Objective This paper aimed to evaluate the effect of preoperative embolization on the intraoperative blood loss of sacrum chordoma.Methods forty patients involved with the spinal chordoma were retrospectively analyzed in this study.The preoperative embolization group consisted of 16 sacrum chordoma patients were embolizationed by gelatin sponge particles (10 male and6 female)age from 35 to 71 years old,(mean 57.9 years) ; and the control group consisted of 4 sacrum chordoma patients (3 male and 1 female),age from 43 to 61 years old(mean 51.8 years).analyzed the predictive value of preoperative embolization in correlation with the intraoperative blood loss.Results The mean blood loss (2025.0 ±818.5)ml of sacrum chordoma in the preoperative embolization group was insignificantly than that (1950.0 ± 802.1) ml in the control group,(P ＞ 0.05).Conclusion The study shows that the preoperative feeding artery embolization of the spinal tumor has no significant effect on the intraoperative blood loss in the surgical excision of the sacrum chordoma.

Objective To investigate the value of multi-slice spiral computed tomography (MSCT) in diagnosing gastric cancer. Methods The MSCT signs of 48 gastric cancers proved histologically were evaluated retrospectively. Results The main CT signs included thickening of gastric wall and mass.The lesion showed marked enhancement in the arterial and portal venous phases, and 35 cases showed marked enhancement in the portal venous phase compared with the arterial phase. 12 cases had tumor invasion in the adjacent organs and lymph mode metastasis, and 11 cases had tumor distant metastasis. The accurate rate of enhancement staging was 87 5%. Conclusions MSCT enhancement scan can help us evaluate the lesion more perfectly, and also is helpful in diagnosing and staging of gastric cancer.

Objective To discuss the CT features of primary retroperitoneal tumor(PRT) ,so that to improve the knowledge of these diseases.Methods 24 cases with PRT confirmed by surgery and pathology were assessed retrospectively,and their CT manifestations were analyzed in comparison with pathology. Results All cases included:8 cases of liposarcoma with predominant fat components, 2 cases of fibrosarcoma with evident involvement of adjacent tissues,2 cases of leiomyosarcoma with multiple centers fused, 4 cases of schwannoma localized at paraspine and cystic generation commonly,1 case of ganglioma with hypodense parenchyma,1 case of neuroblastoma with large calcification, 1 case of paraganglioma and 2 cases of chemodectoma and enhanced obviously,1 case of pheochromocytoma enhanced evidently with cystic generation ,1 case of neuroendocrinoma without specific characteristic and 1 case of teratoma with 3 layers of embryo tissues. Conclusion CT acan is able to localize the primary retroperitoneal tumors accurately,but specific CT features only see in some cases.

Objective To evaluate the methylation status of prostate cancer NDRG1 gene promoter region,and to explore the influence of methylation inhibitor 5-azacytidine on NDRG1 gene's mRNA expression in prostate cancer cells and its effects on cell proliferation.Methods Bisulfite-sequencing PCR (BSP) were used to detect the NDRG1 gene promoter methylation status in prostate cancer and BPH tissue,prostate cancer cell lines (PC3,22RV1,LNCaP and DU145) and human normal prostate cell line's RWPE-1.After 10 μmol/L 5-azacytidine were used on LNCaP and DU145 cells for 72 h,5-azacytidine's influence on cell proliferation was analyzed with MTT,two prostate cancer cell lines NDRG1 mRNA expressions were detected with RT-PCR.Results The methylation rates of NDRG1 gene in prostate cancer cell lines PC-3,22RV1,LNCaP and DU145 were (24.8 ± 3.3) ％,(36.2 ± 2.5) ％,(48.6 ± 2.8) ％ and (69.5 ± 1.7) ％,respectively.Methylation rate of Human normal prostate cell lines RWPE-1 was (4.8 ± 4.5) ％;prostate carcinoma was (48.6 ± 5.3) ％,BPH tissue was (4.3 ± 2.1) ％.The differences between groups were statistically significant.After 10 μmol/L 5-azacytidine added on LNCaP and DU145 cells for 72 h,NDRG1 gene demethylation occurred in both cells,its mRNA expression enhanced 8-9 times compared with previous and its cell growth was inhibited (P ＜ 0.05).Conclusions NDRG1 gene promoter region's hypermethylation is one of the reasons of its aberrant expression in prostate cancer.5-azacytidine can reverse NDRG1 gene promoter methylation status,regulate the expression of the gene and can inhibit prostate cancer cell proliferation.

PET and PET/CT are the methods of displaying the functional and metabolic changes in tissues. With its high sensitivity and specificity, it can be used as a noninvasive systemic functional examination. There are significant values in its diagnosing, staging, treatment directing and prognosis assessing in the malignant lymphoma.

Objective To evaluate the accuracy of Gallina nomogram in predicting seminal vesicle invasion (SVI) in prostate cancer.Methods From January 2009 to December 2011,89 patients with prostate carcinoma underwent open retropubic or laparoscopic radical prostatectomy.Complete data of preoperative serum prostate specific antigen (PSA),clinical stage,biopsy Gleason score,percentage of positive biopsy cores,pelvic MRI and pathological report of prostatectomy specimen were collected,and all the patients met the inclusion criteria of Gallina nomogram,2001 Partin tables and 2007 Partin tables.Postoperative pathological results were respectively compared with MRI and the incidence of SVI predicted by the three tools,and the sensitivity,specificity and accuracy of MRI in predicting SVI were calculated.The receiver operating characteristics curves were performed to test the predictive accuracy of SVI of each tool.Results The incidences of organ-confined disease,capsule invasion,SVI and lymph node metastasis were 58.4％,16.9％,22.5％,and 2.2％,respectively.The sensitivity,specificity and accuracy of MRI in predicting SVI was 45.0％ (9/20),71.0％ (49/69) and 65.2％ (58/89),respectively.The area under the curve (AUC) for SVI disease prediction of 2001 Partin tables,2007 Partin tables and Gallina nomogram was 0.712,0.711 and 0.801,respectively.Conclusions The sensitivity of MRI in predicting SVI is poor,the specificity and accuracy are common.All the predictive tools have a reasonable value for SVI (AUC ＞ 0.7),and Gallina nomogram is superior to two versions of Partin tables in predicting SVI.

Objective To investigate the effects of preserving continence important structures during Studer pouch surgery. Methods Radical cystectomy and Studer orthotopic neobladder surgeries were performed on 68 male patients with muscle invasive bladder cancer.The anatomic configuration of the rhabdosphincter complex,pudendal nerve supply,and musculofascial support system to the proximal urethra were carefully preserved.The neobladder functions were then evaluated. Results The pathological classification of the 68 patients was as follows:T3a N0M0 in 20 cases and T2N0M0 in 48 cases.The patients were followed up for 6 to 36mon(mean 12 mon).Complete urinary continence was achieved in 67 patients 24 hours a day and the remained one had nocturnal incontinence.Of these patients,59 patients could urinate well without residual urine and the other 9 patients had residual urine of 20 to 30 ml. Conclusions A well-performed Studer pouch should pay specific attention to the anatomic configuration of the rhabdosphincter complex,pudendal nerve supply,and musculofascial support system to the proximal urethra to achieve the goal of maximizing continence preservation.

Preeclampsia(PE) is a unique disease to pregnancy women,and women who had a history of preeclampsia significantly increased the risk of cardiovascular disease.Preeclampsia etiology and pathogenesis is not clear yet,it may have common pathophysiology with cardiovascular disease(CVD),such as oxidative stress,endothelial injury,insulin resistance,lipid metabolic disorder and so on.The article reviewed the relationship between preeclampsia and long-term cardiovascular disease among women,especially discussed the disease such as coronary heart disease,hypertension and stroke,to find the association and to explore the potential risk management options for these high-risk women.To block,intervene,and prevent cardiovascular disease starting with preeclampsia,it is of significance to the cardiovascular health of over 300 million women worldwide.

Objective To explore the difference in the incidence of deep vein thrombosis (DVT) following total knee arthroplasty (TKA) or total hip arthroplasty (THA) between different seasons.Methods The present retrospective study examined 2 363 patients undergoing TKA or THA from August 2008 to February 2016.There were 653 male and 1 710 female with the average age of 64.44±13.03 years old (17-91 years old),including 954 patients in TKA and 1 409 in THA.All of the patients received anticoagulant drugs and were compressed with a pressure pump starting on the first postoperative night.Routine venography of the bilateral lower limbs was performed at 3-5 days after the operation.The incidence of DVT in different seasons and different age groups (≥65 years old and ＜65 years old) were counted.Results The present study suggested that the probabilities of DVT after arthroplasty in spring,summer,fall and winter were 15.85％ (116/732),14.92％ (71/476),17.88％ (108/604),22.50％ (124/551) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in spring and summer (P＜ 0.017).The probabilities of DVT after TKA in spring,summer,fall and winter were 19.09％ (59/309),15.67％ (37/236),18.11％ (44/243),27.71％ (46/166) respectively with significantly difference (P＜0.05).The incidence of DVT in winter was higher than that in summer (P＜0.017).The probabilities of DVT after THA in spring,summer,fall and winter were 13.48％ (57/423),14.17％ (34/240),17.73％ (64/361),20.26％ (78/385) respectively with significantly difference (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after arthroplasty in spring,summer,fall and winter were 3.55％ (26/732),3.78％ (18/476),4.97％ (30/604),6.90％ (38/551) with significantly difference in different seasons (P＜0.05),and that in winter was higher than in spring (P＜0.017).The symptomatic DVT after TKA in spring,summer,fall and winter were 3.88％ (12/309),4.24％ (10/236),4.94％ (12/243),9.64％ (16/166) with significantly difference in different seasons (P＜0.05).The symptomatic DVT in winter was higher than that in spring (P＜0.017).The symptomatic DVT after THA in spring,summer,fall and winter were 3.31％ (14/423),3.33％ (8/240),4.99％ (18/361),5.71％ (22/385) respectively (P＞0.05).The probability of DVT following arthroplasty in older patients (age≥65 years old) in spring,summer,fall and winter were 18.49％ (76/411),16.61％ (45/271),22.07％ (81/367),28.05％ (99/353) with significantly difference among the groups (P＜0.05),while symptomatic DVT in older patients (≥65 years old) in spring,summer,fall and winter were 4.38％ (18/411),4.43％ (12/271),5.72％ (21/367),8.78％ (31/353) respectively with significantly difference (P＜0.05).The probability of DVT in four seasons were 12.46％ (40/321),12.68％ (26/205),11.39％ (27/237),12.63％ (25/198) in younger patients (＜65 years old).However,the difference was not detected among different seasons (P＞0.05).The probability of symptomatic DVT in four seasons were 2.49％ (8/321),2.93％ (6/205),3.80％ (9/237),3.54％ (7/198) in younger patients (＜65 years old) without significant difference (P＞0.05).Conclusion Seasonal variations could place an important effect on the incidence of DVT following TKA or THA,especially for the old patients with age ≥65 years.

Objective To evaluate effectiveness of the applying pelvic double-slice retractor in the division of bladder and prostate pedicles in male patients with previous surgery history during radical cystectomy (RC) and anterograde radical prostatectomy (ARP). Methods The pelvic double-slice retractor was used to expose the bladder and prostate pedicles in 43 RC (30 cases with BMI ＞ 28 kg/m2,16 cases had previous partial cystectomy) and 37 ARP ( all cases with BMI ＞ 28 kg/m2 ). Results The pelvic double-slice retractor provided excellent exposure for the division of bladder and prostate pedicles.The handling of bladder and prostate pedicles became easy and safe without unnecessary bleeding and injury to the rectum.The median operating time to control the pedicles during RC and ARP were 12 min and 7 min,and the average blood loss were 30 ml and 20 ml,respectively. Conclusion The use of pelvic double-slice retractor for the exposure of the bladder and prostate pedicles is simple and effective in male patients with complicated pelvic anatomy during RC and ARP.