Objective To analyze the incidence of endometriosis in inpatients with infertility in Peking Union Medical College Hospital in 30 years. Methods The inpatients of Peking Union Medical College Hospital admitted between May 1983 and November 2013 was searched. The infertile patients receiving laparoscopy or laparotomy were included. The discharge diagnosis and the operation were summarized. The incidence of gynecologic diseases were demonstrated, such as endometriosis, pelvic adhesions, uterine fibroid, hydrosalpinx, ovarian benign tumor, and adenomyosis. The age was collected, and the change of age and the incidence of endometriosis was analyzed. Results The incidence of endometriosis in infertile female inpatients was 35.50%(95%CI:34.50%-36.49%). The incidence showed relatively stable increasing tendency after 2004 (with P<0.01). The age had increased significantly since 1996 (with P<0.01);the average age was (29.76±3.74) years old in 1996, and (32.85±4.49) years old in 2013 (P<0.01). The inpatients diagnosed with endometriosis had greater age, (32.67 ± 4.06) versus (32.04 ± 4.55) years old (P<0.01);the incidence of endometriosis differed in different age group, the older group had higher incidence (χ2=85.807, P<0.01). Conclusions Infertile female inpatients showed increasing incidence of endometriosis in recent years. Older infertile patients maybe have higher risk of endometriosis.

Objectives To investigate the expression and clinical significance of HOXA10 gene in the eutopic and ectopic endometrium of endometriosis.Mehtods Between Jan.2009 to Aug.2010,30 patients with endometriosis undergoing laparoscopic surgery in Maternal and Children's Hospital of Foshan.Eutopic and ectopic endometrium were obtained.In the mean time,30 patients with benign ovary cyst or tubal infertihty undergoing laparoscopic surgery were selected as controls.Their uterine endometrium were obtained real-time fluorescent quantitation,western blot and immunohistochemistry technique were used to detect mRNA and protein expression of HOXA10 gene in the eutopic endometrium group,ectopic endometrium group and control group.Results The mRNA and protein expression of HOXA10 gene were 0.61 ±0.07 and 0.47 ±0.05 in the eutopic endometrium of endometriosis,0.64 ±0.06 and 0.50 ±0.05 in ectopic endometrium of endometriosis,which were significantly lower than 1.22 ± 0.14 and 1.42 ± 0.14 in control group ( P ＜ 0.01 ).However,the mRNA and protein expression of HOXA 10 between eutopic and ectopic endometrium of endometriosis did not reach statistical difference ( P ＞ 0.05 ).The expression of HOXA10 in eutopic and ectopic endometrium of endometriosis were decreased by immunohistochemistry staining.Conclusion The lower expression of HOXA10 gene in the eutopic and ectopic endometrium of endometriosis might be associated with pathogenesis and infertility of endometriosis.

BACKGROUND:Abnormal hippocampal neurogenesis during aging has been reported to result in learning and memory dysfunction. But its mechanism is unclear.
OBJECTIVE: To understand the changes of mouse neurogenesis in the hippocampal subgranular zone during aging.
METHODS:C57BL/6 mice 2, 6 and 20 months of age were used. Immunochemistry was used to count the number of neural stem cels (nestin+), neuroblasts (Doublecortin+, DCX+), and proliferative cels (proliferating cel nuclear antigen+, PCNA+) in the hippocampal subgranular zone. mRNA expressions of aging-related genes, p19Arf and p21Cip1/Waf1, in the hippocampus were detected by reverse transcription-PCR.
RESULTS AND CONCLUSION: Compared with the young and middle age groups, the number of PCNA+ cels, nestin+ and DCX+ cels in the hippocampal subgranular zone of the aged group decreased dramaticaly; the expression of p19Arf and p21Cip1/Waf1 mRNA increased in the aged group. Proliferation activity, the number of neural stem cels and neuronal differentiation al decreased. These findings indicate that the decline of hippocampal neurogenesis may be associated with increased expression of aging-related genes p19Arf and p21Cip1/Waf1 in the p19Arf-Mdm2-p53-p21Cip1/Waf1pathway.

BAP1 is a member of the ubiquitin C-terminal hydrolases (UCH) subfamily of deubiquitylases with basic function of removing monoubiquitin or ubiquitin chains from the specific substrate proteins. As well, it is a key factor in regulating gene expression, cell cycle, cell differentiation,cell apoptosis and DNA damage response, dependent or independent of its deubiquitination function. Evidences haverevealed that mutation or downregulation of BAP1 can prominently increase the occurrence of cancers, including uveal melanoma, mesothelioma, renal cell carcinoma, breast cancer and lung cancer. Currently, the tumor spectrum and the pathogenic mechanism on BAP1 have not been illustrated clearly, and need to be further researched,which might bring a new opportunity in treatment of cancers.

Objective To construct an eukaryotic expression vector with human adipose most abundant gene transcript 1 (APM1) gene,and to investigate the transfection and expression of pCDEF-APM1 eukaryotic expression plasmid in HEK293 cells.Methods pCDEF-APM1 eukaryotic expression plasmid was constructed by DNA recombinant method.Expression vector pCDEF-APM1 was transfected into HEK293 cells with Effectene reagent.The level of human adiponectin protein in the supernatant of cell culture media was detected with double antibody sandwich ELISA.Results The sequence of DNA fragment from constructed pCDEF-APM1 plasmid was identical to that published in GenBank.There was raised human adiponectin protein level in culture supernatant of HEK293 cells tnmsfected with pCDEF-APM1.Conclusion The pCDEF-APM1,an eukaryotic expression plasmid for APM1 gene is successfully constructed.High protein expression of adiponectin can be obtained in HEK293 cells transfected with pCDEF-APM1 eukaryotic expression plasmid.

ObjectiveTo research the relationship between the plasma levels of myeloperoxidase (MPO) and the onset and progress of acute coronary syndrome (ACS) and the severity of coronary lesions in patients with ACS.MethodsSeventy-eight patients hospitalized with chest pain were enrolled,including 41 patients with ACS (ACS group),17 patients with stable angina pectoris(SAP,SAP group) and 20 patients serving as control (control group).Forty-one patients undergoing coronary angiography were divided into single vessel lesions group (7 patients),double vessel lesions group (7 patients),multiple vessel lesions group ( 12 patients) and no vessel lesions group ( 15 patients) based on the vessel lesions of the left anterior descending,left circumflex artery and right coronary artery.According to the diameter stenosis of major coronary artery,there were 15 patients in no vascular stenosis group,2 patients in mild vascular stenosis group,6 patients in moderate vascular stenosis group and 18 patients in severe vascular stenosis group.The levels of MPO were measured by enzyme-linked immunosorbent assays(ELISA).ResultsThe levels of MPO in ACS group [( 252.10 ± 27.07 ) μ g/L]were higher than those in SAP group[( 185.81 ± 17.85 ) μ g/L]and control group [( 140.42 ± 71.40) μ g/L](P ＜ 0.05 ),the levels of MPO in SAP group were higher than those in control group(P＜ 0.05 ).The levels of MPO in single vessel lesions group and multiple vessel lesions group were higher than those in no vessel lesions group (P ＜ 0.05 ),but there was no significant difference among single vessel lesions group,double vessel lesions group and multiple vessel lesions group (P ＞ 0.05 ).The levels of MPO in mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group were higher than those in no vascular stenosis group (P ＜ 0.05),but there was no significant differenceamong mild vascular stenosis group,moderate vascular stenosis group and severe vascular stenosis group(P ＞ 0.05 ).A positive correlation was observed between the levels of MPO and neutrophils (r =0.288,P=0.018 ),creatine kinase isoenzyme-MB(r =0.469,P=0.043 ),subject groups( r =0.757,P=0.000),vessel lesions (r =0.584,P=0.000) and the degree of vascular stenosis (r =0.491,P=0.001).Conclusion MPO may predict ACS and reflect the severity of coronary lesions in ACS as a novel inflammatory marker.

Objective To investigate the patterns of mesorectum lymph node (LN) metastases of rectal cancer. Methods Rectal cancer specimens obtained by total mesorectum excision were treated with lymph node revealing solution to retrieve all the nodes, and examined by routine pathology and immunohistochemical staining. Results A total of 443 LN in 26 specimens were harvested, with 128 nodes(28 9%)in 23 cases (88 5%) found positive. Positive nodes with the size less than 5 mm accounted for 59%. Among the 23 metastatic cases, there were 14 cases with tumors locating in the posterior wall, 69 out of 71 positive nodes were found along the superior rectal artery. In the other 9 cases, tumors were found in the lateral wall, 29 out of 57 positive nodes were found around ipsilateral branches of superior rectal artery,7 were around the contralateral branches, 4 were around the ipsilateral branches of middle rectal artery. Conclusions Most positive LN were less than 0 5 cm in diameter. LN metastasis of rectal cancer have close relationship with tumor location. Tumors in the posterior wall tend to spread upward along the superior rectal artery, while tumors in the lateral wall may have upward and lateral LN metastases simultaneously, with most metastatic LN found ipsilaterally.

OBJECTIVETo explore an innovative technique that is aided by multi-disciplinary hybrid approach in identification and treatment of tracheoesophageal fistula (TEF) in children intraoperatively.

METHODFrom April 2008 to October 2011, 4 patients with isolated TEF were presented with 2 H-type fistulas and 2 recurrent TEF. For all the four cases, with the cooperation of the gastroenterologists, respiratory physician and surgeon, methylene blue was first injected into the trachea for detecting the dye in the esophagus by the gastroscopy. Bronchoscopy was performed where the fistula tract was shown by the methylene blue and a guide wire was passed through the fistula. The patients underwent rigid gastroscopy and the guide wire was identified and brought out through the mouth by biopsy pliers. This created a wire loop through the fistula. X-ray was then used to identify the level of the fistula. According to the level of the fistula it was determined whether surgical incision and approach should be used. The fistula was then repaired successfully by surgery.

RESULTIn the 4 patients, with the aid of gastroscopy and bronchoscopy, identification of the fistula intraoperatively was then facilitated by traction on the loop. The fistula was identified and repaired. There were no fistula recurrences.

CONCLUSIONMulti-disciplinary hybrid therapy for tracheoesophageal fistula in children is beneficial for the precise localization of the fistula. This new technique is an effective and definitive method in identification and treatment of TEF in children.

Bronchoscopy ; methods ; Child, Preschool ; Female ; Gastroscopy ; methods ; Humans ; Minimally Invasive Surgical Procedures ; methods ; Patient Care Team ; Retrospective Studies ; Suture Techniques ; Tracheoesophageal Fistula ; diagnosis ; surgery ; Treatment Outcome

OBJECTIVETo investigate the anatomical study and clinical applications of sural neuron-myocutaneous flap transposition for repairing the special patients with soft tissue defect in foot and ankle.

METHODSThe branches, distributions and anastomoses of the vessels and nerves lie in superficial layer of the posterior crural region were observed on 30 sides of adult cadaver lower limb specimens perfused with red latex. Since February 2004, distally based sural neuron-myocutaneous flap was applied for repairing 7 cases of soft tissue defect in foot and ankle.

RESULTSThe nutrient vessels of sural nerve, small saphenous vein and posterior femoral cutaneous nerve anastomosed permanently with the musculocutaneous perforators of medial and lateral head of gastrocnemius. There were 2 - 3 anastomoses found respectively. The musculocutaneous perforators pierced the two heads of gastrocnemius muscle (1.8 +/- 0.5) cm medially and (3.7 +/- 0.9) cm laterally away from the groove of the muscle. The medial anastomoses more closed to the middle groove and their diameters were found larger than the lateral ones. In operation, we routinely observed the compound flap for 15 to 20 minutes and found actively errhysis on the muscle, so the fine blood circulation in the flap was demonstrated. All flap survived after operation and the cases were followed up 2 to 6 months with cured osteomyelitis and satisfied flap outline.

CONCLUSIONSDistally based sural neuro-myocutaneous flap can live. The operative method is simple. The flap offers an excellent donor site for repairing the soft tissue defect in foot and ankle in special cases.

Adult ; Female ; Humans ; Male ; Middle Aged ; Popliteal Artery ; anatomy & histology ; Soft Tissue Injuries ; surgery ; Sural Nerve ; anatomy & histology ; surgery ; Surgical Flaps ; blood supply ; innervation

OBJECTIVETo explore the effect of burying testis in thigh pocket on spermatogenesis.

METHODSGuizhou miniature male pigs at child-bearing period were randomly divided to receive operation of scrotum incision and dissection with the testis burying in thigh pocket (experimental group) or without (control group). 3 months later, testis biopsy was performed on 2 pigs from each group for pathological examination. Then every male pig from both experimental (n = 6) and control group (n = 6) got a mating partner and lived together for 3 months. The fertility of the male pigs was observed. 6 months after operation, testis biopsy was performed again on all the animals from both the groups.

RESULTSBoth at 3 months and 6 months after operation, the pathological examination showed the spermatogenic cells of all stage in contorted seminiferous tubules markedly decreased with no mature sperm in experimental group, while normal spermatogenic cells with mature sperm in control group. After the male pigs lived with mating partners for 3 months, no female pigs staying with the experimental group became pregnant, but the male pigs in control group had a normal fertility.

CONCLUSIONSBurying testis in thigh pocket impedes spermatogenesis in the miniature male pig. So burying testis in thigh pocket is not recommended for patients with scrotum skin defect who wish to remain fertile.

Animals ; Female ; Fertility ; Male ; Pregnancy ; Pregnancy Rate ; Scrotum ; Skin ; injuries ; Spermatogenesis ; Swine ; Swine, Miniature ; Testis ; physiology ; Thigh ; surgery