ObjectiveTo explore the etiology of incision hernia of abdominal wall. Methods 72 cases with incision hernia were analyzed retrospectively in types of incision, technique of suture, materials, infection of incision, increase of intraabdominal pressure, age, nutrition and time of occurrence. ResultsLongitudinal incision, bad technique of suture,infection of incision, increase of intraabdominal pressure, aged, hypoalbuminemia and diabetes mellitus easily induced incision of hernia. ConclusionTransverse incision should be adopted if operation and safety are not affected. Prevent and treat infection or rupture of incision by strict aseptic manipulation, hemostasis and right use of antibiotics. Prevent increase of intraabdominal pressure in every aspect. Pay atention to nutrition supply of the elderly and promote healing of incision. Postoperative half year is high incidence stage of incision hernia and all inducing factors should be avoided.

Objective To testify the lung injury induced by cardiopulmonary bypass(CPB) in canine model and observe the influence of CPB on the aquaporin-1 ( AQP1 ) mRNA expression in canine lung. Methods 8 mongrel dogs were used to perform the cardiopulmonary bypass. The hearts arrested for 90 minutes with mild hypothermia and rebeated for 6 hours. The hemodynamics, the ratio of lung dry weight and wet weight, the plasmic osmotic pressure, and the characteristics of light and fine structure were analyzed. The retro-transcription polyase chain reaction ( RT-PCR ) was used to measure the expression of AQP1 mRNA during the CPB. Results The hemodynamic data were stable in different time point during the CPB (P ＞0.05 ). The ratio of lung dry weight and wet weight was getting lower ( P ＜0.001) and the plasmic osmotic pressure was getting higher due to the prolongation of the CPB time and reperfusion time ( P ＜0.01). The light and electron microscopy showed the prominent aggregation of the white blood cell, severe interstitial edema and mild tear of respiratory membrane after 3 hour and 6-hour rebeat. AQP1 mRNA expression in lung was downregulated, 78.4% after 3-hour reperfusion and 55.5% after 6-hour reperfusion respectively, comparing to the level before CPB. Conclusion We recognize that the lung injury and lung edema were severe following 3-hour and 6-hour rebeat in CPB and hypothesize that the down-regulation of lung AQP1 mRNA expression may be a sign of pulmonary interstitial capillary injury induced by CPB.

Aquaporins (AQPs) is a novel family of membrane protein which is in charge of the transportation of water across the membranes. It has been testified that AQPs may be related to many physiological functions and pathophysiological disorders. In lung, 6 subtypes of AQPs were found, 4 of which have been located in certain tissue. AQP1, AQP3, AQP4 and AQP5 are located in upper respiratory tract and may contribute to the mucus production, bronchial moisturizing and gland secretion. AQP1 and AQP5 are located in lower respiratory tract and may participate in directing the water movement across the blood-gas barrier. AQPs in natal lung may be an important factor to accelerate the reabsorption of the lung liquid. In adult, some diseases such as asthma, pulmonary edema, adult respiratory distress syndrome, which have been considered unbalanced water movement, may be also concerned with AQPs. The relationship between lung edema and AQPs have not been elucidated in details. It should be verified how AQPs work in more organs and tissues as well as in some diseases.

Objective To assess the efficacy and safety of CyberKnife radiotherapy in the treatment of locally advanced pancreatic carcinoma. Methods The data of 59 patients with locally advanced pancreatic carcinoma who were treated with CyberKnife radiotherapy from 2006 to 2014 were retrospectively analyzed. The tumor volume ranged from 13?? 0 cm3 to 125?? 1 cm3 with a median value of 27?? 1 cm3 . A dose of 35?50 Gy (median value= 45 Gy) in 3?8 fractions (median value = 5 fractions) was prescribed. The tumor progression was evaluated based on computed tomography. The overall survival (OS) and local progression?free survival ( LPFS) rates were calculated using the Kaplan?Meier method. Results The 1?and 2?year sample sizes were 26 and 17, respectively. The 1?and 2?year OS rates were 54% and 35%, respectively, while the 1?and 2?year LPFS rates were 91% and 70%, respectively. The median OS and LPFS times were 12?? 5 and 10?? 9 months, respectively. The overall incidence of grade 1?2 acute and late gastrointestinal toxicity was 61%. One patient with grade 3 late gastrointestinal toxicity had incomplete intestinal obstruction. Conclusions CyberKnife radiotherapy can achieve excellent treatment outcomes and mild complications in the treatment of locally advanced pancreatic carcinoma.

Objective To evaluate the response rate and efficacy of Cyberknife in the treatment of iliac lymph node metastases (ILNM).Methods Twenty-two patients with 27 ILNM were treated by Cyberknife from May 2010 to May 2016.Tumor volume range from 0.88 to 125.66 cm3 (median 18.87 cm3).The total doses ranged from 21 to 51 Gy (median 39 Gy) and biological effective doses from 35.7 to 100 Gy (median 72.6 Gy) in 3-8 fractions (median 5).Sixty-four percent to eighty-two percent (median 72％) isodose line covered planning target.The survival rates were calculated by Kaplan-Meier method and compared with Log-rank test.Results Follow-up time ranged from 8 to 97 months (median 33 months).The complete response,partial response,stable disease and progression disease rates were 37％,48％,7.5％,48％,respectively.In addition,effective rate was 92.5％.Overall survival range from 4 to 68 months (median 21 months).The 1-,2-,3-year local control rate was all 90.6％ and the survival rates were 78.8％,60.6％ and 43.3％,respectively.Adverse reactions after treatment were gastrointestinal reactions such as nausea,vomiting,fatigue.The chemotherapy before Cyberknife helped to improve overall survival.The patients with backache or edema of lower extremity got rapid relief after treatment.Conclusion The treatment of ILNM with Cyberknife has provided a high response rate with minimal side effects.Cyberknife is a safe and effective local treatment method for ILNM.

AIM: To investigate the expression of objective gene and the immunosuppressive effect of naked DNA vaccine pγ1.Ig H.SPTT targeting tissue factor by intrasplenic inoculation on colorectal cancer ( CRC) .METH-ODS:A special naked DNA vaccine which carried the SPTT peptides and immunoglobulin H chain gene ( named pγ1.Ig H.SPTT DNA plasmid ) was constructed by molecular biological techniques .After a single injection of this plasmid into the spleen, the concentrations of transgene product SPTT-Ig H in the peripheral blood at different time points were detected by ELISA, and the plasmid transfection efficiency and characteristics were analysis by PCR and Southern blotting .The immu-nologic effect of the plasmid on the CRC was observed in the mice .RESULTS:The strongest expression of SPTT-Ig H was observed during the 4th week after a single injection of the plasmid , which began to decline at the 12th week and disap-peared at the 16th week.The concentration of SPTT-Ig H in the peripheral blood at the 2nd week after transfection of plas-mid was 7.2 μg/L, then increased gradually , and reached a peak of 13.11μg/L at the 8th week.The plasmid-transcrip-tional gene was only expressed in the spleen , and was not detected in the lymph nodes , bone marrow, liver, kidney, and other organisms.Transfection of pγ1.Ig H.SPTT into the spleen had inhibitory effects on colorectal cancer as compared with control group .CONCLUSION:Naked DNA vaccine pγ1.Ig H.SPTT stimulates the immune response for protecting the body against colorectal cancer , which is a safe and effective method for CRC immunotherapy .

Objective To observe the short-term curative effect and toxicity reactions of elemene in combination with three-dimensional conformal radiotherapy for advanced esophageal cancer.Methods A total of 57 patients with advanced esophageal cancer were divided into radiotherapy group (28 cases) and elemene combined with radiotherapy group (29 cases).The control group was given conventional irradiation,and the treatment group received intravenous infusion of elemene on the basis of the control group.Changes of clinical symptoms were recorded.Results The effective rates in the control group and the treatment group were 60.7％ and 75.9％,respectively,when follow-up at the 8th week after radiotherapy (P ＜ 0.05).The patients of 2 groups were generally well tolerated,no grade Ⅳ toxicity occurred.Conclusion The efficacy of elemene combined with threedimensional conformal radiotherapy in the treatment of advanced esophageal cancer is better than radiotherapy alone,and it is safe and effective and had fewer side effects.

Objective To observe the short-term curative effect and toxicity reactions of elemene in combination with three-dimensional conformal radiotherapy for advanced esophageal cancer.Methods A total of 57 patients with advanced esophageal cancer were divided into radiotherapy group (28 cases) and elemene combined with radiotherapy group (29 cases).The control group was given conventional irradiation,and the treatment group received intravenous infusion of elemene on the basis of the control group.Changes of clinical symptoms were recorded.Results The effective rates in the control group and the treatment group were 60.7％ and 75.9％,respectively,when follow-up at the 8th week after radiotherapy (P ＜ 0.05).The patients of 2 groups were generally well tolerated,no grade Ⅳ toxicity occurred.Conclusion The efficacy of elemene combined with threedimensional conformal radiotherapy in the treatment of advanced esophageal cancer is better than radiotherapy alone,and it is safe and effective and had fewer side effects.

Objective: To investigate the impact of blood pressure and age on arterial stiffness in general population. Methods: Participants who took part in 2010, 2012 and 2014 Kailuan health examination were included. Data of brachial ankle pulse wave velocity (baPWV) examination were analyzed. According to the WHO criteria of age, participants were divided into 3 age groups: 18-44 years group (n=11 608), 45-59 years group (n=12 757), above 60 years group (n=5 002). Participants were further divided into hypertension group and non-hypertension group according to the diagnostic criteria for hypertension (2010 Chinese guidelines for the managemengt of hypertension). Multiple linear regression analysis was used to analyze the association between systolic blood pressure (SBP) with baPWV in the total participants and then stratified by age groups. Multivariate logistic regression model was used to analyze the influence of blood pressure on arterial stiffness (baPWV≥1 400 cm/s) of various groups. Results: (1)The baseline characteristics of all participants: 35 350 participants completed 2010, 2012 and 2014 Kailuan examinations and took part in baPWV examination. 2 237 participants without blood pressure measurement values were excluded, 1 569 participants with history of peripheral artery disease were excluded, we also excluded 1 016 participants with history of cardiac-cerebral vascular disease. Data from 29 367 participants were analyzed. The age was (48.0±12.4) years old, 21 305 were males (72.5%). (2) Distribution of baPWV in various age groups: baPWV increased with aging. In non-hypertension population, baPWV in 18-44 years group, 45-59 years group, above 60 years group were as follows: 1 299.3, 1 428.7 and 1 704.6 cm/s, respectively. For hypertension participants, the respective values of baPWV were: 1 498.4, 1 640.7 and 1 921.4 cm/s. BaPWV was significantly higher in hypertension group than non-hypertension group of respective age groups (P<0.05). (3) Multiple linear regression analysis defined risk factors of baPWV: Multivariate linear regression analysis showed that baPWV was positively correlated with SBP(t=39.30, P<0.001), and same results were found in the sub-age groups (t-value was 37.72, 27.30, 9.15, all P<0.001, respectively) after adjustment for other confounding factors, including age, sex, pulse pressure(PP), body mass index (BMI), fasting blood glucose (FBG), total cholesterol (TC), smoking, drinking, physical exercise, antihypertensive medications, lipid-lowering medication. (4) Multivariate logistic regression analysis of baPWV-related factors: After adjustment for other confounding factors, including age, sex, PP, BMI, FBG, TC, smoking, drinking, physical exercise, antihypertensive medication, lipid-lowering medication, multivariate logistic regression analysis showed that risks for increased arterial stiffness in hypertension group were higher than those in non-hypertension group, the OR in participants with hypertension was 2.54 (2.35-2.74) in the total participants, and same results were also found in sub-age groups, the ORs were 3.22(2.86-3.63), 2.48(2.23-2.76), and 1.91(1.42-2.56), respectively, in each sub-age group. Conclusion SBP is positively related to arterial stiffness in different age groups, and hypertension is a risk factor for increased arterial stiffness in different age groups. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-TNC-11001489.

Objective To evaluate the safety and effectiveness of ultra-hypofractionated stereotactic body radiotherapy in the treatment of prostate cancer.Methods A total of 26 patients with prostate cancer treated with Cyber-Knife from May 2010 to May 2018 were analyzed retrospectively.The median age of the patients was 69 years old (range,57 to 87).Ultra-hypofractionated radiotherapy was delivered in five fractions of 7.0-7.5 Gy for a total dose of 35.0-37.5 Gy.Androgen deprivation therapy (ADT) was administered in combination with the Cyber-Knife.The primary endpoints were radiation toxicity,PSA-response,local control and symptom alleviation,while the secondary endpoints were progression-free survival and overall survival.Results No graded ≥ 3 acute and late radiation toxicities occurred during follow-up.The acute toxicity of Grades 1 and 2 was 38.4％ and 19.2％,while the late toxicity of Grades 1 and 2 was 30.8％ and 3.8％,respectively.At a median follow-up of 22.44 months,for patients with localized stage,PSA level was decreased significantly after radiotherapy (Z =2.900,2.794,2.510,2.090,P＜0.05).However,there was no statistically significant difference for the metastatic group (P＞ 0.05).Conclusions Ultra-hypofractionated stereotactic body radiotherapy is a safe and effective treatment for patients with prostate cancer.