Objective To establish a risk assessment model for laparoscopic partial nephrectomy (LPN) with segmental renal artery clamping (SRAC).Methods In the first stage,107 patients who underwent LPN with SRAC from December 2009 to September 2011 were retrospectively reviewed.There were 63 men and 44 women,aged from 11-80 years,mean (58.1 ±10.1) years.The blocking program of target arteries was dependent on the experience of the surgeon and CTA.After multiple Logistic regression analysis,variables used to build a nomogram were selected using a backward elimination scheme.Then,a model for a clamping program customized to the patient was designed.In the second stage,the surgical outcomes of 141 patients who subsequently underwent LPN-SRAC with the applied model from October 2011 to June 2014 were compared with those of the first stage patients.There were 84 men and 57 women,aged from 51-75years,mean (59.9 ± 8.6) years.Outcomes of two stages were compared.Results Five potential predictors were initially assessed including segmental renal artery angle,target artery diameter,and distance to the abdominal aorta,renal hilum,and kidney midline.The regression equation was then set up with Logistic regression analysis.Compared with the patients in the first stage,success rate of clamping in the second stage,with the help of the new SRAC model,was improved from 74.8％ (175/234) to 94.2％(227/241) (P ＜ 0.001),the total operative time was decreased from (88.6 ± 10.9) min to (80.2 ±16.6) min (P＜O.001),and operative blood loss was reduced from (198.7 ±111.6) ml to (168.5 ±117.8) ml (P =0.042).No obvious differences were observed in warm ischemia time,postoperative hospitalization,R.E.N.A.L nephrometry score,or number of final clamped branches.Conclusion The model for assuring clamping success was helpful in designing an SRAC program.

OBJECTIVETo observe the effect of Ginkgo Leaves Tablet (GLT) on memory quotient (MQ) of mild cognitive impairment (MCI) patients.

METHODSOne hundred and thirteen patients were randomly assigned to the control group (55 cases) and the treatment group (58 cases). Patients in the control group received dietetic therapy and physical exercises, while those in the treatment group additionally took GLT, 19.2 mg each time, three times daily. The treatment course was 12 months for all. The MQ of all the patients was assessed by WMS-RC before treatment,at 6-month of treatment, and 12-month of treatment.

RESULTSCompared with the control group, the improvement of MQ increased in the treatment group 0.5 and 1 year after treatment (P < 0.05). The clinical efficiency of MQ obviously increased in the treatment group (48.28% and 50.00%), showing statistical difference when compared with the control group (30.91% and 27.27%, P < 0.05, P < 0.01). There was statistical difference in added scores of recognition, regeneration, understanding, and recitation test at 6-month of treatment and 12-month of treatment between the treatment group and the control group (P < 0.05, P < 0.01).

CONCLUSIONGLT was effective in improving MQ of MCI patients, especially in improving recognition, regeneration, understanding, and recitation test.

Aged ; Aged, 80 and over ; Cognitive Dysfunction ; drug therapy ; psychology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Ginkgo biloba ; chemistry ; Humans ; Male ; Memory ; Middle Aged ; Phytotherapy

OBJECTIVEThe aim of this study was to investigate the clinicopathological characteristics, effective treatment and prognosis in childhood and adolescent Hodgkin's lymphoma.

METHODSA total of 88 patients with childhood and adolescent Hodgkin's lymphoma were treated in the Cancer Hospital of CAMS from 1998 to 2005. The clinicopathological and follow-up data of the patients were retrospectively reviewed. The survival rate was calculated by Kaplan-Meier method and compared by log-rank test. COX multivariate prognosis analysis was performed.

RESULTSThe 2-year event-free survival rate of the 88 patients was 86.4%, the 5-year event-free survival rate was 61.4%, and the 5-year overall survival rate was 95.5%. Univariate analysis showed that the stage of disease (P = 0.033), "B" symptoms (P = 0.028), bulky disease (P = 0.007), splenomegaly (P = 0.050), LDH elevation (P = 0.020), chemotherapy regimen (P = 0.003) were prognostic factors in the 5-year event-free survival rate. Splenomegaly (P = 0.039), LDH elevation (P = 0.033), chemotherapy regimen (P = 0.008) were prognostic factors of 5-year overall survival rate. Multivariate analysis showed that chemotherapy regimen (P = 0.033), stage of disease (P = 0.023), LDH elevation (P = 0.008), "B" symptoms (P = 0.044), bulky disease (P = 0.009) were independent prognostic factors of 5-year event-free survival rate. The chemotherapy regimen (P = 0.012) and LDH elevation (P = 0.046) were independent prognostic factors of 5-year overall survival rate.

CONCLUSIONSThe non-ABVD chemotherapy regimen, stage IV disease, LDH elevation, associated with "B" symptoms and bulky disease are independent prognostic factors of 5-year event-free survival rate. LDH elevation and non-ABVD chemotherapy regimen are independent prognostic factors of 5-year overall survival rate.

Adolescent ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bleomycin ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Cyclophosphamide ; therapeutic use ; Dacarbazine ; therapeutic use ; Disease-Free Survival ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Hodgkin Disease ; complications ; drug therapy ; pathology ; radiotherapy ; Humans ; L-Lactate Dehydrogenase ; blood ; Male ; Mechlorethamine ; therapeutic use ; Neoplasm Staging ; Prednisone ; therapeutic use ; Procarbazine ; therapeutic use ; Retrospective Studies ; Splenomegaly ; etiology ; Survival Rate ; Vinblastine ; therapeutic use ; Vincristine ; therapeutic use

AIMTo study the therapeutic efficiency of amphotericin B liposome (AmB-L) targeting to the brain in mice with meningitis.

METHODSAmphotericin B liposome targeting to the brain were prepared by film-sonication method. Their concentration and encapsulation percentage were determined. The Candida albicans was injected into the brain of BALB/c mice and the meningitis model was set up. Then the therapeutic efficiency of amphotericin B liposome targeting to the brain was studied.

RESULTSThe encapsulation percentage of amphotericin B liposome was 93.3%. The meningitis model was set up after the Candida albicans was injected into the brain of BALB/c mice for 2 h. The therapeutic efficiency was increased after conjugating RMP-7 (the commercial nama is Cereport) to the surface of amphotericin B liposome.

CONCLUSIONThe therapeutic efficiency of Amphotericin B liposome targeting to the brain in the mice with meningitis was better than that of the common amphotericin B liposome and the life of the mice in AmB-L-PEG-RMP-7 group was longer than that of the mice in AmB-L-PEG group and AmB-L-PEG + RMP-7 group.

Amphotericin B ; administration & dosage ; pharmacokinetics ; therapeutic use ; Animals ; Antifungal Agents ; administration & dosage ; pharmacokinetics ; therapeutic use ; Biological Transport ; Blood-Brain Barrier ; drug effects ; Bradykinin ; analogs & derivatives ; pharmacology ; Brain ; metabolism ; Candida albicans ; Drug Delivery Systems ; Female ; Liposomes ; Male ; Meningitis, Fungal ; drug therapy ; microbiology ; Mice ; Mice, Inbred BALB C ; Rats ; Rats, Sprague-Dawley

OBJECTIVETo prokaryoticly express and purify HuD protein and its RNA recognition motifs.

METHODSHuD protein was prokaryoticly expressed and purified by molecular cloning technology. Its biologic activity was testified by Western Blot.

RESULTSPurified HuD protein and its RNA recognized motifs were observed.

CONCLUSIONSThe result might aid for basic research and clinical application.

Antibodies, Antinuclear ; biosynthesis ; genetics ; isolation & purification ; Carcinoma, Small Cell ; genetics ; immunology ; metabolism ; Cloning, Molecular ; DNA, Complementary ; genetics ; ELAV Proteins ; ELAV-Like Protein 4 ; Humans ; Lung Neoplasms ; genetics ; immunology ; metabolism ; Nerve Tissue Proteins ; biosynthesis ; genetics ; isolation & purification ; Neurons ; immunology ; Paraneoplastic Syndromes, Nervous System ; genetics ; immunology ; metabolism ; RNA-Binding Proteins ; biosynthesis ; genetics ; isolation & purification

OBJECTIVE: To explore the value of transthoracic echocardiography (TTE) in transcatheter closure of atrial septal aneurysm (ASA) combined with secoundum-type atrial septal defect (ASD). METHODS: Fourteen patients (3 males and 11 females) who had ASA combined with secoundum-type ASD were diagnosed by TTE or transesophageal echocardiography. The ASA projected to the right atrium in all patients. The width of basilar part was 13 approximately 24 (18.5+/-3.9) mm, and the vertical extent was 7 approximately 11(9.7+/-1.8) mm. Ten patients combined with single hole ASD and 4 patients with multiple hole ASD. Blood shifting from the left atrium to the right atrium was displayed in color Doppler in all patients. All patients were treated by transcatheter closure under the guiding of X fluoroscopy and TTE, and examined with TTE during the follow-up. RESULTS: Transcatheter closure was successfully performed by 14 occluders in all patients. No residual shunt was detected immediately by TTE after the procedure in all patients. During the 6 approximately 12 month follow-up, no residual shunt or occluder shifting was found, the dimensions of the heart became normal in 11 patients (79%) and were significantly decreased in 4. CONCLUSION Transcatheter closure is feasible in patients with ASA combined with secoundum-type ASD, and extra attention must be paid to the specialty. TTE is very important in case selection before transcatheter closure, and it may be used to monitor and guide the procedure during transcatheter closure.
Adult ; Atrial Septum ; Balloon Occlusion ; methods ; Cardiac Catheterization ; Echocardiography ; Female ; Heart Aneurysm ; complications ; therapy ; Heart Septal Defects, Atrial ; complications ; therapy ; Humans ; Male ; Middle Aged ; Ultrasonography, Interventional ; Young Adult

OBJECTIVETo investigate the risk factors of the serious complications related with double-J ureteral stent placement following percutaneous nephrolithotomy (PCNL).

METHODSClinical data were reviewed for 272 patients treated with PCNL and indwelling double-J stents between January, 2014 and April, 2016. The risk factors of serious complications were identified using univariate and multivariate logistic regression analysis.

RESULTSSerious complications of double-J ureteral stenting occurred in 63 patients (23.1%). Univariate and multivariate logistic regression analysis indicated that the ureter abnormalities (β=1.735, P=0.000, OR=5.670), stent indwelling duration (β=1.206, P=0.028, OR=3.340), gender (β=0.895, P=0.016, OR=2.446), preoperative urinary tract infection (β=0.849, P=0.020 , OR=2.338) and stent size (β=0.847, P=0.011, OR=2.333) were all risk factors of serious complications related with the procedure.

CONCLUSIONMale patients are exposed to a higher risk of serious complications following PCNL. Effective management of urinary tract infection and choice of appropriate stent size in cases of ureteral abnormalities help to reduce these complications. The double-J stent should be withdrawn as soon as possible in patients with good postoperative recovery.

Female ; Humans ; Kidney Pelvis ; Logistic Models ; Male ; Nephrostomy, Percutaneous ; Postoperative Period ; Risk Factors ; Stents ; adverse effects ; Ureter ; surgery ; Ureteral Obstruction ; surgery

OBJECTIVETo analyze the clinical features of interstitial pneumonitis (IP) associated with interferon therapy for chronic hepatitis C.

METHODSWe report the first case of IP in China resulting from pegylated interferon alpha-2a in combination with ribavirin for treatment of hepatitis C viral infection. A statistical analysis of the related literatures documenting such IP cases was performed using SPSS 11.5 software.

RESULTSOf the 22 patients reported to develop IP after interferon therapy alone or in combination with ribavirin, 83%, 72% and 56% of the patients had the symptoms of dyspnoea, dry cough and fever, respectively. Twenty of these cases presented with restrictive pulmonary functional impairment and/or hypoxemia, and diffuse infiltration on chest radiography and/or CT. Complications were documented in 71% of the cases within 12 weeks of the treatment. The majority (85%) of the patients had favorable prognoses with an average recovery time of 7.5 weeks. Compared with the patients with mild and moderate pulmonary function impairment, 8 patients with severe pulmonary functional impairment had early onset of IP during the interferon therapy (6.6 vs 14.1 weeks, P<0.05), and a higher rate of corticosteroid treatment (75% vs 54%, P>0.05).

CONCLUSIONIP is a rare pulmonary complication associated with IFN therapy, and patients with chronic hepatitis C should be followed up closely in the first 12 weeks of interferon therapy. Prompt discontinuation of medication is mandatory in the presence of IP, and corticosteroid therapy may not be essential for patients with mild or moderate pulmonary functional impairment under close monitoring. The severity of pulmonary damage is associated with the time of complication occurrence, and corticosteroids are required when obvious pulmonary toxicity occurs in early stage of the treatment (within 6 weeks) to reduce the pulmonary damage.

Adult ; Aged ; Female ; Hepatitis C, Chronic ; drug therapy ; Humans ; Interferon-alpha ; adverse effects ; therapeutic use ; Lung ; diagnostic imaging ; drug effects ; pathology ; physiopathology ; Lung Diseases, Interstitial ; chemically induced ; diagnostic imaging ; pathology ; physiopathology ; Male ; Middle Aged ; Time Factors ; Tomography, X-Ray Computed

BACKGROUNDMany studies have suggested that the imbalance of angiogenic factor and anti-angiogenic factor expression contributes significantly to the development of choroidal neovascularization (CNV), and ultrasound microbubble combination system can increase the gene transfection efficiency successfully. This study was designed to investigate whether ultrasound-mediated microbubble destruction could effectively deliver therapeutic plasmid into the retina of rat, and whether gene transfer of pigment epithelium-derived factor (PEDF) could inhibit CNV.

METHODSHuman retinal pigment epithelial cells were isolated and treated either with ultrasound or plasmid alone, or with a combination of plasmid, ultrasound and microbubbles to approach feasibility of microbubble-enhanced ultrasound enhance PEDF gene expression; For in vivo animal studies, CNV was induced by argon lasgon laser in rats. These rats were randomly assigned to five groups and were treated by infusing microbubbles attached with the naked plasmid DNA of PEDF into the vitreous of rats followed by immediate ultrasound exposure (intravitreal injection); infusing liposomes with the naked plasmid DNA of PEDF into the vitreous (lipofectamine + PEDF); infusing microbubbles attached with PEDF into the orbit of rats with ultrasound irradiation immediately (retrobular injection); infusing microbubbles attached with PEDF into the femoral vein of rats with exposed to ultrasound immediately (vein injection). The CNV rats without any treatment served as control. Rats were sacrificed and eyes were enucleated at 7, 14, and 28 days after treatment. Gene and protein expression of PEDF was detected by quantitative real-time RT-PCR, Western blotting and immunofluorescence staining, respectively. The effect of PEDF gene transfer on CNV was examined by fluorescein fundus angiography.

RESULTSIn vitro cell experiments showed that microbubbles with ultrasound irradiation could significantly enhance PEDF delivery as compared with microbubbles or ultrasound alone. In the rat CNV model, transfection efficiency mediated by ultrasound/microbubbles was significantly higher than that by lipofectamine-mediated gene transfer at 28 days after treatment. The study also showed that with the administration of ultrasound-mediated microbubbles destruction, the CNV of rats was inhibited effectively.

CONCLUSIONSUltrasound-microbubble technique could increase PEDF gene transfer into rats' retina and chorioid, in association with a significant inhibition of the development of CNV, suggesting that this noninvasive gene transfer method may provide a useful tool for clinical gene therapy.

Animals ; Cells, Cultured ; Choroidal Neovascularization ; prevention & control ; Eye Proteins ; genetics ; Female ; Genetic Therapy ; Humans ; Microbubbles ; Nerve Growth Factors ; genetics ; RNA, Messenger ; analysis ; Rats ; Rats, Long-Evans ; Retina ; metabolism ; Serpins ; genetics ; Transfection ; Ultrasonics

OBJECTIVETo investigate the status of pubertal development in children born with assisted reproductive technology (ART).

METHODSA retrospective analysis was performed on the pubertal development data of children born with ART in Peking University Third Hospital from 1994 to 2003 (ART group). The data in the cross-sectional study "Reports on the Physical Fitness and Health Research of Chinese School Students in 2010" were used as a control. The age at menarche and the age at spermarche were compared between the two groups. The status of pubertal development in the overweight and obese children in the ART group was evaluated to investigate the correlation between pubertal development and body mass index (BMI).

RESULTSA total of 200 children born with ART were enrolled in this study, and 72 of them (41 males and 31 females) completed the survey (response rate=36.0%). In the ART group, the mean age at spermarche and the mean age at menarche were 13.9 years (95%CI: 13.7-14.3 years) and 12.2 years (95%CI: 11.8-12.6 years), respectively. There were no significant differences in the age at spermarche and the age at menarche between the ART and control groups (P>0.05). In the ART group, there were no significant differences in the age at spermarche and the age at menarche between the overweight and obese children and the normal weight children (P>0.05). There were also no significant differences in overweight rate and obesity rate between the children in the ART group and the adolescents in Beijing (P>0.05). In the ART group, there was no significant correlation between the age at spermarche or menarche and BMI (P>0.05).

CONCLUSIONSNo delayed or precocious puberty is observed in children born with ART. This is consistent with the normal control data. And there is no significant correlation between pubertal development and BMI in children born with ART.

Adolescent ; Body Mass Index ; Child ; Child Development ; Cross-Sectional Studies ; Female ; Humans ; Male ; Menarche ; Obesity ; physiopathology ; Overweight ; physiopathology ; Puberty ; physiology ; Reproductive Techniques, Assisted ; Retrospective Studies