Analysis of tumor-related features of non-small cell lung cancer based on TCR repertoire workflow / 上海交通大学学报（医学版）

Objective·To explore the immune-related characteristics of non-small cell lung cancer(NSCLC),discover potential tumor markers in V-J genes,and lay the foundation for establishing a TCR-antigen recognition prediction model.Methods·A total of 704 NSCLC samples were collected to establish a comprehensive T-cell receptor(TCR)repertoire analysis workflow.The upstream analysis included steps such as raw data processing,quality control,filtering,TCR sequence identification,and extraction.The downstream analysis included repertoire clone distribution,clone typing,V-J gene sharing,CDR3 distribution characteristics,and clone tracking.The sample clone distribution was analyzed by using indices such as Shannon-Weiner index and Chaol index.Clone typing was performed based on the number of clone amplifications to explore differences among different types.The degree of V-J gene segment sharing was analyzed,and the sharing of low-frequency clone types was determined through clone amplification weight analysis of V-J genes by using two samples of papillary thyroid carcinoma.Finally,analysis of the distribution characteristics of V genes and high-frequency clone type CDR3,and clone tracking analysis were conducted to monitor changes in tumor immune clone frequencies before and after analysis,aiming to identify potential tumor markers.Results·① Significant differences were observed in clone distribution and clone typing among different NSCLC tissues,as well as among different ages and genders.② Specific highly-shared V-J genes were identified in the analysis of V-J gene sharing,and non-normal distribution of high-clone V genes and amino acid high-frequency clone types were found in the CDR3 distribution analysis.③ In the analysis of high-frequency clone type clone tracking,highly expressed or newly expressed high-frequency clone types were observed in NSCLC,suggesting that these clone types could serve as potential tumor-associated antigens or bind with CDR3 reference sequences of new antigens.④ It was found that the expression frequency of TRBJ2-5 gene,originally low-expressed,significantly increased,indicating its potential role as a key low-frequency gene in tumor immune response.Conclusion·The TRAV21 and TRBV6.5 genes show high clone amplification in NSCLC and could serve as potential tumor biomarkers.

Modified retzius-sparing robot-assisted laparoscopic radical prostatectomy for localized transitional zone prostate cancer / 中华泌尿外科杂志

Objective:To investigate the safety and efficacy of modified Retzius-sparing robot-assisted laparoscopic radical prostatectomy for localized transitional zone prostate cancer.Methods:From May 2019 to February 2021, the clinical data of 284 patients with transitional zone(TZ) prostate cancer was retrospectively analyzed. Among them, 91 cases underwent modified Retzius-sparing robot-assisted laparoscopic radical prostatectomy(modified RS-RARP), and 193 cases underwent conventional robot-assisted laparoscopic radical prostatectomy (RARP). The Retzius space was directly entered during modified RS-RARP.The mean age of modified RS-RARP group and conventional RARP group was (67.8±9.1) years old and (69.5±8.4) years old, respectively. BMI of the two groups was (21.57±2.25)kg/m 2 and (21.8±1.8)kg/m 2 respectively; prostate volume was (31.2±13.5)ml and (29.3±12.9)ml respectively; preoperative PSA of the two groups were (10.2±6.1)ng/ml and (9.3±5.8)ng/ml respectively; and there was no significant difference in the above mentioned data( P>0.05). For Gleason score, there were 8 cases of score 6, 74 cases of score 7, 9 cases of score 8 in modified RS-RARP group and 21 cases of score 6, 153 cases of score 7, 19 cases of score 8 in conventional RARP group. For Clinical stage, there were 11 cases of T 1 stage, 80 cases of T 2 stage in modified RS-RARP group, and 20 cases of T 1 stage, 173 cases of T 2 stage in conventional RARP group. There was no significant difference in the above mentioned data( P>0.05). The operation time, intraoperative blood loss, ratio of transfusion, incidence of complication, positive rate of surgical margin and recovery of urinary continence were compared. Results:All 284 cases of surgery were completed. The operative time of modified RS-RARP was (89.2±10.1) minutes, which was significantly less than that of conventional RARP group[(100.5±12.3)min]. The intraoperative blood loss of the two groups was (245.0±50.0) ml and (250.0±50.0) ml respectively. The number of positive surgical margin was 14(15.4%) and 33(17.1%) respectively. There was no significant difference between the two groupsfor the above mentioned parameters( P>0.05). The ratio of urinary continence recovery in the modified RS-RARP group within 1 month was 49.45%, which was significantly higher than that of conventional RARP group (31.09%)( P<0.05). Conclusions:Compared with conventional RARP, modified RS-RARP might shorten the operation time and help the recovery of urinary continence for patients with TZ prostate cancer.

Extraperitoneal approach robotic-assisted urethra-sparing simple prostatectomy for large-gland benign prostatic hyperplasia: initial experience / 中华泌尿外科杂志

Objective To report our initial experience with extraperitoneal approach RoboticAssisted Urethra-sparing simple prostatectomy (US-RASP)on large-gland (＞ 100 ml) benign prostatic hyperplasia(BPH).Methods From August 2015 to April 2018,32 patients with large volume prostate underwent US-RASP performed by single surgical team were retrospectively reviewed.The patient's median age was 73 (range 59-80) years,and median BMI was 24.9 (19.3-34.8) kg/m2,The estimated prostate volume(V),postvoid residual volume(PV) by transrectal ultrasonography and PSA were 152.0 (119.0-223.1) ml,145 (0-280) ml and 13.7 (5.2-27.3) ng/ml,respectively.Four of 32 patients underwent preoperative urinary catheterization.The perioperative functional parameters including international prostate symptom score (IPSS) questionnaire,maximum flow rate (Qmax),maximum voided volume(Vmax),quality of life questionnaires (QOL) and International Index of erectile function-erectile function (IIEF-EF) were 27(23-33),5.9 (2.5-7.8) ml/s,110 (80-210)ml,5(3-6),and 27(26-29),respectively.Functional parameters including IPSS,QOL,Qmax,Vmax,PV and IIEF-EF were compared and analyzed at 3 and 12 months postoperatively during the following-up.Results The US-RASP was completed in all 32 patients and no open conversion.Median operation time was 180 (115-240) min,the estimated blood loss was 300(range 100 to 400)ml,Hemoglobin loss was 17 (5-38)g/L.The median Foley catheterization time was 7 (5-12) days and drainage was removed after a median of 5 (4-7) days with median hospital stay of 8(6-14)days.Median specimen weight on pathological examination was 107.7(79.8-147.4) g with median of 64.2％ (49.4％-86.2％) resection ratio.At 3-mo follow-up,median IPSS score,Qmax,Vmax,PV and QOL were6(4-18),17.3 (13.8-21.1)ml/s,167(140-310)ml,50 (0-61)ml,1(0-3),respectively.At 12-mo follow-up,median IPSS score,Qmax,V PV and QOL were 4(1-9),20.1 (17.9-24.1)ml/s,205(176-305)ml,24(0-35)ml and 1(0-2),respectively.All patients showed great improvement of IPSS,Q V PV and QOL after median 17 (12-44) months follow-up compared with preoperative parameters (P ＜ 0.05).Erectile function was not impaired in 17 patients who have normal erectile function pre-operatively and 14 cases (82.4％) preserved satisfactory anterograde ejaculation.No significant complication occurred during the procedure.No patient developed permanent urinary incontinence.Conclusions US-RASP is a safe and effective treatment option for selected patients with large-gland obstructive BPH(＞ 100 ml).Our data showed significant improvement in voiding function and maintaining satisfactory anterograde ejaculation following urethral-sparing technique.It may be a new alternative method in the future for large-volume symptomatic BPH.

Extraperitoneal approach robotic-assisted urethra-sparing simple prostatectomy for large-gland benign prostatic hyperplasia: initial experience / 中华泌尿外科杂志

Objective@#To report our initial experience with extraperitoneal approach Robotic-Assisted Urethra-sparing simple prostatectomy(US-RASP)on large-gland (>100 ml) benign prostatic hyperplasia(BPH).@*Methods@#From August 2015 to April 2018, 32 patients with large volume prostate underwent US-RASP performed by single surgical team were retrospectively reviewed. The patient's median age was 73 (range 59-80) years, and median BMI was 24.9 (19.3-34.8 ) kg/m2, The estimated prostate volume(V), postvoid residual volume(PV) by transrectal ultrasonography and PSA were 152.0(119.0-223.1)ml, 145(0-280)ml and 13.7(5.2-27.3)ng/ml, respectively. Four of 32 patients underwent preoperative urinary catheterization. The perioperative functional parameters including international prostate symptom score (IPSS) questionnaire, maximum flow rate (Qmax), maximum voided volume(Vmax), quality of life questionnaires (QOL) and International Index of erectile function-erectile function (IIEF-EF) were 27(23-33), 5.9 (2.5-7.8) ml/s, 110 (80-210)ml, 5(3-6), and 27(26-29), respectively. Functional parameters including IPSS, QOL, Qmax, Vmax, PV and IIEF-EF were compared and analyzed at 3 and 12 months postoperatively during the following-up.@*Results@#The US-RASP was completed in all 32 patients and no open conversion. Median operation time was 180 (115-240) min, the estimated blood loss was 300(range 100 to 400)ml, Hemoglobin loss was 17(5-38)g/L. The median Foley catheterization time was 7 (5-12) days and drainage was removed after a median of 5 (4-7) days with median hospital stay of 8(6-14)days. Median specimen weight on pathological examination was 107.7 (79.8-147.4)g with median of 64.2% (49.4%-86.2%) resection ratio. At 3-mo follow-up, median IPSS score, Qmax, Vmax, PV and QOL were 6(4-18), 17.3 (13.8-21.1)ml/s, 167(140-310)ml, 50(0-61)ml, 1(0-3) , respectively. At 12-mo follow-up, median IPSS score, Qmax, Vmax, PV and QOL were 4(1-9), 20.1 (17.9-24.1)ml/s, 205(176-305)ml, 24(0-35)ml and 1(0-2) , respectively. All patients showed great improvement of IPSS, Qmax, Vmax, PV and QOL after median 17 (12-44) months follow-up compared with preoperative parameters (P<0.05). Erectile function was not impaired in 17 patients who have normal erectile function pre-operatively and 14 cases (82.4%) preserved satisfactory anterograde ejaculation. No significant complication occurred during the procedure. No patient developed permanent urinary incontinence.@*Conclusions@#US-RASP is a safe and effective treatment option for selected patients with large-gland obstructive BPH(>100 ml). Our data showed significant improvement in voiding function and maintaining satisfactory anterograde ejaculation following urethral-sparing technique. It may be a new alternative method in the future for large-volume symptomatic BPH.

A comparative study between Retzius-sparing robot-assisted laparoscopic radical prostatectomy and conventional robot-assisted laparoscopic radical prostatectomy / 中华泌尿外科杂志

Objective To compare the postoperative outcomes and early continence rate between conventional robot-assisted laparoscopic radical prostatectomy (RARP) and Retzius-sparing robot-assisted laparoscopic radical prostatectomy (RSRARP).Methods The date from 50 patients who underwent RSRARP and 122 patients who underwent conventional RARP between 2016 September to 2017 included study.Ninety-two patients (forty-six patients in RARP group and forty-six patients in RSRARP group) were collected by propensity-score matching which were performed using eight preoperative variables.Preoperative data of patients in RSRARP group [patients age (67.1 ± 5.7) years,BMI (24.6 ± 2.7) kg/m2,tPSA 10.7 ng/ml (0-40.7 ng/ml),Gleason score 7 points (6-9 points),prostate volume 31.9 ml (10.0-95.4 ml),ECOG score 0 points (0-1 points),urinary domain of EPIC 94.8 points (63.9-100 points),clinical stage from T1cN0 M0 to T3a N0 M0] and conventional RARP group [patients age (67.2 ± 6.7) years,BMI (25.2 ± 3.1) kg/m2,tPSA 10.7 ng/ml (0-40.7 ng/ml),Gleason score 7 points (6-9 points),prostate volume 36.8 ml (8.9-81.0 ml),ECOG score 0 points (0-1 points),urinary domain of EPIC 95.8 points (63.9-100.0 points),clinical stage from T1c N0Mo to T3a N0M0] had no significant differences.We reviewed console time,estimated blood loss,the rate of leakage,complications,average daily drainage,pathological result,continence,urinary domain of EPIC one month,two months and three months after operation.Results All 92 cases were successfully performed robotically.Mean operation time was significantly more in RARP group than in RSRARP group [(223.9 ±48.9) min vs.(198.91 ±34.2)min,P ＜ 0.05)].There was no significant difference between the postoperative data of patients in RSRARP group [estimated blood loss 200 ml (50-1 200 ml),average daily drainage 82.5 ml (11.7-571.0 ml),the rate of leakage 6％,Clavien-Dindo grade Ⅰ (9％),Clavien-Dindo grade Ⅱ (4％),pathological stage pT1 (2％),pT2 (52％),pT3 (46％)] and RARP group [estimated blood loss 200 ml (100-1 200 ml),average daily drainage 102.9 ml (23.3-534.7 ml),the rate of leakage 4％,Clavien-Dindo grade Ⅰ (9％),Clavien-Dindo grade Ⅱ (2％),pathological stage pT1 (0),pT2 (46％),pT3 (54％)] (P ＞ 0.05).Early continence rate one week and one month after surgery was significantly higher in RSRARP group than in RARP group (78％ vs.35％,91％ vs.79％,P＜0.05).Urinary domain of EPIC one month and two months after surgery was significantly more in RSRARP group than in RARP group [(91.4±8.3) vs.(84.6±10.9),(95.0±7.5) vs.(91.6±7.8),P＜0.05].There was no significant difference in the rate of positive surgical margin between RSRARP group and RARP group (22％ vs.17％,P ＞ 0.05).Conclusions RSRARP were time-saving,safe and effective for the surgical treatment of localized prostate cancer.It seemed to yield a better outcome regarding early return to urinary continence postoperatively.

Pharmacokinetic analysis of raltitrexed using different ways of drug delivery / 介入放射学杂志

Objective To study the pharmacokinetics of raltitrexed using different ways of drug delivery, including femoral venous infusion, hepatic artery perfusion, hepatic artery injection of lipiodol suspension, hepatic artery perfusion followed by embolization with Gelfoam. Methods According to the administration way of raltitrexed, a total of 40 New Zealand rabbit models with VX2 liver tumor were randomly divided into group A (femoral venous perfusion), group B (hepatic arterial perfusion), group C (hepatic artery injection of lipiodol suspension), and group D(hepatic artery perfusion followed by embolization with Gelfoam). Drug concentration in plasma were determined by using LC-MS/MS method and the pharmacokinetic parameters were calculated. Results After administration of raltitrexed, the Tmax was 5 minutes in all 4 groups. In group A, B, C and D, the values were (5.88±1.39), (7.31±2.60), (9.86±5.10) and (7.19±2.27) respectively, with group C having the longest t1/2 value, which was significantly different with that of group A (P＜0.05); the (ng·ml-1·h-1) values were (2 056.40± 139.17), (1 389.21±180.28), (911.84±105.62) and (1 133.41±181.42)respectively, with the value of group A being obviously higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest; the AUC0-t(ng· ml-1·h-1) values were (5 482.72±1 007.07), (4 156.99±1 475.77), (2 785.13±1 107.36) and (3 903.64±947.25) respectively, with the value of group A being remarkably higher than that of group B, C and D (P＜0.05) and the value of group C being the lowest. Conclusion Compared with the femoral vein infusion way, the ways of hepatic artery infusion, hepatic artery lipiodol suspension injection and hepatic artery perfusion followed by embolization with Gelfoam may promote more raltitrexed to deposit in the tumor area, thus, the curative effect is enhanced, the drug concentration in plasma is lowered and the side effects are alleviated.

Application of covered stent in treatment of carotid blowout after head and neck tumors resection / 中国耳鼻咽喉头颈外科

OBJECTIVE To assess the treatment reliability of covered stent for carotid artery blowout after head and neck tumors resection. METHODS Five cases with postoperative rupture of carotid artery invaded by the head and neck tumor were reviewed. They presented with life threatening massive neck or oral bleedings. All of them were treated with self expanding covered stents through intervention therapy approach. RESULTS The covered stent were successfully deployed in the target arteries in all cases,the instant isolation effect was quite satisfactory. After treatment, angiography showed successful occlusion of the pseudoaneurysm, patency of carotid artery lumen, and significant improvement of clinical symptoms without neurologic dysfunction. Following up 2 to 36 months, 3 patients were alive with no disease, two patients died of recurrence. CONCLUSION For the treatment of carotid blowout, endovascular occlusion with covered stent is a minimally-invasive, safe and reliable methods.

Ultrasound-guided percutaneous radiofrequency ablation treatment for renal clear cell carcinoma / 中华外科杂志

<p><b>OBJECTIVE</b>To investigate clinical outcomes of ultrasound-guided percutaneous radiofrequency ablation (USG-RFA) in patients with renal clear cell carcinoma.</p><p><b>METHODS</b>Medical records of 34 patients who underwent USG-RFA of renal clear cell carcinoma at the Department of Urology of the Affiliated Drum Tower Hospital of Medical School of Nanjing University from May 2009 to January 2014 were retrospectively reviewed, including 28 male and 6 female patients aged between 25 and 85 years (mean age 60.7 years). Of the included cases, 16 had tumors located in the left kidney, 16 in the right, 1 in the solitary kidney, and 1 in the bilateral kidney. There were 35 tumors in this study totally. The maximum diameter of the tumors was 1.8 to 5.0 cm (mean (2.7 ± 0.3) cm), of which 32 cases of renal tumors were ≤ 4.0 cm and 3 cases of renal tumors were > 4.0 cm to 5.0 cm. Pathological diagnosis were acquired by ultrasound-guided percutaneous biopsy after USG-RFA. Contrast-enhanced ultrasound was used to evaluate tumor outcomes at the time of the surgery, and multi-slice spiral CT enhanced scan and contrast-enhanced ultrasound were used to identify residues and recurrences after treatment.</p><p><b>RESULTS</b>Treatments for all the patients were finished with short postoperative hospital stay about 3-5 days. No complications related to USG-RFA were encountered in any of the cases, such as perirenal fluid collection, perirenal hematoma, and peripheral organ damage. All the cases were diagnosed as clear cell carcinoma according to pathological results. The mean follow-up period was 29 ± 6 (range 3-59) months. Of the 35 USG-RFA-treated subjects, 32 tumors ≤ 4 cm reached the standard of complete treatment after one tumor was found with residue after the first month follow-up, and two tumors were noted recurrence at the 4 and 10 months follow-up after USG-RFA. Nonetheless, no residue or recurrence occurred after secondary treatment for these 3 tumors where pathological diagnosis were acquired again. The other 3 cases with tumors > 4.0 cm to 5.0 cm underwent USG-RFA twice or three times before reaching the standard of complete treatment, of which two had twice and one tumor had three times treatments. There was no carcinoma residue or recurrence during follow-up period.</p><p><b>CONCLUSIONS</b>Percutaneous ultrasound-guided radiofrequency ablation for small renal mass (SRM) has satisfied clinical outcomes, with the advantage of less injury, lower complication rates and shorter recovery time for small size of renal clear cell carcinoma. USG-RFA may become the preferred treatment alternative for SRM.</p>

Comparison of three grading systems for mangled extremity syndrome: amputation versus salvage / 中华创伤杂志

Objective To compare the values of the mangled extremity syndrome index (MESI), the mangled extremity severity score (MESS) and the limb salvage index (LSI) in deciding amputation or salvage in the management of the mangled extremity syndrome (MES). Methods Clinical data of 353 MES patients including 95 with amputation and 258 with salvage admitted in recent eight years were retrospectively evaluated by using MESI, MESS and LSI, the value of which in deciding amputation or salvage was assessed with receiver operating characteristic ( ROC ). Results There was statistical difference in aspect of mean scores of three grading systems between patients with amputation or salvage (P＜0. 01). For MESI, MESS and LSI, the sensitivities was 89.47%, 85.26% and 83.15% respectively, the specificities was 100%, 96.89% and 96.12% respectively, the coincidence was 97.16%,93.76% and 92.63% respectively, the areas under ROC curves was 0. 924, 0905 and 0. 861 respectively and the cut-off points were equal or over 20, 7 and 6 respectively. Conclusions Three scoring systems are all highly capable of predicting early amputation or not in MES management. The MESI is recommended as a quantitative criterion for determining amputation or salvage.

Course Construction of Neurorehabilitation for Higher Vocational Education / 中国康复理论与实践

@#: This paper introduced the experience of choice of materials, contents and teachings as well as the teachers construction in Neurorehabilitation.

Clinical efficacy and safety of uterine artery chemoembolization in abnormal placental implantation complicated with postpartum hemorrhage / 中华妇产科杂志

Objective To investigate the safety and clinical efficacy of uterime artery chemoembolization in postpartum hemorrhage (PPH) caused by abnormal placental implantation.Methods Between December 2006 and September 2009, there were 23 cases of abnormal placental implantation with PPH in our hospital, among which 9 presented with continuous small amount of vaginal bleeding and 14 with acute excessive bleeding.The average bleeding time was (8±6) d and the mean blood loss was (980±660) ml.Abnormal placental implantation was confirmed by color Doppler ultrasound (CD-US) in all cases, the internal lilac artery angiography was performed to identify the uterine artery and bilateral uterine artery chemoembolization (UACE) with methotrexate (MTX) and gelfoam particles to the distal end of uterine artery was conducted after.CD-US rechecked all patients within 48 h after UACE and those patients with blurred margins between placenta and uterus and abnormal blood flow (> 1 cm×1 cm) received ultrasonic-guided per vagina MTX multipoint injections.All cases were followed up for 3-26 months (average 12 months) to observe vaginal bleeding, placenta tissue discharge, serum human chorionic gonadotropin (hCG), uterine involution, menses, and side-effects or complications.Results (1) Curative effect: These 23 cases underwent 24 procedures of UACE successfully and vaginal bleeding ceased at an average of (3.5±1.3) min after UACE.Reduced blood flow in the placental implantation area was detected under CD-US after UACE.Among the 23 patients, wterine curettage was required in 16 cases due to retained placenta tissues with the mean blood loss of (40 ± 28) ml during the operation, 2 underwent subtotal hysterectomy and confirmed to be placenta percreta by pathology examination, and placenta tissues were spontaneously discharged completely in 5 cases.Totally, 91% of the patients (21/23) reserved their uterus.(2) Follow-up: the serum hCG reduced to normal within 1-13 d after the placenta tissue were evacuated.Regular menstruation returned within 2-3 months in those patients who reserved uterus and normal size uterus was found under sonography at 3 months.No severe complication was reported except for some post embolization syndrome, such as pelvic pain or fever.Conclusions UACE, combined with ultrasonic-guided transvaginal MTX injection, is a safe, minimal invasive and quick hemostatic procedure in treatment of abnormal placental implantation with PPH, and allows the preservation of uterus possible.CD-US is helpful in evaluation of the blood flow changes before and after UACE in abnormal placental implantation patients.

Preoperative digital design of structural bone graft for acetabular wall defects / 中华创伤骨科杂志

Objective To discuss the value of preoperative digital design of struetund bone graft for acetabular wall defects. Methods The . dieom data from spiral CT scans were imported into Mimics 10.0 to build the 3D solid model of the pelvis of an old female patient with left acetabular wall defects. The 3D solid model of the defect area was built by Mirror and 3D mask editing. A simulated bone graft was conducted on the 3D model by segmentation and trimming according to the data measured on the reconstructed model. Results The reconstructed 3D model of the patient's pelvis could be presented in different colors, transparenees, or combinations of interested tissues. The acetabular wall defects could be visualized very clearly at different angles. The geometric data of the bone graft could be measured to ensure the bone graft would fit the defects accurately. Conclusion Preoperative digital design based on 3D com-puterized reconstruction of acetabular wall defects may provide a valuable aid to clinical treatment, because it is a simple, rapid, and accurate method of increasing the fitness of bone graft and the defects,

Clinical analysis of operation-related complications of CT-guided percutaneous microwave coagulation therapy of liver malignancies / 中国介入影像与治疗学

Objective To analyze the causes,treatment and prevention of operation-related complications in liver malignancy patients after CT-guided percutaneous microwave coagulation therapy (PMCT).Methods A total of 68 patients with liver malignancy underwent CT-guided PMCT and their complications were analyzed retrospectively.Results The tumor diameter was 2.0-13.8 cm,mean 6.2 cm.Transcatheter arterial chemoembolization (TACE) was performed before PMCT in 64 patients,and 68 patients received 120 times of PMCT (1-8 times per patient).The main untoward reaction of PMCT was vagus nerve accentuation.Seven patients (7/120,5.83%) had complications including needle-tract implantation (n=2),liver abscess (n=2),pneumatothorax (n=1),cardiovascular accident (n=l) and enormous biloma with infection (n=l),6 were treated finally,and implanted tumor advanced in 1 patient.Conclusion CT-guided PMCT in liver malignancies is a safe therapeutic option with low rate of operation-related complications,which can be prevented and treated.Complications of PMCT are associated with the needle tract,frequency,coagulation range and perioperative management.

Selective renal artery angiography and embolization for nephrorrhagia diseases / 中国介入影像与治疗学

Objective To assess the value of selective renal arteriography and embolization in the therapy of nephrorrhagia diseases.Methods Fifteen patients of renal hemorrhages including 10 iatrogenic renal trauma,3 renal harmatoma and 2 renal closed injury with ineffective medical treatment underwent selective renal artery embolization.Results Renal artery an-giographies confirmed renal segmental arteries and/or their branches injuries.Gelatin sponge,PVA or steel coil were used for embolization.During 1-3 months fllowing-up,renal abscess was found in 2 patients without superselective embolization,while haematuria occurred in one case after embolization with gelatin sponge but stopped after medical treatment.The renal function of all patients were normal after embolization.Conclusion Superselective renal artery embolization has reliable effect and slight complication in the treatment of nephrorrhagia,especially suitable for patients after surgery and renal inadequacy.

The effects of rehabilitation training on learning, memory and expression of GAP-43 in hippocampus CA1 area of rats with vascular dementia / 中华物理医学与康复杂志

Objective To study the effects of rehabilitation training on learning and memory ability and the expression of growth-associated protein-43(GAP-43)in rats with vascular dementia.Methods Forty-four female Sprague-Dawley rats were randomly assigned to a rehabilitation group(n=20),an immobilization group(n=20),and a sham-operation group(n=4).The rats in the former 2 groups were operated on to establish the experimental vascular dementia model by repeatedly ischemia/reperfusion injury of brain induced by ligation of bilateral common carotid arteries and lowering of blood pressure induced by intraabdominal injection of sodium nitroprusside.The rats in rehabilitation group were administered with rotating bar and rolling cage exercises for 1 hour once daily,while those in the immobilization group were immobilized and without any exercise:the rats in sham-operation group could move freely in cage.Learning and memory tests were preformed by using step-down avoidance test at the 27th and 28th days after operation.Immunohistochemical staining was used to detect GAP-43 expression in hippocampus CA1 area at different time points after operation. Results The rats in rehabilitation group demonstrated better learning and memory ability than those in immobilization group(P<0.01),and more GAP-43 expression in hippocampus CA1 ar-ea than those in immobilization group and sham-operation(P<0.01).Conclusion Rehabilitation training can im-prove the learning and memory ability of rats with experimental vascular dementia,and the mechanism is probably re-lated to the increase of GAP-43 in hippocampus CA1 area.

The effects of rehabilitation on learning,memory and expression of NCAM in rats with vascular dementia / 中华物理医学与康复杂志

Objective To investigate the effect of rehabilitation training on learning and memory ability and the expression of neural cell adhesion molecule(NCAM)in rats modeling vascular dementia.Methods Foay-five female Sprague-Dawley rats were randomly assigned to a rehabilitation group(20 rats),an immobilization group(20 rats),or a sham-operation group(5 rats).The experimental vascular dementia model was established by repeatedly clipping the common carotid artery to induce repetitive isehemia-reperfusion,and by reducing blood pressure with intra-abdominal injection of sodium nitroprusside.The rats' learning and memory were tested on the 27th and 28th days after the operation using a water-maze step-down avoidance test.A RT-PCR technique was used to detect NCAM expression around the hippocampal area at different times after the operation.Results The rehabilitation group rats showed significantly better learning and memory ability than those in the immobilization group.NCAM was also more strongly expressed in their hippocampi than in those of the immobilization group and sham-operation group.Conclusion Rehabilitation can accelerate recovery of learning and memory ability in rats,and the mechanism possibly is related to the increase of NCAM expression in the hippocampus.

Application of selective external carotid artery embolization in the intractable epistaxis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To evaluate the value of super-elective transcatheter external carotid arterial embolization (TAE) in the treatment of intractable epistaxis.@*METHOD@#Forty-six cases of intractable epistaxis were selected, TAE was performed in 36 cases and externa carotid artery ligation was elected in 10 cases.@*RESULT@#The curing rate was 88.9% (32/36) in cases treated by TAE and was 40.0% (4/10) in cased treated by external carotid artery ligation, and the average hospital days of the former was 4.8 days, while the latter was 10 days. Recurrency were effectively stopped bleeding by all kinds of methods, and complications were rare.@*CONCLUSION@#Transcatheter external carotid arterial embolization is a simple, safe and effective treatment for the intractable epistaxis, which has more advantages than external carotid artery ligation, and comprehensive methods can effectively and thoroughly cure intractable epistaxis.

Study on the characteristics of α-glucosidase inhibitor from Schizandra Chinensis / 中国生化药物杂志

Purpose　The aim is to study α-glucosidase inhibitor from Schisandra Chinensis(Turcz.)Baill.Methods　The inhibitor was purified by soaking,ultrafiltration,ion-exchange chromatography and Lead Acetate deposition.Results　A α-glucosidase inhibitor was obtained.Conclusion　The inhibitor was a kind of non-competition inhibitor with large molecular weight of over 5×105D.

Ethical consideration on the TWO average expense control / 中国医学伦理学

TWO average expense control(TAEC) is the method that the hospital want to control the increasing breadth of medicine expense by limiting the total expense which include both clinic expense and hospitalize expense.TAEC will fake great help to improve the relationship of docfor and patient and to promote the hospital work.But the method of TAEC will also to be optimize further.

The clinical significance of nuclear matrix protein 22 in the diagnosis of bladder transitional cell carcinoma / 医学研究生学报

Objectives: To evaluate the clinical significance of nuclear matrix protein 22 (NMP 22) in the detection of bladder transitional cell carcinoma (BTCC) and compare with voided urine cytology(VUC). Methods: A total of 69 cases with voided urine samples for NMP 22 and VUC test were included in this study. Thirty of them were BTCC patients(BTCC group) and twenty nine suffered from other urological diseases (nonbladder cancer group, NBC group). Ten were healthy volunteers (control group). Results: The NMP 22 values for BTCC group (67.3 U/ml) were significantly higher than that of NBC group(7.4 U/ml) and control group (4.3 U/ml)( P 0.05). NMP 22 was more sensitive than VUC in low grade BTCC(Ⅰ,Ⅱ)(62.50% vs 12.50%,P 0.05). Conclusions:Urinary NMP 22 is a useful marker for the early diagnosis of BTCC. It is more sensitive than VUC in low stage and grade BTCC.