To investigate the effect of propofol on the plasma contents of endothelin(ET) and calcitonin gene related peptide(CGRP).Twelve monkeys with hemorrhagic shock were divided randomly into two groups.The monkeys in propofol group(PG) were administered propofol to 8mg/L plasma concentration by target control infusion with computer,while monkeys in control group(CG) were not .Venous blood were collected to determine plasma ET and CGRP contents by radioimmunoassay before bleeding, 2 hours after hemorrhagic shock and 2h after resuscitation. Compared with control group,the CGRP level and CGRP/ET of PG were significantly increased at 2h after hemorrhagic shock and 2h after resuscitation,while ET level of PG at 2h after resuscitation was significantly lower than that of CG. These findings indicate that propofol can increase the plasma content of CGRP and decrease the plasma content of ET in monkeys after hemorrhagic shock and resuscitation, and ET may play an important role in the development of hemorrhagic shock.

Objective To identify the association between human glucocorticoid receptor gene G166T polymorphism and essential hypertension(EH).Methods DNA samples from 71 normotensive cases and 48 EH cases were analyzed by a polymerase chain reaction(PCR) for restriction fragment length polymorphism(RFLP) to determine the intron 4 variant of human glucocorticoid receptor gene.Results No association was observed between EH group and control group.However,in females,a little association was observed between the EH group and control group.Frequencies of allele G were 0.64 in EH group and 0.46 in control group.Conclusion The G allele may be a predisposing gene marker,HGR gene intron 4 polymorphism contributes to the development of EH in females.

Objective To find out the cause of lung injury due to hemorrhagic shock and resuscitation, and the mechanism of propofol protecting Rhesus macaques from lung injury. Methods Twelve healthy Rhesus macaques were randomly divided into two groups: propofol group and control group. The animal model was made by 2-hour hemorrhagic shock and 2-hour resuscitation. Rhesus macaques in propofol group were given propofol at a plasma concentration of 8 mg/L all through by the technique of target controlled infusion. Hemodynamic parameters, gas analysis and RBC, WBC, HB and PLT contents from collected arterial blood were respectively determined before bleeding, 2 h after hemorrhagic shock and 2 h after resuscitation. Results Mean pulmonary arterial pressure and pulmonary vascular resistance index in propofol group 2 h after hemorrhagic shock and 2 h after resuscitation were significantly lower than those in control group (P

Hilar cholangiocarcinoma (HCCA) is a malignant tumor from the biliary epithelium.Its incidence is concealed,the anatomical structure is relatively complex,and the prognosis is poor.Surgical treatment is the only way to get a cure.At present,there are still many controversies in the preoperative evaluation and surgical treatment of HCCA at home and abroad.Further research on preoperative imaging diagnosis of HCCA,preoperative biliary drainage,portal vein embolization,scope of surgical resection,vascular resection and reconstruction,and orthotopic liver transplantation may provide a new reference for clinical treatment of HCCA.

Objective To analyze the prognostic factors in the surgical treatment of hilar cholangiocarcinoma.Methods The retrospective case-control study was conducted.The clinicopathological data of 93 patients [61 males and 32 females,age (64±8)years with the range of 43-84 years] with hilar cholangiocarcinoma who underwent surgical treatments in the General Hospital of the Northern Theater from January 2010 to December 2017 were collected.According to preoperative different staging and intraoperative exploration of hilar cholangiocarcinoma,corresponding operations were performed.Observation indicators:(1) surgical treatment situations;(2) tumor typing,staging and degree of differentiation:① tumor typing and staging,② degree of tumor differentiation;(3) follow-up situations;(4) analysis of prognostic factors:① univariate analysis,② multivariate analysis;(5) subgroup analysis.Follow-up using outpatient examination and telephone interview was performed to detect survival time and survival rate of patients up to December 31,2017.Kaplan-Meier method was used to calculate survival time and survival rate and to draw survival curves.Survival situations were analyzed byLog-rank test.The univariate analysis and multivariate analysis were performed using the Log-rank test and COX proportional hazard model respectively.Results (1) Surgical treatment situations:93 patients underwent surgical treatments,including 51 undergoing radical resection,23 undergoing palliative resection,16 undergoing internal biliary drainage or external drainage,3 undergoing abdominal laparotomy and intraoperative biopsy.(2) Tumor typing,staging and degree of differentiation.① Tumor typing and staging:of the 93 patients with hilar cholangiocarcinoma,Bismuth-Corlette type Ⅰ,Ⅱ,Ⅲa,Ⅲb and Ⅳ were detected in 26,22,9,18 and 18 patients.TNM stage Ⅰ,Ⅱ,Ⅲ and Ⅳ were detected in 7,34,22 and 30 patients,Mayo Clinic stage 1,2,3,4 were detected in 20,19,51 and 3 patients.② Degree of tumor differentiation:results of pathological examination showed 16 of 93 patients with highly differentiated adenocarcinoma,35 with moderately differentiated adenocarcinoma,37 with poorly differentiated adenocarcinoma,4 with mucinous adenocarcinoma and 1 with papillary adenocarcinoma.(3) Follow-up situations:93 patients were followed up for 6-36 months,with a median time of 24 months.The survival time of 93 patients was (21.4±2.1)months and the 1-,2-,3-year overall survival rates were 62.2％,34.9％ and 17.1％,respectively.(4) Analysis of prognostic factors:① results of univariate analysis showed that preoperative level of TBil,preoperative level of CA19-9,preoperative level of CA24-2,surgical methods,lymph node metastasis,vascular invasion,TNM staging,Mayo Clinic staging,degree of tumor differentiation were related factors affecting prognosis of patients with hilar cholangiocarcinoma (x2 =6.321,7.357,6.590,22.088,11.173,22.914,23.326,25.966,39.512,P＜0.05).② Results of multivariate analysis showed that preoperative level of TBil,preoperative level of CA 19-9,surgical methods,vascular invasion and degree of tumor differentiation were independent factors affecting prognosis of patients with hilar cholangiocarcinoma (odds ratio=1.002,1.001,2.690,2.626,0.420,95％ confidence interval:1.000-1.004,1.000-1.002,1.474-4.910,1.333-5.134,0.206-0.854,P＜0.05).(5) Subgroup analysis:of the 93 patients,the survival time of 51 undergoing radical resection was (28.0±2.3)months,and the 1-,2-,3-year survival rates were 75.3％,57.5％ and 25.7％,respectively;the survival time of 23 undergoing palliative resection was (14.0±2.4)months and the 1-,2-,3-year survival rates were 60.9％,13.0％,0,respectively;the survival time of 19 undergoing biliary drainage or open exploration was (8.0±2.9) months and the 1-,2-,3-year survival rates were 31.6％,7.9％,0,respectively.The survival of patients undergoing radical resection was significantly different from that of patients undergoing palliative resection,biliary drainage and open laparotomy respectively (x2 =10.939,18.343,P＜0.05).The survival of patients undergoing palliative resection was not statistically significant different from that of patients undergoing biliary drainage or exploration group (x2 =2.803,P＞0.05).Of the 35 patients with vascular invasion,the overall survival time was (7.0±2.0)months and 1-,2-,3-year survival rates were 14.5％,7.3％,0 respectively in 18 with portal vein invasion only,(10.0± 2.1)months and 37.5％,18.8％,and 18.8％ respectively in 8 with hepatic artery invasion,showing no statistically significant difference between the two groups (x2 =0.905,P＞0.05).Conclusions Preoperative level of TBil,preoperative level of CA19-9,surgical procedures,vascular invasion and degree of tumor differentiation are independent prognostic factors for patients with hilar cholangiocarcinoma.Radical resection can prolong the survival time of patients compared with other surgical treatments.

This study retrospectively analyzed the clinical data of 28 male patients with urethral stricture who had complications during urethrography, including 14 cases of infection, 8 cases of urethral bleeding, 5 cases of contrast agent hypersensitivity, and 1 case of bladder rupture. The infection manifested as acute cystitis in 11 cases, acute pyelonephritis in 1 case, acute epididymitis in 1 case, and sepsis in 1 case. Hypersensitivity reaction was mild in 3 cases, moderate and severe in 2 cases. A child with bladder rupture was immediately transferred to open surgery for bladder repair. All patients were cured by corresponding treatment. The complications of urethrography have various manifestations and different degrees of severity, so we should pay attention to prevention and proper treatment.

Prostate cancer is a common malignant tumor in male genitourinary system, and radical prostatectomy is one of the important methods to treat prostate cancer. Indocyanine green is a non-radioactive, water-soluble compound, which can help identify anatomical structures and visualize blood vessels through near-infrared fluorescence. The role and injection techniques of Indocyanine green in radical prostatectomy in sentinel lymph node identification, pelvic lymph node dissection and neurovascular bundle preservation are reviewed, so as to provide a reference for improving the surgical effect, reducing the difficulty of surgery, and prolonging the survival period of patients, and evaluate the potential research field of this technology in the future.

Objective:To explore the outcomes of urethra around corpora cavernosus anastomotic urethroplasty for the treatment of complex posterior urethral strictures.Methods:Between June 2008 and June 2020, 35 patients with complex posterior urethral strictures were treated using urethra rerouted under one corpora cavernosus anastomotic urethroplasty. The patients’ age was 3-54 years(mean 23.2 years), the urethral stricture or loss length was 4-7 cm(mean 5.2 cm), and 6 patients associated with urethrorectal fistula. The technique involved: ①The anterior urethra is dissected long more than 5 cm, separation of the proximal corporeal bodies, inferior pubectomy and the dissected proximal urethra.②A channel around the left crus of the penis through the inferior pubectomy is separated and urethra rerouted under left corpora cavernosus to allow a tension-free anastomosis to the proximal urethra.Results:Two patients lost follow-up; the remainder 33 patients were followed-up for 3 to 144 months(mean 37 months). Thirty-two patients could void normally(97%), The examination of maximal urinary flow rates(Q max) were taken in 21 patients, of whom Q max was 13.6-35.5 ml/s (mean 17.5 ml/s) in 7 children and 16.3-77.6 ml/s(mean 27.9 ml/s) in 14 adult patients. All 6 patients associated with urethrorectal fistula successful repaired, of these patients 1 had died of hemorrhage of brain 6 years postop. One patient developed urethral stenosis postoperatively. Continence was achieved in 29 patients, the remaining 3 patients had incontinence from mild to moderate. Conclusions:Urethra rerouted under left corpora cavernosus anastomotic urethroplasty is not only an effective surgical salvage option, with low recurrent rate for patients with complex posterior urethral strictures, but also do not cause curve and affect growth of corpora cavernosus.

Objective:To explore the level of fractional exhaled nitric oxide (FeNO) in preschool children in Beijing and analyze the influencing factors.Methods:Preschool students aged 3-5 in Beijing were selected from May to July 2017.Healthy children were screened through questionnaire survey and on-site physical examination, and their FeNO levels were detected.Results:A total of 317 healthy children were enrolled, including 161 males and 156 females.There was no significant difference in FeNO levels between different genders ( P>0.05). The geometric mean value of FeNO was 8.2 ppb in male(95% CI: 7.0-9.3 ppb)and 8.7 ppb in female (95% CI: 7.4-10.1 ppb). There were statistical differences in FeNO levels among the 3 age groups ( F=4.63, P<0.05). The geometric mean value of FeNO was 7.2 ppb in 3-year-old children (95% CI: 5.5-8.9 ppb), 8.8 ppb in 4-year-old children (95% CI: 7.4-10.2 ppb), and 9.2 ppb in 5-year-old children (95% CI: 7.7-10.7 ppb). The geometric mean value of FeNO of healthy preschool children was 8.5 ppb (95% CI: 7.6-9.3 ppb). There was a positive correlation between FeNO and height ( r=0.135, P<0.05), but there was no significant correlation between FeNO and weight. Conclusions:The geometric mean value of FeNO in healthy preschool children in Beijing is 8.5 ppb (95% CI: 7.6-9.3 ppb)and the 95% reference value is 23.5 ppb.The level of FeNO changes slightly with the increase of age, and height also affects the FeNO.It is highly feasible to use on-line tidal breathing method to measure FeNO of preschool children.