Objective To evaluate the minimally invasive technique of laparoscopy by retroperitoneal access for the treatment of parapelvic cyst. Methods Twelve patients(7 men and 5 women;mean age,52 years;age range,34-75 years) with parapelvic cysts were included.The cyst size ranged from 2.8 cm?3.0 cm to 2.5 cm?11.5 cm.The cysts were on the left side in 6 cases and on the right in another 6 cases.Laparoscopic resection or de-roofing of the parapelvic cysts by retroperitoneal access was performed in them.The relevant parameters of the procedures were summarized.Results The success rate of the operation was 100%.The mean operative time of the first 6 patients was 190 min,while it was 86 min in the rest 6 patients.The mean intraoperative blood loss was 25 ml.No injury to the kidney pedicle or pelvis occurred.The mean hospital stay was 9 d.In 11 patients,no recurrence of the cyst occurred during a follow-up of 7-31 months.Only 1 patient with concomitant renal cyst had recurrence of the cyst found by B-ultrasound 2 years after operation.Conclusions Therapeutic laparoscopy by retroperitoneal access has advantages of minimal trauma,less blood loss,rapid recovery and better effect,therefore it is the ideal treatment choice for parapelvic cyst.

Objective To evaluate t le effects of various mutants of PAK6 kinase on the proliferation of prostate cancer cells and their roles in the pathology of prostate cancer. Methods Variant mutants of PAK6 kinase, including wild type ( WT),kinase activated type (SN) and kinase inactivated type (KM) , were in vitro constructed according to the PAK6 sequence,and were transfected into the LNCaP cells by Lipo-fectamine. G418 was used to select the stable cell line. Phosphorylated PAK6 antibody was used in Western blot to detect the kinase expression in the eel.s. The proliferation rate was measured by MTT assay;the growth effects of the cells stimulated by androgen were also recorded and compared. Results Different LNCaP cell lines expressing wild type, kinase activated and kinase inactivated PAK6 were prepared successfully. Wild type (WT) PAK6 and the kinase activated PAK6-SN significantly inhibited the growth of LNCaP cells by 32. 1% and 39. 3%,respectively (P

To compare the effect and advantage of performing rhegmatogenous retina detachment surgery under operation microscope with under direct ophthalmoscopes .METHODS: Ninety - three patients ( 93 eyes ) were randomized to two groups, Group A ( under operation microscope during rhegmatogenous retina detachment surgery, 47 cases ) , Group B ( under direct ophthalmoscopes during rhegmatogenous retina detachment surgery, 46 cases ) . All patients were followed up for 2wk to observe success rate and visual improving rate.RESULTS: Total percentage of success was 95. 74% in group A and 80. 43% in group B. The visual improving rate of group A was 82. 98% and it was 67. 39% in group B. Operative time in group A was significantly shorter than that in group B (P<0. 05). CONCLUSlON: Performing rhegmatogenous retina detachment surgery under operation microscope is ascertaining and it is more effective and handy than performing that surgery under direct ophthalmoscopes.

Background and purpose: Neck lymph node metastasis, most of which presents in central neck compartment, is common in patients with papillary thyroid carcinoma (PTC). The objective of this study was to investigate the relationship between the number of dissected central neck lymph nodes and clinical outcome after radioactive iodine (RAI) ablation in pN1a PTC with no more than 5 lymph nodes involvement. Methods: A total of 167 PTC patients who had 1-5 proven metastatic lymph nodes according to postoperative pathological diagnosis were retrospectively analyzed, all of whom underwent total or near total thyroidectomy and central lymph node dissection. After a median follow-up period of 26 months, the clinical outcome of each patient was evaluated as excellent response (ER), indeterminate response (IDR), bio-chemical incomplete response (BIR), or structural incomplete response (SIR) according to the new American Thyroid As-sociation guidelines. The accumulative ER rate (ERn) was calculated in patients with different numbers of dissected lymph nodes (ERn was defined as the proportion of patients who achieved ER with the dissected lymph node number of ≤n). The relationship between the number of dissected central neck lymph nodes and ERn were investigated. Results: As the increase in the number of dissected central neck lymph nodes,there was also an overall increase in ERn, especially when n rose from 1 to 10. The values of ER1, ER5, ER10 and ER30 were 25.0%, 66.7%, 74.7% and 79.1%, respectively. Besides, the proportion of patients who achieved ER was higher in those with 10 or more dissected lymph nodes than in those with less than 10 (85.7% vs 73.3%, P=0.05). In the multivariate logistic regression analysis, both the dissected central lymph node number of ≥10 (OR=2.720, 95%CI: 1.052-7.033, P=0.039) and the level of preablation stimulated thyroglobulin (OR=0.955, 95%CI: 0.926-0.984, P=0.003) were shown to contribute independently to ER. Conclusion: As the increas-ing number of dissected central neck lymph nodes, the percentage of pN1a PTC patients that achieved ER after RAI ablation generally rises. In pN1a PTC patients with no more than 5 lymph nodes involvement, a central compartment dissection with 10 or more lymph nodes might help them achieve ER after RAI ablation.

Intraperitoneal administration of timosaponin A-III (TA-III) has therapeutic effects on high-fat diet-induced metabolic dysfunction-associated steatotic liver disease (MASLD), but oral administration has no effect. This suggests that gut microbiota may affect the oral bioavailability of TA-III. Metabolic dysfunction-associated steatohepatitis (MASH) is an inflammatory subtype of MASLD. To investigate the therapeutic effect of different administration modes of TA-III on MASH and its relationship with gut microbiota metabolism. In this study, a MASH mouse model was induced by choline-deficient, L-amino acid-defined, high-fat diet (CDAHFD). Comparing the therapeutic effect of intraperitoneal injection (10 mg·kg^-1, ip) and intragastric administration (100 mg·kg^-1, ig) of TA-III. The concentration of TA-III in serum of rats under the two administration modes was analyzed. On this basis, the metabolic effect of gut microbiota on TA-III in mice was verified by the experiment of metabolism of gut microbiota in vitro. The pharmacokinetic experiment of combined antibiotic intervention in mice further verified the metabolism of TA-III by gut microbiota in mice. Finally, the concentration of TA-III in serum of mice after the administration of TA-III by intragastric administration under different antibiotic intervention conditions was compared, and 16S rRNA sequencing analysis was combined to find the key bacteria that may participate in the metabolism of TA-III. The animal welfare and experimental procedures in this paper were in accordance with the provisions of the Animal Ethics Committee of Shanghai University of Traditional Chinese Medicine. The ethics approval number is PZSHUTCM2307030004 and PZSHUTCM2310200003. The results showed that TA-III (10 mg·kg^-1, ip) had definite therapeutic effect on MASH mice, but TA-III (100 mg·kg^-1, ig) was ineffective. The analysis showed that the prototype concentration of TA-III in serum and liver of mice in TA-III (100 mg·kg^-1, ig) was significantly lower than TA-III (10 mg·kg^-1, ip), suggesting that the oral administration of TA-III may be metabolized by gut microbiota. The concentration of TA-III in serum of streptomycin (Str) treated mice was higher than normal mice. Combined with 16S rRNA gene sequencing analysis, it was found that the abundance of Akkermansia_muciniphila (A. muciniphila) was significantly reduced in the Str group. In vitro experiments showed that A. muciniphila could metabolize TA-III. In conclusion, gut microbiota is an important factor affecting the efficacy of TA-III administration through the gastrointestinal tract, in which A. muciniphila may play an important role.

BACKGROUND: Diabetes mellitus is a chronic metabolic disease caused by various factors,such as environmental factor,inherited factor,etc.,and its cause isn't very clear now. This study aims to investigate the risk factors mentioned above in the onset of diabetes mellitus, and is of significance in the first and second grade of prevention of diabetes mellitus.OBJECTIVE: To investigate the risk factors of type 2 diabetes mellitus to provide evidence for the proper intervention of it.DESIGN: Cross-sectional study based on diagnosis.SETTING: Department of epidemiology in a university and department of endocrinology in a university hospital.PARTICIPANTS: The subjects were residents who have resided in town and country of Dalian for more than 5 years and were elder than 40 years old. The method of stratified cluster random sampling was carried out among natural persons who were divided into two groups according to city and country. Totally 2 500 persons were taken in total and 1 250 persons were from each group. The subjects who had been diagnosed as diabetes mellitus were included.METHODS: Questionnaire survey was employed for all the subjects, including physical examinations such as height,weight,waist girth,hip girth,blood pressure,blood glucose,etc. Patients of type 2 diabetes mellitus were taken as the case group and the normal was as the control group. The unconditional univariate and multivariate logistic regression were used.MAIN OUTCOME MEASURES: Unconditional logistic regression analysis of risk factors of type 2 diabetes mellitus with single factor analysis and multivariate analysis.RESULTS: Family history of diabetes mellitus(OR = 2.339),obesity[body mass index(BMI),OR = 1.462],systolic pressure(OR = 1.016),hyperlipidemia(OR = 1.615), age(OR = 1.043) were the major risk factors for type 2 diabetes mellitus.CONCLUSION: Family history of diabetes mellitus, increase of systolic pressure,obesity,high blood lipid and age are the risk factor for type 2 diabetes mellitus. For all communities,control of body mass and high blood pressure is an important way to prevent type 2 diabetes mellitus.

Objective To evaluate the efficacy and toxicity of combined pegylated liposomaldoxorubicin (PLD) and carboplatin in the treatment of patients with recurrent epithelial ovarian cancer.Methods We retrospectively reviewed 67 patients with recurrent epithelial ovarian cancer or primaryperitoneal adenocarcinoma (8 eases) who were treated with combined PLD and earboplatin. The responserate, survival and toxicity were evaluated. The mean age for 67 patients was 52.1 (39-76) years. All ofthem received eytoreductive surgery followed by platinum-based chemotherapy either with paclitaxel orcyclophosphamide and doxorubicin after diagnosis. Combined PLD and carboplatin was used as first orsecond-line treatment or even after multiple lines of treatment after disease recurred. Patients were treatedwith PLD at 35-40 mg/m2combined with carboplatin at an area under curve ( AUC ) of 5 once every 4weeks. Results Forty-nine. Patients were evaluable for response. Twenty-three (47%) patients had acomplete response, 13 (27%) had a partial response, 3 (6%) had stable disease and 10 (20%) hadprogressive disease. The estimated median progression-free survival (PFS) was 8 months. The 1-year and 2-year survival rates were 73% and 55%, respectively. All of the 67 patients were evaluated for toxicity. Thetreatment was terminated in 2 patients due to allergic-like infusion reaction. Four patients who had acuteinfusion reaction with shortness of breath and tightness of chest did not terminate the treatment because nosuch reaction occurred when restarted the infusion. There were 2 patients with G2and 3 patients with G3hand-foot syndrome, 2 patients had G4stomatitis, and 8 patients had G3leukopeni,, No G4leukopenia orcardiotoxicity eceurred. Conclusion The combination of PLD and carboplatin is an active and wellotolerated regimen in the treatment of patients with recurrent epithelial ovarian cancer.

OBJECTIVETo study the expression and significance of p65 which is an important subtype of nuclear transcription factor kappaB (NF-kappaB) and its inhibitory protein IkappaBalpha in malignant transformation of hamster buccal mucosa.

METHODSThe animal model of malignant transformation in hamster buccal mucosa induced by DMBA (0.5%) was established. Twelve paired specimens including normal buccal mucosa, epithelial hyperplasia, epithelial dysplasia and squamous cell carcinoma (SCC) were subjected to Western blot for the analysis of p65. The expression of IkappaBalpha was observed in 22 normal buccal epithelia, 20 hyperplasia epithelia, 35 dysplasia epithelia and 23 SCC by immunohistochemical evaluation.

RESULTSIn normal buccal epithelia and hyperplasia epithelia, the expression of p65 was not obvious, and there was no significant difference between them (P > 0.05). The expression of IkappaBalpha existed at large, but mostly localizing in cell cytoplasmic staining in the basal cell layer and bottom of spinocelluar layer. With the occurrence of epithelia dysplasia, the expression of p65 gradually increased, comparing with normal buccal epithelia and hyperplasia epithelia (P < 0.01). But the positive intensity of IkappaBalpha was dramatically decreased (P < 0.05). In SCC, p65 expressed at a higher level comparing with normal buccal mucosa and dysplasia (P < 0.01), while the staining of IkappaBalpha was feedbackly higher comparing with dysplasia (P < 0.01) and even with normal buccal mucosa (P < 0.01).

CONCLUSIONNF-kappaB p65 is strongly activated in malignant transformation of hamster buccal mucosa. The abnormal expression of p65 and IkappaBalpha, especially the ascending expression of p65 as well as the descending expression of IkappaBalpha in dysplasia may be an early event during oral carcinogenesis, and can be used as biomarkers for supervising oral malignancy.

Animals ; Carcinogenesis ; Carcinoma, Squamous Cell ; Cheek ; Cricetinae ; Epithelium ; I-kappa B Proteins ; Mouth Mucosa ; Mouth Neoplasms ; NF-KappaB Inhibitor alpha ; Transcription Factors

Objective To analyse the diagnosis and treatment options of serous cystadenoma of the pancreas.Method The clinical data of 57 patients operated in the Tianjin Medical University Cancer Institute & Hospital from August 1996 to December 2011 with pathologically confirmed serous cystadenoma of pancreas after the operation were retrospectively studied.Results There were 13 males (22.8％) and 44 females (77.2％).The median age was 56.8 years.The patients were asymptomatic in 31.6％.CT was accurate in the diagnosis in 70.6％.All patients received surgical resection,inluding pancreaticoduodenectomy (n =17,29.8％),distal pancreatectomy (n =38,66.7％),palliative resection (n=1),and tumor enucleation (n=1).Postoperative complications developed in 6 patients.Histopathologically,there were 50 cases of serous microcystic adenoma (87.7％) and 7 cases of serous oligocystic adenoma (12.3 ％).One of these patients had developed into serous cystadenocarcinoma.At a follow-up of 12 months to 15 years,one patient with serous cystadenocarcinoma died 13 months after the operation.The remaining patients were all alive.Statistical analysis was performed based on the postoperative histopathological type and tumor size.The mean postoperative hospital stay of the group of patients with serous microcystic adenoma were significantly longer than the patients with serous oligocystic adenoma [(17.39±7.61) d vs (19.43±0.98) d,P=0.002].The incidence of patients with clinical symptoms was higher in the group of patients with tumor size ≥4 cm when compared with the patients with tumour size ＜4 cm.There was no significant difference on the other parameters.Conclusions Pancreatic serous cystadenoma is a rare pancreatic tumor,and it often happens in elderly women.Indications for surgical resection included symptomatic tumours,tumor diameter more than 4 cm,malignant biological behavior,malignancy could not be ruled out,and potentially malignant tumors.For asymptomatic patients and tumor size less than 4 cm,surgical resection should also be considered if the tumour progresses on follow-up.

Objective To observe the effect of CO2 pneumoperitoneum combined with position changes on the stability of cardiac electrophysiology in gynecological laparoscopy. Methods The gynecological laparoscopy was performed for 30 patients to undergo elective gynecological laparoscopy under general anesthesia ,with the pneumoperitoneum pressure of 12 mmHg and the Trendelenburg positionat 15° . The observations and analyses were done over the basic monitoring index and the QT interval (QT),T peak tend interval (Tp-e),heart rate corrected QT interval(QTc),QT dispersion(QTd),Tp-e/QT before anesthesia(T0),after anesthesia(T1),1 min after pneumoperitoneum (T2),30 min after pneumoperitoneum and head-down tilt (T3),30 min after deflation and supine position(T4). Results Compared with the time point of T0,QTd increased significantly at T1(P<0.05) and so it was with QT,QTc,QTd,Tp-e,Tp-e/QT at T2,T3,and T4(P<0.05). Compared with the time point of T2,QTc,QTd,Tp-e,Tp-e/QT significantly increased at T3(P < 0.05). Conclusions CO2 pneumoperitoneum combined with Trendelenburg position can prolong ventricular repolarization duration and destroy the stability of cardiac electrophysiology so it may increase the incidence of cardiovascular events.