Research status and prospect of SPOP in renal cell carcinoma / 国际外科学杂志

Renal cell carcinoma is one of the most common urinary tract cancers, accounting for 90% of renal cancer cases, and the clear cell renal cell carcinoma is its most common subtype. Because of poor response to conventional anti-cancer treatment, metastasis may occur in the early stage of renal cell carcinoma. The high degree of metastasis of renal cell carcinoma determines the necessity and importance of early diagnosis. Although a lot of researches about renal cell carcinoma have been carried out, its underlying mechanisms still remain unclear. Recent studies have shown that spot-type POZ protein (SPOP) can perform biological functions in a cancer type-specific way. Based on the latest findings, this article reviewed the current research status and prospectives of SPOP in renal cancer cells.

Influencing factors of stone free rate after flexible ureteroscope lithotripsy / 国际外科学杂志

In recent years, with the rapid development of rigid ureteroscopy and flexible ureteroscope lithotripsy in the field of urology, great changes have been made in the treatment of urinary calculi. Although flexible ureteroscope lithotripsy is easy to be damaged and expensive to maintain, it has high technical requirements for doctors, but it does not need to establish other traumatic channels, but uses the natural cavity of human urinary system, It has been paid more and more attention by urologists and has a good development prospect. Stone free rate is an objective index to judge the efficiency of flexible ureteroscope lithotripsy. The stone free rate and treatment after flexible ureteroscope lithotripsy have always been a difficult problem. Many scholars at home and abroad have studied the influencing factors of stone free rate after flexible ureteroscope lithotripsy, studies have shown that large stone load, hard stone composition, narrow angle of renal pelvis and calyceal and severe hydronephrosis are the main risk factors leading to the reduction of postoperative one-time stone free rate. In this paper, the research results in this field at home and abroad will be summarized.

Enlightenment of ambulatory patient groups on medical insurance payment system in China / 中华医院管理杂志

The current outpatient payment method based on fee-for-service induced serious demand, which increased the waste of medical insurance fund. The authors briefly introduced ambulatory patient groups(APG)with the same concept of diagnosis-related groups. According to the current situation of outpatient medical insurance payment and the degree of informatization in China, suggestions are put forward: launch a pilot project first and starting with chronic disease to promote reform; improve the quality of outpatient electronic medical records, and develop APG suitable for China; under the background of aging, cooperate with the total budget to ensure the security of medical insurance.

Research progress of PD-1/PD-L1 inhibitors in renal cell carcinoma / 国际外科学杂志

Renal cell carcinoma is a malignant tumor originating from the renal parenchyma. Different subtypes of renal cell carcinoma have different pathological features and molecular mechanisms. Because radiotherapy and chemotherapy are difficult to achieve ideal therapeutic effect on renal cell carcinoma, targeted therapy based on vascular endothelial growth factor and mammalian target of rapamycin will eventually in the case of drug resistance, it is currently necessary to explore a new way to improve the treatment status of metastatic renal cell carcinoma. With the continuous research and exploration of programmed death-1 (PD-1)/programmed death-ligand-1 (PD-L1) inhibitors, immunotherapy certain effects have been shown in metastatic renal cell carcinoma. PD-1/PD-L1 inhibitors have considerable prospects for single-agent or other drug treatment in renal cancer, and the long-term adverse reaction rate of this drug is low. At present, there are studies that treat PD-1 or PD-L1 inhibitors in combination with radiochemotherapy, anti-tumor drugs and surgery, bringing new hope to patients who are not sensitive to radiochemotherapy, are resistant to drugs, and have lost surgery. While PD-1 or PD-L1 also significantly improves overall survival in monotherapy. This article reviews and summarizes the application and research progress of PD-1/PD-L1 inhibitors in renal cell carcinoma in recent years, and reviews them.

Application of preimplanted angiography catheter with digital subtraction angiography for surgical treatment of acute lower gastrointestinal bleeding / 中华全科医师杂志

To evaluate the application of preimplanted angiography catheter with digital subtraction angiograply(DSA) for surgical treatment of acute lower gastrointestinal bleeding.Clinical data of 17 patients with acute lower gastrointestinal bleeding admitted from June 2011 to December 2014 were retrospectively reviewed.The angiography catheter was implanted and methylene was injected to find the bleeding sites with DSA,then emergency laparotomy was performed.The results showed the bleeding sites in small intestine in 8 cases and in large intestine in 9 cases.Postoperative pathology revealed vascular malformation in 4 cases,2 in small intestine and 2 in colon;ulcerative colitis in 3 cases;colon cancer in 1 case;colonic diverticula in 3 cases and small intestinal stromal tumor in 6 cases.Results indicate that if the conservative therapy is not effective,surgical treatment assisted by preimplanted angiography catheter with DSA is safe and effective for patients with lower gastrointestinal bleeding.

Damage control surgery in diagnosis and treatment of sharp abdominal injury combined with multiple trauma / 中华创伤杂志

Objective To evaluate the role of damage control surgery (DCS) in the diagnosis and treatment of sharp abdominal injury combined with multiple trauma.Methods Sixty patients with sharp abdominal injury accompanied by multiple trauma treated from January 2005 to August 2014 were reviewed retrospectively.There were 55 males and 5 females,aged at 15-79 years (mean,32.08 years).Thirty patients underwent definite operative treatment (control group),and 30 patients had DCS (DCS group).Between-group differences were examined in pre-and post-operative hemodynamic changes,function recovery,cure rate and complication incidence.Results All patients showed improved hemodynamic parameters after operation.The cure rate was 97％ (29/30) in DCS group versus 50％ (15/30) in control group (P ＜ 0.05).Complications were reported in 17％ (5) of the patients in DCS group versus 40％ (12) of the patients in control group (P ＜ 0.05).Conclusion DCS is associated with decreased rate of complications and increased cure rate in the treatment of sharp abdominal injury combined with multiple trauma.

Fibroblast growth factor-modified bone marrow mesenchymal stem cells promote functional recovery from traumatic brain injury / 中国组织工程研究

BACKGROUND:Bone marrow mesenchymal stem cels (BMSCs) can promote nerve regeneration, but there are no better results because of the limitations of treatment methods. BMSC transplantation alone is not enough to achieve desired therapeutic effects. OBJECTIVE:To investigate the effect of fibroblast growth factor (FGF)-modified BMSC transplantation on functional recovery and expression of glial fibrilary acidic protein after traumatic brain injury. METHODS:Animal models of traumatic brain injury were established in Sprague-Dawley rats using hydraulic shock method, and then randomized into control group (traumatic brain injury group), BMSC group and FGF-BMSC group (FGF-modified BMSC group). After isolation and culture, BMSCs were modified by adenovirus vector-mediated FGF gene. Western blot assay was used to detect transfection efficiency and glial fibrilary acidic protein expression; immunohistochemical detection was used to detect distribution and number of BrdU positive cels in the brain; Longa score was used to evaluate the neurologic function of rats at 1, 3 days, 1, 2 weeks after transplantation; TUNEL assay was used to detect cel apoptosis in the brain. RESULTS AND CONCLUSION:Western blot results showed that FGF gene was successfuly transferred to the adenovirus vector, and capable of expressing in BMSCs; moreover, the glial fibrilary acidic protein expression of FGF-BMSC group was significantly higher than that in the other two groups (P < 0.05). The number of BrdU positive cels in the brain was significantly higher in the FGF-BMSC group than the other two groups (P < 0.05). Two weeks after transplantation, the Longa scores in the FGF-BMSC group were significantly lower than those in the other two groups (P < 0.05). TUNEL results showed that the number of apoptotic cels in the FGF-BMSC group was significantly lower than that in the other two groups (P < 0.05). These findings indicate that FGF-modified BMSCs transplantation is able to improve neurological damage after traumatic brain injury and promote neurological recovery, which is better than BMSC transplantation alone.

Ginsenosides-induced bone marrow mesenchymal stem cells promote nerve regeneration in traumatic brain injury / 中国组织工程研究

BACKGROUND:Previous studies have shown that bone marrow mesenchymal stem cels in the treatment of neurological diseases have achieved some success, which can promote neurological alterations; however, there is no breakthrough on gene and drug regulation. OBJECTIVE:To investigate the influence of ginsenosides-induced differentiation of bone marrow mesenchymal stem cels on nerve regeneration after traumatic brain injury. METHODS: A traumatic brain injury model was built in rats using hydraulic shock method, and then rat models were randomly divided into model group (traumatic brain injury group), bone marrow mesenchymal stem cel group, ginsenosides group (ginsenosides induced differentiation of bone marrow mesenchymal stem cels). At 2 weeks after transplantation, western blot assay was used to detect protein expression levels of nerve growth factor and brain-derived neurotrophic factor, immunohistochemistry assay used to detect the number of BrdU-positive cels. At 1, 3 days and 1, 2 weeks after transplantation, modified neurological severity scores were recorded. RESULTS AND CONCLUSION: The expression levels of nerve growth factor and brain-derived neurotrophic factor protein were significantly higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). The number of BrdU positive nerve cels was also higher in the ginsenosides group than the bone marrow mesenchymal stem cel group and model group (P < 0.05). At 3 days and 1, 2 weeks after transplantation, the modified neurological severity scores in the ginsenosides group were lower than those in the bone marrow mesenchymal stem cel group and model group (P< 0.05). These findings indicate that ginsenoside-induced bone marrow mesenchymal stem cel transplantation can promote nerve regeneration in rats with traumatic brain injury, which has better outcomes than bone marrow mesenchymal stem cel transplantation alone.

The diagnosis and management of penetrating abdominal injury with large vessels damage in 18 cases / 中华普通外科杂志

Objective To investigate the experience of diagnosis and treatment of abdominal penetrating injury with large vessels damage.Methods The clinical data of 18 patients with abdominal large vessels injuries in our hospital from Jan 2003 to oct 2014 were analyzed retrospectively.Results 18 cases of large vessels injuries,accounting for 16.21％ during the same period of all penetrating wounds (18/111),emergency laparotomy was performed.There were 8 cases of arterial injury,4 cases of concurrent arteriovenous injury,6 cases of venous injury,Arterial and venous broken walls were repaired,splenic artery and venous ligation and splenectomy were performed.Vascular repair success rate was 100％,Intraoperative blood loss was 500-6 000 ml,average (3 750 ±670) ml.Operating time varied from 2.5 to 7 h,average (3.9 ±0.8) h.All patients were cured.12 cases were followed-up for 2-36 months,mean follow-up time was (15 ± 7) months,ultrasonography showed normal blood flow without complications.Conclusions Emergency surgical exploration and limited fluid resuscitation is the most effective therapy in abdominal penetrating injury involving large vessels.

SolitaireAB stent-assisted endovascular embolization of intracranial wide-necked aneurysms:a clinical ;follow-up study / 介入放射学杂志

Objective To investigate the mid-term effect of SolitaireAB stent-assisted interventional embolization with spring coils for the treatment of intracranial wide-necked aneurysms. Methods During the period from May 2009 to April 2013, a total of 49 patients with intracranial wide-necked aneurysm (49 aneurysms in total) received SolitaireAB stent-assisted interventional embolization treatment at authors’ hospital. In 41 patients, a total of 41 aneurysms were detected, of which ruptured aneurysm with bleeding was confirmed in 26 and un-ruptured aneurysm in 15. These 41 patients were followed up for 12-48 months. Based on modified Rankin scoring and DSA, CTA or MRA manifestations, the clinical results were evaluated. Results After the embolization treatment, re-bleeding of the aneurysm occurred in 2 cases, cerebral infarction in 3 cases, occlusion of the parent artery in one case and death in one case; the occurrence rate of complications was 14.2%. DSA, MRA or CTA performed at 12 months after the embolization treatment, showed that 32 aneurysms (78.0%) were completely obstructed, which was obviously higher than that observed on DSA performed immediately after the embolization procedure (21 aneurysms, 42.9%), the difference was statistically significant (P=0.02);residue of aneurismal neck was seen in 7 cases (17.1%) and partial occlusion in 2 cases (4.9%), which were much better than those observed on DSA that was performed immediately after the embolization procedure. Twenty-four aneurysms (58.5%) remained stable, showing no any change, and recurrence of aneurysm was observed in 4 cases (9.7%). At the last follow-up exam, the modified Rankin scoring showed that 0 point was seen in 18 cases (43.9%), one point in 10 cases (24.4%), 2 points in 5 cases (12.2%), 3 points in 4 cases (9.8%), 4 points in 2 cases (4.85%) and 5 points in 2 cases (4.85%). The self-care rate for daily activities was 80.5%, the prognosis was good. Conclusion For the treatment of intracranial wide-necked aneurysms, SolitaireAB stent-assisted interventional embolization with spring coils is safe and effective. This technique can improve the embolization rate and reduce the procedure-related complications.

An analysis of the causes of death for patients of peripheral arterial disease during the perioperative period / 中华普通外科杂志

Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.

Combination of transurethral resectoscope outer sheath and ueteroscopy in treatment of bladder stones ( report on 68 cases) / 国际外科学杂志

ObjectiveTo investigate the efficacy and advantages through the combination of transurethral resectoscope outer sheath and ueteroscopy for treatment of bladder stones.MethodsThe Wolf F24 transurethral resectoscope was first placed in bladder to observe the lesions in 68 patients with bladder stones.With the moving out of the body and inner sheath,F8 ureteroscopy sheath was sent into the bladder through outer sheath,then,holmium laser lithotripsy was performed.ResultsSixty-eight patients got successful operations without postoperative stones residual,significant postoperative bleeding,urethral tear,bladder injury and infection complications. The gravel rate reached 100％ 20 - 60 minutes ( 36.7 ± 5 ) min.ConclusionThe combination of transurethral resectoscope outer sheath and ueteroscopy is effective and safe for treatment of bladder stones.

Endovascular procedure for TASC-D type iliac artery lesions / 中华普通外科杂志

Objective To evaluate recanalization for TASC-D type iliac artery lesions.Methods Between June 2006 and June 2010,26 patients with a total of 31 limbs of the TASC-D iliac artery lesions underwent endovascular procedure. Results Technical success rate was 90.3% (28/31).Clinical symptom improvement rate was 100%. Forty-four stents were placed in 28 limbs of the 24 patients.Eleven patients underwent an associated procedure; femoropopliteal endovascular procedures in 8 cases,femoro-popliteal bypass in 3 cases. Eight patients underwent an intravascular ultrasound thrombolysis.Postoperative ankle-brachial index ( ABI) was increased by more than 0. 15 in all patients. Twenty-two patients(26 limbs) were followed-up for 3 -44 mos, the primary patency rate at 12 months was 90% ,and cumulative patency rate was 95%. At 36 months primary patency rate was 70% , and secondary patency rate was 80%. Conclusions Because the technical success rate is high, endovascular techeniques are the choice of therapy in high risk patients with TASC-D type iliac artery lesions.

Transluminal angioplasty and stenting in treating iliac arterial occlusive disease / 中华普通外科杂志

Objective To evaluate therapeutic effect of transluminal angioplasty and stenting on arteriosclerosis related iliac arterial occlusive disease. Methods This retrospective study included a total of 61 cases (76 limbs) with iliac arterial atherosclerotic occlusive disease, grading as TASC A (n =29),B (n = 16), C (n = 11) and D (n = 5). Percutaneous interventional reconstruction and stent implantation were carried out in our hospital from December 2002 to December 2008. Results In 61 patients (76 lesions) 63 stents were implanted successfully with the success rate of 93% (71/76). The rate of clinical improvement was 100% among the patients who had primary technical success. The ankle-branchial index (ABI) improved from an average of 0. 33 ± 0. 17 before intervention to 0. 72 ± 0. 20 on the day following intervention (P < 0. 05). All cases were followed up between 6 month and 60 month. One year patency rate in all treated lesions was 90% (92% in the TASC A and B, 84% in the TASC C and D).Three year patency rate in all was 75% (80% in the TASC A and B, 63% in the TASC C and D). Five year patency rate was 72%. Conclusion There is a tendency towards utilizing transluminal angioplasty and stenting to treat iliac arterial occlusive disease as a therapy instead of traditional vascular surgery.

The evaluation of multislice spiral computed tomography angiography in the diagnosis of moyamoya disease / 中国医师进修杂志

Objective To evaluate the diagnostic value of the multislice spiral computed tomography angiography (MSCTA) in the diagnosis of moyamoya disease and explore its future application. Method The image data of 10 patients with moyamoya disease undertaken MSCTA and digital subtraction angiography (DSA) were reviewed analysis. Results MSCTA could clearly show stenosis, multiple occlusion or abnormalities of the cerebral vessels. Volume-rendering helped to show the relationship between the abnormal vessels and the surrounding tissues. Combined maximum intensity projection (MIP) and multiplsnar reconstruction (MPB) images could clearly show abnormally increased vessels (moyamoya disease vessels). The rate of occlusion and stenosis showed by MSCTA were 66.2%(53/80)and 67.5%(54/80)by DSA. There was no significant difference between the two methods (P>0.05). The images of MSCTA were basically same as those of DSA. Conclusions MSCTA is sensitive in diagnosing moyamoya disease, which is an important basis for early diagnosis. Early diagnosis and treatment is effective in improving prognosis of moyamoya disease.

Effects of Total Saponins of Panax Notoginseng on the Proliferation of Bone Marrow Strowal Cells in Differentiating into Neuron-like Cells in vitro / 医学研究杂志

Objective To study the effects of total saponins of panax notoginseng on the proliferation of bone marrow strowal cells during differentiating into neuron-like Cells in vitro. Methods BMSCs were isolated from femur and tibia of rats and cultured in basal medium(Control),dimethylsulfoxide(DMSO) and butylated hydroxyanisole(BHA) in basal medium as induction group and containing PNS 100mg/L induction medium as PNS group. The morphological changes were observed under inverted microscope.The differentiated BMSCs were detected by immunohistochemistry,and the proliferation were evaluated by MTT assay.Results During induction differentiation,nestin was expressed by all BMSCs with ball-like shape and short process.The nestin expression of PNS group increased as compared with induction group(P