Objective To study the therapeutic effects and mechanism of Sodium Fendate(SF) on rats with severe acute pancreatitis(SAP) induced by L-arginine. Method A total of 60 adult SD rats were randomly and e-qually divided into control group, SAP group and SF group, with 20 rats in each group. The rat model of SAP wes established by injecting 2.5 g/kg L-arginine at a dose of intraperitoneally twice at an interval of 1 hour, and rats in SAP group and SF groups were administrated intraperitoneally with 20% L-arginine solution(2.5 g/kg×2) twice at an interval of 1 hour; rats in control group were injected intraperitoneally with the same volume of physiological saline twice alone.At 5 minutes after L-arginine administration,rats in SF group were injected with SF solution (100 mg/kg, qd×3 d) via the tail vein, and rats in the other two groups received a sham injection of the same volume of physiological saline alone. The characteristics of ascites, the pathological changes of pancreatic tissue and the serum levels of amylase(AMY), endothelin-l(ET-1), tumor necrosis factor-α(TNF-α), interleukin-6(IL-6) and the contents of malonaldehyde (MDA), suede dismutase (SOD), reduced glutathioue (GSH) of pan-creatic tissue of rats and prognosis were compared at 72 hours after L-arginine administration. Measurement data were evaluated by oue-way ANOVA, and numeration data were assessed by Fisher' s exact test. P<0.05 was considered statistically significant. Results Compared with control group,at 72 hours after L-arginine administra-tion,rats in SAP group presented characteristically histopathological changes of SAP with significantly higher serum levels of AMY, ET-1, TNF-α, IL-6 and MDA of pancreatic tissue[(9715.5±301.3) IU/L vs. (729.2±134.2) IU/L;(25.32±3.67) ng/L vs. (14.32±2.69) ng/L;(102.95±11.24) ng/L vs. (38.62±3.87) ng/L; (538.63±9.53) ng/L vs. (186.35±1.19) ng/L;(34.8±3.9) mol/kg vs. (8.1±2.1) mol/kg, all P< 0.01], and lower GSH and SOD in the pancreatic tissue[(7.1±0.6) mg/kg vs. (16.9±1.9) mg/kg; (6423± 1978) kU/kg vs. (29905+2945) kU/kg,both P<0.01].Compared with SAPmodel group,at 72 hours after ad-ministration of L-arginiue, the pathological lesions of SAP in rats of SF group were significantly alleviated with lower pathological scores (P<0.05), lower serum levels of AMY, ET-1 ,TNF-α,IL-6 and MDA in the pancreatic tissue [(8104.6±149.9) IU/L vs. (9715.5±301.3) IU/L; (20.26±5.86) ng/L vs. (25.32±3.67) ng/L; (84.19±15.14) ng/L vs. (102.95±11.24) ng/L;(458±5.37) mol/kg vs. (538.63±9.53) rig/L;(28.3±2.5) moL/kg vs. (34.8±3.9) mol/kg,all P<0.05], and higher SOD and GSH in the pancreatic tissue[(8.5 ±1.4) mg/kg vs. (7.1±0.6) mg/kg;(10 316±2810) kU/kg vs. (6423±1978) kU/kg, both P<0.05].At 72 hours the death rate in SF group was lower than that in SAP group,but the difference had no significance (P= 0.2.5). Conclusions SF can scavenge oxygen-derived free radicals, upgrade the contents of SOD and GSH of pancreatic tissue,decrease the levels of serum proinflammatory cytokines and ET-1, ameliorate the pathological le-sions of pancreatic tissue in rats,and has the capability of decreasing death rate, so it possesses a distinct advantage for the treatment of SAP.

Objective To compare real -time tissue elastography (RTE)and ultrasound in the diagnosis of papillary thyroid carcinoma (PTC)with cervical lymph node (LN)metastasis.Methods A retrospective analysis was carried out on the clinical data of 72 patients with PTC.Eighty -four LNs of them were performed with ultrasound-guided fine -needle aspiration biopsy.Patients were divided into two groups:with cervical lymph node metastasis group and without cervical lymph node metastasis group.All patients were reviewed their B -mode ultrasonography (BUS)on cervical lymph node and RTE on thyroid.RTE elasticity indices (EI)of mean (Emean),minimum (Emin),maximum (Emax)and the ratio of Emean in LNs and surrounding muscle (Emean -m)were measured at the thyroids.The performances of RTE and BUS in predicting of PTC with LN metastasis were compared and ana-lyzed.Results The sensitivity and specificity of BUS on diagnosis of the cervical lymph nodes metastasis were 84.0% and 90.0%.The RTE Emea,Emax,Emin and SI in meta -static LNs were significantly higher than those in benign LNs(P =0.001,0.002,0.001,0.007).The RTE results of PTC patients with lymph node metastasis was ana-lyzed by ROC curve.The largest area was Emin.AUC was 0.918,the critical value was 0.240.AUC of SI was 0.896, AUC of Emean was 0.718,AUC of Emax was 0.670.The sensitivity and specificity were 94.0% and 99.4%,respec-tively.Conclusion Co -operation of RTE and BUS was more accurate than simple BUS in diagnosis of PTC with lymph node metastasis.SI and Emin has a high diagnostic value.

Objective:To explore the role CD4+CD45RO+memory T cells in the pathogenesis of Hashimoto's thyroiditis (HT) by detecting the percentages of CD4+CD45RO+ memory T cells in peripheral blood mononuclear cells in peripheral blood of newly diagnosed HT patients. Methods:53HT patients and 43 matched healthy controls (HC) were included in this study. According to the thyroid functions,HT patients were divided into euthyroid subset(HT-A,n =15) ,subclinical hypothyroidism(HT-B,n=14) and overt hypothyroidism subset (HT-C,n=24). The percentages of CD4+CD45RO+memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,and thyroid functions,and the titers of thyroid-specific autoantibodies (TPOAb,TgAb) were respectively detected by flow cytometry,ELISA,and ECLIA. Results:The percentages of CD4+CD45RO+ memory T cells in PBMCs,as well as the level of serum IFN-γ and IL-17,the titers of TPOAb,TgAb were all significantly higher than that in HC(P<0. 01). Bivariate correlation revealed that the percentages of CD4+CD45RO+ memory T cells positively correlated with the level of serum IFN-γ,TPOAb and TgAb(P<0. 01,P=0. 015,P<0. 01) in HT patients. Conclusion:The significant increase of CD4+CD45RO+memory T cells in peripheral blood of patients with HT suggested a role of CD4+CD45RO+ memory T cells in the pathogenesis of this disease.

Lysine-germanium ( Ge401 ) was a newly synthesized organoger-manium compound in China. The LD50 of Ge401 for mice was 9.26 and 5.62 g/kg po and ip administrations. The inhibition rates of subcutaneously transplanted S-180 sarcoma in mice were 25%, 32% and 55% respectively when ip, po and iv administrations of Ge401 were used. The antitumor activity of cyclophosphamide (30 mg/kg? 2d-1, ip ) in S-180 bearing mice was significantly potentiated by Ge401 (30 mg/kg?d-1, iv ) .

Objective To summarize the clinical technique and experience of one stage combination of renopancreatic transplantation(SKPT) with portal venous drinage of pancreatic endocrine and enteric drainage of exocrine(PE).Methods Five patients with insulin-dependent diabetes mellitus and end-stage renal disease underwent SKPT with PE drainage.The clinical data,operative techbuque,and the prevention of non-technical complications were summarized.Results This procedure was successfully applied in the 5 patients.Three patients recovered excellently;but 2 died perioperatively,one died of sepsis due to pancreatic leakage,and one of FK506 toxicity.On postoperative day 3,in the 3 survivors,blood creatinine and urea nitrogen levels returned to normal;insulin administration was discontinued on 7d postoperatively,and the endogenous and exogenous secretory functions of the graft were normal.Conclusions SKPT with PE is a resonable procedure,because of its potential physiologic,metabolic,and immunologic advantages.PE drainage may become the prefer technique of pancreas transplantation.Intensive perioperative managements are effective methods to prevent complications and to improve the therapeutic effects.

Objective To investigate the effect of thyroid stimulating hormone (TSH) on the expression of endothelial nitric oxide synthase (eNOS) and its mechanism in human microvascular endothelial cells (HMEC-1) in vitro culture.Methods Different concentrations of TSH (0,10,50 mIU/ml) were used to intervene HMEC-1.The expression of eNOS mRNA was detected with quantitative polymerase chain reaction (qPCR) method.The protein expressions of eNOS,phosphorylated protein kinase B (p-AKT),protein kinase B (AKT),phosphorylated extracellular signal-regulated kinase (P-ERK),and extracellular signal-regulated kinase (ERK) were determined with Western Blot.Results (1) The expression level of eNOS was significantly decreased by TSH in dose-dependent manner (P ＜ 0.05).(2) TSH could promote the phosphorylation of AKT and ERK (P ＜ 0.05).Conclusions Thyroid-stimulating hormone may inhibit the expression of nitric oxide synthase in human microvascular endothelial cells by activating AKT and ERK signaling pathways.

Objective To analyze the efficacy and safety of CyberKnife combined with temozolomide (TMZ) in treatment of brain metastasis of non-small cell lung cancer (NSCLC). Methods From March 2013 to March 2016, 62 NSCLC patients with brain metastases in department of oncology of the 187th Hospital of PLA were divided into two groups according to the random number table method, the CyberKnife combined with TMZ group (CyberKnife + TMZ group, 31 cases) and simple CyberKnife group (CyberKnife group, 31 cases). Hypofractionated radiation of CyberKnife was given 18-36 Gy in 1-5 fractions of 5-25 Gy. CyberKnife+ TMZ group was given temozolomide 150 mg·m-2·d-1 for 5 days in first cycle, then every 28 days they received temozolomide therapy from the second to the sixth cycles: 200 mg·m-2·d-1 for 5 days. The clinical symptom remission rate after the treatment of CyberKnife in one week, the effective rate after CyberKnife in 3 months, the median intracranial progression-free survival time, overall survival, and the incidences of adverse reaction were comparatively analyzed. Results The clinical symptom remission rates of CyberKnife+TMZ group and CyberKnife group after the treatment of CyberKnife in one week were 93.6 ％ (29/31) and 96.8 ％ (30/31). There was no significant difference in the clinical symptom remission rates (χ2= 1.207, P=0.547). The effective rates of the two groups after CyberKnife in 3 months were 93.6 ％ (29/31) and 90.3 ％(28/31). There was no significant difference in the effective rates (χ2 = 0.695, P= 0.706). The median intracranial progression-free survival time in CyberKnife + TMZ group (14.0 months) was significantly higher than that in the CyberKnife group (9 months) (χ2=8.977, P=0.003), and the median overall survival time in CyberKnife + TMZ group (15.0 months) was also significantly higher than that in the CyberKnife group (12.0 months) (χ2 = 5.190, P= 0.023). There was no significant difference in the adverse reaction of the central nervous system between the two groups (χ2=0.746, P=0.689), but the adverse reactions of the digestive system (χ2 = 6.062, P= 0.014) and the hematologic system (χ2 = 6.613, P= 0.010) in CyberKnife + TMZ group were significantly higher than those in the CyberKnife group. Systemic adverse reactions of the two groups were tolerated by most patients. Conclusions CyberKnife combined with TMZ is a feasible therapeutic option for NSCLC patients with brain metastases. This therapy can improve the median survival time to cerebral progression of the disease and the median overall survival time.

Objective:To compare the clinical efficacy of transperitoneal robot assisted laparoscopic radical prostatectomy (RARP) versus extraperitoneal single port RARP.Methods:A retrospective analysis was perfoumed on 142 cases of RARP from July 2019 to June 2020 in Robotic Minimally Invasive Center of Sichuan Provincial People's Hospital, including 82 cases(Group A) , aged 70.0(65.6-78.0), undergoing transperitoneal RARP and 60 cases(Group B), aged 68.2 years old(60.1-79.2), undergoing extraperitoneal single port RARP. For group A, PSA was 12.9(5.6-64.0) ng/ml, with 26 cases of less than 10 ng/ml(31.7%), 40 cases of 10-20 ng/ml(48.8%), and 16 cases of more than 20 ng/ml(19.5%), the Gleason score was 7.2(6.0-10.0), with 14 cases(17.1%) of ≤6, 56 cases(68.3%) of 7, and 12 cases(14.6%) of ≥8, and the prostate volume was 61.3(29.0-112.0) ml. There were 49 cases with BMI≤25 kg/m 2, accounting for 59.8%, and 33 cases with BMI>25 kg/m 2, accounting for 40.2%. There were 17 cases(20.7%) of T 1, 44 cases(53.7%) of T 2 and 21 cases(25.6%) of T 3. The proportion of lymph node dissection was 17.1%, and 4 cases(4.9%)had a history of operation. For group B, the PSA was 12.2(1.0-42.6)ng/ml, with 20 cases (33.3%) of <10 ng/ml, 31 cases(51.7%)of 10-20 ng/ml, and 9 cases (15%) of >20 ng/ml. Gleason score was 7.1(6.0-9.0), with 12 cases (20.0%) of ≤6, 42 cases (70.0%) of 7, and 6 cases (10.0%)of ≥8. Prostate volume was 42.4(31.2-72.8)ml on average. There were 37 cases (61.7%) with BMI≤25 kg/m 2, and 23 cases (38.3%)with BMI >25 kg/m 2 . There were 17 cases(28.3%)of T 1, 32 cases(53.3%)of T 2 and 11 cases(18.3%)of T 3.The proportion of lymph node dissection was 11.7% and 4 cases (6.7%) had a history of operation.There was no statistically significant difference in term of age, PSA level, Gleason score, BMI, clinical stage, proportion of lymph node dissection or history of operation between the two groups( P>0.05), but there was statistically significant difference for prostate volume( P<0.05). All operations were performed by the same operator. Four different ways of bladder neck and urethral dissociation was selected according to the intraoperative conditions in Group A, include VIP style, T-shape incision style, VIP plus T-shape incision style or the style along the lateral side of the bladder neck. Small and single anterograde incision stripping of bladder neck was routinely performed in the Group B. Postoperative follow-up was performed to compare the operation time, intraoperative blood loss, bladder neck and urethral anastomosis time, postoperative hospital stay, postoperative exhaust time, postoperative complications, positive rate of surgical margin, indwelling time of urinary catheter, urinary continence satisfaction rate of immediately after operation, 3 months and 6 months after operation, wound healing and aesthetics. Results:All of the operations were successfully completed under robot-assisted laparoscopy, and there was no conversion to open surgery. The operation time was 56.0(45.0-112.0) min in the Group A and 65.4(55.5-96.8) min in the Group B, and there was no statistically significant difference( P>0.05). The intraoperative blood loss was 76.2(30.0-120.5) ml and 55.6(45.5-114.6) ml, respectively, and the difference was not statistically significant( P>0.05). The time of bladder neck urethral anastomosis was 18.9(12.6-25.6) min and 16.2(10.7-19.3) min, respectively, and the difference was not statistically significant( P>0.05). The postoperative hospital stay days were 9.3(8.0-16.0) d and 8.4(7.0-13.0) d, respectively, and the difference was not statistically significant( P>0.05). The postoperative exhaust time was 1.3(0.7-3.0) d and 3.4(2.0-7.0) d, respectively, and the difference was statistically significant( P<0.05). There was 1 case of anastomotic fistula with ureteral injury in Group A, and no serious complication in Group B, and the difference was not statistically significant( P>0.05). The number of positive surgical margin in the two groups was 13(15.9%)and 9(15.0%)respectively, and the difference was not statistically significant( P>0.05). The indwelling time of urinary catheter after operation was 9(7-21) d and 6(4-8) d, respectively, and the difference was statistically significant( P<0.05). The number of patients with satisfactory urinary continence immediately after surgery, 3 months and 6 months after surgery in the two groups were 8(9.8%), 51(62.2%), 62(75.6%) and 17(28.3%), 43(71.7%) and 54(90.0%), respectively. The differences were statistically significant( P<0.05). The total incision lengths in the two groups were 12.1(10.4-13.4) cm and 5.6(5.0-6.0) cm, respectively, and the difference was statistically significant( P<0.05). Conclusions:The extraperitoneal single port RARP is safe and feasible, and the postoperative effect is similar to that of transperitoneal RARP. It has the advantages of shorter recovery time, higher urinary continence satisfaction rate, neater and more beautiful incision. The long-term therapeutic effect needs further confirming by prospective study.

Objective:To investigate the clinical effect of different bladder neck separation methods in robot-assisted laparoscopic radical prostatectomy (RARP).Methods:To retrospective analysis the data of robot-assisted laparoscopic radical prostatectomy (RARP)in our center from October, 2014 to October, 2018. All operations were performed by the same urologist. According to the different methods of bladder neck separationAccording to the different methods of bladder neck separation, all the patients were divided into four groups. Group A routine forward peeling method (500 cases): Make a 1cm incision at 12 o'clock on the front of the bladder neck, cut off the detrusor muscle and cut the bladder neck. Group B T-cut incision of the bladder neck (133 cases): identify the bladder and prostate Junction, T-shaped incision of the anterior wall of the bladder neck. Group C conventional stripping method combined with T-shaped incision of the bladder neck (81 cases). Group D lateral approach (36 cases): along the lateral side of the bladder neck and the medial posterior ligament of the prostate is separated and merges with the previously established Dirichlet space. The general data of patients were analyzed statistically.The average ages of groups A, B, C, and D were 63 years (62.5 to 67 years), 65 years (61 to 68 years), 66 years (64.5 to 70.5 years), and 62 years (59.5 to 66.5 years)respectively, there was no statistical significance difference in terms of age in 4 groups( P>0.05); PSA is 13 ng/ml(9.0 to 22 ng/ml), 7.4 ng/ml(6.4 to 26.0 ng/ml), 6.2 ng/ml(5.3 to 27.0 ng/ml), 14ng/ml(8.4 to 21.0 ng/ml), ( P>0.05); Gleason scores of puncture were 6.9(5 to 9), 7(6 to 12), 9(8 to 16), 10(6 to 18), ( P>0.05); the prostate volume was 66ml(42 to 78 ml), 70ml(50 to 89 ml), 53ml (43 to 72 ml), 80 ml (68 to 92 ml), ( P>0.05); the proportions of body mass index ≤25 kg/m 2 were 60.0%, 63.9%, 39.1%, 42.0%, and>25 kg/m 2 were 40%, 36.1%, 60.9%, and 58.0%, respectively, ( P>0.05). The operation time, bleeding volume, anastomosis time, postoperative hospital stay, postoperative complications, positive rate of proximal incision margin, urinary indwelling time, and urinary control rate in the four groups analyzed. Results:All 750 RARP operations were successful, and none were converted to open.The operation time of groups A, B, C, and D were 100 min(70 to 120 min), 89 min(70 to 95 min), 105 min(80 to 127 min), and 110 min(90 to 130 min), ( P>0.05); anastomosis time was 20.5 min (18.0 to 25.0 min)、16.1min (10.7 to 17.3 min)、25.4 min (18.9 to 27.0 min)、and 28.5 min (21.0 to 32.0 min), the anastomosis time in group B was significantly shorter than other groups ( P<0.05); the postoperative hospital stays were 9.3 days (8.0 to 13.0 days), 8.4 days (6.0 to 16.0 days), 10.8 days (8.0 to 16.0 days)and 7.8 days (7.0 to 14.0 days), ( P>0.05). Postoperative complications: Anastomotic fistula and ureteral injury occurred in 3 cases in group A, and no serious complications occurred in the other 3 groups. Proximal marginal positive rate: 40 cases (8.0%) in group A, 0 cases in group B, 6 cases (7.3%) in group C, 3 cases (8.3%) in group D, and low positive rate of margin incision in group B( P<0.05). The urinary indwelling time was 7 d (6 to 8 d), 6 d(4 to 8 d), 12 d(6 to 18 d), 10 d(6 to 13 d), ( P>0.05). Six-month postoperative urine control rate: 381 cases (75.2%) in group A, 102 cases (76.9%) in group B, 61 (75.4%) in group C, and 27 (73.8%) in group D, ( P>0.05). Conclusions:The above four method of bladder neck separation during robot-assisted laparoscopic radical prostatectomy is safe and feasible, which can effectively avoid ureteral damage. Each method can obtain better urine control within six months after surgery rate. The positive rate of proximal incision margin after T-shaped bladder neck was lowest among four groups.

Six patients with prostate cancer, treated by suprapubic extraperitoneal single-port robot-assisted radical prostatectomy, had been studied retrospectively from December 2019 to January 2020. All 6 patients have been treated by suprapubic peritoneum single port robot assisted laparoscopic surgery without other channels. The robot assisted laparoscopic radical prostatectomy via suprapubic peritoneum is safe and feasible when based on reasonable selection criteria of patients. It has been shown that the postoperative recovery was fast and the tumor control and continence rate were good under the short-term follow-up. However, the long-term outcome should be evaluated by a long-term follow-up.