Application of three-dimensional reconstruction of renal tumor vessels to guide laparoscopic partial nephrectomy of hilar tumors and non-hilar tumors under zero ischemia.

OBJECTIVE: To investigate the safety and efficacy of three-dimensional reconstruction of renal tumor vessels to guide laparoscopic partial nephrectomy of hilar tumors and non-hilar tumors under zero ischemia. METHODS: The clinical data of 82 patients with renal cancer who underwent zero ischemia retroperitoneal laparoscopic partial nephrectomy in the department of urology of our hospital from January 2018 to January 2021 were retrospectively reviewed. The patients were divided into hilar group and non-hilar group. The clinical data of all patients were statistically analyzed by t-test or χ2. RESULTS: There was no significantly difference in gender, age, tumor diameter and pathological stage between hilar and non-hilar tumor group. Most of the target vessels in the hilar tumor group were single targets, while most of the target vessels in the non-hilar tumor group were multiple targets (P<0.05). There was no significantly difference between the groups for mean operative time and length of stay. But hilar tumor group had significantly longer operation time (109.3 ± 9.2 vs. 90.3 ± 9.5 min, p<0.001). There was no significant difference in renal GFR and serum creatinine between the two groups. Hilar tumor group had no significantly difference of change of creatinine and GFR at post-operative 6 and 12 months as compared with non-hilar tumor group. There were no bleeding, urinary leakage, infection and other related complications in the two groups after 1 month follow-up. After 12 months of follow-up, there was no tumor recurrence and metastasis in the two groups. CONCLUSION: The application of three-dimensional renal tumor vascular reconstruction technology can better realize laparoscopic zero ischemia nephron sparing surgery. The target vessels of patients with hilar, single and early renal cancer are easier to find, which is more suitable for three-dimensional renal tumor vascular reconstruction technology to implement laparoscopic zero ischemia nephron sparing surgery.

Effects of xylazole alone and in combination with ketamine on the metabolic and neurohumoral responses in healthy dogs.

OBJECTIVE: To evaluate the effects of xylazole (an analogue of xylazine), also known as Jingsongling, alone and in combination with ketamine, on metabolic and neurohumoral responses in healthy dogs. STUDY DESIGN: Prospective randomized experimental study. ANIMALS: Twelve healthy mongrel dogs (7 male, 5 female, aged 13-20 months, weighing 12.8-15.4 kg). METHODS: Each dog received one of two treatments: xylazole 4 mg kg(-1) (group X n = 6); or xylazole 4 mg kg(-1) plus ketamine 10 mg kg(-1) (group XK; n = 6) intramuscularly. Pulse rate (PR), mean arterial pressure (MAP), respiratory rate (f(R)), and rectal temperature (RT) were recorded before and from 5 to 100 minutes after drug administration. Venous blood samples were taken before and at intervals from 0.5 to 24 hours after drug administration for determination of plasma concentrations of norepinephrine, epinephrine, beta-endorphin, cortisol, insulin, and glucose. Statistical analyses employed anova for repeated measures for changes with time and anova for comparison between treatments. RESULTS: In both treatment groups. PR, f(R) and RT decreased. MAP increased transiently. At some time points PR, MAP and RT were significantly lower in group X than group XK. Plasma norepinephrine, epinephrine, and insulin concentrations decreased, and beta-endorphin and glucose concentrations increased with both treatments. Higher values of plasma norepinephrine, epinephrine, beta-endorphin, and glucose concentrations were observed in the XK group compared with the X group. CONCLUSIONS AND CLINICAL RELEVANCE: This study demonstrates that xylazole administered alone or in combination with ketamine in healthy dogs results in physiological, metabolic and neurohumoral responses similar to those seen after xylazine. Compared with xylazole alone, the combination of xylazole and ketamine reduced some of the responses.

Enhanced levels of soluble and membrane-bound CD137 levels in patients with acute coronary syndromes.

BACKGROUND: Increasing evidence shows that costimulatory molecules of the tumor necrosis factor superfamily such as CD40/CD40 ligand and OX40/OX40 ligand have been implicated in atherosclerosis. We investigated whether the expression levels of the tumor necrosis factor superfamily members CD137 in serum and membrane-bound were related to acute coronary syndromes (ACS). METHODS: Thirty normal controls and 210 patients, including 70 with stable angina (SA), 80 with unstable angina (UA), and 60 with acute myocardial infarction (AMI), were enrolled in our study. The expression of CD137 in peripheral monocytes was analyzed by flow cytometry. Serum soluble CD137 (sCD137) and C-reactive protein levels were measured by commercially available ELISA. RESULTS: The expression of CD137 in peripheral monocytes in patients with UA [14.2+/-3.5 mean fluorescence intensity (MFI)] and AMI (15.1+/-4.4MFI) was significantly higher than those in patients with SA (6.5+/-2.4MFI) and controls (7.1+/-3.5MFI). sCD137 in patients with UA (16.7+/-4.9 ng/ml) and AMI (19.1+/-4.3 ng/ml) were significantly higher than those in patients with SA (3.4+/-1.4 ng/ml) and controls (3.9+/-1. 3 ng/ml) (p<0.001). C-reactive protein level in serum in patients with UA (13.8+/-3.3 ng/ml) and AMI (15.5+/-4.7 ng/ml) were also higher than those in patients with SA (1.4+/-0.4 ng/ml) and controls (1.3+/-0.3ng/ml). It was interesting that percutaneous transluminal coronary angioplasty (PTCA) induced a marked rise in sCD137 levels in SA patients, while CD137 expression in peripheral monocytes showed no difference between SA patients with PTCA before and after. A positive correlation was found between sCD137 and serum C-reactive protein levels (r=0.681; p<0.0001). CONCLUSION: Patients with ACS showed increased soluble and membrane-bound CD137 expression. sCD137 level showed a significantly positive correlation with CRP level in patients with ACS. The relation between sCD137 and ACS needs further researches.