Extraperitoneal robot-assisted laparoscopic radical prostatectomy through single incision: Establishment and application of a modified channel / 中华男科学杂志

Objective@#To assess the feasibility and validity of the establishment of a modified channel for extraperitoneal robot-assisted laparoscopic radical prostatectomy (RARP) through single incision.@*METHODS@#From November 2020 to January 2021, 35 cases of localized PCa were treated by extraperitoneal RARP through single incision in our center. All the operations were performed by the same surgeon, none via the multichannel port for the establishment of the channel. We recorded and analyzed the intra- and postoperative parameters, operation cost, complications, pathological findings and follow-up data.@*RESULTS@#All the operations were successfully completed, without conversion to open surgery or additional channels, or serious postoperative complications, the time for establishing the extraperitoneal space averaging 25.4 (20.0－45.0) min, the operation time 67.3 (35.0－125.0) min, intraoperative blood loss 75.5 (60.0－150.0) ml, time to first postoperative anal exhaust 26 (8－48) h, and postoperative hospital stay 7.89 (7－10) d. Postoperative pathology showed adenocarcinoma in all the cases, with Gleason score (GS) 3+3 in 9 (25.7%), GS 3+4 in 9 (25.7%), GS 4+3 in 8 (22.9%), and GS ≥ 8 in 9 (25.7%) of the cases, 23 (65.7%) in the

Recombinant Human Erythropoietin Augments Neovascularization Responses in a Neonatal Rat Model of Premature Brain Damage by Phosphatidylinositol 3 Kinase/Akt Pathway / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Recombinant human-erythropoietin (rh-EPO) has therapeutic efficacy for premature infants with brain damage during the active rehabilitation and anti-inflammation. In the present study, we found that the rh-EPO was related to the promotion of neovascularization. Our aim was to investigate whether rh-EPO augments neovascularization in the neonatal rat model of premature brain damage through the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway.</p><p><b>METHODS</b>Postnatal day 5 (PD5), rats underwent permanent ligation of the right common carotid artery and were exposed to hypoxia for 2 h. All the rat pups were randomized into five groups as follows: (1) control group; (2) hypoxia-ischemic (HI) group; (3) HI + LY294002 group; (4) HI + rh-EPO group; and (5) HI + rh-EPO + LY294002 group. The phospho-Akt protein was tested 90 min after the whole operation, and CD34, vascular endothelial growth factor receptor 2 (VEGFR2), and vascular endothelial growth factor (VEGF) were also tested 2 days after the whole operation.</p><p><b>RESULTS</b>In the hypoxic and ischemic zone of the premature rat brain, the rh-EPO induced CD34+ cells to immigrate to the HI brain zone (P < 0.05) and also upregulated the VEGFR2 protein expression (P < 0.05) and VEGF mRNA level (P < 0.05) through the PI3K/Akt (P < 0.05) signaling pathway when compared with other groups.</p><p><b>CONCLUSIONS</b>The rh-EPO treatment augments neovascularization responses in the neonatal rat model of premature brain damage through the PI3K/Akt signaling pathway. Besides, the endogenous EPO may exist in the HI zone of rat brain and also has neovascularization function through the PI3K/Akt signaling pathway.</p>

Impacts of Erythropoietin on Vascular Endothelial Growth Factor Receptor 2 by the Extracellular Signal-regulated Kinase Signaling Pathway in a Neonatal Rat Model of Periventricular White Matter Damage / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the impacts of erythropoietin on vascular endothelial growth factor receptor 2 (VEGFR2) by the extracellular signal-regulated kinase (ERK) signaling pathway in a neonatal rat model of periventricular white matter damage.</p><p><b>METHODS</b>All of postnatal day 4 rats were randomized into three groups: the sham group [without hypoxia-ischemia (HI)], the HI group (HI with saline administration), and the erythropoietin (EPO) group [HI with recombinant human erythropoietin (rh-EPO) administration]. Rat pups underwent permanent ligation of the right common carotid artery, followed by 6% O2 for 2 hours or sham operation and normoxic exposure. Immediately after the HI, rats received a single intraventricular injection of rh-EPO (0.6 IU/g body mass) or saline. ERK and phosphorylation-ERK were examined at 60 minutes and 90 minutes after operation, and VEGFR2 were detected at 2 and 4 days after operation by using Western blot.</p><p><b>RESULTS</b>At 60 minutes and 90 minutes after operation, the proteins of phosphorylation-ERK were significantly higher in HI rats than in the sham rats and significantly higher in HI+EPO rats than in the HI rats (P<0.05). Two days after operation, VEGFR2 was not significantly different between sham and HI rats. However, the proteins of VEGFR2 were increased after administration of rh-EPO (P<0.05). Four days after operation, the proteins of VEGFR2 were significantly higher in HI rats than in the sham rats and significantly higher in HI+EPO rats than in the HI rats (P<0.05).</p><p><b>CONCLUSION</b>EPO may regulate VEGFR2 expression by affecting the intracranial ERK signaling pathways.</p>

"Lessons and illuminations of Tianjin port ""8 · 12"" explosion hazard" / 中华急诊医学杂志

Objective To explore how to improve the capability of emergency rescue to cope with the explosion of hazardous chemicals through analyzing the rescue process of Tianjin port 8 · 12 explosion hazard.Methods The process of explosion emergency rescue on the hazardous chemicals warehouse of Ruihai company in Tianjin Port on the evening of August 12,2015,were analyzed,summarize the experience and lessons.Results There were some shortcomings on field assessment,safety zoning,EMSS,treatment in hospital,personal protection equipment and public knowledge on hazardous chemicals explosion in Tianjin port 8.12 explosion hazard.we should learn from the lessons,to provide reference for the future similar rescue.Conclusions The ability of emergency rescue team to deal with the major hazardous chemicals explosion should further improve,to protect the safety of society and health of common people.

Epidemiological study of road traffic injuries in Beijing: a report of 990 cases / 中华创伤杂志

ObjectiveTo investigate the epidemiological features and risk factors of road traffic injury in Beijing.MethodsData of road traffic injuries of Beijing Changping Hospital in 2010 was collected for statistical analysis of the epidemiological features. ResultsA total of 990 cases of road traffic injuries were treated in Beijing Changping Hospital in 2010,with a male/female ratio of 2.57:1 and at average age of 45 yeats.There were 21 cases aged ＜ 18 years,703 cases aged 18-55 years and 266 cases aged ≥56 years.Self-employed individuals and fanning production staffs were the risky population that were easily subjected to road traffic injuries.Summer and autumn were the accident-prone seasons.The most common injury site was the lower limbs,next with the neck and head.The hospital stay was mainly in a range of 5-10 days (12.8 days on average).ConclusionsMale self-employed individuals and agricultural producers are the high-risk groups of road traffie accidents in the area,where shows a high occurrence of road traffic accidents in the summer and autumn.Thereby,traffic safety education and prevention-control measures based on these characteristics should be carried out to effectively reduce the number and severity of the local traffic injuries.

"Characteristics of adolescent (0-25 years) traffic injuries from Beijing ""120"" Emergency Center" / 中华创伤杂志

Objective To analyze the injury characteristics in 2004-2009 road traffic accidents (RTAS) of 0-25 years old adolescents treated in Beijing 120 Emergency Center so as to provide scientific basis for making effective measures in prevention and control of RTAs. Methods The data of all the adolescents with traffic injuries treated in Beijing 120 Medical Emergency Center were collected for a retrospective analysis on sex,age,traffic injury time,wound regions,injury characteristics and death condition of the injured adolescents. Results( 1 ) There were 17 232 injuries and 259 deaths according to the traffic reports from 2004 to 2009. Among the total injury cases,there were 4 229 cases of 0-25 years old adolescents (24.5％),at (20.13 ± 4.43 ) years of age.The injury number showed a significant rising trend with the increase of age and the injury number of 20 years old group were obvious more than that of other age groups.(2) There were 2 252 males and 1 677 females,with ratio of males to females for 1.5:1 ( P ＜ 0.05 ).( 3 ) Total number of patients was decreased yearly.The high incidence of adolescent RTAs could be seen in September,October and May in one year; Friday,Saturday and Sunday in one week; and between 8:00 am and 11:00 pm in one day.The low incidence of adolescent RTAs could be seen in Tuesday in one week,and 3:00-6:00 am in one day (P ＜0.05).(4) Cases of limb and arthrosis wounds (53.4％) were more than those of head and neck wounds (35％).Most of the cases were pedestrians (49.1％ ).(5) There were 38 deaths,including 28 males and 10 females,at ageof (19.29 ± 5.30) years.The death were mainly resulted from craniocerebral injuries (87％),which mainly concentrated in July ( 13.2％ ) and August ( 15.8％ ). Conclusions The present condition ofadolescent traffic injuries is not good enough.We should strengthen traffic security education,increase executive powers in the traffic rush and promote cooperation and communication in pre-hospital emergency,as may be beneficial for decreasing adolescent RTA.

Ultrastructure study on patients with spontaneous rupture of hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate the ultrastructure of small artery wall in patients with spontaneous rupture of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Transmission electron microscopy was used to study 11 specimens from ruptured HCC and 11 cases with non-ruptured HCC.</p><p><b>RESULTS</b>The phenomenon of activated phagocytosis in macrophage could be found in 3 cases with ruptured HCC and 10 cases with non-ruptured HCC, respectively (P < 0.05). In 9 specimens with ruptured HCC, the evidence of vascular injury characterized as less cell junctions and larger fenestrae in endothelial cells, broken elastic lamina, proliferated and fragmented elastin and damaged structure of collagen was found in small arteries. The phenomenon of electron-dense deposit in the elastic lamina, and signs of more protein synthesis in endothelial cells were also present in these specimens. In the patients with non-ruptured HCC, the evidence of vascular injury can be found only in 2 cases (P < 0.01). Less cell junctions and larger fenestrae could increase the permeability of vascular wall. The electron-dense deposition in elastic lamina may represent the deposition of antigen-antibody complex in elastic membrane which had been found in our previous study. The vascular injury was postulated to be caused by the deposition of antigen-antibody complex in vascular wall which was identified by our previous study. The vascular wall in the patient with ruptured HCC could become stiff and weak due to the proliferated fragment elastin and damaged collagen which would make the blood vessels more prone to splitting and result in hemorrhage and the rupture of HCC.</p><p><b>CONCLUSIONS</b>The vascular injury caused by antigen-antibody complex deposition might related to the spontaneous rupture of HCC.</p>

Mechanism of spontaneous rupture of hepatocellular carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To study the mechanism of spontaneous rupture of hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>The specimens of 30 patients with ruptured HCC and 30 patients with non-ruptured HCC were collected. Immunofluorescence, immunohistochemical and flow cytometry techniques were used to detect the phagocytosis of macrophages and the deposition of immune complex (IC) on vascular wall.</p><p><b>RESULTS</b>In this study, the poor function of macrophage phagocytosis was found in patients with ruptured HCC, which could results in the cumulating of IC and deposition on vascular wall. The IC, which composed of hepatitis B virus e1 antigen (HBeAg/1), complement C1q and immunoglobulins, was found deposited in the elastic membrane of arteries. Likely as a result of IC deposition, vascular injury occurs mainly in the small arteries where the deposition of IC was present. As the small arteries were the blood vessels with predominant injury, they would likely to be the ones to split and cause hemorrhage and rupture of HCC during vascular load increase.</p><p><b>CONCLUSIONS</b>We would conclude that the poor function of macrophage phagocytosis, which lead to the IC deposition and vascular injury may be the factors involved in the pathogenesis of ruptured HCC.</p>

The role of IL-15 in the process of acute rejection in liver and heart transplantation in rats / 中华外科杂志

<p><b>OBJECTIVE</b>To study the real effect of IL-15, a kind of T lymphocyte activators which were derived from lymphocytes, on the acute rejection process in heart and liver transplantation in rats.</p><p><b>METHODS</b>Male (body weight 200 - 250 g) 1A (RT1(a)) and LEW (RT1(l)) rats were selected as donors and recipients, respectively. Heterotopic heart transplantation (in abdomen) and orthotopic liver transplantation were performed as the acute rejection model group (experimental group); LEW (RT1(l))-->LEW (RT1(l)) as donors and recipients to establish isografts transplantation as the control group. Animals were sacrificed on day 1, 3, 5, 7 and graft specimens were collected. Microarray, immunohistochemistry and Western-blotting methods were used to detect the expressions of IL-15, IL-2 and IFN-gamma, etc. 48 rats were divided evenly into two groups and each time-point consisted of 6 rats.</p><p><b>RESULTS</b>Acute rejections which were clarified by pathological findings and animal manifestations were found 3 days after operation in the experimental group. The early expression of IL-15 was found on endothelial cells in allografts 1 day after operation in contrast to IL-2, which expressed lately and only be found on inflammatory cells including lymphocytes and Kupffer cells 3 days after graft implantation. The result of INF-gamma was the same as that of IL-2.</p><p><b>CONCLUSIONS</b>IL-15 appeared earlier in heart and liver allografts than IL-2 and IFN-gamma in rat acute rejection model, and the expression site differed from the later two. IL-15 participated in acute rejection reaction earlier in this process and the pathway may be different from IL-2 and IFN-gamma. Early blocking this pathway combined with other blockade would have a promising result in control of the progression of acute rejection.</p>