Objective To discuss the experience of antegrade radical retropublic prostatectomy. Methods Thirty cases of prostate cancer were treated by antegrade radical retropublie prostateeto-my. The mean age of patients was 64 years. There were 8 cases of T_1, 15 cases of T_2, and 7 cases of T_3. The surgery included following procedures: Firstly the vesical neck was divided. Then the seminal vesicle and the prostate were freed from above downward. After the urethra was separated from the prostatic apex, the proximal end of urethra was sutured to the new vesical neck. Results All the 30 laparoscopic surgeries were accomplished successfully. The mean operative time was 2.5 hours. The mean blood loss was 350 ml in the operation. No ureteral injury, rectal injury and other severe compli-cation was observed. Histopathologic study showed prostate cancer for all the cases. Four cases had positive surgical margins. All cases were followed up from 6 to 48 months (average 25 months) with-out dysuria and permanent incontinence. No death occurred. Sexual function recovered in 7/13(54%) cases after the operation. Conclusions Antegrade radical retropublic prostatectomy provides low complication, tittle bleeding and positive surgical margins. It is an effective and sale procedure to treat prostate cancer.

Objective To explore the value of the LigaSure vessel sealing in laparoscopic nephrectomy surgery. Methods Laparoscopic nephreetomies were performed in 41 cases from May 2004 to December 2006 by using LigaSure, including simple nephrectomies, radical nephrectomies and nephroureterectomies. The operative time, estimated blood loss, open conversion rate, duration of postoperative drainage, total amount of postoperative drainage, postoperative hospital day as well as complication rate were recorded and analyzed retrospectively. Results All procedures were finished successfully without conversion to open surgery. No severe vascular complication or other serious complications happened. The mean operative time was 146min (range, 35-240 min) ; mean blood loss was 163ml (range, 30-450 ml); mean time for postoperative drainage was 3d (range, 1-6 d) ; mean amount of postoperative drainage was 229ml (range, 45-435 ml). The postoperative hospital staying was 6-21 d, with the average of 10 days. Conclusions The LigaSure vessel sealing system produees a consistent, reliable, permanent seal of veins, arteries, and tissue bundles. It could decrease operative time and blood loss. This new energy-based vessel-ligation device appears to be effective in advanced laparoscopic procedures.

Objective To investigate the effects of adiponectin (APN) on proliferation,migration and tube formation of RF/6A cells,and explore the effects of APN on choroidal and retinal angiogenesis.Methods Well cultured RF/6A cells were randomly divided into the control group and three groups with different concentrations of recombinant adiponectin (5 pg · mL-1,50 pg · mL-1,500 pg · mL-1) for 1 hour.After 24 hours,cell proliferation,migration and tube formation were detected by MTT assay,wound scratch assay and seeding cells in matrigel,respectively.Results The cell proliferation in all APN groups was weaker than that of control group (P ＜ 0.05),the cell migration area (pixels) of all APN groups was significantly smaller than that of the control group (P ＜ 0.05),and the number of tube formation of all APN groups was significantly less than the control group (P ＜ 0.05).Cell proliferation,migration and tube formation decreased along with the increase of APN concentration.Conclusion APN can obviously inhibit the angiogenesis process of RF/6A cells.This inhibitive effect indicates the protective role of APN in choroidal and retinal angiogenesis.

Objective To assess the clinical features and diagnostic index of progressive macular hypomelanosis(PMH).Methods Eight patients with PMH were recruited into this study.Wood's lamp and in vivo confocal laser scanning microscopy(CLSM)were utilized to observe the lesions of all patients.Microbiological culture of lesion specimens from 2 patients was performed.Tissue specimens from 4 patients underwent immunohistochemieal staining with anti-S-100 and anti-TRP-1 antibodies for the detection of melanocyte quantity.Electron microscopy wag utilized to observe ultrastructural features of lesions.Primary culture of melanocytes was carried out with lesional epidermis.Resnits Under Wood's lamp.the lesions of PMH showed punctiform red fluorescence.CLSM revealed complete pigmented tings in lesions with decreased melanin granules compamd with those surrounding normal skin.Microbiological culture grew red fluorescence-producing,gram-positive bacillus which was identified as Propionibacterium acnes.Immunohistochemistry showed no significant difference in the number of S-100-postive cells or TRP-1-positive cells per high power field (× 400)between lesions and surrounding normal skin (8.25±0.96 vs 8.75±1.71,4.25±0.96 vs 4.50±1.29,both P>0.05).Ultrastructural studies showed a large reduction in the number of type Ⅳ melanosomes in lesions of PMH,along with numemus membrane bound bodies and clusteredly distributed,small type Ⅱ-Ⅳ melanosomes.Melanocytes,with morphological similarity to normal melanocytes,were successfully isolated from the lesional tissue,cuhured and identified.Conclusion A primary diagnostic criteria is pro-posed for PMH according to the clinical and experimental studies.

In the first case, a 15-year-old girl presented with recurrent multiple erythematous edema,bullae and ulceration on the face and extremities for 3 years, which had developed into plaques and nodules on the face and trunk for 6 months. Histology revealed angiocentric and angiodestructive infiltrates with medium-sized atypical lymphoid cells positive for LCA, CD45RO, CD56 and EBV staining throughout the dermis. The patient was diagnosed with extra NK/T-cell lymphoma, nasal-type. She subsequently had a rapid downhill clinical course with resistance to systemic chemotherapy, and died one month later. In the second case, a 44-year-old male was admitted to the hospital with progressive infiltrated mass on the right waist for 1 year, and a 4-month-history of lymphadenectasis. Histologically, there was a massive and dense infiltrate with middle and large-sized, CD4 and CD56-positive lymphoblastics throughout the dennis and subcutaneous tissue. A diagnosis of blastic NK-cell lymphoma was made. The patient was managed with surgical excision followed by systemic chemotherapy. He had been followed up and free of relapse till the time of this writing.CD56 positive cutaneous lymphoproliferative disorders appear to be highly invasive.

Objective To analyze the relationship of melanocyte ultrastructure and expression of microphthalmia-associated transcription factor (MITF) as well as tyrosinase-related proteins (TRP) transcriptionally modulated by MITF to clinical types and duration of vitiligo.Methods Epidermal sheets were taken by suction blisters respectively from lesional,perilesional,and normal skin of 12 patients with vitiligo vulgaris (VV) and 8 with segmental vitiligo (SV).The duration of vitiligo varied from 3 to 300 months in these patients. Transmission electron microscopy was performed in 10 patients with vitiligo,including 6 cases of VV and 4 cases of SV.Epidermal melanocytes from normal skin of 20 patients were subjected to culture followed by Western blot to detect the expression level of MITF and some molecules transcriptionally modulated by MITF,including tyrosinase (TYR),TYR-related protein-1(TYRP1),and TYR-related protein-2 (TYRP2) in cultured melanocytes.Results Epidermal melanocytes were absent in lesional skin of 7 out of 10 patients observed for ultrastructural alterations,whereas melanocytes with reduced or absent melanin (melanosome) could accidently be seen in lesional skin of 1 patient with short-standing vitiligo and 2 patients with long-standing vitiligo.In perilesional skin.abnormal ultrastructure of melanocytes was found in 3 with a duration of vitiligo less than 15 months among 6 patients with VV,and in 1 out of 4 patients with SV.The down-regulated expression of MITF was consistent with that of TYR,TYRP1 and TYRP2 in cultured epidermal melanocytes from normal skin of patients with VV;in those from patients with SV,the down-regulated expression was observed only in MITF,while the expressions of TYR,TYRP1 and TYRP2 were nearly normal.Conclusion Differences may exist between VV and SV in the ultrastructure as well as mechanisms of transcriptional modulation by MITF in epidermal melanocytes.

Angiomyfibroblastoma (AMF)is a kind of rare benign tumour. The clinical and imaging findings of AMF are nonspecific. In October 2019, 1 case of Angiomyfibroblastoma of perineum was admitted to Heze Municipal Hospital for surgical treatment. Final pathological diagnosis was AMF. So far, neither recurrence nor metastasis has been detected for 5 months.

Objective To investigate the changes of T helper type 17 (Thl7) cells and regulatory T (Treg) cells in different stages of mycosis fungoides.Methods Flow cytometry was performed to determine the percentage of Treg and Th17 cells in peripheral blood from 28 patients with mycosis fungoides (MF),13 patients with large plaque parapsoriasis (PP),17 patients with lichen planus (LP) and 10 healthy human controls,and immunohistochemistry to detect the expressions of forkhead box protein 3 (FOXP3) and interleukin (IL)-17 in tissue specimens from 40 patients with MF,13 with PP,17 with LP and 10 healthy human controls.Statistical analysis was carried out by one-way analysis of variance and Pearson correlation analysis.Results As far as the percentage of Treg cells in peripheral blood was concerned,MF,PP and LP patients were significantly higher than the healthy controls (8.09％ ± 1.68％,6.53％ ± 1.67％ and 2.84 ％ ± 1.16％ vs.1.01％ ± 0.35,all P＜ 0.05),PP patients were higher than LP patients and healthy controls (both P ＜ 0.05),and LP patients were higher than healthy controls (P ＜ 0.05).The percentage of Th17 cells in peripheral blood was significantly increased in MF patients compared with PP patients,LP patients and healthy controls (3.22％ ± 0.82％ vs.2.46％ ± 0.79％,1.38％ ± 0.47％ and 0.59％ ± 0.30％,all P ＜ 0.05).Elevated expression rate of FOXP3 was observed in MF,PP and LP lesions as compared with normal skin (14.94％ ± 4.46％,11.95％ ± 4.72％,6.32％ ± 2.81％ vs.3.43％ ± 1.79％,all P ＜ 0.05),and in MF and PP lesions compared with LP lesions (both P ＜ 0.05),but no significant difference was observed between MF and PP lesions (P ＞ 0.05).There was a significant increase in the expression rate of IL-17 in MF lesions compared with PP lesions,LP lesions and normal skin (15.89％ ± 4.27％ vs.12.02％ ± 3.34％,4.84％ ± 1.93％ and 2.62％ ± 0.89％,all P ＜ 0.05).The Th17/Treg ratio in peripheral blood was significantly lower in MF and PP patients than in LP patients and healthy controls (0.41 ± 0.11 and 0.39 ± 0.12 vs.0.50 ± 0.06 and 0.57 ± 0.19,all P ＜ 0.05).A positive correlation was observed between the proportion of Thl7 cells and Treg cells (r =0.423,P ＜ 0.05) in patients with early-stage MF,but not in those with tumor-stage MF.The proportion of Th17 cells decreased,but that of Treg cells continuously increased in patients with tumor-stage MF.However,no significant difference was noted in the proportion of Thl7 cells or Treg cells among patients with different stages of MF.Conclusion The imbalance between Treg and Th17 cells may be involved in the occurrence and development of MF.

Objective To measure the expression of interleukin-13 (IL-13) and its receptors in mycosis fungoides (MF) lesions,and to investigate their clinical significance.Methods A total of 34 paraffin-embedded specimens of MF,which was confirmed by clinical and histopathological features,immunophenotyping and/or T-cell receptor gene rearrangements,were collected from Hangzhou Third People's Hospital between January 2010 and March 2016.According to the tumor-node-metastasis (TNM) staging system,5 patients were at stage I A,9 at stage Ⅰ B,17 at stage Ⅱ A,and 3 at stage Ⅱ B.Ten normal skin tissue specimens served as controls.Immunohistochemical study was conducted to measure the expression of IL-13,IL-13Rα1 and IL-13Rα2.Results IL-13,IL-13Rα1 and IL-13Rα2 were all expressed in atypical lymphoid cells and epidermotropic lymphoid cells in MF lesions at various stages.IL-13Rα2 was highly expressed in all the MF lesions.None of IL-13 and its receptors were expressed in normal skin tissues and lymphocytes.The expression rates of IL-13 and its receptors in MF lesions increased along with the progression of MF.Additionally,the expression rates of IL-13 (10.00％ ± 3.14％),IL-13Rα1 (21.43％ ± 6.88％) and IL-13Ro2 (31.14％ ± 6.38％) significantly decreased in MF lesions at stage Ⅰ compared with those at stage Ⅱ (27.50％ ± 11.00％,39.45％ ± 9.43％,44.40％ ± 11.15％,respectively,all P ＜ 0.05),but no significant differences were observed between stage Ⅰ A and Ⅰ B,or between stage Ⅱ A and Ⅱ B (P ＞ 0.05).Conclusion IL-13 and its receptors,especially IL-13Rα2,may be expected to serve as biomarkers for early diagnosis of MF and prediction of its biological behaviors.

OBJECTIVE To investigate the inhibiting effect of Pingyangmycin on cultured vein endothelial cells in vitro and illustrate the mechanism of Pingyangmycin on treatment cavernous hemangioma of head and neck. METHODS By MTT assay,the inhibiting rates of cultured Ecv-304 cells which were managed with Pingyangmycin for 24h and 48h were compared respectively. The changes in the cell cycle,apoptosis,and Caspase 3 protein expression of the cells managed with Pingyangcin for 24h were examined by flow cytometry(FCM). RESULTS The results showed that the inhibiting rate of Ecv-304 was dependent on the concentration of Pingyangmycin. However,in the same concentration,the inhibiting effect for 24h was stronger than that for 48h. The percentage of G1 phase cells increased while the S phase decreased,but the percentage of G2 phase cells remained unchanged after managed with Pingyangcin for 24h. An apoptosis peak appeared before G1 phase. The apoptosis rate was also concentration-dependant. The expression of caspase 3 increased in every group of different concentration. CONCLUSION Pingyangmycin can possibly arrest the growth of Ecv-304 in the G1 phase through the mechanism of inducing apoptosis. Caspase 3 may play an important role in the induced apoptosis.