Objective To study the initial experience and outcomes of laparoscopic enucleation with preoperative selective arterial embolization ( PSAE) for the treatment of renal angiomyolipomas. Methods A total of 43 patients with sporadic renal angiomyolipomas from July 2013 to November 2014 underwent laparoscopic nephron-sparing surgery ( NSS) .The patients were divided into either PSAE group ( n =19 ) or non-PSAE group ( n =24 ) .The data of patient demographics, success rate of surgery, perioperative complications rate, operating time ( OT ) , warm ischemia time ( WIT ) , estimated blood loss ( EBL ) , length of hospitalization, kidney estimated glomerular filtration rate (eGFR) and serum creatinine (Scr) level over 3 months, and ipsilateral recurrence were collected and compared between the two groups. Results Enucleation was successful in 100%patients (19/19) of the PSAE group and in 62.5%patients (15/24) of the non-PSAE group,with no significant difference ( Fisher' s test, P=0.105) The EBL was (46.4 ±20.6) ml in the PSAE group, which was significantly less than the non-PSAE group [(89.5 ±30.4) ml, t=-5.287, P=0.000].The OT and WIT were significantly shorter in the PSAE group than those in the non-PSAE group [(90.3 ± 21.1) min vs.(131.7 ±18.6) min, t=-6.831,P=0.000;(9.5 ±5.7) min vs.(24.2 ±4.8) min, t=-9.181, P=0.000]. The length of hospitalization was significantly longer in the PSAE group than that in the non-PSAE group [(7.7 ±1.1) d vs.(6.3 ± 1.3) d, t=3.748, P=0.000].No severe complications occurred in the PSAE group, whereas the non-PSAE group had 1 case of urinary leakage and 1 case of hematoma.The Scr level over 3 months after surgery was more ideal in the PSAE group [(70.1 ±13.7)μmol/L vs.(84.2 ±9.1) μmol/L, t=-4.045, P=0.000].No statistically significant difference was found in the eGFR between the PSAE group and the non-PSAE group [(72.6 ±12.8) ml· min-1· 1.73 m-2 vs.(68.0 ±10.7) ml· min-1· 1.73 m-2, t=1.284, P=0.206].No evidence of recurrence was found during follow-up period in both groups. Conclusions Laparoscopic enucleation with PSAE is a safe and effective minimally invasive procedure for the treatment of renal angiomyolipomas.As compared to traditional laparoscopic partial nephrectomy, it has advantages of less WIT, less EBL, and better protection of renal functions.It can be recommended in well-selected patients.

BACKGROUND:The phenomenon of temporary ischemia of the tissues and organs caused by injury is common in the clinic. However, there are few studies on the treatment of ischemia/reperfusion injury. It is significant to investigate the effect of TanshinoneⅡA on improving uterine ischemia/reperfusion injury in a rat model. OBJECTIVE:To observe the effect of TanshinoneⅡA intervention on improving uterine ischemia/reperfusion injury in rats. METHODS:The rat models of uterine ischemia/reperfusion injury were established by suture method. The rats that were intraperitonealy injected with Sodium Tanshinone IIA Silate injection (20 mg/kg) at 5, 3, 1 days and 30 minutes before the operation were included in the experimental group. Model and sham operation groups were established for comparison. RESULTS AND CONCLUSION:Spectrophotometry and immunohistochemical staining results showed that at 1 and 3 hours of ischemia/reperfusion, the malondialdehyde concentration and Bax protein expression in the injuried rat uterine tissue were significantly decreased (P < 0.05), superoxide dismutase (SOD) activity and Bcl-2 protein expression were significantly increased (P < 0.05) in the experimental group than in the model group. The results confirm that TanshinoneⅡA has a protective effect on uterine ischemia/reperfusion injury in rats.

Biomarkers ; blood ; Biopsy, Needle ; utilization ; Hepatitis C ; complications ; Humans ; Liver ; pathology ; Liver Cirrhosis ; diagnosis ; pathology

STUDY DESIGN: Changes of morphology and phenotype of cultured cells in media added lactate were observed. OBJECTIVES: To evaluate the effect of lactate on morphology and phenotype of cultured intervertebral disc cell. SUMMARY OF LITERATURE REVIEW: It was reported that lactate and pH were important factor in the degeneration of intervertebral disc. However the effect of lactate on morphology and phenotype of cultured intervertebral disc cell have not been studied. MATERIALS AND METHODS: Cells were dissociated enzymatically from rabbit nucleus pulposus. After attaining monolayer growth, the cells were incubated in media added 2mM or 5mM lactate. Total cell counts and morphological changes of the cells were periodically observed. Changes in cell phenotype were investigated by use of anti-collagen antibody stain. RESULTS: The cell groups added no lactate and 2mM lactate showed no difference in cell counts, morphology and phenotype. The cell group added 5mM lactate showed a reduction in final cell Counts and highel'ratio of fibroblastic cell in total population. Anti-collagen I Ab stained the Intra-and extra-cellular area of fibroblastic cells and intracellular area of chondrocytic cells. CONCLUSIONS: The current study suggests that high concentration of lactate inhibit intervertebral disc cell proliferation and accelerate morphological and phenotypical change to fibroblastic cell.
Cell Count ; Cell Proliferation ; Cells, Cultured ; Fibroblasts ; Hydrogen-Ion Concentration ; Intervertebral Disc* ; Lactic Acid* ; Phenotype*

Objective To analyze analgesics administration from July 2005 to July 2006 in emergency rooms of the First, the Second and Fourth Affiliated Hospitals of China Medical University in order to provide a reference for clinically rational administration. Method The data of 2313 prescriptions with analgesics administered during one-year period were analyzed in many respects including the overview of the prescriptions, the frequency of anal-gesics administration, the system of defined daily doses (DDDs) and drug utilization index (DUI) of narcotic anal-gesics were analyzed, and a survey of 200 patients managed with some of those analgesics was done by using ques-tionaire as they were admitted to and discharged from the emergency room. The pain intensity was evaluated by a 10-point numerical rating scale (NRS). The respondents, excluding the mute or deaf, police custody, victims of domestic violence,mental disorder and age under 14,rated the levels of satisfaction with medication for pain relief. The data of frequency and percentage of the administration of analgeics were analyzed,and the scores of NRS were evaluated with the Paired-samples t -test. Results Most of analgesics were in the form of parenteral route usage, of which anisodamine and bucinnazine were employed in large proportion, and a small number of them was in the form of tablets. Trauma was the commonest cause of pain. Of the narcotic analgesics, meperidine was the most com-monly used analgesics, and its DDDs and DUI were much lower than that of WHO limits. Of the 200 patients, 71.5% patients rated a considerably high satisfaction with scores of (7.47 ±2.21) and (5.00 ± 3. 16) by NRS before and after medication,respectively ( ( -value 23.38,P < 0.01) .The patients presenting pain intensity with a scores of 4 or greater accounted for 57.5% . Conclusions The patients suffering from pain could lie rationally treated in the emergency rooms of those three hospitals. Narcotic analgesics should be cautiously employed, and there is room for improvement in pain management practice in emergency room.

BACKGROUND: A latest research indicates that γ~δ T cells following touching with microbe products show characteristics as dendritic cells and antigen-presenting cells (APC) and induce intensive immune response of CD4~+ CD8~+ γ~δ T cells.OBJECTIVE: To verify APC-like functions of γ~δ T cells during transplantation rejection, investigate a simple and effective method to amplify γ~δ T cells in vitro, and to infect γ~δ T cells with FasL retrovirus system.DESIGN, TIME AND SETTING: An animal experiment was performed at Central Laboratory of the First Affiliated Hospital of the Fourth Military Medical University of Chinese PLA from August 2007 to August 2008. MATERIALS: A total of 60 healthy adult Wistar rats of clean grade and weighing 200-320 g were used to establish donor and receptor models with segmental heterotopic small intestine transplantation.METHODS: Models of segmental heterotopic small intestine transplantation were established using three sleevelet vascular anastomosis. γ~δ T cells were obtained using flow cytometry and its function was demonstrated. Mononuclear cells were routinely separated and amplified with Mtb-Ag. MAIN OUTCOME MEASURES: Cell proliferation was observed; percentage of γ~δ T cells for lymphocytes was detected using TCRγ~δ magnetic beads kit; γ~δ T cells following transfection were detected using pLXSN FasL retrovirus system. RESULTS: Activated γ~δ T cells showed dendritic cell-like adhesion function and APC-like functions during transplantation rejection. γ~δ T cells accounted 4.5% for mononuclear cells, the purification of γ~δ T cells was up to 72.2% on the 10~(th) day after activated by Mtb-Ag, and the purification of γ~δ T cells was up to 99.1% through positive magnetic sorting. 285 bp FasL fragment demonstrated that the gene integration was observed in PA317 cells. The ration of FasL+ cells was 97.3% after infected by pLXSN FasL retrovirus system.CONCLUSION: This study demonstrated APC-like functions of γ~δ T cells during transplantation rejection. γ~δ T cells were successfully amplified in vitro. PA317/ pLXSN2FasL+ retrovirus system was successfully constructed and γ~δ T cells were modified by FasL retrovirus system.

Computer science and technology has been used to promote the development of objectification of traditional Chinese medicine (TCM), which is also required for international development of TCM. In this paper, on the basis of current situation of Chinese medicine tongue objective research, the analysis was made on involved computer-related technology, relevant standards, and the future trend was discussed.

Objective To evaluate the clinical features of adenocarcinoma of the appendix.Methods The clinical data of 5 patients with adenocarcinoma of appendix hospitalized at our hospital from Sep 2005 to Dec 2010 were analyzed.Results Intraoperatively two cases were highly suspected of malignant tumor of the appendix,diagnosis of adenocarcinoma was confirmed by frozen pathology,and one stage right hemicolectomy was performed.One patient received simple appendectomy,but postoperative pathology showed adenocarcinoma of appendix and secondary right hemicolectomy was carried out two weeks later.One patient was preoperatively misdiagnosed as periappendiceal abscess and as a result fight hemicolectomy was performed because planned appendectomy was technically impossible.The postoperative pathology revealed adenocarcinoma of the appendix.In the last patient preoperative diagnosis was hypogastric space-occupying lesion with extensive intraabdominal metastasis.During exploration adenocarcinoma of the appendix with extensive metastasis was confirmed.Right hemicolectomy and carcinectomy was performed.Postoperatively all the 5 patients underwent regular chemotherapy.We followed them for 2 to 3 years and only the patient with intraabdominal metastasis at first laparotomy suffered from extensive recurrence 2 years after surgery.Conclusions The adenocarcinoma of appendix can be easily misdiagnosed as other diseases.Radiography,careful exploration during operation and frozen pathology help establish final diagnosis.Right hemicolectomy and postoperative chemotherapy are required in order to reduce tumor recurrence and prolong patients' survival.

Objective To investigate the effects of C-terminal fragment of parathyroid hormonerelated protein (PTHrP107-139) on bone mineral density (BMD), bone histomorphometry and biomechanical properties in ovariectomized (OVX) rats and its effect on bone metabolism is also explored. Methods Forty 4-month old female Wistar rats in which 30 were ovariectomized and then divided into 3 groups: the placebo, the PTHrPC and the CT groups, the other 10 rats were Sham-operated as the control group (Sham). Five weeks later, the rats of PTHrPC and CT groups were subcutaneously injected with PTHrP107-139 (40 μg/kg) and Salmon Calcitonin (15 U/kg) respectively once every other day. The rats of the placebo and sham groups were injected with 0.2 ml saline once every other day. After treatment of 12 weeks, all rats were sacrificed and all samples were collected and analyzed. Results ① Compared with the placebo, the BMD and bone strength of PTHrPC and CT groups were significantly increased (P<0.05). ② Histomorphometry revealed that the tetracycline labeled bone surfaces, osteoid surfaces, mineral apposition rate and bone resorption rate were remarkably decreased in PTHrPC, and CT groups comparing with those of the placebo group. Conclusion Cter-minal PTHrP107-139 is effective in increasing the BMD, bone strength and quality when administered intermittently to ovariectomy-induced osteoporotic rats. Its increasing in bone quality may relate to reducing bone turnover and inhibiting resorption.

OBJECTIVE:To investigate the effects of TanshinoneⅡA sodium sulfonate injection on levels of P-selectin,glial fi-brillary acidic protein (GFAP),vascular endothelial growth factor (VEGF) and neurological function in patients with acute cere-bral infarction. METHODS:A total of 114 patients with acute cerebral infarction selected from Lianyungang First People's Hospi-tal during Apr. 2013-Apr. 2016 were divided into control group and observation group according to random number table,with 57 cases in each group. Control group was given routine treatment. Observation group was additionally given Tanshinone ⅡA sodium sulfonate injection 40 mg 0.9％ sodium chlonride injection 250 mL,ivgtt,qd. A treatment course lasted for 7 d,and both received 2 courses of treatment. NIHSS scores,the levels of serum P-selectin,GFAP and VEGF were compared between 2 groups before treatment and after 7,14 d of treatment. The occurrence of ADR was also compared. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). Compared to before treatment,NIHSS score,the levels of se-rum P-selectin and GFAP in 2 groups were decreased significantly after 7,14 d of treatment,while the serum level of VEGF was increased significantly. These indexes of 2 groups after 14 d of treatment were significantly better than 7 d of treatment,except for NIHSS score. Above indexes of observation group was significantly better than those of control group during corresponding period, with statistical significance (P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:For acute cerebral infarction, Tanshinone ⅡA sodium sulfonate injection can significantly reduce the levels of serum P-selectin and GFAP,improve VEGF level and promote the recovery of neurological damage with good safety.