Objective To assess the feasibility and efficacy of robot-assisted laparoscopic simple prostatectomy (RALSP) for the treatment of benign prostatic hyperplasia (BPH) with large prostate.Methods From January 2014 to July 2015,16 patients with large prostate (≥80 ml) were treated by RALSP.The average patient's age was 69 years.The prostate volume was (98.3 ± 12.9) ml,preoperative residual urine was (78.0 ± 24.8) ml,the average IPSS was (22.9 ± 5.9),the average QOL was (4.8 ±1.5) and the average Qmax was (8.9 ± 3.7) ml/s,respectively.All patients agreed to accept RASP.The pre-operative and three months post-operative IPSS,QOL,residual urine and Qmax were compared and analyzed.Results All 16 patients underwent the surgeries uneventfully.The average operation time was (92.5 ± 15.5) minutes,the estimated blood loss was (125.5 ±25.5) ml,drainage time was (4.6 ±0.8)days,catheterization time was (7.9 ± 1.2) days and postoperative hospital stay was (5.1 ± 1.1) days.Three months after surgery,patient's IPSS was (11.8 ± 3.1),QOL was (1.6 ± 0.9),the average residual urine was (12.3 ± 2.6) ml and Qmax was (29.4 ± 11.6) ml/s,respectively.All the parameters significantly improved compared with the preoperative data (P ＜ 0.05).Conclusions Robot-assisted laparoscopic simple prostatectomy is a safe and effective method for the treatment of BPH patients with prostate volume larger than 80 ml.

Age Factors ; Endometrial Hyperplasia ; pathology ; Endometrial Neoplasms ; pathology ; Endometrium ; cytology ; pathology ; Female ; Humans ; Menstrual Cycle ; Papanicolaou Test ; Postmenopause ; Vaginal Smears

Objective To evaluate the clinical application of perforator flap in extended radical vulvectomy of vulvar carcinoma.Methods Retrospectively,twelve cases of vulva carcinoma were treated by radical extensive excision,and the defects were repaired with perforator flap.Results All the flaps were survived and healed with first intention except one infection.The wound infection patient was treated with change of the dressing and antibiotics.The reconstructed vulvae were plump and elastic.It appeared like the normal vulvae and there was no contraction of the vagina.Conclusions Vulvar reconstruction with the perforator flap after the radical vulvectomy could make the patients recover easily,which produces almost normal appearance and function of the vulvae,reduces the time of wound healing,the patient could get the next therapy more quickly and the quality of life improving.It has wide clinical application value.

Objective To investigate the relations between adiponectin(APN) and lipoprotein associated phospholipase A2 (LP‐PLA2) with the development and progress of essential hypertension .Methods 60 patients with essential hypertension were collect‐ed and divided into 3 groups of the hypertension grade 1 ,2 ,3 groups according to the levels of blood pressure ,20 cases in each group .Contemporaneous 20 healthy controls were selected .The peripheral venous blood samples were collected from the cubital vein and the serum levels of APN and LP‐PLA2 were measured by ELISE .The related biochemical indicators were simultaneously detected .Results The serum APN levels in the hypertension grade 1 ,2 ,3 groups were significantly lower than that in the control group ,moreover which in the hypertension grade 3 group was significantly lower than that in the hypertension grade 1 group(P<0 .05);on the contrary ,serum levels of LP‐PLA2 in the hypertension grade 1 ,2 ,3 groups were significantly higher than that in the healthy control group ,moreover which in the hypertension grade 3 group was obviously higher than that in the hypertension grade 1 group(P<0 .05);serum APN was significantly negatively correlated with LP‐PLA2(r= -0 .772 ,P<0 .05) .Conclusion Serum levels of APN and LP‐PLA2 are closely related with the development and progress of essential hypertension .

Objective To evaluate the effects of fluticasone propionate (FP)on Foxp3 expression in CD4+T cells, to explore the possible mechanisms of childhood asthma. Methods Thirty asthmatic children, 15 with inhaled FP and 15 without inhaled FP, and 16 healthy children were recruited. Peripheral blood mononuclear cells (PBMC)labeled for CD4 and intracellular Foxp3 were analyzed using flow eytometry. The levels of IL-2 and IL-6 in serum and supernatant before and after stimulation by Phytohemagglutination (PHA)were measured by ELISA. The expression of phosphorylated signal transducer and activator of transcription 5 (STAT5)in PBMC was detected by Western-blot.Results Compared with healthy control, the percentage of CD4+ Foxp3+ cells in PBMC in asthmatic children without inhaled FP was significantly decreased. After inhaled FP and in remission stage, the percentage of CD4+ Foxp3+ cells in asthmatic children was up regulated with a decreased serum IL-6 level and an increased phosphorylated STATS expression. Conclusions Decreased Foxp3 protein expression in peripheral CD4+ T regulatory cells (Treg)is characterized in childhood asthma. Inhaled glucoeorticoid therapy of childhood asthma might be attributed to its ability of increasing Foxp3 expression by upregulation of phosphorylated STAT5 to balance the T cell response.

Objective To investigate the changes in plasma microRNA-126 and microRNA-1 in children with asthma exacerbation and its relationship with bronchial asthma.Methods From October 2012 to December 2013,48 children with asthma exacerbation from the Outpatient Department and the Inpatient Department in Houjie Hospital Affiliated to Guangdong Medical College were enrolled in the study (asthma group).Meanwhile,52 healthy children wcre selected as the healthy control group.The expression levels of plasma microRNA-126 and microRNA-1 were detected by real-time quantitative PCR (RT-PCR).The content of interleukin-4 (IL-4) and interferon-γ (IFN-γ) in plasma was measured by enzyme-linked immunosorbent assay (ELISA).The predictive value of microRNA-126 and microRNA-1 in plasma to bronchial asthma was evaluated by receiver operating characteristic (ROC) curve.Results The relative expression levels of plasma microRNA-126 in the asthma group were upregulated compared with those in the healthy control group [7.36 (0.96-41.21) vs 3.68 (0.75-38.91),Z =3.135,P =0.038],and microRNA-1 relative expression levels in the asthma group were lower than those of the healthy control group [2.17 (0.18-26.97) vs 5.83 (0.82-39.62),Z =2.156,P =0.045].The content of IL-4 in asthma group was higher than those of the control group [(109.98 ± 74.58) ng/L vs (78.50 ± 75.82) ng/L,t =2.122,P =0.036],and the IFN-γ level in the asthma group was lower than those of the healthy control group [(70.49 ± 12.03) ng/L vs (77.03 ± 17.16) ng/L,t =2.270,P =0.025].In the plasma of patients with asthma exacerbation,the sensitivity of microRNA-126 and microRNA-1 was 85.42％ (41/48 cases)and 79.17％ (38/48 cases),respectively.The specificity of microRNA-126 and microRNA-1 in healthy controls was 78.85％ (41/52 cases) and 73.08％ (38/52 cases),respectively.The area under ROC curve of microRNA-126 and microRNA-1 was 0.919 (95％ CI 0.866-0.973),0.867 (95％ CI 0.796-0.939).Conclusions MicroRNA-126 is significantly elevated in plasma of children with asthma exacerbation.The plasma levels of microRNA-1 were significantly downregulated.These results suggest that microRNA-126 and microRNA-1 may be potential markers for the diagnosis of bronchial asthma.

Objective To explore the efficacy and safety of minimal invasive adrenal sparing surgery for the treatment of Cushing syndrome caused by adrenocortical adenoma.Methods Patients who underwent minimal invasive adrenal surgery for adrenocortical adenoma in our institution from January 2010 to December 2015 were retrospectively analyzed.Preoperative, intraoperative, and postoperative variables were reviewed from the database.The mean patient age at diagnosis was 39 years and male:female ratio was 10:111.Of the 121 adenomas, 50 were located in the right adrenal and 71 in the left.The mean tumor size was 2.6 cm.84 cases had hypertension (69.4％), 36 cases had diabetes mellitus (29.8％), and 45 cases had obesity (37.2％).Postoperative follow-up was performed by evaluating adrenal gland function and imaging.Results Mininal invasive partial adrenalectomy was performed in 121 cases and the success rate of operation was 99.2％ (120/121).Sixty-two cases received operation through retroperitoneal approach,and 59 cases were through transperitoneal approach.The median operative time was 50 min with a median blood loss of 50 ml.The mean postoperative hospital stay were (5.0 ± 3.2) days.The vascular injury occurred in 2 cases (1 case in each surgical approach), while the abdominal organ injury occurred in 2 cases with 1 case of spleen injury and 1 case of liver injury (both in transperitoneal approach).Postoperative complications were observed in 6 cases:1 case of deep venous thrombosis, 1 case of wound hematoma, 4 cases of wound infection.Cortisol substitution was given in 2 to 12 months (mean 6.2 months)postoperatively.One year after operation, the remission rate of hypertension, diabetes and obesity was 58.3％ (49/84), 30.6％ (11/36) and 60.0％ (30/45), respectively.Conclusions Minimal invasive adrenal surgery using retroperitoneal and transperitoneal laparoscopic technique can be performed with low morbidity and achieve an excellent outcome.The perioperative hormone therapy may also play an important role.

Dopamine ; therapeutic use ; Hepatorenal Syndrome ; blood ; therapy ; Humans ; Liver Transplantation ; Vasoconstrictor Agents ; therapeutic use

OBJECTIVETo investigate the color stability and opacity of seven resin-based composite products after ultraviolet irradiation.

METHODSSeven kinds of light-cured resin-based composite products (Aelite Flo, Filtek Z350 Flowable, Clearfil AP-X, Dyract AP, Z100, Durafill VS, Filtek Z350 Universal) were tested in the study (five for each group). Changes in color and opacity of test samples were determined before and after 8, 16 and 24 h ultraviolet irradiation using the CIE 1976 L*a*b* system and CIE 1931 XYZ system by a colorimeter.

RESULTSThe color of resin disks suffering ultraviolet irradiation was different in different irradiating time. Color difference values ranged from 1.85-3.21 for 8 h ultraviolet irradiation to 2.88-4.55 for 24 h ultraviolet irradiation. Opacity values ranged from 0.75-0.82 before ultraviolet irradiation to 0.80-0.98 after 24 h ultraviolet irradiation. Among all the groups, Z100 and Filtek Z350 Flowable showed the biggest color change, while Filtek Z350 Universal showed the highest opacity.

CONCLUSIONIt can be concluded that for some products, ultraviolet irradiation leads to color instability and opacity variation.

Background Erythropoietin (EPO) has a protective effect on retinal neurons in many retinal diseases,but regarding the effect of EPO on apoptosis of retinal photoreceptor cells in retinal detachment (RD) is uncompletely clear.Objective This study was to investigate the protective effect of endogenous EPO on photoreceptors in a rat model of RD and explore its possible mechanism.Methods Seventy-two Sprague- Dawley (SD) rats were randomly assigned to control group,RD group,RD+PBS group,RD+erythropoietin soluble receptor (EPOsR) 2, 20, 200ng groups with 12 rats for each group.1.4% hyaluronic acid was slowly injected into the subretinal space to induce RD in rats,and PBS or 2,20 or 200ng EPOsR was then injected into the vitreous space.On day 3 after RD,apoptotic photoreceptors were detected using transferase-mediated dUTP nickend labeling (TUNEL),and caspase-3 activity was assessed by Western-blot and immunofluorescence staining.On day 14 after RD,retinal histopathologic examination was carried out and outer nuclear layer (ONL) thickness was measured under the light microscope.The use of animals complied with the Statement of Association for Research in Vision and Ophthalmology. Results Apoptotic photoreceptors were seen in ONL of rats of the RD group.Apoptotic photoreceptors were gradually increased with the elevation of EPOsR dose in the vitreous cavity.Western blot and immunofluorescence consistently showed that the gray scale of caspase-3 activity was 0.15±0.04,0.49±0.03,0.50±0.07,0.63±0.03,0.69±0.04 and 0.83±0.04 in the normal group,RD group,RD +PBS group,RD+EPOsR 2,20,200ng groups respectively with statistically significant differences (F=76.016;P=0.000),and caspase-3 activity was considerably stronger in the RD+EPOsR 200ng group than the other groups (P＜0.01).On day 14 after RD,the ONL thicknesses in the normal control group,RD group,RD+PBS group,RD+EPOsR 2,20,200ng groups were (47.39±3.39)μm,(33.96±3.54)μm,(31.83±5.21)μm,(31.40±2.63)μm,(24.99±2.06)μm and (19.30±3.71)μm,showing significant differences among these groups (F=44.733,P=0.000).ONL thicknesses the groups treated with different doses of EPOsR were markedly thinner than that of the RD group and RD +PBS group (P＜0.01).Conclusion EPOsR induces apoptosis of retinal cells and enhances the activity of caspase-3 in a dose-dependent manner.Endogenous EPO can protect photoreceptors against anoxia-mediated damage in RD eyes through decreasing caspase-3 activity and inhibiting apoptosis.