Objective To explore the safety of enteral nutrition(EN)support in non-blood circulation disorders of elderly patients with intestinal obstruction.Methods A total of 40 patients (22 men and 18 women aged 62-84 years)with intestinal obstruction were enrolled in this study.Ileus tubes were rapidly placed in these patients with the assistance of endoscopy and X-ray.Afterwards patients were equally randomized into parenteral nutrition(PN)and EN(PN+EN)group and PN only group.The clinical outcomes and complications were recorded and compared.Results The average time for catheter placement was(24.83 4±7.95)minutes.Abdominal pain were relieved within 1-2 hours in26 pafienta(65.0%)and within 48 hours in 11 patients(27.5%).In the PN+EN group,EN was provided(25.25±8.17)hours after catheter placement,and most patients could tolerate EN.Laboratory findings were not significantly different at admission between two groups.The mean prealbumin leveh were below than normal level at admission but returned normal after one week,which were significantly different inside each group(P<0.05)but were not significantly different between these two groups.The triglyceride leveh were higher than the normal level at admission but returned normal after treatment;however,the difference between the two groups was not significant.The laboratories tests were also not significantly different between two groups one week after admission.Conclusion EN support is safe for elderly patients with intestinal obstruction after effective gastrointestinal decompression.

Objective To investigate the efficacy of ventral bladder mucosa onlay graft urethroplasty for the management of panurethral stricture.Methods From August of 2005 to July of 2013,11 cases of panurethral stricture were treated by ventral bladder mucosa onlay graft urethroplasty.The median age of the patients was 53 years (22-72 year),The median stricture length was 15 cm (12-18 cm).The patient was placed in the lithotomy position,Penile urethra was exposed by circumcoronal incision and degloving of skin,Bulbar urethra was exposed by inverted Y-shaped perineal incision.The strictured urethral segment was then opened ventrally in the midline up to at least 1 cm proximally into the healthy urethra.An appropriate size bladder mucosa graft was harvested,and was quilted to the splited urethra edge,the graft width was 1.5-2.0 cm.Two F10 fenestrated silicone catheters were left as urethral stents,a suprapupic cystostomy tube was left.The urethral stent was removed 4 weeks postoperatively.Follow-up was performed every 3 months for the first year,and annually thereafter.Success was defined as normal voiding with a maximum flow rates ≥ 15 ml/s,and the patients required no further instrumentation,including dilation or urethrotomy.Results The mean follow-up was 18 months (range,9-36 months),the overall success rate was 10/11.One patient developed urethral meatus stenosis 3 months postoperatively,and was managed by meatal dilatation.Conclusion Ventral bladder mucosa onlay graft urethroplasty can be used for the management of panurethral stricture,Bladder mucosa is an alternative substitution for complex urethral reconstruction.

Objective To study the protective effects and mechanism of aqueous extract of arctium lappa root on vas?cular endothelial cell injury in hypertensive rats. Methods The hypertensive rat model was induced by N-nitro-L-argi?nine. Rats were randomly divided into normal control group, model control group, positive control group (aptopril 15 mg/kg), low concentration of aqueous extract of arctium lappa root (0.5 g/kg), medium concentration of (1 g/kg) and high concentra?tion of (2 g/kg) groups. After six weeks of continuous intragastric administration, the systolic blood pressure levels at tail ar?tery were measured at 1, 4, 7, 10, 13, 16, 19, 22, 29, 36 and 42 d after treatment. And other indicators related to inflammato?ry factors were detected including C-reactive protein (CRP) and interleukin (IL)-6. The intercellular adhesion molecule-1 (ICAM-1) level was detected by taking samples of thoracic aorta. Results (1) The systolic blood pressure level at tail ar?tery was significantly lower in aqueous extract of arctium lappa root group than that of model control group ( P<0.05). (2) The aqueous extract of arctium lappa root can significantly improve the vascular endothelial cell injury, suppress vascular endo?thelial cell loss and blood cell adhesion, and cell proliferation with collagen fibers in muscle membrane. ( 3) The serum levels of IL-6, CRP and vascular endothelial ICAM-1 were significantly reduced in aqueous extract of arctium lappa root group than that of model control group (P<0.05). Conclusion Aqueous extract of arctium lappa root can significantly improve vascular endothelial cell injury in hypertensive rats. The mechanism may be related to the inhibition of inflammatory cyto?kines like IL-6, CRP and the expression of ICAM-1, and the improvement of chronic inflammatory response in vascular en?dothelium of hypertensive rats.

Objective: To study the expressions of AAX14401 in the normal bladder tissue and the human bladder transitional cell carcinoma tissue, and to analyze its function in the occurrence and development of bladder cancer. Methods: Seventy-five cases of specimens of bladder transitional cell carcinoma were collected and used as experimental group and 12 cases of normal bladder mucosa specimens were selected as control group. The positive expression rates of glutathione S-transferase pi-1 (GSTP1) and AAX14401 were detected by immunohistochemistry. The differences of positive expression rates of GSTP1 and AAX14401 proteins between bladder cancer tissue and normal bladder tissue were analyzed. Results: The positive expression rate of GSTP1 protein in normal bladder tissue was 58.3%, while it was 90.7% in bladder cancer tissue, and the difference between them was significant (P<0. 01). The positive expression rate of AAX14401 protein in normal bladder tissue was 0%, while it was 2. 7% in blandder cancer tissue, and there was no significant difference between them (P= 0. 596). There was no one with positive AAX14401 expression and positive GSTP1 expression in bladder cancer tissue at the same time. There were 2 cases with positive AAX14401 expression in bladder cancer tissue with negative GSTP1 expression; there was a negative correlation between the positive expressions of AAX14401 and GSTP1 proteins in bladder cancer (r=-0. 274, P=0. 018). Conclusion: The expression of AAX14401 protein may promote the incidence and progression of bladder cancer.

Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy (PCNL) under ultrasonic guidance for the treatment of upper urinary calculus. Methods From June 2004 to July 2009, 1289 patients with upper urinary tract calculi were treated with PCNL under ultrasonic guidance, 386 cases of them were upper ureteral calculi, 463 cases were single renal calculi,355 cases were multiple renal caculi, 85 cases were staghorn calculi. Calculus size was 0.8 cm× 1.2cm-9.0 cm× 5.3 cm,mean 2. 1 cm× 3.1 cm. Nine hunderd and thirty-five cases were with hydronephrosis. Results All patients were performed PCNL successfully, without conversion to open surgery or death. Mean operation time was 90(55-220)min, mean operative blood loss was 175(60-800)ml. Thirty-one cases were given blood transfusion during operation or post operation, 14 cases were given super-selective renal artery embolism for bleeding control. 1105 cases were treated with single tract, 108 cases with double tracts, 76 cases with three tracts. Calculus clearance rate of onestage PCNL was 85.03%(1096/1289);193 cases were found with residual calculi, 67 of them were given extracorporeal shock-wave lithotripsy, 126 of them were given two-stage PCNL, calculi were removed complelety in 85 cases. Total calculus clearance rate was 91.62%(1181/1289). Conclusions PCNL under ultrasonic guidance is an effective and safe method for the treatment of upper urinary calculus with advantages of accurate positioning, high calculus clearance rate, minimal trauma, and fewer complications. The key of successful PCNL is selection of patients, grasp of operation technique, and availability of other equipements.

Objective To compare the safety of laparoscopic live donor nephreetomy(LDN) and open live donor nephrectomy(ODN), evaluate the kidney function and blood pressure of living donors during 1 year follow-up. Methods Thirty cases of LDN and 30 eases of ODN were retrospectively reviewed. The operation time, warm ischemia time, operative blood loss, time to post-operative intake and time to ambulation of the 2 grouups were compared. According to the modified Clavien classifica-tion system procedure-related complications were described and compared. Serum creatinine(SCr) le-vels, blood pressure and 24-h urine protein excretion were measured before nephreetomy and 1 d, 7 d, 3 months, 6 and 12 months after nephrectomy. Glomerular filtration rate (GFR) were measured preo-pratively and at 6 and 12 months postoperatively. These data were statistically analyzed. Results The operation time was (98. 6+13. 6)rain and (96.3+19. 5)rain in the LDN and ODN groups, re- spectively. Warm ischemia time in the LDN group was (90.6±15.1)s, in the ODN group was (86.4±12.3)s. Operative blood loss was (105.2±634.8)ml and (206.3±126.4)ml in the LDN and ODN groups(P<0.01). For the time to post-operative intake and time to ambulation, LDN group was (28.5±2.9)h and (25.8±63.8)h, ODN group was (38.6±63.3)h and (36.5±65.3)h(P<0.01). Perioperative complications rates were 6.6%(2/30) and 23.3%(7/30) for LDN and ODN, respective-ly. SCr was (109.1±7.5), (105.4±69.5), (96.6±10.7), (89.4±11.5), (91.6±69.3)/zmol/L in the LDN group and (107.3±69.6), (103.3±68.4), (95.4±69.1), (90.5±13.6), (90.3±11.7)μmol/L in the ODN group 1 day, 7 days, 3 months, 6 months and 12 months after nephrectomy. The mean GFR of LDN and ODN was 64.7 and 65.8 ml/min at 6 months after nephrectomy, 65.9 and 67.5 ml/min at 12 months postoperatively, which were significantly different comparing with preoperative mean GFR in each group(P<0.05) but no significant difference was found between 6 months and 12 months after nephrectomy and between the 2 groups at the same time point respectively(P>0.05). Mean 24 h protein excretion was elevated after either LDN or ODN during 1 year followup, but was not significantly different either between predonation and 1 year after nephrectomy or between the 2 groups at the same period. Blood pressure increased or decreased slightly with the duration of follow-up,no significant blood presure changes were found before and after nephrectomy or between the two groups at the same period postoperatively. Conclusions LDN has the advantages of minimal trauma, less operative blood loss and quicker convalescence. It is safe and and has no adverse effects regarding kidney function and blood pressure during the first year after living kidney donation comparing to ODN.

Objective To investigate the effect of Shenxiong glucose injection on platelet reactivity during aspirin treatment in patients with acute ischemic stroke.Methods A total of 263 patients with acute ischemic stroke admitted to 12 hospitals from January 2014 to December 2016 were enrolled prospectively.They were randomly divided into aspirin group and aspirin + Shenxiong glucose injection group.The changes of platelet maximum aggregation rate induced by 4 platelet aggregating agents (arachidonic acid,adenosine diphosphate,collagen and platelet activating factor) were detected before and after the treatment.Results There were no significant differences in the demographic data and baseline clinical characteristics between the aspirin group (n =132) and the Shenxiong glucose injection + aspirin group (n =131).At baseline,the maximum aggregation rate of platelet induced by arachidonic acid and platelet activating factor in Shenxiong glucose injection + aspirin group was significantly higher than that in the aspirin group (all P ＜0.05).On the 6th day after treatment,the maximum aggregation rate of platelets induced by the 4 aggregating agents in the Shenxiong glucose injection + aspirin group was significantly lower than that in the aspirin group (all P ＜ 0.001).Conclusion Shenxiong glucose injection had a significant inhibitory effect on platelet reactivity during aspkin treatment in patients with acute ischemic stroke.

Objective: To establish human cancer cell strains with stable Cas9 expression, and to validate the gene editing activity of Cas9 for simple gene editing in future study. Methods: Fifteen cancer cell lines of different tissue origins were infected with pLv-EF1α-Cas9-Flag-Neo or pLv-EF1α-Cas9-Flag-Puro by lentivirus and clone selection was employed to screen Cas9 stably expressed cancer cell lines. Afterward designed guide RNA vectors targeting TSC22 gene were transiently transfected into 3 of cell lines, and subsequently the gene editing activity of Cas9 was evaluated by genomic PCR, sequencing and Western blot. Results: Sixty-nine human cancer cell strains with stable Cas9 expression from different cancers were established, and by transient transfection with designed guide RNA, long fragment deletion was detected in TSC22 gene. Conclusions Sixty-nine human cancer cell strains are successfully established with stable expression of Cas9 protein and gene editing activity. These cell strains may be employed in large-scale drug screening, screening of new drug targets and gene function investigation.

Purpose To investigate the expression of pro-tein of relevant evolutionary and lymphoid interest domain-con-taining 1(PRELID1)in gastric cancer tissues and to analyze its effect on prognosis,and the mechanism of influencing the prolif-eration and invasion ability of gastric cancer cells.Methods Using TCGA data and clinical data of 111 patients with gastric cancer,we analyzed the relationship between the expression of PRELID1 and clinicopathological parameters and the impact on clinical prognosis.The biological function of PRELID1 was pre-dicted by bioinformatics,and further verified by in vitro and in vivo experiments.Lentivirus was applied to regulate the level of PRELID 1 in gastric cancer cell line(MGC803)in vitro,and its effect on the proliferation,migration,and invasion of gastric cancer cells was observed.The nude mouse subcutaneous tumor-igenesis was used to observe the effect of PRELID1 on the growth of gastric cancer tissue in vivo.Results The expression of PRELID1 was significantly higher in gastric cancer tissues than that in the adjacent tissues(P＜0.001)and was positively cor-related with the cell proliferation indicator Ki67(P＜0.001).Cox regression model analysis showed that the high expression of PRELID 1 was an independent risk factor affecting the 5-year survival rate after radical gastrectomy(HR=2.336;95％CI=1.354-4.029).Gene enrichment results showed that the func-tion of PRELID1 was related to proliferation and JAK/STAT sig-naling.CCK-8 and Transwell experiments found that up-regula-tion of PRELID1 promoted the proliferation(P=0.016),mi-gration(P=0.016)and invasion(P=0.025)of gastric cancer cells,while down-regulation inhibited the proliferation(P=0.026),migration(P=0.048)and invasion(P=0.029).Subcutaneous tumor formation experiments in nude mice found that up-regulation of PRELID1 promoted the growth of gastric cancer tissue(P=0.047),while down-regulation was the oppo-site(P=0.005).Western blot detecting gastric cancer cells and gastric cancer tissues found that up-regulation of PRELID1 promoted the expression of JAK and STAT proteins(all P＜0.05),while down-regulation inhibited them(all P＜0.05).Conclusion The high expression of PRELID1 associated with poor prognosis may regulate the proliferation,migration and in-vasion of gastric cancer cells by up-regulating JAK/STAT signa-ling in gastric cancer.