Objective To evaluate the indications and intraoperative management of nephron-spar- ing surgery (NSS) for renal cell carcinoma (RCC).Methods A total of 53 patients (32 men and 21 women;age range,21 -76 years) with unilateral RCC and a normal contralateral kidney underwent NSS.The disease course ranged from 1 week to 13 months.The unilateral RCCs were detected by B-uhrasonography. Partial nephrectomy was performed on 38 cases of polar RCC and wedge nephrectomy was performed on 15 cases of central RCC.Both renal vein and artery were blocked for 10 - 15 min,and unclamped for 1 -2 min if necessary.The resections were finished within 7 -21 min (mean,12 min).No inosine and regional hypo- thermia were used during operation.Absorbable hemostatic gauze and terylene flake were used to suture renal wound surface.After operation all patients were treated with interferon hypodermic injection of 5 000 000 U every other day for 3 months.Results The diagnosis of RCC with negative cutting margin was confirmed by pathological examination in all patients.The greatest dimension of the renal cancers were＜4 cm except for one of 6 cm.The clinical stage was T_1N_0M_0 in all patients.During the follow-up of 6 -48 months,all pa- tients were alive without recurrence and had normal renal function.Conclusions NSS can be rapidly per- formed for T_1 stage renal cancer＜4 cm or single clearly localized cancer＞4 cm in diameter.The follow-up results are satisfactory.

Objective To study local people's habits and customs concerning the prevention of dental fluorosis in an indoor coal-combustion-type fluorosis area of Zhaotong city Yunnan province, and to provide reference value for monitoring and control of the disease. Methods In 2008, 600 people of a 12-year-old group (400 people) and a 35 - 44-year-old group(200 people) were examined for dental fluorosis and oral health status in an indoor coal-combustion-type fluorosis area of Zhaotong. A questionnaire survey of 120 students and 60 adults was carried out on their habits and customs, stove changing status, knowledge of prevention of dental fluorosis, social psychology status, oral health behavior and their need for medical treatment. Results The total prevalence of dental fluorosis was 91.0% (546/600), dental fluorosis index was 2.58. The total prevalence of dental fluorosis of 12-year-old group was 86.5%(346/400), and dental fluorosis index was 2.12. The total prevalence of dental fluorosis of rural student was 90.5% (181/200), which was obviously higher in the rural group than the urban group [82.5% (165/200), χ2 = 5.48, P < 0.05]. The total prevalence of dental fluorosis of 35-44-year-old group was 100% (200/200), which was obviously higher than that of the 12-year-old group(χ2 = 29.67, P < 0.01). The rates of using coal, baking of food, changing stoves were 66.7% (60/90), 14.4% (13/90),57.8% (52/90), respectively, and these values of the urban were much lower than those of the rural[95.6%(86/90) ,31.1%(28/90) ,76.7%(69/90),χ2 = 24.51,7.11,7.29, all P < 0.01]. Only 23.3% (42/180) of people surveied had the knowledge of prevention of dental fluorosis, and the rate in the adult group[56.7% (34/60)]was higher than that of the student group [6.7% (8/120), χ2 = 55.9, P < 0.01]. The same rate in the urban student group was 0(0/60), and the rural student group was 13.3%(8/60), there was a significant difference between them(χ2 = 5.66, P < 0.05). Seventy-three point nine per cent( 133/180) of these people thought dental fluorosis had significant effect on their life, 91.1%(164/180) of these 'people wished to be treated. Eighty-four point four per cent( 152/180) of the people had a habit of toothbrushing,and 50.7% (77/152) of these people were still using toothpaste containing fluorine. Conclusions Zhaotong is a serious indoor coal-combustion-type fluorosis area. Enhancing health education to local people especially to students, and changing people's unhealthy habits and customs are keies to control the prevalence of indoor coal-combustion-type dental fluorosis.

OBJECTIVE: To determine the effects of reacting cortisol on ischemic preconditioning (IPC). METHODS: Thirty rabbits were randomized into ischemic preconditioning (IPC) group, etomidate (Etom) group, ischemic/reperfusion (IR) group, methylprednisolone (MP) group and a control group. The ratios of infarction size versus risk area (Infarct/Risk) were calculated. The elevations of serum CK activity and cTnI concentrations as well as serum cortisol concentrations were measured. RESULTS: The ratios of Infarct/Risk were 5.9%+/-2.8% for IPC, 11.3%+/-3.6% for Etom, 26.8%+/-4.5% for IR and 18.2%+/-3.7% for MP. The elevations of serum CK activity (U/L) were 255+/-89 for IPC, 314+/-160 for Etom, 855+/-371 for IR and 768+/-404 for MP, the elevations of serum cTnI concentrations (microg/L) were 3.6+/-0.6 for IPC, 5.9+/-2.0 for Etom, 8.1+/-3.6 for IR and 6.1+/-2.3 for MP. Those indicators among groups are all significantly different (P<0.01). Cortisol reacting was markedly diminished in Etom group. CONCLUSION A blunted cortisol reaction can markedly undermine the benefit of ischemic preconditioning, methylprednisolone show a certain myocardial protection. Cortisol may play an important role in the IPC process.
Animals ; Creatine Kinase, MB Form ; blood ; Etomidate ; therapeutic use ; Female ; Ischemic Preconditioning, Myocardial ; Male ; Methylprednisolone ; therapeutic use ; Myocardial Reperfusion Injury ; blood ; prevention & control ; Rabbits ; Random Allocation

Humans ; Infant ; Female ; Dandy-Walker Syndrome/diagnosis* ; Tomography, X-Ray Computed ; Craniocerebral Trauma/complications*

Pleomorphic xanthoastrocytoma (PXA) is a rare benign tumor that is usually located in the superficial cerebral hemisphere. Most reports of PXAs have included only a single case or small series. Therefore, the data with respect to the natural history of this tumor are fragmentary. We report a case of a PXA in the unusual location of the right lateral ventricle with extensive subarachnoid dissemination. To our knowledge, this is a rare case of PXA in the lateral ventricle. In addition, extensive subarachnoid space dissemination of this distinctly benign type of glioma is exceedingly rare. In our case, there was meningeal dissemination and metastases to the bilateral trigeminal nerves and oculomotor nerves. The neuroradiographic features, tumor location, and dissemination were reviewed.
Adult ; Astrocytoma ; diagnosis ; Brain Neoplasms ; diagnosis ; Female ; Humans

OBJECTIVETo investigate the preparation method of polystyrene core-poly (acrylamide-acrylic acid) shell fluorescent microspheres.

METHODSThe polystyrene core-poly (acrylamide-acrylic acid) shell (P-(St-co-AAM)) fluorescent microspheres were prepared using fluorescent microspheres as the core and acrylamide/acrylic as polymerization monomer. Reaction conditions affecting the morphology of core-shell structure including feeding mode, initiator, cross linker, pH, concentration and swelling were studied.

RESULTFluorescent microscopy showed that the relatively uniform particle sizes were distributed in a range of 7-8 μm. Fourier transform infra-red spectroscopy (FT-IR) proved the existence of poly (acrylamide-acrylic acid) shell and amide group on the surface. The optimal conditions for seeding polymerization: azobisisobutyronitrile was used as the initiator in the absence of cross linker, after a 40 h swelling treatment by using alcohol with the appropriate reaction temperature (70 degree), reaction time (3 h) and pH(6-7). The average dispersion and stability were 25.14 % and 90.21%, respectively. The fluorescein release percentage was kept stable at approximately 30% after 40 h.

CONCLUSIONThe fluorescent microspheres prepared by this method have core-shell structure and satisfactory fluorescence properties with good dispersion and stability.

Acrylates ; chemistry ; Acrylic Resins ; chemistry ; Fluorescein ; chemistry ; Microspheres ; Polymerization ; Polystyrenes ; chemistry

Objective To investigate the status of taste changes and self care in cancer patients during chemotherapy in order to provide evidence for nurses to help patients taking self care effectively.Methods A questionnaire regarding self-care strategies to cope with taste changes was given to a total of 118 inpatients after two cycle of chemotherapy for collecting information.Results One hundred and twenty questionnaires were released and 118 were retrieved with a effective response rate of 98％.Among 118 patients,the incidence of taste changes was 79.7％,but 54.2％ of them had not taken any methods to cope with it.Conclusions Taste changes were commonly symptoms and had obvious negative effects to patients in chemotherapy,while the patients are lack of self-management of taste changes.Nurses may take interventions to minimize the negative effects and promote patients to perform self-care actions to improve their quality of life.

OBJECTIVETo summarize the results and experiences on extracorporeal membrane oxygenation (ECMO) for post-cardiac surgery of coronary artery disease.

METHODSFrom June 2004 to November 2006, sixteen patients with the mean age of (58 +/- 11) years old undergoing cardiac surgical procedures were placed on ECMO using a heparin-bonded circuit. Fourteen patients were male and two patients were female. Thirteen patients underwent on pump coronary artery bypass surgery (CABG) and three patients underwent off-pump coronary artery bypass grafting. The duration of ECMO support, stay of intensive care unit (ICU stay), complications and turnovers were recorded.

RESULTSThe mean duration of ECMO support was 51 hours, and the mean duration of ICU stay was 5 days. Thirteen patients (81.3%) were successfully weaned form ECMO, ten patients (62.5%) were discharged from hospital. The main complications were bleeding, infection, renal failure and ischemia of the lower limbs with the incidence of 18.8%, 37.5%, 25% and 18.8% respectively.

CONCLUSIONECMO is an acceptable technique for shortterm treatment of refractory low cardiac output after cardiac surgery of coronary artery disease.

Adult ; Aged ; Coronary Artery Bypass ; Coronary Artery Bypass, Off-Pump ; Coronary Artery Disease ; surgery ; therapy ; Extracorporeal Membrane Oxygenation ; Female ; Humans ; Intensive Care Units ; Length of Stay ; Male ; Middle Aged ; Postoperative Care ; Treatment Outcome

Vaccination is an effective way to reduce the morbidity and mortality of infectious diseases. As a needle-free transcutaneous immunization (NF-TCI) vaccination technology, microneedles (MNs), composed of multiple micro-needles orderly attached to a substrate, can overcome the problems of low immune efficiency, poor compliance and waste of resources that exists in the conventional vaccination by injection, thus becoming a research hotspot in biomedicine. The microneedle vaccine can directly break through the stratum corneum barrier of the skin without touching nerves and blood vessels in the dermis, and effectively delivers the vaccine to the immune cells in the skin tissue to initiate the immune response of the body, thus triggering strong humoral and cellular immune processes. Vaccine delivery via the MNs system possesses the advantages of high safety, satisfying immune effect and practical economy, and shows great prospect in the prevention and treatment of infectious diseases and antineoplastic therapy. This article reviews the development background of MNs in transcutaneous immunization, the types of vaccine delivery, the factors affecting the immune effect, the problems to be solved and development direction in the future.

OBJECTIVETo ascertain the causation of a pregnant woman with undefined pneumonia reported from the People's Hospital of Tongling city in Anhui province on November 2005.

METHODSEpidemiological and clinical information of the case was collected from the keypersons close to the case and referring to the medical record. A medical observation was carried out on the close contacts of the case and sick or dead poultry. Tracheal aspirates being collected were tested by both RT-PCR and real-time PCR to detect viral nucleic acids of A/H5N1, and were inoculated into special pathogen free (SPF) embryonated hens' eggs.

RESULTSThe pregnant woman was found to have been contacted with the sick/dead poultry directly on the 4th day before onset of illness. All the 122 close contacts were healthy after a 10-day medical observation. The major clinical features of the case were viral pneumonia with rapidly developed leukopenia and lymphopenia. The progress to acute respiratory distress syndrome and multiple organ dysfunction syndromes was found at clinical presentation. HA and NA gene of A/H5N1 virus were positive. The 8 gene fragments of A/Anhui/1/2005 (H5N1) isolated from the tracheal aspirates had not carried genes from a human virus through reassortment, and the receptor-binding site of the hemagglutinin was polybasic cleavage site.

CONCLUSIONThis was the first documented case of H5N1 infection in pregnant woman. The immunotolerant state of pregnancy might have predisposed to the fatal outcome of the patient.

Adult ; China ; Fatal Outcome ; Female ; Humans ; Influenza A Virus, H5N1 Subtype ; genetics ; isolation & purification ; Influenza, Human ; complications ; pathology ; Multiple Organ Failure ; Pneumonia ; virology ; Polymerase Chain Reaction ; Pregnancy ; Pregnancy Complications, Infectious ; virology ; Respiratory Distress Syndrome, Adult ; Trachea ; virology