ObjectiveTo determined the outcome of modified trabeculecotomy (with paracentesis,mitomycin C,scleral flap adjustable suture and formation of anterior chamber at the end of the surgery)in the management of primary acute angle-closure (PAAC) with high intraocular pressure (IOP) and extremely dilated pupil. MethodsTwenty-one eyes of 21 successive cases with PAAC with high lOP(IOP ＞ 30mmHg) and large pupil (maximum vertical diameter ＞ 5 mm) were evaluated prospectively. They underwent modified trabeculecotomy between January 2005 and March 2009.The operative success was defined as IOP ≤ 20 mmHg (± medical therapy) without the necessity of further surgery for glaucoma. ResultsSuccess was achieved in all of the eyes(100％)at the postoperative first week.The mean preoperative IOP was (48.25 ± 3.14) mmHg under a mean number of 3.35 antiglaucomotous medications, but it reduced to (10.47 ± 1.15,P ＜ 0.01) mmHg without medication at the first week, (13.86 ± 0.93,P ＜ 0.01) mmHg at postoperative 3rd month respectively.Only 1 eye needed 1 kind of antiglaucomotous eye drop from the 2nd month postoperatively. The mean vertical diameter of pupils was (5.81±0.23) mm preoperatively, (5.92 ±0.21 ) mm at the first week(P ＞ 0.05). No case received section iridectomy. No serious complication was observed.ConclusionsModified trabeculectomy provides reduction of IOP and protection of pupil in cases with PAAC with high IOP and large pupil,and the procedures such as releasing aqueous humor gradually,appliance of scleral flap adjustable sutures and formation of anterior chamber at the end of the surgery can effectively reduce the risk of serious complications.

Objective To determine the medium-long term functional outcome of arthroscopic repair of type II SLAP lesions with two loops.Methods According to retrospective study,29 cases patients with arthroscopic repairs of isolated type II SLAP lesions were collected from March 2011 to June 2013,the mean patient age at the time of surgery was 31.8 years(range17 to 47 years).All patients with ground anchor suture,and through double loop knot technology to fix SLAP injury.Visual analogue scale(VAS),Kerlan-Jobe Orthopaedic Clinic(KJOC),Roche Shouder function Score(ROWE) were used to determine the function of shoulder joint.The shoulderjoint range of motion before treatment and post treatment were recorded,shoulder joint mobility was recorded,satisfaction survey was done,compared the preoperative and postoperative data to evaluate its clinical effect.Results All patients were available for follow-up of 2.7-5.2 years.Overall,functional outcome was improved from baseline compared with final follow-up for VAS scores((4.3±1.2) points vs.(1.5±0.8) points,t=5.435,P<0.05),KJOC scores((72.1±4.9) points vs.(92.8±5.4) points,t=5.921,P<0.01),and ROWE scores((54.1±12.4) points vs.(84.3±10.2) points,t=7.326,P<0.01).Only a minority of patients feel pain when they did srenuous exercise.According to satisfaction investigation of patients,patient satisfaction was reported in 89.7%,3 cases had not good results,they could not return to previous level of play,including 2 cases were athletes,1 case was not athlete.Conclusion There is no more persistent pain and dysfunction after surgery,a good or excellent medium-long term functional outcome can be anticipated after arthroscopic repair of type II SLAP lesions with two loops.

OBJECTIVETo investigate the changes of NF-kappa B binding activity, the expression of PPARr and their correlation in the liver of rats with fatty liver disease (FLD) induced by different pathogenic factors and to investigate the molecular mechanism of the inflammation in FLD.

METHODS40 Wistar rats were randomly divided into 4 groups of ten each: normal group, alcohol group, fat-rich diet group, alcohol adding fat-rich diet group. The rats were sacrificed at the end of the 16th week from the starting day of the experiment. Serum and liver specimens were collected. Histological specimens were stained with HE, SudanIV, and Masson and then studied microscopically. The ultrastructural changes were also checked under an electron microscope. NF-kappa B binding activity and the expression of PPARr mRNA were determined by electrophoretic mobility shift assay (EMSA) and RT-PCR respectively. The correlations between NF-kappa B binding activity and the expression of PPARr and the biochemical indexes were analyzed.

RESULTSSteatosis, inflammation, necrosis and fibrosis were present in livers of the rats of all the experimental groups, and were most severe in the alcohol adding fat-rich diet group. NF-kappa B binding activity was markedly increased in the livers of the alcohol group (142+/-16.32) and of the alcohol adding fat-rich diet group (238+/-19.14) in comparison to the livers of the normal (73+/-9.24, F = 6.36, 17.93) and those of the fat-rich diet group (84+/-10.38, F = 5.96, 16.20). Binding activity was higher in the alcohol adding fat-rich diet group than that in the simple alcohol group, but there was no difference between those of the fat-rich diet and normal groups. The level of PPARr mRNA was lower in the livers of the alcohol, fat-rich diet, alcohol adding fat-rich diet groups (0.2530+/-0.069, 0.3647+/-0.082, 0.1226+/-0.054) than that of the controls (0.8097+/-0.094) (F = 15.43, 7.24, 21.45). NF-kappa B binding activity was correlated positively with the level of serum TNF alpha (r = 0.527, 0.639) and the content of MDA in the liver homogenates (r = 0.723, 0.537), but negatively with the expression of PPARr in the livers of the alcohol and the alcohol adding fat-rich diet groups (r = -0.568, -0.891).

CONCLUSIONThe enhanced nuclear factors NF-kappa B binding activity and decreased expression of PPARr play a pivotal role in the inflammatory response of FLD induced by alcohol and fat-rich diet. It may provide a new idea for treating FLD effectively.

Animals ; Fatty Liver ; metabolism ; Liver ; metabolism ; Male ; NF-kappa B ; metabolism ; PPAR gamma ; biosynthesis ; genetics ; RNA, Messenger ; biosynthesis ; genetics ; Random Allocation ; Rats ; Rats, Wistar

Objective:To compare the outcomes of arthroscopic all-inside repair using puncture needle combined with suture hook versus meniscus repair device Fast-Fix for the treatment of meniscal tear in popliteal hiatus region.Methods:A retrospective cohort study was performed on the clinical data of 48 patients with meniscal tear in popliteal hiatus region admitted to Second People′s Hospital of Fujian Province from January 2014 to December 2017. There were 32 males and 16 females, aged 16-44 years [(28.0±7.8)years]. A total of 25 patients were treated with arthroscopic all-inside repair using puncture needle combined with suture hook (needle-hook group) and 23 patients were treated with meniscus repair device Fast-Fix (Fast-Fix group). The operation time and intraoperative blood loss were compared between the two groups. The function of knee joint was evaluated by Lysholm score, Tegner score and International Knee Documentation Committee (IKDC) score before operation, at 6 months after operation and at the last follow-up. The meniscal healing rate was evaluated by MRI scan at the last follow-up. During the period of follow-up, the incidence of complications (infection, popliteal tendon injury, foreign body irritation, etc.) was compared between the two groups.Results:All patients were followed up for 24-36 months [(25.8±2.5)months]. No significant differences were observed in operation time and intraoperative blood loss between the two groups (all P>0.05). The preoperative Lysholm score, Tegner score and IKDC score were not significantly different between the two groups (all P>0.05). The Lysholm score, Tegner score and IKDC score in needle-hook group were (96.7±3.8)points, (4.3±1.6)points and (95.5±5.4)points at 6 months after operation, significantly higher than those in Fast-Fix group [(93.3±1.6)points, (3.6±0.8)points, (91.9±0.8)points] (all P<0.05). The Lysholm score, Tegner score and IKDC score in needle-hook group were (99.6±1.3)points, (6.1±0.8)points and (99.4±0.2)points at the last follow-up, significantly higher than those in Fast-Fix group [(94.5±1.6)points, (4.8±0.2)points and (97.4±0.5)points] (all P<0.01). The above three scoring systems scored significantly higher in the two groups at 6 months after operation and at the last follow-up than those before operation (all P<0.01). MRI scan showed that the meniscus healing rate in needle-hook group was 92% (23/25) at the last follow-up, higher than 70% (16/23) in Fast-Fix group ( P<0.05). During the period of follow-up, no complication was observed in needle-hook group, but 6 patients [26% (6/23)] in Fast-Fix group had discomfort in the posterolateral muscle of the knee, which was related to popliteal tendon injury or foreign body irritation ( P<0.01). Conclusion:For meniscal tear in popliteal hiatus region, arthroscopic all-inside repair using puncture needle combined with suture hook is superior to meniscus repair device Fast-Fix in aspects of better knee function, higher meniscus healing rate and lower complication rate.

OBJECTIVETo investigate the effects of neuropeptide Y (NPY) Y1 receptor antagonist PD160170 in promoting osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and accelerating healing of femoral defect in rats.

METHODSThe third generation of rat BMSCs were treated with PBS (control) or 10, 10, or 10 mol/L NPY Y1 receptor antagonist PD160170. After 7 and 14 days of treatment, the cells were examined for osteogenic differentiation with alkaline phosphatase (ALP) and alizarin red staining. At 7 and 21 days of treatment, the mRNA and protein expressions of collagen type I (COLI), osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) in the cells were detected using q-PCR and Westem Blotting. In a male SD rat model (body weight 300∓20 g) of bilateral femoral condyle defects (2.5 mm in diameter), the effect of daily local injection of 0.2 mL PD160170 (10 and 10 mol/L, for 28 consecutive days) in promoting bone defect repair was evaluated with micro-CT scans.

RESULTSALP and alizarin red staining showed that the BMSCs treated with PD160170, at the optimal concentration of 10 mol/L, contained more intracellular cytoplasmic brown particles and mineralized nodules in extracellular matrix than PBS-treated cells. PD160170 (10 mol/L) significantly up-regulated the mRNA and protein expressions of COLI at day 7 and those of OCN and Runx2 at day 21 (P<0.05). In the rat models of femoral bone defect, the volume/tissue volume ratio, bone mineral density and the number of bone trabeculae were significantly greater in 10 mol/L PD160170 group than in the control group (P<0.05), but the bone trabecular thickness (P=0.07) and bone volume (P=0.35) were similar between the two groups.

CONCLUSIONNPY Y1 receptor antagonist PD160170 can promote osteogenic differentiation of BMSCs and healing of femoral defects in rats, suggesting the potential of therapeutic strategies targeting NPY Y1 receptor signaling in the prevention and treatment of bone fracture and osteoporosis.

OBJECTIVEDoubly labeled water (DLW) method is the gold standard for measuring total energy expenditure (TEE). We used this method to measure TEE in Chinese young men.

METHODSSixteen healthy young men age 23±1 years with body mass index 22.0±1.4 kg/m2 were recruited. TEE was measured by the DLW method, and basal energy expenditure (BEE) was determined by indirect calorimetry. We also conducted 24-h activity, energy balance and factorial approach to estimate energy requirements of the subjects.

RESULTSTEE of subjects by DLW method was 9.45±0.57 MJ/day (2258±180 kcal/day). The 24-h activity was 10.80±0.33 MJ/day (2582±136 kcal/day). The energy requirement, derived from energy balance observations, was 9.93±1.32 MJ/day (2373±315 kcal/day). The BEE of 6.65±0.28 MJ/day (1589±67 kcal/day), calculated by the adjusted Schofield equation, was significantly higher (P<0.001) than that measured by indirect calorimetry, 5.99±0.66 MJ/day (1433±158 kcal/day). The TEE derived from the factorial approach was 10.31±0.43 MJ/day (2463±104 kcal/day).

CONCLUSIONThe TEE of Chinese young men measured by the DLW method was about 10% lower than the current recommended nutrient intake (RNI), suggesting that the RNI for Chinese men maybe overestimated. Further studies are warranted to determine the value of the estimated energy requirement.

Asian Continental Ancestry Group ; Energy Metabolism ; physiology ; Humans ; Isotope Labeling ; Male ; Motor Activity ; physiology ; Water ; Young Adult

BACKGROUND AND OBJECTIVEPatients with clinical stage I seminoma accounts for 70%-80% of patients with this disease. This study was to analyze the relationship between different therapeutic methods and the prognosis of this disease.

METHODSThe data of all patients with clinical Stage I seminoma treated by multi-disciplinary approach from 1999 to 2008 in Sun Yat-sen University Cancer Center were analyzed. The patients were divided into 3 groups based on the treatment they received after orchiectomy: 30 patients treated with chemotherapy, 8 with radiotherapy, and 20 under surveillance. The prognosis of different treatment groups was evaluated.

RESULTSAmong the 58 patients with stage I seminoma, 57 were followed up successfully. The median follow-up time was 50 months (range, 8-115 months). No relapse or metastasis was seen in the chemotherapy group. One patient relapsed in the radiotherapy group. Four patients had metastasis of retroperitoneal lymph node in the surveillance group. The disease-free survival was higher in the chemotherapy group than that in the surveillance group (P=0.005). There was no significant difference in the relapse-free survival between the surveillance group and the radiotherapy group (P=0.364).

CONCLUSIONSChemotherapy is a safe and effective treatment for patients with Stage-1 seminoma after radical orchidectomy.

Adolescent ; Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; therapeutic use ; Cisplatin ; therapeutic use ; Combined Modality Therapy ; Disease-Free Survival ; Etoposide ; therapeutic use ; Follow-Up Studies ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Orchiectomy ; methods ; Retrospective Studies ; Seminoma ; drug therapy ; pathology ; radiotherapy ; surgery ; Testicular Neoplasms ; drug therapy ; pathology ; radiotherapy ; surgery ; Treatment Outcome ; Young Adult

BACKGROUNDThe incidence of prostate carcinoma (Pca) has been increasing in China. We detected Pca in elderly men in Changchun, north China and the significance of prostate specific antigen (PSA) in mass screening and clinical staging of Pca.

METHODSSerum PSA from 12,027 men over 50 years old from Changchun was analyzed. In case of serum PSA greater than 4.0 ng/ml, the patient was suspected of potentially suffering from Pca, and transrectal six-point puncture prostate biopsies were performed under ultrasound guidance. Pathological examinations were performed on the biopsy tissue, and ABCD and TNM clinical stagings were used in accordance with international standards. Correlations between serum PSA level and clinical stage were analyzed.

RESULTSPSA was greater than 4.0 ng/ml in 813 patients (6.8% of the 12,027 men). Transrectal six-point prostate puncture biopsies guided by ultrasound were performed in 273 patients (33.6% of the 813 patients who were tested positive in the initial mass screening). Of these 273 patients, 69 cases of Pca (25.3% of 273) were confirmed by biopsy in the second screening, with an overall detection rate for Pca of 0.57% (69/12,027). The total number of patients in stages A, B, T1, or T2 was 57.9%, and over 20% of them suffered from late stage Pca with lymph node and bone metastasis. An obvious positive correlation was observed between ABCD staging, TNM staging, and serum PSA level.

CONCLUSIONSSerum PSA level is not only the golden standard for mass screening of Pca, but also the predictor for clinical stage of Pca. PSA testing revealed asymptomatic Pca cases in early, middle, and later stages in the elderly, suggesting that mass screening is of paramount importance.

Aged ; Aged, 80 and over ; Biopsy, Needle ; Humans ; Male ; Mass Screening ; methods ; Middle Aged ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis

Adolescent ; Adult ; Aged ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged

BACKGROUND AND OBJECTIVEThe most effective therapy against renal cell carcinoma (RCC) is surgical treatment; however, there have been few large-scale studies that focused on the oncological outcome of this disease in China. The aim of the current study was to report the clinicopathological results and cancer-specific survival (CSS) rate in RCC patients after surgical treatment in our center.

METHODSWe retrospectively analyzed the clinicopathological data of 336 RCC patients who underwent radical or partial nephrectomy between 1999 and 2006. Of the 336 patients, 226 were male and 110 were female; the median age was 51 years. Univariate and multivariate analyses were conducted to identify the independent prognostic predictors for this cohort of RCC patients.

RESULTSDuring follow-up, the overall 5-year CSS rate was 81.4%. The 5-year CSS rates for patients with stage-I, -II, -III, and -IV RCC were 94.7%, 88.9%, 68.8%, and 19.3%, respectively. The patients with T1N0M0 (T1) and T2N0M0 (T2) tumors had similar survival curves. For patients with T1 category tumor, the survival rate did not differ significantly between the radical nephrectomy and nephron-sparing surgery groups. For the 21 patients with metastasis confined to the local lymph nodes, the 5-year survival rate was 31.6% after radical nephrectomy and lymph node dissection. For the 15 patients with vena caval tumor thrombus, the 5-year survival rate was 52.5% after radical nephrectomy and tumor thrombus extirpation. Multivariate Cox regression showed that stage was an independent predictor for CSS (hazard ratio, 3.359; P < 0.001).

CONCLUSIONSFor localized RCC, the oncological outcome of this cohort is comparable to that reported in the Western literature. For some patients with locally advanced RCC, aggressive surgical treatment can lead to better long-term survival. However, the prognosis of the patients with metastasis still needs to be improved.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell ; pathology ; surgery ; Child ; Child, Preschool ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Neoplastic Cells, Circulating ; Nephrectomy ; methods ; Retrospective Studies ; Survival Rate ; Treatment Outcome ; Young Adult