Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.
Animals ; Swine ; Bundle of His/physiology* ; Ventricular Septum ; Cardiac Pacing, Artificial ; Heart Conduction System ; Electrocardiography ; Iodine

Objective: Explore the relationship between tip of the left bundle branch pacing lead and anatomic location of left bundle branch as well as the mechanism of left bundle branch current of injury. To clarify the clinical value of left bundle branch current of injury during operation. Methods: The pacing leads were implanted in the hearts of two living swines. Intraoperative electrophysiological study confirmed that the left bundle branch or only the deep left ventricular septum was captured at low output. Immediately after operation, the gross specimen of swine hearts was stained with iodine to observe the gross distribution of His-purkinje conduction system on the left ventricular endocardium and its relationship with the leads. Subsequently, the swine hearts were fixed with formalin solution, and the pacing leads were removed after the positions were marked. The swine hearts were then sectioned and stained with Masson and Goldner trichrome, and the relationship between the anatomic location of the conduction system and the tip of the lead was observed under a light microscope. Results: After iodine staining of the specimen, the His-purkinje conduction system was observed with the naked eye in a net-like distribution, and the lead tip was screwed deeply and fixed in the left bundle branch area of the left ventricular subendocardium in the ventricular septum. Masson and Goldner trichrome staining showed that left bundle branch pacing lead directly passed through the left bundle branch when there was left bundle branch potential with left bundle branch current of injury, while it was not directly contact the left bundle branch when there was left bundle branch potential without left bundle branch current of injury. Conclusion: The left bundle branch current of injury observed on intracardiac electrocardiogram during His-purkinje conduction system pacing suggests that the pacing lead directly contacted the conduction bundle or its branches, therefore, the captured threshold was relatively low. Left bundle branch current of injury can be used as an important anatomic and electrophysiological evidence of left bundle branch capture.
Animals ; Swine ; Bundle of His/physiology* ; Ventricular Septum ; Cardiac Pacing, Artificial ; Heart Conduction System ; Electrocardiography ; Iodine

To reduce the problems of poor solubility, high in vivo dosage requirement, and weak targeting ability of paclitaxel (PTX), a hyaluronic acid-octadecylamine (HA-ODA)-modified nano-structured lipid carrier (HA-NLC) was constructed. HA-ODA conjugates were synthesized by an amide reaction between HA and ODA. The hydrophobic chain of HA-ODA can be embedded in the lipid core of the NLC to obtain HA-NLC. The HA-NLC displayed strong internalization in cluster determinant 44 (CD44) highly expressed MCF-7 cells, and endocytosis mediated by the CD44 receptor was involved. The HA-NLC had an encapsulation efficiency of PTX of 72.0%. The cytotoxicity of the PTX-loaded nanoparticle HA-NLC/PTX in MCF-7 cells was much stronger than that of the commercial preparation Taxol®. In vivo, the HA-NLC exhibited strong tumor targeting ability. The distribution of the NLCs to the liver and spleen was reduced after HA modification, while more nanoparticles were aggregated to the tumor site. Our results suggest that HA-NLC has excellent properties as a nano drug carrier and potential for in vivo targeting.

OBJECTIVETo compare three different methods in transfection of plasmid pGPU6/GFP/Neo into chicken embryo fibroblast.

METHODSDifferent doses (1.25 μl,2 μl,2.5 μl) of Lipofec-tamin2000, Gbfectene-Elite and HilyMax were used to transfect 1 μg plasmid pGPU6/GFP/Neo. The transfection efficiency was observed by the fluorescence and the cell viabilities were measured.

RESULTSThe transfection efficiency of HilyMax was significant higher than that of Lipofectamin2000 and Gbfectene-Elite (86.85%±2.32% compared with 48.33%±3.24% and compared with 37.35%±5.41%; F=18.882, P<0.05). The transfection efficiency of 2.5 μl HilyMax was highest(90.53%±1.15%). The cell viability of Lipofectamin2000 was significantly lower than that of HilyMax and Gbfectene-Elite(65.76%±5.78% compared with 89.54%±0.86% and compared with 82.45%±3.56%;F=90.676, P<0.05).

CONCLUSIONHilyMax has the highest transfection efficiency and the lowest cell toxicity in transfection of plasmid pGPU6/GFP/Neo into chicken embryo fibroblast, with the optimal ratio of 2.5 μl HilyMax:1 μg plasmid.

Animals ; Cell Line ; Chick Embryo ; Fibroblasts ; cytology ; Green Fluorescent Proteins ; genetics ; Plasmids ; genetics ; Transfection ; methods

We present a rare case of colonic metastasis of renal cell carcinoma (RCC) and review the literature. A 54-year-old male was referred to our hospital with a history of bloody stools and fever. A right kidney tumor measuring about 10 cm in diameter was found by abdominal computed tomography. Right radical nephrectomy and a right hemicolectomy with ileotransversostomy were performed. Pathological diagnosis was chromophobe RCC with sarcomotoid change involving the colon. Chromophobe RCC with sarcomotoid change is very rare.
Carcinoma, Renal Cell ; complications ; diagnosis ; Colonic Neoplasms ; diagnosis ; secondary ; Humans ; Kidney Neoplasms ; complications ; diagnosis ; Male ; Middle Aged

BACKGROUNDRetrocaval ureter is a rare congenital abnormality. Operative repair is always suggested in cases of significant functional obstruction. Laparoscopic procedures have been employed as the minimally invasive therapeutic option for retrocaval ureter. However, the laparoscopic techniques for retrocaval ureter might be technically challenging to some surgeons. The aim of this article was to present our experience and surgical techniques of pure transperitoneal laparoscopic pyelopyelostomy and ureteroureterostomy in nine patients with retrocaval ureter.

METHODSA total of nine patients of retrocaval ureter underwent pure laparoscopic pyelopyelostomy or ureteroureterostomy. The operation was performed with the patients placed in the 70-degree lateral decubitus position via a three port transperitoneal approach with two 10-mm and one 5-mm ports. The distal part of the dilated renal pelvis was transected at the ureteropelvic junction and the ureter was relocated anterior to the inferior vena cava. The tension-free pyeloureteral or ureteroureteral anastomosis was completed with the intracorporal freehand suturing and in situ knot-tying techniques combined with interrupted and continuous fashion. A double J ureteral stent was inserted in an antegrade manner during laparoscopy. Intravenous urography or computerized tomography and renal ultrasonography were performed after 3 months postoperatively.

RESULTSAll operations were completed laparoscopically, and no open conversion was required. The mean operative time was 135 minutes (range, 70 - 250 minutes), with minimal blood loss (less than 60 ml). No intra-operative complications or significant bleeding occurred. All patients presented mild postoperative pain and quick convalescence. The symptoms disappeared and hydronephrosis decreased substantially after surgery.

CONCLUSIONSPure transperitoneal laparoscopic correction for retrocaval ureter was associated with an excellent outcome, minimal invasiveness and short hospital stay. It is technically feasible and reliable for retrocaval ureter treatment. Laparoscopic surgery could be the standard treatment for retrocaval ureter.

Adult ; Humans ; Laparoscopy ; methods ; Male ; Middle Aged ; Treatment Outcome ; Ureter ; surgery ; Ureteral Obstruction ; surgery ; Young Adult

BACKGROUNDThe etiology and pathology of functional constipation (FC) is unclear. Some researches suggest that psychological factors may be related to this common problem. This study aimed to investigate the relationship between attention processing and emotional status in FC patients compared with healthy controls.

METHODSWe investigated selective attention and emotional status in patients with FC using the counting Stroop task. Thirty-five FC patients (FCP group) and 24 healthy controls (HCs) underwent an event-related potential (ERP) study while performing the task. Response time, latency and amplitude of P300 were collected and compared between the two groups. The Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Scale (HAMA), Symptom Checklist-90 (SCL-90) and Eysenck Personality Questionnaire (EPQ) were administered prior to the counting Stroop task.

RESULTSScores for the FCP group differed significantly from those for the HCs on the HAMD-17, HAMA, SCL-90 (Global Severity Index, Positive Symptoms Total, dimensions of somatization, obsessive-compulsive, depression, anxiety, and psychosis), as well as extraversion and neurosis dimensions of the EPQ (P < 0.05). There was no significant difference in response time or accuracy rate between the two groups (P > 0.05). ERP results showed prolonged latency at F4, additionally found enhanced activation at F3, FC1 and T8, and decreased activation at sites FC6 and P7 in the patients with FC. Statistically, significant differences of P300 latency at site F4 (P < 0.05) and P300 amplitude at F3, F4, T8, P7, FC1 and FC6 (P < 0.05) between the patients with FC and the HC were revealed.

CONCLUSIONSThe findings suggest that patients with FC are more susceptible to depression and anxiety, as well as somatization, obsessive-compulsive tendencies and other neurotic personality characteristics. Patients may employ psychological defense mechanisms to avoid the pain of depression and anxiety. ERP results imply there may be some brain dysfunction and attention deficits in patients with FC.

Adolescent ; Adult ; Aged ; Anxiety ; etiology ; physiopathology ; Constipation ; complications ; physiopathology ; Depression ; etiology ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Young Adult

OBJECTIVETo investigate the effects of the novel proteasome subunit Adrm1 knockdown by RNA interference on proliferation of colorectal cancer cells.

METHODSThe shRNA eukaryotic expression vector against Adrm1 was constructed and transfected into colon cancer RKO cells. The Adrm1-shRNA stable transfected clones were selected. Experimental cells were divided into 3 groups: the experimental group containing stable Adrm1-shRNA transfected cells, the control group containing only RKO colon cancer cells and stable empty vector transfected control group. The Adrm1 protein expression level was analyzed by Western blot. The colony-forming ability of the three groups was assessed by soft agar assay. The cell proliferation and apoptosis were analyzed by methyl thiazolyl tetrazolium (MTT) method and in situ end labeling (TUNEL) assay. Cell cycle changes were assayed by flow cytometry.

RESULTSAdrm1-shRNA effectively suppressed Adrm1 expression in the experimental group. Silencing of Adrm1 in RKO cells significantly inhibited their anchorage-independent growth, only occasional individual colonies were formed. The apoptosis rate of experimental group was (12.4 +/- 1.1)%, significantly higher than that of the stable empty vector transfected control group. The proportion of G(0)/G(1) and S/G(2) phase cells in the experimental group was (41.2 +/- 1.1)% and (58.8 +/- 1.1)%, respectively. The cells were arrested at G(1) phase. In addition, Adrm1 RNA interference combined with 5-Fu treatment significantly suppressed colorectal cancer cell growth in vitro.

CONCLUSIONSilencing of Adrm1 by RNA interference can significantly suppress proliferation of RKO cells through inducing apoptosis and arresting the cell cycle. The combined application of Adrm1 RNA interference and chemotherapy may become as a novel therapeutic strategy for Adrm1 overexpressed colorectal cancer.

Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; Cell Cycle ; Cell Line, Tumor ; Cell Proliferation ; Colorectal Neoplasms ; metabolism ; pathology ; Drug Resistance, Neoplasm ; Fluorouracil ; pharmacology ; Genetic Vectors ; Humans ; Membrane Glycoproteins ; genetics ; metabolism ; Plasmids ; RNA Interference ; RNA, Small Interfering ; genetics ; Transfection

Objective To summarize the experience in laparoscopic resection of metastic liver cancer. Methods The clinical data of the patients receiving laparoscopic resection of metastic liver cancer performed in Brisbane hospital from 1999 to 2006 were retrospectively analyzed. Results A total of 28 patients received the laparoscopic resection of metastic liver cancer. Procedures included left lateral segmentectomy in 13 patients, right hemihepatectomy in 9 and segmental or subsegmental resection in 6. Survival rate and disease free survival rate in 12 patients with colorectal metastasis being followed up for 2 years were 75% and 67%. Conclusion Laparoscopic liver resection is safe and feasible in strictly selected patients with malignancy in an appropriate stage. The surgeons should have rich experience of open liver resection and advanced laparoscopic technique.

OBJECTIVETo investigate the correlation between the proteasome subunit PSMA7 expression in colorectal cancer and its role in liver metastasis.

METHODSTo identify the PSMA7 protein expression in 62 primary site colorectal cancers, 34 lymph node metastatic sites and 13 liver metastatic sites by immunohistochemistry and clarify the correlation of its expression with the clinicopathological parameters.

RESULTSHigh expression of PSMA7 was detected in 38.7% (24/62) of primary site colorectal cancer, 52.9% (18/34) of lymph node metastatic sites and 100% (13/13) liver metastatic sites but not in the normal colorectal tissue. High expression of PSMA7 was significantly correlated with liver metastasis (P = 0.028). The survival rate was significantly lower in patients with high expression of PSMA7 than in those with low expression of PSMA7 (P = 0.0008). As well, in multivariate analysis, PSMA7 expression demonstrated to be an independent prognostic factor (P = 0.004, relative risk 5.057; 95% confidence interval, 1.682-15.201).

CONCLUSIONPSMA7 may play an important role in the colorectal cancer progression. Evaluation of PSMA7 expression in primary colorectal cancer at the time of surgery might be a valuable test in defining patients with a high risk of developing liver metastasis.

Adult ; Aged ; Colonic Neoplasms ; enzymology ; pathology ; surgery ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Humans ; Liver Neoplasms ; enzymology ; secondary ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging ; Proteasome Endopeptidase Complex ; metabolism ; Rectal Neoplasms ; enzymology ; pathology ; surgery ; Survival Rate ; Young Adult