Objective To evaluate the safety and efficacy of nephron sparing surgery (NSS) for renal angiomyolipoma (RAML). Methods Thirty-nine patients of RAML were underwent NSS. Tumor enucleation was done in 23, partial nephrectomy in 16, and selective arterial embolization in 2. Results The average diameter of enucleated tumor was 5.8 cm(from 3.0 to 14.0 cm), the average of blood loss was 190 ml(from 75 to 800 ml),none of the patients developed hemorrhage or urinary fistula. The average follow-up of 38 patients was 48 months(from 1 to 120 months). Postoperative serum level of creatinine was stable, no patients had a local recurrence. Conclusions NSS can be performed with satisfactory result in RAML. Effective control of hemorrhage and conservancy of renal function are the key points.

Objective To study the comprehensive therapeutic effect of interventional embolization chemotherapy in advanced cervical cancer. Methods 136 patients with advanced cervical cancer were selected as research object,and they were randomly divided into control group(radiotherapy group) 68 cases and observation group(interventional embolization chemotherapy group) 68 cases,then the total effective rate,incidence of adverse reactions,secondary operation rate and serum CA125 ,SCC and CY211 of two groups before and after the treatment were analyzed and compared. Results The total effective rate( 83. 8% vs 66. 2% ) and secondary operation rate(89.7% vs 48.5% )of observation group was higher than that of control group, incidence of adverse reactions (63.2% vs73.5 % ) was lower than that of control group,serum CA125 [(37. 89 ± 16. 78) vs(52. 36 ± 16. 98) U/ml], SCC[(0. 68 ± 0. 42) vs (1.52±0.36)μg/L]and CY211[(4.86 ±2.21)vs(8.45 ±2.85)ng/L]were all lower than those of control group. ( P ＜0.05 or P ＜0.01) , there were significant differences. Conclusion The comprehensive therapeutic effect of interventional embolization chemotherapy in advanced cervical cancer was better,and it was one of effective methods in advanced cervical cancer.

Objective To investigate the factors that related to acute biliary pancreatitis including size and the location of the common bile duct stone. Methods Clinical data from 3497 patients with common bile duct stone admitted to the hospital between Jan. 2002 and Dec. 2008 were retrospective analyzed. All patients were grouped according to the size and the location of the bile duct stones. The incidence of acute pancreatitis was compared among groups. Results In patients with common bile duct stone accompanying the acute pancreatitis,common symptoms were fever, bellyache and jaundice, as well as elevated serum amylase. There was a negative correlation between size of the common bile duct stone and the severity of acute hiliary pancreatitis, which was easily induced by the stone in the Vater's ampullar or distal common bile duct. Conclusion Early endoscopic treatment should be carried out in patients with microlith located in the Vater's ampullar or distal common bile duct in order to prevent the acute biliary pancreatitis.

Objective To estimate the long-term efficacy of endoscopic sphincterotomy (EST)in treatment of choledocholithiasis and to analyze the potential risk factors for disease recurrence.Methods A total of 154 patients with choledocholithiasis,who underwent EST between January 2006and December 2006, were enrolled. Multivariate analysis was used to evaluate the association of clinical features and experimental parameters with recurrence of choledocholithiasis. Results Longterm complications developed in 22 patients (14.29%) including recurrent choledocholithiasis (18/154,11.69 % ) and combined cholangitis (16/154). Cholangitis without calculi was found in 1 case (0.65%), acute pancreatitis in 2 cases (1.30%) and cholangiocarcinoma in 1 case (0.65%). High body mass index and serum cholesterol were proved to be risk factors for recurrence of choledocholithiasis. Whereas the incision size (0.5 cm-1.5 cm) of vater's papilla was the protective factor for recurrence of choledocholithiasis. Conclusions Body mass index, serum cholesterol and the incision size of vater's papilla are related to recurrence of choledocholithiasis.

Objective To evaluate the relationship between emergence agitation (EA) during recovery from general anesthesia and postoperative cognitive dysfunction (POCD).Methods Two hundred and eighty ASA Ⅰ or Ⅱ patients,aged 18-70 yr,weighing 52-80 kg,undergoing elective surgery,were included.Anesthesia was induced with midazolam,fentanyl,propofol and cisatracurium.The patients were tracheal intubated and mechanically ventilated.Anesthesia was maintained with remifentanil,propofol and cisatracurium.EA was assessed at 15-40 min after extubation by using Post-operative Quality Recovery Scale and the cognitive function was assessed at day 1 before operation and days 1-7 after operation.Patients were divided into POCD or nonPOCD group according to the occurrence of POCD.The general data of patients,preoperative complications and types of surgery were recorded.If there was significant difference between the 2 groups,the factor was analyzed using multi-factor logistic regression to select the risk factor for incidence of POCD.Results The incidence of POCD was 40.7 ％.The results of logistic regression analysis showed that the dangerous degree of the risk factors for POCD in order from high to low were emergence agitation,duration of anesthesia and age.Conclusion EA during recovery from general anesthesia is an independent risk factor for POCD.

Objective To explore the images and diagnostic evaluation of X-ray combined with ultrasound in paralytic intestinal obstruction caused by antipsychotic agents. Methods The data of X-ray and ultrasound of 124 cases of clinically diagnosed paralytic intestinal obstruction caused by antipsychotic agents were analyzed retrospectively, as well as their rates of confirmed diagnosis. All the 124 patients were examined by erect abdominal radiography and fluoroscopy,68 of the 124 patients by ultrasound. Results According to their typical images,the rate of X-ray confirmed diagnosis was 87.9%(109/124) with 15 missed diagnosis and the rate of missed diagnosis was 12.1%( 15/124);the rate of ultrasound confirmed diagnosis was 82.4%(56/68) with 12 missed diagnosis and the rate of missed diagnosis was 17.6%(12/68). There was no significant difference between X-ray and ultrasound (P＞ 0.05 ). Compared with X-ray or ultrasound ,X-ray combined with ultrasound in the diagnosis of paralytic intestinal obstruction could increase the rate of confirmed diagnosis (100.0% ,68/68),and decrease the rate of missed diagnosis (0),the difference was statistically significant (P＜ 0.05 ). Conclusions X-ray examination is the first choice to diagnose paralytic intestinal obstruction caused by antipsychotic agents,but ultrasound has the advantage of finding fluid in abdominal cavity. To reduce missed diagnosis, X-ray should be combined with ultrasound.

Objective:To evaluate the effect of Nutlin-3,a MDM2 antagonist,on the pyroptosis in SMMC-7721 cells.Methods: The expression of actived caspase-1(p20) and IL-1β was detected using Western blot analysis.Pyroptosis was investigated by a standard lactate dehydrogenase release assay(LDH).IL-1β content in the cell culture supernatant was quantified by ELISA.Results: Nutlin-3 up-regulated the expression level of actived caspase-1 and IL-1β in SMMC-7721 cells.Meanwhile,Nutlin-3 increased significantly the content of LDH and IL-1β in the cell culture supernatant(P<0.05).Conclusion: Nutlin-3 activated pro-caspase-1,promoted pyroptosis and IL-1β release in SMMC-7721 cells.

OBJECTIVE:To study the in vitro antioxidant activity of chitosan(CTS)degradation derivatives and its preventive effects on drug-induced liver injury fibosis. METHODS:Acid hydrolysis method was used to prepare the CTS degradation deriva-tives CTS-3,CTS-6,CTS-8,CTS-10 for different hydrolysis time(3,6,8,10 h). The viscosity-average relative molecular mass and deacetylation degree of CTS and its degradation derivatives were determined,and its antioxidant activity was evaluated by de-tecting its in vitro scavenging ability on 1,1-diphenyl-2-trinitrophenylhydrazine (DPPH) and superoxide anion (O2-) radicals. Us-ing CTS-10 for in vivo liver injury fibosis prevention test,mice were randomly divided into normal control group(water),model group(water),CTS-10 high-dose,medium-dose,low-dose groups(100,50,25 mg/mL),8 in each group. Mice were intragastri-cally administrated 0.2 mL,then withdrawal after continuous 24 d. Then levofloxacin hydrochloride was intragastrically given for 7 d to establish drug-induced liver injury model(except for normal control group). Western blot method was used to detect the expres-sions of tumor necrosis factor α(TNF-α),transforming growth factor β1(TGF-β1)and Decorin protein in liver tissue of mice. RE-SULTS:The viscosity-average relative molecular mass of CTS,CTS-3,CTS-6,CTS-8,CTS-10 were 21.70×104,6.70×104,6.30× 104,5.01×104,4.87×104;and deacetylation degree were 83.44％,74.62％,67.28％,64.83％,54.23％,respectively. All of them had certain scavenging ability on DPPH and O2-,in which,CTS-10 was the strongest(25.47％ and 56.31％). Compared with nor-mal control group,expressions of TNF-α,TGF-β1 and Decorin protein in liver tissue in model group were enhanced (P<0.05). Compared with model group,expressions of TNF-α,TGF-β1 and Decorin protein in liver tissue in CTS-10 medium-dose and high-dose groups were weakened(P<0.01). CONCLUSIONS:The viscosity-average relative molecular mass and deacetylation de-gree of CTS-10 in CTS degradation derivatives are lower with stronger antioxidant activity,and show certain preventive effects on drug-induced liver injury fibosis in mice.

Objective To investigate the changes of thrombomodulin and matrix metalloproteinase-9 in sepsis and determine their significance in the early diagnosis and prognosis of multiple organ dysfunction syndrome. Methods The plasma levels of thrombomodulin and matrix metalloproteinase-9 in 32 ICU patients with sepsis were measured by immunofluorescence. Results Compared with control group,the levels of TM and MMP-9 were significantly higher on the day of the diagnosis of sepsis(P

Objective To research the relationship between the gene polymorphism of serum amyloid A protein(SAA)1 and coronary heart disease(CHD).Methods By using PCR-RFLP and sequencing,the gene polymorphism of SAA1 of 183 patients with coronary heart disease and 152 healthy controls were analyzed.Result In the both groups 3 alleles(1.1,1.3,1.5)and 6 genotypes(1.1/1.1,1.1/1.5,1.1/1.3,1.3/1.3,1.3/1.5 and 1.5/1.5)were found.The frequency of 1.5 allele in healthy controls group was notably higher than that in CHD group(P