Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods To review the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy from September 2013 to September 2015.There were 14 males and 21 females, aged 15-70 years, with an average of 45.8 years.Preoperative CT scan was performed to determine the size, shape and location of the tumor.Tumor diameter 10-60 mm, average 31 mm.Results 35 operations were successfully accomplished via the posterior approach.The operation time was 38-138 min (mean 70.1 min) ,and the drainage tube indwelling time was 1-5 d(average 2.1 d) ,the hospital stay was 2-6d(average 3.7 d).Total hospital costs were 14 789-31 992 yuan, average of 21 239 yuan.No complications occurred during the perioperative period.Conclusions Posterior retroperitoneoscopic adrenalectomy might provide clear anatomical views.It could be a safe and effective operation for the clinical treatment of adrenal tumors.

Objective To investigate the feasibility and efficacy of posterior retroperitoneoscopic adrenalectomy (PRA).Methods From September 2013 to September 2015,the clinical data of 35 patients who underwent posterior retroperitoneoscopic adrenalectomy were reviewed.There were 14 males and 21 females,aged 15-70 years,with the average of 45.8 years.Preoperative CT scan showed 19 adrenal tumors in the left side,16 in the right side,and one case with the left adrenal adenoma combining with right renal cyst.Tumor diameter is between 10 ～ 60mm,with the average of 31mam.Twenty-two cases were diagnosed as primary aldosteronism,4 pheochromocytoma,and 9 non-functional adrenal tumor.The posterior retroperitoneoscopic adrenalectomy were performed in all of the cases,which are under general anesthesia with tracheal intubation and prone position with hip joints and knee joints flexion of 90.Results Thirty-five operations were successfully completed via the posterior approach demonstrating clear anatomical layers.The operation time was 38-138min(mean 70 min),the drainage tube indwelling duration was l-Sd(average 2d),and the hospital stay was 2-6d (average 4d).Total costs of hospitalization were 14 789-31 992 yuan RMB,with an average of 21 239 yuan RMB.No complications occurred during the perioperative period.The average follow-up was 11 months,and no complications such as tumor recurrence occured.Conclusions Retroperitoneoscopic adrenalectomy provided clear anatomical views.It could be a safe and effective operation for the treatment of adrenal tumors.

Objective:To investigate the prognostic value of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) before radiation in pancreatic cancer patients underwent radiation therapy. Methods:Clinical data of 61 patients with pathologically confirmed pancreatic cancer were retrospectirely analyzed. Query index values for each patient were clinically tested through electronic medical records. Overall survival (OS) data were collected through electronic medical records or telephone follow-up. Survival curves were compared using Kaplan-Meier methodology and log-rank test. Cox regression methodolo-gy was used for univariate analysis. Results:Using log-rank test and univariate regression analysis, we found that patients with lower NLR, PLR, CA19-9, increased PNI, and lower TNM-staging lived longer than those with increased NLR, PLR, CA19-9, lower PNI, and high-er TNM-staging, and that the difference was statistically significant. Through multivariate analysis, we found that NLR (P=0.029, OR 2.344, 95%CI:1.090-5.041) and PNI (P=0.026, OR 0.477, 95%CI:0.248-0.917) were independent predictors of OS in patients with pan-creatic cancer. Conclusion:NLR, PLR, and PNI are simple, effective, and reliable indicators for evaluating the prognosis of pancreatic cancer.

AIM: To investigate the injuring effect of DMSO-soluble particles from cigarette smoke(DSP) on human umbilical vein endothelial cells. METHODS: Human umbilical vein endothelial cell line EA. hy 926 was used as target cells in the study. The growth and viability of the cells treated with various dosages (1, 2, 4 or 4 mL/L) of DSP and low dose (2 mL/L) of DSP at different time points were evaluated by MTT colorimetric assay and celllular protein assay in 96-well plates. Transmission electron microscopy study was carried out to observe the ultrastructure of human umbilical vein endothelial cells under DSP treatment.RESULTS: DSP inhibited the proliferation of human umbilical vein endothelial cell line EA. hy 926. Under DSP treatment, the reducing cellular protein and increasing cell death(mainly necrosis) were observed in time-dependent and dosage-dependent manners.CONCLUSIONS: These results indicated that the toxic effect of DSP caused functional disturbance and structural damage of human endothelial cells.

Objective To study the effect of sevoflurane pretreatment or aftertreatment on intrapulmonary shunt for patients with one lung ventilation(OLV)during thoracic surgical procedures .Methods 80 ASA I or II patients underwent thoracic surgery with OLV were randomly divided into four groups(n= 20 for each):(1)Propofol group(group P);(2)Sevoflurane pretreatment group(group S1);(3)Sevoflurane aftertreatment group(group S2);(3)Sevoflurane whole-treatment group(group S3) .Blood sam-ples were taken from radial artery and right atrial blood before induction of anesthesia(baseline T .0) ,before OLV(sevoflurane pre-treatment 30 min ,T1) ,after OLV 30 ,60 min and before the end of OLV(T2-T4)and after the end of OLV(T5)for measurement of blood gases and calculation of Qs/Qt .The indexs of hemodynamics and relative clinical data were recorded .Results Arterial oxy-gen pressure of the four groups for OLV significantly reduced ,when compared with double lung ventilation(P<0 .05) ,but there was no significant difference among the four groups(P>0 .05) .Intrapulmonary shunt of the four groups for OLV significantly in-creased ,when compared with double lung ventilation(P<0 .05) ,but intrapulmonary shunt of S1 ,S2 and S3 groups significantly de-creased ,when compared with P group ,and there was no significant difference for S1 ,S2 and S3 groups(P> 0 .05) .Conclusion Sevoflurane can decrease intrapulmonary shunt for patients during OLV ,but there is no significant difference for pretreatment or af-tertreatment or whole treatment and do not increase arterial oxygen pressure .

group Nor(P0.05).Conclusions The changes of ambulatory pulse pressure can reflect the degree of EH.The obvious increase of PP and decrease of DBP maybe are the exclusive features of ABPM in EH patients with target organs damage.

Objective To investigate the value of thyroid transcription factor-1(TTF-1) in the diagnosis and biological behavior assessment of hepatocellular carcinoma (HCC). Methods Thirty liver specimens obtained from benign lesions were analysed, among which 25 were hepatic cirrhosis and inflammatory diseases, and the other 5 were adenomas. And there were 176 specimens of liver tumors, among which 142 were HCC (well differentiated, n=12; moderately differentiated, n=57; poorly differentiated, n=73), 17 were intrahepatic cholangiocellular carcinoma (ICC) and the other 17 were liver metastatic carcinoma (MC). The expression of TTF-1 was examined immunohistochemically in the above tissues, and the difference in expression of TTF-1 among different tissues was examined by Fisher's exact test, Kruskal-Wallis test and Spearman rank correlation analysis. Results TTF-1 was significantly expressed in the cytoplasms of all the hepatocytes besides tumors and liver benign lesions. The expression rate of TTF-1 in HCC was 78.9% (112/142), however, TTF-1 was negatively expressed in ICC and MC(P

Objective To analyze the function of let-7e in the carcinogenesis of non-small-cell lung cancer.Methods The microRNA let-7e expression levels in cancer tissues and adjacent normal lung tissues were detected by quantitative real-time reverse transcription-PCR from 35 non-small-cell lung cancer patients,U6 RNA as an actin.Results The expression of microRNA let-7e in cancer tissues was significantly higher than adjacent normal lung tissues (10.111±6.135,P ＜ 0.0001),there was a significantly different between squamous carcinoma group (9.635±8.300) and adenocarcinoma group (10.301 ±5.228,P ＜ 0.05),independently of sex,smoking history,stage,and histologic characteristics of the tumor.Conclusion The expression of microRNA let-7e in cancerous tissues is high,microRNA let-7e should play oncogene role in process of non-small-cell lung cancer,and would be an useful biomarker.

BACKGROUND:With the development of industry and agriculture, organotin compounds have been widely used in China. Organotin compounds cause a common occupational poisoning. The toxicity of organotin was reported in animal studies; however the reports about human organotin intoxication are very rare. In this study we retrospectively analyzed the clinical manifestations of 15 organotin-poisoned patients who had been treated at our hospital from 2002 through 2007. METHODS:Fifteen patients with organotin poisoning were admitted to Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine from 2002 to 2007. They were 9 males and 6 females, aged from 25 to 52 years. Clinical manifestations and Glasgow Coma Scales showed that the poisoning was mild in 4 patients, moderate in 6 and severe in 5. The severe patients were given glucocorticoid after hospitalization by intravenous guttae of 500 mg methylprednisolone for the first day, followed by 160 mg methylprednisolone per day for three days, and then 80 mg methylprednisolone per day for another three days. Potassium glutamate and sodium glutamate were intravenously dripped to reduce blood ammonia; intravenous guttae plus oral administration of potassium 9 g/day was used to correct intractable hypokalemia; sodium bicarbonate was used to correct metabolic acidosis, and sedatives were used to control spasm and twitch; mechanical ventilators were used in 4 patients with dyspnea. RESULTS:Most of the patients showed elevated level of blood ammonia, decreased level of blood potassium and metabolic acidosis, but some had demyelination changes shown by CT and MRI. Treatments included correction of metabolic acids, blood potassium and ammonia, and mechanical ventilation when necessary. For patients with injuries of the nervous system, glucocorticoids were given immediately after hospitalization. These patients showed intractable hypokalemia and metabolic acidosis during the treatment. Forteen patients recovered completely without long-term side-effect. One patient in the aphasiac stage restored the linguistic capacity during a 6-month follow-up. CONCLUSIONS:Elevated level of blood ammonia, decresed level of blood potassium, and metabolic acidosis are common in patients with organotin poisoning. Demyelination can be observed in patients with severe poisoning. The abnormalities of the patients are reversible after suitable treatments.