Objective To evaluate the feasibility and clinical results of laparoseopic reoperation for patients with history of previous ipsilateral urology laparoscopic surgeries. Methods Thirteen patients that underwent second ipsilateral urology laparoscopic surgeries were retrospectively ana-lysed. The reasons for a second operation included nonfunctional kidney after pyeloplasty, ure-terolithotomy or pyelolithotomy in 4 cases, recurrence of urinary calculi in 3 cases, pelviureteric june-tional stenosis after pyeloplasty in 1 case, recurrence of renal cyst in 1 case, recurrence of adrenal tumor in 1 case, residual adrenal tumor in 1 case, progression of polycystic kidney in 1 case and renal carcinoma after laparoscopic surgery for renal cyst in 1 case. Transperitoneal laparoscopie surgeries were performed in all cases and the first trocar was placed with open incision to avoid puncture injury. The adhesion between intestines and retroperitoneal space was dissected to expose the operative field. The lateral peritoneum and perirenal fascia were sutured after surgery in all cases except nephrectomy cases. Results For the first operation, the mean operative time was 93 min, the mean estimated blood loss was 70 ml and the average postoperative hospital stay was 4.8 d. The second operations on the 13 cases were successfully performed with mean operative time of 97 rain, mean estimated blood loss of 62 ml and average postoperative hospital stay of 5.0 d which were not significantly different from the first operation parameters(P＞0.05). During the secondary operations, adhesions and abnor-mal anatomic structure observed increased the difficulty of surgery. All patients after secondary opera-tions were followed up for 2--24 months and no major complication was observed. Conclusion La-paroscopic reoperation on patients with history of ipsilateral urology laparoscopic surgery is feasible in skilled and experienced hands and in properly selected cases.

Objective To investigate the influence of the serum vascular endothelial growth factor (VEGF) in the glioma patients by the malignant degress.Methods Quantitative analysis the serum VEGF levels with the double antibody sandwich assay (ELISA) for 35 cases of glioma patients and 10 cases of healthy human and analyze the correlation of them.Results Mean serum VEGF expression in glioma patients was 120.71 ±45.99 pg/ml,normal value of the healthy people was 63.70 ± 6.50,the difference was statistically significant (P ＜0.05); serum VEGF expression was 156.43 ± 14.90 pg/ml in high-grade glioma patients (Ⅲ-Ⅳ grade) and 67.14 ± 6.12 pg/ml in low-grade glioma patients (Ⅰ-Ⅱ grade),the difference was statistically significant (P ＜ 0.05) ; there' s no different from low-grade glioma patients (Ⅰ-Ⅱ grade) and nomal(P ＞ 0.05).Conclusion The serum VEGF levels in the glioma patients was influence by the malignant degress.

Objective To investigate the effect of kaempferol(KAE)on the function of drug-resistant Bel-7402/5-Fu cells.Methods Bel-7402/5-Fu cells were treated with KAE,and cells were divided into the control group and the drug group(0.064,0.320,1.600,8,40,200 μmol/L KAE).Cells were divided into the si-NC group and the DNA-PKcs interference group,or the control group,the KAE group,the KAE+si-DNA-PKcs group or the KAE+DMSO group,the KAE+MG132 group and the KAE+CQ group based on interfering DNA dependent kinase catalytic subunits(DNA-PKcs)or addition of proteasome inhibitor MG132 or autophagy inhibitor CQ.Cell proliferation was detected using CCK-8.The expression level of histone H2AX phosphorylation(γ-H2AX),DNA-PKcs,DNA double strand break repair/V(D)J recombinant protein(Artemis)and drug pump gene(P-gp)were analyzed using real-time fluorescence quantitative PCR(RT-qPCR)and Western blot assay.Cell cycle and apoptosis were detected by flow cytometry.The stability of DNA-PKcs proteins was analyzed by protein stability experiments.Ubiquitination of DNA-PKcs protein was evaluated by immunoprecipitation assay.Results Compared to the control group,treating cells with 8 μmol/L KAE for 24 h inhibited about 50%of cell proliferation ability.Therefore,this time and concentration were chosen for subsequent research.Compared to the control group,the expression level of γ-H2AX mRNA and protein significantly increased,while expression levels of DNA-PKcs,Artemis and P-gp mRNA and proteins significantly decreased in the KAE group(P＜0.05).Compared to the control group,KAE promoted cell cycle arrest in the G2/M phase of Bel-7402/5-Fu cells and increased cell apoptosis.Compared to the si-NC group,siRNA-1664 significantly downregulated the mRNA and protein expression levels of DNA-PKcs(P＜0.05).Compared with the KAE group,the effect of KAE was further promoted in the KAE+si-DNA-PKcs group of Bel-7402/5-Fu cells.Compared with the control group,the protein expression level of DNA-PKcs decreased in the KAE+DMSO group(P＜0.05).Compared with the KAE+DMSO group,the protein expression level of DNA-PKcs increased in the KAE+MG132 group(P＜0.05),while there was no significant change in the protein expression level of DNA-PKcs in the KAE+CQ group(P＞0.05).Compared to the control group,there was promoted ubiquitination of DNA-PKcs in the KAE+DMSO group,and the inhibited ubiquitination in the KAE+MG132 group(P＜0.05).Conclusion KAE may induce cell apoptosis and cell cycle arrest in drug-resistant Bel-7402/5-Fu cells.