soda lime). It took significant less time to reach the peak CO concentration with baralyme than with the other two CO2 absorbents. The temperature of top canister went up faster than that of the bottom one with soda lime; whereas with baralyme the temperature of the bottom canister went up faster. Conclusion In a simulated closed circuit the risk of CO poisoning was higher with baralyme than with soda lime. But KOH-free soda lime which still contains NaOH, such as sofnolime, may produce more CO than standard soda lime.

Purpose To explore the relation between the expression of Bmi-1 and cancer stem cells and its relation to chemotherapy re-sistance in breast cancer. Methods MTT method was applied to detect the inhibition effect on proliferation of different concentrations (0. 01, 0. 1, 1, 10 μg/ml) of 5-Fluorouracil (5-FU) to MDA-MB-468 cells with 48 and 72 hours culture, a curve of proliferation in-hibition rate was drawn, and a suitable experiment concentration of 5-FU was chosen. MDA-MB-468 cells was serially passaged under continuous interference with the suitable concentration of 5-FU, 6 generations of cells were collected, cells with 5-FU interference were designed as experiment group and a corresponding control group with no 5-FU was set. RT-PCR and Western blot were employed to ex-amine mRNA and protein expression of Bmi-1 and Sca-1, Oct-4 in the 6 generations of cells of both control group and experiment group. Results Results of the MTT test showed that 5-FU could inhibit the proliferation of human breast cancer cell line MDA-MB-468, the 5-FU concentration of 0. 1 μg/ml was chosen as the suitable experiment concentration. RT-PCR tests showed that the differ-ences between the relative mRNA expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were not sta-tistically significant in control group (all P>0. 05) and that the differences between the relative mRNA expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were of statistical significance in experiment group cells (all P<0. 05). The mRNA expression of Bmi-1, Sca-1 and Oct-4 showed the following tendency in the 6 generations of passaged cells:decrease (1st gen-eration)—increase (2nd generation)—continuous increase (3rd generation)—decrease (4th generation)—increase (5th genera-tion)—decrease (6th generation). Western blot tests indicated that the differences between the relative protein expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were not statistically significant in control group and that the differ-ences between the relative protein expression values of Bmi-1 and Sca-1, Oct-4 in the 6 generations of MDA-MB-468 cells were of sta-tistical significance in experiment group cells (all P<0. 05). The expression of Bmi-1 was positively correlated with stem cell associat-ed factors Sca-1, Oct-4 (r=1, all P<0. 01). Conclusions The expression of Bmi-1 gene is positively correlated with expression of stem cell associated factors Sca-1 and Oct-4 in breast cancer cell line MDA-MB-468 cell, and Bmi-1 may be a novel marker for cancer stem cells in breast cancer. Administration of 5-FU can affect the expression level of Bmi-1 and the ration of cancer stem cells in breast cancer cell line MDA-MB-468. Bmi-1 gene may be associated with drug resistance to chemotherapy and recurrence in breast cancer.

Objective To evaluate an improved technique of vertical mammaplasty with purse string suture for correction of breast ptosis and its clinical application.Methods The adjustable markings of vertical mammaplasty was improved with an upper pedicle for the areola,and breast reduction was adapted with the lower part.The breast tissue was lifted and fixed on the second rib level to reshape the breast,which did not rely on the skin,with purse string suture for the lower half of vertical incision.32 patients with breast ptosis had been operated from May 2009 to February 2014.Results 32 cases were treated with vertical mammaplasty with short scar.The shape of the breasts was strengthen,without obvious scar,and follow-up results of patients were satisfied.Conclusions The vertical mammaplasty with short scar design is simple,operation is convenient,breast shape is plump,and postoperative long-term effect is great.This procedure can be used as one of the feasible operation for breast ptosis correction.

Objective To investigate mechanism involved in the differentiation of FBL-3 cells(eryth-roleukemia cells)induced by dendritic cells(DC). Methods To cultural the FBL-3 cells together with the DC supematant of different concentration for 72 hours,then we used the Wright's staining methed to record the ma-ture monocyte cell population, the transmission electron microscope to observe the ultramicrostructure, the flow eytoraetry to detect the expression rate of the surface molecular CD14. Results The Wright's staining methed, the transmission electron microscope and the flow cytometry all presented that after being induced by the super-natant of the DC ,the FBL-3 cells can partly differentiate into monocytes,inversion monocyte consistent with the personal characteristics. And the intensity of the DC supernatant was connected with interleukin-12. Conclusion The DC supernatant can induce the FBL-3 cells into monocytoid cell, the differentiated cells correspond to monocyte in macro-appearance,uhramicrostructure and phenotype. The competence of the DC supematant are partly concerned with interleukin-12.

Objective To induce and identify the differentiation of rat bone marrow mesenchymal stem cells(MSCs)into cardiomyocytes in vitro,and observe the expression of Nesprin protein during the differentiation. Methods Rat MSCs were isolated and purified by Ficoll density gradient centrifugation,and adhered for serial subcultivation.Surface-associated antigens of MSCs of the second passage were dedected by flow cytometry.MSCs of the second passage were induced by 10μmol/L 5-azacytidine(5-Aza)to differentiate into cardiomyocytes,and the morphological changes were observed.The expression of Desmin,α-sarcomeric actin and cardiac Troponin I(cTnI) mRNA and protein was detected by RT-PCR,immunocytochemistIv and immunofluorescence staining, and the expression of Nesprin protein was detected by Western blotting. Results The morphology of MSCs induced by 5-Aza was bigger and longer,and the nuclei became bigger,exhibiting more consistent patterns.The expression of Desmin,α-sarcomeric actin and cTnI mRNA and protein of MSCs was positive.Immunofluorescence staining revealed that Nesprin protein positioned in the nuclear membrane,and Western blotting detection demonstrated that the expression of Nesprin protein significantly increased after differentiation(P<0.05).Conclusion MSCs may be successfully induced to differentiate into cardiomyocytes.The expression of Nesprin protein in the differentiated MSCs may significantly increase,indicating Nesprin may play a role in the differentiation from MSCs to cardiomyocytes.

ObjectiveTo investigate the effect of finasteride on hemorrhage in peri-operation of transurethral plasmakinetic enucleation of prostate (TUPKEP).Methods150 patients with benign prostatic hyperplasia (BPH) were randomly divided into 3 groups:control group without finasteride (n= 50),treatment groupl 1 with finasteride 5 mg daily for 7 days(n= 50) and treatment group 2 with finasteride 10 mg daily for 7 days(n= 50) before and after operation.All patients received TUPKEP and the data were recorded,including total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time after operation,amount of washing fluid after operation,and rebleeding rate within 3 months after operation.ResultsThe 150 patients successfully received TUPKEP.The total blood loss,amount of washing fluid during operation,operation time,blood loss per gram tissue,amount of washing fluid after operation,washing time after operation and rebleeding rate within 3 months after operation in treatment group 1 and 2 significantly reduced as compared with control group (P＜0.05).The blood loss per minute were (1.77±0.89) ml/min,(1.71±0.82) ml/min and (1.70±0.81) ml/min in 3 groups,respectively,and there were no significant differences among groups (P＞ 0.05).There were no significant differences between treatment group 1 and 2 in the total blood loss,operation time,amount of washing fluid during operation,blood loss of per gram tissue,blood loss per minute,washing time and amount of washing fluid after operation (P＞0.05).The rebleeding rate within 3 months after operation in treatment group 1 (8/35) and treatment group 2 (3/26) decreased as compared with control group (17/39) (x2= 3.544 and 7.523,P=0.016 and 0.025)and it was lower in treatment group 2 than in treatment group 1 (x2 = 1.293,P = 0.044).Conclusions The application of finasteride in peri-operation of TUPKEP can reduce hemorrhage.

Objective To compare the efficacy between autologous fat and hyaluronic acid in filling nasolabial grooves.Methods Sixty patients who wanted improvement of nasolabial grooves were involved in the study.They were randomly and equally classified into two groups:autologous fat injection group and hyaluronic acid injection group.Photographs were taken before,half a year,and one year after injection.The nasolabial grooves were also graded before,half a year,and one year after injection.The grade improvement was obtained after postoperative grade minus preoperative grade.If the grade improvement was more than 1 grade,the treatment was regarded as effective to evaluate the outcome between the two methods.Results The results of the two groups were tested by SPSS 13.0 software.The effects of the two methods were not significantly different after half a year of filling (P＞0.05).The difference was significant one year after filling (P＜0.05).In autologous fat injection,the patients had a long and magnificant swelling and redness around the nasolabial grooves;on the contrary,the patients who underwent hyaluronic acid had slight and short-time local reaction like swelling and redness.No other serious complications were found in both the groups.Conclusions The effects of the autologous fat and the hyaluronic acid are equal after half a year of filling.The autologous fat has a longer effect in one year.Both methods are safe and effective.Surgeons can select the method accordingly.

Objective:To analyze the radiotherapy-related factors affecting the survival of non-small cell lung cancer (NSCLC) patients complicated with malignant pleural effusion (MPE)(MPE-NSCLC).Methods:From 2007 to 2019, 256 patients pathologically diagnosed with MPE-NSCLC received primary treatment. Among them, 117 cases were enrolled in this study. All patients were divided into two groups according to the radiation dose (<63 Gy and≥63 Gy). Propensity score matching (PSM) was performed to further adjust the confounding factors (Calipers value=0.1). The impact of radiotherapy-related factors on the overall survival (OS) was analyzed by Kaplan—Meier method, log-rank test and Cox’s regression model. Results:Primary tumor radiotherapy significantly prolonged the OS ( P<0.001). The radiation dose escalation (36.0-44.1 Gy, 45.0-62.1 Gy, 63.0-71.1 Gy) of primary tumor significantly prolonged the OS ( P<0.001). The corresponding median OS were 5, 13 and 18 months, respectively. Before the PSM, univariate analysis suggested that radiation dose ≥63 Gy, gross tumor volume (GTV)<157.7 cm 3 and stations of metastatic lymph node (S-mlN)≤5 were significantly associated with better OS (all P<0.05) and T 4N 3 was significantly associated with worse OS ( P=0.018). After the PSM, univariate analysis indicated that radiation dose ≥63 Gy was significantly associated with better OS ( P=0.013) and S-mlN ≤5 had a tendency to prolong the OS ( P=0.098). Prior to the PSM, multivariate analysis showed that radiation dose ≥63 Gy was an independent favorable factor of OS ( HR=0.566, 95% CI 0.368-0.871, P=0.010) and GTV<157.7 cm 3 had a tendency to prolong the OS ( HR=0.679, 95% CI 0.450-1.024, P=0.065). After the PSM, multivariate analysis revealed that radiation dose ≥63 Gy was still an independent favorable factor of OS ( HR=0.547, 95% CI 0.333~0.899, P=0.017). No ≥grade 4 radiation toxicity occurred. The incidence rates of grade 3 radiation esophagitis and pneumonitis were 9.4% and 5.1%, respectively. Conclusion:For MPE-NSCLC, radiotherapy dose of primary tumor may play a key role in improving OS on the basis of controllable MPE.

Objective:To investigate the efficacy and safety of semisupine-lithotomy position placement of Allium ureteral stent to treat ureteral stricture caused by pelvic tumours.Methods:The clinical data of 29 patients who received Allium ureteral stent(URS) placement for ureteral stricture in Sun Yat-sen Memorial Hospital, Sun Yat-sen University between April 2020 and March 2022 were retrospectively analyzed. There were 3 males and 26 females, with the median age of 56(54, 61) years old. All patients had a pathology confirmation of carcinoma before the treatment, including 26 patients with gynaecological tumours, two with urinary system tumours, and one with rectal carcinoma. A preoperative imaging examination confirmed the diagnosis of ureteral stricture. There were 15 patients with unilateral and 14 with bilateral stenosis, median stenosis length was 3.6(2.0, 4.9)cm. Preoperative median urine white blood cell count was 62(21, 354) U/L, median serum creatinine (SCR) was 170.0(85.5, 273.5) μmol/L, and renal pelvis separation was (32.98±6.64) mm. The median time of long-term indwelling double J (D-J)ureteral stent before surgery was 12.0 (6.5, 35.5) months. Seven patients had mild hydronephrosis, 18 had moderate hydronephrosis, and four had severe hydronephrosis. In all patients, Allium URS were placed in the way of the semisupine-lithotomy position (Galdakao-modified supine Valdivia position). Anterograde flexible ureteroscope was inserted into the percutaneous nephrostomy channel, and the retrogradel rigid ureteroscope were advanced simultaneously, looking for location of strictures. Allium URS were inserted retrogradely with transureteroscope when the two ureteroscope were connected. Perioperative conditions and postoperative follow-up for the last examination of SCR, renal pelvis width under ultrasound, and plain abdominal film (KUB). Allium URS patency and complications, hydronephrosis and renal function were evaluated.Results:A total of 61 Allium URS were successfully placed. Seven patients were placed in stages, and 18 patients were placed in series with multiple stents. The mean follow-up period was (12.1±5.8) months. At last follow-up, median SCR was 124.0(81.5, 193.0)μmol/L and renal pelvis separation was(14.96±5.18)mm, which were significantly decreased compared with preoperative(all P<0.01). There were 24 cases of hydronephrosis disappeared and 5 cases of mild hydronephrosis in the last follow-up. Postoperative follow-up, urinary tract infection occurred in 3 patients after operation, such as hematuria and fever within one week, and the symptoms were relieved after anti-infective and symptomatic treatment. One case had mild urine leakage, and 4 patients had occasional low back pain, which may be related to the activity. One case occurred stent displacement due to stent migration to the bladder after eight months, the URS was replaced and a D-J stent was inserted .The patency rate was 96.6%(28/29). Conclusions:Allium URS was placed in the semisupine-lithotomy position for treating pelvic tumour-induced ureteral stricture, with low incidence of complications, high patency and good curative effect.

Objective To investigate the impact of the changes of posttreatment karnofsky performance status (KPSpost) on the overall survival (OS) for patients with stage Ⅳ non-small cell lung cancer (NSCLC) underwent concurrent chemoradiation.Methods A total of 279 patients (male 198 and female 81) with histological confirmed stage Ⅳ NSCLC were enrolled in this study with a median age of 58 years old (range 22 to 80 years old).There were 166 cases of squamous carcinoma,87 cases of adenocarcinoma,and 22 cases of unclassified carcinoma,respectively.All enrolled patients received more than 2 cycles of chemotherapy and more than 36 Gy of concurrent radiotherapy.Kaplan-Meier method and Log-rank test were applied to evaluate OS.Multivariate analyses were carried out by the Cox proportionalhazard model.Chi-square test and logistic regression analysis were used to explore the related factors of KPSpost.Results There were 198 patients with improved KPSpost and 81 patients with decreased KPSpost,respectively.Univariate and multivariate analyses indicated that the improvement of KPSpost was associated with longer OS.Logistic regression analysis showed that the improvement of KPSpost was positively related with treatment of more than 4-6 cycles chemotherapy concurrent with over 63 Gy radiation to primary tumor.The improvement of KPSpost also correlated positively with disease control rate (DCR),but negatively with PLT toxicity and radiation esophagitis.Conclusions KPSpost was an independent prognostic factor of OS for patients with stage Ⅳ NSCLC underwent concurrent chemoradiation.Chemotherapy of 4-6 cycles and concurrent over 63 Gy radiotherapy dose to primary tumor,as well as DCR were positive factors for KPSpost improvement.However,stage 3-4 PLT toxicities and radiation esophagitis decreased the KPSpost.