To observe the changes in hemorheology, endotoxin and TNF ? in blood after hemoperfusion(HP) with adsorbent immobilized polymyxin B (PMB) on sepsis in rats. Wistar rats were randomly divided into three groups:LPS+HP+PMB,LPS+HP and LPS. All the rats received intravenously injection of lipopolysaccharide (LPS, Escherichia coil O111:B4,1mg/kg). Plasma of the rats in the group of LPS+HP+PMB was passed through a column containing sepharose coated activated charcoal immobilized polymyxin B at the 4th hour after LPS injection. The treated plasma was transfused bak after being mixed with blood cells. In LPS+HP group, the column did not contain immobilized polymyxin B. The animals of LPS group received LPS only. Quantitative endotoxin determination in blood was done with limulus amebocyte lysate test,TNF ? of the plasma assayed with ELISA, and hemorheology parameters were also observed after hemoperfusion. In LPS+HP+PMB group, the concentration of plasma was significantly decreased after hemoperfusion, but it was still significantly higher than the baseline value, and there was a decrease of blood cell ratio after hemoperfusion. The results suggest that specific adsorbent could remove endotoxin in the circulation and improve hemorheology.

Response surface analysis (uniform precision of central composite design, SAS 9.1.3 software) was applied to optimize the four major factors (ratio of soybean meal to water, enzyme quantity, fermentation time and inoculation quantity) for soybean meal solid fermentation. According to the change of the hydrolyzation degree of soybean protein, the equation of polynomial regression was established between those factors and the response. The result showed that the optimum condition included as follows: ratio of soybean meal to water 1∶1.00,enzyme quantity 2.55%, fermentation time 65h and inoculation quantity 1.00%. Under the optimum level, the degree of hydrolyzation reached 13.3%, which increased 56% over pre-optimization.

Objective To investigate the effect of sumical resection in the management of gestafional trophoblastic neoplasia(GTN)patients with pulmonary metastases.Methods A retrospective review of the medical records of 62 GTN patients who underwent pulmonary resection was carried out.The cases were divided into recurrent group(group A,,l=10),drug-resistant group(group B,n=28),and the group with satisfactory response to chemotherapy but residual pulmonary lesion(s)(group C,n=25).One patient underwent lobectomy twice,and she was allocated simultaneously to groups A and B.The patients'median age,antecedent pregnancy,International Federation of Gynecology and Obstetrics(NGO)risk score,number of preoperative chemotherapy courses,preoperative β-human chorionic gonadotrophin (β-hCG)titer,lesion size,number of lobes affected,positive rate of histology,follow-ups and prognosis were compared between the three groups.Results The proportion of hish-risk patients in the three groups wag 90%,82%and 44%,respectively.The complete remission rates of the three groups were 90%,79%and 100%,with relapse mtes of 2/8,15%and zero,respectively.Positive histology of the resected specimen wasmore frequently recognized in recurrent and drug-resistant groups(A 60%,B 36%,C 12%).In the drug-resistant group there were more preoperative chemotherapy 8essiorls(A 3,B 7,C 5)and more patients with abnormal preoperative B-hCG titer(A 50%,B 61%,C 12%).Conclusions Surgical resection is effective in the treatment of pulmonary metastases of GTN.Surgery is indicated when clinical evidence suggests that pulmonary metastatic disease causes relapse or drug—resistance and the lesions are relatively localized.Surgical resection is not recommended for patients with satisfactory response to chemotherapy but residual pulmonary lesions.

Objective To discuss the efficacy of the modified subinguinal approach for the treatment of acetabular anterior column and wall fractures.Methods A clinical retrospective study was performed of the 5 patients who had been treated at our department from January 2011 to April 2015 for acetabular anterior column and wall fractures and conformed to follow-ups.They were 3 males and 2 females,aged from 19 to 45 years (mean,35.6 years).The duration from injury to surgery averaged 7.6 days (range,from 4 to 10 days).The subinguinal ligament approach was adopted in the 5 cases,through which the inguinal ligament was preserved intact after sharp dissection of its insertion at the anterior superior iliac spine and medial-upper advancement,the advantage of expanded exposure of the first window by the Farid sub-ilioinguinal approach was retained,and additional lesions due to iliac osteotomy were avoided.The operation time,intraoperative bleeding,postoperative reduction and time for fracture union were documented.Merle d' Aubigne and Postel scoring system was used to assess the hip joint function of the affected limb at the final follow-ups.Results The operation time ranged from 110 to 150 minutes (mean,125 minutes);the intraoperative bleeding ranged from 415 to 550 mL (mean,450.2 mL).By the Matta's criteria,the postoperative reduction was rated as excellent in 4 cases and good in one.The 5 patients were followed up for an average of 32.4 months (range,from 6 to 43 months).Their fractures united clinically after an average of 4.6 months (range,from 3 to 6 months).The hip joint function was rated as excellent in 2 and good in 3 by the Merle d' Aubigne and Postel scoring system at the final follow-ups.Follow-ups observed no serious complications like inguinal hernia,internal fixation failure,myositis ossificans,or avascular necrosis of the femoral head.Conclusions As the modified subinguinal approach can provide a broad surgical exposure,lead to minimal injury to the inguinal ligament,avoid lesions caused by iliac osteotomy,and decrease operation time and bleeding,it may be a better approach for acetabular anterior column and wall fractures.

Objective To investigate the clinical characteristics, management and prognosis of gestational trophoblastic disease in women aged 50 years or more. Methods Thirty-eight cases of gestational trophoblastic disease in women aged 50 years or more, who were treated in Peking Union Medical College Hospital between 1992 and 2002, were reviewed retrospectively. Results The median age was 52 years (range from 50 to 58 years ). The lesions included 5 hydatidiform moles (13%), 19 invasive moles (50%), 12 choriocarcinomas (32%) and 2 placenta site trophoblastic tumors (5%). All of 38 cases presented with abnormal vaginal bleeding. Twenty-three cases of hydatidiform moles were diagnosed at their first visit to the hospital, and 15 of them received prophylactic chemotherapy, of whom 10 progressed to invasive mole, 3 developed lung metastasis. All of the other 8 cases without prophylactic chemotherapy progressed to malignant changes with metastasis of lung. The use of prophylactic chemotherapy reduced the incidence of subsequent metastasis. All of 38 cases received chemotherapy. Thirty-two cases underwent hysterectomy, complete remission was achieved in 91% of patients; complete remission was achieved in 2 of 6 patients without hysterectomy. Conclusions The diagnosis of pregnancy and pregnancy-related disease should be considered in the elderly women presenting with abnormal vaginal bleeding. Once gestational trophoblastic disease in women aged 50 years or more is diagnosed, chemotherapy should be given as soon as possible. Hysterectomy is frequently required to improve the prognosis of gestational trophoblastic disease in the elderly women.

Objective To measure the quality of life (QoL) of gestational trophoblastic neoplasia ( GTN ) survivors after chemotherapy by using a self-invented scale, and to explore the factors associated with QoL Methods The design of questionnaire was based on a series of internationally valid QoL scales,which was tested by epidemiology and showed good reliability and validity. A total of 100 survivors of GTN patients from Peking Union Medical College Hospital participated in this survey from December 2008 to May 2009. Results Patients with disease-free more than three months after chemotherapy enjoys a good QoL,while only 16% (16/100) of survivors feel general overall QoL, but no one feels bad Qol. As refer to sexual function, more than half of these patients (70%, 70/100) satisfied with their sexual life, while there were still 47% (47/100) and 45% (45/100) of the patients complaining of decreased sexual desire and dryness of vagina. 66% (66/100) of the GTN survivors expressed depression, and 50% (50/100) of patients complained anxiety, which were potential factors influencing QoL of GTN survivors. Relevant analysis explored the possible predictors of QoL for GTN patients, including physical function ( r = 0. 609,P ＜0. 01 ), sexual function ( r = 0. 473, P ＜ 0. 01 ), and social psychology ( r = 0. 294, P ＜ 0. 01 ).Conclusions GTN survivors have an overall good QoL after chemotherapy, the possible predictors of QoL for GTN patients include physical function, sexual function and social psychology. The sexual dysfunctions mostly present with short of sexual desire and dryness of vagina. Fear of recurrence may be a potential factor influencing QoL a long term after remission.

Objective To explore expression of plexinA1 and Ki-67 in tissue of human brain glioma cells and their clinical significance.Methods 43 specimens from patients with brain glioma were collected.Immunohistochemical (IHC) staining was used for detecting the expression of tissue plexinA1 and Ki-67 in human glioma cells of 43 cases of patients with brain glioma.The positive expression rate of plexinA1 and Ki-67 among the different pathological grade tissues and their clinical significance were analyzed.So did correlation studies about plexinA1 and Ki-67.Results The positive expression rates of plexinA1 in Ⅰ-Ⅱ grade group (18 cases) and Ⅲ-Ⅳ grade group (25 cases) were 22.22 ％ (4/18) and 72.00 ％ (18/25) (P ＜ 0.05).The positive expression rates of Ki-67 in Ⅰ-Ⅱ grade group and Ⅲ-Ⅳ grade group were 16.67 ％ (3/18) and 56.00 ％ (14/25),respectively (P ＜ 0.05).PlxinA1 and Ki-67 expression in the tissue of human brain glioma were positively correlated (r =0.997,P ＜ 0.05).Conclusions The positive expression rate of plexinA1 is higher in high malignancy human glioma group than that in low malignancy group which has an important reference value in the estimation of prognosis for human glioma.PlexinA1 and Ki-67 maybe synergism in occurrence and development of glioma.

Objective To investigate the prognostic factors and survival of patients with bronchopulmonary carcinoid tumors (BPC) after surgical treatment .Methods The clinical data of 87 patients undergoing surgery for BPC from Jan .2002 to Dec .2008 were reviewed retrospectively .Kaplan-Meier method was used to analyze the survival of the patients .The risk factors such as age , gender ,smoking history ,histological type ,tumor size ,were analyzed by Cox proportional hazards regression model .Results The 1-,3-and 5-year overall survival rates were 85 .1% ,71 .3% and 63 .2% .Univariate analysis revealed that age (P=0 .016) ,smoking history(P=0 .007) ,histological type(P=0 .000) ,tumor stage(P= 0 .000) ,tumor size(P= 0 .006) lymph node metastasis(P=0 .000) ,surgery type (P= 0 .045) and postoperative chemotherapy (P= 0 .000) were prognostic factors .Multivariate analysis showed that histological type(P=0 .008) ,tumor stage(P=0 .000) ,lymph node metastasis(P=0 .033) were independent prognostic factor .Conclusion The survival rate of the BPC patient after surgical treatment is high ,histological type ,tumor stage and lymph node metastasis were independent prognostic factors .

ObjectiveTo investigate the effect of intrathecal injection of TRPV3-siRNA lentivirus on bone cancer pain(BCP) behaviors in rats.Methods40 female SD rats successfully received intrathecal catheter implantation and without motor dysfunction were randomly divided into 4 groups (n=10 in each group):Sham group (S),BCP group (B),negative control lentivirus group (C) and TRPV3-siRNA lentivirus group (T).Group B,C and T were induced bone cancer pain by intra-right-femur inoculation of Wallker 256 cells,while rats in group S were injected of inactivated cell.Rats in group T were intrathecally treated with 5 μl TRPV3-siRNA lentivirus while rats in group C received 5 μl negative lentivirus on 1~6 d after surgery.All the rats received pain behaviors including paw withdrawal thermal latency(PWTL) and paw withdrawal mechanical threshold (PWMT) at 1 d before BCP and 1,3,6,9,12,15,18 and 21 d after BCP.L4~L6 spinal cords were reserved for RT-PCR and Western Blot.ResultsCompared with group S,PWTL and PWMT of group B were decreased (P<0.05).On the 9th day,PWTL of group T was higher than that of group C((17.52±2.15)s vs (14.36±1.67)s,P<0.05).However,there was no significant difference in PWMT between group T and group C((16.89±1.54)g vs (15.53±1.36)g,P>0.05).The results of RT-PCR and Western blot demonstrated that the expression of TPPV3 in group T was decreased compared with that in group C(P<0.05).ConclusionIntrathecal injection of TRPV3-siRNA lentivirus can inhibit the expression of TRPV3 and thus alleviate symptom of PWTL,but not PWMT.