Adenocarcinoma, Sebaceous ; pathology ; Humans ; Male ; Middle Aged ; Parotid Neoplasms ; pathology

Objective To evaluate the feasibility and advantages of transvaginal hysterectomy (TVH) for enlarged uterus without prolapse. Methods Six hundred and ninety-six patients underwent TVH for gynecological disorders from Sept, 1998 to Dec, 2002. Meanwhile, the method of operation, complications of surgery, operation time, estimated operative blood loss, postoperative recovery and hospital stay days were retrospectively analyzed. Results The operation was successful in 693 out of 696 cases (99.6%). The mean operative time was 49.3 minutes (11-125 minutes). The estimated blood loss was 69.7ml (15-450ml). Operative injuries were found in 3 patients (0.4%). Complications attributable to surgery were found in 6 cases (1%). The mean time of subsidence of fever was 1.2 days (0-5 days) and the time of passing flatus was 22.6 hours (8-32 hours). The average hospital stay was 5.3 days (4-15 days). Conclusion TVH can be performed safely for most of non-prolapsed large uterus. Because it has the advantages of less bleeding, short operating time, rapid recovery and less cost compared to TAH and LAVH, it is our opinion it should be the first option for enlarged uterus.

Objective To evaluate the advantages and feasibility of transvaginal excision of ovarian tumor. Methods A series of 62 patients with ovarian benign tumors had the tumors excised transvaginally from Dec 2001 to Oct 2003. The indications of transvaginal surgery, the method of operation, the complications following the operation, the overall operation time, the estimated blood loss during operation, the postoperative complications, and hospital stay days were analyzed retrospectively. Results Transvaginal ovarian tumor excision was successfully completed with neither the aid of laparoscopy or shift to laparotomy. No intra-abdominal spillage of cystic contents occurred. The mean operation time was 39.4 minutes. The estimated blood loss was 37.5ml. No postoperative complications occurred. The mean length of a low fever was 1.3 days, and the time of recovery of bowel movement was 20.1 hours. The average hospital stay was 4.2 days. Conclusion For free benign ovarian tumors, the transvaginal route should be considered to minimize trauma. There would be no skin incision, and it could be carried out in patients who had relatively large ovarian tumors with no intra-abdominal spillage. There would be less blood loss, shorter operation time, shorter hospital stay and lower cost.

Objective To evaluate the feasibility and advantages of the excision of uterine fibroids by vaginal myomectomy. Methods A series of 58 patients with uterine fibroids were managed with myomectomy from May 2001 to Dec 2003. Meanwhile, the indications of vaginal surgery, the methods of operation, the complications of surgery, the overall operating time, the estimated operative blood loss, the postoperative recovery and hospital stay were explored. Results Myomectomy were successfully completed vaginally without shifting laparotomy in 57 patients. The successful rate was 98 3%. The mean operative time was 48 16 minutes. The estimated blood loss was 70 58ml. The postoperative complication was occurred in one patient with uterine infection. The mean length of lower fever was 1 8 days and the bower movement was 1 3 days. The average hospital stay was 4 9 days. Conclusions For uterine fibroids, the vaginal myomectomy is a good choice when the indication of operation are managed properly. It can be used in patients who have numerous, relatively large, and intramural fibroids with micro invasive surgery, little interfering with abdominal organs, less blood loss, less operating time, less cost and less hospital stay in comparison with abdominal myomectomy or laparoscopic myomectomy

Objective To evaluate the feasibility and efficacy of treatment of leukoplakia vulvae with high-intensity focused ultrasound. Methods 65 patients with leukoplakia of the vulva were treated with high-intensity focused ultrasound. The patients were followed up after the treatment, and the symptoms including itch of the vulva, color change, the elasticity of the vulva lesions, and release of adhesions were observed and evaluated at the different times after treatment. Result All of the patients experienced relief in different degree (the ratio of effectiveness was 100%). Of them 28 patients were complete cured, 29 were distinctly improved, 8 were improved. In 5 patients there was a recrudescence with mild itch 2-3 months after treatment, but there was still a positive response to the second course of treatment. Conclusions High-intensity focused ultrasound is a highly effective instrument in the treatment of leukoplakia of the vulva. The treatment not only stops itch, but enables the color and elasticity of the vulva to recover as well.

Objective To evaluate the value of bispectral index(BIS)monitoring as an indicator for extubation sedation level after children's oper?ation by total intravenous anesthesia. Methods One hundred and eighty children(2?13 years old)were randomly divided into six groups with 30 cases in each. Group A kept BIS 56?60,and Group B 61?65,Group C 66?70,Group D 71?75,Group E 76?80,Group F 81?85 till extubation. All children were given fentanyl,propofol and cisatracurium besilate when induced,and maintained with propofol and remifentanil. All cases kept BIS 40?55 during the operation. Then the changes of electrocardiogram,mean arterial pressure,heart rate,SpO2,postoperative complications and recovery time were observed. Results Groups A and B were extubated at deep anesthesia,cycle stability,but with high incidence of adverse reactions and awaked with a long time. Groups E and F were extubated when awaked,but with greater stimulation and easier agitation. Groups C and D were lighter hemodynamic responses,less respiratory effects and less postoperative complications of anesthesia. Conclusion The BIS level of 66?75 is a good se?dation level for extubation,especially in the level of 71?75.

ObjectiveTo explore clinical distribution rule of manifestations in patients with CAS,to provide objective basis of standardization,clinical diagnosis and treatment.MethodsEpidemiological methods were used to investigate on guanan'men hospital patients with CAS.Altogether 298 records of CAS patients were enrolled in this study,the frequency of main syndromes and the distribution characteristics of accompanying symptoms were analyzed.ResultsThe main syndromes of CAS were sputum stasis syndrome,qi stagnation and blood stasis syndrome,and deficiency syndrome of both liver and kidney yin,all together accounted for 39.3％.The major symptoms were vertigo or dizziness (64.1％),chest distress (60.1％),dry mouth (63.8％),amnesia (58.7％),and insomnia (50.0％) separately.ConclusionSputum stasis syndrome,Qi stagnation and blood stasis syndrome and deficiency syndrome of both liver and kidney yin group were as a combine form in patients with CAS,and dizziness or vertigo was its main clinical manifestation.

A highly sensitive electrochemical deoxyribonucleic acid(DNA) biosensor based on multi-walled carbon nanotubes(MWNT)/Ag-TiO_2 composite film was developed. The solution containing Ag-TiO_2-MWNT composite was casted on the carbon paste electrode surface to form a robust film, which combine the advantages of the good biocompatibility of Ag-TiO_2 naocomposite and the fine conductivity, as well as the large active surface area of carbon nanotubes. The composite could greatly improve the immobilization capacity of the probe DNA. The morphologies and electrochemistry of the nanocomposite film were investigated by scanning electron microscopy and electrochemical techniques including electrochemical impedance spectroscopy and cyclic voltammetry, respectively. DNA hybridization events were monitored by a label-free method of electrochemical impedance spectroscopy. This label-free electrochemical impedance DNA biosensor showed high sensitivity and selectivity for phosphinothricin acetyltransferase gene sequence assay. The multicomponents films also displayed a high stability during repeated regeneration and hybridization process.

Objective To explore the effects of baicalin in the treatment of a preeclampsia (PE) rat model by detecting the expression of X-linked inhibitor of apoptosis protein (XIAP) and cysteine containing aspartate-9 (Caspase-9) and observing the ultrastructure of mitochondria in trophoblast cells.Methods Forty-eight pregnant Wistar rats were randomly divided into two groups:12 in the control group and 36 in the PE model group.The PE model was established with subcutaneous injection of l-nitro arginine methyl ester with 100 mg/kg per day from the 13th day of pregnancy.Beginning from the 16th day of pregnancy,the PE rats were injected with different doses of baicalin till cesarean section,and divided into three groups:non-intervention PE model group treated with saline (NIP group),low-dose baicalin intervention group (IDB group) at 50 mg/kg per day,and high-dose baicalin intervention group (HDB group) at 100 mg/kg per day.The rat tail artery blood pressure and 24-h urine protein level were measured at pregnant day 10,16 and 20.The levels of XIAP and Caspase-9 in placenta were measured by immunohistochemistry.The ultrastructure of mitochondria of trophoblast cells of the rat placenta was observed under electron microscope.T test,F test and LSD-t test were applied for statistical analysis.Results (1) On pregnant day 10,no significant differences were observed in rat tail artery systolic blood pressure,diastolic blood pressure and 24-h urine protein level between the control group and PE model group (all P＞0.05).On pregnant day 16 and 20,the systolic blood pressure,diastolic blood pressure and 24-h urine protein level of NIP,IDB and HDB groups were significantly higher than those of control group [pregnant day 16:systolic blood pressure:(137.74±5.21),(136.15±4.86),(138.28±4.79) and (110.57±3.79) mmHg (1 mmHg=0.133 kPa),diastolic blood pressure:(89.58 ± 5.50),(88.45 ± 8.59),(89.42 ± 6.29) and (80.28 ± 7.36) mmHg,24-h urine protein:(7.78 ± 0.45),(7.53 ± 0.54),(7.86± 0.57) and (6.45 ± 0.56) mg;pregnant day 20:systolic blood pressure:(145.26 ± 4.67),(131.28 ± 4.34),(130.93 ± 5.33) and (110.40 ± 6.92) mmHg,diastolic blood pressure:(89.87±6.55),(85.34±7.33),(84.64±7.36) and (80.19±7.34) mmHg,24-h urine protein:(11.18±0.42),(9.65±0.54),(9.06±0.56) and (6.31 ±0.45) mg] (all P＜0.01).On pregnant day 20,the systolic and diastolic blood pressure and 24-h urine protein level in IDB and HDB groups were significantly lower than in NIP group (all P＜0.05),but showed no significant differences between IDB and HDB groups (allP＞0.05).(2) Compared with NIP group,the expression of XIAP in control group,IDB and HDB groups were significantly increased(210.39±0.78,180.56±0.82,195.36±0.96 and 192.84± 1.06,all P＜0.01).There was no significant difference in the expression of XIAP between IDB and HDB groups (P=0.66).The expression of Caspase-9 in control group,IDB and HDB groups were significantly decreased compared with NIP group (210.36±0.55,195.53±0.96,198.42± 1.01 and 185.25±0.64,all P＜0.01).There was no significant difference in the expression of Caspase-9 between IDB and HDB groups (P=0.65).Ultrastructure of mitochondria in NIP group showed different degrees of damage,matrix swelling,and mitochondrial cristae bresk or disappearance.In IDB group,mitochondrial matrix swelling was not obvious,and mitochondrial cristae were visible.In HDB group,mitochondrial cristae were neat and clear.Conclusions Baicalin may play an important role in the treatment of preeclampsia by reversing the trophoblast apoptosis and improving the ultrastructure of mitochondria through its regulation of XIAP expression and downregulation of Caspase-9 expression.

Chronic activation of the B-cell antigen receptor (BCR) signaling pathway performs a critical function in the pathogenesis of numerous subtypes of B-cell malignancies and transforms normal cells into malignant cells. Bruton tyrosine kinase (BTK) is a member of the TEC family of tyrosine kinases and is a key regulator of the BCR signaling pathway. BTK inhibition has emerged as a new target for therapeutic intervention in B-cell malignancies. This review summarizes recent developments of BTK inhibitors in B-cell malignan-cies.