Objective To summarize the clinical experience of urethral realignment for treating early urethral injury under the guidance of ureteroscope,and evaluate its curative effect.Methods Twenty-nine male patients with urethral injury were selected,and 12 patients of posterior urethral injury,17 patients of former urethral injury.All the patients were treated with urethral realignment under the guidance of ureteroscope,postoperative indwelling catheter 3-8 weeks,every 7-16 days changed diameter increase 2 F the catheter 1 time.Results The 29 patients with urethral injury were a indwelling catheter success,all patients were no incontinence after operation 3 months.In the 29 patients,27 patients were urination unobstructed after catheter removal,2 patients were appeared urine line slim after 2 weeks,the 2 patients were normal urination after short urethral expansion.Conclusions The urethral realignment for treating early urethral injury under the guidance of ureteroscope has simple,lower complication,rapid recovery,better effect.The continuous flexible progressive urethral expansion and the strict nursing,which can effectively reduce the occurrence of urethral stricture.

ObjectiveTo study the expression level of HER-2 gene in the same pathological stage gastric cancer,and discuss the feasibility of HER-2 gene being the prognostic indicator.MethodsThe expression of HER-2 in gastric cancer was detected by immunohistocehmical technique and analyzed in relation with the pathological stage and prognosis of the patients.ResultsThe total positive rate of HER-2 in gastric cancer was 33.64％ (37/110).In stage Ⅱ,the weakly and strongly positive rates of gastric cancer were 21.31％ ( 13/61 ) and 9.84％ (6/61).In stage Ⅲ,the weakly and strongly positive rates of gastric cancer were 20.41％ (10/49) and 16.33％ (8/49).In the same pathological stage,the survival rate of patients with negative HER-2 expression was higher than weakly positive ones.And the survival rate of patients with strongly positive HER-2 expression was the lowest.The difference had statistical significance (P ＜ 0.01).ConclusionThe prognosis of patients in the same stage was correlated with the expression level of HER-2,which can be used to evaluate the biological behavior and prognosis of gastric cancer.

Objective To investigate the methods of anesthesia,infusion and the skill of removing urinary calculus for the treatment of uretemlith stones using ureterescope air pressure path lithoclasty.Methods Six hundred and ninety ureterolith stone patients using ureterescope air pressure path lithoclasty,383 patients were anesthetized by single sacro-anesthesia,and the diclofenac sodium suppositories were added in 312 cases to strengthen the anesthesia effeets.Antegrade perfusion with furosemide in the operation was used.Results Broken the stones in orthophoria were successful in 645 patients.the total success rate Was 93.5%and the total rate of removing urinary calculus was 93.8%.Conclusions Ureteroscope air pressure path lithoclasty is high efficiency,safety and easy manipulation.It is a satinfactory method for the treatment of ureterolith stones,and the correct method of anesthesia and infusion perfect skill of removing urinary calculus can improve the rate of removing urinary calculus and decrease the costs.

Objective To evaluate the effect of neoadjuvant chemotherapy on advanced gastric cancer before laparoscopic radical gastrectomy.Methods 46 advanced gastric cancer cases in our hospital from January 2010 to January 2013 were included in experimental group who were given two courses of neoadjuvant chemotherapy with FOLFOX regimen prior to surgery,the responsives (38 cases) received two more courses of neoadjuvant chemotherapy before surgery,and those in whom the chemotherapy was judged as ineffective (8 cases),received radical gastrectomy 21 days later.As a control,36 diseasematched cases went on upfront surgery without neoadjuvant chemotherapy.All these 82 cases underwent successful laparoscopic gastrectomy.Results The overall effective rate of neoadjuvant chemotherapy was 59％.Before the operation,the differences of pathological staging between the two groups were significantly different; The difference in operation time,the intraoperative blood loss and harvested lymph node number between the experimental group and control group was not statistically different (P ＞ 0.05).The R0 resection rate in experimental group (63％) was higher than in the control group (36％),P ＜0.05.The recurrence rate and mortality rate in experimental group was lower than that in the control group,P ＜ 0.05.Conclusions In advanced gastric carcinoma preoperative neoadjuvant chemotherapy significantly improved the resection rate and reduced postoperative recurrence and mortality rate.

Aim To evaluate the effects of Brucine of restraining transplanted tumor growth,prolonging their survival time and its toxicity on haematopoietic and immune systems as well as hepatic and renal function in mice transplanted with Hepatocarcinoma Heps cells.Methods ICR male mice of Hepatocarcinoma Heps tumor model(Heps mice)was made through Heps cells inoculation.Anti-tumor activity of Brucine was evaluated in terms of tumor inhibitory ratio and life elongational ratio of mice transplanted with Heps tumor.The toxicity of Brucine was measured the mice weight,immune organ weight,blood cell index(leukocyte,erythrocyte,platelet,and hemachrome protein),and hepatic function index(ALT,AST)as well as renal function index(BUN) of Heps mice.Results Brucine had significant restraining effect on the growth of Heps tumor in mice.Its inhibitory rate was 30.34%(1.61 mg?kg~(-1)),46.21%(3.23 mg?kg~(-1))and 42.07%(6.46 mg?kg~(-1))respectively,and 3.23 mg?kg~(-1)(1/20 LD_(50)) was the best dosage of Brucine for treating Heps tumor in vivo,while Brucine had no distinct effect of prolonging the life of Heps mice.Moreover,it enhanced the weight of body and thymus index as well as spleen index,and had no distinct influence on blood cell index as well as ALT,AST and BUN in Heps mice.Conclusion Brucine can inhibit the growth of transplanted Heps tumor,enhance the weight of immune organ index significantly,and has no toxicity on haematopoietic and immune systems as well as hepatic and renal function of mice transplanted with Heps tumor.It may be developed into a promising anticancer drug through further study

AIM: To study preparation of strychnine solid liposome. METHODS: Sorbitol carrier aggradation method and freeze drying method were used to prepare strychnine solid liposomes. They were evaluated by particle morphology, the size range, resolvable peculiarity in the water, encapsulation efficiency. RESULTS: The particles of liposome by sorbitol carrier aggradation method were less than that by freeze drying method, and its encapsulation efficiency was higher than that by freeze drying method. CONCLUSION: Sorbitol carrier aggradation method is better than freeze drying method.

Objective To study the safety and short-term clinical outcome of different body mass index (BMI) patients with rectal cancer undergoing laparoscopic total mesorectal excision (TME). Methods The clinical data of 179 rectal cancer patients who had underwent laparoscopic TME from November 2016 to November 2017 were retrospectively analyzed. The patients were divided into 3 groups according to the BMI:leanness group (BMI<18.5 kg/m2, 15 cases), normal group (BMI 18.5 to 22.9 kg/m2, 89 cases) and overweight/obesity group (BMI ≥23.0 kg/m2, 75 cases). The general clinical data and the operation-related situation were compared. Results The rate of preoperative complications in overweight/obesity group was significantly higher than that in leanness group and normal group: 45.33％(34/75) vs. 4/15 and 28.09％(25/89), the preoperative albumin level in leanness group was significantly lower than that in normal group and overweight/obesity group:(36.3 ± 2.8) g/L vs. (38.6 ± 3.2) and (39.1 ± 3.7) g/L, and there were statistical differences (P<0.05). The operation time and blood loss in overweight/obesity group were significantly higher than those in leanness group and normal group: (149.2 ± 32.9) min vs. (129.3 ± 28.7) and (133.5 ± 23.6) min, (135.5 ± 29.0) ml vs. (117.5 ± 22.6) and (122.5 ± 25.9) ml, and there were statistical differences (P<0.05). There were no statistical differences in sex, age, tumor location, tumor maximum diameter, depth of tumor invasion, lymph node metastases, surgical approach, circumferential margin, number of lymph node dissections, length of resected specimens, incidence of postoperative complications, surgical site infection, postoperative urinary retention, postoperative exhaust time and postoperative hospitalization among 3 groups (P>0.05). Conclusions The differences of BMI mean different complications and nutritional status of patients. Overweight and obesity can lead to difficult operation of laparoscopic TME, but do not affect the radical cure of operations and the safety of clinical outcomes.

Objective:To investigate the safety of minimally invasive liver resection for resectable hepatocellular carcinoma (HCC) complicated with portal hypertension.Methods:The propensity score matching and retrospective cohort study was conducted. The clinicopathological data of 807 patients with resectable HCC who underwent minimally invasive liver resection in 8 medical centers, including Sir Run Run Shaw Hospital, Affiliated with the Zhejiang University School of Medicine et al, from June 2011 to November 2022 were collected. There were 670 males and 137 females, aged 58(50,66)years. Of the 807 patients, 173 cases with portal hypertension were divided into the portal hypertension group, and 634 cases without portal hypertension were divided into the non-portal hypertension group. Observation indicators: (1) propensity score matching and comparison of general data of patients between the two groups after matching; (2) intraoperative and post-operative situations; (3) subgroup analysis. Propensity score matching was done by the 1:1 nearest neighbor matching method, with the caliper setting as 0.001. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was conducted using the rank sum test. Count data were described as absolute numbers, and comparison between groups was conducted using the chi-square test or Fisher exact probability. Comparison of ordinal data was constructed using the non-parameter rank sun test. Results:(1) Propensity score matching and comparison of general data of patients between the two groups after matching. Of the 807 patients, 268 cases were successfully matched, including 134 cases in the portal hypertension group and 134 cases in the non-portal hypertension group. The elimination of the tumor diameter and robot-assisted surgery confounding bias ensured comparability between the two groups after propensity score matching. (2) Intraoperative and postoperative situations. The occlusion time of porta hepatis, cases with intraoperative blood transfusion, cases with postoperative complication, cases with complication >Ⅱ grade of Clavien-Dindo classification, cases of Clavien-Dindo classification as Ⅰ grade, Ⅱ grade, Ⅲ grade, Ⅳ grade, cases with liver related complication were 27.0(15.0,43.0)minutes, 33, 55, 15, 13, 29, 14, 1, 37 in the portal hypertension group, versus 35.0(22.0,60.0)minutes, 17, 25, 5, 14, 9, 4, 1, 13 in the non-portal hypertension group, showing significant differences in the above indicators between the two groups ( Z=-2.15, χ2=6.30, 16.39, 4.38, 20.72, 14.16, P<0.05). (3) Subgroup analysis. Results of subgroups analysis showed that in cases with major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 243.5(174.6,296.3)minutes, 200.0(150.0,600.0)mL, 7.5(6.0,13.0)days in the portal hypertension group, versus 270.0(180.0,314.5)minutes, 200.0 (75.0,450.0)mL, 7.0(5.5,10.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.54, -1.73, -0.92, P>0.05). In cases with non-major live resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 8.0(5.0,10.0)days in the portal hypertension group, versus 170.0(120.0,227.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.5,9.0)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-1.39, -0.10, 1.05, P>0.05). In cases with anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 210.0(150.0,285.0)minutes, 150.0(50.0,200.0)mL, 8.0(6.0,9.3)days in the portal hypertension group, versus 225.5(146.3,306.8)minutes, 100.0(50.0,250.0)mL, 7.0(6.0,9.0)days in the non-portal hypertension group, showing no significant difference in the above indica-tors between the two groups ( Z=-0.75, -0.26, -0.91, P>0.05). In cases with non-anatomical liver resection, the operation time, volume of intraoperative blood loss, duration of postoperative hospital stay were 173.5(120.0,231.5)minutes, 175.0(50.0,300.0)mL, 7.0(5.0,11.0)days in the portal hyper-tension group, versus 186.0(123.0,262.5)minutes, 100.0(50.0,200.0)mL, 7.0(5.0,9.5)days in the non-portal hypertension group, showing no significant difference in the above indicators between the two groups ( Z=-0.97, -1.12, -0.98, P>0.05). Conclusion:Minimally invasive liver resection or even major liver resection is safe and feasible for screened HCC patients complicated with portal hyper-tension, but attention should be paid to the prevention and treatment of postoperative complications.

Autism spectrum disorder (ASD) is one of the common neurodevelopmental disorders in children. Its etiology and pathogenesis are poorly understood. Previous studies have suggested potential changes in the complement and coagulation pathways in individuals with ASD. In this study, using multiple reactions monitoring proteomic technology, 16 of the 33 proteins involved in this pathway were identified as differentially-expressed proteins in plasma between children with ASD and controls. Among them, CFHR3, C4BPB, C4BPA, CFH, C9, SERPIND1, C8A, F9, and F11 were found to be altered in the plasma of children with ASD for the first time. SERPIND1 expression was positively correlated with the CARS score. Using the machine learning method, we obtained a panel composed of 12 differentially-expressed proteins with diagnostic potential for ASD. We also reviewed the proteins changed in this pathway in the brain and blood of patients with ASD. The complement and coagulation pathways may be activated in the peripheral blood of children with ASD and play a key role in the pathogenesis of ASD.
Child ; Humans ; Autism Spectrum Disorder/metabolism* ; Proteomics ; Brain/metabolism*