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.

Five genes that are closely related with leukemia were detected and identified using COREMINE Medi-cal, and the abstracts of related papers covered in PubMed were analyzed with the biomedical text mining tool, Chilibot, which showed that leukemia interacts with the 5 genes detected using COREMINE Medical.

Objective To study the gene expression and the expression change rule of c-fos in the canines posterior to craniocerebral gunshot wounds in order to provide the experimental base for further understanding of the mechanism of gunshot craniocerebral injury. Methods Using the canine model of penetrating craniocerebral injury made by the bullets of the small-calibre rifle made in Germany, the c-fos expressions in the control cerebral tissues and the contusion and concussion areas of the trajectory and the brain stem neurons at different time points after trauma were observed by immunohistochemical method. Results Feeble c-fos expression was detected in the control group. After craniocerebral gunshot wounds, the c-fos expression increased in the contusion and concussion areas of the trajectory and in the brain stem at the 30th minutes, reached the peak at the 2nd hour and began to decrease at the 3rd hour. The c-fos expression in the concussion area was much more significant than that in the contusion area ( P

Objective To study the change in blood-brain barrier (BBB) permeability in dog with craniocerebral gunshot injury and its significance. Methods Twelve dogs were randomly divided into control group, 15min ofter penetrating craniocerebral injury (PCI) group, 1h after PCI group and 6h after PCI group (n=3). The injury was produced by a small-calibre rifle made in Germany (type 5.56mm, weight of bullet 2.57g). Lanthanum nitrate was infused through the heart. The changes in BBB permeability were observed under electronic microscope. Results In 15min PCI group and 1h PCI group, changes in BBB permeability was observed, with manifestation of opening of tight junctions, with lanthanum nitrate particles passing through BBB into the brain tissues. These changes were more marked in 1h PCI group. Comparing with the above two groups, even more lanthanum nitrate particles were found in the brain tissue in the 6h group (P

OBJECTIVE:To provide some references for rational application of intravenous infusion drugs to ensure the safety of drug use. METHODS:Statistical analysis was made to irrational prescriptions intercepted by the pharmacy intravenous admixture service of our hospital from 2009 to 2013. RESULTS:There were 5,802 groups of irrational prescriptions from 2009 to 2013,accounting for 0.12% of total prescriptions. For the irrationality,the top three reasons were improper solvent dosage, drug overdose and improper solvent selection in order,and the involved types of drugs were mainly antimicrobial agents,anti-neoplastic drugs,common drugs and parenteral nutrition drugs (arranged from more to less). Under the pharmacist’s interven-tion,the percentage of irrational prescriptions of intravenous drugs reduced from 0.169 4% in 2009 to 0.082 8% in 2013. The decrease in the irrational prescriptions involving with improper administration was the most significant,followed by those related to drug overdose,frequency,prescribing errors errors improper solvent dosage,incompatibility and improper solvent. CONCLU-SIONS:Pharmacists’intervention can effectively reduce the irrational prescriptions and significantly promote rational use of in-travenous drugs.

Objective To explore the effect of uric acid (UA) on the rat glomerular mesangial cells (GMCs) and its possible mechanism in vitro. Methods Cultured rat GMCs were treated with various concentrations of UA (50 μmol/L, 100 μmol/L, 300 μmol/L) in the presence or absence of U0126, apocynin, rotenone. The incorporation of 3H-thymidine (3H-TdR) and cell counting were used to measure GMCs proliferation. GMCs cell-cycle was analyzed by flow cytometry. CyclinD1 and cyclin A2 expression were determined by real-time PCR and Western blotting analysis. ERK1/2 phosphorylation was detected by Western blotting. Reactive oxygen species (ROS) was measured by 2, 7-dichlorofluorescein diacetate (DCFDA) fluorescence. Results (1) Uric acid increased GMCs proliferation in dose-dependent manner compared with the control groups, as assessed by 3H-TdR incorporation and cell counting. GMCs proliferation induced by 300 μmol/L uric acid was increased by more than 1.5-fold assessed by both of the methods. (2) Uric acid decreased cell number in G1/G0 phase and increased cell number in S phase in dosedependent manner, as assessed by flow cytometry. (3) Uric acid iuduced cyclin D1 and cyclin A2 expression in dose-dependent manner. (4)Uric acid increased pospho-ERK1/2 in dose-dependent manner and ERK1/2 specific inhibitor U0126 could suppress uric acid-induced cell proliferation.The inhibition percentage of U0126 was 22% and 31% assassed by cell counting and 3H-TdR incorporation, respectively. (5) Uric acid increased ROS production in dose-dependent manner.NADPH oxidase inhibitor apocynin could also significantly inhibit uric acid-induced ROS production, ERK phosphorylation and cell proliferation. In contrast, rotenone had no effect on them.Conclusion Uric acid can stimulate rat GMCs proliferation, partially by the activation of ERK pathway via NADPH oxidase-derived ROS generation.

Objective To translate the English version of Safety Attitudes Questionnaire (SAQ) into Chinese,and to test the reliability and validity of the Chinese version of SAQ. Methods The SAQ was developed into Chinese version through translation, back-translation and cross-culture adaption. The reliability and validity of the Chinese version of SAQ were tested in 823 first-line nurse managers in Henan. Results The scale content validity index was 0.90 of the Chinese SAQ, and the item content validity index ranged from 0.83 to 0.96. The correlations between the items and the full scale, the dimensions and the full scale separately ranged from 0.32 to 0.64 and 0.50 to 0.81 (P<0.01). The confirmatory factor analysis resulted in a good model fit for the six dimensions and the full construct, the goodness-of-fit index was 0.96, Tucker-Lewis index was 0.93, comparative fit index was 0.95, and root mean square error of approximation was 0.06. The Cronbach alpha coefficient for the scale was 0.913 and for the six dimensions were 0.565, 0.655, 0.825, 0.804, 0.880, 0.725 separately, the test-retest reliability coefficient was 0.934. Conclusions The Chinese version of SAQ is a valid and reliable tool to assess the safety culture of first-line nurse managers in Chinese hospitals.

Objective To explore expression of plexinA1 and Ki-67 in tissue of human brain glioma cells and their clinical significance.Methods 43 specimens from patients with brain glioma were collected.Immunohistochemical (IHC) staining was used for detecting the expression of tissue plexinA1 and Ki-67 in human glioma cells of 43 cases of patients with brain glioma.The positive expression rate of plexinA1 and Ki-67 among the different pathological grade tissues and their clinical significance were analyzed.So did correlation studies about plexinA1 and Ki-67.Results The positive expression rates of plexinA1 in Ⅰ-Ⅱ grade group (18 cases) and Ⅲ-Ⅳ grade group (25 cases) were 22.22 ％ (4/18) and 72.00 ％ (18/25) (P ＜ 0.05).The positive expression rates of Ki-67 in Ⅰ-Ⅱ grade group and Ⅲ-Ⅳ grade group were 16.67 ％ (3/18) and 56.00 ％ (14/25),respectively (P ＜ 0.05).PlxinA1 and Ki-67 expression in the tissue of human brain glioma were positively correlated (r =0.997,P ＜ 0.05).Conclusions The positive expression rate of plexinA1 is higher in high malignancy human glioma group than that in low malignancy group which has an important reference value in the estimation of prognosis for human glioma.PlexinA1 and Ki-67 maybe synergism in occurrence and development of glioma.

Cell viability of Pichia pastoris was detected by flow cytometry (FCM) with two reagents fluorescein diacetate (FDA) and propidium iodide (PI). Compared with FDA/PI double-stained dot plots and PI single-stained dot plots,the latter could divide dead and living cells into two separate zones,and get the correct proportion. Then PI single-stained method was used to detect the change of cell viability in Pichia patoris fermentation. At glycerol batch and fed-batch phase,little dead cells were detected. At methanol fed-batch phase,cell viability decreased when cell weight increased,and was only 73.8% at 88 h.

Objectives To observe the anesthetic effects of an improved anesthetic method on goat by comparing with the original method, and to provide theoretical and practical reference for anesthesia during the establishment of goat models.Methods A total of 72 goats were selected to make tibial fracture models, 36 were enrolled as group A and others as group B.The group A was injected with Sumianxin and diazepam.The group B was injected with Sumianxin, diazepam and pumped propofol by intravenous pump.The times of animal struggle, total dose of additional Sumianxin, death rate, and recovery time were evaluated.Results The death rate of group A was 16.67% and there was no death in the group B.The times of struggle, the total dose of additional Sumianxin and the recovery time of the group A were higher than group B, showing a significant difference (P<0.05).Conclusions The improved anesthetic method can decrease the times of goat struggle times, reduce the dose of anaesthetics, and lower the death rate.