Objective To explore the influence of no drainage on pelvic lymphocyst following laparoscopic radical hysterectomy and pelvic lymphadenectomy . Methods A total of 105 patients with cervical cancer undergoing laparoscopic radical hysterectomy and pelvic lymphadenectomy in this hospital from January 2012 to February 2016 were divided into either non-drainage group (50 cases) or drainage group (55 cases) according to whether the pelvic drainage tube was placed after surgery .Comparative analyses on the incidence of postoperative complications such as pelvic lymphocyst were made between the two groups . Results No significant difference in lymphocyst rate was found between the two groups [27.3%(15/55) vs.24.0%(12/50), χ2 =0.147, P=0.702].The incidence of pelvic infection was lower in the non-drainage group (2.0%, 1/50) than that in the drainage group (14.5%, 8/55), but the difference was not statistically significant (χ2 =3.781, P=0.052).Other postoperative complications including urinary retention , urinary fistula, and deep venous thrombosis of lower limb had no statistical differences between the two groups (P>0.05). Conclusions Drainage after radical hysterectomy and pelvic lymphadenectomy for cervical cancer does not make a difference to the incidence of lymphocyst .Non-drainaging doesn ’ t increase the risk of infection .

Background Epipolis laser in situ keratomihusis(Epi-LASIK) is an potential surgery for myopia because it synthesize advantages of LASEK and LASIK. But its clinical effectiveness and safeness is remarkable.Objective This study was to evaluate the clinical curative effects and safeness of Epi-LASIK for myopia in different diopter of population. Methods Retrospective study was designed for 208 eyes of 104 patients who underwent EpiLASIK for the correction of myopia. The patients were divided into two groups according to preoperative diopter:lower myopia group( ≤ -6.00 D, 111 eyes) and high myopia group ( ＞-6.00 D,97 eyes). The time of epithelial healing, postoperative syndrome, postoperative visual acuity, refraction, intraocular pressure (IOP) , the safe index, the efficacy index and haze were evaluated at 1,3,6,12 months postoperatively. The written informed consent was obtained from each individual before surgery. Results After operation, 20 eyes ( 18.02% ) of lower myopia group and 29 eyes (29.90%) of high myopia group had obvious pain, presenting statistically significant difference between two groups (X2 = 4. 060, P＜0.05 ). The mean time of epithelial healing was (5.49±0. 83 )days in lower myopia group and (5.85± 0.68 )days in high myopia group with a delayed epithelial healing time in high myopia group( u= 3. 377 ,P＜0.05 ).One year after the treatment,the uncorrected visual acuity( UCVA ) ≥ 1. 0 was 90. 99% ( 101 eyes) in lower myopia group and 75.26% ( 73 eyes) in high myopia group, and 9.91% ( 11 eyes) and 15.46% ( 16 eyes) of the eyes improved byl line or more in best spectacle corrected visual acuity(BCVA) ;whereas 3.60% (4 eyes)and 6. 18% (6 eyes)lost a line or more. 91.89% ( 102 eyes) and 85.57% (83 eyes) in both groups gained within 1.00 D of the attempted correction. The safety index and efficacy index were 1.04 and 0. 98 in lower myopia group,and 1. 01 and 0. 96 in high myopia group without statistically significant difference( P＞0. 05 ). haze occurred in 6 eyes in lower myopia group and 9 eyes in high myopia group and the difference in haze grading was not statistically significant between two groups ( P＞0. 05 ). The high intraocular pressure appeared in 10 eyes and 9 eyes in low myopia group and high myopia group respectively during the fellow up duration and back to normal after topical use of timolol. Conclusion Epi-LASIK is an effective and safe method for correction of different diopters of myopia because of its mild symptom and lower incidence of haze.

[Summary] The mechanisms of gastroesophageal reflux disease ( GERD) include abnormal antireflux function and esophageal mucosa attacked by regurgitation .Gastroesophageal flap valve ( GEFV) located in the gastroesophageal junction is one mechanism of the antireflux barrier .An increased GEFV grade is associated with an increased incidence of erosive esophagitis and Barrett ’ s epithelium.With abnormal esophageal acid exposure and prevalence of a mechanically defective sphincter , patients usually have severe symptoms and lower efficiency of medication .Therefore , GEFV is valued in the diagnosis and treatment of GERD .This review summarized the relationship between GEFV and GERD .

Triple-negative breast cancer (TNBC) is a subtype of breast cancer known for the poor prognosis due to its strong invasiveness, high recurrence rate, and lack of effective treatment. Therefore, there is an urgent need to find targeted therapy for TNBC. Cathepsin A (CTSA) is an acidic serine carboxypeptidase that is highly expressed in various tumor tissues. However, the role and molecular mechanism of CTSA in TNBC are still unclear. This study found that the expression of CTSA was upregulated, and the high expression of CTSA was positively correlated with the poor prognosis of TNBC. The results further showed that knocking down CTSA inhibited the proliferation, invasion, and colony formation of TNBC cells, improved drug sensitivity of cells, and inhibited the progression of TNBC. Mechanistically, CTSA inhibited the ubiquitination and degradation of the promyelocytic leukemia protein (PML) protein by blocking the interaction between PML and its E3 ubiquitin ligase RNF4, thus maintaining the stability of PML nuclear bodies (PML-NBs). The inhibitor of CTSA had a positive therapeutic effect on inhibiting the characteristics of TNBC stem cells. In conclusion, this study demonstrates that inhibiting CTSA to decrease the stability of PML protein may be a promising therapeutic strategy for TNBC. All animal experiments in this experiment were approved by the Ethics Committee of Institute of Medicinal Biotechnology, Chinese Academy of Medical Sciences and Peking Union Medical College (approval number: IMB-20240326D502).

AIM: To observe the effect of angiotensinⅡ subtype 2 receptor (AT_2 receptor) on the cultured rat aortic vascular smooth muscle cells. METHODS: The plasmid contained the cDNA of AT_2 receptor was transfected into cultured rat vascular smooth muscle cells. The effects of AngⅡ, Ang Ⅱ+losartan, Ang Ⅱ+PD123319 on the expression of PCNA, the NOS activity and the cell number were observed. RESULTS: The cell number and the expression of PCNA decreased after the cells were treated with losartan. When treated with PD123319, the cell number and the expression of PCNA increased, but the expression of NOS decreased. CONCLUSIONS: These data suggest that when being activated, AT_2 receptor inhibits the proliferation of vascular smooth muscle cells and antagonizes the effect of AT_1 receptor, such an effect may be related to the activation of NOS. [

OBJECTIVETo evaluate clinical outcomes of anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) reconstruction under arthroscopy and repair of the injured posteromedial complex structure of the knee joint in the treatment of posterolateral knee dislocation with multiple ligament injuries.

METHODSFrom March 2008 to August 2012,22 patients (16 males and 6 females, ranging in age from 20 to 53 years old, with an average of 30.5 years old) with posterolateral dislocation of the knee were treated with primary reconstruction of ACL and PCL, combined with the repair of injuries in the posteromedial complex and soft-tissue. Eight patients had injuries caused by sports,5 patients road accidents and 9 patients falling down. The ACL was reconstructed using the gracilis and semitendinosus tendons. The PCL was reconstructed using LARS artificial ligaments (14 cases), or gracilis and semitendinosus tendons (8 cases). Suture repair was performed in 17 patients with posteromedial ligament injuries,and self-semitendinosus strengthening operations were performed in 5 patients. Continuouspassive montion (CPM) and active exercises were executed after operation at early stage. The IKDC and Lysholm system were used to evaluate therapeutic effects.

RESULTSAll the patients were regularly followed up, and the duration ranged from 11 to 56 months (averaged, 39 months). According to the IKDC scale,9 patients got a grade A result, 10 got a grade B result, and 3 got a grade C result. The IKDC subject score was 89.6±3.1 and the Lysholm scores was 90.7±1.8 at the latest follow-up, which were both better than those before operation.

CONCLUSIONReconstructing the ACL and PCL and repairing injured posteromedial complex of the knee followed by an active rehabilitation is an effective method to treat posterolateral knee dislocation.

Adult ; Anterior Cruciate Ligament ; surgery ; Anterior Cruciate Ligament Injuries ; Arthroscopy ; methods ; Female ; Humans ; Knee Dislocation ; surgery ; Male ; Middle Aged ; Posterior Cruciate Ligament ; injuries ; surgery ; Reconstructive Surgical Procedures ; methods

Objective To investigate the effects of adenosine postconditioning (AP) on serum IL-10 and TNF-α concentrations following myocardial ischemia-reperfusion(VR)in rats.Methods Twenty-four SD ratsweighing 180-250 g were randomly divided into 4 groups(n=6 each):group I sham operation (group S);group Ⅱ myocardial I/R;group Ⅲ ischemic postconditioning(group IP)and group Ⅳ AP.Myocardial I/R was induced by 30 rain occlusion of anterior descending branch of left coronary artery followed by 120 min reperfnsion.IP was induced by 3 cycles of 30 s myocardial ischemia followed by 30 s reperfusion at the end of ischemia.In AP group adenosine 1.5 mg/kg was infused at 40μg·kg-1·min-1 before the onset of reperfusion.SP,DP and HR were recorded before ischemia (baseline) at 30 min of ischemia and 30 and 120 min of reperfusion.Arterial bloodsarnples were collected at 120 min of repednsion for determination of serum TNF-α and IL-10 concentrations.Theanimals were then killed.Their hearts were removed for microscopic examination.Myocardial infarct size wasmeasured and myocardial MDA content was determined.Results BP and HR were signilicandy decreased duringreperfusion while myocardial infarct size.MDA content and serum concentrations of IL-10 and TNF-α weresignificantly increased in I/R group compared with group S.Ischemic and adenosine postconditioning significantlyattenuated hypotension,reduced infarct size,myocardial MDA content and serum TNF-α concentration and increased serum IL-10 concentration in group AP and IP as compared with I/R group.There was no significant difference in the above changes between group AP and IP. Myocardial injury was ameliorated in group AP and IP as compared with I/R group. Conclusion Adenosine postconditioning can protect myocardium from I/R injury by increasing IL-10 production and inhibiting TNF-a release.

Objective To evaluate the effects of pretreatment with different doses of phosphocreatine on hepatic ischemia-repeffusion (I/R) injury in rats.Methods.Thirty male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 5 groups (n =6 each):sham operation group (group S),hepatic I/R group (group I/R),and pretreatment with different doses of phosphocreatine groups (groups P1-3).Hepatic I/R was induced by 90 min occlusion of the hepatic artery and portal vein entering the middle and left lobes of the liver followed by 4 h reperfusion in anesthetized rats.Phosphocreatine 50,150 and 450 mg/kg were injected via the tail vein at 60 min before ischemia in groups P1-3,respectively.In groups S and I/R,the equal volume of normal saline was given instead.Blood samples were taken from the abdominal aorta at 4 h of reperfusion for determination of plasma alanine aminotransferase (ALT),aspartate aminotransferase (AST),TNF-α and IL-1β concentrations.The rats were then sacrificed and the livers were removed for determination of myeloperoxidase (MPO) activity (by ELISA),intercellular adhesion molecule-1 (ICAM-1) expression (by immunohistochemistry),and cell apoptosis (by TUNEL) and for microscopic examination (by electron microscopy).Results The MPO activity in liver tissues,plasma ALT and AST activities,TNF-α and IL-1β concentrations and the number of apoptotic cells were significantly higher in groups I/R and P1-3 than in group S,while lower in groups P1-3 than in group I/R (P ＜ 0.05).The parameters mentioned above were decreasedin turn in groups P1-3 (P ＜ 0.05).Conclusion Phosphocreatine pretreatment can attenuate the hepatic I/R injury in rats in a dose-dependent manner and inhibition of the inflammatory responses is involved in the mechanism.

Objective To analyse risk factors for bile leakage after liver resection.Methods Between January 2011 and December 2012,469 patients underwent elective hepatectomy.We prospectively collected and retrospectively analyzed demographic data,pathological variables,and perioperative variables.Univariate analysis screened the related factors of bile leakage after liver resection.Multivariate analysis identified the independent risk factors of postoperative bile leakage.Results 469 patients were included in the analysis.The prevalence of bile leakage was 22.6％ (n =106).Univariate analysis identified the following risk factors as male gender,portal hypertension,steatosis,cirrhosis,ChildPugh grade,ascites,operative time,intraoperative transfusion,intraoperative blood loss,portal triad clamping,microwave solidification,lymphadenectomy,number of tumor,tumor margin,tumor capsular,diameter of tumor,portal vein invasion or portal branch thrombosis,number of abdominal drains.Multivariate analysis identified 4 independent risk factors for postoperative bile leakage:Cirrhosis [OR =13.2 (2.3,76.9),P =0.004],steatosis [OR =73.1 (17.7,301.5),P ＜ 0.001],infusion volume of the surgery day [OR=1.0 (1.0,1.0),P=0.019] and diameter of tumor [OR=1.2 (1.1,1.3),P=0.003].Conclusions Cirrhosis,steatosis,transfusion volume of the surgery day,and tumor size were risk factors for bile leakage after major liver resection.

Scientific research output of clinical trials in Chinese medicine (CM) is insufficient, but international papers hold an important scientific position in China. Based on the current situation, we analyzed the present publication situation of international medical papers in our country, and the feasibility and urgency of publishing international papers on clinical trials of CM. Finally, we proposed to use the PDCA (plan-do-check-action) cycle method to improve the quality control and management of CM clinical trials. Moreover, by combining our experience in relevant scientific research launched at our department, we expounded strategies for improving the quantity and quality of international papers in CM.
Bibliometrics ; Clinical Trials as Topic ; Medicine, Chinese Traditional