Objective To explore the safety and feasibility of endoscopic-assisted inguinal lymphadenectomy via a small incision (3 cm) for vulvar carcinoma . Methods From September 2013 to December 2015, local wide excision and endoscopic-assisted inguinal lymphadenectomy via a 3-cm incision was performed to treat vulvar carcinoma in 6 women.There were 2 cases of unilateral operation and 4 cases of bilateral operations .A small incision (3 cm) was made in the groin.The skin edge was lifted to separate subcutaneous tissue and obtain a surgical exposure .Then endoscopic inguinal lymphadenectomy was conducted . Results The surgeries were successful in all the 6 patients, with no conversion to open surgery or intraoperative secondary injury .The operation time of inguinal lymphadenectomy was 60-90 min (78.3 ±14.7 min), and the blood loss was 20-40 ml (31.6 ±9.8 ml).The number of lymph nodes desected was 3-13 (8.7 ±3.0) in each side.Pathological examinations showed squamous cell carcinoma . The FIGO staging showed 2 cases of stage ⅠB and 4 cases of stage Ⅱ.The postoperative stitches removal time was 7-9 d (7.8 ±0.7 d) .No surgical complications , such as incision disruption , delayed healing , inguinal skin necrosis , or lower extremity lymphedema , were recorded during a 3-12 months (6.5 ±4.4 months) of follow-up.No tumor recurrence or metastasis was found . Conclusions Endoscopic-assisted inguinal lymphadenectomy via mall incision in the treatment of vulvar carcinoma is effect , safe and feasible .It achieves radical effects .

Objective Explore the value of video-assisted thoracoscopic extended thymectomy in the treatment of myasthenia gravis.Methods This is a prospective randomized control study.Fifty-four patients who were confirmed to be MG preoperatively from 2005 to 2008 were divided into VATS group(27 cases)and thoracotomy group(27cases).Thymectomy and dissection of all faity tissue anterior to pericardium were performed in both groups.Results When compared with thoacotomy group,VATS group had less blood loss,shorter postoperative hospital stay and time of postoperative chest drainge tube left.One patient was converted to open surgery because of the injury to the brachiocephalic vein.During a period of followed-up 624 months,symptom was improved in 81% of the patients in VATS group and 85% in thoractomy group(P>0.05).Conclusion Extened thymectomy with VATS is safe and feasible with the advantage of less invasion,less surgical trauma and pain,lower rate of complication and good curative effect.

Objective The loss of NF2 gene in cutaneous schwannomas of neurofibromatosis type 2 patients was investigated in order to explore the tumorigenesis and characteristics of NF2 tumor suppressor gene, and to provide evidence for presymptomatic gene diagnosis for NF2 patients. Methods DNA was extracted from whole blood and frozen tumor tissue, respectively. Genotyping was performed using 6 microsatellite markers flanking or within the NF2 gene: CRYB2－ D22S193－ NF2CA1－ NF2CA3－ D22S268－ D22S430, which is tightly linked to the NF2 gene and analyzed on an ABI Genetic Analyzer 310 after PCR amplification. Results A total of 18,14,0,13,16,12 samples showed loss of heterozygosity at microsatellite markers CRYB2， D22S193， NF2CA1， NF2CA3， D22S268， D22S430 in 43 samples of cutaneous schwannomas, respectively. Conclusions The method for detection of NF2 allelic loss was established. Frequent allelic loss reconfirms that NF2 gene is a tumor suppressor gene. The observation that tumors with or without allelic loss of the NF2 gene exist in the same patient indicates that these tumors are originated from different clones in which genetic alterations occurred independently.

0.1). Conclusion This method is simple, rapid and accurate for determining formaldehyde in indoor air.

AIM: To study the inhibitory effects of the licoric extracts on the activity of tyrosinase, which is constituted of monophenolase and diphenolase. METHODS: The 50%(V/V) alcohol is used as extractant. To investigate the effects of the licoric extracts on the monophenolase and diphenolase activity, the absorbance of the solution containing several concentrations of the licoric extracts was measured at 475 nm and 390 nm, using the L-tyrosine and pyrocatechin as the substrate, respectively. RESULTS: The licoric extracts has showed a strongly inhibition on the activity of tyrosinase, either monophenolase or diphenolase. The IC_ 50 is 1.94 and 2.94 mg?ml -1 , respectively. CONCLUSION: The licoric extracts has inhibitory effects on both monophenolase and diphenolase. The diphenolase activity test system using pyrocatechin as the substrate is a useful procedure to study the activity of tyrosinase.

Background and purpose:The radio-labeled glucose analogue F-18-fluoro-2-deoxyglucose(FDG) is the most widely used tracer in PET imaging,and its application in oncology has become one of the standard imaging modalities.But FDG uptake is not tumor specifi c.The aim of this paper was to study the endoscopic result with the patients of 18F-FDG accumulations in gastrointestinal tract after PET-CT examinations.Methods:Thirtythree patients with 18F-FDG accumulations in gastrointestinal tract were correlated with endoscopic and histopathologic results.Results:Of these,14 patients were harboring newly occurring cancers in gastrointestinal tract(esophagus cancer,2 patients;gastric cancer,5 patients;colorectal cancer,7 patients) .Eight patients were identified with precancerous lesions(adenoma,4 patients;hyperplastic polyp,1 patient;Barrett’s esophagus,1 patient;intestinal metaplasia of the gastric mucosa,2 patients) .Inflammatory lesions were detected in six patients(active colitis,5 patients;anastomotic leakage,1 patient) .In fi ve patients,PET/CT showed normal fi ndings in endoscopic examinations.The false positive rate of PET-CT was 33.33%(11/33) .Conclusion:Endoscopic result is important for patients of 18F-FDG accumulations in gastrointestinal patient.

Objective To investigate the clinical significant and the difference of predicting the risk of dysglycemia and dyslipidemia by body mass index (BMI),waist circumference (WC) and waist-to-hip ratio (WHR) in order to look for the best predicting index.Methods Five thousand and thirty residents were participated to this study who were from Jinshan New Area and nearby of Jinshan,Shanghai,including 2004 males and 3026 females.They were divided into obesity group and non-obesity group based on the index of BMI,WC and WHR respectively.The ROC was made based on the above indies in different gender groups.Results The ROC area of BMI was the biggest with 0.641 (P ＜0.05) for male and 0.617(P ＜0.05) for female.The cut off value was 24.67 or 23.88 based on the male or the female.The same trend was seen in terms of WC with 88.5 cm for the male and 84.5 cm for the female.The small cut off value was seen in terms of WHR and there was no significant between male and female.Among male people,the cut off values was 26.01 in terms of BMI and 88.5 cm in terms of WC,0.89 cm in terms of WHR.Among the female people,there was the less predicting significant in terms of WC or WHR.The area under the curve had no significant differences,and the BMI predicted abnormal blood glucose of no value,the area under the curve is only 0.513 (P ＞ 0.05).Conclusion BMI is proved the best predictor for the risk of dyslipidemia.There are significant among BMI,WC and WHR in terms of predicting dysglycemia in different gender.BMI is proved without significant regarding of predicting dysglycemia in females.

Objective To study the application of VATS and gasless laparoscopy to the treatment of portal hepertension Methods 12 operations of the splenectomy combined with ligation of pericardial vein and lower part of lung covered by omentum majus were performed throngh the thoracoscopy and laparascopy Results All of the 12 operations were successful. The procedures lasted (2.5～5.2) hours with mean time being 3.3 hours. Gastrointestinal function recovered in (48-72) hours after operation. The duration of hospitalization was (9～11)days. No postoperative thoracic and abdominal cavity complications were found. The average duration of hospitalization after operation was 10.3 days.12 cases were followed up for 2 month to 4 years and no rebleeding was found. Conclusions The procedures including ligation of pericardial vein under VATS combined with gasless laparoscopy assisted splenectomy and lower part of lung covered by omentum majus for the treatment of portal hypertension is passable.

Objective To investigate the effect of glucose-based peritoneal dialysis fluids and icodextrin-based peritoneal dial-ysis fluids on the expression of TLR2 and TLR4 on huamn peritoneal mesothelial cells .Methods Human peritoneal mesothelial cell line 5 - 10 generations(HMrSV5) was cultured in DMEM /F12 medium supplemented with 10% (v/v) fetal calf serum (FCS) .Cell viability and cell proliferation were assessed using M TT method .The experiment were divided into 5 different groups :group A (control group) ,1 .5% dextrose group ,2 .5% dextrose group ,4 .25% dextrose group and 7 .5% Lcodextrin group .Icodextrin group (aikau dextrin) ,TLR2 and TLR4 expression were detected by Western blot .Results Treatment with different concentrations of glucose-based peritoneal dialysis fluids for 24 h did not affect the expression of TLR2 and TLR4 protein .In addition ,after stimula-tion for 48 h ,1 .5% dextrose ,2 .5% dextrose ,4 .25% dextrose decreased TLR2 expression by (5 .5 ± 2 .8)% ,(31 .4 ± 7 .5)% , (54 .9 ± 1 .9)% respectively ,TLR4 expression by (32 .9 ± 17 .6)% ,(47 .7 ± 13 .5)% ,(66 .4 ± 13 .5)% respectively .Stimulation for 72 h ,decreased TLR2 expression by (29 .4 ± 14 .7)% ,(38 .9 ± 9 .9)% ,(63 .5 ± 16 .5)% respectively ,TLR4 expression by(59 .5 ± 16 .8)% ,(63 .1 ± 9 .5)% ,(79 .2 ± 14 .0)% respectively .There was no significant change in TLR2 and TLR4 protein expression on 7 .5% icodextrin group .Conclusion Glucose-based peritoneal dialysis fluids ,but not icodextrin-based peritoneal dialysis fluids downregulates expression of TLR2 and TLR4 by HM rSV5 .

Objective To evaluate the efficacy and safety for cervical ripening by double-balloon catheter among full-term pregnancy women underwent labor induction.Methods It was a prospective nonrandomly controlled research.Totally 128 singleton-pregnancy women in full-term who had to undergo labor induction because of pregnancy complications or comorbidities from August 2011 to April 2013 in Peking University First Hospital were selected as study subjects.Participants were allocated to preinduction cervical ripening with either a double-balloon catheter (66 participants,study group) or prostaglandin vaginal insert (62 participants,control group).Compare the efficacy for cervical ripening and adverse reactions between the two groups.Results The efficacy for cervical ripening (Bishop scores improved by ≥ 2) had no significant differences between study and control groups [82％ (54/66) compared with 81％ (50/ 62),P＞0.05].The time interval between intervention and parturiency was significantly higher in the doubleballoon catheter group than in the prostaglandin vaginal insert group [(24.2±8.5) compared with (14.5±8.0) hours,P＜0.05].The proportion of women who achieved parturiency within 12 hours was significantly lower in the double-balloon catheter group than that in the control group [9％ (6/66) compared with 21％ (13/62),P＜0.05].The cesarean section rate showed no significant differences [41％ (27/66) compared with 43％(27/62),P＞0.05].The prevalence of intrauterine infection demonstrated by clinical diagnosis was significantly higher in the double-balloon catheter group [11％ (7/66) compared with 6％ (4/62),P＜O.05].The double-balloon catheter group had significantly lower rates of contraction overfrequency [0(0/66) compared with 42％ (26/62),P＜0.05],hyperthermia [3％ (2/66) compared with 19％ (12/62),P＜0.05],fetal heart rate abnormalities before removing the device or drug [5％ (3/66) compared with 19％ (12/62),P＜0.05],as well as precipitate labour [2％ (1/66) compared with 16％ (10/62),P＜0.05].Conclusions The efficacy of a double-balloon transcervieal catheter is similar to that of a prostaglandin vaginal insert.However,the double-balloon catheter cannot significantly reduce the cesarean section rate while it increases the risk of intrauterine infection.The materual and fetal safety of transcervical catheter is superior to the prostaglandin vaginal insert.In cases of oligohydramnios,fetal growth restriction,pregnancy complicated with asthma,hypertension and scar uterine are in favor of a balloon catheter using for cervical ripening on account of high risk of using prostaglandin.