Objective To compare the clinical efficacy of primary closure versus T-tube drainage after laparoscopic common bile duct exploration in acute cholangitis cases.Methods The clinical data of 100 patients with acute cholangitis undergoing laparoscopic common bile duct exploration from January 2012 to December 2014 were reviewed.54patients received primary closure of the common bile duct and 46 patients were subjected to T-tube drainage after choledochotomy.Results One hundred patients underwent the surgery successfully.Compared with the T-tube group,the operation time(96.72 min vs 123.00 min,P =0.001),intraoperative blood loss(27.13 ml vs 38.48 ml,P =0.009),postoperative gastrointestinal function recovery time(1.57 d vs 2.33 d,P=0.003) and postoperative hospital stay(6.19 d vs 9.20 d,P=0.000) were significantly less in the primary closure group.There were no statistical differences in the incidence of postoperative drainage (309.22 ml vs 212.46 ml,P =0.070),drainage time (3.96 d vs 4.02 d,P =0.875),incidence of bile leakage(9.3％ vs 0,P =0.060) and postoperative bleeding rate(5.1％ vs 2.2％,P =0.622) between these two groups.Conclusion Laparoscopic common bile duct exploration with primary closure of the common bile duct is an effective and safe procedure in acute cholangitis cases compared with T-tube drainage.

OBJECTIVETo investigate the impact of metal implants with different materials on radiation dose distribution based on film measurement method.

METHODSTitanium plate, titanium intramedullary pin and stainless steel plate were set into phantom and irradiated separately by 6 MV and 15 MV X ray from linear accelerator. Dose distributions derived from different materials metal implants were measured and analyzed by film dosimeter.

RESULTSFor 6 MV X ray, the maximum interface dose increments of titanium plate, titanium intramedullary pin and stainless steel plate were 12.3%, 15.4% and 20.3%. As the radiation energy was increased from 6 MV to 15MV, the maximum interface dose increment of the titanium plate rose from 12.3% to 15.1%, the maximum interface dose increment of the steel plate rose from 20.3% to 30.8%.

CONCLUSIONSMetal implants with different materials have obvious impact on radiation dose distribution. With the increase of the metal atomic number and energy of radiation, the degree of elevated dose also increases. These results suggest that correction of dose distribution is required for radiotherapy of patients with metal implants.

Metals ; Prostheses and Implants ; Radiotherapy Dosage

Objective To explore the relationship of height,weight and body mass index with fists size among adults,and to compare the regression coefficient of different models.Methods Adults aged 20 -80 years were selected by stratified cluster sampling methods.T -test and univariate analysis of variance were used to compare the height,weight and fists size stratified by gender and BMI group.Regression model for fists volume was established.The regression coefficients were compared through covariance interaction analysis.Results The height,weight,BMI and fists size of male were higher than that of female (P <0.01 ).The regression model for fists size(Y)of BMI(X)for male,female and total population were Y=1 67.603 +9.445X,Y =1 1 1 .1 83 +7.779X and Y =77.1 57 +1 1 .028X(R2 =0.324,0.322,0.271 ,P <0.05).Fists size of different BMI groups were related to their height (R2 =0.501 ,0.432,0.624,0.692,P <0.05),respectively, and their regression coefficients have no statistically differences (P =0.07).The fists sizes of different BMI groups were different(P <0.01 ).Fists size of overweight or obesity groups (365.641 ±68.51 4,365.641 ±68.51 4,respectively)were larger than that of the normal and slim groups(P <0.01 ),and fists size of normal body (31 4.261 ±59.590)was larger than that of slim body(261 .081 ±59.478).Conclusion The fists sizes of male were higher than that of female.Fists size was positively related to their BMI.The height had the some impact on fists size among people in different BMI groups.

Objective:To investigate whether hydrogen sulfide (H 2S) protects against intestinal ischemia/reperfusion (I/R) injury in rats by regulating c-Jun N-terminal kinase/activator protein-1 (JNK/AP-1) signaling pathway. Methods:Thirty male Wistar rats were divided into sham operated group (Sham group), I/R group, and H 2S donor sodium hydrosulfide (NaHS) intervention group (I/R+NaHS group), with 10 rats in each group. The I/R injury model was established by blocking the superior mesenteric artery with a non-traumatic vascular clip, with 60 minutes of ischemia followed by 120 minutes of reperfusion. In the I/R+NaHS group, 100 μmol/kg of NaHS was injected through the tail vein 10 minutes before reperfusion, followed by continuous infusion of 1.07 mmol·kg -1·h -1 until the end of the 120-minute reperfusion period. Plasma H 2S concentration was measured using a sensitive sulfur electrode. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels in the small intestine tissue were assayed spectrophotometrically. Histological sections of the small intestine were stained with hematoxylin-eosin (HE) staining and scored using the Chiu scoring system to assess the degree of intestinal mucosal injury. Western blotting was used to detect the protein expressions of phosphated-JNK (p-JNK), JNK, AP-1, and BCL-2 in the small intestine tissue. Results:Compared with the Sham group, the I/R group exhibited damage to the lamina propria, hemorrhage, and ulceration, with a significantly higher Chiu score (4.80±0.63 vs. 0.70±0.09, P < 0.01); plasma H 2S concentration and SOD activity in the ileum tissue were significantly reduced [H 2S (μmol/L): 17.29±1.40 vs. 34.62±1.48, SOD (kU/g): 5.38±0.93 vs. 20.56±1.85, both P < 0.01], while MDA level was significantly elevated (μmol/g: 16.06±1.71 vs. 4.80±0.92, P < 0.01); expression of BCL-2 protein in the ileum tissue was significantly down-regulated (BCL-2/β-actin: 0.32±0.06 vs. 0.79±0.05, P < 0.01), while expressions of p-JNK and AP-1 proteins were significantly up-regulated (p-JNK/β-actin: 0.69±0.03 vs. 0.10±0.03, AP-1/β-actin: 0.82±0.02 vs. 0.22±0.02, both P < 0.01). Compared with the I/R group, the I/R+NaHS group showed moderate separation between the epithelial and lamina propria layers, with partial damage to the tips of the villi; the Chiu score was significantly lower (2.90±0.56 vs. 4.80±0.63, P < 0.01); plasma H 2S concentration and SOD activity in the ileum tissue were significantly increased [H 2S (μmol/L): 24.48±1.84 vs. 17.29±1.40, SOD (kU/g): 10.29±1.26 vs. 5.38±0.93, both P < 0.01], while MDA level was significantly reduced (μmol/g: 7.88±1.01 vs. 16.06±1.71, P < 0.01); expression of BCL-2 protein in the ileum tissue was significantly up-regulated (BCL-2/β-actin: 0.44±0.06 vs. 0.32±0.06, P < 0.01), while expressions of p-JNK and AP-1 proteins were significantly down-regulated (p-JNK/β-actin: 0.54±0.05 vs. 0.69±0.03, AP-1/β-actin: 0.66±0.04 vs. 0.82±0.02, both P < 0.01). There was no statistically significant difference in the expression of JNK in the ileum tissue among the Sham group, I/R group, and I/R+NaHS group (JNK/β-actin: 0.63±0.02, 0.66±0.02, 0.64±0.02, respectively, P > 0.05). Conclusion:H 2S exerts a protective effect on intestinal I/R injury in rats by down-regulate the expression of the JNK/AP-1 signaling pathway, as well as reducing oxidative stress levels.

OBJECTIVETo study the clinical and enzymological characteristics of the children with mitochondrial respiratory chain complex III deficiency.

METHODThe clinical manifestations of five patients (3 males, 2 females) were summarized. Spectrophotometric assay was used for the analysis of respiratory chain complex I to V enzyme activity in peripheral blood leukocytes, after obtaining venous blood.

RESULT(1) Five patients were hospitalized at the age of 1 month to 15 years. Three patients had Leigh syndrome with progressive motor developmental delay or regression and weakness. One had severe liver damage and intrahepatic cholestasis. One presented muscle weakness. (2) Deficient complex I + III activity was identified in five patients. Their complex I + III activities in peripheral blood leukocytes were 3.0 to 14.2 nmol/min per mg mitochondrial protein (control: 84.4 ± 28.5 nmol/min per mg mitochondrial protein). The ratio of complex I + III to citrate synthase decreased to 3.5 to 22.9% (normal control 66.1 ± 14.7%). The activities of complex III decreased to 10.4 to 49.3% of the lowest control value, while complex I, II, IV and V activities were normal. The results supported the diagnosis of isolated respiratory chain complex III deficiency.

CONCLUSIONComplex III deficiency is a kind of disorder of energy metabolism with various manifestations. The complex I + III activities and the ratio of complex I + III to citrate synthase were lower than those of the control. The activities of complex I, II, IV and V were normal.

Adolescent ; Child ; Child, Preschool ; Electron Transport Complex I ; metabolism ; Electron Transport Complex II ; metabolism ; Electron Transport Complex III ; metabolism ; Female ; Humans ; Infant ; Leigh Disease ; Leukocytes, Mononuclear ; enzymology ; Male ; Mitochondrial Diseases ; diagnosis ; metabolism ; physiopathology

Mitochondrial respiratory chain complex II deficiency is a rare documented cause of mitochondrial diseases. This study reported a case of Leigh syndrome due to isolated complex II deficiency. A boy presented with progressive weakness, motor regression and dysphagia after fever from the age of 8 months and hospitalized at the age of 10 months. Elevated blood levels of lactate and pyruvate were observed. Brain magnetic resonance image showed symmetrical lesions in the basal ganglia. Mitochondrial respiratory chain complex I-V activities in peripheral leukocytes were measured using spectrophotometric assay. Mitochondrial gene screening of common point mutations was performed. The complex II activity in the peripheral leukocytes decreased to 21.9 nmol/min per mg mitochondrial protein (control: 47.3±5.3 nmol/min per mg mitochondrial protein). The ratio of complex II activity to citrate synthase activity (22.1%) also decreased (control: 50.9%±10.7 %). No point mutation was found in mitochondrial DNA. The boy was diagnosed as Leigh syndrome due to isolated complex II deficiency. Psychomotor improvements were observed after the treatment. The patient is 22 months old and in a stable condition.
Diagnosis, Differential ; Electron Transport Complex II ; deficiency ; Humans ; Infant ; Leigh Disease ; diagnosis ; etiology ; therapy ; Male ; Mitochondrial Diseases ; complications

OBJECTIVEThis study aimed to review the available literature on fertility-preserving treatment and pregnancy outcomes in patients with early-stage endometrial carcinoma who desired to preserve their fertility.

DATA SOURCESThe PubMed database (1992-2012) was searched for the words "conservative "OR" fertility sparing "OR" fertility preserving" AND "endometrial neoplasms" (MeSH). All relevant articles in English and the relevant references were collected.

STUDY SELECTIONData from published articles about fertility-preserving treatment of endometrial cancer, including the response and recurrence rate of conservative treatment, strategies of infertility treatment, pregnancy, and obstetric outcomes, were selected. Data were mainly extracted from 41 studies, which are listed in the reference section of this review.

RESULTSHormone therapy was the most common method used for early-stage endometrial carcinoma in patients who wished to preserve fertility. Sixty percent of the patients became pregnant after remission of the carcinoma. The percentage of patients who conceived in the assisted reproductive technology group was higher than that of the natural pregnancy group (80.0% vs. 43.2%, P < 0.01). A higher rate of preterm labor and multiple pregnancies was observed in the assisted reproductive technology group than that in the natural pregnancy group. The majority of pregnancies (71.4%) in the assisted reproductive technology group were achieved by in vitro fertilization-embryo transfer. The clinical pregnancy rate of transfer cycles in patients with endometrial carcinoma was 34.1%.

CONCLUSIONSAssisted reproductive technology is a good option in well-selected patients with early-stage endometrial carcinoma who have completed conservative treatment. In vitro fertilization-embryo transfer offers an opportunity to achieve an immediate pregnancy.

Endometrial Neoplasms ; therapy ; Female ; Fertility Preservation ; methods ; Humans ; Neoplasm Staging ; Pregnancy ; Pregnancy Complications, Neoplastic ; Pregnancy Outcome ; Reproductive Techniques, Assisted

3-Hydroxy-3-methylglutaric aciduria is a rare disorder of organic acid metabolism caused by 3-hydroxy-3-methylglutaryl-coenzyme A lyase deficiency. The disorder was common in neonatal or infant period. Here a case of late onset 3-hydroxy-3-methylglutaric aciduria complicated by leucodystrophy was reported. The patient was a 7-year-old boy. He presented with progressive headache, drowsiness and vomiting. Hepatic lesions, ketosis and leucopenia were found. Symmetrical diffused leucodystrophy was shown by MRI. Blood levels of isovalerylcarnitine and acetylcarnitine increased significantly. Urinary levels of 3-hydroxy-3-methylglutaric, 3-methylglutaconic, 3-hydroxyglutaric acids and 3-methyl-crotonylglycine increased significantly. Symptoms were released by intravenous infusion of L-carnitine and glucose. After treatment for 6 months, urinary levels of 3-hydroxy-3-methylglutaric aciduria decreased in the boy and his health improved.
Acetyl-CoA C-Acetyltransferase ; deficiency ; Amino Acid Metabolism, Inborn Errors ; complications ; Child ; Hereditary Central Nervous System Demyelinating Diseases ; diagnosis ; etiology ; Humans ; Male

Objectives: High dose chemotherapy supported therapeutic outcome by AHSCT has developed dramatically in recent years and become the most effective approach to improve for the chemo-sensitive lymphoma. The purpose of this study was to evaluate the efficacy of mobilization regimen, effectiveness and tolerance of BEAC regimen in Chinese patients with advanced and recurrent lymphoma,and hemotopoietic reconstitution. Methods: After confirmed complete or partial remission from conventional chemotherapy, 20 patients with advanced or recurrent lymphoma, 1 recurrent HD and 19 NHL;14 male and 6 female with median age 28(range,13-48)years old， were enrolled into this study and treated with BEAC regimen(CTX 3600-4000 mg/m2, VP-16 1200 mg/m2. BCNU 300 mg/m2 and Ara-C 1500-2000 mg/m2). Three patients were supported by ABMT and 17 by APBSCT. Mobilization regimen for APBSCT was CTX 3500 mg/m2＋ G-CSF 3.5-5 μ g/kg＋ Dexamethasone 10 mg. Autologous hemotopoietic stem cells was re-infused 24-48 hours after completion of high dose chemotherapy. Results: MNC 1.3(range,1.0～1.7)× 108/kg and,MNC 1.8(range,1.0-4.4)× 109, CFU-GM 5.1(range,1.9-9.6)× 105/kg and CD34＋ cells 2.9 (range,1.9～8.7)× 106/kg were re-infused in the ABMT group and APBSCT group respectively. All patients obtained prompt and sustained hemotopoietic reconstitution. ANC ≥ 0.5× 109/L and Pt ≥ 2.0× 109/L were at day 9 (range,6～17) and day 10 (range,0～31) respectively. Fourteen patients were alive with median 18(range,1～67)months follow-up till end of April,2000. The 1,2,and 3 years survival rate were 61.2％ , 53.4％ and 53.4％ ,respectively. Non-hemotologic toxicity was mild and tolerable. Conclusion: High dose chemotherapy supported by AHSCT in the treatment of poor-prognostic and recurrent lymphoma is a safe and effective modality. However further investigation is warranted.

OBJECTIVETo identify specific protein markers for renal cell carcinoma detection and diagnosis, as well as develop new potential therapeutic targets of the disease.

METHODSWe used two-dimensional difference in-gel electrophoresis (2-D DIGE) technique conjunction with mass spectrometry (MS) for the identification of significant differentially expressed proteins between 15cases of paired clear cell renal cell carcinoma (ccRCC) and adjacent normal renal tissues. The protein spots were considered as differentially expressed if a 1.5-fold altered expression level was observed (Student's t test, P value<0.05).

RESULTSOf the 27 differentially expressed protein spots, 26 proteins were successfully identified. 11 proteins up-regulated in renal cell carcinoma,15 proteins down-regulated. Among them Short/branched chain specific acyl-CoA dehydrogenase, mitochondrial (ACDSB), Aldose 1-epimerase (GALM), Peroxiredoxin-4 (PRDX4), Macrophage-capping protein (CAPG), Beta-defensin 107 (D107A), Microfibril-associated glycoprotein 4 (MFAP4) were first time screening as new differential expressed proteins by protomic study in renal cell carcinoma.

CONCLUSIONS2-D DIGE is a useful technique for screening and analysis differential expressed proteins in renal cell carcinoma. These new differently expressed proteins may be useful for development new molecular markers for the tumor.