Study on VEGF, bFGF and TGF-β_1 in the Endometrium of Norplant Users

To investigate the relationship between abnormal uterus bleeding and endometrium vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) as well as transforming growth factor β 1 (TGF β 1) expressions among Norplant users. Materials & Methods Thirty six endometrium samples from Norplant users with normal and abnormal bleeding were studied morphologically and immunohistochemically for VEGF, bFGF and TGF β 1 expression. Six normal samples of proliferate endometria were studied as control. Results In the Norplant users, the characteristics of endometrium changed and glands decreased in numbers. The VEGF expression in epithelium and vascular endothelium was lower in those with abnormal uterine bleeding. However, no difference was detected on bFGF and TGF β 1 expression. Conclusion The decline of VEGF expression may relate to the abnormal uterine bleeding in Norplant users.

Randomized Multi-center Study of Baofuxin for Treatment of Bleeding Side-effect Induced by IUD

To observe the efficacy of Baofuxin for treatment of bleeding side effect induced by IUD. Method The study is a multi-center trial. The subjects were randomly allocated into two groups, Baofuxin group (90 cases) and Indomethacin group (90 cases). In the Baofuxin group, the subjects took the medicine on the first day of menses, once a bag, twice a day for 10 days. In the Indomethacin group,only one capsule was taken once a time, twice a day for 7 days. The treatment was given for three menstrual cycles. The subjects were asked to record their bleeding/spotting by using menstrual diary card not only during the treatment cycles but also during the three months previous and after the treatment cycles. The menstrual profile was analyzed by using MDSv2. 3 program that was provided by WHO. Results Within each 90-day reference period of treatment and post-treatment cycles, the number of bleeding/spotting days decreased obviously and bleeding/spotting free days were greatly increased. Both medicines have little effect on number of episode of bleeding/spotting. The subjects who thought the treatment were highly effective were 81. 1% in the Baofuxin group and 56.2% in the Indomethacin group respectively (P <0.01). Conclusion Both Bat,fuxin and indomethacin are highly effective on treatment of bleeding side effect induced by IUD, but Baofuxin had longer effects and was more acceptable.

Radical Nephrectomy Using a Chevron Incision to Treat Complicated Renal Carcinoma:a Report of 15 Cases

OBJECTIVE To investigate the outcome and indications for radical nephrectomy with a Chevron incision to treat complicated renal carcinoma. METHODS Large renal carcinomas were found in 15 patients during a preoperative CT and/or MRI examination. A tumor thrombus in the renal vein or inferior vena cava was found in 5 cases, and a complication of metastasis in the contralateral adrenal gland was found in 2 patients. All of the 15 patients underwent a radical nephrectomy by a chevron incision and the postoperative pathological results noted. RESULTS Of the 15 patients who underwent a radical nephrectomy and lymphadenectomy, 5 also received a thrombectomy, and 2 a contralateral adrenalectomy. All surgical operations were safe and successful. The mean operation time was （4.45 ± 0.83） h, and the intraoperative blood loss was （785 ± 910） ml. All patierfts recovered well after the surgery. Multimodal therapy was conducted in these cases, with rigorous follow-up. CONCLUSION In determining the type of incision for surgery of renal carcinoma, a chevron incision is suitable for cases with a large tumor, local nodal metastasis, thrombus of the renal vein or inferior vena cava and complicated metastasis to the contralateral adrenal gland. The incision produces a clear operating field with less intra- and post-operative complications.

Value of transthoracic echocardiography combined with cardiac troponin I in risk stratification in acute pulmonary thromboembolism

Background Acute pulmonary thromboembolism （APE） causes right ventricular dysfunction （RVD） and cardiac troponin I （cTnl） elevation. Patients with RVD and cTnl elevation have a worse prognosis. Thus, early detection of RVD and cTnl elevation is beneficial for risk stratification. In this study, we assessed 14-day adverse clinical events and combined RVD on transthoracic echocardiography （TTE） with cTnl in risk stratification among a broad spectrum of APE patients. Methods The prospective multi-centre trial included 90 patients with confirmed APE from 12 collaborating hospitals. Acute RVD on TTE was diagnosed in the presence of at least 2 of the following： right ventricular dilatation （without hypertrophy）, loss of inspiratory collapse of inferior vena cava （IVC）, right ventricular （RV） hypokinesis, tricuspid regurgitant jet velocity 〉2.8 m/s. The study patients were divided into two groups according to clinical and echocardiographic findings at presentation： Group Ⅰ： 50 patients with RVD; Group Ⅱ：40 patients without RVD. Results More than half of the patients （50/90, 55.6%） had RVD. Nearly one third （26/90, 28.9%） of patients had elevated cTnl at presentation and only 4.2% on the fourth day after initial therapy. A multiple Logistic regression model implied RVD, right and left ventricular end-diastolic diameter ratio （RVED/LVED）, and cTnl independently predict an adverse 14-day clinical outcome （P〈0.01）. Receiver operating characteristics （ROC） curves revealed that the cut-off values of RVED/LVED and cTnl yielding the highest discriminating power were 0.65 and 0.11 ng/ml, respectively. Furthermore, the incidence of an adverse 14-day clinical event in patients with RVD and elevated cTnl was greater （40.7%） than in patients with elevated cTnl or positive RVD alone （0% and 8.3%, respectively） （P〈0.001）. Conclusions RVD, RVED/LVED, and cTnl are independent predictors of 14-day clinical outcomes. The patients with RVED/LVED greater than 0.65 and cTnl higher than 0.11 ng/ml at presentation possibly have adverse 14-day events. RVD combined with cTnl can identify a subgroup of APE patients with a much more guarded prognosis.

Protection of carbon monoxide-releasing molecule against lung injury induced by limb ischemia-reperfusion

Objective： To observe the role and mechanism of CO- releasing molecule （CORM）-2 in lung injury induced by ischemia-reperfusion （IR） of hind limbs in rats. Methods： Arat model of lung injury induced by IR of hind limbs was established. A total of 40 Sprague Dawley （SD） rats were randomly divided into 5 groups （n = 8）： sham, sham ＋ CORM-2, IR, IR ＋ CORM-2 and IR ＋ dimethyl sulfoxide （DMSO）. Rats in the IR group received hind limb ischemia for 2 hours and reperfusion for 2 hours, rats in the sham group underwent sham surgery without infrarenal aorta occlusion, rats in the IR＋CORM-2 group and in the sham ＋ CORM-2 group were given CORM-2 （10 μmol/kg intravenous bolus） 5 minutes before reperfusion or at the corresponding time points, while rats in the IR ＋ DMSO group was treated with the same dose of vehicle （DMSO） at the same time. The lung tissue structure, polymorphonuclear neutrophil （PMN） count, wet-to-dry weight ratio （W/D）, malondialdehyde （MDA） content, myeloperoxidase （MPO） activity, intercellular adhesion molecule- 1 （ICAM- 1）expression, I κBα degradation and nuclear factor （NF）-κB activity in the lungs were assessed. Results： As compared with the sham group, lung PMNs number, W/D, MDA content, MPO activity, ICAM-1 expression and NF- κB activity significantly increased in the IR group, but the level of I κBα decresed （P〈0.01）. Compared with the IR group, lung PMNs number, W/D, MDA content, MPO activity and ICAM- 1 expression significantly decreased in the IR＋COMR-2 group （P〈0.01）, while the level of IκBα increased. Conclusions： These data demonstrate that CORM-2 attenuates limb IR-induced lung injury through inhibiting ICAM-1 protein expression, NF-κB pathway and the leu- kocytes sequestration in the lungs following limb IR in rats, suggesting that CORM-2 may be used as a therapeutic agent against lung injury induced by limb IR.