Objective To evaluate the diagnosis and treatment of primary retroperitoneal tumor. Methods The clinical data of 75 patients with primary retroperitoneal tumor confirmed by operation and pathology in recent 20 years in our hospital were analyzed retrospectively. Results About 57.3% of the patients were diagnosed accurately before the operation. Correct diagnostic rates of ultrasound and CT were 60.0% and 84.0% ,respectively.Of them 57cases(76.0%) were malignant and18 (24.0%) benign tumor. Tumor size was not related to the pathological characteristics.Radical resection was done in 42 patients(56.0%),partial resection in 23 patients (30.7%),and biopsy in 10 patients(13.3%).Conclusions Ultrasonic and CT are the major diagnostic methods. Early operation is recommended after necessary preparation. Surgical resection is a major procedure for the management of primary retroperitoneal tumor and might provide long surrival time.

Objective: The chemical composition, extraction and biological activity of antioxidant substance of sweet potatoes were studied. Method: The antioxidant substance was extracted with alcohol and purified with AB-8 big-hole resin and its elimination rate of _?O 2 and OH and SOD activity were determined.Results: The content of antioxidant substance stockpiled respectively in the root tubers, stems and leaves of sweet potatoes and was different in varieties. The highest content in the root tuber was 0.324%, which accounted 70% of total content in sweet potatoes. Its extraction ratio was 85%. The major composition of the antioxidant substance was phenol acid, including chlorogenic acid,isochlorogenic acid,neochlorogenic acid and 4-0-caffeonyl quinic butyl ester. They had intense antioxidant function and their elimination rate to _?O 2 and?OH at concentration 90 mg/ml was 88.02% and 82.21% respectively. The antioxidantsubstance restrained oxidation of lipid and hemolysis of red cell induced by H2O2,and increased SOD activity in serum and skin of mice. Conclusion: Several kinds of phenol acid as antioxidant substance stockpiled in sweet potatoes were proved to have strong antioxidant activity.

Objective To evaluate the curative effect of potassium magnesium aspartate on arrhythmia and heart function in valve replacement postoperative patients of rheumatic heart disease. Methods Two hundred and eighty patients with rheumatic heart disease were divided into 2 groups in random,with no statistical significance. Treatment group (n=155) were received i.v. potassium magnesium aspartate 40 ml every day and control group (n=125) were only given conventional therapy. At the same time they were given same treatment. Blood magnesium level,blood potassium levels,arrhythmia incidences and heart function were also observed. Results Blood magnesium and potassium levels of the treatment group were higher than those of the control group (P

Objective To analyze and summarize the skills and complications of extracorporeal membrane oxygenation( ECMO) cannu-lation and vein intubation. Methods The clinical data of 21 patients of V-A or V-V ECMO in our hospital from January 2009 to July 2014 were analyzed retrospectively. And the techniques of different catheter sites were summarized. Results Three cases were successfully insert-ed catheter by jugular vein puncture with one time. Four patients with ascending aorta intubation died from uncontrolled severe hemorrhage. Eight peripheral catheter site had a small amount of bleeding,with no more bleeding after pressurized bandage. There were no complications like bleeding, hematoma, hemothorax and pneumothorax in the period of ECMO. Conclusion In the process of the ECMO catheter, the standardized operation could reduce the incidence of serious complicaions including bleeding.

Objective To explore the relationship of MDR1 and its encoded product P-gp expressions with clinical efficacy of transcatheter arterial chemoembolization (TACE)in primary liver cancer and their clinical significance.Methods We selected 108 patients with primary liver cancer who came to our hospital between June 2010 and June 2013 as observation subjects.Meanwhile 50 healthy people in our hospital for liver biopsy were selected as controls.MDR1 mRNA level in observation group and control group was determined by real-time quantitative PCR.P-gp protein level was analyzed by immunohistochemistry.According to P-gp level,the 108 patients were divided into drug-resistance groups and non-resistance group;the relationship between P-gp expression level and clinical efficacy was analyzed.Results MDR1 mRNA level in liver tissues significantly enhanced in observation group compared with that in control group (P <0.05).In observation group 32 patients had the ratio of MDR1 mRNA level-normal level of more than 2 and 76 patients had the ratio of MDR1 mRNA level-normal level of less than 2. Immunohistochemistry revealed that MDR1 encoded product P-gp was brownish yellow, mainly expressed in the cell surface of liver cancer cells.There were 35 P-gp protein-negative patients (non-resistance group)and 73 positive patients (resistance group).Clinical efficacy was significantly higher in non-resistance group (74.28%)than in resistance group (43.28%)(P <0.05).The 1 year and 2-year cumulative survival rates were 54. 12% and 27.40% in resistance group and 77.14% and 42.86%% in non-resistance group.They were significantly higher in the latter group (P <0.05 ).Conclusion The overexpressed MDR1 encoded product P-gp in primary liver cancer is associated with multidrug resistance in tumor chemotherapy,suggesting that P-gp can be used as one of the guiding clinical markers of chemotherapy.

Objective To study the effects of recombinant human growth hormone(rhGH) on the treatment for valve replacement postoperative in rheumatic heart disease associated cardiac eaehex.Methods Fortytwo patients with rheumatic heart disease associated cardiac eachexia were divided into two groups.Group one(n=20,rhGH group) received standard enteral nutrition (15 kal·kg-1 · d-1)with rhGH 10U injection subeutaneously from postoperation day 7 to day 14 and group two(n = 22,eontrol group) received standard enteral nutrition (15 kal·kg-1· d-1) for the same period.Haemoglobin, serum total protein, serum albumin, blood glucose, handgrip exercise and triceps skin_fold thickness were determined.Meehanieal ventilation, hypostatie pneumonia incidence rate, and length of stay were observed.Results The levels of serum total protein, serum albumin and blood glucose eoneentration in the rhGH group at the 14th day were inereased significantly compared to that in the control group(P <0.01).Haemoglobin, triceps skinfold thiekness and handgrip exercise in rhGH group were significantly different from those in the control group(P <0.05).Postoperative meehanieal ventilation time, intensive care unit time, hospital stay time were signifieantly shorter than those in the eontrol group (P < 0.05), and hypostatie pneumonia was significantly lower than that in the eontroi group(P < 0.01).Conclusions The rhGH can obviously improve anabolie effects of patients with rheumatic heart disease associated cardiac eachexia whieh can reduce hypostatie pneumonia and shorten postoperative hospital stay time.

Objective To study the relationships between airway inflammation,reticular basement membrane (RBM) thickness and bronchial hyperresponsiveness (BHR) before and after treatment with inhaled corticosteroids (ICS) in patients with asthma.Methods Twenty-eight patients with asthma (asthma group) were treated with inhaled budesonide (200 μg,twice a day for 12 months).Lung function,bronchoalveolar lavage (BAL) fluid and airway biopsy pathology were carried out before and after treatment.And 10 patients without asthma were acted as control group.Results BAL fluid eosinophils,epithelial cell and mast cell proportions before treatment in asthma group were significantly higher than those in control group [asthma group:(1.60 ±0.11)％,(2.50 ±0.29)％,(0.1100 ±0.0100)％ ;control group:(0.50 ±0.02)％,(1.20 ±0.08)％,(0.0200 ±0.0001)％,P ＜0.01].RBM and smooth muscle thickness were increased in asthma group than those in control group [ asthma group:( 14.25 ± 2.15 ),(0.36 ± 0.01 ) μ m;control group:(4.45 ± 1.22),(0.20 ± 0.01 ) μ m,P ＜ 0.01 ].BAL fluid eosinophils,epithelial cell and mast cell proportions,RBM and smooth muscle thickness decreased after treatment in asthma group [ (0.80 ±0.04)％,(1.60 ±0.07)％,(0.0500 ±0.0020)％,(6.18 ± 1.30) μm,(0.26 ±0.02) μm,P ＜0.01].RBM thickness was negative correlation with methacholine provoking dose which made forced expired volume in one second reduce by 20％ (r =-0.672,P ＜ 0.01 ).Conclusions Airway inflammation,RBM thickness and BHR in patients with asthma are interrelated and improved with ICS.The results of this study support the need for early and long treatment with ICS.

BACKGROUND: The dynamic changes of pneumocyte apoptosis and aspartate-specific cysteine proteases-3 (caspase-3) expression in lung tissue of rats during the process of lung ischemia/reperfusion (I/R) injury and the possible action mechanisms remain unclear.OBJECTIVE: This study was to observe the dynamic changes of pneumocyte apoptosis and caspase-3 expression in the rat lung tissue during the process of lung I/R injury, and to analyze the role of pneumocyte apoptosis and the possible action mechanism.DESIGN: A randomized controlled animal experiment.SETTING: Emergency Center, First Hospital, Nanjing Medical University.MATERIALS: This study was carried out in the Animal Laboratory of the First Hospital of Nanjing Medcial University and Nanjing Center for Radioimmunity between April 2006 and September 2006. Twenty-eight male healthy SD rats of clean grade, with body weight of 250 to 350 g, aged 49 to 76 days, were provided by the Experimental Animal Center of Nanjing Medical University. The involved rats were randomized into experimental group and control group, with 14 rats in each.METHODS: ①Experimental intervention: Rats in the experimental group were created into models of lung I/R injury according to the method of Eppinger et al. They were occluded for 45 minutes at the porta of lung (no systolic and diastolic reactions in lung tissue being considered as successful occlusion), and then they were reperfused (recovery of systolic and diastolic function being considered as successful reperfusion); After that, lung tissues were harvested at 3 and 6 hours after lung I/R injury, 7 rats at each time point. Each rat in the control group was subjected to a thoracotony only, but lung tissues were isolated at the same time point by the same method. ②Experimental evaluation: Apoptotic cells in the lung tissue were detected with a flow cytometer by Annexin-V-PI staining, and apoptosis rate was calculated. Caspase-3 expression in the lung tissue was observed by immunohistochemical method and image analysis. Wet to dry weight ratio(W/D) of lung tissue of rats in the two groups was calculated; the number of injured pulmonary alveoli at I/R 3 hours/that at I/R 6 hours was calculated for quantitative evaluation of injured lung tissue; Patho-morphological changes of lung tissue were observed by haematoxylin & eosin staining under an optical microscope.MAIN OUTCOME MEASURES: ①Pneumocyte apoptosis rate and caspase-3 expression in the lung tissue. ②W/D of lung tissue and quantitative evaluation of injured lung tissue. ③Patho-morphological changes of lung tissue.RESULTS: Twenty-eight rats were involved in the final analysis, without deletion. ①Pneumocyte apoptosis rates in the experimental group at I/R 3 and 6 hours were significantly increased as compared with control group (P＜0.01). In the experimental group, pneumocyte apoptosis rate was decreased a little at I/R 6 hours than at I/R 3 hours (P＜0.05). ②Caspase-3 expression in the lung tissue of rats of experimental group reached its top at I/R 3 hours, and was decreased a little at I/R 6 hours. At each time point, caspase-3 expression in the experimental group was increased as compared with control group (P＜0.01). ③In the experimental group, the number of injured pulmonary alveoli at I/R 3 hours/that at I/R 6 hours and W/D ratios of lung tissues were significantly increased as compared with control group (P＜0.01). In the experimental group, two ratios at I/R 6 hours were higher than those at I/R 3 hours (P＜0.05).④In the experimental group, the structure of pulmonary alveoli was destructed, collapsed and disappeared; lots of inflammatory cell infiltration was found; Patho-morphological changes of injured lung tissue at I/R 6 hours were severer than those at I/R 3 hours. No obvious changes were found in the control group.CONCLUSION: At the early stage of lung I/R injury, the alteration of caspase-3 maybe activate pneumocyte apoptosis and induce the apoptosis of lung tissue, and thereby leads to lung injury.

Objective To investigate the effects of ischemic preconditioning on pneumocyte apoptosis and the expression of HSFT0 after lung isehemia-reperfusion(I/R) in rats and discuss its possible mechanism of extenu-ating ischemia-repedusion injury. Method Thirtysix male Sprague-Dawley rats were randomly divided into three groups [ sham operation(SO ) group, ischemia-teperfusion(L/R) group, and ischemic preconditioning(IP) group],twelve in each group. Lung croas-clamping was used to build the L/R model. In IP group, three cycles of 5-minute-ischemia + 5-minute-reperfusion were given to the pulmonary artery before the procedure. Sham operation rats had a thoracotomy only. Two hours(or five hours) reperfusion was given to both L/R and IP group. Tenninal-deoxynucleotidyl Transferase Mediated d-UTP Nick End Labeiing(TUNEL) was used to evaluate apoptosis. Expression of HSP/0 in lung was observed by immunohistochemical stain and image analysis. Index of quantitative assessment of histologic lung injury(IQA), wet to dry weight ratio(W/D) were measured. The pathological change of lung tissue was observed under both hght and electron microscopy. Statistical analysis was carried out by One-way Anova. Scheffe test was used for intragroup comparison. Results The apoptosis index and expression of HSP70、W/D,IQA of hng tissue in I/R group were higher than those in the sham operation group (P<0.01). Compared with the L/R group, the apoptosis index and expression of HSP70, W/D, IQA of lung tissue significantly decreased (P<0.01), the levels of expression of HSPTO increased significantly in IP group ( P<0.01 ). The pathological and ultrastructure change of lung tissue was better in IP group than those in I/R group. Condusions Ischemic preconditioning can extenuate lung I/R injury by the possible mechanism of increasing the expression of HSPT0 which inhibits the apoptosis during lung I/R injury.

Objective According to the fine artery anatomy of the lower lip, we developed an innovative partial-thickness myocutaneous flap based on the vascular network of the submucosal and subcutaneous layers of the lower lip.We attempted to treat the secondary bilateral cleft lip deformities using this innovative cross-lip flap.Methods From July 2009 to June 2015, this new technique was used in 98 patients with secondary bilateral cleft lip deformities.The central defects usually occurred in these patients.The defects were reconstructed partially or completely according to the severities of the defects.The operative procedures were as follows: The split flap was elevated from the posterior portion of the oris orbicularis muscle after the inferior labial arteries were divided.Then the partial-thickness flap was rotated 180 degrees horizontally and inverted 180 degrees upward to the upper lip defect.Results All 98 musculomucosal pedicle flaps were viable.The upper lips were reconstructed according to the severities.Conclusions This myocutaneous cross-lip flap with musculomucosal-pedicle has a more reliable blood supply, better flexibility and plasticity.It is an effective method for aesthetic reconstruction for the secondary bilateral cleft lip deformities.