Hypoplastic myelodysplastic syndrome(Hypo-MDS),with the derangement of BM texture,is characterized by the hypoplasia of bone marrow(BM)accompanied with the deterioration of MDS. Hitherto there isn't a definite therapeutic definition about Hypo-MDS. Is therapy should be paid more attention to. This article introduces the study of therapy of Hypo-MDS.

Objective To summarize out experience in the first case of transperitoneal laparoendoscopic single-site live donor nephrectomy (LESS-DN) in mainland China and to assess its safety and feasibility. Methods The female donor was aged 59-year-old, with a body mass indexCBMI) of 21. 6 kg/m2 and a preoperative serum creatinine level of 45 μmol/L. Tc 99m-DTPA was used to determine the glomerular filtration rate (GFR). The preoperative unilateral renal function was 50 ml/min for the left side and 56 ml/min for the right side. Recipient was a 41-year-old male, with a BMI of 19. 5 kg/m2 and a preoperative serum creatinine level of 1,446 μmol/L, and who was to receive transplantation due to chronic renal dysfunction (renal failure stage). On Nov. 9th, 2011, the LESS-DN was performed via a multi-channel TriPort™ (Advanced Surgical Concepts, Wicklow, Ireland) through a 5 cm skin incision at our institute. The dissection of the kidney was facilitated with the standard laparoscopic instruments at all the steps. The renal artery and the renal vein were skeletonized after the adrenal vein and the lumber vein, if any, were clipped. The ureterogonadal packet was left en bloc and transected at the level when crossing the common iliac vessels. The kidney was entrapped, and the mouth of the bag loosely cinched around the intact renal artery and vein. The renal artery and the vein were separated. The pre-entrapped kidney was extracted through the original incision after generous cranial and caudal extension of the rectus fascia incision. Results The procedure was smoothly completed without any extra skin incision. The operating time was 210 min, with an estimated blood loss of 50 ml, and a warm ischemia time of 3. 8 min. The lengths of harvested renal artery, vein and ureter were 3. 6 cm, 4. 5 cm and 13 cm, respectively. The length of skin incision at closure was 5 cm. Allograft functioned immediately on transplantation. Donor Visual Analog Pain Scores at postoperative day 1, 2 and 3 were 2. 5/10, 1/10, and 0/10, respectively. The recovery of the donor was uneventful and she was discharged on the 4th postoperative day. Postoperative serum creatinine levels of the recipient at 12 h, 24 h, 2 d, 3 d, 4 d, 5 d, 6 d, 7 d, discharge day, and 1 month postoperatively were 475, 282, 148, 145, 117, 100, 103, 98, 80, and 84 μmol/L, respectively. He was discharged on the 10 day after transplantation. Conclusion Our initial experience shows that the laparoendoscopic single-site live donor nephrectomy is a safe, feasible and effective procedure. It has the clinical benefits of less pain, rapid recovery and good cosmesis, with an encouraging future. But more clinical experience needs to be accumulated.

Objective To summarize the clinical data of renal cell carcinoma (RCC) in our hospital in the past 15 years, and to investigate the mini-invasive rate, resection rate and safety of surgical treatment for RCC. Methods We retrospectively analyzed the clinical data of 2,052 consecutive cases with renal tumors during Jan. 1995 to Nov. 2009. The patients were divided into 3 groups according to the time theywere treated. The 1st group: from Jan. 1995 to Dec. 1999; the 2ndgroup: from Jan. 2000 to Dec. 2004; and the 3rd group: from Jan. 2005 to Nov. 2009. The operation method, resection rate and safety were compared between different groups. Results Among 2, 052 patients, 1, 516 had T1 stage RCC; 536 cases had T2-4 stage RCC, including 277 with locally advanced RCC (lymphatic metastasis, venous tumor thrombus, resectable local invasion, solitary hepatic or lung metastasis) ; 217 cases received radical nephrectomy, 41 received palliative surgery, and the surgical procedures were not finished in 19 cases (including 3died during operation due to cancer embolus defluxion). All the 546 patients in the 1st group received open surgery, including 42 receiving nephron-sparing surgery; for 89 cases with locally advanced RCC, radical nephrectomy was done in 64 cases, palliative surgery in 16 cases, and surgery procedures were not finished in 9 cases (including 2 died during operation due to cancer embolus defluxion). Of the 673 cases in the 2nd group, 556 cases received open surgeries, including 95 receiving nephron-sparing surgery and 117 received laparoscopic surgery (via lumbar flank approach); for the 88 caseswith locally advanced RCC, radical nephrectomy was done in 68 cases, palliative surgery in 13 cases, and surgery procedureswere not finished in 7 cases (including 1 died during operation due to cancer embolus defluxion). Of the 833 cases in the 3rd group, 248 received open surgery, including 142 cases receiving nephron-sparing surgery and 585 received laparoscopic surgeries; 100 cases had locally advanced RCC, and 85 of them received radical nephrectomy, 12 received palliative surgery, and surgical procedures were not finished in 3 cases, with no death cases during the perioperative period. Conclusion Minimally invasive surgery has become the dominant approach for treatment for renal cell carcinoma owning to fast development of laparoscopy. Improvement in surgical technique has promoted the safety and resectable rate of locally advanced RCC, and nephron-sparing surgery has been more widely used and has gradually been done in a minimally invasive manner. Single-port laparoscopic surgery is gaining increasing attention in treatment of RCC.

Objective To compare different methods for blockage of renal artery in transperitoneal laparoscopic radical nephrectomy, and evaluate the safety and feasibility of direct access to the renal artery. Methods From May 2008 to December 2010, 64 patients withT1N0M0-T2N0M0 stage renal carcinoma underwent transperitoneal laparoscopic radical nephrectomy using a standard procedure to isolate and block renal artery (group A, 33 patients) or a direct access to the renal artery via ligament of Treitz (left side) or aorta-inferior vena cava (right side; group B, 31 patients). The age, gender, body mass index (BMI), history of previous abdominal surgery, tumor side, tumor maximum diameter, and preoperative TNM stages were all matchable between the two groups. Results One patient in group A was conversed to open surgery due to extensive perirenal adhesion and the others successfully received transperitoneal laparoscopic radical nephrectomy. The operation time, estimated blood loss, intraoperative and postoperative complications, postoperative TNM stage, postoperative fasting time, postoperative indwelling time of drainage tube, postoperative hospital stay and pathological types were similar between the two groups. Patients with T2 stage tumors in Group B had less intraoperation blood loss than those in Group A (P<0. 05). Conclusion Direct access to the renal artery is feasible and safe of transperitoneal laparoscopic radical nephrectomy. The method not only fulfils the tumor-free principles and reduces intraoperative blood loss, but also broadens the indications of laparoscopic operations for renal cell carcinoma.

To summarize the clinical data of renal cell carcinoma (RCC) in our hospital in the past 15 years, and to investigate the mini-invasive rate, resection rate and safety of surgical treatment for RCC. Methods We retrospectively analyzed the clinical data of 2,052 consecutive cases with renal tumors during Jan. 1995 to Nov. 2009. The patients were divided into 3 groups according to the time they were treated. The 1st group: from Jan. 1995 to Dec. 1999; the 2nd group: from Jan. 2000 to Dec. 2004; and the 3rd group: from Jan. 2005 to Nov. 2009. The operation method, resection rate and safety were compared between different groups. Results Among 2,052 patients, 1,516 had T1 stage RCC; 536 cases had T2-4 stage RCC, including 277 with locally advanced RCC (lymphatic metastasis, venous tumor thrombus, resectable local invasion, solitary hepatic or lung metastasis); 217 cases received radical nephrectomy, 41 received palliative surgery, and the surgical procedures were not finished in 19 cases (including 3died during operation due to cancer embolus defluxion). All the 546 patients in the 1st group received open surgery, including 42 receiving nephron-sparing surgery; for 89 cases with locally advanced RCC, radical nephrectomy was done in 64 cases, palliative surgery in 16 cases, and surgery procedures were not finished in 9 cases (including 2 died during operation due to cancer embolus delluxion). Of the 673 cases in the 2nd group, 556 cases received open surgeries, including 95 receiving nephron-sparing surgery and 117 received laparoscopic surgery (via lumbar dank approach); for the 88 cases with locally advanced RCC, radical nephrectomy was done in 68 cases, palliative surgery in 13 cases, and surgery procedures were not finished in 7 cases (including 1 died during operation due to cancer embolus defluxion). Of the 833 cases in the 3rd group, 248 received open surgery, including 142 cases receiving nephron-sparing surgery and 585 received laparoscopic surgeries; 100 cases had locally advanced RCC, and 85 of them received radical nephrectomy, 12 received palliative surgery, and surgical procedures were not finished in 3 cases, with no death cases during the perioperative period. Conclusion Minimally invasive surgery has become the dominant approach for treatment for renal cell carcinoma owning to fast development of laparoscopy. Improvement in surgical technique has promoted the safety and resectable rate of locally advanced RCC, and nephron-spaeing surgery has been more widely used and has gradually been done in a minimally invasive manner. Single-port laparoscopic surgery is gaining increaeing attention in treatment of RCC.

Objective: To use videomimicography to display the skills of retroperitoneal laparoscopic radical nephrectomy in a self control manner, so as to help the beginners to learn the skills quickly. Methods: The videos of 147 cases of retroperitoneal laparoscopic radical nephrectomy for renal-cell carcinomas (T1 N0 M0), which were performed by a surgeon in our department from Jan. 1, 2002 to Dec. 31, 2006, were retrospectively analyzed. The first 30 cases were compared with the last 30 cases in terms of operative manipulation, outcomes, problems in operation, and complications after operation. The difficulties in learning retroperitoneal laparoscopic radical nephrectomy from videos were discussed. Results: There were no differences between the two patient groups in age, gender, the location or size of the tumors. The bleeding volumes, operation time, frequencies of transferring to open surgery, and addition of Trocar in the first 30 patients were significantly more than those in the last 30 patients (all P<0.01). Results of videomimicography demonstrated that the beginners had a poor anatomic knowledge, the exposure and tissue isolation were not enough, and they had a poor basic skill in manipulating laparoscope. Conclusion: Videomimicography can better display the difficulties in retroperitoneal laparoscopic radical nephrectomy in a self control manner, which can help the beginner to understand the operating skills; the method is worth popularizing.

Objective To investigate the therapeudc effect of treating lung mbereulosis with integrated traditional Chinese and western medicine. Methods 152 patients with lung tuberculosis aging from 25 to 35 years were randomly recruited into 2 groups. Western medicine and integrated traditional Chinese and western medicine were applied to each group respectively. Observe the therapeutic effects after the treatment. Results The group treated with integrated traditional Chinese and western medicine was significantly better than the group treated with western medicine in terms of therapeutic effect speaking, with P＜0.05. Conclusion The therapy of integrated traditional Chinese and western medicine has good effect in treating lung tuberculosis.

Objective To investigate the effects of broadband ultraviolet B (BB-UVB) on the proliferation of, tyrosinase activity and melanogenesis in melanocytes.Methods Melanocytes isolated from human foreskin were subjected to primary culture.Some cultured primary melanocytes were irradiated with BB-UVB at 10, 20, 30, 40, 50, 100, 200 and 300 mJ/cm2.Then, CCK-8 assay was performed to evaluate the proliferative activity of melanocytes, dopa oxidation assay to estimate the activity of tyrosinase, and sodium hydroxide (NaOH)-lysis method was used to determine melanin content.Real-time fluorescence-based quantitative PCR was conducted to measure the mRNA expressions of genes involved in non-canonical Wnt pathways in melanocytes after irradiation with BB-UVB at 30, 50 and 100 mJ/cm2.Western blot was carried out to determine the expressions of proteins involved in non-canonical Wnt pathways in melanocytes before and after irradiation with BB-UVB of 100 mJ/cm2.The melanocytes receiving no treatment served as the control group.Statistical analysis was carried out by one-way analysis of variance followed by least significant difference (LSD)-t test for multiple group comparisons and by the independent sample t test for two-group comparisons.Results After irradiation with BB-UVB at 10-300 mJ/cm2, the proliferative activity of melanocytes was gradually reduced compared with the control group (all P ＜ 0.05), and the survival rate of melanocytes was less than 50％ when the irradiation dose of BB-UVB was higher than 100 mJ/cm2.Furthermore, tyrosinase activity gradually increased in melanocytes after irradiation with BB-UVB at 10-100 mJ/cm2 compared with the control group, and the increase was statistically significant at the radiation dose of 100 mJ/cm2 (P ＜ 0.05).Compared with the control group, the WIF-1 mRNA expression level decreased, while c-Jun N-terminal kinase (JNK), microphthalmia-associated transcription factor (MITF), Ras-related C3 botulinum toxin substrate 1 (RAC 1) and tyrosinase (TYR) mRNA expression levels increased in melanocytes after irradiation with BB-UVB at 30, 50 and 100 mJ/cm2 (all P ＜ 0.05);the WNT5A mRNA expression significantly decreased in melanocytes irradiated with 30 and 50 mJ/cm2 BB-UVB, but increased in those irradiated with 100 mJ/cm2 BB-UVB (all P ＜ 0.05).The radiation with 100 mJ/cm2 BB-UVB significantly decreased the expression of WIF-1 protein, but enhanced the expressions of WNT5A, JNK, MITF, RAC1 and TYR proteins in melanocytes compared with the control group (all P ＜ 0.05).Conclusions BB-UVB can decelerate the proliferation of, elevate tyrosinase activity and melanin level in, melanocytes.The WIF-1 gene may inhibit melanogenesis, and the decrease in its expression may promote melanogenesis by activating the JNK/MITF/TYR pathway through the combined effects of proteins involved in non-canonical Wnt pathways.

Adult ; Aged ; Female ; Granuloma, Laryngeal ; etiology ; Humans ; Intubation, Intratracheal ; adverse effects ; Male

Animals ; Aorta ; metabolism ; pathology ; Atherosclerosis ; etiology ; metabolism ; pathology ; Cholesterol, Dietary ; Male ; Matrix Metalloproteinase 2 ; metabolism ; PPAR gamma ; agonists ; Rabbits ; Random Allocation