Objective To evaluate the efficacy of pneumocystoscopy for congenital malformation of the vesicoureteral junction. Methods A total of 18 children (male 11 and female 7, aged from 3 months to 7 years with a mean of 3.6 years) with congenital malformation of the vesicoureteral junction (22 ureters) were enrolled in this study. Among the patients, 9 had vesicoureteral reflux (4 of them had bilateral reflux), 2 had bladder diverticulum complicated with urethral stenosis, and 7 had urethral stenosis and ipsilateral hydronephrosis. After the bladder was insufflated with CO2 through a Foley catheter (16 mm Hg), three trocars were inserted into the bladder, and the bladder was fixed on the abdominal wall using silk thread. By pneumocystoscopy, the Cohen procedure was done through the trocars. A Foley catheter was indwelled at the end of the procedure. Results The procedure was completed in all but one patient, who was converted to open surgery because the contraction of the urethra. The mean operation time was 130 min (110 to 145 min) for unilateral cases (13), and 242 min (225 to 250 min) for bilateral cases. The patients were discharged form hospital 9 to 12 days after the operation, and were followed up fro 6 months to 5 years with a mean of 3.8 years. During this period, MUC showed no ureteral reflux. One of the cases developed mild infection of the urethra, and was cured by circumcision. Conclusion Pneumocystoscopy is effective for congenital malformation of the vesicoureteral junction.

Objective To investigate the feasibility of sentinel lymph node(SLN) biopsy by laparoscopy in patients with early-stage cervical cancer,and its accuracy for predicting pelvic lymph nodes metastasis.Methods A total of 26 patients with early-stage cervical cancer were enrolled in this study.Laparoscopic bilateral pelvic lymphadenectomy and radical hysterectomy were carried out in all the cases.During the operation,4 ml of methylene blue dye(1%) were injected into the cervix at 4 sites around the tumor.Both the blue-dyed lymph nodes and the other resected tissues were removed for pathological examination by HE staining.The blue-dyed lymph node was considered as SLNs,and the pathological results of all the removed pelvic lymph nodes were set as a gold standard,based on which the accuracy and false-negative rate of SLN biopsy,as well as the distribution of the SLN were determined.Results Of the 26 cases,a total of 51 SLNs were found in 23 patients(88.5%),among which 6 patients had 1 SLN,9 had 2,6 had 3,1 had 4,and 1 had 5;65.2%(15) of the patients had bilateral SLN.Five of the 26 patients(19.2%) showed pelvic lymph nodes metastases.In the 23 patients diagnosed as having SLN,3 had metastases in the SLNs(totally 6 SLNs were involved,2 of the 3 cases had the metastasis both in the SLN and pelvic lymph nodes,the other had the metastasis only in the SLN).In one patient,the biopsy was negative in SLN,but positive in the pelvic lymph nodes.In this series,the accuracy,sensitivity,specificity and negative predictive value of SLN biopsy were 95.7%(22/23),75%(3/4),100%(19/19),and 95%(19/20),respectively.There was a correlation between SLNs and pelvic lymph nodes status(?=0.832).Conclusions It is feasible to accurately detect SLNs using laparoscopic SLNs biopsy in patients with early-stage cervical cancer.The method is capable of predicting the disease,as well as the metastasis of local lymph nodes.

p53 gene mutation (exon4 , 5 , 6 . 7 . 8 and intron6) in gastric cancer and precancerous le- sions and p53 gene (exon4 and intron6) .APC gene deletion in gastric carcinomas were studied by PCR/ SSCP and PCR/RFLP. Results showed: mutation rate of p53 in intestinal metaplasia ,dysplasia and gas- tric carcinoma was 37. 5% (3/8) ,42. 1 % (8/19) , 53. 3% (16/30) ,respectively. There was significant dif- ference between groups of metaplasia、dysplasia、cancer and that of normal control. We found there were no exon8 mutation in metaplasia and dysplasia , but 4 cases in cancer group. lt is suggestted that exon8 mutation occurs at the late stage of gastric cancer , but exon 5 , 6 , 7 mutation occur in the course of pre- cancerous lesions to cancer. Loss of heterozygosity (LOH) of exon4 . intron6 . APC was 47. 4 % ( 9/19) . 8. 7%C2/23).16. 7%(3/18) ,respectively. There are some relationship between LOH of exon4 and poor- ly differentiation , lymph node metastas , depth of invasion. LOH of exon4 may be one of prognostic marker of gastric cancer. We concluded that p53 gene mutation is an early event and perhaps has syner- gism with ras oncogene in gastric carcinogenesis

Objective To describe a new surgical approach to treatment of scapular neck and body fractures and evaluate the clinical outcomes. Methods From December 2002 to October 2004, 13 cases of the scapular neck and body fractures including 9 males and 4 females with age range of 22-48 years (mean 31 years) were admitted into our hospital. There were seven cases with neck fractures, two with associated clavicle fractures, six with mere body fractures, seven with associated subluxation of humeral head and three with associated rib fractures. Internal fixation and open reduction reconstruction using titanium plate and screws were for treatment of scapular neck and body fractures in all 13 cases by making straight incision along lateral border of the scapula. Results The operation lasted for 40-80 minutes, with intraoperative blood loss for 30-80 ml. The follow up for 4-24 months showed average fracture healing time for 6-8 weeks and satisfactory results in 10 cases. Conclusion The surgical approach with straight incision along the lateral border of the scapula can attain perfect reduction and internal fixation of scapular neck and body fractures as well as satisfactory functional recovery with minor (trauma.)

The biological effects mediated by vitamin D and vitamin D receptor (VDR) are involved in the regulation of multiple pathophysiologic processes,including calcium phosphorus metabolism,immune regulation,anti-inflammation,anti-infection and cancer prevention,etc.Autophagy is a eukaryotic cell lysosome-mediated catabolic pathway,which is classified into 3 different types:macroautophagy,microautophagy,and chaperone-mediated autophagy.Since autophagy is vital to maintain energy and metabolism in cells,autophagy dysfunction is closely associated with various pathological processes such as inflammation,infection and tumor.Studies have shown that vitamin D/VDR can affect the different stages of autophagy and regulate inflammation in autophagy.Moreover,vitamin D/VDR and autophagy play an important role in autoimmune disease,diabetes,cardiovascular disease,cancer and other inflammatory diseases.

Objective To explore the effects of upper limb robot-assisted therapy on motor function and activities of daily living in con-valescent stroke patients. Methods From June to September, 2016, 12 chronic stroke patients at their first-ever stroke were enrolled and ran-domized into experimental group (n=6) and control group (n=6). Both groups received routine rehabilitation. Additional robot-assisted thera-py was provided to the experimental group, and additional repetitive movement training was provided to the control group, 20 minutes a day, five days a week for four weeks. Fugl-Meyer Assessment-Upper Extremities (FMA-UE), modified Ashworth Scale (MAS) and Func-tional Independent Measure (FIM) were used to assess the motor function of the upper limbs and hands, the muscular tension of shoulder and elbow, and activities of daily living (ADL) before and after treatment. Results After treatment, the scores of FMA-UE and FIM were bet-ter in both groups (Z>2.032, P<0.05), and no significant difference was found between two groups (t<0.723, P>0.05), however, the scores were a little bit higher in the experimental group than in the control group. After treatment, for the experimental group, the MAS scores of shoulder abduction/adduction and elbow flexion/extension improved (Z>2.121, P<0.05);for the control group, the MAS scores of shoulder abduction/adduction improved (Z>2.000, P<0.05), but the MAS scores of elbow flexion/extension were not significantly different (Z<1.890,P>0.05). There was no significant difference in the MAS scores of shoulder abduction/adduction and elbow flexion/extension between two group (Z<1.734, P>0.05). The moving trail recorded by the computer, gradually became a regular pattern from the mass, saying the motor control ability became better. Conclusion Upper limb robot-assisted therapy can promote the recovery of the motor function of upper limbs and ADL in convalescent stroke patient, similar to the repetitive movement training.

Cells, Cultured ; Fibroblasts ; cytology ; drug effects ; metabolism ; Humans ; Lung ; cytology ; metabolism ; Macrophages, Alveolar ; metabolism ; Matrix Metalloproteinase 2 ; metabolism ; Matrix Metalloproteinase 9 ; metabolism ; Silicon Dioxide ; toxicity ; Silicosis ; metabolism

Objective To investigate the clinical characteristic,diagnosis and treatment of familial adenomatous polyposis (FAP).Methods According to family history of the proband,we surveyed the pedigree and retrospectively analyzed the clinical characteristics of 10 FAP patients in 3 generations of the family.Result Among all 10 cases,3 died of colorectal cancer including two of whom had history of intestinal obstruction.Seven people of the third generation were all diagnosed as FAP.Among them,only 2 patients had clinical symptoms.Colonoscopy was done in all 7 patients before 35 years old.However,none of them had polyps or evidence of cancer.Surgical operation was performed on 1 patient and high frequency electric cutting under endoscopy was performed on 6 patients.Conclusions The early clinical manifestations of FAP are nonspecific.Pedigree investigation and colonoscopy screening for high-risk population are important to find early asymptomatic FAP patients.

Objective To observe the expression of retinol-binding protein 4 (RBP4) and phosphatidylinositol 3 kinase (PI3K) in insulin resistant (IR) rats and the role of pioglitazone intervention. MethodsThirty-five male Wistar rats in SPF level were randomly divided into control fed with normal diet (n= 11 ) and IR model fed with high fat sucrose diet (HFSD) (n= 24). The IR rats were then randomly divided into two subgroups, namely IR fed with HFSD(n = 12) and pioglitazone intervention (n= 12) given a daily dose of 20 mg · kg 1 · d-1 pioglitazone and HFSD (IR +Pio group )for 8 weeks.All rats were killed after 16 weeks and the levels of serum TG, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), fasting blood-glucose (FBG), fasting serum insulin (FIns) and insulin resistance index (HOME-1R) were measured.Enzyme-linked immunosorbent assay (ELISA) and RT-PCR were employed to detect the level of serum RBP4 and the mRNA expression of RBP4 in the epididymis adipose tissues, respectively. Immunohistochemistry was used to detect the protein expression of PI3K in skeletal muscles while UV spectrophotometer was employed to measure level of serum AOPP. The ratio of visceral fat weight of mesentery, epididymis and peritoneum in abdominal cavity to body weight (BW) was calculated. Results(1) the level of BW, TG, LDL-C, FINS and the ratio of visceral fat weight to BW were higher in IR group than in control group, but HDL-C decreased significantly. After the intervention of pioglitazone, the level of BW,TG, LDL-C, FINS, and the ratio of visceral fat weight to BW in IR+Pio group were lower and HDL-C increased significantly than those in IR group.(2) The level of RBP4 from serum and epididymis adipose and serum AOPP were higher in IR group than in control and lower significantly in IR+Pio group than in IR group (all P＜0.05). (3) The expression of PI3K in skeletal muscles were lower in IR group than in NC group, and increased after the invention of pioglitazone. (4) FIns, the ratio of visceral fat weight to BW and LDL-C were positively correlated with RBP4 while HDL-C and PI3K negatively correlated with RBP4. Conclusions(1) The increased RBP4 can lead to metabolic disturbances and oxidative stress in IR rats.(2) RBP4 may decrease the insulin sensibility by weakening insulin signal transduction. (3) Pioglitazone can ameliorate insulin resistance by decreasing the level of RBP4 and serum AOPP and increasing the level of PI3K in skeletal muscles of IR rats.

Objective To investigate the correlation and clinical diagnosis significance between ultrasound elastography and the distribution of myofibroblast in breast tumor.To assess the value of ultrasonic elastography and myofibroblast in the diagnosis of breast cancers.MethodsThree-hundred and fifteen patients recruited from May 2009 to November 2010 were divided into benign group and malignant group according to postoperative pathological diagnosis results considered as gold standard.The clinical value of the score of ultrasonic elastography was evaluated.The expression levels of CD34 and α-SMA protein in breast tissues were examined by immunohistochemistry.ResultsThe difference was statistically significant for the expression level of CD34 and α-SMA between malignant breast tumor patients compared with benign ( P ＜0.05).The expression level of CD34 was lower,but α-SMA was higher in the patients of breast cancer compared with benign tumor.However,the expression level of CD34 and α-SMA was just the opposite in the patients of benign tumor.The expression level of CD34 was the negative correlation with the elastography score ( P ＜0.05) in the breast tumor,but α SMA just the opposite situation.Conclusions The score of ultrasound elastography can represent MFS distribution characteristics in breast tumors in the result that α-SMA +/CD34- can determine the existence of myofibroblast.