82 spastic cerebral palsy and normal children were selected, including 27 younger and 27 older spastic cerebral palsy( observation group) ,and 14 younger and older normal children( control group) . The tumor necrosis factor α( TNF-α) levels were measured in the serum with ELISA. The TNF-α levels in the serum of the younger and older spastic CP groups were higher than those of the control groups ( P<0.01 ) . In observation groups, the TNF-α levels of younger spastic cerebral palsy were higher than those of the older (P<0.01). On the contrary, the normal children in the control group of different ages had no difference of TNF-α. TNF-αexpression was signifi-cantly higher in the serum of the spastic CP group than that in the control group ( P<0.01 ) . TNF-α expressed continuously in vivo of children with spastic cerebral palsy involve subsequent brain injury.

Objective To evaluate the effect of auxiliary trocar located on various positions on obese patients treated with retroperitoneoscopic radical nephrectomy.MethodsRetrospective analysis was performed for 61 consecutive obese patients who underwent retroperitoneoscopic radical nephrectomy for localized renal cell carcinoma at our institution from March 2004 to December 2010.An auxiliary trocar was placed into retroperitoneal space according to the position of tumor.It was placed infro-costal magin in the mid-axillary line with uppre-median pole tumor,and 4 cm medial to mid-axillary line and 1 cm cephalad to illac spine with lower-median pole,respectively.ResultsAll 61 patients were completed successfully with no conversion to open surgery.Mean operating time was ( 153.1 ± 23.5 ) min.Mean estimated blood loss was (57.6 ±29.7) ml.Mean hospital stay after operation was (5.7 ±2.6) d.The rupture of peritoneum and liquefaction of fat were occurred in 5 and 4 patients respectively.There was no major intraoperative and postoperative complications occurred.Conclusions Reasonable position of the auxiliary trocar according to the tumor's location would be safe and feasible on obese patients treated with retroperitoneoscopic radical nephrectomy.Obese patients with localized renal cell carcinoma would better benefit from minimally invasive procedure.

Objectives: To investigate the affecting factors on expenditure in Medical insurant inpatients. Methods: 593 medical insurant inpatients, who were from Feb 1, 2001 to Feb 31, 2002 in Nanjing Jinling hospital, were enrolled in this study. The inpatient expenditure was analyzed from the aspect of operation or not, age, and payment mode, used the descriptive analysis and multi factor analysis on affecting factors of the total expense, self bearing expense, and self affording expense. Results: The hospitalized days, operation or not, severity of disease were important affecting factors. The self bearing expense of medical insurant inpatients was associated with hospitalized days, operation or not, and total expense. While the self affording expense of them was associated with expense of drug, hospital bunk, radiation and others. Conclusions: We can control these associated affected factors to lighten the economic weight of patients, and to reduce the ratio of individual payment.

Objective To study the genetic variation of two mitochondrial DNA molecules (CO1 and Cytb gene) of Oncomelania hupensis isolated from different areas. Methods Snails were collected from Jingxi of Guangxi,Yueyang of Hunan and Eryuan of Yunnan. Genomic DNA was extracted from the snails,Co1 and Cytb gene fragments were amplified by PCR,then purified and sequenced. Sequences of each isolates were edited by using Clustal W(1.82) software,and the nucleotide composition,transition and transversion were accounted by using MEGA(3.1) software. The genetic distances were computed with Kimura method and phylogenetic trees were constructed with UPGMA and MP method respectively. Results CO1 and Cytb gene fragments were about 700 bp and 600 bp(including 2 primers) respectively. A total of 106 mutation spots (15.9%) were tested in CO1 homological nucleotides,and 165 mutation spots (28.5%) were tested in Cytb homological nucleotides. The distance matrix between Guangxi isolate and Hunan isolate was 0.051 and 0.031 for CO1 gene and Cytb gene respectively;while that between Guangxi and Yunnan isolates was 0.158 and 0.405 respectively. Phylogenetic trees constructed by UPGMA and MP took on the similar topo-structure:isolates of Guangxi and Hunan clustered into one group,while the Yunnan isolate exhibited as another group. Conclusion Oncomelania hupensis in Guangxi,Hunan and Yunnan are of relatively rich polymorphism in CO1 and Cytb genes in general.

Objective To introduce a new method for correcting prominent malar complex deformity. Methods Through an intraoral incision, the highest area of zygomatic body marked preoperatively was grinded. Then an L shape incomplete osteotomy of the zygomatic body was performed with a reciprocating saw, and a complete osteotomy just 1 cm anterior to the articular tubercle of the zygomatic arch was made. Light pressure on the posterior part of the arch produced a greenstick fracture of the anterior osteotomy site, resulting in posterior-inward repositioning of the malar complex. Internal fixation was unnecessary. Results Operative procedures for reductive malar complex plasty were performed in 650 cases, which included 60 males and 590 females whose age ranged from 19 to 39 years.Incisions of all cases healed well. One case had maxillary sinusitis 2 weeks postoperatively, and recovered after 1 week by using antibiotics and drainage. There was 1 case with skin necrosis about 1 cm in diameter in the area of zygomatic body because of local liposuction, and the wound was healed by changing dressing. The forehead wrinkle of one side had disappeared in 1 case 1 week postoperatively, but had recovered 2 weeks later. Postoperative follow-up for 2-24 months showed satisfactory results.Conclusions This modified method has many advantages, such as simplicity, without internal fixation, short operation and recovery time, and little complications. The authors conclude that this technique is an effective and safe method of reduction malarplasty.

BACKGROUND: Whether the differences exist between adipose-derived stem cells isolated from different parts of rats when cultured in vitro has been poorly understood. OBJECTIVE: To compare the growth characteristics and adipogenic ability of adipose-derived stem cells isolated from different parts of rats. METHODS: Freshly isolated adipose-derived stem cells were obtained from 5 mL inguinal groove and greater omentum adipose tissue of F344 rats using type Ⅰ col agenase digestion method. Then, adipose-derived stem cells were counted and cultured in vitro. Morphological and growth characteristics of adipose-derived stem cells derived from the two sites were observed. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was utilized to examine the doubling time of adipose-derived stem cells from different parts. The passage 2 adipose-derived stem cells were induced adipogenical y. Fourteen days after being induced, the differentiated cells were stained with oil red O and the positive cells were counted. The adipogenic differentiation ability of adipose-derived stem cells from the different parts was assessed. RESULTS AND CONCLUSION: (1) The number of adipose-derived stem cells from the greater omentum fat tissue in the same group was (281±10)×107/L, which was significantly higher than that from the inguinal groove fat tissue [(85±10)×107/L] (P < 0.01). Adipose-derived stem cells from the greater omentum and inguinal groove fat tissue achieved the exponential growth period on days 5 and 6, respectively, and achieved the platform period on days 9 and 10, respectively. The corresponding doubling time was 50 hours and 60 hours, respectively. After being passaged, adipose-derived stem cells grew in fibroblast-like shape actively. The adipogenic differentiation rate of adipose-derived stem cells from the greater omentum fat tissue was higher than that from the inguinal groove fat tissue [(38.90±2.86)% vs. (35.30±3.29)%, P < 0.01]. This shows that the number and the adipogenic differentiation ability of adipose-derived stem cells from different parts of the same F344 rat are different.

Objective To explore the clinical value of transumbilica single-port laparoscopic surgery in the treatment of bilateral varicocele.Methods From Jan. 2010 to Sep. 2010,42 patients with bilateral varicocele underwent laparoscopic high ligation of bilateral spermatic vein.Of these patients,20 were treated with transumbilica single-port laparoscopic surgery,22 with traditional laparoscopic surgery.The two groups of patients were compared for the parameters such as intraoperative blood loss,testicular artery preservation,operating time,time of activities after surgery,time of intestinal function recovery and hospitalization duration.The semen quality 1 year after the surgery was compared with that before treatment.At the out-patient re-examination at 1,3,6months and 1 year after the surgery,the incision,scrotum,spermatic cord,testis were checked for possible complications.The relief of discomfortness in the scrotum was also followed up.Results Both operation procedures were successful,without severe complications.In the single-port laparoscopic surgery produced blood lose ( [ 5 ± 1 ] ml vs.[ 5 ± 1 ] ml,t =- 0.452,P ＞ 0.05 ),the operating time ( [ 41 ± 7 ] min vs.[ 39 ± 3 ] min,t =0.686,P ＞ 0.05 ),postoperative intestinal function recovery time ( [ 11 + 1 ] h vs.[ 11 + 2 ] h,t =- 1.631,P ＞0.05 ) and postoperative hospital stay ( [ 3.1 + 0.7 ] d vs.[ 3.4 + 0.7 ] d,t =- 1.447,P ＞ 0.05 ) which were all comparable to that from conventional laparoscopic surgery.There was significant difference in the population using analgesics,single-port laparoscopic surgery vs.conventional laparoscopic surgery ( 1 case [ 5.0％ ] vs 7case [ 31.8％ ].The difference was statistically significant (x2 =4.886,P ＜ 0.05 ).The single-port laparoscopic surgery produced neglectable scar at the incision.All of the patients were questionaired for their satisfaction with the incision 1 year after the surgery.The difference was statistically significant (x2 =7.636,P ＜ 0.01 )Conclusion Single-port laparoscopic high ligation of bilateral spermatic vein produces comparable outcomes to that of conventional laparoscopic surgery,but it is a more microinvasive procedure producing good aesthetic appearance,representing the trend of laparoscopic technique.

In order to understand the distribution of schistosomiasis in mobile population in Guangxi zhuang Autonomous Region, field investigation was conducted in 19 endemic villages selected by cluster sampling. The mobile people who were older than 3 years old were investigated by questionnaire and indirect hemagglutination( IHA) , then the IHA-positive ones were detected by fecal examination. Meanwhile, a snail survey was carried out. The results showed that a total of 2 866 people were investigated , among which 1 380 came from 143 endemic areas. A total of 2 428 people were involved in IHA examination with a positive rate of 3.46% , and the rate of people from endemic areas were significantly higher than that of ones from non-endemic areas( P < 0.01). Sixty people were involved in fecal examination, and the results were all negative. An area of 899. 3 hm~2 was surveyed, and the snail area was 4.97 hm~2, while none of positive snails were found. It is suggested that the mobile population is the main risk factor for potential schistosomiasis transmission in Guangxi, and the surveillance on this population should be strengthened.

Objective To set up the trimester-specific reference ranges of thyroid hormones for normal pregnant women to provide reference criteria for diagnosis, treatment and monitoring or screening of thyroid disease during pregnancy and related research. Methods A cross-sectional survey was conducted in pregnant and non-pregnant women in iodine sufficient areas. A total of 505 normal pregnant women and 153 normal non-pregnant women (as control) were selected for establishing trimester-specific reference ranges of thyroid hormones after rigorous screening through the survey questionnaire and laboratory tests. Thyroid hormones were measured by Bayer automated chemiluminescence immunoassay, and the reference range of each hormone was calculated as median (the 50th percentile value) and two-sided limits (the 2.5th and 97.5th percentile values). Results All women investigated were in iodine sufficient status within optimal urine iodine level. The serum TSH level during the 1st trimester was obviously declined compared with that in the non-pregnant individuals (P < 0.01), and started to rise during the 2nd trimester, but was still not restored to non-pregnant level until the 3rd trimester. Serum FT4 and FT3 levels gradually decreased from the 2nd trimester to the 3rd (P < 0.01), and the TT4 and TT3 levels were markedly elevated since early pregnancy (P < 0.01) and reached peak levels at the 2nd trimester approximately making up to 1.5 times of those in the non-pregnant individuals. Conclusion The thyroid hormone levels during pregnancy differ completely from those of the non-pregnant individuals, and also differ during different gestation periods. Therefore, to establish trimester-specific reference data of thyroid hormones during normal pregnancy may be important for clinical practice.

Fifty residual Oncomelania snail points were found in Guangxi Zhuang Autonomous Region from 1998 to 2009,and the snail area was 14.9 hm2.The residual snail area increased year by year with complex environment.