Objective To evaluate the clinical efficacy of retroperitoneal laparoscopic nephroureterectomy (RLNU) combined with transurethral electric coagulation on upper urinary tract urothelial carcinoma (UUTUC).Methods Sixty UUTUC patients were enrolled from Jun.2012 to Apr.2013.The prospective clinical controlled analysis method was adopted in this study.All patients were divided into test group and control group according to the order of admission.Thirty cases (test group) underwent RLNU combined with electric coagulation,and 30 cases (control group) underwent RLNU combined with electric resection.The differences in operation time,blood loss,hospital stay and tumor recurrence rate between the 2 groups were compared.Results All the 60 operations for UUTUC were successful without conversion to open surgery.No intraoperative complications such as great vessels or surrounding organs damage occurred.There were 2 cases loss to follow-up in test group and 3 cases in control group.There were no significant differences in operation time,blood loss,follow-up time,tumor stage and tumor grade between the 2 groups.The hospital stay in the test group was shorter (5.5±2.0 d versus 7.1±2.2 d),the tumor recurrence rate was lower [4％ (1/28) versus 30％ (8/27)],and the differences were significant (P＜0.05).Conclusion Compared with RLNU combined with transurethral electric resection,RLNU combined with electric coagulation has advantages of shorter hospital stay and lower tumor recurrence rate.

Objective To evaluate the application of inguinal incision in retroperitoneal laparoscopic nephroureterectomy(LNU)in the treatment of upper urinary urothelial carcinoma(UUUC).Methods From Mar.2007 to Jan.2012,186 retroperitoneal LNU procedures on 115 males and 71 females for the treatment of UUUC were performed in our institute.All cases were grouped as inguinal incision group(n =112)and lumbar incision group(n =74)according to specimen retrieval incision.Operative time,estimated blood loss,postoperative analgesia,hospital stay,incision complications,cosmetic satisfaction and tumor recurrence were compared between the 2 groups.Results All the 186 cases of operation were successfully accomplished.There were no differences in tumor stage,tumor grade,mean operative time,blood loss between the 2 groups.In inguinal incision group,the incidence of incision fat liquefaction,incision hernia,incision bulging,lumboabdominal unsymmetry and postoperative analgesia was less than that of lumbar incision group.In inguinal incision group,the mean hospital stay was shorter,cosmetic satisfaction(Ⅰ/Ⅱ/Ⅲ)was better(7/24/81 versus 22/18/34,P ＜ 0.01).Recurrence rate of UUUC in middle and inferior segment of ureter was fewer than that of lumbar incision group(5.3％ versus 35.0％,P ＜0.01).Conclusion Retroperitoneal LNU for UUUC combined with inguinal incision offers advantage of less trauma,less complications,higher cosmetic satisfaction and lower tumor recurrence.

Objective To characterize the clinical manifestations, laboratory findings of patients with occult sys?temic malignant neoplasms, whose initial manifestation presented as multiple acute cerebral infarcts including coagula?tion function,radiological imaging and microembolic signals (MES) detection by transcranial Doppler sonography (TCD) and to explore the possible underlying mechanisms. Methods All clinical records, laboratory hematological tests includ?ing hypercoagulable states measured by D-dimer levels, brain MRI including DWI, and TCD monitoring MES, the treat?ment and prognosis were retrospectively reviewed in 12 patients with multiple acute cerebral infarcts as the first manifes?tation of occult systemic malignancy. Results The clinical manifestations presented as localized neurological dysfunction, e.g. hemiparesis, aphasia, hemiparesthesia, dysarthria, vertigo and seizures, etc. DWI revealed multiple disseminated acute cerebral infarcts in multiple arterial territories such as the bilateral anterior or anterior plus posterior cerebral circu?lation in all patients. Eleven of 12 patients tested had elevated D-dimer. TCD detected MES in 5 of 7 patients. There were 12 patients diagnosed with occult systemic malignancy including 5 lung cancer, 3 pancreatic cancer, 1 gastric can?cer, 1 colon cancer, 1 endometrial adenocarcinoma and 1 metastatic poorly differentiated mucinous adenocarcinoma with unknown primary. Ten patients already had remote metastasis at diagnosis. The prognosis was usually poor and there were 7 cases with ischemic stroke recurrence, 4 cases with acute myocardial infarction, 3 cases died during hospitaliza?tion. Conclusions When patients present with multiple disseminated acute cerebral infarcts involving multiple arterial territories as initial manifestation, the underlying occult systemic malignancy should be considered. Hypercoagulopathy and MES might provide the clues to the diagnosis.

Objective To investigate the clinical features and TCD-detected microembolic signals in patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, and to explore the possi?ble underlying mechanisms. Methods A retrospective review was conducted on all clinical, laboratory, radiological and TCD monitoring records from patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, who admitted to the neurology department in our hospital. Results The data from twenty-two cases were finally included in this study. All patients presented with acute-onset localized neurological dysfunction, e.g. hemi?paresis, aphasia, hemiparesthesia, dysarthria, hemianopsia and cortical blindness. Their hypercoagulability related diseas?es included 10 cases of systemic malignancy, 5 moderate to severe hyperhomocystynemia (HCY>50μmol/L), 2 nephrot?ic syndrome, 2 antiphospholipid syndrome, 1 ulcerative colitis, 1 polycythemia vera,1 paroxysmal nocturnal hemoglobin?uria. In 18 cases, the hypercoagulability related diseases were diagnosed after their initial stroke onset. DWI showed mul?tiple disseminated acute cerebral infarcts in non-single arterial territories involving bilateral anterior or anterior plus pos?terior cerebral circulation simultaneously. Foci involved lobar cortex/subcortex of cerebral hemisphere in 22 cases, deep cerebral hemisphere in 12 cases, cerebellum foci in 10 cases,brainstem foci in 2 cases. TCD revealed microembolic sig? nals in ten of 22 patients monitored. Conclusions Patients with multiple acute cerebral infarcts involving non-single arte?rial territories, should be screened for hypercoagulability as in that hypercoagulability and microembolism might be in?volved in the etiology of cerebral infarction.

OBJECTIVETo establish a culture system of HBV positive serum infected Hep G2 cells in vitro.

METHODSHep G2 cells were seeded into six-well cluster dishes, at 1 x 10(-6) cells per well and incubated with 3 ml 10% fetal calf serum/ Dulbecco's modified Eagle's medium (10% FCS/DMEM) at 37 degrees in 5% CO2 air. At 24 h after plating, infection group Hep G2 cells were cultured with 0.5 ml HBV positive serum, in control group HBV negative serum was used, 24 h later the inoculums was removed. The cells were then extensively washed with 0.01 mol/L phosphate-buffered saline (PBS). After washing with PBS, 4 ml 2% FCS/DMEM were added to each well and the medium was collected every 12 h. ELISA method was used to detect HBsAg in culture medium. HBV DNA in cells and culture medium was detected by PCR.

RESULTSIn infection group, HBsAg could be detected from cell culture medium from 12 h (after PBS washed) to 84 h. HBV DNA could be detected by PCR in culture medium and cells.

CONCLUSIONInfection of Hep G2 cells by HBV positive serum is feasible.

Carcinoma, Hepatocellular ; pathology ; virology ; Cell Line, Tumor ; DNA, Viral ; genetics ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B ; blood ; virology ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B virus ; genetics ; growth & development ; immunology ; Humans ; Liver Neoplasms ; pathology ; virology ; Polymerase Chain Reaction ; Serum ; virology

OBJECTIVECase-control study was employed to explore the association of sexual behavior during pregnancy and hepatitis B virus (HBV) intrauterine infection.

METHODS212 HBsAg positive pregnant women were consecutively collected and investigated as objects. Those neonates detected for HBsAg with S/N value > or = 5 by Abbott reagents in periphery sera were selected as cases, others as controls. Information on sexual behavior during pregnancy, maternal HBeAg status and other factors was collected, and were analyzed with univariate analysis, multivariate logistic regression analysis, etc, to explore the association of factors with HBV intrauterine infection.

RESULTSTen of the 214 neonates were validated as occurrence of HBV intrauterine infection. Sexual behavior in the second trimester during pregnancy, with odd ratios 9.15 (95% CI: 1.10 - 76.28), as well as maternal positivity for HBeAg and HBV DNA, was significantly associated with HBV intrauterine infection, and sequently affirmed by multiple logistic regression analysis. The strength of association increased with frequency of sexual behavior. Interaction analysis suggested that there was synergistic interaction between maternal positivity of HBeAg and sexual behavior in the second trimester.

CONCLUSIONSexual behavior was a newly discovered risk factor for HBV intrauterine infection, which need to be estimated in future studies. Inhibition of virus replication and moderate control of sexual behavior would be helpful to prevent HBV intrauterine infection.

Case-Control Studies ; Female ; Hepatitis B ; transmission ; Humans ; Infectious Disease Transmission, Vertical ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Trimester, Second ; Retrospective Studies ; Risk Factors ; Sexual Behavior

Objective To explore the mechanical properties of erythrocytes in the patients with hypertension.Methods Venous blood of 32 patients with hypertension were collected and divided into three groups of H1,H2,and H3 (degree Ⅰ,Ⅱ,Ⅲ),with 8 cases of healthy adults into a control group.Erythrocytes were isolated,the diameter,height and elastic modulus were detected by the atomic force microscope (AFM).Statistical analysis was carried out.Results The RDW-CV of H2,H3 were much larger than the control group (P＜0.05,P＜0.01);The height of erythrocyte in H2,H3 groups were lower than that of the control group (P＜0.05).The elastic modulus of H 1,H2 groups were larger compared with normal erythrocytes (P＜0.05).Furthermore,erythrocytes elastic modulus correlated with RDW-CV (R2=0.629).Conclusion Hypertension could affect the elasticity modulus of erythrocytes.AFM could be an effective tool in measuring the mechanical characteristics of erythrocytes at single cell level.This study investigates the relationship between hypertension and the structure and function of erythrocytes from a biomechanical aspect.

Objective:To carry out opening experiments on occupational health and occupational medicine for students majoring in preventive medicine, reform the experimental teaching mode, and explore the teaching methods to improve students' professional quality and scientific research ability.Methods:Opening experiments were carried out in the experimental course of occupational health and occupational medicine for students of preventive medicine major. A total of 147 students majoring in preventive medicine of Batch 2016 were classified as the control group, and the routine confirmatory experiment was carried out in the group; 176 students majoring in preventive medicine of Batch 2017 were classified as the experimental group, and this group carried out opening experiment. The evaluation was made from three aspects: comprehensive evaluation results, teacher self-evaluation and student satisfaction survey. SPSS 22.0 software was used for analysis and comparison by independent-samples t-test and Chi-square test. Results:The theoretical scores of the experimental group and the control group students were (84.37±10.45) vs. (81.44±9.22) ( t=2.68, P=0.008), and the experimental skills scores were (93.66±3.89) vs. (88.41±5.67) ( t=9.51, P<0.001). Questionnaire investigation showed that the students in the opening experimental group were more satisfied with the courses arrangement ( χ2=8.31, P=0.004), group cooperation ( χ2=21.10, P<0.001), assessment form ( χ2 =7.92, P=0.005), improvement of the writing ability of scientific research papers ( χ2 =17.56, P<0.001), improvement of practical skills ( χ2=11.70, P=0.001), logical thinking, language organization and expression ability ( χ2=10.33, P=0.001). They considered the opening experiment was helpful to cultivate innovative thinking and ability, but it had limited effect on the cultivation of employment advantages. And the students considered the opening experiments of setting up professional courses was sufficient and necessary. Conclusion:Carrying out opening experiments for students majoring in preventive medicine is helpful to improve students' professional quality and cultivate their practical ability and scientific research ability.

Adult ; Female ; Humans ; Kidney Transplantation ; Laparoscopy ; methods ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods

OBJECTIVETo observe the changes of human trophoblast cells after infected with hepatitis B virus.

METHODSHBV positive serum was used to infect human trophoblast cells in vitro. HBsAg in cell culture medium were detected by ELISA method and HBV DNA in cell culture medium and cells were detected by PCR method. HBV fluorescence polymerase chain reaction diagnose kit were used to detect the HBV DNA concentration. Ultra structure of trophoblast cells were observed with transmission electron microscopy (TEM).

RESULTSHBsAg could be detected in infection group by ELISA. Infection group cell culture medium and infection group cells were HBV DNA positive. HBV DNA concentrations in HBV infection cell culture medium in 0, 12, 36, 60, 84 h after extensively PBS washed were < 10(3), 3 x 10(4), 6 x 10(5), 5 x 10(5), 3 x 10(5) copies/mL. HBV infected trophoblast cells were found many forms of endosomes, some of which contents virus like particle.

CONCLUSIONHBV might take advantage of clathrin-mediated endocytosis to enter trophoblast cell, which might lead to cell infection or across the cell bar by transcytosis.

Animals ; Culture Media, Conditioned ; metabolism ; DNA, Viral ; analysis ; Endosomes ; virology ; Enzyme-Linked Immunosorbent Assay ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B virus ; genetics ; isolation & purification ; physiology ; Humans ; Microscopy, Electron, Transmission ; Polymerase Chain Reaction ; Time Factors ; Trophoblasts ; ultrastructure ; virology