Objective To investigate the optimal extraction process of Jiangtang Tongluo Granule. Methods The orthogonal design was used in the extraction, according to the yield rate and content of paeoniflorin, with the volume of water, extraction times and extraction time as factors. The content of paeoniflorin was detected by HPLC method to determine the best extraction technology. Results The optimal water extracting technology of Jiangtang Tongluo Granule was performed by 1 h extraction for 3 times, with 10-fold volume of water. Conclusion The process is stable, feasible and reasonable, and provides a foundation for the further production and quality control.

Objective:To investigate the role of SDF-1/CXCR4 in metastasis of renal cell carcinoma and to observe the intracellular location of different CXCR4 segments in renal carcinoma cells.Methods:The potential nuclear localization sequences of different CXCR4 were discovered by nuclear localization software and experiments.Full length and truncated forms of CXCR4 were fused with green fluorescent protein pEGFP-N1 and their influence on subcellular localization was examined by confocal microscopy after transfecting them into renal carcinoma cell line A498.Results:Analysis with PSORT Ⅱ Prediction revealed that the nuclear localization sequence region of CXCR4 was located between amino acids 146 and 149(RPRK).Expression products of the recombinant plasmids with SDF-1 stimulation,including EGFP-CXCR4(1-510 bp),EGFP-CXCR4(1-765 bp) and wild-type EGFP-CXCR4,were mainly located in the cell nuclei.However,expression product of EGFP-CXCR4(1-267 bp) with SDF-1 stimulation was mainly located in the renal cell cytoplasm.Expression product of wild-type EGFP-CXCR4 full length plasmid without SDF-1 stimulation was mainly located in the cell cytoplasm;these results accorded with the results of bioinformatics analysis.Conclusion:Nuclear localization sequence of CXCR4 is located in the amino acids 90 to 170,which provides a theoretical basis for further clarifying the nuclear localization sequences of CXCR4 in renal cell carcinoma cells and for finding new potential target for inhibiting the metastasis of renal cell carcinoma.

Objective To explore the clinical utilization value of regional blood flow fluorescence visualization in selective arterial clamping robotic partial nephrectomy.Methods 12 cases of robotic partial nephrectomy with indocyanine green-based regional blood flow fluorescence visualization selective arterial clamping between October 2016 and June 2017 by our team were retrospectively analyzed.There were 9 males and 3 females with age between 36-78 years,mean age(51.2 ± 11.0) years,BMI 20.1-36.2 kg/m2,mean of (25.6 ± 4.8) kg/m2,tumor diameter 2.0-5.1 cm,mean of(3.3 ± 0.9) cm,and R.E.N.A.L.score 4-10,mean(7.3 ± 2.0).Preoperative renal function status of eGFR (estimated glomerular filtration rate) was 82-133 ml/(min · 1.73 m2),mean (101.9 ± 13.7)ml/(min · 1.73 m2) and split ECT-GFR of 44.5-70.6 ml/min,mean of(53.8 ± 8.5) ml/min in operated kidney;48.2-71.1 ml/min,mean of(56.8 ±6.8) ml/min in contralateral kidney;in total,92.7-139.1 ml/min,mean of(109.8 ± 14.6)ml/min.Perioperative information including operative time,blood loss,warm ischemia time,surgical complications,pathologic outcomes and follow-up data of included patients were analyzed.Results All procedures were done smoothly without open or radical conversion,with operative time of 95-203 min,mean of (170.6 ±38.6)min,and estimated blood loss of 60-1 000 ml,mean of(178.3 ± 206.9)ml.According to the visualize uptake of fluorescence imaging perfusion area visualization after selective arterial clamping,1 case underwent unclamping robotic partial nephrectomy,1 case converted to main renal artery clamping with warm ischemia time of 18 min,10 cases performed via renal arterial branch clamping with an average ischemia time of (25.5 ± 10.5) (range 17-46)min,1 of which due to parenchymal bleeding obscuring visualization necessitated clamping of the main renal artery with 1000 ml blood loss,46 min of arterial branch occlusion and 16 min of main artery clamping.The average postoperative hospital stay was (5.8 ± 0.9) (range 5-8)days,and the duration of drainage was (3.5 ± 0.5) (range 3-4) days.No postoperative complications occurred.Postoperative pathology:all margins were all negative,11 cases of clear cell carcinoma,eosinophilic adenoma in 1 case.The average eGFR of 9 cases of renal arterial branch clamping was (94.5 ±22.5)(range 56-140)ml/(min · 1.73 m2) at discharge with a 5％ percentage decrease versus preoperative level.Among them,4 cases obtained with ECT-GFR data 1 month postoperatively had a mean of(37.6 ±13.2)(range 20.8-55.8) ml/min with 29％ percentage decrease on the surgical side,an average of (58.5 ± 6.9) (range 51.2-68.4) ml/min with 2％ compensatory increase of the contralateral side,and (98.7 ± 16.2) (range 79.3-124.3) ml/min in total with a 10.4％ overall decrease.Conclusions The visualization of blood flow imaging based on indocyanine green fluorescence can clearly and intuitively show the effect of branching arterial occlusion in robotic partial nephrectomy,guide the optimization of surgical resection strategy,and improve safety and clinical outcome.

Objective:To prepare a pig model of obstructive sleep apnea-hypopnea syndrome(OSAHS) and to observe the hemodynamics and pathological characteristics of common carotid artery,so as to lay a foundation for further studying the effect of OSAHS on cardiovascular system.Methods: Twelve male small-type pigs were randomly divided into model group and control group(n=6).Animals in the model group were housed in a negative pressure chamber for 6 months to establish OSAHS model and those in the normal control group were fed routinely.After pigs in the model group presented the symptoms of OSAHS,the changes in hemodynamics of carotid artery were detected with color Doppler ultrasound.The morphological changes of common carotid artery were analyzed under light microscope and electron microscope.Results: Animal model of OSAHS was successfully created.The internal diameter of carotid artery of pigs in the model group was decreased,the intima was increased,and the peak-systolic mean velocity(S) and the resistance index(RI) were both increased compared with those of the control group(P

Objective To summarize the clinical features,diagnosis and treatment of autologous urologic neoplasms in renal transplant recipients.Methods A retrospective analysis on the clinical data of 25 renal transplant recipients was done in our center.The onset time of new neoplasms was between 29 to 72 months after transplantation,with an average of 48.2 months.Intermittent hematuria was the first symptom in 23 patients,and the rest two cases were diagnosed through routine examination. The pathological diagnoses of thee cases were renal carcinoma,which were treated by transperitoneal laparoscopic radical nephrectomy.Eight cases were diagnosed as having renal pelvic tumor,which was treated by radical resection for the renal pelvic carcinoma.Fourteen cases were diagnosed as having bladder cancer,which was treated by transurethral resection of bladder tumor (13 cases) or radical cystectomy (one case).All patients were subjected to surgical treatment.The dosage of MMF,CSA/Tacrolimus was decreased to 1/2-2/3 of their original dosage. Sirolimus was used in place of calcineurin inhibitors in four patients.Immunosuppressive regimes and adjuvant therapy were given after surgery treatment.Results Twenty-five patients were followed up for 12-84 months.Contralateral renal carcinoma combined with lung and chest multiple metastases occurred in one case after radical nephrectomy,who died after targeted therapy 6 months later.Two patients with lymph node metastasis died 14 months and 20 months after surgery respectively.The rest 22 patients were closely followed up,whose creatinine remained 98-163μmol/L.Conclusion More attention should be paid to patients with hematuria after renal transplantation to screen the autologous urinary neoplasms.Patients should be treated with surgical procedures,and immunosuppressive regimens should be adjusted postoperatively.

To investigate effects of l% l-acetylforskoin (l-aF) suspension eye-drops administeredtopically on intraocular pressure (IOP) in rabbits and men, and observe the loca l irritation of the drug． l% l-aF suspension eye-drops was prepared and was instilled into one of e yes while the corresponding vehicle into the contralateral eye as control． IOP was measured b y pneumatonometer before and after administration． l%1-aF suspension eye-drops s ig nificantly reduced IOP in rabbits reaching the maximum reduction of 2.2 mmHg and lasting a t least 3 hours． But it didnt show significant effects in men． There was little local irritati on neither in rabbits nor in men． l% l-aF suspension eye-drops significantly reduced IOP in normal rabbit s, but not in men． No local irritation was observed in rabbits and in men．

Objective To compare the differences between endoscopic resection and laparoscopy?assisted surgery or transanal endoscopic resection for rectal neuroendocrinal tumor. Methods Clinical data of patients who underwent endoscopic or surgical resection of neuroendocrinal tumor of less than 2 cm which were confirmed by pathology from December 2010 to November 2013 were retrospectively analyzed. Results Twenty cases of endoscopic treatment, including 17 cases of ESD, 3 cases of EMR,were included in endoscopy group;while 18 cases treated with surgery were included in surgery group, among which 12 ca?ses underwent transanal endoscopic microsurgery and 6 cases laparoscopic resection. The mean lesion sizes were 7 mm(4?18 mm)and 8 mm(3?15 mm),respectively. Pathology showed there were 16 cases of grade G1 neurocrinal tumor and 2 G2 cases in surgical group. There was no lymphvascular invasion with clear margin in the endoscopy group,but three cases of lymphvascular invasion in surgical group. No treatment?related se?vere adverse event occurred in either group. The time for oral food intake was 2?0 d(1?4 d) in endoscopy group, while that in surgery group was 2?4 d(1?7 d)(P=0?295). The hospital stay was(6?80±2?12) d in endoscopy group and(8?59±2?85)d in surgery group, respectively(P=0?034). And the total hospitalization cost was 10 488(4 128?15 296) yuan and 15 590(3 024?40 503) yuan(P=0?031) in the two groups, re?spectively. The follow?up was 25 months(2?48 months)and no recurrence was found. Conclusion Endo?scopic resection, especially ESD, is a new approach to treat colorectal neuroendocrinal tumor,advantageous over surgery in shorter hospitalization time, minimal invasiveness, faster postoperative recovery, less compli? cation, and reduced hospitalization cost.

Objective To investigate the relationship of the metastasis-associated genes and its copy numbers variation in the highly metastatic human epithelial ovarian cancer cell line HO-8910PM. Methods The differentially expressed genes and its copy number variation between HO-8910PM cell line and normal ovarian tissues was detected by human genome UI33A 2.0 gene chip and human mapping 10K array 2.0 gene chip, and the data was analyzed by bioinformatics. Some of metastasis-associated genes were validated the results of single nucleotide polymorphism (SNP) and cDNA chips by fluorescence in situ hybridization (FISH) and real-time quantitative PCR. Results Integrate analysis of two gene chips data showed that there were 385 differentially expressed genes in the same and 379 SNP positional point (6 of them, included 2 genes) between HO-8910PM cell line and normal ovarian tissues, these copy number amplification of 379 SNP positional point of chromosome were ≥3, which had 240, deletion ≤ 1 had 139. Chromosome location analysis showed that there were 385 differentially expressed genes located at all chromosomes, and 261 of them ( 67.8%, 261/385 ) located at 10 chromosomes, included that 34 (8.8% ), 33 ( 8.6% ), 28 (7.3%), 27 (7.0%), 25 (6.5%), 24 (6.2%) of them located at chromosome 3, 2, 9, 10, 1 and 11 respectively, and 23 (6.0%) of them at chromosome 6 and 12 each, 22 (5.7%) of them at chromosome 4 and 5 each. For the function of differentially expressed genes, the results showed that 99 (25.7% ) genes belonged to the family of enzymes and their regulators, 54 ( 14.0% ) genes associated with signal transduction, 50 (13.0%) genes associated with nucleic acid binding, and 36 (9.4%) genes associated with protein binding. Conclusion We have demonstrated that there are 4 kinds of differentially expressed genes related to metastasis of ovarian cancer, which belonged to the families enzyme and its regulator, nucleic acid binding, signal transduction and protein binding, and located at chromosome 1, 2, 3, 4, 5, 6, 9, 10, 11 and 12.

Through literature method,expert consultation method,K-means algorithm and empirical analysis method,the paper analyzes the methods for evaluation on the layout of first-aid sites,discusses the indexes for scientific evaluation on the rationality of layout of first-aid sites,conducts visualized and practical calculation based on the first-aid related data of Wuhan city in 2015,verifies the rationality and operability of the evaluation indexes,and provides reference for overall allocation of first-aid resources and rational layout of first-aid sites.

Objective This study is to explore the safety,feasibility and efficacy of robotic laparoendoscopic single-site(LESS) zero-ischemia partial nephrectomy.Methods Two patients underwent robotic laparoendoscopic single-site zero-ischemia partial nephrectomy by our urologic surgical team at 22-May-2017 and 31-May-2017 in our institution.The salient patient demographics and tumor characteristics,including age,gender,body mass index (kg/m2),Charlson Co-morbidity Index (Age-weighted),tumor laterality,diameter (cm),R.E.N.A.L.nephrometry score and preoperative split renal function GFR [ml/(min · 1.73 m2)] were:73/56,female/male,25.2/19.8,2/0,lcft/right,1.8/1.4,5a/4a,left 43.8、right 49.2/left 38.8 、right 48.7 respectively.A 2-3 cm longitudinal skin incision was made at 4 cm below the inferior margin of rib arch at the level of midaxillary line (case NO.1) or peri-umbilicus (case NO.2).The da Vinci Si robotic Single-siteTM Port was inserted.The line of Toldt was incised with the colon medially mobilized.Gerota's fascia was opened,the main renal artery or its branches were dissected,then the renal mass fully dissected and exposed.The renal mass was entirely removed with approximately 0.5-1.0 cm surrounding normal renal parenchyma (unclamping in case NO.1,and selective branch clamping in case NO.2) and kidney reconstruction was conducted with 1-0 Quill Suture via hem-o-lock sliding technique.Results The two procedures were smoothly completed without any extra skin incision.Operative duration,estimated blood loss and skin incision length was respectively 230/190 min,100/60 ml,3.6/2.5 cm.Duration of two selective renal artery branches clamping in case NO.2 was 39 and 24 min.Postoperative pain measured by the visual analog pain scale (VASP) at day 1,day 2,day 3 was 5/4,3/3,2/1,Time off oral intake,duration of drainage and length of stay after surgery was 2/4 d、2/4 d、6/7d,respectively.The recovery of both patients were uncomplicated and discharged smoothly.Pathological examination revealed oncocytoma in case NO.1 and papillary renal cell carcinoma in case NO.2.Conclusions The initial experience shows the robotic laparoendoscopic single-site zero-ischemia partial nephrectomy is a safe,feasible and efficacious procedure.It may exhibit clinical benefits for patients in terms of pain control,convalescence and cosmesis,but in this early stage the clinical indications should be strictly controlled.