Robot-assisted transperitoneal and retroperitoneal adrenalectomy for huge adrenal tumors in 45 cases / 现代泌尿外科杂志

【Objective】 To compare the outcomes of robot-assisted laparoscopic transperitoneal and retroperitoneal operation for huge (>6 cm) adrenal tumors. 【Methods】 The clinical data of 45 patients with huge adrenal tumors who underwent robotic surgery during Jan.2017 and Dec.2021 were retrospectively analyzed, including 28 cases via the transperitoneal approach and 17 cases via the retroperitoneal approach. 【Results】 No patients were converted to open operations. There were no significant differences in postoperative drainage time (2.24±0.44 vs. 2.36±0.49) d, operation time (130.88±5.96 vs. 136.61±8.39) min, blood loss (189.41±13.91 vs. 192.5±12.36) mL and postoperative hospital stay (7.06±0.56 vs. 7.46±0.69) d between the retroperitoneal and transperitoneal approaches. Retroperitoneal approach was better than transperitoneal approach in early postoperative feeding [(38.82±6.75 vs. 74.14±6.57) h, P<0.01] . 【Conclusion】 Robotic surgery is safe and effective in the treatment of large adrenal tumors. The choice of surgical approach should be based on patients’ condition, tumor volume and location.

Effect of laparoscopic hysterectomy on vaginal microflora and the effect of lactobacillus intervention / 国际检验医学杂志

Objective To analyze the effect of laparoscopic hysterectomy on vaginal microflora and the effect of lactobacillus intervention.Methods 80 female patients undergoing laparoscopic hysterectomy in Wu-han University of Science and Technology Hospital from May 2014 to December 2016 were enrolled in the study.The patients were randomly divided into the observation group and the control group,40 cases in each group.The observation group received 3 courses of intervention with Live Lactobacillus Capule for Vsginal Use in 3 months after operation while the control group were not given any treatment.The rate of vaginal mi-croecological imbalance,the detection rate of lactobacillus,pH and female sexual function index(FSFI)were compared between the two groups.Results 2 month and 3 month after operation,there were significant differ-ences in the density of vaginal microflora,the diversity of vaginal microflora,the vaginal pH and the number of vaginal lactobacilli,compared with those before operation(P<0.05).3 month after operation,the above inde-xes were significantly better than those at 2 month after operation(P<0.05).After treatment,the rate of va-ginal microecological imbalance and vaginal pH value were lower in the observation group than the control group[37.50% vs.70.00%,(4.81 ± 0.26)vs.(5.16 ± 1.02)],while the detection rate of vaginal lactobacil-lus and FSFI score were higher than the control group[97.50% vs.57.50%,(81.14 ± 1.75)vs.(75.34 ± 1.18)](P<0.05).Conclusion Laparoscopic hysterectomy may affect vaginal microflora in the female,espe-cially 2 month after operation,the microecological environment is relatively poor.The application of Live Lac-tobacillus Capule for Vsginal Use can improve the vaginal microecological environment and the quality of sex-ual life,which is worth of clinical promotion.

Effects of Entecavir Combined with Silymarin on Inflammatory Markers and Oxidative Stress Level in Patients with Hepatitis B Virus-related Decompensated Liver Cirrhosis / 中国药房

OBJECTIVE:To prospectively study the effects of entecavir combined with Silymarin on the inflammatory markers and oxidative stress level in patients with hepatitis B virus-related decompensated liver cirrhosis (HBV-DLC).METHODS:A total of 85 HBV-DLC patients in Hospital of Wuhan Technology University during Jan.2015-Aug.2016 were divided into control group (42 cases) and observation group (43 cases) according to the single and double number random.Control group was given entecavir 0.5 mg,qd.Observation group was additionally given Silymarin capsules 140 mg,tid,on the basis of control group.Both groups were treated for 48 weeks.After treatment,HBV DNA and HBeAg negative conversion rate were observed.The levels of liver function indexes (TBil,AST,ALT),the Child-pugh score and levels of inflammatory indexes (IL-18,IL-8,TNF-α),the levels of oxidative stress indexes (MDA,SOD,NO) were compared between 2 groups before and after treatment.The occurrence of ADR was recorded.RESULTS:Before treatment,there was no statistical significance in liver function indexes,inflammatory factors or oxidative stress indexes of 2 groups (P＞0.05).After treatment for 48 weeks,serum HBV DNA and HBeAg negative conversion rate of observation group were higher than those of control group,but without statistical significance (P＞0.05).Compared with before treatment,liver function indexes levels,Child-pugh score,inflammatory indexes,MDA and NO levels of 2 groups were decreased significantly after treatment for 48 weeks (P＜0.05),while SOD level was decreased significantly (P＜0.05);the degree of improvement of above indexes in observation group was higher than control group (P＜0.05).There was no statistical significance in the incidence of ADR between control group and observation group (P＞0.05),and both were improved after drug withdrawal.CONCLUSIONS:Entecavir combined with Silymarin can inhibit inflammatory reaction and relieve oxidative stress reaction to improve the liver function of HBV-DLC patients;drug combination better than entecavir alone.

Effect of comprehensive care for chronic filariasis patients with lymphedema / 中国血吸虫病防治杂志

Objective To evaluate the effect of chronic filariasis patients with lymphedema after comprehensive cared. Meth?ods A total of 386 chronic filariasis patients with lymphedema received the comprehensive care including soaking feet by TCM washing feet by single Chinese medicine or clear water preventing and eliminating invasive wound physical training raising the limb and wearing suitable shoes. The attack frequency of inflammation of lymphatic vessels the stage of lymphedema dis?ease and leg circumference were observed before and after the care. Results After the comprehensive care the attack rates of inflammation of lymphatic vessels decreased from 9.65%to 4.67% and there was a significant difference χ 2=7.34 P=0.006 7 . The proportion of the patients with high stage of lymphedema disease decreased significantly all P 0.01 and the average leg circumference decreased of 1.06 cm. The skin appearance improved significantly. Other signs such as pitting edema ulcer and skin folds also improved significantly all P 0.01 . Conclusion The comprehensive care for chronic filariasis patients with lymphedema has a remarkable effect and is worthy of further application.

Effects of inhaled aerosolized low dose ambroxol on inflammatory response to one-lung ventilation in patients undergoing open-chest esophagus surgery / 中华麻醉学杂志

Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation (OLV) in patients undergoing open-chest esophagus surgery.Methods Sixty patients (aged 39-64 years,weighing 50-85 kg and with height of 153-181 cm) with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into three groups:20 patients receiving intravenous infusion of normal saline (control group,group C),20 receiving intravenous infusion of ambroxol 10 mg/kg after induction of anesthesia (group IA) and 20 inhaling aerosolized ambroxol 30 mg after induction of anesthesia (group AIA).Arterial blood samples were taken after induction of anesthesia before ambroxol administration (T0,baseline),after 90 minutes of OLV (T1) and at 30 minutes after OLV (T2) for determination of plasma concentrations of tumor necrosis factor-alpha (TNF-α),interleukin-1 beta (IL-1β),IL-8 and IL-10 by enzyme linked immunosorbent assay (ELISA).Results The levels of TNF-α,IL-1β,and IL-8 in plasma significantly increased while the level of IL-10 in plasma significantly decreased at T1 and T2 as compared with the baseline at T0 in all the three groups.The levels of TNF-α,IL-1β,and IL-8 in plasma were significantly lower and the level of IL-10 in plasma was significantly higher at T1 and T2 in groups IA and AIA than in group C.Conclusion Both intravenous injection of large dose ambroxol and inhaled aerosolized low dose ambroxol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.

Biocompatibility of surface modified PHBHHx with rat embryonic neural stem cells / 生物工程学报

To study the attachment, proliferation and differentiation of neural stem cells (NSCs) on surface modified PHBHHx films and to establish the theory of PHBHHx application in NSCs-based brain tissue engineering. PHBHHx film was fabricated by a solution-casting method, and the morphology of the film was observed under scanning electron microscopy(SEM). The films were treated by NaOH or lipase, then the surface hydrophilic property was characterized using water contact angle measurement. NSCs were isolated from the cerebral cortex of rat embryos on embryonic day 14.5, and cultured on surface treated PHBHHx films. The morphology of NSCs attached on the film was visualized under SEM, and the survival and differentiation of NSCs were observed through immunocytochemical staining. Compared with the untreated PHBHHx films, the water contact angle of NaOH or lipase treated PHBHHx films decreased dramatically, and the number of NSCs attached significantly increased. NSCs survived well on treated PHBHHx films and differentiated into neurons and glial cells. The amelioration of hydrophilic property of PHBHHx film improved its biocompatibility with NSCs. PHBHHx can serve as a novel CNS tissue engineering biomaterial applied for NSCs transplantation, brain repairing and regeneration.

Prospective study of increasing doses of tamsulosin in lower urinary tract symptoms of benign prostatic hyperplasia / 中华泌尿外科杂志

ObjectiveTo evaluate the effect of increasing doses of tamsulosin in lower urinary tract symptom (LUTS) of benign prostatic hyperplasia (BPH).MethodsA prospective self-controlled clinical trail was performed.Two hundred and sixty-one patients who had LUTS of BPH were enrolled in this prospective 4 weeks study of tamsulosin.The patients were randomly divided into 2 groups:took tamsulosin 0.2 mg QN (n =126,group A) and 0.4 mg QN (n =135,group B) respectively.The IPSS score and maximum flow rate before and after treatment were compared between the 2 groups.ResultsThe IPSS score of group A decreased from 17.72 ± 2.50 to 10.21± 1.95,average decreased 7.59 ± 2.74 ； maximum flow rate was elevated from (8.78 ± 3.70) ml/s to ( 12.74 ± 2.99 ) ml/s,average increased (4.31 ± 3.01 )ml/s.The IPSS score of group B decreased from 19.24 ± 3.22 to 11.21 ± 3.02,average decreased 8.49 ±3.73； maximum flow rate was elevated from (7.74 ± 1.97) ml/s to ( 12.04 ± 2.46) ml/s,average increased (4.73 ± 2.97) ml/s.There was no significant difference of the changes of IPSS score between the 2 groups ( P ＞ 0.05 ),but there was a significant difference of the changes of maximum flow rate between the 2 groups ( P ＜ 0.05 ).The results was further analyzed by sub grouped ( by patient body weight,divided into ≤55.0 kg,55.1 -65.0 kg,65.1 -75.0 kg,＞75.0 kg group).There were significant differences of the changes of IPSS score and maximum flow rate between the 2 groups in 65.1 - 75.0 kg and ＞ 75.0 kg subgroups ( P ＜ 0.05 ).The incidence of side effects between the 2 groups was not significantly different (P ＞ 0.05).ConclusionsFor most patients,the use of high-dose tamsulosin in improving LUTS caused by BPH can not bring significant benefits.But if the patient's weight is more than 65.0 kg,increasing the dose of tamsulosin is suggested for consideration.

Effects of inhaled aerosolized low dose ambroxol on inflammatory response to one-lung ventilation in patients undergoing open-chest esophagus surgery / 中华麻醉学杂志

Objective To investigate the effects of inhaled aerosolized low dose ambroxol on the inflammatory response to one-lung ventilation ( OLV) in patients undergoing open-chest esophagus surgery. Methods Sixty patients with normal heart and lung function undergoing open-chest esophagus surgery were randomly divided into 3 groups ( n = 20 each): control group (group C) ; group IA received Ⅳ ambroxol 10 mg/kg after induction of anesthesia and group AIA inhaled aerosolized ambroxol 30 mg after induction of anesthesia. Arterial blood samples were taken after induction of anesthesia before ambroxol administration (T0, baseline) , at 90 min of OLV (T1 )and at 30 min after OLV (T2) for determination of plasma concentrations of TNF-α, IL-1β, IL-8 and IL-10 by ELBA.Results Plasma TNF-α, IL-1β, and IL-8 concentrations were significantly increased while plasma IL-10 concentration was significantly decreased at T1 and T2 as compared with the baseline at T0 in all 3 groups. Plasma TNF-α, IL-1β, and IL-8 concentrations were significantly lower and plasma IL-10 concentration was significantly higher at T1 and T2 in groups IA and AIA than in group C. Conclusion Both Ⅳ large dose ambroxol and inhaled aerosolized low dose ambroxol can inhibit the inflammatory response to OLV in patients undergoing open-chest esophagus surgery.

Surgical treatment of two different pathological type primary aldosteronisms / 中华泌尿外科杂志

Objective To evaluate the clinical characteristics, surgical treatment effect and prognostic factors of post-operative hypertension in the 2 subtypes of primary aldosteronism (PHA),aldosterone adenoma (APA) and unilateral adrenal hyperplasia (UNAH). Methods In the collection of surgical treatment of PHA from 2002-2009, 135 cases, 68 males and 67 females, with age of 26-79 years (mean, 51 years) were analyzed. Of them, there were 83 APA patients, 52 UNAH cases. All the cases with PHA were with hypertension symptoms and met the preoperative diagnosis criteria. All the patients were performed preoperatively blood biochemical and hormonal tests and CT scans. The diagnosis was confirmed by pathology. All cases undergone adrenal reserved surgery (ASS) and followed-up. According to the postoperative recovery of blood pressure was normal or still in hypertension, Logistic regression analysis and comparison between the 2 groups were carried out,the clinical data of various factors in predicting the role of postoperative blood pressure were considered. Results One hundred and thirty-five patients were operated successfully. The mean follow up was 2. 5± 1.6 years (1-7 years). There were significant decreases in both systolic blood pressure and diastolic blood pressure at final follow up compared with those before surgery. Antihypertensive requirement was decreased at final follow-up. Serum aldosterone levels, plasma renin activity and potassium levels were improved significantly. Overall, blood pressure returned to normal in 51 cases(37.8%). Other 84 cases (62.2%) continued with high blood pressure, of whom 58 cases reduced antihypertensive drug use. Patient's age over 49.5 years, hypertension duration over 6. 5 years, family history of hypertension were higher risks of postoperative continuous high blood pressure. Conclusions APA and UNAH are 2 types of PHA with similar performance of patients, surgical treatment effect. ASS can be used in the treatment of these 2 types of disease. Age, hypertension duration, family history of hypertension are independent factors predicting sustained hypertension after surgery.

Association of genetic polymorphism in the DNA repair gene XPD with risk of lung cancer in nonsmoking females / 中国肺癌杂志

<p><b>BACKGROUND</b>Xeroderma pigmentosum group D (XPD) is one of the important DNA repair genes. XPD polymorphism at Lys751Gln site has been shown to alter XPD protein function, modulate DNA repair capacity and therefore affect cancer risk. The aim of this study is to explore the relationship between XPD polymorphism and susceptibility to lung cancer in nonsmoking female via a population-based case-control study.</p><p><b>METHODS</b>There were 105 female patients who were diagnosed with lung cancer between January 2004 and December 2005 from Liaoning Tumor Hospital and 202 Hospital, and the control group included 105 healthy volunteers who were obtained from community centers at the same time. Information concerning demographic and risk factors was obtained for each case and control by a trained interviewer. XPD genotypes of cases and controls were determined by PCR-RFLP method. Two-sided Chi-Square test was used to compare the distribution of the genotypes and risk factors between cases and controls. Unconditional logistic regression analysis was performed to calculate the odds ratios (OR) with 95% confidence intervals (CI) for estimating the association between certain genotypes and lung cancer and exploring the interaction of environmental risk factors and genetic polymorphism.</p><p><b>RESULTS</b>All of the subjects in this study were nonsmoking females in Shenyang. There was no significant demographic difference (age, economic level and education) between cases and controls. There was a significant difference in the frequencies of XPD polymorphism between cancer cases and controls. The frequencies of XPD 751Gln allele were 6.2% in controls and 13.8% in cases (P < 0.05). The risk of lung cancer was higher in those with the Lys/Gln or Gln/Gln genotype than in those with the Lys/Lys genotype and adjusted OR was 2.80 (95% CI: 1.21-6.48). The result showed that cooking fumes exposure was a risk factor for lung cancer (OR was 2.44). Furthermore, an interaction between environmental risk factors and the variant XPD 751Gln allele on the risk of lung cancer was observed. Individuals with both risk gen-otype and exposure to cooking fumes had a higher elevated risk of cancer than those with only one of them (adjusted OR= 6.85 ; 95% CI: 1.69-27.67; P=0.007).</p><p><b>CONCLUSIONS</b>The above findings indicate that the Lys751Gln polymorphism in XPD gene is associated with the risk of lung cancer in nonsmoking females. Individuals with both XPD 751Gln allele genotype and exposure to cooking fumes have a higher elevated risk of cancer than those with only one of them in nonsmoking female population.</p>

Association of genetic polymorphism in DNA repair gene XRCC1 with risk of lung adenocarcinoma in nonsmoking women / 中国肺癌杂志

<p><b>BACKGROUND</b>XRCC1 polymorphism at Arg399Gln site has been shown to modulate DNA repair capacity. The aim of this study is to assess the relationship between XRCC1 polymorphism and susceptibility to lung adenocarcinoma in nonsmoking female via a hospital-based case-control study.</p><p><b>METHODS</b>Cases were 126 female patients with lung adenocarcinoma from January 2002 to October 2004 in China Medical University Hospital and Liaoning Tumor Hospital. Controls were selected from patients with other pulmonary diseases in the hospitals at the same time. These controls were matched to cases on age (±5 years). Information concerning demographic and risk factors was obtained for each case and control by a trained interviewer. XRCC1 genotypes were determined by PCR-RFLP. The adjusted odds ratio (OR) and 95% confidence interval (CI) were calculated using logistic regression.</p><p><b>RESULTS</b>Cases showed a higher prevalence of oil smoke compared with controls (P < 0.05). The frequencies of Arg/Arg, Arg/Gln and Gln/Gln in lung adenocarcinoma group (32.54%, 42.86%, 24.60%) were significantly different from those in controls (54.76%, 40.48%, 4.76%) (P < 0.05). The individual carrying Gln/Gln genotype was at a significantly increased risk of lung adenocarcinoma compared with those with Arg/Arg genotype (OR=8.695, 95%CI 3.343-22.614, adjusted for age and oil smoke exposure). Furthermore, the OR of lung adenocarcinoma for the variant XRCC1 399Gln allele combined with exposure to oil smoke was 5.21 (95%CI 1.85-14.70, P < 0.001).</p><p><b>CONCLUSIONS</b>The results indicate that the Arg399Gln polymorphism in XRCC1 is associated with the risk of lung adenocarcinoma in nonsmoking women.</p>

Effects of prone position on functional residual capacity,pulmonary gas exchange and hemodynamics in patients with acute lung injury / 中华麻醉学杂志

Objective To investigate the effects of prone position on functional residual capacity (FRC) , pulmonary gas exchange and hemodynamics in mechanically ventilated patients with acute lung injury (ALI) .Methods Eight patients (6 male, 2 female) aged 29-61 yr who developed ALI with PaO2/FiO2

Effects of obesity on pulmonary function in patients during and after cholecystectomy / 中华麻醉学杂志

Objective To investigate the effects of obesity on functional residual capacity ( FRC ) , ventilatory function and gas exchange during and after cholecystectomy. Methods Twenty ASA Ⅰ or Ⅱ patients of both sex aged 26-58yr undergoing elective cholecystectomy were divided into 2 groups according to the body mass index (BMI): control group BMI 30 (n = 10) . The patients were premedicated with intramuscular luminal 1.0 g and atropine 0.5 mg. Anesthesia was induced with midazolam 2-3 mg, fentanyl 5?g?*kg-1, propofol 1.5-2.0 mg?kg and vecuronium 0.1 mg?kg-1 and maintained with infusion of propofol (at 8-10 mg?kg-1?h-1) and fentanyl (at 1-2 ?g?kg-1?h-1) and intermittent i.v. boluses of vecuronium after tracheal intubation. The patients were mechanically ventilated (VT 10ml?kg-1,I:E=1:2, FiO2 100%) and PETCO2 was maintained at 35-40 mm Hg by adjusting the respiratory rate. Pethidine 1 mg?kg-1 was given i.m. every 8 h after operation for analgesia. BP, HR, ECG, SpO2, PET CO2 , FiO2, VT , RR were monitored during anesthesia. Arterial blood samples were taken before anesthesia (T0, baseline), 15 min after induction of anesthesia (T1), 30 min after skin incision (T2) and 6, 24 h after operation (T3,4) for blood gas analysis. FRC (closed-circuit helium dilution method), forced vital capacity (FVC), forced expiratory volume at 1 second (FEV10) and maximal mid-expiratory flow volume (MMF) were measured before and 6 h and 24 h after operation.Results FRC was significantly decreased after induction of anesthesia, during and after operation compared with the baseline value (T0) in both groups and the decrease in FRC was significantly larger in obesity group than in control group (P