Objective To investigate the efficacy and safety of non-blocking renal artery laparoscopic partial nephrectomy in the treat-ment of renal cell carcinoma of stage T 1~T2.Methods From January 2012 to May 2016,the 140 patients with renal cell carcinoma of stage T1~T2 were selected ,and their clinical data were retrospectively analyzed .All the patients were equally divided into the observation group and the control group with 70 patients in each group according to the different treatment methods .Patients of the observation group were trea-ted with non-blocking renal artery laparoscopic partial nephrectomy ,while patients of the control group were treated with blocking renal artery laparoscopic partial nephrectomy .Recorded the postoperative complications ,postoperative recovery condition and renal function changes of the two groups.Results All the patients completed the surgery sucessfully and there was no conversion to laparotomy .The perative time,amount of bleeding ,gastrointestinal recovery time and postoperative hospital stay in the observation group were less than those of the control group (P<0.05).The postoperative drainage and drainage tube indwelling time in the two groups were of no significant difference (P>0.05).One week after the operation , the incidence of secondary bleeding ,urinary leakage ,pulmonary infection ,incision infection ,renal infection and other complications in the observation group was 2.9%,which was significantly lower than 15.7%in the control group(P<0.05).The postoperative serum SCr values in the observation group and the control group were respectively (89.24 ±11.92)μmol/L and (137.24 ±11.49)μmol/L, which were significantly higher than (67.24 ±12.49)μmol/L and (68.14 ±13.11)μmol/L before the operation(P<0.05).In the mean time,the postoperative serum SCr values of the observation group was significantly lower than that of the control group (P<0.05).All the pa-tients were followed up to now , and the median survival time of the observation group and the control group were (25.32 ±3.14) months and (19.39 ±4.10) months respectively.That is to say,the median survival time of the observation group was significantly longer than that of the control group(t=4.209,P<0.05).Conclusion Non-blocking renal artery laparoscopic partial nephrectomy for treatment of renal cell car -cinoma of stage T1~T2 can avoid warm ischemia ,reduce postoperative complications ,protect renal function ,promote the patient ’ s recovery , and prolong the survival time ,which is a safe and effective method .

Objective To evaluate the long-term effect of hepatic arterial embolization with pingyangmycin-lipiodol emulsion (PLE) in patients with cavernous hemangiomas of the liver (CHL)and its influence factors.Methods One hundred and fifty-six hemangiomas that were diagnosed by imaging examinations or confirmed pathologically by surgery in 105 patients with integral follow-up data were analyzed retrospectively in this paper.All hemangiomas were divided into 4 groups according to their size (the largest size of hemangioma)by the authors as follows; A group(≤3 cm, n=25); B group(>3 cm and<5 cm, n =32) ;C group(≥5 cm and<10 cm, n=58); and D group(> 10 cm, n=41) .According to the number of abnormal sinusoids filled with the contrast medium in the angiography, 156 hemangiomas of this series were further classified as three types: abundant type (n=90) ; sparse type (n=9) and the middle type (n=57) .Hepatic arterial embolization with PLE was performed in the 105 patients with total 135 procedures (including single procedure in 75 patients, twice procedures in 30 patients).All of the 105 patients were followed up 3 to 8 years(mean 4 years) using US, CT or MRI or DSA.The criteria for the evaluation of curative effect were classified as best, good, recovery and no change in this series, and the sum of best and good effects were defined as the total effective rate.Then, the total effective rate of single procedure between the A, B groups and C, D groups; and the total effective rate of single procedure and twice procedures in the D groups, were compared statistically by X~2 test respectively.And the influence factors, included of the variant size of hemangiomas, abundant or sparse of abnormal sinusoids and the number of treatment procedures, were also analyzed and evaluated respectively.Results The total effective rate of the 156 hemangiomas in 105 patients was 92.95% (145/156).After single procedure of hepatic arterial embolization with PLE, the total effective rate of A and B groups were 100% (57/57), that of C and D groups were 85.86% (85/99), and the difference reach significant (X ~2=8.8553, P<0.01).In the D group, the total effective rate in group with twice procedures (100.00%,30/30) was significant higher (X~2 =5.2642,P<0.05) than those of group with single procedure (72.73%,8/11).Of this series, during the period of following-up, no recurrent or severe complications were observed.Conclusions A best long-term curative effect (complete cure) is usually obtained in the small hemangiomas with abundant abnormal sinusoids, and a satisfactory long-term curative effect can also be achieved in the larger or multiple hemangiomas, particularly in those hemangiomas with abundant abnormal sinusoids by using the repeat procedures of hepatic arterial embolization with PLE.

Clostridium cellulolyticum, as one of obligate anaerobic bacteria capable of secreting cellulosome, has not been efficiently cultured due to its strict requirement of growing conditions. In this study, culture conditions of C. cellulolyticum were optimized using response surface methodology. Plackett-Burman design was first used to screen the dominant impact factors for the growth of C. cellulolyticum, which were determined as yeast extract concentration, cellobiose concentration and culture temperature. The steepest ascent path design was then applied to gain the suitable range close to the optimal culture conditions for obtaining high cell density. The central composite design and the response surface analysis were finally used to determine the optimal levels of the influential factors, which were 3 g/L for yeast extract concentration, 7 g/L cellobiose concentration and 34 degrees C for culture temperature. The optimized medium was used for flask culture, and OD600 of C. cellulolyticum was increased from 0.303 to 0.586. With a pH-controlled fermentor at batch mode, OD600 reached 3.432, which was 2.8 times higher than elsewhere reported. These results support further study on the high-density culture of C. cellulolyticum and its application.
Bacteriological Techniques ; methods ; Clostridium cellulolyticum ; growth & development ; Culture Media ; Population Density

Objective To retrospectively analyze the clinical data of 47 young NSCLC patients mutation style of EGFR and PD-L1 expression in tumor cells, to understand their clinicopathological and molecular characteristics. Methods We enrolled 47 young (≤40 years old) patients confirmed as NSCLC who underwent surgical resection, and 94 old patients (≥60 years old) were matched as 1:2 by R language. EGFR mutation status was detected by ARMS-PCR, and the expression of PD-L1 was detected by immunohistochemistry. Results The median age of 47 young patients with NSCLC was 37 years old. The disease was more common in women and the majority type was adenocarcinoma. In youth group, the 19del and 20ins were more frequent, but the exon 21 L858R point mutation proportion was higher in elder group. The expression of PD-L1 was significantly increased in the solid predominant histological subtype. The PD-L1 expression in 19del patients was higher than that in the patients with L858R mutation in youth group. Conclusion The majority of young NSCLC patients are female, nonsmokers and suffered from adenocarcinoma cancer. The proportion of EGFR alteration in 19del and 20ins in youth group is higher than that in elder group. The positive rate of PD-L1 expression in solid predominant histological subtype is higher than that with other subtypes. The expression of PD-L1 in young patients with EGFR 19del is higher than that with L858R.

Background and objectiveEpidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) are the standard ifrst-line treatment regimen forEGFR mutated non-small cell lung cancer (NSCLC) patients. However, the ef-ifcacy of EGFR-TKIs widely varies. hTe aim of this study is to determine whether the pretreatment serum cytokeratin-19 frag-ments (CYFAR21-1) and carcinoembryonic antigen (CEA) are associated with the effcacy of EGFR-TKIs inEGFR-mutated NSCLC patients.MethodsWe retrospectively enrolled 194 NSCLC patients harboringEGFR mutations who received EGFR-TKIs. Clinical characteristics were collected, and the relation between the effcacy of EGFR-TKIs and pretreatment serum CYFAR21-1 and CEA was analyzed.Results In all cases, progression-free survival (PFS) in patients with high CYFAR21-1 level was signiifcantly shorter than PFS in patients with normal CYFAR21-1 (7.0vs 11.9 months,P<0.001). Overall survival (OS) in patients with high CYFAR21-1 was signiifcantly shorter than in the normal-CYFAR21-1 group (12.6vs28.0 months, P<0.001). In adenocarcinoma patients, PFS in the high-CYFAR21-1 level group was signiifcantly shorter than in patients with normal CYFAR21-1 (7.0vs 12.0 months,P<0.001). OS in patients with high CYFAR21-1 was signiifcantly shorter than that in the normal-CYFAR21-1 group (13.1vs 28.1 months,P<0.001). Among squamous carcinoma patients, CYFAR21-1 level did not affect survival. No signiifcant difference in PFS and OS was observed between patients with high CEA and patients with normal CEA.ConclusionEGFR-mutated patients with high CYFAR21-1 had signiifcantly shorter PFS and OS than patients with normal CYFAR21-1 atfer receiving EGFR-TKIs. Pretreatment serum CYFR21-1 level was a predictive marker of EGFR-TKI treatment inEGFR-mutated NSCLC patients.

Objective To analyze the changes and correlation of serum Hcy level in patients with type 2 diabetes mellitus (T2DM) complicated with acute cerebral infarction (AIS). Methods A total of 427 T2DM patients admitted to our hospital from June 2019 to June 2021 were selected and divided into the control group (T2DM, n=129) and experimental group (T2DM combined with AIS, n=298) according to whether the patients were complicated with AIS. According to NIHSS score, the patients in the experimental group subsequently were divided into the mild group (NIHSS score <7 points, n=51), moderate group (7≤NIHSS score 7-15 points, n=43) and severe group (NIHSS score >15 points, n=35). According to infarct size, the patients in the experimental group were divided into the lacunar cerebral infarction group (n=57), small area cerebral infarction group (n=45) and large area cerebral infarction group (n=27). The basic data of all patients, including age, gender, history of hypertension, stroke and smoking, were collected by self-made scale. The levels of FBG, TG, LDL-C, SBP and serum Hcy were compared between the groups. Logistic regression analysis was used to screen the independent risk factors for development of AIS in T2DM patients. Spearman was applied to analyze the correlation between serum Hcy level and the degree of neurological impairment as well as infarct area in T2DM patients with AIS. Results There were statistically significant differences in age, history of hypertension, stroke, smoking, and the levels of TG, LDL-C, FBG, SBP, Hcy between the control and experiment groups (P<0.05). Logistic regression analysis showed that age and the levels of TG, FBG, SBP, Hcy were independent risk factors for development of AIS in T2DM patients (P<0.05). The serum Hcy level in severe group was significantly higher than that in mild and moderate groups, and it in moderate group was significantly higher than that in mild group (t=16.995, t=8.850, t=12.163, P<0.05). The serum Hcy level in large area cerebral infarction group was significantly higher than that in lacunar and small area cerebral infarction groups, and it in small cerebral infarction group was significantly higher than that in lacunar cerebral infarction group (t=8.677, t=2.858, t=7.028, P<0.05). Spearman correlation analysis showed that serum Hcy level was positively correlated with the degree of neurological impairment and infarct area in T2DM patients with AIS (r₁=0.459, r₂=0.513, P<0.05). Conclusions T2DM patients with old age, poor control of smoking, blood glucose, blood pressure and blood lipids are at greater risk of AIS development. The serum Hcy level of T2DM patients with AIS is significantly increased, which can be monitored to determine the degree of neurological impairment and infarct area of T2DM patients with AIS..

BACKGROUND: In recent years, a number of clinical trials have shown that immunocheckpoint inhibitors (ICI) have brought survival benefits to patients with advanced non-small cell lung cancer (NSCLC), however, such clinical trials comprise cohorts selected based on strict and complex entry and exclusion criteria, and the results cannot fully reflect the real world situation. The purpose of this study was to investigate the clinical efficacy and safety of immunotherapy in the real world, as well as possible prognostic factors. METHODS: Patients with advanced NSCLC receiving immunotherapy in Beijing Chest Hospital from January 2017 to July 2019 were retrospectively collected, and the following information were collected: curative effect, progression-free surival (PFS) and adverse reactions. The occurrence of adverse reactions and clinical curative effect and prognosis factors that may be relevant were explored. RESULTS: 34 patients were enrolled in this study, median PFS was 5.66 months (95%CI: 4.48-6.84), grade 1-2 and 3-4 incidence of adverse events was 61.71% (22/34) and 14.71% (5/34), there were 3 patients (8.82%) experienced fatal immune related adverse events (irAE), 2 cases were immune associated pneumonia, 1 case was immune related myocarditis. Univariate analysis showed that tumor-node-metastasis (TNM) stage and metastatic site were correlated with median PFS (P<0.05), and multivariate analysis showed that patients with extrapulmonary metastasis (OR=6.42, P=0.029) and pleural metastasis (OR=14.14, P=0.006) had shorter median PFS. CONCLUSIONS In the real world, immunotherapy has good efficacy in patients with advanced NSCLC, but the incidence of severe irAE is also higher. Distant metastasis and pleural metastasis are poor prognostic factors for advanced NSCLC patients receiving immunotherapy.