Objective To explore the diagnosis and re-operation of the recurrent retroperitoneal soft tissue sarcoma(RPS).Methods Clinical data of 25 patients with recurrent RPS were retrospectively analyzed.Results All of 25 cases of recurrent RPS were diagnosed by operation and postoperative pathologic examination.They underwent a total of 42 time operations,with mean time of re-operations was 1.68.Of the 42 time operations,26 time were complete resection,11 time partial resection and 5 time only biopsy.A total of 19 cases underwent removal of contiguous intra-abdominal organs and 5 underwent resection of major invaded blood vessel.The 1-,3-and 5-year survival rate of recurrent RPS was 52.0%,40.0% and 28.0% respectively.The rate of complete resection in recurrent RPS with major blood vessel invasion was 35.7%.In contrast,the complete resection rate in recurrent RPS without major blood vessel invasion was 75%(P=0.013).On the other hand,there was no significant difference in complete resection rate between the recurrent RPS with adjacent organs invasion and the recurrent RPS with no adjacent organs invasion(P=0.462).Conclusions Preoperative imaging results are crucial factor for assessment of operative resectability.Unless there are obvious comtraindications,recurrent RPS should undergo aggressive surgical excision.

Objective To study the effect of postoperative patient-controlled intravenous analgegia.using dezocine on uterine contraction-induced pain after cesarean section.Methods Sixty patients undergoing cesarean section were randomly divided into two groups with 30 cases each.Group D received patient-controlled intravenous analgesia(PCIA)with dezocine and tramadol.Group T received PCIA with tramadol.Ten minutes before completion of the operation,loading dose was given:in group D intravenous dezocine 0.1 mg/kg,in group T intravenous tramadol 2 mg/kg.Visual analogue scale(VAS)of wound pain and uterine contraction-induced pain,adverse effects were recorded at 4,8,16 and 24 h during analgesia.Results There was no siguiciant difference on VAS of wound pain between the two groups(P ＞ 0.05).The VASs of uterine contraction-induced pain at the4,8,6 and 24th hour after surgery were(1.53 ±0.37),(2.28 ±0.15),(2.43 +0.56)and (2.01 ±0.64)respectively in Group D,which were significantly lower than those of(4.73 +0.43),(5.86 ±0.35),(5.83 ± 0.27)and(4.18 ± 0.53)in Group T(Ps ＜ 0.05).Ramsay sedation scores were(3.97 ±1.41)and(3.12 ±0.06)at the 4 and 8 h,which were significantly lower than those of(1.12 ±0.49)and (1.09 ±0.73)in Group D(Ps ＜0.01)).However,there was no significant difference between the two groups in adverse effect(P ＞ 0.05).Conclusion Intravenous patient-controlled analgesia with dezocine composite tramadol is not only effective for wound pain scores,but also can suppress uterine contraction-induced pain with less adverse effect in patients underwent cesarean section.

Objective To investigate the pathological significance of expression of IL-23 in colon tissues of patients with steroid-dependent uncreative colitis at remission.Methods Expression of IL-23 was measured by means of Western Blot and immunohistochemistry SABC in inflammation repairing areas from 15 patients with steroid-dependent ulcerative colitis at remission, 30 patients with common ulcerative colitis at remission (15 treated with SASP and 15 with prednisone) and 10 normal colon tissues.The results were analyzed by SPSS 16.0.Results Compared with normal control, expression of IL-23 in patients of SASP maintenance therapy and prednisone with common ulcerative colitis were slightly increased ( P > 0.05), which was significantly lower that of steroid-dependent specimens ( P < 0.01).Conclusion Over-expression of IL-23 may plas a key role in the pathogenesis of steroid-dependent ulcerative colitis.

OBJECTIVE: Analysis of multislice CT (MSCT) on the misdiagnosis reasons of children bronchial foreign body, avoid missed diagnosis, to achieve reasonable application. METHOD: Fourteen cases of misdiagnosed cases of data were retrospectively analyzed in our department of suspicious in children with bronchial foreign body, and discuss the misdiagnosis reasons. RESULT: Fourteen cases of misdiagnosis of children with 9 cases by MSCT examination showed no obvious foreign matter. Through bronchoscopy intraoperative found foreign body, 5 cases by multislice CT (MSCT) to found foreign body, 4 cases of phlegm scabs, 1 case is inflammatory granulation, all recovered after treatment. Reasons of misdiagnosis were threshold selection error, scanning level from the inception glottis, imaging error, etc. CONCLUSION MSCT is a very valuable diagnostic on airway foreign body check method, but there are certain limitations, we should improve the understanding of misdiagnosis and reduce the occurrence of this phenomenon.
Bronchi ; Child, Preschool ; Diagnostic Errors ; Female ; Foreign Bodies ; diagnostic imaging ; Humans ; Infant ; Male ; Retrospective Studies ; Tomography, Spiral Computed ; methods

Objective To study the immune response induced by the mice immunized with Trichinella spiralis(T.spiralis) adult worm soluble antigen(AWSAg). Methods T.spiralis AWSAg was prepared to immunize Kunming strain mice. Dynamic changes of IgG, IL 2 and T lymphocyte subsets from immunized mice were determined after challenge infection on d 7, d 14 , d 21 , d 28 and d 35 . Results On d 7 after challenge infection, IgG and CD4 + T cells of immunized group were markedly elevated and persisted higher over the observation period. In contrast, CD4 + T cells and CD4/CD8 ratio were significantly decreased in unimmunized group resulted from immune suppression after infection. IL 2 levels reached the peak on d 7 and persisted in high level from d 7-d 21 in both immunized and unimmunized group after infection, then decreased gradually. Till 35 days after infection, IL 2 level was still higher than the normal mice. Conclusion Mice immunized with AWSAg of T. spiralis produced a potential cellular and humoral immune response.

To study the effects of TNF ? on the protein metabolism and the ubiquitin system gene expression in isolated skeletal muscles, after dissecting and isolating the extensor digitorium longus (EDL) muscles, the in vitro oxygen rich muscle incubation system and as high performance liquid chromatography were used to assess proteolytic rate of the samples. The EDL muscles in study group were incubated with media containing 6 000 U/ml recombinant rat TNF ?. In control group, the media were of the same composition as that of the study group except recombinant rat TNF ?. The expressions of ubiquitin mRNA and C 2 mRNA in rat EDL muscles were determined by Northern blot analysis. No notable difference was observed in the total and myofibrillar proteolytic rate in EDL muscles between the two groups. The expressions of ubiquitin mRNA(2 4kb) and C2 mRNA of EDL muscle incubated with medium containing TNF ? were increased by 151% and 56%, respectively, as compared with those in control group. TNF ? could directly strengthen the function of ubiquitin dependent proteolytic system, but further studies are necessay to elucidate whether TNF ? could directly increase the proteolytic rate in skeletal muscle.

AimTo explore the kinetic change of the IgG,T-cell subsets and IL-2 level from the mice infected with T. Spiralis. Methods The level of specific IgG A band IL-2 was determined by ELISA,the percentage of CD4+and CD8+ T-cells were examined by flow cytometry on 7, 14,21,28,35 days after mice infected with T. spiralis respectively. ResultAfter infected with T. spiralis,the level of IgG in mice rised gradually,and reached its peak on the 35th day. The change of T-cell subsets showed that CD4+T cells decreased,which CD8+Tcells increased. The ration of CD4+/CD8+cells decreased,and which was the obvious on the 14thday. It did not recover to normal level even on the 35th day. The IL-2 of level reached the peak on the 7th day after infected,then IL-2 level decreased quickly and lower than that of normal mice on 35th day after infected. Conclusion When the acute phase of T. spiralis infection,the immune function of host was inhibited. The protective immunity of against T. spiralis infection was cellular immunity mainly ,in cooperation with humoral immunity.

Objective To review the advance of gene diagnosis and gene therapy on gastric cancer. Methods Literatures about the advance of gene diagnosis and therapy on gastric cancer were reviewed. Results Detection of tumor marker by gene technique is important for early diagnosis, follow-up and therapy evaluation of gastric cancer in clinic. But there are still many problems in gene therapy of gastric cancer. Conclusion Gene detection and gene therapy will become important supplementary means for diagnosis and treatment of gastric cancer.

Objective To investigate the influence of CO2 pneumoperitoneum on the adhesive and invasive ability of gastric cancer cells based on the expression of adhesive and invasive molecules. Methods With an artificial CO2 pneumoperitoneum model in vitro, human gastric cancer cells MKN-45, SGC-7901 and MKN-28 were exposed to 3 different CO2 gradients: 9 mm Hg, 15 mm Hg and control group (0 mm Hg). The expression of E-cadherin, ICAM-1, MMP-2 and VEGF-A were measured at 2 and 4 hours exposure by using RT-PCR, CytoMatrixTM kit and ECMatrixTM kit. The pretreated gastric cancer cells were injected into abdominal cavity of nude mice(2×106 cells per mouse). Five mice in each group were sacrificed 4 weeks later to record the number of tumor nodules in abdominal cavity. The remaining mice were kept for observation of survival time. Results The expression of E-cadherin (MKN-45: from 2.26 to 2.19, SGC-7901 :from 2.16 to 2.09、MKN-28 :from 2.06 to 1.99), ICAM-1 (MKN-45 : from 2.20 to 2.28、SGC-7901: from 2.10 to 2.18、MKN-28: from 2.00 to 2.08), MMP-2 (MKN-45:from 2.05 to 2.13、SGC-7901: from 1.95 to 2.03、MKN-28: from 1.85 to 1.93) and VEGF-A(MKN-45 : from 2.10 to 2.16、SGC-7901 :from 2.00 to 2.06、MKN-28: from 1.90 to 1.96) didn't change significantly with increasing pressure and time (P>0.05). The expression of adhesive and invasive molecules didn't change significantly between the experimental groups and the control group. There was no statistical significance of tumor metastasis in abdominal cavity of nude mice(MKN-45:from 22 to 23、SGC-7901 :from 20 to 22、MKN-28:from 21 to 22) and survival time(MKN-45 :from 23 to 21、SGC-7901 :from 22 to 21、MKN-28 :from 22 to 21) among all the groups. Conclusion Under low pressure and short time of CO2 exposure, the adhesive and invasive capacity of gastric cancer cells did not change significantly hence did not increase the possibility of neoplasm metastasis.

OBJECTIVE:To systematically evaluate therapeutic efficacy of local application of gentamicin collagen sponge in the prevention of surgical incision infection,and to provide evidenced-reference for clinical treatment. METHODS:Retrieved from PubMed,EMBase,Cochrane Library,CBM,CJFD,VIP and Wanfang databases,randomized controlled trials (RCTs) about lo-cal application of gentamicin collagen sponge(trial group)vs. routine surgery disposal(control group)in the prevention of surgical incision infection were collected. After data extraction and quality evaluation with modified Jadad scale,Meta-analysis was per-formed by using Rev Man 5.3 statistical software. RESULTS:A total of 16 literatures were included,involving 7752 patients. The results of Meta-analysis showed that the incidence of surgical incision infection in trial group was significantly lower than control group,with statistical significance [OR=0.71,95%CI(0.61,0.84),P<0.001]. The packet statistics showed that the incidence of surgical incision infection in cardiovascular surgery group [OR=0.59,95%CI(0.37,0.96),P=0.03] and skin soft tissue operation group [OR=0.34,95%CI(0.15,0.75),P=0.008] were significantly lower than control group. There was no statistical significance in the incidence of incision infection between digestive system operation group and control group [OR=0.62,95%CI(0.25,1.54), P=0.30]. The incidence of surgical incision infection in≤30 d group was significantly lower than control group[OR=0.58,95%CI (0.41,0.82),P=0.002];there was no statistical significance between more than 30 d group and control group [OR=0.86,95%CI (0.71,1.04),P=0.13]. The incidence of surgical incision infection [OR=0.65,95%CI(0.52,0.82),P<0.001] in gentamicin high-dose group (>100 mg) was significantly lower than control group;there was no statistical significance between gentamicin low-dose group (≤100 mg) and control group [OR=0.96,95%CI(0.72,1.28),P=0.77]. CONCLUSIONS:Local application of gentamicin collagen sponge may have certain effect on the prevention of surgical infection. Different types of surgery,observation time and dose have different prevention effects. It should be used carefully according to clinical practice.