BACKGROUND:Anticancer drugs-loaded magnetic nanopartides,as a novel targeting drug delivery system,are characterized by high drug loading dose,targeting location transport,heat effect of magnetic grains,and biological degradation.Thus,this system brings new hopes for chemical therapy with high efficiency and low toxic and side effects.OBJECTIVE:To observe in vitro toxic effects of complexing cis-diaminedichloroplatinum (CDDP)-loaded magnetic nanopartides on human nasopharyngeal carcinoma (NPC) CNE2 cells.DESIGN,TIME AND SETTING:The in vitro controlled study was performed at the Laboratory of Pharmacology,Northern Region,Sun Yet-sen University in March 2005.MATERIALS:CDDP was provided by Shandong Qilu Pharmaceutical factory.CDDP-loaded magnetic nanoparticles (CDDP-SAMNP),43-52 nm in particle diameter.Utilization rate of CDDP was about 65%.NPC CNE2 cell line was supplied by the Laboratory of Cell Pathology,Cancer Hospital,Sun Yat-sen University.METHODS:This study contained medication and control groups.The medication group was assigned to CDDP and CDDP-SAMNP groups.CDDP and CDDP-SAMNP were diluted by RPMI-1640 medium.Drug concentration was in accordance with CDDP content.The control group was divided into RPMI-1640 medium and SAMNP groups (adding ferroso-ferric oxide,magnetic nucleus concentration was 7 g/L,diluted by the medium).MAIN OUTCOME MEASURES:MTT assay was used to observe kill and wound rate of 1.89-11.34 mg/L CDDP and corresponding dose of CDDP-SAMNP on NPC CNE2 cells following 24 and 48 hours.Uptake of CDDP-SAMNP by CNE2 cells was investigated under a transmission electron microscope.RESULTS:SAMNP as the medium group had no effect on killing or wounding CNE2 cells (P＞0.05).With the increment of CDDP and CDDP-SAMNP dose,the kill and wound rate presented an obvious dose-effect relationship.At the same dose,the same medicine showed an increasing kill and wound rate with the extension of reaction time,presenting an obvious time-effect relationship.At 24 hours after reaction,the kill and wound rate of CDDP-SAMNP and CDDP were similar (P＞0.05).At 48 hours,at the dose from 1.89 to 5.04 mg/L,the kill and wound rate of CDDP-SAMNP was lower than that of CDDP (P＜0.05),but when increased to 6.93 mg/L,the kill and wound rate of CDDP-SAMNP was dose to that of CDDP.SAMNP and CDDP-SAMNP could be easily taken into CNE2 cells.CONCLUSION:Effect of CDDP-SAMNP on killing and wounding NPC CNE2 cells is close to that of cis-diaminedichloroplatinum at the same high dose.The active sources are the cis-diaminedichloroplatinum released from the nano-camers.The stability of modified CDDP-SAMNP has been increased and its therapy effect has not been influenced.

ObjectiveTo investigate the ultrasonic clinical value of scalpel in abdominal surgery for D2 radical gastrectomy for gastric cancer.MethodsA retrospective analysis was made in Zhengzhou University Affiliated Luoyang Central Hospital from September 2008 to September 2010 gastric group.The patients were divided into ultrasound knife group and normal operative in 136,including 75 cases using ultrasonic scalpel,61 using cases electric knife.The lymph node dissection time,intraoperative blood loss,the drainage 72 h after were compared between the two groups.Results The average operation time ultrasound knife group was ( 114 ± 35 ) min,the surgery blood loss was ( 110.4 ± 32) mL.The drainage 72 h after operation was (180 ± 24) mL,which were significantly reduced compared with the normal operative group.The difference in detection rate between the two groups was not statric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastri cancer.ConclusionsUltrasound knife used in D2 radical gastrectomy for gastric cancer can improve efficiency,reduce trauma,accelerate postoperative recovery,showing good application prospect in radical resection of gastric cancer.

Objective To study the protein expression and gene amplification of human epidermal growth factor receptor-2(Her-2)in adenocarcinoma of the gastroesophageal junction and its association with the clinicopathological features .Methods Immunohistochemical method and fluorescence in situ hybridization ( FISH) were used to detect Her -2 expression and gene amplification in 80 surgically resected gastroesophageal junction cancer tissue .We further analyzed the relationship between the gastroesophageal junction cancer histolog -ical differentiation ,as well as depth of invasion ,clinical stage and lymph node metastasis .Results Her-2 am-plification of gastroesophageal junction carcinoma by FISH was 22.5%,while the overexpression by IHC was 15%.Her-2 gene amplification and protein overexpression were correlated with the differentiation ,clinical TNM stage,invasive depth and lymph node metastasis of the carcinoma (all P<0.05).Her-2 expression was not asso-ciated with the patients age,gender,invasive depth and lymph node metastasis(P<0.05).Conclusion Her -2 protein expression and gene amplification may be a prognostic indicator for the patients with gastroesophageal junction cancer .The joint detection of Her -2 protein expression level and the gene amplification can guide the prognosis and therapy for adenocarcinoma of the gastroesophageal junction .

Aim To evaluate the protective effects of salvianolic acid B on the ISO-induced myocardial is-chemic injury model of rats and the influence of regula-ting NLRP3 associated protein on myocardial ischemia. Method All rats were randomly divided into control group, model group and Sal B 5, 10, 15 mg · kg-1 groups. For 7 days, rats in Sal B groups were given by introperitoneal injection of 5, 10, 15 mg·kg-1 Sal B, rats in control group and model group were given the same volume of normal saline. Rats were subcutane-ously multi-point injected ISO ( 30 mg · kg-1 ) for 2 days on the fifth administrating day. The myocardial protective effect of Sal B was evaluated from electrocar-diogram( ECG), myocardial tissue pathological chan-ges, serum myocardial enzymes, oxidation index and inflammatory cytokine, myocardial tissue of NLRP3 related protein expression. Results Sal B could re-duce the degree of myocardial tissue necrosis and the infiltration of inflammatory cells, reduce T-wave values of ECG(P<0. 05 or P<0. 01). Compared with model group, CK values, GOT values and IL-1β values of rats in different dose groups were significantly lower, and MDA values and LDH values of rats in middle-and high-dose groups were significantly lower ( P<0. 05 or P<0. 01 ) . However, T-SOD values of rats middle-and high-dose groups were significantly higher ( P <0. 05 or P<0. 01). Meanwhile,the NLRP3, Caspase-1 and IL-1β protein level in myocardial tissue of the rats in different dose groups compared with model group had reduced ( P <0. 05 or P <0. 01 ) . Conclu-sion Sal B has protective effects on myocardial ische-mic rats, its mechanism may be related with inhibition of decreasing the expression of NLRP3 inflammasome associated protein, which can suppress the generation of inflammatory cytokines.

ObjectiveTo investigate the clinical value of CEA, CA19-9, CA242 and CA72-4 four serum tumor markers in colorectal cancer diagnosis, surgery and postoperative evaluation of their. Methods Immunohistochemical assay was used in 80 patients with colorectal cancer and 50 cases of colorectal benign diseases to detect the CEA, CA19-9, CA242 and CA72-4 and other four serum tumor markers, with 2-year follow- up. ResultsFour kinds of serum tumor markers CEA, CA19-9, CA242 and CA72-4 levels in colorectal cancer group were significantly higher than the control group ( P ＜ 0.05 ) ; levels of the four serum tumor markers in patients in Dukes stages C, D were significantly higher than those in Dukes stages A, B;four serum tumor markers were significantly increased in patients with recurrence of metastasis. Conclusion Combined detection of serum CEA, CA19-9, CA242 and CA72-4 has clinical value in diagnosis, surgical treatment evaluation and monitoring of metastasis and recurrence after surgery of colorectal cancer can improve detection sensitivity and specificity.

Small for gestational age (SGA) infants are special populations, whose birth weights are less than the 10th percentile or two standard deviations below the mean for gestational age based on the Fenton growth chart in 2013. SGA is caused by various reasons and affects the short- and long-term health of infants. This review focused on the early health, physical and neurological development and incidence of metabolic diseases of SGA infants.

Objective To analyze the follow-up results and clinical characteristics of one case of highly sensitized recipient after combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.Methods This patient was diagnosed as having chronic renal insufficiency in the uremia period 10 years ago,subjected to kidney transplantation 9 years ago,and got renal allograft loss 8 years ago.The recipient was positive for PRA (for class Ⅰ,31％,and for class Ⅱ,63％).Under the general anesthesia,the patient was given combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation.The ATG was used for immune induction.Rituximab and plasma exchange were applied to prevent acute rejection.Regular follow-up was done after discharge.Results On the postoperative day (POD) one,ALT was 256 IU/L,AST was 342 IU/L and serum creatinine was 502 μmol/L.On the POD 6,ALT and AST levels were normal and serum creatinine was 141 μmol/L.Serum creatinine increased to 202 μmol/L and the volume of urine reduced on the POD 7.The ultrasound displayed graft size increased slightly,substantial echogenicity enhanced,artery blood flow RI increased to 0.8,suggesting the occurrence of acute rejection.A single dose of Rituximab,intravenous IG,and plasma exchange were given.On the POD 60,serum creatinine was reduced to 131 μmol/L.During a follow-up period of 28 months,imrnunosuppresants were given:Tac + MMF + Pred.FK506 valley concentration was maintained at 6-8 μg/L.The function of the transplanted kidney and liver was normal,and the general conditions were good.Conclusion Combined kidney transplantation and splenic fossa auxiliary heterotopic liver transplantation is safe.Individualized medication and regular follow-up are the important factors for long-term survival of recipients.

Objective To evaluate the safety and efficacy of ex vivo ureteroscopy (ExURS) as means of rendering a donated kidney stone-free in a living related renal transplantation.Methods Clinical data were analysed of ExURS as means of rendering a donated kidney stone-free in a living related renal transplantation and relative literature was reviewed.The ECT results showed that GFR of left and right kidney was 38.7 and 42.3 ml/min respectively.The donor underwent a left laparoscopic donor nephrectomy.Immediately after cold perfusion,ExURS was performed with 4 ℃ ice-cold saline irrigation.Basket extraction and holmium laser lithotripsy was performed.Calculi were fragmented with pneumatic intracorporeal lithotripsy and fragments were removed with forceps.F6 indwelling ureteral stents were kept during transplantation.Urine flowed out immediately after reperfusion of the allograft and the distal ureter appeared edema 2 min later.Routine ureter-bladder wall anti-reflux replantation was done after the resection of the edema part.Results Pyeloscopy was successfully performed.A total of 2 calculi,diameter 8,12 mm,were visualized in donor kidney.The ex vivo treatment time was 30 nin.The warm and cold ischenia time was 60s and 50 min,respectively.There were no intraoperative complications.At a follow-up at 8 months,there was no recurrent calculi formation in the recipient and donor.Conclusion ExURS is technically feasible to render a stone-bearing kidney stone free without compromising ureteral integrity or renal allograft function.

Objective To evaluate the safety and efficacy of robot﹣assisted laparoscopic living donor nephrectomy. Methods Clinical data of 31 donors and recipients undergoing robot﹣assisted laparoscopic living donor nephrectomy in Xijing Hospital of the Fourth Military Medical University from November 2013 to August 2015 were retrospectively analyzed. Results Donor nephrectomy was successfully performed in 31 cases.The operation time ranged from 110 to 190 min.Intraoperative hemorrhage volume was measured as 20﹣100 ml.The warm ischemia time of the donor kidney was 100 to 160 s.The retained length of renal vein was between 1.8 and 3.0 cm and the length of renal artery was 1.4 to 2.3 cm.In 2 cases,spleen injury occurred during the kidney extraction and was treated with splenorrhaphy.One donor had postoperative hemorrhage,which was treated with hemostasis and anemia correction.Thirty one donors received postoperative follow﹣up for over 6 months.No long﹣term complications were observed.Among 31 recipients,one patient had delayed recovery of renal graft function and the serum creatinine level returned to normal range after treatment at postoperative 1 month.The survival rate of kidney grafts was up to 100%. Conclusions Robot﹣assisted laparoscopic living donor nephrectomy is a safe and efficacious surgical procedure for kidney resection,which possesses the advantages of small trauma,rapid recovery and no influence upon renal function.

Objective To investigate the clinical characteristics, prevention and treatment of multi-drug resistant organisms (MDROs) infection early after renal transplantation from donation after citizen's death. Methods Clinical data of 166 patients undergoing allogeneic renal transplantation and regular follow-up in Xijing Hospital from November 2011 to September 2016 were retrospectively analyzed. General conditions were statistically compared between the recipients undergoing renal transplantation from donation after cardiac death (DCD) and their counterparts receiving living related donor renal transplantation. The incidence of MDROs infection, onset time, course of diseases, complications, infection site and etiological type were observed. The therapeutic methods and clinical prognosis were summarized. Results The incidence of MDROs infection early after renal transplantation in the recipients undergoing DCD renal transplantation was 14%, significantly higher than 2% in those receiving living related donor renal transplantation, and 13% and 2% for the incidence of delayed graft function with statistical significance (both P<0.05). The incidence of renal graft loss was 8%and 2%, and 5% and 1% for the mortality rate without statistical significance between two groups (both P>0.05). MDROs infection occurred in 11 patients after DCD renal transplantation. The most common infection site was urinary system(n=6) and the most prevalent pathogenic bacterium was Escherichia coli (n=4). All patients infected with MDROs were treated with a sufficient dosage of effective antibiotics according to the outcomes of bacterial culture and drug sensitivity test. Eight patients obtained favorable clinical prognosis, one underwent nephrectomy and two died. Conclusions The incidence of MDROs infection early after DCD renal transplantation is higher than that after living related-donor renal transplantation. Strict donor screening, early detection, intimate monitoring and timely treatment can effectively reduce the risk of MDROs and enhance clinical prognosis.