Objective To study the safety and efficacy of retroperitoneal laparoscopic resection of adrenal neurilemmoma.Methods The data of 7 cases with adrenal neurilemmoma undergoing retroperitoneal laparoscopic resection were analyzed.2 cases were diagnosed by ultrasound scan,3 cases had blood pressure elevation,and 2 cases had pain in waist and abdomen.All cases underwent ultrasound and CT scan.The neurilemmoma was located in left adrenal area in 2 cases and located in right adrenal area in 5 cases.Results All the 7 cases were successfully operated.No conversion or severe blood loss happened.The average tumor size was 5.0 cm,ranging from 3.0 to 7.0 cm.The average operation time was 75 min,ranging from 45 to 120 min.The estimated blood loss was 50 ml,ranging from 20 to 100 ml.The patients were discharged 7-8 day after the operation.During the 2-12 months of follow-up,no recurrence or metastasis was found.Conclusion Retroperitoneal laparoscopic resection offers an effective and better treatment for adrenal neurilemmoma,with the advantages of less blood loss,less trauma,and faster recovery.

Objective To study the clinical effect of specific immune therapy for children with allergic rhini-tis(AR)and its influence on the level of serum IL -17 and IL -35.Methods 174 children with AR were chosen as the research group,who were used specific immune therapy for 24 months.In same period,110 cases of healthy chil-dren were selected as the control group.Curative effect was evaluated by rhinitis symptoms total score(TRSS)points rate.quality of life was evaluated by nasal conjunctivitis related quality of life questionnaire(RQLQ)score.Pulmonary function before and after treatment,serum Eos counting,IL -17,IL -35 were detected.Results (1 )In research group,the total effective rate after treatment of 2 years was 89.66%,which was significantly higher than 71.26% after treatment of 1 year,there was statistically significant difference(χ2 =18.716,P <0.05).(2)In the research group, TRSS score and RQLQ score after treatment of 1 year and 2 years were lower than that before treatment(t =28.360, 42.850,7.749,42.850,all P <0.05 ),and the data after treatment of 2 years were less than that after treatment 1 year(t =19.207,10.558,all P <0.05).(3)In the research group,FEV1 /predictive value after treatment of 1 year and 2 years elevated compared to that before the treatment,the airway resistance value /forecast and Eos count were lower than that before the treatment(t =15.972,27.811,48.780,62.211,10.930,62.211,all P <0.05).FEV1 /pre-dicted value after treatment of two years was higher than that after treatment of 1 year,airway resistance value /forecast and Eos counts were less than that after treatment of 1 year(t =8.728,14.707,16.488,all P <0.05 ).(4)In research group,serum IL -17 after treatment of 1 year and 2 years reduced,while IL -35 rose (t =9.162,14.522, 10.235,14.522,all P <0.05).And IL -17 after treatment of 2 years was lower than that after treatment of 1 year,IL-35 was higher than after treatment of 1 year(t =5.795,7.731,all P <0.05).(5)Correlation analysis showed that the serum IL -35 and the level of IL -17 showed a negative correlation(r =-0.36,P <0.05).Conclusion Effect of specific immune treatment on children with allergic rhinitis is better,specific immune treatment can improve the clinical symptoms,inhibit IL -17,promote IL35 and improve lung function and quality of life of patients.

A strain producing eggshell membrane protease (ESM protease) was isolated from the soil and identified as Pseudomonas aeruginosa. The enzyme isolated from the fermentation liquid of this strain and purified by ammonium sulfate precipitation, quadratic anion-exchange chromatography exhibited eggshell membrane degrading activity of 304.5 U/mg. By SDS-PAGE, the protein molecular mass is 32 kD. The N-terminal amino acid sequence of this protease is: Ala, Glu, Ala, Gly, Gly, Val, Ala, Gly, Lys, Glu, Asp, Ala, Ala, Glu, Leu.

0.05).In SVZ,nNOS expression in ischemic model group was reduced on days 1-14,but increased on day 21;after Ligustrazine administration,nNOS expression was obviously decreased on days 3-14 in all Ligustrazine dose groups,but began to increase on day 21.In CC,nNOS expression in ischemic model group was reduced on days 3-14,and began to increase on day 21;in the different-dose Ligustrazine groups,nNOS expression was significantly decreased on days 3-14,especially in medium-and high-dose groups,but increased on day 21.In striatum and cortex peri-infarction,nNOS expression in ischemic model group was obviously decreased on days 3 and 7,but enhanced on days 14 and 21;in various-dose Ligustrazine groups,nNOS expression was decreased on days 3-21,especially in medium-and high-dose groups,but increased slightly on day 21.In DG and CA1 areas,nNOS expression in ischemic model group was reduced on days 3 and 7,but began to increase on day 14;nNOS expression in all Ligustrazine groups were decreased during 3-21d.There were significant differences between ischemic model group and different-dose Ligustrazine groups at different time points(P

Objective To investigate the effects of different DO2-directed hemodynamic man-agement on postoperative prognosis of orthotopic liver transplantation (OLT)patients with different degrees of liver function insufficiency.Methods Seventy patients (male 48 cases,female 22 cases, aged 37-66 years,ASA grade Ⅲ or Ⅳ)scheduled non veno-venous bypass OLT were divided into two groups (n = 35 each ).The oxygen delivery (DO2 )maintained respectively between 350 ml·min-1 ·m-2 and 500 ml·min-1 ·m-2 (group control)and more than 500 ml·min-1 ·m-2 (group study).After induction of anesthesia,the left radial artery was cannulated,allowing continu-ous blood pressure monitoring as well as serial blood sampling,then the Swan-Ganz catheter was in-serted via the right internal jugular vein to continuously monitor CI and S-vO2 .After anesthesia induc-tion and before operation (T1 ),10 min before anhepatic phase (T2 ),30 min after onset of anhepatic phase (T3 ),30 min after neohepatic phase (T4 )and the end of surgical procedure (T5 ),the SaO2 , PaO2 ,Hb,CI and S-vO2 were recorded to calculate the DO2 ,VO2 and ERO2 .Postoperatively,ICU and hospital length of stay,quality of life (QOL)and 1-5 year survival rate were recorded.Results In the two groups,CI,DO2 and VO2 declined at T3 to a statistically significant degree in comparison with T1 (P <0.05).CI,DO2 and VO2 in group study significantly higher than those of group control (P <0.05).ERO2 in group study was lower than that of group control significantly (P <0.05).ICU and hospital length of stay were significantly shorten in group study in comparison with group control (P <0.05).Survival rate and QOL in group study tended to be slightly higher than those of group control until the end of study period,but there was no significant difference.Conclusion The DO2-directed hemodynamic management can improve prognosis with enhanced DO2 in OLT patients with different degrees of hepatic insufficiency.It has a positive impact on their outcome of shortening ICU stay and the hospitalization days.

Objective To evaluate the anatomic changes and dosimetric variations of patients with nasopharyngeal carcinoma (NPC) during the course of simultaneous integrated boost intensity-modulated radiotherapy (SIB-IMRT) by comparison of the dosimetric differences with or without replanning.Methods Twelve cases with NPC treated with SIB-IMRT underwent repeated CT scans after 20- 25 fractions of the initiation of therapy.The original treatment plan ( Plan1 ) based on the first CT scan ( CT1 ) and the second IMRT plan (Plan 2) based on the second CT scan (CT2) were calculated with an inverse planning system (Pinnacle3,Philips Medical System).In addition,the hybrid IMRT plan,Planl (CT2),was generated by deformable registration with MIMVISTA software,and the doses in Plan 1 ( CT1 ) and Plan 2 ( CT2 ) were accumulated based on CT2.The dosimetric differences were compared among the Plan 1 ( CT1 ),Plan 1 (CT2) and Plan 1 + 2(CT2).Results Compared with CT1,the mean volumes of the right and left parotid glands in the CT2 were significantly smaller by ( 24.6 ± 11.9 ) ％ and ( 35.1 ± 20.1 ) ％,respectively.Compared with Plan 1 ( CT1 ),the dose received by 95％ of the target ( D9s ) to PGTV,PTV1 and PTV2,and mean dose (D ) to PGTV,and PTV2 were all significantly lower in the Plan 1 (CT2),indicating that the doses to targets decreased without replanning.With repeated CT and replanning after 25 fractions as shown in Plan 1 + 2 (CT2),the doses to targets would be improved.The doses to normal tissue were increased without replanning,although no statistical significance was observed.In 5 of 12 cases,the doses to the spinal cord and brainstem exceeded the constraint without replanning,while the corresponding values decreased with replanning.Conclusions During the course of IMRT for cases with NPC,the volumes of the targets and parotid glands decrease significantly.Mid-treatment CT scanning and replanning should be recommended to ensure adequate doses to the targets and safe doses to the normal tissues.

OBJECTIVETo compare the efficacy difference in the treatment of chronic pelvic pain syndrome of Sev-damp-heat stagnation pattern between acupoint catgut embedding therapy and western medication.

METHODSenty cases were randomized into a catgut embedding group (40 cases) and a western medication group (30 cases) at the ratio of 4 : 3. In the catgut embedding group, the catgut embedding therapy was applied to Sanyinjiao (SP 6), Quchi (LI 11), Huiyin (CV 1), Zusanli (ST 36), Zhongji (CV 3), Shenshu (BL 23), etc. The treatment was given once every two weeks, the treatment for 4 weeks was as one session and totally 2 sessions were required. In the western medication group, tamsulosin hydrochloride capsules 0. 2 mg, oral administration, once a day, and Indometacin sustained release tablets, 75 mg, once a day, 3 tablets each time were prescribed. The symptom score of TCM, score of NIH Chronic Prostatitis Symptom Index (NIH-CPSI), lecithin body number in prostatic fluid, (SAS) score of Self-Rating Anxiety Scale and score of Self-Rating Depression Scale (SDS) were compared before and after treatment in the patients of the two groups. The efficacy was evaluated in the two groups.

RESULTS(1)The total effective rate was 91. 9% (34/37) in the catgutembedding group and was 86. 2% (25/29) in the western medication group. The efficacy in the catgutembedding group was better than that in the western medication group (P<0. 05). (2) The symptom score of TCM was all reduced significantly after treatment in the two groups (both P<0.01), and the result in the catgut embedding group was superior to the western medication group (6.42 +/-2. 81 vs 10. 99+/-3. 11 ,P<0. 01). (3) Lecithin body number was increased apparently in the two groups after treatment (both P<0.01), and the result in the catgut-embedding group was superior to the western medicine group (33.56+/-5.88 vs 29. 78+/-7. 06,P<0. 05). (4) Total score of NIH-CPSI, score of pain, score of SAS and score of SDS were all improved apparently after treatment in the two groups (all P<0. 01), and the results in the catgut embedding group were superior to the western medication group (P<0. 01, P<0. 05).

CONCLUSIONThe acupoint catgut embedding therapy achieves the superior efficacy on chronic pelvic pain syndrome of damp-heat stagnation pattern as compared with conventional western medicine. This therapy relieves clinical symptoms, improves the states of anxiety and depression and increases lecithin body number obviously.

Acupuncture Points ; Acupuncture Therapy ; Adolescent ; Adult ; Catgut ; utilization ; Chronic Disease ; therapy ; Humans ; Male ; Middle Aged ; Pelvic Pain ; therapy ; Prostatitis ; therapy ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the relationship of the common Traditional Chinese Medicine (TCM) syndrome pattern of chronic pelvic pain syndrome (CPPS) with the contents of substance p and beta endorphin in the plasma, and provide reference data for the clinical diagnosis, differentiation and treatment of CPPS by TCM.

METHODSWe observed 98 cases of CPPS, which were classified into a lower-part damp-heat invasion group (group A, n = 32), a blood stasis-induced collateral obstruction group (group B, n = 34), and a damp-heat stagnation group (group C, n = 32) according to the TCM syndrome differentiation. Another 35 normal healthy young men were enrolled as controls. We measured the contents of substance p and beta endorphin in the plasma by immunoradiometry and ELISA, and analyzed their relationship with the TCM syndrome pattern.

RESULTSThe contents of plasma substance p were significantly higher in groups A ([1135.76 +/- 166.45] pg/ml), B ([1 337.84 +/- 170.81] pg/ml), and C ([1 210.01 +/- 162.27] pg/ml) than in the control ([574.99 +/- 113.09] pg/ml) (all P < 0.01), while the contents of plasma beta endorphin in groups A ([212.70 +/- 29.49] pg/ml), B ([157.99 +/- 24.01] pg/ml), and C ([180.81 +/- 20.20] pg/ml) were remarkably lower than that in the control ([274.73 +/- 27.64] pg/ml) (all P < 0.01).

CONCLUSIONIn the plasma of CPPS patients, the content of substance p is significantly elevated and that of beta endorphin markedly reduced, which suggests that they may be involved in the inflammatory reaction of CPPS. The levels of plasma substance p and beta endorphin can be used as valuable reference for the TCM classification of chronic prostatitis.

Case-Control Studies ; Chronic Disease ; Humans ; Male ; Medicine, Chinese Traditional ; adverse effects ; Pelvic Pain ; blood ; classification ; Prostatitis ; blood ; classification ; Substance P ; blood ; Syndrome ; beta-Endorphin ; blood

OBJECTIVETo evaluate the efficacy and safety of testosterone undecanoate (TU) in the treatment of late-onset hypogonadism (LOH) by meta-analysis.

METHODSWe searched Pubmed (until April 1, 2014), Embase (until March 28, 2014), Cochrane Library (until April 17, 2014), CBM (from January 1, 2001 to February 2, 2014), CNKI (from January 1, 2001 to February 2, 2014), Wanfang Database (from January 1, 2000 to February 2, 2014), and VIP Database (from January 1, 2000 to Febru ary 2, 2014) for randomized controlled trials of TU for the treatment of LOH. We evaluated the quality of the identified literature and performed meta-analysis on the included studies using the Rveman5. 2 software.

RESULTSTotally, 14 studies were included after screening, which involved 1 686 cases. Compared with the placebo and blank control groups, TU treatment significantly increased the levels of serum total testosterone (SMD = 6.22, 95% CI 3.99 to 8.45, P < 0.05) and serum free testosterone (SMD = 4.35, 95% CI 1.86 to 6. 85, P < 0.05) but decreased the contents of luteinizing hormone (WMD = -2.23, 95% CI -4.03 to -0.42, P < 0.05), sex hormone binding globulin (WMD = 2.00, 95% CI 1.38 to 2.63, P < 0.05). TU also remarkably reduced the scores of Partial Androgen Deficiency of the Aging Males (WMD = -9.49, 95% CI -12.96 to -6.03, P < 0.05) and Aging Males Symptoms rating scale (WMD = -2.76, 95% CI -4.85 to -0.66, P <0.05) but increased the hemoglobin level (SMD = 2.35, 95% CI 0.29 to 4.41, P < 0.05) and packed-cell volume (SMD = 4.35, 95% CI 1.36 to 7.33, P < 0.05). However, no significant changes were shown in aspertate aminotransferase, alanine transaminase, prostate-specific antigen, or prostate volume after TU treatment (P > 0.05).

CONCLUSIONTU could significantly increase the serum testosterone level and improve the clinical symptoms of LOH patients without inducing serious adverse reactions. However, due to the limited number and relatively low quality of the included studies, the above conclusion could be cautiously applied to clinical practice.

Androgens ; therapeutic use ; Hemoglobin A ; metabolism ; Humans ; Hypogonadism ; blood ; drug therapy ; Luteinizing Hormone ; blood ; Male ; Prostate-Specific Antigen ; Randomized Controlled Trials as Topic ; Sex Hormone-Binding Globulin ; metabolism ; Testosterone ; adverse effects ; analogs & derivatives ; blood ; pharmacology

BACKGROUND: The occurrence and severity of acute high-altitude disease(AHAD) are determined by the speed entering the highland, the altitude of highland and seasons. The association between obesity and AHAD has not been fully investigated.OBJECTIVE: To investigate the association between obesity and acute high-altitude in people exposed rapidly to the highland.DESIGN: Comparative observation.SETTING: Department of Cardiology, General Hospital of Chinese PLA and Department of Cardiology, Tibetan General Hospital of Chinese PLA.PARTICIPANTS: The experiment was conducted at the Department of Cardiology, General Hospital of Tibetan Military Area Command of Chinese PLA in August 2006. Totally 82 Henan subjects aged 28-45 years were selected from the male workers constructing the Qinghai-Tibet Railway and their managers with acute high-altitude exposure. They had never been to the highland before, and all agreed to the detection.METHODS: ①Every subject completed the AHAD self-report questionnaire at sea level and 12 hours and 24 hours after ascending high-altitude. The items in the questionnaire included symptoms of headache, gastrointestinal symptoms,fatigue or weakness, dizziness, and insomnia. Each symptom was graded from 0-3 with 0 as no symptoms, 1 as mild symptoms, 2 as moderate symptoms, and 3 as severe symptoms and a total score of 15. A score of 4 or more could by identified as AHAD. ②The height and body mass were measured to calculate the body mass (BMI). Those with BMI≥28 kg/m2 served as the obesity group [n =39, mean age (35±8) years], and those with BMI of 18.5-23.9 kg/m2 as the normal body mass group [n =43, mean age (35±8) years]. ③Arterial blood was taken to evaluate arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. ④The measurement data was compared by t test.MAIN OUTCOME MEASURES: BMI, vital capacity of lungs, SO2, PaO2 and PaCO2 levels of obese and normal people.RESULTS: Totally 39 obese people and 43 normal people were involved in the result analysis. ①AHAD score: No symptom was reported at sea level in all participants (scored 0), but the AHAD scores in the obesity group were significantly higher than those in normal group 12-hour and 24-hour after ascending high-altitude. ②Blood gas analysis:At sea level, there were no statistical differences in the levels of SO2, PaO2, and PaCO2 between two groups (P ＞ 0.05).But 24 hours after ascending high-altitude, SO2 and PaO2 of the obesity group were much lower than in the normal group (P＜ 0.01), and PaCO2 was significantly higher than in the normal group (P＜ 0.01).CONCLUSION: Obese men are more vulnerable to high-altitude hypoxia than people with normal body mass. Obesity is an important risk factor for the development of acute high-altitude disease.