Objective To investigate the efficacy of transurethral resection of bladder tumor(TURBT).Methods From August 2001 to January 2007,26 patients with bladder tumor were treated with TURBT.Cutting electrode was used to resect the tumor,including also the normal mucous membrane,away from the base of the tumor by 0.5-1.0 cm,and reaching shallow muscle layer of the bladder in depth.The wound was treated with electrocoagulation.Postoperatively,drugs such as mitomycin were used through intravesical instillation for chemotherapy.Results Operation time was 15-90 min(52.5?37.5 min).One case had serious postoperative bleeding of the bladder,1 case of bladder perforation.Follow-up was conducted in 22 cases for 0.5-2 years,(mean:1 year).Six cases had recurrence in which 4 were in situ,the other 2 were ectopia.One of the recurrent cases had chyluria,treated with ligation of renal lymphatic tissue.Conclusions TURBT has advantages such as simple surgical manipulation,and reliable efficacy etc,in treating bladder tumor.

Objective To evaluate the efficacy of closed retroperitoneoscopic decortication of renal cysts.Methods Closed retroperitoneoscopic decortication of renal cysts was performed in 11 cases from December 1996 to September 2003 in this hospital.A 1~2 cm skin incision 2 cm above the iliac crest was made in the middle axillary line.A 10 mm trocar was introduced into the retroperitoneal cavity.A self-made water-filled balloon was used to create a retroperitoneal space for clearing the renal cyst.An electrocautery scalpel was used to excise the cyst wall until 0.5~1.0 cm away from the renal parenchyma.Results The procedure was successfully completed in 10 cases,with an operation time of 30~100 min(mean,77.5 min) and an intraoperative hemorrhage volume of 20~60 ml(mean,30.9 ml).A conversion to open surgery was required in 1 case because of difficult exposure of the renal cyst.Peritoneal injury was encountered in 1 case.The length of postoperative hospital stay was 6~9 days(mean,7.4 days).(Follow-up) observations in 7 cases for 7~26 months(mean,15.2 months) showed no recurrence of renal cyst under ultrasonography.Conclusions Closed retroperitoneoscopic decortication of renal cysts is a surgical option with little invasion,quick recovery,and good efficacy.

Objective To evaluate peri-operative clinical effects of transurethral electrovaporization of the prostate(TUVP) combined with transurethral resection of the prostate(TURP) versus open prostatectomy for benign prostatic hyperplasia(BPH).Methods A total of 156 cases of BPH were surgically treated in this hospital from November 1997 to December 2004,including 53 cases of TUVP combined with TURP(Combination Group) and 103 cases of open suprapublic prostatectomy(Open Group). Results There were no significant differences in the operation time between the two groups(90?70 min vs 108?68 min;t=(-1.550),P=0.123).The Combination Group was superior to the Open Group in the blood transfusion rate(8% vs 38%;?~2=16.109,P=0.000),the time to clear urine(2?1 d vs 4?1 d;t=-11.831,P=0.000),the postoperative catheterization time(10?8 d vs 19?10 d;t=-5.680,P=0.000),the time to get out of bed(6?4 d vs 20?10 d;t=-9.785,P=0.000),and the postoperative hospital stay(20?14 d vs 34?24 d;t=-3.914,P=0.000).The incidence of complications was higher in the Combination Group than in the Open Group(15.1% vs 2.9%;?~2=6.173,P=0.013).Conclusions TUVP in combination with TURP for benign prostate hyperplasia has advantages of little invasion and rapid recovery.

Objective To investigate the ultrasonic imaging features of thyroid follicular adenoma for conducting the correct diagnosis and differentiation diagnosis.Methods The clinical and imaging data in 64 cases of pathologically proven thyroid follicular adenoma were analyzed on the maximal diameter of tumor,nodularity number,high and low echogenicity,peripheral halo,echo hom-ogeneity,calcifications,and so on.The misdiagnosis causes were investigated.Results The mass was mainly solid or cystic-solid mixed echo.The ultrasonic imaging features of thyroid follicular adenoma were non-peripheral halo or thin wall halo,hyperecho or isoecho,internal macrocalcifications and peripheral calcifications,homogeneous echo structure.Conclusion The ultrasonographic examination can provide the better diagnosis and differentiation diagnosis on thyroid follicular carcinoma.

Objective To explore the effect of calycosin(CAL)on neuronal autophagy and apoptosis in rats with spinal cord injury(SCI)by regulating PI3K/Akt signaling pathway and its mechanism.Methods A total of 32 male or female adult SD rats were randomly divided into the sham group,the SCI group,the CAL low(20 mg/kg)dose group and the CAL high(40 mg/kg)dose group with 8 rats in each group.The rat model of moderate SCI was established by modified Allen's method.After successful modeling,rats were injected intraperitoneally immediately with different dosage of CAL or equal amount of saline once a day for 7 consecutive days.Basso,Beattie and Bresnahan(BBB)scores were used to evaluate the recovery of motor function of rats at 1,3 and 7 d after surgery.At 7 d after surgery,Nissl staining was used to detect the surviving number of motor neurons in anterior horn of spinal cord.Western blot assay was used to assess expression levels of p62,Beclin-1,microtubule-associated protein 1 light chain 3(LC3B),phosphatidylinositol 3-kinase(PI3K)/protein kinase B(Akt)pathway,Cleaved-Caspase-3,B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)proteins.Immunofluorescence staining was used to measure the expression of LC3B in anterior neurons of spinal cord.Results Compared with the sham group,BBB scores,the surviving number of motor neurons and levels of Bcl-2,Bcl-2/Bax,p-PI3K,p-PI3K/PI3K,p-Akt and p-Akt/Akt were significantly decreased(P＜0.05),and levels of p62,Beclin-1,LC3B Ⅱ,LC3BⅡ/Ⅰ,Cleaved-Caspase-3 and Bax were significantly increased in the SCI group(P＜0.05).Compared with the SCI group,BBB scores,the survival of anterior horn motor neurons and levels of LC3B Ⅱ,LC3B Ⅱ/Ⅰ,Bcl-2,Bcl-2/Bax,p-PI3K,p-PI3K/PI3K,p-Akt and p-Akt/Akt were increased in the CAL low dose group and CAL high dose group,and levels of p62,Cleaved-Caspase-3 and Baxcould were significantly decreased(P＜0.05).Conclusion CAL could promote autophagy and inhibit apoptosis of neurons through activating PI3K/Akt signaling pathway,thereby conferring a protective role following SCI in rats.

Objective To investigate the safety,efficacy,and clinical value of a fracture reduc-tion and fixation system.Methods The design and application of components[Kirschner wire(K-wire)limiter and K-wire guiding locking device]of the fracture reduction and fixation system were described.Six surgeons implanted K-wires into synthetic bones using the K-wire limiter or by percep-tion respectively,and the length of K-wire protrusion was assessed.K-wire guiding locking device combined with locking plates and two 1.5 mm K-wires,two 1.5 mm K-wires,as well as two 2.0 mm K-wires were used to fix a fracture model constructed by synthetic bones,and the torque at failure was measured.Results The K-wire limiter reduced the length of K-wire protrusion(P＜0.001).The failure torque of fractures fixed by K-wire guiding locking device with locking plates and two 1.5 mm K-wires was larger than those fixed with two 1.5 mm K-wires and two 2.0 mm K-wires(P＜0.05).Conclusion The fracture reduction and fixation system offers a new technique for reducing and recon-structing fractures,assessing and optimizing the position of locking plate screws,as well as protecting the blood supply of fractures.

Objective To investigate the safety,efficacy,and clinical value of a fracture reduc-tion and fixation system.Methods The design and application of components[Kirschner wire(K-wire)limiter and K-wire guiding locking device]of the fracture reduction and fixation system were described.Six surgeons implanted K-wires into synthetic bones using the K-wire limiter or by percep-tion respectively,and the length of K-wire protrusion was assessed.K-wire guiding locking device combined with locking plates and two 1.5 mm K-wires,two 1.5 mm K-wires,as well as two 2.0 mm K-wires were used to fix a fracture model constructed by synthetic bones,and the torque at failure was measured.Results The K-wire limiter reduced the length of K-wire protrusion(P＜0.001).The failure torque of fractures fixed by K-wire guiding locking device with locking plates and two 1.5 mm K-wires was larger than those fixed with two 1.5 mm K-wires and two 2.0 mm K-wires(P＜0.05).Conclusion The fracture reduction and fixation system offers a new technique for reducing and recon-structing fractures,assessing and optimizing the position of locking plate screws,as well as protecting the blood supply of fractures.

OBJECTIVE：To observe the p rotective effects of resveratrol （Res）on LPS-induced acute lung injury （ALI）model mice，and to explore its possible mechanism based on TLR 4/NF-κB pathway. METHODS：Kunming mice were divided into normal group，model group ，positive control group （dexamethasone，0.5 mg/kg），Res low-dose ，medium-dose and high-dose groups （50， 100，200 mg/kg），with 10 mice in each group. Normal group and model group were given normal saline intragastrically ，once a day，for 7 days；positive control group were intraperitoneally injected with Dexamethasone sodium phosphate injection ，once a day，for 3 days；Res groups were given relevant medicine intragastrically ，once a day ，for 7 days. After last administration ，all the mice except the normal group were dripped LPS （5 mg/kg）into the nose to induce ALI model. The apoptosis of neutrophils in BALF was observed by Hoechst 33242 staining；the apoptosis rate of neutrophils were detected by flow cytometry. The contents of IL- 6 and TNF-α in the plasma were detected by ELISA. After wet mass to dry mass （W/D）ratio of lung was E-mail：492234709@qq.com calculated，the morphological characteristics of lung tissue were observed by HE staining. Western blotting assay was used to detect the expression o f TLR 4 and NF-κ B in lung tissue. RESULTS ：In normal group ，there were few apoptotic neutrophils in the BALF ，and the lung tissue structure was intact ， without edema，hyperemia，exudation，inflammatory cell infiltration or other inflammatory manifestations. In model group ，the number of apoptotic neutrophils in BALF increased ，and the apoptotic rate of neutrophils were enhanced significantly （P＜0.01）； edema and hyperemia of lung tissue were significantly increased ，and the red consolidation area was observed ；the contents of IL- 6 and TNF-α in plasma，the ratio of lung W/D，the relative expression of TLR 4 and NF-κB in lung tissue were significantly increased （P＜0.01）. Compared with model group ，the number of apoptotic neutrophils in BALF were increased ，and the apoptotic rate of neutrophils were enhanced significantly （P＜0.05 or P＜0.01）above symptoms of lung tissue were improved to different extents ； the contents of IL- 6 and TNF-α in plasma，lung W/D ratio as well as relative expression of TLR 4 and NF-κB in lung tissue（except for Res low-dose group ）in administration groups were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS ：Res has a protective effect on ALI model mice ，the mechanism of which may be related to reducing the generation of inflammatory cytokines TNF-α and IL-6 by inhibiting TLR 4/NF-kB expression.

Objective    To compare the 5-year survival rates between two different follow-up patterns of postoperative stage Ⅰ-ⅢA non-small cell lung cancer (NSCLC) patients. Methods    Pathological stage Ⅰ-ⅢA NSCLC 11 958 patients who underwent surgical resection and received follow-up within 6 months after initial diagnosis through telephone follow-up system were included in nine hospitals from July 2014 to July 2020. The patients were divided into two groups including a proactive follow-up group (n=3 825) and a passive follow-up group (n=8 133) according to the way of following-up. There were 6 939 males and 5 019 females aged 59.8±9.5 years. The Kaplan-Meier and Cox proportional hazards regression model were used. Results    The median follow-up frequency was 8.0 times in the proactive follow-up group and 7.0 times in the passive follow-up group. The median call duration was 3.77 minutes in the proactive follow-up group and 3.58 minutes in the passive follow-up group. The 5-year survival rate was 81.8% and 74.2% (HR=0.60, 95CI 0.53-0.67, P<0.001) in the proactive follow-up group and the passive follow-up group, respectively. Multivariate analysis showed that follow-up pattern, age, gender and operation mode were independent prognostic factors, and the results were consistent in all subgroups stratified by clinical stages. Conclusion    The proactive follow-up leads to better overall survival for resected stage Ⅰ-ⅢA NSCLC patients, especially in the stage ⅢA.

Objective To explore the risk factors for postoperative respiratory failure (RF) in patients with esophageal cancer, construct a predictive model based on the least absolute shrinkage and selection operator (LASSO)-logistic regression, and visualize the constructed model. Methods A retrospective analysis was conducted on patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic Surgery, Sun Yat-sen University Cancer Center Gansu Hospital from 2020 to 2023. Patients were divided into a RF group and a non-RF (NRF) group according to whether RF occurred after surgery. Clinical data of the two groups were collected, and LASSO-logistic regression was used to optimize feature selection and construct the predictive model. The model was internally validated by repeated sampling 1000 times based on the Bootstrap method. Results A total of 217 patients were included, among which 24 were in the RF group, including 22 males and 2 females, with an average age of (63.33±9.10) years; 193 were in the NRF group, including 161 males and 32 females, with an average age of (62.14±8.44) years. LASSO-logistic regression analysis showed that the percentage of forced expiratory volume in one second/forced vital capacity (FEV1/FVC) to predicted value (FEV1/FVC%pred) [OR=0.944, 95%CI (0.897, 0.993), P=0.026], postoperative anastomotic fistula [OR=4.106, 95%CI (1.457, 11.575), P=0.008], and postoperative lung infection [OR=3.776, 95%CI (1.373, 10.388), P=0.010] were risk factors for postoperative RF in patients with esophageal cancer. Based on the above risk factors, a predictive model was constructed, with an area under the receiver operating characteristic curve of 0.819 [95%CI (0.737, 0.901)]. The Hosmer-Lemeshow test for the calibration curve showed that the model had good goodness of fit (P=0.527). The decision curve showed that the model had good clinical net benefit when the threshold probability was between 5% and 50%. Conclusion FEV1/FVC%pred, postoperative anastomotic fistula, and postoperative lung infection are risk factors for postoperative RF in patients with esophageal cancer. The predictive model constructed based on LASSO-logistic regression analysis is expected to help medical staff screen high-risk patients for early individualized intervention.