Objective To present the technique and short-term results of retroperitoneal laparoscopic renal cryoablation for small renal tumors. Methods Ten selected patients cases with 11 renal tumors were included in present study. There were 3 cases of left renal tumor, 6 cases of right renal tumor and 1 case of bilateral renal tumors. Tumors were located at the upper pole (2), middle (6), or lower pole (3). All tumors were located distant from the collecting system, without evidence of metastatic disease. Mean tumor size was 2. 8 cm (range: 1.5-4.0). All the patients were managed with a double freeze-thaw cycle of retroperitoneal laparoscopic renal cryoablation. The preoperative Hb was (137± 21)g/L, ESR was (27±12)mm/1 h, SCr was (92±41)μmol/L, GFR was (42±10)ml/min.All the patients were taken routine biopsies. Results Cryoablation was technically successful in all 10 patients (11 tumors). The mean time of the operations was (101 ± 31) min, and the mean blood loss was (42±21) ml. None of the cases received blood transfusion post-operation. No operative complication was seen. The postoperative hospital stay was (4±2) d. The postoperative Hb was (129 ±18)g/L,ESR was (31±14)mm/1 h,SCr was (95±39)μmol/L,GFR was (40±11)ml/min. There was no statistic change of Hb, ESR, SCr and ECT-GFR after operations(P＞0. 05). The biopsy results revealed that 8 tumors were renal clear cell carcinomas, and 2 tumors were papillary renal cell carcinomas, and 1 tumor was renal angiomyolipoma. All the patients had a minimum follow-up of 6 months (mean 16, range 6 to 21). Follow-up magnetic resonance imaging at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesions. Follow-up biopsie of the cryoablated tumor site was negative in the only patient who have undergone the biopsy. No evidence of local or port-site recurrence was found, and no metastatic disease. ConclusionsRetroperitoneal laparoscopic renal cryoablation for small renal tumors could be an accurate and effective intervention with a relatively low incidence of complications. Critical long-term data regarding laparoscopic renal cryoablation are awaited.

OBJECTIVEThe aim of the present study is to explore the effects of exhaustive exercise-induced oxidative stress on the antioxidant capacity and diformability of rat red blood cells.

METHODSRats were divided into three group (n = 10): sedentary control (C), exhaustive running exercise (ERE) and moderate running exercise (MRE) groups. Animals in the ERE group started treadmill running at a speed of 20 m/min speed with a 5% gradient, and reached a speed of 25 m/min with gradient 15% in 20 min. Running was continued until exhaustion. MRE group rats running at a speed of 20 m/min with a 5% gradient for 40 min. The levels of free thiol in erythrocyte membrane protein, lipidperoxidation levels and membrane protein components were analyzed. The red blood cell deformability of different groups was also observed.

RESULTSThe results showed that red blood cells were damaged by severe oxidative stress and the anti-oxidative capacity decreased significantly under exhaustive exercise conditions. Besides, lipid peroxidation and protein sulfhydryl cross-link based clustering of membrane were found after exhaustive exercise, and polymers high molecular weight (HMW) was formed. The elongation index (EI) was found to decline significantly in the ERE group compared with the C and MRE groups under shear stress (control group, 0.41 +/- 0.01 at 3 Pa and 0.571 +/- 0.008 at 30 Pa; ERE group, 0.314 +/- 0.013 at 3 Pa and 0.534 +/- 0.009 at 30 Pa; P < 0.05 and P < 0.01, respectively).

CONCLUSIONThese exercise-induced oxidative injure result in a significant decrease in deformability of rat erythrocytes, which in turn leads to dysfunction in the microcirculatory.

Animals ; Disease Models, Animal ; Erythrocyte Deformability ; Fatigue ; metabolism ; physiopathology ; Male ; Oxidative Stress ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

Objective To understand the prevalence and risk factors of healthcare-associated infection(HAD,and provide evidence for prevention and control of HAI.Methods A cross-sectional survey was adopted,bedside survey and medical record reviewing method was combined to investigate and analyze the prevalence of HAI in a tertiary first-class hospital in 2012-2015.Results A total of 4 725 hospitalized patients were surveyed,the prevalence rates in 2012-2015 were 6.00％,4.77％,3.93％,and 3.05％ respectively,difference was significant(P＜0.05);antimicrobial usage rates were 30.56％,33.82％,32.84％,and 34.48％ respectively,difference was not significant (P＞0.05);the main infection site was lower respiratory tract (43.00 ％),followed by surgical site (16.43 ％);the risk factors for HAI were age ≥65 years,chronic systemic diseases(diabetes,cirrhosis,chronic renal failure,chronic lung disease),immunodeficiency(white blood cell＜1.5 × 109/L),coma,tracheotomy,and mechanical ventilation.Conclusion Survey on HAI prevalence can promote continuous improvement of HAI management,surveillance on surgical site infection and risk factors of HAI should be strengthened.

OBJECTIVETo study the expression and pathological implication of transforming growth factor-1 (TGF-1) and endothelin-1 (ET-1) in intraacinar pulmonary arterioles of children with congenital heart disease and pulmonary hypertension (HP).

METHODSForty-one children with left-to-right shunt congenital heart disease were studied including 25 cases of HP (group A), 16 cases without HP (group B) and 10 children without congenital heart disease as the contols (group C). Expression of TGF-beta1 mRNA and ET-1 mRNA in intraacinar pulmonary arteriolar (IAPA) was studied using in-situ hybridization and image pattern analysis of their absorption values (A value). Changes of the intraacinar arterioles and lung tissue were studied by elastic fiber staining and electronic microscopy respectively.

RESULTS(1) There was a significant difference in the amount of intraacinar pulmonary arterioles (partial-muscular and muscular) counted in either group A or B in comparing with that of group C (F values 149.96 and 142.01 respectively, P < 0.01); (2) Electronic microscopy demonstrated endothelial proliferation of the small arteries, thickening of arteriolar wall, increased density of collagen fibers at adventitia and increased thickness of the capillary basal membrane; (3) The A value of TGF-beta1 mRNA expressed in the pulmonary arterioles of groups A and B by in-situ hybridization were 0.1988 +/- 0.0498 and 0.1098 +/- 0.0428 respectively, however, the expression was weak in group C (A value: 0.0578 +/- 0.0096). There were all significant between each two groups (F = 45.95, P < 0.01). The expression of ET-1 mRNA was markedly increased as well in the endothelial cells of pulmonary arterioles in both groups A and B, with A values of 0.1692 +/- 0.0205 and 0.1004 +/- 0.0140 respectively, whereas the expression was weak in group C (A value of 0.0746 +/- 0.0119). There were all significant between each two groups (F = 139.996, P < 0.01).

CONCLUSIONSThe number of intraacinar pulmonary partial-muscular and muscular arterioles in patients with left-to-right shunt congenital heart defect is drastically increased, along with marked restructuring of the pulmonary vasculatures. In addition, there seems a correlation present between the overexpression of TGF-beta1 mRNA and ET-1 mRNA in intraacinar pulmonary arterioles and the occurrence of pulmonary hypertension in patients with congenital heart disease.

Child ; Child, Preschool ; Endothelin-1 ; biosynthesis ; genetics ; Female ; Heart Defects, Congenital ; complications ; metabolism ; pathology ; Humans ; Hypertension, Pulmonary ; complications ; metabolism ; pathology ; Infant ; Lung ; pathology ; ultrastructure ; Male ; Pulmonary Artery ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Transforming Growth Factor beta1 ; biosynthesis ; genetics

OBJECTIVETo compare the clinical outcomes of laparoscopic cryoablation (LCA) and laparoscopic partial nephrectomy (LPN) in the treatment of renal cell carcinoma (RCC).

METHODSBetween April 2005 and March 2009, 47 patients were treated with minimally invasive nephron sparing surgery (LPN or LCA) for RCC. The LCA group included 18 selected primary RCC cases (14 men and 4 women, mean age 63 years). There were 6 tumors located in the left, 11 located in the right and 1 located bilaterally. The maximum diameter of tumors was 1.5 - 5.0 cm (mean: 2.9 cm). The LPN group included 29 renal tumors patients (19 men and 10 women, mean age 61 years). The maximum diameter of tumors in this group was 2.0 - 4.5 cm (mean: 2.8 cm). Changes of hemoglobin (Hb), erythrocyte sedimentation rate (ESR), serum creatinine (SCr) and glomerular filtration rate (GFR) after operations were compared between LCA group and LPN group. The operative time, average intra-operative bleeding volume, postoperative hospital stay and incidence of postoperative complications of the 2 groups were analyzed and compared.

RESULTSThe 2 surgical procedures were both successful. There was no significant change of Hb, ESR, SCr and GFR after operations in LCA group and LPN group (P > 0.05). The operative time was (94 ± 29) min and (146 ± 45) min in LCA group and LPN group, respectively. The average estimated blood loss was (37 ± 20) ml and (274 ± 69) ml. The postoperative hospital stay was (4 ± 2) d and (10 ± 2) d. These differences between the 2 groups were significant (P < 0.01). No laparoscopic operative complications were noted in LCA group. Follow-up magnetic resonance imaging (MRI) at 1, 3, and 6 months identified the punched-out, nonenhancing, spontaneously resorbing, renal cryolesion. LCA group had completed a minimum follow-up of 6 months (mean 16, range 6 to 21 months). No evidence of local or port-site recurrence was found, and no patient developed metastatic disease. 3 - 36 months' (mean 20 months) follow-up showed no recurrence of tumors or metastatic disease in LPN group.

CONCLUSIONSLCA for RCC is an accurate and effective intervention with a relatively low incidence of complications, and is superior to LPN in operative time, intraoperative bleeding volume and postoperative recovery.

Adult ; Aged ; Carcinoma, Renal Cell ; surgery ; Cryosurgery ; methods ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; surgery ; Laparoscopy ; Male ; Middle Aged ; Nephrectomy ; methods ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo evaluate the association between two single nucleotide polymorphisms located in the promoter of transforming growth factor-β1 receptor 2 (TGFBR2) gene and hypertension in Han Chinese population.

METHODSThe subjects were recruited from the population of cluster sampling survey for essential hypertension (EH) in two townships of Yixing city, Jiangsu province in 2009. Overall, 2012 patients with hypertension and 2116 age (± 2 years) and sex-matched unrelated controls were selected. Epidemiological data, physical measurements results and serum glucose and lipid biomarker were collected and detected. Linkage disequilibrium (LD) analysis were applied and two tagging single nucleotide polymorphisms (tagSNP) in 5' upstream of TGFBR2 gene (rs6785358, -3779A/G; rs764522, -1444C/G) were selected for genotyping and analyzing for the association with hypertension.

RESULTSThe frequencies of AA, AG, GG in case and control of rs6785358 were 1455 (72.3%), 517 (25.7%), 40 (2.0%) and 1582 (74.8%), 490 (23.2%), 43 (2.0%) respectively, and CC, CG, GG of rs764522 were 1524 (75.7%), 464 (23.1%), 24 (1.2%) and 1654 (78.2%), 436 (20.6%), 26 (1.2%) respectively. SNP rs764522 was significantly associated with EH and OR (95%CI) were 1.17 (1.01 - 1.36) (P < 0.05) in dominant model after adjustment for confounding factors such as age, sex, glucose, lipids, smoking and alcohol drinking. Further stratification analysis by age, sex, smoking and alcohol drinking indicated that individuals carrying G allele (CG/GG genotype) of SNP rs764522 had higher susceptibility to EH than CC genotype (OR = 1.21, 95%CI: 1.01 - 1.45) (P < 0.05) in ≥ 55 years group. No statistical significance was detected in the distribution of genotypes and allele frequencies for SNP rs6785358 between cases and controls (P > 0.05). Haplotype analysis showed that no significant frequency difference of haplotype structured by rs6785358 and rs764522 was found between cases and controls (P > 0.05), and no significant blood pressure change was found between genotype variations of rs6785358 and rs764522 (P > 0.05).

CONCLUSIONSNP rs764522 of TGFBR2 gene is associated with increased risk of EH in elderly Han Chinese population.

Aged ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Haplotypes ; Humans ; Hypertension ; epidemiology ; genetics ; Male ; Middle Aged ; Polymorphism, Single Nucleotide ; Protein-Serine-Threonine Kinases ; genetics ; Receptors, Transforming Growth Factor beta ; genetics

OBJECTIVETo find the best treatment of penile strangulation and to analyze the sexual psychological factors of the patients.

METHODSWe retrospectively analyzed the experiences in removing foreign objects around the penis in 21 patients aged 19 - 61 years with the strangulation time varying from 10 hours to 4 days. The objects were mostly made of metal or plastics.

RESULTSAll the objects were successfully removed, 5 of them with the help of lubricant, 4 by aspirating the corpus cavernosum, 8 by shipping with pliers, 2 with the diamond-tipped dental drill, and the other 2, which virtually defied cutting, by aspirating the corpus cavernosum following degloving surgery.

CONCLUSIONIn removing foreign objects around the penis, simpler methods should be given precedence over more complex ones, and for those that virtually defy cutting, the best option is degloving surgery with particular attention to the survival of the penile skin flap.

Adult ; Foreign Bodies ; psychology ; surgery ; Humans ; Male ; Middle Aged ; Penis ; pathology ; surgery ; Retrospective Studies ; Young Adult

Objective To observe the clinical therapeutic effect of cine-pazide maleate in the treatment of renal colic .Methods Seventy -six patients of renal colic were randomly divided into 2 groups.The control group(36 patients) received lornoxicam 8 mg and progesterone 40 mg by intramuscular injection qd.The treatment group ( 40 patients ) received cinepazide maleate 320 mg by intravenous drip qd additionally.The de-gree of pain relief , recurrence and incidence of adverse reactions were observed in 6 h.Results The efficiency and significant efficiency of the treatment group were 100.00%and 92.50%.In contrast , the efficiency and significant efficiency of the control group were 88.89%and 69.44%respectively and the differences were statistically significant .Within 6 hours of treatment, treatment group recurrent rate of renal colic (0), was lower than that of control group ( 13.89%) .The two groups were no obvious adverse reaction of drug associated .Conclusion Cinepazide maleate could obviously relieve renal colic , reduce the recurrence rate , and not lead to significant adverse reactions .So, cinepazide maleate is a new choice for the treatment of renal colic .

Obejective To explore the inhibition effects of erlotinib on invasion and metastasis in non -small cell lung cancer brain metastasis cell PC14/B.Methods MTT method was used to detect the viability of PC14/B cells 48 h after the cultivation with erlotinib of 0 ( control group), 1, 5 and 25 μmol· L -1(erlotinib ,test groups).The cell inva-sion was detected by tranaswell method.The phosphorylation of protein kinase B ( AKT ) and the expression of matrix metalloproteinase 2 ( MMP2 ) , MMP9 epithelial -mesenchymal transition ( EMT ) related proteins including E -cadhherin and Vimentin were detected by Western blot.Results Compared with control group (0.75 ±0.09), three dose test groups[(0.63 ±0.06), (0.52 ±0.04), (0.38 ±0.03)] inhibited the cell viability.Compared with control group , three dose test groups inhibited invasion, up -regulated the expression of E -cadherin, and down-regulated the expressions of MMP2, MMP9, Vimentin and the phosphorylation of AKT.Conclusion Erlotinib suppressed PC 14/B cell invasion and metastasis , which was related to the down -regulation of the expression of MMPs , and the inhibition on the generation of EMT and the phosphorylation of AKT.

Objective To investigate the expression of connective tissue growth factor (CTGF) and their correlative factors in cervical cancer.Methods We quantified CTGF expression levels in 61 cervical cancer tissues(treatment group) and normal cervical tissues (control group) around the tumor with real time polymerase chain reaction (PCR) assay and Western blot and analyzed correlative factors by logistic regression.Results The expression of CTGF mRNA in control group and treatment group were (1.00 ± 0.01),(0.30 ± 0.03) respectively,and (0.98 ± 0.02),(0.22 ± 0.05) in terms of the expression of CTGF protein,which had statistical significance (all P ＜ 0.01).Multiple factor logistic regression showed that the expression of CTGF mRNA was negatively correlated with Federation International of Gynecology and Obstetrics (FIGO) staging,lymph node metastasis and differentiation of cervical cancer,and the expression of CTGF protein was negatively correlated with FIGO staging.Conclusion CTGF may play a role as tumor suppressor gene in the progression of cervical cancer.