Investigation about atorvastatin resist to tobacco smoking inducing endothelial inflammation / 重庆医学

Objective To explore the role of atorvastatin resist to tobacco smoking inducing endothelial inflammation .Meth‐ods HUVECs were divided into normal control group ,cigarette smoking extract(CSE) group and atorvastatin(AS)+CSE group . The cellular morphology of HUVECs in three group were observed ,then the expressions of VCAM‐1 and E selectin in HUVECs in three group were detected by western blot assay .Results In CES group ,drastic morphological change of HUVECs were observed . In AS+CSE group ,minor morphological change of HUVECs were observed .Also ,the protein levels of VCAM‐1 and E selectin were much higher in CSE group than that of in other two groups(P<0 .05) ,and the protein levels of VCAM‐1 and E‐selectin in AS+CSE group were a little higher than that of in control group ,but much lower than that of in CSE group(P<0 .05) .Conclusion Our results showed that atorvastatin might partly resist to tobacco smoking inducing endothelial inflammation .

Treatment of upper urinary calculi with MPCNL : experience of 10,452 cases of 19 years in a single-center / 中华泌尿外科杂志

Objective　To analyze the clinical indications,efficacy and safety of Chinese minimally invasive percutaneous nephrolithotomy (MPCNL) in treating upper urinary calculi based on our experience.Methods　From June 1992 to September 2010,a total of 10,452 patients (6060 males and 4392 females)with a mean age of (47.6 ± 13.7) years (7 months-93 years) received MPCNL in our center.The mean stone burden was (777.4 ± 740.3) mm2 (20 - 4 080 mm2 ).The data of stone burden,operative techniques,operating time,stone-free rate,major complication,hospital stay and stone composition were investigated.　Results　Of the 10 452 cases,11 801 procedures were performed on 10 876 (5493 left and 5383right) renal units,including 10 102 first stage procedures,1604 secondary procedures,86 third procedures and 9 fourth procedures.There were 11 830 tracts established,including 373 (3.15％ ) tracts of 14 F,7867 (66.50％) tracts of 16 F and 3590 (30.35％) tracts of 18 F.There were 1207 (10.20％),9174(77.55％) and 1449 (12.25％) punctures located in upper,middle and lower pole,respectively.956(8.79％) renal units were managed with multiple tracts,which including 2 tracts in 846 (7.78％) units,3tracts in 85 (0.78％) units,4 tracts in 18 (0.17％) units and 5 tracts in 7 (0.06％) units.Pneumatic lithotripsy was used in 8563 (72.56％) procedures,Holmium:YAG laser lithotripsy was used in 2981(25.26％)　procedures and Pneumatic lithotripsy + Holmium: YAG laser lithotripsy was used in 257(2.18％) procedures.762 (7.29％) cases needed ESWL to clean the stone after MPCNL.The average operating time was ( 101.3 ± 44.2) min ( 10 -240 min).The stone-free rate of MPCNL was 89.9％,which increased to 93％ by adjunctive ESWL.And the mean hospital stay was ( 13.2 ± 6.4) days (2 - 72 days).The major complications happened on 321 (3.07％) cases,including 294 (2.81％ ) cases of blood transfusion,12 (0.11％ ) cases of sepsis,2 (0.02％) cases of renal abscess,9 (0.09％) cases of pleura injury,2 (0.02％) cases of colon injury and 2 (0.02％) cases of death.53 (0.51％) cases needed selective renal arterial embolization to achieve hemostasis.The main stone compositions were analyzed in 4345 cases.Calcium oxalate,calcium phosphate,magnesium ammonium phosphate,uric acid,ammonium urate,carbapatite and cystin were 91.74％,90.33％,14.91％,17.77％,4.83％,8.47％ and 0.51％,respectively. Conclusions　MPCNL is an effective and safe treatment option for all kinds of upper urinary calculi in patients at all ages with a high stone free rate and low major complication rate.

The study of laparoscopic-guided radiofrequency ablation of prostate cancer / 中国医师进修杂志

Objective To evaluate the feasibility and efficiency of laparoscopic-guided radiofrequency ablation on advanced prostate cancer.Methods From March 2003 to December 2008,a total of 6 previous prostate cancer patients who had been diagnosed with pathological results were treated by laparoscopic-guided radiofrequency ablation.All patients underwent pre-and post-operative IPSS,serum PSA,MRI and normal blood biochemistry examination.The treatment outcome,surgery-related complications were also recorded.Results All operations were successfully completed,no serious intra-and post-operative complications happened.Although there was no significant difference of IPSS between pre-operative [ ( 19.05 + 4.28 ) scores ] and 1 month after operation [ ( 19.87 + 5.72) scores ],but there were significantly decreased in 3 months [ (9.45 ± 2.03 ) scores ] and 6 months [ (6.18 + 1.79) scores ] after operation (P ＜0.05).Also being followed up to 6 months after operation,the serum PSA was significantly decreased compared with the pre-operative value [from(24.80 ± 14.56) μ g/L reduced to( 13.79 ± 7.76) μ g/L](P＜0.05).Conclusion Laparoscopic-guided radiofrequency ablation on advanced prostate cancer is safe and feasible,and can be used as an effective treatment in selective cases.

Anatomic study of lumbar sympathetic nerve for endoscopic lumbar sympathectomy / 解放军医学杂志

Objective To study systematically regional anatomy of lumbar sympathetic trunk to provide anatomic information for endoscopic lumbar sympathectomy (VALLS). Method The anatomy of the lumbar sympathetic trunk and its relationship with neighboring structures were studied in 128 sides of adult cadavers, and it was substantiate in 13 cases of endoscopic lumbar sympathectomy. Results (1) The location, shape and number of the sympathetic ganglia were quite variable. The number varied from 1 to 6 on one side. (2) It was found that the lumbar sympathetic trunk split into 2-3 branches at the distal portion. (3) Lumbar arteries were all located under the lumbar sympathetic trunk and the lumbar veins situated superior to the trunk in 68.42%±4.35% of instance. (4) Genitofemoral nerve was found to pierce the psoas muscle at the level of 2nd to 4th vertebra or its intervertebral discs. It was only 0.81±0.48 cm away from the medial rim of the psoas muscle. (5) Distance between ureter- iliac vessel junction and the lateral edge of the psoas muscle was 3.36±0.59 cm on the left side, and 3.41±0.59 cm on the right side. (6) A report of the experience of our 13 VALLS was presented. Conclusions Because of great variation and complicated anatomic relation between lumbar sympathetic trunk with its neighboring structures, familiarity to the anatomy of the retroperitoneal space is cracial for a successful minimal invasive laparoscopic lumbar sympathectomy.

Anatomic study for retroperitoneoscopic lumbar sympathectomy / 第三军医大学学报

Objective To research regional anatomy of lumbar sympathetic trunk and provide anatomic information for video-assisted laparoscopic lumbar sympathectomy(VALLS).Methods Lumbar sympathetic trunk and its neighboring anatomic relation in 128 sides of adult cadavers and 21 clinic VALLS were retrospectively reviewed.Results ① The location,shape and number of the sympathetic ganglia were quite variable.There was 1 to 6 in number unilaterally.② Lumbar sympathetic trunks of 12 sides in 128 sides were found dividing into 2-3 branches at the distal part.③ Lumbar arteries were all located under the lumbar sympathetic trunk and the lumbar veins consisting 68.42% situated superficially to the trunk.④ Genitofemoral nerve pierced the psoas muscle at the level of 2nd to 4th vertebrate or its intervertebral disc.It was only(0.81?0.48)cm away from the medial rim of the psoas muscle.⑤ Distance between ureter-iliac vessel junction and the lateral rim of the psoas muscle was(3.36?0.59)cm at left side and(3.41?0.59)cm at right side.The operation time was 2-3.5 hours and the intraoperative blood loss was 50-80 ml.There were no severe complications and the effects were satisfying.Conclusion Because of great variants and complex neighboring anatomic relation of lumbar sympathic nerve,the critical factor of successful microinvasive VALLS is to grasp the laparoscopic operation skill and anatomy of retroperitoneal space(especially the regional anatomy of lumbar sympathetic trunk)and carefully operating.

A comparative study on different lumbar gangliosympathectomies / 解放军医学杂志

Objective To compare the video-assisted laparoscopic lumbar gangliosympathectomy with open lumbar gangliosympathectomy on their advantages and disadvantages. Method From June 2002 to May 2006, a total of 21 adults with Buerger's disease underwent the video-assisted laparoscopic lumbar gangliosympathectomy. The operation time, intraoperative blood loss, hospitalization time, postoperative effects and postoperative complications were analyzed. The data of the 21 cases were compared with those from other 27 cases with Buerger's disease who had undergone open lumbar gangliosympathectomy in the same period. Results The operation time was longer in the laparoscopic group (174?14.84min) than that in the open group (132?32.81min, P