Objective To investigate the antitumor effects on ovarian cancer using recombinant adenoviruses expressing autocatalytic caspase-3 driven by amplified human telomerase reverse transcriptase promoter (AdHTVP2G5-rev-casp3) combined with flavopiridol. Methods Following the treatment with AdHTVP2G5-rev-casp3 combined with flavopiridol, cell survival rate was measured by cell counting kit 8;cell apoptotic rate and cell cycle distribution were detected by flow cytometry. Western blot was performed to observe the expression of p17, the active subunit of caspase-3, and p85, the cleavage segment of substrate of caspase-3, in AO cells. The mice survival rates were measured for abdominally metastatic tumor models and the volume of tumor nodules were determined for subcutaneous tumor models following the treatments of AdHTVP2G5-rev-casp3 combined with flavopiridol. HE staining was used to detect the histopathological changes of various organs, and the serum level of alanine transaminase (ALT) and aspartate aminotransferase (AST) were measured to monitor liver damages following the intraperitoneal administration of AdHTVP2G5-rev-casp3 and flavopiridol. Results There was no significant cell-killing effects or apoptosis in AO cells following treatments with AdHTVP2G5-rev-casp3 or flavopiridol at low dosage alone (apoptotic rate all ＜ 11% ), whereas significant synergism of their sequential combination was observed in AO cells. This sequential treatment of AdHTVP2G5-rev-casp3 [multiplicity of infection (MOI) was 20]infection for 72 hours, followed by flavopiridol ( 300 nmol/L) for 48 hours, could result in the most substantial cell death, and AO cells survival rate and apoptotic rate were 73. 5% and 11.6%, respectively.Following treatments with AdHTVP2G5-rev-casp3 at low doses ( MOI = 10), there was a significant increase in cell number with S-phase content ( 62. 5% ), which resulted in the most marked apoptosis induced by sequential treatments with flavopiridol. The sequential combination could induce significantly higher levels of p17 and p85 expression than that when their applications alone. Combined AdHTVP2G5-rev-casp3 and flavopiridol treatment prolonged mouse survival [ mean survival time of ( 286 ± 6) days ] and suppressed tumor growth significantly (tumor growth suppression rate of 81% ), when compared with treatment using either alone. The levels of serum ALT and AST were not significantly elevated and no obvious lesions were found in any organs in treatments with AdHTVP2G5-rev-casp3 of low doses combined with flavopiridol.Conclusions AdHTVP2G5-rev-casp3 at low doses results in a significant increase in cell number with Sphase content, which significantly enhanced the sensitivity of cells to flavopiridol. Treatments of autocatalytic caspase-3 combined at low doses with flavopiridol result in significant synergistic antitumor effects,significant tumor growth suppression and prolonged survival of mice. When compared with normal dose flavopiridol alone, the combination could resulted in minimal liver toxicity.

OBJECTIVE To enhance the quality of cleaning and avoid nosocomial infection. METHODS To contrast the cleaning quality of two groups by using enzyme cleaning product and normal cleaning with cleaning system.In the test OB test paper was used. RESULTS Between two groups,the surfaces of medical instrument were ?2=18.939,P=0.0000;the joint of medical instrument was ?2=22.844,P=0.0000;intersect of medical instrument was ?2=23.389,P=0.0000;P

Objective To investigate the surgical approach for adult patients with presacral cystic teratoma.Methods In this study,16 female patients,aged at 26-45 years,with presacral cystic teratoma underwent surgical resection between March 2007 and August 2012.Tumor was primary in 9 cases and recurrent in 7 cases,Rectal examination revealed retrorectal tough semi-circular poorly movable massess with intact rectal mucosa.MR examination showed cystic or solid mass in the anterior sacral,clear boundary,rectum and or vagina compressed.Tumors were completely removed in all cases.Results All patients were cured by surgery,13 cases were cured by one stage resection and 1 was cured by two stage resection.Two cases suffered from recurrence and was cured by reoperation.There were no injury to rectum,anal sphincter,cauda equina,presacral vein.Pathological diagnosis was cystic teratoma.Conclusions By sacrococcygeal surgical resection of presacral cystic teratoma was safe and effective ; complete resection of the tumor capsule is the key to successful operation.

The molecular delivery vectors used in gene therapy need provide the features of safety,stability, efficiency and capacity. The current studies on the structure and action mechanism of pRNA, a packaging RNA of phage?29, showed that pRNA with multiple binding sites can through cell membrane easily and escort exogenous molecules to target cell, without inducing immune reaction. As an ideal nano-scale gene therapy vehicle, pRNA presents a promising application in delivering multiple therapeutic components to detect and treat human diseases.

Objective To explore the cause of acute myocardial ischemia early after coronary artery bapass graft (CABG) and surgical management on it. Methods From 2001 to 2009, 28 patients underwent urgent reoperation early after CABG due to acute myocardial ischemia. The incidence of reoperation is about 0.02%. The cause of reoperation inclouded early graft occlusion (10 cases) ,IMA damage or injury during harvesting(9 cases), inexactitude distal anastomosis(2 cases)and radial artery spasm(4 cases). The mean interval time between two operations was 8 hours. Reoperation was done under offpump bypass in 2 patients and on-bypass used in other patients. Unsatisfactoey graft were substituted with new graft material and thrombotic was removed. If LIMA was the reson for myocardial ischemia, an additional vein graft was inserted. The spasm radial artery were substituted with new vein graft. Completely revascularization was used in re-do CABG. Results Two patients died during reoperation. 8 patients was died between 1 day and 14 days after reoperation. IABP was used in 16 patients,which 2 patients received ECMO suppord and 2 patient received LVAD suppord at mean time. Conclusion There have very high mortality in acute myocardial ischemia early after CABG. The early diagnosis and correct surgical management can improve the rates of survival. The active prevent should be emphasized during the first CABG.

OBJECTIVE To discuss the management method of the Hospital OR Department to set up a highly cleaned and safe operating room (OR) environment to prevent nosocomial infection. METHODS As to the features of OR Department,the standardizd management of work process was reinforced. RESULTS The available resources in OR Department were made good use and infection control assured medical safety. CONCLUSIONS The setup and standardized management of Clean OR Department is in favor of the cleaniness of the OR Department and decreasing the infection rate.

ObjectiveTo assess the feasibility of seeding adipose-derived stem cells (ADSCs) onto bladder acellular matrix grafts (BAMGs) for bladder reconstruction in a rabbit model.MethodsAutologous ADSCs were isolated,expanded and identified by flow cytometry.In the experimental group,ADSCs were seeded onto BAMGS for reconstructing bladder defects in 12 male rabbits.Unseeded BAMGs were used for bladder reconstruction in the control group of 12 rabbits.Cystography was performed at 24 weeks after grafts implantation.Following cystography,the animals were scarified and grafts were harvested； H&E and immunohistochemical staining were performed with cytokeratin AE1/AE3,smooth muscle α-actin and S-100 markers.ResultsFlow cytometry demonstrated that the ADSCs expressed CD90,CD44,CD105,CD166 and CD34,but not CD45 or CD106.The cells demonstrated good biocompatibility with BAMGs.At 24 weeks,in the experimental group,the reconstructed bladders reached a mean volume of (94.68 ± 3.31 )％ of the precystectomy bladder capacity.Complete regeneration of smooth muscle and nerve tissue was evident.Regenerated SMCs,urothelium and nerve cells stained positively for α-smooth muscle actin,AE1/AE3 and S100.In the control group,the mean bladder volume was (69.33 ± 5.05 )％ of the pre-cystectomy volume.Histologically,the control group was characterized by multi-layered urothelium without evidence for organized muscle or nerve tissue.Conclusion The tissue engineering bladder constructed by ADSCs and BAMG can be used as an ideal biomaterial to replace and repair the bladder.

Objective To study the use of laparoscopic cholecystectomy (LC) and laparoscopic common bile duct exploration (LCBDE) in patients with cholecystocholedocholithiasis.Methods From July 2006 to June 2010,127 patients with cholecystocholedocholithiasis were treated either by LC+LCBDE (n=78) or LC+endoscopic sphincterotomy (EST,n=49).The treatment success rate,complications,retained bile duct stones rate,recovery of gastrointestinal function and hospital-stay were retrospectively analyzed.Results The LCBDE+ LC group:The operative success rate was 94.87 ％.The incidence of postoperative complications was 5.41 ％.The EST+ LC group:Complete removal of bile duct stones was achieved in 46 of 48 patients (95.92％).The incidence of postoperative complications was 12.77％.There was a significant difference in the incidences of postoperative complications between the EST+ LC group and the LCBDE+ LC group (P＜0.05).The operative time and the cost for hospital stay between the two groups were significantly different (P＜0.05).After a follow-up of 3.2 years (mean,range 1-5 years),there was no significant difference in long-term complications such as bile duct recurrent stones,duodenal papilla stenosis and cholangitis between the two groups (P＜0.05).ConclusionsLCBDE was a safe,efficacious and feasible minimal invasiveness treatment for cholecystocholedocholithiasis.Primary closure of common bile duct in selected cases brought additional benefits to the minimal invasive technique.

Objective To compare the clinical outcomes of patients who underwent remnant-preserved anterior cruciate ligament (ACL) reconstruction with those who underwent conventional ACL reconstruction (ACLR).Methods From January 2010 to October 2012,93 eligible patients suffered from ACL injuries were randomly allocated into remnant-preserved group (ACLR with remnant preservation;n=48;Male/Female=34/14;Left/Right=25/23) and conventional group (ACLR without remnant preservation;n=45;Male/Female=33/12;Left/Right=22/23).The mean age of patients,time from injury to surgery,rates of combined meniscal injuries,and medial collateral ligament injury all showed no significant difference between the two groups preoperatively.All the patients underwent ACL reconstruction using 4-strand hamstring autografts.The postoperative assessments included knee functional scales (IKDC grade classification and Lysholm score),stability examinations (Lachman,pivot-shift,and KT-1000 arthometer),proprioceptive evaluations,and second-look arthroscopy.Results The average follow-up time was 25.4 months for the remnant-preserved group and 25.2 months for the conventional group.For IKDC grade classification,there were 32 patients with grade A,9 with grade B,1 with grade C in remnant-preserved group,whereas 30 with grade A,8 with grade B,2 with grade C in conventional group,which showed no significant difference between the two groups.Moreover,the Lysholm score (95.9±5.2 vs.95.4±1.7),Lachman test,pivot-shift test,KT-1000 arthometer (1.1±1.2 mm vs.1.2±0.9 mm),proprioceptive evaluations (joint position sense:3.6°± 1.8° vs.3.9°±2.2°) all showed no significant differences between the two groups.Additionally,the synovial coverage of grafted tendon under second-look arthroscopy was categorized as grade A in 11,grade B in 6,grade C in 2,grade D in 2 in remnant-preserved group,whereas grade A in 10,grade B in 5,grade C in 2,and grade D in 2 in conventional group,which still showed no significant difference.Conclusion In terms of the knee functional scales,stability examinations,joint position sense and graft synovial coverage,remnant-preserved ACLR group showed no superiority to the conventional ACLR group.

Objective To evaluate the clinical application of the fistulography of multi-slice spiral CT(MSCT)in the diagnosis of anal fistula.Methods A total of 28 patients who were verified operatively of fistula in ano underwent preoperative fistulography of MSCT.The multi-planar reformation(MPR)and surface shadow display(SSD)images were generated and analyzed retrorespectively.Results There were 8 cases with perianal abscess and 20 cases with anal fistula in 28 patients.Complex fistula was diagnosed in 16 cases,and simple inter-sphincteric fistula was found in 4 cases;the inner orificiums of anal fistulas were revealed accurately with MPR images in 18 cases.Conclusion The fistulography of MSCT is valuable for preoperative assessment of anal fistula,in particular for investigation of the inner orificiums of anal fistulas with MPR.