Objective To evaluate the clinical value of laparoscopic,retroperitoneal laparoscopic,and open radical nephrectomy.Methods Clinical data of 32 cases of laparoscopic radical nephrectomy(Laparoscopic Group),18 cases of retroperitoneal laparoscopic radical nephrectomy(Retroperitoneal Group),and 32 cases of open radical nephrectomy(Open Group) were compared in respect of operation time,length of hospitalization after operation,intraoperative hemorrhage volume,and incidence of postoperative complications.Results With exception of 1 case of conversion to open surgery because of ruptured renal vein in the Laparoscopic Group,the operation was successfully completed in all the cases.Of the Laparoscopic Group,Retroperitoneal Group,and Open Group,the operation time was 100.5?19.2 min,90.3?21.4 min,and 127.2?20.5 min,respectively,the intraoperative hemorrhage volume was 40?15 ml,50?15 ml,and 200?30 ml,respectively,and the length of postoperative hospitalization was 5.2?1.3 d,5.6?1.1 d,and 9.1?1.8 d,respectively.Both the Laparoscopic Group and the Retroperitoneal Group were superior to the Open Group(P

The 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR) catalyzes the conversion of HMG-CoA to mevalonate in mavalonic acid pathway, which is the first committed step for isoprenoid biosynthesis in plants. However, it still remains unclear whether HGMR gene plays a role in the isoprenoid biosynthesis in Dendrobium officinale, an endangered epiphytic orchid species. In the present study, a HMGR encoding gene, designed as DoHMGR1 (GenBank accession JX272632), was identified from D. officinale using the reverse transcription polymerase chain reaction (RT-PCR) and rapid amplification of cDNA ends (RACE) methods, for the first time. The full length cDNA of DoHMGR1 was 2 071 bp in length and encoded a 562-aa protein with a molecular weight of 59.73 kD and an isoelectric point (pI) of 6.18. The deduced DoHMGR1 protein, like other HMGR proteins, constituted four conserved domains (63-561, 147-551, 268-383 and 124-541) and two transmembrane motifs (42-64 and 85-107). Multiple sequence alignment and phylogenetic analyses demonstrated that DoHMGR1 had high identity (67%-89%) to a number of HMGR genes from various plants and was closely related to Vanda hybrid cultivar, rice and maize monocots. Real time quantitative PCR (qPCR) analysis revealed that DoHMGR1 was expressed in the three included organs. The transcripts were the most abundant in the roots with 2.13 fold over that in the leaves, followed by that in the stems with 1.98 fold. Molecular characterization of DoHMGR1 will be useful for further functional elucidation of the gene involving in isoprenoid biosynthesis pathway in D. officinale.

Objective To investigate the effect of airway lavage on patients with inhalation injury.Methods Sixty patients in our department with simple inhalation injury were divided into experimental group(n=30)and control group(n=30).The control group accepted traditional nursing care(aspiration of sputum,aerosol inhalation,backslap and body position adjusting) and the experimental group accepted timed airway lavage and necessary ventilator-assisted breathing in addition to traditional nursing.The arterial blood gas value(PaO2,PaCO2),rate of sputum crab plugging and lung infection were compared.Result The lung function, SpO2 and PaO2 significantly increased and rate of sputum crab plugging and lung infection significantly decreased in experiment group (P<0.05).Conclusion Airway lavage can clear sputum crab in time,improve lung fuction and reduce lung infection of patients with inhalation injury.

Objective To study the clinical features and prognostic risk factors of patients with autoimmune hepatitis-related hepatocellular carcinoma (AIH-HCC).Methods We reviewed the clinical data of 40 patients with AIH-HCC who were treated at the 302 Hospital between May 1,2008 and April 30,2013,and analyzed the clinical characteristics and prognostic risk factors of these patients.Results These patients were diagnosed to have HCC at a mean ± SD of 55.1 ± 13.5 years (range 28-76 years).The median duration from the time of confirmed cirrhosis to a diagnosis of HCC was 49.2 ± 44.5 months (range 3-194 months).The median survival of the AIH-HCC patients was 16.0 ±4.0 months (range 1-44 months),and the 1-year survival rate was 54.0％.Univariate analysis showed AFP,tumor size,tumor number were related to prognosis (P ＜ 0.05) ; while gender,age,IAIHG score,category,history of blood transfusion,alcohol-drinking and smoking did not significantly affect the patients' survival (P ＞ 0.05).Multivariate regression analysis showed AFP and tumor number were independent prognostic factors.Most of these patients received transcatheter arterial chemoembolization(TACE),however the survival rate of those patients who received hepatectomy was significantly higher than those who received TACE or accepted conservative treatment.Conclusion Liver cirrhosis in AIH is the sine qua non for HCC development,which subsequently occurs at a rate of 1.65％ per year.Patients who had AFP-negativity or a single tumor had a better prognosis.Surgical treatment prolonged survival.

Objective To investigate the expression of lipoprotein(a)and fibrinogen different genders of patients with coronary heart disease(CHD)and its clinical significance.Methods 1 500 patients with CHD in the hospital from January 2009 to December 2013 were selected as the observation group,including 954 males and 546 females.Contemporaneous 500 healthy people with physi-cal examination were selected as the control group,including 329 males and 171 females.The myocardial enzymes,serum lipid,blood coagulation function and various proteins were detected.Results Whether males or females,CK,CKMB,AST,LDH,α-HBDH, TC,TG,LDL-C,Fib,D-D,TT,FDP,LPa,cTnI,MYO and HCY in the observation group were significantly higher than those in the control group.HDL-C,APTT,INR and PT in the observation group were significantly lower than those in the control group.The differences were statistically significant(P <0.05 ).Conclusion Whether males or females,the different degrees of abnormal ex-pression of myocardial enzyme spectral indexes,blood lipid indexes,coagulation indexes,apolipoprotein,troponin,myoglobin and ho-mocysteine exist in the patients with CHD.Lipoprotein(a)and fibrinogen have high expression in the CHD patients,which can pro-vide the reliable scientific basis for diagnosis and treatment of the disease.

OBJECTIVE: To assess the association of genomic instability of epithelial cadherin 1 (CDH1) gene and clinicopathological characteristics of gastric cancer. METHODS: In total 120 paraffin-embedded gastric cancer tissue specimen were prepared, and genomic DNA was extracted. The genomic instability of the CDH1 gene was analyzed by immunohistochemistry and silver staining PCR-single-strand conformation polymorphism. RESULTS: The number of information individuals (heterozygotes) was 98 for the D16S752 locus. The detection rates for microsatellite instability (MSI) and loss of heterozygosity (LOH) at the D16S752 locus and the positive rate of CDH1 protein were 19.39%, 16.33% and 51.02%, respectively. The detection rate of MSI in TNM stages I or II was significantly higher than that in stages III or IV (P<0.05) while the detection rate of LOH was significantly lower than that in stages III or IV (P<0.05). The positive rate of CDH1 protein in TNM stages III or IV was significantly lower than that in stages I or II (P<0.05). The detection rate of MSI of cases with lymph node metastasis was significantly lower than that of without lymph node metastasis (P<0.05) while the detection rate of LOH was significantly higher than that without lymph node metastasis (P<0.05). The positive rate of CDH1 protein in patients with lymph node metastasis was significantly lower than that in patients without lymph node metastasis (P<0.05). The positive rate of CDH1 protein in MSI-positive group was significantly higher than that in MSI-negative group (P<0.05), and the positive rate of CDH1 protein in the LOH-positive group was significantly lower than that the LOH-negative group (P<0.05). CONCLUSION The genomic instability of the CDH1 gene is associated with the progression of gastric cancer. MSI at the D16S752 locus may be used as a molecular marker for early gastric cancer, while LOH at this locus mostly occurs in advanced gastric cancer and can be regarded as an effective indicators for malignancy evaluation and prognosis.
Humans ; Stomach Neoplasms/pathology* ; Lymphatic Metastasis ; Cdh1 Proteins/genetics* ; Microsatellite Instability ; Loss of Heterozygosity ; Genomic Instability ; Microsatellite Repeats ; Antigens, CD/genetics* ; Cadherins/genetics*

Background and Objectives: The search for a suitable alternative for urethral defect is a challenge in the field of urethral tissue engineering. Induced pluripotent stem cells (iPSCs) possess multipotential for differentiation. The in vitro derivation of urothelial cells from mouse-iPSCs (miPSCs) has thus far not been reported. The purpose of this study was to establish an efficient and robust differentiation protocol for the differentiation of miPSCs into urothelial cells. Methods: and Results: Our protocol made the visualization of differentiation processes of a 2-step approach possible. We firstly induced miPSCs into posterior definitive endoderm (DE) with glycogen synthase kinase-3β (GSK3β) inhibitor and Activin A. We investigated the optimal conditions for DE differentiation with GSK3β inhibitor treatment by varying the treatment time and concentration. Differentiation into urothelial cells, was directed with all-trans retinoic acid (ATRA) and recombinant mouse fibroblast growth factor-10 (FGF-10). Specific markers expressed at each stage of differentiation were validated by flow cytometry, quantitative real-time polymerase chain reaction (qRT-PCR) assay, immunofluorescence staining, and western blotting Assay. The miPSC-derived urothelial cells were successfully in expressed urothelial cell marker genes, proteins, and normal microscopic architecture. Conclusions We built a model of directed differentiation of miPSCs into urothelial cells, which may provide the evi-dence for a regenerative potential of miPSCs in preclinical animal studies.

Objective:To seek the biomarkers of diagnostic value for an early postoperative onset of intensive care unit acquired weakness(ICUAW)in liver transplant(LT)recipients.Methods:Between September 2017 and August 2019, A total of 62 consecutive allogeneic orthotopic LT liver transplantation recipients at The First People's Hospital of Kunming between September 2017 and August 2019 are prospectively reviewedenrolled in this study. Upon After entering ICU, blood samples are assayed taken for adenosine 5'-monophosphate-activated protein kinase alpha(AMPK-α)、and glucose transporter type 4(GLUT-4)test. Clinical and bBiochemical specimens are collected. When transplant recipients are during awake and cooperative hours. Their muscle strength is recordedexamined. The score table of Medical Research Council(MRC)is utilized sed as the diagnostic standard of ICUAW. And ICUAW is diagnosed with < 48 points. Based on this, 62 subjects are divided into two groups of ICUAW group(17 cases)and non-ICUAW group (45 cases). The age, sex, mechanical ventilation time, ICU hospitalization time, partial blood oxygen pressure, systolic blood pressure, central venous pressure(CRP), blood glucose, total bilirubin, alanine aminotransferase(ALT), aspartate aminotransferase(AST), γ- Glutamyl transpeptidase(γ- GGT), blood urea nitrogen, blood creatinine and levels of AMPK-α and GLUT-4 are compared between patients in ICUAW group and non-ICUAW two groups. and levels of AMPK-α and GLUT-4 were compared between patients in ICUAW group and non-ICUAW two groups. The powers of AMPK-α And and GLUT-4 in predicting ICUAW was were evaluated by receiver operating characteristic curve(ROC)and area under the curve(AUC). Differences with P<0.05 is deemed as significant. Results:ICUAW is diagnosed in 17/62(27.42%)LT recipients. ICUAW patients had longer mechanical ventilation time(27 vs. 10h, P<0.05)and extended ICU hospitalization time(4 vs. 3d, P<0.05). No significant inter-group difference existed in AMPK-α(1.01±2.43 vs. 1.74±4.24 units/ml, 95% CI: -2.92~1.45, P>0.05). And the expression of GLUT-4 declined in ICUAW patients(137.86±127.87 vs. 419.15±267.68 ng/L, 95% CI: -417.13~-145.45, P<0.05). GLUT-4 ROC curve hint at some negative predictive value for the occurrence of ICUAW. ROC curve area was 0.88 and SE 0.05( P<0.05, 95% CI: 0.78~0.98). Conclusions:ICUAW patients have longer mechanical ventilation time and extended ICU hospitalization time. Monitoring GLUT-4 offers some predictive value for ICUAW in LT recipients. Elevated GLUT-4 is associated with a low probability of ICUAW.

Objective:To study the clinical characteristics of ureaplasma urealyticum (UU) infection in preterm infants with gestational age <34 weeks.Methods:From January 2017 to December 2021, premature infants with gestational age <34 weeks admitted to neonatal department of our hospital were enrolled in this prospective cohort study. UU-DNA from respiratory tract samples were examined using quantitative fluorescence polymerase chain reaction method. The infants were assigned into UU (+) group and UU (-) group. Perinatal factors and clinical characteristics were compared between the two groups.Results:A total of 182 preterm infants were enrolled, including 59 cases (32.4%) in UU (+) group and 123 (67.6%) in UU (-) group. UU (+) group had significantly lower gestational age and birth weight and significantly higher incidences of vaginal delivery, premature rupture of membranes (PROM) >18 h and maternal chorioamnionitis than UU (-) group ( P<0.05). Compared with UU (-) group, UU (+) group had significantly higher leucocyte count, neutrophil count and interleukin-6 at 1, 24 and 72 h after birth ( P<0.05). No significant differences existed in C-reactive protein and procalcitonin between the two groups at each time point ( P>0.05). In UU (+) group, the incidences of intrauterine pulmonary infection and bronchopulmonary dysplasia (BPD) were higher and the incidence of respiratory distress syndrome was lower than UU (-) group ( P<0.05). No significant differences existed in the incidences of intraventricular hemorrhage, periventricular leukomalacia, feeding intolerance, necrotizing enterocolitis, retinopathy of prematurity between the two groups ( P>0.0 5). UU (+) group had significantly longer duration of oxygen therapy than UU (-) group ( P<0.05). No significant differences existed in the duration of invasive mechanical ventilation and hospital stay between the two groups ( P>0.05). Conclusions:Preterm infants <34 weeks with positive UU in respiratory tract secretions have higher incidences of vaginal delivery, PROM>18 h and maternal chorioamnionitis. Leukocyte and neutrophil count and interleukin -6 are higher in these infants. They need prolonged oxygen therapy and have increased risks of intrauterine pulmonary infection and BPD.

Objective To investigate the long-term effects of repeated neonatal administration of dizocipline maleate (MK-801),the glutamate N-methyl-D-aspartate (NMDA) receptor antagonist,on recognition memory and hippocampal excitatory-inhibitory balance at the synaptic level in adult female rats.Methods Neonatal female Sprague-Dawley (SD) rats were randomly divided into model group and control group.Rats were administrated subcutaneously with MK-801 or normal saline from postnatal day (PND) 5 to PND14 (0.25 mg/kg,twice daily).(1) Object-in-context recognition test was performed on PND73-75.(2)The expression levels of vesicular glutamate transporter 1 (VGLUT1) and vesicular GABA transporter (VGAT) in hippocampus were detected by immunohistochemical staining.Results (1) The preference index of model group for new objects was significantly lower than that of the control group (t =-2.762,P=0.012).(2) There was no significant difference in the expression of VGLUT1 in hippocampus of MK-801 mode group(P＞0.05).Compared with control group(48.19±2.10),the VGAT level of model group in CA1 (39.60±2.19) was lower.Compared with control group (CA1:(0.99±0.05),CA3:(1.28±0.02),the ratio of VGLUT1/VGAT was significantly upregulated in CA1(1.16±0.05) and CA3(1.44±0.03) (P＜0.05).Conclusion Early NMDA receptor inhibition produces long-term deleterious effects on associative recognition memory and excitatory-inhibitory balance of hippocampus in female rats.These biochemical abnormalities may contribute to cognitive impairments observed in this study.