Volume 88  ·   Issue 34  ·  2008

In the mid-1980s, nitric oxide (NO), a gas signal molecule, attracted widespread attention in the scientific circles because of its unique characteristics such as continuous generation, rapid propagation and rapid dispersion, and was later rated as a "star molecule" by Science magazine.

In recent years, bacterial drug resistance has become an important problem in the global medical field. All kinds of drug-resistant bacterial infections have posed a great threat to human health and life. Early administration of appropriate anti-infective drugs is of great significance to save patients' lives.

Objective To analyzed the role of genetic factors in pathogenesis of acute intermittent porphyria (AIP). Methods Peripheral blood sample was collected from a Chinese female AIP patients, aged 36, to undergo direct sequencing to analyze all the exons and flanking introns of the porphobilinogen deaminase (PBGD) and protoporphyrinogen oxidase (PPOX) genes. The sequencing results were compared with the established human PBGD and PPOX sequences (GenBank Accession No. b195623; NC_000001.9). Results Direct sequencing showed three kinds of single nucleotide polymorphism (SNP) in the PBGD gene. No mutation was found in the coding regions of either PBGD or PPOX gene. Condusion The three SNPs may underlie the genetic defects of AlP in Chinese. SNP may serve as genetic markers for linkage analysis to track presymptomatic carriers in AIP families.

Objective To explore the best waist circumference (WC) cut-point for identifying cardiovascular risk factors among adolescents. Methods Human basic parameters were measured among 3986 adolescents aged 14 - 18 in Qinhuangdao. Receiver operator characteristic curve (ROC) analysis was employed to determine the optimal WC cut-point for detecting cardiovascular risk factors. Results The prevalence of the clustering of cardiovascular risk factors significantly increased after the WC was ≥ 80th percentiles (77.0 - 79. 0 cm for the boys and 70. 0 - 72.5 cm for the girls). The age standardization detection rate was 24.9% in boys and 9.9% in girls. ROC analysis showed that the optimal WC cut-point was 80th percentiles, with the sensitivity of 84.3% and specificity of 85.9% in boys, and with sensitivity of 90.7% and specificity of 83.2% in girls. Conclusion There is a significant correlation between WC and cardiovascular risk factors. The optimal WC cut-point for predicting the clustering of cardiovascular risk factors is the 80th percentile.

Objective To investigate the effects of continuous early enteral nutrition (EEN) supplemented with glutamine and arginine on gut barrier function in patients with severe acute pancreatitis (SAP). Methods Thirty two patients with a diagnosis of acute pancreatitis predicted to develop severe disease were randomized into 2 groups: EEN group (n = 18) and EEN + glut-mine and arginine group (enteral immunonutrition group, n = 14). EEN was initiated when homeostasis was achieved within 72 hours after attack, and both group received isocaloric isonitrogenoas nutrition. Glutamine and arginine were administered into jejunum in the enteral immunonutrition group. Serum amylase, plasma diamine oxidase (DAO), C-reactive protein (CRP), plasma endotoxin, urinary excretion of lactulose (L), and mannitol (M) were measured, and APACHE-Ⅱ scores were recorded on days 1, 7, and 14. Complications, and length and cost of hospitalization were recorded as well. Results EEN and enteral immunonutrition were both tolerated well. There was no difference in APACHE-Ⅱ score between the two groups(P ＞ 0.05). The DAO, CliP, plasma endotoxin, and urinary L/M levels decreased with the course of SAP. However, the plasma endotoxin and urinary L/M on day 7 of the enteral immunonutrition group were (10.0 ± 3.8) EU/ml and 0.29 ± 0.15 respectively, both significantly higher than those of the EEN group [ (7.9 ± 2.8) EU/ml and 0. 16±0.08 respectively, both P＜0.05]. The length of hospital stay and cost showed no differences between the two groups. Conclusion EEN is safe and feasible in treatment of SAP. Enteral immunonutrition containing glutamine and arginine improves the gut barrier function by reducing the gut permeability and decreasing plasma endotoxin level in the early stage of SAP.

Objective To investigate whether abnormal translocation of nuclear factor-E2 related factor 2 (Nd2) exists in the lesion of vitiligo. Methods Skin specimens from 8 vitiligo patients and 3 healthy controls were collected, haft of them underwent laser co-focal microscopy to detect the Nrf2 location and haft of them underwent cell culture. Blister fluid was collected form the 8 vitiligo patients and skin donor sites to detect the levels of serum superoxide dismutase (SOD), catalase (CAT), and melonyldialdehyde (MDA) by using detection kit. Expression of Nrf2 in epidermal cell of the 8 vitiligo patients and primary epidermal cell of the 3 healthy controls was identified with cell immunofluorescence histochemistry method. The nuclear and cytoplasmic proteins of all above samples were isolated to be identified by Western blotting. Results The levels of SOD and CAT in the lesion tissue were significantly lower than those in the skin donor site. The levels of MDA in the lesion tissue were significantly higher than those in the skin donor sites (beth P＜0.05). Immunofluorescenee histochemistry, showed that Nrf2 was predominantly cytoplasmic in the epidermal cells in the lesion, while Nrf2 expression could be seen in both the cytoplasm and nucleus in the epidermal cells in the normal skin donor sites and skins of the healthy controls. Western blotting showed that the nuclear Nrf2 level in the vitilign skin lesion was(0. 11±0.03), significantly lower than that in the normal skin donor site (0.27 ± 0.06) and in the skins of the healthy controls (0.32 ± 0.02) ( both P＜0.01). However, there was no significant difference in the Nrf2 level of in cytoplasm among the three types oftissues (0.63±0.04,0.61±0.03,and 0.65±0. 04,all P＞0.05). Conclusion Nrf2 does not translocate from cytoplasm into the nucleus in the lesion of vitiligo patients.

Objective To explore the changes and clinical implications of plasma resisfin level in obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Plasma resistin level was measured by radioimmunoassay in 30 obese OSAHS patients (obese OSAHS group), 7 in the low apnea hypopnea index (AHI) subgroup, 9 in the medium AHI subgroup, and 14 in the high AHI subgroup, 30 obese subjects (obese group), and 28 normal healthy adults (control group). Stepwise multiple linear regression analysis was conducted to determine the correlation of plasma resistin level with body mass index (BMI), body fat percentage, waist to hip ratio (WHR), fasting blood glucose (FBG), blood lipid, AHI, and lowest arterial oxygen saturation (LSaO2). Results The plasma resistin levels of the obese OSAHS group and obese group were (8.48 ± 1.44) and (7.60 ± 1.53) μg/L respectively, both significantly higher than that of the control group [(5.78 ± 1.62) μg/L, both P＜0.05], and that of the obese OSAHS group was significantly higher than that of the obese group (P＜0.05). The plasma resisfin level of the high AHI obese OSAHS subgroup was (9.60 ±0.51) μg/L, significantly higher than those of the medium and low AHI obese OSAHS subgroups [ (7.96 ± 1.06) and (6.90 ± 1.32) μg/L respectively, both P＜0.01]. Correlation analysis demonstrated that the fasting plasma resistin level was positively eorrelated with BMI, neck circumference, waist circumference, WHR, FBG, total cholesterol, triglyceride, and AHI (r = 0.52, 0.66, 0.74, 0.52, 0.59, 0.48, 0.46, and 0.80, all P＜0.05) ; and negatively correlated with high-density hpoprotein cholesterol and LSaO2 ( r = - 0.52, r = - 0. 60, both P＜0.01). A stepwise multiple linear regression analysis showed that AHI was the most significant contributing factor for the increased plasma resistin level in the obese OSAHS group (R2 = 0.618). Conclusions Plasma resistin level in obese OSAHS patients are increased, and are positively correlated with AHI. It may be used as an important biological index to evaluate the severity of OSAHS.

Objective To assess the diagnostic value of oxygen saturation combined with airflow (OF) monitoring for diagnosis of obstructive sleep apnea hypopnea syndrome (OSAHS). Methods Sixty-two subjects including suspected OSAHS and non-snorers underwent overnight polysomnography (PSG) and OF monitoring simultaneously in sleep laboratory. The apnea-hypopnea index (AHI), lowest oxygen saturation (LSaO2), and oxygen desaturation index (ODI) recorded by OF were compared with those recorded by PSG. The AHI and ODI data that showed skew distribution underwent square root transformation to approximate to normal distribution. Pair t test was used for difference hypothesis test. The agreement between the two measures was analyzed using Bland-Ahman plot. Results Forty-five of the 62 subjects were diagnosed as with OSAHS based on PSG with the mean AHI value of (40 ± 27) events per hour. The mean AHI values derived from OF (OF-AHI) and PSG (PSG-AHI) according to total sleep time were (28 ± 26) and (29 ± 28 ) times per hour respectively, and those after square mot transformation were (4.6 ± 2.7) and (4.7 ± 2.7) times per hour respectively (P = 0.08). The mean LSaO2 derived from OF (OF-LSaO2) was (82 ± 11)%, not significantly different from that derived from PSG (PSG-LSaO2) [(82 ± 10) %, P = 0.65]. The ODI derived from OF (OF-ODI) after square root transformation was (3.0±2.4) times/h, significantly lower than that derived from PSG (PSG-ODI) after square root transformation [ (4.0 ± 2.9) times/h, P = 0.00]. The Bland-Altman plot revealed a good agreement between the OF-AHI and PSG-AHI in non-OSAHS people and patients with mild OSAHS (P = 0.28), however, the OF-AHI was lower than PSG-AHI (P = 0.00) in the patients with moderate to severe OSAHS. There was no significant difference between OF-LSaO2 and PSG-LSaO2 (P =0.65). Conchusions There is a good agreement between OF and PSG for AHI and LSaO2. OF can be used to screen patients with suspected OSAHS in high risk population. However, OF tends to underestimate the AHI in moderate to severe OSAHS so additional manual analysis is necessary to confirm the diagnosis.

Objective To compare the values of measurements of obesity, including body mass index(BMI), waist circumference (WC), waist-w-hip ratio (WHR), bioelectrical impedance analyzer (BIA) (fat mass and FAT%), ultrasonograpby (US) ( subcutaneous fat distance and intraabdominal fat distance), and computed tomography (CT) in predicting the quantification of visceral adipose in abdominal obesity , and to evaluate the best cut-off point, sensitivity and specificity of these methods. Methods 4301 inpatients with hypertension, 2155 males and 2146 females, aged(56.4 ± 13.8) (11 - 89), all with at least 1 risk factor of cardiovascular diseases, underwent simple body fat measurement. 3458 received BIA, 2553 received B mode uhrasonography, 1039 underwent CT examination, and 659 received all kinds of examination. Abdominal visceral adipose area (VA) measured with CT ≥ 100 cm2 was the diagnostic criteria of visceral fat obesity (VFO). Receiver operating characteristic (ROC) curve was used to analyze the body fat indexes to determine the best cut-off point. Results (1) It was accurate for WC, fat mass, BMI, intraabdominal fat distance, FAT%, and WHR were all accurate in diagnosis of VFO with the values of area under ROC of 0.730 -0.867. WC was the most effective measurement. (2) The best cut-off points of these methods in predicting abdominal visceral obesity in males and females were as follows: WC : 89.5 cm and 85.5 cm for WC. 25 kg/m2 and 26 kg/m2 for BMI, 0. 97 and 0.95 for WHR, 29% and 38% for fat composition, 18.6 kg, and 20.4 kg for fat mass, and 38.5 nun and 34.7 mm for intraabdominal fat distance. Conclusions WC, fat mass, BMI, intraabdominal fat distance, simple fat parameters, and WHR all can predict visceral adipose in abdominal obesity, in which WC is the best. For a given WC, the type of obesity can be determined by BIA and US.

Objective To study the strategy of management of non-malignant results in core needle biopsy (CNB) of breast lesions. Methods Consecutive 2654 breast lesions underwent CNB with 14-gauge automated needles. 1130 lesions with diagnosis of non-malignant breast lesions examined by CNB were followed up. The histological diagnosis of CNB, subsequent excision or repeat CNB, and the follow-up for cases without repeat biopsy were studied. Results Among the 1130 non-malignant breast lesions examined by CNB, 530 underwent re-biopsy and 73 cases of carcinoma were found. 491 lesions were followed up for 1-38 months (median, 13.3 months) and another 4 cases of carcinoma were found during the follow-up. 109 cases were lost to follow-up. 57.9% (22/38) of the atypical ductal hyperplasia, 22.2% (4/18) of the atypical ductal cells, 27.9% (24/86) of the papillary lesions, and 90. 0% (9/10) of the suspicions carcinoma diagnosed by CNB were re-diagnosed as breast cancer finally. Conclusions Repeat biopsy is required for the high-risk lesions diagnosed by breast CNB. Excision can be avoided on the benign lesions whose CNB diagnosis is consistent with those by physical examination and imaging.

Objective To study the BRCA1/2 gene mutation frequency and characteristics in Chinese familial breast cancer patients. Methods Denaturing high-performance liquid chromatography (DHPLC) and following DNA sequencing in BRCA1/2 gene whole coding region and exon-intron splicing sites were performed in the specimens obtained during operation from 115 probands of familial breast cancer from 4 breast cancer centers in China. Results Fourteen cases of gene mutation (11 in BRCA1 and 3 in BRCA2) were found in the 115 breast cancer specimens with an overall mutation rate of 12.2%. After stratification with number of breast cancer patients in family, the frequency of mutation did not change significantly. The average age of disease onset of the families carrying BRCA1/2 mutations was significantly younger than that of the families without mutations (P＜0.01), and the higher the number of young patients in family, the higher the mutation rate. Conclusion In Chinese familial breast cancer patients, age of disease-onset is an effective predictive factor of BRCA1/2 mutation, however, the predictive effect of the number of affective relatives in family is not good.

Objective To study the effects of interleukin 1 receptor antagonist (IL-1ra) on allergy asthma and its mechanism. Methods Thirty female SD rats underwent intraperitoneal and hypodermic injection of ovalbumin (OVA) on days 1 and 14, and then underwent spraying of OVA aerosol since day 21 for7 days so as to'provoke asthma, and then the rats were randomly divided into 3 equal groups: asthma model group, low dose IL-1ra treatment group undergoing intravenous injection of IL-1ra 6 mg/kg before each provocation (low dose treatment group), and high dose IL-1ra treatment group undergoing intravenous injection of IL-1ra 30 mg/kg before each provocation(high dose treatment group). Another 10 rats were used as normal controls. Twenty-four hours after the last provocation physiological monitoring equipment was used to detect the pulmonary function. Then the rats were killed. Bronchoalveolar lavage fluid (BALF) was collected. ELISA was used to detect the serum IgE content. The ratio of inflammatory cells from the BALF was calculated. Microscopy was conducted to observe the histopathology of lung. RT-PCR was used to examine the mRNA expression of NF-κB and signal transducer and activator of the transcription 6 (STAT6). Results The respiratory rate, expiratory flow, percentage of eosinophils in BALF inflammatory cells, peripheral blood IgE concentration, mRNA expression of STAT6 and NF-κB of the asthma group were (206±11) times/min, (77±8 ) μl/s, 24.8% ± 1.3%, (72.5 ± 8.1) ng/ml, 0.294 ± 0.048, and 0.686 ± 0.052 respectively, all significantly higher than those of the low dose treatment group [ (183 ± 9) times/min, (64±5) μl/s, 18.5%±3.1%, (63.4±4.8) ng/ml, 0.229±0.038, and 0.613±0.062 respectively, all P＜0.05] and those of the high dose treatment group [ (181 ± 11) times/min, (57 ± 4) μl/s, 14.7% ±2.1%, (41.4±7.4) ng/ml, 0.194±0.076, and 0.352±0.267, all P＜0.05]. The therapeutic effect of high dose treatment group is superior to that of low dose treatment group (P＜0.05). Conclusion IL-1ra is significantly effective in treatment of allergic asthma, and its potential mechanism is through regulating both STAT6 mRNA and NF-κB mRNA expression simultaneously.

Objective To investigate the effects of trichostatin A (TSA) and paclitaxel (PTX) on the apoptosis and microtubulin stabilization in human endometrial carcinoma cells and its mechanism. Methods Human endometrial carcinoma cells of the line Ark7., KLE and AN3 were cultured in the presence OfTSA (TSA group), or PTX(PTX group) , or TSA plus PTX (TSA +PTX group) respectively. The growth curve was obtained by trypan-blue exclusion assay. Apoptosis was observed by annexin V and Hoechst staining. Perturbation of mitochondrial membrane potential (MMP) was detected by flow cytometry. Western blotting was used to detect the protein expression of caspaae-9, poly ADP-riboae polymerase (PARP), and acetylated microtubulin. Results The growth of the Ark2, KLE, and AN3 cells of the TSA, PTX, and TSA + PTX group, especially in the latter group, was inhibited. The Ark2 cell apoptotic rates 4 days later of the TSA, PTX, TSA + FTX, and control group were 4.25%±0.25%, 12.12% ±0.62%, 16.56%±0.74%, and 46.78%±2.68% respectively by annexin V staining, and 3.39%±0.12%, 6.00%±0.25%, 10.05%±0.53%, and 22.30%±1.25% respectively by Hoechst staining. The apeptotie rates of the TSA + PTX group by both staining methods were both significantly higher than those of the other groups (all P＜0.05). Lysis of caspase-9 and PARP in the Ark2 and KLE cells increased greatly 24 hours after the TSA and PTX treatment. The disappearance rate of MMP in the Ark2 and AN3 cells of the TSA +PTX groups were 16.80%±0.92% and 11.28%±0.78% respectively, significandy higher than that of the PTX group (5.34%±0.45% and 5.61%±0.56% respectively) and TSA group (4.96%± 0.47% and 6.46%±0.62% respectively, all P＜0.05). The expression of acetylated mieretubulin was increased in the Ark2 and KLE cells of the TSA + PTX groups. Condusions Synergy of TSA and PTX inhibits the cell growth and induces apoptosis. The acetylation of non-histone protein induced by histone deacetylase inhibitor is one of the possible mechanisms of its anti-cancer effects.

Objective To investigate the mechanism of Ca2+-independent pathways mediated by Rho-kinase in contraction of hepatic steLlate cells (HSCs) induced by angiotonin Ⅱ (Ang )Ⅱ. Methods Human HSCs of the line HSC-T6 were cultured and randomly divided into 6 groups: negative control group, AngⅡ group treated by Ang Ⅱ 10 μmol/L for 15 min, Ang Ⅱ + irbesantan (Ang Ⅱ receptor inhibitor) group, exposed to irbesantan for 60 rain prior to Ang Ⅱ treatment, Ang Ⅱ + Y27632 (Rho kinase specific inhibitor) exposed to Y27632 for 60 min prior to Ang Ⅱ treatment, Ang Ⅱ + ML-7 (myosin fight chain kinase specific inhibitor) + saturo (protein kinase C specific inhibitor) group exposed to stauro for 60 min prior to Ang Ⅱ treatment, and Ang Ⅱ + Y27632 + ML-7 + stauro group, exposed to Y27632 and stauro for 60 min prior to Ang Ⅱ treatment. The cell contraction was detected by sillcone-tubber-membrane cultivation directly. The protein levels of MLC and phosphorylated MLC were detected by Western blotting 5, 15, 30, 60, and 120 min after Ang Ⅱ treatment. RT-PCR was used to detect the expression of Rock?., RhoAGTP, and RhoGEF in Ca2+- independent pathways mediated by Rho-kinage. Results The silicone-rubber- membrane covered by Ang Ⅱ treated HSCs showed obvious wrinkles indicating the contraction of HSCs. The ratios of phosphorylated MLC protein at the time pints 5, 15, 30, 60, and120 min of the Ang Ⅱ group to the control group (0 min)were 11.7±0. 1, 26.9±0.1, 11.2 ±0.1, 4.1 ±0. 1, and 1.0±0.1, showing that Ang Ⅱ increased the phosphorylated MLC protein level time-dependently with the peak level at the time point of 15 minutes. The levels of phosphorylated MLC protein of the Ang Ⅱ + irbesartan and Ang Ⅱ + Y27632 groups were (1.12±0.09)and (1.22±0.10) respectively, both significantly lower than that of the Ang Ⅱ group (1.33±0.06, both P＜0.01). The level of phosphorylated MLC protein of the Ang Ⅱ + ML-7 + stauro group was (1.43 ± 0.09), significantly higher than that of the Ang Ⅱ + Y27632 group (0.64±0.04, P＜0. 01) . The level of phosphorylated MLC protein of the Ang Ⅱ +Y27632 +ML- 7 + stanro group was (0.64 ± 0.04), significantly lower than that of the Ang Ⅱ group (P = 0.003). The mRNA expression levels of Rock2, RhoAGTP, and RhoGEF of the Ang Ⅱ group were(0.36 ± 0.01), (0.80±0.01), and(0.65±0.11) respectively, all significantly higher than those of the control group [(0.12±0.01), (0.40±0.02), and (0.33±0.09) respectively, all P=0.000], and the mRNA expression levels of Rock2, RhoAGTP, and RhoGEF of the Ang Ⅱ + irbesartan + group were (0.21 ± 0.02), (0.62±0.02), and (0.41±0.10) respectively, all significantly lower than those of the control group. The mRNA expression levels of Rock2 (0.15±0.01) and RhoGEF (0.28±0.08) were lower, but The mRNA expression level of RhoAGTP(1.14±0.02) was higher in the Ang Ⅱ + Y27632 group. The mRNA expression levels of Rock2, RhoAGTP, and RhoGEF of the Ang Ⅱ + ML-7 + stauro group were (0.22±0.01), (0.55±0.03), and (0.44±0.10) respectively, all significantly higher than those of the control group. The mRNA expression levels of Rock2, RhoAGTP, and RhoGEF of the Ang Ⅱ + Y27632 + ML-7 + stauro group were (0.23±0.01), (0.83 ± 0.02), and (0.69 ± 0.08) respectively, all significantly higher than those of the Ang Ⅱ + ML-7 + stauro group. Conclusion Aug Ⅱ induces HSCs contraction in Ca2+ -independent pathways mediated by Rho-kinase.

Objective To investigate the effects of tumor necrosis factor (TNF)-α induced insulin resistance (IR) on glucose and lipid metabolism and adipose triglyceride lipase (ATGL). Methods Forty male C57BL/6J mice were randomly divided into 2 equal groups: TNF-α group with undergoing intraperitoneal injection of TNF-α 6 μg · kg-1·d-1 for 7 days and normal control (NC) group with saline injection. Hyperinsulinemic-euglycemic clamp technique combined with 2-deoxy-[3H] glucose as a tracer was used on 20 mice, 10 from each group, to examine the fasting blood glucose (FBG), plasma insulin (INS), total cholesterol (TC), triglyceride (TG), and free fatty acid (FFA). The glucose infusion rate (GIR) was recorded. Other 20 mice, 10 in each group, were killed with their adipose and/or muscle tissues taken out. RT-PCR was used to detect the Mrna expression of ATGL, hormone-sensitive lipase (HSL), carnitine palmitoyl transferase-1 (CPT-1), and peroxisome proliferator activated receptor-γ (PPARγ). Western blotting was used to measure the protein expression of ATGL. Muscle glucose uptake (MGU) was measured. Results After TNF-α treatment, the FBG, plasma INS, and FFA were significantly elevated in the TNF group compared with the NC group (all P＜0.05). During the steady-state of clamp test, the plasma INS level of the TNF group was (341.7 ± 17.7) Mu/L, significantly higher than that of the NC group [(84.7±5.5) Mu/L,P＜0.01]. The FFA level of the TNF group was (0. 82±0.03) mmol/L, significantly higher than that of the NC group [(0.43±0.07) mmol/L,P＜0.01] . The GIR of the TNF group was (39.1±2.3) mg·kg-1·min-1 ,significantly lower than that of the NC group [ (54.2±2.2) mg · kg-1 . Min-1 ,P＜0.01]. The MGU level of the TNF group was (15.8 ± 1.7) μmol · 100 g-1 min-1, significantly lower than that of the NC group [(20.9 ± 2.5)μ mol · 100 g-1 min-1, p＜0.01]. The ATGL Mrna expression level in adipose tissues of the TNF group was (0. 85 ± 0. 09), significantly lower than that of the NC group (1.37±0.12, P＜0.01). The ATGL protein expression level of the TNF group was 0.53 ± 0.03, significantly lower than that of the NC group (0.65 ± 0.05, P＜0.05). The PPARγ Mrna expression level in adipose tissues of the TNF group was 0.83 ± 0.07, significantly lower than that of the NC group (1.07 ± 0.07, P＜0.05). Conclusion In TNF-α induced insulin resistance, AGTL may be involved in the pathways of lipid metabolism.

Objective To analyze the effects, complication, and outcome of laparoscopic radical cystectomy. Methods 108 patients with bladder cancer, 96 males and 12 females, aged 61 (36 -81) underwent laparoscopic radical cystectomy with orthotopic ileal neobladder. Five-port transperitoneal approach was applied. The surgical procedure included standard laparoscopic pelvic lymphadenectomy, radical resection of bladder, extracorporeal formation of ileal pouch; extracorporeal implantation of ureters; and laparoscopic urethra-neobladder anastomosis. Erectile nerve sparing procedure was performed for 26 cases. The patients were followed up for 1 -53 months. Results The median operation time was 330 min, and the median blood loss was 320 ml. Conversion to open surgery was not necessary in any of the patients. There was no peri-operative mortality. The complication rate was 18.5% (20/108). Surgical margins were tumor free for all cases. The day-time and night-time continence rates were 90.7% and 82.6% respectively in 6 months postoperatively. 10 of the 26 patients undergoing erectile nerve-sparing procedure had potency for intercourse. Follow-up showed 5 cases with local recurrence, 1 case with trocar site seeding and 6 cases with distant metastasis, 8 of the patients died of tumor-related disease and 3 died of diseases not related to tumor. Conclusion Laparoscopic radical cystectomy with extracorporeal formation of orthotopic ileal neobladder is a feasible technique with low morbidity and acceptable neobladder function.

The patient was a 74-year-old male who was admitted to the hospital on October 10, 2007 due to intermittent hemoptysis for 8 days. More than 4 months ago (May 30), the patient had come to the hospital for half a month due to cough, sputum sputum and peculiar smell of sputum. The chest CT examination showed a flaky dense shadow in the left upper lung (Figure 1), and no other abnormalities were found.

Medical science popularization undertakes the task of publicizing and popularizing medical scientific knowledge, advocating healthy lifestyle and improving the physical quality of the whole nation.Medical science and technology workers have the responsibility to turn these new knowledge, new theories, new ideas, new technologies and new trends in the medical field into more popular and easy-to-understand popular scientific articles, so as to be understood by the wider public, so as to improve the scientific literacy of the public in the medical field and provide a good scientific environment for the further development of medicine.

In East Asia, D2 lymphadenectomy is the standard surgical procedure for the treatment of curable gastric carcinoma. Whether adding paraaortic lymph node dissection (PAND) to D2 radical resection can improve the survival rate of patients with T2, T3 and T4 gastric carcinoma has been controversial.

Due to its high efficacy and no hypnotic effect, phenytoin is often used as the first choice drug for clinical anti-epilepsy. The research results of Dr. Pack, a clinical neurologist at Columbia University in New York, were reported on HealthDay website on April 28, 2008. He found that the risk of osteoporosis in young women who took the anti-epileptic seizure drug phenytoin for more than 1 year will be 8 times that of premenopausal women who did not take any anti-epileptic drugs.

Acute cardiogenic pulmonary edema is a common medical emergency, with a mortality rate of 10% ~20%. When the initial treatment effect is not good, tracheal intubation and mechanical ventilation are often needed. Non-invasive ventilation can improve oxygenation, reduce respiratory work and increase cardiac output. The two most commonly used methods of non-invasive ventilation are continuous positive airway pressure (CPAP) and non-invasive intermittent positive pressure (NIPPV).

Extensively drug-resistant tuberculosis (XDR-TB) has been reported in 45 countries since 2006, including some with lack of medical resources and high incidence of TB.

Enterotoxic Escherichia coli (ETEC) is one of the main causes of diarrhea in travelers and infants in developing countries. About 27 million travelers and 210 million infants have acute diarrhea every year, of which about 380,000 infants die directly from the disease.

Fluorouracils, such as 5-fluorouracil (5-Fu) and carbetacitabine (Xeloda), are important drugs for anti-tumor treatment. Xeloda is a prodrug of 5-Fu, which is converted into 5-Fu by carboxylic acid lipase, cytidine deaminase and thymidylate phosphorylase (TP) in vivo, and plays a role in killing malignant tumor cells.