BACKGROUND:Knowledge of retropedtoneal space communications might influence catheter placement,and understanding the normal anatomy of the retroperitoneal space is a prerequisite for predicting the distribution of inflammation or other fluid collections in this region. Until recent years,the media/ attachment of the posterior renal fascia remained controversial. The multiple detector spiral CT can show the abdominal anatomic details. So,using the multiple-detector spiral CT to study the anatomy of posterior renal fascia has clinical significance. OBJECTIVE:To describe the medial attachment of the posterior renal fascia by using multiple-detector spiral CT. DESIGN,TIME AND SETTING:A retrospective case analysis was performed at Department of Radiology,Affiliated Hospital of Weifang Medical College between June 2003 and November 2007. PARTICIPANTS:A total of 52 patients with retropedtoneal inflammatory diseases were retrospectively reviewed through analysis of their CT data. METHODS:Toshiba Akuilion 16-detector spiral CT was employed for scanning. Of the 52 patients,15 were proved by clinical and laboratory findings and 37 were proved by surgery and pathology. Among the 52 patients,17 suffered from appendicitis,1 from ureteritis,2 from abscesses in the perirenal space,3 from abscesses in the posterior pararenal space,and 29 from pancreatltis. MAIN OUTCOME MEASURES:Medial attachment of the bilateral posterior renal fascia. RESULTS:At the level of the upper pole of kidney,the posterior renal fascia fused with the fascia of the ipsilateral quadratus lumborum muscle. Forty-six patients manifested the attachment site of the left posterior renal fascia transforming from the quadratus lumborum muscle fasciae to the psoas major muscle fascia at the level of the lower pole of kidney or the infrarenal space. Fifty patients showed the attachment site of the right posterior renal fascia transforming from the quadratus lumborum muscle fascia to the psoas major muscle fascia at the level of the lower pole of kidney or the infrarenal space. CONCLUSION:The posterior renal fascia attachment site is not the same all the time. At different levels,the attachment site of the posterior renal fascia is distinct.

Objective:To investigate the effects of survivin antisense oligonucleotide (ASODN) on expression of survivin and ACC-M cell apoptosis. Methods: A phosphorothioate antisense oligonucleotide (ASODN) of specific target survivin was designed and synthesized and then transferred to ACC-M cell line by lipofectin. At the same time blank control group, sense oligonucleotide (SODN) group were set up for comparison. MTT assay was used to detect cytotoxicity. Apoptosis was observed by flow cytometry. Survivin expression was determined by RT-PCR and Western-Blotting. Results: Compared with control group and SOND group, in ASODN groups, the expression of survivin mRNA and protein were obviously weak, apoptosis rate apparently increased, cells growth was inhibited. There was no obviously difference in SODN and control groups.Conclusion:ASODN can down-regulate the expression of survivin gene in ACC-M cell line specifically. It plays an important role in inducing tumor apoptosis and suppressing cell proliferation.

Objective:To study the antihyperglycemic effect of water soluble polysaccharides (MCW) and alkaline soluble polysaccharides (MCB) from Momordica charantia L. on streptozotocin-induced diabetic mice. Method:Twelve mice were selected randomly as control, while the other l08 mice were injected with STZ 200 mg/kg?bw to induce diabetes.The diabetic mice were divided into 4 groups,the model, MCW (300 mg/kg bw), MCB (300 mg/kg bw), Gilbenclamide (15 mg/kg bw). The above components were administered intragastrically for 10 d and then blood samples were taken to determine concentrations of serum glucose and insulin. Results: The blood glucose levels could be obviously decreased by MCW and MCB in the diabetic mice. MCB has the best antihyperglycemic effect, in terms of improving the serum insulin level and decreasing the blood glucose level of diabetic mice. Conclusion:The polysaccharides from Momordica charantia can repair the injured pancreatic islet tissues and enhance insulin secretion so as to reduce blood glucose level of the diabetic mice.

OBJECTIVE:To establish a HPLC method to determine the content of compound tramadol tablets METHODS:Stationary phase:Kromasil C18 column,internal standard:phenacetin,mobile phase:methanol-water-triethlamine(55∶45∶0 2),adjusting pH to 4 2 with acetic acid,flow rate∶0 7ml/min,detecting wavelength∶267nm RESULTS:The linear range of tramadol (TR) was 50～500?g/ml(r=0 9 999,n=5) The linear range of nefopam(NFP) was 50～500?g/ml(r=0 9 999,n=5) The average recovery of TR was 99 69% The average content of TR was 100 71%,RSD=0 76%(n=5) The average recovery of NFP was 99 76% The average content of NFP was 99 64%,RSD=0 62%(n=5) CONCLUSION:The method is accurate,rapid and simple

BACKGROUND:Three-dimensional finite element simulation has been widely used in biomechanics. However, there is little research in knee joint replacement. The study of femoral prosthesis is less.
OBJECTIVE:To analyze the optimal positioning parameters of knee replacement and femoral prosthesis implantation, and to verify the efficacy of Gemini-PS knee prosthesis in total knee arthroplasty.
METHODS: (1) Knee finite element model in total knee replacement was constructed. Orthogonal experiment was performed in femoral osteotomy positioning parameters. The shift amount A, external rotation degree B, and valgus degree C of femoral prosthesis were selected as the relevant factors for orthogonal experiment. Three values were taken for each parameter to establish orthogonal tables. Nine experimental combined knee replacement finite element models were created and analyzed with finite element. Analysis of variance and range analysis were used by optimization. (2) Totally 42 patients (47 knees) with knee osteoarthritis received total knee arthroplasty with Gemini-PS knee joint prosthesis. Knee joint function was evaluated after replacement with Hospital for Special Surgery knee score and American Knee Society knee score. Knee pain was assessed with Visual Analogue Scale score.
RESULTS AND CONCLUSION:(1) Minimal polyethylene substrate surface compressive stress peak was translation 0 mm, external rotation of 3°, valgus 6°; the peak stress was 15.9 MPa. Among the influential factors, the effects of internal and external translation were larger than that of external rotation angle, and greater than that of valgus angle. The optimal positioning parameter combination was pan 0 mm, external rotation 3°, valgus 6° by range analysis and variance analysis. Orthogonal experiment was valid by simulation. (2) 42 patients were folowed up for 12-36 months. One patient affected subcutaneous fat liquefaction of the lower segment of the incision. Hospital for Special Surgery knee score and American Knee Society knee score were significantly higher after implantation (P < 0.05). Visual Analogue Scale score was significantly lower after replacement (P < 0.05). X-ray films showed that osteolysis, dislocation or loosening was not found. The recovery of knee joint was good after operation. (3) These findings

The purpose of this research was to understand fecal micro-flora of Enterococcus-related diarrhea feces and the clone characteristics of isolated Enterococcus strains.Primer was designed according to 16S rRNA gene and integrated DNA extracted from patients' fecal samples was used as the template to amplify the conserved sequence of 16S rRNA by PCR.After the PCR product was purified and cloned into T vector to sequence,PFGE was used to analyze 20 out of 50 Enterococcus isolates from each specimen.The 16S rRNA gene sequencing analysis indicated that these 4 portions of diarrhea feces were dominated by Enterococcus faecium (>68%) and the isolates were clonal except only one portion.Although the basic flora characteristics of diarrhea feces could be revealed by 16S rRNA gene sequencing analysis and PFGE analysis,the pathogenicity and mechanism of Enterococcus were still waiting for further experimental exploration.

OBJECTIVE: Chengde is a city with many corneal blindness patients In north China. Lacking of corneas donation is the main reason which prevents corneal transplantation. Survey was made by questionnaire in Chengde to evaluate the current situation and the influential factors of corneal donation.METHODS: Survey was made in 3 200 Chengde residents aged 18 years or older, includes outpatients and inpatients of ophthalmology, some undergraduate students and people met accidentally in park, supermarket, station and centre for elders.48.6% are male and 51.4% are female. Self-made questionnaire includes general state, questions about cornea donation and factors influencing cornea donation.RESULTS: Among 3 200 questionnaires, 2 971 were valid. The effective rate was 92.84%. Over 50% people support donating cornea. More than 40% people intend to donate their corneas and support their relatives to donate. Among the factors for not intending to donate cornea, lacking knowledge of cornea donation was the main reason accounting for 42.81%, and worrying about the misusage of donating cornea without corresponding law became the second factor, which accounting for 21.07%. It has no influence on the consciousness of cornea donation by the difference of sex and location between city and countryside.Whereasfession and level of education indeed influence the consciousness of cornea donation, which of the people from 18 to 40 years old was greater than those of over 40, medical workers was greater than those from other fields, the people graduating from secondary specialized school or higher was greater than those graduating under secondary specialized school.CONCLUSION: People in Chengde have a positive attitude towards cornea donation. It is very necessary to enhance the education of cornea donation, establish an easy and smooth way for donation may promote cornea donating. Consummate legislation is also needed for cornea donation.

Clinical data of 4 patients with chronic obstructive pulmonary disease who underwent allogenic single-lung transplantation were retrospectively analyzed. All cases received corpse donor lungs. One case with diffuse emphysema underwent right lung transplantation. and 3 received left lung transplantation. including one underwent fight lung volume reduction during surgery and 2 cases underwent right lung volume reduction post-transplantation. The inductive treatment with daclizumab or antithymocyte globulin was done and the rejection was prevented with Tacrolimus. mycophenolate and prednisone. The surgery was successfulin 4 cases. One case developed acute rejection on the fifth day post-transplantation. and controlled using methylprednisolone. Two cases discharged successfully, of whom one lived more than 2 years. Two cases died 74 days and 77 days after lung transplantation. respectively.

Objective To summarize the first 16 eases in mainland China and to discuss the cli-nical experience of robot-assisted laparoseopie radical prostateetomy(RLRP). Methods Sixteen pa-tients with localized prostate carcinoma underwent RLRP with da Vinci S surgical system (Intuitive Surgical Inc.). The age of the patients was 62-76 years, average 69 years. The preoperative t-PSA level was 0.2-79. 2. Ng/ml. The volume of prostate was 9.8-232.9 ml. Fifteen patients were with biopsy-proven prostate cancer, the average Gleason score was 7(4-9). Three were T2a. N0 M0, 4 were T2b N0 M0 and 8 were T2c N0/M0 by clinical stage. One was prostatic intraepithelial neoplasm-Ⅲ. The level of t-PSA in serum and the result of urinary continence were followed up after RLRP. Results All the operations were accomplished successfully. The mean preoperative set-up time of the da Vinci surgical system was 64(60--90)min;the mean operation time was 236(190--390)rain;the mean esti-mated blood loss was 231(50-500)m.L The patients were ambulant between the 2nd and 3rd postop-erative days. Foley catheter was sueeeasfully removed on day 10 to 14, and mean hospital stay was 13 (6-19) days. Two eases had positive surgical margins, the pathological stages were both pT3b N0 M0. The average serum t-PSA was less than 0. 1 ng/ml during a median follow-up of 9(6-12) months. By the conventional definition of urinary continence (0 to 1 pads daily), 94%(15/16) and 100% (16/16)of patients were continent at 3 and 6 months, respectively. Of the patients, 75% (12/16)and 88% (14/16)had no urinary leakage(0 pads daily). Conclusions RLRP is small incision and safe. It is the direction of minimally invasive urologic surgery.

Objective To investigate the value of CT in localization diagnosis of the neoplasm of the transverse mesocolon.Methods 26 cases of neoplasm of the transverse mesocolon proved by surgical pathology or pathology from May 1998 to Dec.2007 were retrospectivley studied.All cases underwent CT scan.Image analysis was focused on the relation between neoplasm and SMA,SMV,middle colonic vessels,duodenum,and the small bowel.Readipose sarcoma (n=1),transverse colonic carcinoma invaded the transverse melocolon (n=2),pancreatic carcinoduodenum in 22 cases.Superior mesenteric artery and vein were displaced in 21 cases;middle colonic vessels were showed different CT manifestation.Conclusion The relation between neoplasm and adjacent structure is helpful for the localizing neoplasm of the transverse mesocolon.