Objective To investigate the effect of argatroban on C-reactive protein (CRP) and therapeutic efficacy in patients of malignant tumor complicated by acute lower limbs deep venous thrombosis (DVT).Methods 56 patients of malignant tumor complicated by acute lower limbs DVT were randomly divided into two groups.In observation group (n =28),argatroban was given intravenously as anticoagulation.Urokinase as thrombolysis and warfarin as anticoagulation were used in the control group (n =28).The concentrations of serum CRP were detected before treatment and on the 14th day of post-treatment in observation group and control group.Recanalization and therapeutic effect of DVT were compared.Results Before treatment,there was no significant differences in the serum CRP concentrations between observation group and control group [(46.44±28.82) mg/L vs (45.96±29.40) rmg/L,F =0.004,P =0.951].On the 14th day of post-treatment,the CRP concentrations in observation group and control group were lower than those of pretreatment (F =25.996,P ＜ 0.05,F =4.828,P ＜ 0.05).Compared with the 14th day of post-treatment,the CRP concentration of observation group was lower than that of control group [(16.97±10.22) mg/L vs (31.63± 18.07) mg/L,F =13.965,P ＜ 0.01].Recanalization rate of observation group on the 14th day of post-treatment (96.43 ％,27/28) was higher than that in control group (67.86 ％,19/28) (x2 =8.204,P =0.017).Therapeutic effect rate of observation group on the 14th day of post-treatment (96.43 ％,27/28) was higher than that in control group (75.00 ％,21/28) (x2 =6.205,P =0.045).Conclusion Argatroban can decrease serum level of CRP in patient of malignant tumor complicated by acute lower limbs DVT,which is favorable for improvement of clinical effectiveness.

Objective To investigate the safety and effectiveness of transurethral bipolar plasmakinefic resection in treating urethral stricture. Methods Totally 46 patients with urethral stricture were treated with transurethral bipolar plasmakinetic resection, and they were followed up for 3～12 months to observe the clinical effects. Results The segments of urethral scar were accurately incised and resected in all the 46 cases,24～26F bougies could pass through the urethra smoothly, and miction should be kept unobstructed. Totally 41 cases were followed up postoperatively, the maximal flow rate(Qmax) was ( 18.6±4.1 ) ml/s, which was obviously ameliorated as compared with that before operation(t=14.25, P＜0.05);sexual function had no obvious changes before and after operation;no serious complications of urethral massive bleeding, urinary incontinence, fistula of urethral diverticulum,urethral perforation, rectal injury, etc. was observed. Conclusion Transurethral bipolar plasmakinetic resection is an effective method for treating urethral stricture, because it has fewer complications, faster postoperative recovery and lower recurrence.

Objective To explore the clinical effect of laparoscopic radical nephrectomy by retroperitoneal in 65 cases.Methods 65 patients who received retroperitoneal laparoscopic radical nephrectomy were selected as the observation group,and their clinical data were analyzed.At the same period,S0 patients treated by open operation were selected as the control group.The clinical effect was compared between the two groups.Results The operation time,intraoperative blood loss,hospital stay,incision infection,pulmonary infection,hypercapnia,intestinal injury of observation group were lower than those of control group (t =7.60,8.38,8.83,x2 =8.33,6.19,4.08,4.08,all P ＜0.05).The positive margin rate,local recurrence rate,distant metastasis rate of two groups were not significantly different (P ＞ 0.05).Conclusion Laparoscopic radical nephrectomy by retroperitoneal has advantages of small wound,quicker recovery,less complications and good prognosis,which is worthy of clinical application.

Objective To approach the clinical curative effect of retroperitoneal laparoscopic adrenalectomy.Methods 120 adrenal tumors patients clinical data of urinary surgery in our hospital were analyzed,who was divided into detection group(80 cases) and control group(40 cases).Results The operation time,bleeding volume,postoperative exhaust time,hospitalization time,incision infection,pulmonary infection,intestinal injury of detection group were lower than those of control group (t =5.59,21.17,26.32,6.01,x2 =7.79,7.79,5.13,all P ＜ 0.05).Conclusion Retroperitoneal laparoscopic adrenalectomy has some advantages:the small incision,less trauma,faster postoperative recovery,less complication,,which was worth of applying.

Objective To investigate the expression of bone sialoprotein (BSP) in prostate cancer and its clinical significance. Methods Prostate cancer tissues of different pathological grades (68 cases) and benign prostatic hyperplasia tissues (22 cases) were selected. SP method was used to detect the expression of BSP. Serum total prostate-specific antigen (tPSA) levels of prostate cancer were detected by electrochemiluminescence immunoassay before the operation. Results Compared with no or low expression in the adjacent normal glandular tissues, the detectable levels of BSP were examined in most of the prostate cancer tissues. The expression rate of BSP in prostate cancer tissues was higher than that in benign prostatic hyperplasia tissues [76.47%(52/68) vs 13.64%(3/22),χ2=27.614, P<0.001]. The expression rates of BSP in well differentiated, moderately differentiated and poorly differentiated tissues according to cell differentiating degree (Gleason system) were 75.0 % (12/16), 77.5 % (31/40) and 75.0 % (9/12) respectively. There was no significant difference in various pathological grading (χ2=0.057, P=0.972). The expression rates of BSP in pathological stage pT2, pT3 and pT4 tissues were 62.16%(23/37), 95.24%(20/21) and 90.0%(9/10) respectively. A statistically significant association was found between BSP expression and pathological stage (χ2=9.338, P=0.009). Serum tPSA level of prostate cancer group with BSP expression was higher than that with no BSP expression [(69.06±25.52)μg/L vs (38.00±21.64)μg/L, F=19.355, P<0.001]. Conclusion The high expression of BSP in prostate cancer has a relationship with pathological stage and serum tPSA level, it may play an important role in the biological behaviour of prostate cancer.

Objective To evaluate clinical efficacy of retroperitoneal laparoscopic adrenalectomy in patients with adrenal disease.Methods 21 cases of adrenal disease undergoing retroperitoneal laparoscopic adrenalectomy from Jun.2006 to Oct.2010 were retrospectively reviewed.Results All operations were performed successfully except 2 cases were converted to open surgery due to peritoneal rupture,which resulted in difficult exposure of retroperitoneal cavity.The operation time ranged from 55 to 300 minutes,with 90 minutes as the medium.Blood loss volume ranged from 10 to 100 ml during operation (30 ml as the medium ).No blood transfusion was given.No complication such as massive hemorrhage,infection,abdominal visceral injury etc.occurred.19 patients were treated successfully and followed up from 3 to 55 months with 12.3 months as the medium.No tumor recurrence and metastasis was found in the 19 cases.Conclusion Retroperitoneal laparoscopic adrenalectomy has advantages of high safety,less complications and satisfactory efficacy in patients with adrenal diseases.

Objective To investigate the effect of atorvastatin on blood lipid and carotid atherosclerosis in patients with hyperlipidemia and cerebral infarction.Methods 98 patients with hyperlipidemia and cerebral in-farction in our hospital from September 2014 to February 2017 were selected and divided into observation group(49 cases)and control group(49 cases)according to the random number table method.The control group was treated with conventional treatment,the observation group was treated with atorvastatin on the ba-sis of the control group.The two groups were treated for 4 weeks.The ADL score,NIHSS score,blood lipid index,carotid IM T and carotid plaque area were compared between the two groups before and after treatment. Results ADL score of the patients in the observation group after treatment higher was than the control group (t=12.7783,P<0.05),NIHSS score was lower than the control group(t=10.941,P<0.05);LDL-C,TC and TG levels after treatment in the observation group were than in the control group(t= 17.239,9.216, 9.800,P<0.05),while the HDL-C level was higher than the control group(t=7.683.P<0.05);the patients in the observation group were treated by carotid artery IM T and carotid plaque area was higher than that of the control group(t=8.919,6.344,P<0.05).Conclusion Atorvastatin can improve hyperlipidemia in pa-tients with cerebral infarction and carotid atherosclerosis,dyslipidemia,has the important research signifi-cance.

Objective:To investigate the clinical value of carbon nanoparticles zonal tracer technique in lymph node retrieval of gastric cancer (GC).Methods:A retrospective cohort study was carried out. Clinicopathological data of GC patients who underwent radical D2 resection with carbon nanoparticles tracer in The First Affiliated Hospital of Hainan Medical University and Hainan Cancer Hospital from December 2015 and February 2019 were collected. Those with postoperative pathology of T1-2, Borrmann IV type GC, distant metastasis, preoperative neoadjuvant chemotherapy and incomplete data were excluded. A total of 181 patients were enrolled in this study, including 113 cases from the First Affiliated Hospital of Hainan Medical University and 68 cases from Hainan Cancer Hospital. Patients were categorized into two groups based on the methods of carbon nanoparticles tracer: zonal tracer group and traditional tracer group. In the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the upper, lower, left and right 4 injection points 0.5 cm away from the edge of the tumor in the normal serous membrane. In the zonal tracer group, on the basis of the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the first branch of the suprapyloric right gastric artery into the stomach, the first branch of the subpyloric right gastroepiploic artery into the stomach, the first branch of the minor curvature left gastric artery into the stomach and the first branch of the greater curvature left gastroepiploic artery into the stomach, respectively. The display of lymphatic vessels in each location and lymph nodes in each group by the tracing method was observed. The number of black-stained lymph nodes, the black staining rate of lymph nodes, the total number of detected lymph nodes, the total number of positive lymph nodes, and the metastatic rate of lymph node were compared between the two groups.Results:Eighty-nine patients were assigned to zonal tracer group, and 92 patients to traditional tracer group. There were no significant differences in baseline information between the two groups (all P>0.05). The median number of black-stained lymph nodes (median: 25.0 vs. 13.5, Z=-7.158, P<0.001) and the black staining rate of lymph nodes [(70.8±12.0)% vs. (47.1±15.7)%, t=11.399, P<0.001) in the zonal tracer group were significantly higher than those in the traditional tracer group. The total detected number of lymph nodes (37.5±11.5 vs. 29.6±11.8, t=4.581, P<0.001) and the total number of negative lymph nodes (31.3±12.5 vs. 24.9±11.1, t=3.621, P<0.001) were significantly higher in the zonal tracer group than those in the traditional tracer group. There were no significant differences in the total number of positive lymph nodes (median: 4.0 vs. 3.0, Z=-1.485, P=0.137), lymph node metastatic rate [78.7% (70/89) vs. 72.8% (67/92), χ 2=0.834, P=0.361] and metastatic degree [median: 11% vs. 10%, Z=-0.483, P=0.629] between the two groups. Conclusion:The carbon nanoparticles zonal tracer method can increase the black-staining rate of lymph nodes and the detected number of lymph nodes, thus improving the accuracy of gastric cancer staging.

Objective:To investigate the clinical value of carbon nanoparticles zonal tracer technique in lymph node retrieval of gastric cancer (GC).Methods:A retrospective cohort study was carried out. Clinicopathological data of GC patients who underwent radical D2 resection with carbon nanoparticles tracer in The First Affiliated Hospital of Hainan Medical University and Hainan Cancer Hospital from December 2015 and February 2019 were collected. Those with postoperative pathology of T1-2, Borrmann IV type GC, distant metastasis, preoperative neoadjuvant chemotherapy and incomplete data were excluded. A total of 181 patients were enrolled in this study, including 113 cases from the First Affiliated Hospital of Hainan Medical University and 68 cases from Hainan Cancer Hospital. Patients were categorized into two groups based on the methods of carbon nanoparticles tracer: zonal tracer group and traditional tracer group. In the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the upper, lower, left and right 4 injection points 0.5 cm away from the edge of the tumor in the normal serous membrane. In the zonal tracer group, on the basis of the traditional tracer group, 0.1-0.3 ml of carbon nanoparticle was injected subserously at the first branch of the suprapyloric right gastric artery into the stomach, the first branch of the subpyloric right gastroepiploic artery into the stomach, the first branch of the minor curvature left gastric artery into the stomach and the first branch of the greater curvature left gastroepiploic artery into the stomach, respectively. The display of lymphatic vessels in each location and lymph nodes in each group by the tracing method was observed. The number of black-stained lymph nodes, the black staining rate of lymph nodes, the total number of detected lymph nodes, the total number of positive lymph nodes, and the metastatic rate of lymph node were compared between the two groups.Results:Eighty-nine patients were assigned to zonal tracer group, and 92 patients to traditional tracer group. There were no significant differences in baseline information between the two groups (all P>0.05). The median number of black-stained lymph nodes (median: 25.0 vs. 13.5, Z=-7.158, P<0.001) and the black staining rate of lymph nodes [(70.8±12.0)% vs. (47.1±15.7)%, t=11.399, P<0.001) in the zonal tracer group were significantly higher than those in the traditional tracer group. The total detected number of lymph nodes (37.5±11.5 vs. 29.6±11.8, t=4.581, P<0.001) and the total number of negative lymph nodes (31.3±12.5 vs. 24.9±11.1, t=3.621, P<0.001) were significantly higher in the zonal tracer group than those in the traditional tracer group. There were no significant differences in the total number of positive lymph nodes (median: 4.0 vs. 3.0, Z=-1.485, P=0.137), lymph node metastatic rate [78.7% (70/89) vs. 72.8% (67/92), χ 2=0.834, P=0.361] and metastatic degree [median: 11% vs. 10%, Z=-0.483, P=0.629] between the two groups. Conclusion:The carbon nanoparticles zonal tracer method can increase the black-staining rate of lymph nodes and the detected number of lymph nodes, thus improving the accuracy of gastric cancer staging.

Objective To explore the feasibility of needle-embedding therapy in the treatment of chronic myocardial ischemia using a miniature pig model established by placement of an Ameroid constrictor at the left anterior descending branch (LAD) of coronary artery in Bama miniature pigs during surgery. Methods The miniature pig model of chronic myocardial ischemia was established by placement of an Ameroid constrictor at the left anterior descending branch of the left coronary artery in Bama miniature pigs. The pig models were randomly divided into the treatment group (the"Neiguan " group) and the control group (the "Zusanli " group), and were treated with needle- embedding electroacupuncture at the"Neiguan" (PC6) and "Zusanli" (ST36) acupoints, respectively. Myocardial samples were taken at 6 weeks after surgery for light and electron microscopic examinations. Results Gross pathology showed that ischemic area in the myocardium appeared in both experimental groups. The ischemic area in the "Zusanli "group was larger than that of the"Neiguan"group. Histopathology showed that the acupuncture treatment at the"Neiguan"acupoint reduced the ischemic injury in the pig myocardial tissues. Ultrastructural observation of the myocardium showed mitochondrial vacuolization in cardiomyocytes and myocardial fibrosis in both groups. Conclusions Acupuncture therapy at the"Neiguan"acupoint of pericardial channel may exert protective effect on the myocardial ischemia by reducing the ischemia-injury of cardiomyocytes, but can not inhibit the already existed ischemia-induced cardiomyocytic injuries. Our findings suggest that the establishment of miniature pig model of chronic myocardial ischemia by surgically placing an Ameroid constrictor on the left anterior descending branch of left coronary artery and the needle-embedding in acupoints is feasible for the treatment of chronic myocardial ischemia in this pig model.