Objective To study the cerebral protective effect of intravenous propofol anaesthesia on the patients with acute severe brain injury.Methods 70 patients with acute severe brain injury were randomly divided into control group and observation group,each group had 35 cases.The observation group was given intravenously propofol 2mg/kg for anesthesia induction,then maintaining anesthetization by 4mg · kg-1 · h-1.The control group was given midazolam,then discontinuous indrawed isoflurane.Diprivan 1.2mg/kg,fentanyl 4μ g/kg and vecuronium bromide 0.15 mg/kg were also used intravenously for the maintenance of anesthesia.The changes of intracranial pressure (IP)and cerebral oxygen partial pressure(COP) before anesthetization,surgery,3 hours after surgery and the waking time of surgery were recorded.Results After treatment,IP of two groups was decreased and COP was increased sharply; the IP of observation group was (18.98 ± 3.98) mm Hg,which was lower than (21.76 ± 4.01)mm Hg of the control group(t =7.20,P ＜ 0.05),COP was (17.09 ± 3.03) mm Hg,which was higher than (14.67 ± 2.63)mm Hg of the control group (t =7.23,P ＜ 0.05).The wake time of observation group was (15.98 ± 2.01) h,which was shorter than (20.01 ± 1.23) h of the control group (t =7.96,P ＜ 0.05).Conclusion The cerebral protective effect of intravenous propofol anaesthesia is good in patients with acute severe brain injury;it is worth to popularize in clinic.

Background and purpose: Bladder cancer is the most common urological malignancy in our country which seriously threatens human health, and its incidence increased year by year. This study aimed to investigate the effects of hinokitiol on the proliferation, apoptosis and autophagy in human bladder cancer cell lines. Methods:CCK-8 assays were performed to analyze the effects of hinokitiol on the proliferation of J82 cells. Apoptosis rate was determined by lfow cytometry. Cleaved caspase 3, LC3 and P62 protein expression was determined using Western blot. EGFP-LC3 microscopy assay was performed to assess autophagy. Results: Hinokitiol significantly inhibited the proliferation of J82 cells and induced cell apoptosis via caspase pathway. The apoptosis effect of hinokitiol could be partially antagonized by Z-VAD-FMK. Hinokitiol induced autophagy of J82 cells, increased LC3 expression and down-regulated P62 expression. 3-MA is able to rescue Tet-induced cell death. Conclusion:Hinokitiol can inhibit the proliferation of J82 cells and induce cell apoptosis via autophagy activation.

Objective To assess the efficacy of dorsal vein complex(DVC)ligation free in laparoscopic radical prostatectomy. Methods The data of 25 patients underwent laparoscopic radical prostatectomy that performed by the same surgeon in our hospital from January 2012 to January 2014 were retrospectively analyzed. Among them,14 cases underwent sutured DVC,11 cases received sutured DVC. Results All the operations were completed with laparoscope and without convert to open surgery. The mean operation time was 246±24.7 min and 236±26.1 min in DVC liga?tion and DVC ligation free,the blood loss was 337.5±120.2 mL and 322.2±104.9 mL in DVC ligation and DVC ligation free,the blood transfusion rate was 14.3%and 18.2%in DVC ligation and DVC ligation free ,the urinary incontinence rate of 6 months after operation was 21.4%and 9.1%in DVC ligation and DVC ligation free,no significant difference was found in the operation time,blood loss,blood transfusion rate and urinary in?continence rate among the two groups(P>0.05). Conclusion DVC ligation free is a safe and effective technique during laparoscopic radical prostatectomy and may simplify the operative procedure and without increase of the risk of bleeding ,which can be more conducive to the early re?covery of postoperative urinary control.

Our university actively carried out the reform and innovation of the training mode of clinical medicine postgraduates . We implemented the standardized training of resident physicians throughout postgraduate training process , and carried out the comprehensive reform of the training mode of cultivating master degree students of clinical medicine and the standard training of resident doctors. Meanwhile, we trained the master degree students with the synergy of medical education and strengthened the cultivation of students' clinical practice ability, to cultivate qualified doctors for the country, and to improve the quality of postgraduate training.

ObjectiveTo assess the safety and efficacy of contrast-enhanced ultrasound (CEUS)-guided percutaneous microwave ablation (MWA) treatment of renal carcinomas.MethodsFifteen patients with 17 renal tumors were retrospectively analyze. The patients’ ages were in the range of 46-80 years (65.2±9.4 years), the tumor diameters were in the range of 1.1-3.9 cm (2.3±0.7 cm) and biopsy pathological results were renal cell carcinoma. All of the tumors were inconspicuous on conventional ultrasound, while conspicuous on contrast enhanced-computed tomography (CT) or magnetic resonance imaging (MRI). Seventeen tumors were ablated under the guidance of CEUS.ResultsAll tumors were successfully visualized on CEUS and MWA was performed under CEUS guidance. The durations of energy application for each tumor were in the range of 5-11 min (mean± SD 7.3±2.2 min). The mean session of CEUS-guided MWA for each tumor was 1.1±0.3. All patients were followed up for 3-49 months (median, 17 months) to observe the therapeutic effects and complications. There was no local tumor progress and major complication. ConclusionCEUS-guided PMWA is a safety, efficient and feasible therapy for patients with RCC which is inconspicuous on conventional US.

Objective To evaluate the clinical efficacy of extraperitoneal laparoscopic radical prostatectomy(ELRP)for prostate cancer patients, and to summarize the experience of surgical treatment. Methods The clinical data of 50 prostate cancer patients who underwent ELRP by the same performer from January 2010 to June 2015 were retrospectively reviewed. Results All cases were all successfully completed ,no case was converted to open surgery. The average operation time was 238.8 min,average operative blood loss was 409.1 mL,and intraoperative or postopera?tive blood transfusion was 6(12%). The mean postoperative catheterization time was 23.7(17?38)d. The mean postoperative hospital stay was 15 (10?34)d. The postoperative recovery time of eating was 2?4 d,and the ambulation time was 1?3 d. Totally 3 cases(6%)had lymph node metasta?sis,and 7 cases(14%)had positive surgical margin. Totally 9 cases(18%)had surgery?related complication. Patients were followed up for 6 to 58 months,with an average of 12.5 months. One case(2%)had biochemical recurrence,and the tumor?free survival rate was 84%. At the end of fol?low?up,all of the patients were continent. Conclusion ELRP is safe and effective for the treatment of prostate cancer. With the development of minimally invasive techniques,the applications of RP are increasingly widespread. However,large?scale and long?term follow?up studies are still needed for high?risk prostate cancer patients.

Objective To study the genome molecular characteristics of Getah virus(DY0824)which isolated in Shandong province,2008 by molecular biology methods.Methods Reverse transcriptasepolymerase chain reaction(RT-PCR)was used to amplify the structural gene and 3'UTR fragments then the RT-PCR products were inserted into PGEM-T easy to be sequenced.Computer software was used to analyze the nucleotide and deduced amino acid sequence,and draw phylogenetic trees,including Clustal X1.83 and MegaAlign and Mega4.Results The capsid protein of DY0824 consists of 804 nucleotides,encoding 268 amino acids and the full-length of E2 protein is 1266 nucleotides,encoding 422 amino acids.The nucleotide homology of the capsid protein and the E2 protein with other strains were 95.4%-99.9%and 94.8%-99.5%,and the amino acid were 97.4%-100%and 97.6%-100%.The 3'UTR of the virus include 401 nucleotides and there are three repeat sequence elements.Conclusion Compared with the prototype virus,the Getah virus isolated in Shandong province had 7 amino acid differences in capsid protein genes and 10 amino acid differences in E protein genes.The 3'UTR region had multi-nucleotide changes.

Objective To evaluate low-mechanical-index contrast-enhanced ultrasound (CEUS) in assessing the clinical efficacy and feasibility of percutaneous microwave ablation (MWA) for the treatment of renal cell carcinoma (RCC). Methods From March 2006 to July 2013, a total of 105 RCC patients with 109 lesions, mean size being (3.1 ± 1.3) cm, were treated with ultrasound-guided percutaneous MWA. CEUS results obtained on the third day after MWA were compared with the contrast-enhanced CT/MRI and biopsy findings in the corresponding period. Follow-up examinations with CEUS and CT/MRI were carried out 1, 3 and 6 months after the treatment and once every 6 months thereafter to evaluate the short-term and the long-term therapeutic effectiveness. Results Three days after MWA, CEUS showed that 94 of 109 lesions (86.2%) were completely ablated, and residual tumor tissue was seen in 15 of 109 lesions (13.8%). Among the 15 lesions with residual tumor tissue, 13 (86.7%) were proved by contrast-enhanced CT/MRI and/or biopsy performed in the corresponding period. The sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) of CEUS for the evaluation of the short-term MWA effectiveness were 100%, 97.9%, 98.2%, 86.7% and 100%, respectively. Patients were followed up for 3 - 90 months with a median period of 24.6 months. During the follow - up period, CEUS detected recurrence in 7 patients, and 6 of them were consistent with CT/MRI results. The sensitivity, specificity, accuracy, positive and negative predictive value of CEUS for the evaluation of the long-term MWA effectiveness were 85.7%, 99.0%, 98.2%, 85.7% and 99.0%, respectively. Conclusion For the evaluation of the effectiveness of percutaneous microwave ablation in treating renal cell carcinoma, CEUS is a sensitive, reliable and convenient technique.

OBJECTIVETo investigate the feasibility, safety and efficacy of ultrasound-guided percutaneous microwave ablation (MWA) of splenic tumors.

METHODSSeven patients with 8 pathologically confirmed splenic tumors (including 2 metastases from the ovary and 4 from the lung, gastric adenocarcinoma, hepatocellular carcinoma, or rectal carcinoma; 1 hemangioma and 1 inflammatory pseudotumor) with sizes ranging from 1.3 to 6.2 cm (mean 3.1 ± 1.9 cm) were treated with MWA. A cooled shaft needle antenna was percutaneously inserted into the tumor under ultrasound guidance. A thermocouple was placed about 0.5 cm away from the tumor to monitor the temperature in real time during the ablation. The microwave emitting power was set at 50-60 W. The treatment efficacy was assessed by contrast-enhanced imaging at 1, 3 and 6 months following the procedure, and every 6 months thereafter.

RESULTSAll the tumors were completely ablated in a single session and no complications occurred. No local tumor progression was observed during a median follow up time of 13 months (4 to 92 months). The ablation zone, well defined on contrast-enhanced imaging, was gradually reduced with time. A new metastatic lesion was detected in the spleen at 11 months after the ablation in a ovarian carcinoma patient and was successfully treated by a second MWA. The post-ablation survival of the patients with splenic metastasis was 13 months (range 4 to 92 months). No complications other than fever and abdominal pain were observed in these patients.

CONCLUSIONUltrasound-guided percutaneous MWA is a safe and effective minimally-invasive technique for treatment of splenic tumors in selected patients.

Adenocarcinoma ; pathology ; Carcinoma, Hepatocellular ; pathology ; Catheter Ablation ; Contrast Media ; Female ; Humans ; Liver Neoplasms ; pathology ; Microwaves ; Minimally Invasive Surgical Procedures ; Ovarian Neoplasms ; pathology ; Splenic Neoplasms ; diagnostic imaging ; radiotherapy ; secondary ; Stomach Neoplasms ; pathology ; Treatment Outcome ; Ultrasonography

OBJECTIVETo investigate the value of real-time contrast-enhanced ultrasound (CEUS) in the diagnosis and differential diagnosis of renal solid renal lesions (RSLs).

METHODSWe retrospectively analyzed 140 cases of 152 RSLs with a mean diameter 3.1∓1.9 cm. CEUS was performed and the perfusion characteristics were analyzed using contrast pulse sequences (CPS) technique. CEUS findings were compared with biopsy histopathologic findings.

RESULTSA total of 137 malignant lesions (including 127 renal clear cell carcinomas, 8 renal papillary carcinomas and 2 chromophobe cell carcinomas) and 15 benign lesions (13 angiomyolipomas and 2 renal oncocytomas) were detected. Of the 137 malignant lesions, 98 (71.5%) showed contrast agent fast perfusion and hyper-enhancement or iso-enhancement in cortical phase, 104 (75.9%) showed hypo-enhancement in later corticalmedullary and late phase, and 125 (91.2%) showed rim-like enhancement. Tumors with a diameter ≤2 cm presented with homogeneous enhancement, and those ranging from 2 to 4 cm showed heterogeneous enhancement with a honeycomb feature; tumors greater than 4 cm featured heterogeneous enhancement with large no-enhancement necrotic areas. Of the benign lesions, 13 angiomyolipomas and 2 renal oncocytomas showed slow wash-in and slow wash-out mode. The diagnostic specificity, accuracy and positive predictive value of CEUS for RSLs were 94.9%, 96.1%, and 73.7%, as compared to 72.3%, 71.1%, and 19.1% with conventional US, respectively (P<0.001). The sensitivity and negative predictive value of CEUS were 93.3% and 99.2%, respectively, significantly higher than those of conventional US (60% and 94.3%, P=0.084, and 0.062, respectively).

CONCLUSIONReal-time CEUS can provide valuable information for improving the diagnosis and differential diagnosis of RSLs.

Adenoma, Oxyphilic ; diagnostic imaging ; Carcinoma, Renal Cell ; diagnostic imaging ; Contrast Media ; Diagnosis, Differential ; Humans ; Kidney Diseases ; diagnostic imaging ; Kidney Neoplasms ; diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Ultrasonography