Objective To investigate the clinicopathologic characteristics of clear cell papillary renal cell tumor and the medium to long-term effect of surgical treatment.Methods A total of 23 cases of clear cell papillary renal cell tumor treated in our department from October 2013 to January 2024 were retrospectively analyzed.For patients undergoing partial nephrectomy,the renal artery was dissociated and blocked through abdominal or retroperitoneal approach to remove the tumor,and then the wound was sutured.For patients undergoing radical nephrectomy,the renal artery,vein,and ureter were dissociated and clipped by Hem-o-lok for cutting off,and then the kidney was removed.Results The operations were accomplished in all the patients,including 18 laparoscopic operations and 5 robot-assisted laparoscopic operations.Among them,17 cases underwent partial nephrectomy,with an operating time of 73-229 min (median,149 min),blocking time of 9-35 min (median,21 min),blood loss of 10-100 ml ( median,20 ml),and postoperative hospitalization time of 3-28 d ( median,6 d).Six cases underwent radical nephrectomy,with an operating time of 110-232 min ( median,123 min),blood loss of 5-200 ml ( median,10 ml),and postoperative hospitalization time of 3-7 d ( median,4 d).Postoperative pathology showed clear cell papillary renal cell tumor with nuclear grade ( WHO/ISUP grade) of Ⅰ-Ⅱ.The 23 cases were followed up for 7-121 months (mean,53 months),of which 10 cases were followed up for more than 3 years and 9 cases for more than 5 years.One case was found to have contralateral renal lesions one year after operation and underwent laparoscopic partial nephrectomy,with a pathological result of clear cell papillary renal cell tumor.Subsequent re-examinations showed that there were cysts in both kidneys.At 7 years after the first operation,solid nodules in both kidneys were found,and a recurrence was considered.The patient was given active monitoring for 2 years ( CT re-examinations every 3-6 months) and was in stable condition.Another case was found gastric cardia tubular adenocarcinoma at 29 months after operation and was resected under gastroscopy.No recurrence was found during follow-ups for 121 months.The remaining 21 cases had no recurrence.Conclusions Preoperative diagnosis of clear cell papillary renal cell tumor is difficult,and surgery is an effective method for treating this disease.Medium to long-term follow-up shows a good prognosis,but there are still some cases of recurrence or combined with multiple primary cancer.Postoperative follow-ups should be noted.

Objective To investigate the clinicopathologic characteristics of clear cell papillary renal cell tumor and the medium to long-term effect of surgical treatment.Methods A total of 23 cases of clear cell papillary renal cell tumor treated in our department from October 2013 to January 2024 were retrospectively analyzed.For patients undergoing partial nephrectomy,the renal artery was dissociated and blocked through abdominal or retroperitoneal approach to remove the tumor,and then the wound was sutured.For patients undergoing radical nephrectomy,the renal artery,vein,and ureter were dissociated and clipped by Hem-o-lok for cutting off,and then the kidney was removed.Results The operations were accomplished in all the patients,including 18 laparoscopic operations and 5 robot-assisted laparoscopic operations.Among them,17 cases underwent partial nephrectomy,with an operating time of 73-229 min (median,149 min),blocking time of 9-35 min (median,21 min),blood loss of 10-100 ml ( median,20 ml),and postoperative hospitalization time of 3-28 d ( median,6 d).Six cases underwent radical nephrectomy,with an operating time of 110-232 min ( median,123 min),blood loss of 5-200 ml ( median,10 ml),and postoperative hospitalization time of 3-7 d ( median,4 d).Postoperative pathology showed clear cell papillary renal cell tumor with nuclear grade ( WHO/ISUP grade) of Ⅰ-Ⅱ.The 23 cases were followed up for 7-121 months (mean,53 months),of which 10 cases were followed up for more than 3 years and 9 cases for more than 5 years.One case was found to have contralateral renal lesions one year after operation and underwent laparoscopic partial nephrectomy,with a pathological result of clear cell papillary renal cell tumor.Subsequent re-examinations showed that there were cysts in both kidneys.At 7 years after the first operation,solid nodules in both kidneys were found,and a recurrence was considered.The patient was given active monitoring for 2 years ( CT re-examinations every 3-6 months) and was in stable condition.Another case was found gastric cardia tubular adenocarcinoma at 29 months after operation and was resected under gastroscopy.No recurrence was found during follow-ups for 121 months.The remaining 21 cases had no recurrence.Conclusions Preoperative diagnosis of clear cell papillary renal cell tumor is difficult,and surgery is an effective method for treating this disease.Medium to long-term follow-up shows a good prognosis,but there are still some cases of recurrence or combined with multiple primary cancer.Postoperative follow-ups should be noted.

Objective To investigate the influence of flufenamic acid (FFA) on gap junction intercellular communication in vascu-lar smooth muscle cells(VSMC) in situ of acutely isolated arteriole segments .Methods Whole-cell patch clamp recordings were used to study the effects of FFA on membrane input capacitance (Cinput ) ,membrane input conductance(Ginput ) or membrane input re-sistance(Rinput ) of VSMCs embedded in arteriole segments .Results FFA concentration-dependently and reversibly suppressed Ginput or increased Rinput ,with an IC50 of 56 and 33μmol/L in acutely isolated mesenteric artery(MA) and brain artery(BA) segments re-spectively .There was not significant difference between MA and BA (P> 0 .05) .After application of FFA (≥ 300 μmol/L) ,the Cinput ,Ginput and Rinput of the in situ cells were very close to the respective dispersed cell in MA and BA .Conclusion FFA is a reversi-ble gap junction blocker ,achieving a complete electrical isolation of the recorded VSMC at ≥300 μmol/L .FFA suggesting a homo-geneous property of the gap junctions between MA and BA .

Aim To explore the relationship between Snail and P-gp in breast cancer cell,and to reveal the effect of epithelial-mesenchymal transformation(EMT)on the multidrug-resistance(MDR)of breast cancer cell.Methods The eukaryotic expression vector pCDNA3.1-Snail was constructed, and then transfected into human breast cancer cell line MCF-7 to constuct MCF-7/Snail.Both cell lines MCF-7 and MCF-7/Snail were induced by adriamycin(ADM).Cell cytotoxicity assay and ADM efflux assay were used to measure the ability of drug resistance.The positive rate of P-gp of the two cell lines was detected by flow cytometry;the mRNA of MDR1 and Snail was evaluated by real-time PCR.Results MCF-7,the expression of MDR1 mRNA and Snail mRNA in MCF-7/Snail cell lines significantly increased;the expression of P-gp was increased too;the RR increased to 109.2;fluorescence intensity intracellular was reduced to 7.1.Conclusion After transfected the eukaryotic expression vector,the capacity of MCF-7/Snail strongly increases compared with that of MCF-7.

Objective To analyze the effect and safety of cerebral protection filter in carotid artery and stenting(CAS) for the treatment of severe symptomatic carotid artery stenosis.Methods Elective CAS with the use of cerebral protection filters were undergone in 26 consecutive patients with severe carotid artery stenosis.The filter devices were advanced through lesions and opened distal to the lesions followed by CAS.The incidence of cerebral ischemic events and the debris collected in the filters were observed and analyzed.Results In all the patients,it was feasible and successful to position the filters devices in the internal carotid artery.After the filter devices were positioned,CAS were performed successfully in all the 26 patients.Thrombus or plague debris were found in 14 out of 26 retrieved filters(54%).There was no death or symptomatic cerebral thromboembolic event during the CAS procedure.Asymptomatic cerebral embolization lesions were detected in 3 patients by the means of diffusion-weighted magnetic resonance imaging after 1-6 days of the CAS.No major cerebral or cardiovascular ischemic events were recorded in all patients during their follow up period of 6-12 months.Conclusion Carotid artery stenting is an effective microinvasive therapy for severe carotid artery stenosis which effect and safety can be enhanced with the use of cerebral protection filter.

Objective To observe the effectiveness and safety of endovascular stent assisted angioplasty for symptomatic intracranial arteriostenosis.Methods 4 patients with symptomatic intracranial arteriostenosis were treated with endovascular angioplasty using balloon expandable stents. Therapeutic effects were evaluated by clinical manifestations, digital subtraction angiography (DSA) and transcranial Dopple (TCD) before and after the operation. Follow up was made for 7~10 months.Results Technical success was achieved in all patients, with no complication of cerebral embolism and hemorrhage except one of transient seizure during operation. Angiographic results immediately after stenting suggested that the residual postoperation stenosis was 8%(0%~17%), with significant reduction from preoperation stenosis of 75%(70%~80.7%). No recurrent TIA and stroke occurred and no restenosis was found with serial TCD in all 4 patients during follow up of 7~10 months.Conclusions Endovascular stenting is a safe and effective therapeutic tool for symptomatic intracranial arteriostenosis.