Microenviroment hypoxia is one of the common phenomenon in cancer,studies have indiacat-ed that hypoxia induces genetic instability via activating many DNA danlage-repair signal pathways,which asso-ciates with tumor invasion and resistance and chemi-radiotherapy resistivity.Here,we overview three main DNA damage-repair pathways:mismatch repair,homologous recombination and non-homologous end joining,and how hypoxia influences their mechanisms.

Objective To investigate main causes leading to conversions to open surgery during laparoscopic cholecystectomy (LC) in the treatment of acute cholecystitis. Methods A total of 32 cases of acute cholecystitis received LC were analyzed. Results Out of the 32 cases of acute cholecystitis, LC was successfully accomplished in 25 cases (78.1%) and a conversion to open surgery was required in 7 cases (21.9%). Major causes of the conversion included the necrosis of the gallbladder(4 cases) and the failure to expose the Calot’s triangle(3 cases). Conclusions Conversions to open surgery should be made during LC when a gangrenous cholecystitis is confirmed or the Calot’s triangle cannot be well exposed.

Objective To assess the value of procalcitonin (PCT) levels compared to C-reactive protein (CRP) levels and blood white cell count in early detection of sepsis following percutaneous nephrolithotomy.Methods This prospective observational study included 91 patients,including 59 male patients and 32 female patients,undergoing percutaneous nephrolithotomy between April 2014 and October 2015.Their mean age was (54 ± 15)years old,ranging 15 to 88 years old.The average size of stone was (20.9 7.0) am.Those patients were classified into two groups,based on whether the postoperative sepsis existed.In this group,51 cases were concluded in the sepsis group and 40 in the non-sepsis group.A statistically significant difference between patients with and without sepsis was found in the hydronephrosis (44 vs.25,P =0.009),urine white cell count [(402 ± 970) / μ1 vs.(70 ± 171) / μ1,P ＜ 0.01],positive urine culture(36 vs.20,P ＜ 0.05),positive pelvic urine culture (22 vs.5,P =0.001).There was not any significant difference in sex,age,size of calculi and blood culture between patients with and without sepsis (P ＞ 0.05).Blood white blood cell count,CRP,and PCT were measured in patients with an acute onset of sepsis.Diagnostic accuracy of PCT values was analyzed by the receiver operating characteristics (ROC) curve.Results A statistically significant difference between patients with and without sepsis was found in the PCT [(7.43 ± 10.15)μg/L vs.(0.14 ± 0.10)μg/L,P ＜ 0.01] and blood white cell count [(14.18 ± 6.47) × 109/L vs.(11.22±4.22) × 109/L,P ＜0.05].There was not any significant difference in CRP [(64.93 ± 68.60) mg/ml vs.(70.76 ± 53.36) mg/ml,P ＞ 0.05] between patients with and without sepsis.ROC curve analysis showed that blood white cell count and PCT concentrations had similar predictive values for the development of sepsis (area under the curve,0.78 and 0.90,respectively) with the best cut-off values of blood white cell count for 12 × 109/L (sensitivity 50％,specify 88％) and 0.5 μg/L (sensitivity 64％,specify 100％)for PCT.54 cases were performed blood culture,which showed positive in 12 cases and negative in 42 cases.The significant difference of PCT level could be noticed in two groups [(16.99 ± 11.64) μg/ L vs.(3.77 ± 7.23) μg/ L,P ＜ 0.05)].No significant difference was found in CRP,Blood white cells count among those groups (P ＜ 0.05).ROC curve analysis showed that PCT concentrations had predictive values for the positive blood culture (area under the curve,0.80) with the best cut-off values of 8 μg/L (sensitivity 71％,specify 88％) for PCT.Conclusions PCT was a useful marker for the diagnosis of the sepsis after percutaneous nephrolithotomy as compared with WBC and CRP.

Recent epidemiologic data indicate that metfomin has an anti-tumor effect.However,the underlying anti-tumor mechanisms remain unclear.MicroRNAs (miRNAs)can exhibit pro-oncogenic or anti-oncogenic effects by regulating the differentiation and proliferation of cells.In vitro studies show that metformin can regulate the expressions of multiple miRNAs which are closely associated with tumor development,a process possibly relating to the anti-cancer roles of metformin.

Objective: To investigate the expression of MDR1 and GFP in the human hematopoietic cells mediated by adeno-associated virus. Methods: The GFP gene was transferred into the human hematopoietic cells by AAV vectors and created strong visible fluorescence by purely molecular biological means. Using adeno-associated virus vectors, we have transferred human mdr-1 gene into human hematopoietic cells and investigated the drug resistence of human hematopoietic cells modified with mdr-1 gene. PCR analysis confirmed that mdrl cDNA had been successfully transferred into the human hematopoietic cells. An assay of MTT proved that the human hematopoietic cells modified by mdrl gene had resistance to colchicine. Results: It was about 30% of the hematopoietic cells that expressed the green fluorescent proteins. The resistance of hematopoietic cells was increased parently when the cells were infected by the crude virus stocks. Conclusion: It is conducted that the AAV vector could successfully transfer the foreign gene into the human hematopoietic cells. The cells modified with mdrl gene have increased the resistance to drugs.

Objective To investigate the effects of total nutrient admixture (TNA) on the recovery of patients with gastric cancer after radical gastrectomy.Methods The clinical data of 50 patients with gastric cancer who were admitted to the Affiliated Hospital of Luzhou Medical College between March 2013 and March 2014 were retrospectively analyzed.Among 50 patients receiving radical gastrectomy,26 patients receiving TNA were allocated to the experimental group and 24 patients receiving conventional fluid infusion were allocated to the control group.Patients in the experimental group received the nutritional support therapy using TNA at preoperative day 5 and at postoperative days 1-5,and patients in the control group received the postoperative intravenous rehydration including water,glucose,electrolyte,vitamins and micro elements.The nutritional indexes [albumin (Alb),prealbumin,transferrin and hemoglobin (Hb)],time to anal exsufflation,incidence of complications (wound infection,anastomotic leakage,blooding and intestinal obstruction) and duration of hospital stay were observed before nutritional support therapy and at postoperative day 8.The count data were analyzed using the chi-square test.The chi-square value of correction for continuity was used when 1 ≤ minimum theoretical frequency ≤ 5.The measurement data with normal distribution were presented as (x) ±s and analyzed using the t test or repeated measures ANOVA.The ordinal data were analyzed by the analysis of variance.Results The Alb,prealbumin,transferrin and Hb in the experimental group were (38.6 ± 2.0) g/L,(281 ± 33) mg/L,(2.5 ± 0.9) g/L and (111 ± 20) g/L before nutritional support therapy and (38.2 ± 1.9) g/L,(277 ± 16) mg/L,(2.3 ± 1.1) g/L and (112 ± 37) g/L at postoperative day 8,respectivley.The Alb,prealbumin,transferrin and Hb in the control group were (38.3 ±2.4) g/L,(287 ± 34) mg/L,(2.4 ± 1.1) g/L and (107 ± 21) g/L before nutritional support therapy and (30.3 ±2.3) g/L,(190 ± 41) mg/L,(1.6 ± 0.3) g/L and (93 ± 22) g/L at postoperative day 8,respectivley.There were significant differences in the nutritional indexes at postoperative day 8 between the 2 groups (F =174.042,95.637,9.529,4.919,P ＜ 0.05).The time to anal exsufflation in the experimental group were (52 ± 11) hours,which was significantly different from (70 ± 12) hours in the control group (t =-5.176,P ＜ 0.05).The incidence of complications was 15.4％ (4/26) in the experimental group,which was significantly different from 58.3％ (14/24) in the control group (x2=6.460,P ＜0.05).Patients with complications in the 2 groups were cured by anti-infective or symptomatic treatment.The duration of hospital stay was (9 ± 3) days in the experimental group and (12 ± 4) days in the control group,with a significant difference between the 2 groups (t =-2.912,P ＜ 0.05).Conclusion TNA can improve the nutritional status of patients after radical gastrectomy in a short time.It could help patients to get through the perioperative period smoothly,and enhance the postoperative recovery.

Objective To observe the contents of acid phosphatase (ACP) of Oncomelania snails infected with Schistosma japonicum.Methods Both the blood lymphocytes of positive and negative Oncomelania snails were dyed with the histochemistry staining method and their ACPs were observed under a microscope. Results The contents of ACP in the positive Oncomelania snails increased, being significantly higher than those in the negative snails. Conclusion The contents of ACP increase in Oncomelania snails infected with Schistosoma japonicum and ACP may have the defence function.

Objective To compare the effects of flexible ureterorenoscope holmium laser for treatment of different sizes lower pole caliceal stones. Methods 140 patients with lower pole caliceal stones from August 2011 to April 2015 were enrolled, 40 patients were divided into observation group which the largest stone diameter > 2.0 cm, 100 patients were divided into control group which the largest stone diameter ≤ 2.0 cm. All these patients received flexible ureterorenoscope holmium laser treatment. Then we observe and compare the prognosis. Results The postop﹣erative 3 d and 1 month of gravel success rates were 97.5 % and 80.0 % in observation group, while the control group were 98.0% and 95.0%. The postoperative 1 month of gravel success rates in observation group was signifi﹣cantly lower than that in control group (P< 0.05). The operative time and postoperative hospital stay in observation group were significantly higher than control group (P<0.05). The postoperative 1 month complications of lung infec﹣tion, hematuria, urinary extravasation and so on in observation group were significantly higher than that in control group (P<0.05). The postoperative 3 d creatinine contents in observation group were significantly higher than preop﹣erative (P< 0.05), and significantly higher than that in control group (P< 0.05). The creatinine contents compared between the two groups at other time points were not statistically significant (P> 0.05). Conclusion Compared with small lower pole caliceal stones, the success rate of flexible ureterorenoscope holmium laser treatment of large lower pole caliceal stones is declined, the patients also have some trauma, and the renal function is also fluctuate, postop﹣erative disease is relatively higher that clinically to be carefully chosen.

Objective To present the distinction on clinical features,laboratory features,treatment schemes between the patients with and without brucellar epididymo-orchitis,and to provide a theoretical basis for clinical diagnosis and treatment.Methods A retrospective analysis of 223 male patients with brucellosis in the First Hospital of Jilin University from June 2010 to November 2016 was carried out.A comparative analysis of the clinical and laboratory features of 22 patients with epididymo-orchitis and 201 cases without epididymo-orchitis was done.The SPSS 23.0 software was used to analyze the statistical results,P ＜ 0.05 was defined as statistically significant.Results Epididymo-orchitis occurred in 9.87％ (22/223) of all male patients with brucellosis.The median ages of patients with and without epididymo-orchitis were 35.5 and 42.0 years old,respectively,the difference was not statistically significant (Z =1.323,P ＞ 0.05).Cases with and without epididymo-orchitis of brucellosis with fever [90.9％ (20/22) vs 69.2％ (139/201)],chills [54.4％ (12/22) vs 28.9％ (58/201)],hepatomegaly [22.7％ (5/22) vs 3.5％ (7/201)],abdominal symptoms [59.1％ (13/22) vs 17.4％ (35/201)],and urinary tract infection symptoms [31.8％ (7/22) vs 3.5％ (7/201)],the differences were statistically significant (x2 =4.586,6.076,14.424,20.392,27.059,all P ＜ 0.05).The medians of white blood cell (WBC) count (7.9 × 109/L),erythrocyte sedimentation value (ESR,38.0 mm/h),and aspartate aminotransferase (AST,110.0 U/L) in brucellosis with epididymo-orchitis were higher than those without epididymo-orchitis (5.1 × 109/L, 30.0 mm/h,73.8 U/L),the differences were statistically significant (Z =2.239,2.064,2.762,all P ＜ 0.05).All brucellosis patients with epididymis-orchitis were treated with antibiotics for 8 weeks.The defervescence time was 4.5 days,the time of pain relief was 3.9 days,21 patients were cured,and only Ⅰ patient relapsed.Conclusions Epididymo-orchitis is a common complication of brucellosis.Brucellar epididymo-orchitis is usually characterized with a severe acute clinical presentation,which needs timely diagnosis.Combination of antibiotics treatment for 8 weeks in brucellosis patients with epididymis-orchitis is effective.

Objective Observe the effect and the indications of intermittent short veno-venuous hemofiltration(ISVVH) in severe acute pancreatitis(SAP). Methods APACHE II scores≥14 and fluids imbalance were respectively used to define as the indication of starting hemofiltration and ending hemofiltration. In 39 patients with SAP,19 underwent ISVVH(IS group),and the other 20 patients were not accepted hemofiltration (N group). APACHE II scores, Balthazar CT grades and the plasma levels of procalitonin(PCT), TNF-?, IL-6, IL-8, IL-1ra, IL-2 and IL-10 were observed. Results At admission and 2d after admission, APACHE II scores in IS group and N group were (13.8?3.1)and (17.8?3.2) ( P