Objective To explore the clinical value of different transcatheter arterial embolization methods for renal carcino-ma before radical nephrectomy.Methods The related data of 43 patients with renal carcinoma who were confirmed by surgical pa-thology were retrospectively analyzed.Renal artery,renal capsular artery and adrenal artery of lesion side kidney were super-selec-tive embolized before surgery was set as group A,while Lesion side renal artery embolized was set as group B.Direct surgical radical nephrectomy was set as group C.The related data of operation time,ease or complexity of operation,intraoperative blood loss,suc-cess rate of lesion resection and postoperative survival rate were analyzed and compared in the three groups with statistical meth-ods.Results There were significant differences among the three groups in the average operation time,ease or complexity of opera-tion,intraoperative blood loss,success rate of lesion resection and postoperative survival rate (P < 0.01 ).There were significant differences between group A and B about all indexes except success rate of lesion resection(P <0.01).Conclusion The cases with additional transcatheter arterial embolization before radical nephrectomy improved obviously,especially in the cases who underwent completely embolization of lesion side renal artery and renal capsular artery.

The effects of Wumeiwan (WMW) on TNF-alpha, IL-6, IL-8, IL-10 and NF-kappaBp65 in rats with ulcerative colitis (UC) were investigated, the curative effectiveness of WMW vs salicylazosulfapyridine (SASP) was compared, and the action mechanism was analyzed. Fifty-Six Sprague-Dawley (SD) rats were randomly divided into four groups (n=14 in each group, with equal ratio of male and female): normal control group, model group, SASP group, and WMW group. Except normal control group, the rat UC models in the remaining three groups were established using the method of 2.4-dinitrochlorobenzene (DNCB) immunization and acetic acid local enema. The rats in model group, SASP group, and WMW group were treated with distilled water, SASP, and WMW respectively. The changes in the symptoms and signs were observed, and levels of IL-6, IL-8, TNF-alpha, IL-10 and the expression of NF-kappaBp65 in the colonic tissues were statistically analyzed. The results showed that the levels of IL-6, IL-8, and TNF-alpha were significantly increased (P<0.01), while those of IL-10 significantly reduced (P<0.01) after establishment of rat UC models as compared with normal control group. The levels of IL-6, IL-8, and TNF-alpha were obviously lower, but the level of IL-10 was obviously higher in WMW and SASP groups than those in model group (P<0.05). The levels of IL-6, IL-8, and TNF-alpha were lower, while the level of IL-10 was higher in WMW group than in SASP group. NF-kappaBp65 was expressed negatively or weakly in normal colonic tissues. The positive expression rate of NF-kappaBp65 in WMW group and SASP group was obviously lower than in model group (P<0.01), and there was significant difference between WMW group and SASP group (P<0.05). It was concluded that rat UC model was established successfully. WMW could up-regulate the expression of IL-10, down-regulate the expression of TNF-alpha, IL-6, IL-8, and inhibit the NF-kappaBp65 activity to adjust immune function, indicating WMW had better curative effects on UC in rats.

BACKGROUND:Valgus-varus constrained polyethylene insert is selected in strict accordance with the principle of“to obtain reliable stability using minimum restriction”. The stability of the prosthesis is elevated, but the restriction is not increased.
OBJECTIVE:To retrospectively analyze the application experience of constrained polyethylene insert in valgus and varus instability of primary total knee arthroplasty for older patients and to summarize the indications and clinical effects of this kind of implements.
METHODS:From March 2010 to March 2012, a total of 70 patients combined valgus and varus malfomation who accepted primary total knee arthroplasty were enrol ed in this study, including 56 varus patients (averagely 15°-30°) and 14 valgus patients (averagely 10°-20°). Constrained polyethylene insert was performed in 23 patients (25 knees) who stil had remaining unilateral valgus or varus<6 mm (18 patients were varus instability and 7 patients were valgus instability) when finished operation of standard osteotomy and soft tissue balancing. The bone cement knee prostheses in 23 cases were purchased from Smith&Nephew. The stem implant was not used in al cases. Cement or autografts were used in 11 valgus knees to fil the bone defects.
RESULTS AND CONCLUSION:Patients were fol owed up for 2 years on average (18-42 mouths). The knee pain symptoms of al cases disappeared. The joint stability was obviously improved. The lower limb power lines were correct. The Knee Society Score scores were improved from an average of 39.4 points preoperation to an average of 88.5 points postoperation. Al cases did not need the protection of knee braces. The maximum degree of flexion was 110°(96°-130°). The satisfaction degree of 36-Item Short Form Health Survey was 98%. No dislocation or infection happened. Results indicated that constrained polyethylene insert could be applied in the cases of less than 6 mm valgus and varus instability when finished operation of standard osteotomy and soft tissue balancing in total knee arthroplasty for older patients. This kind of implements can preserve bone mass, simplify operational process and have good clinical outcome in a short period.

Objective To investigate the treatment of octanol on matrix metalloproteinase-9(MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) protein expression,cerebral water content,infarction volume after ischemia-reperfusion in rats.Methods 150 SD rats were randomly divided into sham operated group (n=24),MCAO group (n=24),DMSO solvent control group (n=24) and octanol treatment group (n=24).A model of middle cerebral artery occlusion was induced by suture method.TTC stain was used to detect the infarction volume,dry-wet weight method to determine the brain water content.The expression of MMP-9 and TIMP-1 protein was detected by immunofiuorescence and Western blot.Results At 24 h of reperfusion after ischemia for 2 h,the octanol treatment group compared with MCAO group brain infarction volume obviously decreased(P＜0.05),water content significantly reduced ((78.16± 1.47) ％ vs (80.88±0.73) ％,P＜0.05),the number of MMP-9 positive cells obviously decreased((10.67±2.16) vs (29.00±3.40),P＜0.05),the expression of MMP-9 protein significantly reduced ((0.14±0.01) vs (0.21±0.02),P＜0.05)and the number of TIMP-1 positive cells significantly increased ((27.83 ±2.13) vs (5.67± 1.03),P＜0.05),the expression of TIMP-1 protein obviously increased((0.42±0.01) vs (0.28± 0.01),P＜0.05).The difference between MCAO group and DMSO solvent control group was not statistically significant(P ＜0.05).Conclusion Octanol may reduce brain edema,brain infarction volume.Up-regulation the expression of MMP-9 and down-regulation the expression of TIMP-1 may be one of the underlying mechanisms of the octanol neuroprotection.

Objective To evaluate the expression of epithelial cadherin (E-cad) and proliferating cell nuclear antigen (PC-NA) in various stages of tongue carcinogenesis and explore its relevance.Methods SP immunohistochemical method was employed to detect the expression of E-cad and PCNA protein in 82 rat tongue carcinogenesis specimens which induced by 4-nitroquinoline 1-oxide(4NQO).Chi square test for trend and the spearman correlation were used to analysis the correlation between E-cad and PC-NA.Results In normal mucosa,epithelial hyperplasia,mild dysplasia,severe dysplasia and squamous cell carcinoma,the positive rate of E-cad were 100％,95.24％,92.86％,80％,68.75％,the differences were statistically significant(P＜0.05);The positive rate of PCNA were 9.52%,14.29%,35.71%,50%,56.25%,the difference were statistically significant(x2 =16.676,P＜0.05).The expression of E-cad and PCNA has negative correlation(r=-0.614,P＜0.01).Conclusion E-cad and PCNA may be one of the biomarkers of carcinogenesis of tongue mucosa.

Objective To retrospectively evaluate the safety ,technical success rate and long‐term efficacy of the hepatic mul‐tiple cavernous hemangioma with super selective arterial cheoembolization .Methods 6 cases multiple hepatic cavernous hemangio‐ma by clinical diagnosed between 2004-2011 years in our hospital ,Through arterial super selective and completely filling cheoem‐bolization by Pingyang mycin lipiodol emulsion(PYM‐Lip) ,To assess the long‐term efficacy .by multi slice spiral CT enhanced scan‐ning and carry on relevant statistics processing in postoperative 6 ,12 ,36months .Results 26 lesions were embolismed in 6 cases multiple hepatic cavernous hemangioma ,Among the number of successful embolization were 15 of 1 cases ,2 of 4 cases ,3 of 1 cases , respectively .26 lesions was decreased with different degrees ,which the diameter of lesions were reduced with embolismed by CT enhanced scanning in postoperative 6 ,12 ,36months and diameter reduced> 50% ,diameter reduced≤50% ,lesions disappear was 38% (10/26) ,54% (14/26) ,8% (2/26) ,62% (16/26) ,23% (6/26) ,15% (4/26) ,69% (18/26) ,12% (3/26) ,19% (5/26) .Technical operation success rate 100% ,not serious complications occurred .There are statistically significant differences in the size of lesions before and after operation(P<0 .01) .Conclusion The technique success rate was high ,minimally invasive ,the complications was less ,the curative efficacy was obvious by transcatheter arterial super selective cheoembolizaton with hepatic multiple cavernous he ‐mangioma .

Objective:To report the clinical outcome of finger replantation in Tibetan plateau.Methods:From August, 2018 to August, 2019, a total of 12 patients with 15 amputed digits treated in the Department of Emergency of Lasa People’s Hospital. All these cases were performed replantation without exclusion, including 4 cases of machine-mangled injury, 3 cases of steel rope crushing injury, 4 cases of electric saw injury, and 1 case of rotation avulsed injury. Replantations were performed under microscope by a fresh team of microsurgery surgeons. Antibiotics, anticoagulants and vasodilators were prescribed postoperatively. Application of oxygen inhalation through nasal tube and warm room temperature were advised. Tabaco and coffin were strictly forbidden postoperatively. All patients were regular followed-up after operation.Results:Twelve out of total 15 amputed digits successfully replanted, 3 digits turned to necrosis eventually. The survival rate was 80% (12/15). All cases were followed up for 4-16 months. According to the Functional Evaluation Standard of Replantation by the Hand Surgery Society of Chinese Medical Association, the results were excellent in 3 digits, good in 7 digits, fair in 1 digit, poor in 4 digits. The excellent and good rate was 66.6%(10/15).Conclusion:In this group, the survival rate and excellent and good rate of finger replantation in Tibetan plateau is unexpected high. Thus, it is deducible that digit amputation can be successfully replanted with good functional result when meticulous microsurgical techniques are applied, although the unique adverse factors of Tibetan plateau exist.

The effects of Wumeiwan (WMW) on TNF-α, IL-6, IL-8, IL-10 and NF-κBp65 in rats with ulcerative colitis (UC) were investigated, the curative effectiveness of WMW vs salicylazosul-fapyridine (SASP) was compared, and the action mechanism was analyzed. Fifty-Six Spra-gue-Dawley (SD) rats were randomly divided into four groups (n=14 in each group, with equal ratio of male and female): normal control group, model group, SASP group, and WMW group. Except normal control group, the rat UC models in the remaining three groups were established using the method of 2.4-dinitrochlorobenzene (DNCB) immunization and acetic acid local enema. The rats in model group, SASP group, and WMW group were treated with distilled water, SASP, and WMW re-spectively. The changes in the symptoms and signs were observed, and levels of IL-6, IL-8, TNF-α,IL-10 and the expression of NF-κBp65 in the colonic tissues were statistically analyzed. The results showed that the levels of IL-6, IL-8, and TNF-α were significantly increased (P<0.01), while those of IL-10 significantly reduced (P<0.01) after establishment of rat UC models as compared with normal control group. The levels of IL-6, IL-8, and TNF-α were obviously lower, bat the level of IL-10 was obviously higher in WMW and SASP groups than those in model group (P<0.05). The levels of IL-6,IL-8, and TNF-α were lower, while the level of IL-10 was higher in WMW group than in SASP group.NF-κBp65 was expressed negatively or weakly in normal colonic tissues. The positive expression rate of NF-κBp65 in WMW group and SASP group was obviously lower than in model group (P<0.01), and there was significant difference between WMW group and SASP group (P<0.05). It was concluded that rat UC model was established successfully. WMW could up-regulate the expres-sion oflL-10, down-regulate the expression ofTNF-α, IL-6, IL-8, and inhibit the NF-κBp65 activity to adjust immune function, indicating WMW had better curative effects on UC in rats.

Objective:To intestigate the clinical efficacy between modified Overlap anastomosis and traditional auxiliary incision anastomosis in laparoscopic total gastrectomy.Methods:The retrospective cohort study was conducted. The clinicopathological data of 115 patients with gastric cancer who were admitted to the Second Affiliated Hospital of Fujian Medical University from January 2016 to December 2018 were collected. There were 62 males and 53 females, aged from 27 to 83 years, with a median age of 62 years. Of 115 patients, 51 patients undergoing totally laparoscopic total gastrectomy with modified Overlap anastomosis using linear stapler were divided into modified Overlap group and 64 patients undergoing laparoscopic assisted total gastrectomy with traditional auxiliary incision anastomosis using circular stapler were divided into traditional assisted group. Observation indicators: (1) surgical situations; (2) postoperative situations; (3) anastomotic complications; (4) follow-up. Follow-up using outpatient examination or telephone interview was conducted to detected tumor recurrence and survival of patients up to December 2019. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Comparison of ranked data was analyzed using the rank sum test. Results:(1) Surgical situations: the operation time, time of esophagojejunostomy, volume of intraoperative blood loss, the number of lymph node dissected, length of proximal incisional margin and length of auxiliary incision of the modified Overlap group were (234.0±11.0)minutes, (29.4±2.1)minutes, (53±14)mL, 42±13, (2.0±0.3)cm and (5.1±0.4)cm, respectively. The above indicators of the traditional assisted group were (231.0±11.0)minutes, (29.2±2.2)minutes, (50±13)mL, 40±10, (2.2±0.4)cm and (8.2±0.4)cm, respectively. There was significant difference in the length of auxiliary incision between the two groups ( t=-43.098, P<0.05), and there was no significant difference in the operation time, time of esophagojejunostomy, volume of intraoperative blood loss, the number of lymph node dissected, length of proximal incisional margin between the two groups ( t=1.168, 0.460, 0.990, 1.127, -1.926, P>0.05). (2) Postoperative situations: cases with mild, moderate, severe pain (postoperative pain degree), time to first flatus, time to initial fluid diet intake, duration of postoperative hospital stay of the modified Overlap group were 40, 9, 2, (2.9±1.0)days, (4.8±2.2)days, (11.7±2.8)days, respectively. The above indicators of the traditional assisted group were 31, 27, 6, (3.9±1.4)days, (6.5±2.5)days, (13.0±3.1)days, respectively. There were significant differences in the above indicators between the two groups ( Z=-3.217, t= -4.344, -3.888, -2.261, P<0.05). (3) Anastomotic complications: cases with anastomotic leakage, cases with anastomotic bleeding, cases with anastomotic stenosis of the modified Overlap group were 1, 1, 0, respectively. The above indicators of the traditional assisted group were all 1. There was no significant difference in the above indicators between the two groups ( P>0.05). Cases with anastomotic leakage were cured after the treatment of enteral nutritional support through nasogastric catheterization, which were confirmed by gastroenterography. Cases with anastomotic bleeding were improved by active hemostatic therapy. Cases with anastomotic stenosis were improved after the symptomatic treatment of anti-inflammatory and anti-swelling. (4) Follow-up: 109 of the 115 patients were followed up. Forty-eight of 51 patients in the modified Overlap group were followed up for 15.0-45.0 months, with a median follow-up time of 33.5 months. Sixty-one of 64 patients in the traditional assisted group were followed up for 16.0-46.0 months, with a median follow-up time of 27.0 months. There was no tumor recurrence in the modified Overlap group. One patient in the traditional assisted group had tumor recurrence with liver metastasis and survived with tumor. There was no significant difference in tumor recurrence rate between the two groups ( P>0.05). There was no patient died during the follow-up. Conclusion:Compared with traditional auxiliary incision anastomosis, patients undergoing total laparoscopic total gastrectomy with modified Overlap anastomosis have small incision, good postoperative recovery.