ObjectiveTo evaluate the effect and safety d sorafenib in treatment of patients with metastatic renal cell carcinoma.Methods40 patients with metastatic renal cell carcinoma,were given sorafenib tablets methanesulfonate treatment,the initial dose of 800mg/d,bid,continuous administration of 21d,stopping 7d,The adverse reactions,efficacy and immunohistochemistry results were observed.Results40 cases with metastatic renal cell carcinoma were not found complete remission (CR) and partial remission (PR) ; The 32 cases in stable disease (SD)(80.0％ ) and 8 cases ( 20.0％ ) in PD; The incidence of 28 cases ( 70.0％ ) in digestive system; The expression of positive rate 30.5％ of local in connexin 32,Cx32 was significantly lower than that 1.2％ in metastatic renal cell carcinoma( x2 =8.123,P ＜0.01 ),The expression of Cx32 was negatively correlated with the clinical stage( r =-0.419,P ＜0.05 ) ;The expression positive rate of vascular endothelial growth factor(VEGF) in renal cell carcinoma was significantly higher than 18.5％ in normal renal tissue( x2 =8.723,P ＜ 0.01 ) ; The expression positive rate 72.0％ in the limitations of renal cell carcinoma and metastatic renal cell carcinoma 89.1％ was not statistically significant( x2 =1.978,P ＞ 0.05 ).ConclusionSorafenibin for advanced kidney cancer had better disease control effect,and was new choice for treatment of metastatic renal cell carcinoma.

The femora! arteries in 38 rabbits were transected and repaired with autogenous venous grafts with different diameters. The measurements of blood flow, patency rate and thrombosis rate, and scanning electron microscopic examination were made over a period of 14 days. The result showed that a venous graftl with a diameter 20 per cent less than that of the recipient artery was most satisfactory.

Objective To discuss the efficiency of fibrin glue amikacin complex in controlling infection by observing the changes of leukocyte and neutrophilic granulocyte classifying counts after fibrin glue amikacin complex treated deep wound. Methods Clinical case-control study was used in the study. All patients were divided randomly into test group (100 patients) and control group (100 pa-tients), matched by wound location, wound size, time from injury to operation, combined injury and gen-eral antibiotics use to compare leukocyte and neutrophilic granulocyte classifying counts between both groups and observe possible toxic and side-effect in test group. Results Firstly, the test group and control group had the comparability in aspects of gender distribution, average age and injury mechanism (P >0.05). Secondly, there was statistical difference in classifying counts of leukocyte and neutrophilic granulocyte in the test group at different time points (P <0.05). The classifying counts of leukocyte and neutrophilic granalocyte peaked at 24 hours after operation, then decreased with treatment time and reached the lowest at 24 days after surgery or at day 1 before discharge. Thirdly, there existed statistical significance upon leukocyte counts in the test group and control group except for at day 1 after operation (P > 0.05), with lower counts in test group than control group. In aspect of neutrophil classifying counts, there was statistical significance (P < 0.05) at other time points in beth groups except for time points at days 1,2 and 12 (P >0.05). The test group had lower neutrophil classifying counts compared with con-trol group at different time points. Conclusion The fibrin glue amikacin complex has good clinical effort and high security, with no toxic or side effort in treatment of deep wound infection, and is worth clinical applicaiton.

Objective To explore the pathogenesis of steroid-induced osteonecrosis of the femoral head(SONFH)and the mechanism of Traditional Chinese Medicine(TCM)-based prescription for"Bringing Blood Downward"targeting SONFH through the OPG/RANKL/RANK signaling pathway.Methods Fifty male SD rats were randomly divided into model group and control group.The rats in the model group were treated with LPS and methylprednisolone to build a SONFH model.After 6 weeks,two rats were randomly selected respectively from the two groups,and the SONFH model was confirmed by histomorphological examination under light microscopy.The rats in a low,medium and high dose treatment groups(group L,M,and H)were intragastrically administrated with the Prescription for"Bringing Blood Downward"at concentrations of 2.5/5/10 g/kg.While the rats in the model group and control group were intragastrically administrated with normal saline at a concentration of 5 g/(kg·d).The pathological changes and expression levels of OPG,TRAF-6,and RANKL in each group were examined 4 weeks later.Results Compared with the model group,chondrocytes and cell matrix of groups L,M and H were less reduced,osteoclastic absorption and trabecular structure were less destroyed and the cells were less adipose.The adipocyte density in the control group and each treatment group was significantly lower than that in the model group(P<0.01).In the control group,the bone marrow cavity area was smaller than that in the model group(P<0.05),but there was no significant difference between each dose treatment groups and the model group(P>0.05).The expression levels of OPG,RANKL,TRAF-6 and OPG/RANKL ratio in the control group and groups L,M and H were significantly lower than those in the control group(P<0.01).Conclusion The TCM-based prescription for"Bringing Blood Downward"works to treat SONFH byregulating the activity of osteoclasts and osteogenic differen-tiation process of osteoblasts,improving the microcirculation environment of the femoral head,and inducing the formation of trabecular bone through the OPG/RANKL/RANK signaling pathway.It functions with its multitargetsin diverse methods.