Objective To explore the relationship between condition of hypoxia and prognosis in patient with renal clear cell carcinoma (RCCC).Methods The expression of hypoxia-inducible factor-lo( HIF-1 α) protein in cancer tissue of 89 RCCC cases was examined by streptavidin-biotin complex immunohistochemistry.Clinical and pathological data and prognosis of 89 cases were analyzed retrospectively.There were 66 males and 23 females,with an average age of 57 years.The patients were divided into two groups,the chronic pulmonary disease (CPD) group ( 19 cases) and non CPD (NCPD) group (70 cases),with 46cases in clinical stage I,15 cases in stage Ⅱ,26 cases in stage Ⅲ,and 2 cases in stage Ⅳ.The relationship between survival time and clinicopathological variables including the presence of CPD,the positive rate of HIF-1α protein,smoking history and hemoglobin level were evaluated by the Kaplan-Meier method.And the Cox proportional hazards regression model was build to analyze the correlation between each variable and survival time.Results The 89 cases were followed up for a median time of 19 months (6 to 84 months).Twenty cases died,and 69 cases survived.Between the CPD group and NCPD group,clinical stage,hemoglobin level and the degree of expression of HIF-1 α were significantly different (P ＜ 0.05 ).The median survival time was 44 and 71 months in CPD group and NCPD group,respectively,and the difference was significant ( P ＜ 0.05 ).The median survival time was 43 and 70 months in Hb≤ 110 g/L group and Hb ＞ 110 g/L group,respectively,and the difference was significant ( P ＜ 0.05).The stronger the degree of expression of HIF-lα was,the shorter the overall survival was.And the difference was significant ( P ＜0.05 ).Associated with CPD,hemoglobin level,the expression of H1F-1α were independent factors affecting overall survival of the patients (P ＜0.05 ).CPD and HIF-1 α expression were positively related to disease-free survival time,and hemoglobin level was negatively related to disease-free survival time.Conclusions Systemic hypoxia caused by CPD may aggravate the hypoxie state in the organization of the patients with RCCC.The condition of hypoxia and prognosis in patient with RCCC is negatively correlated.

Objective: To observe the co-effect of antioxidant compound, soybean isoflavone (SI), VC and VE on glucose and insulin response after oral glucose load in Type 2 Diabetes Mellitus (T2DM) . Methods: 96 selected T2DM patients (50% male, 50% female) were randomly divided into 4 groups according to the dosage of the compound given , none (group B), low dosage (group C), medium dosage (group D) and high dosage (group E) . The normal control (group A) included 24 persons half male, half female . Blood glucose and insulin were determined at OGTT 0 h, 1 h, 2 h, 4 h, 6 h, and the areas under the curve (AUC) of blood insulin/glucose were calculated. Results: The AUC of blood insulin/glucose of male was higher than female in control group, but both were lower than those of four diabetes groups. In both genders of the diabetes groups, blood insulin AUC of group C, D, E was lower than group B, blood glucose AUC of group D, E was lower than group C and B. There was significant difference in blood insulin and glucose AUC of group E as compared to group B in female (P

OBJECTIVETo evaluate the clinical results of tube gastrostomy in radical cystectomy and ileal conduit.

METHODSWe retrospectively analyzed the data of 98 patients undergoing radical cystectomy and ileal conduit between March 2007 and February 2010. According to postoperative gastrointestinal decompression methods, the patients were divided into nasogastric decompression group (n=50) and tube gastrostomy group (n=48), and the gastrointestinal recovery time, surgical complications and hospital stay were compared between them.

RESULTSNo statistical difference was found in gastrointestinal recovery time, hospital stay, or surgical complications between the two groups, but the incidence of pulmonary infection was significantly lower in tube gastrostomy group than in nasogastric decompression group (P<0.05).

CONCLUSIONTube gastrostomy is an easy, safe and effective means for gastric decompression after radical cystectomy with ileal conduit, especially suitable for elderly patients and those with potential pulmonary disorder.

Aged ; Aged, 80 and over ; Cystectomy ; Decompression, Surgical ; methods ; Female ; Gastrostomy ; Humans ; Male ; Middle Aged ; Postoperative Period ; Retrospective Studies ; Urinary Diversion

Objective To evaluate the effect of modified and traditional subcostal and anterior quadratus lumborum block on postoperative analgesia in patients with laparoscopic nephrectomy.Methods 46 patients underwent laparoscopic nephrectomy.They were randomly divided into two groups:traditional subcostal quadratus lumborum block(group T)and modified subcostal quadratus lumborum block(group M),with 23 cases in each group.Before anesthesia induction,the T group was subjected to the traditional subcostal and anterior quadratus lumborum block under ultrasound guidance,and the M group was subjected to the modified subcostal quadratus lumborum block under ultrasound guidance.All were given 0.5％ropivacaine 20 ml.Patients controlled intravenous analgesia(PCIA)was performed in both groups.The dermatomal levels of 5min,10 min and 15min after block was recorded.VAS pain scores at rest and cough were recorded at 6,24 and 48 h after the block.The dosage of Sufentanil,the number of analgesic pump compressions and the flurbiprofen rescue were recorded 24 h after surgery.Results The number of block plane segments in group M at 5,10 and 15 minutes after block were 6(4,8),8(6,9)and 8(6,9),respectively,which were significantly more than the T group[4(2,6),6(2,9),6(2,9)](P＜0.05).The VAS pain scores of patients in group M were(1.6±0.5)points at rest and(3.7±0.6)points at cough 6 hours after block,24 hours after the block were(2.3±0.4)points and(3.4±0.4)points,respectively,48 hours after the block were(2.5±0.8)min and(3.2±0.7)min,respectively.The VAS pain scores of and at rest and cough 6 hours after block in T group were(2.5±0.7)points and(5.6±0.8)points,respectively,24 hours after the block were(3.1±0.5)points and(4.5±0.7)points,respectively,48 hours after the block were(3.3±0.6)min and(4.2±0.6)min,respectively.Group M was lower than group T(P＜0.05).In group M,the dosage of sufentanil,the times of analgesic pump and the rate of analgesic relief 24 hours after operation were(23.1±4.3)μg,5(4,7)times and 4.3％,respectively,which were significantly lower than those in T group[(34.7±6.8)μg,11(9,12)times,21.7％](P＜0.05).Conclusion Ultrasound-guided modified subcostal and anterior quadratus lumborum block has better analgesic effect than traditional technique in patients undergoing laparoscopic nephrectomy,which can reduce the amount of postoperative analgesic drugs and effectively relieve postoperative pain.