Ring finger protein 43 (RNF43) gene is closely associated with the development of various types of human tumors.The mainly mechanisms of RNF43 gene are mutation and aberrant expression.Activated RNF43 protein participates in the proliferation, apoptosis, metastasis through some signal pathways and influences the tumorigenesis and development in colorectal cancer, hepatocellular carcinoma, which plays a role of oncogene.However, it is considered as a tumor suppressor gene in mucinous ovarian tumors and intraductal papillary mucinous neoplasms of the pancreas.

Objective To study the occurrence of renal adverse reactions caused by cephalosporin antibiot-ics.Methods Reviewed 2000 -2014 Chinese medicine literature databaseadverse reaction under the cephalospo-rin antibiotics kidney damage caused by the reports,and the results were retrospectively analyzed.One by one to find and examine relevant literature,for which complete data of 52 papers in 182 cases of statistical analysis.Results In due to the use of cephalosporins and renal damage in 158 patients in neonates and the elderly accounted for the high-est proportion,respectively 26.58% and 22.78%.In addition,the statistical analysis found that the proportion of women(55.06%)was higher than men(44.94%),but the difference was not statistically significant(χ2 =0.65,P >0.05).In the event of 158 patients with renal damage of adverse reactions to use of the third generation cephalospo-rins was most,accounted for 59.49% (94 /158 );The second was patients with first generation cephalosporin [(20.25%(32 /158)];The second generation box of the fourth generation cephalosporin use accounted for the smal-lest proportion,13.92%(22 /158),6.33%(10 /158).The statistical analysis showed that the third generation cepha-losporin use ratio was significantly higher than that of the first generation,the second and the fourth generation,the differences were statistically significant(χ2 =50.74,70.61,92.32,all P <0.05).Add up to of all cephalosporins involves 11,which lead to renal adverse reactions were the most three kinds of cephalosporins antibiotics were ceftazi-dime,cefoperazone /sulbactam,ceftriaxone,the three belong to the third generation cephalosporins.In 158 patients appeared in 132 cases of hematuria,accounted for 83.54%.The main clinical manifestations for the course of medica-tion appeared visible to the naked eye hematuria,and few patients had pain in the waist or abdominal pain.In addi-tion,there were 12 cases of acute renal failure accounted for 7.59%,including 7 cases of death.14 cases of patients with urinary retention occurred,which accounted for 8.86%.Among them,8 patients for the use of cefazolin 2 -4 days after appeared dysuria,all male,aged 45 -75 years old,prompt discontinuation of the drug,after symptomatic treatment returned to normal.In addition,6 patients had dysuria,abdominal distension and pain in the use of ceftezole and cefuroxime,after discontinuation of the drug,symptoms improved obviously.Conclusion The clinical use of head hold bacteria cephalosporins drugs,if indeed there is a sign to caution in the use of the drugs,for age,kidney function is not complete person should also reduce drugs or careful with these drugs.At the same time,we should according to the patients'condition and individual differences in selecting the right drugs,should not give with other nephrotoxic drugs such as non steroidal anti -inflammatory drug,cyclosporine,and in the use process should closely monitor the blood concentration of patients and detect at any time in urine and kidney function change,and strive to achieve the rational use of the head hold bacteria carotenoid drugs.

Objective To evaluate the clinicophatholgic benefits and safty of antivirus therapy in patients with liver cirrhosis resulting from hepatitis B.Methods 80 patients with HBV-ralated liver cirrhosis were divided into three groups by the histopathology of liver:group of lamivudine treated with lamivudine 100 mg once daily;Adefovir group treated with Adefovir 10 mg once daily;control group treated with liver protective treatment only.Liver and renal function,PTA and HBV DNA were regularly measured.The Child push-Turotte sore and histopathology wag compared before and after treatment.All courses of treatment were 36 weeks.Results The scores of Child Pugh-Turotte sore in groups of lamivudine and Adefovir were lowered sinificantly (3.9 and 2.1 respectively),the load of HBV-DNA was decreased also[(4.1±0.9) copies/ml and(2.8±1.0) copies/ml],liver inflammmation decreased by more than 2 scores and liver fiber was improved by more than one score,with obviously significant difference(P<0.05) as compared with control group.Conclusion Patients with HBV-related cirrhosis treated with lamivudine and adefovir for antivims are improved and antivirus is important and safe to those during cirrhosis decompensation.

Objective To explore the MRI features of ejaculatory duct obstruction.Methods During January 2003 to Dccember 2010,transrectal ultrasonography (TRUS) was performed for 106 patients and underwent surgical treatment for ejaculatory duct obstruction.Among them,16 patients underwent MRI examination.The MRI features of ejaculatory duct obstruction in these patients were summarized.Results Ejaculatory duct cysts,ranging in size from 4 mm ×4 mm ×7 mm to 4 mm ×4 mm ×9 mm and locating in the paramedian line,were detected in 5 of the 16 patients; ejaculatory duct dilation located in the paramedian line was detected in 7 patients,with the internal diameter of 5 to 30 mm. After contrast injection,significant enhancement of the wall of the ejaculatory duct was observed in 2 patients.Mullerian duct cysts complicated with dilated ejaculatory duct and seminal vesicles were detected in 4 patients,in whom the cysts were located in the median line,ranging in size from 4 mm × 5 mm × 6 mm to 34 mm×35 mm ×44 mm,with inverted teardrop shaped pointing toward the seminal colliculus.ConclusionThe most common MRI features of ejaculatory duct obstruction are ejaculatory duct dilation and ejaculatory duct cysts.

Objective To investigate the imaging features of adrenal rest tumor.Methods Twelve patients of adrenal rest tumor proved by surgery or clinical diagnosis were retrospectively analyzed.Among these 12 patients,12 were examined with ultrasound,11 with MR and 1 with CT. MR and CT were performed without and with intravenous injection of contrast material.The imaging features of adrenal rest tumor were retrospectively summarized and the relevant literatures reviewed. Results The adrenal rest tumors were found in testis in 10 of the 12 patients,and in ovaries and broad ligament in the remaining two.The imaging features of the testicular adrenal rest tumor were summarized as following:all patients had bilateral testicular masses without change of the testicular contour. On ultrasonography,the lesions were hypoechoic, with some hyperechoic areas and appeared highly vascularized on Colour Doppler ultrasonography.The masses showed iso-density on plain CT,and avid enhancement on post-contrast CT images.The masses ranging in size from0.7 cm×1.0 cm×2.2 cm to 2.3 cm ×2.7 cm ×2.9 cm with uniform signal intensity,lobulated margin on MRI.They exhibited iso- or slight hyperintensity on T1 WI and hypointensity on T2WI relative to normal testicular parenchyma.The tumors showed intense enhancement on post-contrast MR images. No abnormality was detected with Colour Doppler uhrasonography and MR in 2 patients of adrenal rest tumor in ovaries and broad ligament. Conclusion Combining imaging features with the typical clinical history,the diagnosis of adrenal rest tumor could be suggested pre-operatively.

Objective To investigate the clinical application of early postoperative enteral nutrition in patients undergoing colon cancer operation.Methods 90 patients suffering from colon cancer were randomly divided into the enteral nutrition group,indwelling stomach tube group and the control group.The control group was given conventional treatment and the indwelling gastric tube group was received postoperative intermittent clamping of stomach tube and enteral nutrition.Moreover,patients in the enteral nutrition group were pulled out the tube on the first postoperative day while giving enteral nutrition.All patients were observed for exhaust defecation time,length of hospital stay postoperative and nutrition indicators.Results Exhaust defecation time,length of hospital stay postoperative had significant difference among three groups.Indwelling stomach tube group set minimum length of stay and first passage of flatus and defecation in the three groups [the enteral nutrition group:(50.07±11.59) h,(76.75±27.37) h,(10.1 1±1.57) d,the control group:(62.03±12.31) h,(90.67±25.64) h,(11.80±1.83) d,indwelling stomach tube group:(43.53±11.94) h,(61.17± 22.67) h,(8.70±1.53) d (P ＜ 0.05)].The levels of hemoglobin and plasma albumin one week after operation were statistically lower than pre-operation,while that the level of these nutrition indicators were higher in indwelling stomach tube group compare to control group (all P ＜ 0.05).The same result was observed between enteral nutrition group and control group.Whereas,the change of nutrition indicators between the enteral nutrition group and the control group was not statistical significant (P ＞ 0.05).Conclusion Indwelling stomach tube combined with enteral nutrition is a reasonable choice for patients after colonic cancer surgery.

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In order to investigate the potential anti-leukemic effect of cyclosporin A(CsA), MTT method and cell viability assay in vitro were carried out in this study to observe the effect of CsA on the proliferation and cell viability of various leukemic cell lines, such as T-cell Jurkat, Molt-4, CCRF-CEM, Nalm-6, K562 and multi-drug-resistant leukemic cell line K562/AO2. The results fully showed that CsA did possess the same cytotoxic action on all the leukemic cell lines, particularly including multi-drug-resistant leukemic cell line,and could then inhibit the proliferation and cell viability of these leukemic cells, thereby indicating that CsA might be applied as one of the new, safe and effective anti-leukemic agents when used with clinically adoptable dosage in leukemias.

Objective To investigate the diagnosis,the treatment methods and the prognosis of rectal cancer patients after renal transplantation.Methods Four patients with rectal cancer were found in 1035 renal transplantation recipients.Three of four patients were treated with anterior resection (AR) or abdomenoperineal resection (APR) with total mesorectal excision (TME).The two patients accepted regular adjuvant chemotherapy for six months period after surgery,but one patient rejected to accept any chemotherapy after surgery.Otherwise,one patient was only treated with chemotherapy and best support therapy for diagnosed as rectal cancer with multiple liver metastases.Results Two patients were fine to be followed up,8 months and 21 months after rectal resection respectively.Two other patients eventually died of metastasized cancer 5 months and 31 months respectively after therapy had been initiated.Conclusion Transplantation patients should receive standard oncology treatment,including operation and adjuvant treatment,so long as their general condition and organ graft functions allow to do so,although a higher degree of morbidity might be encountered,and periodical colorectal screening should be performed before and after renal transplantation.

Objective To investigate the safety and clinical outcome of laparoscopic resection of rectal cancer. Methods The clinical data of 347 patients with rectal cancer who were admitted to the Shanxi Tumor Hospital from May 2004 to July 2008 were prospectively analyzed. Of all the patients, 343 met the inclusion criteria,and they were randomly allocated to laparoscope group (n = 169) and open group (n= 174). The diameter of the tumors, number of lymph node dissected, length of rectum resected, morbidity, the mean operation time, number of patients receiving blood transfusion, time to out-of-bed activity, first flatus, bowel movement and liquid diet were observed. All data were analyzed using the t test and chi-square test. The survival rate was calculated using the Kaplan-Meier method. Results The diameter of the tumors, number of lymph node dissected, length of rectum resected and number of patients receiving blood transfusion in the laparoscope group were (4.3 ± 1.3 ) cm, 7 ± 5,(19.1±2.2)cm and 4, and they were (4.2±1.3)cm, 7 ±5, (19.0±2.3)cm and 8 in the open group,respectively, with no significant difference between the two groups ( t = 0. 629, - 0. 726, 0. 562, x2 = 1. 264,P ＞0.05). The mean operation time in the laparoscope group was 19 minutes longer than that in the open group (t = 7. 904, P ＜ 0.05 ). The time to out-of-bed activity, first flatus, bowel movement and liquid diet in the laparoscope group were 0.6, 0.3, 0.3 and 0.6 days earlier than those in open group( t = - 6. 392, - 3.581, - 3. 802,- 3. 493, P ＜ 0.05 ). There were no significant differences in postoperative infection, anastomotic leakage, intestinal obstruction and deep vein thrombosis between the two groups ( x2 = 0. 236, 0. 354, 0. 000, 0. 000, P ＞0.05). A total of 167 patients in the laparoscope group and 172 patients in the open group had been followed upuntil 1 may, 2010. The 1-, 2-year survival rates were 94.0% and 82.6% in the laparoscope group and 95.3% and 91.2% in the open group. There was no significant difference in the 2-year survival between the two groups (x2 =0.541, P ＞0.05). The survival time of the patients in the laparoscope group and open group were 55.9 and 57.9 months, respectively. Conclusions Laparoscopic surgery is safe and feasible for patients with rectal cancer, with quick recovery after the operation.