Inflammatory myofibroblastic tumor (IMT)is a potentially or low-grade malignant mesenchymal neoplasm, which is rare in clinic. Renomedullary interstitial cell tumor(RICT) is a clinically rare benign renal tumor. The combination of these two diseases in one patient has not been reported. A 25-year-old female patient was admitted to the hospital due to left back pain for 12 days and hematuria for 1 week. MRI of kidneys showed a mass in the left renal pelvis, which was considered as renal pelvic carcinoma. Urine cytopathological examination was negative. Robot-assisted laparoscopic radical left nephroureterectomy was performed. There was no tumor recurrence or metastasis during the follow-up for more than 6 months after operation.

Objective:To investigate the experience and results of the modified lateral prostate capsule sparing robot-assisted radical cystectomy-orthotopic ileal neobladder (LPCS-RARC-OIN).Methods:From December 2018 to November 2020, 19 patients received LPCS-RARC-OIN by a single surgeon in Sun Yat-sen Memorial Hospital, Sun Yat-sen University. LPCS-RARC-OIN was performed on male patients with high-risk non-muscle-invasive bladder cancer or muscle-invasive bladder cancer cT 2N 0M 0 without tumour in the bladder neck or urethra, and prostate cancer was ruled out by MRI and serum PSA<2.5ng/ml. The average age was 57.6 years, the average IIEF-5 score was 20.4. Separating the prostatic adenoma and the lateral prostate capsule from the base to the apex of the prostate, and retaining the lateral prostate surgical capsule or lateral prostate capsule about 1-2mm thickness. Patients were followed up and urinary function, sexual function and oncological outcomes were recorded. Results:All 19 operations were finished successfully. The average operation time was 279.9 (225-345) min and average estimated blood loss was 88.9 (30-200) ml. The average postoperative hospital stays was 15.8 (9 -23) days. The average lymph node yields was 23.3 (11-42). All surgical margins were negative and no incidental prostate cancer was found. 2 weeks, 1 month, 3 months and 6 months after catheter removal, the daytime and nighttime continence were 42.1% (8/19)and 36.8% (7/19), 63.2% (12/19)and 63.2% (12/19), 78.9% (15/19) and 73.7% (14/19), 94.7% (18/19) and 89.5% (17/19), respectively. 3 months and 6 months after operation, the average IIEF-5 score was 7.2 and 10.1 points respectively. The average follow-up was 10.6 months (5.4-26.1 months)and no recurrence or distant metastasis was found in this study.Conclusions:LPCS-RARC-OIN could improve the urinary and sexual function in selected patients. However, the long-term follow up is needed for functional and oncological outcomes.

【Objective】 To investigate the effect of allogeneic platelet-rich on the healing and regeneration of diabetic foot wounds. 【Methods】 A total of 86 patients with diabetic foot ulcer treated in our hospital from January 2019 to June 2020 were selected for this study. They were divided into 2 groups by the random number table method, with 43 patients in each group. The control group was given conventional treatment according to the Guidelines for the Diagnosis and Treatment of Diabetic Foot in China, and the observation group was further treated with platelet-rich gel (APG) from the allogeneic blood bank.The clinical efficacy, general conditions, wound conditions, inflammatory factors, serum levels of transforming growth factor-β1 (TGF-β1), vascular endothelial growth factor (VEGF) and hyaluronic acid (HA) were compared between the two groups. 【Results】 The total effective rate of patients in the observation group was 93.02%, higher than 76.73% in the control group (P<0.05). The wound healing time (15.08±3.19 vs 17.38±4.02) d and hospitalization time (16.12±4.03 vs 18.27±5.11) d in the observation group were shorter than those in the control group (P<0.05). Before treatment, there were no significant differences in hsCRP (4.25±0.39 vs 4.10±0.41) mg/L, TNF-α (5.70±1.29 vs 5.81±1.33) μ g/L and IL-6 (96.38±24.02 vs 99.64±25.17) mg/L between the two groups (P>0.05). After treatment, hsCRP (2.35±0.50 vs 2.83±0.44) mg/L, TNF-α(3.15±0.82 vs 4.02±1.07) μ g/L and IL-6 (50.82±18.54 vs 72.93±20.25) mg/L in the observation group were lower than those in the control group (P < 0.05). Before treatment, there were no significant differences in TGF-β 1 (5.66±1.25 vs 5.81±1.31) ng/L, VEGF (11.03±3.62 vs 10.83±3.72) μ g/L and ha (71.19±20.84 vs 70.82±21.03) mg/L between the two groups (P>0.05). After treatment, the levels of TGF-β 1 (17.29±4.09 vs 14.03±3.72) ng/L, VEGF (43.03±14.17 vs 37.04±11.05) and ha (177.96±39.08 vs 151.94±36.17) in the observation group were higher than those in the control group (P<0.05). 【Conclusion】 On the basis of conventional treatment, allogeneic blood bank concentrated platelet APG can effectively improve the curative effect of diabetic foot wound and shorten the wound healing time and hospitalization time. The mechanism may be related to reducing the level of inflammatory factors and increasing TGF-β 1, VEGF and HA.

Objective To compare split-cuff nipple and direct ureteroileal anastomosis during ureteroileal anastomosis.Methods Between December,2014 and March,2017,a prospective randomized study was conducted on 70 patients who underwent radical cystectomy and urinary diversion.In every patient,both ureters were randomized to be implanted using an antireflux,split-cuff nipple technique (group A) or a reflux,direct technique (group B).After pelvic lymph node dissection and radical cystectomy,a Mshape orthotopic ileal neobladder was constructed and two ureters were implanted with single-J tubes placed for 10-12 days.For split-cuff nipple technique,a 0.5 cm longitudinal incision in the ureter was made,and the ureteral wall was turned back on itself,construction a nipple.The cuff was stabilized at the corners with sutures.The ureter was then placed into the bowel with 0.5 cm nipple.The ureter was sutured to the full thickness of the bowel wall with interrupted 4-0 PDS.For direct technique,a 0.5 cm incision in the ureter was made,the full thickness of the ureter was sewn to the mucosa of the bowel.Results 70 patients were enrolled in the study,63 males and 7 females,(62.5 ± 10.4) years old.Over a median follow-up of 13.2 months,one patients had bilateral anastomosis stricture 3 months after operation,1 patient in group A had stricture 6 months after operation,2 patients in group B had stricture 6 and 12 months after operation,respectively.Six patients (8.6％) in group A found reflux compared with 21 patients (30.0％) in group B (P =0.004).The reflux pressure was (23.5 ± 9.0) cmH2O and (15.5 ± 4.9) cmH2O in group A and group B (P =0.042),respectively.The GFR of group A was (38.1 ± 7.6) ml/min compared with (38.6 ± 12.9) ml/min in group B at 12 months after operation.One patient in group A and four patients in group B had acute nephropyelitis.Four patients in group A had renal stones formation compared with 1 patients in group B.The time of anastomosis was (8.8 ± 3.5) minutes and (6.7 ± 1.5) minutes (P =0.037) for group A and group B,respectively.The patients in both groups had no urine leakage.Conclusion Compared with direct technique,split-cuff nipple technique had lower reflux rate,higher antireflux pressure and longer anastomosis time than direct technique.

Objective To observe the in vitro influence of recombinant human B7-H4 protein on the cell proliferation cycle, apoptosis and cytokine secretion of peripheral blood activated T lymphocytes in cervical cancer patients.Methods After 48 h co-culture of peripheral blood T lymphocytes in 1 5 cases of cervical cancer with B7-H4 48 h,T lymphocytes′cell proliferation cycle, apoptosis and T lymphocytes subtypes changes were detected by FCM;the cytokines concentration in the culture supernatant was tested by ELISA array.Results After 48 h co-culture of peripheral blood T lymphocytes with B7-H4 48hs,G1,G2 and S phase of T cells accounted for 90.59%,8.55% and 0.87% respectively,which of the blank group were 92.83%,6.09% and 1.13% respec-tively;the Ki67 positive rates of CD4 + T and CD8 + T cells in the B7-H4 group were 2.13%±0.13% and 1.03%±1.33% respec-tively,which of the blank group were 2.74% ±0.98% and 1.71% ± 1.32% respectively;the proportion of CD4 + T and CD8 + T cells accounting for T cells in the B7-H4 group was decreased compared with the blank group,but the ratio of CD4 + T/CD8 + T and the proportion of CD4 + CD25 + Foxp3 + T cells were increased,in addition,the TGF-β1 secretion;concentration in the co-culture su-pernatant in the B7-H4 group was (259.25±32.78)pg/mL,which was higher than (202.75 ±20.1 7)pg/mL in the blank group. B7-H4 had no significant influence on the peripheral blood activated T cells apoptosis.Conclusion B7-H4 block the peripheral blood activated T cells at G2 phase,the S phase cells are obviously decreased;B7-H4 inhibits the cellular proliferation of CD4 + T and CD8 + cells,but may have the promoting effect on Foxp3 + T proliferation and TGF-β1 secretion;B7-H4 has no significant influ-ence on T cell apoptosis.B7-H4 plays a role in depressing anti-tumor T cell immune response of cervical cancer and may become a potential target of cervical cancer immunotherapy.

OBJECTIVE:To provide reference for rational use of opioids analgesics. METHODS:1 882 prescriptions of opi-oids analgesics for cancer pain collected from our hospital in 2014 were analyzed by defined daily dose(DDD)and drug utilization index(DUI). RESULTS:The diseases of opioids analgesics prescriptions for cancer pain in our hospital in 2014 were mainly lung cancer,accounting for 42.19%. Commonly used opioids analgesics included Morphine sulfate sustained-release tablets,Oxycodone Hydrochloride sustained-release tablets and so on,and their DUI were all below 1.0. Top one drug in the list of amount and con-sumption sum was Morphine sulfate sustained-release tablets,and its main dosage form were tablets,injection and patches,in which tablets occupied the largest proportion,reaching 97.30%. CONCLUSIONS:The application of opioids analgesics for cancer pain in our hospital is basically rational in terms of drug types,dosage form and route of administration,but the dose of opioids an-algesics is small and their DUI is lower than 1;at the same time,there are a few irrational prescription.

Objective To observe the clinical effect of mannatide treatment with burn infection. Methods 100 burn patients admitted to Sichuan Nanchong Central Hospital from May 2009 to July 2012 were randomly divided into control group and treatment group, each group had 50 cases. Both of two groups were given conventional treatment, treatment group were treated with intravenous mannatide,control group were injected recombinant human growth hormone. Results The average length of stay in treatment group was signiifcantly shorter than control group (P=0.042). The clinical total effective rate, serum IgA, IgG, IgM and other indicators of immune function were improved signiifcantly compared with control group (P=0.037). There was no statistical signiifcance in blood protein, transferrin, prealbumin, glucose, insulin, urinary sodium, urinary potassium, chloride and other indicators of patients between two groups. Conclusion Mannatide can effectively enhance immune function, promote wound healing, shorter hospital stay and improve the clinical efifcacy.

Objective To investigate the expression of JNK2 in hyperoxic lung injury ,and explore the protective effect of sub-stance P (SP) on hyperoxic lung injury and its mechanism .Methods Sixteen SD rats were divided into four groups with 4 rats in each group :room-air and f 9 g/L saline group (group A) ,room-air and SP group (group B) ,hyperoxia injury group and f 9 g/L sa-line group (group C) ,hyperoxia injury group and SP group (group D) .Rats ingroup B and D were injected with SP 1 × 10-6 mol · L -1 · kg -1 · d-1 intraperitoneally ,group A and group C were injected with an equal volume of 9 g/L saline .The animals were sac-rificed after 14 days of experiment .Lung pathology was examined with light microscopy ,lung wet/dry (W/D) ratio and the level of SP and PCNA and TUNEL in lung were evaluated .The Superoxide dismutase (SOD) ,malondialdehyde (MDA) and glutathione (GSH) level were assayed respectively in lung tissue .The quanlity of JNK2 protein was detected by Western blot analysis .Results Compared with group A ,the high oxygen groups all had different degrees of lung injury ,,while the lung pathological pictures in group D was improved significantly compared with group C .Western blot showed that level of JNK2 in group C was obviously higher than that of group A ;After the intervention ,level of JNK2 in group D was lower than that of group C .The lung W/D retio , TUNEL and PCNA expression and distribution SOD ,MDA and GSH was consistent with the trends of JNK2 protein expression . Conclusion High oxygen stress can activate damage lung tissue JNK 2 activity ;SP protection mechanism of high oxygen lung injury may be induced by cutting high oxygen activation of JNK 2 to inhibit oxidative damage .

Objective To determine PD-L2 expression in human cervical squamous cell carcinomas and analyze its association with the clinical and pathologic characteristics of these cases ;observe the role of recombinant PD-L2 protein on apoptosis of active peripheral blood T lymphocytes of cervical carcinoma patients .Methods PD-L2 expression in cervical squamous cell carcinomas was determined by immunohistochemistry staining ,and the association between PD-L2 expression with the clinical and pathologic characteristics of these cases was analyzed .In vitro ,the peripheral blood T lymphocytes of cervical carcinoma patients were divided into blank group ,PD-L2 group and PD-L2+anti-PD-1 group respectively .After these active T cells were cultured 72 h ,their apop-totic rates were detected by flow cytometry .Results PD-L2 expressed in 53 .3% (32/60)cervical squamous cell carcinomas ,and it′s expression associated with lymph node metastasis of these cases (P< 0 .05) .In vitro ,PD-L2 promoted apoptosis of CD4+ T and CD8+ T lymphocytes ,the apoptotic rates were 17 .0% and 22 .4% respectively ,which were higher than 9 .0% and 16 .2% of blank group;however ,the apoptotic rates dropped to 11 .1% and 17 .5% in PD-L2+anti-PD-1 group .Conclusion PD-L2 aberrantly ex-presses in cervical squamous cell carcinomas and is associated with their lymph node metastasis .PD-L2 promotes apoptosis of T lymphocytes and depresses the anti-tumor immunity of cervical microenvironment ,and promotes lymph node metastasis of these cancers .PD-L2/PD-1 pathway may be a potential immunotherapy target of cervical squamous cell carcinomas .

Objective To investigate the efifcacy of thalidomide combined with VAD in treatment of elderly multiple myeloma(MM). Methods 76 cases of elderly MM were randomly divided into two groups, control group (n=38) were treated with VAD alone while the observation group (n=38) were treated with thalidomide and VAD. Clinical efifcacy and adverse reactions in two groups were compared. Results The total effective rate in observation group was 84.21%, which was signiifcantly higher than 55.26%in control group (P<0.05). After treatment, the M protein, myeloma cells andβ2-microglobulin in observation group were (20.77±4.15)×10-2μg/mL, (12.84±2.85)×10-2μg/mL and (2.48±0.53)μg/mL, which were signiifcantly lower than before treatment and control group(P<0.05). Hemoglobin in observation group was (108.83±5.81) g/L, which was signiifcantly higher than before treatment and control group(P<0.05). The adverse reactions were nausea, vomiting, drowsiness, constipation, infection and rash and so on in two groups after treatment, and there was no signiifcant difference between two groups. Conclusion Thalidomide combined with VAD regimen has a better effect in treatment of elderly multiple myeloma than single VAD, has less adverse reactions and well tolerated.