Objective To investigate clinical value of transurethral bipolar plasma cutting and transurethral resection for benign prostatic hyperplasia,to provide a reference for clinical treatment.Methods 100 cases with benign prostatic hyperplasia were selected,according to surgical treatment,they were divided into control group and observation group.50 patients in the control group received TURP surgical treatment,50 patients in the observation group were given TUPKP surgical treatment.The patients were followed up for 3 months,the indwelling catheter time, weight and other clinical indicators of glandular tissue were compared,serum sodium and hemoglobin levels were observed,the quality of life index,international Prostate Symptom Score,complications and other indicators were compared. Results In the observation group,operative time was (60.54 ±8.37)min,blood loss was (108.43 ±21.27)mL, hospital stay was (7.09 ±2.25)d,which were shorter than those of the control group (70.24 ±12.22)min,(188.76 ± 21.36)mL,(8.63 ±2.76)d,the differences were statistically significant (t =5.441,P =0.012;t =8.326,P =0.001;t =6.216,P =0.006).In the observation group after three months,maximum flow rate was (18.95 ±4.11)mL/s, residual urine volume was (28.74 ±4.55)mL,IPSS was (5.12 ±1.27)points,QOL was (1.43 ±0.24)scores, which were better than those of the control group (14.24 ±3.77)mL/s,(20.85 ±5.11)mL,IPSS(6.95 ±1.44)points, QOL(2.03 ±0.32)points,the differences were statistically significant (t =8.763,P =0.000;t =7.616,P =0.003;t =5.472,P =0.011;t =8.044,P =0.002).The incidence rate of complication in the observation group was 10.00%, which was significantly lower than 22.00% in the control group,the difference was statistically significant (χ2 =5.437,P =0.012).Conclusion TUPKP treatment for benign prostatic hyperplasia has significant clinical effect, which can effectively improve the clinical symptoms and quality of life with good safety,it is worthy of clinical application.

Objective To explore whether CCL18 is involved in regulating the expression of miRNAs in breast cancer.Methods The expression profile of miRNAs in the breast cancer cell following CCL18 treatment was determined by miRNAs microarray analysis.Then we performed QRT-PCR and Luciferase Reporter Assay to validate the results from the miRNAs microassay.We used transient transfection to change the expression of miR98 and c-myc in breast cancer cells.We then used QRT-PCR and Western blot to analyze the mechanism by which CCL18 downregulates the expression of miR98 in breast cancer cells.Results miRNAs microarray analysis showed that cells treated with CCL18 differentially expressed 20 miRNAs genes compared with those in the control group. Our QRT-PCR and Luciferase Reporter Assay confirmed the result.The mRNA and protein expressions of C-myc and lin28 were increased after CCL18 stimulation in breast cancer cells.Transfection with c-myc siRNAs rescued the increase of lin28 and loss of miR98 expression caused by CCL18 stimulation.Our results also showed that CCL18 could upregulate the expression of N-Ras at post-transcription level.Conclusion CCL18 downregulates the expression of miR98 via N-Ras/c-myc/lin28 pathway.The downregulated miR98 increases the expression of N-Ras after transfection,which further activates c-myc/lin28 pathway and forms a positive feedback loop.

The advantages and disadvantages , internal and external environments of Medical Journal of PAPF were analyzed by SWOT strategic management theory analysis with its opportunity and threats pointed out.Different fac-tors for the development of Medical Journal of PAPF were ranked to produce a SWOT matrix.The strategies were put forward for the development of Medical Journal of PAPF that represents the future direction of medical sciences in PAPF in order to keep abreast of competition with other domestic and foreign journals .

Objective To evaluate the role of native ureter for the management of renal transplantation urological complications retrospectively.Method Twenty-six renal transplant recipients (18 males and 8 females) experienced the following urological complications:upper ureter injury,urinary leaks and moderate or severe ureteric obstructions secondary to ureterovesical anastomotic stricture.These complications have been managed with minimally invasive endourologic techniques or percutaneous nephrostomy as the first-line intervention.While endourologic treatment did not succeed,and the recipients have been treated with intraperitoneal open surgical correction.Urinary continuity was established by pyeloureterostomy or ureteroureterostomy using recipient native ureter.A pigtail ureteral stent was placed with the tip positioned in the pelvis of the graft and native bladder and removed after 4 to 6 weeks.Result The recipients were managed successfully during a follow-up period of 6 months to 6 years without occurrence of urological complications.One case underwent graft loss due to chronic rejection 5 years later postoperation,and the rest developed stable renal function with baseline serum creatinine.Conclusion Excellent outcomes have been achieved by the use of recipient native ureter for the management of urological transplant complications.This simple and efficient procedure should be considered as the superior choice for the recipients who experienced urological complications while less invasive endourologic techniques failed.

Objective To discuss the prognostic value of aspartate aminotransferase (AST) to neutrophils ratio index (ANRI) in patients with hepatocellular carcinoma (HCC) after receiving transarterial chemoembolization (TACE).Methods The clinical data of 107 HCC patients,who were admitted to authors' hospital to receive treatment during the period from January 2008 to June 2011,were retrospectively analyzed.TACE was successfully performed in all patients.Based on the 5-year overall survival rate,ROC curve was drawn and the cutoff value was determined.Preoperative ANRI,AST-lymphocytes ratio index (ALRI),AST-platelet count ratio index (APRI),neutrophil-lymphocytes ratio index (NLR),platelet count-lymphocytes ratio index (PLR) and other clinical pathological parameters were calculated.Univariate analysis,multivariate Logisitc regression analysis and Kaplan-Meier survival analysis were used to assess the value of the above indexes in prejudging the disease-free survival (DFS) and overall survival (OS).Results ANRI bore a close relationship to the presence of HBsAg,AST,presence of cirrhosis,tumor size,portal vein tumor thrombus (PVTT) and recurrence of tumor (P＜0.05).Univariate analysis showed that ANRI,ALRI,APRI,NLR and PLR were significantly correlated with DFS and OS in HCC patients after receiving TACE (P＜0.05).Logisitc regression analysis revealed that ANRI was independent factor influencing DFS and OS (P＜0.05).Kaplan-Meier survival analysis indicated that the prognosis after TACE was poor in patients whose preoperative ANRI ＞7.8.Conclusion Preoperative ANRI level is an independent and effective predictor for judging the prognosis of HCC patients.A high preoperative ANRI level usually suggests a poor prognosis after TACE.

Objective To report the modified technique and the short-term results of simultaneous pancreaticoduodenum-kidney transplantation (SPK) with the enteric drainage (ED) of exocrine secretions. Method Between June 2000 and Jan 2006, thirty-five patients with diabetes and uremia underwent SPK. The pancreas graft is placed intraperitoneally with its exocrine secretions drained into the proximal jejunum without Roux-en-Y procedure. The mean cold ischemic times of kidney was 6. 92?2. 17 hours and that of pancreas, 9. 65?2. 02 hours. Quadruple immunosuppressive therapy with antilymphocyte globulin or antiCD25 monoclonal antibody ( Zenapax ) , tacrolimus, mycophenolate mofetil and steroids was adopted. Results Postoperative patient and graft survival rates were 97. 3%. All patients achieved insulin-free euglycemia at 8.3?4.5 days postoperatively. Preoperative patient's mean fasting insulin and C-peptide values were 7.45?7. 35 mU/L and 5. 68?4. 66 mU/L. After operation, patients had fasting insulin and C-peptide values of 11. 9?5.70 mU/L and 5. 57?4. 90 mU/L, respectively, which peaked to an insulin level of 57. 9?46.6 mU/L and a C-peptide level of 11.75?6.99 mU/L with stimulation. The pancreas grafts also functioned well as evidenced also by normal serum amylase values of 92. 10?12. 24 U/L on 10th postoperative day. There were five cases of delayed renal graft function. All other patients achieved immediate renal graft function. No graft losses occurred due to leakage or intra-abdominal infection. The most commn surgical complications were wound infection (n - 11) , enteric anastomostic hemorrage ( n = 5) , and peri-renal hemorrage (n =2). Conclusions SPK is a effective treatment option for patients with diabetes mellitus and uremia. Enteric exocrine drainage by direct side-to-side anastomosis (without Roux-en-Y loop) seems to be a simple and reliable technique.

BACKGROUND:Cytokine induced kil er cells therapy as an effective means of adoptive immunotherapy, becomes a new way to treat acute myeloid leukemia. But, the researches about sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation in acute myeloid leukemia patients are stil less, which deserve further research.
OBJECTIVE:To observe the clinical efficiency and safety of sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation in acute myeloid leukemia M2 patients.
METHODS:Total y 45 patients with low-or intermediate-risk acute myeloid leukemia M2 were recruited in this study. Among them, 19 patients received sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation and 26 patients only received autologous peripheral blood stem celltransplantation. The relapse rate, disease-free survival, and overal survival were compared between two groups, and safety of cytokine induced kil er cells therapy was observed.
RESULTS AND CONCLUSION:(1) Compared with the patients only receiving autologous peripheral blood stem celltransplantation, the relapse rate was lower (21.05%vs. 38.46%;P<0.05), and elevated percentages of the disease-free survival and overal survival were observed in the patients receiving sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation (P<0.05). (2) The 19 patients who received sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation al completed the treatment scheme successful y. Only four patients appeared to have chil s and fever, and no more side effects were observed. These findings suggested that the sequential cytokine induced kil er cells therapy after autologous peripheral blood stem celltransplantation can improve the disease-free survival and overal survival of low-or intermediate-risk acute myeloid leukemia M2 patients without remarkable side effects, which is a safe, effective and feasible way for the treatment of acute myeloid leukemia M2.

Objective: To evaluate the surgView-RFT electromagnetic navigation system in radiofrequency thermocoagulation(RFT). Methods: 6 foramen ovales of 3 cadavers were punctured by 3 beginners. Every one tried 5 times by free-hand and 5 times by SurgView-RFT electromagnetic navigation-guidance. After each puncture, CT scans were used as golden standard to measure the distance between the tip of needle and the anterior margin of the foramen ovale. T test and variance of SAS 6.12 statistical software was used to do the statistic analysis. Results: The punctures by free-hand failed, and the distances between the tip of needle and the anterior margin of the foramen ovale were 8-10.6 mm. The punctures by navigation guidance were successful, and the distances between the tip of needle and the anterior margin of the foramen ovale were 2.68-3.54 mm. The error of navigation system was 0.59 mm which was verified by CT scan. There was significant difference between free-hand puncture and navigation-guided puncture. Conclusion: The surgView-RFT electromagnetic navigation system is characteristic with high performance, high accuracy and minimal invasion, while it is applied in training or clinical using.

Objective To analyze the clinical effects of the diverse prevention strategies on donation after citizen's death (DCD) donor fungal infection.Methods A retrospective study was performed on the clinical data of the antifungal preventive scheme to 261 DCD donors from January 2015 to August 2015 (the first period) and September 2015 to December 2016 (the second period) in Tongji Hospital.During the first period,the donors were administrated by ICU doctors and the antifungal agents were not applied as routine.The processes of organ procurement and trim were in accordance with the past experience.During the second period,the donor maintenance was reinforced,including antifungal preventive scheme,aseptic manipulation of organ procurement and rinsing and immersing allografts with broad-spectrum antibiotics or diluting povidone-iodine solutions during organ trim.Microbial culture specimens were performed in 1 574 samples including blood samples,perfusion fluids and arterial tissues and the pathogen distribution at the different periods was identified.Result In the microbial culture specimens of 1 574 samples,907 strains of pathogens were detected,including 799 strains of bacteria and 108 strains of fungi.The positive rate of fungi was 12.0％ (108/907) of all pathogens,and 17.3％ (108/626) of fungal cultures specimens.The fungi positive rate in the second period (13.6％,59/433) was significantly lower than that in the first period (25.4％,49/193,P＜ 0.05).Conclusion It is essential to reduce the incidence of donor fungal infection by increasing the microbial cultures and antifungal preventive scheme.And it is necessary that the organ procurement organization team enhances the risk awareness of donor-derived fungal infection and improves the aseptic manipulation of organ procurement.Additionally,rinsing and immersing allografts with broad-spectrum antibiotics or diluting povidone-iodine solutions may be a better option for preventing the donor-derived fungal infection during the allograft trim.

Objective To study the value of ultrasound in operation for traumatic brain injury (TBI) in simulation field hospitals where computed tomography (CT) equipment is unavailable.Methods The wartime conditions were simulated, and the patients at age of 18-60 years were randomly selected.According to the principles of medical ethics, all patients received CT scanning.Two neurosur-geons from the field hospital who did not know the result of CT examination cooperated with another two neurosurgeons who got the results of the CT examination to determine whether operation should be ap-plied.Forty-five patients who needed emergency craniotomy were finally selected.The operations were performed by two neurosurgeons from the field hospital, with real-time ultrasound monitoring.The results of ultrasound were compared with that of CT scanning.Results A total of 64 lesions were found by ul-trasound , and 60 of which should be treated by operation.In the meantime, 82 lesions were found by CT scanning, 64 of which should be treated operatively.Epidural hematoma and subdural hematoma had high ultrasound detection rate, followed by intracerebral hematoma, subdural effusion and brain contusion.The overall detection rate of ultrasound was 87.1%.Conclusion Ultrasound plays an important role in correctly finding the focus so as to reduce blind operation and avoid omission of the focus in field hospi-tals, where CT equipment is usually unavailable.