Objective To assess the effect of thoracoscopic surgery under laryngeal mask anesthesia and explore the nursing strategies. Methods Thirty-five patients from April to December in 2014 undergoing video-assisted thoracoscopic surgery (VATS) were given intubation anesthesia and another thirty-five ones undergoing the same surgery in 2015 received laryngeal mask anesthesia. The two groups were compared in terms of surgery conditions, surgery complication and ambulation time. Results No significant differences were found in surgery time or blood loss between two groups (P>0.05). The postoperative waking time in the mask anesthesia group was significantly shorter than that of the intubation anesthesia group (P<0.05), and ambulation time was significantly shortened (P<0.05). The rates of throat discomfort, hoarseness and gastrointestinal reactions were significantly lower. Conclusions Laryngeal mask anesthesia used in small thoracoscopic surgery for airway management is safe and feasible. Combined with training in respiration and limb function, better analgesia and nursing, it can keep away complications related to intubation anesthesia, shorten hospital stay and accelerate postoperative rehabilitation.

Objective To study the feasibility and effect of implantation of the biliary stent for treatment of biliary obstruction.Methods A retrospective analysis of the diagnostic and therapeutic procedure was done in 131 cases of the inpatients from Apr.2006 to Feb.2007.The 131 patients with biliary obstruction underwent successfully 138 cases/times implantation of biliary stent.The results of recession of jaudince and the rate of complication were evaluated.Results All patients were implanted biliary stent successfully.The serum total bilirubin,direct bilirubin,alkaline phosphatase,?-glutamyl transpeptidase decreased obviously in three days,and the difference was remarkable.The main complication was infection of biliary tract and pancreatitis.Conclusion Implantation of biliary stent is an effective management for biliary obstruction,especially for patients who have lost the chance of operation.

The effect of siRNA-mediated Sox4 gene silencing on Wnt/β-catenin signaling pathway of human malignant melanoma cell line A375 was investigated. Two types of dsRNA targeting Sox4 were constructed and transfected into A375 cells, and untreated cells and cells transfected with scramble RNA were used as blank control and negative control respectively. The expression levels of mRNA and protein of Sox4, Wnt3a, β-catenin and Wnt/β-catenin signaling target gene Survivin were detected after real-time PCR and Western blot respectively. MTT assay was used to measure cell proliferation after Sox4 knockdown. β-catenin/TCF transcription reporter assay was used for assessing Wnt/β-catenin signaling pathway activity. Our results showed that the two types of Sox4 siRNA were transfected into A375 cells successfully. As compared with untreated cells, Sox4 siRNAs had no significant influence on Wnt3a expression, and Sox4 siRNAs led to the decrease of β-catenin at protein level. Wnt/β-catenin signaling pathway activity was inhibited significantly. As a target of Wnt/β-catenin signaling, Survivin was decreased at both mRNA and protein levels, and cell proliferation was attenuated. Our study suggests that Sox4 may play an important role in Wnt/β-catenin signaling pathway in human malignant melanoma cells by regulating β-catenin protein level, indicating that Sox4 is involved in the progression of malignant melanoma through Wnt/β-catenin signaling pathway.

Objective To investigate vascular endothelial growth factor-c (VEGF-C) and vascular endothelial growth factor receptor-3(VEGFR-3) mRNA expression, microvessels density (MVD) and lymphatic microvessels density (LVD) in human hepatocellular carcinoma and normal liver tissue. Try to illuminate the relationship among VEGF-C,VEGFR-3,MVD,LVD and the clinical pathological features of hepatocellular carcinoma. Methods Liver tissue of 60 cases definitely diagnosed as hepatocellular carcinoma and 20 normal cases were collected. VEGF-C and VEGFR-3 mRNA expression were examined by RT-PCR, MVD and LVD were examined by immunohistochemistry staining. Relationship between these indexes and clinical pathological features of hepatocellular carcinoma was also analysed. Results VEGF-C and VEGFR-3 mRNA expression, MVD and LVD in hepatocellular carcinoma were higher than those in normal liver tissue (P<0.01); In hepatocellular carcinoma tissue, expression of VEGF-C mRNA positively related with VEGFR-3 mRNA, MVD and LVD(P<0.01). VEGF-C and VEGFR-3 expression positively related with portal vein tumor thrombus, intrahepatal metastasis and lymph node metastasis (P<0.01). MVD positively related with portal vein tumor thrombus and intrahepatal metastasis (P<0.01). LVD positively related with lymph node metastasis (P<0.01). Conclusion VEGF-C and VEGFR-3 expression increase in hepatocellular carcinoma tissue. They might play roles in tumor invasion and metastasis by inducing angiogenesis and lymphangiogenesis.

Female ; Follow-Up Studies ; Hearing Loss ; etiology ; Hearing Tests ; Humans ; Infant, Newborn ; Male ; Risk Factors

Adult ; Aged ; Breast Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Female ; Gene Amplification ; Genital Neoplasms, Male ; genetics ; metabolism ; pathology ; surgery ; Humans ; Male ; Middle Aged ; Paget Disease, Extramammary ; genetics ; metabolism ; pathology ; surgery ; Paget's Disease, Mammary ; genetics ; metabolism ; pathology ; surgery ; Penile Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Receptor, ErbB-2 ; genetics ; metabolism ; Scrotum ; Vulvar Neoplasms ; genetics ; metabolism ; pathology ; surgery

Objective To explore the clinical features of renal and urinary lesions in IgG4-related disease (IgG4-RD).Methods Clinical manifestation,laboratory profiles,iconography images,pathologic findings,treatment and prognosis of 6 IgG4-RD patients with renal and urinary system involvement from Peking Union Medical College Hospital during Aug 2010 to Dec 2011 were analyzed retrospectively.Results Six patients had renal and/or urinary lesions among IgG4-RD cases diagnosed in our hospital,including 4 males and 2 women,with median age of 59 years (36 to 72 years) and median disease course of 10.5 months.All the patients presented multiple organ involvement simultaneously.Urinary system lesion varied,including renal dysfunction,abdominal pain and edema.Hyperglobulinemia,elevated serum IgG (median 23.3 g/L) and IgG4 (median 4227.0 mg/L),tubular proteinuria were found in all the 6 patients,and elevated Scr (median 237 μmol/L) in 5 cases.Kidney CT image often showed renal swelling,hydronephrosis,multiple low density focus with attenuation and kidney atrophy.Renal pathology revealed interstitial inflammatory cells infiltration comprising predominantly plasma cells and lymphocytes,with a high prevalence of IgG4-positive cells often admixed with fibrosis,which fit the features of tubulointerstitial nephritis.Patients with IgG4-RD nephropathy presented good response to glucocorticoids.After therapy,the symptoms were improved and serum IgG,IgG4 and Scr decreased.Conclusions Renal and urinary lesions of IgG4-RD are heterogeneous in clinical manifestation,and are often complicated with various organ lesions.The feature of renal histopathology is tubulointerstitial nephritis infiltrated by plasma cells and lymphocytes with positive IgG4.Glucocorticoids treatment is effective for this disease.

To explore the safety of ropinirole in the treatment of Parkinson′s disease( PD).A total of 221 PD patients participated in a multi-center,12-week randomized,bromocriptine-controlled,double-blind, double-dummy and parallel-group trial.The safety was assessed on the basis of adverse reactions , blood pressure,pulse,laboratory parameters and electrocardiography recordings.The incidence of adverse reaction was 34.9%in ropinirole group and 34.8% in bromocriptine group.And the frequency of adverse reactions had no inter-group statistical significance (χ2 =0.000,P=0.995).Ropinirole has an excellent profile of safety in the treatment of Chinese PD patients.

According to the TCM theory, human growth, development and aging are closely related to kidney function and the main cause of human senility is deficiency of “kidney essence”. Recent studies showed that the “kidney” in TOM include the regulatory function of the neuroendocrine and immune systems.
In this paper, the effect of Guzhen Recipe (_??__??__??_), an aging retarding prescription composed of kidney tonifying herbs such as Radix Polygoni Multiflori (_??__??_), Herba Cistanchis (_??__??_) Rubus Chiagii (_??__??__??_) etc. on the hippocampus and HPAT axis in senile rats were observed. The results showed : (1) With age the number of glucocorticoid receptors (GCR) in the hippocampus, the concentrations of NE, DA, 5-HT in the hypothalamus were markedly decreased, while the plasma corticosterone concentration in senile rats was obviously increased. (2) The thymocyte GCR nuclear transition rate was increased significantly ; (3) The contents of cytoplasmic protein, nuclear RNA and DNA, the thymus weight/body weight ratio, the serum thymic factors as well asthe rate of lymphocyte transformation, the activity of IL-2 and NK cells in senile rats were obviously decreased compared to those of young control rats. Guzhen recipe however, was capable of improving these changes in the neuroendocrine-thymic net work in senile rats to varying degrees, suggesting that the kidney with Chinese Medicine might retard the functional degeneration of thymic endocrine partly by improving the feedback regulation of the hippocampal GCR and increasing the concentrations of NE and 5-HT of hypothalamus, thus decreasing the plasma corticosterone ; Simultaneously weakening the nuclear transition rate of thymocyte GCR, which in turn improving the immune function of the senile animal.
We concluded that Guzhen Recipe may retard the functional degeneration of both the hypo-thalamuspituitary-gornadal-thymic and hypothalamus-pituitary-thyroidal-thymic axis. All the above results revealed that retarding the aging effect using TCM in volves multiple-leves, multiple-systems and links. Using holistic regulation, imbalance links in aging process are modulated and the equilibrium of Yin and Yang are maintained. This is an important characteristic of the TCM to retard aging.
This research was supported by funds from National Natural Science Foundation of China No. 38970908.

Objective To investigate the influence of kaempferol on transforming growth factor(TGF)-β1/Smads signal trans-duction in liver tissue of mice with schistosomiasis liver fibrosis. Methods Forty BALB/c mice were randomly divided into a normal control group(8 mice),a praziquantel group(8 mice ),and 4 praziquantel+kaempferol groups with different kaempfer-ol dosages(5,10,15,20 mg/kg respectively,6 mice each group). Besides the normal control group,all the mice in the other 5 groups were infected with Schistosoma japonicum. After the infection for 6 weeks,the praziquantel group and the 4 praziquantel+ kaempferol groups were treated with praziquantel 500 mg/(kg · d) for 2 d,then the mice in the praziquantel group were drenched with normal saline for 6 weeks,and those in the 4 praziquantel+kaempferol groups were drenched with kaempferol 5, 10,15,20 mg/kg respectively for 6 weeks. After the treatment,all the animals were sacrificed by the cervical dislocation meth-od,and the area of egg granuloma and the degree of fibrosis in the livers of the mice were observed by HE and Masson staining. The expressions of TGF-β1,Smad2/3,Smad7 proteins were measured by the immunohistochemical method,and the mRNA lev-els of the 3 proteins were detected by RT-PCR. Results Compared with the mice in the praziquantel group,the areas of egg granuloma of the liver of the mice in the 4 praziquantel+kaempferol groups were smaller,and the degrees of the hepatic fibrosis of the mice were lesser,and their expressions of Smad2 and Smad3 at protein and their mRNA levels were significantly lower (all P<0.05),while the expression of Smad7 at protein and its mRNA level were significantly higher(all P<0.05). Conclu-sion By decreasing the expressions of TGF-β1 and Smad2/3,and increasing the expression of Smad7,kaempferol can signifi-cantly reduce the degrees of hepatic fibrosis and granuloma caused by schistosome eggs after the praziquantel treatment.