Objective To explore the home-made U-shaped retractor ’ s effect on reducing the traction injury of recurrent laryngeal nerve in the video-assistance thyroidectomy . Methods The patients with unilateral and unifocal papillary thyroid microcarcinoma , which were diagnosed by ultrasound preparation and by pathological postoperation , were enrolled .They all underwent the ipdilateral lobectomy , isthmus resection and the clearance of central lymph nodes with video-assistance technology .From January 2013 to June 2014, 79 cases ( control group ) were received conventional method , by which the thyroid lobe was elevated onto the trachea surface.From January 2015 to March 2016, 71 cases (U-shaped group) accepted the procedure which adopted home-made U-shaped retractor to pull the thyroid lobe to carotid artery horizontally .The operations were completed by the same surgeon .There were no significant differences between the two groups in age , gender and lesion size , which is comparable .The incidence rate of hoarseness was compared postoperation . Results Postoperative hoarseness of the U-shaped group occurred in 6 cases (8.5%) and the control group in 17 cases (21.5%), which show a significantly statistical difference (χ2 =4.919, P=0.027).And there was no significant difference in voice recovery time [median:16.5 d (8-31 d) vs.18 d (4-50 d), Z=-0.246, P=0.806]. Conclusion In the video-assisted thyroidectomy , using the U-shaped retractor to pull the thyroid lobe laterally and horizontally will be beneficial to reduce the recurrent laryngeal nerve tension and the incidence of the retract injury .

Objective To investigate the feasibility and safety of three-dimensional video-assisted thyroidectomy (3D VAT). Methods During January to April of 2014, 10 cases with unilateral or bilateral thyroid benign diseases , thyroid cancer, or parathyroid lesions were enrolled .The 3D VAT was carried out by using a 10-mm 3D stereoscopic endoscope .Local excision or lobectomy was performed via a 2-4 cm curve skin incision one finger above the sternal notch .In two patients , lobotomy combined with systematic lymphadenectomy was performed when papillary thyroid microcarcinoma was identified during operation . Results All the procedures were accomplished successfully under 3D video-assisted system, without intra-operative abnormal blood loss or conversion to conventional thyroidectomy .The operative time was 30-90 min (61.8 ±22.4 min);the intra-operative blood loss was 1.3-93.0 g (median, 5.2 g).All the patients were followed up for 1-4 months.Neither intra-nor post-operative complications about recurrent laryngeal nerve , superior laryngeal nerve , or parathyroid were observed . Conclusions Preliminary impression emerging from this study seems to suggest that 3D VAT is safe and effective.Compared with 2D surgery, a good perception of depth and easy recognition of anatomic structures are noticeable .

Objective To investigate the feasibility and safety of minimally-invasive video-assisted parathyroidectomy ( MIVAP) for parathyroid adenoma ( PA) . Methods Clinical data of 14 patients with primary hyperparathyroidism ( PHPT) caused by PA between April 2011 and September 2014 in our hospital were analyzed retrospectively.Coexistent thyroid lesions were found in 6 patients.With preoperative definite diagnosis and localization, we performed parathyroidectomy and local excision or lobectomy of the thyroid gland.All the patients were confirmed by intra-operative fast frozen section pathological examination and postoperative pathological immunohistochemistry.Intra-and post-operative parathyroid hormone monitoring was conducted.Hoarseness, choking cough, and active bleeding were observed. Results All the procedures were accomplished successfully, without intra-operative abnormal blood loss or conversion to conventional operation.The operative time was 35-60 min ( mean, 50 min);the intra-operative blood loss was 1.7-32.0 g (mean, 9.75 g).Neither transient nor everlasting injury to recurrent laryngeal nerve or superior laryngeal nerve happened.No hemorrhage was observed.All the patients were followed up for 2-43 months ( mean, 16 months) , during which there was no recurrence. Conclusion MIVAP with thyroidectomy is feasible and safe for PA and coexistent benign thyroid lesions, on the basis of pre-operative adequate diagnosis and proper localization and intra-operative parathyroid hormone monitoring.

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 To investigate the expression of nm23-H1 in human benign and malignant colorectal lesions and the relationship between invasion,metastasis in colorectal carcinoma.Methods The expression of nm23-H1 were determined by ABC immunohistochemical technique in 80 cases human colorectal carcinoma,and compared with that in adenoma and normal mucus.Result Positivity expression rates of nm23-H1 were 66.7% in colorectal carcinoma.No significant difference of the expression of nm23-H1 in normal mucus,adenoma and cancerous tissue (P>0.05).The positive rates of nm23-H1 expression in different pathological grading,lymph node metastasis and post-operative survival (3 years) were showed significant difference (P<0.05).Conclusions It is suggested that the deletion of nm23-H1 low expression might play an important role in the carcinogenesis,development,metastasis and prognostic value of human colorectal carcinoma.

Objective:To present our initial experience with robot-assisted laparoscopic prostatectomy (RALP) for complicated cases.Methods:Clinical and pathological data from 4 complicated prostate cancer cases,who underwent RALP from October to November in 2015,were analyzed retrospectively.All the cases were conducted transurethral plasmakinetic enucleation of prostate and hormonal therapy before RALP.Results:All surgeries were done successfully.The age,baseline prostatic special antigen,clinical tumor stage,operation time and estimated blood loss were 58-70 years,6.04-70.15 ng/mL,T2bT3b,210-360 min and 50-250 mL,respectively.No blood transfusion was needed.All surgical margin were negative.Conclusion:Although previous transurethral surgeries and hormonal therapies may increase the difficulty for operations,RALP is still appropriate for the complicated cases of prostate cancer.

Previous studies have demonstrated that the Chinese medicine paeoniflorin, derived from the Ranunculaceae plant peony, peony, purple peony root, was able to have anti-inflammatory, anti-ulcer, anti-hypersusceptibility and anti-oxidation activity. In order to elucidate the pesticide effect and the mechanisms by which paeoniflorin exerts its effect of anti-inflammation and immunoregulation on oxazolone-induced colitic mice, disease activity index (DAI) and histological grading of colitis (HGC) were evaluated in animal model. Moreover, the expressions of HBD-2, IL-6 and IL-10 of mice with experimental colitis were observed with immunohistochemistry and RT-PCR in this study. Results showed that DAI and HGC of oxazolone control group was significantly higher than that of normal control group, and that paeoniflorin groups and 5-ASA group, compared with oxazolone control group, could alleviate the symptoms and histological damages of colitic mice (P < 0.05, P < 0.01). The expression of HBD-2 and IL-6 cytokine on the colon of colitic mice was higher than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01), but the expression of IL-10 is lower than that of normal control, paeoniflorin and 5-ASA groups (P < 0.05, P < 0.01). The positive correlations were demonstrated between the expression of (HBD-2 and IL-6) and DAI (Pearson r = 0.728, Pearson r = 0.758, P < 0.01, respectively), (HBD-2 and IL-6) and HGC (Pearson r = 0.819, Pearson r = 0.825, P < 0.01, respectively), whereas, the negative correlations were demonstrated between the expression of IL-10 and DAI (Pearson r = -0.789, P < 0.01), IL-10 and HGC (Pearson r = -0.725, P < 0.01). It can be concluded that to some extent paeoniflorin effectively alleviate the symptoms of oxazolone-induced colitis through regulating the expression of HBD-2, IL-6 and IL-10.

Objective To investigate the relationship between prostate histologic inflammation classification and prostate cancer (PCa) in needle biopsy specimens with serum prostatic specific antigen (PSA) under 20 μg/L.Methods The clinical records of patients who underwent prostate biopsy were retrospectively analyzed in Beijing Hospital Urological Department from January 2011 to December 2013.The patients underwent prostate biopsy because of PSA raised and without pelvic radiotherapy.The needle biopsy specimen was evaluated by the pathohistologic criteria of location,extent and grade classification of prostate inflammation.Results PCa was detected in 84 (37.2％) biopsies and benign prostatic disease (BPD) in 142 (62.8％) biopsies.There were significant differences between PCa and BPD in inflammation classification (location:P＜0.001,extent:P＜0.001,grade:P＜0.001).On multivariable Logistic regression analysis,both location and extent classification of chronic histologic prostatitis were found tobe significantly associated with a lower risk of PCa in biopsy (location:P =0.001,OR =0.114,95％ CI 0.032-0.405 ; extent:P =0.021,OR =0.232,95％ CI 0.067-0.804).There was no relationship between grade classification and PCa (P=0.223,OR=1.805,95％CI 0.698-4.667).Under the evaluation of location and extent classification,it could differentiate PCa with BPD in biopsy with a sensitivity,specificity,positive predictive value and negative predictive value of 91.7％,50.7％,52.4％,91.1％,respectively.Conclusion The location and extent classification of chronic prostatitis is found to be associated with a lower risk of PCa independently.

Objective To investigate the diagnosis and treatment of septic shock and multiple organ dysfunction syndrome (MODS) following transrectal ultrasound-guided prostate biopsy (TRUSPB). Methods We reported two cases,45 and 46 years old,of septic shock and MODS after TRUSPB from June 1996 to May 2011.10 cases like these two cases in literatures were acquired (3 cases in Chinese and 7 cases in English) from 1991 to 2011,and the causes of severe infections following transrectal prostate biopsy and its prophylactic procedures were discussed as well. Results The two cases,suffered postoperative septic shock and MODS 16 -40 h after being smoothly performed TRUSPB.One patient died four days after surgery and the other improved after five days antibiotic treatment.All the 12 cases had abrupt onsets and deteriorated rapidly,2 cases died and 1 case was performed amputation due to double lower limb gangrene,resulted in high mortality and morbidity.There are many risk factors,such as repeated puncture (4/12),diabetes (3/12),chronic infections (3/12) and used immune suppression (1/12),et al; blood culture was positive in 9 case and E.coli bacteria was the main bacteria(8/9),besides,half of them were multi-drug resistant (4/8) and other 2 cases were ESBLs ( + ) or 1 case was quinolone-resistant repectively.9 cases recovered after actively controlled infection using carbapenem and other treatment. Conclusions Transrectal ultrasound-guided prostate biopsy could cause serious complications such as septic shock,to which more attentions should be paid.Preoperative use of carbapenem should be recommended for patients with repeating biopsy or other risk factors.

AIM: To study the basic mechanism of transcriptional regulation, NKX3.1 gene promoter was cloned and its promoter activities in prostate cancer cell lines and other cancer cell lines were tested. METHODS: 1.04 kb - promoter fragment of NKX3. 1 gene was obtained by PCR and cloned into pGL3 - basic and pEGFP - 1 that are promoter - less reporter vectors to examine its promoter activity driving the reporter gene transcription. The promoter activity was determined by dual -luciferase reporter assay and the expression of GFP reporter observed under fluorescence micro scope. RESULTS: The sequence of the cloned 1.04 kb promoter proved to be correct by DNA sequencing. The dual - lu ciferase reporter assay (M1/M2) showed that the promoter activity in LNCaP cell transfected with pGL3 - 1.04 kb promoter was about 1.5 - fold higher than that of pGL3 - control transfection and 50 - fold higher than that of pGL3 - basic transfec tion. To investigate the 1.04 kb - promoter activity in different tumor cell lines, the constructed pGL3 - 1.04 kb promoter and pEGFP - 1.04 kb promoter were transfected into several cell lines, respectively. The results showed that the activity of 1.04 kb promoterin LNCaP was highest among the tested cell lines. Multiple consensus sequence elements have been iden tified within the 1.04 kb fragment using TRANSFAC database. Further experiments will be done to determine their founc tions. CONCLUSION: Cloned 1.04 kb fragment upstream of NKX3.1 gene presented a strong promoter activity and its activity was highest in LNCaP cell among the tested tumor cell lines.