Objective In order to choose the best surgical approach for minimally trauma varicocelectomy color Doppler ultrasound(CDU) was used to detect the anatomic relationships of spermatic vein in groin. Methods Sixty varicocele patients were randomly selected. Their spermatic veins were examined by CDU which beginning from superficial inguinal ring,passing the crossing point of spermatic vein and femoral artery ,and ending at the 3cm above the deep inguinal ring. The depths from skin to spennatic vein were measured and the relationships between spermatic vein and femoral artery were recorded. Results The average length of incision is 2.1cm and the average duration of operation is 22 minutes. The average depth from skin to spermatic vein was 1.1cm,1.55cm and 3.56cm respectively at the site of the superficial inguinal ring,the crossing point of spermatic vein and femoral artery,and the deep ingui-nal ring. Conclusion The best approach for minimally trauma varicocelectomy is at the crossing point of spermatic vein and femoral artery because here the spermatic vein is relative superficial and has merged into two or three vessels and the femoral artery can be easily touched by fingers.

Objective To observe the efficacy of percutaneous vertebroplasty (PVP) combined with zoledronic acid in treatment of spinal metastatic carcinoma.Methods Fifty cases of spinal metastatic carcinoma were divided into control group and treatment group by random digits table method with 25 cases each.The control group was given zoledronic acid 4 mg,intervals of 28 d intravenous drip 1 time.The treatment group was given PVP besides zoledronic acid.The visual analog scale score,activity ability score and analgesic usage score after treatment for 3 months were observed and compared.The quality of life was evaluated and the occurrence of relapse of fracture was also recorded.Results After treatment for 3 months,the visual analog scale score,activity ability score and analgesic usage score were (2.00 ± 0.17),(2.12 ± 1.38),(1.47 ± 0.10) scores in treatment group,and (7.84 ± 0.18),(3.21 ± 0.13),(3.30 ± 0.09) scores in control group,and there were significant differences between two groups (P ＜ 0.01 or ＜ 0.05).The occurrence of relapse of fracture was 2 cases (8％,2/25) in treatment group and 9 cases (36％,9/25) in control group,and there was significant difference between two groups (P ＜ 0.05).Conclusions PVP combined with zoledronic acid in treatment of spinal metastatic carcinoma has many advantages such as small incision,short surgery time and rapid relief from pain.It can obviously improve the quality of life,and it is worthy of spreading in the clinic.

Objective To analyze the characteristics and risk factors of preoperative deep vein thrombosis in patients with hip fracture,and provide a theoretical basis for clinical treatment and intervention.Methods 470 patients with hip fracture were chosen as the objects of study.The clinical data of the patients were retrospectively analyzed,including age,gender,injury,combined with other systemic diseases,fracture type (whether old fractures),two D-dimer level.All the patients with deep venous thrombosis of lower extremity were divided into DVT group and nonDVT group.There were 83 cases in DVT group,387 cases in non-DVT group.The factors like aboves as independent variables,presence of deep vein thrombosis as dependent variable,,preoperative deep venous thrombosis of the characteristics and risk factors were analyzed.Results 83 patients had DVT,the incidence rate was 17.7％.There were significant difference in age (40/83 vs 268/387),combined with other system diseases (57/83 vs 283/387),prevention measures (58/83 vs 196/387),D-thrombosis two dimer level (16/83 vs 122/387) of the two groups (x2 =13.712,14.836,9.876,5.313,all P ＜ 0.05).3 age ≥ 40 years,with other system diseases and injury,did not take to prevent the formation of thrombus measures were independent risk factors influencing the occurrence of DVT.Conclusion Age ≥40 years,combined with other system diseases and injury,don't take to prevent the formation of thrombus measures are independent risk factors influencing the occurrence of DVT.

Objective To study the effects of PIAS3 knocking down on the proliferation,cell cycle and apoptosis of human prostate cancer cell line DU145 in vitro.Methods PIAS3 specific short hairpin RNA(shRNA) expressing plasmid was constructed and named pSilencer4.1/PIAS3.DU145 cells were transfected with pSilencer4.1/PIAS3.The proliferation of DU145 cells was analyzed by MTT assay.Cell cycle and apoptosis of DU145 cells were analyzed by flowcytometry.Results PIAS3 shRNA expressing plasmid was succefully constructed and then confirmed by sequencing.Expression of PIAS3 in DU145 was significantly reduced after pSilencer4.1/PIAS3 transfection.MTT assay showned accelerated proliferation after PIAS3 knocking down,and showned dose-effect curve.Flowcytometry showed cells in S phase increased,cells in G0/G1 decreased and percentage of apoptotic cells decreased after PIAS3 knocking down.Conclusion Knocking down of PIAS3 expression accelerates DU145 cell proliferation and inhibit cell apoptosis in vitro.

Objective: To analyze the clinical application of manual therapy (MT) to tumor-related adverse reactions via summarizing the research at home and abroad, in order to provide more theoretical evidence for the clinical promotion of MT. Methods: We searched 7 Chinese and English databases, including China National Knowledge Infrastructure (CNKI), Wanfang Academic Journal Full-text Database (Wanfang), Chongqing VIP Database (CQVIP), PubMed, Excerpta Medica Database (EMBASE), Ovid and EBSCO. The publication date was between the establishment date of the database and December 31, 2020. We screened the literature according to the inclusion and exclusion criteria, and then sorted and analyzed the selected information. Results: A total of 46 papers were analyzed. Most studies focused on the adverse reactions in breast cancer patients. MT interventions demonstrated the best efficacy for fatigue, followed by pain, depression and anxiety. In different MT interventions, Tuina (Chinese therapeutic massage) was mainly adopted for fatigue, pain, anxiety, depression, and limb dysfunctions. Acupoint pressing was mainly adopted for gastrointestinal and psychological problems such as abdominal bloating, insomnia, depression and anxiety. The application of reflexotherapy was similar to that of Tuina. Conclusion: MT can alleviate various adverse reactions by effectively relieving patients' somatic symptoms and improving their psychological states and overall functions. It can be popularized as a significant non-drug therapy. Currently, however, the clinical application of MT is neither extensive nor has sufficient basic research. Consequently, we should attach importance to this application.

Objective To investigate the relationship of preoperative level of serum anterior gradient 2 (AGR2)with clinicopathological features and prognosis of patients with prostate cancer. Methods The serum levels of AGR2 were detected by ELISA in 72 patients with prostate cancer, 30 patients with benign prostatic hyperplasia (BPH) and 20 healthy controls. The receiver operating characteristic (ROC) curve was drawn to determine the optimal cut-off value of clinical diagnosis, and to analyze the diagnostic value of serum AGR2 in prostate cancer. Kaplan-Meier method was used to plot the survival curve. Log-rank test was used to analyze the difference of survival time between the two groups. The effect of AGR2 on the prognosis of prostate cancer patients was analyzed by Cox regression. Results The level of serum AGR2 in prostate cancer group was obviously higher than those in BPH group and health control group (t=4.441, t=5.285, both P<0.01).Serum AGR2 level was correlated with Gleason score,tumor stage, lymph node metastasis and preoperative PSA level (F=11.343, F=9.613, t=3.882, t=7.514, all P<0.01). The area under the ROC curve(AUC) of AGR2 was 0.803(95%CI 0.726-0.880,P=0.000), when the cut-off value was 17.25 ng/ml, the sensitivity rate was 63.9%, specificity rate was 80.0%. Kaplan-Meier survival analysis showed that the survival rate in low AGR2 expression group was significantly higher than that in high AGR2 expression group (χ 2=5.565, P=0.018). Cox regression analysis showed that AGR2 was an independent risk factor for prostate cancer patients (HR=5.412, 95%CI 1.143-25.624, P=0.033). Conclusions The elevated level of serum AGR2 is related with tumor progression in prostate cancer. It may be a potential marker for predicting prognosis of patients with prostate cancer.

Recent years, the development of medical devices kits is rapid. How to make the technical evaluation of medical devices kits more perfect bases on the two major principles of safe and effective, and to make kits in the market more normative and orderly, these issues for technical evaluation have to be considered. This article makes a study on current situation of production, classification of management and registration status, combined with existing regulations and related standards, and discusses technical evaluation related issues.
Equipment and Supplies ; standards

Objective To investigate the diagnostic value of lipocalin 2 (LCN2) combined with prostate-specific antigen (PSA) in prostate cancer (PCa).Methods Enzyme-linked immunosorbent assay (ELISA) was used to determine the levels of serum LCN2 in patients with PCa (PCa group,n =82),patients with benign prostatic hyperplasia (BPH group,n =40) and healthy subjects (NC group,n =30).The levels of serum PSA were measured by chemiluminescence.The diagnostic value of LCN2 combined with PSA in PCa was analyzed by the receiver operating characteristic (ROC) curve.The relationship between the level of LCN2 and clinical parameters in PCa patients was analyzed.Results The levels of serum LCN2 in PCa group,BPH group and NC group were (88.97 ±40.83) pg/ml,(53.12 ±25.66) pg/ml,(13.34 ±4.86) pg/ml (F=61.306,P ＜0.001).The level of LCN2 in PCa group was significantly higher than that in BPH group and NC group (both P＜0.001).The levels of serum PSA in PCa group,BPH group and NC group were (17.65 ± 8.43) ng/ml,(11.27 ±3.56) ng/ml,(2.61 ±0.87) ng/ml (F=60.959,P＜0.001).The level of serum PSA in PCa group was significantly higher than that in BPH group and NC group (both P ＜0.001).There was positive correlation between serum LCN2 and PSA levels (r =0.360,P ＜ 0.001).The levels of serum LCN2 in PCa patients with different Gleason score,TNM stage and distant metastasis were significantly different (F =8.546,P ＜ 0.001;t =3.421,P =0.001;t =3.622,P =0.010).The area under the curve (AUC) of serum LCN2 was 0.763 (95％ CI:0.677-0.850,P ＜0.001).The sensitivity and specificity of serum LCN2 were 62.2％ and 85.0％.The AUC of PSA was 0.750 (95％ CI:0.665-0.836,P ＜ 0.001).The sensitivity and specificity of serum PSA were 51.2％ and 87.5％.The AUC of LCN2 combined with PSA was 0.822 (95％ CI:0.749-0.895,P ＜0.001).Conclusion Serum LCN2 level in the patients with PCa is significantly higher,which participates in tumor invasion.LCN2 may be a potential serum marker for the diagnosis of PCa.Combined detection of LCN2 and PSA contributes to the early diagnosis of PCa.

Objective:To investigate the effect of long-term oral administration of β-blocker on septic myocardial injury and prognosis.Methods:A retrospective study was conducted. Patients who were admitted to the emergency intensive care unit (EICU) and intensive care unit (ICU) of Tongde Hospital of Zhejiang Province from January 2015 to June 2020 were enrolled. A total of 289 patients who met the criteria of myocardial injury induced by sepsis were included in the analysis. Among them, 187 patients who had never taken β-blocker within 3 months before diagnosis were divided in the non-β-blocker group, and 102 patients who took β-blocker daily for more than 3 months before diagnosis were in the β-blocker group. The physiological and biochemical characteristics were compared between the two groups, including heart rate, mean arterial pressure (MAP) at the time of diagnosis, cardiac troponin I (cTnI), brain natriuretic peptide (BNP), MB isoenzyme of creatine kinase (CK-MB), blood lactic acid (Lac), central venous oxygen saturation (ScvO 2), sequential organ failure assessment (SOFA) score, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score within 24 hours of diagnosis, left ventricular ejection fraction (LVEF), early and late mitral orifice diastolic peak flow velocity ratio (E/A), utilization rate of vasoactive drugs during hospitalization and 28-day mortality. Results:The heart rate in the β-blocker group at the time of diagnosis was significantly lower than that in the non-β-blocker group (bpm: 107±8 vs. 110±7, P < 0.01), and the levels of cTnI and BNP within 24 hours of diagnosis were significantly lower than those in the non-β-blocker group [cTnI (μg/L): 0.191 (0.220) vs. 0.291 (0.300), BNP (ng/L): 627 (133) vs. 690 (201), both P < 0.05]. However, there were no significant differences in MAP, CK-MB, Lac, ScvO 2, SOFA score, APACHE Ⅱ score, LVEF, E/A, vasoactive drug utilization rate, and 28-day mortality between the β-blocker and non-β-blocker groups [MAP (mmHg, 1 mmHg = 0.133 kPa): 70.6±3.9 vs. 69.9±3.8, CK-MB (μg/L): 4.24 (3.33) vs. 4.32 (3.13), Lac (mmol/L): 3.50 (1.80) vs. 3.50 (1.90), ScvO 2: 0.729±0.032 vs. 0.735±0.041, SOFA score: 7.74±2.34 vs. 7.25±2.23, APACHE Ⅱ score: 17.19±5.13 vs. 18.27±6.12, LVEF: 0.567±0.058 vs. 0.557±0.051, E/A: 0.71 (0.20) vs. 0.69 (0.20), vasoactive drug utilization rate: 60.8% (62/102) vs. 56.7% (106/187), 28-day mortality: 23.5% (24/102) vs. 25.7% (48/187), all P > 0.05]. Conclusion:Long-term oral administration of β-blocker reduce myocardial injury in septic patients, and has no effect on disease severity and prognosis.

Hepatocellular carcinoma (HCC) is still one of common malignant cancers worldwide, with increasing incidence and mortality rates. Early diagnosis and effective treatment for HCC remain to be explored. This article introduces the research advances in the early specific diagnosis and effective therapies for HCC in 2016, such as molecular markers in the specific diagnosis and targeted therapy for HCC, main therapeutic regimens, robot-assisted liver resection, and no-touch radiofrequency ablation.