Objective To investigate the efficacy and safety of non-blocking renal artery laparoscopic partial nephrectomy in the treat-ment of renal cell carcinoma of stage T 1~T2.Methods From January 2012 to May 2016,the 140 patients with renal cell carcinoma of stage T1~T2 were selected ,and their clinical data were retrospectively analyzed .All the patients were equally divided into the observation group and the control group with 70 patients in each group according to the different treatment methods .Patients of the observation group were trea-ted with non-blocking renal artery laparoscopic partial nephrectomy ,while patients of the control group were treated with blocking renal artery laparoscopic partial nephrectomy .Recorded the postoperative complications ,postoperative recovery condition and renal function changes of the two groups.Results All the patients completed the surgery sucessfully and there was no conversion to laparotomy .The perative time,amount of bleeding ,gastrointestinal recovery time and postoperative hospital stay in the observation group were less than those of the control group (P<0.05).The postoperative drainage and drainage tube indwelling time in the two groups were of no significant difference (P>0.05).One week after the operation , the incidence of secondary bleeding ,urinary leakage ,pulmonary infection ,incision infection ,renal infection and other complications in the observation group was 2.9%,which was significantly lower than 15.7%in the control group(P<0.05).The postoperative serum SCr values in the observation group and the control group were respectively (89.24 ±11.92)μmol/L and (137.24 ±11.49)μmol/L, which were significantly higher than (67.24 ±12.49)μmol/L and (68.14 ±13.11)μmol/L before the operation(P<0.05).In the mean time,the postoperative serum SCr values of the observation group was significantly lower than that of the control group (P<0.05).All the pa-tients were followed up to now , and the median survival time of the observation group and the control group were (25.32 ±3.14) months and (19.39 ±4.10) months respectively.That is to say,the median survival time of the observation group was significantly longer than that of the control group(t=4.209,P<0.05).Conclusion Non-blocking renal artery laparoscopic partial nephrectomy for treatment of renal cell car -cinoma of stage T1~T2 can avoid warm ischemia ,reduce postoperative complications ,protect renal function ,promote the patient ’ s recovery , and prolong the survival time ,which is a safe and effective method .

OBJECTIVE: To use super-selective renal artery embolization in treatment of patients with renal injuries. METHODS: From 1991 to 1998, 11 cases of renal injuries due to d ifferent causes underwent super-selective renal artery embolization. In these p atients, 91% of injury sites were segmental arteries and their branches. All the patients were treated with steel coil for embolization. RESULTS: Nine patients showed prompt cessation of hematuria, an d in 2 patients hematuria stopped 2-4 days after embolization. CONCLUSIONS: Super-selective renal artery embolization (SSRAE) is suitable for severe hematuria, limited size of kidney injuries, stable hemod ynamic parameters after conservative treatment and low reserve of renal function. Steel coil is an effective embolic material, rapid hemostasis can be fulfilled and renal function can be reserved. Super-selective renal artery embolization has low incidence of complications and can shorten hospitalization time.

Lipid nanoparticles(LNPs),composed of ionizable lipids,are currently the most promis-ing non-viral nucleic acid drug delivery vectors in clinical practice,and have great potential in gene ther-apy drug delivery and vaccine delivery.Ionizable lipids,the main components of LNPs,play a decisive role in the endosome escape rate,transfection efficiency,organ targeting and safety of LNPs.Among them,the hydrophilic head group of ionizable lipids contains tertiary amine groups,which can improve the buffering capacity of LNPs and thus change the pKa value,and imidazole can enhance the stability and transfection activity of mRNA-LNP.The ligand contains ester groups,which can induce gene silencing efficiently and improve the degradation rate and safety.When the number of hydrophobic tails is 3-4,with 1-2 unsaturation and 8-18 carbon chain length,LNPs can effectively induce gene silencing.Meanwhile,the presence of branching or asymmetric hydrophobic tails can improve the transfection efficiency of LNPs.Based on the chemical structure of ionizable lipids,this review summarizes the influ-ence of the structure of ionizable lipids on the transfection efficiency and safety of nucleic acid carrying drugs LNPs,and the structure-activity relationship of ionizable lipids so as to provide reference for studies on novel ionizable lipids.