Renal cancer is a common malignant tumor in urology, with complicated pathogenesis and no obvious clinical symptoms. Metastatic renal cancer accounts for 20%-30% of the newly diagnosed renal cancer. The 5-year survival rate for metastatic patients is less than 10%.At present, the main non-surgical treatment means of mRCC include cytokines and targeted drug therapy, and immunotherapy has also become a research hotspot of mRCC. The current status and research progress of mRCC therapy were reviewed. The medical treatment methods of metastatic renal cancer, such as receptor tyrosine kinase inhibitors and mTOR inhibitors; immunotherapies, such as immunosuppressants for PD-1/PD-L1 were also discussed.

Purpose:To study the significance of resecting the lymph nodes adjacent to the recurrent laryngeal nerve in the operation on cNo thyroid papillary carcinoma,and its value inselecting the fashion of operation .Methods:Reviewing the clinical-pathological material of 186 cases of cNo thyroid papillarycary cinoma,and analyzing the relationship between lymph nodes adjacent to the recurrent laryngeal nerve and lateral cervical nodes metastasis. Results:Of 186 cases of cNo thyroid papillary cacinoma,there were 42.5% (79/186) with metastatic lymph nodes adjacent to the recurrent laryngeal nerve,63.2% of which had lateral cervical nodes or distant metastasis,while only 8 cases had metastasis in the negative group. Conclusions:The thyroid papillary carcinoma with metastatic nodes adjacent to the recurrent laryngeal nerve means there is a higher chance of metastasis in regions of the neck. Resecting the lymph nodes adjacent to the recurrent laryngeal nerve and frozed pathological examination can be a basis to determine whether redical neck dissection should be performed.

Objective:To investigate the effect of enteral nutrition support one week before surgery and postoperative periods on the postoperative immune function and nutritional status in old patients with gastric cancer. Methods:A retrospective analysis was con-ducted on 77 stomach cancer patients who were admitted and received surgical treatment in our hospital. Among the patients, 38 re-ceived enteral nutrition support one week before surgery and early period of postoperation, and were labeled as the experimental group. The remaining 39 patients did not receive enteral nutrition support one week before surgery and early period of postoperation, and were named as the control group. The levels of prealbumin, albumin, transferrin, CD4+T (%), CD8+T (%), and CD4+/CD8+cells were also an-alyzed before surgery and 1 d and 8 d after surgery. Results:No statistical differences in the gender, age, site of tumor, TNM staging, and differentiated degree were found between the two groups. All operations were successful and the patients recovered well after sur-gery. In the nutritional status, the levels of prealbumin, albumin, and transferrin in the patients of the two groups had no significant dif-ference (P>0.05). On the first day after the surgery, the levels of prealbumin, albumin, and transferrin were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). No differences in the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were found between the two groups (P>0.05). On the first day after surgery, the levels of CD4+T (%), CD8+T (%), and CD4+T/CD8+T cells were significantly low in both groups;the control group had lower levels than the experimental group (P<0.05). Conclusion:Elderly patients with gastric cancer who receive appropriate enteral nutrition support one week before sur-gery would have better immune function and nutritional status after surgery than those who did not, and the recovery of old patients im-proved.

Objective To compare the effect of application of autologous iliac alone and NovaBone combined with autologous iliac in the acetabular osteotomy of children with developmental dislocation of the hip (DDH).Methods Data of 113 cases of children with DDH who had undergone open reduction and acetabular osteotomy surgery from 2007 to 2011 were retrospectively analyzed.According to bone material using after acetabular osteotomy,the patients were divided into autogenous iliac bone graft group (52 cases,60 hips) and NovaBone combined with autologous iliac bone graft group (61 cases,67 hips).There were no statistical differences in gender,age,side,dislocation type,osteotomy and acetabular index between the two groups.The patients were evaluated by Lane's scoring criteria,Severin standards and McKay standards at 6 weeks,3 months,6 months,1-year and 2-year post-operation follow-up.The bone healing of acetabular osteotomy zone,radiography and function of hip were compared.Results 6 weeks and 3 months after operation,Lane bone healing score in NovaBone combined with autologous iliac bone graft group (6.4±1.3 points and 9.6±1.7 points respectively) was obviously superior to autogenous iliac bone graft group (4.7±1.5 points and 7.8±1.2 points respectively).And 6 months and 1 year after operation,the two groups were basically reached bone healing.The Severin standard results showed that the rate (94％,63/67) of Excellent and Good in NovaBone combined with autologous iliac bone graft group (excellent:41 hips,good:22 hips,Fair:4 hips) was significantly higher than the rate (83.3％,50/60) in autogenous iliac bone graft group (excellent:28 hips,good:22 hips,Fair:10 hips).The rate (16.7％,10/60) of Fair in autogenous iliac bone graft group was significantly higher than the rate (6.0％,4/67) in NovaBone combined with autologous iliac bone graft group.McKay standard results were consistent with the results of radiological evaluation.Conclusion As a novel bone defect repair material,NovaBone can promote early bone healing process of acetabular osteotomy areas.It also can improve the resistance of osteotomy area.NovaBone can get a satisfied result in acetabular osteotomy in children with DDH.

Objective To evaluate the effects of asymptomatic arteriovenous fistula closure on left ventricular morphology and function in renal transplant recipients.Methods Between March 2007 and March 2011,a total of 60 patients undergoing consecutive kidney transplantation with asymptomatic arteriovenous fistula were divided randomly into two groups: arteriovenous fistula closure group,and non-arteriovenous fistula closure group.By using echocardiography,the changes in CO,CI,EF,LVEDV and LVMI were analyzed.Results At 12th month after transplantation,the values of CO,LVEDV and LVMI were significantly lower than those before transplantation (P＜0.05).The value of CI also showed a tendency to decrease (P＞0.05),and the value of EF was increased significantly (P＜0.05).At 6th month after arteriovenous fistula closure (18 months after transplantation),the values of CO,CI,LVEDV and LVMI were significantly lower than those before arteriovenous fistula closure (12 months after transplantation) (P＜0.05),and the value of EF was increased significantly (P＜0.05),but the values of CO,CI,EF,LVEDV and LVMI remained unc(b)anged in controls (P＞0.05).At 18th month after transplantation,the values of CO (4.4 ±0.8 L/min),CI [3.0 ± 0.8 L·min-1·m-2],LVEDV (110.0 ± 17.4 ml) and LVMI (114.7 ± 42.5g/m2) in trial group were significantly lower than the values [CO: 5.1 ± 0.9 L/min,CI: 3.5 ± 1.0L·min-1·m-2,LVEDV: 121.4±19.3 mL,LVMI: 138.4±44.1 g/m2] in controls (P＜0.05),and the value of EF (75.2％ ± 7.4％ vs.70.5％ ± 8.2％) significantly higher (P＜005).Conclusion In both groups,kidney transplantation benefits significantly the regression of cardiac mass,cardiac index and left ventricular dimensions,but closure of asymptomatic AVF induces more significant regression.

OBJECTIVE: To investigate the dynamic trends of activities of matrix metalloproteinase (MMP)-2/9 and protein expressions of their inhibitors-tissue inhibitor of matrix metalloproteinase (TIMP)-1/2 during the progression of pulmonary fibrosis in rats so as to get insight of the roles played by MMP-2/9 in lung injury and fibrogenesis. METHODS: Forty-eight SD rats were randomly divided into normal control group (n=18) and bleomycin (BLM)-treated group (n=30). The pulmonary fibrosis was induced by intratracheal injection of BLM once. At the consecutive time of 1 day, 3 days, 1 week, 2, 3, and 4 weeks after intoxication, the lung-to-body weight ratio was calculated and the inflammation and collagen deposition in lung tissue were checked by HE and Masson stainings respectively. Meanwhile, the content of hypdroxyproline (Hyp) in lung tissue was assayed with Jamall's method, the protein expressions of MMP-2/9, TIMP-1/2 were examined by Western blotting, and the activities of MMP-2/9 were detected by gelatin zymography. RESULTS: The histopathological changes in lung tissue in the BLM-treated group from 1 day to 2 weeks after intoxication presented local lesions, broadened alveolar wall and septum, infiltration with lots of inflammatory cells and few of fibroblasts inside alveolar space and septum. At this early stage in the BLM-treated group, the lung-to-body weight ratio was increased significantly, the protein expressions and activities of MMP-2/9 were obviously increased especially for activity of active MMP-2, and the protein expressions of TIMP-1/2 were also increased gradually, as compared with those in the normal control group. From 3 to 4 weeks after intoxication in the BLM-treated group, the alveolar structure was damaged, parts of the alveolar space collapsed and replaced by collagens and fibroblasts, and the alveolar wall and septum obviously widened with remarkable fibrotic characteristics, as compared with those in the normal control group. Meanwhile, the lung-to-body weight ratio and the activities of MMP-2/9 were decreased in the BLM-treated group as compared with those in the same group at 2 weeks after intoxication, but the content of Hyp and the protein expressions of TIMP-1/2 were both increased dramatically, especially at 4 weeks after intoxication. CONCLUSIONS: During the lung fibrogenesis induced by BLM in rats, the alveolar inflammation is the most important alteration with enhanced MMP-2/9 activities in the early stage. While in the late stage, the main change is displayed as pulmonary fibrosis, characterized by increased TIMP-1/2 and declined MMP-2/9 activities.

Objective :To study a simplified method of isolation of rat hepatocytes and to observe the pro-cess of cell morphology in long-term culture. Methods :Rat hepatocytes were isolated by a single two-stepperfusion method. The yield and viability were assessed by trypan blue exclusion. [3-(4,5-dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide] (MTT) was used to test the effect of serum concentration of newborn calf serum on the proliferation of hepatocytes. Hepatocytes were inoculated in the culture mediumconsisted of Williams' E supplemented with insulin,dexamethasone and 10％ new born calf serum. Themorphologic change of cultured hepatocytes was observed. Results:The average yield of hepatocytes was 2.26× 108 cells per rat, with an average viability of 95.6％. New born calf serum had strong biological activi-ty to stimulate the proliferation of hepatocytes and there was close-effect relationship followed by the in-crease of new born calf serum concentration. The rat hepatocytes can be cultured for 5～ 6 weeks withpreservation of normal morphologic appearance. Conclusion:The rat hepatocytes isolated by the abovemethod have high yields and viability and can be long-term cultured in vitro.

OBJECTIVE:To evaluate the characteristics and regularity of adverse drug reactions (ADR) in children's hospital. METHODS:The clinical drug use and ADR of 3 653 children during 2006～2008 in our hospital were analyzed statistically by designing a child medication registration form. RESULTS:The incidence of 498 ADR cases was about 13.63%; ADR were mostly occurred in 1～3 year-old children(36.14%); 71.29% were caused by intravenously; 66.87% were induced by antibiotics; ADR were more common in spring and winter. CONCLUSION:The drugs have a dual nature. Moreover,children belong to a special group. The measures such as strictly mastering clinical indications,reducing irrational drug use,sufficient therapy and avoiding or reducing the occurrence of ADR can guarantee children grow healthily.

Hirudin as a novel anticoagulant and antithromotic agent, is a kind of protein that is obtained from the salivary gland secretion of one kind blood-sucking leech.It increases the difficulty extraction and purification of hirudin that composition of no anticoagulant activity of peseudo-hirudin in the body of leech and a large number of complex material from the salivary gland secretion of one kind blood-sucking leech.This article focuses on reviewing the structure of hirudin, genetic makeup, extraction and purification of hirudin according to the related research.Analysis of the pros and cons of various extraction and purification methods.Looking forward to its developing tendency, so as to provide reference for extraction and purification of Hirudin.

The killing effects of herpes simplex virus thymidine kinase gene/ganciclovir (HSV-tk/GCV) approach by the addition of several commonly clinical chemotherapeutic agents on hormone refractory prostate cancer (HRPC) cells PC-3m were investigated. After transferring of the HSV-tk gene into PC-3m cells, mRNA and protein expression of HSV-tk was detected by reverse-transcript polymerase chain reaction (RT-PCR) and strept avidin-biotin complex (SABC) immunohistochemical method. The killing effect of GCV, cisplatin (CDDP), etoposide (VP-16), vincristine (VCR), methotrexate (MTX), 5-fluorouracil (5-Fu), and suramin on PC-3m cells was evaluated by morphological assessment analysis, trypan blue exclusion assay and MTT assay respectively. Additionally, the cooperative effect of HSV-tk/GCV system combined with the above agents on the target cancer cells was determined by MTT. Furthermore, apoptosis and necrosis induced by GCV plus 5-Fu or suramin was analyzed by flow cytometry (FCM). The results showed that that there was HSV-tk mRNA and protein expression in pDR2-tk plasmid transduced PC-3m cell. Combination of GCV with VP-16, VCR, 5-Fu or suramin led to an enhanced cellular killing effect, but with CDDP resulted in a reduced one and with MTX in an approximate one. FCM revealed that synergistic use of GCV and 5-fu or suramin resulted in a rather large proportion of apoptosis and necrosis with the apoptosis index being 36.38% and 35.51%, and the proportion of necrosis being 33.05% and 28.87%, respectively. In conclusion, HSV-tk/CGV approach by addition of certain clinical available chemotherapeutic drugs brings on statistically significant enhanced cell killing over single-agent treatment. Our results highlight the potential for such new combination therapies for future treatments of HRPC.