0.05).But the difference of the length between the interior side and the basal side was obvious under different visual angles(P

Objective To evaluate the safety and feasibility of retroperitoneal laparoscopic adrenalectomy for different diameter adrenal tumor.Methods The clinical dam of 61 patients who underwent retroperitoneal laparoscopic adrenalectomy from January 2009 to June 2013 were retrospectively analyzed,the patients were divided into A group (the diameter of adrenal tumor ＞ 6 cm,24 cases) and B group (the diameter of adrenal tumor 3-6 cm,37 cases) according to the diameter of adrenal tumor.The therapeutic effect was compared between 2 groups.Results All procedures were performed successfully.There were statistical differences in operative time and estimated blood loss between A group and B group [(138 ± 66) min vs.(106 ± 45) min and (324 ± 168) ml vs.(165 ± 50) ml] (P ＜ 0.05).There were no statistical differences in the rate of complication and blood transfusion between 2 groups (P ＞ 0.05).There was no statistical difference in hospital stay after operation between 2 groups [(6.7 ± 1.2) d vs.(5.4 ± 0.6)d] (P ＞ 0.05).A group was followed up for (22 ± 10) months,during which time no local recurrence was noted in 19 cases by B-mode ultrasonography,3 cases were missed,and 2 cases were alive with hydronephrosis or pancreatic cyst.B group was followed up for (24 ± 11) months,during which time no local recurrence was noted in 32 cases by B-mode ultrasonography,4 cases were missed,and 1 case was found with renal dysfunction.The pathology of most tumors in A group included medullary lipoma,pheochromocytoma and ganglioneuroma,in B group included adenoma,pheochromocytoma and medullary lipoma.Conclusion Minimally invasive and safe procedure for skillful surgeons in the treatment of tumor diameter larger than 6 cm.

Objective To observe the effect of recombinant human tumor necrosis factor receptor-Fc fusion protein (rhTNFR-Fc, etanercept) on the expression of transforming growth factor-β1 (TGF-β1) in bleomycin induced interstitial lung disease of rats. Methods Forty-five male Sprague-Dawley (SD) rats were randomly divided into three groups (control group, model group and rhTNFR-Fc treatment group, 15 rats in each), on the 7th, 14th and 28th days, five rats of each group were killed. The lungs were incised to make pathological sections which were stained with HE and Masson, and the expression of TGF-β1 was detected by immunohistochemical technique. Results There was no collagen deposition, alveolitis and fibrosis changes in the control group. The alveolitis and fibrosis of the treatment group was less severe than that in the model group (P<0.01). The expression of TGF-β1 in the model group was significantly higher than that in the control group (P<0.01). In the 7th and 14th days, the expression of TGF-β1 in the treatment group was signific-antly higher than that in the control group (P<0.01). Although that in the 28th day was a slightly higher but no statistical significance (P>0.05) could be detected. In the treatment group, the expression of TGF-β1 was lower in the 7th day (P>0.05) and was significantly lower in the 14th and 28th days than that in the model group (P<0.01). Conclusion Recombinant human tumor necrosis factor receptor-Fc fusion protein can alleviate the severity of alveolitis and pulmonary fibrosis induced by Bleomycin-A5 in rats, which may be due to the inhibition of TGF-β1 overexpression.

Objective To investigate the value of colonoscopy with narrow band imaging (NBI) in predicting the histology of colorectal polypoid lesions. Methods A total of 173 colorectal polypoid lesions from 125 patients were included in the study. The lesions were diagnosed as neoplastic (adenoma or cancer)or non-neoplastic based on pit patterns and/or capillary patterns (CP), which was compared with the results of pathology, and the sensitivity, specificity and accuracy of each method were evaluated. Results In differentiation between neoplastic and non-neoplastic lesions, the sensitivity, specificity and accuracy of CP (94. 83% , 91. 23% and 93.64% , respectively), and those of CP combined with pit patterns (95. 69% ,96.49% and 95. 59% , respectively) were significantly higher than those of conventional colonoscopy (80. 17% , 84.21% and 81.50% , respectively, P<0.05). In differentiation between adenoma and cancer,the sensitivity, specificity and accuracy of CP were 86.90% , 100.00% and 87.93% , respectively.Conclusion NBI is superior to conventional colonoscopy in differentiation between neoplastic and non-neoplastic lesions, as well as in differentiation between adenoma and carcinoma.

Objective To investigate the antitumor activities of adenovirus-mediated NDRG2 gene (Ad-NDRG2) and docetaxel on human prostate cancer DU145 cells.Methods The protein expressions of cyclin D1,cycliu E,and NDRG2 in the cells were determined by Western blot.MTT and flow cytometry were used to observe the effects of docetaxel (10-6 mol/L,10-7 mol/L,and 10-s mol/L) and Ad-NDRG2 on prostate cancer cell line DU145 in single or synergistic administration ways for 24 and 48 hours in vitro.Male BALB/C-nu mice with DU145 prostate cancer cell lines were treated by docetaxel and Ad-NDRG2 singly or synergistically in vivo.Results After infected by adenovirus,the protein expression of NDRG2 increased,but cyclin D1 and cyclin E decreased in DU145 cells.Ad-NDRG2 inhibited the cell growth (inhibition ratio =41.8％,t =4.18,P ＜0.01),promoted apoptosis (apoptosis ratio =32.4％,x2 =11.66,P ＜0.05),changed the ratio of G2/M phase from 50.2％ to 23.6％,and reversed partially the G2/M arrest,of DU145 cells induced by 10-7 mol/L docetaxel.In vivo experiment showed that docetaxel,Ad-NDRG2,and combination of docetaxel and Ad-NDRG2 inhibited tumor growth with a inhibition rate of 30.7％,28.2％,and 55.8％,respectively.The coefficient of drug interaction (CDI) of docetaxel and Ad-NDRG2 was 0.89.Conclusions Ad-NDRG2 can enhance the growth suppression and apoptosis induced by docetaxel in synergistic way in vitro and in vivo.It demonstrated the great potential of Ad-NDRG2 in the treatment of androgen-independent prostate carcinoma.

Objective To analyze the differences of morphological and microvascular characteristics between hyperplastic polyps and colorectal adenoma (CA) under narrow band imaging (NBI) without magnification endoscopy,and to evaluate the value of NBI in differential diagnosis.Methods Patients with rectal polyps diagnosed by common endoscopy and pathologically confirmed CA and hyperplastic polyps were recruited in this study and under NBI examination.The pit pattern was divided into type A and B according to modified Kudo pit pattern classification.And the vascular pattern was classified into three types,type Ⅰ with invisible microvascular,type Ⅱ with even microvascular arranged along pit and type Ⅲ with uneven microvascular and irregular arranged.The differences of morphological and microvascular characteristics between hyperplastic polyps and CA were compared and the inter-observer consistency of NBI without magnification endoscopy was evaluated.Results Overall,87 patients with 107 polyps (73 CAs,34 hyperplastic polyps) underwent NBI without magnification endoscopy examination.The maximum diameter and the proportion of polyps with sublobe was higher in CA group than that of hyperplastic polyps group (P =0.0023 and 0.0047).In CA group,most pit shapes were type B (86.3％,63/73),and most vascular pattern types were Ⅱ/Ⅲ (82.2％,60/73).The sensitivity,specificity and accuracy of CA diagnosed with features of type B pit shape or Ⅱ/Ⅲ vascular pattern type was 97.3％,82.4％ and 92.5％.The sensitivity,specificity and accuracy of CA diagnosed with combined features of type B pit shape and Ⅱ/Ⅲ vascular pattern type was 71.2％,91.2％ and 77.6％.The mean kappa value of inter-observer consistency was 0.761.Conclusions There are differences in pit shapes and vascular pattern characteristics between CA and hyperplastic polyps.According to these two facts,CA and hyperplastic polyps can be initially differential diagnosed by NBI without magnification endoscopy.

Objective To explore the expression of early growth response gene-1 (EGR-1) in T cells that were positive for Tax protein of human T-cell leukemia virus type 1 (HTLV-1) and its possible reg-ulatory mechanism .Methods A series of expression structures carrying the regulatory elements of EGR-1 in different length and luciferase reporter genes were constructed .TaxP cells were transfected with the con-structs containing reporter genes and cultured with 5μmol/L of NF-κB inhibitor BAY 11-7082 or equal vol-ume of DMSO.After cultured for 24 hours the cells were collected to test the luciferase activity .BAY 11-7082 or equal volume of DMSO was added into the supernatant of TaxP cell culture to test the expression of EGR-1 protein by Western blot after 24 hours of culture .Tax and its mutants M22 and M47 were transfected into 293 T cells respectively to test the expression of EGR-1 protein by Western blot after 24 hours of culture . Results The expression structures carrying the regulatory elements of EGR-1 in different length and their mutants followed by luciferase reporter genes were successfully constructed .The luciferase activity in the cells transfected with the constructs containing the elements E 1 and E2 were higher than that transfected with E3, DelE and MutE, but the reporter gene expressions were decreased with the interference of BAY 11-7082 (P<0.01).However, there were no significant changes with the luciferase activity in the cells transfected by elements E3, DelE and MutE.Western blot analysis indicated that the expression of EGR-1 protein was significantly decreased with the interference of BAY 10-7082 .The expression of EGR-1 protein in M22 mu-tants-transfected 293 T cells were decreased significantly in comparison with those by wild type tax-and M47-transfected cells .Conclusion NF-κB was the key nuclear factor in regulating the expression of EGR-1 pro-tein in Tax-positive T cells .

Objective To investigate the effect of aerobic exercise combined with Levocarnitine in treating stable angina pectoris ( SAP ) and its effect on vascular endothelial function and serum levels of superoxide dismutase ( SOD ), total antioxidant capacity ( TAC ), glutathione peroxidase ( GSH-px ), malondialdehyde (MDA),and lipid peroxide( LPO) . Methods One hundred and fifty patients with SAP were selected in Affiliated Hospital of Yan′an University from september 2017 to september 2018 and randomly divided into control group and observation group( 75 cases in each group) . Both groups received routine intervention according to the guidelines. The control group was given with intravenous drip of left carnitine(3 g／time and once a day). On basis of the control group,the observation group was treated with regular aerobic exercise therapy. After 8 weeks＇ treatment for two groups,attack frequency degree of angina pectoris,score of life quality of Seattle angina scale(SAQ),and clinical effect were compared between the two groups. And the vascular endothelial function ( plasma endothelin ( ET ) 1, nitric oxide ( NO )), flow mediated vasodilation(FMD) of brachial artery and antioxidant effect(serum levels of SOD,TAC,GSH-px, MDA and LPO) were detected. Results After 8 weeks＇treatment,frequency of angina pectoris and episode of duration of angina pectoris in the observation group were less(( 4. 19± 0. 56) vs. ( 6. 22 ± 0. 89) time, (4. 31±0. 50) vs. (5. 25±0. 71) min),while life quality indexes SAQ score was higher,than those in the control group,and the difference was statistically significant (( 18. 44 ± 2. 30) vs. ( 12. 49 ± 1. 82) score, (56. 31±6. 62) vs. (48. 05± 5. 88) score,(14. 46 ± 1. 99) vs. ( 9. 22 ± 1. 10) score,( 21. 41 ± 2. 95)) vs. (18. 09±2. 26) score,(16. 14±2. 17) vs. (12. 05±1. 82) score,(all P＜0. 01)). The total clinical effective rate of the observation group ( 92%( 69 ／ 75)) was higher than that of the control group ( 80%( 60 ／75)),the difference was statistically significant (χ2＝4. 485,P＝0. 034). After 8 weeks′ treatment,level of ET-1,FMD of brachial artery,MDA,and LPO were lower than those in the control group(( 65. 38± 7. 91) ng／L vs. (77. 12±8. 56) ng／L,( 9. 44± 1. 34)% vs. ( 12. 55± 1. 81)%,(2. 81± 0. 43) μmol／L vs. ( 3. 90 ±0. 50) μmol／L,(3. 14±0. 44) μmol／L vs. (4. 40± 0. 63) μmol／L),while NO,SOD,TAC,GSH-px were higher than control group(( 67. 51 ± 7. 79) μmol／L vs. ( 52. 17± 6. 08) μmol／L,( 85. 25± 9. 67) U／L vs. (76. 01±8. 33) U／L,(12. 79±1. 80) kU／L vs. (9. 64±11. 05) kU／L,(117. 65±15. 03) U／L vs. (111. 76 ±14. 19) U／L),and the difference was statistically significant (all P＜0. 01). Conclusion Aerobic exercise combined with Levocarnitine in treating SAP can reduce the attack of angina pectoris, improve the life treatment of patients,and improve the clinical effect,which may be related to the improvement of endothelial function and antioxidant effect.

The article describes the epidemiology of spinal cord injury (SCI), the measurement methods and affecting factors of post-traumatic growth of SCI patients and treatment strategy of promoting post-traumatic growth of SCI patients. The purposes of the article are to provide help of promote positive psychological changes and improve the quality of life of SCI patients.

Objective To investigate the feasibility and clinical significance of membrane anatomy theory in the application of thoracoscopic and laparoscopic radical esophageal resection.Methods A retrospective analysis was performed on 142 cases of thoracoscopic and laparoscopic radical esophagectomy based on membrane anatomy theory from December 2018 to October 2021.The esophageal mesangium,esophageal cancer,and nerves,blood vessels,lymphatic system,adipose tissue,upper stomach,left mesangium,and left gastric lymph nodes in the esophageal mesangium were removed as a whole.During the surgery,the space containing loose connective tissue around the esophagus was seen to be the esophageal fascial fusion space.The first 10 cases were labeled with nanocarbon tracer markers,showing esophageal lymphatic drainage to the left gastric lymph node.Results All the 142 patients had smooth surgery.The operation time was 150-230 min(mean,184.6±21.3 min),the intraoperative blood loss was 20-100 ml(mean,46.7±16.8 ml),the number of lymph nodes dissected was 12-41(mean,23.5±7.3),and the positive lymph nodes were found in 97 cases.The postoperative chest drainage time was3-10 d(mean,7.1±2.5 d),the postoperative oral intake time was 5-10 d(mean,7.6±1.7 d),and the total hospital stay was 9-20 d(mean,14.0±4.6 d).The total incidence of postoperative complications was 21.8%(31/142),including 7 cases(4.9%)of anastomotic leakage,9 cases(6.3%)of anastomotic stenosis,9 cases(6.3%)of hoarseness,and6 cases(4.2%)of residual gastritis.There was no postoperative bleeding,chyllevial leakage,infection,or death within 30 d after surgery.The follow-ups of the 142 patients lasted for 11-35 months,with a median of 26 months,and there was no recurrence and death.Conclusions There is a mesangial structure that constitutes an"envelope"around the esophagus.The membrane anatomy theory is suitable for the treatment of esophageal cancer,and radical resection of esophageal cancer based on the theory is safe,effective,and feasible.