Endometrial Neoplasms ; metabolism ; pathology ; secondary ; Female ; Humans ; Mesentery ; Middle Aged ; Neprilysin ; metabolism ; Peritoneal Neoplasms ; metabolism ; pathology ; Receptors, Estrogen ; metabolism ; Receptors, Progesterone ; metabolism ; Sarcoma, Endometrial Stromal ; metabolism ; pathology ; secondary

Acupuncture Therapy ; Humans ; Infant ; Male ; Middle Aged ; Pain Measurement ; Phantom Limb ; therapy

Objective To evaluate the clinical effects of surgical treatment for diabetic retinopathy (DR) with diffuse diabetic macular edema (DDME) and massive subretinal hard exudates (MSHE) with vitrectomy, endolaser photocoagulation to the retina under perfluorocarbon liquid and long acting gas tamponade. Methods Fifteen eyes of twelve patients with DR complicated with DDME and MSHE admitted from October 2001 to December 2003 were enrolled for study, in whom 9 eyes were in 7 males and 6 eyes in 5 females. The patients were aged from 36~65 years (mean 53.4). The best corrected visual acuity (BCVA), color fundus photography and fundus fluorescein angiography were recorded, and optic coherence tomography was performed preoperatively. Pars plana vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade were the therapeutic modalities used to treat the diseased eyes. Results Preoperative BCVA was finger counting to 0.05 in all 15 eyes. Improved vision was observed in eyes during 4~25 months of follow up period (mean 10.26 months), 0.03~0.04 in 2 eyes(13.3%), BCVA ≥0.09 in 13 eyes(86.7%), and 1 eye(6.7%)showed an improved vision from 0.04 to 1.0. Significant decrease in macular edema and retinal thickness were observed, and marlsed to complete absorption of intra-retinal and pre-retinal hemorrhage as well as MSHE was also seen. Conclusions Vitrectomy, posterior hyaloid removal, endolaser retinal photocoagulation under perfluorocarbon liquid and long acting gas tamponade may offer satisfactory effects in the treatment for DDME complicated with MSHE.

Objective To investigate the effects of autoantibodies (β1-AA) against second extra-cellular loop of the β1-adrenergic receptor (β1-AR-ECⅡ) in sera of patients with dilated cardiomyopathy (DCM) on proliferation of rat CD4+T lymphocytes.Methods β1-AA in the sera of patients with DCM was purified by affinity chromatography .CD4+T lymphocytes were isolated by immunomagnetic microbeads from peripheral blood mononuclear cells of rats and its positive rate was detected by flow cytometry .CCK-8 meth-od was used to detect the proliferation of CD 4+T lymphocytes and flow cytometry was performed to measure the ratio of CD4+/CD8+T lymphocyte .Results The purity of isolated rat CD 4+T lymphocytes by immu-nomagnetic microbeads reached 97.7%.The proliferation of CD4+T lymphocytes stimulated by CD3/CD28 was inhibited by β1-AA in a concentration-dependent manner .However , IgG antibodies extracted from sera of healthy controls did not suppress lymphocyte proliferation (P>0.05).The suppression effect of β1-AA was inhibited after binding to antigenic peptides corresponding to β1-AR-ECⅡ and was completely blocked by metoprolol, a specific antagonist of β1-adrenergic receptor (β1-AR).In addition,β1-AA had no effects on the ratio of CD4+/CD8+T lymphocyte .Conclusion β1-AA isolated from DCM patients suppresses the pro-liferation of CD4+T lymphocytes through β1-AR pathway , which indicates that β1-AA can directly reduce the number of T lymphocytes and impair the function of T lymphocytes , resulting in immune system disorders and the development of DCM .

Objective To discuss the efficacy of intravesical instillation of sodium hyaluronate for the treatment of cystitis glandularis after transurethral resection.Methods 85 patients (9 male and 76 female,age range 37-70 years,mean age 51) who were diagnosed as CG in China-Japan Union Hospital of Jilin University underwent transurethral resection.After the operation they were divided into three groups randomly according to different intravescal instillation:sodium hyaluronate for group A,epirubicin for group B and no medicine for group C.The group A started to instill with sodium hyaluronate 40mg once a week for four weeks,and then once a month for four months.The group B did the same way of intravesical instillation of epirubicin.All the patients were followed-up for 12 months.The cystoscopy was done every three months to detect recurrence and the clinical symptom score was evaluated at 1,3,6 and 12 months.Results No patients in group A treated by sodium hyaluronate relapsed but 6 cases and 9 cases in group B and group C respectively.Recurrence rate of group A is significant low compared with group B and C (P ＜ 0.05).The scores of clinical symptom score appendix after 1,3,6 and 12 months for group A were (3.18 ± 1.44),(1.29 ±0.66),(1.25 ±0.65) and (1.21 ±0.63),respectively.It was (3.37 ±1.62),(3.33 ±1.59),(1.37±0.74) and (1.30±0.61) for group B,and (3.47±1.81),(3.40±1.52),(3.27±1.41) and (3.23 ± 1.19) for group C.Compare the score of clinical symptom in the same group,there were significant differences for the score after 3 months compare with the score after 1 month in group A (P ＜ 0.05).But in group B,the significant differences showed after 6 months (P ＜ 0.05).There was no significant difference in group C (P ＞ 0.05) in the whole year.Conclusions Intravesical sodium hyaluronate therapy can effectively decline the recurrence rate of cystitis glandularis after transurethral resection.It could also significantly improve the urinary tract symptoms.

The article gives a brief analysis of student characteristics of medical independent college and the aim and purpose of medical education to propose the corresponding measures to improve the students work of independent college.

Objective To explore the immune characteristic of a patient with hypogammaglobulinaemia and low natural killer(NK)cell numbers. Methods Case histories were analyzed repeatedly to grasp important characteristics of the disease. A routine blood examination and peripheral blood immunological detection was done. Complete neutrophil function test,lymphocyte proliferation ability and cytokine profile were evaluated. Results A 3-year-old boy was referred to the hospital because of fever and abdominal pain as well as partial intestinal obstruction. Laboratory examination revealed low immunoglobulin,reduced absolute numbers of B and NK cells and deficient B cell function of lower IFN-γ and IL-12 production. The patient also had mesenteric lymphadenopathy and a caecal mass with histology suggestive of ileocecal junctional tuberculosis. The patient was infected with cytomegalovirus(CMV)and fungus,which are not common in simple antibody deficiencies. The patient was followed for four years and during this period the patient had recurrent periodontitis resulting in the loss of one tooth. Conclusions Although the precise mechanism of the defect is unclear,we speculate that the case may cast new light on primary immunodeficiencies predominantly with antibody deficiency.(J Clin Pediatr,2011,29(7):601-608)

Objective To identify if intraoperative injecting carbon nanoparticles (CNP) is a feasible,precise and safe method of sentinel lymph node mapping (SLNM).Methods In this study,63 colon cancer patients from July 2009 to March 2011 were included.1 ml (50 mg) CNP was locally injected into subserosa around the neoplasm intraoperatively.In comparison 90 colon cancer patients underwent radical resection without CNP injection (control group).After operation both SLN and non-SLN were collected and analyzed compared with the lymphnodes collected in control group.Clinical feasibility,detection rate,and sensitivity of the method were analyzed.The categorical variables were analyzed with the Pearson Chi-square or Fisher's exact test,whereas the continuous variables were analyzed with t test,significance was determined as P ＜ 0.05.Results 1640 lymph nodes were detected in 63 patients(with an average 26.0 per case),SLNs were identified in all cases(100％),481 SLNs were collected (with an average 7.6).Totally 198 metastatic lymph nodes were detected in 31 patients (average 3.1),including 34 metastatic SLNs.Total number of lymph nodes and number of metastatic lymph nodes detected in CNP group were higher than those of control group (P =0.000,P =0.001).The sensitivity,accuracy,specificity and false negative rate were 52％,76％,100％ and 48％ respectively.The sensitivity,accuracy,specificity and false negative rate were adjusted to 79％,90％,100％ and 21％ respectively if all T4 stage patients were excluded.Conclusions SLN detection can increase the number of lymph nodes harvested and improve the detection rate of lymph node metastasis.

Objective To compare the efficacy of pirarubicin with other intravesical chemothera peutic agents in preventing bladder tumor recurrence. Methods Databases such as Medline,EM Base,CBMDisc and PubMed,ScienceDirect,LWW,Springer,CJFD(Chinese Journal Fulhext Data base)and Chinese Periodicals Database of Science and Technology were systematicallv searehed for controlled studies involved with intravesical pirarubicin for the treattnent of bladder cancer.Eligible studies according to inclusion and exclusion criteria were selected,then recurrence data from included studies were retrieved for a meta-analysis. Results Fifteen studies met the inclusion criteria.Of these studies 10 compared efficacy of pirarubicin with mitomycin C,and the meta-analysis based on these 10 studies showed that pirarubicin was statistically superior to mitomycin C(OR=0.41,95%CI 0.27～0.61,P＜0.01).Of 6 studies,pirarubicin was compared with thiotepa(OR=0.35,95%CI 0.11～1.13,P＞0.05),adriamyein(OR=0.15,95% CI 0.03～O.76,P＜0.05),epirubicin(OR=0.53,95% CI 0.23～1.23,P＞0.05),hydroxycamptothecin(OR=0.25,95% CI 0.10～0.64,P＜0.05)and blank control respectively,statistical analysis indicated pirarubicin was significantly better than adriamycin,hydroxycamptothecin and blank control,and not statistically different from thiotepa and epirubicin. Conclusion Pirarubicin is effective in preventing bladder tumor recurrence,with efficacy better than chemotherapeutic agents such as mitomycin C,hydroxyeamptothecin,and adriamycin,thus can be a novel optional intravescial chemotherapeutic agent for bladder cancer.

Objective To investigate the number, distribution and metastatic rule of lymph nodes in the mesorectum of rectal cancer specimen after processing the recta] cancer specimen with modified fat clearance technique. Methods Sixty patients with mid-low rectal cancer who had been admitted to Peking University School of Ontology from 2003 to 2008 were assigned to test group. All the 60 patients who denied neo-adjuvant therapy were treated with total mesorectal excision, and the rectums resected were processed with the modified fat clearance technique. Rectums from another 50 patients with mid-low rectal cancer in control group were fixed in formalin solution for 24 hours. The mesorectum was divided into anterior, posterior, left and right quadrants, and each quadrant was further divided into upper, middle and lower parts. The numbers of lymph nodes harvested and metastatic rate of lymph nodes between the 2 groups were analyzed by t test and chi-square test. Results (1) The numbers of lymph nodes harvested in the test and control groups were 1436 and 525, with statistical difference between the 2 groups (t =- 12. 153, P <0.05). The number of small lymph nodes(diameter≤5 mm) harvested in test group was 985. (2) The numbers of lymph nodes harvested in the anterior, posterior and bilateral mesorectum were 125,696 and 615, respectively. The numbers of lymph nodes harvested in the upper, middle and lower part of the mesorectum were 395,534 and 507, respectively. The metastatic rate of lymph nodes in the upper part of the mesorectum was 18.5% (37/200), which was significantly lower than in the middle [43.5% (87/200)] and lower [38.0% (76/200)] part of the mesoreetum (X2= 9. 414, 6.406, P < 0.05). Two hundred metastatic lymph nodes in 33 patients were harvested, 48.0% (96/200) of which with a diameter of ≤ 5 mm. Twenty percent patients had their TNM stage changed after the retrieval of metastatic small lymph nodes. Conclusions Modified fat clearance technique significandy improves the retrieval of lymph nodes, and more small lymph nodes retrieved can increase the accuracy of staging. Rectal cancer cells have strong tendency to disseminate to the distal mesorectum. Adequate excision of the distal mesorectum is key in controlling the local recurrence.