Objective To improve the diagnosis and treatment of renal inflammatory pseudotumor (RIP). Methods 10 cases of RIP treated from 1970 to 1999 were reviewed and the diagnosis and treatment were discussed. Results The main clinical manifestation of RIP were fever,lumbago and hematuria.6 of 10 underwent nephrectomy because of the suspicion of kidney cancer whereas the other 4 were cured by antibiotics without recurrence on following up for 1～5 years. Conclusions RIP is rare,the diagnosis being based on clinical symptoms together with dynamic B ultrasound and CT scan.Needle biopsy is indicated to establish the diagnosis if necessary.Antibiotics is usually effective.

The aim of this study was to investigate the hypnosis of the combination of propofol and ketamine. Two hundred healthy Kunming mites were randomly divided into five groups, and each groups included five subgroups receiving five designed doses in turn. Propofol or ketamine was administered in traperitoneally or subcutanously. The combination of propofol and ketamine was given in group Ⅱ, Ⅲ and Ⅳ, and propofol or ketamine in group Ⅰ or Ⅴ. The abolition of righting reflex lasting 10 seconds served as the parameter for hypnosis The data were treated with algebraic analysis. When the dose ratios of ketamine to propofol were 1 : 1.32, 1 : 5.28 and 1 : 0.33, the combined ED_(50) values were much more lower than those of the theoretical additive ED_(50). The sums of ratios of combined ED_(50) to single ED_(50) were less than 1.0. It is concluded that there is a hypnotic synergism between propofol and ketamine in mice

Objective To analyze the serum inflammation related factors of influenza A ( induced by sub-type H1N1 virus) patients with epidemic febrile damp-heat syndrome and warm-heat syndrome. Results Fifty-six patients confirmed as influenza A ( H1N1) were differentiated into epidemic febrile damp-heat syndrome ( 36 cases) and epidemic febrile warm-heat syndrome (20 cases) . And then we observed the serum immune globulins IgM and IgG, interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-ɑ), tumor growth factor beta 1 (TGF-β1), lipolysaccharide binding protein (LBP), Toll-like receptor 4 (TLR4) and soluble CD14 (sCD14) levels of the influenza A patients. Results Insignificant differences of serum IgM, IgG, IL-8, TNF-ɑand TGF-β1 levels were shown between epidemic febrile damp-heat syndrome patients and epidemic febrile warm-heat syndrome patients (P>0.05), but the differences of LBP, TLR4 and sCD14 were significant (P<0.05) .Conclusion Influenza A (H1N1) patients with epidemic febrile damp-heat syndrome have higher serum LBP, TLR4 and sCD14 levels than patients with epidemic febrile warm-heat syndrome, indicating that inflammatory reaction is severer in influenza A (H1N1) patients with epidemic febrile damp-heat syndrome.

Problem-based learning (PBL), which originated in foreign countries, advocates the core idea of multidisciplinary integrated learning, which coincides with the trend of curriculum integration in current medical education. First, this article systematically introduces the process of PBL in the organ system integrated course which is conducted in Nanshan College of Guangzhou Medical University. Second, this article discusses the teaching results and reflection so as to provide reference for the continuous localization reformation of PBL and further medical curriculum integration in college and university.

Objective To investigate the effect of concentrated suture fixation in subdermal vascular network flap method for treatment of axillary osmidrosis in reducing postoperative complications,increase the wound dressing effect of comfort.Methods Ninety-six cases of bilateral axillary osmidrosis patients were randomly divided into concentrated suture group (group A) and 8 bandage compression group (group B),48 cases in each group.They were cleared of sweat gland retaining subdermal vascular network skin flap method in treatment of axillary osmidrosis.Group A was treated with concentrated suture fixation after the separation of the subdermal vascular network flap by in situ,group B was treated by routine compression bandage fixation after the separation of the subdermal vascular network flap.Observation of subcutaneous hematoma,infection,necrosis of skin after operation and understood dressing comfort.To observe the peculiar smell and axillary scar,operation area 6 months postoperative growth.Results The postoperative observation:group A subcutaneous hematoma complication rate was lower in group B,the incidence of 1.04％ (1/96) vs.19.79％ (19/96),the difference was statistically significant (P ＜ 0.01).Group A postoperative dressing comfort satisfaction rate was 93.75％ (45/48),group B po or comfort,satisfaction rate was only 10.42％(5/48),the difference had statistically significant (P ＜ 0.01).After 6 months of postoperative,the total efficiency of two groups were 100.00％,no significant difference (P ＞ 0.05).Group A district scar formation rate was higher than that in group B [3.12％(3/96) vs.21.88％(21/96)] (P ＜ 0.05).The armpit hair and sweat in the two groups was significantly reduced,there was no significant difference (P ＞ 0.05).Conclusion Concentrated suture fixation method in the treatment of axillary osmidrosis by subdermal vascular network is a reliable fixation of the axillary free after the subdermal vascular network flap,and have flap high healing rate,scar,low rate of complications; postoperative dressing is simple,comfortable,living freely,overall is better than 8 bandage compression method.

Objective To evaluate the treatment effect of acute liver failure(ALF) by xeno-transplantation of co-microencapsulated Sertoli cells and hepatocytes and the intraperitoneal immune privilege effects of Sertoli cells on hepatocytes. Methods ALF rats were induced by intraperitoneal injection of D-galactosamine and, thereafter, were treated with physical saline, free hepatocytes, microencapsulated hepatocytes, or co-microencapsulated Sertoli cells and hepatocytes (CMSH), respectively. Alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) were detected in rats' blood samples from various groups. Expression of Smac/Diablo and caspase-3 were determined by reverse transcription-polymerase chain reaction (RT-PCR). Fifteen rats in each group were used for survival rate analysis. The intraperitoneal microencapsules were observed and lymphocytes in ascites were counted. The data were analyzed by multi-factor or single factor analysis of variance and the comparison between groups was done by t test. Results In CMSH treatment group, ALT level decreased to (533.7 ± 76.5) U/L, AST level decreased to (381.2 5± 46.7) U/L after 48 h. TBil level reduced to (7.36 ± 2.18) μmol/L after 72 h. Albumin level increased to (28.4±2.5) g/L after 48 h. All these values were significantly different from those in other groups (F=10.7,6.5,12.2,8.4;P＜0.05). The expression levels of Smae/Diablo and caspase-3 mRNA at 48 h and 72 h were lower in CMSH group than in other groups (F=3.7,4.8,3.6,4.2; P＜0.05). Survival rates in microencapsulated hepatocytes group and CMSH group were similar while both of them were higher than other groups. Microencapsules neither in microencapsulated hepatocytes group nor in CMSH group were adhered to intraperitoneal mucosa. Lymphocyte counts in ascites of CMSH group were lower than those in microencapsulated hepatocytes group (t= 4.21, P＜0. 05). Conclusions Intraperitoneal transplantation with CMSH is a promising approach for ALF treatment. Furthermore, Sertoli cells can help reduce lymphocytes' aggregation caused by encapsulated hepatocytes in ascites.

Objective To investigate the changes of fractalkine (FKN) in rat model of acute liver failure (ALF) and the role of FKN in liver inflammatory injury.Methods SD rats were divided into tWO groups:6 in normal group and 36 in model group.D-galactosamine(D-Gal) was used to induce ALF in model group.The sera and hepatic tissue samples were collected at 12,24,48,72,120 andl68 h.After D-Gal injection.FKN mRNA and nuclear factor(NF)-kB mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR).Results The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) at 12 h were(208.3±43.5)U/L and (375.2±117.3)lJ/L,respectively,which were both significantly higher than those in normal group[(31.8±2.9)U/L and (90.8±3.1)U/L](t=-9.912 and-5.935,respectively,both P<0.01);the levels of ALT and AST peaked at 72 h after D-Gal injection.The levels of FKN mRNA(O.086±0.009)in model group at 12 h were significantly higher than those (O.044±0.009) in normal group(t=-7.999.P<0.01),and peaked at 72 h (O.333±0.033),then decreased obviously at 120 h. The levels of NF-KB mRNA in the liver of normal rats were very little;and the levels in model group were increased gradually over time,then peaked at 72 h (O.583±0.i01,t=-12.607,P<0.01).FKN mRNA and NF0kB mRNA were positively correlated (r=0.760,P<0.01).Conclusion The FKN expression may play all important role in liver inflammatory injury in rat model of acute liver failure, which could provide a new approach for ALF therapy.

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

Objective To explore the relationship between different hemorrhage position,hemorrhage volume,surgical time and outcome of treatment with surgical methods of HICH.Methods A total of 1310 patients were admitted from six hospitals from January 2004 to January 2008,the 1310 patients were divided into six groups according to different operation:craniotomy through bone flap (group A),craniotomy through small bone window (group B),stereotactic drilling drainage (group C1 and group C2),neuron-endoscopy operation (group D) and external ventricular drainage (group E),considering hemorrhage position,hemorrhage volume,surgical time and result of surgical methods were reviewed and analyzed.Results ①Craniotomy through bone flap should be selected with the case of superficial or deep hematoma volume (＞ 80 mL),median line structure distinct motion,metaphase or advanced stage of hernia of brain.②Craniotomy through small bone window and neuron-endoscopy should be selected with the case of moderate hematoma volume (50-80 mL) ③Drilling drainage should be selected with the case of small hematoma volume in superficial or deep hematoma volume (20-50 mL) ④Extemal drainage should be selected in dealing with ventricular hemorrhage.Small bone window or neuron-endoscopy should be selected in ventricular casting mould.⑤The appropriate operation time for patients with hematoma volume less than 80 mL should be 6-12 hours and large hematoma should be immediately operated to save lives.The operation time should depend on patients detail condition.Conclusions Craniotomy through bone flap was suitable for large hematoma and hernia of brain; Stereotactic drilling drainage should be selected in patients with hematoma volume less than 80mL; and the operation results in dealing with HICH would be improved via suitable operation time and surgical methods and adividual according to Hemorrhage position and Hemorrhage volume.