Objective To analyse the clinical practicability and significance of fertility-sparing surgery for women with recurrent borderline ovarian tumors ( BOT).Methods The clinical and pathological recordings of 12 patients suffered from recurrent BOT in the Obstetrics and Gynecology Hospital of Fudan University from Jan.2002 to Dec.2012 were analyzed retrospectively.The menstruation situation , fertility function , recurrence rate and survival after second conservative surgery were collected and analyzed .Results The average onset age of these 12 patients was 26 years, and none of them had procreation before the second operation.The pathological diagnosis were still BOT and the recurrent sites of 10 patients were still restricted to the ovaries.Of the 12 cases, 8 cases of them had normal menstruation functions and 4 cases had less menstrual volumes or longer menstrual periods.Among 6 cases desired for pregnancy after the second operation,4 cases of them were successful.The spontaneous pregnancy rate was 4/6.The mean duration of follow-up was 53 months(range:23-97 months).All recurrent BOT, three cases developed recurrence once more,two cases of them were just be hinted by B ultrasounds and only one cases was approved to be BOT again by a once more surgical pathology.But no disease related deaths occurred.Conclusions The second fertility-sparing surgery may be feasible for women with recurrent BOT who are young and strongly desired for preservation of fertility.The spontaneous pregnancy rate is satisfactory.However, carefully follow-up is still needed.

Objective To discuss the nonoperative management strategy to prevent the conversion of acute pancreatitis to the severe form.Methods In recent 4 years,286 patients with mild acute pancreatitis admitted to our hospital were divided into control group and treatment observation group;routine conservative management was performed in control group,and the strategy of improving pancreatic microcirculation and preventing cell Ca~2+ overload and inhibiting pancreatic protease was added to the treatment observation group.Results Among the 144 patients with mild acute pancreatitis in control group,conversion to severe acute pancreatitis occurred in 20 patients,and 14 of the 20 patients with severe acute pancreatitis developed systemic complications.Among the 142 cases in treatment observation group,the conversion of mild to severe acute pancreatitis occurred in 8 patients,and 2 of the 8 patients developed systemic complications.Serum C-reactive protein levels and Balthazar CT severity index were significantly decreased at each time point in treatment observation group compared to control group.Conclusions In addition to routine management,improving pancreatic microcirculation,preventing cell Ca~2+ overload and inhibiting pancreatic protease might serve as a benificial strategy for preventing the progression of mild acute pancreatitis to the severe form.

Purpose To investigate the effect of resveratrol on acute lung injury induced by lipopolysaccharide (LPS) in mice.Methods Acute lung injury (ALI) was induced by LPS in mice. The changes of lung airway inspiratory resistance (Ri), expiratory resistance (Re), and dynamic lung compliance (Cdyn) were observed with pulmonary function test apparatus. Brochoalveolar lavage fluid (BALF) was collected, and the concentrations of interleukin 1β (IL-1β)、interleukin 6 (IL-6) and tumor necrosis factory α (TNF-α) were measured by ELISA. The ratio of wet to dry weight was calculated to assess lung edema. Pulmonary vascular permeability was examined with injection Evans blue to judge the destructive extent of alveolar epithelial cell and endothelial. Pathological section was made, and the histopathological change was observed with light microscope.Results Resveratrol can inhibit the elevation of Ri and Re, and the descent of Cdyn. Simultaneously, resveratrol reduced the concentration of IL-1β, IL-6 and TNF-α,as well as the wet to dry weight ratio and the pulmonary vascular permeability significantly. Furthermore, it also could attenuate the lung injury on histopathology.Conclusion The results show that pretreatment with resveratrol has a protective effect on ALI induced by LPS. The ultimate inhibiting and release of inflammatory factors were involved in the mechanism of the effects.

Objective To understand the levels of plasma endothelin (ET) and calcitonin gene-related peptide (CGRP) in cough variant asthma(CVA) patients, and to investigate their correlation and clinical implications. Methods Thirty CVA patients,30 typical bronchial asthma patients and 25 healthy controls were recruited. Three milliliter limosis venous blood were drawn from each patient to measure the levels of plasma ET and CGRP by radioimmanity. Results ①The levels of ET in the CVA group and typical bronchial asthma group were higher than that in healthy controls (P < 0.01). Their values were (103.58±28.66) ng/L, (129.37±27.28) ng/L and (72.63±21.52)ng/L, respectively. The levels of CGRP in the CVA group and typical bronchial asthma group were (7.62±2.56) ng/L and(6.63±2.09)ng/L The level of CGRP in the healthy controls group was (21.60±3.29) ng/L. The first two groups were lower than the latter(P < 0.01). However, there was no significant difference between the CVA group and typical bronchial asthma group(P >0.05). ②ET and CGRP were negatively correlated in both CVA group(r= -0.819,P<0.05) and typical bronchial asthma group(r= -0.738,P<0.05). Conclusions ET and CGRP were negatively correlated in both CVA group and typical bronchial asthma group, which means that ET and CGRP were a couple of antagonistic factors participated in the regulation of CVA, and may play an important role in the process of CVA.

Objective To evaluate the efficacy of laryngeal mask airway (LMA) Guardian for airway management in the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy.Methods Sixty patients of both sexes,aged 26-64 yr,weighing 48-95 kg,of American Society of Anesthesiologists physical status Ⅰ-Ⅲ,with Mallampati grade Ⅰ-Ⅲ,scheduled for elective laparoscopic cholecystectomy under general anesthesia,were divided into group Ⅰ and group Ⅱ (n =30 each) using a random number table.In group Ⅰ,the nasogastric tube was inserted through the drain tube of LMA Guardian.In group],the nasogastric tube was inserted through the nostril before operation,and after successful LMA Guardian placement,another nasogastric tube was inserted through the drain tube of LMA Guardian.The hemodynamic parameters,SpO2,end-tidal pressure of carbon dioxide and peak airway pressure (Ppeak) were monitored during operation.The fiberoptic laryngoscopy scores were assessed after successful LMA placement,and the nasogastric tube displacement was recorded.The LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,occurrence of air leakage of LMA and nasogastric tube drainage were recorded.The bloodstains and gastroesophageal reflux were observed after removal of the LMA.The pH values were tested at the tip of LMA and on the dorsal and ventral sides of the body of LMA using pH test papers.The development of adverse reactions in the oropharynx was recorded within 24 h after operation.Results The hemodynamics was stable,the SpO2 and Ppeak were within the normal range during operation,and Ppeak was lower than airway sealing pressure in the two groups (P＞0.05),and there was no significant difference between the two groups.There was no significant difference between the two groups in the LMA placement time,success rate of LMA placement at first attempt,airway sealing pressure,score for exposure of oropharynx,development of adverse reactions in the oropharynx,consumption of anesthetics,development of bloodstains within the body of LMA and gastroesophageal reflux,and pH values at the tip of LMA and on the dorsal and ventral sides of the body of LMA (P＞0.05).Nasogastric tube drainage:the rate of nasogastric tube drainage through the LMA Guardian was 67％ in group Ⅰ;the rate of nasogastric tube drainage through the nostril was 40％,and the rate of nasogastric tube drainage though the LMA Guardian was 50％ in group Ⅱ.No nasogastric tube displacement was found after operation in group Ⅱ.Conclusion For the patients requiring insertion of nasogastric tube before laparoscopic cholecystectomy,insertion of LMA Guardian is easy,and LMA Guardian can assure good airway sealing and adequate ventilation and can be safely and effectively used for airway management in this type of patients.

,A retrospective case-control study of totally 573 (3x191) subjects wasinvestigated.They come from residents living in the urban area of Shanghai for more than ten years at an age interval from 30-70. Every case waspaired by two controls. They were all inquired by a same interviewer with a carefully prepared questionaire list which involved past dietary habits and other factors thought to be related to breast cancer. From these data our tentative impressions are as follows. Rich fat (80g) and protein (80g) diet is closely associated with breast cancer. The relationship is much more significant among the patients over 50 years old than those under fifties. The consumption of carbohydrate and crude fiber showed, in this study, no association with the carcinogenesis of breast cancer. The risk of polyunsaturated fatty acid is higher than saturated fatty acid in association with breast cancer. The more the animal protein intake (30g), the higher risk of breast cancer occurs, and soybean protein tends to decrease the risk of breast cancer. There are multiple etiological factors for bre- ast cancer, however nutrition and diet would be considered as one of the important factors. With regard to the dietary component, animal foods such as eggs and pork may increase the risk of breast cancer. But as a whole, the dietary component of the patients studied here is rather proper. Obesity as shown by the increased skinfold thickness is one of risk factors for breast cancer. Finally breast cancer patients have a normal level of blood lipids, but their HDL-cholesterol is lower than that of control groups.

Objective To investigate the correlation between serum homocysteine (Hcy) and macrophage migration inhibitory factor(MIF) with carotid atherosclerosis and between serum Hcy and MIF ,and to study whether serum Hcy influence the carotid atherosclerosis formation by MIF .Methods 258 inpatients and outpatients were performed the color ultrasound examination to ob-serve the carotid arterial vascular anatomic form ,endomembrane circumstance ,plaque and the plaque echo nature ,and the carotid in-tima-media thickness(IMT) was measured .According to the results of color ultrasound ,the cases were divided into three groups :IMT normal group(control group) ,thickening group and plaque group .According to the plaque echo characteristics ,the plaque group was redivided into two subgroups :stable plaque group and unstable plaque group .Serum Hcy and MIF levels and biochemical parameters were measured simultaneously in all cases .The differences of serum Hcy and MIF levels were compared between groups .The correlation coefficients among serum Hcy levels ,MIF levels and IMT were calculated .Results The serum Hcy and MIF levels in the control group ,thickening group and plaque group were increased in turn ,the difference among groups was statisti-cally significant(P<0 .01);which in the unstable plaque group was significantly higher than that in the stable plaque group ,the difference between them was statistically significant (P<0 .01) .The positive correlation was found among serum Hcy levels ,serum MIF levels and IMT (r=0 .584 ,0 .562 ,0 .607 ,P<0 .01) .Conclusion The serum Hcy and MIF levels are closely related with the carotid atherosclerosis degree and the plaque stability ;the serum Hcy and MIF levels are positively correlated with the carotid arte-rial IMT ;serum Hcy is positively correlated with the MIF level ,Hcy may cause the carotid atherosclerosis formation via MIF .

AIM:To investigate the molecular mechanism of Xijiao Dihuang decoction combined with Yinqiao powder (XDY) in treating viral pneumonia, and the effects of XDY on TNF-α-induced permeability in pulmonary microvascular endothelial cells (PMVEC) and the role of PKC-SSeCKS pathway involved.METHODS:The electric conductivity method was used to detect transendothelial electrical resistance (TER) of primarily cultured PMVEC on Transwell chamber at different time points to determine the permeability of PMVEC.After pretreatment for 24 h, the activity of PKC, TER, and the expression of SSeCKS at mRNA and protein levels were detected.Laser scanning confocal microscopy was used to observe the location of SSeCKS and construction of F-actin in PMVEC.RESULTS:The permeability of PMVECs induced by TNF-α reached the peak at 24 h.Compared with control group, the TER in TNF-α group was decreased, and the activity of PKC was increased.Compared with TNF-α group, the activity of PKC in TNF-α with PKC inhibitor group and TNF-α with XDY group was decreased, while the TER was increased, without difference from control group.Compared with control group, the mRNA expression of SSeCKS and phospho-SSeCKS was increased in PMVEC of TNF-α group, but decreased in TNF-α with XDY group compared with TNF-α group.In control group, F-actin was mainly located around the nucleus and at cytoplasmic borders of PMVEC, forming the dense peripheral bundle, and SSeCKS was evenly scattered in the cell.In TNF-α group, the dense peripheral bundle of F-actin surrounding the cells almost disappeared, and SSeCKS was concentrated around the nucleus.Compared with TNF-α group, the distribution and the structure of F-actin and SSeCKS nearly returned to normal in TNF-α with XDY group.CONCLUSION:XDY inhibits the activation of PKC signaling pathway in PMVEC caused by TNF-α to reduce the mRNA expression of SSeCKS and the phosphorylation of SSeCKS, thus preventing the deformation of endothelial cells and reducing the permeability of PMVEC.

Objective To explore the safety and effectiveness of diagnostic ultrasound associated with microbubbles to open the blood brain barrier(BBB).Methods Microbubbles were injected through caudal vein,the rat head was radiated by GE Vivid 7 diagnostic ultrasound immediately.The radiated depth was located in the basal ganglia assisted by magnetic resonance imaging(MRI)scanning.The degree of BBB opening was evaluated by enhanced MRI and Evans blue dyeing.The safety was inspected by observation of cell morphology under hematoxylin eosin(HE)staining.Results After the rat head radiated by diagnostic ultrasound with microbubbles,signal enhancement of the radiated area was observed on post contrast T1-weighted images.Red fluorescence of Evans blue was detected by fluorescence microscope in the same area.Normal cellular morphology and structural integrity were showed by HE staining.Conclusions The BBB of rat could be opened targetedly and noninvasively by diagnostic ultrasound associated with microbubbles.This may provide a new strategy for the drugs and stem cells treatment in the central nervous system diseases.

Objective To study the influence factors of real-time shear wave elastography(SWE) on the elasticity of focal liver lesions (FLLs) measurement.Methods The mean Young's modulus of 160 FLLs were measured by SWE.The relation between elasticity with different aspects of FLLs were analyzed including postures (supine and left lateral position),respiratory phases (end of inspiratory and expiratory),the probe position (rib and intercostal space) and different operators.Results There were significant differences between different postures and respiratory phases in the elasticity measurement of FLLs by SWE (P ＜0.05).There was no significant difference between robe position and different operators in the elasticity measurement of FLLs by SWE(P ＞0.05).Conclusions The postures and respiratory phases can impact the elasticity measurement of FLLs by SWE.