Expression of serum connective tissue growth factor, glyoxalase Ⅰ, pyruvate kinase M2 in endometrial carcinoma and its relationship with clinicopathological features / 中国医师进修杂志

Objective:To explore the expression of serum connective tissue growth factor (CTGF), glyoxalase Ⅰ (GLO-I) and pyruvate kinase M2 (PKM2) in endometrial cancer and their relationship with clinicopathological characteristics.Methods:A total of 96 endometrial cancer patients in Yuechi County People's Hospital from February 2015 to February 2017 were selected as the research group, 48 patients with endometrial hyperplasia during the same period were selected as the benign control group, and 48 patients with healthy physical examination during the same period were selected as the healthy control group. The serum levels of CTGF, GLO-Ⅰ, and PKM2 in the three groups were analyzed. The correlation between serum levels of CTGF, GLO-Ⅰ and PKM2 in the research group was analyzed, and the relationship between each serum index and clinicopathological characteristics was analyzed.Results:The levels of serum CTGF, GLO-Ⅰ and PKM2 in the research group were higher than those in the benign control group and healthy control group: (184.31 ± 37.14) μg/L vs. (110.45 ± 20.59), (17.28 ± 0.42) μg/L; (95.17 ± 16.56) pmol/L vs. (56.29 ± 10.14), (9.08 ± 0.66) pmol/L; (20.25 ± 6.13) μg/L vs. (13.11 ± 4.58), (9.05 ± 2.74) μg/L; and the levels of serum CTGF, GLO-Ⅰ and PKM2 in the benign control group were higher than those in the healthy control group, there were statistical differences ( P<0.05). The results of Pearson correlation analysis showed that the level of CTGF had positive correlation with GLO-Ⅰ and PKM2 ( r = 0.713, 0.741, P<0.05), and the level of GLO-Ⅰ had positive correlation with PKM2 ( r = 0.823, P<0.05). The results of Spearman correlation analysis showed that the levels of CTGF, GLO-Ⅰ, PKM2 had positive correlation with FIGO stage ( r = 0.609, 0.704, 0.721; P<0.05), myometrial invasion depth ( r = 0.753, 0.695, 0.719; P<0.05), lymph node metastasis ( r = 0.776, 0.744, 0.640; P<0.05); had negative correlation with the degree of differentiation ( r = - 0.711, - 0.720, - 0.668; P<0.05). Conclusions:Serum CTGF, GLO-I, PKM2 expression levels are abnormally elevated in patients with endometrial cancer, which are significantly related to multiple clinicopathological characteristics.

Nimbolide targeting SIRT1 mitigates intervertebral disc degeneration by reprogramming cholesterol metabolism and inhibiting inflammatory signaling

Inflammation, abnormal cholesterol metabolism, and macrophage infiltration are involved in the destruction of the extracellular matrix of the nucleus pulposus (NP), culminating in intervertebral disc degeneration (IDD). Whether nimbolide (Nim), a natural extract, can alleviate IDD is unclear. In this study, we demonstrated that Nim promotes cholesterol efflux and inhibits the activation of the nuclear factor kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) signaling pathways by activating sirtuin 1 (SIRT1) in nucleus pulposus cells (NPCs) during inflammation. Thus, Nim balanced matrix anabolism and catabolism of NPCs. However, the inhibition of SIRT1 significantly attenuated the effects of Nim. We also found that Nim promoted the expression of SIRT1 in RAW 264.7, which enhanced the proportion of M2 macrophages by facilitating cholesterol homeostasis reprogramming and impeded M1-like macrophages polarization by blocking the activation of inflammatory signaling. Based on these results, Nim can improve the microenvironment and facilitate matrix metabolism equilibrium in NPCs. Furthermore, in vivo treatment with Nim delayed IDD progression by boosting SIRT1 expression, modulating macrophage polarization and preserving the extracellular matrix. In conclusion, Nim may represent a novel therapeutic strategy for treating IDD.

Fontan-associated liver disease current status and transplantation consideration / 中华肝脏病杂志

Fontan-associated liver disease (FALD) is one of the main complications after the Fontan procedure, manifesting mostly as liver fibrosis and even cirrhosis, with a high incidence rate and a lack of typical clinical symptoms that seriously affect patient prognosis. The specific cause is unknown, although it is considered to be associated with long-term elevated central venous pressure, impaired hepatic artery blood flow, and other relevant factors. The absence of association between laboratory tests, imaging data, and the severity of liver fibrosis makes clinical diagnosis and monitoring difficult. A liver biopsy is the gold standard for diagnosing and staging liver fibrosis. The most important risk factor for FALD is time following the Fontan procedure; therefore, it is recommended to do a liver biopsy 10 years after the Fontan procedure and to be cautious for the presence of hepatocellular carcinoma. Combined heart-liver transplantation is a recommended choice with favorable outcomes for patients with Fontan circulatory failure and severe hepatic fibrosis.

Current situation of treatment and research progress of fetal congenital heart disease / 中华胸心血管外科杂志

Congenital heart disease is one of the most common birth defects, and its structural changes often require surgical or non-surgical intervention after delivery. Some scholars believe that because early primary intrauterine heart abnormalities may hinder the normal development of the heart and cause irreversible secondary structural changes, the current treatment of congenital heart disease focuses on prenatal diagnosis and fetal intervention. Since the first successful fetal surgery in 1984, and with the development and progress of diagnostic techniques such as fetal cardiac ultrasound, the treatment of congenital heart disease has gradually become the focus of research. This article will focus on the intrauterine cardiac intervention of a specific type of congenital heart disease, fetal cardiac surgery guided by fetal scope, the impact of cardiopulmonary bypass on the fetus or the mother, intrauterine cardiac surgery and targeted therapy of fetal congenital heart disease are summarized in this article.

Analysis and evaluation of risk factors associated with poor prognoses of children with tetralogy of Fallot during perioperative period / 中国胸心血管外科临床杂志

@#Objective    To quest the risk factors of poor prognoses in children with tetralogy of Fallot (TOF) during perioperative period and evaluate its clinical application values. Methods    A retrospective analysis of the clinical data of 119 children who underwent one-stage correction of TOF in Guangdong Provincial People's Hospital from September 2016 to January 2019. The cohort includes 75 males and 44 females, with ages ranging from 3.2-137.1 (13.2±1.4) months and weights ranging from 4.6-21.0 (8.3±0.2) kg. Perioperative poor prognosis was defined as duration of mechanically assisted ventilation >48 h or secondary intubation, vasoactive-inotropic score (VIS) within 48 h >40, postoperative length of stay >14 d, and the occurrence of the major adverse events. Major adverse events were defined as early death, malignant arrhythmia, low cardiac output syndrome, non-fatal cardiac arrest, postoperative reintervention, diaphragm paralysis, and other clinical complications. Univariate and multivariate logistic analyses were used to analyze the correlation between risk factors and poor prognoses. Results    There was 1 perioperative death, and 9 with major adverse events. Variables selected by Least Absolute Shrinkage and Selection Operator (LASSO) included 2 preoperative variables (McGoon index, aortic root diameter index) and 4 intra-operative variables [left-right direction of bicuspid pulmonary valve, total length of right ventricular outflow tract (RVOT) incision index, pulmonary valve with commissurotomy, and minimum temperature in cardiopulmonary bypass (CPB)]. Univariate and multivariate logistic analyses were used to the above factors, respectively. The variables with statistical significance (P≤0.05) were McGoon index, aortic root diameter index, left-right direction of bicuspid pulmonary valve, and minimum temperature in CPB. A nomogram was established based on the above factors, and the results showed that the left-right direction of bicuspid pulmonary valve was more risky than the tricuspid pulmonary valve and the anterior-posterior direction of bicuspid pulmonary valve. The lower the McGoon index, the higher aortic root diameter, and the lower temperature in CPB, the higher risk of poor prognostic events in children with TOF. Conclusion    The left-right direction of the pulmonary bicuspid valve has a higher risk of poor prognosis than the tricuspid pulmonary valve and the anterior-posterior direction of bicuspid pulmonary valve. With the smaller McGoon index and the larger aortic root diameter, the risk of poor prognoses in children with TOF is higher. The temperature in CPB being lower than medium-low temperature obviously relates to the high incidence of poor prognostic events, which can be used as an auxiliary reference standard for decision-making in pediatric TOF surgery in the future.

Modified single-patch technique for children with complete atrioventricular septal defect in a single center / 中国胸心血管外科临床杂志

@#Objective    To sum up the experience of the primary modified single-patch (MSP) technique applied in our hospital for children with complete atrioventricular septal defect (CAVSD). Methods    The clinical data of 141 children who underwent primary MSP technique for CAVSD between June 2009 and December 2017 were retrospectively analyzed, including 62 males and 79 females with a median age of 6 (3, 11) months and a median weight of 5.8 (4.5, 7.0) kg. According to Rastelli classification, there were 116 patients in type A, 14 in type B and 11 in type C. Among them, 15 patients were diagnosed with Down’s syndrome. Cardiopulmonary bypass time, aortic cross clamp time, atrioventricular valve regurgitation and other clinical data were recorded during and after operation. Results    Postoperatively, 17 patients suffered from severe left atrioventricular valve regurgitation (LAVVR) and 6 patients severe right atrioventricular valve regurgitation (RAVVR). In the follow-up period, 5 patients suffered from severe LAVVR and 1 patient severe RAVVR. Left ventricular outflow tract obstruction (LVOTO) appeared in 1 patient during follow-up period and none at the end of follow-up. There were 5 early deaths and 2 late deaths. Twelve patients underwent reoperation with a median interval time of 268 (8, 1 270) days. Conclusion    MSP technique is a wise surgical strategy for CAVSD children with good outcomes, improved postoperative mortality and decreased atrioventricular valve regurgitation.

Analysis of dosimetry and clinical efficacy of intracavitary/interstitial brachytherapy in locally advanced cervical cancer / 中华放射肿瘤学杂志

Objective:To study the dosimetric differences and short-term efficacy between intracavitary/interstitial brachytherapy (IC/ISBT) and conventional intracavitary brachytherapy (ICBT).Methods:Forty-five patients with locally advanced cervical cancer were treated with IC/ISBT and ICBT. Points A (A 1, A 2), D 90%, D 100%, organs at risk, and the doses of bladder, colon, rectum and small intestine were calculated and the short-term efficacy was observed between two groups. Results:Point A dose was significantly improved in IC/ISBT compared with ICBT ( P<0.05). The D 90% and D 100% in IC/ISBT were significantly higher than those in ICBT (both P<0.05). After brachytherapy, IC/ISBT could obtain a significantly larger increase in target dose when residual tumor diameter was ≥3 cm compared with ICBT ( P<0.05). The D 2cm 3 and D 0.1cm 3 of bladder, rectum, colon and small intestine did not significantly differ between IC/ISBT and ICBT (all P>0.05). The 1-, 3-and 6-month clinical efficacy did not significantly differ between two technologies (all P>0.05). Conclusion:During brachytherapy for locally advanced cervical cancer (residual tumor diameter ≥3 cm), IC/ISBT significantly increases the doses of target area and point A without increasing the dose of organs at risk or lowering the short-term clinical efficacy, which has significant dosimetric advantages.

Analysis of protective mechanism of silk protein based cryoprotectants / 生物医学工程学杂志

Dimethyl sulfoxide (Me SO) supplemented with fetal bovine serum (FBS) is a widely used cryoprotectant combination. However, high concentration of Me SO is toxic to cells, and FBS presents problems related to diseases such as bovine spongiform encephalopathy and viral infections. Silk protein is a kind of natural macromolecule fiber protein with good biocompatibility and hydrophilicity. The aim of this paper is to analyze the cryoprotective mechanism of silk protein as cryoprotectant. Firstly, differential scanning calorimetry (DSC) was used to measure the thermal hysteresis activity (THA) of silk protein. The THA of 10 mg/mL sericin protein was 0.96°C, and the THA of 10% (V/V) fibroin protein was 1.15°C. Then the ice recrystallization inhibition (IRI) of silk protein-PBS solution was observed with cryomicroscope. The cold stage was set at - 7°C, after 40 minutes' incubation, the mean grain size rate (MGSR) of sericin protein and fibroin protein were 28.99% and 3.18%, respectively, which were calculated relative to phosphate buffer saline (PBS) control. It is indicated that sericin and silk fibroin have certain effects of inhibiting recrystallization of ice crystals. Finally, the structure and physicochemical properties of silk protein were analyzed by Fourier transform infrared spectroscopy (FTIR). The results showed that the content of the random coil was 75.62% and the β-sheet structure was 24.38% in the secondary of sericin protein. The content of the β-sheet structure was 56.68%, followed by random coil structure 22.38%, and α-helix 16.84% in the secondary of fibroin protein. The above analysis demonstrates the feasibility of silk fibroin as a cryoprotectant, and provides a new idea for the selection of cryoprotectants in the future.

Short-term efficacy of iodine-125 radioactive seed implantation therapy for hypoxic tumors / 中华放射肿瘤学杂志

Objective To study the short-term efficacy of computed tomography (CT)-guided iodine-125(125I) radioactive seed implantation in the treatment of hypoxic tumors.Methods Twenty-two patients treated with 125I radioactive seed implantation in our department from 2014 to 2016 were divided into hypovascular tumor group (hypoxic group,n =12) and hypervascular tumor group (non-hypoxic group,n=10) based on the hemodynamics of solid tumor evaluated by color Doppler ultrasound.The enhanced CT images were loaded to the three-dimensional particle implantation planning system for preoperative planning.After 125I radioactive seed implantation,the D90 for target volume was verified to be 106-128 cGy.Treatment outcomes were evaluated according to the World Health Organization criteria at 1-3 months after surgery.Results In all the patients,the overall response rate was 82％ at 3 months after surgery.There were no significant differences in response (complete response + partial response) rates at 1,2,or 3 months after surgery between the hypoxic group and the non-hypoxic group (P=0.840,0.696,0.840).Conclusions In the treatment of solid malignant tumor,125I radioactive seed implantation can overcome the resistance of hypoxic tumor to radiotherapy in vitro and achieve satisfactory short-term efficacy.

3D printing technology-based diagnosis and therapeutic pattern in complex congenital heart disease: single center experience in 40 patients / 中华胸心血管外科杂志

Objective To evaluate the value of three-dimensional(3 D) printing technique in the diagnosis and treatment of complex congenital heart disease(CHD).Methods From March 2016 to February 2018,40 patients with complex CHD underwent heart CT scanning.The CT images were imported to Standard Template Library(STL) files after 3D reconstruction and then exported for 3D printing.The 3D printed models were then used for decision making and navigation during surgery.Results Thirty patients were indicated for surgical operation.Three patients underwent single ventricular repair,and biventricular repair were operated on 27 patients.The 3D printed models were quite in accordance with the actual anatomical findings in all the patients.And all the procedures carried on were exactly same as planned based on 3D printed model.Conclusion The 3D printing may help improve the diagnosis and treatment level in complex CHD.

Research progress of cardioscopy / 中华胸心血管外科杂志

So far,thoracoscopy(video-assisted thoracic surgery) has been maturely used in the field of thoracic and cardiovascular surgery,and already has achieved satisfactory results.In compare,the developing cardioscopy technique to perform intracardiac surgery,due to its own characteristics,was rarely applied as an supplementary clinical means over a long period of time.But more and more studies suggested that cardioscopy technique has it's own advantages in cardiovascular surgery,such as not extend the operation time and aortic clamping time,can provide a clearer operative field,and cause less tissue damage.Although there are a few cases reported completely cardioscopy technique treatment experience,it has not been widely used in clinical because of it's limitations.Even no such kind of research has been reported in China yet.This article aims to review the status of cardioscopy technique and its development prospects,to investigate the feasibility of its'widely clinical application in the future

Surgical treatment of adult tetralogy of Fallot in 227 patients / 中华胸心血管外科杂志

Objective To summarize the experience and early outcomes of surgical treatment of adult tetralogy of Fallot (ATOF).Methods We retrospectively analyzed the clinical data of 227 patients with ATOF who underwent surgical repair in the Department of Cadiovascular Surgery,Guangdong Cardivascular Institute from January 2004 to December 2014.There were 112 males and 115 females at a median age of 34 years(range,18 to 58 years) and a mean weight of(49.00 ± 8.27) kg.All patients were underwent one stage repair,including 129 cases with transannular patch and 61 cases with MAPCAs in which 4 cases were underwent hybrid occlusion.Results There were 12 cases died in hospital(5.3％),24 cases with Re-thoratomy for hemaostsis,5 cases with poor wound healing,10 cases with postoperative pneumonia.There were 25 cases with residual VSD including 8 cases caused by surgeon in congenital heart disease department and 17 cases caused by surgeon in adult heart disease department(P ＜ 0.05).The repair with transannular patch required significantly longer bypass time [(87.83 ± 26.02) min vs.(78.47 ± 26.00) min,P =0.009].The cases with MAPCAs had higher cost than that with no MAPCAs [(83 137.01 ±69363.05) RMB vs.(66 184.29 ±44219.38) RMB,P=0.03].Conclusion The early outcomes of ATOF is good.The cases with MAPCAs had higher cost than that with no MAPCAs.The CHD surgeon had lower probability of residual VSD.Preoperative evaluation of MAPCAs by CHD surgeon and perioperative maintain of the right ventricular function were helpful.

Effect of antenatal taurine supplementation on the taurine levels in brain of fetal rat with intrauterine growth restriction / 中华实用儿科临床杂志

Objective To examine the taurine levels and determine the influence of antenatal taurine on the taurine content in the brains of fetal rats with intrauterine growth restriction (IUGR).Methods Fifteen pregnant rats were randomly divided into 3 groups:normal control group,IUGR group and the IUGR + antenatal taurine supplement group(taurine group) (n =5).IUGR models were induced by low protein diet throughout gestation period.Taurine was added to the diet of the taurine group with a dose of 300 mg/(kg · d) from 12 days after conception until natural delivery.Two fetal rats were randomly selected from each nest and were sacrificed to obtain the brains,and the taurine levels in fetal rat brains were detected by high performance liquid chromatography-mass spectrometry.Results The average weight of fetal rats in the normal control group,the IUGR group and the taurine group were (6.619 ± 0.413) g,(4.509±0.454) g,(5.176 ±0.436) g,there was a significant difference among the 3 groups(F =429.818,P ＜ 0.01).The taurine levels in fetal rat brain in the normal control group,the IUGR group,and the taurine group were (2.399 ±0.134) × 103 μg/g,(1.881 ±0.166) × 103 μg/g and(2.170 ±0.191) × 103 μg/g,there was a significant difference among the 3 groups(F =24.828,P ＜ 0.01).Conclusion Antenatal taurine supplementation can significantly increase the taurine level in fetal rat brain with IUGR.

Significance of neuropsychological single-item scales in the diagnosis of mild cognitive impairment / 中华老年医学杂志

Objective To identify the significance of neuropsychological single-item scales in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods A total of 676 elderly people living around Dongzhimen district in Beijing were recruited using multistage sampling method.Cognitive function was assessed by minimum mental state examination (MMSE)and other scales.MCI was diagnosed based on the criteria proposed by Petersen (1999),and AD was diagnosed based on the NINCDS-ADRDA.Subjects were divided into normal cognitive group (n=213 cases,31.5％),Alzheimer's disease (AD) group (n=167 cases,24.7％),amnestic mild cognitive impairment (aMCI) group (n=186 cases,27.5 ％) and non-AD dementia group (110 cases,16.3 ％).Results The MMSE scores in AD,aMCI and normal groups were 23.0 ± 5.9,25.9±2.6,8.1 ± 1.7,respectively.There were significant differences in MMSE scores between AD,aMCI and NC groups separately (all P＜0.01).Compared with MCI and NC group,th scores of time orientation,attention,calculation and immediate recall and delayed recall were significantly decreased in AD group (all P＜0.01).Comparing with normal group,the scores of attention and calculation were reduced in aMCI group (both P＜0.01).The delayed story recall (DSR) scores in AD,aMCI and NC groups were 15.7 ± 11.7,7.6 ± 4.9,26.5 ± 9.3,respectively.There were significant differences in mean DSR scores between AD,aMCI and NC groups separately (all P＜0.01).Compared with normal group,the clinical dementia rating (CDR) scores were higher and the mean clock drawing task (CDT)scores were lower in AD and aMCI groups (both P＜0.01).Conclusions Both neuropsychological assessment tools such as MMSE and single-item scales such as delayed story recall have the certain significance in the diagnosis of MCI and AD.

Management of renal vein injury during percutaneous nephrostolithotomy: An experience with 2 cases / 第二军医大学学报

Objective To discuss the reasons and management of renal vein injury during percutaneous nephrostolithotomy (PCNL). Methods From 2007 to 2008 renal vein injury was caused in two patients by malposition of nephrostomic catheter in our hospital. The two patients were both males, aged 61 years old and 41 years old. They underwent PCNL due to left kidney stones. The percutaneous nephrostomy (PCN) catheters were malpositioned into the left kidney vein and vena cava, which was confirmed by prograde radiography and spiral CT scan after operation. The PCN catheter in the 41 years old patient was pulled back to renal collecting system on the 7th day, and was extracted on the 10th day under X-ray monitoring. The PCN catheter in the 61 years old patient was pulled back to the renal collecting system on the 14th day and wasstable extracted on the 18th day under X-ray monitoring. Results The bleeding was controlled and the hemodynamic status in the two cases after removal of PCN catheters. There was no renal arteriovenous fistula bleeding, surgical intervention, kidney infections or further damage of kidney function. Conclusion Renal vein injury during the PCNL can be managed by clamping the PCN catheter and gradual withdrawal. The method is safe and reliable, and it can avoid surgical intervention.

Modular flexible ureteroscope and Holmium laser lithotripsy for upper urinary calculi less than 2 cm: A report of 117 cases / 第二军医大学学报

Objective To evaluate the clinical value of the PolyScope™ endoscope system (F8 modular flexible ureteroscope) in treatment of upper urinary calculi less than 2 cm in diameter. Methods A total of 117 patients with upper urinary calculi, who were hospitalized in Xinhua Hospital from Nov. 2010 to Aug. 2012, were recruited in this study. The patients included 71 males and 46 females, aging from 20-86 (average age:49.7±13.9). Ninety-six patients had single calculi and the rest 21 had multiple calculi; 61 patients had left calculi and 56 had right calculi. The mean diameter of calculi was (1.19±0.34) cm. Twenty-two patients had been indwelled with D-J tube in advance under ureteroscope for 2-8 weeks, including 13 with ureteral stenosis, 7 with urinary tract infection and 2 with renal insufficiency. General or spinal anaesthesia were used and the patients were at cutting stone position. F8/9.8 rigid ureteroscope was inserted to the ureter for dilating the ureter, and the Holmium laser lithotripsy was performed for upper ureteral stone in situ. After dilating the ureter, the guide wire was inserted under the direct vision of F8/9.8 rigid ureteroscope, and then the F12/14 flexible ureteral access sheath was placed along the guide wire. Finally, further examination and Holmium laser lithotripsy were performed by F8 "PolyScope" modular flexible ureteroscope. The power of the laser was set at 1.0 J and the frequency was 10-20 Hz. F6 D-J tube was regularly indwelled for 4 weeks after operation and Forley urethral tube was indwelled for 1 to 7 days. KUB was performed 1 day after operation to detect the result of lithotropsy and the position of D-J tube. KUB was performed again 2-4 weeks after operation in some patients. Extracorporeal shock wave lithotripsy (ESWL) should be performed if the diameter of residual stones was larger than 6 mm. Results Lithotripsy was successfully performed in 103 patients, with the operation time being 25-85 min (mean time: [46±14] min) and with less bleeding. Four patients developed high fever after operation and were cured after anti-inflammatory treatment. There was no ureteral perforation or septicaemia. The single stone-free rate of single-pass lithotripsy was 88% (103/117); when combined with ESWL, the total stone-free rate was 95.7% (112/117).Conclusion F8 modular flexible ureteroscope is safe, convenient, and effective for the lithotripsy of the upper urinary calculi.

Ureteroscopic lithotripsy for treatment of ureteral calculi in children: Efficacy and safety / 第二军医大学学报

Objective: To assess the efficacy and safety of the ureteroscopic lithotripsy in treatment of ureteral calculi in children. Methods, From March 2008 to May 2009, thirteen pediatric patients with ureteral stones were admitted to our department. There were six males and seven females, with an age range of 23 months to 11 years old. Six patients with stones located at the lower segments of the ureter, four at the middle segments, two at the upper segments, and one at pyelo-ureteral junction and lower ureter. The average diameter of the stones was (1.1 ± 0.47) cm (range 0.6 - 2.0 cm). The patients were placed in a lithotomy position; under general or venous anesthesia, ureteroscopy was performed using a semirigid ureteroscope (WOLF Fr 7.5/6), and the ureteral orifice was dilated to 10-12 Fr. Then holmium laser (1.5 J, 10 Hz) or pneumatic lithotripter was employed to fragment the stones (diameter of fragment less than 3 mm). Fr4. 7 double-J stent was placed after operation and was removed 4 weeks later. Results: Eleven of the 13 patient underwent successful lithotripsy, with the first time successful rate being 84.6%. The mean lithotripsy time was 8 min and the mean operation time was 21 min. There was slight bleeding during operation, but with no noticeable perforation of ureter or post operation fever, etc. Post-operation B ultrasound examination and X ray image revealed no residual stones with diameter > 3 mm in the 11 cases. Partial fragmentation was achieved in one patient with stone at upper ureter segment and one patient with stone at pyelo-ureteral junction and lower ureter, and the stones were excreted after extracorporreal shock wave lithotripy. Conclusion: Ureteroscopic lithotripsy is safe and effective in treatment of children with ureteral stones, which might become one of the first line treatment for children.

Construction of bicistronic DNA vaccine expressing prostate-specific membrane antigen and granulocyte-macrophage colony-stimulating factor and determination of its activity / 第二军医大学学报

Objective: To construct DNA vaccines expressing prostate-specific membrane antigen (PSMA) and/or granulocyte-macrophage colony-stimulating factor (GM-CSF) and to determine their immunoactivity. Methods: Recombinant plasmids pIRES-PS-MA-mGM-CSF, pIRES-PSMA, and pIRES-mGM-CSF were constructed with DNA vaccine vector pIRES. After identified by endonuclease digestion, the above 3 plasmids and blank pIRES vector were used to immunize C56BL/6 mice (n=15). LDH release assay was used to exam the cytotoxicity of cytolytic T lymphocytes in each group. Results: We successfully constructed the above mentioned recombinant plasmids. Mice in pIRES-PSMA-mGM-CSF immunized group had the highest specific cytotoxicity, followed by pIRES-PS-MA and pIRES-mGM-CSF immunized groups. The blank pIRES group had the lowest cytotoxicity (P<0.05). The cytotoxicity was the highest in all 4 groups at an effector/target ratio of 10/1. Conclusion: The bicistronic DNA vaccine expressing PSMA and mGM-CSF may have a promising therapeutic value in gene therapy of prostate cancer.

Analysis of SRY gene in 8 cases of sex abnormality / 华中科技大学学报（医学）（英德文版）

In order to investigate the relationship between sex dysplasia and sex-determining region Y (SRY) gene, 8 patients with sexual abnormality were analyzed by cytogenetic and molecular genetic methods. Fluorescence in situ hybridization (FISH) using PY3.4, X alpha satellite, and SRY probes was performed in each case to analyze the sex chromosome translocation and gene translocation. SRY gene was amplified by polymerase chain reaction (PCR) and its mutation was detected by direct sequencing. The results showed that among 8 patients, 5 were positive for SRY and the remaining negative for SRY. In the patients positive for SRY genes, 3 presented testes and the left 2 streak ovaries. In the patients negative for SRY, only one case presented testes, while 2 ovaries. Direct sequencing demonstrated that all SRY genes were normal in the patients positive for SRY genes. FISH technique demonstrated that SRY genes translocated from Ypter to Xpter in 2 46,XX phenotypic males positive for SRY genes. It was concluded that SRY gene is strongly involved in male sex determination, while a sequence of other genes may be taken into account in sexual development.

Analysis of SRY gene in 8 cases of sex abnormality / 华中科技大学学报（医学）（英德文版）

In order to investigate the relationship between sex dysplasia and sex-determining region Y (SRY) gene, 8 patients with sexual abnormality were analyzed by cytogenetic and molecular genetic methods. Fluorescence in situ hybridization (FISH) using PY3.4, X alpha satellite, and SRY probes was performed in each case to analyze the sex chromosome translocation and gene translocation. SRY gene was amplified by polymerase chain reaction (PCR) and its mutation was detected by direct sequencing. The results showed that among 8 patients, 5 were positive for SRY and the remaining negative for SRY. In the patients positive for SRY genes, 3 presented testes and the left 2 streak ovaries. In the patients negative for SRY, only one case presented testes, while 2 ovaries. Direct sequencing demonstrated that all SRY genes were normal in the patients positive for SRY genes. FISH technique demonstrated that SRY genes translocated from Ypter to Xpter in 2 46,XX phenotypic males positive for SRY genes. It was concluded that SRY gene is strongly involved in male sex determination, while a sequence of other genes may be taken into account in sexual development.