Energy-based surgical instrumentation (ESI) are surgical devices ablating or cutting tissues via the application of electrical,luminous,acoustic or other energy.High frequency electrotomes are widely used due to the low price,but they produce smoke in the process of surgery and incisions heal slowly.Ultrasonically activated scalpels' cutting performance is satisfying with easily healing incisions while its coagulating capability is poor.Laser scalpels are qualified for both cutting and coagulating in spite of the need of novel technology to overcome the characteristic that tissues absorb laser wavelength selectively.

BACKGROUND:Wide variation between individuals leads to instability of drug concentration that stil troubles transplant recipients. Therefore, individual therapy has always been a hot topic folowing transplantation. OBJECTIVE:To review the research progress in the genomics and gene polymorphism of the main categories of immunosuppressive drugs after kidney transplantation. METHODS:A computer-based search of Wanfang and PubMed databases was used to retrieve relevant articles published from January 2005 to August 2014. The keywords were “renal transplantation; immunosuppressant drugs; polymorphism; individual treatment” in Chinese and English, respectively. Finaly, 50 articles related to genomics and gene polymorphisms of immunosuppressive drugs after kidney transplantation were enroled in result analysis. RESULTS AND CONCLUSION: Immunosuppressant drugs have been widely used among renal transplant recipients to decrease post-renal transplantation rejection rate and greatly improve the survival rate of renal transplant recipients. Because of its certain side effects and wide variation between individuals, therapeutic drug monitoring should be employed routinely after transplantation to keep blood levels within the therapeutic range. This monitor system is effective to avoid post-renal transplantation rejections and drug side effects to a certain extent. Research on the relationship between pharmacokinetics and pharmacodynamics and genetic factors which combined with therapeutic drug monitoring provides possibility to give specific doses that wil improve efficacy while decrease side effects of immunosuppressive drugs, thereby further improving the long-term graft survival rate.

Objective:To analyze the predictive value of soluble cytotoxic T lymphocyte-associated antigen 4 (sCTLA-4) and RAD51 paralogous gene C (RAD51C) protein in the recurrence of cervical cancer patients after interventional therapy.Methods:A total of 107 patients with cervical cancer who underwent interventional surgery in our hospital from May. 2015 to Apr. 2019 were selected as the research group. postoperative recurrence were recorded. Another 107 patients with benign cervical disease during the same period were selected as the control group. The protein expressions of sCTLA-4 and RAD51C were compared between the two groups and patients with or without recurrence. Logistic regression was used to analyze the influencing factors of postoperative recurrence of cervical cancer patients, and a nomogram model of postoperative recurrence of cervical cancer patients was constructed and verified by calibration curve. The postoperative recurrence rate of cervical cancer patients with different sCTLA-4 and RAD51C protein expressions was compared.Results:The level of sCTLA-4 and the high expression rate of RAD51C protein in the study group were higher than those in the control group ( P<0.05). High-risk human papillomavirus positive, vascular infiltration, interstitial infiltration ≥1/2, paracterine infiltration, high expression of RAD51C protein and high SCTLA-4 level were independent risk factors for postoperative recurrence of cervical cancer ( P<0.05). High-risk human papillomavirus, vascular invasion, interstitial invasion, parametrial invasion, RAD51C protein and sCTLA-4 levels were used to construct a nomogram prediction model for postoperative recurrence of cervical cancer patients. The consistency indices were 0.610 (95% CI: 0.511-0.702), 0.616 (95% CI: 0.517-0.708), 0.640 (95% CI: 0.541-0.730), 0.609 (95% CI: 0.510-0.702), 0.728 (95% CI ranged from 0.633 to 0.809), 0.817 (95% CI ranged from 0.731 to 0.885), and the calibration curve validation showed high consistency. The net benefit rate of combined detection of sCTLA-4 and RAD51C proteins was greater than that of single detection. Conclusions:sCTLA-4 and RAD51C proteins are highly expressed in cervical cancer patients, and the high expression of both indicates that cervical cancer patients have a higher risk of recurrence after surgery. Clinically, the detection of sCTLA-4 and RAD51C protein expression can be used to screen patients with high recurrence risk.