Objective To investigate surgical treatment for tumor involved inferior vena cava at the upper segment of kidney.Methods The clinical data of 35 patients with tumor involved inferior vena cava at the upper segment of kidney who were admitted to Changhai Hospital affiliated to the Second Military Medical University from January 2007 to May 2015 were retrospectively analyzed.All the patients received preoperative imaging examinations to insure the site and range of inferior vena cava involvement at the upper segment of kidney.Renal cell carcinomas with inferior vena cava involvement were found in 19 cases,leiomyosarcomas of inferior vena cava in 5 cases,leiomyomatosis involving inferior vena cava in 3 cases,adrenocortical carcinoma involving inferior vena cava in 3 cases,liver cancer involving inferior vena cava in 2 cases,right adrenal pheochromocytomas in 2 cases,retroperitoneal fibrosarcoma involving inferior vena cava in 1 case.According to tumor involvement types,the different surgical approaches,planes and method of inferior vena cava exclusion,reconstruction method and prevention of tumor embolus detachment were selected.Patients were followed up by outpatient examination and telephone interview till May 2015.Results Among 19 patients with renal cell carcinomas with inferior vena cava involvement,10 patients were placed inferior vena cava filters through internal jugular vein before surgery,10 patients underwent total hepatic vascular exclusion and 9 patients underwent intrahepatic inferior vena cava exclusion.All the 19 patients received tumor resection and inferior vena cava embolectomy.Of the 5 patients with leiomyosar-comas of inferior vena cava,3 patients underwent total hepatic vascular exclusion and 2 patients underwent intrahepatic inferior vena cava exclusion.The diseased segments of 5 patients were resected,including 4 patients of artificial vascular graft and 1 patient complicated with resection of right kidney receiving simple ligation of inferior vena cava and left renal vein at proximal and distal tumors.Of the 3 patients with leiomyomatosis involving inferior vena cava,2 patients received total hepatic vascular exclusion and 1 was treated surgically under cardiopulmonary bypass.All the 3 patients underwent inferior vena cava embolectomy and hysterectomy.Three patients with adrenocortical carcinoma involving inferior vena cava and 2 patients with liver cancer involving inferior vena cava underwent total hepatic vascular exclusion.Among the 5 patients,4 had direct suture after tumor removal combined with partial inferior vena cava resection,and 1 had patch repair after partial inferior vena cava resection.Two patients with right adrenal pheochromocytomas were exposed proximal and distal lifting devices of inferior vena cava without clamp,and the tumors were peeled off completely.Intraoperative death happened in the patient with retroperitoneal fibrosarcoma involving inferior vena cava who was prepared to undergo intrahepatic inferior vena cava exclusion but encountered intraoperative pulmonary embolism due to tumor thrombus shedding.Thirty-four patients of 35 patients underwent operation successfully without serious perioperative complications and a patient died in the perioperative period.The mean operation time,volume of intraoperative blood loss and duration of postoperative hospital stay were 2.8 hours (range,1.5-5.0 hours),2 000 mL (range,400-5 000 mL) and 9.2 days (range,6.0-16.0 days).Thirty-four patients were followed up for a median time of 12 months (range,1-60 months).During the follow-up period,a patient with leiomyosarcomas of inferior vena cava and 2 patients with adrenocortical carcinoma involving inferior vena cava died of tumor recurrence,a patient with liver cancer had tumor recurrence,other patients were tumor-free survival.Conclusions Inferior vena cava at the upper segment of kidney is not contraindication for tumor resection.The appropriate way to expose,clamp and reconstruct are selected to safely remove the tumor based on extension and method of tumor involving inferior vena cava.

Humans ; Poliomyelitis/diagnosis* ; Fractures, Bone ; Lower Extremity ; Spinal Cord Injuries/diagnosis*

Aged ; Aneurysm, Dissecting ; therapy ; Aorta ; Catheterization ; methods ; Humans ; Male

Cell Cycle Checkpoints ; drug effects ; Cell Line, Tumor ; Gene Expression Regulation ; drug effects ; Humans ; NF-kappa B ; metabolism ; Scorpion Venoms ; pharmacology

Calcitonin ; blood ; Fluorine ; adverse effects ; Humans ; Occupational Exposure ; adverse effects ; Osteocalcin ; blood

Animals ; Male ; Organ Size ; Rats ; Rats, Sprague-Dawley ; Spermatozoa ; drug effects ; growth & development ; Testis ; drug effects ; Triazines ; toxicity

Animals ; HSP70 Heat-Shock Proteins ; metabolism ; Male ; Physical Conditioning, Animal ; Physical Endurance ; physiology ; Quadriceps Muscle ; metabolism ; physiology ; Rats ; Rats, Sprague-Dawley ; Vascular Endothelial Growth Factor A ; metabolism

The aim of the present study was to detect the transmission rate of ultrasonic low intensity pulsed ultrasound (LIPUS) through polytetrafluoroethylene (PTFE) membrane (Thickness: 0.01 mm) and Bio-Gide collagen membrane, and to provide the basis for the barrier membrane selection on the study of LIPUS combined with guided tissue regeneration (GTR). The ultrasonic (LIPUS, frequency 1.5 MHz, pulse width 200 micros, repetition rate 1.0 kHz) transmission coefficient of the two kinds of barrier membrane were detected respectively through setting ten groups from 10 to 100mW/cm2 every other 10 mW/cm2. We found in the study that the ultrasonic transmission coefficient through 0.01 mm PTFE membrane was 78.1% to 92.%, and the ultrasonic transmission coefficient through Bio-Gide collagen membrane was 43.9% to 55.8%. The ultrasonic transmission coefficient through PTFE membrane was obviously higher than that through Bio-Gide collagen membrane. The transmission coefficient of the same barrier membrane of the ultrasonic ion was statistically different under different powers (P < 0.05). The results showed that the ultrasonic transmittance rates through both the 0.01 mm PTFE membrane and Bio-Gide collagen membrane were relatively high. We should select barrier membranes based on different experimental needs, and exercise ultrasonic transmission coefficient experiments to ensure effective power.
Biocompatible Materials ; Collagen ; chemistry ; Membranes, Artificial ; Permeability ; Polytetrafluoroethylene ; chemistry ; Ultrasonics

Objective To observe the position and mobility of the tape after tension-free vaginal tape-obturator(TVT-O) surgery using transperineal two and three dimensional ultrasonography in patients with stress urinary incontinence.Methods A total of 32 patients with stress urinary incontinence who had TVT-O surgery and cured were enrolled.Transperineal two and three dimensional ultrasonography were performed after operation 3 months later.Both the position,morphology and mobility of the tape at rest and during Valsalva menuaver were observed.Results The tapes were mainly located in the 1/3 connection of the middle and distal urethra.The length of the urethra and the length of the urethra between the bladder neck and the proximal tape at valsalva menuaver were longer than those at rest.The tapes moved front-down at valsalva manuaver according to the mean distance between the tape and the symphysis pubis.The angles of the tapes were smaller at valsalva manuaver without significant difference.Conclusion It is useful to observe the position,morphology and mobility of the tape using transperineal two and three dimensional ultrasonography.The changes of the position and morphology of the tapes at valsalva menuaver were not significant.But the tapes can strengthen the urine control in the middle of urethra.

Background Human leucocyte antigen (HLA)-B27-associated uveitis is one of the most common causes of non-infectious uveitis.T helper 17 (Th17) cells play an important role in human autoimmune diseases,but the pathology research on the production of Th17 cells in acute anterior uveitis patients positive for HLA-B27 was rarely reported.Objective The aim of this study was to investigate the expression and significance of the peripheral blood T helper cell subsets (Th1,Th2,Th17) in acute anterior uveitis patients positive for HLA-B27.Methods This study meets the criteria of the Helsinki Declaration.Informed consent was obtained from all the participants.A prospective cohort design was used in this study.Twenty-two patients with acute anterior uveitis positive for HLA-B27 were enrolled from Affiliated Second Hospital of Nanjing Medical University,and 16 normal healthy subjects with matched gender and age were enrolled as controls.The expression of interferon-γ (IFN-γ),interleukin-4 (IL-4) and IL-17 on lymphocytes (CD4+) in blood were assessed by flow cytometry,and immunoturbidimetry was used to detect the C reactive protein (CRP) level in blood.The degree of the severity of disease was evaluated by clinical scoring.The correlations between the percentage of IFN-γ+Th1,IL-4+Th2,or IL-17+Th17 with clinical factors and CRP were analyzed.Results The percentages of IFN-γ+Th1 and IL-17+Th17 in the peripheral blood were (23.11 ±9.69) ％ and (3.96±2.92) ％ in the patient group,showing a significant increase in comparison with (16.00±4.26)％ and (1.68±0.60) ％ in the control group (P=0.041,P=0.002).However,the IL-4+Th2 level was not significantly different between the patient group (0.33％ ±0.36％) and the control group (0.56％ ±0.34％) (P=0.122).No significant correlations were found between the percentage of IFN-γ+ Th1 with disease severity and CRP (r =0.197,P =0.500 ; r =0.253,P =0.383),between the percentage of IL-4+ Th2 with disease severity and CRP (r =0.068,P =0.817 ; r =0.439,P =0.116) as well as between the percentage of IL-17 + Th17 with CRP (r =0.226,P =0.436).However,a positive correlation was seen between the percentage of IL-17+ Th17 with disease severity (r =0.805,P =0.001).Conclusions IFN-γ and IL-17 in human CD4+T cells are significantly elevated in the blood of HLA-B27-related acute anterior uveitis patients.Disease severity is associated with the percentage of IL-17 +Th17,suggesting that Th1 cells together with Th17 cells participate in the pathogenesis of the disease and Th17 cells might play a dominant role in the disease.