Objective To introduce the experience for managing the renal artery and vein during retroperitoneal laparoscopic nephrectomy. Methods A series of 52 consecutive patients underwent retroperitoneal laparoscopic nephrectomy. The operation was performed under a general anesthesia. Patients were maintained in the lateral decubitus position. Two 10 mm trocars and one 5 mm trocar were introduced into the lumbar part. A self-made water-filled balloon was used to dilate the retroperitoneal cavity. In the performance of dissection of the renal artery, the renal hilum should be kept away from as much as possible. When the artery had been separated for 1~2 cm in length, a linear cutter was utilized to sever it. The management of the renal vein was identical with that for the artery. During the management of the renal artery and vein, utmost care should be exercised to dissect the vessels longitudinally; else they were liable to be ruptured. Results All procedures were completed smoothly. A double artery supply was found in 6 patients and a triple artery supply in 1. Five patients had a double venous return-flow. A conversion to open surgery was required in 1 patient for spermatic vein injuries. No postoperative vascular complications were observed. Conclusions Use of a linear cutter to sever the renal artery and vein under retroperitoneal laparoscope is safe and reliable.

Objective To evaluate the expressions of estrogen receptor (ER) α and β in human prostate cancer and adjacent non-cancerous tissues,and to evaluate the correlation between the expression and the clinicopathological features and prognosis.Methods Immunohistochemical staining was used to detect ERα and ERβ in 85 prostate adenocarcinoma tissues,adjacent non-cancerous tissues,and 29 benign prostatic hyperplasia (BPH) tissues.The correlation between the expression and the clinicopathological features was analyzed by Spearman's coefficient.Cox's proportional hazards regression model was used to identify the risk factors for biological recurrence.Results There were significant differences between the expression of ERα in prostate cancer,adjacent non-cancerous tissues,and BPH [epithelial cell 0 (0/85),11.8％ (10/85) and 24.1％ (7/29),P=0.000; and in stromal cell 52.9％ (45/85),67.1％ (57/85),31.0％ (9/29),P =0.003].There were significant differences between the expression of ERβ in these groups [epithelial cell 36.5％ (31/85),61.2％ (52/85),100.0％ (29/29),P =0.000; and in stromal cell 49.4％ (42/85),72.9％ (62/85),79.3％ (23/29),P =0.001].The ERα expression in cancerous stromal cells was positively correlated with the PSA level (r =0.296,P =0.006) and Gleason score (r =0.404,P =0.000).The ERβ expression was negatively correlated with Gleason score in cancerous epithelial cells (r =-0.254,P =0.019) and stromal cells (r =-0.315,P =0.003).Multivariate analysis revealed that negative expression was an independent poor prognostic factor for the biological recurrence free survival after radical prostatectomy (HR =0.107,95.0％ CI 0.019-0.592,P =0.010).Conclusions There were significant differences between the expression of ERα and ERβ in prostate cancer,adjacent non-cancerous tissues,and BPH.ERα in cancerous stromal cells,ERβ in cancerous epithelial and stromal cells were related to the differentiation of prostate adenocarcinoma.ERβ in cancerous epithelial cells can be used as an independent prognostic factor for biological recurrence after radical surgery.

ObjectiveTo compare the clinical characteristic and postoperative histopathological parameters in different prostate size and to assess the effect of prostate volume on histopathological outcomes in patients after laparoscopic radical prostatectomy. MethodsTwo hundred and sixteen patients from 2006 to 2011 who were proved prostatic carcinoma by biopsy and performed laparoscopic radical prostatectomy wewe retrospectively evaluated.All patients were divided into the small group ( ＜ 30 ml,103 cases),intermediate group(30 -60 ml,71 cases) and large group ( ＞60 ml,42 cases) according to prostate volume.Clinical variables included age,body mass index (BMI),preoperative PSA level,prostate volume,percentage of positive needles,clinical stage,and biopsy Gleason score (GS).Histopathological parameters included pathological GS,upgrading or not compared to biopsy GS,pathological stage and surgical margins status.Preoperative clinical variables and postoperative histopatholgogical parameters were compared among the 3 prostate groups. ResultsPatients with smaller prostates had lower PSA levels than those with intermediate and larger prostates (P =0.000).They also had worse histopathological outcomes such as pathological GS ( P =0.034 ),upgrading of GS ( P =0.037 ),and pathological stage ( P =0.025 ).35.0％ of patients in smaller prostate group had a positive surgical margin compare to 33.8％ and 19.0％ in intermediate and larger prostate groups,but there was no significant difference (P =0.152).ConclusionMen with smaller prostate may have more high-grade cancer and more advanced disease after laparoscopic radical prostatectomy.

Animals ; Basic Helix-Loop-Helix Transcription Factors ; metabolism ; physiology ; Cadherins ; metabolism ; Cell Transformation, Neoplastic ; metabolism ; pathology ; Epithelial Cells ; pathology ; Homeodomain Proteins ; metabolism ; physiology ; Humans ; Mesenchymal Stromal Cells ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neoplasms ; metabolism ; pathology ; Snail Family Transcription Factors ; Transcription Factors ; metabolism ; physiology ; Zinc Finger E-box-Binding Homeobox 1

Objective To evaluate the effect of methylprednisolone on hepatic ischemia-reperfusion (I/R) injury in the patients undergoing hepatolobectomy.Methods Sixty ASA physical status Ⅱ or Ⅲ patients,aged 30-64 yr,weighing 45-75 kg,scheduled for elective hepatolobectomy,were randomized to control group or methylprednisolone group (n =30 each).After induction of anesthesia,methylprednisolone 500 mg (in 100 ml of normal saline) was infused intravenously at 5 ml/min before skin incision in group M.Anesthesia was induced with propofol,fentanyl and cisatracurium.The patients were endotracheally intubated and mechanically ventilated.PETCO2 was maintained at 35-45 mmHg.Anesthesia was maintained with 1％-3％ sevoflurane inhalation,remifentanil infusion,and intermittent iv boluses of fentanyl and cisatracurium.MAP was maintained at 70-100 mmHg and HR at 50-90 bpm.At 10 min before induction of anesthesia,and on postoperative day 1,3 and 5,venous blood samples were collected for determination of the plasma levels of alanine aminotransferase (ALT),aspartate amminotransferase (AST),total bilirubin (TBIL),tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6).Results Compared with group C,the plasma levels of ALT,AST and TBIL were significantly decreased on postoperative day l and 3,and the plasma concentrations of TNF-α and IL-6 were decreased on postoperative day 1,3 and 5 in group M.Conclusion Methylprednisolone can reduce hepatic I/R injury in the patients undergoing hepatolobectomy and inhibition of systemic inflammatory responses is involved in the mechanism.

Adult ; Chemical and Drug Induced Liver Injury ; etiology ; Dinitrobenzenes ; poisoning ; Humans ; Male ; Occupational Diseases ; chemically induced

Aim To observe the influences of ginsenoside Rg1 on the spontaneous contraction of small intestine smooth muscle of rabbits in vitro and explore the mechanism.Methods With the isothermal perfusion of small intestine in vitro,the influences of ginsenoside Rg1 on the spontaneous contraction of small intestine was observed and the mechanism of ginsenoside Rg1 was studied.Results Ginsenoside Rg1 reduced the amplitude of contraction of small intestine smooth muscle in rabbits in a dose-depended manner.Bay K8644 and nitro-L-arginine methylester(L-NAME)could completely block the inhibition of ginsenoside Rg1 on the contraction of small intestine smooth muscle.Ginsenoside Rg1 inhibited the intracellular calcium-depended contraction induced by rynodine in the Ca2+ free Tyrode's solution.Conclusions Ginsenoside Rg1 inhibits the contraction of small intestine smooth muscle of rabbits in vitro.The mechanism may be related to increase NO concentration in small intestine smooth muscle so that it inhibits extracellular Ca2+ inflowing via cell membrane and intracellular Ca2+ releasing via sarcoplasmic reticulum.

Aim To observe the cardioprotection of chronic intermittent hypobaric hypoxia (CIHH) against ischemia/reperfusion injury in adult and young rats.Methods Adult and postnatal male Sprague-Dawley rats were divided randomly into four groups:control 28-day group (CON28),control 42-day group (CON42), CIHH 28-day treatment group (CIHH28), and CIHH 42-day treatment group (CIHH42). CIHH animals with maternal rats were put into a hypobaric chamber 2 days before birth to get 28 days and 42 days CIHH mimicking 3000 m altitude (P_B=525 mmHg,P_(O_2)=108.8 mmHg), 5 h daily, respectively.The control animals were kept in the same environment as CIHH rats with free access to water and food except hypoxic exposure. The isolated hearts were perfused in the Langendorff apparatus, undergoing 30 min global ischemia and 60 min reperfusion.Cardiac function was recorded continuously during the whole experiment. Parameters of left ventricular function included left ventricular developing pressure (LVDP), left ventricular end-diastolic pressure (LVEDP), maximal positive (+LVdp/dt) and negative (-LVdp/dt) velocity of left ventricular pressure, coronary flow (CF) and heart rate(HR).Results ① For adult rats, there was no significant difference in the parameters of left ventricular function between CIHH28 and CON28 groups. However, the recovery of cardiac function in CIHH42 rats was much better than that in CON42, including LVDP, LVEDP, ±LVdp/dt and CF (P<0.05). ② For young rats, the basic coronary flow (CF) in CIHH rats was significant higher than that in CON rats, while other parameters of cardiac function didn't change. The recovery of cardiac function in CIHH rats was much better than that in CON rats, including LVDP, LVEDP,±LVdp/dt and CF (P<0.05).Conclusion CIHH confers cardioprotection against ischemia/reperfusion injury in rat cardiomyocytes, which is predominant in CIHH42 group and significantly affected by the age of animals. Cardioprotective effects produce more easily in young rats by CIHH.

The study is aimed to distinguish morphological characteristics of Dalbergiae Lignum collected from crude drug's markets and establish a identification methods and the quality standard for Dalbergiae Lignum. The macroscopic and microscopic features of Dalbergiae Lignum from crude drug's market were observed, analyzed and compared according to Hongmu specification issued by the People's Republic of China in 2000, and by the characteristics recorded in domestic monograph of Mucai Shibie (wood identification). The redwood of Dalbergiae Lignum cut into small pieces as medicinal material are dry heart wood of mahogany (trees from Dalbergia sp.), which characteristics of the small pieces as crude drug are different. There are differences in macroscopic and microscopic features about texture of wood and color, odor, taste, transverse section, radial section, tangential section. The results can provide basis for identification, application and improment of the quality standard of Dalbergiae Lignum as medicinal material.
China ; Dalbergia ; anatomy & histology ; chemistry ; classification ; Herbal Medicine ; economics ; Plants, Medicinal ; chemistry ; classification ; Quality Control ; Xylem ; anatomy & histology ; chemistry

Objective:To explore and analyze the points-selection rules in acupuncture treatment of mammary gland hyperplasia (MGH) by data mining and statistical method. Methods:Clinical literatures about the treatment of MGH with acupuncture published in the recent 16 years were retrieved from Chinese Journal Full-text Database (CJFD) and established into a database by Excel. The SPSS 20 version software and Clementine 12.0 version software were adopted to analyze the frequency and association rules of points-selection in the treatment of MGH with acupuncture. Results:The top 3 points used most frequently in acupuncture treatment of MGH were Danzhong (CV 17), Taichong (LR 3) and Zusanli (ST 36); points from the Stomach Meridian of Foot Yangming and Liver Meridian of Foot Jueyin were most commonly used; the commonly selected points were predominantly distributed in thoracic and abdominal regions and lower limbs; emphasis on the combination use of local and distal points; of the specific points, the five Shu-Transmitting points were mostly used; association analysis showed that the associations among Taichong (LR 3), Danzhong (CV 17) and Zusanli (ST 36) were the most significant. Conclusion: The data mining results substantially accord with the general rules of acupuncture-moxibustion theories in traditional Chinese medicine, able to reflect the points-selection principles and features in acupuncture treatment of MGH and provide evidence for the points selection in the treatment of MGH in acupuncture clinic.