Volume 91  ·   Issue 36  ·  2011

Tracheal stent placement is an important method for the treatment of tracheal stenosis, but stent placement cannot be done once and for all. A lax grasp of its indications could have catastrophic consequences. In recent years, there have been cases of abuse of tracheal stents in clinical practice, and the author has also received many cases of improper stent placement in clinical work. The relevant knowledge of tracheal stent and its clinical application indications are described as follows.

ObjectiveTo evaluate the clinical characteristics, diagnosis and treatment for adrenal ganglioneuroma. MethodsThirty cases of adrenal ganglioneuroma at our hospital from 1999 to 2010 were reviewed. Their clinical, radiological, laboratory and pathologic findings as well as follow-up data were analyzed retrospectively. ResultsThere were 12 males and 18 females with an age range of 7 -63 (23.8 ±11.4) years old. Tumor size ranged from 2. 5 cm to 15 cm. Fourteen(46. 7％ )cases were found incidentally without any overt symptom. And the presenting symptoms and signs of the others were paroxysmal headache and palpitation (n = 7, 23.3％ ), hypertension ( n = 5, 16. 7％ ) and flank or abdominal pain ( n = 4,13. 3％ ). All cases underwent open or laproscopic operations and their diagnosis of adrenal ganglioneuroma was confirmed pathologically. An oval or crescentic well-defined mass, low or intermediate attenuation on CT (computed tomography) scan was found in most cases. Tumors partially or completely surrounded major blood vessels in 9 cases while 7 cases had discrete punctuate calcification. The 24-hours urinary catecholamine and urinary free cortisol output were within a normal range. Seventeen cases underwent a 99Tc-octreotide scan and negative results were found in 15 cases. Seven cases had a 131 I-Metaiodobenzylguanidine (131I-MIBG) scan and all results were negative. Twenty-one cases were diagnosed empirically as adrenal ganglioneuroma. One case was found pre-operatively with multiple bone metastases.Among all cases, either open operation (n = 11 ) or retroperitoneal laparoscopic excision ( n = 19 ) was performed successfully.All recovered smoothly. One patient with pre-operative bone metastasis developed progression. No recurrence was detected after a follow-up period of 1 - 11 years. ConclusionMostly benign in nature, adrenal ganglioneuromas is often found incidentally without specific clinic symptoms. A relatively accurate preoperative diagnosis can be made on the basis of a detailed history and the relevant imaging and laboratory results. Surgical resection of tumor is a preferred choice with a fairy good prognosis.

ObjectiveTo evaluate the efficacy and safety of ABO-incompatible liver transplantation in adult patients with fulminant hepatitis B. MethodsThe clinical data of 97 cases of adult liver transplantation for fulminant hepatitis B were retrospectively analyzed. The patients were grouped as ABOidentical (ABO-Id, n = 58), ABO-compatible ( ABO-C, n = 19) and ABO-incompatible ( ABO-In, n =20). The rates of rejection, infection, biliary tract complications, vascular complications, and patient and graft survivals were compared among 3 groups. ResultsThe 3-month, 1-year and 3-year graft survival rates were 87.9％/77. 6％/65.3％ in ABO-Id group, 84. 2％/73.7％/66. 5％ in ABO-C group and 50. 0％/35.0％/33.3％ in ABO-In group respectively. There were significant differences between ABO-Id and ABO-In (P ＜ 0. 05 ). The incidences of rejection, infection, vascular complications and biliary tract complications were 8.6％ , 20. 7％ , 3.4％ and 6. 9％ in ABO-Id group, 35％, 60％, 20％ and 30％ in ABO-In group (P ＜0.05) and 10.5％, 26.3％, 5.3％ and 10.5％ respectively in ABO-C group (P ＞ 0.05).Conclusion ABO-C liver transplantation is an important therapeutic option in adult patients with acute liver failure awaiting an emergency procedure.ABO-In transplantation can be used only for life-rescuing in patients with fulminant hepatitis since it is associated with a higher risk of rejection, infection, vascular thrombosis, ischemic bile duct complications and poor patient and graft survival.

ObjectiveTo explore the efficacy and safety of palonosetron in the prevention of acute and delayed chemotherapy-induced nausea and vomiting after moderate to severe emetogenic chemotherapy.MethodsFrom November 2008 to November 2009, a multicenter, randomized, double-blind and selfcrossover phase Ⅱ clinical trial with a total planned enrollment of 160 patients was carried out to compare palonosetron (drug A) with tropisetron (drug B). The subjects were randomized divided into groups AB and BA. The dosing sequence in the group AB was drug A the first cycle and drug B the second cycle while the BA group was administered reversely. The efficacy was evaluated within a period of 5 days after cisplatin or adriamycin-based regimen chemotherapy. Adverse effects were assessed by CTCAE 3.0. ResultsAmong 155 enrolled cases, 132 cases were assessable for efficacy. The complete control rate of acute chemotherapyinduced nausea and vomiting was 54. 55％ vs 51.52％ for drug A vs drug B ( P ＞ 0. 05), but that of delayed reaction was 53.03％ vs 38.64％ respectively. There were significant differences (P =0. 01 ). Meanwhile,the rate of adverse effects was 4. 90％ for investigational agent without severe adverse events.The main adverse reactions were headache and dizziness. ConclusionWith a high safety profile, palonosetron is an effective agent for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.

ObjectiveTo report the initial urological applications of single trocar laparoscopic surgery. MethodsFrom April to December 2010, a total of 45 urologic patients underwent single trocar laparoscopic surgery. The procedures included high ligations of spermatics vessels (n = 17 ), unroofing of renal cysts (n =24) and ureterolithotomy (n =4). Transperitoneal approach: A 15 mm incision was made in umbilicus and CO2 pneumoperitoneum created. A 10-mm trocar was inserted into enterocoelia. After the installation of single punch laparoscope (STROZ), the operating instruments were guided through integrated working channel to complete operative procedures.Retroperitoneal approach: A 15 mm incision was made above thediseased-sidecristailiacafor around4cm.Retroperitonealcavitywaspreparedfor retroperitoneoscopy with the IUPU (Institute of Urology, Peking University) technique. In the same way, a 10-mm trocar wasinserted.And the single punch laparoscope was installed to complete operative procedures. ResultsThe procedures were successful in 41 cases.But the others ( renal cysts, n = 2 ;ureteral calculus,n = 2 )were successfully managed by adding a 5mm trocar.Operation time:transperitoneal approach, 23 -70 min; retroperitoneal approach, 45 -175 min. The intra-operative volume of blood loss was minimal. And the hospital stay was 1 - 5 days. No significant postoperative complication occurred. ConclusionFor some relatively simple procedures, a new and more minimally invasive approach of single trocar laparoscopic surgery may be attempted.

ObjectiveTo evaluate the clinical feasibility of radiofrequency ablation-assisted laparoscopic partial nephrectomy(RF-LCPN) without renal hilar vessel clamping. MethodsFrom January 2009 to June 2010, 14 cases with renal tumors were treated with RF-LCPN. The mean tumor size was 3. 1 cm (range: 2. 2-4. 0 cm). All cases were staged at T1a N0M0. The preoperative serum creatinine (SCr)was (87 ± 36) μmol/L and glomerular filtration rate (GFR) (45 ± 11 ) ml/min. ResultsRF-LCPN was technically successful in all patients (14 tumors). The mean operative time was (152 ±4.6) min and the mean blood loss (89 ± 52) ml. All tumor margins were negative. One patient with a brief period of urine leakage from lower pole calix was managed successfully by ureteral stenting and Foley catheter drainage of bladder. The postoperative hospital stay was (5 ± 2 ) days. The postoperative SCr was (90 ± 38 ) μmol/L and GFR (41 ± 12) ml/min. There was no statistic post-operative change of SCr and GFR (P ＞ 0. 05). All patients completed a minimum follow-up of 6 months (mean: 17 months, range: 6 -25 months).No evidence of local or port-site recurrence or metastasis was found. ConclusionAs an accurate and effective intervention with a relatively low incidence of complications, RF-LCPN may eliminate renal warm ischemia. But its long-term efficacy remains to be further studied.

ObjectiveTo explore the expression and clinical significance of LI ( liver-intestine)-cadherin mRNA and protein expression level in hepatocellular carcinoma. MethodsReverse transcriptionpolymerase chain reaction(RT-PCR)and immunohistochemical techniques were used to detect the expression of the LI-cadherin mRNA and protein in 56 cases of hepatocellular carcinoma, 44 cases of corresponding paracancerous tissues and 9 cases of normal liver tissues.The relationships with its clinicopathological characteristics were analyzed. ResultsThe mRNA of LI-cadherin was expressed in 56 cases of hepatocellular carcinoma tissues and 44 cases of corresponding paracancerous tissues.But its expression was not detected in normal tissues. Semiquantitative analysis showed that the mRNA expression level of LI-caherin was greater in hepatocellular carcinoma tissues than that in corresponding paracancerous tissues (0. 653 ± 0. 147 vs 0. 534 ± 0. 138 ). The differences were statistically significant (P ＜ 0. 01 ). The positive rates of LI-cadherin protein were 64. 29％ (36/56) in hepatocellular carcinoma tissues, 22.73％(10/44) in paracancerous tissues and 0％ (0/9) in normal tissues. ConclusionThe expression of LI-cadherin is up-regulated significantly in HCC. The over-expression of LI-cadherin protein is correlated with the lymph node metastasis and tumor thrombi in portal vein. It indicates that LI-cadherin may play an important role in the progression and metastasis of HCC.

ObjectiveTo detect the protein expressions of survivin and NF (nuclear factor)-кB and investigate their roles in the pathogenesis of hepatocellular carcinoma. MethodsA total of 206 cases were diagnosed as hepatocellular carcinoma, and immunohistochemical technique was used to detect the protein expressions of survivin and NF-кB in hepatocellular carcinoma samples and normal liver tissue specimens. Statistical analysis was performed to analyze the relationship of protein expressions of survivin and NF-кB and clinico-pathological parameters and prognosis. ResultsThe expression of survivin was predominant in cytoplasm while that of NF-кB was in nucleolus. The positive rate of survivin protein was 78.2％ in hepatocellular carcinoma and that of NF-кB was 81.1％. The positive rate of survivin and NF-кB was higber in hepatocellular carcinoma than that in benign hepatic tissue ( 11.7％ and 15.5％ ). Significant differences existed in the expressions of survivin and NF-кB between hepatocellular carcinoma and normal hepatic tissue ( P ＜ 0. 01 ). The expression of survivin was related to amicula invasion, portal vein tumor thrombus, lymph node metastasis and clinical stage in hepatocellular carcinoma (P ＜0. 01 ). The expression of NF-кB was also related to portal vein tumor thrombus, lymph node metastasis and clinical stage in hepatocellular carcinoma (P ＜ 0. 05 ). There was an obviously positive correlation between the expressions of survivin and NF-кB in hepatocellular carcinoma ( r = 0. 52, P ＜ 0. 01 ). Survival rate of patients for 1, 3 year of positive expression of survivin and NF-кB in hepatocellular carcinoma was 70. 3％ and 30. 4％,respectively.And it was obviously lower than that of those of negative expression (88. 5％ and 61.5％ ).There was significant difference in the expressions of survivin and NF-кB between positive and negative subjects in 1, 3 year ( P ＜ 0. 05 ). ConclusionProtein expressions of survivin and NF-кB are higher in hepatocellular carcinoma.And they play mutually promoting roles in the development of hepatocellular carcinoma. Thus, an important prognostic indicator may be adopted.

ObjectiveTo review and summarize the clinical characteristics and therapeutic approaches of Kasabach-Merritt syndrome ( KMS). MethodsThe combined and sequential therapy was used to for 51 KMS infants between 2005 and 2009. And all cases were retrospectively analyzed. There were 27 males and 24 females with a median age of 1. 8 months ( range: 2 days to 2. 5 years).Among them,lesions were located in maxillofacial ( n = 20), truck ( n = 4), upper extremities ( n = 11 ) and lower extremities (n = 16). ResultsAmong them, 47 of 51 patients were cured, 3 cases were effectively treated and only 1 patient died of multiple organ failure post-operation.Of the 51 cases, emergency surgery was given in 3 cases while other 48 cases were initially treated with methylprednisolone. The responses were varied : excellent and rapid improvement ( n = 12 ) ; moderate response ( n = 15 ) and total failure ( n = 21 ).Immunoglobulin was used a second-line therapy for those (n = 21 ) unresponsive to steroid, with sensitive response( n = 5 ), effective response ( n = 7 ) and invalid response ( n = 9 ) respectively.And adjunct carbonyldiamide therapy was combined. Conservative treatment was tried in 14 patients. Then 11 curative cases and 3 effective cases were observed. The thrombocyte count in 4 cases returned to normal within 4 -7days, 5 cases within 8 - 14 days, and 2 cases within 15 -28 days. In the remaining 3 cases, it normalized more than 28 days.The hemangiomas in 6 cases disappeared completely in 6 - 12 months and 8 cases disappeared in 13 - 24 months.19 patients were treated with the ligation of external carotid artery, the insertion of a tube inside the lesion and the injections of carbonyldiamide and methylprednisolone. The platelet counts of 13 cases increased to normal in 4 -7 days of the treatment, and 6 cases in 8 - 14 days.The tumors of 12 cases disappeared within 6 - 12 months, and 7 cases within 13 - 24 months. Combined surgical resection including emergency operation (n = 3 ) and selective operation (n = 15 ) was performed in 18 patients. And all cases except for one were cured. The platelet counts of that the hemangiomas of 10cases were excised surgically completely increased rapidly and reached the normal range in post-operative 1 - 3 days. The counts of 8 cases after subtotal resection increased to normal within 8 - 14 days. Conclusion A stepwise multimodal approach is recommended for the treatment of KMS.With a higher curative rate, it has minimal side effects.

ObjectiveTo analyze the changes of liver function, renal function, electrolytes, heart function and serum nitric oxide( NO)in chronic severe hepatitis patients with hepatorenal syndrome (HRS)by plasma exchange( PE), study the relationship of NO, hyponatremia, heart function with HRS. Methods A total of 20 chronic severe hepatitis patients with HRS were recruited. All were treated thrice by PE. The parameters of blood pressure, heart rate, 24 h urinary volume, liver function indicators, renal function indicators, NO, cardiac troponin T (cTnT), brain natriuretic peptide (BNP) , aldosterone, interleukin-6,tumor necrosis factor-α and plasma ammonia were measured before PE, during PE and after PE. Their differences were compared before, during and after PE.ResultsThe NO level of HRS before PE was (113 ±26)μmol/L, the level of Day 1 after PE (78 ±24) μmol/L and the level of Day 3 after PE was (85 ±29)μmol/L. All NO levels were lower than that before PE (all P ＜0. 05). Creatine level of HRS before PE was ( 191 ±43 ) μmol/L and the level of Day 1 after PE ( 142 ±42) μmol/L. All levels were lower than that before PE (all P ＜0. 05 ). The level of Day 3 after PE was 221 ± 105 μmol/L and it was higher than that before PE (P ＜0.05). At pre-, during- and post-PE, the level of sodium was low than normal (normal range: 135 - 145 mrnol/L), the level of aldosterone higher than normal (normal range:10 -27 ng/L),the level of cTnT higher than normal ( normal range: ＜ 14 ng/L) and the level of BNP higher than normal (normal range: ＜ 366 ng/L). The levels of model for end-stage liver disease(MELD) score, bilirubin,urea, cysteine proteinase inhibitor C and ammonia decreased during PE, but increased post-PE. Systolic pressure and 24 h urinary volume decreased gradually. In this study, 8 patients died and 12 were discharged from hospital. ConclusionSerum nitric oxide is not the sole occurring factor for hepatorenal syndrome. Hyponatremia and impaired heart function may be the key factors for hepatorenal syndrome.

Objective To investigate the correlation between orthostatic hypotensionand cardiovascular risks and hospitalization rate in the elders. MethodsA total of 1174 people over 65 years old underwent health screening physical examination through a self-made questionnaire at our hospital. Their clinical data were collected. The orthostatic blood pressure and heart rate were measured in supine position after resting for over 5 minutes and at 0 and 2 min after standing. Orthostatic hypotension was defined as 20 mm Hg or greater decrease in SBP or/and 10 mm Hg or greater decrease in DBP after standing. All cases were followed up by telephone or hospitalization medical records for a mean period of 315.8 days. The primary endpoint was the occurrence of such cardiovascular or cerebrovascular events as angina, fatal or nonfatal myocardial infarction (MI), congestive heart failure, sudden cardiac death, ischemic and hemorrhagic stroke. ResultsThe prevalence of OH was 25. 6％ in this cohort. Significant differences could be found in the rate of all-cause and cardiovascular-related hospitalization between OH positive and OH negative(45. 1％ vs 32. 5％ ;19. 1％ vs 7.4％ ) ; the rates of angina and myocardial infarction in the OH positive group were significantly higher than those in the OH negative group(7. 5％ vs 3. 7％ : 4. 8％ vs 0. 5％, P ＜0. 05 ) ; after adjusting for age, supine blood pressure, heart rate and cerebrovascular history by logistic regression, statistical differences could also be observed between OH and angina [ P = 0. 011, HR (hazard ratio) : 2. 122,95％ CI (confidence interval): 1. 184- 3.802 and MI (P ＜ 0.001, HR: 8.995, 95％ CI: 2.909- 27.819)].Conclusion Orthostatic hypotension may increase the rates of all-cause and cardiovasular-related hospitalization. And it is a robust predictor of angina and myocardial infarction in the elders.

ObjectiveLiver metastasis is a major cause of mortality in patients with colorectal cancer. However, the mechanisms underlying this process remain largely unknown. Osteopontin (OPN) is a secreted phosphorylated glycoprotein known to be involved in tumor migration and metastasis. Gap junction intercellular communication (GJIC) is a pathway of direct cell to cell communication. This study analyzed gap junctional intercellular communication(GJIC)changes in colon cancer SW-480 cell lines after osteopontin had been transfected in. MethodsTransfect sense-osteopontin eukaryotic expression plasmids into SW-480 cell lines and detect the GJIC changes in two different cell lines by flurescence redistribution after photobleaching ( FRAP).ResultsCompared with control, signal exchange is impaired and GJIC function is inhibited in SW-480-pcDNA3. 1 ( + )-OPN cell lines. FRAP after 5 min in SW-48O-pcDNA3. 1 ( + )-OPN is 24. 65％ ± 4. 08％, the control SW-480-pcDNA3. 1 ( + ) is 44. 74％ ± 6. 23％, P ＜ 0. 001 ;FRAP after 10 min in SW-480-pcDNA3. 1 ( + )-OPN is 25.98％ ±4.48％, while SW-480-pcDNA3. 1 is up to 64. 92％ ± 5.39％, P ＜ 0.001. ConclusionOPN could inhibit GJIC function of colon cells to accelerate the metastatic process in colorectal cancer.

ObjectiveTo investigate the expression of aquaporin-4 (AQP4) during brain edema in rats with thioacetamide-induced acute liver failure and encephalopathy. MethodsThe rat model of acute hepatic failure and encephalopathy was induced by intraperitoneal injection of thioacetamide (TAA) at a 24-hour interval for 2 consecutive days. Thirty-two SD rats were randomly divided into the model group ( n =24) and the control group (normal saline, n = 8).And then the model group was further divided into 3 subgroups by the timepoint of decapitation : 24 h ( n = 8 ), 48 h ( n = 8 ) and 60 h ( n = 8 ). Then we observed their clinical symptoms and stages of HE, indices of liver function and ammonia, liver histology and brain water content. The expression of AQP4 protein in brain tissues was measured with Western blot and the expression of AQP4mRNA with RT-PCR(reverse transcription-polymerase chain reaction ).Results Typical clinical manifestations of hepatic encephalopathy occurred in all TAA-administrated rats. The model rats showed the higher indices of ALT (alanine aminotransferase), AST (aspartate aminotransferase), TBIL (total bilirubin) and ammonia than the control rats (P ＜0. 05). The brain water content was significantly elevated in TAA-administrated rats compared with the control (P ＜0. 05 ). The expressions of AQP4 protein and mRNA in brain tissues significantly increased in TAA-administrated rats (P ＜ 0.05 ). In addition, the expressions of AQP4 protein and mRNA were positively correlated with brain water content( r = 0. 536, P ＜0. 01; r =0. 566, P =0. 01 ). ConclusionsThe high expression of AQP4 in rats with TAA-induced acute liver failure and encephalopathy plays a significant role during brain edema. AQP4 is one of the molecular mechanisms for the occurrence of brain edema in hepatic encephalopathy.

ObjectiveTo investigate the effects of vascular endothelial growth factor (VEGF) DNA plasmids, encoded in collagen-sulfonated carboxymethyl chitosan porous scaffold, on the angiogenesis in fullthickness burn wounds. MethodsWounds and pathological changes were observed at Week 1,2, 3 and 4after pure collagen-sulfonated carboxymethyl chitosan porous scaffold (group A ) and collagen-sulfonated carboxymethyl chitosan porous scaffold encoding VEGF DNA plasmids (group B ) were transplanted onto eachar-removed wounds of full-thickness bum in 6 Bama miniature pigs respectively. Wound healing was observed by pathologic slides "after epidermal grafting for 2 weeks ( at Week 4) onto the surface of different dermal scaffolds transplanted on wounds for 2 weeks.At the same time, new-forming vessels expressing CD31 and mature vessels expressing α-SMA (α-smooth muscle actin) and the expression of VEGF in wounds at Week 1, 2, 3 and 4 were detected in situ by immunohistochemical staining. The bum wounds without any transplanted scaffold (group C) were studied as the controls.ResultsWounds with various scaffolds were different from those without any scaffold. Angiogenesis of the group B was better than that of the group A. Neo-forming micro-vessels expressing CD31 in the wounds of group A or B at Week 1, 2, 3and4 were as follows: 18.7 ±3. 1, 25.7 ±2.3, 36.8 ±2.5 & 26.2 ±2.9; 24.5 ±3.8, 32.3 ±2.8,39.2±2.2 & 27.3 ±3.0.Mature vessels expressing α-SMA: 11.7 ±1.9, 20.5 ±1.9, 35.0 ±4.5 &24. 0 ± 2. 8 ; 20. 2 ± 3. 1, 33.5 ± 3.7, 38. 2 ± 4. 5 & 26. 5 ± 2. 3. The expressions of VEGF: 48. 7 ± 7.9,141.7±9.1, 201.5 ±8.6 & 107.0 ±8.2; 97.3 ±7.9, 172.3 ±8.1, 208.7 ±8.3 & 114.0 ±5.8.Expressing intensity of CD31, α-SMA and VEGF in the wounds of group C at Week 1, 2, 3 & 4: 6.0 ±2.0, 9.8±3.4, 19.3±2.5 & 18.7±2.2; 3.7±2.0, 8.7±1.8, 13.0±2.5 & 14.0±2.8; 3.5 ±2.3,10. 3 ± 3.5, 23.0 ± 5.6 & 21.5 ± 5. 1. There were significant statistical differences among three groups.ConclusionArtificial dermal scaffold encoding exogenous pDNA-VEGF can promote a quicker angiogenesis through a high expression of VEGF. Thus a full-thickness bum wound may be better repaired.

ObjectiveTo explore the in vitro synergistic anti-tumor efficacy of mammalian target of rampamycin (mTOR) inhibitor (RADO01) and 5-fluorouracil (5-FU) for radio-resistant tumors. Methods Radio-resistant cells of human pancreatic cancer cell and human colon cancer cell were established. The expression profiles of VEGF ( vascular endothelial growth factor) and TP ( thymidine phosphorylase) were compared between parental and radio-resistant tumor cells. The tumor proliferation was analyzed after 5-FU alone or in combination with a mTOR inhibitor. ResultsMter several cycles of radiation induction (3 Gy ),the radio-resistant ceils of human pancreatic cancer(AsPCres) and colon cancer(HT29res) were established.There was a higher expression of VEGF in radio-resistant tumor cells than their parental cells. They were 1215 ±67 pg/ml in AsPCres and 689 ±25 pg/ml in HT29res respectively (P ＜0. 01 ). The up-regulation of TP was observed in both AsPC-res and HT29-res. The combined therapy of 5-FU plus a mTOR inhibitor might exert synergistic tumor inhibition. ConclusionRAD001 decreases the radiation-induced expression of VEGF in tumor. And the post-radiation up-regulation of TP promotes the efficacy of 5-FU. The combined therapy of RAD001 and 5-FU may inhibit synergistically the growth of radio-resistant tumors.

Paget's osteopathy is a localized bone metabolic disorder characterized by accelerated bone remodeling. It has a high incidence in European countries such as Britain and the United States, and is the second most common metabolic bone disease after osteoporosis [1]. In the past, it was believed that the incidence rate in China was low. In the 1950s and 1960s, only more than 10 cases of this disease were reported in China, but more than 200 cases have been reported since the 1980s. Maybe we didn't know enough about this disease before, which led to many misdiagnoses and misdiagnoses of this disease. Once misdiagnosed, the development of the disease will lead to fracture, disability and malignant transformation, greatly reducing the quality of life of patients, and life-threatening in severe cases. Therefore, we are required to strengthen our understanding and avoid missed diagnosis and misdiagnosis.

Hair follicle stem cells belong to the epidermal stem cell line of hair follicle, and belong to the same adult stem cells of epithelial origin as epidermal stem cells. Because of its advantages of wide sources, easy access to materials, and no ethical and moral issues, it has gradually become a new favorite in the field of stem cell therapy. The research progress in tissue regeneration and skin tissue engineering is summarized as follows. 1. Characteristics of hair follicle stem cells Hair follicle stem cells mainly exist in the protuberance area of hair follicle and the lower 1/3 of hair follicle [1].

Chronic obstructive pulmonary disease (COPD) is characterized by emphysema and thickening of the respiratory tract wall, and its main causative factor is long-term exposure to particulate matter. Cigarette smoke is the most common particulate matter, and its combined cytotoxicity and pro-inflammatory activity cause alveolar destruction and emphysema. It is unclear whether cigarette smoke itself can cause thickening of the respiratory tract wall.

Borylol is a naturally purified monocyclic terpene alcohol, which has been used in consumer products and pharmaceutical products for its mint taste and aroma and cooling and analgesic properties. Peppermint has a calming and narcotic effect. Adding peppermint ingredients to cigarettes can reduce the discomfort caused by smoking. On September 22, 2009, the U.S. Food and Drug Administration (FDA) issued a ban on flavored cigarettes, but it did not include mint-flavored cigarettes, which account for 30% of the current U.S. tobacco market. In June 2011, Benowitz NL and Samet JM published a study on the effects of peppermint cigarettes on public health (N Engl J Med, 2011, 364:2179-2181).

A 47-year-old male was admitted to the Department of Cardiac Surgery, Provincial Hospital affiliated to Anhui Medical University on February 26, 2010, mainly due to sudden chest and back pain for 12 days. The patient had sudden chest and back pain without obvious trigger and went to the local hospital for 10 days. CT examination showed: descending aortic aneurysm, left pleural effusion, and left pleural closed drainage with a daily drainage volume of about 1000 ml. After the pleural effusion was gradually reduced to<50 ml per day, the pleural drainage tube was removed. After 2 days, the patient came to our department for hospitalization. CT angiography (CTA) after hospitalization showed that the descending aorta showed tumor-like dilatation, enlarged lumen, with a diameter of about 88.9 mm ×70.5 mm, and scattered calcification and annular low-density shadows along the vessel wall. After symptomatic control of blood pressure, control of heart rate, and reduction of myocardial oxygen consumption, multi-stent endovascular aortic isolation was performed on March 11, 2010.

A 52-year-old male was admitted for "intermittent claudication of the right lower limb for 2 months, aggravated with resting pain for half a month". Has a history of smoking for more than 30 years and denies a history of hypertension. Physical examination: The right femoral artery and below did not pulse, the skin temperature of the lower thigh was significantly reduced, and the first toe of the right foot had a black ulcer. Magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) confirmed that the right iliac artery was completely occluded, the surrounding collateral branches were established, the right deep femoral artery was acceptable, the right superficial femoral artery was basically occluded, and the anterior, posterior tibial and peroneal arteries were unclear (Figure 1). TASCD according to the Pan-Atlantic Collaboration (TASC) organization classification [1]. Operation on 14 Dec 2010. Surgical method: The patient's right lateral decubitus position is about 60° ~70°. After disinfection, a straight incision of about 7 cm was made in the right groin, exposing the femoral artery. Seven trocars (trocar) were inserted into the abdomen respectively, and the left posterior transabdominocolonic approach was performed to expose the abdominal card artery.

The patient, a 65-year-old male, was admitted for "repeated cough, expectoration for 1 month, aggravation with shortness of breath for 3 days". The patient developed a cough without obvious trigger 1 month ago, coughing a small amount of white sticky sputum, accompanied by choking after eating. Three days ago, he had sudden shortness of breath and could not lie down. He went to an external hospital for treatment. Chest CT showed an intraluminal mass in the middle of the trachea and a posterior mediastinal mass of 5 cm ×4 cm. He was urgently transferred to our hospital for treatment. On admission, severe shortness of breath, laborious breathing, orthocitary breathing at a frequency of 35 beats/min, oxygen saturation (SpO2) of 90%, and two lungs full of biphasic inferior rales. Because the patient could not tolerate conventional fiberoptic bronchoscopy and gastroscopy, and had the possibility of asphyxia and cardiac respiratory arrest at any time, after consultation and discussion, it was decided to undergo emergency endotracheal stent implantation with the support of extracorporeal membrane lung (ECMO).

The first International Standardized Biobank Management and Quality Control Conference sponsored by Shanghai Medical Clinical Research Center was held in Shanghai on July 8-9, 2011. The conference invited well-known experts from seven countries including China, France, Britain, the Netherlands and Austria, as well as more than 230 doctors and researchers from 19 provinces and cities including Beijing and Shanghai. The leaders of the Shanghai Municipal Science and Technology Commission, the Shanghai Municipal Development and Reform Commission and the Shanghai Municipal Health Bureau attended the meeting and delivered speeches at the opening ceremony. Gan Rongxing, Director of Shanghai Medical Clinical Research Center, and Professor Hu Qingli, former Deputy Director-General of the World Health Organization, respectively delivered opening speeches.