Animals ; Danazol ; pharmacology ; Endometriosis ; drug therapy ; Endometrium ; drug effects ; Female ; Interleukin-6 ; metabolism ; RNA, Messenger ; genetics ; Rats ; Rats, Sprague-Dawley

Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.

Objective To evaluate the clinic efficacy of sufentanil and remifentanil by target- controlled infusion (TCI) combined with propofol in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixty patients,ASA Ⅰ ～ Ⅱ,undergoing elective EBUS-TBNA were randomly divided into group S ( sufentanil group),group R (remifentanil group) and group SR (sufentanil + remifentanil group),each group were twenty patients.The anesthesia of all groups is propofol intravenous anesthesia with 2％ lidocaine topical anesthesia,to controll BIS between 50 and 60 during surgery.Heart rate(HR),mean arterial pressure(MAP) pulse oxygen saturation( SpO2 ) and respiratory rate (RR) were recorded and compared 5mins after entering room(T0),30mins after the beginning of surgery(T1 ) and after surgery(T3).Arterial blood gas and the times of cough during surgery were also recorded and compared in all groups.The use of propofol and lidocaine,the wake-up time,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were also obtained.Results ( 1 ) RR decreased distinctly in group R and PaCO2 increased distinctly in group S and group R compared with that of group SR (P ＜0.05) during surgery.(2)The times of cough and the wake-up time lessened distinctly in group R and group SR compared with that of group S ( P ＜0.05 ).(3) The use of propofol and lidocaine,satisfaction with anesthesia and adverse reactions in 6 hrs after surgery were similar in all groups ( P ＞ 0.05 ).Conclusion Sufentanil compounded remifentanil by TCI combined with propofol is a safe and feasible anesthesia option for EBUS-TBNA,which provides better efficacy,high satisfaction and less side effects compared with using alone of sufentanil and remifentanil respectively.

Objective To observe effects of ganoderma lucidum triterpenoids(GLT) on learning and memory function and anti-oxidative ability of aging model mice induced by D-galactose. Methods Senile model mice were established by D-galactose hypodermic injection for 8 weeks.GLT had been administered to two therapy groups.All the mice of different groups were tested with Morris water maze.Then the mice were killed and biochemically assayed of total anti-oxidative capacity(T-AOC),superoxide dismutase(SOD) and malondialdehyde(MDA) in the brain. Results The model mice showed worse ability in learning and memory in comparison with control mice.The T-AOC activity and SOD activity in the brain decreased and the MDA content increased in model rats in comparison with control.GLT significantly improved the changes mentioned above. Conclusion GLT improved the learning and memory dysfunction in aging model mice by modulation of the anti-oxidative ability.

AIM: To observe the effect of combined goniosynechialysis in treating absolute glaucoma after trabeculectomy.
METHODS:Phacoemulsification combined goniosynechialysis was performed on 16 patients ( 16 eyes ) with absolute glaucoma after trabeculectomy, and they were followed up for 6 ~12mo, The postoperative intraocular pressure ( IOP ) and anterior chamber depth, preoperative and postoperative medication types (quantity), preoperative and postoperative 1 month's status of anxiety and depression, symptoms of ocular surface were observed. RESULTS: The IOP decreased significantly after phacoemulsification combined goniosynechialysis. The mean IOP was 35. 00±15. 43mmHg preoperatively, and it was 12. 00±6. 69mmHg, 15. 00±4. 26mmHg and 15. 3±5.2mmHg on 1d, 6 and 12mo after the surgery. The statistic difference was found between preoperative and postoperative (t=6. 22, P<0. 05). The anterior chamber depth was 1. 45 ± 0. 19mm before the surgery, and increased to 3. 37±0. 13mm after the surgery (t=6. 65, P<0. 05). After the surgery, 2 patients needed two kinds of drugs, 2 patients needed one kind of drug. After 12mo of follow-up, anxiety and depression status were improved in all 16 patients. Subjective discomfort symptoms of 16 patients such as eye bilges, eye pain were relieved. All of the patients' eyeballs were preserved, and no serious complications.
CONCLUSION: Phacoemulsification combined goniosynechialysis in treating absolute glaucoma after trabeculectomy is a safe and effective surgical option.

Objective To study the CT perfusion features of various lymph nodes in the neck.Methods Dynamic perfusion CT scanning was performed in 83 neck lymph nodes proved by pathology,including tuberculosis lymph nodes, lymphoma and metastatic lymph nodes. The shapes, blood flow modes,and perfusion parameters of these lymph nodes were compared among 3 groups. Statistical analysis of L/T and CT perfusion parameters was performed by one-way ANOVA and LSD test. Results The values of MTT of tuberculosis lymph nodes, lymphoma and metastatic lymph nodes were (28. 13 ±5.08), (31.08 ±5.82),and ( 11.24 ±5.31 ) s,respectively. The MTT of metastatic lymph nodes was statistically lower than that of tuberculosis lymph nodes and lymphoma (P ＜ 0. 05). Their frequencies of marginal blood flow were 5/9,4/19, and 39/55 (70. 9% ), respectively. The frequency of marginal blood flow in the tuberculosis lymph nodes and metastatic lymph nodes was statistically higher than that of lymphoma ( P ＜ 0. 05 ). Their frequencies of central blood flow were 2/9, 11/19, and 9/55 (16.4%), respectively. The frequency of central blood flow in the lymphoma was statistically higher than that of tuberculosis lymph nodes and metastatic lymph nodes ( P ＜ 0. 05 ). Their values of L/T were 1.82 ± 0. 32, 1. 80 ± 0. 39, and 1.84 ± 0. 36,(40. 98 ±6. 62) s,respectively. There were no significant differences in L/T, BF, BV and TTP among tuberculosis lymph nodes, lymphoma and metastatic lymph nodes( P ＞ 0. 05 ). Conclusion CT perfusion,especially combination functional imaging with perfusion images may be helpful in judging the nature of neck lymph nodes.

Objective To analyze the clinical characteristics and the outcome of severe trauma of various ages in emergency department,to improve the therapeutic effect of emergency rescuing.Methods Two thousand and sixty nine patients of severe trauma were treated during a seven-year period from October 1997 to October 2004.The studied patients were divided into 5 groups:(1)adolescent group(Group A,＜13 years old,n=106);(2)juvenile group(Group B, 13-18 years old,n=128);(3)youth group(Group C,18-40 years old,n=1518);(4)middle age group(Group D, 40-60 years old,n=215);and(5)elderly group(Group E,＞60 years old,n=102).All the patients were evaluated with Injury Severity Score(ISS),and the result was≥16 in all of the studied patients.Results The incidence of severe trauma in male in all 5 groups was higher than that in female,and it was significantly higher in Group C,Group D and Group E when compared with that in the other groups(P＜0.01).Traffic accident was the leading cause of injury,and its incidence in Group A,Group B and Group D was higher than that in other groups(P＜0.01).However,injury caused by falling from high places was the second cause of injury,being significantly increased in Group A,while armed fighting and injury during work being significantly increased in Group B,Group C and Group D,slip fall injury being significantly increased in Group E(P＜0.01).Head injury was mainly found in Group A and Group E,extremities injury and/or spinal injury were increased markedly in Group B,Group C and Group D(P＜0.05),abdominal injury was significantly decreased in Group E(P＜0.001).The total mortality was 11.9%(246/2069).The mortality within 24 hours (20.6%,21/102)was significantly higher than that beyond 24 hours(7.8%,8/102)in Group E(P＜0.01).The time of staying in the emergency department differed significantly between the survived patients and those died in all 5 groups (P＜0.01).Conclusion The gender,the incidence and the characteristics of the injury causes and injury sites differed between severely injured patients of various ages.Mortality in the elderly is significantly increased following severe trauma. The idea of“golden one hour”and“platinum ten minutes”,measures of shortening the time of staying in the emergency clinic,early definite operation and damage control operation should be emphasized.

Objective To construct and implement the training model of eight-year medical education with characteristics of Shanghai Jiaotong University. Methods Based on survey,discussion and consultation,the experiences of long schooling medical education in Shanghai Jiaotong University School of Medicine were summarized.Training plan and education reform scheme were established. Results Training objective,guideline and major reform measures had been clarified.The training plan and reform scheme were under process of implementation. Conclusion The training objective of eight-year medical education should be further confirmed.The curriculum should be in accordance with the training objective,and education reform is important and necessary for the eight-year medical education.

OBJECTIVETo observe the therapeutic angiogenesis effect of naotai recipe (NR) on local ischemia/reperfusion (I/R) injury of rats by observing signaling pathway of hypoxia-inducible factor-lα (HIF-1α) and vascular endothelial growth factor (VEGF).

METHODSTotally 120 Sprague-Dawley (SD) rats were randomly divided into 4 groups, namely, the normal control group (n =12), the sham-operation group (n =12), the I/R model group (n =48), and the NR group (n =48). Cerebral I/R injury models were established using thread suture method. Rats in the I/R model group and the NR group were sub-divided into 4 sub-groups according to the 1st, 3rd, 5th, and 7th I/R day (n =12). The phenomenon of neovasculization was observed by immunofluorescence staining. The protein and mRNA expression levels of HIF-la, VEGF-A, and VEGFR II receptor were detected by RT-PCR.

RESULTSThere were a large amount of labels for neovasculization in the ischemic area of the NR group. Double-immunofluorescence labeling [vWF (red) and BrdU (green)] was observed in the NR group. Compared with the model group, the HIF-1α protein expression was obviously enhanced on the 1 st day of I/R (P <0.01), and the VEGF protein expression started to enhance on the 3rd day in the NR group (P <0.01). The VEGFR protein expression level was the highest in the NR group on the 5th day of I/R (P <0.01). The protein expression of VEGF and HIF-1α started to decrease on the 7th day of I/R.

CONCLUSIONNR could strengthen angiogenesis after I/R by elevating the expression of HIF-lα and activating HIF-lα/VEGF signaling pathway.

Animals ; Brain Ischemia ; metabolism ; Cerebral Infarction ; Hypoxia-Inducible Factor 1, alpha Subunit ; genetics ; metabolism ; Hypoxia-Ischemia, Brain ; metabolism ; Ischemia ; Neovascularization, Pathologic ; Rats, Sprague-Dawley ; Reperfusion Injury ; Signal Transduction ; Vascular Endothelial Growth Factor A ; biosynthesis

OBJECTIVE: To compare the outcomes of endoscopic combined ultrasound-guided access (EUGA) with the conventional ultrasound-guided access (UGA) to achieve percutaneous renal access in endoscopic combined intrarenal surgery (ECIRS). METHODS: A retrospective review of 53 patients undergoing ECIRS to treat upper urinary tract calculi between January 2017 and October 2019 was con-ducted. All of the cases were of complex upper urinary tract stones larger than 2 cm in diameter. The com-plex stone situations, such as multiple renal calyces calculi or staghorn calculi necessitated ECIRS. Under general anesthesia, the patients were placed in the galdakao-modified supine valdivia (GMSV) position, thus allowing both antegrade and retrograde accesss. The patients were divided to UGA and EUGA groups according to the protocol of achieving percutaneous renal access. In 28 cases, endoscopic combined ultrasound-guided accesss were obtained. Puncture and dilation were performed under direct flexible ureteroscopic visualization, while percutaneous renal access of 25 cases were performed with the conventional technique employing ultrasound guidance. Demographic and perioperative information, such as stone burden, presence of hydronephrosis and number of calyces involved was compared. Primary outcomes included total operative time, renal access time, repeat puncture, hemoglobin level, perioperative complications, and stone-free rate. RESULTS: No major intra-operative complication was recorded in all the 53 ECRIS. No significant difference was observed between the groups in age and gender. There was no significant difference in body mass index[BMI (29.21±3.14) kg/m² vs.(28.53±2.56) kg/m²], stone burden (37.68±6.89) mm vs. (35.53±6.52) mm, number of calyces involved 2.72±0.68 vs. 2.86±0.71, presence of hydronephrosis (56.0% vs. 46.4%), total operative time (93.0±12.2) min vs. (96.8±14.2) min, hemoglobin level reduction (6.56±2.16) g/L vs. 97.54±2.64) g/L, stone-free rate (92.0% vs. 92.8%), hospital stay (5.52±0.59) d vs. (5.64±0.62) d, perioperative complication rate (8.0% vs. 7.2%). Two patients in EUGA group experienced perioperative complications (one urinary tract infection and one hematuria) while two patients in UGA group experienced perioperative urinary tract infection. None in both groups received blood transfusion. The patients undergoing EUGA had shorter renal access time [(4.0±0.7) min vs. (6.8±2.6) min, P < 0.01] and less repeat puncture (0 vs. 4 cases, P < 0.05). CONCLUSION EUGA is an optimal technique to establish percutaneous renal access in ECIRS, which minimizes access time and repeated procedures.
Humans ; Kidney Calculi ; Nephrostomy, Percutaneous ; Retrospective Studies ; Treatment Outcome ; Ultrasonography, Interventional ; Ureteroscopy