Objective To observe the effects of different gastrointestinal reconstruction methods after dis -tal subtotal gastrectomy on nutritional condition and blood glucose in patients with type 2 diabetes ( T2DM) and gastric cancer.Methods 88 patients with T2DM and gastric cancer undergoing radial distal gastrectomy were studied and among them 43 patients had Billroth I gastrointestinal reconstruction , 22 patients had Billroth II gas-trointestinal reconstruction and 23 patients had Roux-en-Y gastrointestinal reconstruction .Body mass index ( BMI) , serum albumin and prealbumin of the 3 groups were measured preoperatively and 1 year after surgery . The patients were followed up .Results There was no significant difference among the 3 groups in preoperative values(P>0.05).One year after surgery, BMI, serum albumin and peralbumin in the 3 groups had different de-grees of reduction , but showed no statistical difference ( P>0.05 ) .The effective rate of diabetes control was 18.60%in Billroth I group , 72.73%in Billroth II group , and 73.91% in Roux-en-Y group and the difference had statistical significance(χ2 =17.390 3,P<0.05).The effective rates of diabetes control in Billroth II group and Roux-en-Y group were higher than that in Billroth I group (χ2 =18.340 9,P<0.05;χ2 =19.480 4,P<0.05), and there was no evident difference between Billroth II group and Roux-en-Y group(χ2 =0.008 1,P=0.928 4).Conclusion Billroth II and Roux-en-Y gastrointestinal reconstruction can improve glycemic metabo-lism of patients with T2DM and gastric cancer without significantly reducing the nutrition status .

OBJECTIVE: To analyze the correlation between UPLC-MS/MS method and HPLC-UV method for determination of mycophenolic acid (MPA) blood concentrations in renal transplant patients and to establish a generally applicable conversion method of the determination results. METHODS: MPA concentrations in whole blood and plasma of transplant patients were determined by UPLC-MS/MS method. Plasma concentrations of MPA were determined by HPLC-UV. Variance analysis of the measure results was done by LEVENE and LSD methods, and the correlation between the methods was analyzed by Spearman method. RESULTS: Three conversion formula were obtained as follows; YUPLC_MS/MS plasma)=1.612 XUPLD_MS/M/Swhole blood+0.686, YUPLC_MS/MS plasma=1.414XUPLD_MS/M/S whole blood-0.206, and YHPLC-LV plasam=0.848 XUPLD_MS/M/S whole blood-0.692. CONCLUSION: There is good correlation between UPLC-MS/MS method and HPLC-UV method for the determination of MPA concentration in whole blood and plasma in renal transplant patients. The results can be transformed by equations.

Objective: To evaluate the clinical outcome of botulinum A toxin (BTX-A) injection into external sphincter combined with oral baclofen in treatment of detrusor-external sphincter dyssynergia (DESD) after spinal cord injury (SCI). Methods: A total of 38 urodynamic examination-confirmed DESD patients, male 31 and female 7, with an average age of (36.5 ± 17.8) years old, were included in this study. 200 U of BTX-A toxin was dissolved in 8 ml of normal saline and the solution was injected at 8 different sites (1 ml per site) of the external sphincter via a 5F flexible cystoscopic needle. On the second day, 9 patients (BTX-A + baclofen group) were randomly selected for baclofen oral administration, 3/d for 3 months, the other 26 patients were taken as control. Urodynamic examination was repeated in all patients 4 weeks later; the voiding diary and urodynamic outcomes were compared before and after treatment. The adverse and toxic effects were observed in the patients who were followed up for 2-9 months. Results: One month after treatment the voiding and storing functions of bladder were improved to different degrees, with the mean maximum uroflow rate (Qmax), the mean urine volume, the mean maximal eystometric capacity and the bladder compliance increased significantly and the mean postvoid residual urine volume and the mean maximal voiding pressure decreased significantly (all P

Objective: To summarize our experience on 164 cases of retroperitoneoscopic nephrectomy and to analyze the clinical outcomes of retroperitoneoscopic nephrectomies. Methods: From October 1998 to July 2006, a total of 164 patients (91 males and 73 females; age range 2-80 years, mean age [49.5±25.7] years) have undergone retroperitoneoscopic nephrectomies in our department, with 95 undergoing radical renal cancer resection and 69 undergoing simple nephrectomies. Fifteen renal cancer patients visited doctors due to painless hernaturia and the rest 80 were detected during physical examination. The tumors were averagely (4.3 ± 1.2) cm (range 1.0-8.0 cm) in diameter, with 40 at T1N0M0 stage, 47 at T2N0M0 stage, and 8 at T3aN0M0 stage. Among the 69 simple nephrectomy cases, 3 were kidney atrophy, 46 were kidney dropsy, 3 were kidney maldevelopment, and 7 were kidney tuberculosis. All the kidneys were confirmed to have no function by radiological renal pictures. Results: The operative time was 25-180 min (mean, [53.5 ± 27.2] min) and the blood loss was 20-1 500 ml (mean, [150 ± 66] ml). Three cases were converted to open operations. The average hospital stay was (8.0 ± 4.4) days. Three renal cancer patients died of metastasis during a follow-up of 1-90 months and all the other patients survived. Conclusion: Retro entoneoscopic nephrectomy, with shorter operative time and quicker postoperative recovery, is a practical surgical procedure.

Objective: To investigate the influence of sirolimus on the disease progression of a rat model of autosomal dominant polycystic kidney disease (ADPKD) - Han : SPRD with chronic renal insufficiency. Methods: Twenty 6-month-old male ADPKD heterozygous (Cy/+) rats with chronic renal insufficiency were divided into 2 groups at random (n=10). Rats in experimental group received intragastric administration of sirolimus (0.2 mg · kg-1 · d-1) for 45 days and those in control group were bred routinely. The general state and renal function of rats were monitored throughout the treatment. The rats were sacrificed 45 days later and both kidneys were harvested, weighed; and the 2-kidney/ total body weight (2K/TBW) ratio was determined. Then the kidneys were subjected to immunohistochemistry examination and the numbers of cells positive of proliferating cell nuclear antigen (PCNA) were counted. Results: There was no death in the 2 groups and all rats gained weights, with no significant difference between the 2 groups, Blood urea nitrogen (BUN) increased progressively in both groups, with the increase in experimental group lower than that in the control group by 12.5 % on 45 days after administration (P<0.05). The 2-kidney-weight and 2K/TBW ratio in experimental group was lower by 11.8 % (P<0.05) and 7.1 % (P<0.01) than those in the control group, respectively. Renal enlargement and cystogenesis were inhibited by sirolimus, with the number of PCNA-positive cells per cyst being 0.23±0.11 in experimental group and 0.47±0.24 in the control group (P<0.05). Conclusion: Sirolimus can slow down the disease progression in Han: SPRD rats with ADPKD, even though they had been in a condition of renal insufficiency.

Objective: To investigate the differential expression of matrix metalloproteinases-1/tissue inhibitor of metalloproteinase-1 (MMP-1/ TIMP-1) between normal kidney, kidneys of patients with autosomal dominant polycystic kidney disease (ADPKD), and the original kidneys after renal transplantation (OKRT). Methods: DNA microarray technique was used to analyze the differential gene expression in the above 3 tissues. Semi-quantitive RT-PCR was performed to verify the differentially expressed genes. Results: There were 463 differentially expressed genes between normal kidney and ADPKD tissues and 130 differentially expressed genes between ADPKD and the OKRT tissues. Expression of MMPI/TIMP1 in the ADPKD and the OKRT tissues were significantly higher than that in the normal kidney tissue (P<0.05), with no significant difference found between the former 2 groups. Results of RT-PCR were consistent with the microarray findings. Conclusion: The pathogenesis of ADPKD may be related with the high expression of MMPs/TIMPs and the inhibitor of MMPs may have therapeutic effect on ADPKD.

Objective To explore the early diagnosis and treatment of acute superior mesenteric arterial embolism (ASMAE).Methods The clinical data of 25 patients with acute superior mesenteric arterial embolism were retrospectively analyed.Results All 25(100%) patients had severe abdominal pain with abdominal signs,21(84%) patients had history of valvular heart disease or atrial fibrillation,and 17(68%) patients had hematochezia.All the cases were misdiagnosed preoperatively,including 11 patients were misdiagnosed as abdominal pain of unknown causes,3 patients as acute pancreatitis,3 patients as acute gastroenteritis,2 patients as necrotizing enteritis.1 patient as acute appenditis,1 patient as acute myocardial infarction,and 1 patient as acute cholecystitis;but 3 patients were preoperatively suspected to have impairment of mesenteric blood flow.All of the 25 patients underwent necrotic bowel resection,6 patients died,and 7 patients abandoned treatment because of serious complications such as short bowel syndrome etc.Mortality rate was 51%(13/25).Conclusions Early diagnosis of patients with acute superior mesenteric arterial embolism is difficult;the main cause of misdiagnosis is lack of recognition of its clinical signs.Fully grasping the characteristics of patients with early stage disease and effective early intervention are the fundamental measures for reducing mortality.

Child ; Gene Rearrangement, T-Lymphocyte ; Humans ; Neoplasm, Residual ; diagnosis ; Polymerase Chain Reaction ; methods ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; diagnosis ; Receptors, Antigen, T-Cell ; genetics

OBJECTIVE To establish the isolation and identification system of human mesenchymal stem cells(hMSCs)in vitro, and then to establish a stable cultured system in which the hMSCs can be induced to osteoblasts, chondroblasts and lipoblasts in vitro. To study the possibility if hMSCs can be used as the seed cells in bone tissue engineering.This study would lay a foundation for the clinical application of tissue engineering. METHODS 5ml bone marrow of the patient was aspirated from iliac crest. The human MSCs were isolated using Percoll gradient centrifugation. The hMSCs were cultured in DMEM medium in vitro, FACS(fluorescence axtivated cell sorter)was used to identify the phenotype of hMSCs. The hMSCs were cultured in vitro, and induced to osteoblasts, chondrocytes and lipocytes. The changes of phenotype were tested by mmunohistochemisty and molecular biology technique. RESULTS The hMSCs were isolated by Percoll gradient centrifugation from patient’s bone marrow. The expression rate of MSC markers including CD105, CD166, CD29 were(78?6)%, (43?7)%, (69? 12)% respectively. The phenotype of osteoblasts induced from hMSCs was verified by the mineralized nodes formation when cultured in vitro and Col, and OCN expression showed by immunohistochemistryand RT-PCR. The phenotype of chondrocytes induced from hMSCs was verified by type, collagen, SOX9 expression with immunohistochemical staining technique and type, collagen, aggrecan mRNA expression with RT-PCR. The lipocytes’ phenotype was verified by positive result of oil red O staining and PPAR 2mRNA expression by RT-PCR. CONCLUSION The highly pure hMSCs can be harvested by means of density gradient centrifugation, and the hMSCs have multi-potentiality of cell differentiation via induced culture in vitro. The third passage of hMSCs can be induced to express osteoplast phenotype and meet the qualitative and quantitative demands of seed cells when bone tissue engineering was used in clinical practice.

Objective To explore the effects of co-culture of chondrocytes and bone mesenchymal stem cells (BMSCs) on constructing engineered cartilages, and confirm the most suitable ratio of chondrocytes to BMSCs. Methods Chondrocytes and BMSCs were isolated from articulars cartilages of rabbit (1 month old)cells (40 μl 4×107/ml) were seeded into a poly(lactic-co-glycolic acid) (PLGA) scaffold and cultured statically for 2 days. They were transferred into the cyclic pressures system, and cultured under cyclic pressures for 3 weeks. The engineered cartilages were harvested and examined by gross observation, histological staining, immunohistochemisty of collagen Ⅱ, the content of glyeosaminoglycans, GAGs, DNA and the percentage of collagen Ⅱ dyeing area. Results The engineered cartilages of the co-cultured groups grew bigger than those of the chondrocytes alone group, and their surfaces were smooth and glossy. The distributions of cartilaginous extracellular matrices in the co-cultured groups were more homogenous than those of the chondrocytes alone group.gen Ⅱ dyeing area of the co-cultured groups were higher than those of the chondrocytes alone group. The conConclusion Co-culture of chondrocytes and BMSCs could improve the quality of engineered cartilages. The