Objective To investigate the clinicopathologic features,the complications of splenectomy and the survival of epithelial ovarian cancer patients with splenic metastasis.Methods A retrospective study was performed of 32 pailents with epithelial ovarian cancer who underwent splenectomy for tumor cytoreduction at Zhejiang Cancer Hospital between Jan 1998 and Jun 2006.Results Of 32 patients,23 patients(72%)were serous adenocarcinoma and 9 were non-serous adenocarcinoma.According to pathological grade,none was of G1,11 were of G2,21 were of G3.Postoperatively,20 patients were left with no residual tumor.7 were with≤2 cm and 5 were with＞2 cm residual tumor.Postoperative complications developed in 8 patients(25%),including subphrenic abscess,wound infection,gastric perforation,gastrorrhagia,phlebothrombosis,and bowel obstruction.The median follow up was 38 months,estimated 2-year and 5-year overall survival were 70%and 36%.Univariate analysis revealed that histological grade,residual tumor and courses of chemotherapy were influencing factors of the survival(P＜0.05),but multivariate analysis indicated that only residual tumor and courses of chemotherapy independently influenced survival(P＜0.05).Conclusions In epithelial ovarian cancer patients with splenic metastasis,low grade serous adenocarcinoma is most common.Splenectomy as part of cytoreductive surgery is associated with modest morbidity and mortality.Residual tumor and courses of chemotherapy are independent factors associated with the prognosis of the patients.

ObjectiveTo summarize the clinical features of ulcerative eolitis (UC) complicated by toxic megacolon for early diagnosis and proper treatment. MethodsSix cases of toxic megacolon in the patients suffered from UC in Peking Union Medical College Hospital from 1983 to 2010 were analyzed,and related literature was searched and reviewed.ResultsThe incidence of the toxic megacolon in the patients with UC in our center was 0.7％ (6/824),which was lower than those reported in the literature.There were always risk factors triggering the disease.The prognosis of the patients was poor,even after medical care and surgery intervention.Evaluation of the patients and making right timing to perform the surgery would improve the prognosis of the patients in foreign literature. ConclusionIt's crucial to make early diagnosis of the toxic megacolon in the patients suffered from UC. The right choice and timing to perform urgent surgery or selective surgery may improve their prognosis.

Objective:To study the effects of group counseling which based on interpersonal activities and aimed at the college students with computer gaming addiction in China.Methods:Seventeen college students with computer game addiction were chosen as the experimental group,and 10 college students from another college were chosen as the control group.The two groups had no difference in the scores of Computer Gaming Addiction Invention(CGAI)and several other scales before group counseling.There were a pre-test and a post-test separately set when the group counseling was started and finished,focused on CGAI and negative emotions and cognitions.Results:In post-test,the score of CGAI in experimental group was significantly lower than that in control group[(92.6±16.7)vs.(105.9±13.0)] and lower than that in pre-test(98.9±16.4)by analysis of covariance(Ps<0.01).The scores of Beck Depression Inventory(BDI),Self-Rating Anxiety Scale(SAS),and the negative cognition of oneself in socical settings in experimental group were also lower than those in control group [(6.4±7.9)vs.(13.5±5.6),(39.7±6.4)vs.(49.9±10.3),(15.1±4.3)vs.(19.9±3.0),Ps<0.01],while the score of Rosenberg Self-Esteem Scale(SES)was higher than that of the control group [(29.3±2.9)vs.(24.6±4.8),P<0.01].Conclusion:Group counseling based on interpersonal activities has obvious effects on the college students with computer gaming addiction.

Objective To investigate the expression of Na+/H + exchanger isoform-1 (NHE-1) during ischemia-reperfusion (IR)in rat lung tissue and determine whether cariporide preconditioning protects lung from inflammatory injury via inhibiting NHE-1 protein expression.Methods Twenty i-solated perfused lungs were randomly divided into 4 groups:the lungs in control group (group C) were continuously perfused for 120 min;the lungs in group IR were subjected to 30 min perfusion, followed by 60 min ischemia and 30 min reperfusion;in group LiCl preconditioning,the lungs were preconditioned with LiCl for 30 min,then continuously perfused for 90 min;in cariporide precondi-tioning+IR (CIR)group,the lungs were preconditioned with cariporide for 30 min,following 60 min ischemia and 30 min reperfusion.After reperfusion,the NHE-1 protein expression was determined by immunohistochemistry and the histopathologic change and pathology scores were ascertained from HE sections.Results The NHE-1 protein expression in lung tissue in groups IR and LiCl were signifi-cantly increased compared with groups C and CIR (P <0.05),and there was no difference between groups C and CIR.Histological examination revealed marked inflammatory changes in groups IR and LiCl,whereas no significant changes in lungs of groups C and CIR.The pathology score of lung in groups IR and LiCl were higher than that in groups C and CIR (P <0.05),and there was no differ-ence between the last two groups.Conclusion IR results in an increased NHE-1 protein expression in rat isolated perfused lung,and the selective NHE-1 inhibitor cariporide could repress the NHE-1 pro-tein expression,thereby decrease the lung inflammatory injury after IR.

Objective To explore the effects of lipoxinA4 on expression of cyclooxygenase-2 (COX-2) and prostaglandin E2 (PGE2) in rat primary lung fibroblast cells (LF) after lipopolysaccharide (LPS) challenge.Methods Primary lung fibroblast cells were incubated with various concentrations (0.1,1,10 μg/mL) of LPS for different lengths of time (3,6,9 h).Then primary lung fibroblast cells were still incubated in DMEM medium containing LPS in the presence or absence of lipoxinA4.After incubation,the supematant of medium was collected and the level of PGE2 was detected by using ELISA.The cells were harvested,and COX-2 protein was analyzed by Western blot.Results The model of acute inflammation in fibroblasts was well established by administering 1 μg/mL LPS in fibroblasts for 6 hours.Induction of COX-2 protein by LPS was inhibited by lipoxinA4.The levels of PGE2 in control group,LPS group and LPS + LipoxinA4 group were 55.84 pg/mL,411.73 pg/mL and 307.07 pg/mL,respectively,and there was a significantdifference between LPS group and LPS + LipoxinA4 group (P ＜0.01).Conclusion LipoxinA4 down-regulates the expression of the COX-2 induced by LPS in primary lung fibroblast cells and consequently inhibits the production of PGE2 in a dose dependent manner.

Objective To investigate the diagnostic values of serum free fatty acids (FFA) and urine podocalyxin (PCX) in the patients with type 2 diabetic nephropathy(DN).Methods A total of 120 patients with type 2 diabetes mellitus (DM) were enrolled,and they were divided into three groups,normal albumin group(NA),microalbuminuria group(MA) and heavy albuminuria group(HA),based on the urinary albumin-creatinine ratio(UACR).In addition,40 healthy persons participated in medical examination were selected as the control group.Serum FFA levels were detected by a biochemical analyzer and urine PCX levels by ELISA.The correlation between them was analyzed by Pearson correlation,and their diagnostic values in type 2 DN were evaluated by the receiver operating characteristic curve (ROC).Results Serum FFA levels in the NA,MA,HA and control groups were (0.61 ± 0.14),(0.81 ± 0.13),(0.95 ± 0.18) and (0.49 ± 0.11) mmol/L,respectively,and urine PCX levels were (1.86 ± 0.45),(4.47 ± 1.48),(6.72 ± 1.40)and(1.38 ±0.24) ng/mL,respectively.The levels of serum FFA and urine PCX in type 2 DM patients were significantly higher than those in the control group(P ＜ 0.05),and increased with the progression of type 2 DM.Pearson correlation analysis showed that serum FFA levels were positively correlated with urine PCX levels(r =0.73,P ＜ 0.05).The sensitivity of serum FFA,urine PCX and combined detection in the diagnosis of type 2 DN were 74.1％,80.6％ and 89.5％,respectively,and the latter significantly higher than the former two (P ＜ 0.05).Conclusion Serum FFA and urine PCX levels increase significantly in diabetic patients with renal injury,and both of them have important clinical values in the diagnosis of type 2 DN.

Objective To investigate the prognostic value of arterial blood lactate(Lac) and lactate clearance rate(LCR) for severe neonatal asphyxia.Methods One hundred and fifteen cases of severe neo natal asphyxia admitted in NICU of our hospital from January 2011 to October 2014 were retrospectively analyzed.Lac and LCR values were measured at multiple time points and were compared between those died (27 cases,the death group) and those survived (88 cases, the survival group).The correlation between prognosis and Lac as well asLCR was investigated.Receiver operating characteristic(ROC) curves were drawn to evaluate the prognostic value of Lac and LCR at different time points.Results No significant differences in initial lactate levels and neonatal critical illness score (NCIS) were detected between the two groups (P ＞0.05), while Lac and LCR values at 1 h,2 h,and 6 h showed significant differences between the two groups (P ＜ 0.05).The low-LCR group showed a higher rate of multiple organ dysfunction syndrome and mortality rates than the high-LCR group (44.64％ vs.15.25 ％, P =0.001;32.14％ vs.15.25 ％, P =0.033, respectively).Post-treatment Lac level was positively correlated with prognosis, while LCR at 1 h,2 h, and 6 h were negatively correlated with prognosis.Areas under curve of Lac ROC at 1 h,2 h, and 6 h were 0.625,0.719,and 0.835 respectively, while areas under curve of LCR ROC at 1 h, 2 h, and 6 h were 0.676,0.784, and 0.898 respectively.Conclusion Low LCR for severe neonatal asphyxia predicts poor prognosis.Lac level and LCR at 6 h after emergency treatment is a prognostic indicator for severe neonatal asphyxia.

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Objective To evaluate the efficacy and safety of recombinant human brain natriuretic peptide (rh-BNP) combined with levosimendan on acute myocardial infarction complicated by heart failure.Methods Patients who suffered from anterior wall acute myocardial infarction (AMI) with heart failure (KillipⅡ ～ Ⅲ) within 12 to 24 hours after the onset of chest pain were randomized into two groups: the control group (n=30, receiving dobutamine and/or cedilanid) and the experimental group (n=30, receiving rh-BNP combined with levosimendan).The hemodynamics, parameters of laboratory tests and adverse events were observed before and after treatment.Results The experimental group showed that the respiratory rate (RR), heart rate (HR), systolic blood pressure (SBP), arterial blood gas oxygen saturation (SaO2), cardiac index (CI), extravascular lung water index (EVLWI) were significantly different between 2 h and sequential time points after treatment and pre-treatment (allP＜0.05).The control group showed that RR, HR, SaO2, CI, EVLWI were significantly different between 6 h and sequential time points after treatment and pre-treatment (P＜0.05 for all).There were significant differences in RR, HR, SBP, SaO2, CI, EVLWI at 2 h and 6 h after treatment between the two groups (P＜0.05 for all).Parameters of RR, HR, CI, EVLWI at 72 h after treatment had differences between the experimental group and controls.Patients in the experimental group presented larger urine volume, lower level of plasma NT-pro BNP, higher left ventricular ejection fraction (LVEF) and shorter length of stay in CCU as compared with patients in the control group (P＜0.05 for all).In adverse events monitoring in hepatic parameters, electrolyte level and coagulation function before and after treatment, there was no significant difference between the two groups.Conclusions Compared with the conventional treatment, the combination therapy with rh-BNP and levosimendon can improve the hemodynamics, increase the urine volume, decrease the level of plasma NT-proBNP and elevate LVEF significantly, so as to improve the clinical symptoms and shorten the hospital stay in patients with acute myocardial infarction complicated by heart failure.

Objective To investigate the effect of intraurethral irrigation with honeysuckle water-decoction on formation of bacterial biofilm on the surface of the catheter. Methods Eighty male patients,who had no history of catheterization and no urinary infection with negative results of urine bacterial culture,were enrolled in the study. All patients were randomly divided into 4 groups with 20 cases in each: group A (patients underwent intraurethral irrigation with honeysuckle water-decoction); group B (intraurethral irrigation with 25% PVP); group C (intraurethral irrigation with normal saline ) and group D (no intraurethral irrigation). The urethral catheters were removed at the 7th day and the bacterial biofilm on the surface of the catheter was examined by scanning electron microscopy (SEM). Results SEM demonstrated uneven- distributed matrixes coated on the surface of the catheter, and bacteria adhered to the matrixes. The average thickness of biofilm in group A, B, C and D was (17.876 ±11.788)μn, (31.090±15. 006)μm,(33.716±11.927)μm, (67.762±23.588)μm, respectively. The average thickness of biofilm in group A, B, C was significantly thinner than that in group D (P<0.01), and the thickness in group A was thinner than that in group B and C (P<0.01), but there was no significance difference between group B and group C (P>0.01). Conclusions Intraurethral irrigation with honeysuckle water-decoction can effectively reduce the formation of bacterial biofilm on the surface of the catheter.