Objective To evaluate the Thompson procedure in the treatment of chronic mallet finger with tendon defect.Methods From July 2014 to October 2016,9 cases of chronic mallet finger with tendon defect were treated by Thompson procedure at Department of Hand Surgery,Wuhan Puai Hospital.They were 4 males and 5 females,aged from 25 to 56 years (average,36 years).Their disorder was on the left side in 3 cases and on the right side in 6 ones,involving 2 index fingers,3 middle fingers,3 ring fingers and one little finger.The ranges of motion (ROM) for distal and proximal interphalangeal joints were measured after operation.Operative complications were observed and recorded.Dargan functional assessment was used to evaluate the outcomes at the final follow-up.Results All the 9 patients were followed up for 5 to 36 months (average,16.5months).The wounds healed primarily without such complications as infection,skin breakage,abnormal fingertip sensation or nail deformity.All cases of mallet finger malformation were corrected.About 10 weeks after operation,one case presented with mild mallet finger malformation which was completely corrected after active fixation for 8 weeks.The Dargan assessment at the final follow-up showed 8 excellent and one good cases.Conclusion Thompson procedure can lead to satisfactory outcomes and limited complications in the treatment of chronic mallet finger with tendon defect.

Objective To evaluate the clinical effect after laparoscopic sacral colpopexy (LSC) of combined transabdominal-transvaginal approach on stage Ⅳpelvic organs prolapse (POP). Methods The clinical data of 65 patients undergoing LSC of combined transabdominal-transvaginal approach from January 1st, 2010 to July 30th, 2017 due to POP stage Ⅳ in First Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. Objective outcome was assessed by comparing preoperative and postoperative pelvic organ prolapse quantification (POP-Q) systems. Subjective effects were assessed by comparing pelvic floor distress inventory-short form 20 (PFDI-20), pelvic floor impact questionnaire short form (PFIQ-7), pelvic organ prolapse/urinary incontinence sexual questionnaire-12 (PISQ-12) and patient global impression of improvement (PGI-I). Results All 65 patients were successfully performed without any intraoperative complications. Fifty-three patients were followed in the clinic department and 12 were followed up by telephone. The follow-up duration was 6.1-80.3 months and the median follow-up duration was 24.5 months. The bleeding loss was 20-250 ml. Postoperative urethral catheter residence day was (2.5± 1.1) days, length of postoperative stay was (6.2±1.7) days. The postoperative POP-Q scores were compared with preoperative scores which had significantly improved except pb (all P<0.01). The objective cure rates of vaginal anterior wall, apical and posterior wall prolapse stageⅣwere 90% (47/52), 100% (23/23) and 95% (20/21).About PGI-I, except for 1 patient who chose"improvement", the other 64 patients (98%, 64/65) all chose"significant improvement". Furthermore, preoperative and postoperative PFDI-20, PFIQ-7, and PISQ-12 scores were all statistically significant (all P<0.01). Subjective efficacy was significant. Three cases (5%, 3/65) of postoperative fever occurred. Two cases (4%, 2/53) had mesh exposure. Six patients (11%, 6/53) had recurrence of postoperative prolapse. Five cases had recurrence of vaginal anterior wall prolapse and no reoperation was performed; 1 case was recurrence of posterior vaginal wall prolapse who diagnosed as vaginal posterior wall prolapse stage Ⅲ; no recurrence of apical prolapse. The rate of reoperation (including exposed-mesh removal and pelvic floor reconstruction surgery) was 5% (3/65). Conclusions The LSC of combined transabdominal-transvaginal approach has a high subjective efficacy rate. The objective cure rate in the case of apical prolapse stage Ⅳ is one hundred percent.The LSC of combined transabdominal-transvaginal approach has low mesh exposure, low postoperative infection and the reoperation rate, which is one of optional pelvic floor reconstruction surgery. However, there is still a risk of recurrence in patients with POP stageⅣwith severe bladder bulging.

Objective: To compare the effects of various interventions on the incidence of central line-associated bloodstream infection (CLABSI) . Methods: The clinical data of 218 patients with central venous catheterization were retrospectively analyzed. Infected patients were treated as CLABSI group and non-infected patients as control group. Results: Of the 218 patients, 24 patients were developed CLABSI. There was no significant difference in sex, age, primary infection status and puncture site between CLABSI group and control group. Univariate analysis showed that axillary vein puncture could significantly reduce the incidence of CLABSI (P=0.028), and the infection rate of axillary vein puncture per 1000 days under B-ultrasound was significantly reduced by 0.93‰. The average indwelling days of deep venous catheter in patients with pulse puncture were significantly longer than those in other groups (47.32 days vs 19.90 days). The average indwelling days in patients with axillary vein puncture positioned by B ultrasound were longer than those in patients with other parts of vein puncture positioned by B ultrasound (P < 0.05). Logistic multiple regression analysis showed that the main risk factors for CLABSI were anatomically located puncture (P = 0.031) and non-axillary venous catheterization (P = 0.068). Conclusions Choosing axillary vein as the position of deep venous catheterization and using ultrasound-guided central venous puncture can reduce the incidence of CLABSI and prolong the average catheterization time.

Objective To investigate the expression of Fascin-1 in gastric carcinoma and its association with clinicopatho-logical features. Methods A total of 98 gastric cancer specimens were collected from our hospital from August 2014 to De-cember 2016.The expression of Fascin-1 mRNA and protein was detected in gastric cancer cell lines(MKN28,MKN45 and AGS)and gastric cancer tissues by real-time PCR,Western blotting and immunohistochemistry,respectively.The relationship between Fascin-1 protein expression and clinicopathological features was analyzed. Results Fascin-1 was highly expressed at mRNA and protein levels in MKN28 and MKN45 gastric cancer cell lines,and it was weakly expressed in AGS cell line.The ex-pression of Fascin-1 mRNA was much higher in gastric cancer tissues than in adjacent tissues.The expression of Fascin-1 was correlated with invasive depth,lymph node metastasis,lymphatic invasion,tumor differentiation and TNM stage(all P<0.05). Conclusion Fascin-1 is overexpressed in gastric cancer tissues.It is associated with the progression,invasion and malignancy of gastric cancer.It is expected to become a molecular marker for the progression of gastric cancer.

Purpose To investigate the clinicopathological characteristics and treatment of combined hepatocellular carcinoma-cholangio carcinoma (cHCC-CC).Methods 24 cases of cHCC-CC were collected.The clinical pathological characteristics,imaging,immunophenotyping and clinical features were retrospectively analyzed and reviewed the literature.Results There were 18 males and 6 females in 24 cases of cHCC-CC.The age ranged from 36 to 68 years (mean age was 54.38).Tumour location:right hepatic lobe in 15 cases,left hepatic lobe in 6 cases,both left lobe and right hepatic lobe in 1 case,hepatic caudate and left lateral lobe in 1 case,diffuse nodular liver tumors in 1 case.Grossly,the texture and color of tumor was related to the composition of tumor.Microscopically,classic cHCC-CC had two areas composed of hepatocellular carcinoma area and cholangiocar cinoma area of mixed distribution or migration distribution.3 cases were cHCC-CC with stem cell properties (cholangiolocellular carcinoma type,CLC type).Immunohistochemical staining revealed that HCC like area mainly expressed CD10,CK8,Hepatocyte and CD10,cHCC-CC area expressed CK7 and EMA.CLC type expressed the immunophenotypic features of intermediate type of HCC.Conclusion The clinical manifestations of cHCC-CC are not specific,the preoperative diagnosis is difficult,and it should be combined with pathological characteristics,imaging features and immunophenotype diagnosis.

Objective To study the clinical effect of total parathyroidectomy with subcutaneous autotransplantation (TPTX + AT) in the treatment of secondary hyperparathyroidism(SHPT) in patients with chronic renal failure.Methods One hundred and thirty-four patients undergoing TPTX + AT in our hospital from January 2013 to October 2014 were includud in this study.The preoperative,postoperative and follow-up intact parathyroid hormone (iPTH),serum calcium,serum phosphorus and calcium-phosphorus product were statistically analyzed.The Kidney Disease Quality of Life Short Form (KDQOL-SFTM) scale was used to evaluate quality of life before and one year after parathyroidectomy.Postoperative complications and recurrence were observed.Results Postoperative iPTH,serum calcium,serum phosphorus and calciumphosphorus product decreased significantly compared with that before surgery.The difference had statistical significance (all P ＜ 0.05).One patient died in perioperative period.Temporary injury of recurrent laryngeal nerve was found in eight patients.Early postoperative hypocalcemia was frequently seen in 124 patients (92.5％) and in 7 cases (5.2％) occured intractable hypocalcemia.The quality of life was significantly improved one year after parathyroidectomy.Recurrence developed in 5 patients after operation.Conclusions TPTX + AT is safe and effective in the treatment of SHPT in patients with chronic renal failure and can significantly improve the patient's quality of life.

Objective To compare the effects of intramuscular or subcutaneous forearm parathyroid autotransplantation after total parathyroidectomy on patients with renal hyperparathyroidism.Methods From Jan.2012 to Dec.2013,total parathyroidectomy was carried out in 90 patients with renal hyperparathyroidism.According to the location of their parathyroid autograft,patients were divided into intramuscular group (n =39)and subcutaneous group(n =51).One patient in the intramuscular group and two in the subcutaneous group were excluded for the high levels of intact parathyroid hormone (iPTH) the day after operation.iPHT was analyzed 2 weeks,1 month,3 and 6 months after surgery.Results The time of autotransplantation was significantly shorter in subcutaneous group than in intramuscular group (11.46 (2.63) min vs 22.12 (3.78) min;t =0.632,P ＜ 0.05).iPTH levels were significantly lower in subcutaneous group than in intramuscular group 2 weeks after operation (P ＜ 0.05).There was no significant difference between the 2 groups regarding iPTH levels at 1 month,3 or 6 months after surgery.In the follow-up one patient in intramuscular group and one in subcutaneous group had graft-dependent hyperparathyroidism.Conclusion As compared to intramuscular parathyroid autotransplantation,subcutaneous parathyroid autotransplantation has advantages of simpler to operate,shorter autoimplantation time and easier to autograftectomy.

Objective To investigate the effect of the replication-deficient adenovirus carrying miR-138(Ad-miR138) on the pro-liferation of human gastric cancer cell line BGC-823 and the possible mechanism .Methods The human gastric cancer cell line BGC-823 was infected with Ad-miR138 .Then the expression level of miR-138 was measured by RT-PCR .The growth curve of BGC-823 was measured using CCK-8 method .The ability of cell invasion was measured using Transwell chambers .Results After infected with Ad-miR138 ,the expression of miR-138 in BGC-823 cells was up -regulated significantly (1 .07 ± 0 .07 vs .4 .89 ± 0 .45 ,P<0 .05) .Absorbance of the 6th day decreased significantly (0 .52 ± 0 .06 vs .0 .77 ± 0 .06 ,P<0 .05) ,and the invasion ability was de-creased obviously (32 .00 ± 11 .00 vs .56 .00 ± 12 .00 ,P<0 .05) .Conclusion miR-138 can effectively suppress the proliferation and invasion of human gastric cancer cell line BGC-823 in vitro .

Objective To investigate the association of ERCC1 and BRCA1 gene expression with clinical features and sensitivity to platinum-containing chemotherapy in patients with ovarian epithelial carcinoma. Methods Primary ovarian epithelial carcinoma tissues were harvested from 48 patients receiving staging surgery or cytoreductive surgery. Expression of ERCC1 and BRCA1 in the tumor samples was detected by immunohistochemistry. Results ERCC1 expression was correlated with clinical stage(P﹤0. 05)but not with age,pathological type or degree of differentiation(P﹥0. 05). BRCA1 expression was not correlated with any of the clinicopathological features(P﹥0. 05);ERCC1 expression was significantly higher in drug-resistant tissues than in drug-sensitive samples(P﹤0. 05);The expression of ERCC1 and BRCA1 was positive in 89. 58%and 25. 00%of the samples,respectively. Conclusion ERCC1 gene expression is correlated with clinical stage but not with age,pathological type or degree of differentiation. BRCA1 gene expression is not correlated with clinicopathological features. ERCC1 has high positive expression in epithelial ovarian cancer and is correlated with sensitivity of platinum-containing adjuvant chemotherapy.

BACKGROUNDFollicle stimulating hormone is necessary for normal reproduction in men. The biochemical actions of follicle stimulating hormone result from binding to the follicle stimulating hormone receptor in the plasma membrane of Sertoli cells. Here, we investigated the expression of the follicle stimulating hormone receptor in different testicular histological phenotypes of patients with idiopathic azoospermia.

METHODSFifty-seven cases of idiopathic azoospermia were classified into three groups according to the results of testicular biopsy: patients with hypospermatogenesis, patients with maturation arrest, and patients with Sertoli cell-only syndrome. Thirteen azoospermic patients identified by testicular biopsy as being capable of completing spermatogenesis acted as the control group. Immunohistochemistry and real-time quantitative reverse-transcriptase polymerase chain reaction were performed in each case, and the serum hormone level was also measured in all patients.

RESULTSThe serum follicle stimulating hormone level in patients with Sertoli cell-only syndrome was significantly higher than in patients with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P < 0.01). The serum follicle stimulating hormone level in patients with maturation arrest was significantly higher than in patients with hypospermatogenesis and complete spermatogenesis (P < 0.05). There was no difference in serum follicle stimulating hormone levels in patients with hypospermatogenesis and complete spermatogenesis. The follicle stimulating hormone receptor expression level of testicular samples with Sertoli cell-only syndrome was significantly higher than in those with hypospermatogenesis, maturation arrest, and complete spermatogenesis (P < 0.05), but no significant difference was observed among hypospermatogenesis, maturation arrest, and complete spermatogenesis testicular samples.

CONCLUSIONSDifferent serum follicle stimulating hormone levels and follicle stimulating hormone receptor expression were found in the different testicular histology phenotypes in azoospermic patients. Differential follicle stimulating hormone receptor expression in testicular tissue of patients with idiopathic azoospermia may be associated with the degree of spermatogenesis.

Adult ; Azoospermia ; blood ; metabolism ; Follicle Stimulating Hormone ; blood ; Humans ; Male ; Oligospermia ; blood ; metabolism ; Receptors, FSH ; genetics ; metabolism ; Spermatogenesis ; physiology ; Testis ; metabolism