It is very difficult to operate the patients with malignant neoplasms combined with superior vena cava syndrome because of SVC has a special place.And it's prognosis is not good. Now we will use some relative articles to draw a synoptic conclusion in the indications ,surgical skills, and curative effects of this operation.

There are a variety of serological changes in the blood circulation of patients with lupus nephritis,including complement,autoantibodies,immunoglobulin and cytokines and so on.These substances not only involved in the development of the disease leads to renal pathological damage,but also can be used as a biomarker to reflect changes in disease.In this paper,the detection of serum markers in lupus nephritis diagnosis,determine the pathological classification,disease activity,evaluation of therapeutic effect and prognosis were reviewed,in order to provide scientific basis for the early diagnosis and treatment of lupus nephritis by monitoring the changes of serum indicators.

BACKGROUND:Hepatic vascular exclusion is important for liver transplantation that can reduce blood loss and make for liver recovery. A variety of favorable hepatic vascular exclusion techniques occur in the development of liver surgery technology, which is stil a research hot in surgical study. OBJECTIVE:To introduce the latest research and the hot spot of hepatic vascular exclusion techniques. METHODS:A computer-based online search of PubMed and Wanfang databases for articles relevant to Pringle maneuve, total hepatic vascular exclusion, selective hepatic vascular exclusion and sectional vascular exclusion under hepatectomy published from January 1999 to January 2014. Totaly 50 articles were included in result analysis. RESULTS AND CONCLUSION:There are a variety of hepatic vascular exclusion technologies, and intermittent hepatic vascular occlusion and semihepatic vascular exclusion are used most commonly. The applicable principles are as folows: (1) Surgery without vascular exclusion is suitable for < 5 cm lesions at the liver edge. (2) Semi-hepatic vascular exclusion is fit for semi-hepatic lesions, especialy for patients accompanied by liver cirrhosis. Hepatic vascular exclusion with preservation of semi-hepatic artery and liver hanging maneuver are also reported to have a certain value in clinical practice stil need further studies. (3) Intermittent hepatic vascular exclusion is suitable for lesions over half a liver or spanning liver halves (huge lesions). (4) Total hepatic vascular exclusion and its modified technologies are suitable for lesions involving the inferior vena cava and (or) hepatic vein, or lesions closely related to the second and third porta hepatis. (5) Segmental hepatic vascular exclusion is considered for smaler lesions confined to the liver segment under alowed conditions, but semi-hepatic vascular exclusion and Pringle maneuver can be also considered. Depending on patient’s conditions, to select the appropriate method is the key to reduce bleeding and to ensure patient safety.

The malignant pleural mesothelioma is kind of tumor that has close contact with theasbestos to oncolytic,and its attack is very strong.Because the reasons of it iS not obviously and always be found in the middle of late period,the present treatment plan dosnt have a satisfied effect.However oncolytic herpes simplex viruses and obliging platinum induction to oncolyti herpes simplex viruses that generate the GADD34 protein may have the relative specificity to themesothelioma cancer cell,therefore is a prospect ive treatment plan.

Objective To examine the relationship of exposure and potential dose of human exposed to indoor and outdoor air pollutants. Methods The definition and calculation methods of exposure and potential dose were analyzed and compared. Personal exposure and potential dose of formaldehyde and carbon monoxide in indoor and outdoor air were calculated by scenario evaluation approach respectively, and the relationships between exposure and potential dose were analyzed also. Results Potential dose could much better accurately reflect the amount of air pollutants entering human body through respiratory tract than exposure did. Exposures and potential doses of human exposed to formaldehyde and carbon monoxide in indoor and outdoor air were significantly correlated in some cases, but not correlated well in other cases. Conclusion Potential dose might be more accurately linked to health effects of air pollutants than exposure did.

Objective To investigate the expression of E26 transformation-specific-1 (E26ts-1),matrix metalloproteinase-1 (MMP-1) and tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) in choroidal melanoma and the correlation with the tumor′s infiltration and metastasis. Methods Immunohistochemistry was used to detect the expression of E26ts-1,MMP-1and TIMP-1 in 78 cases of choroidal melanoma who were divided into shuttle-cells,paraepithelial-cells and mixed-cells type according to the configuration of tumor cells.The patients were followed up and their average existing time was calculated.The results were statistically computed with statistic SPSS 10.0 package. Results In the 78 cases,shuttle-cells type was found in 21,paraepithelial-cells type in 34,and mixed-cells type in 23. Expression of TIMP-1was low in uveal melanoma,while expression of E26ts-1 and MMP-1 was obviously found in the three types of choroidal melanoma;the sequence of expression intensity was shuttle-cells,mixed-cells and paraepithelial-cells type.Among 37 cases who had been followed up,the shuttle-cells type was in 18 with the average existing time of (78.33?24.69) months,the mixed-cells type was in 10 with the average existing time of (61.44?20.46) months,and the paraepithelial-cells type was in 9 with the average existing time of (36.76?12.19) months.The existing time was negative correlated with the intensity of expresion of E26ts-1 and MMP-1. Conclusion The high expression of E26ts-1 and MMP-1and low expression of TIMP-1may relate to the choroidal melanoma′s infiltration and metastasis.

Objective To investigate the effects of phenylephrine and norepinephrine on tissue oxygen metabolism in elderly patients undergoing fluid restriction. Methods Eighty elderly patients who had underwent elective colorectal surgery were selected, with ASA of Ⅰ-Ⅱ grade. The patients were divided into restricted fluid administration combined with phenylephrine group (group Ⅰ) and restricted fluid administration combined with norepinephrine group (groupⅡ) by random digits table with 40 cases each. The compound recipe sodium lactate was given at a rate of 5 ml/(kg · h). Small dose of phenylephrine was infused intravenously at 0.1-0.3μg/(kg · min) simultaneously during the surgery in group Ⅰ, or norepinephrine 0.01-0.03 μg/(kg · min) in group Ⅱ. Mean arterial pressure (MAP) was maintained ≥ 65 mmHg (1 mmHg = 0.133 kPa). The intraoperative blood loss was replaced with the equal volume of 6% hydroxyethyl starch 130/0.4. The blood gas analysis, hemoglobin and so on were determined before the surgery (T0), 1 h after beginning of surgery (T1), 2 h after beginning of surgery (T2) and at the time of leaving operation room (T3). The complications were recorded. Results There were no statistical differences in MAP, central venous pressure (CVP), heart rate, lactic acid, arterial partial pressure of oxygen, central venous oxygen pressure, central venous blood oxygen saturation, oxygen uptake rate, hemoglobin, albumin, blood urea nitrogen, creatinine and incidence of complication between 2 groups (P>0.05). The T1-3 hemoglobin and arterial oxygen content (CaO2), T1 and T3 venous oxygen content (CcvO2) and T2 atrerial venous oxygen content differences (Da-cvO2) in groupⅠwere significantly higher than those in groupⅡ, hemoglobin:(103.8 ± 7.9) g/L vs. (110.8 ± 8.6) g/L, (101.7 ± 7.7) g/L vs. (107.3 ± 7.8) g/L and (101.6 ± 6.9) g/L vs. (106.8 ± 5.6) g/L; CaO2: (140.6 ± 9.7) mmol/L vs. (149.6 ± 10.5) mmol/L, (137.5 ± 9.3) mmol/L vs. (144.9 ± 10.2) mmol/L and (137.2 ± 9.2) mmol/L vs. (143.1 ± 8.9) mmol/L;CcvO2:(119.8 ± 10.2) mmol/L vs. (126.4 ± 10.8) mmol/L and (102.3 ± 8.6) mmol/L vs. (108.5 ± 8.9) mmol/L;Da-cvO2:(19.6 ± 3.9) mmol/L vs. (23.0 ± 4.5) mmol/L, and there were statistical differences (P<0.05). Conclusions Phenylephrine has more effect on tissue oxygen metabolism in the elderly patients undergoing fluid-restricted abdominal surgery.

Objective To prospectively study the effects of different fluid resuscitation on kidney function in pediatric patients with sepsis.Methods One hundred and eighteen pediatric patients with sepsis shock who needed fluid resuscitation in Intensive Care Unit,Zhengzhou Children′s Hospital from June 2012 to June 2015 were selected, and they were randomly divided into group A,B and C by random number in the table.The patients received fluid resus-citation of hydroxyethyl starch,50 g/L albumin and 9 g/L saline.After that,neutrophil gelatinase associated lipocalin (NGAL),α-1 microglobulin,urea nitrogen,creatinine,urine volume,the incidence of acute kidney injury (AKI),and the renal replacement therapy rate accepted by the patients were recorded.Then all the data were analyzed with SPSS 19.0 software.Results Serum levels of NGAL and α-1 microglobulin in group A [(103.50 ±1.23)μg/L,(3.32 ± 0.20)mg/L]were higher than those in group B [(93.54 ±1.42 )μg/L,(2.71 ±0.18 )mg/L]and group C [(79.57 ±1.54)μg/L,(2.08 ±0.14)mg/L],which were statistically different(all P <0.05 );serum levels of NGAL and α-1 microglobulin in group B were higher than those in group C,which were statistically different(all P <0.05).Serum levels of urea nitrogen and creatinine in group A[(5.23 ±0.34)mmol/L,(112.00 ±7.12)μmol/L] were higher than those in group B [(3.56 ±0.31)mmol/L,(77.25 ±5.34)μmol/L]and group C[(2.95 ±0.42) mmol /L,(72.12 ±6.34)μmol/L],which were statistically different (all P <0.05);serum levels of urea nitrogen and creatinine in group B were higher than those in group C,which were not statistically different(P >0.05).The urine volume in group A [(0.50 ±0.12)mL/(kg·h)]was less than that in group B[(0.90 ±0.23)mL/(kg·h)]and group C[(1.30 ±0.14)mL/(kg·h)],which was statistically different(all P <0.05);the urine volume in group B was less than that in group C,which was not statistically different(P >0.05).In three groups,there were 13 cases (34.2%)with AKI in group A,9 cases(23.1%)with AKI in group B,and 8 cases(19.5%)with AKI in group C, the incidence of AKI in group C was less than that in group B and group C,which was statistically different(χ2 =12.74,10.43;all P <0.05).All the groups all had children accepted renal replacement therapy,there were 8 cases (21.1%)in group A,7 cases(17.9%)in group B,and 6 cases (14.6%)in group C,and the cases who accepted renal replacement therapy rate in group C were less than those in group A and group B,which was statistically different(χ2 =11.36,8.73;all P <0.05).Conclusions The adverse effect of 9 g/L saline on kidney function is less than hydrox-yethyl starch and 50 g/L albumin,and hydroxyethyl starch has more adverse effects on kidney.Thus,9 g/L saline is a better option for fluid resuscitation in pediatric sepsis patients.

Objective To compare the impact of conventional vs. zero-balanced ultrafiltration on serum pro-inflammatory factors,acute kidney injury and clinical prognosis after cardio-pulmonary bypass procedure. Methods Forty patients receiving cardiac surgery under cardio-pulmonary bypass procedures in Xiangyang Central Hospital during January 2013 to June 2013 were randomly divided into conventional ultrafiltration group(group A,n=20)and zero-balanced ultrafiltration group(group B,n=20). Blood and urine samples were collected on different time points( pre-operation,T0;pre-ultrafiltration,T1;immediately after ultrafiltration,T2;24 hours post-operation,T3;48 hours post-operation,T4;7 days post-operation, T5). TNF-α,IL-6,KIM-1,CysC,serum creatinine and urea nitrogen were detected and compared. Pre-and post-operative clinical data were also collected. Results There was no difference in baseline data or intra-operative data(p>0. 05). TNF-αand IL-6 started to increase when the operation began. Compared with conventional ultrafiltration,zero-balanced ultrafiltration alleviated the increase of TNF-α and IL-6,espe-cially on T2,T3,and T4(p<0. 05). Zero-balanced ultrafiltration also decreased CysC,Rbp,serum creati-nine and urea nitrogen on T2,T3,and T4 compared with conventional ultrafiltration(p<0. 05). A total of 11 patients experienced AKI( >grade I)in group A and 2 patients experienced in group B(p<0. 01). There were significant differences of ventilation time,total complication incidence and ICU stay time be-tween two groups. There was no difference in other complications,post-operative days in hospital or death rate within 30 days. Conclusion Though there is a trend of more patients receving renal replacement therapy,no statistical difference has been achieved. In conclusion,zero-balanced ultrafiltration can effec-tively decrease the concentration of serum pro-inflammatory factors,alleviate acute kidney injury and improve the clinical prognosis after cardio-pulmonary bypass procedures. It is a safe and reliable method valuable for promotion.

BACKGROUND: Current treatmemt strategy cannot efficiently relieve or reverse the disk degeneration, and neither surgical treatment nor nonsurgical treatment has gained satisfactory long-term effect. Therefore, more and more researches have focused on the cell therapy. OBJECTIVE: To explore the present states and application prospect of cell therapy, especially stem cells for degenerative intervertebral disc repair.METHODS: A computer-based search for related articles in PubMed database published between January 2011 and January 2016 using the English keywords of stem cell, intervertebral disk degeneration. Literatures addressing cell therapy for degenerative intervertebral disc repair were selected, and the articles published lately or original researches in authoritative journals were preferred.RESULTS AND CONCLUSION: A total of 205 articles were selected firstly, and 50 eligible articles were enrolled finally in accordance with the inclusion criteria. The mixtures of stem cells and carrier are injected into the degenerative intervertebral disk, to repair or displace abnormal cells. This strategy has been accepted by many researchers, and considered as a promising treatment. However, there is little evidence about the safety of clinical treatment with cell therapy, which still needs to be explored in depth.