Influence of 3D laparoscopic surgery on surgeon's visual pattern and mental workload.

Previous studies have found that surgeons perform better in three-dimensional (3D) surgery than in two-dimensional (2D) surgery. However, no comparative studies have revealed the impact of 3D laparoscopic surgery on the surgeon's vision. To explore the effect of laparoscopic surgeons' depth perception during 3D laparoscopic surgery, 10 participants were recruited and performed 4 sets comparative simulated laparoscopic procedures in a virtual simulator, and eye movement signals were acquired, which were used to characteristics the visual differences. Fixation rate and saccade speed were used to characterise the influence of moderating variables for visual characteristics. The results from the data showed significant differences in eye movement behaviour. Compared with 2D laparoscopic surgery, surgeons have more average fixation rate (p-values = 0.001, 0.000, 0.003 and 0.015, respectively) and faster saccade speed (p-values = 0.037, 0.003, 0.073 and 0.105, respectively) in 3D laparoscopic surgery. The results of this study showed that surgeons had more efficient visual search in 3D laparoscopic surgery. At the same time, the results also indicated that surgeon's mental workload in 3D laparoscopic surgery was low. The relevant conclusions of this paper revealed the advantages of 3D laparoscopic surgery through visual efficiency.

An unusual case of ectopic corticotrophin-releasing hormone syndrome caused by an adrenal noncatecholamine-secreting pheochromocytoma: a case report.

BACKGROUND: Pheochromocytoma, especially for noncatecholamine-secreting pheochromocytoma, is an extremely rare cause of ectopic corticotrophin-releasing hormone (CRH) syndrome. CASE PRESENTATION: A 27-year-old Chinese woman was administered dexamethasone for a skin allergy, but her general condition rapidly deteriorated over a month. She was subsequently hospitalized for typical clinical features of Cushing's syndrome. Endocrinological investigation confirmed severe hypercortisolism along with elevated plasma adrenocorticotropin hormone (ACTH). However, magnetic resonance imaging (MRI) revealed no pituitary adenoma. Abdominal contrast-enhanced computed tomography (CT) revealed a 6.5 cm heterogeneous right adrenal mass with mildly contrast enhancement. The tumor was found during a routine physical check-up at a local hospital 16 months ago; however, the patient did not have any symptoms and did not seek further medical attention at that time. Laparoscopic resection of the right adrenal tumor led to a rapid remission of Cushing's syndrome. Based on pathological findings and the presence of normal catecholamine metabolites in her serum and urine, the patient was diagnosed with noncatecholamine-secreting pheochromocytoma. Immunohistochemical staining of the adrenal tumor revealed positive staining for CRH and negative staining for ACTH. CONCLUSIONS: This is an extremely rare case of ectopic CRH syndrome caused by an adrenal noncatecholamine-secreting pheochromocytoma. Both ectopic ACTH syndrome and ectopic CRH syndrome should be considered in patients presenting with ACTH-dependent Cushing's syndrome caused by extrapituitary diseases.

Nonfunctional pancreatic endocrine tumor in the peripancreatic region in a Chinese patient with multiple endocrine neoplasia type 1.

Nonfunctional pancreatic neuroendocrine tumors (NF-pNETs) in patients with multiple endocrine neoplasia type 1 (MEN1), which results from a mutation in the MEN1 gene, are commonly small, multiple tumors located in the pancreatic head and inside the pancreatic parenchyma. We herein describe a 35-year-old woman with bone pain and a 7-year history of a prolactinoma. She was clinically diagnosed with MEN1 based on the presence of the prolactinoma and parathyroid hyperplasia. Abdominal computed tomography revealed a 5-cm mass close to the splenic hilum. This soft tissue tumor, which was located outside the pancreatic parenchyma and the tissue origin of which could not be identified preoperatively, was found to be connected to the pancreatic tail. After resection, histological examination revealed a well-differentiated neuroendocrine tumor of pancreatic origin. Genetic testing revealed a heterozygous transition mutation of guanine to adenine at the coding nucleotide 133 in exon 2 (c.133G>A), resulting in an amino acid substitution of glutamic acid with lysine (E45K) in the MEN1 gene. This patient with MEN1 presented with a clinical condition involving a single non-metastatic NF-pNET located outside the pancreatic parenchyma with a missense mutation in the MEN1 gene, which could easily have been misdiagnosed as an accessory spleen.

Active form of vitamin D ameliorates non-alcoholic fatty liver disease by alleviating oxidative stress in a high-fat diet rat model.

The purpose of this study was to determine whether treatment using the active form of vitamin D (1,25(OH)2D3) could protect against high-fat diet (HFD)-induced non-alcoholic fatty liver disease (NAFLD) in rats and ameliorate oxidative stress. Male Sprague-Dawley rats were divided into three groups and treated with standard chow, HFD, or HFD plus intraperitoneal injection of 1,25(OH)2D3 (5 µg/kg body weight, twice per week), respectively, for 16 weeks. Serum lipid profiles, hepatic function, intrahepatic lipid, and calcium levels were determined. Hepatic histology was examined using hematoxylin/eosin, Masson's trichrome, and Oil Red O staining. Oxidative stress was assessed by measuring hepatic malondialdehyde (MDA) and F2α-isoprostane content. Expression of nuclear factor-erythroid-2-related factor 2 (Nrf2) and downstream target genes was analyzed using quantitative RT-PCR. 1,25(OH)2D3 treatment improved the serum lipid profile, reduced intrahepatic lipid levels, and attenuated hepatic steatosis and inflammation in HFD rats. Furthermore, MDA and F2α-isoprostane levels in liver tissue were reduced by 1,25(OH)2D3 administration. Although 1,25(OH)2D3 did not regulate the expression of Nrf2 mRNA, it did induce Nrf2 nuclear translocation. The expression of Nrf2 target genes, including Gclc, Nqo1, Sod2, and Cat, was up-regulated by 1,25(OH)2D3. We conclude that 1,25(OH)2D3 protects against HFD-induced NAFLD by attenuating oxidative stress, inducing NRF2 nuclear translocation, and up-regulating the expression of genes encoding antioxidant enzymes.

[Evaluation of renal tissue ischemia-reperfusion injury with ultrasound radiation force and targeted microbubbles].

OBJECTIVE: To study the sensitivity and feasibility of detecting microvascular inflammation in renal ischemia- reperfusion injury using microbubbles (MB) targeted to the intercellular adhesion molecule ICAM-1 and ultrasound radiation force (USRF). METHODS: Mouse models of kidney ischemia-reperfusion were randomized into 5 groups with reperfusion time of 1, 3, 6, 12, and 24 h (IRlh, IR3h, IR6h, IR12h, and IR24h group, respectively). Each group was subdivided into targeted MB group (MBICAM group) and targeted MB +USRF group (MBICAM+USRF group). Kidney enhancement and the video intensity (VI) of the kidneys were compared among the groups. RESULTS: In normal mice in either MBICAM or MBICAM+USRF group, no obvious enhancement of the kidney or significant increase in VI of the kidneys was observed (P=0.923). The kidneys were enhanced in all the mice with renal ischemia-reperfusion injury, and with the passage of time, the enhancement increased progressively. VI in the kidneys of mice with renal ischemia-reperfusion injury in MBICAM+USRF group increased more significantly compared with the MBICAM group. Significant difference in the VI was noted among the groups with different perfusion time but not between IR12h and IR24h groups. CONCLUSION: Microbubbles targeted to ICAM-1 combined with USRF can effectively evaluate renal ischemia-reperfusion injury in mice and can be used for early evaluation of microvascular inflammation and other endothelial responses.

Motility, progressive motility score and DNA integrity of spermatozoa from cold-preserved mouse cauda epididymis.

This study attempted to investigate and validate whether epididymis cold storage could be a suitable alternative for short-term preservation of spermatozoa. Mouse cauda epididymides and spermatozoa were preserved at 4-8°C from 1 day to 6 weeks. From days 1 to 10, motility and fertility were daily examined when motility loss occurred. From week 1, spermatozoa were used for intracytoplasmic sperm injection (ICSI) at weekly intervals to test their fertility, and spermatozoa DNA integrity was determined by comet assay. We found that motility and progressive motility scores gradually decreased with storage time. In nearly all spermatozoa, DNA integrity was maintained from days 1 to 10, but the percentage of spermatozoa with damaged DNA significantly increased from week 2 to week 6. Spermatozoa retained fertility until day 6, although fertility gradually decreased after day 3. From week 1 to week 5, fertilization rates by ICSI were more than 82.69% but decreased gradually after week 3. We found that spermatozoa preserved in the epididymis at 4-8°C had progressively lower motility, fertility and proportion of undamaged DNA, but could still fertilize oocytes. However, all the parameters of cold-preserved spermatozoa were completely inferior to that from cold-preserved cauda epididymides. The results imply that cold storage of cauda epididymides could be conducive to short-term preservation of spermatozoa, and the cold-stored spermatozoa can resist DNA denaturation, which is necessary for maintaining reproductive ability.

Experimental method for testing diffraction properties of reflection waveguide holograms.

Waveguide holograms' diffraction properties include peak wavelength and diffraction efficiency, which play an important role in determining their display performance. Based on the record and reconstruction theory of reflection waveguide holograms, a novel experimental method for testing diffraction properties is introduced and analyzed in this paper, which uses a plano-convex lens optically contacted to the surface of the substrate plate of the waveguide hologram, so that the diffracted light beam can be easily detected. Then an experiment is implemented. The designed reconstruction wavelength of the test sample is 530 nm, and its diffraction efficiency is 100%. The experimental results are a peak wavelength of 527.7 nm and a diffraction efficiency of 94.1%. It is shown that the tested value corresponds well with the designed value.

[Association of RNASET2 gene polymorphisms and haplotypes with Graves disease in Han Chinese population from coastal regions of Shandong].

OBJECTIVE: To assess the association of RNASET2 gene polymorphisms and haplotypes with Graves disease (GD) in Han Chinese population from coastal regions of Shandong Province. METHODS: A total of 471 GD patients and 472 controls were enrolled. Genotypes of single nucleotide polymorphisms (SNPs) in RNASET2 gene were determined with a Taqman probe on a Fluidigm EPl platform. Haplotypes and their frequencies were analyzed with a SHEsis online software. RESULTS: There was a significant difference in allele frequencies of rs3777722, rs3777723 and rs9355610 between the GD patients and the controls (P=0.018; P=0.028; P=0.021).Allele frequencies of rs3777722 and rs9355610 were significantly lower in GD than in the controls (P=0.018, P=0.021). Haplotypes A-A-C-A and A-A-T-A were significantly more common in the control group compared with the GD group (P=0.046, OR=0.448, 95%CI:0.200-1.006; P=0.049, OR=0.823, 95%CI:0.678-0.999). The frequency of C-G-C-G haplotype was significantly higher in GD patient group than the control group (P=0.018). CONCLUSION: RNASET2 gene polymorphisms and haplotypes are associated with GD in Han population from coastal areas of Shandong Province. rs3777722 and rs9355610 may contribute to the risk for GD.

Advanced understanding of stickiness on superhydrophobic surfaces.

This study explores how contact angle hysteresis and titling angle relate with stickiness on superhydrophobic surfaces. The result indicates that contact angle hysteresis could not be mentioned as a proper factor to evaluate the surface stickiness. By analyzing the system pinning force of droplet placed on a titled surface, we concluded that both solid fraction and surface geometric factor are the critical factors determining the surface stickiness.

Insulin improves ß-cell function in glucose-intolerant rat models induced by feeding a high-fat diet.

Insulin therapy has been shown to contribute to extended glycemia remission in newly diagnosed patients with type 2 diabetes mellitus. This study investigated the effects of insulin treatment on pancreatic lipid content, and ß-cell apoptosis and proliferation in glucose-intolerant rats to explore the protective role of insulin on ß-cell function. A rat glucose-intolerant model was induced by streptozotocin and a high-fat diet. Plasma and pancreatic triglycerides, free fatty acids, and insulin were measured; and pancreatic ß-cell cell apoptosis and proliferation were detected by a propidium iodide cell death assay and immunofluorescence for proliferating cell nuclear antigen. Relative ß-cell area was determined by immunohistochemistry for insulin, whereas insulin production in pancreas was assessed by reverse transcriptase polymerase chain reaction. Islet ß-cell secreting function was assessed by the index ΔI30/ΔG30. Glucose-intolerant rats had higher pancreatic lipid content, more islet ß-cell apoptosis, lower ß-cell proliferation, and reduced ß-cell area in pancreas when compared with controls. Insulin therapy reduced blood glucose, inhibited pancreatic lipid accumulation and islet ß-cell apoptosis, and increased ß-cell proliferation and ß-cell area in glucose-intolerant rats. Furthermore, impaired insulin secretion and insulin production in glucose-intolerant rats were improved by insulin therapy. Insulin can preserve ß-cell function by protecting islets from glucotoxicity and lipotoxicity. It can also ameliorate ß-cell area by enhancing ß-cell proliferation and reducing ß-cell apoptosis.

[Preliminary study of an intracavitary convex array probe for detecting distal extracranial internal carotid artery by transoral carotid ultrasonography].

OBJECTIVE: To explore the feasibility of using an intracavitary convex array probe for detecting the distal extracranial internal carotid artery (ICA) by transoral carotid ultrasonography (TOCU). METHODS: Forty patients underwent examinations with bilateral ICA inspected with an intracavitary convex array probe by TOCU to observe the internal diameter, visible length, peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI). RESULTS: Eight of the 40 patients were excluded from the observation for the presence of carotid plaques. The examination was terminated in two patients due to sensitive throat and severe pharyngeal reflex. The rest of the patients completed the examination of the internal diameter, visible length, PSV, EDV and RI, which showed no statistically significant differences among them (P>0.05). CONCLUSION: Using intracavitary convex array probe, the distal extracranial ICA disease can be diagnosed with higher accuracy.

Renoprotective effects of fenofibrate in diabetic rats are achieved by suppressing kidney plasminogen activator inhibitor-1.

To investigate mechanisms of protective effects of fenofibrate on the diabetic kidney, male Wistar rats were divided into control, untreated diabetes, and fenofibrate-treated (32 mg kg(-1) d(-1), 8 weeks) diabetes groups. Diabetes induced by streptozotocin (25 mg/kg) and a high-fat diet was characterized by the disorders of plasma glucose and lipids. In untreated diabetic rats, there were increases in glomerular volume, matrix content, expressions of laminin and urinary albumin excretion. These nephropathies were associated with the upregulations of plasminogen activator inhibitor 1 (PAI-1) mRNA expression and its protein activity in the renal cortex, and a significant increase in transforming growth factor beta1 (TGF-beta1) expression. Treatment with fenofibrate suppressed the expression of PAI-I mRNA and its protein activity, and inhibited TGF-beta1 overexpression. It also partially reversed metabolic disorders and pathophysiologic changes associated with diabetic nephropathy. Our results indicate that fenofibrate delays the progression of diabetic nephropathy in rats to some extent. These renoprotective effects are likely to be achieved through suppression of PAI-1 and TGF-beta1 in the renal cortex, and consequently less extracellular matrix deposition.

[Effect and risk analysis of misoprostol in stimulating cervical maturity for post-term pregnancy].

OBJECTIVE: To evaluate the effect and risk of misoprostol for stimulating cervical maturity in women with post-term pregnancy negative for insulin-like growth factor binding protein-1 (IGFBP-1) in cervical secretion with modified Bishop score less than 3. METHODS: Seventy-one women with post-term pregnancy randomized into misoprostol group (n=37) and control group (n=34) received misoprostol placement at the posterior vaginal fornix and routine intravenous oxytocin infusion, respectively, to stimulate cervical maturity. Failure to respond to the treatment within the initial 24 h necessitated a repeated administration for no more than 3 times in all. Modified Bishop score was recorded and fetal heart monitored once every 24 h, and IGFBP-1 in the cervical secretion was detected at 24 and 48 h after drug administration. RESULTS: The misoprostol group showed better effect of cervical maturity stimulation than the control group (P<0.001), and the positivity rates of IGFBP-1 24 and 48 h after drug administration were significantly higher than that of the control group (P<0.01 and 0.001). The number of cases with indication for cesarean section was significant higher in the control group (P<0.001). There were no significant differences in postpartum hemorrhage, excessive uterine contraction, incidence of fecal contamination of the amniotic fluid or Apgar score of the newborn between the two groups (P>0.05). CONCLUSIONS: Misoprostol is safe and effective for stimulating cervical maturity in women with post-term pregnancy who have modified Bishop score lower than 3 and are negative for IGPBF-1 in cervical secretion. Oxytocin is not advised for use in such gravida for stimulating cervical maturity. IGFBP-1 in cervical secretion may serve as an important index for evaluating the cervical maturity.

[Effects of insulin treatment on intracellular lipid content in livers and insulin resistance in type 2 diabetic rats].

OBJECTIVE: To study effects of insulin treatment on intracellular lipid content in livers and insulin resistance of type 2 diabetic rats. METHODS: Type 2 diabetic rats were induced by injecting streptozotocin (25 mg/kg) and fat rich food. Then according to the results of the oral glucose tolerance test (OGTT) and glucose-induced insulin secretion test (IST), the rats were divided into two groups: control group (DC) and insulin treated group (DI). Normal rats (NC) served as controls. The treatment of each group with either NPH insulin (4 approximately 6 U . kg-1. d-1), or saline continued for 4 weeks. Body weight, OGTT, IST, blood lipids, intracellular lipids in liver and liver histology were studied. The insulin sensitivity index (ISI) was applied to assess the status of insulin resistance. RESULTS: Blood lipid and intracellular lipids in livers in the DC were higher than those in NC (t = 2.59 approximately 15.77, P < 0.05) and the ISI was lower (t = 3.16, P < 0.05), with many fatty droplets appearing in the livers. In comparison to DC, DI showed that blood lipids were decreased, but lipids in livers were markedly increased (TG, TC, FFA increased 55.7%, 19.87%, 22.2%, respectively), and fatty droplets in hepatocytes were larger, but the ISI did not change significantly. CONCLUSION: Insulin treatment can make blood glucose normal, increase the intracellular lipid content in the liver, and not increase the insulin resistance significantly.

[Impact of epidural anesthesia during delivery on breast feeding].

OBJECTIVE: To explore the influence of epidural anesthesia during delivery on breast feeding. METHOD: A total of 170 healthy women hospitalized for vaginal delivery without obstetric complications during the year 2001 to July 2003 were analyzed, who were divided into observation group (n=96) with continuous epidural anesthesia and control group (n=74) without continuous epidural anesthesia or postpartum analgesia. The data of analgesic efficacy, postpartum mental state, starting time of lactation, milk quantity and the feeding times in 24 h and prolactin level before and 48 h after delivery were analyzed statistically. RESULTS: The women in the observation group reported better analgesic efficacy than the control group (P<0.01) with also better postpartum mental state (P<0.05). The observation group had shorter starting time of lactation and larger quantity of milk secretion (P<0.05) with higher prolactin level 48 h after delivery (P<0.05) than the control group. CONCLUSIONS: Continuous epidural anesthesia and postpartum analgesia are effective and safe with little side effects in pain relief, improving the mental state, and promoting breast feeding. Obvious analgesic effect reduces catecholamine level, promotes prolactin secretion, and benefits the breast feeding.