Objective To evaluate the safety and efficacy of the photoselective prostate vaporization (PVP) for the patients of benign hyperplasia of prostate (BPH) with oral anti-coagulant.Methods From September 2008 to May 2010,7 cases of BPH with oral anti-coagulant were treated by PVP,with an average age of 74 years.The prothrombin time before the surgery was (13.14 ± 0.15) s.An 100 W Green-light laser source was applied in this study.The prostate volume,operating time,blood loss,catheter indwelling time after the surgery,hospital stay,PVR,Q IPSS score were recorded.Results The mean operating time was (65 ± 22) min without active bleeding or transfusion in this cohort.The haemoglobulin concentration was intact and catheter indwelling time was (22 ± 8) h,while the hospital stay was (2.7 ± 1.2) d.The PVR,Q IPSS score were significantly improved after follow-up of 1 month (P ＜0.01).One case complicated acute urinary retention after operation in this cohort,and the catheter was removed 4 weeks after α-blocker administration.Conclusions PVP is a safe and effective surgical strategy for BPH patients with oral anti-coagulant.However,since there were relatively limited cases enrolled in this study,more randomized controlled clinical trials are needed in the near future.

According to the limited class hours and requirements of medicinary major curriculum application,this paper attempts to make some choice of physical chemistry teaching contents and emphasize on the first class,and also to explore bilingual teaching of partial chapters and experimental teaching.

Objective To investigate the effect of continuous blood purification (CBP) on pro-or anti-inflammatory immune function and prognosis in patients with sepsis. Methods One hundred and two patients with sepsis were randomized into the CBP group (60 cases) and the control group (42 cases). The patients in the control group were treated with conventional therapy, and the patients in the CBP group received at least 72 h CBP treatment additionally. The APACHEⅡ score, SOFA score, the 28 day survival rate and ICU length of stay were recorded and levels of spleen Th1, Th2 were assessed by FACS flow cytometry. Enzyme linked immunoadsordent assay (ELISA) was used to determine the levels of serum IL-1, IL-10 and TNF-α before and at 24, 48, 72 h after the treatment. Results The APACHEⅡscore and SOFA score decreased markedly in the CBP group after the treatment (Р <0.05). The period of staying in ICU of patients in the CBP group was shorter than that of patients in the control group (Р < 0.05). There was no significant difference of the 28 day survival rate between the two groups (91.6% vs 71.2%, Р > 0.05). Compared with the control group, levels of IL-1, IL-10 and TNF-α were decreased markedly, and the ratio of Th1 / Th2 was increased significantly at 72 h after the treatment in the CBP group (Р < 0.05). Conclusion CBP can eliminate inflammatory mediators, and help to enhance the immune function, and restore the balance of Th1 / Th2 in patients with severe sepsis.

Objective To investigate the effect of IL-1 7A on lipopolysaccharide (LPS)-induced neuroinflammation and fear conditioning test.Methods Among 70 male SD rats aged 18 months, firstly,thirty rats were randomly divided into five groups:control group(group A),LPS 6 h group (group B),12 h group(group C),24 h group(group D),48 h group(group E).Group A were injected intraperitoneally with normal saline and groups B,C,D and E were injected with LPS 500 μg/kg.Ani-mals of groups A,B,C,D and E were killed respectively after LPS injection and their hippoeampus tis-sue was detected for the concentration of IL-1 7A.Secondly,forty rats were randomly divided into 4 groups:control group(group O),IL-1 7A antibody group(group P),LPS group (group Q),IL-1 7A antibody+LPS group(group R).Group P and group R were injected intracerebroventricularly with IL-1 7A antibodies 3 μl (200 μg/μl),groups O and Q were injected equal volume of normal saline.30 min later,groups Q and R were injected intraperitoneally with LPS 500 μg/kg,groups O and P were in-jected equal volume of normal saline.24 h later,contextual fear conditioning test was performed. Then,all animals were killed and their hippocampus tissue would be detected for the concentration of TNF-αand IL-6,as well as the expression of Iba1-positive cells.Results The concentration of IL-1 7A of groups B,C,D and E increased significantly compared with group A (P <0.01 ),there was no difference between groups E and A.The freezing time of groups Q and R was significantly shortened than that in group O(P <0.01 or P <0.05 ),the freezing time of group R was significantly longer than that in group Q(P <0.01).The concentration of TNF-αand IL-6 of groups Q and R was obvi-ously higher than group O(P <0.01 ),the concentration of TNF-α and IL-6 of group R lower than group Q(P <0.01).The expression of Iba1-positive cells in hippocampal area CA1 of groups Q and R was obviously increased compared with group O(P <0.01).Compared with group Q,the expression of Iba1-positive cells in hippocampal area CA1 of group R were obviously decreased (P < 0.05 ). Conclusion IL-1 7A is implicated in the early stage of LPS-induced neuroinflammation and the chan-ging of freezing time in contextual fear conditioning in aged rats.

Objective:To compare the quality of life following total gastrectomy(TG) with that folliwng subtotal gastrectomy(SG) in patients with gastric carcinoma.Methods:Sixty-six patients underwent gastrectomy between 2003 and 2005 at the Department of General Surgery of the Qilu Hospital were enrolled into this study.Among them,15 underwent TG,42 accepted distal end subtotal gastrectomy(DSG) and 9 underwent proximal end(PSG) .The EORTC quality of life questionnaire QLQ-STO20 was used in the present retrospective study to assess follow quality of life of thes patients.The food-intake,local symptom and quality of life of the 3 groups were compared.Results:Patients recovered worse in short term after TG compared with PSG,but there was no statistical difference in the near future.But both of them were not as good as DSG.The contraflow was common and serious after PSG.The incidence rate of abdominal distension was high.Conclusion:The indication of TG for carcinoma of the superior part of stomach can be extented properly.Evidence-Based Medicine should be used to screen better reconstruction mode.On the base of radical cure,quality of life should be improved as far as possible.

Objective To assess the effects of surgical treatment for patients with blepharochalasis and its associated abnormali- ties. Design Retrospective case series, Participants 35 cases (52 eyes) with blepharochalasis in stable phase. Methods The correction of the abnormalities in upper eyelids: after designing the lid crease incision, the redundant eyelid skin and prolapsed fat were excised, and prolapsed lacrimal glands were sutured back into position in 18 cases (36 eyes) and ptosis was treated in 10 cases (16 eyes). The correction of abnormalities in lower eyelids: lower eyelid retraction was corrected in 4 cases (6 eyes). The correction of lateral canthus malformation: lateral canthus rounding was treated in 7 cases (14 eyes), accompanied with or followed by correction of baggy eyelid or ptosis. Main Outcome Measures The shape, location and movement of bilateral eyelids, the location of lacrimal glands and the cir- cumstance of tear secretion. Results During the follow-up of 6～60 months, the appearance and location of bilateral eyelids and can- thuses were satisfying, the function of eyelids were normal, and no dry eye symptoms were found. Two cases (3 eyes) appeared recurrent lacrimal gland prolapse 29 and 36 months postoperation and received surgeries for correction again. There was no recurrence after the second prolapse correction surgery in the follow-up of 18 and 24 months respectively. Conclusions Surgical treatment for patients with blepharochalasis and its associated abnormalities is safe and effective. Its recurrence rate is low.

Objective Given the significant differences of ischemia-time tolerance observed in clinical heart transplantation between heart and other solid organs,it is important to make a clinical assessment of the correlation between the cold ischemic time of the donor heart and the survival rate after heart transplantation.With these results,we may standardize the management of clinical heart transplantation by providing a proper heart cold ischemic time frame for reference.Method The clinical data of 131 orthotopic heart transplantation patients in our hospital,from September 2008 to March 2014,were collected and analyzed retrospectively.All donor hearts were preserved in histidinetryptophan-ketoglutarate solution (HTK solution) during cold ischemic time.The cold ischemia time was 103-485 min,with an average of 245.2 ± 120.4 min.According to the cold ischemic time,all patients were divided into three groups:＜ 3 h (n =62); 3-6 h (n =41); ＞6 h (n =28).Result (1) Prolonged cold ischemia time could result in high IABP usage perioperatively (postoperative IABP support rate for the three groups was 3.2％,9.8％ and 14.3％ respectively,P =0.155) and high rejection rate (incidence of rejection was 6.4％,9.8％ and 17.9％ respectively,P =0.245),but there was no statistically significant difference.(2) Three weeks after the transplantation,all EF values of the three groups were reduced within the normal range,with no significant difference.Perioperative overall survival rate was 97.7％ (128/131),while survival rate of the three groups was 97.29％ (72/74),100％ (30/30) and 96.29％ (26/27),respectively (P =0.61).(3) One-year overall survival rate was 89.87％ (71/79),and the one-year survival rate of three groups was 92.2％ (47/51),90.9％ (10/11) and 82.4％ (14/17) respectively (P=0.51).Fifty-two patients were still under 1 year follow-up period.This study aimed to illustrate the effect of different cold ischemic time on perioperative cardiac function,rejection rate,IABP usage postoperatively (intra-aortic balloon pump or intra-aortic balloon counterppulsation) and early/mid-term efficacy after transplantation.Conclusion Cold ischemic time within 6-8 h is clinically safe for heart transplantation,and can provide satisfactory early and medium-term effect.Donor heart with cold ischemia time longer than 6 h may extend the recipient inclusion criteria.But considering the safety of transplantation,these donor hearts may be more applicable for the marginal recipients.This study describes the relationship between cold ischemic time and early and medium-term effect of heart transplantation.However,its long-term effects still require further investigation.

OBJECTIVE: To observe the effects of Jianpi Yishen Recipe (JPYSR), a compound Chinese herbal medicine, on recurrence, metastasis and life span of mice transplanted with proventriculus squamous carcinoma cells after tumorectomy. METHODS: JPYSR was orally administered to 615 mice transplanted with proventriculus squamous carcinoma cells in the palma of left hind limb after tumorectomy. The local tumor recurrence, lung metastasis and life span of the mice were evaluated and compared with those of the 5-FU-treated mice and untreated mice. RESULTS: The pulmonary metastasis rate was 94.4% and the recurrence rate was 94.44% in untreated group. The pulmonary metastasis rate was 68.4%, the inhibition rate of pulmonary metastasis was 27.5%, the recurrence rate was 78.95%, and the inhibition rate of tumor recurrence was 65.35% in JPYSR-treated group. The average and median life spans were obviously prolonged in JPYSR-treated group, as compared with those in untreated group. The life-prolonging rate was 100%. CONCLUSION: JPYSR can effectively inhibit the local recurrence and pulmonary metastasis of the transplanted proventriculus squamous carcinoma in mice after tumorectomy, and prolong the life span.

Objective To determine the effectiveness of endovascular embolization through pulmonary artery access in patients with refractory massive hemoptysis in whom systemic artery (SA)embolization is ineffective or contraindicated. Methods A total of 102 patients were treated with SA embolization for hemoptysis. Of the 102 patients, 6 patients had severe persistent hemoptysis despite complete SA embolization and 1 patient had severe hemoptysis following complete bronchial artery embolization and other SA embolization was contraindicated. The underlying diseases were chronic cavitary pulmonary tuberculosis (n = 3), chronic cavitary pulmonary tuberculosis complicated with aspergilloma (n=1), tuberculous bronchiectasis (n=1), severe necrotizing pneumonia (n=1) and bronchiectasis complicated with pneumatocele (n=1). The findings of SA angiography, main pulmonary angiography and selective pulmonary angiography were analyzed. Endovascular embolization was performed in patients with the detectable pathology in PA and the clinical results were observed. Results The findings of SA angiography showed bronchopulmonary shunting in all cases, and pseudoaneurysm of PA in 2 cases and hypertrophy of peripheral PA in 2 cases. The main PA angiography demonstrated pseudoaneurysm of PA in 1 case and hypoperfusion of the diseased PA in other case. The selective PA angiography demonstrated pseudoaneurysm of PA in 4 cases (1 case with extravasation of constrast medium) and hypertrophy ofperipheral PA in 2 cases. Coil embolizations of the pathologic PA were successfully performed and bleeding ceased in all patients. During follow-up, 1 patient had episodic bloody sputum after embolization, and 2 died day 6 and 15 of severe infection and respiratory failure and the remaining patients were all stable.Conclusions In patients with refractory massive hemoptysis after systemic embolization, the possibility of PA pathology, especially pseudoaneurysm of PA should be considered. Selective pulmonary angiography is necessary to demonstrate the pathology in PA. Endovascular management of the pathologic PA appears to be a safe and effective treatment.