The main disadvantage of conventional ureteral stents commonly used to provide urinary drainage after urological practice is that the patients have to undergo a secondary surgical procedure to remove stents. A new bra...The main disadvantage of conventional ureteral stents commonly used to provide urinary drainage after urological practice is that the patients have to undergo a secondary surgical procedure to remove stents. A new braided thin-walled biodegradable ureteral stent composed of PGA （ polyglycolic acid） and PLGA （ eopolymer of polylactic and polygiycolic acid） mnltifilaments was evaluated in v/tro in this study. In vitro degradation was performed in artificial urine with pH of 5.8 and the temperature of 37~C. The mass loss, mechanical properties, and morphology were observed at different degradaing time intervals of 0, 1, 2, 3, 4, and 5 weeks. The stent had a thinner wail than those of other degradable stents and provided better mechanical properties. The braided thin-walled biodegradable ureteral stents began to degrade after 2 weeks. At the week of 5, the stents were fully degraded. The degradative process of stents is smooth and well controlled.展开更多
Objective To investigate the association between preoperative,operative,and postoperative factors and persistent pleural effusion after the extracardiac Fontan procedure. Methods Ninety-five consecutive patients diagn...Objective To investigate the association between preoperative,operative,and postoperative factors and persistent pleural effusion after the extracardiac Fontan procedure. Methods Ninety-five consecutive patients diagnosed with univentricular heart underwent extracardiac connection using Gore-Tax conduits at the Department of Children’s Heart Centre,Justus-Liebig-University Giessen in Germany from June 1996 to July 2007. The outcome measures were duration and volume of chest tube drainage after surgical intervention. The investigated factors included age and weight at the time of operation,anatomical diagnosis,preoperative oxygen saturation,mean pulmonary artery pressure,ventricular end-diastolic pressure,fenestration,cardiopulmonary bypass time,conduit size,postoperative pulmonary artery pressure,administration of angiotensin-converting enzyme inhibitors,and postoperative infection. Associations between these factors and persistent pleural effusion after the extracardiac Fontan procedure were analyzed. Results Every patient suffered postoperative effusion. The median duration of postoperative chest tube drainage was 9 days (range,3-69 days),and the median volume was 12 mL·kg-1·d-1 (range,2.0-37.5 mL·kg-1·d-1). Thirty-seven (38.9%) patients had pleural drainage for more than 15 days,and the volume in 35 (36.8%) patients exceeded 25 mL·kg-1·d-1. Nineteen (20%) patients required placement of additional chest tubes for re-accumulation of pleural effusion after removal of previous chest tubes. Fifteen (17.8%) patients were hospitalized again due to pleural effusion after discharge. The median length of hospital stay after the operation was 14 days (range,4-78 days). Multivariate analysis results showed that non-fenestration,low preoperative oxygen saturation,and postoperative infections were independent risk factors for prolonged duration of pleural drainage (P<0.05). Long cardiopulmonary bypass time,non-fenestration,small conduit size,and low preoperative oxygen saturation were independent risk factors for excessive volume of pleural drainage (P<0.05).Conclusions For reduing postoperative duration and volume of pleural drainage following Fontan procedure,it seems to be important to improve the preoperative oxygen saturation,use large size of conduit,shorten cardiopulmonary bypass time,and make fenestration during the operation,as well as avoid postoperative infections.展开更多
Purpose.To evaluate the diagnosis and treatment of adrenal incidentalomas.Methods.One hundred and twenty-six patients with incidentalomas were analyzed,among them98underwent operation.Results.Eighty-eight of the adren...Purpose.To evaluate the diagnosis and treatment of adrenal incidentalomas.Methods.One hundred and twenty-six patients with incidentalomas were analyzed,among them98underwent operation.Results.Eighty-eight of the adrenal incidentalomas were discovered by ultrasound.Of all the types of adrenal incidentalomas,52(41.3%)of them were adenomas;43(34.1%)were hypersecretory adrenal tumors,including29pheochromocytomas,9primary aldosteronisms ,1adrenogenitol syndrome combined with adrenal adenoma ,2Cushing’s syndrome combined with adenomas and2Cushing’s syndrome com-bined with nodular hyperplasias.All nonhypersecretory adrenal adenomas were under6cm,and all a-drenal carcinomas were above6cm.Conclusions.To search for hypersecretory adrenal tumors and to detect malignant adrenal tumors are quite essential in the process of diagnosing adrenal incidentalomas.For nonhypersecretory adrenal adeno-mas,the size of tumor is the most important index in determining whether the tumor is benign or malig-nant and whether the tumor needs to be treated with operation.展开更多
Background and objective： Hepatic sinusoidal obstruction syndrome （HSOS） is characterized by painful hepatomegaly, ascites, increased body weight, and jaundice. Gynura segetum （Compositae）, a plant widely used in...Background and objective： Hepatic sinusoidal obstruction syndrome （HSOS） is characterized by painful hepatomegaly, ascites, increased body weight, and jaundice. Gynura segetum （Compositae）, a plant widely used in Chinese traditional medicine, often leads to the development of HSOS. However, the mechanism is unclear. The aim was to study the role of matrix metalloproteinase-9 （MMP-9） in the onset of HSOS induced by Gynura segetum. Methods： Twenty-five male Sprague-Dawley rats were randomly divided into two groups. Twenty were exposed to 600 mg/kg daily Gynura segetum extract solution for three weeks; five control rats were exposed to tap water alone. Liver sections were evaluated by light microscopy with a modified scoring system. Routine transmission electron microscopy （TEM） methods were used to evaluate the ultrastructual features of fixed liver tissue, and blood samples were collected to determine liver enzyme concentrations. MMP-9 expression was assessed by both immunohisto- chemical staining and enzyme-linked immunosorbent assay （ELISA） methods. Results： A stable and reproducible rat model of HSOS was achieved by long-term exposure to Gynura segetum extract. The treated rats presented clinical symptoms and the histopathological manifestation of HSOS, including abnormal liver enzyme concentrations （alanine aminotransferase （ALT）： （84.8＋13.62） vs. （167.0±72.63） U/L, P〈0.05; aspartate aminotransferase （AST）： （27.6±6.31） vs. （232.8±108.58） U/L, P〈0.05）. Hematoxylin and eosin （H＆E） staining and TEM together revealed deposition of red blood cells, the damage and destruction of hepatic sinusoidal endothelial cells, collapse of hepatic sinusoids, hem- orrhage of subendothelial cells, atrophy and destruction of hepatocytes, etc. Compared with controls, the expression of MMP-9 in the blood sample, the lung and liver tissues of HSOS rats was increased. Conclusions： MMP-9 may have an important role in early patholoclical chanqes of HSOS, and thus the onset of the disease.展开更多
基金Program for Outstanding Medical Academic of Shanghai,China (No. LJ10016)Joint Key Project for the New Technology of Shanghai Municipal Hospital,China (No. SHDC12010108)+1 种基金111 Project"Biomedical Textile Materials Science and Technology",China (No.B07024)Doctoral Fund of Ministry of Education of China (No. 20100075110001)
文摘The main disadvantage of conventional ureteral stents commonly used to provide urinary drainage after urological practice is that the patients have to undergo a secondary surgical procedure to remove stents. A new braided thin-walled biodegradable ureteral stent composed of PGA （ polyglycolic acid） and PLGA （ eopolymer of polylactic and polygiycolic acid） mnltifilaments was evaluated in v/tro in this study. In vitro degradation was performed in artificial urine with pH of 5.8 and the temperature of 37~C. The mass loss, mechanical properties, and morphology were observed at different degradaing time intervals of 0, 1, 2, 3, 4, and 5 weeks. The stent had a thinner wail than those of other degradable stents and provided better mechanical properties. The braided thin-walled biodegradable ureteral stents began to degrade after 2 weeks. At the week of 5, the stents were fully degraded. The degradative process of stents is smooth and well controlled.
文摘Objective To investigate the association between preoperative,operative,and postoperative factors and persistent pleural effusion after the extracardiac Fontan procedure. Methods Ninety-five consecutive patients diagnosed with univentricular heart underwent extracardiac connection using Gore-Tax conduits at the Department of Children’s Heart Centre,Justus-Liebig-University Giessen in Germany from June 1996 to July 2007. The outcome measures were duration and volume of chest tube drainage after surgical intervention. The investigated factors included age and weight at the time of operation,anatomical diagnosis,preoperative oxygen saturation,mean pulmonary artery pressure,ventricular end-diastolic pressure,fenestration,cardiopulmonary bypass time,conduit size,postoperative pulmonary artery pressure,administration of angiotensin-converting enzyme inhibitors,and postoperative infection. Associations between these factors and persistent pleural effusion after the extracardiac Fontan procedure were analyzed. Results Every patient suffered postoperative effusion. The median duration of postoperative chest tube drainage was 9 days (range,3-69 days),and the median volume was 12 mL·kg-1·d-1 (range,2.0-37.5 mL·kg-1·d-1). Thirty-seven (38.9%) patients had pleural drainage for more than 15 days,and the volume in 35 (36.8%) patients exceeded 25 mL·kg-1·d-1. Nineteen (20%) patients required placement of additional chest tubes for re-accumulation of pleural effusion after removal of previous chest tubes. Fifteen (17.8%) patients were hospitalized again due to pleural effusion after discharge. The median length of hospital stay after the operation was 14 days (range,4-78 days). Multivariate analysis results showed that non-fenestration,low preoperative oxygen saturation,and postoperative infections were independent risk factors for prolonged duration of pleural drainage (P<0.05). Long cardiopulmonary bypass time,non-fenestration,small conduit size,and low preoperative oxygen saturation were independent risk factors for excessive volume of pleural drainage (P<0.05).Conclusions For reduing postoperative duration and volume of pleural drainage following Fontan procedure,it seems to be important to improve the preoperative oxygen saturation,use large size of conduit,shorten cardiopulmonary bypass time,and make fenestration during the operation,as well as avoid postoperative infections.
文摘Purpose.To evaluate the diagnosis and treatment of adrenal incidentalomas.Methods.One hundred and twenty-six patients with incidentalomas were analyzed,among them98underwent operation.Results.Eighty-eight of the adrenal incidentalomas were discovered by ultrasound.Of all the types of adrenal incidentalomas,52(41.3%)of them were adenomas;43(34.1%)were hypersecretory adrenal tumors,including29pheochromocytomas,9primary aldosteronisms ,1adrenogenitol syndrome combined with adrenal adenoma ,2Cushing’s syndrome combined with adenomas and2Cushing’s syndrome com-bined with nodular hyperplasias.All nonhypersecretory adrenal adenomas were under6cm,and all a-drenal carcinomas were above6cm.Conclusions.To search for hypersecretory adrenal tumors and to detect malignant adrenal tumors are quite essential in the process of diagnosing adrenal incidentalomas.For nonhypersecretory adrenal adeno-mas,the size of tumor is the most important index in determining whether the tumor is benign or malig-nant and whether the tumor needs to be treated with operation.
基金Project supported by the National Natural Science Foundation of China (No.30925033)the Administration of Traditional Chinese Medicine of Zhejiang Province (No.2007ZA016),China
文摘Background and objective： Hepatic sinusoidal obstruction syndrome （HSOS） is characterized by painful hepatomegaly, ascites, increased body weight, and jaundice. Gynura segetum （Compositae）, a plant widely used in Chinese traditional medicine, often leads to the development of HSOS. However, the mechanism is unclear. The aim was to study the role of matrix metalloproteinase-9 （MMP-9） in the onset of HSOS induced by Gynura segetum. Methods： Twenty-five male Sprague-Dawley rats were randomly divided into two groups. Twenty were exposed to 600 mg/kg daily Gynura segetum extract solution for three weeks; five control rats were exposed to tap water alone. Liver sections were evaluated by light microscopy with a modified scoring system. Routine transmission electron microscopy （TEM） methods were used to evaluate the ultrastructual features of fixed liver tissue, and blood samples were collected to determine liver enzyme concentrations. MMP-9 expression was assessed by both immunohisto- chemical staining and enzyme-linked immunosorbent assay （ELISA） methods. Results： A stable and reproducible rat model of HSOS was achieved by long-term exposure to Gynura segetum extract. The treated rats presented clinical symptoms and the histopathological manifestation of HSOS, including abnormal liver enzyme concentrations （alanine aminotransferase （ALT）： （84.8＋13.62） vs. （167.0±72.63） U/L, P〈0.05; aspartate aminotransferase （AST）： （27.6±6.31） vs. （232.8±108.58） U/L, P〈0.05）. Hematoxylin and eosin （H＆E） staining and TEM together revealed deposition of red blood cells, the damage and destruction of hepatic sinusoidal endothelial cells, collapse of hepatic sinusoids, hem- orrhage of subendothelial cells, atrophy and destruction of hepatocytes, etc. Compared with controls, the expression of MMP-9 in the blood sample, the lung and liver tissues of HSOS rats was increased. Conclusions： MMP-9 may have an important role in early patholoclical chanqes of HSOS, and thus the onset of the disease.
