Fast-track surgery (FTS) protocols was introduced to reduce surgical stress and facilitate postoperative recovery.It has been more than 20 years since it had been proposed and it was successfully used in many special subjects such as orthopedic,upper gastrointestinal,gynecological,thoracic,vascular,endocrine et al,but the implication in radical cystectomy was insufficient.The propose of this article was to summarize the implication of FTS in radical cystectomy and to promote the development of the protocol in radical cystectomy.

20% ) were assigned to 2 groups according to study intervention: group A ( n =72) receiving DFPP and group B ( n =41) as controls.Group A was subdivided into 2 groups:group A1 ( n =44) was treated by DFPP alone and group A2 ( n =28) was treated by DFPP plus Dac.The incidence rates of HAR,AR,adverse reaction,patie nt/kidney survival,kidney function were observed. All the patients obtained a fo llow-up ≥12 months. Results In 72 patients of group A ,the level of PRA decreased from (60.5?17.7)% to (19.3?11.2)%,with a mean of (41.2?16.9)% ( P 0.05),with 1 kidney-year survival of 94.4% in group A and 78.0 % in group B ( P 0.05);those of AR were 36.4% and 14.3%,respectively ( P 0.05).No difference in infection episodes an d adverse events between group A and PRA-negative recipients, the same as those between group A1 and A2. Conclusions DFPP can decrease the level of PRA significantly before transplantation by selectively eliminating the sensitive antibody,especially when combined with Dac,which can make sensiti zed recipients get the chance of transplanting and further reduce the incidence of AR.The patient/kidney survival rates of 1 year are satisfactory.Being well to lerated by the sensitized patients,treatment of DFPP combined with Dac is safe a nd effective.

Objective To study the indication and means in dissection lymph nodes of the No.10 and No.11 without splenectomy in radical gastrectomy for gastric cancer. Methods According to the location, type of pathology, clinical and pathological classification, lymphatic drainage and spread of gastric carcinoma togather with the immunological function of spleen, selection of operative procedure without splenectomy should be considered, so the related literatures were reviewed. Results Retained spleen had been shown to improve 5 year survival of patients with gastric cancer of stage Ⅰ,Ⅱ and Ⅲ,splenectomy had been shown to improve 5 year survival of patients with gastric cancer of stage Ⅳ,whose carcinoma was infiltrating splenic and the lymph nodes of the No.10. The complications of different means of dissection of the lymph nodes made no difference.Conclusion Dissection of the lymph node without retained spleen or allogenic spleen transplantation is indicated for the patients with cancer of stage Ⅳ,whose spleen is invaded by the tumor.

Objective To observe the effect and safety of Ginkgo biloba extract (EGb) in patients with chronic allograft nephropathy (CAN),and to study the clinical protective mechanism of EGb.Method A prospective,non-randomized,controlled study was conducted on 103 cases of CAN from March 2013 to March 2015.All patients were divided into experimental group (group A,53 cases) and control group (group B,50 cases).The group A was treated with EGb.Patients were followed up for at least 6 months.Before and after treatment,the changes in renal hemodynamic parameters were observed.The biochemical parameters were also observed,including 24-h urinary protein,urinary albumin,serum creatinine (Scr),triglyceride (TG),total cholesterol (TC),estimated glomerular filtration rate (eGFR),platelet count (PLT),fibrinogen (FIB),D-dimer (DD),activated partial thromboplastin time (APTT).The clinical efficacy and safety were analyzed.Result (1) Therewere no significant differences in clinical and biochemical parameters between the two groups before treatment (P＞0.05).(2) After treatment,the systolic peak flow velocity (Vmax) of segmental artery and arcuate artery in the experimental group was significantly higher than in the control group,and the resistance index (RI) in the experimental group was significantly lower than that in the control group,P＜0.05.(3) In both two groups,the 24-h urinary protein,urinaryalbumin,TG,TC and Scr were decreased after treatment (P＜0.05),and eGFR was elevated (P＜0.05).Moreover,the changes in 24-h urinary protein and urinary albumin in the experimental group were more significant than the control group after treatment (P＜0.05).(3) PLT,FIB and DD in experimental group were significantly decreased after treatment,and APTT was increased significantly (P＜0.05).PLT,FIB,DD and APTT had significant change after treatment in the experimental group as compared with control group.(4) There were no significant differences in adverse reactions between two groups (x2 =0.047,P =0.828).Conclusion The therapy of EGb in patients with CAN could reduce urinary protein and improve hypercoagulable state,and had few adverse reaction with good security.

ObjectiveTo evaluate the reliability of the Cybex 6000 isokinetic dynamometer in measuring the shoulder extensor contracted concentrically and eccentrically.Methods15 male subjects with no previous shoulder injuries were studied. The extensor muscles groups of asymmetrical shoulder were tested at 60°/s, 120°/s, and 180°/s respectively. Variables studied included peak torque (PT), average power (AP) and total work (TW). The interclass correlation coefficient (ICC) was used to determine the reliability.ResultsHigh test-retest reliability, ICC ranging from 0.86 to 0.97, was demonstrated for all tests.ConclusionThe Cybex 6000 isokinetic dynamometer shows a good reliability in measuring the shoulder extensor isokinetic contracted concentrically and eccentrically.

Objective To evaluate the value of the thumper cardiopulmonary resuscitator in the emergency cardiopulmonary resuscitation(CPR).Methods Fifty cardiac mspiratory sudden stop patients with thumper cardiopulmonary resuscitator from January 2004 to December 2007 were recruited into treatment group,and 80 cardiac respiratory sudden stop patients with barehanded CPR from May 2000 to December 2003 were recruited into control group.The SBP and blood oxygen saturation 5 to 10 minutes after the resuscitation was compared.The rate of restoration of spontaneous circulation(ROSC),hospitalization and the complication in the two groups was compared.Results The treatment group was better than the control group in improving the SBP and blood oxygen saturation(P＜0.05).The rates of ROSC and hospitalization in the treatment group were higher than those in the control group(44%,40%and 25%,21%).P＜0.05.The rate of complications had no significant difference between the two groups.Conclusions Thumper cardiopulmonary resuscitator Can surmount the factors of medical staff or patients.It can make the CPR more standard andmore effective.MeanwhileitCan raisethe SBP,strokevolume and blood supplv to the heart and brain,and then mcrease the successful rate of CPR.

Autologous red blood cells (RBC) labeled with fluorescence were immitted into microvessel of SD rat and observed under microscope. The movement of each individual labeled RBC was recorded by microscope video camera system. The recorded videotape is replayed to sample dark background fluorescent images through frame grabber. Sampled frame images were separated into odd and even field sequence images. Then these sequence images were analyzed to get the flow rate. The error between the actual flow velocity value and the flow velocity value of fluorescent globules in the chamber measured under the same system was below 7%. The upper limit was 9.6 mm/s. There are no obvious differences (P > 0.05). This system has been applied in the research of rat microcirculatory disturbance, and the temporal flow rate change in microvessel was obtained.
Animals ; Blood Flow Velocity ; physiology ; Image Processing, Computer-Assisted ; Microcirculation ; physiology ; Microscopy, Fluorescence ; Rats ; Rats, Sprague-Dawley ; Splanchnic Circulation ; physiology ; Videotape Recording

Objective To study the effects of CYP3A5 * 1 and CYP3A5 * 3 genotypes on tacrolimus dose requirement.Method We tested archival peripheral blood of 69 kidney recipients for CYP3A5 genotyping by polymerase chain reaction.The dose,blood concentrations and dose-normalized blood concentrations of tacrolimus were measured at 1st and 2nd month after the renal transplantation.Result There were 6 cases of CYP3A5 * 1/* 1 (8.7％),22 cases of CYP3A5 * 1/* 3 (31.9％),and 41 cases of CYP3A5 * 3/* 3 (59.4％).At 1st and 2nd month after the renal transplantation,the carriers of CYP3A5 * 1 genotype had a higher mean tacrolimus dose than CYP3A5 * 3/* 3 genotye (both P＜0.000 1),and those of CYP3A5 * 1 genotype had lower mean tacrolimus concentrations than CYP3A5 * 3/* 3 genotye (P=0.020 8,and P =0.019 1 respectively).Meanwhile,the carriers of CYP3A5 * 1 genotype had lower dose-normalized blood concentrations of tacrolimus than CYP3A5 * 3/* 3 genotye (P＜0.000 1) at 1st month after the renal transplantation,as well as at 2nd month after the renal transplantation (P =0.0191).Hepatic and renal function showed no significant effect on tacrolimus dose adjusted concentration at 1st and 2nd month after transplantation.Gender did not show a significant impact on tacrolimus dose.Conclusion CYP3A5 * 1 carriers needhigher tacrolimus dose than CYP3A5 * 3 homozygote to achieve the target blood concentration.CYP3A5 genotyping is a new approach for detecting tacrolimus dose requirement in kidney recipients.

Objective To investigate the biological effect of anti-leukemic cells induced by eosinophilic granulocyte (EOS) in bone marrow of patients with chronic myelogenous leukemia (CML).Methods The BCR-ABL fusion gene as well as the expression of IL-12 and IL-17 mRNA were performed by RT-PCR.The serum concentrations of cytokine IL-12 and IL-17 were determined by enzyme-linked immuno sorbent assay (ELISA).Immunochemistry staining and cytochemistry staining were used to observe the peroxydase (POX) and human Leukocyte antigen (HLA)-DR expression of EOS in bone marrow.Immunofluorescence staining was used to observe mannose receptor (MR),IL-12,IL-17A and IL-17receptor A (IL-17RA) expression of EOS.The results between the CML patients and the healthy controls were compared.Results Serum levels of IL-12 and IL-17 were higher in the 60 CML patients [(196.33 ±21.79) ng/L and (36.55-±3.01) ng/L] than those in the controls [(96.60 ±4.92) ng/L and (23.74 ±1.36) ng/L].In the 32 patients with activated EOS,the levels of IL-12 and IL-17 were (273.12 ± 17.16)ng/L and (40.11 ± 6.13) ng/L,which were significantly higher than those in the non-activated EOS [(126.16 ± 14.27) ng/L and (28.14 ±5.29) ng/L] (P values ＜0.01).IL-12 and IL-17 mRNA were expressed in activated EOS,while BCR-ABL fusion gene was not found.The amounts of EOS were increased abnormally in the bone marrow and peripheral blood of the CML patients with POX positive staining in the cytoplasm and weakly positive HLA-DR staining.It was observed easily by a microscope that EOS could attack leukemic cells in bone marrow through adhesion,capture and phagocytosis.Activated EOS could express IL-12,IL-17A and MR,which was related with the serum levels of these cytokines.Conclusions Activated EOS in bone marrow of CML patients could express IL-12 and IL-17.Activated EOS could induce coup injury to leukemic cell by releasing POX and expressing IL-12 and IL-17.It can also capture or swallow target cells via the expression of MR on the membrane.EOS may play an important role in the anti-tumor immunologic function in bone marrow of CML patients.

Objective To compare the long-term effectiveness of anti-interleukin-2 receptor antibodies vs.rabbit antithymocyte globulin as induction therapy in kidney transplantation.Methods Between 2006 and 2010,371 recipients of kidney transplants were treated with calcineurin inhibitors (CNI),mycophenolate mofetil and prednisone.261 patients of them received induction therapy with anti-interleukin-2 receptor antibodies (IL2Ra group),and 88 patients received rabbit antithymocyte globulin (rATG group).All the patients received ganciclovir against cytomegalovirus and SMZ against pneumocystis carinii.The data of delayed graft function (DGF),the rate of acute rejectin (AR) and infection in the first year and patient/allograft long survival rate in two groups were retrospectively analyzed during a follow-up period of 1 to 5 years postoperatively.Results There was no significant difference in the sex,age and causes of end-stage renal disease between the two groups.The rATG group had more kidney transplants from deceased donors (P＜0.01 ) and the cold ischemia time was longer than that of the IL2Ra group (P＜0.01 ).The IL2Ra group and the rATG group had similar incidence of DGF (3.1％ vs.1.8％,P＞0.05).One year after operation,the incidence of AR in IL2Ra group and rATG group was 10.7％ and 2.7％ respectively (P＜0.05),and the incidence of infection in IL2Ra group and rATG group was 14.9％ and 21.8％ respectively (P＞0.05).One-,two- and three-year patient survival rate in IL2Ra group was 98.9％,98.9％ and 98.5％ respectively,and that in rATG group was all 98.2％ (P＞0.05).The one-,two- and three-year allograft survival rate in IL2Ra group was 98.5％,98.1％ and 97.7％ respectively,and that in rATG group was all 97.3％ (P＞0.05).Conclusion rATG is more effective than IL2Ra preventing from acute rejection and does not increase the risk of infection for induction in kidney transplant recipients.