Objective To evaluate the clinical application of retroperitoneal laparoscopic adrenal gland sparing adrenalectomy in the treatment of primary hyperaldosteronism with adrenal adenoma. Methods From 2001 to 2006, clinical data of 196 primary hyperaldosteronism with adrenal adenoma patients (78 males and 118 females with mean age of 41±12, ranging 16-69 years old) confirmed during operation were retrospectively analyzed. All cases were with preoperatively high plasma aldo-sterone, low plasma renin, hypokalemia and arterial hypertension. Results Retroperitoneal laparo-scopic adrenalectomy were successfully completed in all cases. No major complication occurred. of them, partial adrenaleetomies were performed in 51 cases and enucleationa of adrenal adenoma were performed in 145 cases. The operative time was ranged from 15 to 87 min (MD=33 min) and the esti-mated blood loss was ranged from 5 to 200 ml (MD=20 ml). There was no case accepted transfusion. The length of hospital stay was ranged from 2 to 5 d (mean 2.7±1.3 d). All the 196 cases were fol-lowed up with the range from 6 months to 3 years (mean, 1.8 years). Postoperatively, kalemia was normalized in all cases, blood pressure was normalized in 168 cases (85.7%). The abnormal blood pressure cases were under control with anti-hypertension drugs. The CT scan showed adrenal glands were normal. Serum test showed normal hormonal levels. The serum potassium levels were in normal range in all cases. One cases with abnormal post-operative blood pressure had accepted second surgery to remove the adrenal adenoma and the blood pressure turned to be in normal range afterwards. Con-clusion Retroperitoneal laparoscopic adrenal gland sparing adrenalectomy is a safe and feasible tech-nique and is the first choice in the management of primary hyperaldosteronism with adrenal adenoma.

Objective To investigate the role of subdural puncture(SDP)in the diagnosis and treatment of subdural fluid collection in young children with purulent meningitis.Methods Totally 207

?As a globally recognized irreversible blindness disease, glaucoma can lead to pathological intraocular hypertension, loss of optic ganglion cells and axonal progressive, more and more deep optic cup, and the expanded visual field defect. Various researches show that excitatory amino acid toxicity, oxidative damage, apoptosis, intracellular Ca2+overloading etc. , pathogenic factors are all involved in the occurrence and development of glaucoma. Now, a variety of clinical drugs and operation treatment are applied to control the glaucoma progress. Further more, there are many new drugs and methods in the process of development. This is an article on the current anti-glaucoma drugs.

Amino Acid Sequence ; Animals ; Birds ; Cell Transformation, Viral ; Herpesvirus 2, Gallid ; genetics ; physiology ; Marek Disease ; virology ; Models, Biological ; Molecular Sequence Data ; Oncogene Proteins, Viral ; genetics ; physiology

Objective To observe the ultrasonographic features of local chest wall tumor recurrence after mastectomy for breast cancer and its clinical and histopathological characteristics. Methods The ultrasonographic features, clinical and histopathological characteristics of 27 patients with local chest wall tumor recurrence after mastectomy confirmed histopathologically were retrospectively reviewed. Results The disease-free intervals of twenty-seven patients ranged from 3 to 129 months [mean (31.9±31.4) months]. Most of the recurrence(18/27, 66.7%) occurred within 3 years after mastectomy. The clinical manifestations were:7 cases (7/27, 25.9%) with regional skin redness and swelling, red rash or ulceration on chest wall associated with or without palpable mass, 20 cases(20/27, 74.1%) with chest wall palpable masses without obvious skin change. On ultrasonography, 2 cases showed diffuse inifltrative type with ill-deifned inhomogeneous hypoechoic lesion and skin thickening. And twenty-ifve cases(43 lesions) showed mass type with a lesion size range of 5.4-114.7 mm [mean (24.4±21.6) mm]. Among them, 32 lesions were located near to the operation incision scar, 36 involved muscle layer, 38 were hypoechoic, 31 had irregular shape, 24 had indistinct margin, and 31 had blood lfow signal. In addition, calciifcation, halo, and taller-than-wide shape were absent in all 43 lesions. Conclusions The tumor recurrence often occurred within 3 years after mastectomy in high-risk patients. Ultrasonographic feature of chest wall recurrent lesion is of great value in the diagnosis.

AIM: To compare the therapeutic effects of transplantation of human umbilical cord mesenchymal stem cells (hUCMSC) through different ways on diabetic mice.METHODS: hUCMSCs were labeled with enhanced green fluorescent protein (EGFP) and luciferase (Luc) reporter gene, and then the cells were transplanted into the diabetic mice through pancreas or tail vein to monitor the migration of the hUCMSCs in vivo.The pathological changes of pancreas tissue sections were determined by HE staining.Weight and blood glucose of the mice were measured dynamically.To compare the therapeutic effects, serum insulin levels were analyzed and glucose tolerance test were also performed.RESULTS: In vivo bioluminescence imaging results showed that the hUCMSCs transplanted into pancreatic capsule was mainly located in the pancreas while the hUCMSCs transplanted through vein tail injection was mainly located in the lung.HE staining illustrated that islet cells presented distinctive boundary and no infiltration of inflammatory cells in pancreatic capsule transplantation group was observed, but a little inflammatory cell infiltration and fibrosis formation in tail vein injection group were seen.A significant decrease in blood glucose level and a significant increase in serum insulin level in pancreas transplantation group were showed as compared with vein tail injection group.CONCLUSION: Transplantation of hUCMSCs through different approaches demonstrates different effects.The transplantation of hUCMSCs into pancreatic capsule is more effective on hyperglycemia reversion, insulin secretion and improvement of beta-cell function than that through tail vein.

Objective:To investigate the expression of human telomerase reverse transcriptase (hTERT) in urine exfoliated cells of benign and malignant urothelial diseases, in an attempt to evaluate the role of detecting hTERT gene expression in cytologic diagnosis of transitional cell carcinoma. Methods: The expressions of hTERT gene were detected by immunocytochemistry staining in 54 patients with transitional cell carcinoma(25 cases with grade Ⅰ, 26 with grade Ⅱ and 13 with grade Ⅲ) and 20 controls, including 10 patients with urinary tract stone and 10 healthy volunteers. The urine exfoliative cells of both groups were also stained by H-E and the results were compared with those of immunocytochemistry.Results: hTERT was detected in 74.1% (40/54) of patients with transitional cell carcinoma and in 5%(1/20) of the controls (P

Objective To investigate the expression of BRCA1 in chemosensitive and chemoresistant ovarian cancer specimens,so as to provide a novel insight into the epigenetic mechanism involved in BRCA1 transcription. Methods Serous ovarian cancer patients(10 chemosensitive and 10 chemoresistant cancer)were enrolled for the study. BRCA1 levels was analyzed by real?time quantitative PCR. The methylation levels of BRCA1 core promoter(sites 1?4)was determined by pyrosequencing. Regression analysis was used to examine the possible relationship between BRCA1 levels and the methylation levels of sites 1?4 in ovarian cancer specimens. Results Compared to chemosensitive ovarian cancer tissues,BRCA1 levels were increased,but the methylation levels of BRCA1 core promoter(sites 1?4)were decreased in chemoresistant ovarian cancer tissues. How?ever,it is interesting to note that only a significant inverse correlation was observed between BRCA1 levels and the methylated levels of site 4 (r=-0.612,P<0.05). Conclusion Our findings imply that the methylation levels of site 4 in the core promoter of BRCA1 may be widely involved in the regulation of BRCA1 expression and chemosensitivity in ovarian cancer.

Objective To compare the effect of different puncture positions in the combined spinal epidural anesthesia (CSEA)in cesarean section.Methods Ninety uterogestation women under-going elective Caesarean section were randomly divided into two groups,45 in each group.L3-4 inter-vertebral space was selected as puncture point.Group R kept right lateral position for two minutes af-ter puncture and turned 30°left tilt supine position until ready for surgery.Group L was turned to su-pine position after left lateral punctured and then turned to 30 left tilt supine position until ready for surgery.1% ropivacaine 1.5 ml+ 10% glucose 0.5 ml was used for spinal anesthesia.The sensory block level and adverse reaction within 1 5 min after the spinal anesthesia were observed,and the neo-natal Apgar score and the pH value of umbilical artery blood were recorded.Results The final block level of the group R was significantly lower than group L,and the time achieving final block height was significantly shorter than that in group L(P <0.05 ).The ephedrine dosage of group R 0 (0-6) mg was significantly lower than that of group L6 (0-12)mg (P <0.05).The PH value of umbilical artery blood in group R was significantly higher than that in group L (P <0.05).There was no sig-nificant difference in neonatal Apgar score.Conclusion In Cesarean section,keeping right lateral puncture position for two minutes after infusion and then turning 30° left tilt supine position can a-chieve better effects than 30°left tilt supine position immediately after puncturing.

Objective To investigate the expression of HPV-DNA and p16,Ki-67 proteins in intraepithelial lesion of cervix (CIN) so as to provide the aluable evidence for the early clinical diagnosis and genetic therapy of the CIN.Methods Hybrid capture2 was used to detect HPV DNA in 35 cases of CIN Ⅰ,44 cases of CIN Ⅱ,and 20 cases of CIN Ⅲ.Immunohistochemical MaxVision was used to research the expression of p16 and Ki-67 protein in CIN Ⅰ,CIN Ⅱ and CIN Ⅲ.The results were analyzed with clinicopathological factors.Results Positive expression rates of HPV-DNA were 31.4 ％ (11/35),63.6 ％ (28/44),85.0 ％ (17/20) in CIN Ⅰ,CIN Ⅱ and CIN Ⅲ,respectively.The expression rates of p16 in the three groups were 65.7 ％ (23/35),97.7 ％ (43/44),100.0 ％ (20/20),there were statistically significant difference (x2 =21.30,P =0.00).The expression rates of Ki-67 in the three groups were 77.1％ (27/35),79.5 ％ (35/44),95.0 ％ (19/20),there were no difference (x2 =3.00,P =0.22).Conclusions HPV infection is closely related to the occurrence and development of CIN.p16,Ki-67 can be used as objective marks in diagnosis of CIN.