As a weapon of mass destruction ,the biological weapon , composed of biological warfare agents and their re-lease devices,is characterized by strong pathogenicity , large pollution areas, various routes of infection, low cost, user-friendliness and a large number of impact factors .Although the United Nations has banned the use of biological weapons , there are still some countries and regions that continue biological weapon researches .In addition, illegal use of biological warfare agents in the field of terrorism and non-military arena poses a serious threat to public safety .Early detection of bio-logical warfare agent use and determination of its type are crucial to biological weapon defense and epidemic control .There-fore, to enhance researches on rapid detection and early warning of biological warfare agents is of great significance .This paper reviews the main technologies currently applied to the field of biological warfare agent detection and their progress .

Objective To assess the safety,efficacy and reliability of IUPU(Abbreviation of Institute of Urology,Peking University)technique in setting up the retroperitoneal cavity for retroperitoneoscopy. Methods From February 1996 to March 2006,more than 1100 retroperitoneoscopic procedures were performed with the IUPU technique in setting up the retroperitoneal cavity,First,at the cross point of the line 2 cm above the iliac crest and the longitudirml line close to the anterior auxiliary line,a 1 cm skin incision was made and the Veress needle was penetrated into the retroperitoneal space(RPS)with a 0°-30° angle to the perpendicular line.The CO2 gas was pumped into the RPS till the pressure increases to 14mmHg and the first port was inserted into the RPS.The laparoscope was then inserted into the RPS through the first port and kept swinging right and left with its tip and trunk tO set up the retroperitoneal cavity.Other 2 ports were put into the RPS at cross points of the sub-costal line and anterior and posterior auxiliary lines under monitor observation.Then other appliances are introduced into the RPS to expand the cavity.More than 1100 procedures had been done with the IUPU technique,including 54 cases of simple nephrectomy (loss of function due to tuberculosis,hydronephrosis and atrophy), 188 radical nephrectomy, 154 ureteronephrectomy, 344 adrenalectomy, 302 renal cyst decortications, 35 partial nephrectomy, 37 pyeloplasty. Results The average time for the IUPU technique was (5.4±2.8)min (range 4. 5 to 14. 5 min) to set up the RPS. Complications included converting to open surgery due to bleeding in 8 cases(8/1114,0. 72%) when the first port was inserted into the RPS and entered into the peritoneal cavity for the first port penetration in 32 cases (32/1114,2. 87%),although the retroperitoneal cavity could be set up successfully by adjusting the laparoscope into the RPS.There was no injury to other viscera. Conclusions The IUPU technique is safe, efficient and reliable in setting up the RPS and no other special instrument is needed. It can be finished within 5 min on skilled hands and is valuable as a routine method to set up the retroperitoneal cavity.

Objective To evaluate the safety and efficacy of the anatomical retroperitoneoscopic nephrectomy(RSN)and standardize the procedure of RSN. Methods The retrospective analysis was performed on 405 consecutive patients underwent anatomical RSN in Our institute from January 2002 to June 2008.There were 232 male and 173 female patients with the average age of(57.2±14.2)years,among whom there were 228 renal cell carcinoma patients accepted RSU,96 and 49 renal pelvic carcinoma and ureteral carcinoma cases accepted retroperitoneoscopic ureteronephrectomy (RSUN) and 32 cases accepted simple RSN due to loss of renal function caused by benign renal discsses.The tadical RSN was performed by dissecting outside Gerota's fascia and in the latent cavities between this fascia and lateral conal fascia in the dorsal side and between this fascia and prerenal fusion fascia in the ventral side,whereas the simple RSN was done inside Gerota's fascia by making direct incision on it and dissecting between this fascia and perirenal adipose tissue.Kidneys and perirenal adipose tissue were completely removed by dissection along several avascular planes around the kidney under the amplified view of laparoscopy. The software SPSS 12.0 was used for the statistical analysis of all data. Results The mean operative time was (132±48)min for radical and simple RSN and (245 ± 62)min for radical RSUN, which included the time for position change and second skin preparation. The medium estimated blood loss was 100 ml(10-2500 ml) and the average drainage volume was 150 ml (0-1152 ml) postoperatively. 15 cases (3. 70%) required blood transfusion with the median volume of 400ml (400-1650 ml). Four cases (0. 99%) were converted to open surgery due to severe adhesion (2 cases), difficult exposure of renal helium (1 case) and severe bleeding (1 case).The mean drainage time was (3. 9±1.8)d, the mean time to first oral intake was (2.7±1.2)d and the mean postoperative hospital stay was (8.6±3. 8)d. Conclusion The anatomical RSN is safe and effective and should be the standard surgical procedure for laparoscopic nephrectomy.

Objective:To investigate the feasibility of detecting excision repair cross-complementing 1(ERCC1)and ERCC2 in peripheral venous blood instead of cancer tissues from esophageal squamous cell carcinoma patients. Methods:The expressions of ERCC1 and ERCC2 mRNA were detected by using RT-PCR in 39 cases of peripheral venous blood samples, esophageal squamous cell carcinoma tissues, and adjacent normal tissues. ELISA was used to determine the levels of ERCC1 and ERCC2 proteins in serum. The periphe-ral blood from 10 healthy volunteers was used as control. Results:Expression levels of ERCC1 and ERCC2 mRNA and protein were significantly higher in peripheral blood from healthy control than those in esophageal carcinoma patients (P<0.05). There was a positive correlation between the expression of ERCC1 and ERCC2 mRNA in peripheral blood and cancer tissues (P<0.01). Conclusion:The expression levels of ERCC1 and ERCC2 mRNA in peripheral blood can indirectly reflect their expression levels in human esophageal squamous cell carcinoma tissues.

Objective:To evaluate the optimization strategy of labor analgesia in obese parturients using dural puncture epidural (DPE) combined with programmed intermittent epidural bolus (PIEB).Methods:Eighty American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ obese primiparae, who were at full term with a singleton fetus in vertex presentation, aged 20-40 yr, with body mass index of 30-40 kg/m 2, at 37-42 week gestation, with cervical dilation of 2-5 cm, and with visual analogue scale score ≥50 mm, were divided into 2 groups ( n=40 each) using a random number table method: DPE plus PIEB group (DPEP group) and DPE plus continuous epidural infusion group (DPEC group). All parturients received DPE labor analgesia, and parturients received PIEB (DPEP group) and continuous epidural infusion (DPEC group) to maintain analgesia during labor. In DPEP group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 2 ml/12 min after an initial dose of 8 ml. In DPEC group, the patient-controlled epidural analgesia pump was set up to deliver a 5 ml bolus dose with a 20-min lockout interval and background infusion at 10 ml/h after an initial dose of 8 ml. The analgesia solution contained 0.1% ropivacaine plus 0.3 μg/ml sufentanil. The time to achieve adequate analgesia, consumption of ropivacaine per unit time, height of sensory block at the thoracic vertebral level, modified Bromage score, effective pressing times of patient-controlled analgesia, the number of rescue analgesia, Apgar score, delivery mode, occurrence of adverse reactions and maternal satisfaction with labor analgesia were recorded. Results:Compared with DPEC group, the time to achieve adequate analgesia was significantly shortened, the consumption of ropivacaine per unit time was decreased, and the number of rescue analgesia and effective pressing times of patient-controlled analgesia were decreased in DPEP group ( P<0.05). There were no significant differences in the height of sensory block at the thoracic vertebral level, modified Bromage score, Apgar score, delivery mode, incidence of adverse reactions and maternal satisfaction with labor analgesia between the two groups ( P>0.05). Conclusions:DPE combined with PIEB offers faster onset and better effect and achieves a greater local anesthetics-sparing effect when used for labor analgesia in obese parturients.

Objective To investigate the feasibility of extraction site preservation using injectable calcium phosphate cement (CPC) combine with poly (lactic-co-glycolic acid) (PLGA) microspheres.Methods Immediate extraction defects models were created in canine mandibles,and the defects were filled with CPC/PLGA (experimental group,E),Bio-Oss (positive control,P),non-treatment (blank control,B) respectively.Dogs were sacrificed after 4,8,12 weeks post operation.Statistical analysis were conducted using SPSS 19.Results Results of radiological observation showed that there were not significantly different between groups in 4 and 8 week(P ＞0.05).After 12 week,E(114.9 ±8.4)were not significantly different compared with P(117.4 ± 12.1) (P ＞ 0.05),both were significantly higher than B (95.0 ± 12.6)(P ＜0.05).Histology examination showed that at 4 week following surgery,the result of newly formed bone was as follow,P [(87.5 ± 1.5) ％] ＞ B [(78.7 ± 2.7) ％] ＞ E [(69.2 ± 1.8) ％] (P ＜ 0.05).At8,12 week,results of P[(94.0 ±2.3)％ and (93.5 ±1.9)％]and E[(94.7 ±1.1)％ and (96.0±0.9)％] were better than those of B[(76.8 ±3.0)％ and (87.0 ±2.4)％] (P＜0.05).Conclusions The effect of CPC/PLGA repair immediate alveolar ridge defects is the same as that of BioOss,and CPC/PLGA can be used as a material in extraction site preservation.

Objective To evaluate the efficacy and safety of sunitinib in the treatment of metastatic renal cell carcinoma (RCC). Methods A total of 37 patients with metastatic RCC were treated with between June 2008 and April 2010, including 28 males and 9 females. The median age was 52 (17-74) years. All patients received a pathologic diagnosis of RCC, which consisted of 1 papillary cell carcinoma and 36 clear cell carcinomas, 4 of which accompanied with partial sarcoma differentiation. Thirty cases were treated with first line therapy and 7 cases showed progression on first-line cytokine or sorafinib therapy. Sunitinib monotherapy was administered in repeated 6-week cycles of daily oral therapy for 4 weeks, followed by 2 weeks off in 34 patients, while another 3 patients received 37. 5 mg Qd continuously until disease progression or unacceptable toxicities occurred. Overall response rate and safety were evaluated. Results The median follow up was 12 months (8 cycles),range 1.5-19. 5 months (1-13 cycles). 26.5% (9/34) patients achieved partial responses, 70.6%(24/34) patients demonstrated stable disease over≥3 months and 1 (2. 9%) patient developed progressive disease. The objective response rate was 26.5%, and the disease control rate was 97. 1%.The 12 months' overall survival rate was 95.8% (23/24), and 12 months' progression-free survival rate was 62.5 % (15/24). The most common treatment-related adverse events were thrombocytopenia (30 cases, 81.1%), thyroid dysfunction (18/22, 81.8%) ,hand-foot syndrome (27 cases, 73.0%),neutropenia (23 cases, 62.2%) and hypertension (18 cases, 48.6%). The major grade 3 adverse events included thrombocytopenia (8 cases, 21.6%), hand-foot syndrome (4 cases, 10.8%) and diarrhea (2 cases, 5. 4%). Most adverse events were ameliorated by treatment interruption. Ten (27.0%) patients had dose decrement or drug discontinuation and 1 patient quit the treatment for intolerable fatigue. Conclusion The efficacy and manageable adverse event profile of sunitinib as a single agent in first- or second-line therapy for patients with metastatic RCC.

The syndrome/pattern of defensive qi deficiency is a common basic syndrome of traditional Chinese medicine in clinical practice. However,there is a lack of standardized and operable diagnostic specifications in practical applications. Based on the previous literature,this study proposed the idea of starting from the elements of the syndrome,qualitative diagnostic criteria for the syndrome/pattern of defensive qi deficiency oriented to the entire region of the disease were constructed based on the two dimensions of " deficient defensive qi failing to consolidate the exterior" and " qi deficiency" and constructing a set of quantitative evaluation criteria as the supporting content for the diagnostic items. The core members of the research group attempted to formulate the draft standard,then reached a consensus through the Delphi method expert questionnaire consultation and the Nominal group technique,and finally evaluated the reliability and validity of the standard through clinical verification to provide ideas for the standardization and normalization of research on syndromes.

Objective:To evaluate the risk factors of clinical cure and biochemical recurrence (BCR) after radical prostatectomy (RP).Methods:The clinical data of 896 patients who underwent RP at Peking University First Hospital from April 2001 to December 2020 were retrospectively analyzed. Average age was (65.90±6.3) years, median preoperative prostate specific antigen (PSA) was 10.75 (0.36-264.20) ng/ml, median prostate volume was 40.0 (12.0-220.9) ml, median PSA density (PSAD) was 0.27 (0.02-3.42) ng/(ml·g). Clinical staging: 432 cases in T 1c stage, 333 cases in T 2a/bstage, 76 cases in T 2c stage, and 55 cases in ≥T 3 stage. Preoperative Gleason score of biopsy: 193 cases in 3+ 3, 315 cases in 3+ 4, 162 cases in 4+ 3, 226 cases in ≥8. The RP surgery was operated by open or laparoscopic or robot-assisted approach. Clinical cure and BCR were used as the end points for analysis. Clinical cure was defined as a decrease in serum PSA level below 0.03 ng/ml 6 weeks after surgery. BCR was defined as the 2 consecutive serum PSA >0.2ng/ml during the follow-up after RP. Multivariate logistic regression was used to analyze the independent risk factors of clinical cure. The Kaplan-Meier method was used to draw the biochemical recurrence-free survival curve, the log-rank method was used for univariate analysis of BCR, and the Cox regression analysis was used for multivariate analysis. Results:All 896 patients were followed-up for 58 (5-241) months, 678 cases (75.7%) achieved clinical cure. Based on univariate analysis and multivariate analysis, among the preoperative indicators, whether the proportion of positive biopsy needles ≥33% ( P=0.007) and preoperative Gleason score of biopsy ( P=0.041) were independent risk factors of clinical cure. A total of 890 cases were included in the analysis of risk factors of BCR, of whom 172 cases (19.3%) had BCR. The 1-, 5-, and 10-year biochemical recurrence-free survival(BFS)rates were 98.1%, 83.1% and 68.4% respectively. The median BFS has not been reached, and the average BFS was 181 months (95% CI 172-189). The results of univariate and multivariate analysis showed that whether achieved clinical cure ( P=0.001) and postoperative pathological staging ( P<0.001) were independent risk factors of BCR. Conclusions:Whether the proportion of positive biopsy needles≥33% and preoperative Gleason score of biopsy were independent risk factors of clinical cure. Postoperative pathological staging and whether achieved clinical cure may be independent risk factors of BCR.