Comparable long-term survival outcomes after endoscopic and gastrectomy treatment of pT1acN0M0 gastric adenocarcinoma in patients who met the expanded criteria.

BACKGROUND: Whether the Western pT1acN0M0 gastric cancer (GC) patients who met the Japanese expanded criteria could be the candidates for endoscopic treatment (ET) remains unclear because of unknown long-term survival outcomes. METHODS: A retrospective cohort study using data from the Surveillance, Epidemiology, and End Results (SEER) program was performed. The survival differences between pT1acN0M0 gastric adenocarcinoma patients who received ET or gastrectomy treatment (GT) were evaluated using multivariate survival analysis. RESULTS: A total of 314 pT1acN0M0 gastric adenocarcinoma patients who met the expanded criteria were included, 46 patients received ET and 268 patients received GT. pT1acN0M0 gastric adenocarcinoma patients met the expanded criteria underwent ET experienced a similar hazard of cancer-specific death compared with those underwent GT both in the multivariate Cox survival analysis (adjusted hazard ratio [HR]; 1.18, 95% confidence interval [CI] 0.40-3.49; P = 0.766) and the multivariate competing risk model (subdistribution HR [SHR], 1.12, 95% CI 0.38-3.29; P = 0.845). The result that pT1acN0M0 gastric adenocarcinoma patients met the expanded criteria underwent ET experienced comparable survival outcomes to those who underwent GT did not change even compared with those who underwent GT with > 15 lymph nodes examined (adjusted HR, 1.55, 95% CI 0.44-5.49; P = 0.499; SHR, 1.47, 95% CI 0.44-4.88; P = 0.532). CONCLUSIONS: The ET can be considered in Western pT1acN0M0 gastric adenocarcinoma patients who met the Japanese expanded criteria. However, a prospective study should be warranted.

Comparable long-term outcomes after endoscopic therapy and gastrectomy of early adenocarcinoma of esophagogastric junction: a population-based study.

BACKGROUND AND AIMS: Current guidelines recommend consideration of endoscopic therapy (ET) when treating selected early gastric cancers. However, clinical decision-making on ET versus gastrectomy for early adenocarcinoma of esophagogastric junction (AEGJ) remains challenging because of uncertain long-term outcomes. METHODS: We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results database from 2004 to 2017 of early AEGJ patients underwent ET or gastrectomy. Multivariate models were used to compare cancer-specific survival (CSS). RESULTS: Of 881 included early AEGJ patients, 227 (36.2%) patients underwent ET and 654 (63.8%) patients underwent gastrectomy. Early AEGJ patients who underwent ET experienced a similar hazard of cancer-specific death compared with those underwent gastrectomy in both multivariate Cox regression (HR [hazard ratio], 0.93; 95% CI [confidence interval], 0.55-1.56; P = 0.78) and the multivariate competing risk model (subdistribution HR [SHR], 0.86; 95% CI 0.50-1.45; P = 0.56). Propensity score matching was used, 210 patients underwent ET were matched with 210 patients underwent gastrectomy. Patients underwent ET experienced a similar hazard of cancer-specific death compared with those underwent gastrectomy in both multivariate Cox regression (HR, 0.97; 95% CI 0.53-1.77; P = 0.92) and the multivariate competing risk model (SHR, 0.96; 95% CI 0.52-1.77; P = 0.89). CONCLUSION: Early AEGJ patients who received ET or gastrectomy had comparable long-term outcomes, which lend support to the role of ET in the treatment of these patients.

Impact of Lymph Nodes Examined on Survival in ypN0 Gastric Cancer Patients: a Population-Based Study.

BACKGROUND: Our aim was to evaluate the prognostic value of the number of lymph nodes examined (eLNs) on survival in ypN0 gastric cancer (GC) patients, and further to define the optimal number of lymph nodes needed to be examined during radical gastrectomy of ypN0 GC patients. METHODS: A total of 1127 ypN0 GC patients during 2004-2015 from the Surveillance, Epidemiology, and End Results (SEER) database were included. The number of eLNs cutoff points that determined the greatest actuarial survival difference was calculated by the X-tile program. Univariate and multivariate analyses were performed to assess the impact of eLNs on overall survival (OS). RESULTS: The optimal number of eLNs thresholds was determined to be 15 for ypN0 GC patients. Kaplan-Meier analysis revealed that ypN0 GC patients with ≥ 16 eLNs had a significantly better OS than those with ≤ 15 eLNs (5-year OS; 60.8 vs 45.4%, P < 0.001). Similarly, multivariate Cox analysis revealed that ypN0 GC patients with ≥ 16 eLNs experienced a significantly lower hazard of death than those with ≤ 15 eLNs (adjusted HR; 0.73, 95% CI, 0.60-0.90, P = 0.003). CONCLUSIONS: The number of eLNs was an independent predictor of survival for ypN0 GC patients. A minimum of 15 eLNs is recommended as the cutoff point for the evaluation of the quality of postoperative or prognostic stratification in ypN0 GC patients.

Influence of Tumor Location on Lymph Node Metastasis and Survival for Early Gastric Cancer: a Population-Based Study.

BACKGROUND: The question that whether the criteria for endoscopic resection of early gastric non-cardia cancer (GNCC) is appropriate for early gastric cardia cancer (GCC) remains unclear. Thus, our aim was to evaluate the influence of tumor location on lymph node metastasis (LNM) and overall survival (OS) for early gastric cancer (GC). METHODS: A total of 5440 early GC patients in the Surveillance, Epidemiology, and End Results (SEER) database were identified. Multivariable analysis was performed to evaluate the influence of tumor location on LNM and OS for early GC. RESULTS: The rate of LNM was 17.48% for early GCC patients (232/1327) and 18.62% for early GNCC patients (766/4113). The early GCC patients experienced no significantly different risk of LNM compared with the early GNCC patients (adjusted OR 0.92, 95% CI 0.76-1.12, P = 0.405). The early GC patients were further stratified by node status. Tumor location was not a predictor of OS for node-negative early GC patients (adjusted HR 1.07, 95% CI 0.96-1.21, P = 0.225) but a predictor of OS for node-positive early GC patients (adjusted HR 1.80, 95% CI 1.48-2.20, P < 0.001). CONCLUSIONS: Tumor location was not a predictor of LNM for early GC patients. Moreover, tumor location was not a predictor of OS for node-negative early GC patients. Thus, the criteria for endoscopic resection of early GNCC might be appropriate for the treatment of early GCC.

Efficacy and complications of intravesical instillation of BCG for prevention of recurrence of moderate and high-risk non muscle invasive bladder cancer / 中华泌尿外科杂志

Objective To assess the efficacy and side effects of intravesical instillation of BCG after transurethral resection of the bladder tumor (TURBT) in non-muscle invasive bladder cancer (NMIBC) patients.Methods The clinical data of patients treated with BCG 120 mg per course induced perfusion or more after TURBT from December 2013 to October 2016 in 18 hospitals of northeast China region,were analyzed retrospectively.The first part,data of 106 patients with moderate,high-risk NMIBC were collected.A total of 83 patients were male,while the other 23 patients were female.The average age was 66.7 years old.The clinical staging were T1 in 86(81.1％) cases,Ta in 20(18.9％) cases and carcinoma in situ in 6 (5.7％) patients.Intravesical instillation of BCG was executed after transurethral resection of the bladder tumor.The incidence rate of recurrence and progression during more than 6 months' follow-up time were observed.Multivariate analyses were done by using logistic analysis and Cox proportional hazards regression model with Kaplan-Meier method.The second part,treatment compliance of 276 patients with bladder cancer,including moderate/high-risk NMIBC in 263 cases,moderate/high-risk NMIBC followed with renal pelvis/ureteral carcinoma in 8 cases were and moderate/high-risk NMIBC with renal pelvis/ureteral carcinoma in 5 cases who treated with BCG after the surgeries,were observed.Patients consisted of 211 males and 65 females with average age of 68.3 years.Results With a median follow-up of 12 months,9 (8.5％) patients experienced tumor recurrence and 2 (1.9％) patients were found progression in the first part.The one-year cancer free recurrence rate of the patients was 91.5％.Statistically significant prognostic factors for recurrence identified by multivariable analyses were prior recurrence of the tumors (OR =3.214,95％CI0.804-12.845,P =0.099).In the second port,an incidence rate of adverse effects was 64.1％ (177/276).The Ⅲ/Ⅳ degree complications were occurred in 11 patients and satisfactory outcomes achieved with active treatment.A total of 36 patients withdrawal with the major causes were recurrence and progression of bladder tumor in 12 cases (4.4 ％),9 cases (3.3 ％) with economic reasons and 11 cases (4.0％) with serious complications.Conclusions NMIBC patients treated with intravesical BCG therapy have approving cancer free recurrence rates and acceptable adverse effects.Prior recurrence may be prognostic factor of recurrence after intravesical BCG therapy.

Effects of andrographolide in proliferation, migration and apoptosis of renal cell carcinoma 786-0 cells / 吉林大学学报(医学版)

Objective:To study the inhibitory effects of andrographolide (Andro) on the proliferation,migration and clone formation ability of renal cell carcinoma (RCC) cells and the induction on the apoptosis,and to clarify their related mechanisms.Methods:The RCC cells were treated with different concentrations (5,10,20,40 and 80 μmol · L-1) of Andro as experimental groups,and 0μmol · L 1 Andro group was used as blank control group,MTS assay was used to detect the proliferation rates of RCC cells in various groups.The RCC cells were treated with different concentrations (0.50,1.25 and 2.50 μmol · L-1) of Andro as experimental groups,and 0 μmol · L 1Andro group was used as blank control group.Clonogenic assays was used to detect the colony formation ability of RCC cells in various groups.The RCC cells were treated with different concentrations (10,20and 40 μmol · L-1) of Andro as experimental groups,and 0 μmol · L-1 Andro group was used as blank control group.Wound healing assay was used to detect the migration ability of RCC cells in various groups.Flow cytometry was used to detect the apoptotic rates of RCC cells in various groups.Western blotting was performed to detect the expression levels of apoptosis related proteins in RCC cells in various groups.Results:Compared with blank control group,the proliferation rates of RCC cells in 10,20,40 and 80 μmol · L-1 Andro groups were markedly decreased (P＜0.05 or P＜0.01).Compared with blank control group,the colony formation rates of RCC cells in 0.50 and 1.25μmol · L-1 Andro groups were markedly decreased (P＜0.05 or P＜0.01).Compared with blank control group,the scratch healing rates of RCC cells in 10,20 and 40 μmol · L-1 Andro groups were markedly decreased (P＜0.01),and the apoptotic rates of RCC cells in 20 and 40 μmol · L-1 Andro groups were markedly increased (P＜0.01).Compared with blank control group,the expression level of γ-H2AX protein in 40μmol · L-1 Andro group was markedly increased (P＜0.01),the expression level of Caspase-8 protein was decreased (P＜0.05),and the expression level of cleaved Caspase-8 protein was markedly increased (P＜0.01).Conclusion:Andro can effectively suppress the proliferation,migration and colony formation ability of RCC cells and induce the apoptosis of RCC cells.The mechanism of apoptosis might be related to inducing the DNA damage and the apoptotic pathways induced by JNK / H2AX and Caspase-8.

Investigation and analysis of influencing factors ofanxiety and depression in patients with intravesical perfusion chemotherapy / 中国实用护理杂志

Objective To investigate the level of anxiety and depression and its influencing factors in patients with intravesical perfusion chemotherapy. Methods Totally 148 patients with intravesical perfusion chemotherapy were investigated using the Hospital Anxiety and Depression Scale, Self-Perceived Burden Scale and Social Support Rating Scale. Results Among the patients,14.2%(21/148) and 20.3% (30/148) of them expressed respectively their anxiety and depression, and the incidence of anxiety and depression was significantly correlated with the self-perceived burden,social support and its dimensions(P<0.05),in addition to the influence of the course time(P=0.002),religion(P=0.040),and the functional status of the caregiver(P=0.009). Conclusions The incidence rate of anxiety and depression in patients with intravesical perfusion chemotherapy is still to be further controlled.Nursing staff should pay attention to patients' self-perceived burden, and play an important role in social support in order to reduce the incidence of anxiety and depression.

Idiopathic retroperitoneal fibrosis misdiagnosed as renal cancer: a case report and literature review / 南方医科大学学报

A 51-year-old male patient was presented to our hospital for inspection of right renal space-occupying lesions. CT revealed soft tissue density in the right renal pelvis and renal pelvis ureter transitional crumb, for which a clinical diagnosis of right renal cancer was made. After laparoscopic radical resection of the right kidney, pathological examination supported the diagnosis of idiopathic retroperitoneal fibrosis. With an unclear pathogenesis, idiopathic retroperitoneal fibrosis presents with atypical clinical manifestations but shows specific features in imaging examination. Its treatment is individualized according to the specific condition for which conservative medical or surgical treatment can be considered. Retroperitoneal fibrosis has a low incidence and a high misdiagnosis rate, and imaging examinations remain currently the primary modality for diagnosis with specific findings.

Preparation of polycaprolactone/poly (lactic acid-glycolic acid) biodegradable nano-structure ureteral stent and its degradation assay in vitro / 中华泌尿外科杂志

Objective To investigate the preparation of a polycaprolactone (PCL)/poly (lactic acid-glycolic acid) (PLGA) degradable ureteral stent and its degradation ability in vitro.Methods From December 2010 to September 2012,degradable ureteral stent was fabricated by electrospinning,using different concentration of PCL/PLGA (5％,10％,15％,20％,25％,30％).The structure of stent was scanned by electron microscopy (SEM).The Instron system was used to test the mechanical property of those stents.The PCL/PLGA stents of different concentration (5％,15％,25％) were immerged into the urine to assess their degradable ability 7,14,21,28,35,42,49,56 days later.Results The inner diameter of the white tubular scaffold was 1.5 mm and the outer diameter was 2.0 mm.The SEM results showed that the scaffold had been made by nanofiber with the structure of multi-porous.The tension test showed that the mechanical property was enhanced with the increasing in the proportion of the PCL.The lowest stress at break was found in 5％ PCL/PLGA stent,while it was still sufficient for the mechanical criteria of degradable biomaterial.The degradation curves of different ratio of PCL/PLGA stent were close to a straight line.The 5％ PCL/PLGA stent collapsed into pieces within 28 d.The 15％ and 25％ PCL/PLGA collapsed within 42 d and 56 d,respectively.Conclusion The PCL/PLGA biodegradable ureteral stent has a good mechanical property and the degradation time can fully meet the demand of a ureteral stent.

Anatomical and clinical research on splenic infarction / 中华肝胆外科杂志

Objective To study the anatomical basis and clinical causes of splenic infarction with an attempt to improve on the diagnosis and treatment of splenic infarction.Methods This study was conducted on 11 patients with splenic infarction seen in our hospital from December 2003 to September 2012,131 patients with a clinical diagnosis and treatment reported in the literature since 1999,and 25 adult cadavers showing the anatomy of the splenic arteries with an aim to find out the causes of splenic infarction.Results The clinical data showed that splenic infarction occurred more commonly in patients 60 years of age or older (73％ vs 27％,P＜0.05),and in males more than in females (62％ vs 38％,P＜0.05).The diagnosis was first made significantly more often by physicians than by surgeons 88/32 (79％ vs 21％,P＜0.05).The anatomical data showed that the majority of the splenic arteries in the 25 adult cadavers was curved.Conclusions The clinical manifestations of splenic infarction easily led to a misdiagnosis.Improvement in the diagnosis and treatment of splenic infarction would depend on the clinical awareness of this condition,the prothrombotic state detection and the implementation of timely and standardized treatment.

Expression of cyclin-dependent kinase 5 in cerebral cortex after subarachnoid hemorrhage in rats / 国际脑血管病杂志

Objective To investigate the expression and cellular localization of cyclin-dependent kinase 5 (Cdk5) in cerebral cortex after subarachnoid hemorrhage (SAH) in rats.Methods Fifty-two male Sprague Dawley (SD) rats were randomly divided into either a sham operation group (n =12) or a SAH group (n =40).The latter was randomly redivided into 6,12,24 h,and day 2 and 3 subgroups (n =8 in each group).A rat SAH model was induced by injecting fresh blood into the prechiasmatic cistern.Western blot and immunohistochemistry were used to detect the expression of Cdk5 in rat brain cortex.Double labeling immunofluorescence staining was used to detect the cellular localization of Cdk5 protein in cerebral cortex.Neuronal nuclear antigen labeled neurons,and glial fibrillary acidic protein labeled astrocytes.Results Western blot showed that the expression of Cdk5 protein was up-regulated at 12 hours after SAH (t =3.709,P =0.001),and it reached the peak on day 1 (t =3.475,P=0.002).Immunohistochemistry showed that the proportion of Cdk5 positive cell was also increased gradually after SAH,and the changes of time course were consistent with the results of Western blot,and it reached the peak on day 1 (t =4.320,P =0.000).Double labeling immunofluorescence showed that Cdk5 was mainly expressed in the neuronal cytoplasm in the sham operation group,and Cdk5 shifted to the neuronal nuclei in the SAH group.Cdk5 was mainly colocalized between astrocytes and neurons.Conclusions SAH up-regulates the expression of Cdk5 protein in cerebral cortex.Cdk5 may be involved in early brain injury after SAH.

Analysis of risk factors affecting bleeding in percutaneous nephrolithotomy for treatment of kidney stones / 中华泌尿外科杂志

Objective The present study was designed to investigate the risk factors affecting bleeding during percutaneous nephrolithotomy. Methods The records of 218 patients with percutaneous nephrolithotomy procedure by a single surgeon were retrospectively reviewed.The mean age was 48 years ( range,19 -70).One hundred and forty six patients had staghore stones,and 7 patients had previous open or percutaneous nephrolithotomy histories.Forty-one patients had concomitant diabetes mellitus,and 89 cases had hypertension.The following factors including age,sex,BMI,diabetes status,hypertension status,stone type,calix of puncture,previous open or percutaneous nephrolithotomy history,number of accesses,size of accesses,operative time,and surgeon experience were analyzed.Univariate analysis and multivariate step regression analysis were used for statistical assessment. Results 207 procedures were successfully performed,and 11 patients failed because of difficulty to establish the accesses.Single-tract was used in 176 cases and multiple-tract was used in 31 cases.163 cases were performed via a 18 F access and 44 cases via a 24 F access.The mean operative time was 78.4 min.The overall blood transfusion rate was 7.7％,and stone type ( P =0.034),diabetes ( P =0.030),number of accesses ( P =0.019 ),size of accesses ( P =0.008) and operative time (P =0.001 ) were the risk factors affecting blood transfusion requirement.The average hemoglobin (Hb) drop after percutaneous nephrolithotomy procedures was 11.2 g/L,and stone type ( P ＜ 0.001 ),diabetes ( P =0.015 ),number of accesses ( P =0.016),size of accesses ( P ＜ 0.001 ) and operative time ( P ＜ 0.001 ) were the risk factors affecting Hb drop.The following covariates including Hb drop:age,sex,BMI,previous open or percutaneous nephrolithotomy history,hypertension status,calix of puncture and surgeon experience were not risk factors affecting blood transfusion requirement and Hb drop.Multivariate stepwise regression analysis showed that diabetes ( OR =1.75 ),stone type ( OR =1.92),number of accesses ( OR =2.45 ),size of accesses ( OR =1.32) and operative time ( OR =1.66) significantly increased risk of bleeding. Conclusions Stone type,diabetes,number of accesses,size of accesses and operative time were the risk factors affecting blood loss during percutaneous nephrolithotomy.

Retroperitoneal laparoscopy rather than an open procedure for resection of pheochromocytomas could minimize intraoperative blood pressure fluctuations and transfusion events.

OBJECTIVES: We retrospectively reviewed the outcomes after laparoscopy versus an open procedure for the resection of pheochromocytoma. PATIENTS AND METHODS: Forty-nine patients were enrolled into the study between June 2004 and December 2008 having been diagnosed with pheochromocytoma. The selection criteria were patients who were diagnosed with pheochromocytoma on admission based on clinical manifestations, imaging examinations and laboratory tests. Twenty-six patients underwent a retroperitoneal laparoscopic resection of their pheochromocytoma (LRP), and another 23 patients underwent an open resection of the pheochromocytoma (ORP). RESULTS: The ORP was similar to the LRP on the incidence of intraoperative blood pressure fluctuation. While compared to ORP, the process of LRP could effectively control the degree of fluctuations in intraoperative blood pressure(P < 0.05). Patients who received LRP had a significantly reduced volume of fluid in their drain on the first postoperative day than those who received ORP(P < 0.05), and due to the drain being removed sooner, they were consequently able to mobilize earlier(P < 0.05). The LRP cohort consisted of four patients with tumors ranging from 6 to 7 cm and three of them were successfully achieved. Intraoperatively or within 24 h postoperatively, 10 out of 23 patients who had undergone ORP received a transfusion, while none of those in the LRP cohort received a transfusion. CONCLUSIONS: Retroperitoneal LRP allowed patients to mobilize earlier and minimized the occurrence of intraoperative blood pressure fluctuations and transfusion events. Adequate preoperative preparation and skilled laparoscopic manipulation appeared to guarantee the safety of the procedure, and large tumors did not absolutely contraindicate the use of laparoscopy.

Urethral Stricture Complicated with Infection An Analysis of 150 Patients Treated with Piperacillin and Tazobactam / 中华医院感染学杂志

0.05).CONCLUSIONS Piperacillin/tazobactam in the treatment of urethral stricture complicated with infection is significantly effective and safely.

Expression of enhancer of zeste homolog 2 in transitional cell carcinoma of the bladder cell lines and tissues / 中华泌尿外科杂志

Objective To study the expression of enhancer of zeste homolog 2 (EZH2) gene in transitional cell carcinoma (TCC) of the bladder celt lines, carcinoma tissues and normal bladder tis-sues and to evaluate the roles of EZH2 in the development and progression of bladder carcinoma. Methods RT-PCR, Western-blot and immunocytochemistry were used to analyze the expression of EZH2 of the bladder cell lines (T24, EJ, MGH-U1, BIU-87). The prostate cancer cell line PC-3M was used as an EZH2-positive cell line. EZH2 gene expressions in 45 cases of bladder carcinoma and 12 cases of normal bladder mueosa were detected by RT-PCR. Of cancer cases, 31 were superficial tumors and 14 were invasive tumors; 13 were G1, 21 were G2 and 11 were G3. Results EZH2 was detected in the 4 TCC cell lines. The EZH2 expression rate of TCC (82.2%) was significantly higher than that of normal bladder tissues (8.3%, P<0.05). The expression rate in superficial tumors was 74.2% and in invasive tumors was 100.0%, but there was no significant difference (P>0.05). The expression rates increased with tumor cell grade increase, but there was no significant difference (P> 0.05). Conclusions EZH2 could play an important role in the development and progression of blad-der carcinoma. It could be used as a potential gene therapy target of bladder cancer.

Vascular prosthesis implantation for treatment of isolated lilac artery aneurysm A 33-case report / 中国组织工程研究

A total of 33 patients with isolated lilac artery aneurysms, 19 males and 14 females, who received treatment between January 1997 and June 2007, were retrospectively analyzed. Among these patients, 29 suffered from unilateral iliac artery aneurysm and 4 from bilateral iliac artery aneurysm. Under general anesthesia, all patients were subjected to aneurysmectomy, followed by vascular prosthesis implantation for vascular reconstruction. Results revealed that among 4 cases of bilateral iliac artery aneurysm, there was 1 case who was subjected to aorta-bilateral femoral artery vascular prosthesis implantation, and there were 3 cases who underwent aorta-bilateral lilac artery vascular prosthesis implantation; among 29 cases of unilateral lilac artery aneurysm, there was 1 case receiving aorta-common lilac artery vascular prosthesis implantation, 3 cases undergoing iliac-femoral artery vascular prosthesis implantation, 21 cases subjected to common-external iliac artery vascular prosthesis implantation, and 4 cases undertaking common -common lilac artery bypass. Color Doppler ultrasonic examination, spiral CT angiography, or digital subtraction arteriography was performed 3, 6 months, 1, 3, 5, 8, and 10 years after surgery. The mean follow-up time was 5 years. Three cases died of acute cerebral infarction, myocardial infarction, and traffic accident 3, 6, and 2 years after surgery, respectively. The remaining cases well survived as determined by no recurred Uiac artery aneurysm, anastomotic stoma stenosis or lower limb ischemia found. These results indicated that aneurysmectomy and subsequent vascular prosthesis implantation remained a good and primary means for treatment of isolated iliac artery aneurysm under the present medical condition.

Vascular prosthesis graft bypass in the treatment of 78 patients with Leriche syndrome / 中国组织工程研究

BACKGROUND: Effective drugs for improving vascular elasticity and revascularization are few for treating Leriche syndrome (chronic lower extremities ischemia) induced by abdominal aortic occlusion.Vascular outflow tract reconstruction in vascular prosthesis transplantation can rapidly improve blood supply in the distal extremities.OBJECTIVE: To evaluate the biocompatibility and outcome of vascular prosthesis transplantation for the treatment of Leriche syndrome.DESIGN: Controlled study before and after surgery.SETTING: Department of General Surgery of General Hospital of Chinese PLA and Department of Thoracic and Cardiovascular Surgery of Shijingshan Hospital.PARTICIPANTS: Sixty-two patients and sixteen patients with Leriche syndrome were enrolled in this study,who were respectively from Department of General Surgery of General Hospital of Chinese PLA between January 1995 and January 2007 and from Department of Thoracic and Cardiovascular Surgery of Shijingshan Hospital between January 2001 and January 2007.The subjects were 66 males and 12 females,whose age ranged from 46-75 years (averagely 58 years) and onset time from 6 months-8 years (averagely 2 years and 6 months).Informed consents were obtained from all patients.METHODS: After general anaesthesia or epidural anesthesia,vascular bypass was performed,including aortofemoral bypass in 63 cases and aortoiliac bypass in 15 cases.Vascular prostheses included polytetrafiuoroethylene (FIFE)vascular prosthesis in 18 cases and polyester vascular prosthesis in 60 cases.PTFE vascular prosthesis (Gore,USA) is a kind of inert material with low biological response.Its fibers with micropores arrange irregularly.Polyester vascular prosthesis (Intervascular,France) is a kind of knitting polyester products,which is made from high-purity cattle collagen Ⅰ with high biocompatibility.To inlay heparin molecules that can retain 4 weeks into the surface of vessels coated with collagen can prevent thrombogenesis and inhibit hyperplasy of smooth muscle cells (SMC).The type is IGK1608;internal diameter of the bole is 16 nun; internal diameter of the branch is 8 mm.Therapeutic prescriptions were approved by Hospital's Ethics Committee.Follow-up was performed for 3 months-5 years by vascular Color Doppler Sonography,spiral CT angiography (SCTA) three-dimensional reconstruction or digital subtraction angiography (DSA) in hospital.MAIN OUTCOME MEASURES: Biocompatibility of vascular prosthesis and outcome of vascular prosthesis transplantation.RESULTS: Three months after vascular prosthesis transplantation,thrombus was not detected on vascular anastomosis and in vascular prosthesis by Color Doppler Sonography and SCTA.Seventy-seven patients were followed up for over one year,and their stomas were unobstructed.Seventy-six patients were followed up for over five years,and the patency rate of stomas was 89% (68/76).No changes in blood plaque,lencocyte count,haematoglobin or liver and kidney function were found after transplantation.Seven days after surgery,affected extremities with ischemic symptom were improved.Three months later,ischemic symptom disappeared.CONCLUSION: With good biocompatibility of vascular prosthesis,vascular prosthesis transplantation in the treatment of Leriche syndrome has a good outcome following aortofemoral bypass and aortoiliac bypass.

Construction and screening of plasmid expression vectors encoding short hairpin RNA targeting TWIST gene / 吉林大学学报(医学版)

Objective To construct a plasmid expression vector coding for the short hairpin RNA(shRNA) targeting Twist mRNA.Methods Two plasmid expression vectors coding for shRNA targeting 777 and 845 of Twist gene sequence and a control vector containing random DNA fragment were constructed.The recombinant plasmids were identified by PCR,and then transfected separately into bladder cancer cell line T24.The Twist gene silencing effect was detected by RT-PCR and Western blotting.Results The expected band of 400 bp was amplified from the plasmids coding for shRNA by PCR.By DNA sequencing,it was the same with the insertion element as with the shRNA of synthetic.Transfection of T24 cells expressing Twist gene with the shRNA plasmids resulted in inhibition of Twist mRNA and protein expressions by 90% and 86%,respectively.The shRNA1 had the most obvious effect in Two types of plasmids interference.Conclusion The plasmid expression vectors coding for shRNA targeting Twist mRNA have been constructed successfully,of which pGenesil-shRNA1 most effectively silences Twist gene in T24 cells.

Influence of HIWI gene silencing in biological behavior of bladder carcinoma cells / 吉林大学学报(医学版)

Objective To investigate the influence of HIWI gene silencing in biological behavior of T24 cells and explore the possibility for HIWI gene to be used as the molecular target of inhibiting bladder carcinoma cell proliferation with gene transfection and RNA interference(RNAi) technique.Methods T24 cells were divided into transfection group with pGenesil-2-HIWI,transfection group with pGenesil-2-HIWI2263,transfection group with pGensil-2-control,and two control groups transfected with PEI only,and PBS only,respectively.T24 cells were transfected with shRNA expression vectors targeting HIWI gene by PEI,and the cell proliferation and cell cycle were measured by MTT assay and FCM.Results At the time of post-transfection 24 h,the inhibitory rate of cell proliferation in transfection groups were 32.60% and 26.09%,they were lower than that in control group(3.54%).At the time of post-transfection 48 h,the percentages of cells at S phase in transfection groups were(29.39? 3.27)% and(30.87?10.88)%,they were lower than that in control group(39.36%?2.09%)(P

Inhibitory effect of TIP30 gene on growth of human renal carcinoma786-0 cells / 吉林大学学报(医学版)

Objective To explore the effect of TIP30 gene on the growth inhibition of renal carcinoma cell line 786-0 and look for a potential therapeutic target for renal carcinoma.Methods TIP30 gene was amplified by reverse transcription-polymerase chain reaction(RT-PCR).A eukaryotic expression vector pcDNA3.1-TIP30 was constructed and transfected into 786-0 cells;pcDNA3.1(+)was also transfected as control.After transfection,the expression of TIP30 in 786-0 cells was detected by RT-PCR and Western blotting.The changes of cell proliferation and cell cycle were observed by MTT and FCM assay.Results The mRNA and protein expressions of TIP30 gene in pcDNA3.1-TIP30-transfected 786-0 cells were significantly increased than those in untreated and pcDNA3.1(+)-transfected cells(P0.05).The inhibitory rate of pcDNA3.1-TIP30-transfected 786-0 cells was significantly higher than those in untreated and pcDNA3.1(+)-transfected cells(P