Objective To develop a more ideal procedure of living donor nephrectomy. Methods Ten cases of living relate donor who received laparoscopic nephrectomy were regularly followed up from 2 to 12 months. Results These donors were discharged on the day 5 after operation. Renal function of the recipients was normal in 4 days after operation. The advantages of laparoscopic living related donor nephrectomy included smaller incisions, less pain, faster recovery and short hospitalization. Conclusion Laparo- scopic living related donor nephrectomy is effective and safe.

Objective To investigate the effect of Zhibaidihuangwan combined with clindamycin hydrochloride on serum IL-8, TNF-α, IL-10 levels in periodontitis and its clinical efficacy.Methods A total of 98 patients with periodontitis from our hospital were collected and randomly divided into the control group and the experimental group, 49 cases each group.Patients in the control group were treated on the basis of the foundation therapy with clindamycin hydrochloride, patients in the experimental group were treated with Zhibaidihuangwan on the basis of control group .The periodontal pocket depth, plaque index, gingival index and positive rate of probe bleeding, serum IL-8, TNF-a, IL-10 levels were measured, and the clinical efficacy were compared.Results The effective rate of the experimental group(93.88%) was higher than the control group(79.59%), with statistical significance (P<0.05).The positive rate of probe bleeding in experimental group (38.78%) was lower than control group of two groups(59.18%), with statistical significance (P<0.05).The periodontal pocket depth, plaque index, gingival index in experimental group were lower than the control group after treatment, the TNF-αand IL-8 levels in experimental group were lower than the control group, IL-10 was higher than the control group after treatment, with statistical significance (P<0.05).Conclusion Zhibaidihuangwan combined with clindamycin hydrochloride could reduce periodontitis serum IL-8 and TNF-αlevels, improve the level of IL-10.

OBJECTIVETo evaluate the small fiber function in patients with type 2 diabetes mellitus of the early stage by measuring the sensory threshold with the quantitative temperature testing technology.

METHODSTwenty cases of patients with type 2 diabetes with no neurological deficit (DM group) and twenty age and sex-matched healthy controls underwent the detecting of cold sensory threshold (CST), warm sensory threshold (WST), cold pain threshold (CPT), heat pain threshold (HPT) in both inside of their hands.

RESULTSThere was no significant difference in CST, WST, CPT and HPT between left and right inside of hand of the same sample among all the testers. But the four kinds of threshold showed significant difference in the right inside of hand between patients and healthy people ( P < 0.05). In addition, the CST and WST differed significantly in the left inside of hand between the patients and healthy controls while the CPT and HPT showed no significant difference in the left inside of hand between them. Patients group and control group with CST and WST on the left side of the comparison difference was statistically significant (P < 0.05).

CONCLUSIONQuantitative analysis of temperature sense threshold can not only reflect increase of the pain threshold value, also can reflect its decrease, i. e. hyperalgesia, which may help to diagnose small fibrous peripheral neuropathy recognition, especially in early diabetic peripheral neuropathy.

Case-Control Studies ; Cold Temperature ; Diabetes Mellitus, Type 2 ; physiopathology ; Diabetic Neuropathies ; diagnosis ; Hot Temperature ; Humans ; Hyperalgesia ; Pain Threshold ; Sensory Thresholds ; Thermosensing

Objective To evaluate the angiogenic effect of the bone marrow mesenchymal stem cells (MSCs) transfected with adeno-associated virus (rAAV) -mediated human vascular endothelial growth factor 165 (VEGF165) gene, to detect the expression and bioactivity of VEGF in the MSCs.and to detect the expression and bioactivity of VEGF165 gene in the area of ischemic skeletal muscle in rats. Methods The MSCs were cultured by whole bone marrow culture method, then the MSCs were transfected with rAAV-VEGF165, the expression of VEGF was examined using ELISA and RT-PCR. The model of ischemic skeletal muscle was established by ligation in inbred rats. The rats were injected with PBS at the ischemic zone (group A), MSC (group B), hVEGF-transfected MSC (group D), and 7 days later they were injected with hVEGF transfected MSC (group C). Six weeks after the transfection, the capillary density of the ischemic zone was examined by factor Ⅷ stain. Results The MSCs were cultured successfully according to the expressions of positive CD44 and CD90,negative CD34. In rAVV-VEGF165 transfected group, the secretion levels of VEGF165 in supernatant were significantly higher than in non-transfected group 1,3,5,7 and 9 days after injection [(131. 98±6.00) ng/L vs. (68. 72±1.99) ng/L; (263. 96±4.58) ng/L vs. (76. 47±4.98) ng/L;(540. 85±5.97) ng/L vs. (89. 86± 1.99) ng/L; (208. 98± 5.06) ng/L vs. (84. 93±8. 97) ng/L;(174.45±5.00) ng/L vs. (68.71±5.98) ng/L, all P＜0.05]. On the position of 579 bp, highbrightness strip could be seen. There were no significant differences in growth curve and cell morphology between transfected group and non-transfected group. Six weeks after the transplantation, the capillary density was significantly greater in group D [(9.35 ± 2.72)/ vision]than in group A [(1. 05±0. 50)/vision] ,group B [(3.10± 1.43)/vision, both P＜0. 01)] and group C [(6. 95± 1.69)/ vision, P＜0. 05] Conclusions MSCs are helpful for the stable expression of hVEGF gene, and it is good cellular vehicle for VEGF genes. The effect of combined therapy is much better than separate transplantation of MSCs. The best time to transplant is 10 days after surgical operation.

Objective To investigate the effect of DPP-4 inhibitor sitagliptin on atherosclerosis and its mechanism.Methods Thirty male ApoE-/-mice were randomly divided into two groups:experimental group(n=15) and control group(n=15).The mice in the experimental group were fed with high-fat mixture of sitagliptin and the control group was fed with high fat.Collected blood in the eyeballs in order to analyze serum levels of blood lipids and blood glucose after 16 weeks of feeding,and detected serum nitric oxide synthase(eNOS),vascular adhesion molecule-1(VCAM-1) with ELISA method.Collected aortic tissue in order to analyze atherosclerotic plaque.Results There was no significant difference in blood glucose,triglyceride and total cholesterol level between the two groups(P>0.05).The serum high density lipoprotein in the experimental group was significantly higher than that in the control group(P<0.05).The atherosclerotic plaque in the experimental group(7.55±1.87)%, which was significantly smaller than that in the control group(11.67±1.32)%.The serum VCAM-1 in the experimental group was lower and the eNOS was higher than that in the control group(P<0.05).Conclusion DPP-4 sitagliptin can increase the expression of HDL and eNOS and inhibit the expression of VCAM-1,thereby inhibiting the progression of atherosclerosis in ApoE-/-mice.

OBJECTIVE: To explore curative effect with pedicle flap of nasal septum-basis nasi and temporal muscucofascial flap to repair nasal septal perforation. METHOD: Dissecting mucoperichondrium and mucoperioseptum around the perforation and taking dowm and out xia-ward to the floor of nasal cavity to make a inferior extremity pedicle flap. Then,the flap was tumbled and sutured onto raw surface of contralateral side through perforation. Reapplicating autoallergic temporal musculofascial flap to repair another side perforation. RESULT: Repairing perforation Sin twelve cases were sucessfully healed in endoscope. CONCLUSION The pedicle flap of nasal septum-basis nasi and temporal muscucofascial flap is easy to acquire and no rejection. The flap has good blood supplying, high survival rate and provides adequate transplantating materail to repair comparatively large perforation.
Endoscopes ; Humans ; Nasal Cavity ; Nasal Septal Perforation ; Nasal Septum ; pathology ; surgery ; Paranasal Sinuses ; Surgical Flaps ; Wound Healing

Adolescent ; Anti-Bacterial Agents ; therapeutic use ; Child ; Child, Preschool ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis ; diagnosis ; drug therapy ; pathology ; Humans ; Lymph Nodes ; pathology ; Male ; Retrospective Studies ; Treatment Outcome

Objective To observe the expression of high mobility group A 1(HMGA1)protein in pituitary adenoma(PA)and explore its relationship with the aggressiveness and recurrence of PA .Methods The labeling index(LI)of HMGA1, detected by immunohistochemistry staining , was compared between aggressive and non-ag-gressive PA, recurrent and non-recurrent PA.Results The expression of HMGA1 were observed in all 52 cases of PA and homogenously distributed in nuclear of tumor cells .The LI of HMGA1 showed no significant difference between functioning and nonfunctioning PA (P=0.79), as well as among different immunophenotypical variants of PA(P=0.28).The expression of HMGA1 was significantly higher in the aggressive PA than in the nonaggres-sive PA(0.50 ±0.20 vs 0.24 ±0.17, P=0.000).Patients with a recurrent PA had a higher value of HMGA 1 than patients with a non-recurrent PA(0.60 ±0.20 vs 0.24 ±0.18, P=0.000).The expression of HMGA1 in-creased stepwise with the tumor size, as the highest was present in macro-sized PA(0.52 ±0.20)and the lowest was in micro-sized PA(0.18 ±0.17).A similar trend was found in Hardy's grade I(0.18 ±0.17),II(0.30 ± 0.20)and III-IV(0.50 ±0.20)(P=0.003).The area under the ROC curve was 0.918(>0.90).When the LI reached 49.2%, the predicting specificity was 90.5%and the sensitivity was 71.4%.Conclusions The LI of HMGA1 has a positive correlation with the tumor size , aggressiveness and recurrence of PA and also has a valua-ble predicting efficacy for PA recurrence .The characteristics of HMGA 1 in PA can help pathologists make repro-ducible evaluation on prognosis of PA .

Objective To investigate the expression of hepatic glucose transporter-2 ( GLUT-2 ) and glu-cokinase(GCK)after gastric bypass(GBP)in type 2 diabetes mellitus(T2DM)GK rats and to discuss the mecha-nism of GBP improving insulin resistance .Methods 30 male GK rats aged 8 weeks were randomly divided into 3 groups:the operation group(10 rats), the sham operation group(10 rats)and the diet control group(10 rats), and 10 male SD rats aged 8 weeks were made as blank control group .The levels of fasting plasma glucose ( FPG) and fasting insulin(FINS)were measured and compared among the 4 groups before and 1,2 and 4 weeks after the operation and then the rats were sacrificed to retrieve the liver .The expressions of GLUT-2 and GCK mRNA and protein were detected by PT-PCR and Western blot respectively .Results As for GK operation group ,FPG levels at the 1st, 2nd,and 4th week after surgery ((11.06 ±0.52) mmol/L,(7.49 ±0.34) mmol/L,(5.20 ±0.08) mmol/L)respectively)were all lower than that before surgery (all P<0.05),and FINS level at the 4th week after surgery increased from(11.90 ±0.75)mmol/L to(14.20 ±1.23)mmol/L(P<0.05).The expressions of GLUT-2 and GCK mRNA and protein significantly increased in GK operation group 4 weeks after surgery ( P<0.01 ) . Conclusion The expressions of hepatic GLUT-2 and GCK in insulin signal transmission in T2DM rats are up-regu-lated after GBP , which enhance the signal transmission of insulin receptor , and improves the insulin sensibility .

BACKGROUND: Adequate preparation of donors and recipients prior to living-related donor renal transplantation, short warm and cold ischemia time for donor kidney, good histocompatibility of human leukocyte antigen match, and low postoperative rejection incidence provide feasibility for use of low-dose immunosuppressive agents after living-related donor renal transplantation. OBJECTIVE: To investigate the safety and effectiveness of low-dose calcineurin inhibitors (CNI), an immunosuppressive agent, in living-related donor renal transplantation. METHODS: A total of 38 recipients who underwent living-related donor renal transplantation at the Center of Renal Transplantation of the First Affiliated Hospital of Nanjing Medical University from January 2006 to June 2008 were randomized for treatment with mycophenolate mofetil (750 mg twice a day), prednisone, and either standard-dose CNI (n=18) or low-dose CNI (n=20) during 12 months post-transplantation. Ciclosporin A was given orally (starting dose, 6 and 4 mg/kg per day, respectively) in two divided doses to achieve the 12-hour whole blood concentration as measured by fluorescence polarization immunoassay. The starting dose of tacrolimus was 0.12 and 0.08 mg/kg per day respectively, and its whole blood concentration was measured by enzyme-multiplied immunoassay technique. After transplantation, patients were followed up. Renal function, pulmonary infection, liver dysfunction, and CNI nephrotoxicity at different time periods were compared between different regimens. RESULTS AND CONCLUSION: During 12 months post-transplantation, patient death occurred in one of 18 patients (5.6%) in the CNI standard-dose group and none of 20 patients (0%) in the CNI low-dose group. There was no significant difference in renal function and acute rejection between CNI standard-dose and CNI low-dose groups (P > 0.05). The incidence of liver dysfunction and CNI nephrotoxicity was significantly lower in the CNI low-dose group than in the CNI standard-dose group (P < 0.05). In addition, a low-dose CNI regimen helped recipients to lessen the economic burdens. These findings indicate that it is effective, safe and economical to use a low-dose CNI regimen in living-related donor renal transplantation.