Objective To elaborate the risk factors for leiomyoma residue and relapse after different approaches of myomectomy.Methods From Jan.2005 to Dec.2010 and Jan.2011 to Jan.2013,769 patients underwent myomectomy were recruited in Beijing Obstetrics and Gynecology Hospital.The patients demographic,leiomyoma characteristics,preoperative gonadotropin-releasing hormone agonist (GnRH-a) therapy,surgical approach,pathological type,follow-up information were collected.Results Leiomyoma number was the risk factor of postoperative residue and relapse,with the leiomyoma number increased one,the risk of residue and relapse increase 1.085 times (OR=1.085,95％CI:1.019-1.154,P=-0.010),1.043 times (RR=1.043,95％CI:1.014-1.073,P=0.003) respectively.Leiomyoma type (intramural leiomyoma) was the risk factor of relapse (RR=1.665,95％CI:1.029-2.693,P=0.038).Age was not the risk factor for postoperative residue rate (P=0.828) and relapse rate (P=0.193).GnRH-a didn't increase the postoperative residue and relapse rate (P=0.542,0.133).The postoperative residue rate (P=0.764),relapse rate (P=0.279) between transabdominal and laparoscopic myomectomy groups had no significant difference.Bizarre leiomyoma (RR=5.678,95％CI:1.373-23.490,P=0.017) and celluar leiomyoma (RR=2.201,95％CI:1.466-3.303,P＜0.01) were the risk factors for postoperative relapse rate.Conclusions Leiomyoma number,leiomyoma type (intramural leiomyoma) are the main risk factors for postoperative relapse.Pretreatment of GnRH-a and laparoscopic approach wouldn't increase the rate of residue and relapse.Bizarre leiomyoma and cellular leiomyoma have a higher relapse rate than common leiomyoma.

Objective:To explore the effect of leptin on proliferation of human hepatocellular carcinoma cells Huh 7 and its probable molecular mechanism.Methods:The human hepatocellular carcinoma cells Huh 7 cultured in vitro was treated with leptin at different concentrations.The proliferation of the cells was measured by MTT assay.The cell cycle was monitored by flow cytometry analysis(FCM).The expression of cell cycle regulatory proteins Cyclin D1 and P21waf1 were determined by immunocytochemistry and imageanalysis system,and real-time quantitative PCR.Results:Leptin significantly raised the proliferation rate of Huh 7 cells.The effect was dose and time-depended partly.Leptin promoted Huh 7 cells in entering the S phase from the G0/G1 phase.mRNA of Cyclin D1 in the leptin treated Huh 7 cells was increased,as compared with that in the control cells(P

Objective To investigate the effect of pioglitazone on the expression of thrombospondin-1(TSP1)and transfor ming growth factor-β1 (TGF-131)in the kidney of diabetic rats.Methods Forty Sprague-Dawley(SD)rats were randomly divided into 4 groups:normal control(NC),streptozocin-induced diabetic mellitus(DM),diabetic rats treated with pioglitazone(DP)and normal control rats treated with pioglitazone(NP).24-h urine protein quantity,serum creatinine(Scr) and kidney hypertrophy index were measured after treatment for 10 weeks,and the expression of TSP1 and TGF-β1 in the kidney was detected by using RT-PCR and immuohistochemistry.Results As compared with DM group,urine protein level and kidney hypertrophy index were significantly attenuated in DP group(P<0.05),but there was no significant difference in plasma glucose between them(P>0.05).As compared with NC and NP groups,the expression of TSP1 and TGF-β1 was significantly elevated in the kidney of DM and DP groups(P<0.01).Both TSP1 and TGF-β1 expression in DP group was lower than in DM group(P<0.05).Conclusion Pioglitazone can exert a direct protective effect on the kidney in diabetic rats,which is independent of the role of insulin sensitizer,and the mechanism may be associated with the decreased TSP1 expression in the kidney.

SUMMARY Diffusion spectrum imaging ( DSI) , a newly developed MRI technique, affords the capacity to map complex fiber architectures in tissues with sufficient angular resolution by imaging the spectra of tissue water diffusion. By contrast, diffusion tensor imaging (DTI) , the currently widely used technique based on the 2nd order tensor model, obtains an approximation of the complex diffusion, and provides only one global maximal direction corresponding to the primary eigenvector for each voxel. As a generalized model-free diffusion imaging technique, firstly, DSI employs the probability density function to describe the diffusion process in each voxel; secondly, a sufficient dense signal sample derived from repeated applications of diffusion-weighed gradients ensures its capability to resolve the diffusion probability density function; thirdly, specific computer visualization techniques are used to extract the diffusion information and reconstruct the geometrical properties of tissue microstructure. The capacity to unravel complex tissue architecture, recent improvements in hardware and ongoing optimization of sequence design and algorithm enable a rapid growth of DSI for research use and future incorporation into clinical protocols. This paper introduces the basic principles of DSI and then compares the characteristics of DSI and DTI schemes. Finally, the typical applications of DSI to date are reviewed.

Objective To assess the effect of intraperitoneal interstitial implant of Sustained-release 5-Fluorouracil during operation for advanced rectal cancer. Methods One hundred and four cases with advanced rectal cancer were enrolled into the study and divided into 3 groups: treatment group 1(n = 37), underwent combined hypotonic peritoneal chemo-hyperthermia and Sustain-released 5-fluorouracil implantation treatment during operation; treatment group 2(n = 34), underwent combined intraoperative hypotonic peritoneal chemohyperthermia and early postoperatively intraperitoneal chemotherapy treatment; and control group(n = 33),underwent peritoneal lavage during radical resection alone. Results Digestive tract toxicity in group 1 was significantly lower than that in group 2(2. 70% vs. 20. 59%, x2 = 9. 104, P ＜ 0. 05). There were significant difference on 1 year survival rate among the three groups. The 2-year survival rate of group 1 was significantly higher than that in the control group (78. 37% vs. 48. 48%, x2 = 1. 297 ,P ＜ 0. 05). After two years follow-up the 2-year local recurrence rate of group 1 was significantly lower than that in the control group(21.62% vs 32. 35 %, x2 = 7. 001, P ＜ 0. 05). However, no significant difference was found compared to group 2, which was 32. 35%. Conclusion lntraperitoneal interstitial implant of Sustain-released 5-Fluorouracil during operation is an effective intraperitoneal chemotherapy with mild side effects for advanced rectal cancer.

Objective To compare the clinical effects between continuous renal replacement therapy (CRRT) and intermittent haemodialysis (IHD) for the treatment of sepsis-induced acute kidney injury (AKI). Methods A prospective study was conducted. Seventy-three patients with sepsis-induced AKI admitted to the intensive care units (ICUs) of Tianjin Hospital and Tianjin First Center Hospital from January to December in 2014 were enrolled. They were randomly divided into two groups: CRRT group (n = 35) and IHD group (n = 38). Data were recorded for the patients in two groups before treatment, including acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score, mean arterial pressure (MAP), urine volume, and the levels of C-reactive protein (CRP) and serum creatinine (SCr) before and 1 week after treatment, the time of recovery of urine volume, the length of ICU stay, the duration of organ support, and the incidence of cardiovascular events. Results There was no statistically significant difference in APACHE Ⅱ scores (21.63±2.46 vs. 21.34±2.46), MAP [mmHg (1 mmHg = 0.133 kPa): 71.26±10.70 vs. 75.74±15.17], urine volume (mL: 404.00±79.13 vs. 438.97±87.17), CRP (mg/L: 100.94±14.73 vs. 95.17±27.03), and SCr (μmol/L: 394.02± 50.26 vs. 390.47±54.42) before treatment between CRRT group and IHD group (all P > 0.05). One week after treatment, compared to the IHD group, CRRT could dramatically reduce the levels of CRP (mg/L: 41.05±10.15 vs. 60.21±14.78, t = 6.401, P < 0.001), SCr (μmol/L: 185.97±65.48 vs. 232.02±71.93, t = 2.862, P = 0.006), urine output recovery time (days: 7.94±3.06 vs. 11.08±3.71, t = 3.923, P < 0.001), the length of ICU stay (days: 9.54±3.39 vs. 13.42±3.89, t = 4.521, P < 0.001), organ support time (days: 3.23±2.70 vs. 6.34±3.36, t = 4.343, P < 0.001), and the incidence of cardiovascular events [23.53% (8/35) vs. 39.47% (15/38), χ2 = 5.509, P = 0.025]. Conclusion Compared to IHD, CRRT can more efficiently help patients with sepsis-induced AKI in removing excessive water, metabolic waste, and lower the levels of pro-inflammatory cytokines, maintain homeostasis of the internal environment, lower the adverse effects on cardiovascular system, so that it significantly improve the prognosis of patients, shorten the time of organ support and the length of ICU stay.

Sperm DNA fragmentation index (DFI) refers to the percentage of DNA strand breaks in the total sperm. Many studies suggest that elevated DFI can lead to male infertility and early spontaneous abortion. High-DFI patients are more likely to fail in assisted reproduction and preliminary treatment or prevention methods have been developed for this population. This review focuses on the impact of DFI on clinical pregnancy outcomes and progress in the studies of its treatment.
Abortion, Spontaneous ; Chromatin ; DNA Fragmentation ; Female ; Humans ; Infertility, Male ; Male ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic ; Spermatozoa

Objective To observe the behavior changes and connexin 32(CX32),connexin 43(CX43)expressions in hippocampus and the effect of carbenoxolone on their expression in epileptic immature rats induced by lithium-pilocarpine.Methods Seventy-two SD immature rats of 21 d were randomly divided into control group(n=24),lithium-pilocarpine kindled group(n=24)and carbenoxolone treated group(n=24),each group by 24 h,3 d,7 d and 30 d were subdivided into 4 groups(n=6).Immuno-histochemisty was used to observe the expressions of CX32 and CX43 in hippocampus areas of immature rats,and to observe their behavior changes.Results The scores of the severe elileptiform seizures(Racine Ⅳ/Ⅴlevel)in lithium-pilocarpine group were significantly higher than those in carbenoxolone treated group;The latency in carbenoxolone treated group was prolonged significantly(P

The double-lumen endobronchial tubes are usually applied to the anesthesia of wet lung operation for the isolation of both lungs during anesthesia and one-lung ventilation.Many young physicians of the department and on-the-anesthesia training doctors are very interested in the intubatton.According to the past teaching experiences,some opinions are given in such aspects as the tube standard,pre-checking,estimation of the intubation depth and the significance of monitoring the airway resistance.These basic considerations are always easily overlooked by some young anesthetists.

Objective To explore the current management strategy and effect of damage control operation(DCO)for severe pancreatic trauma. Methods The clinical data of 19 cases with severe pancreatic trauma were selected as the object of this study.A retrospective analysis was done on preference of DCO moduses and perioperative therapies.Results Operations were performed in all 19 patients including six cases(32%) treated with rapid surgical haemorrhage control,wound excision and drainage,three(11%) with Cogbill operation and 10(53%) with Whipple operation without reconstituted digestive tract.Then,all cases were under reoperations after SICU resuscitation.Death was caused by associated organs injuries and secondary infection,with mortality rate of 11%.The pancreatic fistula occurred in two cases(11%) that were healed by conservative treatments.Conclusion For severe pancreatic trauma cases in accordance with DCO indications,active and reasonable operation should be done according to location and degree of pancreas injury.