Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods From September 2013 to September 2015,the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy were reviewed.There were 14 males and 21 females,aged 15-70 years,with the average of 45.8 years.Preoperative CT scan showed 19 adrenal tumors in the left side,16 in the right side,and one case with the left adrenal adenoma combining with right renal cyst.Tumor diameter is between 10 ～ 60mm,with the average of 31mam.Twenty-two cases were diagnosed as primary aldosteronism,4 pheochromocytoma,and 9 non-functional adrenal tumor.The posterior retroperitoneoscopic adrenalectomy were performed in all of the cases,which are under general anesthesia with tracheal intubation and prone position with hip joints and knee joints flexion of 90.Results Thirty-five operations were successfully completed via the posterior approach demonstrating clear anatomical layers.The operation time was 38-138min(mean 70 min),the drainage tube indwelling duration was l-Sd(average 2d),and the hospital stay was 2-6d (average 4d).Total costs of hospitalization were 14 789-31 992 yuan RMB,with an average of 21 239 yuan RMB.No complications occurred during the perioperative period.The average follow-up was 11 months,and no complications such as tumor recurrence occured.Conclusions Retroperitoneoscopic adrenalectomy provided clear anatomical views.It could be a safe and effective operation for the treatment of adrenal tumors.

This paper aims to find out the use status of medical and sanitary equipment in primary unit. By means of investigating grass-roots health institutions and summarizing practical works, such problems in equipment were detected as standard vacancy, datedness and laggardness, partly absence, nonstandard management, untimely maintenance and low rate of utilization, etc. This paper puts forward some suggestions corresponding to the above disadvantages.

Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods To review the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy from September 2013 to September 2015.There were 14 males and 21 females, aged 15-70 years, with an average of 45.8 years.Preoperative CT scan was performed to determine the size, shape and location of the tumor.Tumor diameter 10-60 mm, average 31 mm.Results 35 operations were successfully accomplished via the posterior approach.The operation time was 38-138 min (mean 70.1 min) ,and the drainage tube indwelling time was 1-5 d(average 2.1 d) ,the hospital stay was 2-6d(average 3.7 d).Total hospital costs were 14 789-31 992 yuan, average of 21 239 yuan.No complications occurred during the perioperative period.Conclusions Posterior retroperitoneoscopic adrenalectomy might provide clear anatomical views.It could be a safe and effective operation for the clinical treatment of adrenal tumors.

BACKGROUND:Experiments have shown that the col agen substrate has the capability of stimulating cartilage generation, but the stimulating role of different types of col agen substrates remains controversial. OBJECTIVE:To investigate the effect of type I and type II col agen on the biological characteristics of human chondrocytes cultured in vitro. METHODS:Human chondrocytes at passage were cultured onto the ordinary culture plates (ordinary plate), type I col agen-coated culture plates (type I plate), and type II col agen-coated culture plates (type II plate). cellgrowth curves were determined by MTT method after cells were cultured for 10 days. By ELISA, PCR, and 1,9-dimethyl methyleneblue technology, type I and type II col agen and glycosaminoglycan contents were quantitatively detected in cartilage cells 28 days after culture. RESULTS AND CONCLUSION:The number of cartilage cells was the highest in type II plate, which was twice of that in type I plate and five times of that in ordinary plate. Cartilage cells in type II plate secreted the least amount of type I col agen, which showed significant differences compared with the ordinary plate (P<0.01) and had no statistical y significant difference with type I plate (P>0.01). Cartilage cells in type II plate secreted the most amount of type II col agen and glycosaminoglycan, showing significant differences compared with the other two plates (P<0.01). The cartilage cells cultured in col agen plates are better than that cultured in ordinary culture plate, type II col agen culture plate is better than type I col agen culture plate in maintaining cellshape, extending the dedifferentiation pattern, and promoting celldifferentiation.

Objectives To explore the effects of the blood supply extent on the temperature of target site of tumor and volume of coagulation necrosis (V),and to provide experimental evidence for further precise control of dosage of high intensity focused ultrasound (HIFU) and improve the efficiency of HIFU in the treatment.Methods Twenty-four rabbit liver VX2 tumor models were established and were divided into four groups:10 d group,15 d group,20 d group,no blood supply group (rabbits were put to death in the 10 d after the models were established).The same irradiation parameters of HIFU were used to irradiate the hepatic tumor tissue of every group,the real-time temperature of target site of tumor were measured,the software from temperature controller was used to plot the time-temperature curve (TTC),V was measured after HIFU.Residual tumor tissue was resected for pathological observation and microvascular density (MVD) determination.Results (1) Histopathological analysis showed that the extent of a tumor's blood supply followed the order 10 d group ＞ 15 d group ＞ 20 d group (P ＜ 0.01).(2)Tmax,T1,k1:betweengroups had no statistical difference among 10 d group,15 d group,20 d group (P ＞0.05),T T1,and k1 between three groups with no blood supply group had statistical difference (P ＜ 0.05).(3) k2:10 d group ＞ 15d group ＞ 20d group ＞ no blood supply group;T2:10d group ＜ 15d group ＜ 20d group ＜ no blood supply group;(4)V:10 d group ＜ 15 d group ＜ 20 d group ＜ no blood supply group.Conclusions The extent of a tumor's blood supply had a significant effect on the temperature-decrease phase but not on the temperature-increase phase during HIFU treatment.The more abundant blood supply of the tumor was,the faster heat abstraction after HIFU was;and the easier the tissue return to normal temperature,the smaller the volume of coagulation necrosis tissue were.

Gene chip is a research tool on molecular biology which can detect generous gene expression rapidly.The studies on gene chip of leiomyoma have revealed the changes of gene expression related to cell growth,proliferation,apoptosis,metabolism,angiogenesis,formation of extracellular matrix,cell differentiation and immunity.The article reviews the advance on gene chip of leiomyoma and approaches the pathogenesis of leiomyoma on molecular level.

Gliomas constitute the most common type of primary brain tumor. Alternative pre-mRNA splicing may play roles in the carcinogenesis, cell growth and invasion in various types of gliomas. Factors regulating the alternative spicing in gliomas include cis-regulatory element (for example, ESE, ISS and ESS) and trans-regulatory factors (such as SRp55, SC35, SF2/ASF and PTB). Recent progresses demonstrate that many genes associated with gliomas, including those encoding tumor suppressors or promoters, enzymes, receptors and ion channels are subject to regulation by alternative pre-mRNA splicing. Therefore, studying the alternative pre-mRNA splicing in gliomas will be of benefit to understanding the molecular basis of gliomas and identifying new targets potentially useful for early diagnose as well as therapy of gliomas.

Objective To evaluate the effect of alveolar recruitment maneuver on the perioperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.Methods Forty morbidly obese patients of both sexes,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-64 yr,with body mass index ≥ 40 kg/m2,scheduled for elective laparoscopic sleeve gastrectomy,were randomly divided into either control group (group C) or alveolar recruitment maneuver group (group R) using a random number table,with 20 patients in each group.Patients in group C were treated with volume-or pressure-controlled ventilation after creation of pneumoperitoneum,maintaining the peak inspiratory pressure (Ppeak) ≤ 30 cmH2O and partial pressure of end-tidal CO2 35-40 mmHg.Patients in group R received alveolar recruitment maneuver once every 30 min starting from creation of pneumoperitoneum until the end of surgery.Patients were transfered to post-anesthesia care unit (PACU) with endotracheal tube which was extubated when the unified extubation standard was achieved in PACU.The patients who stayed in PACU for 2 h showing no indications for extubation were transfered to intensive care unit for continuous ventilation support.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,and at the end of pneumoperitoneum,blood samples were collected from the radial artery for blood gas analysis.Immediately after intubation,immediately after creation of pneumoperitoneum,at 30,60 and 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak,plateau pressure (Peat),and dynamic lung compliance were recorded.The time for achieving extubation standard and time for achieving the standard for discharge from PACU were recorded.Patients were followed up until discharge,and the feeding time and duration of hospital stay were recorded.Results Compared with group C,PaO2 and oxygenation index were significantly increased at 90 min of pneumoperitoneum,at the end of surgery,and immediately before discharge from PACU,Ppeak was decreased at 60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,Pplat was decreased at 60 and 90 min of pneumoperitoneum,the dynamic lung compliance was increased at 30,60 and 90 min of pneumoperitoneum and immediately after the end of pneumoperitoneum,and the time for achieving extubation standard,time for achieving the standard for discharge from PACU,feeding time,and duration of hospital stay were shortened in group R (P＜0.05 or 0.01).In group C,one patient did not present with indications for extubation and were transfered to intensive care unit for continuous ventilation support.Conclusion Intraoperative alveolar recruitment maneuver can effectively improve the intraoperative pulmonary function and promote the recovery of postoperative pulmonary function in the morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

Background Optic neuritis is closely associated with multiple sclerosis (MS).Its pathogenesis is uncompletely clear,and less basic researches are carried out at home and abroad. Objective This study was to reveal the expression of myelin basic protein (MBP) in the optic nerve of rat with experimental allergic encephalomyelitis (EAE) and to provide a theoretical evidence for the research of the relationship of optic neuritis with MS. Methods Fifty clean Wistar rats were randomized into the control group and immune 8,12,18 and 25 days groups.Myelencephalon was collected from 5 guinea pigs to prepare the homogenate and mixed with the isovolumetric complete Freud' s adjuvant (CFA).The 0.5 ml mixed antigen emulsifier was subcutancously injected into the 4 maps together with Bordetella pertussis 0.2 ml under the cutancous of dorsalis pedis at 0 and 48 hours to induce the EAE.Behavior of the rats was evaluated to score the neurological function.The optical nerve sections were prepared 8,12,18 and 25 days after immunology for the histopathological examination,and immunochemistry and Western blot were used to detect the expression of MBP in optic nerve.The use of the animals complied with the Regulation for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission. Results The disorder of motor nerve was seen 12 days following the immune,and the clinical neural functional scores were significantly higher 12 day and peaked on 18 days myelination and then gradually reduced.The histopathological examination showed that the irregular alignment of neural fiber was found at 12 days,and changes of cellular structure,edema of neural shaft bunch were observed at 18 days.However,the abnormal cells were significantly less 25 days following the immune.Immunochemistry showed that the MBP was expressed mainly in the myelination of optic nerve fibers.The numbers of positive cells for MBP were (115.75±26.49)cells/5 fields at the 12th day,showing a significant lowing in comparison with (167.44±22.49)cells/5 fields of control group (t=4.537,P＜0.05 ).The positive cells were lest at the 18th day with the values ( 75.57 ± 34.54) cells/5 fields ( t =6.362,P＜0.01 ).At the 25th day,positive cells increased to ( 117.63 ± 13.78) cells/5 fields,which still was lower than those of the control group ( t =4.068,P＜0.05 ).Western blot assay illuminated that with the prolong of immune time,MBP/β-actin ratio in optic nerve was gradually reduced and followed the same pattern at the 12th day( t =4.639,P＜0.05 ).At 18 days after immune in comparison with the control group,the expression of MBP/β-actin ratio in optic nerve was the least (t=8.427,P＜0.01). Conclusions MBP can be degraded in rat optic nerve.This is a further evidence that optic neuritis is a severe demyelination disease.It is clearly related to MS.

The brown slime inside pipeline of the polluted mineral waters well was analyzed. It was confirmed that the brown slime was a biofilm formed mainly by growth of bacteria contaminant, using microscope analysis. After treated with HCl, the brown crystals and mycelioid matter presented in slimes disappeared. It was verified these were metal deposits. The samples produced Prussia blue deposits by dropping K 4Fe(CN) 6 and HCl, which proved that the metal deposits were iron compound. Also it was believed the biofilm was produced by growth of iron bacteria, mixed with deposits of iron compound. The iron bacteria have been isolated from the slimes and cultured in the laboratory. The colony on agar plate also produced Prussia blue deposits after treated with K 4Fe(CN) 6 and HCl. The cells form of pure culture was the same as that in the samples by electronmicroscope analysis. Therefore, It indicated that the bacteria on biofilm inside pipeline were iron bacteria mainly.