Renal cancer is a common malignant tumor in urology, with complicated pathogenesis and no obvious clinical symptoms. Metastatic renal cancer accounts for 20%-30% of the newly diagnosed renal cancer. The 5-year survival rate for metastatic patients is less than 10%.At present, the main non-surgical treatment means of mRCC include cytokines and targeted drug therapy, and immunotherapy has also become a research hotspot of mRCC. The current status and research progress of mRCC therapy were reviewed. The medical treatment methods of metastatic renal cancer, such as receptor tyrosine kinase inhibitors and mTOR inhibitors; immunotherapies, such as immunosuppressants for PD-1/PD-L1 were also discussed.

The therapy of removing beat and toxic,strengthening the body to cultivate the fundamental is the mainstream of treating cancer in traditional Chinese medicine up to now,and the therapy of warming yang has been rarely involved.While the pathogenesis of tumor is spleen and kidney yang deficiency in root,and phlegm,stasis,and poison entangled with each other at the secondary position; the main therapeutical principle of tumor is simultaneous application of purging-tonifying therapy while focusing on protecting yang.The author believes that the treatment of cancer should pay attention to the whole concept,especially warming yang for patients with advanced tumors.The therapy of warming yang is an effective way to get rid of phlegm and blood stasis.Patients after radiotherapy and chemotherapy should be paid more attention to warming yang.

Background To explore the roles of human papilloma virus(HPV)and herpes simplex virus (HSV)in pathogenesis of pterygia are very important for provide more basis for the study of pterygia mechanisms.Objective The aim of the study was to detect the expression of HSV and HPV in pterygia. Methods A total of 68 specimens of pterygia and specimens of normal conjunction tissue were obtained during the operation.The expression of HSV DNA and HPV DNA in pterygia specimens and conjunetival tissue were detected and compared by real time fluorescence quantitative polymerase chain reaction(PCR).Written informed consent was obtained from each patient before the any medical procedure related to this study. Results Real time fluorescence quantitative PCR showed that HPV DNA was detected in 12(17.65％)pterygia specimens,and HSV DNA was found in 15 (22.06％)pterygia specimens；however them were detected in 6(8.82％)and 1(1.47％)in conjunctival tissue respectively.Significant differences were found in the expression both HSV DNA and HPV DNA between pterygium tissue and eonjunctival tissue(HPV：χ2=10.291,P<0.05；HSV：χ2=4.561,P<0.05).The co-expression of HSV DNA and HPV DNA was seen in 5(7.35％)pterygium specimens,but no any co-expression of HSV DNA and HPV DNA was in conjunctival specimen. Conclusion HSV and HPV may participate in the pathogenesis and development of pterygium.The detection of virus DNA can offer an experiment evidence of HSV and HPV in pterygium generation.

Objective To investigate the effect of 6 % hydroxyethyl starch (HES) 200/0.5 infusion before operation on postoperative immne function in patients. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 21-58 yr weighing 47-79 kg were randomly divided into 2 groups ( n = 20 each): 6% HES 200/0.5 group (group H) and compound sodium acetate group (group A). 6% HES 200/0.5 10 ml/kg or compound sodium acetate solution was infused intravenously over 15 min before anesthesia induction. Anesthesia was induced with iv injection of propofol, fentanyl and vecuronium and maintained with target-controlled infusion of propofol and infusion of remifentanil. Venous blood samples were collected before operation and at 1 h, 1 day and 3 days after operation to detect the serum concentrations of IL-6, IL-8, TNF-α, IL-2, IL-10, IgG, IgA andIgM. Results Serum concentrations of IL-6, IL-8, TNF-α, II-2 and IL-10 were significantly higher after operation in the two groups, and serum concentrations of IgA and IgG were significantly lower after operation in group A than those before operation ( P ＜ 0.05 or 0.01 ). Serum concentrations of IL-6, IL-8 and TNF-α were significantly lower, while serum concentrations of IL-2, IL-10, IgA and IgG were significantly higher after operation in group H than in group A ( P ＜0.05). Conclusion Preoperative infusion with 6% HES 200/0.5 can improve the immune function after operation in patients.

Objective To observe the clinical efficacy of abdominal electroacupuncture plus umbilicus application with Chinese medication in treating poststroke constipation.Method A total of 160 patients with poststroke constipation were randomized into a treatment group and a control group, 80 cases in each group. The treatment group was intervened by abdominal electroacupuncture plus umbilicus application with Chinese medication, while the control group was intervened by oral administration of Phenolphthalein tablets. The constipation symptoms scores were observed before and after the treatment, and the clinical efficacies were compared.Result In the treatment group, the constipation symptoms scores were significantly changed after the treatment (P<0.05). In the control group, the scores of defecation duration and abdominal bloating were significantly changed after the treatment (P<0.05). The constipation scores in the treatment group were significantly different from those in the control group after the treatment (P<0.05). The recovery rate and total effective rate were respectively 66.3% and 92.5% in the treatment group, versus 40.0% and 78.8% in the control group, and the between-group differences were statistically significant (P<0.05). Conclusion Abdominal electroacupuncture plus umbilicus application with Chinese medication is an effective method in treating poststroke constipation.

Objective To investigate the relationship between edema and aquaporin 4 (AQP4) within traumatic penumbra (TP) of rats with brain trauma.Methods Eighty-eight healthy adult Wistar rats were randomly divided into control group (n =11) and trauma group (n =77),according to the random number table.Trauma group were further subdivided into seven time points (1 h,6 h,12 h,24 h,48 h,72 h and 7 d) of 11 animals each.Brain tissue samples from the moderate brain models were collected to evaluate brain edema with histological observation,blood brain barrier (BBB) permeability with semiquantitative immunohistohemical staining of IgG,and AQP4 expression with immunofluorescence and Western blotting.Results In control group pathology and IgG staining revealed no abnormalities and expression of AQP4 was few.In trauma group light edema zone was visualized at 1 h,began widening,reached the peak at 12 h [(1.589 ±0.020)mm],and then began narrowing.There were significances in width of the edematous band at each time point except for the comparison at 24 h vs.48 h and 72 h vs.7 d (P ＜ 0.05).After trauma,vasogenic edema was found in edema zone at 1 h,intracellular edema was found at 6 h,both aggravated at 12 h and alleviated slightly at 24 h,and intracellular edema predominated at 48 h.IgG showed intensively positive staining at 1,12 and 48 h,and weak staining at 6 h,24 h,72 h and 7 d.After trauma,expression of AQP4 decreased at 1 h (0.659 ± 0.021),returned slightly at 6 h (1.257 ±0.058),peaked at 12 h (2.499 ±0.136),declined again at 24 h (2.267 ± 0.068),re-raised at 72 h (2.078 ± 0.065),and returned to the baseline at 7 d (1.280 ± 0.065).There were significant differences in level of AQP4 at each time point except for the comparison at6h vs.7 d,24 h vs.72 h and 24 h vs.72 h (P＜0.05).Conclusions In the early phase vasogenic edema characterized by BBB damage is significant within TP,which leads to decreased expression of AQP4.However,the subsequent up-regulation of AQP4 results in intracellular edema,which accelerate the spreading of TP.AQP4 may involve in body's defense reaction.

Objective: To investigate the effect of Fu Zheng Hua Yu-319 Recipe on hepatic sinusoid capillarization in the rat of hepatic fibrogenesis. Methods: Hepatic fibrosis model rats were induced by intraperitoneal injection of dimethyl nitrosamine (DMN). thrice a week for 4 weeks, and they were divided into the treatment group which were treated with Fu Zheng Hua Yu-319 Recipe for 4 weeks, and the model control group. Serum and hepatic tissue were taken for examination of pathohistology, microstructure by electron microscopy, immunohistochemistry, and hydroxyproline content in the liver tissue and hepatic function. Results: In the normal group, peripheral cytoplasma of endothelial cells in the hepatic sinusoid is very thin with a lot of small fenestra, and no basement membrane under endothelium was found. In the model group, crookedness and stricture of the hepatic sinusoid were found , and the fenestra in cytoplasma of the endothelial cell reduced or disappeared with obvious basement membrane, and hemorrhage necrosis in the liver tissue could be found, with a great proliferation of connective tissue in the portal area, and fibrous septum extended towards into the lobuli, the content of hydroxyproline (HYP) in the liver tissue increased significantly. The VI factor-related antigen, a-actin of smooth muscle, LM and type IV collagen positive staining on the hepatic sinusoid wall increased significantly with a wider range as compared with the normal rat. In the treatment group, the extents of crookedness and stricture of hepatic sinusoid and reduction and disappearence of endothelial fenestra were lower, with thiner or discontinuous basement membrane, and a part of hepatic sinusoid construction approached to normal, and degeneration and necrosis of hepatic cells were mild and fibrous septum in the liver tissue decreased significantly, and HYP content decreased significantly (P

Objective] To observe the clinical effect of“eliminating the accumulative stagnation and heat with pressing and kneading manipulation”treatment efficacy of children with functional constipation. [Method] Randomly divide 60 cases into control group and treatment group, 30 cases in each;the control one took conventional pediatric tuina method; the treatment one took “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”method. Compare their effects after three courses. [Result] After three courses treatment, in treatment group, 20 cases had marked effect, 8 effective, 2 void, total effective rate 93.33%;in control group, they were respectively 10,12,8 and 73.33%. The comparison of total effective rates had difference of statistical significance(P<0.05). [Conclusion] The method of “eliminating the accumulative stagnation and heat with pressing and kneading manipulation”has better curative effect than the conventional pediatric tuina method. And it is very simple to manipulate, and worthy of being popularized.

Objective To investigate the change of inflammatory factor and blood coagulation in patients with laparo?scopic gastric cancer radical surgery. Methods Data of seventy-seven stomach cancer patients hospitalized in our hospital and received the surgical treatment from June 2012 to June 2014 were retrospectively analyzed. Thirty-eight of these pa?tients underwent laparoscopic treatment (laparoscopic group) and 39 cases received laparotomy treatment (laparotomy group). The values of interleukin-6 (IL-6), IL-8 and tumor necrosis factor alpha (TNF-α) were analyzed at the time points of preop?eration and 6 h, 24 h after the surgery in two groups. The levels of activated partial thromboplastin time (APTT), prothrombin time (PT), international standardization ration (INR), fibrinogen (FIB) and D dimer (D-D) were also analyzed at the same time points in two groups. The postoperative thrombosis and tumor recurrence rate were also analyzed in two groups of pa?tients. Results There were no significant differences in the gender, age, the size of tumor, differentiation degree and TNM staging between two groups of patients. The serum levels of IL-6, IL-8 and TNF-αwere significantly increased after surgery in two groups (P < 0.01), and which were significantly higher in laparotomy group than those of laparoscopic group (P<0.01). The levels of APTT, PT and INR were significantly lower after surgery in two groups of patients, and which were signifi?cantly lower in laparoscopic group than those of laparotomy group (P<0.05). The levels of FIB and D-D were significantly increased after operation in two groups of patients (P<0.05), which were significantly higher in laparoscopic group than those of laparotomy group (P<0.05). The postoperative recurrence of cancer was less in laparoscopic group than that of lapa?rotomy group. But, the postoperative thrombosis was more in laparoscopic group than that of laparotomy group. Conclusion There was less release of inflammatory mediators and less effect on the body’s immune function in patients with laparoscopic gastric cancer radical surgery. But, the surgery has a large influence in blood coagulation, we should pay attention to it in the clinical treatment.

[Objective]To investigate feasibility and efficacy of clinical application of endoscopic anterior cervical decompression and fusion.[Method]With Metrx MED system and modified working tube and decompression instruments,endoscopic anterior cervical decompression and fusion were performed on 15 patients with cervical spondylotic myelopathy.A paramidline right transverse incision of 2 cm long was made.A channel between the neurovascular and visceral sheath was created through finger dissection.The dilators were inserted sequentially.An original one arm working tube or a modified,shortened working tube with double arms was inserted over the dilators.Then decompression and fusion with autologus graft was performed under endoscope.[Result]Once the tubular retractor was stably fixed throughout the operation,releasing of the discomfort was observed.All the compression tissue such as soft disc tissue or hard osteophyte and anterior longitudinal ligament or dura sac were clearly visualized under the endoscope.Shortened working tube provided improved visual field and increased manipulation space for the decompression instrument.The double arms enhanced stability of the working tube but could not eliminate moving of it during operation.Intraoperative blood loss was 200 ml to 800 ml.The operation lasted 80 to 210 minutes.The incision healed in one week.Postoperative discomfort in laryngeal region was light.All of the cases showed thorough decompression on postoperative MRI films and gained better spinal cord function at postoperative follow-up.No surgery-related complication were encountered.[Conclusion]Endoscopic anterior cervical decompression and fusion based on the use of a working tube is technically feasible.Compared with conventional method,this technique has the advantages of improved intraoperative visualization,thorough decompression,minimal trauma,quicker recovery and improved cosmetic result.Disadvantages waiting for further improving include:limited manipulation space,discomfort and potential hazards to the surrounding structure resulted from moving of the working tube.