Orphan nuclear receptor steroidogenic factor 1 (SF-1) is a member of the nuclear receptor superfamily. It regulates the expression of multiple genes involved in adrenal and gonadal development,steroidogenesis,and reproductive function. Twenty five different mutations have been described and their clinical features are various. Detection of SF-1 gene may be contribute to the etiological diagnosis for 46, XY disorder of sex development patients.

Objective To investigate the feasibility of video-assisted thoracoscopic surgery for anterior mediastinal modules. Methods Thoracoscopic surgery was performed with the patients in supine position and the thoracoscope set at 30?. Three trocars were used during the procedure. One of the trocars was inserted through the fifth or sixth intercostal space at the midaxillary line for direct observation. And the other two were placed at the second or third intercostal space at the midclavicular line,and the fifth intercostal space at the anterior axillary line. The nodules were removed directly during the operation. For inseparable nodules,the whole thymus and the fat tissues in the anterior mediastinum were removed all together. Results The procedure was completed under a thoracoscope in all of the 32 cases. Small assistant incision was made in 3 cases because of hemorrhage in the chest cavity. Postoperative pathological examination showed thymus tumor in 14 cases,hyperplasia of the thymus in 3,thymic cyst in 5,bronchial cyst in 3,pericardial cyst in 2,neurilemmoma in 2,lymph node in 2,and angioma in 1. The accordance rate of pre-and post-operative diagnosis was 68.8% (22/32). Postoperative complications were found in two patients,including one case of pericardial effusion,and one case of lung infection. Both the cases were cured afterwards. Conclusions Thoracoscopic surgery is a minimally invasive procedure for the treatment of anterior mediastinal nodules. It is optimal for young patients and cases with low lung function,as it causes less pain,quicker recovery,and satisfying cosmetic outcomes.

Objective To investigate the clinicopathologic characteristics of metaplastic thymoma.Methods The histological features and immunophenotype of three cases with metaplastic thymoma were studied, and the literatures were reviewed.Results There were 2 females and 1 male of 3 patients with 45, 52 and 40 years old, respectively.All tumors were characterized by a biphasic pattern composed of epithelial components and spindle cells.The epithelial areas consisted of anastomosing cords and islands or broad trabeculae of cohesive neoplasia cells.Some epithelial cells showed mild cytologic atypia, the presence of prominent nuclear grooves or pseudoinclusion body, and very low mitotic activity.The cells appeared bland and a fine nuclear chromatin pattern, and the mitoses were not found.The epithelial cells were diffusely and strongly positive for AE1/AE3.The spindle cells were diffusely positive for Vimentin.The Ki-67 fraction was low (＜5 ％) in both components.Conclusions Metaplastic thymoma is a rare primary thymic epithelial tumor, and its biologic behavior is likely benign or lowly malignant process.Occasionally, the tumor invades adjacent tissue or recurrence.With complete tumor resection, the patients have good prognosis.The diagnosis of metaplastic thymoma mainly relies on its morphologic features and immunohistochemical profiles.

Stress urinary incontinence is a common and frequently disease among middle and old women.However,it did not cause enough attention by patients.In recent years,people have learned more about incontinence mechanism,and designed some tension-free vaginal tape operation.Those operations have showed excellently effects.We introduce some highlights about stress urinary incontinence to help reader understand the disease,such as operation principle,influencing factors about surgery,indications,concomitant disease and surgical treatment for failure cases,etc.

Lipid extract of burn eschar (D_1) added to isolated rat liver mitochondrialcaused depression of respiratory control ratio (RCR), ADP/O ratio, rate of ATP produc-tion, respiration rate in state 3 but it stimulated the respiration rate in state 4. Pretreat-ment with vitamin E significantly prevented the inhibition of mitochondrial respiratoryfunction caused by D_1. The addition of vitamin E after that of D_1 had no protective ef-fect. Heat-treatment of D_1 markedly reduced its inhibitory effect on mitochondrial respira-tory function. Cumene hydroperoxide (CHP) markedly depressed mitochondrial respiration.Vitamin E caused a significant increase in RCR, which was inhibited by CHP at lowerconcentrations. Vitamin E reduced MDA formation considerably in normal mitochondriaand in those mitochondria incubated with D_1, heated D_1 or CHP. These findings indicatedthat D_1 -and CHP-induced depression of mitochondrial respiratory function was probablydue to lipid peroxidation damage which was proved by the protective effct of the pota-tive antioxidant vitamin E.

Objective To investigate the effect of Simoyinzi Decoction on serum 5-HT and inflammatory factors in the treatment of perimenopausal women with early onset of severe depression.Methods 82 cases of perimenopausal women with primary severe depression were selected and randomly divided into 2 groups, 41 cases of each group.Control group received basic medicine treatment, the research group received Simoyinzi Decoction treatment,serum neurotransmitter, inflammatory factor and sex hormone levels were detected before and after the treatment, and clinical symptom score and clinical curative effect were compared after the treatment.Results Compared with before treatment, levels of noradrenaline norepinephrine(NE), 5 serotonin(5-HT), dopamine(DA), glutamate(Glu) and N-methyl-D-aspartate(Asp) increased in 2 groups after treatment, levels of gamma amino acid (GABA) and glycine(Gly) decreased, levels of follicle stimulating hormone(FSH) and luteinizing hormone(LH) decreased, levels of estradiol(E2) increased, levels of IL-1β, IL-6, TNF-αand CRP decreased, scores of HAMD and Kupperman decreased, the differences were statistically significant (P<0.05), compared with the control group, levels of NE, 5-HT, Glu and Asp in the research group after treatment were higher, levels of GABA and Gly were lower, levels of FSH and LH were lower, levels of E2 were higher, levels of IL-1β, IL-6, TNF-αand CRP were lower, and scores of HAMD and Kupperman were lower, the differences were statistically significant(P<0.05), and the effective rate in the control group(70.73%) was lower than the research group ( 90.24%) ( P <0.05 ) .Conclusion Simoyinzi Decoction in the treatment of perimenopausal women with early onset of severe depression was curative effective, and it can improve the 5-HT and reduce the levels of inflammatory factors.

The formation of Staphylococcus epidermidis biofilm on the surface of medical biomaterials may resist the antibiotics treatment and cause chronic infection,which has become a research focus in recent years.Multiple genes constitute complex regulatory network which affect the biofilm formation,and play different roles in the different stages of biofilm formation.Accessory gene regulator (agr) is one of the most important genes in the process of biofilm formation.The process of bacterial biofilm formation,research status of regulation mechanism of agr system and its related genes in the formation of biofilm are reviewed,to provide reference of using agr as a target for the treatment of staphylococcus epidermidis biofilm related infections.

Background:The ability of tumor cells to evade destruction by immune system is known as tumor immune escape. Regulatory T cells( Treg cells)and myeloid-derived suppressor cells( MDSCs)are considered to be the most critical cell subsets participating in tumor immune escape. Aims:To determine the percentages of Treg cells and MDSCs in peripheral blood of patients with gastric cancer for investigating the effects of these two cell subsets on development and progression of gastric cancer. Methods:Peripheral blood specimens from 77 patients with gastric cancer and 20 healthy controls were collected for measurements of CD4+CD25+Foxp3+ Treg cells and MDSCs by flow cytometry. Correlations between Treg cells,MDSCs and clinicopathological characteristics of gastric cancer were analyzed. Results:Percentage of CD4+CD25+Foxp3 + Treg cells in peripheral blood CD4+ T cells and percentage of MDSCs in peripheral blood mononuclear cells were both significantly higher in gastric cancer patients than in healthy controls( Treg cells:4. 72% ± 1. 01% vs. 1. 57% ± 0. 99%,P<0. 01;MDSCs:21. 72% ± 10. 12% vs. 2. 90% ± 1. 80%,P<0. 01). Percentage of Treg cells in peripheral blood was correlated with the clinical stage,depth of invasion and lymph node metastasis of gastric cancer(P<0. 05), while percentage of MDSCs was correlated with the clinical stage of gastric cancer(P<0. 05). Furthermore,a significant positive correlation was observed between percentages of Treg cells and MDSCs in peripheral blood of gastric cancer patients ( rs =0. 681,P<0. 01). Conclusions:Gastric cancer patients are characterized by high expressions of immunosuppressive cells in peripheral blood,such as Treg cells and MDSCs,which might be related with the development and progression of gastric cancer via tumor immune escape.

Points Fengfu(GV 16), Fengchi(GB 20) and Anmian were selected as main acupoints to treat painful heels and the total effective rate of 96.9% was got. The technique of lifting needle was the key to the therapy.

Objective To evaluate the clinical therapeutic effects oftrimetazidine on the treatment of unstable angina (UA) as well as its effects on endothelin-I level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group (n =60) and the control group (n =60), the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells (CEC) and endothelin-1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1) The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%,respectively (P<0.05), and the excellence rates were 36.7% and 15% (P<0.01)respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%,respectively (P<0.05), and the excellence rates were 30.0% and 11.7%, respectively (P<0.01 ). 2) The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased (P<0.05), but the decreases in the trimetazidine group were even significant (P<0.01). 3) The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% (P<0.05), respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively (P<0.05), and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively (P<0.05). Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.