Objective To evaluate the effect of controlled hypotension with nitroglycerin and esmolol in the operation of endoscopic nasal surgery.Methods 60 patients undergoing selective endoscopic nasal surgery were randomly divided into three groups averagely: control group (groupⅠ), controlled hypotension with nitroglycerin group(group Ⅱ), controlled hypotension with nitroglycerin and esmolol group (groupⅢ). Every group has 20 patients.Mean artery pressure (MAP), HR, scores of surgical field quality(SSFQ) were recorded before anaesthesia and 10,20,30,40 minutes after anaesthesia. After the operation, bleeding capacity, operation time and dosage of nitroglycerin were recorded too.Results The bleeding capacity and operation time in groupⅡ and Ⅲ was significantly less than that in groupⅠ(P

Epigenetic modification, which involve DNA methylation, RNA-associated silencing and histone modification, is implicated in cell proliferation, differentiation, survival, apoptosis and malignant transformation. Some leukemogenesis has been shown to be aberrance of epigenetic modification. This paper discussed the potential causes of some of leukemias correlating with the methylation of cell cycle regulation genes, small interference RNA and modification abnormality of histone after translation. The study on epigenetic modification abnormality of leukemia cells provides a new strategy for treatment of leukemia.
DNA Methylation ; Epigenesis, Genetic ; Gene Silencing ; Histones ; Humans ; Leukemia ; genetics ; RNA, Small Interfering ; genetics

Epistaxis ; diagnosis ; etiology ; Hemophilia B ; complications ; diagnosis ; Humans ; Male ; Young Adult

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 evaluate the impact of comorbidity and age on the tolerance of firstline single-agent chemotherapy in elderly patients with advanced non-small cell lung cancer(NSCLC).Methods Clinical data of 61 elderly patients with advanced NSCLC(aged over 70 years,median age 72 years) receiving first-line single agent chemotherapy were retrospectively analyzed in this study.Performance status(PS) between 0-1 score was in 52 patients,PS 2 score in the other 9 patents.Patients were treated with gemcitabine or docitaxel as the first line chemotherapy,and the median number of chemotherapy cycles was 3.4.Comorbidity was assessed by Charlson comorbidity index (CC1).Patients with CCI equal to 0 were classified as non comorbidity group(n=26),and patients with CCI≥1 were classified as comorbidity group(n=35).Adverse reactions were graded by using the criteria of NCI-CTC v3.0.Results Age and PS could not predict adverse effects of grade 3 or 4.The incidence of hematologic toxicity of grade 3 or 4 was higher in comorbidity group than in noncomorbidity group(40.0％ vs.15.4％,x2 =4.36,P=0.037).The incidences of febrile neutropenia,non hematologic toxicity of grade 3 or 4 and treatment suspension were higher in comorbidity group than in non-comorbidity group.The most common types of comorbidity were diabetes and chronic pulmonary disease.The incidence of non-hematologic toxicity of grade 3 or 4 was increased in patients with chronic pulmonary disease as compared with patients without chronic pulmonary disease(41.4 ％vs.11.5％,x2=6.061,P=0.032).Conclusions The incidences of adverse reactions,especially hematologic toxicity of grade 3 or 4 are significantly increased in patients with comorbidity after singleagent chemotherapy.Evaluation of comorbidity before treatment is helpful to predict the tolerance of single-agent chemotherapy in elderly NSCLC patients.

Objective To investigate the risk factors for the prognosis of radical resection in elderly patients with colorectal cancer.Methods A total of 416 patients with colorectal cancer aged over 65 years were analyzed retrospectively,who came from Peking University First Hospital and Beijing Hospital from July 2008 to July 2011.Survival analysis was conducted by Kaplan-Meier and the survival rate was compared by Log-rank method.Multivariate analysis was conducted to analyze the prognostic factors by Cox regression.Results In this group of patients,the age was(74.3 ±5.4)years,and the post operative 5-year survival rate were 84.5％,77.3％,48.2％ respectively for staging Ⅰ,Ⅱ,Ⅲ patients.Univariate analysis showed that age,ASA score,co morbidity,preoperative hypohemia,preoperative hypoalbuminemia,postoperative complications,elevated preoperative carcinoembryonic antigen (CEA),intraoperative blood loss,perioperative blood transfusion,vascular cancer embolus,nerve invasion,depth of invasion,lymph node metastasis,tumor TNM stage and adjuvant therapy were correlated with the prognosis.Multivariate analysis showed that age ≥75 years,co morbidity,postoperative complications,preoperative albumin＜30 g/ L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy were the independent risk factors for prognosis.Conclusions The risk factors for prognosis after radical resection in elderly patients with colorectal cancer include age≥75 years,co-morbidity,postoperative complications,preoperative albumin ＜30 g/L,depth of invasion,and lymph node metastasis,tumor TNM stage and adjuvant therapy.

Objective To investigate the feasibility whether clearance of iohexol can be a reliable, sensitive and safe method for the determination of GFR. Methods The GFR of 19 patients with different renal functions were examined using clearance of 99m Tc-DTPA and clearance of iohexol. Then the correlation of them was analyzed. Serum and urinary iohexol was determined by X-ray fluorescence analysis. Results, These two methods were significantly correlated (r = 0. 98). Conclusion Clearance of iohexol is a safe, comfident, no-radioactivity method for the clinical practice of GFR determination.