The relationship between ?-globulin and neurons in sympathetic ganglion was investigated. In the present study, the rabbit superior cervical ganglion neurons were found to react selectively with sheep antiserum to rabbit ?-globulin and appear to be stained deeply by immunocytochemical method. The existence of ?-globulin-like substance in these neurons was shown. These neurons are divided into four types according to the intensity of their staining.The significance and functional role of the different staining types are not clear and a further study is needed.

Objective To investigate the expression of human leucocyte antigen-G (HLA-G) in the endometrium of patients with endometriosis (EM). Methods The expression of HLA-G protein was detected in ovarian endometriosis (OEM) and adenomyosis (AM) using immunohistochemistry method, and the expression of HLA-G mRNA was detected using in situ hybridization technique (ISH), to compare with that in the endometrium of hysteromyoma as the control group. Results The rate of positive HLA-G expression in EM (including AM and OEM) was significantly higher than that in control group (P0.05). The expression of HLA-G protein showed no relation with different clinical phase or different endometrial cycle. Conclusion HLA-G is overexpressed in EM, which may play certain role in the pathogenesis of the disease.

ObjectiveTo identify the differential expressed proteins,and to investigate the relationship between altered expression of annexin A4 during window of implantation [ WOI ( at day-6 after ovulatory day )] in infertile patients with endometriosis and endometrial receptivity.MethodsTwo-dimensional fluorescence differential in-gel electrophoresis (2D-DIGE) and matrix-assist laser desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS) were used to detect protein expression in endometrial WOI in 10 infertile cases with endometriosis as endometriosis group and 10 infertile cases with tubal factors as control group.The semi-quantitative validation of annexin A4 in the eutopic endometrial tissue during WOI was analyzed by western blot.Results By comparing protein profiles,there were 7 meaningful differential proteins during WOI in infertile patients with endometriosis.One protein with an isoelectric point of 5.84 and relative molecular weight of 36 100 were down regulated 348％ in samples of endometriosis group.It was identified as annexin A4 by mass spectrometry.By western blot,relative intensity of annexin A4 in endometriosis group was 7.2 ±0.9,which was lower than 17.8 ± 2.6 in control group significantly (t =7.654,P =0.002 ).ConclusionLower expresssion of annexin A4 during WOI in infertile patients with endometriosis might be associated with the decrease of endometrial receptivity.

The United States is one of the pioneers in the world to introduce a heath strategy, making its practice highly significant for other countries. The paper described the four health strategies developed by the US government in succession, including the goals, focused areas and key health indicators of the strategies in different stages. In addition, it analyzed the patterns of evolution and key features of the strategy, offering references for the development and implementation of the "Health China by the Year 2020".

OBJECTIVETo compare the clinical efficacy of robotic and laparoscopic radical surgery in the treatment of middle-low rectal cancers.

METHODSFrom January 2015 to March 2016, intra-operative and postoperative follow-up data of 30 patients with middle-low rectal cancers who underwent robotic radical resection(robot group) and 32 patients with middle-low rectal cancers who underwent laparoscopic radical resection (laparoscopy group)n in our department were retrospectively collected. The distance from cancer to anal margin was less than 10 cm in both two groups and advanced rectal cancers were confirmed by preoperative colonoscopy biopsy. Associated data were compared between two groups.

RESULTSThere were 13 males and 17 females in robot group with age of 27 to 85 (mean 59.7) years, disease course of 3 to 12 (mean 6.2) months and clinical stage T2-3N0-1. There were 16 males and 16 females in laparoscopic group with age of 32 to 79 (mean 60.3) years, disease course of 2 to 10(mean 5.9) months and clinical stage T2-3N0-1. The baseline data of two groups were not significantly different (all P>0.05). All the patients in two groups completed operations successfully without conversion to open operation. Compared with laparoscopic group, the blood loss was less [(100.3±43.7) ml vs. (150.3±68.2) ml, t=3.413, P=0.001], the first flatus time [(49.3±12.4) h vs. (58.6±12.5) h, t=2.838, P=0.006] and urinary catheter removal time [(3.0±0.7) d vs. (4.8±0.9) d, t=5.491, P=0.000] were shorter, while the operation time [(217.3±57.8) min vs. (187.9±23.1) min, t=2.772, P=0.009] was longer in robot group. No cancer tissue was observed in resection margin of two groups. Number of harvested lymph node per case (15.2±7.4 vs. 13.9±4.9, t=-0.764, P=0.448), distance from anal margin to tumor distal edge [(7±3) cm vs. (6.5±3) cm, t=-1.952, P=0.056] and postoperative hospital stay [(13.6±1.3) d vs. (13.8±1.8) d, t=0.925, P=0.359] were not significantly different between two groups. No serious complications occurred in two groups during intra-operative and postoperative period. During following up of 3 to 12 (average 8.7) months, 1 case of anastomotic fistula occurred in each group and was cured by conservative treatment without significant difference [3.3%(1/30) vs. 3.1%(1/32), P=1.000]. No sexual dysfunction was found in either groups. Two cases in laparoscopic group presented relapse and metastasis, but no recurrence and metastasis was observed in robot group. There was no death in two groups.

CONCLUSIONRobotic radical surgery in the treatment of middle-low rectal cancers is safe and effective with the advantages of less trauma, less bleeding, rapid recovery of intestinal function and urinary function.

Adult ; Aged ; Blood Loss, Surgical ; Comparative Effectiveness Research ; Defecation ; Digestive System Surgical Procedures ; adverse effects ; methods ; Female ; Fistula ; etiology ; surgery ; Humans ; Laparoscopy ; adverse effects ; Length of Stay ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Operative Time ; Postoperative Period ; Recovery of Function ; Rectal Neoplasms ; surgery ; Retrospective Studies ; Robotic Surgical Procedures ; adverse effects ; Treatment Outcome ; Urination

Objective:To evaluate the effect of transcutaneous electrical acupoint stimulation (TEAS) on function of lung ventilation in the patients undergoing laparoscopic cholecystectomy using electrical impedance tomography (EIT).Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18.5-24.9 kg/m 2, undergoing elective laparoscopic cholecystectomy, were divided into 2 groups ( n=30 each) using a random number table method: control group (CON group) and TEAS group.EIT was carried out after entering the operating room.In group TEAS, bilateral Feishu (BL13) and Chize (LU5) acupoints were stimulated, while stimulation electrodes were only placed without electricity in group CON.The percentages of area in center of ventilation and tidal volume in the dependent areas were determined on admission to the operating room (T 1), at 5 min after tracheal intubation (T 2), at 5 min after CO 2 pneumoperitoneum (T 3), at 5 min after CO 2 was exhausted (T 4), and at 5 and 30 min after removal of the tracheal tube (T 5, 6). Radial artery blood samples were collected for blood gas analysis at T 1, T 3 and T 6, and the oxygenation index (OI) and alveolar-arterial oxygen difference (A-aDO 2) were calculated.Blood samples were taken from the peripheral vein at T 1, T 3 and T 6 for determination of the serum concentrations of Clara cell secretion protein (CC16), interleukin (IL)-6 and tumor necrosis factor (TNF)-α. Results:Compared with the baseline at T 1, the percentages of area in center of ventilation and tidal volume in dependent areas at T 2-6 and OI and A-aDO 2 at T 6 were significantly decreased, and the serum concentrations of TNF-α, IL-6 and CC16 were increased at T 3 and T 6 in two groups ( P<0.05). Compared with group CON, the percentage of tidal volume in dependent areas at T 5, 6 and OI at T 6 were significantly increased, and A-aDO 2 and serum concentrations of TNF-α, IL-6 and CC16 were decreased at T 6 in group TEAS ( P<0.05). Conclusions:TEAS can improve the function of lung ventilation in the patients undergoing laparoscopic cholecystectomy.

Objective:To evaluate the effect of transcutaneous electrical stimulation of different acupoints on pulmonary ventilation function in the patients undergoing laparoscopic cholecystectomy.Methods:Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-64 yr, with body mass index of 18.5-25.0 kg/m 2, undergoing elective laparoscopic cholecystectomy, were divided into 3 groups ( n=20 each) using a random number table method: control group (group C), Zusanli-Sanyinjiao group (group S 1) and Feishu-Chize group (group S 2). Pulmonary ventilation function was monitored by electrical impedance tomography after admission to the operating room, group S 1 and group S 2 underwent transcutaneous electrical stimulation of bilateral Zusanli-Sanyinjiao and Feishu-Chize acupoints at 30 min before induction of anesthesia, with disperse-dense waves, a frequency of 2/100 Hz and the wave width of 0.6 ms at 2 Hz and 0.2 ms at 100 Hz.The intensity of stimulation was the maximum current that patients could tolerate.In group C, electrodes were only placed without electrical stimulation.The percentages of area in center of ventilation (CoV) and tidal volume in the dependent areas were determined on admission to the operating room (T 1), at 5 min after tracheal intubation (T 2), at 15 min after pneumoperitoneum (T 3), and at 30 min after removal of the tracheal tube (T 4). The extubation time and development of hypoxemia and atelectasis within 48 h after tracheal extubation were recorded. Results:Compared with the baseline at T 1, the percentages of area in CoV and tidal volume in dependent areas at T 3-4 were significantly decreased in S 1 and S 2 groups ( P<0.05). Compared with group C, the percentage of tidal volume in dependent areas at T 4 was significantly increased, and the extubation time and incidence of hypoxemia and atelectasis within 48 h after tracheal extubation were decreased in S 1 and S 2 groups ( P<0.05). Compared with group S 1, the percentage of tidal volume in dependent areas at T 4 was significantly increased, and the incidence of hypoxemia within 48 h after tracheal extubation was decreased in group S 2 ( P<0.05). Conclusions:The efficacy of transcutaneous electrical stimulation of Feishu-Chize acupoints in improving pulmonary ventilation function is better than that of Zusanli-Sanyinjiao acupoints in the patients undergoing laparoscopic cholecystectomy.

Objective:To evaluate the effect of astragaloside IV on phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway in substantia nigra of mice with Parkinson′s disease.Methods:Forty-five SPF healthy male C57BL/6 mice, aged 8 weeks, weighing 19-25 g, were divided into 3 groups ( n=15 each) using a random number table method: control group (group C), Parkinson′s disease group (group PD) and astragaloside IV group (group A). The mouse model of Parkinson′s disease was developed by intraperitoneal injection of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine (MPTP) 30 mg/kg everyday for 7 consecutive days.Astragaloside 20 mg/kg was intraperitoneally injected everyday at 30 min before MPTP injection for 7 consecutive days before the model was prepared in group A, and the equal volume of normal saline was given instead in group C. Behavior was measured at 1 day interval after completion of administration.The mice were then sacrificed, and the substantia nigra of the brain tissue were obtained for determination of the expression of tyrosine hydroxylase(TH), phosphorylated PI3K(p-PI3K), phosphorylated Akt(p-Akt), glial fibrillary acidic protein (GFAP) and brain-derived neurotrophic factor (BDNF) (by Western blot). Results:Compared with C group, the total distance of movement and latency of falling were significantly shortened, the hanging score was decreased, the step width was increased, the expression of TH, p-PI3K, p-Akt and BDNF in substantia nigra was down-regulated, and the expression of GFAP was up-regulated in PD group and A group ( P<0.05). Compared with PD group, the total distance of movement and the latency to fall were significantly prolonged, the hanging score was increased, the step width was reduced, and the expression of TH, p-PI3K, p-Akt and BDNF in the substantia nigra was up-regulated, and the expression of GFAP was down-regulated in group A ( P<0.05). Conclusions:The mechanism by which astragaloside IV improves motor dysfunction is related to the activation of PI3K/Akt signaling pathway, up-regulation of BDNF expression and inhibition of astrocyte activation in mice with Parkinson′s disease.

Objective:To investigate the feasibility and safety of a robotic surgical system (or laparoscopy) in combination with colonoscopy (combined) for the treatment of stage T1N0M0 colorectal cancer.Methods:This was a descriptive case series. Indications for combined dual-scope surgery in this study were as follows: (1) preoperative colonoscopic examination of lesions in the middle and upper rectum and colon with pathologically confirmed high-grade intraepithelial neoplasia, intramucosal adenocarcinoma, or adenocarcinoma; (2) no distant or local lymph node metastases; and (3) endoscopic ultrasound and magnetic resonance imaging evidence of tumor invasion of the mucosal or submucosal, but not the muscular, layer (i.e., T1). The clinical data of 13 patients with stage T1 colorectal cancer who had undergone dual-scope combined resection using a robotic surgery system or laparoscope-assisted combined colonoscopy surgery at the First Affiliated Hospital of Zhengzhou University from April to October 2022 were retrospectively collected, including 6 males and 7 females, with a median age of 59 (48~88) years old. The tumors were located in the upper and middle rectum in six patients, in the sigmoid colon in three, and in the ascending colon in four. The median maximum diameter of the tumors was 3.0 (1.8–5.0) cm. The surgery was performed by a robotic surgery system (or laparoscopy) with peritumoral D1 lymph node dissection at the first station in the tumor area. The tumors were resected under direct vision and the defects in the intestinal wall were using a robotic surgery system (or laparoscopy). A robotic surgery system was combined with colonoscopy in eight cases and laparoscopy combined with colonoscopy in the remaining five. Studied variables includes surgical and pathological features, postoperative factors, and outcomes.Results:Surgery was successful in all 13 patients with no need for conversion to open surgery or intraoperative blood transfusion. The median operating time was 85 (60–120) minutes, median intraoperative bleeding 3 (2–5) mL, median number of lymph nodes harvested 3 (1–5), and the median circumferential resection margin 0.8 (0.5–1.0) cm. Postoperative pathological examination showed lymph node metastasis in one patient, who therefore underwent additional radical surgery. The median postoperative time to ambulation was 1 (1–2) days. The urinary catheters of all patients were removed 1 day after surgery and the median length of stay was 4 (3–5) days. No abdominal infection, anastomotic leakage or bleeding occurred in any of the study patients. The median follow-up time was 10 (6–12) months, during which no tumor recurrence or metastasis was found, and the quality of life was satisfactory.Conclusions:The combination of two minimally invasive platforms, a robotic surgery system (or laparoscopy) and colonoscopy, is safe and feasible for resection of stage T1 colorectal cancer and has a good short-term prognosis.

Objective:To investigate the feasibility and safety of a robotic surgical system (or laparoscopy) in combination with colonoscopy (combined) for the treatment of stage T1N0M0 colorectal cancer.Methods:This was a descriptive case series. Indications for combined dual-scope surgery in this study were as follows: (1) preoperative colonoscopic examination of lesions in the middle and upper rectum and colon with pathologically confirmed high-grade intraepithelial neoplasia, intramucosal adenocarcinoma, or adenocarcinoma; (2) no distant or local lymph node metastases; and (3) endoscopic ultrasound and magnetic resonance imaging evidence of tumor invasion of the mucosal or submucosal, but not the muscular, layer (i.e., T1). The clinical data of 13 patients with stage T1 colorectal cancer who had undergone dual-scope combined resection using a robotic surgery system or laparoscope-assisted combined colonoscopy surgery at the First Affiliated Hospital of Zhengzhou University from April to October 2022 were retrospectively collected, including 6 males and 7 females, with a median age of 59 (48~88) years old. The tumors were located in the upper and middle rectum in six patients, in the sigmoid colon in three, and in the ascending colon in four. The median maximum diameter of the tumors was 3.0 (1.8–5.0) cm. The surgery was performed by a robotic surgery system (or laparoscopy) with peritumoral D1 lymph node dissection at the first station in the tumor area. The tumors were resected under direct vision and the defects in the intestinal wall were using a robotic surgery system (or laparoscopy). A robotic surgery system was combined with colonoscopy in eight cases and laparoscopy combined with colonoscopy in the remaining five. Studied variables includes surgical and pathological features, postoperative factors, and outcomes.Results:Surgery was successful in all 13 patients with no need for conversion to open surgery or intraoperative blood transfusion. The median operating time was 85 (60–120) minutes, median intraoperative bleeding 3 (2–5) mL, median number of lymph nodes harvested 3 (1–5), and the median circumferential resection margin 0.8 (0.5–1.0) cm. Postoperative pathological examination showed lymph node metastasis in one patient, who therefore underwent additional radical surgery. The median postoperative time to ambulation was 1 (1–2) days. The urinary catheters of all patients were removed 1 day after surgery and the median length of stay was 4 (3–5) days. No abdominal infection, anastomotic leakage or bleeding occurred in any of the study patients. The median follow-up time was 10 (6–12) months, during which no tumor recurrence or metastasis was found, and the quality of life was satisfactory.Conclusions:The combination of two minimally invasive platforms, a robotic surgery system (or laparoscopy) and colonoscopy, is safe and feasible for resection of stage T1 colorectal cancer and has a good short-term prognosis.