Aged ; Autoimmune Diseases ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Pancreatitis ; diagnosis ; drug therapy ; surgery ; Prednisone ; therapeutic use

Common bile duct (CBD) stones are a frequent problem in Chinese populations, and their incidence is particularly high in certain areas (Wang et al., 2013). In recent years, laparoscopic common bile duct exploration (LCBDE) and endoscopic retrograde cholangiopancreatography (ERCP) have been the main surgical procedures for CBD stones, although each has different advantages and disadvantages in the treatment of choledocholithiasis (Loor et al., 2017; Zhou et al., 2017). For patients with large stones, a dilated CBD, especially concurrent gallstones, LCBDE is the preferred and most economical minimally invasive procedure (Koc et al., 2013). However, a T-tube is often placed during LCBDE to prevent postoperative bile leakage; this is associated with problems such as bile loss, electrolyte disturbance, and decreased gastric intake (Martin et al., 1998). In addition, the T-tube usually must remain in place for more than a month, during which time the patient's quality of life is seriously compromised. Many skilled surgeons currently perform primary closure of the CBD following LCBDE, which effectively speeds up rehabilitation (Hua et al., 2015). However, even in sophisticated medical centers, the incidence of postoperative bile leakage still reaches ≥10% (Liu et al., 2017). Especially for a beginner, bile leakage remains a key problem (Kemp Bohan et al., 2017). Therefore, a safe and effective minimally invasive surgical approach to preventing bile leakage during primary closure of the CBD after LCBDE is still urgently needed.
Aged ; Aged, 80 and over ; Choledocholithiasis ; Common Bile Duct Diseases ; Drainage/methods* ; Female ; Gallstones ; Gastroscopy ; Humans ; Laparoscopy ; Male ; Middle Aged

OBJECTIVETo investigate the effect of dihydrotestosterone (DHT) on the gene transcriptions and expressions of Smad3 and Smad4 in androgen dependent prostate cancer cell line LNCaP, and whether this effect can be suppressed by the androgen receptor inhibitor flutamide.

METHODSThe androgen dependent prostate cancer cell line LNCaP was cultured in RPMI 1640 medium and treated with different concentrations of DHT(2, 10, 50 nmol/L) and flutamide (100 nmol/L). Quantitative reverse transcription PCR (RT-PCR) was used to detect the mRNAs of Smad3 and Smad4. The expressions of Smad3 and Smad4 protein were detected by Western blot assay.

RESULTSCompared with the control group without any DHT or flutamide, higher concentration(10, 50 nmol/L) of DHT enhanced the transcription of Smad3 mRNA (P <0.05). Serial concentrations of DHT increased the expression of Smad3 protein(P < 0.05). Flutamide inhibited the up-regulation of both Smad3 mRNA transcription and expression significantly (P <0.05). 10 nmol/L DHT significantly suppressed the transcription of Smad4 (P <0.05). There was considerable suppressions of Smad4 expression at the presence of DHT in different concentrations (P < 0.05). And the degree of this suppression was more significant than that of DHT on Smad4 mRNA transcription. Flutamide inhibited the suppressive effects of DHT on both Smad4 mRNA transcription and expression.

CONCLUSIONDHT can enhance the transcription and expression of Smad3, while it decreases the transcription and expression of Smad4 in LNCaP cell line. There is a possible crosstalk between the AR signal and TGF-beta signal passways at the level of Smads.

Androgens ; physiology ; Cell Line, Tumor ; Dihydrotestosterone ; pharmacology ; Flutamide ; pharmacology ; Humans ; Male ; Neoplasms, Hormone-Dependent ; metabolism ; Prostatic Neoplasms ; metabolism ; RNA, Messenger ; genetics ; Reverse Transcriptase Polymerase Chain Reaction ; Signal Transduction ; drug effects ; Smad3 Protein ; biosynthesis ; genetics ; Smad4 Protein ; biosynthesis ; genetics ; Transcription, Genetic

Adult ; Cysts ; pathology ; surgery ; Endoscopes ; Female ; Humans ; Liver Diseases ; pathology ; surgery ; Surgical Procedures, Operative ; methods ; Tomography, X-Ray Computed ; Treatment Outcome

Adult ; Aged ; Chyle ; Humans ; Kidney ; surgery ; Laparoscopy ; Lymphatic Vessels ; surgery ; Male ; Middle Aged ; Urine

OBJECTIVETo review the clinical experience of muscle-sparing thoracotomy in intrathoracic surgery.

METHODSThoracotomy was performed in 386 patients from 1998 to 2002, during the procedure lateral-transverse incision, free dissection of muscular flap and entering to the thoracic cavity through certain intercostal space were applied. Two sets of rib retractors were used to ensure the excellent field exposure.

RESULTSIntrathoracic surgery was carried out by this method with the advantage of excellent surgical field exposure, less pain and relative quick recovery.

CONCLUSIONMuscle-sparing thoracotomy has the merits of less injury and the same good exposure as routine thoracotomy and it can be carried out in majority of chest surgery.

Adolescent ; Adult ; Aged ; Child ; Female ; Humans ; Lung Neoplasms ; surgery ; Male ; Middle Aged ; Pectoralis Muscles ; surgery ; Pneumonectomy ; Postoperative Complications ; prevention & control ; Thoracic Surgical Procedures ; methods ; Thoracotomy ; methods

OBJECTIVE: To evaluate the value of virtual colonoscopy in diagnosis of colorectal neoplasia. METHODS: Virtual colonoscopy was performed in 29 patients with colorectal neoplasia confirmed by colonoscopy. The results were compared with colonoscopy for each case. RESULTS: Virtual colonoscopy was successfully performed in each patient without any complications. All colorectal carcinomas detected by colonoscopy were identified by virtual colonoscopy. Twenty-five polyps were detected with colonoscopy, whereas only 16 identified by virtual colonoscopy. Compared with the results of colonoscopy, detection rate of polyps greater than 1.0 cm between 0.5 approximate, equals 0.9 cm and less than 0.5 cm in size was 90.0% 62.5% and 28.6% respectively. CONCLUSION: Virtual colonoscopy is fast, minimal invasive and well tolerated. This technique is a valuable clinical method in diagnosis of colorectal cancer and polyps larger than 0.5 cm in size.

BACKGROUNDTo avoid the irritation of tendons and soft tissues as well as hardware-related problems, we designed an intramedullary fixation with bioabsorbable rods for the treatment of the metacarpal shaft fractures.

METHODSFive patients with nine shaft fractures of the fourth and fifth metacarpi were treated with intramedullary absorbable implants and followed up with an average of 4.2 months postoperatively.

RESULTSAt final follow-up, all patients achieved fracture union with no signs of inflammatory or subcutaneous effusion. There was no shortening, angulatory, or rotatory deformity. There was almost full active extension range of motion (ROM) of the metacarpophalangeal joints while the active flexion ROM of these joints was 80.7 ± 9.6°. Compared with the contralateral hand, the grip strength of the injured hand was 94.0 ± 9.6%. X-rays showed that the arch of the second to fifth metacarpal heads was smooth. There were no intramedullary lytic changes and soft tissue swellings.

CONCLUSIONThe intramedullary absorbable implants are a safe, simple, and practical treatment for fourth and fifth metacarpal fractures with good early clinical outcomes and no significant complications.

Absorbable Implants ; Adolescent ; Adult ; Fracture Fixation, Intramedullary ; methods ; Fractures, Bone ; surgery ; Humans ; Internal Fixators ; Male ; Metacarpal Bones ; injuries ; surgery ; Range of Motion, Articular ; physiology ; Treatment Outcome ; Young Adult

OBJECTIVEThis study was designed to investigate the effect of human cytomegalovirus (HCMV) on the proliferation of colony forming unit granulocyte-macrophage (CFU-GM), CFU-erythroid (CFU-E), burst forming unit-erythroid (BFU-E), CFU-multipotential (CFU-Mix) and CFU-megakaryocytic (CFU-Mk) progenitor cells of cord blood in vitro as well as the possible mechanism.

METHODSTwenty cord blood specimens were collected from the umbilical vein of normal full-term neonates delivered spontaneously. This study consisted of five groups: 3 Infection groups in which 0.1 mL 10(3), 10(4) and 10(5) plague forming unit (PFU) HCMV-AD169 virus solution was added to the culture system, an Inactivated control group in which the equal volume of inactivated virus solution was added, and a Blank control group (normal progenitor cells culture system without HCMV virus infection). Colony forming unit-assay was applied to detect the effects of HCMV-AD169 strain on the colony formation, inhibition rate and colony-maintaining duration of CFU- GM, CFU-E, BFU-E, CFU-Mix and CFU-Mk of cord blood. PCR technique was used to demonstrate the existence of HCMV-DNA in the colony cells of cultured CFU-GM, CFU-E, CFU-Mix and CFU-Mk.

RESULTSHCMV-AD169 (10(3)PFU) in low concentration had inhibition effects on colony formation of the CFU-Mix and CFU-Mk (P < 0.05), whereas 10(5) PFU and 10(4) PFU HCMV-AD169 lead to decreased colonies in CFU-GM, CFU-E, BFU-E, CFU-Mix and CFU-Mk compared with the Blank control and the Inactivated control groups (P < 0.05). The suppression effect of HCMV on the colony formation was dose-dependent. The colony-maintaining duration of the CFU-GM, CFU-E, BFU-E, CFU-Mix and CFU-Mk in the 10(5) PFU and 10(4) PFU HCMV infection groups was significantly shorter than that in the two control groups (P < 0.01). The low concentration of HCMV-AD169 (10(3)PFU) infection resulted in a shortened colony-maintaining duration of the CFU-Mix and CFU-Mk (P < 0.01), but had no effects on the colony-maintaining duration of CFU-GM, CFU-E and BFU-E. PCR amplification demonstrated the existence of HCMV-AD169 DNA in the colony cells of the three Infection groups.

CONCLUSIONSHCMV-AD169 strain can infect hematopoietic progenitors of cord blood and inhibit the proliferation of hematopoietic progenitors, associated with anemia, neutropenia and thrombocytopenia in HCMV patients.

Cell Proliferation ; Cytomegalovirus ; pathogenicity ; Fetal Blood ; cytology ; Hematopoietic Stem Cells ; cytology ; Humans

This study was aimed to investigate clinical and prognostic significances of 4 target antigens (CD19, CD20, CD22 and CD33) for antibody-based immunotherapy and to evaluate the applications of these antibody-based target therapy to adult acute lymphoblastic leukemia (ALL). The immunophenotype of 220 adult patients with ALL were analyzed by four-color flow Cytometry, and cytogenetic and molecular parameters were detected by conventional cytogenetics, fluorescence in situ hybridization, real-time quantitative PCR, nested PCR and DNA sequencing. The results showed that CD19 positive (CD19(+)) cases were more in female (46.4% vs. 23.4%, P = 0.006), elderly patients aged > 60 years (14.4% vs. 2.1%, P = 0.022), CD33(+) co-expression cases (47.8% vs. 12.0%, P = 0.001) and genetic high-risk group (55.8% vs. 20.8%, P = 0.002) compared with CD19 negative (CD19(-)) cases; CD20(+) cases had lower co-expression of CD13 than CD20(-) cases (31.6% vs.67.1%, P = 0.000) and no significant prognostic indications for CD20(+) was observed; CD22(+) cases had higher relapse rate at 12-month than CD22(-) cases (93.9% vs.57.1%, P = 0.041) in B-ALL patients; CD33(+) cases had higher incidence of Ph(+) than CD33(-) cases (43.5% vs.19.4%, P = 0.007) and significantly correlated with Ph(+) (r = 0.261, P = 0.006). It is concluded that elucidation of the characteristics of the target antigens (CD19, CD20, CD22, CD33) used for antibody-based immunotherapy will help hematologists making the correct decision whether and when to use these antibody-based target therapies.
Adolescent ; Adult ; Aged ; Antigens, CD19 ; immunology ; Antigens, CD20 ; immunology ; Child ; Female ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; genetics ; immunology ; Sialic Acid Binding Ig-like Lectin 2 ; immunology ; Sialic Acid Binding Ig-like Lectin 3 ; immunology ; Young Adult