgery.Bevacizumab inhibit fibroblast-meditated tissue formation significantly in the later phase of vascularization after trabeculectomy.

Objective To overcome the fact that SRV-NM virus can only multiple and amplify through partially pu-rified jaagsiekte retrovirus inoculated intratracheally in sheep but it cannot be augmented using in vitro cell culture, we con-structed JSRV-NM pseudovirions based on high efficiency packing system of lentivirus. Methods Lentivirus of three high efficiency packing plasmids system pMD.G, pCMV-HIV 8.2 and pHIV-eGFP was developed, and JSRV-NM-env coated plasmid pCMVJSRV-NM was used to substitute VSV-G virus coated plasmid pMD.G then co-transfected into 293T cells to replicate, package and produce restructured JSRV-NM pseudovirions. Gene expression of pseudovirion was determined through WPRE using real time PCR; Virus infectivity was detected through inoculating JSRV-NM pseudovirions into 24 pore plates. Results We construct JSRV-NM pseudovirions successfully based on the lentivirus system. JSRV-NM pseudo-virions can also be concentrated to higher titer (108 TU/mL detected by real time PCR by ultracentrifugation without signifi-cant loss of activity. JSRV-NM and VSV-G pseudovirions infected on Hela cells (both MOI= 3) respectively and no obvi-ous difference were shown on their infection efficiency detected by real time PCR. Conclusion Based on lentivirus system, JSRV-NM pseudovirions can be multipled and amplified in 293T cell culture in vitro. JSRV-NM pseudovirions is stable without loss its infection activity and the requirements of biological laboratory safety II was also met. JSRV-NM pseudoviri-ons will provide a useful tool for further study of JSRV-NM-env infection across species or its induction of lung adenocarci-noma.

BACKGROUND:For patients in intensive care unit (ICU), mechanical ventilation is an effective treatment to survive from acute illness and improve survival rates. However, long periods of bed rest and restricted physical activity can result in side effects. This study aimed to investigate the feasibility of early rehabilitation therapy in patients with mechanical ventilation. METHODS:A randomized controlled trial was carried out. Sixty patients, with tracheal intubation or tracheostomy more than 48 hours and less than 72 hours, were admitted to the ICU of the Affiliated Hospital of Medical College, Qingdao University, from May 2010 to May 2012. These patients were randomly divided into a rehabilitation group and a control group. In the rehabilitation group, rehabilitation therapy was performed twice daily, and the training time and intensity were adjusted according to the condition of the patients. Early rehabilitation therapy included heading up actively, transferring from the supine position to sitting position, sitting at the edge of the bed, sitting in chair, transferring from sitting to standing, and ambulating bedside. The patient's body mass index, days to first out of bed, duration of mechanical ventilation, length of ICU stay, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality of patients were all compared between the rehabilitation group and the control group. The differences between the two groups were compared using Student's t test. RESULTS:There was no significant difference in body mass index, APACHE Ⅱ score, highest FiO2, lowest PaO2/FiO2 and hospital mortality between the rehabilitation group and the control group (P>0.05). Patients in the rehabilitation group had shorter days to first out of bed (3.8±1.2 d vs. 7.3±2.8 d; P=0.00), duration of mechanical ventilation (5.6±2.1 d vs. 12.7±4.1 d; P=0.005) and length of ICU stay (12.7±4.1 d vs. 15.2±4.5 d; P=0.01) compared with the control group. CONCLUSION:Early rehabilitation therapy was feasible and effective in improving the outcomes of patients with mechanical ventilation.

Objective:To investigate the impact of aging on the correlation between the intestinal microorganism Akkermansia and obesity, and to analyze the features of the correlation in the elderly population. Methods:This was a cross-sectional study.A total of 6896 cases were collected from the Guangdong intestinal microbiome in 2018, aged 18-94 years old, including 3806 females, 1641 cases with abdominal obesity(23.7%)and 707 cases with systemic obesity(10.3%). The 16S rRNA sequencing data were from individuals of Cantonese descent.The abundance of Akkermansia was calculated after data cleaning, clustering and annotation.The type of abdominal obesity or systemic obesity was diagnosed based on the standards of the Working Group on Obesity in China(2002). According to the five quintiles of the abundance of Akkermansia, subjects were divided into Q1~Q5(Q1-Q4: n=1379, Q5: n=1380). Logistic regression was used to study the relationship between Akkermansia and obesity after adjusting for common confoundors such as gender.Subjects were subgrouped into two types of age groups: the <65 group(n=5467)and the ≥65 group(n=1519); the <70 group(n=6136)and the ≥70 group(n=850). Age windows were used to analyze changes in characteristics of this relationship with increasing age. Results:There were significant differences in age and gender among different Akkermansia groups( t/ χ2=3.51, -5.03, P<0.01). Logistic regression analysis showed that after adjusting for two main confounding factors, age and gender, the risk of systemic obesity and abdominal obesity gradually decreased from Q2 to Q5 group, compared with Q1 group( P<0.001). The correlation between Akkermansia and obesity decreased with age.The protective effect of Akkermansia on obesity was weaker in the ≥65 and ≥70 groups, respectively, than in the <65 and <70 groups. Conclusions:Akkermansia is a protective factor for obesity, but the protective effect is affected by aging and weakened in the elderly.

?AIM:To observe the values and changing rules of angle Kappa in corneal refractive surgery under light and dark conditions.?METHODS:Two hundred and thirty-four eyes of 118 patients for corneal refractive surgery were enrolled for this study.Pupil diameters and angle Kappa values under light and dark conditions were measured by Keratron Scout corneal topography.?RESULTS: There were significant differences in pupil diameters between light and dark conditions (P<0.01). More angle Kappa of both eyes distributed in the superior nasal quadrant under light conditions, and more angle Kappa distributed in the superior temporal quadrant under dark conditions.The differences of horizontal and vertical offsets of angle Kappa under two conditions were statistically significant (P<0.01).?CONCLUSION: The changes of pupil diameters in light and dark conditions could affect angle Kappa and then affect the accuracy of corneal refractive surgery centered on angle Kappa.