Objective To investigate the mechanism of renal cell carcinoma (RCC) in affecting the immune system of the host. Methods FasL expression and the apoptosis of tumor infiltrating lymphocytes (TIL) were examined by immunohistochemical technique in 44 cases of RCC.FasL function was assessed by coculture assays in vitro using the renal cancer cells 786 0 or GRC 1 and the Fas sensitive Jurkat T cells. Results (1)FasL expression rate in RCC (46.5%) was higher than that in the normal kidney tissues (23.2%, P

Objective To develop a method used for sex discrimination of thyroid cartilage. Method Seven conspicuous indicators were obtained through examination of the thyroid cartilages from 142 adult Chinese Han individuals. Adopting Fisher and Bayes discriminant analysis, series discriminating functions for sexing thyroid cartilage were set up. Results The discriminating power of the integral and mostly integral thyroid cartilags was 100 % , while the incomplete thyroid cartilages 90 % . Conclusion This method can be used for sex discrimination of the thyroid cartilage in adult Chinese Han population.

nts were tend to suffer from AKI, with the most common cause of pre-renal injury and drugs such as antibiotics and contrast medium used in X-ray imaging. Outcomes of the patients with AKI depends on severity of their kidney injury.

Objective To explore the therapeutic effects of Ni-Ti memory alloy embracing fixator on the multiple fracture of ribs and flail chest. Method From January 2006 to December 2009, the effects of operation and long-term follow-up after internal fixation operation with memory alloy embracing fixator in patients with multiple fracture of ribs and flail chest were observed. Results The hospital stay of patients treated with memory alloy embracing fixator was 10.31 ± 3.14 days and pain was significantly reheved after treatment ( P= 0.02) .The rate of post-operative complications was 17.65% such as atelectasis, pulmonary infection, etc. There were fewer longterm complications and less influence to daily activity of life. Conclusions It is a advanced and practical method for patients with the multiple fracture of ribs by using Ni-Ti memory alloy embracing fixator with slighter trauma,simple, safe, reliable, good histocompatibility and fewer post-operative complications.

Objective To investigate the corelation between miRNA-126-3p and pathogenesis of pulmonary hypertension . Methods Totally 25 patients with congenital heart disease ,including 11 cases with pulmonary hypertension and 14 control cases , were recruited .The expression of miRNA-126-3p was detected by qRT-PCR ,and we used starBase to predict the biological informa-tion miRNA-126-3p ,and then verified it by the level of mRNA and protein .Results There was no statistical difference in age ,gen-der ,and biochemical examination(P> 0 .05) ;the expression of miRNA-126-3p in the pulmonary hypertension cases was significantly higher(P< 0 .01) ;starBase found that miRNA-126-3p may participate in binding protein ,signal transduction ,cell differentiation and regulation of cell morphology ,the regulation of MAPK and insulin receptor signaling pathways ,etc .Its target genes mainly contain VEGFA ,SPRED1 ,PIK3R2 ,etc ;the mRNA and protein level of VEGFA in PH group were statistically significantly than control group(P< 0 .01) ;the miRNA-126-3p and VEGFA showed positive correlation(P< 0 .01) .Conclusion miRNA-126-3p may partici-pate in the occurrence of pulmonary hypertension by regulating VEGFA .

Objective To conduct a meta-analysis to evaluate the outcomes of donation after cardiac death (DCD) compared with donation after brain death (DBD) liver transplantatior.Methods The MELDINE (1950-2011),EMBASE,and Cochrane Library databases were searched.All original single institution studies reporting outcomes of comparing donation after DCD and DBD liver transplantation were considered.A meta-analysis of complication incidence and patients/grafts survival after liver transplantation was conducted.Odds ratios (OR) and 95 ％ confidence intervals (CI) based on random effects models were calculated.Results Thirteen studies,all retrospective cohort studies,involving 5867 DCD and 619 DBD recipients,were included.DCD recipients had a 2.5 times increased odds of biliary complications (95 ％ CI =2.0～3.12),an 11.24 times increased odds of ischemic cholangiopathy (IC) (95 ％ CI =5.58 ～ 22.64 ),and a 2.12 times increased odds of primary nonfunction (PNF).DCD recipients also experienced lower odds of 1-year patient survival (OR =0.78,95 ％ CI=0.59～1.02),83.8 ％,87.2 ％,separately,and 1-year graft survival (OR=0.55,95％ CI=0.45～0.68),72.2 ％ and 82.4 ％,separately.Three-year patient survival was present in 81.5 ％ of DCD vs 78.9 ％ of DBD,which has no significant difference.The 3-year graft survival was lower inDCD than that in DBD (OR =0.73,95 ％ CI =0.56～0.94),69.5 ％ and 73.6％,separately.Conclusion DCD liver transplantation is associated with higher risks of biliary complications.But regarding the comparable general outcomes with DBD transplantation,DCD could be a source of liver.

Objective To compare the early renal function recovery after kidney transplant from donation after cardiac death (DCD) and brain death (DBD).Methods The Medline (1950-2011),Embase and Cochrane library database were searched and supplemented by review of conference proceedings and publication bibliographies.All original single institution studies reporting outcomes for DCD and DBD kidney transplant recipients were considered.Odds ratios (OR) and 95％ confidence intervals (CI) based on random effects models were calculated.Results Nine publications,all cohort studies,involving 2049 DCD and 5498 DBD recipients,were included.DCD recipients had 7.24 times increased odds of DGF (OR=7.24,95％ CI =3.86-13.58),and 4.97 times increased odds of PNF (95％ CI =3.77-6.55).Conclusion DCD renal transplantation is associated with higher risks of DGF and PNF.

Objective:To evaluate the quality of the current foreign clinical practice guidelines (CPG) on obstetric venous thromboembolism (VTE), providing reference for standardizing the prevention and treatment of domestic VTE clinical practice.Methods:The GPGs for the management of obstetric VTE published abroad from inception to July 2020 were electronically searched. Two researchers independently evaluated the quality of the included guidelines in accordance with the internationally recognized guideline evaluation tool, AGREE Ⅱ.Results:A total of 12 guidelines, 2 recommendations and 1 consensus for obstetric VTE were included, covering 3 continents and 9 countries, and the published time span was 2009-2020. The standardized scores of the six domain (scope & purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability and editorial independence) included in the guidelines were: 99.44%, 62.78%, 70.35%, 95.74%, 68.80% and 76.94% respectively, and the scores in each domain were ≥ 50.00%, indicating that the included CPGs were of good quality. Except for the domain scope & purpose, the ranges of the other five domains were ≥ 50.00%, suggesting that the quality of the CPGs differed significantly. Among the 15 included CPGs, 4 CPGs were level A (recommended), 11 CPGs were level B (recommended after being revised), and there was no CPG in level C (not recommended). The difference in the recommended content of obstetric VTE management mainly focused on the risk assessment, drug type, dosage and period.Conclusions:The overall quality of the CPGs for obstetric VTE management is high, while the quality of the CPGs varies greatly. In addition, there are differences in the recommended content of obstetric VTE management. More high-quality researches are required to provide evidence-based support for the improvement of the CPGs.

Objective:To investigate the efficacy and safety of dexmedetomidine and dexamethasone in inhibiting opioid-induced cough (OIC) during general anesthesia induction in patients with gynecological tumors.Methods:A total of 180 patients who were scheduled for elective gynecological tumor surgery under general anesthesia in Shanxi Provincial Cancer Hospital from March to November 2019 were selected. They were randomly divided into blank control group, dexmedetomidine group and dexamethasone group according to the random number table method, each group had 60 cases. Firstly, all patients had a 10-minute rest (T 0) after they entered the operate room. Treatment before general anesthesia induction:dexmedetomidine group was pumped dexmedetomidine 0.5 μg/kg (diluted to 10 ml with 0.9% NaCl injection) using an electronic infusion pump; dexamethasone group was injected intravenously dexamethasone 10 mg; blank control group was pumped with 10 ml 0.9% NaCl injection. The pumping was finished within 5 minutes, and the end time of pumping was denoted as T 1. Induction of general anesthesia was performed 5 minutes after the end of pumping: firstly, sufentanil was given intravenously at 0.3 μg/kg, and the injection was finished within 5 seconds (T 2). Two minutes after sufentanil injection (T 3), cis-atracurium 0.3 mg/kg and propofol medium/long-chain injection 2 mg/kg were sequentially injected. Then preoxygenation, endotracheal intubation and mechanical ventilation were implemented in turn. One minute after intubation was recorded as T 4. The incidence and severity of cough in patients within T 2-T 3 of each group were recorded, as well as the incidence of tachycardia, bradycardia, hypertension, hypotension, respiratory depression and myotonia during T 1-T 4. Results:The incidence of OIC in the dexmedetomidine group (10.0%, 6/60) and dexamethasone group (8.3%, 5/60) was lower than that in the blank control group (33.3%, 20/60), and the difference among the three groups was statistically significant ( χ2 = 16.445, P < 0.01), while there was no significant difference in the incidence of OIC between the dexmedetomidine group and the dexamethasone group ( P > 0.05). The incidence of sinus bradycardia in the dexmedetomidine group (16.3%, 10/60) was higher than that in the blank control group (0, 0/60) and dexamethasone group (8.4%, 1/60), and the difference was statistically significant ( P < 0.05). Respiratory depression and myotonia did not occur in the three groups. Conclusions:Pretreatment with dexmedetomidine or intravenous dexamethasone before anesthesia induction can effectively reduce the incidence of OIC in patients with gynecological tumors, and there is no significant difference between the effects of the two drugs. The incidence of sinus bradycardia increases significantly after dexmedetomidine infusion.

Objective To evaluate the pulmonary protection of dexmedetomidine in combination with parecoxib in pa?tients undergoing thoracotomy with one-lung ventilation. Methods Eighty patients undergoing elective resection of esopha?geal or lung cancer, including both sex, aged 40-70 yr, ASAⅠ-Ⅲ, were randomly divided into four groups (n=20), dexme?detomidine group (D group), parecoxib group (P group), dexmedetomidine in combination with parecoxib group (DP group) and control group (C group). Dexmedetomidine 1μg/kg was infused in ten minutes and then continued infusion at the rate 0.6μg·kg-1·h-1 until the chest was closed in group D. Parecoxib 40 mg was infused 10 min before the induction of anesthesia in group P. DP group was given parecoxib 40 mg and parecoxib 40 mg 10 min before the induction of anesthesia. The equal volume of normal saline was given in group C. Blood samples were collected for determination of blood gas analysis and the serum concentration of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and IL-8 immediately after the induction of anes?thesia (T1), 30 min (T2) and 60 min(T3) after one-lung ventilation, and at the end of the operation (T4). Oxygenation index (OI) was calculated. The serum levels of TNF-α, IL-6 and IL-8 were detected by ELISA. Results Compared with time T0, the serum concentrations of TNF-α, IL-6 and IL-8 (except IL-8 at the time T2 in DP group) were significantly increased, and OI was decreased in all groups at the time T2-4 (P<0.05). Compared with group C, concentrations of TNF-α, IL-6 and IL-8 decreased and OI increased significantly at the time T2-4 in D group, P group and DP group (P<0.05). There were no obvious differences in concentrations of TNF-α, IL-6, IL-8 and OI value between D group and P group (P > 0.05). Conclusion Combination of dexmedetomidine and parecoxib can further mitigate inflammatory response, improve lung oxygenation dur?ing one-lung ventilation, and provide pulmonary protection in patients undergoing thoracotomy.