Objective To discuss the influence of clean-up frequency of the operative cavity on the curative effect after endoscopic sinus surgery.Methods 368 patients with sinusitis or nasal polyps were randomly divided into observation group and control group,184 patients in each group.Control group was treated with operative cavity cleaning in moderate frequency,while observation group in intensive frequency.Results The obvious effective rate of observation group was 80.98％,which was significantly higher than that of control group(69.02％) (x2 =12.468,P ＜0.05).The ineffective rate of observation group was 2.17％,which was significantly lower than that of control group (9.78％) (x2 =15.717,P ＜ 0.05).The recurrence rate of observation group was 11.96％,which was significantly lower than that of control group (26.09％) (x2 =9.361,P ＜ 0.05).Conclusion The clean-up frequency of the operative cavity after endoscopic sinus surgery can influence curative effect,moderate clean-up frequency can significantly improve the treatment effects and deserved promotion.

Transcranial doppler (TCD) was used to measure the flow velocities of middle cerebrial artery (MCA) in 4 patients of clinical brain death. The reaults showed that the changes were similar in all the patients studied; 1) the dierotic notch (DN) was deeper in the spectrum of flow velocities of MCA, end diastolic flow rate (VD) significantly decreased, and the pulastility index (PI) increased ; 2) VD decreased progressively; 3) all patients showed characteristic to-and-fro TCD pattren with antegrade flow in systole and retrograde flow in diastole; 4) the pattern totally disappeared when the patients were claimed dead. It is found that TCD is valuable for the determination of brain death.

Objective:Toinvestigate the influence of MMP7 antisense oligodeoxynucleotide(ASODN)on adhesion and invasion ofhuman lung adenocarcinoma cell line A549.Methods:Phosphorothioate MMP7 ASODN was transfected to A549 cells mediated by liposome. The expression of MMP7 was examined by RT-PCR.The adhesive and invasive ability were examined by plate adhesion model and Boyden Chamber transwell assay.Results:After MMP7 ASODN was transfected,the relative optical density(ROD)of electrophoresis strip was decreased obviously(P

[ABSTRACT]AIM:Toexploretheeffectsofchrysinoninsulinresistance(IRe)inamousemodel.METHODS:Male C57 mice were randomly divided into control group , IRe group, low-dose chrysin group ( IRe+chrysin-low) and high-dose chrysin group (IRe+chrysin-high).After 24 weeks, the body weight, liver index and fat mass in all mice were detected.The blood glucose , insulin level and HOMA-IR were measured to determine the changes of the insulin resistance in the animals.The oxidative stress (SOD, GSH-Px and MDA) was also measured.The mRNA expression of insulin sig-naling pathway molecules (IR, IRS1, IRS2, Glut2 and Glut4) and inflammatory factors (TNF-α, IL-1β, IL-6 and NF-κB) was analyzed by real-time PCR.The protein levels of IRS1 and p65, and their phosphorylation were detected by West-ern blot.RESULTS:After 24-week intervention , the indicators in IRe group were higher than those in control group , in-cluding body fat deposition, serum glucose, serum insulin, HOMA-IR and liver oxidative stress (P<0.01), indicating that the model of insulin resistance was successfully established .Low dose and high dose of chrysin decreased the body weight, serum glucose, serum insulin and HOMA-IR in the IRe mice (P<0.05).The liver oxidative stress was also re-duced in both groups (P<0.05).However, no statistical difference of the indexes between IRe +chrysin-low group and IRe+chrysin-high group was observed.Chrysin upregulated the mRNA expression of IR , IRS1, IRS2, Glut2 and Glut4 (P<0.05), and down-regulated the mRNA expression of various inflammatory factors .The inhibitory effect of chrysin on the mRNA expression of NF-κB was observed (P<0.05), especially in high dose group (P<0.05).It was confirmed that the effect of chrysin on liver IRe was related with the increase in the p-IRS1 levels and decrease in the p-p65 levels by Western blot .CONCLUSION:Chrysin inhibits obesity , hyperglycemia and hyperinsulinemia , and relieves insulin resist-ance and oxidative stress , which might be closely related to the regulation of insulin signaling pathway and the inhibition of inflammatory factor expression .

Objective To discuss the application of core needle aspiration biopsy to diagnosis of breast csncer. Methods 64 cases with breast cancer tumor were checked byCNB and compared with surgical pathology results.Then the method of CNB operation technology was analyzed. Results The diagnostic sensitivity was 96.0% and specificity was 100%. There was no complication during biopsy. The false negative raty was 4.0%. Conclusion The application of core needle aspiration biopsy was simple, safe and reliable. And it could improve the diagnosis of breast cancer.

Objective To analyze the pathophysiological variation in patients with penetrating cardiac trauma (PCT) and discuss the classified treatment strategies.Methods A retrospective analysis was conducted on pathogenetic condition,medical interventions and other clinical information of 133 PCT patients.The patients were divided into four groups in accordance with their symptom classification on arrival at emergency department,including sub-clinic type,cardiac tamponade type,hemorrhagic shock type and agonal type.Meanwhile,the patients were classified into three groups according to their pathogenesis phase,including sub-clinical phase,clinical phase and agonal phase.Development characteristic of patients' condition in each group was investigated in each time point by survival analysis.Impacts of medical interventions on prognosis of those patients were analyzed,such as pericardial space exploration,emergency room thoracotomy (ERT),operating room thoracotomy (ORT).Results Some patients at sub-clinical phase were aggravated into clinical phase or agonal phase,as well as some patients at clinical phase were aggravated into agonal phase during in-hospital treatment.There were significance differences of posttraumatic suvival course among the four groups,namely sub-clinical type,cardiac tamponade type,hemorrhagic shock type and agonal type (P ＜ 0.01).The differences of posttraumatic survival course were also significant among the three groups,namely sub-clinical phase,clinical phase and agonal phase (P ＜ 0.01).Conclusion Clinical symptom classification (or pathogenesis phase) of PCT may not be always unchangeable,thus it is recommended that PCT patients should be treated based on their clinical symptom classification or patbogenesis phase at consultation.

No abstract available.
Organ Transplantation* ; Transplants*

Objective To make an initial attempt to use robotic single-site surgery for laparoscopic partial nephrectomy and ureteropelvic angioplasty in pigs, so as to assess the feasibility and ergonomics of the robotic single-site surgery in laparoscopic urological reconstruction surgery and to summarize the manipulation experience. Methods Partial nephrectomy: at a lateral position, a 4 cm incision was made at the level of hilum on the lateral border of the rectus muscle, and the subcutaneous tissue layer was dissected bluntly with the Kelly clamp. After pneumoperitoneum was established by the veress needle, four trocars were introduced in the shape of diamond, including two 8 mm robotic trocars on the left and right rides and two 10 mm surgiquest trocars on the upper and lower rides. After the robotic tower was docked, the procedure of nephrectomy was performed routinely. And the renal defect was closed by a horizontal mattress suture with "sliding-clip technique". Pyeloplasty: all trocars were removed and a 4 cm long incision was made; the novel suriquest robotic port was introduced into the abdominal cavity. Two 8 mm robotic metal trocars were introduced from two sides of the surgiquest port in the way of "1 + 1". After the robotic arm was docked, the pyeloplasty was performed. Results Partial nephrectomy were successfully performed in two cases, with the time for establishing access bring 5 min and 8 min, time for docking the robotic system bring 11 min and 9 min, time for operation bring 55 min and 42 min, and time of warm ischemia bring 23 min and 18 min, and with the blood loss bring 50 ml and 20 ml. Pyeloplasty were successfully performed in two cases, with the time for establishing access bring 17 min and 12 min, time for docking the robotic system bring 5 min and 4 min, and time of operation bring 32 min and 25 min, andwith no blood loss. Conclusion After proper setup of trocars, the roboic single-site operation under laparoscope can complete the complex urological reconstructive surgery. And the novel surgiquest port can obtain more ideal ergonomics outcomes.

Objective: To assess the feasibility of the single-port laparoscopic transvesical prostatectomy in pigs, and to summarize the technique difficulties, so as to lay a foundation for future clinical application. Methods: Six uncastrated male pigs were used in this study. The skin stomas were made through bladder exstrophy and the TriPort system was inserted into the bladder. Radical prostatectomy was performed as did in human using laparoscopic instruments through the TriPort system after inflating the bladder. The bladder and abdomen were closed after vesicourethral anastomosis, and the prostate specimens were removed through the skin stoma. Results: The first three procedures failed due to inappropriate positioning of TriPort system, limited space of bladder, and the high tension of vesicourethral anastomosis. The other 3 procedures were successful, with the periods used being 190 min,160 min, and 110 min. The whole prostates were resected completely, and the completeness of the urinary tract was recovered using interrupted suture (6 sutures). Conclusion: The single-port laparoscopic transvesical prostatectomy is a feasible procedure, but there are technical difficulties. Further experiments are needed on human cadavers before clinical application.

Objective: To assess the feasibility of nephrectomy via combined transgastric and transvesical approach in a porcine model, and to summarize our experience. Methods: Three female pigs were used in this study. The transvesical access was established using ureteroscope. The vesical hole was enlarged with the dilator of ureteroscope sheath and a self-designed Trocar was inserted. The gastroscope was inserted through a hole on gastric wall, which was made using a needle knife and dilator under ureteroscopy. The ultrasound knife, scissor and clips were introduced via the Trocar, and the nephrectomy was completed under the guidance of gastroscope. Results: The six kidneys of the three pigs were successfully resected, with the operation time being (132±10.5) min, without noticeable hemorrhage or complications. Mild hemorrhage occurred after ultrasonic ligation in the first nephrectomy, and was managed by clips. Clips were used to block the vessels before resection for the remaining five kidneys. Conclusion: Our method via combined approach is technically feasible for nephrectomy in a porcine model, but the kidneys have not been taken out and the puncture wounds on the bladder and gastric wall have not been closed, so further study is still needed.