Objective To investigate the effect of extracts from Periplaneta americana L.on reversing MDR in HepG2/ADM.Methods HepG2/ADM was induced by continuous stepwise exposer to ADM.To investigate the effect of extractive from Periplaneta americana L.on drug resistance-associated protein( P-gp、MRP、LRP和BCRP) by immunocytochemical method and RT-PCR method.Results HepG2/ADM cells to ADM shows a strong multiple drug resistance that is 10.4 times,For DDP,5-FU showed weak resistance.The extractive from Periplaneta americana L.can cut the expression of P-gp and MRP1 protein in HepG2/ADM from immunocytochemical method,and it has statistically significant.The extractive from Periplaneta americana L.can cut the expression of P-gp gene,and it has statistically significant.Conclusion The extract from Periplaneta americana L.can effectively reverse MDR in HepG2/ADM,which targets for P-gp and MRP1 protein and P-gp gene of HepG2/ADM cells.

It is reported in this article that ?-lipoprotein and partial ?_1-and X_2-globulin in scrum are apparently lower, but haptoglobin and ?-lipoprotein are apparently higher by polyacryamide gel clectrophoresis in 50 cases of uremi(?) patients, and that albumin and partial ?_1-and ?_2-globulin in scrum are apparently lower, but partial ?_2-globulin and ?-lipoproteinare apparently higher by polyacryamide gel clectrophoresis in 50 cases of nephrotic syndrome patients. The mechanism and clinical significance of these changes are discussed.

Objective To investigate the efficacy of percutaneous transhepatic variceal embolization (PTVE) with Cyanoacrylate (TH glue) in treating large gastric fundal variceal bleeding.Methods PTVE was performed on 24 patients with TH glue injected into the main stem of left gastric vein and its fundic branches.The degree of varices in gastric fundus,rebleeding rate and survival rate after the procedure were compared with those before.Results Varices in gastric fundus were all embolized successfully with TH glue.The diameter of varices was reduced to below 5mm or disappeared in 20 patients (83.3％),and reduced to 5-10mm in the other 4 ( 16.7％ ) During the follow-up period of 3-36 months(mean 16.6 months),the rebleeding rate and mortality were 12.5 ％ ( 3/24 ),and 12.5 ％ (3/24),respectively.One patient died of liver cancer,and two others died of chronic liver failure.Conclusion PTVE with TH glue is of ideal therapeutic effect to block the feeding veins of large gastric fundal varices.

Objective To review the diagnosis and treatment of epithelioid angiomyolipoma of the kidney. Methods Five cases of epithelioid angiomyolipoma of the kidney were retrospectively analyzed in the aspects of imaging and pathologic characteristics. There were 3 males and 2 females with average age of 46 years (ranging from 26-64 years). There were 3 patients complained of pains of lumber. Two cases were found renal masses in routine physical examination. The mass diameter was 2.9-10. 1 cm. Two cases were diagnosed as angiomyolipoma and three as malignant tumors as kidney cancer, tumor of the adrenal gland or tumor of the liver with ultrasound and CT scan. Four of the 5cases accepted partial nephrectomy and 1 with radical nephrectomy. Results Epithelioid angiomyolipoma of the kidney was composed of abnormal thick parietal vessel, smooth muscle and adipose tissue in different proportional. The cytoplasm of epithelioid cells was acidophilia or lucency, which had acidophilia particles and abundant blood vessels. Epithelioid cells were round or polygon, surrounded to blood vessels, distributed in lipoid. The SMA, Vimentin and HMB45 were positive by immunohistochemisty. The post-operative histological diagnosis showed that all cases were epithelioid angiomyolipoma of the kidney. All patients were followed up for 2 to 12 months. No patients had locally recurrence or distant metastasis. Conclusions The diagnosis of epithelioid angiomyolipoma of the kidney relies on histopathology results. The immunohistochemical staining could be helpful for diagnosis and differential diagnosis.

Objective To compare the effect of transurethral resection of prostate (TURP) and TURP combine with transure-thral incision of the bladder neck(TUIBN) in the treatment of small size prostate hyperplasia .Methods From March 2002 to Octo-ber 2010 ,124 cases of small-size prostate hyperplasia patients were treated .All patients were randomized to undergo TURP or TURP with TUIBN .There were 62 patients in TURP group .Of which ,54 cases were followed up .There were 62 patients in TURP plus TUIBN group .Of which ,50 cases were followed up .The treatment effect of the two different surgical methods was evaluated by comparing international prostate symptom (IPSS) ,maximum flow rate(Qmax) and post voiding residual urine volume(PVR) et al .Results No statistical difference (P>0 .05)was found in age ,medical histories ,prostatic weight ,IPSS ,Qmax ,PVR between the two groups before operation .But significant difference(P<0 .01)was observed in IPSS ,Qmax ,PVR between the two groups after operation .There was no statistical difference(P>0 .05) in resected tissue weight and follow up between the two groups .The inci-dence rate of bladder neck contracture was 4% in TURP plus TUIBN group ,and it was significantly lower than that of TURP group(11% )(P< 0 .01) .Conclusion TURP plus TUIBN was better for the treatment of small size prostatic hyperplasia than TURP .

Objective To investigate the significance and safety of repeat transurethral resection(Re‐TUR) for treating stage T1 of non‐muscle invasive bladder cancer .Methods The clinical data were retrospectively analyzed on 41 cases of stage T1 of non‐muscle invasive bladder cancer in this department of our hospital from January 2013 to November 2014 .All cases underwent Re‐TUR at 4-6 weeks after primary surgery .Among them ,33 cases were male and 8 cases were female ,24 cases were single tumor and 17 cases were multiple tumors at first operation .The maximal tumor diameter was ≥ 3 cm in 13 cases and <3 cm in 28 cases . The first treatment was transurethral resection of bladder tumor(TURB‐t) .The pathological report was the stage T1 of urothelium cancer .Results All 41 cases were completed the operation smoothly ,and no serious complication occurred .In the postoperative pathological examination ,7 cases(17 .07% ) had tumor residue or tumor recurrence ,among them ,3 case had residue f tumor base and 4 cases were new onset tumor;the pathological grade at Re‐TUR in 1 case was increased from G2 to G3 .The follow up lasted for 3―27 months(average 13 .2 months) ,9 cases relapsed ,3 cases (42 .86% ,3/7) were positive at Re‐TUR and 6 cases(17 .65% , 6/34) were negative at Re‐TUR .Conclusion Re‐TUR for treating stage T1 of non‐muscle invasive bladder cancer is safe and feasi‐ble ,its significance to pick out high‐risk patient for conducting further active treatment ,which may have certain effect for reducing the recurrence rate of non‐muscle invasive bladder cancer .

National regional medical center is a major measure to balance the distribution of high-quality medical resources.The construction of a large number of national regional medical centres in Jiangxi Province,with accurate disease selection,frequent consultation and scheduling,and rapid ideological unity.However,from the perspectives of interest groups such as the government,exporting hospitals,and dependent hospitals,there are still problems such as unclear top-level design,insufficient power of export and dependent hospitals.It is necessary to accelerate and improve the coordination mechanism,clarify the rights and responsibilities of the three parties,improve the evaluation and special shift system,optimize the green channel,strengthen the power of export hospitals,support the dislocation development of dependent hospitals,and create a sustainable model of bilateral cooperation and self-development of project hospitals.

Objective To compare the therapeutic effect of percutaneous transhepatic variceal em-bolization (PTVE) with Cyanoacrylate(TH glue) with that of endoscopic variceal ligatien (EVL) in the treatment of esophageal varlceal bleeding. Methods In this prospective randomized controlled trial, cirrhot-ic patients with acute or recent esophageal variceal bleeding were assigned randomly to PTVE (n = 52) or EVL (n=50) groups. Variants including upper gastrointestinal (UGI) re-bleeding, esophageal variceal re-bleeding, relapse of esophageal variees and survival were evaluated. Results During the follow-up (median 24 and 25 months in the PTVE and EVL groups, respectively), UGI re-bleeding developed in 8 patients (15. 4%) in PTVE group and in 21 (42%) in EVL group (X2 =8. 87, P=0. 005). Recurrent esophageal varices bleeding occurred in 3 patients (5. 8%) in FIVE group and 12 (24%) in EVL group (X2 =5.38, P =0. 012, relative risk 0. 24, 95% confidence interval 0. 05 -0. 74). Reccurent rates of esophageal vari-ces in two groups were 17.3% (9/52) and 52% (26/50), respectively (X2 =13.61, P<0.001). There was no significant difference in survival rate between two groups (X2 = 3.30, P = 0. 054). Conclusion With sufficient embolization of lower esophageal and pefi-esophngeal varices and/or the cardial submucosal and perforating vessels, PTVE was more effective than EVL in the management of esophageal varices recur-rence and re-bleeding.

Objective:To study the effect of mindfulness-based training intervention on clinical efficacy in patients with nitrous oxide(laughing gas) addiction.Methods:From June 2019 to June 2020, sixty-six patients with nitrous oxide addiction in Beijing Gaoxin Hospital were selected and randomly divided into experimental group( n=33) and control group( n=33). The control group received Taijiquan training and physical training, while the experimental group added mindfulness-based training intervention on the basis of Taijiquan training and physical training.Symptom checklist 90 (SCL-90) scores and visual analog scales (VAS) craving scores were compared between the two groups at admission and 8 weeks after treatment.SPSS 22.0 software was used for statistical analysis.Independent sample t test and paired sample t test were used to compare the differences between groups and within groups. Results:(1)Before treatment, there were no significant differences in subscale scores of SCL-90 between the two groups except for depression factor((2.45±0.86), (2.03±0.46), t=2.474, P<0.05). After treatment, the subscale scores of somatization((1.38±0.35), (1.68±0.34), t=-3.656, P<0.05), phobic anxiety((1.49±0.37), (1.81±0.30), t=-3.993, P<0.05), paranoid ideation((1.50±0.47), (1.88±0.31), t=-3.898, P<0.05) and psychotism((1.34±0.54), (1.55±0.27), t=-3.094, P<0.05) of SCL-90 in the experimental group were significantly lower than those in the control group.(2)Before treatment, there was no significant difference in VAS craving score between the two groups( t=0.857, P=0.395). After treatment, the score of VAS in the experimental group was significantly lower than that in the control group( t=27.427, P<0.05). Conclusion:Mindfulness training intervention can effectively improve the clinical symptoms of patients with nitrous oxide addiction, which is worthy of clinical application.

Objective To explore the feasibility of tubeless 2 μm laser vaporesection in treating pediatric ureter cysts by ureteroscopy.MethodsClinical data of 33 ureter cysts patients who received tubeless 2 μm laser vaporesections by ureteroscopy were reviewed. The median age of patients was 4 years with a range from 1 to 7 years. The operations were carried out by RevoLix 2 μm laser through ureteroscopy without ureter stents and catheters indwelling.ResultsAll operations were successfully performed. And no serious complications occurred after the operations.ConclusionsTubeless transurethral 2 μm laser treatment by ureteroscopy was a superior micro-invasive surgery method for pediatrics with ureter cysts, with advantages of little blood loss, high safety, convenient operation and infrequent complications.