AIM:To investigate whether propofol can alter the pulmonary inflammation induced by severe acute pancreatitis(SAP)in rats during its early period.METHODS:Seventy-two adult male Sprague-Dawley(SD)rats were randomly divided into nine groups with 8 animals in each group:sham group,SAP 30,60,120,360 min groups and propofol treatment 30,60,120,360 min groups.The preparation of SAP were induced by retrograde injection of 5% sodium taurocholate into the pancreatic duct of rats.And the treatment groups received propofol with doses of 150 ?g?kg-1?min-1 injected continually immediately in vena caudalis after the preparation of ASP were made.Rats were sacrificed at different time points,and the level of AMY and LIP,the wet dry weight ratio(W/D)of pulmonary and pancreatic tissue,the pathological change of pulmonary and pancreatic tissue were examined.RESULTS:Water content and pathological score of pulmonary tissue were decreased significantly within 360 minutes after reproduction of SAP were received propofol(both P0.05).CONCLUSION:propofol can alleviate pulmonary inflammation induced by severe acute pancreatitis in its early period.But propofol can not alleviate the injury of pancreatitis tissue.

Objective To investigate the causes of death and the influencing factors in patients with peripheral arterial disease(PAD) during the perioperative period and reduce the perioperative mortality.Methods A retrospective analysis of the causes of death was performed for PAD during the perioperative period in our hospital from July 2005 to July 2010. Results Nine patients died preoperatively.The causes of death were multible organ failure in 5,heart failure in 2,sudden cardiac death in 1,and respiratory failure in 1.Six patients died postoperatively.The causes of death were acute renal failure in 2,heart failure in 2,cerebral infarction in 1,and hemorrhagic shock in 1.The causes of death which were related to heart,kidney and lung were in 10,6 and 2,respectively.The causes of death which were directly due to heart failure,sudden cardiac death,renal failure,respiratory failure,cerebral infarction and hemorrhagic shock were in 4,1,2,1,1 and 1,respectively.The main causes of death were multible organ failure,heart failure and acute renal failure,which accounted for 73.33％ of all deaths.In this series the overall perioperative mortality was 3.11％ (15/483),Operative mortality was 1.47％ (6/407).Conclusions The influencing factors and the function of organs were closely correlated with the causes of death. To reduce the perioperative mortality of PAD,it is necessary both to intervene in the influencing factors and to monitor and treat the dysfunction of vital organs.

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Maspin belongs to the serine protease inhibitor (serpin) family and has been proven to be a suppressor of tumor growth and metastasis in many types of tumors. The purpose of this study was to investigate the expression of maspin in non-small cell lung cancer (NSCLC) and its relationship to vasculogenic mimicry (VM). A total of 160 specimens of NSCLC were involved in this study and 20 specimens of normal lung tissue served as controls. VM, microvessel density (MVD) and the expression of maspin were detected by using immunohistochemical staining. The results showed that the positive rates of maspin and VM in the NSCLC group were 48.1% (77/160) and 36.9% (59/160), respectively, which were significantly different from those in the control group with the positive rates of maspin and VM being 100% and 0% respectively (P<0.05). VM, MVD and the expression level of maspin were significantly related to tumor differentiation, lymph node metastasis, clinical stages and postoperative survival time (all P<0.05). The maspin expression in patients with squamous cell carcinoma was significantly higher than that in those with adenocarcinoma (P<0.05). The maspin expression was negatively correlated with VM and MVD, and there was a positive correlation between VM and MVD. Maspin-negative expression, VM and high MVD score were negatively related to the 5-year-survival rate. PTNM stages, VM, MVD and maspin expression were independent prognostic factors for NSCLC (P<0.05). It was suggested that the loss of expression of maspin may participate in the invasion and metastasis of NSCLC and it has a positive relationship to VM in NSCLC. Combined detection of maspin, VM and MVD may help predict the progression and prognosis of NSCLC.

Objective To investigate the clinical application value of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney.Methods Fifty-four cases of retroperitoneal laparoscopic nephrectomy for nonfunctioning kidney were reviewed,including 9 cases with nonfunctioning tuberculosis pyonephrosis,18 cases with infection nonfunctioning pyonephrosis and 27 cases of nonfunctioning hydronephrosis.Fifty-four cases were received retroperitoneal laparoscopic nephrectomy,tuberculous and infection pyonephrosis underwent laparoscopic resection surrounding adipose capsule,nonfunctioning hydronephrosis underwent laparoscopic resection by pumping water to increase the peritoneal space.Results The operation of 54 cases were perfomed successfully.None of the patient required conversion to open surgery.During the surgery,1 case showed mild extravasation of cheese-like pus induced by laceration of the kidney capsule;2 cases had injuried on the peritoneum.The mean operation time was 125 (95-230) min,the mean blood loss was 84 (50-420) ml.All patients showed primary healing of the wound,the patients were discharged from the hospital in 6 to 11 d (mean 7.5 d).After followed up for 5-27 months,none of them had long-term complication.Conclusions Retroperitoneal laparscopic nephrectomy for nonfunctioning kidney has advantages of minimal invasion,less blood loss and quicker recovery,so it is a fairly safe and effective procedure for nonfunctioning kidney.

OBJECTIVE: To explore new hallmarks affecting the prognosis of patients with laryngeal squamous cell carcinoma (LSCC) via investigating the expression of CyclinE and p27 in LSCC tissues. METHOD: The expression of CyclinE and p27 was detected via Elivision immunohistochemical staining in 160 LSCC tissues and 20 normal laryngeal tissues (NLT). The relationship between CyclinE/ p27 and LSCC/ NLT was analyzed via Log-rank analysis. The relationship of CyclinE and p27 protein was statistically analyzed by spearman correlation analysis. The relationship between CyclinE/p27 and clinical-pathology-factors of patients with LSCC, such as age, gender, tumor site, diameter, differentiation, lymph node metastasis and PTNM stage were analyzed by Chi-square test. The relationship between clinical-pathology-factors, CyclinE, p27 and overall survival time of patients with LSCC was analyzed via Cox multiplicity and Kaplan-Meier survival analysis. A significant difference was recognized by P<0.05. RESULT: In LSCC the positive rates of CyclinE and p27 protein was 62.50% and 41.25% respectively (P<0.05). In NLT the positive rates of CyclinE and p27 protein was 35% and 70% respectively (P<0.05). The expression of CyclinE or p27 protein was closely correlated with lymph node metastasis, PTNM stage of patients with LSCC (P<0.05). The expression of CyclinE and p27 had no significant correlations with patients' gender, age and tumor site, diameter differentiation (P>0.05 for all). A negative correlation was found between the expression of CyclinE and p27 protein, r= -0.767(P<0.05). Kaplan-Meier survival analysis showed that the overall survival rate of patients with LSCC was 36.9% (P<0.05). The 5-year survival rate in positive group of CyclinE was 8%, in negative group was 80% (P<0.05). On the contrary, the 5-year survival rate of patients with LSCC in positive group of p27 protein was 77.27%, the rate was 5.32% in negative group (P<0.05). Cox multivariate regression analysis revealed that lymph node metastasis, PTNM stage, CyclinE and p27 were independent risk factors of prognosis for patients with LSCC. CONCLUSION It is the molecular basis underlying the development and invasion/ metastasis of LSCC that activation of CyclinE gene accompanying inactivation of p27 gene. It is very important of co-detecting CyclinE and p27 protein to predict the prognosis of patients with LSCC.
Carcinoma, Squamous Cell ; metabolism ; pathology ; Cyclin E ; metabolism ; Cyclin-Dependent Kinase Inhibitor p27 ; metabolism ; Female ; Head and Neck Neoplasms ; metabolism ; pathology ; Humans ; Laryngeal Mucosa ; metabolism ; pathology ; Laryngeal Neoplasms ; metabolism ; pathology ; Lymphatic Metastasis ; Male ; Middle Aged ; Oncogene Proteins ; metabolism ; Prognosis ; Squamous Cell Carcinoma of Head and Neck ; Survival Rate

Objective: To investigate the clinicopathological features, diagnosis, and differential diagnosis of gallbladder sarcomatoid carcinoma. Methods: The clinical manifestations and the microscopic and immunohistochemical characteristics of six patients with gallbladder sarcomatoid carcinoma were analyzed with a follow-up period. Related literature was reviewed. Results:Immunohistochemical markers of gallbladder sarcomatoid carcinoma with spindle cell morphology were epithelial and mesenchymal positivity. Conclusion: Gallbladder sarcomatoid carcinoma could be firmly diagnosed by microscopic morphology and immunohistochemistry. Radical resection is currently used to treat such patients. However, more cases with longer follow-up period are needed to discover better treatments and improve the survival of these patients.

Objective To analyze the serious complications of transurethral resection of the prostate (TURP).Methods A retrospective study was conducted to summarize the clinical data of 1950 patients with benign prostatic hyperplasia from January 2005 to December 2014.All patients received TURP.The mean patient Age,disease course,IPSS score,PV and Qmax of 1 950 eligible patients were 71 years (54 to 87 years),7.6 years(0.5 to 15.0 years),(65.1 ±33.4)ml,25.5 ±3.9 and (8.1 ±2.6)ml/s,respectively.Intraoperative and postoperative complications were graded according to the CLASSIC and modified Clavien classifications,respectively.Serious complications were defined as grade Ⅲ or higher.Results Among the TURP procedures,99 serious complications occurred,resulting in a serious complication rate of 5.1％,Serious intraoperative and postoperative complication rates were 1.2％ (24 cases) and 3.9％ (75 cases),respectively.Serious intraoperative complications included ureteral orifice injury (3 cases),bladder explosion (4 cases),and transurethral resection syndrome (17 cases).Serious postoperative complications included massive hemorrhage (26 cases),severe dysuria (18 cases),permanent urinary incontinence (4 cases),cardio-cerebral vascular accident (5 cases),pulmonary thrombosis (3 cases),severe infection(18 cases),and death (1 case).Conclusions Serious complications may occur at any stages during TURP.Understanding the causes and characteristics of complications,strengthening the prevention and effective treatment is the key measure to reduce the incidence rates.

Objective To evaluate total pelvic exenteration (TPE) in the treatment of locally recurrent rectal cancer (LRRC). Methods Clinical data of 35 patients with LRRC who underwent TPE between 1989 and 2003 were analyzed retrospectively. Results Thirty patients underwent TPE, the remaining 2 did sphincter-preserving TPE, 2 with lower sacrectomy and 1 with hemipelvectomy, among them 80% cases received radical resection. Operative mortality rate was 3%, and morbidity rate was 51%. The overall post TPE tumor local recurrence rate was 48%. The 5-year survival rate was 16% in all cases and 19% in radical resection group. The 5-year survival rate in patients without lymph node metastasis was 24%, and 0 in patients with metastasis. Conclusion Effective TPE treatment lies in strict patient selection and radical resection.

Objective To analyze the role of tissue factor (TF) regulating the invasive ability of human colorectal carcinoma cells (HT-29). Method The plasmids pcDNA3.1/Zeo bearing either sense or antisense TFcDNA were transfected into HT-29 cells by lipofactamine 2000. TF proteins in transfectants and its parental cells were detected by Western blot. Matrigel invasion assays and nude mice inoculation assays were used to show the invasive ability of cancer cells in vitro and in vivo respectively. Microvessel density of the implanted tumors was counted. Result HT-29 cells with sense-TFcDNA transfection upregulated TF expression and invasive ability compared with the parental cells, and tumor tissues after sense transfection were of greater microvessel density than the parental cells. HT-29 cells transfected with antisense-TFcDNA had a downregulated TF expression and are of less microvessel density. Conclusion Positive TF expression increases the invasive ability of HT-29 cell in vitro and in vivo.