Objective To evaluate the clinical efficacy and complication rate by open or retroperitoneal laparoscopic radical nephrectomy for renal tumor with stages T1N0M0 or T2N0M0.Methods Between October 2003 and October 2006,90 patients with renal cell carcinoma,which were clinically localized stages T1N0M0 or T2NOM0 Based on the patients' options to undergo retroperitoneal laparoscopic radical nephrectomy (group A,49 patients)and open radical nephrectomy(group B,41 patients).The clinical efficacy were compared between group A and group B,retrospectively.Results In group A,the operations of 46 patients were successful,4 cases occurred major complications(8.7%)during the follow-up visit which lasted for (21.9±6.1)months.The operations in group B were all successful.9 cases occurred major complications (22.5%)during the follow-up visit which lasted for(24.9±7.8)months.All cases were renal malignant tumors with pathologically confirmed stages T1N0M0 or T2N0M0 and there were no renal pedical lymph node metastasis.The age,weight,body mass index(BMI),tumor size,operating time and the time of follow-up were no statistically significant differences between the two groups(P＞0.05),while the blood loss,amount of postoperative drainage,time to ambulation,recovery of intestinal function after operation,hospital stay,use of analgesic and transfusion blood or plasma in group A were significantly reduced than those in group B(P＜0.01). Conclusions As compared with open radical nephrectomy,retroperitoneal laparoscopic radical nephrectomy afords patients with renal cell carcinoma an impreved postoperative course with minimal invasion,less pain,quicker recovery and less complications,while providing equally effective cancer control for patients with T1N0M0 or T2N0M0 tumor.

Objective To evaluate the clinical efficacy of transcatheter super-selective hepatic artery embolization (TAE) in treating symptomatic polycystic liver disease (PLD). Methods A total of 8 patients with PLD, who were admitted to authors’ hospital during the period from 2009 to 2013 to receive TAE, were enrolled in this study. The patients included 6 females and 2 males with a mean age of 59.5 years (54-65 years). The used embolic agents were polyvinyl alcohol (PVA) microspheres and micro spring coils. Both plain and contrast-enhanced CT scans of the upper abdomen were performed before TAE as well as at 12 months after TAE; the total volume of the hepatic cysts was measured and the changes of the cystic volume were determined. Statistical analysis was conducted using paired t test. Results The technical success rate was 100%. After TAE, the patients developed fever and different degrees of discomfort at liver area, which were disappeared after active symptomatic medication, and no serious complications occurred. The patients were followed up for 12 months , the mean total volume of the intrahepatic cysts decreased from preoperative (5 794±2 066) cm3 (range 3 120-8 935 cm3) to postoperative (3 832±1 525) cm3 (range 2 019-5 925 cm3), the difference was statistically significant (t=6.971, P<0.001). The reduction ratio of total volume of intrahepatic cysts was 34.6%±11.3%(24.3%-60.4%). Conclusion For symptomatic polycystic liver disease, transcatheter super-selective hepatic arterial embolization is a newly-developed treatment. This technique is safe and effective with reliable response and fewer complications. Therefore, it should be recommended in clinical practice.

Objective To study on the association of apolipoprotein E(apoE)genotype with coronary heart disease(CHD)and type 2 diabetes mellitus(T2DM).Methods PCR-RFL,multiplex amplification refractory mutation system(muli-ARMS)and PCR-SSCP methods were used to detect the genotype of apoE,and DNA sequencing technique were used for further confrm the genotype and gene variations in 2 446 Chinese individuals,including 238 cases of CHD,316 cases of T2DM and 1 892 healthy controls.Fasting blood glucose(FBG)and plasma lipids levels[TC,TG,HDL-C,LDL-C,apoA I,apoB and Lo(a)]were measured by usual methods.Results Compared with the controls,plasma HDL-C(t=2.66)and apoA I(t=2.30)levels in the CHD group were significantly lower(P<0.05),but not in T2DM group;plasma TC level(t=5.22)in the T2DM group were significantly higher(P<0.05),but not in CHD group;systolic pressure(t=8.48,5.74)diastolic pressure(t=5.66,3.35),plasma TG(t=3.38, 4.56),LDL-C(t=2.48,7.00),apoB(t=1.67,2.24),Lp(a)(t=4.16,4.15)and FBG(t=7.04, 16.93)levels were significantly higher in both CHD group and T2DM group(P<0.05).The distributions of apoE ε2/2,ε2/3,ε3/3,ε2/4,ε3/4 and ε4/4 respectively were 0.4%,13.4%,58.0%,1.3%, 26.5%,0.4% in the CHD group;0.6%,5.7%,72.8%,1.9%,14.9%,4.1% in the T2DM group; 0.5%,10.5%,69.6%,1.6%,16.8%,1.1% in the control group.Significant differences were found between the CHD group(χ2=14.90,P=0.00),T2DM group(χ2=7.08,P=0.03)and the control group for the frequencies of apoE genotype.The distribution of ε3/4 was higher(26.5% vs 16.8%)and ε3/3 Was lower(58.0% vs 69.6%)in the CHD group.In the T2DM group.the distribution of εε4/4 Was higher (4.1% vs 1.1%),and 2 cases of ε3/3 with Arg 150 His mutation in exon 4 of apoE gene were firstly reposed in China,which is none in the CHD and control groups.Conclusions The results suggested that apoE ε3/4 and ε4 genotypes might be associated with the susceptibility of CHD and T2DM.respectively. To some extent,apoE ε3/3 may not be a good genotype for T2DM because of the Arg 150 His mutation. Blood pressure and plasma lipids could be used for diagnosis of the two diseases.

Objective To investigate the role of a small RNA interference against VEGF in radiation sensitivity in melanoma .Methods A375 human melanoma cell lines were transplanted into nude mice ,which with malignant melanoma were randomly divided into control group , VEGF negative plasmid group and VEGF positive plasmid group, followed by 4Gy irradiation twice a week for 2 weeks.The volume of tumor was calculated twice a week, the area of tumor necrosis was assayed by HE,the expression of VEGF in tumor was determined by Western-blot and Immunohistochemical. ResuIts The expression of VEGF in VEGF positive plasmid group decreased significantly (P<0.05), VEGF positive group had more tissue necrosis, tumor growth was significantly inhibited (P<0.05).ConcIusion siRNA-VEGF in tumor injection liposome encapsulated in malignant melanoma has a role in the radiation sensitization, which provides an experimental basis for the clinical development of targeted therapy combined with radiotherapy for the treatment of VEGF gene.

Objective To investigate whether Tian Jiu therapy can regulate Th1/Th2 ratio effectively for bronchial asthma patients.Methods A total of 30 bronchial asthma patients who were treated with Tian Jiu therapy in the hospital were enrolled in the study as patients group and 20 healthy individuals were enrolled as control group.The mRNA of T-bet,GATA3,Foxp3 and STAT-6 were detected by using realtime-PCR,while IFN-γ and IL-4 were detected by using ELISA for control group and patents group before and after treatment. Flow cytometry was used to detect Th1/Th2 ratio.Results After Tian Jiu therapy,Th2 proportion decreased and Th1/Th2 ratio increased,secretion of IFN-γ decreased,mRNA of T-bet and GATA3 significantly in-creased,while STAT-6 decreased significantly(P<0.05).Conclusion Tian Jiu therapy has therapeutic effect on bronchial asthma patients through decreasing Th2 proportion and regulating Th1/Th2 ratio.

Objective:To explore the short-term and long-term prognostic outcomes of anatomical liver resection(AR)for patients with perihilar cholangio-carcinoma. Methods:This is a retrospective study.All data were obtained from 4 centers,including The First Affiliated Hospital of Army Medical University,Eastern Hepatobiliary Hospital of Naval Medical University,Sichuan Provincial People's Hospital and Affiliated Hospital of Qinghai University,of a multi-center database.A total of 305 consecutive perihilar cholangiocarcinoma patients receiving radical resection between January 2013 and June 2021 were included in this study.According to the method of liver resection,all patients were divided into the AR group(n=205)and the non-anatomical liver resection(NAR)group(n=100).The baseline characteristics,short-term prognosis and long-term prognosis of the 2 groups were compared. Results:The perioperative transfusion rate and the 30-day complication rate were significantly lower in the AR group than those in the NAR group(P＜0.05).There was no statistically significant difference in the survival rates between the AR and the NAR groups(P＞0.05). Conclusion:The 2 hepatic resection modalities had no obvious effect on the long-term prognosis of perihilar cholangiocarcinoma patients after radical resection,but choosing AR tends to achieve a better short-term prognosis and is worth promoting in clinical practice.