Objective To present the preliminary experience on the operative approach in the surgical management of complex posterior urethral stricture. Methods The operative approach of 72 cases of complex posterior urethral stricture was reviewed. Results The total success rate was 89%(64/72). 34 cases were operated with simlpe transperineal approach and the success was rate 91%, transperineal inferior pubic approach was adopted in 14 and the success rate was 93%;simple transpubic approach was conducted in 6 with a success rate of 67% and transpubic perineal approach in 18 with a success rate of 89%. 41 cases with long posterior urethral stricture were operated with a success rate of 85% and 18 cases with complication with a success rate of 94%. Conclusions Each operative approach has it own advantages and disadvantages.Transperineal approach is preferred because the procedure is simpler,less traumatic with less occurrence of complication.

Since 1988,our school has been enrolling in increasing numbers students in 7-year programs of clinical medicine and stomatology. During the period, we have accumulated some experience, which can be embodied in five major points. On this basis, we have, starting from this year, enrolled students working on doctoral degree in 8-year programs with candidates who have completed 4-year undergraduate programs of science and engineering, designed to further intensify reforms in medical education programs.

Objective To investigate the effect of propofol pretreatment on hippocampal monocyte chemotactic protein-1 ( MCP-1 ) and CC-chemokine receptor type 2 (CCR2) expression following forebrain ischemiarepcrfusion (I/R) in rats. Methods Twenty-four male SD rats weighing 250-300 g were randomly divided into 3 groups ( n = 8 each): group Ⅰ control; group Ⅱ I/R and group Ⅲ propofol pretreatment. Cerebral I/R was induced by clamping bilateral common carotid arteries for 10 min combined with hypotension ( MAP was maintained at 35-45 mm Hg) induced by exsanguinations in group Ⅱ and Ⅲ. In group Ⅲ propofol 50 mg/kg was injected into femoral vein immediately before cerebral ischemia. The animals were sacrificed at 6 h of reperfusion. Hippocampal tissue was obtained for detection of MCP-1 mRNA and CCR2 mRNA and their protein expression by RT-PCR and Western blot technique. Results I/R significantly increased the expression of MCP-1 and CCR2 in hippoeampal tissue as compared with control group. Propofol pretreatment significantly attenuated cerebral I/R induced increase in MCP-1 and CCR2 expression. Conclusion Propofol pretreatment can significantly inhibit forebrain I/R-induced hippocampal MCP-1 and CCP2 expression.

Objective:To explore the effect of goal-directed fluid therapy (GDFT) on the gastrointestinal function of patients after laparoscopic radical resection of cervical cancer.Methods:A total of 60 patients who were scheduled for laparoscopic radical resection of cervical cancer in Shanxi Provincial People's Hospital from October 2016 to September 2018 were selected. They were randomly divided into observation group and control group by random number table method, with 30 cases in each group. Patients in the observation group received GDFT, they were connected to the Flotrac/Vigile monitoring system, and the fluid supplementation was guided according to the changes in mean arterial pressure (MAP), stroke volume variability (SVV) and cardiac index, the goal was to maintain MAP≥60 mmHg (1 mmHg = 0.133 kPa), SVV≤13%, and cardiac index 2.5-4.0 L·min -1·m -2. The conventional fluid therapy was applied in the control group, and the liquid's input speed was adjusted according to the changes of MAP and central venous pressure (CVP) which were respectively maintained at 60-110 mmHg and 8-12 cmH 2O (1 cmH 2O = 0.098 kPa). The crystal/colloid input, bleeding volume and urine output were recorded. The first bowel sounds recovery time, exhaust time, postoperative hospitalization time, and the incidence of nausea and vomiting after surgery were recorded. Arterial blood and central venous blood were drawn before anesthesia induction and 12, 24 and 36 hours after operation to determine the concentrations of arterial blood lactate and central venous oxygen saturation (ScvO 2) as well as intestinal type fatty acid binding protein (IFABP). Results:Compared with the control group, the urine output was increased ( t = -7.738, P < 0.01), the crystal input was reduced ( t = -13.439, P < 0.01), the colloid input was increased ( t = -8.360, P < 0.01), the recovery time of first bowel sounds after surgery was shortened ( t = 6.694, P < 0.01), the exhaust time was shortened ( t = -10.326, P < 0.01), and the time of postoperative hospitalization was shortened ( t = -7.377, P < 0.01). The incidence of nausea and vomiting in the observation group were 10.0% (3/30) and 6.7% (2/30), which were lower than 33.3% (10/30) and 26.7% (8/30) in the control group ( χ2 = 4.812, P = 0.028; χ2 = 4.320, P = 0.038). Compared with the control group, the concentration of IFABP in the observation group was reduced at 12 h ( t = 2.983, P = 0.004), 24 h ( t = 6.452, P < 0.01), and 36 h ( t = -3.880, P < 0.01) after surgery; the concentration of lactate in the observation group was reduced at 12 h ( t = -7.377, P < 0.01), 24 h ( t = -6.036, P < 0.01), and 36 h ( t = -8.933, P < 0.01) after surgery; the value of ScvO 2 in the observation group was increased at 12 h ( t = 2.710, P = 0.009) and 24 h ( t = 2.387, P = 0.020) after surgery. Conclusion:GDFT can maintain the balance between oxygen delivery and oxygen consumption in the gastrointestinal mucosa cells, which can promote the recovery of gastrointestinal function of patients undergoing laparoscopic radical resection of cervical cancer.

OBJECTIVETo investigate the effect of antisense TGF-beta 1 in inhibiting scar formation during wound healing.

METHODSSD rats were divided into three groups after skin burn: group one was treated with antisense TGF-beta 1 oligonucleotide; group two was treated with antisense TGF-beta 1 recombinant plasmid and the control group. In different time, RT-PCR and immunohistochemistry were used to verify the expression of TGB beta 1 mRNA and protein. Type I Collagen mRNA expression was determined by hybridization in situ. Inflammatory reaction and collagen distribution were observed pathologically.

RESULTSIn the groups received antisense ODN and recombinant plasmid, the expression of TGF-beta 1 mRNA and protein reduced during 14 days after burn. In the control group, type I collagen mRNA began to express at the second week and reached a peak at the fourth week, while the antisense groups kept low expression. The antisense group also showed mild inflammatory reaction and less synthesis of collagen.

CONCLUSIONAntisense TGF-beta 1 could prevent the scar formation during wound healing.

Animals ; Burns ; drug therapy ; physiopathology ; Cicatrix ; prevention & control ; Male ; Oligonucleotides, Antisense ; therapeutic use ; Rats ; Rats, Sprague-Dawley ; Transforming Growth Factor beta ; antagonists & inhibitors ; Transforming Growth Factor beta1 ; Wound Healing ; physiology

Objective To investigate the clinical diagnostic value and pathogenesis of serum protein identification in Keshan disease (KD).Methods A total of 65 chronic KD patients were selected as the patient group in KD endemic areas,while 29 cases of dilated cardiomyopathy (the DCM group),62 healthy cases from KD endemic areas (control 1 group) and 28 healthy cases from non-endemic areas (control 2 group) were selected as controls.Liquid chip time of flight mass spectrometry (ClinProtTM MALDI-TOF-MS) was used to determine the expression of proteins/peptide peaks.ClinProTools 2.2 software was used to analyze the protein profiles to determine differentially expressed proteins/peptide peaks.The Genetic Algorithm (GA),QuickClassifer Algorithm (QC) and Supervised Neural Network Algorithm (SNN) methods were used to screen marker proteins.Matrix-assisted laser desorption/ionization time-of-flight Mass Spectrometry technique (MALDI-TOF/TOF) was also used as a secondary mass spectrometry to identify differentially expressed peptides.Results Between the KD and control 1 groups,34 differentially expressed proteins/peptides and 5 marker proteins were identified,while 52 differentially expressed proteins/peptides and 5 marker proteins were identified between the KD and control 2 groups,and there were 67 differentially expressed proteins/peptides and 5 marker proteins between the KD and DCM groups.During secondary mass spectrometry,two peptides for mass-to-charge ratio (m/z) 2 079 and 1 465 were obtained,peptide of matching β-globin showed low expression while peptide of matching fibrinogen showed high expression in the KD patients.Conclusions Serum marker proteins can be used as biomarkers for diagnosis and differentiation of KD.β-globin and fibrinogen play an important role in the development of KD myocardial injury.

Objective To provide more valuable information for diagnosis of dilated cardiomyopathy (DCM),we detected differentially expressed proteins in serum from patients with DCM and healthy people and protein biomarkers were selected.Methods During the period from march 2011 to may,a total of 29 samples of resident patients with DCM from Qilu Hospital of Shandong University,Jinan Central Hospital and Jinan First Peoples Hospital and 30 local healthy people in Jinan were selected as DCM and control groups,respectively.Serum samples from these patients with DCM and controls were detected by ClinProt MALDII-TOF-MS.ClinProTools 2.2 software was used to get mass spectrometric data.The ClinPrott discrimination model was established to screen out differentially expressed proteins as potential biomarkers.Results Via comparing proteins/polypeptides peaks of DCM patients and healthy controls,57 of all 73 peaks were found to be significantly different between the two groups.Compared with the control group,35 peaks were up-expressed while the other 22 peaks were downexpressed.Five peaks were screened out as protein biomarkers.They were mass-to-charge ratio (m/z):4 247.95,4 209.37,1 058.69,1 074.78,and 2 364.71.The sensitivity and specificity of ClinPrott discrimination model was 99.14％ and 99.16％,respectively.Conclusion Patients with DCM have expressed serum proteins differently and we have found five protein markers which might have some value for diagnosis of DCM.

Objective To investigate the differences in gene expression profiles of peripheral blood from patients with Keshan disease (KD) and the apoptosis mechanism in KD,to obtain diagnostic markers and establish diagnostic centroids plot for KD.Methods RNA was isolated from ten patients with KD diagnosed according to the clinical criteria for KD in China and ten health controls.The expression profiles were evaluated by Agilent 4 ×44K Whole Human Genome density oligonucleotide microarray analysis.The data were extracted by Agilent Feature Extraction Software t test,Pathway studio analysis and prediction analysis for microarray (PAM) were used to identify differently expressed genes,gene pathways,diagnostic markers and establish diagnostic centroids plot.Results Totally 1 570 up-regulated genes and 1 498 down-regulated genes were identified.Thirty-eight enrichment pathways were also identified,and the highest ranked by Pathway studio analysis was related to apoptosis.Six genes involved in apoptosis pathway were up-regulated in KD included ataxia telangiectasia mutated (ATM),cAMP-dependent protein kinase,protein kinase A (PKA),baculoviral IAP repeat-containing 2 (BIRC2),NLR family,apoptosis inhibitory protein (NAIP),BCL2-1ike 11 (Bim),BCL2-related protein A1 (BCL2A1) and down-regulated were 7 which included caspase 8 (CASP8),BCL2 binding component 3 (BBC3),BCL2--associated athanogene (BAG1),BCL2-associated X protein (BAX),BCL2-1ike 1 (BCL2L1),BCL2-related ovarian killer (BOK),and caspase 6 (CASP6).Forty-two diagnostic markers were obtained through PAM analysis.Conclusions Apoptosis related to genes and pathways might play an important role in the pathogenesis of KD.Forty-two markers could be used as molecular markers for the diagnosis of KD,which is important to the diagnosis of KD.