Objective To study the relationship between the level of homocysteine(HCY)and platelet and acute cerebral diseases in young/middle-aged.Methods HCY,plat from 82 cases with plate manyfold,48 cases with acute cerebral diseases in young/middle-aged,36 cases without syndrom,other 30 cases were healthy.The results were compared and analyzed.Results HCY from acute cerebral disease in young/middle-aged significant increase comparing with without syndrome and healthy(P

Objective:To research PHA-CIK cells' phenotype and cytotoxicity. Methods: Using phytohemagglutinin(PHA)to stimulate peripheral blood mononuclear cells(PBMNCs) for 24 h,then cultured like incubating cytokine induced killers by traditional method. On 15th day examined its immunophenotype by flow cytometry and using MTT method to evaluate cytotoxicity. Results: The ratio of CD3+,CD8+, CD3+ CD8+ and CD3+ CD56+ cells were high.PHA-CK cells cytotoxicity was strong in some degree.Conclusion:PHA-CIK cells had strong cytotoxicity.The result provides an experimental basis for biotherapy.

Objective To investigate the different responses of diaphragm and peripheral muscles to cisatracurium in rabbits.Methods 8 male New zealand rabbits were anaesthetized with pentobarbital,and then the diaphragm,tibialis anterior,soleus muscles,phrenic nerves,tibial nerve,and peroneal nerve were gently freeded.The muscles were secured to force displacement transducers,and the nerves were directly stimulated by electrodes with supramaximal square waves.The isometric force of twitch tention of each muscle was recorded.The cumulative dose-response technique was separately used for obtaining the ED50and ED95 values of the cisatracurium in each muscle.Results The muscle-relaxing of cisatracurium on the three muscles in were observed in a dose-dependent manner.The ED50 values and ED95 values were: diaphragm(39.3 ± 2.5)μg/kg and(75.7 ± 4.2)μg/kg,tibialis anterior(80.6 ± 7.5)μg/kg and(123.3 ±9.3)μg/kg,soleus(80.0 ± 7.1)μg/kg and(126.9 ± 9.4)μg/kg,respectively.It had significant difference between diaphragm vs tibialis or soleus,P ＜ 0.05.Conclusions The muscle relaxant effects of cisatracurium on diaphragm and peripheral muscles were different,and diaphragm was more sensitive than peripheral muscles.

Objective To study the clinical efficacy of laparoscopic retroperitoneal lymph node dissection (LRPLND) for stage Ⅱ nonseminomatous testicular cancer. Methods Seven patients (mean ages 28 years, 4 had the tumors on the left side and 3 on the right) underwent LRPLND during 1 to 4 weeks after orchiectomy for clinical stage Ⅱ nonseminomatous testicular cancer. The dissection-al boundaries included the ipsilateral ureter laterally, the renal vessels superiorly, abdominal aorta and the bifurcation of the iliac artery inferiorly. The operative time, intraoperative blood loss, intra-or postoperative complications, tumor markers and ejaculation were observed. Results LRPLND was completed in all patients. Operative time ranged from 140 to 220 min (mean 180 min). Intraoperative blood loss ranged from 80 to 127 ml (mean 95 ml) and no transfusions were required. No intra- or postoperative complications occurred because of the procedure. At 2 weeks after operation, serum al-pha fetoprotein decreased from (15 to 1247 μg/L) to (2 to 8 μg/L), and beta human chorionic gona-dotropin decreased from (5 to 59 μg/L) to (0.5 to 2.5 μg/L). All patients recovered ejaculation dur-ing 10 to 12 weeks after operation. After a mean follow-up period of 21 months (range 12 to 26), no disease recurrence or metastasis was observed. Conclusion LRPLND is a safe, effective, minimally invasive procedure in the management of stage Ⅱ nonseminomatous testicular cancer patients.

Field operations,work and war on plateau is an important part of future war. It is necessary to study the early treatment and evacuation of scull injury. Research and survey were made in 7 field hospitals and hundreds of records were summaried before treatment criterion in early phase was put forward for patients on plateau as well as the evacuation in different level and stage,which aims to actively save patients' lives within limited time and reduce the death rate and prevent deformity. References are provided for war,training,and construction in battlefield.

ObjectiveTo systematically review the efficacy and safety of norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of type 1 hepatorenal syndrome (HRS1). MethodsPubMed, EMBASE, Medline, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for comparative studies on norepinephrine combined with albumin versus terlipressin combined with albumin in the treatment of HRS1. Quality assessment was performed for articles. Related indicators were extracted, including hepatorenal syndrome (HRS) reversal rate, mortality rate, incidence of adverse events, mean arterial pressure, and renal function, and Review Manager 5.3 was used for data analysis. The chi-square test was used to determine the heterogeneity between studies. Odds ratio (OR) was used for the analysis of dichotomous variables, weighted mean difference (WMD) was used for the analysis of continuous variables, and 95% confidence interval (CI) was calculated for these two types of variables. ResultsA total of 6 randomized controlled trials which met the inclusion criteria were included, with a total sample size of 298 patients (149 patients in the norepinephrine+albumin group and 149 in the terlipressin+albumin group). The meta-analysis showed that there were no significant differences between the two groups in HRS reversal rate (OR=0.95, 95%CI: 0.6-1.49, P=0.81), mortality rate (OR=0.84, 95%CI: 0.51-1.41, P=0.51), incidence rate of adverse events (OR=042, 95%CI: 0.16-1.07, P=0.07), mean arterial pressure (standardized mean difference=0.05, 95%CI: -0.92 to 1.03, P=092), and renal function. ConclusionNorepinephrine combined with albumin has similar efficacy and safety as terlipressin combined with albumin in the treatment of HRS1, and terlipressin can be replaced by norepinephrine in clinical practice when necessary.

Objective To evaluate the safety and efficacy of ex vivo ureteroscopy (ExURS) as means of rendering a donated kidney stone-free in a living related renal transplantation.Methods Clinical data were analysed of ExURS as means of rendering a donated kidney stone-free in a living related renal transplantation and relative literature was reviewed.The ECT results showed that GFR of left and right kidney was 38.7 and 42.3 ml/min respectively.The donor underwent a left laparoscopic donor nephrectomy.Immediately after cold perfusion,ExURS was performed with 4 ℃ ice-cold saline irrigation.Basket extraction and holmium laser lithotripsy was performed.Calculi were fragmented with pneumatic intracorporeal lithotripsy and fragments were removed with forceps.F6 indwelling ureteral stents were kept during transplantation.Urine flowed out immediately after reperfusion of the allograft and the distal ureter appeared edema 2 min later.Routine ureter-bladder wall anti-reflux replantation was done after the resection of the edema part.Results Pyeloscopy was successfully performed.A total of 2 calculi,diameter 8,12 mm,were visualized in donor kidney.The ex vivo treatment time was 30 nin.The warm and cold ischenia time was 60s and 50 min,respectively.There were no intraoperative complications.At a follow-up at 8 months,there was no recurrent calculi formation in the recipient and donor.Conclusion ExURS is technically feasible to render a stone-bearing kidney stone free without compromising ureteral integrity or renal allograft function.

Objective To observe the proliferation ability of cocultured dendritic cells(DCs)loaded with tumor antigen and cytokine-induced killer cells( CIKs)and its killing effect on hepatocarcinoma cells HepG2. Methods The antigen of hepatocarcinoma cells HepG2 was prepared by repeated freezing and thawing of liquid nitrogen. Peripheral blood mononuclear cells(PBMNCs)were isolated from healthy donors by blood cell separator,then DCs and CIKs were induced. Ag-DCs were obtained by impinging DCs with tumor antigens. CIKs were divided into three groups:the first group was CIKs alone,the second group was mixed in the propor-tion of DCs : CIKs = 1 : 5,and the third group was mixed in the proportion of Ag-DCs : CIKs = 1 : 5. The three groups of cells were recorded as CIK group,DC-CIK group and Ag-DC-CIK group. The proliferation and cell phenotype of the three groups of cells were observed and the killing effects on hepatocarcinoma cells HepG2 were detected by methyl thiazolyl tetrazolium(MTT)assay. Results The proliferation multiples of the three groups of cells were gradually increased with the prolongation of culture time,and the proliferation rates of Ag-DC-CIK on the 9th day(61. 32 ± 1. 72),the 12th day(190. 83 ± 3. 53)and the 15th day(399. 09 ± 5. 60) were significantly higher than those of CIK group(22. 47 ± 2. 07,55. 91 ± 1. 81,83. 20 ± 2. 34)and DC-CIK group(40. 26 ±2. 49,125. 03 ±4. 16,251. 55 ±3. 25),and the difference between the three group was statisti-cally significant(F =185. 78,P =0. 033;F = 297. 35,P = 0. 018;F = 455. 37,P < 0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). The cytotoxicity of Ag-DC-CIK to HepG2 cells at the effective target ratios of 5 : 1(31. 71％ ±0. 29％ ),10 : 1(42. 43％ ±1. 86％ )and 20 : 1 (57. 69％ ±1. 11％ )were significantly higher than those of CIK group(12. 11％ ±1. 14％ ,21. 30％ ±0. 52％ , 30. 71％ ±1. 26％ )and DC-CIK group(20. 06％ ± 0. 67％ ,29. 89％ ± 1. 37％ ,39. 11％ ± 0. 92％ ),and the difference between the three group was statistically significant(F =159. 64,P =0. 037;F =199. 36,P =0. 025;F =302. 08,P <0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). On the 15th day of cell culture,the flow cytometry analysis showed that all the three groups were expressed CD3 + CD8 + ,CD3 + CD56 + double positive cells,the contents of CD3 + CD8 + 、CD3 + CD56 + double positive cells in the Ag-DC-CIK group(88. 12％ ± 1. 24％ ,61. 35％ ± 2. 63％ )were significantly higher than those in the CIK group(54. 37％ ± 3. 08％ ,18. 22％ ± 1. 83％ )and DC-CIK group(69. 80％ ± 1. 46％ , 39. 51％ ±2. 17％ ),and the difference between the three group was statistically significant(F = 414. 32,P <0. 001;F =378. 60,P <0. 001),in addition,the differences between each two groups were statistically signifi-cant(all P <0. 001). Conclusion The proliferation ability and killing effect of Ag-DC-CIK that obtained from antigen-pulsed DCs co-cultured with CIKs are significantly higher than those of CIKs and DC-CIKs.

Objective:To investigate the correlations of human leukocyte antigen (HLA)-A, B, C, and DRB1 genotypes with cross-reactivity caused by aromatic antiepileptic-drugs.Methods:A case-control association study was carried out on subjects who accepted treatments/physical examination in our hospitals from September 2016 and September 2020; 31 patients with aromatic antiepileptic drugs (carbamazepine, phenytoin, oxcarbazepine, lamotrigine and phenobarbital)-induced cross-reactivity were enrolled as patient group, 52 tolerant subjects who took the 5 antiepileptic drugs for more than 3 months without cross-reactivity were chosen as tolerant control group, and 500 healthy volunteers were recruited as normal control group. The ethnicity of all patients and controls was Han Chinese. High-resolution genotyping was performed to compare the HLA-A, B, C, and DRB1 genotypes in subjects of the 3 groups. χ2 test or Fisher's exact test were used to analyze the correlations of HLA genes with cross-reactivity caused by aromatic antiepileptic-drugs. Results:The presence of HLA-B*13:01 genotype in the patient group, the tolerant control group, and the normal control group was 45.2% (14/31), 15.4% (8/52) and 14.6% (73/500), respectively. The presence of HLA-B*13:01 genotype in the patient group was significantly higher as compared with that in the tolerant control group and normal control group ( Pc<0.017). No other HLA genotypes were found to be associated with cross-reactivity caused by aromatic antiepileptic-drugs. Conclusion:HLA-B*13:01 is the risk genotype for cross-reactivity caused by aromatic antiepileptic-drugs.

[Abstact] Objective To investigate the efficacy and safety of sunitinib as first line therapy in treating those patients with metastatic renal cell carcinoma ( mRCC ) .Methods A total of 66 patients , including 42 male and 24 female cases ,with metastatic renal cell carcinoma were enrolled from January 2009 to June 2014.The median age was 52 years (range 26-75 years).According to American Joint Committee On Cancer (AJCC) staging,there were 35 cases of T3 stage,31 cases of T4 stage.All patients had distant metastasis ,including single organ metastasis in 52 patients and multiple organ metastasis in 14 cases.Sixty-one patients received prior radical nephrectomy ,5 patients received biopsy .Sixty-two patients were diagnosed as renal clear cell carcinoma and 4 patients were diagnosed as renal papillary cell carcinoma .Sunitinib was administered in standard 4/2 regimens.Briefly, patient takes 50 mg once a day orally for 4 weeks.Then the sunitinib will be stopped for 2 weeks.Six weeks was defined as 1 cycle.It should be continued until disease progression or occurrence of intolerable adverse reactions .The efficacy of sunitinib should be evaluated within 2 cycles.Results The duration of following-up ranged from 5 to 66 months.The efficacy could be evaluated in 63 patients.Two patients ( 3.2%) achieved complete remission .Twelve patients ( 19.0%) achieved partial remission.Forty-five patients (71.4%) demonstrated stable disease and 4 patients (6.3%)
developed progressive disease .The disease control rate was 93.7%(59/63) and the objective response rate was 22.2%(14/63).2 (3.2%) patients died due to the progression of disease .The most commonⅠ-Ⅱadverse events included fatigue in 36 cases ( 57.1%) , thrombocytopenia in 36 cases ( 57.1%) , hand-foot syndrome in 32 cases (50.8%),hypertension in 27 cases (42.9%),neutropenia in 15 cases (23.8%), hypothyroidism in 12 cases (19.0%), diarrhea in 6 cases (9.5%) and alopecia in 4 cases (6.3%).Ⅲ-Ⅳ adverse events were hand-foot syndrome in 4 cases ( 6.3%) , hypertension in 2 cases ( 3.2%) , neutropenia in 5 cases (7.9%) and thrombocytopenia in 5 cases (7.9%).Most mild adverse reactions after symptomatic treatment could be alleviated ,did not affect the medication .When the adverse events returned to the Ⅰ-Ⅱdegree, the 37.5 mg sunitinib was resumed once daily by orally.NoⅢ-Ⅳadverse events were reported again.Conclusions Sunitinib was efficacious in the treatment of advanced renal cell carcinoma.Most mild adverse events were tolerable ,and severe adverse events need medical treatment .