Objective To look for a standard way to cure uric acid calculi in transplanted kidney with medicine.Methods Under the guide of the standard and widespread metabolic evaluation, citrate and allopurinol were used to treat 4 patients with uric acid calculi after kidney transplantation. These two kinds of medicines were used in the long term together with other conservative treatment to prevent the recurrence of calculi.Results In these 4 cases, all clinical syndromes disappeared and all the calculi dissolved. After follow-up for 1～2 years, no recurrence of calculi was found. Conclusion Citrate should be used to dissolve uric acid calculi in transplanted kidney and to prevent the recurrence of calculi under the guide of the standard metabolic evaluation.

Objective To investigate the effect of monosialoganglioside GM-1 on cardiopulmonary bypass (CPB)-induced brain injury in rats.Methods Twenty-seven adult male Sprague-Dawley rats,weighing 350-450 g,aged 15 months,were randomly divided into 3 groups (n=9 each): control group (C group),CPB group and GM-1 group.The animals were anesthetized with chloral hydrate,tracheostomized and mechanically ventilated.Right common carotid and right jugular vein were cannulated for closed-chest CPB.In groups CPB and GM-1,the rats underwent 1 h CPB.GM-1 20 mg/kg was added to the priming solution in group GM-1,while the equal volume of normal saline was given in group CPB.The animals were sacrificed at 3 h after termination of CPB or 3 h after the end of ventilation in group C,the brains were removed and the hippocampi isolated for microscopic examination and for determination of apoptosis (using TUNEL) and Bax and Bcl-2 protein expression (by immunohistochemistry and Western blot).Results Compared with group C,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly increased,and the expression of Bcl-2 and Bax protein was up-regulated in groups CPB and GM-1 (P ＜ 0.05).Compared with group CPB,the number of apoptotic neurons and ratio of Bax/Bcl-2 were significantly decreased,the expression of Bax protein was down-regulated and the expression of Bcl-2 protein was up-regulated in group GM-1.The pathological changes were severe in group CPB and attenuated in group GM-1.Conclusion GM-1 can attenuate CPB-induced brain injury in rats and inhibition of the apoptosis in neurons may be involved in the mechanism.

Objective To evaluate the effect of sevoflurane on brain injury in pigs with hemorrhagic shock (HS).Methods Twenty-four adult male Bama miniature pigs, aged 6 months, weighing 22-25 kg, were equally and randomly divided into 3 groups using a random number table: sham operation group (group Sham) , group HS, and sevoflurane group (S group).In group Sham, the bilateral femoral arteries and internal jugular vein were only punctured.The animals were anesthetized with iv propofol 3.0 mg/kg, tracheostomized and mechanically ventilated.The right femoral artery was cannulated for blood-letting.HS was induced by blood-letting (40％ blood volume within 15 min), and it was then maintained for 1 h after the end of blood-letting to induce brain injury.In group S, 2％ sevoflurane was inhaled for 30 min after successful establishment of the model.Immediately before establishment of the model (T0) , and at 30, 60,90, 120, 180 and 240 min after HS (T1-6) , blood samples were collected from the internal jugular vein for determination of interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) concentrations in serum (by enzyme-linked immunosorbent assay), and neuron-specific enolase (NSE) and S-100β protein concentrations in serum (using double antibody sandwich method).Results Compared with group Sham, the serum IL-1β, TNF-α, NSE and S-100β protein concentrations were significantly increased at T2-6 in HS and S groups (P＜0.05).Compared with group HS, the serum IL-1β, TNF-α, NSE and S-100β protein concentrations were significantly decreased at T3-6 in group S (P＜ 0.05).Conclusion Sevoflurane can mitigate brain injury in pigs with HS, and the mechanism is associated with inhibition of inflammatory responses.

Objective To evaluate the effect of monosialoganglioside (GM-1) on hippocampal protein kinase B (Akt) /glycogen synthase kinase 3β (GSK-3β) signaling pathway in the rats undergoing cardiopulmonary bypass (CPB).Methods Eighteen healthy male Sprague-Dawley rats, aged 6 months, weighing 400-500 g, were randomly divided into 3 groups (n =6 each) using a random number table:control group (group C), CPB group and GM-1 group.GM-1 20 mg/kg was added to the priming solution in group GM-1, while the equal volume of normal saline was given in group CPB.At 3 h after termination of CPB, blood samples were taken from the jugular vein for determination of plasma neuron-specific enolase (NSE) and S-100β protein concentrations using enzyme-linked immunosorbent assay.After blood sampling, the rats were sacrificed, and the hippocampi were isolated for microscopic examination of the ultrastructure of the hippocampal neurons (with electron microscope), and for detection of neuronal apoptosis (with light microscope) and phosphorylation of Akt and GSK-3β (by Western blot).Results Compared with group C, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly increased in CPB and GM-1 groups, the phosphorylation of Akt and GSK-3β was decreased in group CPB, and the phosphorylation of Akt and GSK-3β was increased in group GM-1 (P＜0.05).Compared with group CPB, the concentrations of plasma NSE and S-100β protein, and the number of apoptotic neurons were significantly decreased, the phosphorylation of Akt and GSK-3β was increased (P＜0.05), and the pathological changes were reduced in group GM-1.Conclusion GM-1 can reduce apoptosis in hippocampal neurons through activating Akt/GSK-3β signaling pathway, thus mitigating CPB-induced brain injury in rats.

Objective To evaluate the complication rate of secondary surgery in patients with benign thyroid disease. Methods From June 1992 to June 2003, 65 patients underwent reoperation. Operative procedures. pathology and complications were reviewed. Results The first surgery was unilateral in 27 cases (41.5%), bilateral in 38 (58.5%). Reoperation identified carcinoma in 8 cases with complications developed in 8 cases and left over permanent in 1 case (1.5%). Conclusion The complication rate of second operation is higher than that of first thyroid surgery, but still acceptable.

Objective To evaluate the effect of sevoflurane on activation of nuclear factor kappa B (NF-κB) during brain injury induced by hemorrhagic shock (HS) in pigs.Methods Thirty-two adult male Bama miniature pigs,aged 6 months,weighing 22-25 kg,were divided into 4 groups (n=8 each) using a random number table:sham operation group (group Sham),HS group,sevoflurane preconditioning group (group Sev-Pre) and sevoflurane postconditioning group (group Sev-Post).The animals were anesthetized,and tracheostomized and mechanically ventilated.In group Sham,the bilateral femoral arteries and internal jugular veins were only cannulated.HS was induced by removing 40％ of blood volume within 15 min (30 ml/kg) via the right femoral artery and maintaining at this level for 1 h before resuscitation in HS,Sev-Pre and Sev-Post groups.In group Sev-Pre,2％ sevoflurane was inhaled for 30 min,and then HS was induced.In group Sev-Post,2％ sevoflurane was inhaled for 30 min starting from the time point immediately after HS was induced.Immediately before establishment of the model and at 30,60,90,120,180 and 240 min of HS (T1-6),blood samples from the jugular vein were collected for determination of serum interleukin-1beta (IL-1β) and tumor necrosis factor-alpha (TNF-α) concentrations by enzymelinked immunosorbent assay.At 4 h of HS,the rats were sacrificed,and brains were removed for microscopic examination of hippocampal CA1 region (using haematoxylin and eosin staining) and for determination of the expression of NF-κB in nucleoprotein (by Western blot).Results Compared with group Sham,the concentrations of serum IL-1β and TNF-α were significantly increased at T2-6,and the expression of NF-κB in nucleoprotein in hippocampal CA1 region was up-regulated in HS,Sev-Pre and Sev-Post groups (P＜0.05).Compared with group HS,the concentrations of serum IL-1β and TNF-α were significantly decreased at T3-6,and the expression of NF-κB in nucleoprotein in hippocampal CA1 region was down-regulated in Sev-Pre and Sev-Post groups (P＜0.05).There were no significant differences between group SevPre and group Sev-Post in concentrations of serum IL-1β and TNF-α and expression of NF-κB in nucleoprotein in hippocampal CA1 region (P＞0.05).The pathologic changes were significantly attenuated in SevPre and Sev-Post groups as compared with group HS.Conclusion The mechanism by which sevoflurane attenuates brain injury induced by HS may be related to inhibition of NF-κB activation and reduction of inflammatory responses in pigs.

Objective To prepare a new bioadhesive material-chitosan-thioglycolic acid conjugates from chitosan,and analysed the structure moreover.Methods Preparing chitosan-thioglycolic acid conjugates with a new synthesis method under catalytic reaction by NHS,and the contents of thiol groups in the conjugates were determined.Furthermore,elemental analysis and the IR spectrum of the polymer were determined.Results The content of thiol groups in the chitosan-thioglycolic acid conjugates was 1034?mol?g~(-1),and the structure was elucidated.Conclusion The new synthesis method was feasible,and the structure can be elucidated by IR spectrum.

Objective To investigate the effect of monosialoganglioside GM1 on cardiopulmonary bypass (CPB)-induced inflammatory response in rats.Methods Twenty-four adult male Sprague-Dawley rats,weighing 350-450 g,were randomly divided into 3 groups (n =8 each):sham operation group (group S),group CPB and CPB + GMi group (group G).GM1 20 mg/kg was added to the priming solution in group G.While the equal volume of normal saline was given in group CPB.Blood samples were collected from the jugular vein at 3 h after termination of CPB for determination of plasma concentrations of neuron-specific enolase (NSE) and S-100β protein (by ELISA) and tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) (by radioimmunoassay).The hippocampi were isolated to detect the expression of hippocampal matrix metalloproteinase-9 (MMP-9) and IL-10 and NF-κB activity in hippocampal tissues by Western blot.Results Compared with group S,the plasma concentrations of NSE,S-100β protein,TNF-α and IL-6 and NF-κB activity were significantly increased,the expression of MMP-9 was up-regulated,and the expression of IL-10 was down-regulated in groups CPB and G (P ＜ 0.05).Compared with group CPB,the plasma concentrations of NSE,S-100β protein,TNF-α and IL-6 and NF-κB activity were significantly decreased,the expression of MMP-9 was down-regulated,and the expression of IL-10 was upregulated in group G (P ＜ 0.05).Conclusion The mechanism by which GM1 reduces the CPB-induced brain damage may be related to reduction of the central and systemic inflammatory response in rats.

Objective To evaluate the advantages of transrectal contrast-enhanced ultrasound assis-ted prostate biopsy by comparing with systemic prostate biopsy . Methods From Jan.2010 to Dec.2011, 213 cases were selected randomly.Patient's mean age was 71.0±8.9 (54-83) years.Their PSA level was 22.5±19.4 (4.1-150.0) μg/L.The positive rates of DRE and transrectal ultrasound were 55.9%( 119/213) and 37.6%(80/213).This group of patients were biopsied according to transrectal contrast-enhanced ultrasound assisted prostate biopsies ( experimental group ) .During the same period , another 218 cases were selected randomly.Patient′s mean age was 65.0±9.1 (36-94) years.Their PSA level was 23.3±18.9 (4.6-147.0) μg/L.The positive rates of DRE and transrectal ultrasound were 57.3%( 125/218 ) and 38.1%(83/213).This group of patients were biopsied according to systemic prostate biopsy (control group).The data of two groups were compared to find out the advantages and disadvantages of transrectal contrast -en-hanced ultrasound assisted prostate biopsy . Results Comparing these two groups , the positive rates of prostate cancer in experimental group and control group were 38.0%(81/213) and 34.9%(76/218), with no statistically significance ( P>0.05); the numbers of cores were 9.5 and 12.0, with statistically signifi-cance (P<0.05);the positive rates of single needle were 18.2%(369/2 025) and 11.5%(301/2 616), with statistically significance (P<0.05); and the mean Gleason scores were 7.1 and 6.6, with statistically significance (P<0.05). Conclusions The efficiency of transrectal contrast-enhanced ultrasound assisted prostate biopsy is higher than systemic prostate biopsy .Transrectal contrast-enhanced ultrasound assisted prostate biopsy can be considered as a new option for prostate biopsy .

Objective To analysis the modified Gleason scoring system for predicting the prognosis after radical prostatectomy.Methods A total of 242 patients who received radical prostatectomy from April,2006 to October 2011 were recruited.The patients who lost follow-up or had adjuvant radiation or hormonal therapy or had visceral or bone metastasis were excluded,the remaining 168 patients were evaluated in the present study.The patients' age ranged from 53 to 85 years old (mean age 69 years old).The mean PSA level was 13.31ng/ml (ranging from 4.59 to 36.12 ng/ml).According to the traditional Gleason scoring system,there were 50 patients in Gleason ≤ 6 group,86 patients in Gleason 7 group and 32 patients in Gleason≥8 group.Patients were divided in five groups according to the modified Gleason scoring system.There were 50 patients in Gleason ≤6 group,67 in Gleason 3 + 4 group,19 in Gleason 4 + 3 group,15 in Gleason 8 group and 17 in Gleason 9-10 group.The biochemical-free-survival curve was drawn by Kaplan-Meier method and the multivariate Cox regression models were used to evaluate the clinical and pathological variables for the development of biochemical recurrence.ROC curve analysis was used to determine the predicted value for 5-year BCR of modified and traditional Gleason scoring.Results Significant differences were noted between the modified Gleason scoring groups and traditional Gleason scoring groups in PSA value (P =0.005),pathological stage (P =0.002),extraprostatic extension (P =0.003),seminal vesicle invasion (P =0.004),lymph node involvement (P =0.049) and positive surgical margin (P =0.006).With a median follow-up of 68 months(ranging from 7 to 98 months),5-year BFS rates for men with Gleason grade ≤6,3 + 4,4 + 3,8 and 9-10 tumours on RP pathology were 84.0％ (42/50),76.1％ (51/67),57.9％(11/19),40.0％ (9/15),29.4％ (5/17),respectively.On multivariate analysis,the HR value of Gleason 3 + 4 group and Gleason 4 + 3 group were 1.736 and 2.075 (P ＜ 0.05).The area under the curve in modified and traditional Gleason scoring were 0.698 (95％ CI 0.609-0.788) and 0.674 (95％ CI O.584-0.764),respectively.Conclusions The modified Gleason scoring system is related to the prostate cancer grade and its survival rate.Therefore,it can predict prognosis accurately in patients with prostate cancer.It can potential to reduce overtreatment in patients with Gleason 3 +4 prostate cancer.