Renal cell carcinoma(RCC)is currently one of treatment-resistant malignancies and is not sensitive to conventional radiotherapy or chemotherapy.The effective rate of high dose of recombinant human interleukin-2(IL-2)and recombinant human interferon-α(IFN-α)was only 10%-15%.Advances in the understanding of cancer at molecular level have led to more progress in the development of anti-cancer agents.Recently,mutation of Von Hippel-Lindau(VHL),Ras,PTEN genes have been observed in RCC and the mutation can result in different expression levels of RTK.Among the newly invented medications for targeted cancer therapy,protein kinase inhibitors target intracellular molecules crucial in sighaling pathways of cancer cell survival and proliferation.Compared with conventional chemotherapy and immune therapy,targeted therapy is effective,with fewer adverse effects.According to 2009 NCCN Clinical Practice Guidelines in oncology,this article reviewed the clinical application of sunitinib,sorafenib,temsirolimus,and bevacizumab in the targeted therapy for renal cell carcinoma.

Renal cell carcinoma (RCC) accounts for approximately 2% of all malignancies. The incidence of RCC has increased by 2% per year for the past 65 years. Over the past two decades, with the widespread use of imaging methods, the frequency of incidental detection of RCC has increased. Surgery is an important therapeutic method for renal cell carcinoma. Originally, nephron-sparing surgery was indicated only for those treated with radical nephrectomy which would render the patients functionally anephric and requiring dialysis. These settings include RCC in a solitary kidney, RCC in one kidney with contralateral inadequate renal fuction, and bilateral synchronous RCC. However, nephron-sparing surgery has been used increasingly in patients with T_(1a) and T_(1b) renal tumors (i.e. up to 7 cm in the greatest dimension) and a normal contralateral kidney, with equivalent outcomes to radical nephrectomy. Compared with radical nephrectomy, nephron-sparing surgery can increase patient survival and reduce the risk of cardiovascular events. However, nephron-sparing surgery has not been widely used yet because most surgeons are confused of its safety, indication, resection range and complications.

Objective To investigate the changes of diamine oxidase(DAO) and endotoxin(ET) during the treatment of systemic inflammatory response syndrome with human growth hormone and the relationship between human growth hormone and intestinal mucosal barrier injury. Methods One hundred and forty six patients with systemic inflammatory response syndrome were randomly divided into operative group and non operative group, which were again randomly divided into the study group and control group.Plasma concentration of DAO and ET were determined before the treatment and 1 week after the treatment.Results Plasma concentration of DAO and ET in study group decreased after treatment with significant difference ( P

Objective To evaluate clinical effects of laparoscopic radical colectomy for colon carcinoma.Methods Laparoscopic radical colectomy were performed in 25 patients with carcinoma of colon,including 17 cases of laparoscopic-assisted radical colectomy,and 8 cases of laparoscopic radical colectomy.Results Operation time was 100-310 min,with an average of 195 min.The mean of intraoperative blood loss was 180 ml(range,100-350 ml).Time to first bowl movement was 1-4 days(mean,1.7 days).Postoperative pathological examination revealed no residual and infiltration of tumor cells in stump.Infection of incision wound occurred in 2 cases,with no bleeding,leakage and stenosis of anastomosis.The length of postoperative hospital stay was 6-10 days,with an average of 7.5 days.19 cases were followed up for 2-38 months(mean,13 months),which showed no tumor recurrence and port-site metastasis in 17 cases,2 cases died from extensive metastasis at 12 and 14 months postoperatively.Conclusions Laparoscopic radical colectomy has advantages of minimal invasion,safety,quicker recovery after operation,better radical curative results.

Objective To discuss key techniques of laparoscopic resection of hydatid liver cysts. MethodsLaparoscopic resection of hydatid cysts was performed in 56 patients with hepatic echinococcosis.Under laparoscopic visualization,wicks with 3% dioxide hydrogen were routinely used for avoiding the contamination of the peritoneal cavity related with the spillage.A specially-designed puncture-aspiration cannula was employed to irrigate and evacuate all the contents of the cysts.Then the cysts were sterilized by the injection of 20% hypertonic saline solution.Afterwards,the residual cystic cavity was explored.Results The laparoscopic operation was successfully completed in all the 56 patients,without conversions to open surgery.The operation time was 45~150 min(mean,60 min).The intraoperative blood loss was 10~120 ml(mean,70 ml).No complications occurred.Follow-up observations for 1~12 years(mean,2 years and 6 months) in the 56 patients found no recurrence of hepatic echinococcosis.Conclusions Application of 3% dioxide hydrogen wicks for preventing the contamination,specially-designed puncture-aspiration cannula for irrigation,injection of 20% hypertonic saline solution for sterilization,and residual cystic cavity exploration are crucial to good surgical outcomes.

Objective To investigate the bacterial distribution and resistance to antibiotics of severely burned patients in our institute.Methods The bacteria culture of secretions from burn wounds was performed and bacterial susceptibility testing was carried out using Kirby-Bauer method.The correlation data were compared with those of years 1985～1998. Results gramnegative bacteria were still more than grampositive ones. Pseudomonas aeruginosa took the first place in gramnegative bacteria and staphylococcus aureus was the most often dectected grampositive bacteria. Almost all isolated bacteria had an increasing drug resistance to frequently used antibiotics. Conclusions More efforts should be put on to the regular bacteriological surveys and antibiotics usage to postpone the occurrence of drug resistance of bacteria and lengthen the effective period of antibiotics.

0.05);group C is the lowest-cost treatment options and the most economical one.

Objective To elucidate the clinical, electrophysiological, neuropathological features of two cases of hereditary neuropathy with liability to pressure palsies (HNPP) in one pedigree, and to review the literature of HNPP, so as to promote the understanding and diagnostic acuity of the disease. Methods Detailed electromyogram, motor and sensory conduction velocity, and distal motor latency were measured for clinically affected and unaffected nerves in the two patients. Sural nerve biopsy was performed for case one and the specimen was observed under light microscope and elcctronmicroscope. The cases reported in China up to the present were collected. Results Case one was an 18 year old male with a 9 year history of recurrent weakness and numbness of limbs precipitated by compression or stretch. Case two was his father. Although he had not experienced clinical episode of limb weakness and numbness, physiological examination revealed signs of peripheral neuropathy. Eletrophysiological study demonstrated diffuse peripheral nerve damage with decreased nerve conduction velocity, delayed distal motor latency, especially a decrease in motor conduction velocity at common entrapment sites, including clinical unaffected nerves. Sural nerve biopsy showed that myelin sheath of most myelinated fibers with normal axons was thickened. Some thickened myelin sheath was seen to invaginate into the axon. No onion bulb was found and unmyelinated fibers were relatively normal. Only 9 cases of HNPP were reported in China, but no DNA analysis was performed for any of them. Conclusions HNPP is a rare disease with autosomal dominant inheritance. Nerve conduction study is an important diagnostic method for screening. Its definite diagnosis relies on the typical pathological findings in nerve biopsy specimen. Sural nerve biopsy could be avoided for diagnosis if the family history were positive and nerve conduction study should show diffuse peripheral nerve damage

Objective To study the characteristics of peripheral nerve conduction (PNC) in advanced-stage amyotrophic lateral sclerosis (ALS) patients undergoing mechanical ventilation.Methods The sensory conduction velocity (SCV),motor conduction velocity(MCV),distal motor latency(DML) and amplitude of compound muscle action potential(CMAP) were determined in three ALS patients undergoing mechanical ventilation.The clinical data and PNC characteristics of the patients were analyzed.Results The 12 motor nerves were abnormal in all the three patients,including absence of responsive wave (66.7%,8/12),decreased amplitude of CMAP(33.3%,4 /12),prolongation of DML(16.7%,2 /12) and reduction of MCV(16.7%,2 /12).The CMAP amplitude of patients gradually decreased with the progression of disease,and finally led to adverse reactions.The SCV and amplitude of sensory nerve action potential were normal in all the three patients.Conclusion ALS patients undergoing mechanical ventilation may have severely damaged motor nerve conduction,and their sensory nerve is generally not affected,with the specific reason remains to be further studied.

Analgesics are widely used in fracture patients before and after operation.The analgesics frequently used include non-steroidal anti-inflammatory drugs,as well as central nerve and local medications.Recently,researches report that some analgesics may inhibit fracture healing,which has attracted much attention from orthopedic surgeons.However,there are researchers who hold opposite opinions.Accordingly,this paper reviews the progress in research concerning the effect of analgesics on fracture healing.