Adult ; Aged ; Carcinoma, Renal Cell ; diagnosis ; surgery ; Disease-Free Survival ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms ; diagnosis ; surgery ; Male ; Middle Aged ; Nephrectomy ; methods ; Treatment Outcome

Autophagy is a catabolic process responsible for the degradation and recycling of misfolded proteins and damaged organelles for cellular homeostasis. This degradative pathway,closely related to many diseases including cancer,has become a focus of cancer research. lt can serve as a tumor suppressor,also functions as a protective cell-survival mechanism against chemotherapies. Of the autophagy-related proteins,vacuolar protein sorting 34(VPS34)has attracted major attention over the past decade because of its role in autophagic procedure. Recently,three specific inhibitors of VPS34,PlK-Ⅲ,VPSlN1 and SlR405,have been invented,showing unique implications for autophagy reduction and therapeutic benefit in tumor treatment. This paper summarizes the different roles of autophagy in clinical settings and the functional regulation of VPS34 upon post-translational modification and also discusses the application prospects of inhibitors targeting VPS34 or autophagy in cancer prevention and treatment.

Objective Observe the results and reality of the peripheral nerve stimulator in the obtu- rator nerve block in TURBt.Methods 18 cases received the peripheral nerve stimulator in obturator nerve block before TURBt.Results In 17cases obturator nerve reflection vanished;lcase had a little symptom of adductor spasm.Conclusion Obturator nerve block with the help of the nerve stimulator can increase the achievement and quality of obturator nerve block and avoid some complications caused by obturator nerve re- flection in TURBt,such as perforation of bladder and injury of nerve and vessel.

Objective To evaluate the security and effect of combination of adjuvant hormonal thera- py and brachytherapy for localized prostate cancer.Methods 22 patients with T1-T2c prostate cancer were treated with transperineal ultrasound-guide 125I seeds prostate implantation and adjuvant hormonal therapy for 4～7 months.The hormonal therapy include 2-4 months before brachytherapy and 1～4 months after brachytherapy.Results The median operation time was ninety minutes,the median number of ~(125)I seeds used was 56.The follow up time was 12～48 months,the cases of PSA

Objective To investigate the efficiency of autologous transplantation of peripheral blood stem cell for treatment of patients with chronic lower limb ischemia. Methods Forty-six patients with chronic lower limb ischemia were treated by autologous peripheral blood stem cell transplantation. Results Fortytwo patients had pain relief on legs, and cold and cool feelings in lower limbs disappeared. Thirty-five patients had pain relief on feet, and 29 of them had disappearance of cold and cool feelings. Due to necrosis in middle and lower part of leg, 4 patients took extremity amputation after 4 weeks of the transplantation. In the 42 patients who kept their legs 3 months after transplantation, the distance of anginacruris extended from (87. 45 ±41.22) m to (348.52 ± 147.24) m, skin temperature increased from(28.52 ±0.51 ) ℃ to(33.56±0.62) ℃ ,and ankle-brachial index (ABI) increased from(0.48 ±0.06)to(0.75 ±0.07). There were statistical differences, and the scores of the distance of anginacruris, skin temperature, and ABI after transplantation were better than before. six months after transplantation autobiography of lower extremity was used, and neonatal lateral vessels of different degrees were found in 37 patients. Conclusion Autologous transplantation of peripheral blood stem cell is a simple, safe, and effective method, especially in treating patients with lower limb ischemia in which no arterial reconstruction is feasible.

In this paper, the effects of the blend of nanoparticles and microneedle matrix materials on the mechanical properties of dissolving microneedles were studied mainly, so as to construct microneedles with excellent mechanical properties. Different kinds of nanoparticles (calcium carbonate, hydroxyapatite, silica), particle sizes (20, 60, 100 nm) and the proportion of prescription (2%, 6%, 10%) were blended with the matrix material [polyvinyl pyrrolidone (PVP), poly(1-vinylpyrrolidone-co-vinyl acetate)(PVP/VA)] to form dissolving microneedles. The effects of nanoparticles on the elastic modulus and hardness of the microneedles were investigated using a nanoindenter. The results showed that the elastic modulus and hardness of PVP microneedles were significantly improved by nano-calcium carbonate (P < 0.001), and the elastic modulus and hardness of PVP/VA microneedles were significantly improved by nano-hydroxyapatite (P < 0.001). When the particle size of hydroxyapatite was 20 nm, the elastic modulus of PVP/VA microneedles was (10.6 ± 1.0) GPa, and the hardness was (0.47 ± 0.06) GPa. As the size of the nanoparticles increases, the mechanical performance of the microneedles decreases. When the mass proportion of nano-hydroxyapatite increased from 2% to 6%, the elastic modulus and hardness of the microneedles were significantly improved (P < 0.001), but the effect of continue increasing the proportion of nanoparticles on the microneedles was not significant. The nano-enhanced PVP/VA dissolving microneedles has no irritant effect on intact skin and has a slight irritation to damaged skin, but they disappear completely after 72 h. Animal experiments have been approved by the Laboratory Animal Welfare and Ethics Committee of Zhejiang University of Technology. Therefore, the nano-enhanced dissolving microneedles has good biological safety. To sum up, it is necessary to select the appropriate kind of nanoparticle, particle size, and prescription ratio when microneedles constructing with a given matrix material, so as to effectively improve its mechanical performance.

Objective To explore the competency of community health administrators in a survey of such administrators at large in Shanghai. Methods McClelland's Competency Dictionary was used to set two benchmark positions, while the behavioral event interviewing and questionnaires were made to survey 19 community health service centers in Shanghai. Results The competency model benchmarking on the head of a medical branch consists of 6 character clusters, 11 characteristic items, 27 evaluation dimensions and 27 typical behavior descriptions. The model benchmarking on the community team leader consists of 5 character clusters, 8 characteristic items, 21 evaluation dimensions and 21 typical behavior descriptions. Conclusion Findings of the survey provide objective criteria for competence appraisal of community health administrators, and serve as reference for formulating their development plans as well.

Objective To investigate the influence of infasound therapy on Raji cells. Methods The Raji cell line was cultivated routinely and grouped as an infrasound and a control groups.Infrasound 8TM was used as a therapeutic infrasound generator which worked in 3 modes(frequency range 4～20 Hz,infrasound energy less than 90 dB).The applicator of the infasound generator was put on 1.5～2.0 cm fom the surface of liquid in the dish containing Raji ceil.Raji cells would be treated for 15,30,60,and 90 minutes,then tested with trypan blue assay,MTT assay,flow cytometry anatysis,and scanning electron microscope(SEM)after 0,24,and 48 h cultivations,respectively. Results Trypan blue assay showed that there were no significant differences between the 2 groups(P>0.05).MTT assay showed that although optical density value of the infrasound groups seemed to be lower than that of the control group.the differences were not significant(P>0.05).Flow cytometry analysis showed that the rate of necrotic cells and apoptosis cells in all groups was less than 10%;and that the differences between all groups were not significant(P>0.05).The scanning electron microscopy showed that the cells treated by infasound exposure for 120 minutes and then cuhivated for 24 h showed that the prominent or micro-floss of the membrane become shorten and decreased.The surface of the membrane became smooth. Conclusion Infrasound(less than 90 dB)treatment in the experiment had no obvious influence on multiplication and apoptosis of Raji cells.But the membrane of Raji cell Would be affected directly by the infrasound,and the penetration of the membrane could be changed.

Objective To evaluate regional airway obstruction with balloon catheter in stabilizing the vital signs in experimental animals suffered from acute massive pulmonary embolism. Methods Pulmonary embolism of right lung artery by using auto-blood clots or detachable latex balloons was established in 27 healthy sheep. When the blood oxygen saturation decreased by 25% compared to that before the procedure,the placement of balloon catheter in corresponding right main bronchus was carried out in 18 sheep (study group). Five sheep were used as control group. The blood oxygen saturation in the remaining four sheep did not reach the intervention level. The pulmonary arterial pressure, the peripheral arterial pressure, the central venous pressure, the heart rate, the blood oxygen saturation, the arterial partial pressure of oxygen as well as of carbon dioxide were invasively determined. Results The experimental model of acute massive pulmonary embolism was successfully established in 23 sheep. After the establishment of pulmonary embolism, increased heart rate, tachypnea, a decrease of ≥ 25% in blood oxygen saturation within 30 minutes and a rise in pulmonary arterial pressure were detected. After the placement of balloon catheter in study group, a reduction of the pulmonary arterial pressure and an elevation of the blood oxygen saturation as well as the arterial partial pressure of oxygen rose. were observed. The difference between study group and control group was statistically significant (P < 0.05). Conclusion The result of this animal experiment indicates that obstruction of airway with balloon can be served as a first aid for acute massive pulmonary embolism, which can stabilizes the animal's vital signs and, therefore, can help gain precious time for the follow-up thrombolysis treatment.

Objective To evaluate regional airway obstruction with balloon catheter in stabilizing the vital signs in experimental animals suffered from acute massive pulmonary embolism.Methods Pulmonary embolism of right lung artery by using auto-blood clots or detachable latex balloons was established in 27 healthy sheep.When the blood oxygen saturation decreased by 25%compared to that before the procedure, the placement of balloon catheter in corresponding right main bronchus was carried out in 18 sheep(study group).Five sheep were used as control group.The blood oxygen saturation in the remaining four sheep did not reach the intervention level.The pulmonary arterial pressure,the peripheral arterial pressure,the central venous pressure,the heart rate,the blood oxygen saturation,the arterial partial pressure of oxygen as well as of carbon dioxide were invasively determined.Results The experimental model of acute massive pulmonary embolism was successfully established in 23 sheep.After the establishment of pulmonary embolism,increased heart rate,tachypnea,a decrease of≥25%in blood oxygen saturation within 30 minutes and a rise in pulmonary arterial pressure were detected.After the placement of balloon catheter in study group,a reduction of the pulmonary arterial pressure and an elevation of the blood oxygen saturation as well as the arterial partial pressure of oxygen rose were observed.The difference between study group and control group was statistically significant(P