Objective To explore the clinical efficacy and safety of off-clamping in robotic-assisted partial nephrectomy (RAPN) for the treatment of renal tumors.Methods From January 2015 to March 2017,the data of 48 patients who underwent off-clamping RAPN were reviewed retrospectively.There were 31 males and 17 females,and the mean age was 57 years (range:23-84 years).The mean tumor size was 3.1 cm (range:1.2-6.4 cm),with the upper,middle,and lower polar tumors account for 35.4％,27.1％,and 37.5％,respectively.The clinical tumor stage was T1N0M0 in all 48 cases,according to the AJCC tumor staging system for renal cancer.Results RAPNs were performed successfully in all 48 cases,without conversion to open surgery.In those patients,the application of off-clamping in robotic-assisted partial nephrectomy was performed in 44 cases.The renal artery and vein was exposed,dissected,isolated and then clamped in 4 cases due to bleeding.The mean surgical time was 85 min (range:75-185 min).The mean estimated blood loss was 134 ml (range:60-270 ml),and no blood transfusion was needed.The wound surface was closed using interrupted suture with Hem-o-lok clips securing each needle point.The mean time for renorrhaphy was 22 min (rang:11-31 min).No intraoperative severe complications such as vascular injury,trauma of abdominal organ occurred.There were 5 complications,including 2 cases of hematuria,2 cases of delayed healing of incision,and 1 case of pneumohypoderma.The pathological diagnosis included 40 cases of renal clear cell carcinoma,3 cases of papillary renal cell carcinoma,and 5 cases of angiomyolipomas.No tumor recurrence or distant metastasis was observed during the average follow-up of 17 months (range 3-27 months).Conclusions Off-clamping RAPN is safe and feasible approach to excise certain kidney tumors.It carries the benefits of less complication,quick recovery,and less ischemia reperfusion renal injury.Off-clamping RAPN would be suitable for those patients with solitary kidneys,renal insufficiency,and bilateral tumors.

Objective To explore the clinical feasibility of robot-assisted laparoscopic radical cystectomy (RARC) with total intracorporeal othotopic ileal neobladder (TIOIN).Methods A consecutive series of 4 patients (2 male,2 female),who underwent RARC with TIOIN by a single surgeon,were included in the retrospective study,between March 2017 and June 2017.Their age ranged from 59 to 71 years,which the mean age was (65.7 ± 4.9) years.Preoperative urinary CT scan,cystoscopic examination and transurethral resection of bladder tumor were performed for diagnosis.Among these,2 patients underwent side-to-side bowel anastomosis using a linear stapler,while hand-sewn anastomosis was performed in the other 2 patients.The detubularized bowel segment was arranged in a U shape,and then the two medial borders were closed to create the posterior wall of the neobladder,which completed a partial U shape and anastomosed with the end of urethra.After placing the single J stents into the ureter,the uretero-neobladder was anastomosed.To close the urine reservoir,each border of the U-shaped segment was folded again and sutured to form a sealed pouch.Results All operations were performed successfully.The average operation time for RARC was 93.2 min (ranging 79-117 min).The average operation time for urinary diversion was 214.2 min (ranging 163-251 min).The mean estimated blood loss was 304.5 ml (ranging 200-400 ml).The mean hospital stay was 20.5 d (ranging 13-32 day).The number of dissected lymph node ranged from 11 to 16 (mean 3.7 ± 2.6).All the surgical margins were negative.The time for postoperative out-of-bed activity and bowel function recovery was 2-3 days and 3-4 days,respectively.The single-J stents were removed 1 months after operation,generally.No urine leakage was noticed after removing the drainage tube and catheter.The lymph leakage was observed in one case,which was resolved 15 days post-operatively after given nutrient therapy.The performance of urinary continence was satisfactory,except one patient complained about the nocturnal incontinence.After the regular pelvic exercise,the symptom improved two months after the operation.Hydronephrosis and intestinal leakage were not observed.Conclusions Our initial experience showed that RARC with TIOIN is feasible and alterative for experienced surgeon.

Periodontitis is a common chronic inflammatory disease. Recent studies have shown that chronic stress (CS) might modulate periodontal disease, but there are few models of CS-induced periodontitis, and the underlying mechanisms are unclear. The present study established a rat model of periodontitis associated with CS induced by nylon thread ligatures. The severity of periodontitis was evaluated in this model by radiographic and pathological examination. The inflammatory reaction indicated by the elevated serum levels of interleukin (IL)-1β, IL-6 and IL-8 was assessed by enzyme-linked immunosorbent assay. Toll-like receptor-4 (TLR4) and glucocorticoid receptor-α (GR-α) expressions were detected by reverse transcriptase-PCR and western blotting. Open-field tests and serum corticosterone were used to evaluate CS. The results showed that CS induced behavioral changes and increased corticosterone levels of the animals with periodontitis. CS stimulation markedly increased alveolar bone loss, periodontal pocket depth and the number of plaques. It also enhanced the inflammatory reaction. These results suggest that CS accelerated the ligature-induced pathological changes associated with periodontitis. Further analysis of the mechanisms involved showed that GR-α expression was significantly downregulated in periodontal tissues of the animals undergoing CS. Blocking GR-α signaling in lipopolysaccharide and corticosteroid-treated human periodontal ligament fibroblast cells in vitro significantly upregulated the expression of p-Akt (protein kinase B) and TLR4, promoted nuclear factor-κB activity and increased levels of IL-1β, IL-6 and IL-8. This research suggests that CS might accelerate the pathological progression of periodontitis by a GR-α signaling-mediated inflammatory response and that this may be a potential therapeutic target for the treatment of periodontal disease, particularly in patients with CS.
Alveolar Bone Loss ; Animals ; Blotting, Western ; Corticosterone ; Enzyme-Linked Immunosorbent Assay ; Fibroblasts ; Humans ; In Vitro Techniques ; Interleukin-6 ; Interleukin-8 ; Interleukins ; Ligation ; Models, Animal ; Nylons ; Periodontal Diseases ; Periodontal Ligament ; Periodontal Pocket ; Periodontitis* ; Phosphotransferases

This study assessed the roles of chronic stress (CS) in the stimulation of the sympathetic nervous system and explored the underlying mechanisms of periodontitis. Using an animal model of periodontitis and CS, the expression of tyrosine hydroxylase (TH) and the protein levels of the alpha1-adrenergic receptor (alpha1-AR) and beta2-adrenergic receptor (beta2-AR) were assessed. Furthermore, human periodontal ligament fibroblasts (HPDLFs) were stimulated with lipopolysaccharide (LPS) to mimic the process of inflammation. The proliferation of the HPDLFs and the expression of alpha1-AR and beta2-AR were assessed. The inflammatory-related cytokines interleukin (IL)-1beta, IL-6 and IL-8 were detected after pretreatment with the alpha1/beta2-AR blockers phentolamine/propranolol, both in vitro and in vivo. Results show that periodontitis under CS conditions enhanced the expression of TH, alpha1-AR and beta2-AR. Phentolamine significantly reduced the inflammatory cytokine levels. Furthermore, we observed a marked decrease in HPDLF proliferation and the increased expression of alpha1-ARfollowing LPS pretreatment. Pretreatment with phentolamine dramatically ameliorated LPS-inhibited cell proliferation. In addition, the blocking of alpha1-ARsignaling also hindered the upregulation of the inflammatory-related cytokines IL-1beta, IL-6 and IL-8. These results suggest that CS can significantly enhance the pathological progression of periodontitis by an alpha1-adrenergic signaling-mediated inflammatory response. We have identified a potential therapeutic target for the treatment of periodontal disease, particularly in those patients suffering from concurrent CS.
Adrenergic alpha-1 Receptor Antagonists/*therapeutic use ; Animals ; Cells, Cultured ; Cytokines/immunology ; Fibroblasts/immunology/pathology ; Humans ; Lipopolysaccharides/administration & dosage/immunology ; Male ; Periodontal Ligament/cytology/immunology/pathology ; Periodontitis/*drug therapy/*etiology/immunology/pathology ; Phentolamine/*therapeutic use ; Rats ; Rats, Wistar ; Receptors, Adrenergic, alpha-1/analysis/*immunology ; Signal Transduction/drug effects ; *Stress, Physiological/drug effects ; Tyrosine 3-Monooxygenase/analysis/immunology

Objective:Spectrophotometer is a device to be verified obligatory in hospital. This article introduced some techniques to avoid ordinary mistakes in measurement. Methods:We introduced principle and verification regulation of spectrophotometer. Such methods as parameter configuration, proper maintenance can reduce our mistakes. Results: This article analyzed some common problems in measurement and also offered solutions. Conclusion: In the measurements of spectrophotometers, because the operators have less spectrophotometer operation experience, they often get inaccurate data which lead to an error. Conclusion: To avoid these mistakes, strictly regulate operations in spectrophotometer’s verification and proper routine maintenance are necessary.

Objective Cardiac muscle cells play a critical role in maintaining normal function of the heart.Cardiotrophin-1(CT-1),a potent cardiac survival factor,is capable of inhibiting apoptosis or promoting survival in cardiomyocytes.To elucidate the mechanism of CT-1 promoting cardiac myocyte survival in cultured neonatal rat cardiomyocytes.To explore the potential signaling pathway that might be responsible for this effect.Methods We examined the cardiac myocyte survival effect of CT-1 in cultured neonatal rat cardiomyocytes.The cardiomyocytes were stained [3-(4,5-dimethyl-thiaziazol-2-yl)-2-5-diphenyltetrazolium bromide,MTT] and the counted.Results The survival rate of cardiac myocytes was increased by CT-1 in a dose-dependent manner(10-10～10-7 mol/L) and in a time-dependent manner(1～4 d,10-8 mol/L) in cultured neonatal rat cardiomyocytes.Pretreatment of PD098059(5?10-5mol/L),a MAPK blocker,decreased significantly survival rate of cardiac myocytes by promoted CT-1.The phorbol 12-myristate 13-acetate(PMA)(10-5mol/L),a PKC activator,increased significantly this effect of CT-1,but inhibited significantly by MAPK blocker PD098059.Conclusion CT-1 is a potent factor of promoting cardiac myocyte survival,and increase significantly survival rate of cardiac myocytes in a dose-dependentand a time-dependent manner in cultured neonatal rat cardiomyocytes.The MAPK signaling pathway mediates CT-1 induced cardiac myocyte survival.PKC signaling molecule may be a upstream signaling transduction pathway which cascades of MAPK in CT-1 induced cardiac myocyte survival.

BACKGROUND: The dynamic characteristics of electroencephalogram (EEG) include a decrease in the chaotic dimension, the correlation dimen sion, the Lyapunov exponent, the chaotic complexity, the freedom of EEG and an enhanced synchronization and periodicity of the EEG from several minutes to tens of minutes before epileptic seizures. All these characteristics prefigure the forthcoming seizures. Some studies have proven that the non linear dynamical system can be used as a feasible approach to explore the potential variables for describing the chaos portrait of EEG. OBJECTIVE: To analyze the electric characteristics of EEG signal in the epileptic seizures in rat model by investigating the nonlinear dynamical variables, such as the approximate entropy (ApEn) and correlation dimen sion. DESIGN: Observational and experimental study based on animals. SETTING: Department of Medical Engineering, Department of Gastroen terology, Second Artilleryman General Hospital of Chinese PLA; Department of Physics, Faulty of Biomedical Engineering, Fourth Military Medical Uni versity of Chinese PLA. MATERIALS: From September 2001 to January 2002, this study was conducted at the Complexity Laboratory of the Biomedical Department of the Fourth Military Medical University of Chinese PLA. Six male SD rats,weighing 150- 200 g, were selected.INTERVENTIONS: After intraperitoneal injection of chloral hydrate (0. 5 mL), the male SD rats were deeply anesthetized. When their EEG signal became stable, bemegride injection was diluted at 1:1 with saline and was given on a volume of 0.5 mL to the rats intraperitoneally. After a while,the epileptic seizures started marked by a spasm with a deep roar. The entire epileptic seizures were recorded. According to the shape of EEG waves and the corresponding symptoms of the rats during their seizures, data of the four phases, referring to normal condition, preictal phase, ictal phase and postictal phases of epileptic seizures, were selected for nonlinear analysis. The variations of the ApEn and the correlation dimension were calculated.MAIN OUTCOME MEASURES: In the four phases of the seizures, before seizures, preictal phase, ictal phase and postictal phases, the changes in the ApEn and correlation dimension were observed.RESULTS: All the 6 rats entered the statistical procedure. During epilepsy, the ApEn and correlation dimension of the EEG signal in ictal phases (0. 447 ±0. 126, 2. 166 ±0. 377) decreased significantly while those in preictal phases(0. 807 ±0. 182, 4. 773 ±0. 319) and postictal phases (1. 241 ±0. 125, 6. 042 ±0. 373) (t = -3. 984to 17. 902, P ＜0. 01). The ApEn and the correlation dimension of the EEG signal in preictal and ictal phases had significant difference with those observed under normal conditions (1.313 ± 0. 090, 6. 405 ± 0. 694) (t = -5. 228 to 12. 740, P ＜ 0. 01 ).CONCLUSION: The changes in ApEn and correlation dimension showed by nonlinear dynamical approach in this study reflect the characteristics of EEG signals in preictal time, ictal time and postictal timeof the epileptic seizures and the differences among them. Additionally, they also reveal the laws in the changes of the complex ictal EEG signal.

In order to further research into the EEG information of rats epileptic model, we applied different nonlinear dynamic methods. After having analyzed the EEG signal of rat falling sickness by means of approximate entropy and correlation dimension, we adopted a the new method, unstable periodic orbits, which was used to analyze complex activity of neurons system to look for the change regularity of change in the EEG signal in the whole course of rat's falling sickness. We found period 1 orbits and period 2 orbits to be statistically significant in the data of ictal time of epilepsy. At the same time, we found period 1 orbits to be statistically significant in the data of preictal time of epilepsy.
Animals ; Disease Models, Animal ; Electroencephalography ; Entropy ; Epilepsy ; physiopathology ; Nonlinear Dynamics ; Rats ; Signal Processing, Computer-Assisted

The check & acceptance is an important component of medical equipment management,and it is the key to guarantee the quality,application and safety of medical equipment.In this article,we introduce some methods to check & accept the medical equipment according to our own experience.

The aim of this study was to develop a new method of epileptic prediction using nonlinear dynamic theory. When rat was falling sickness, its EEG was researched by using approximate entropy and correlation dimension. The results showed the approximate entropy and correlation dimension during epileptic seizure are obviously lower than those before seizure and after seizure. The span of time before seizure is a special phase. Before the seizure symptom appeared, the complexity of EEG had begun declining. Thus, the outbreak of epilepsy could be predicted in short time using nonlinear dynamic methods.
Algorithms ; Animals ; Disease Models, Animal ; Electroencephalography ; Entropy ; Epilepsy ; diagnosis ; physiopathology ; Male ; Nonlinear Dynamics ; Rats ; Rats, Sprague-Dawley ; Signal Processing, Computer-Assisted