Objective To analyze the clinical features of limb salvage surgery with epiphyseal preservation in children and adolescents, and to evaluate the recurrence rate, metastasis, complications, and the joint functional results after tumor resection. Methods From December 1995 to January 2003, we operated on 33 patients aging from 8 to 16 years (average 12.2 years) with diagnosis of primary malignant bone tumor of the extremities with preserving the epiphysis in the limb salvage surgery. In this group, the tumor located in distal femur in 24 cases and in proximal tibia in 9 cases. There were 23 osteosarcomas, 6 Ewing sarcomas, 2 chondrosarcomas, and 2 invasive osteoblastomas. The tumors were staged clinically, 2 cases inⅠA, 2 cases inⅠB, 17 cases in ⅡA, and 12 cases inⅡB. According to the relationship between the tumor and epiphyseal plate, the metaphyseal tumors in children were classified into 3 types: 18 cases were categorized as type Ⅰ, 13 as type Ⅱ, and 2 as type Ⅲ. The patients received 2-4 cycles of preoperative adjuvant chemotherapy, and another 6 cycles after surgery. Serious bone defects after tumor resections were repaired with massive allograft bone transplantation, followed by internal fixation by intramedullary nails and cancellous screws. Results Among the 33 cases, 3 cases were lost to follow up. 29 cases had complete clinical data. Postoperative follow-up was 12-72 months (average 37.6 months). Recurrences were seen in 3 cases, with one local recurrence in type Ⅲ case one year after tumor resection, other 2 recurrences around the femoral vessels in typeⅡcases 15 and 30 months after the tumor resection respectively. The recurrence rate accounted for 10.3%. Amputation was performed for the cases with recurrences. But pulmonary metastasis developed and the patients died. In this cohort, 9 cases died. Five-year survival rate was 57.9%. 4 cases reported 5 complications (17.2%). No patient reported skin necrosis, hematoma, infection, rejection to the allograft, and nonunion at the end of the follow-up. According to the functional evaluation criteria of Enneking, excellent were 11 cases, good 13 cases, fair 3 cases, and poor 2 cases. The excellent or good rate was 82.8%. Conclusion The limb salvage surgery with preservation of epiphysis for malignant bone tumors in children and adolescents guarantees the patient's satisfactory postoperative limb functional results. Preoperative effective adjuvant chemotherapy and prevention of postoperative complications deserve great attention.

Aim To find out the effect of the different organic solvents extracts and plumbagin from Plumbago zeylanica L.on EMT-6 breast cancer of BALB/C mouse and transplanted S180 of KM mouse primarily.Method Experiments of animal transplanted tumor in vivo were adopted.Results ① The high dose of chloroform group and plumbagin group could inhibit the growth of EMT-6 breast cancer in BALB/C mice in vivo.Compared with that of physiological saline group,tumor weight has obviously lightened(P

Objective To aim at the problem of bedsore which is always occurred on the crowd of the aging population,empty-nest family and the disabled patients etc,a two-way side turn over mechanism for intelligent sanitation nursing instrument is designed.Methods The turn over angle of the mechanism was analyzed and calculated after establishing the mechanism's three-dimensional model.The forces situation of the state of lying,side lean against and left/right side turn over were carried out through finite element analysis by using of Pro/Mechanica.Results The results showed that the sum of two-way side turn over mechanism's two-way side turn over angle was 30 degrees.The materials met the mechanism's force requirement.Conclusions The results can provide a theoretical basis for the designer to determine the structure parameters and sizes of mechanism.

Objective:To study the expression of human Era.Methods:The encoding region of human Era gene was inserted into pUC19 plasmid and sequenced,the gene fragment was then cloned into the prokaryotic fusion expression vector pRSET B to contruct recombinant expression plasmid pRSET B hEra.The recombinant protein was expressed in E.coli BL21DE3(plys S).Results:6His hEra was expressed after induced by IPTG and took 51.2% of the total cell lysate and mainly existed in the inclusion body.Conclusion:High level of human Era was established and this result may shed light on the further study on function of human Era.

Objective To explore the related infection factors of the internal jugular vein indwelling central venous catheter , and make prevention countermeasures according to the infection factors of central venous catheter infections .Methods A total of 564 patients admitted in liver and gallbladder surgical ward with external jugular vein indwelling central venous catheter were se‐lected ,extract the relevant hospital infection data in patients by the XingLin hospital infection real‐time monitoring system ,and SPSS15 .0 statistical analysis was conducted .Results The infection rate of 564 cases of patients was 4 .07% .The rate of gram‐neg‐ative bacteria infection was 43 .5% ,the gram positive bacteria infection accounted for 34 .8% ,fungi accounted for 21 .7% ,including multiple drug‐resistant bacteria infection accounted for 52 .1% .Catheter indwelling 14 d or more infection rate was 8 .5% ,14 d fol‐lowing infection rate was 2 .1% ,and infected patients for more advanced cancer and patients with severe acute pancreatitis .Pipe joint respectively with heparin cap and needle positive pressure infusion joint connections ,infection rate was statistically different (P<0 .05) .Conclusion The infection of internal jugular vein indwelling central venous catheter should not be ignored ,and the oc‐currence of catheter‐related infection of patients is closely related to state of an illness ,the time of catheter insertion ,and the joint device and so on .

Objective To explore the clinical utilization value of regional blood flow fluorescence visualization in selective arterial clamping robotic partial nephrectomy.Methods 12 cases of robotic partial nephrectomy with indocyanine green-based regional blood flow fluorescence visualization selective arterial clamping between October 2016 and June 2017 by our team were retrospectively analyzed.There were 9 males and 3 females with age between 36-78 years,mean age(51.2 ± 11.0) years,BMI 20.1-36.2 kg/m2,mean of (25.6 ± 4.8) kg/m2,tumor diameter 2.0-5.1 cm,mean of(3.3 ± 0.9) cm,and R.E.N.A.L.score 4-10,mean(7.3 ± 2.0).Preoperative renal function status of eGFR (estimated glomerular filtration rate) was 82-133 ml/(min · 1.73 m2),mean (101.9 ± 13.7)ml/(min · 1.73 m2) and split ECT-GFR of 44.5-70.6 ml/min,mean of(53.8 ± 8.5) ml/min in operated kidney;48.2-71.1 ml/min,mean of(56.8 ±6.8) ml/min in contralateral kidney;in total,92.7-139.1 ml/min,mean of(109.8 ± 14.6)ml/min.Perioperative information including operative time,blood loss,warm ischemia time,surgical complications,pathologic outcomes and follow-up data of included patients were analyzed.Results All procedures were done smoothly without open or radical conversion,with operative time of 95-203 min,mean of (170.6 ±38.6)min,and estimated blood loss of 60-1 000 ml,mean of(178.3 ± 206.9)ml.According to the visualize uptake of fluorescence imaging perfusion area visualization after selective arterial clamping,1 case underwent unclamping robotic partial nephrectomy,1 case converted to main renal artery clamping with warm ischemia time of 18 min,10 cases performed via renal arterial branch clamping with an average ischemia time of (25.5 ± 10.5) (range 17-46)min,1 of which due to parenchymal bleeding obscuring visualization necessitated clamping of the main renal artery with 1000 ml blood loss,46 min of arterial branch occlusion and 16 min of main artery clamping.The average postoperative hospital stay was (5.8 ± 0.9) (range 5-8)days,and the duration of drainage was (3.5 ± 0.5) (range 3-4) days.No postoperative complications occurred.Postoperative pathology:all margins were all negative,11 cases of clear cell carcinoma,eosinophilic adenoma in 1 case.The average eGFR of 9 cases of renal arterial branch clamping was (94.5 ±22.5)(range 56-140)ml/(min · 1.73 m2) at discharge with a 5％ percentage decrease versus preoperative level.Among them,4 cases obtained with ECT-GFR data 1 month postoperatively had a mean of(37.6 ±13.2)(range 20.8-55.8) ml/min with 29％ percentage decrease on the surgical side,an average of (58.5 ± 6.9) (range 51.2-68.4) ml/min with 2％ compensatory increase of the contralateral side,and (98.7 ± 16.2) (range 79.3-124.3) ml/min in total with a 10.4％ overall decrease.Conclusions The visualization of blood flow imaging based on indocyanine green fluorescence can clearly and intuitively show the effect of branching arterial occlusion in robotic partial nephrectomy,guide the optimization of surgical resection strategy,and improve safety and clinical outcome.

Background and purpose: Primary signet ring cell carcinoma(SRCC) of the bladder is rarely diagnosed in the clinic. Few cases have been reported in the literature, so there was lack of understanding of the primary bladder SRCC in terms of diagnosis and treatment. Our study was to investigate the clinical features and treatment strategy for primary SRCC of the bladder and review the status of the disease along with the literature. Methods: 3 cases of primary bladder SRCC were studied, including clinical features, treatment, follow-up and their prognosis.The literature was reviewed. Results: All cases received ultrasound, computerized tomography, cystoscopy, biopsy and other related lab tests for diagnosis and differential diagnosis. Laparoscopic radical cystectomy and orthotopic ileal neobladders were performed in 2 cases, while the other case received laparoscopic radical cystectomy and ileal conduit diversion, Chemotherapy (cisplatin and 5-fluorouracil) was delivered in one case after surgery. One patient died at 6 months postoperatively because of multiple metastasis. The other 2 cases have been followed-up only for 8 and 12 months postoperatively, and no recurrence or metastasis have been observed. Conclusion: Primary SRCC of the bladder lacks distinctive clinical and imaging manifestations. The tumor grows very invasively. Radical cystcctomy is one of the optimal approaches for treatment of SRCC of bladder.

Background and purpose: The prognostic factors on survival for the patients with prostate carcinoma are still underdeterrnined. This study was to analyze the survival of three common treatment methods for prostate carcinoma and the prognostic factors on survival. Methods: 494 male patients who were diagnosed as prostate cancer were enrolled into the retrospective study. All of the data like age, stage, grade, PSA level, ALP, Hb and treatments were collected. Overall survival and disease specific survival rates for patients were analyzed by Kaplan-Meier method. Prognostic factors on disease specific survival were also analyzed by Log-rank test and Cox proportional hazards model. Results: Disease specific survival rates at 1, 3 and 5 year were 96.0%, 89.0% and 80.0% for all 494 patients, respectively. Disease specific survival rate at 3-year was 92.4% for brachytherapy, 100.0% for radical prostatectomy and 80.6% for hormonal therapy (P=0.008). Multivariate analysis by Cox model showed that stage, PSA level and age significantly impacted on disease specific survival. Conclusion: Brachytherapy and radical prostatectomy provides longer survival time than hormonal therapy for patients with prostate cancer. Clinical stage and PSA level and age of prostate cancer are independent factors impacting on survival significantly.

In order to construct a eukaryotic co-expression plasmid containing membrane-anchored Sjcl4FABP and Sjc26GST genes and identify their expression in vitro, Sj14 and Sj26 genes were obtained by RT-PCR with total RNA of Schistosoma japonicum adult worms as the template and cloned into eukaryotic expression plasmid pVAC to construct recombinant plasmids pVAC-Sj14 and pVAC-Sj26. Then a 23 amino-acid signal peptide of human interleukin-2 (IL-2) upstream Sj14 or Sj26 gene and a membrane-anchored sequence containing 32 amino-acids of carboxyl-terminal of human placental alkaline phosphatase (PLAP) downstream were amplified by PCR as the template of plasmid pVAC-Sj14 or pVAC-Sj26 only to get two gene fragments including Sj14 gene and Sj26 gene. The two modified genes were altogether cloned into a eukaryotic co-expression plasmid pIRES, resulting in another new recombinant plasmid pIRES-Sj26-Sj14. The expression of Sj14 and Sj26 genes was detected by RT-PCR and indirect immunofluorescent assays (IFA) when the plasmid pIRES-Sj26-Sj14 was transfected into eukaryotic Hela cells. Restriction enzyme analysis, PCR and sequencing results revealed that the recombinant plasmids pVAC-Sj14, pVAC-Sj26 and plRES-Sj26-Sj14 were successfully constructed and the expression of modified Sj14 and Sj26 genes could be detected by RT-PCR and IFA. A bivalent membrane-anchored DNA vaccine encoding Sj14 and Sj26 genes was acquired and expressed proteins were proved to be mostly anchored in cellular membranes.

Objective To investigate the value of three-dimensional digital subtraction angiography (3D-DSA)in the diagnosis and interventional treatment of Budd-Chiari syndrome caused by the obstruction of inferior vena cava(IVC).Methods Twenty-one patients with complex Budd-Chiari syndrome caused by the obstruction of IVC underwent 3D-DSA after two-dimensional-DSA(2D-DSA)was performed with posterior-anterior view.The images of 2D-DSA and 3D-DSA were independently reviewed by two senior interventional radiologists iu a double-blinded way.Percutaneous transluminal angioplasty or stent placement of IVC were performed according to the results of 2D-DSA and 3D-DSA.Results Different aspects of the IVC in all patients were demonstrated on the 3D-DSA images,including the mowhology and the location of obstructions,the origins of collateral vessels and their relationships to the IVC.Collateral vessels originated from the site of IVC occlusions in 9 patients were detected by the 3D-DSA.However.the 2D-DSA provided excellent visualization of the vascular structures of the IVC in 7 patients.and the collateral vessels origihated from the site of IVC occlusions were shown in 2 patients.The 3D-DSA was significantly superior to the 2D-DSA in detecting the IVC obstructions and the collateral vessels(P＜0.05).The virtual angioscopy of the 3D-DSA was able to visualize free IVC thrombosis in 3 paitents.and mural IVC thrombosis in 1 patient.The procedures were successful in all patients.There were no other complications except the rupture of IVC in 1 patient.Conclusion The 3D-DSA can offer valuable informations in diagnosis of IVC obstruction.and it may play an important role in interventional treatment of Budd-Chiari syndrome.