Objective To investigate the effects of tumor necrosis factor-α ( TNF-α ) on the resensitization of human lung cancer cell lines A549/DDP to cisplatin (DDP) and to explore the relationship between the expression of TNF-αand resistance-related protein (LRP) in lung tissue.Methods The cytotoxic effects of combinational treatment by TNF-α and cisplatin on A549/DDP were measured by MTT assay.The expression of LRP was assessed by immunocytochemistry methods.Results The IC50 of A549/DDP to cisplatin were decreased from 7.12 ng/L to 5.02 ng/L,4.41 ng/L respectively by 250 U/ml and 1000 U/ml TNF-α treatment ( P ＜ 0.01 ),with the sensitivity of A549/DDP to cisplatin increased by 1.42 and 1.62 fold respectively.LRP was overexpressed in A549/DDP cell.250 U/ml or 1000 U/ml TNF-α plus cisplatin treatment down-regulated the expression of LRP with the positive rates of ( 60.14 ± 6.54 ) ％ and ( 57.23 ± 5.98 ) ％respectively,which were significantly lower than that of cisplatin alone treatment ( 75.97 ± 5.32 ) ％ and control group (79.63 ± 4.78 ) ％ ( both P ＜ 0.01 ).Conclusion Tumor necrosis factor-α can reverse the resistance of A549/DDP to cisplatin,which may be partially attributed to down-regulating LRP expression.

Objective To investigate the etilolgy of failed pyeloplasty in children and to study the feasibility of redo laparoscopic surgery for recurrent nreterupelvic junction obstruction.Methods The clinical data of 39 patients with recurrent ureteropelvic junction obstruction after the primary pyeloplasty underwent redo laparoscopic surgery were analyzed retrospectively between September 2009 and June 2016 in our institution.There were 31 males and 8 females with a mean age of 66 months,ranged from 4 to 204 months.28 patients had left obstructions and 11 had fight obstructions,who were diagnosed by ultrasonography,MRU,and MAG3 renal scan et a1.Under general anesthesia,we identified that two patients (5.1％) had renal calices strictures,four patients (10.3％) had unsolved disease ureter and anastomotic strictures,two patients (5.1％) had adhesion band and anastomotic strictures,one patient had adhesion band,high ureteropelvic anastomosis and ureter torsion,and 30 (76.9％) patients had anastomotic strictures.Thirty-three patients underwent cdismembered pyeloplasty,five patients underwent onlay appendiculoureteroplasty and one patient underwent ureterocalicostomy.Results All surgeries were successfully completed without conversion.No intraoperative complication was encountered.One patient had persistent,frequent and intolerable flank pain with severe hydronephrosis after surgery,he subsequently underwent nephrectomy.One patient had persistent severe hydronephrosis which was repaired with on-lay appendiculoureteroplasty.One patient had anastomotic adhesion and balloon dilatation was performed with no further obstruction in follow up imaging.The rest of the patients got complete clinical or radiologic resolution.The successive rate was 36 of 39 (92.3％) at a mean follow up of 25 months (ranging 3-60 months).Conclusions Unsolved ureteric pathologies,anastomotic stricture,renal calices stricture,adhesion band,torsion of ureter and high ureteropelvic anastomosis all contribute to recurrent obstruction after the primary pyeloplasty.Laparoscopic redo pyeloplasty is safe and feasible for skilled surgeons.

Objective To analyze the clinical characteristics and outcome of pregnancy combine with cerebral cavernous malforma-tion(CCM),and to investigate the management during perinatal period of pregnancy combine with CCM.Methods A total of 15 cases of pregnancy combine with CCM were admitted to Xuanwu Hospital,Capital Medical University from August 2015 to August 2022.A ret-rospective analysis was performed on the data.Results The 15 patients had a total of 16 pregnancies and CCM were found in pre-preg-nancy examination.The initial manifestations were epilepsy in 5 cases,sudden headache in 4 cases,headache due to cerebral hemorrhage in 1 case,transient syncope in 1 case,ataxia in 1 case and no clinical symptoms in 3 cases.Among the clinical manifestations of epilep-sy,4 patients were relieved or disappeared after treated by operation or radiotherapy before pregnancy,1 patient without treatment had fre-quent seizures during pregnancy and disappeared after increasing drug dosage.No new cases of operation and cerebral hemorrhage during pregnancy.3 cases had vaginal delivery and 11 cases selected cesarean section after 37 weeks of labor and 1 case required termination of pregnancy at the week of 18 weeks.1 patient suffered status epilepticus after postpartum,and the remaining cases were healthy.Conclu-sion Pregnancy combine with CCM needs multi-disciplinary team(MDT)management.Pregnancy may increase the risk of epilepsy.Risk assessment should be performed by neurosurgery department before pregnancy,and antiepileptic drugs should be adjusted during pregnancy,Close monitoring after delivery is also important.The mode of delivery is decided after discussion and evaluation by the MDT team composed of obstetrics,neurology,anesthesiology and maternal-fetal medicine.

Objective To explore the efficiency improvement in segmenting neural network with the application of Transformer + U-Net artificial intelligence (AI) and modeling with the application of Python scripts in three-dimensional (3D) printing brachytherapy. Methods A Transformer + U-Net AI neural network model was constructed, and Adam optimizer was used to ensure rapid gradient descent. Computed tomography or magnetic resonance imaging data of patients were standardized and processed as self-made data sets. The training set was used to train AI and the optimal result weight parameters were saved. The test set was used to evaluate the AI ability. Python programming language was used to write an automated script to obtain the output segmentation image and convert it to the STL file for import. The source applicator and needle could be automatically modeled. The time of automatic segmentation and modeling and the time of manual segmentation and modeling were entered by two people, and the difference was verified by paired t-test. Results Dice similarity coefficient (DSC), mean intersection over union (MIOU), and Hausdorff distance (HD95) were used for evaluation. DSC was 0.9341, MIOU was 0.8762, and mean HD95 was 2.516. The mean time of manual segmentation was 1187 s, and the mean time of AI segmentation was 145 s (P < 0.01). The mean time of manual modeling was 321 s, and the mean time of modeling with Python automated scripts was 18 s (P < 0.01). Conclusion The application of Transformer + U-Net automatic segmentation and Python automated scripts can effectively improve work efficiency in the 3D printing brachytherapy for cervical cancer.