Objective:To detect the expression of microchromosome maintenance protein 6 (MCM6) in bladder cancer tissues, and to explore the relationship between MCM6 and the clinical prognosis of bladder cancer. To explore the possibility of MCM6 as a potential biomarker for bladder cancer.Methods:Bioinformatics methods were used to analyze the mRNA levels of MCM6 in bladder cancer tissues and adjacent normal tissues, and to analyze the relationship between its expression and the survival rate of bladder cancer patients. The clinicopathological data of 83 patients with bladder cancer underwent surgical treatment were retrospectively analyzed. Immunohistochemical method was used to detect the expression level of MCM6 protein in bladder cancer tissue and normal tissue adjacent to the cancer, and analyze its relationship with clinicopathological characteristics of bladder cancer patients.Results:The results of bioinformatics analysis showed that MCM6 mRNA was significantly highly expressed in bladder cancer tissues and was significantly correlated with the overall survival rate ( P=0.036) and disease-free survival rate ( P=0.01) of the patients. The results of immunohistochemistry showed that the expression of MCM6 in bladder cancer tissue was significantly higher than that in normal tissues adjacent to the cancer, and high expression of MCM6 in bladder cancer tissue was related to tumor stage ( P=0.025), but had nothing to do with age, gender and tumor grade (all P>0.05). Conclusions:The expression of MCM6 in bladder cancer tissue is significantly high and indicates a poor prognosis, and its expression level is related to the tumor stage of bladder cancer patients. MCM6 may serve as a new potential biomarker for bladder cancer.

Objective To discuss the feasibility and safety of sevoflurane inhale anesthesia with portable combined inhalation anesthesia induction device in solving the difficulty of children entering the operation room.Methods One hundred pediatric patients were enrolled into the study.The pediatric patients were randomly divided into two groups,50 cases in each group.Group A was fraught with a new mode of administration,using portable combined inhalation anesthesia induction device with sevoflurane 2 ml before entering the operation room;group B was fraught with a traditional mode of administration,using in-tramuscular injection with ketamine 4-5 ml/kg before entering the operation room.The analog scale of anes-thetic effect,the number of body movement,adverse reaction were compared between the two groups. Results Compared with group B,time of falling asleep and retention time in the operating room was signif-icantly shorter (P <0.01).And body movement during vein puncture decreased significantly (P <0.01). Moreover,the incidence of adverse affect showed significant reduce compared with group B (P < 0.05 ). Conclusion The combined inhalation anesthesia induction device is simple to produce and easy to carry.To solve the difficulty of convoying children into the operating room,combined inhalation anesthesia induction device with sevoflurane is more effective, safer and more humanized way when compared with the traditional one.

Objective To evaluate the safety and efficacy of one-stage endoscopic sphincterotomy plus laparoscopic cholecystectomy for the treatment of patients who have concurrent gallstones and CBD stones.Methods We conducted a prospective study from Mar 2008 to Nov 2011 in our department.A total of 63 consecutive patients of concurrent gallstones and CBD stones were included and divided into two groups:31 patients in test group first underwent ERCP and EST to remove CBD stones,and then during the same general anesthesia underwent laparoscopic cholecystectomy (LC) ; while 32 patients in control group first underwent ERCP and ES,and then LC 3-5 days later.Results The stone clearance rate in test group and control group were 96.9％ and 96.7％ (P ＞ 0.05),respectively.The postoperative lung infection rate in the test group and the control group were 7.1％ and 16.1％ (P ＜0.05),respectively.The length of hospital stay (LOS) of the two groups was (7.5 ± 1.7) days and (12.6 ±2.5) days,respectively (P ＜ 0.05).The total expense of hospitalization was (￥) (2 356 ± 126) and (￥) (37 056 ± 152),respectively (P ＜ 0.05).Conclusions One-stage laparoendoscopic management of patients with concurrent gallstones and CBD stones is safe,effective and more economic approach than two-stage treatment for patients suffering from concurrent gall stone and choledocholithiasis.

Objective To determine the expression of ZNF217 protein in bladder cancer tissues and to analyze its clinicopathological characteristics, so as to clarify its clinical significance. Methods The clinicopathological data of 123 patients with bladder cancer who underwent bladder cancer resection were retrospectively analyzed. The expression of ZNF217 protein in bladder cancer tissues and corresponding adjacent tissues was detected by immunohistochemistry, and its correlation with clinical characteristics of patients was analyzed. Results ZNF217 protein was highly expressed in tumor tissues, and the ratio of high expression of tumor tissues was 67.4％, but it was lowly expressed in adjacent tissues. By comparing with clinicopathological features, the expression level of ZNF217 was significantly correlated with tumor T stage and tumor recurrence (all P<0.05), but not correlated with age , gender , tumor differentiation and lymph node metastasis (all P>0.05). The survival analysis showed that patients with high expression of ZNF217 in bladder cancer had significantly shorter overall survival and progression-free survival than those with low ZNF217 expression ( all P<0 . 05 ) . Conclusions ZNF217 is highly expressed in bladder cancer tissues, and its expression level is associated with tumor stage, tumor recurrence and poor prognosis, suggesting that it can be used as a potential therapeutic target for bladder cancer.

Objective To discuss the practicability and safety of 3.5 mm superfine bronchoscope in children's difficult airway.Methods Twenty-eight children with difficult airway,aged 4 months to 8 years were selected.Intravenous anesthesia was used and autonomous respiration was maintained.The 3.5 mm superfine bronchoscope was used to guide tracheal intubation by nose(mouth).Results Among 28 cases, 1 case had oral bleeding and succeeded after suction and pressurized oxygen supply, and the rest was successful in the first time.The intubation time was(1.50 ± 0.25)min.There was no damage to the whole airway.Success rate was 100%.Conclusions The 3.5 mm superfine bronchoscope in guiding tracheal intubation of children's difficult airway has obvious advantages and security, and it deserves clinical attention and promotion.

Objective:To analyze the feasibility, safety and clinical efficacy of laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes patients (BMI≤32.5 kg/m 2). Methods:The clinical data of 135 patients who underwent laparoscopic side-to-side jejunoileal anastomosis at our hospital from Jan 2018 to Oct 2018 were retrospectively analyzed. They were followed up for 12 months until the end of Oct 2019. SPSS software was used to compare patients′ fasting blood glucose, glycosylated hemoglobin, c-peptide, insulin, body weight, BMI with the values after 12 months of the surgery, and then evaluate factors affecting the prognosis.Results:135 patients successfully completed laparoscopic side-to-side jejunoileal anastomosis without conversion to open surgery. After 12 months of the operation, the patients′ fasting blood glucose was (5.80±0.18)mmol/L, glycosylated hemoglobin was 5.9%±0.4%, fasting c-peptide was(1.32±0.21) nmol/L, and fasting insulin was (42±54) mU/L ( t=10.654, 12.657, 11.214, 10.698, all P<0.05). The body weight was (72.4±9.9)kg, BMI was( 25.6±2.8)kg/m 2, and the difference was not statistically significant ( t=7.658, 6.958, P>0.05). In patients with preoperative glycosylated hemoglobin controlled below 8% and the duration of T2DM less than 10 years, the chances being cured was better than that of those with glycosylated hemoglobin>8% and the medical history >10 years. Conclusion:Laparoscopic side-to-side jejunoileal anastomosis in the treatment of non-obese type 2 diabetes is effective, safe and reliable.

Renal cancer with multiple differentiation and multiple components is rare in clinic. It has the character of high malignancy, early metastasis, and poor prognosis. A patient with multiple differentiated renal cell carcinoma was diagnosed in our hospital mainly because of emaciation, fatigue and loss of appetite. CT scan showed the 6.5 cm×6.0 cm mass in the lower pole of right kidney with unequal enhancement and necrosis. The chest CT scan showed multiple enlarged lymph nodes in the mediastinum and right superior clavicle. The patient accepted the laparoscopic retroperitoneal right nephrectomy and right supraclavicular lymph node biopsy. Postoperative pathology showed multiple differentiated renal cell carcinoma with localized sarcomatoid leisions, including clear cell carcinoma, collecting duct-like carcinoma and medullary carcinoma combined with right supraclavicular lymph node metastasis. Targeted therapy was performed at 1 month after surgery. Liver and lung metastasis occured at 6 months and the patient died of multi-organ failure at 12 months after surgery.