Objective To study the value of transurethral electro-resection for renal pelvic tumor.Methods Transurethral electro-resection was performed on 11 patients after resection of the kidney.A F8 catheter was inserted into the bladder via the distal end of the ureter.The mucosal tissues around the ureter were then cut,and the ureter was fixed to the catheter and removed by pulling out the catheter.Results The operation was completed in all of the cases with a mean operation time of 115 min(65 to 170 min).None of the patients developed infection or hemorrhage after the surgery.11 patients were followed up for 6 to 18 months(mean,11 months),and no one died during the period.No tumor implantation or other intra-bladder masses were found.ConclusionsTransurethral electro-resection is feasible and safe for renal pelvic tumor.

Objective To study the epidemiology of breast diseases based on a vast amount of data collected from a number of hospitals. Methods The pathological data of breast diseases collected from 14 hospitals were statistically analyzed. Grouping was made according to the patients′ age, i.e. every 10 years from 0 to 69 as a group, and the patients aged 70 and over as another group. A database was established using software SPSS (10.0). A statistical analysis was made on the types of breast diseases, the incidence was calculated, and curves were plotted up based on the types of disease and the contribution of patients′ age in different hospitals. Results A total of 35948 cases, including 46 diseases of breast diseases, were analyzed. The common diseases were fibroadenoma, carcinoma, adenosis, hyperplasia of male breast, cystic hyperplasia and accessory-breast, which made up 37.99%, 21.49%, 20.60%, 4.54%, 3.60% and 2.80%, respectively, of the total cases analyzed. Conclusion The number of patients suffering from breast diseases is proportional to the size of the hospital. It has been found that different pathology of the breast had its peak preponderant age of discovery. In all the cases analyzed, tumors were found in 23 167 cases, accounting for 64.45% of all patients, among which benign and malignant lesions constituted 66.13% and 33.74%, respectively. Fibroadenoma was the predominant tumor among benign tumors (89.14%), while the breast cancer constituted 98.82% of malignant tumors. The incidences of the both types of tumor, were similar in different hospitals. No significant difference was found on the peak ages of different breast diseases among the hospitals. 12 781 cases of nontumorous lesions accounting for 35.55% for all the cases showed marked differences in age distribution among hospitals, implying that there were different diagnostic criteria for such lesions.

OBJECTIVE:To observe clinical efficacy and safety of naloxone hydrochloride combined with Danshen injection in the treatment of neonatal hypoxic ischemic encephalopathy(HIE). METHODS:104 patients with HIE were randomly divided into observation group and control group with 52 cases in each group. The control group was treated with Naloxone hydrochloride injec-tion 0.02 mg/kg,ivgtt,qd and conventional symptomatic treatment;while observation group was additionally treated with Danshen injection 4-6 ml+10% Glucose injection 20 ml,ivgtt,qd,on the basis of the control group. Treatment course of 2 groups lasted for 7 d. Clinical efficacy,symptom and sign recovery of 2 groups were compared,as well as levels of serum MMP-9,IL-6 and TNF-α,cerebral hemodynamic parameters and ADR. RESULTS:There was no statistical significance in MMP-9,IL-6,TNF-α and cerebral hemodynamic parameters before treatment(P>0.05). The total effective rate of observation group(92.31%)was signifi-cantly higher than that of control group (75.00%);after treatment,the recovery time of consciousness disturbance,primitive re-flex and muscle tension in the observation group were shorter than those in the control group;the levels of serum MMP-9,IL-6 and TNF-α in observation group were significantly lower than those in control group;peak systolic flow velocity(PSFV),end-dia-stolic flow velocity (EDTV) were higher in the observation group than in the control group,with statistical significance (P<0.05);resistance index (RI) was lower than in control group,but without statistical significance (P>0.05). No ADR was ob-served in 2 groups. CONCLUSIONS:Naloxone hydrochloride combined with Danshen injection can significantly promote HIE and signs recovery,reduce the levels of serum MMP-9,IL-6 and TNF-α,and improve hemodynamic parameters with good safety.

Objective To investigate the relationship between the expression ofα1-antichymot-rypsin (α1-ACT)in plasma and postoperative cognitive dysfunction(POCD).Methods The cognitive function of 64 patients undergoing operation under general anesthesia was evaluated by a battery of cognitive assessment instruments(BCAI)and the levels ofα1-ACT were measured at the time 1 d pre-operatively and 7 d and 3 months postoperatively.The patients were randomly divided into two groups:30 patients in ulinastatin group (group U)were injected with 10 000 U/kg ulinastatin,which was dissolved in 100 ml saline,within 20 min at the time of 30 minutes before induction;while control group (group C)were injected with the same volume saline.Results There was no significant differ-ence between the expression of α1-antichymotrypsin in patients with POCD and in control patients at the time before operation.Compared with control patients,the levels of α1-ACT in patients with POCD at the time of 7 d and 3 months postoperation were significantly higher (P <0.05).The levels of α1-ACT at 7 d postoperation were significantly higher than that preoperatively in both groups (P <0.05).The incidence of POCD in group U were significantly lower than that in group C,at the time of 7 d and 3 months after surgery (P <0.05).Conclusion POCD is associated with high expression of plasma α1-ACT.

Objective To investigate the influence of the radical resection and the optic canal unroofing on the postoperative vision in the patients with tuberculm region meningeal tumors.Matheods A retrospective analysis was made in 44 patients with tuberculm region meningeal tumors,from January 2010 to October 2012.The clinical data including the Simpson grades,adhesion between tumor and the surrounding structures,optic canal decompression,and postoperative vision were studied,and followed-up.Results In all 44 cases,there were 31 patients with Simpson grade Ⅰ resection,their postoperative vision of 17 patients were improved,eleven unchanged,and 3 worse.Out of them,tumors showed more adhesive in 9 cases,unroofed the optic canal in 17 cases.There were 13 cases in the other group including 8 cases with Simpson grade Ⅱ and 5 cases with Simpson grade Ⅲ,their postoperative vision of 8 patients were improved,four unchanged,and 1 worse.Out of them,tumors showed more adhesive to the surroundings in 10 cases,unroofed the optic canal in 3 cases.There were no different postoperative vision among the Simpson grades by the Chi-Square test (P ＞ 0.05).The less adhesive of the meningeal tumors,the better resection grade would be (P ＜ 0.05).And unroofed the optic canal group showed better postoperative vision than the not unroofed ones (P ＜ 0.05).Conclusion In the tuberculum region meningeal tumors,the Simpson resection grade was related to adhesion between the meningeal tumors and the surroundings,not to postoperative vision.The optic canal decompression can improve their visual outcome in some cases.

ObjectiveTo study the treatment and prognosis of the breast phyllodes tumors.MethodsKG1Clinical data, and the results of follow-up in 203 cases of breast phyllodes tumors were analyzed using Logistic analysis and Cox regression in SPSS statistic software.ResultWT5”BZLocal recurrence and tumor mortality were in direct proportion to the pathologic grade of the tumor. There was a direct proportion between local recurrence and tumor infiltration; and between tumor caused-mortality and tumor mitosis and necrosis.Mitotic activity and tumor necrosis were the independent prognostic factors. After surgical resection 21 1% of patients with benign tumor, 45 2% of patients with borderline tumor, 64 3% of patients with malignant tumor suffered recurrence. The 5-year survival rate was 100% in patients with benign phyllodes tumor, 92 0% with borderline tumor, and 33 3% with malignance.KG2Conclusion Local excision is not the appropriate treatment for phyllodes tumor. Patients with benign or borderline phyllodes tumor should undergo wide local excision including a margin of uninvolved tissue, and that with local recurrent borderline and malignant phyllodes tumor receive mastectomy.

OBJECTIVETo study the relationship between pathological features and classification criteria of the breast Phyllodes tumor.

METHODS203 cases of breast phyllodes tumor diagnosed in 22 hospitals since 1956 were analyzed and reappraised by a retrospective study.

RESULTS133 cases were benign, 42 cases were borderline and 28 were malignant. The follow-up (6 to 372 months) showed that 28/133 benign, 19/42 borderline and 18/28 malignant cases recurred, and 17 patients (2 borderline and 15 malignant) died. The statistic cluster analysis demonstrated that stromal cellar atypia, margin involvement, mitotic activity and tumor necrosis were retained in the variable group, and no error distinguish were showed.

CONCLUSIONSThe breast phyllodes tumor can be classified as the following three types: benign, borderline and malignant. It is important to diagnose and classify the breast phyllodes tumor according to the involvement of tumor margin, stromal cellar atypia, mitotic activity, stromal overgrowth and tumor necrosis. There are significant differences of 5 years survival rates, recurrent rates and death rates between the benign, borderline and malignant breast phyllodes tumor. With wide excision the recurrence of the tumor decreased suggesting that broad excision is preferred for the benign phyllodes tumor and mastectomy is indicated for recurred borderline and malignant tumors.

Objective:To investigate the effects of triptolide (TPL) and BET protein inhibitor JQ1 on proliferation inhibition and apoptosis induction of MLL-rearranged acute myeloid leukemia (AML) cell line MV4-11, and to explore their synergistic mechanisms.Methods:MV4-11 cells in logarithmic growth phase were treated with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1, 4 nmol/L TPL or different concentrations of JQ1 combined with 4 nmol/L TPL for 48 h. Cell proliferation was detected by CCK-8 method, apoptosis was detected by flow cytometry (FCM), mitochondrial membrane potential was detected by JC-1 method, and expressions of mitochondrial apoptosis pathway-related proteins were detected by Western blot.Results:The 50% inhibitory concentration ( IC50) value of MV4-11 cells treated with JQ1 for 48 h was (283.9±10.7) nmol/L. However, 4 nmol/L TPL significantly enhanced the inhibitory effect of JQ1 on proliferation of MV4-11 cells, the IC50 value of MV4-11 cells treated with JQ1 combined with TPL was (148.1±2.6) nmol/L, and the difference was statistically significant ( t = 25.31, P = 0.029). The result of FCM assay showed that compared with the JQ1 alone group [(9.6±2.3)%, (12.6±1.4)%, (19.5±3.3)%, and (22.7±2.1)%], 4 nmol/L TPL combined with different concentrations (100, 200, 300, and 400 nmol/L) of JQ1 acted on MV4-11 cells for 48 h, the proportions of apoptotic cells were (16.4±1.9)%, (27.5±2.1)%, (32.9±3.6)%, and (35.5±3.0)%, respectively, the difference was statistically significant ( F = 9.25, P < 0.01). After treated with 4 nmol/L TPL and JQ1 for 12 h, the level of cell membrane potential in MV4-11 cells was significantly lower than that of JQ1 single agent group, and the difference was statistically significant ( P < 0.05). After treated by 4 nmol/L TPL combined with JQ1 for 24 h, the levels of anti-apoptotic proteins bcl-2 and Mcl-1 decreased, and the level of pro-apoptotic protein bax increased. Conclusion:TPL can significantly enhance the proliferation inhibition and apoptosis induction effects of BET protein inhibitor JQ1 on MLL-rearranged AML cells, and the mechanism may be related to enhancing the mitochondrial apoptosis pathway.

Objective:To explore indicators related to visceral fat index by constructing a random forest model.Methods:In this cross-sectional study, the laboratory measures and body composition analysis records of 617 hospital employees (in-service and retired) who underwent physical examination in Heilongjiang Provincial Hospital Health Management Center from March to September 2021 were selected. The subjects were divided into a training set ( n=411) and a test set ( n=206) with the ratio of 2∶1. A total of 110 predictors were included in the model. The model was constructed with the training set and was evaluated with the test set. The optimal number of nodes and decision trees were selected to evaluate the prediction performance of the optimal model. And the top 10 relatively important factors were selected for further investigation. The 617 participants were further divided in to groups according to the visceral fat index: the normal or high visceral fat index group, and the differences of the top 10 relatively important factors were further compared between the two groups. Results:The optimal number of nodes of the final random forest model was 39 and the number of decision trees was 300. The accuracy, precision, sensitivity and specificity of the model was 83.3%, 73.9%, 89.4% and 78.7%, respectively. The area under the receiver operating characteristic curve and 95% confidence interval of the model was 0.881 (0.832-0.931). The top 10 relatively important factors in the model were body mass index, gender, age, serum uric acid, red blood cell count, monocyte cell count, C-peptide, carcinoembryonic antigen, glycosylated hemoglobin and glutamyl transpeptidase. There were significant differences in the up-mentioned 10 indicators between the subjects with normal and high visceral fat index (all P<0.05). Conclusions:The random forest model built in this study has good performance in predicting visceral fat index, and visceral fat is related with changes in liver function, pancreas function and immune function.

Objective:To investigate the predictive value of cerebroplacental ratio (CPR) for adverse perinatal outcomes of induction of labor in prolonged pregnancy.Methods:This retrospective study recruited 315 singleton pregnant women who had induced labor due to prolonged pregnancy (≥41 gestational weeks) in the First Affiliated Hospital of Chongqing Medical University from January 1, 2019 to April 30, 2020. Based on the occurrence of adverse perinatal outcomes (emergency delivery due to persistent abnormal fetal heart rate monitoring, umbilical artery blood pH at birth <7.2, 5 min Apgar scores<7, transferring to neonatal intensive care unit after birth, chorioamnionitis and vaginal delivery converted to cesarean section), they were divided into two groups: case group ( n=76) and normal group ( n=239). Clinical features and umbilical artery blood flow, middle cerebral artery (MCA) flow and CPR measured in the last ultrasound scan before induction were compared between the two groups using student's t-test, Mann-Whitney U test and Chi-square test. Receiver operating characteristic (ROC) curve was used to analyze the predictive values of umbilical artery blood flow, MCA flow and CPR for the adverse perinatal outcomes. Multivariate logistic regression analysis was used to screen the meaningful predictors. Results:Compared with the normal group, the umbilical artery pulsatility index (PI) (0.9±0.1 vs 0.8±0.1, t=-5.458, P<0.001) and the percentage of abnormal CPR (<1.0) increased significantly [21.1%(16/76) vs 6.3%(15/239), χ2=14.190, P<0.001] in the case group, while the MCA-PI and CPR decreased significantly (1.1±0.2 vs 1.3±0.3, t=5.658, P<0.001; 1.2±0.3 vs 1.6±0.5, t=8.940, P<0.001). The areas under the ROC curves of umbilical artery PI, MCA-PI and CPR for predicting adverse perinatal outcomes were 0.71, 0.71 and 0.77, respectively. CPR had the highest sensitivity (0.74) compared with umbilical artery PI (0.68) and MCA-PI (0.71), but the specificity of them were similar (0.67, 0.66 and 0.66). Multivariate logistic regression analysis showed that only CPR was the independent risk factor for adverse perinatal outcomes ( OR=0.028, 95% CI: 0.010-0.080, P<0.001). Conclusions:As an indicator for early prediction of adverse perinatal outcomes of induction of labor in prolonged pregnancy, CPR was more sensitive but less specific.