Efficacy analysis after surgical treatment for gastric cancer with synchronous hepatic metastases / 中国现代普通外科进展

Objective:To clarify the indications and efficacy after simultaneous surgical treatment in gastric cancer patients with synchronous hepatic metastases (GCHM).Methods:A total of 21 GCHM patients who underwent D2 gastrectomy with R0 hepatic resection (11 cases) or non-R0 hepatic resection (10 cases) from March 2004 to April 2016 were analyzed retrospectively.The clinicopathological characteristics and survival were compared between the two groups.Results:Cumulative survival rate was improved in R0 hepatic resection group compared with non-R0 hepatic resection group:1-year (54.5％ vs 48.0％),2-year(27.3％ vs 0％),and 5-year(27.3％ vs 0％,P=0.044).The median survival time in R0 hepatic resection group and non-R0 hepatic resection group were 16.2 and 5.9 months (P=0.008).Univariate analysis revealed that Bormann's classification (P=0.010) and state of regional lymph node (P=0.004) were significant predictive factors regarding cumulative survival rate.However,there was no significant prognostic factor (P=0.031) in multivariate analysis might partly owing to interaction among them and/or a small number of patients.Conclusion:Multidisciplinary treatments based on R0 hepatic resection combined with D2 gastrectomy could improve survival in selected GCHM patients.

Influence of different treatment with banked suspended red blood cells on the inflammatory response after cardiopulmonary bypass in infants / 中华实用儿科临床杂志

Objective To compare the influence of washing processed of banked suspended red blood cells (RBCs) by cell saver and the influence by zero-balanced ultrafiltration(Z-BUF) on the inflammatory response after cardiopulmonary bypass(CPB) in infants.Methods Sixty infants with ventricular septal defect (VSD) were randomly divided into a control group (group A,20 cases), group B(20 cases)and group C (20 cases).Banked suspended RBCs were washed by cell saver before priming in group B,in group C the banked suspended RBCs were treated with Z-BUF and in group C the banked suspended RBCs were primed directly without any pre-treatment.Samples of the arterial blood were obtained respectively before the start of the CPB (T1), when the CPB stopped(T2) ,2 h after CPB (T3), 12 h after CPB (T4) and 24 h after CPB (T5).The levels of tumor necrosis factor-α (TNF-α), interleukin(IL)-6, IL-8, IL-10 were detected and analyzed comparatively among 3 groups.Results The levels of TNF-α, IL-6, IL-8 ,IL-10 in 3 groups at T2,T3 ,T4 showed a rising trend markedly,and the above four indicators of A,B and C at T4respectivelywere:(110.3±14.0) ×10-9g/L,(90.6±10.3) ×10-gg/L,(103.3±9.7) ×10-9g/L;(54.1 ± 6.5) ×10-9 g/L,(39.3±4.2) ×10-9 g/L, (46.2±5.7) ×10-9 g/L;(96.8 ±9.2) ×10-9 g/L, (82.5 ±6.5) × 10-9 g/L,(88.4±5.1) ×10-9 g/L;(228.4 ±42.9) ×10 9 g/L,(171.5 ±26.4) ×10-9 g/L,(202.9 ±42.8) × 10-9 g/L.The levels of TNF-α and IL-8 in group B and group C were significantly lower than those in group A at T2, T3 ,T4 and T5(all P ＜0.05) ,but there was no significant differences in the levels of IL-6 and IL-10 among 3 groups at T5;the levels ofTNF-α,IL-6,IL-8 ,IL-10 in group B were significantly lower than those in group C at T2,T3 and T4(all P ＜ 0.05).Conclusions Processing of banked suspended pre-RBCs with cell saver and Z-BUF can relieve systemic inflammatory response, and the effect of washing with cell saver is better compared with that of Z-BUF.

FGFR1 selective inhibitor PD173074 can reduce proliferation and induce apoptosis of nasopharyngeal carcinoma / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the influence of PD173074 on proliferation and apoptosis of nasopharyngeal carcinoma.@*METHOD@#With immunoblotting and RT-PCR, FGFR1 expression was detected in CNE, PONE1 and C666-1 cell lines. With MTT assay,the time-effect and dose-effect correlation between PD173074 and inhibition of CNE proliferation was evaluated. After PD173074 stimulation, the phosphorylation level of FGFR1 and AKT was detected with immunoblotting assay. Furthermore, influence of PD173074 on the activation of Caspase3 and Caspase9 was detected to study the underlying mechanism of why PD173074 could inhibit CNE proliferation.@*RESULT@#FGFR1 has the highest expression in CNE cell line. Under incubation of 10 nmol/L PD173074 stimulation for 36 hours to 72 hours, the phosphorylation of FGFR1 and AKT was impaired significantly, which further reduced the proliferation of CNE. Moreover, PD173074 can activate the intrinsic apoptotic pathway by stimulating Caspase9,which activated Caspase3 and induced the apoptosis.@*CONCLUSION@#PD173074 could inhibit proliferation of nasopharyngeal carcinoma cell through reducing the phosphorylation of FGFR1 and AKT. Additionally, PD173074 can induce CNE apoptosis by activating intrinsic apoptotic pathway via cleaving Caspase9 and Caspase3.

Inhibition of YAP gene by siRNA suppresses the proliferation and migration of T24 bladder cancer cells / 中国癌症杂志

Background and purpose:Urothelial carcinoma of the bladder (UCB) is the most common cancer in urinary system. Yes associated protein (YAP) gene is closely associated with urothelial carcinoma of the bladder. The study was aimed to explore the effect of siRNA targeting the YAP gene on cell proliferation and migration of T24 cells. Methods:Small interfering RNA (siRNA) was transfected together with LipofectamineTM2000 in T24 human bladder cancer cells to block the YAP signal pathway. The effect of siRNA on cell proliferation and invasiveness was assessed by cell counting kit-8 (CCK-8) assay, Transwell migration assay and wound healing assay. Quantitative real time-Polymerase chain reaction (qRT-PCR) and Western blot analysis were used to conifrm the successful suppression of YAP gene and protein by siRNA. Results:Expression of YAP gene and protein was successfully suppressed after transfected with siRNA which verified by qRT-PCR and Western blot(RNA:F=93.91, P<0.000 1; Protein: F=4.62, P<0.05). As CCK-8 test showed, the proliferation of T24 bladder cancer cells was successfully restrained by inhibition of YAP gene compared with blank control and negative control(12 h: F=6.00, P=0.037;24 h: F=41.72, P=0.000 3;36 h:F=462.8, P<0.000 1;48 h:F=236.6, P<0.000 1;72 h:F=140.5, P<0.000 1). Transwell and wound healing test were performed after YAP gene was interfered by siRNA. The result demonstrated that migration of T24 bladder cancer cells was signiifcantly inhibited (Transwell: F=43.55, P<0.05;Wound healing: F=43.55, P<0.05). Conclusion:This study suggested that YAP gene was an important enhancer for the proliferation and migration of bladder cancer cells.

Cause of puncturing failure in ultrasonography guided minimal-invasive percutaneous nephrolithotomy / 中华泌尿外科杂志

Objective To analyze the cause of puncturing failure in ultrasonography guided minimal-invasive percutaneous nephrolithotomy (MPCNL). Methods A retrospective analysis involved total 612 patients with upper urinary tract lithialisis treated with MPCNL from May 2005 to May 2010.382 cases were acupunctured by traditional G18 puncturing instrument (group A),and the other 230 cases were performed by the improved ARROW Raulerson blue syringe (group B).The average renal pelvis range was 24 mm vs.21 mm before operation,and largest diameter of renal calculi was 3.7 cm vs.3.8 cm (P ＞ 0.05).Success rate and time cost as well as therapeutic effect were compared between the 2 groups. Results There were 29 cases of puncturing failure in group A (totally 382 cases) while only 2 in group B (totally 230 cases).The successful rate of establishment of working channel was significantly higher in group B (P ＜ 0.05).Average time of puncture procedure was 5.1 min and 4.8 min respectively (P ＞ 0.05).There was no puncturing-related severe complication in any group.The unsuccessful cases in the group A and related causes were:5 cases for obesity,13 cases for puncture needle slipping,9 cases for channel dropout,and 2 cases for needle route dropout.However,only 2 cases failed in group B,the accurate position of calculi was at upper and lower calyx.One case was over-weighted,another was because of pathway-loss during the calculi elimination processs.And the one-off puncture successful rate of A and B group was 92.4％ vs.99.1％,and the one-off puncture successful rate was significantly higher in group B. Conclusions Overobesity of patients is an important cause of puncturing failure for sonographically MPCNL.The establishment of working-channel with ARROW Raulerson blue syringe could be feasible and the success rate was significantly higher.

Detection of invasive fungi DNA load in human whole blood samples with universal fungi primers and probe / 中华临床营养杂志

Objective To establish a real-time quantitative PCR(RQ-PCR)assay for fast detection of invasive fungi DNA in human whole blood samples with universal fungi primers and probe.Methods The universal fungi primers and the TaqMan-probe were designed on the basis of the multi-copy 5.8S region of the rDNA of the clinically most common invasive fungi.The invasive fungi genomic DNA were extracted with QIAamp?DNA Blood Mini Kit.A 20 μl RQ-PCR amplification system was established,and the simulated blood samples containing various given load of invasive fungi genome and the 71 whole blood samples of the surgical febrile patients were examined.Results The detection limit is 101 copies/μl amplification mixture,namely 105 copies/ml whole blood.The sensitivity and the specificity were 95.5％ and 97.6％,respectively; and the positive predictive value and negative predictive value were 98.7％ and 92.0％,respectively.The correlation coefficient of standard curve was between 0.9931 and 0.9977.The intra-and the inter-assay average coefficients of variation were(10.4 ±4.0)％ and(27.9 ± 2.0)％,respectively.The average relative recovery rate of fungi genomic DNA in blood samples was(91.0 ±7.6)％,and the average coefficients of variation of the relative recovery rate was(14.9 ±4.0)％.No fungi DNA was detected among the 71 blood samples of the surgical febrile patients.Conclusions The RQ-PCR assay for fast quantitative detection of invasive fungal DNA in human whole blood samples with the universal fungi primers and the TaqMan-probe was of high sensitivity,specificity,accuracy and precision,and is able to discriminate fungi from bacteria.The invasive fungi genome was not detected in this group of surgical patients,which may imply the less possibility of fungi translocation in the surgical febrile patients.

Morphometric and functional alterations of amygdale and hippocampus in patients with depression: a MRI study / 中华放射学杂志

Objective To explore the morphometric and functional alterations of amygdale and hippocampus in patients with depression by anatomical and functional MRI, and try to reveal the pattern and pathogenesis of the changes in depression. Methods Sixty patients (divided equally into mild, moderate and major groups according to patient′s scores of HAMD) and 20 healthy control groups were scanned using T1WI and fMRI. The outlines of hippocampus and amygdale were drawn manually by observer and the volumes were calculated and normalized subsequently. Functional MRI was processed using SPM5 and individual activation map was got subsequently. Dunnett-t test and Pearson correlation analysis were separately used to analyze the morphometric and functional changes and the correlations between cerebral changes and clinical severity. Results The hippocampal volumes of control groups were 2296±202 left for left side and 2283±199 for right side. The hippocampal volumes of depressive patients were smaller than those of control groups, especially for the major group (left 1978±176,Dunnett-t=-10.0,P0.05,right 2210±191,Dunnett-t=-1.6,P>0.05). The amygdale′s volumes of control groups was 1762±185,the right was 1749±182, while those in patient group reduced along with the patient′s condition, i.e., the mild groups (left 1992±200,Dunnett-t=4.8,P<0.01,right 1989±191, Dunnett-t=5.0,P<0.001), the moderate groups (left 1889±192, Dunnett-t=2.8,P<0.05,right 1896±195,Dunnett-t=2.8,P<0.05), and the major groups (left 1539±178,Dunnett-t=-6.8,P<0.01,right 1543±180,Dunnett-t=-7.0,P<0.01).For fMRI study, patient group demonstrated more activation of the amygdale and hippocampus under the stimulations of negative images than controls. Furthermore, the strengthens of activation decreased along with the patient′s condition, i.e., the major ones showed the weakest activation among the patients, though it was higher than that of control group. In patient group, both the volumes and activations of hippocampus and amygdale showed significant negative correlations with HAMD scores(r=-0.80--0.90,P＜0.05). Conclusion The hippocampal volumes of depressive patients reduced, which may be due to the change of the amygdale, and the amygdale′s volumes were changed along with the patient′s condition. There were more activation in the amygdale and hippocampus of depressive patients under the stimulations of negative images.

Detection of Aspergillus fumigatus genome load in human whole blood samples by real-time quantitative polymerase chain reaction and its clinical application / 中华临床营养杂志

Objective To establish a real-time quantitative polymerase chain reaction (RQ-PCR) assay for fast detection of Aspergillus fumigatus genome in human whole blood samples and explore its clinical application.Methods The primers and the TaqMan-probe were designed on the basis of the multi-copy ITS1-5. 8S region of the rDNA of Aspergillus fumigatus. The Aspergillus fumigatus genomic DNA were extracted with QIAamp(R) DNA Blood Mini Kit.A 20 μl RQ-PCR amplification system was established, and the simulated blood samples containing various given load of Aspergillus fumigatus genome and the 66 whole blood samples of the surgical febrile patients were examined. Results The detection limit of the RQ-PCR instrument is 10-1 genomes/μl DNA sample,namely 78 CFU/ml whole blood. The specificity and the sensitivity were 94. 25% and 99. 04% respectively; and the positive predictive value and negative predictive value were 97. 63% and 97. 62% respectively. The average relative error of the quantitative results was (3. 67 ±13. 19)%, and the intra- and the inter-assay average coefficients of variation were (12.38 ± 1. 53)% and (16. 27 ±2. 72)% , respectively. The average recovery rate of Aspergillus fumigatus genomic DNA in human whole blood samples was (107. 81 ±25. 92)% , and the average coefficient of variation of the average recovery rate was (26. 24 ± 5.62) % . No Aspergillus fumigatus genomic DNA was detected among the 66 blood samples of the surgical febrile patients. Conclusions The RQ-PCR assay for fast quantitative detection of Aspergillus fumigatus genome in human whole blood samples is of high sensitivity, specificity,accuracy and precision. The Aspergillus fumigatus genome was not detected in this group of surgical febrile patients.

MRI enhancement scanning features and pathology of the orthotropic transplantation nude mouse model with human pancreatic cancer / 中华胰腺病杂志

Objective To investigate the MRI imaging features, and pathologic basis of the orthotropic transplantation nude mouse model with human pancreatic cancer. Methods Adopting Siemens Magnetom Trio Tim 3.0 Tesla superconductive MRI and breast coil was used to examine 30 orthotropic transplantation nude mouse models of the human pancreatic cancer, these mouse were sampled to acquire TSE-T1 -weighted and T2-weighted transverse axial images. Intraperitoneal injection of Gd DTP A was used to perform continuous dynamic enhancement scanning. Signal intensities of tumors were measured in plain scanning and each phase' s enhancement scanning images, respectively. Intensification rates of tumors were calculated. Pathologic examination of tumors was performed to be compared with the findings of MRI scanning. Results The successful rate of inoculation of 30 nude mice was 100%. The histological findings were comparable with poorly differentiated adenocarcinoma. Compared with signal of adjacent tissues, the MRI findings of the tumors were uniformly slightly hypointensity (90% , 27/30) , or unevenly (10% , 3/30) on TSE-T1WI; uniformly (20% , 6/30) or unevenly (80% , 24/30) hyperintensity with equal or more hyper signal spots on TSE-T2WI. Signal intensities on plain scanning was 228.35 ±11.71, and 1.5,3,6,9, 12 min after enhancement scanning, thesignal intensities were 258.20 ± 11.17, 301.75 ± 17.09, 358.65 ±25.13, 480.05 ± 19.01, 558.35 ± 40.49, which were significantly higher than those in plain scanning (P <0.01). The intensification rate of every phase was 0.13 ±0.04, 0.35 ±0.11, 0.56 ±0.10, 1.10 ±0.10, 1.45 ±0.18, and the difference among these phases was statistically significant (P <0.01). The significantly intensified area was the area where the tumor cells grew actively with rich capillaries; the central area without intensification was the area of necrotic tissue and/or densely packed tumor cells and few capillaries. Conclusions High resolution MRI imaging of implanted tumors can be obtained by intraperitoneal injection of contrast, and it is consistent with pathologic examinations.

Sexual function changes after transurethral plasmakinetic resection of the prostate / 中华泌尿外科杂志

Objective To investigate the influence of transurethral plasmakinetic resection of the prostate(PKRP)on sexual function. Methods From January 2007 to December 2007.165 patients received PKRP,who had sexual active and completed the follow-up data forms before and after surgery.The average age of this cohort was 71 years(from 55 to 79 years).The average history of disease was 5.5(3-15)years while the average prostate volume 57(33-82)g,IPSS(26.4±2.6),quality of lire score(5.54±0.50),the maximum flow rate(7.04±4.10)ml/s,the average residual 120(55～250)ml.45 cases were complicated with urinary retention,and bladder stones 45 cases.15 cases with prostate stones.Their sexual function was assessed by the international index of erectile function,ejaculation function and sexual satisfaction before and 6 months after surgery by questionnaires,and compared the respective scores using SPSS14.0 and χ2 test. Results All of 165 patients,the IIEF-5 improved from(23.4±4.7)point to(24.1±4.9)point 6 months after operation(P>0.05),there was not significant.The abnormal ejaculation rate increased from 18.8%(31/165 patients)to 75.2%(124/165 patients)(P<0.001)after PKRP,respectively.The retrograde ejaculation rate increased from 11.6% (19/165 patients) to 64.2%(106/165 patients) after PKRP, respectively.There was a significant difference.128 patients (77.6 % ) and 132 patients (80.0 % ) were satisfied with their sexual active before and after 6 months PKRP, respectively. Conclusions The results of this study confirmed that PKRP has no negative influence on the quality of erections measured by IIEF-5.The loss of ejaculatory function has no influence on patients sexual active.

Carotid Atherosclerotic Plaque:MR Imaing at 3.0T Magneton / 实用放射学杂志

Objective To study the capability in detection and qualitative analysis of carotid atherosclerotic plaque with 3.0T MR scanner.Methods Bilateral carotid arteriae in thirty-two patients with arterosclerosis which detected by Doppler ultrasound were examined with a 3.0T MR scanner.The pulse sequences included 3D time of flight,FLASH-3D,TSE-DIR T_1WI,TSE-DIR PDWI-FS,DIR TSE-T_2WI-FS and TSE-T_2WI.According to AHA modified criteria of atherosclerosis typing,the signal characteristics of plaques were analysed.Results Carotid plaques were homogeneous signal intensity on all sequences in 30/49,heterogeneous signal intensity on at least one sequence in 15/49,among them,7 with lipid core,3/49 plaques contained calcification ,2/49 appeared as thrombosis and resulting in vessel occulusion,28/49 plaques presented the character of thick fibrous cap,13/49 plaques showed character of thin fibrous cap,the surfaces of 5/49 plaques were rough.Conclusion High resolution multiple sequences imaging with 3.0T MR scanner can be used for detection and qualitative analysis of the carotid atherosclerotic plaque in a certain degree.

Dynamic research about the change of the behavior and hippocampal volume of rat depressive model / 中华行为医学与脑科学杂志

Objective To explore the dynamic change and correlation of the behavior and hippocampal volumes by MRI of rat depressive model. Methods Based on the evaluation of ethology, thirty SD rats were randomly and equally divided into control group and model group which was exposed to chronic unpredictable mild stress for 8 weeks. The body weight, fluid consumption test and Morris water maze test were done at the beginning and per week while the bilateral hippocampal volumes of every rat were measured by high field MRI at the beginning and per two weeks. Results Based on the behavioral data,the rat depressive model was established successfully,and changed dynamically. On 4th week,the left hippocampal volumes of depressive rat were significantly reduced (model group(37.13 ±2.40)mm3 ,control group (39.05 ±2.05)mm3, t=2.36, P＜0.05) while the right ones did not. On 6th week, the right ones began to reduce significantly ( model group ( 37.85 ± 2.11 ) mm3, control group ( 39.44 ± 2.10 ) mm3, t = 2.07, P ＜ 0.05 ) while the left one still reduced, but the extent of the left's reduction was bigger than the right( left:15% ,right:8% ). And there was apparent correlation between the behavior and the reduction of hippocampal volumes. Conclusion The behavior and hippocampal volumes of rat depressive model changes dynamically,and there was a regularity of them.

Laparoscopic radical nephrectomy for clinical stage T_2 renal cell carcinoma patients / 中华泌尿外科杂志

Objective To report the experience and results in comparing laparoscopic radical nephrectomy (LRN) and open radical nephrectomy (ORN) in the treatment of clinical T_2 stage renal cell carcinomas. Methods Between Feb. 2004 and Jul. 2007, 30 patients (12 females and 18 males with average age of 58.0±8.5 years, range 42-68 years) received LRN and 36 patients (16 females and 20 males with average age of 60.0±9. 0 years, range 52-70 years) received ORN. The average tumor sizes in the LRN and ORN groups were (8. 5±2.2)cm (range 7-12 cm) and (8. 8±2.1)cm (range 7-14 cm) respectively. Renal cell carcinoma was histopatologically confirmed in all the patients of these 2 groups after surgery. Results The operative time in the ORN group (130±27 min) was significantly shorter than that in the LRN group (176±23 min), P<0. 01. The estimated blood loss in the LRN group (200±80 ml) was also significantly less than that in the ORN group (380±185 ml) , P<0. 01. Patients in LRN group experienced significantly earlier bowel function recovery (P<0. 01) and shorter duration of drainage (P<0. 01) than those in the ORN group after operation. No severe perioperative complications occurred in all patients. The follow-up range was 6-27 months (average 15±2 months). During the follow-up, 2 patients in the LRN group developed lung metastasis. In the ORN group, 2 patients developed liver metastasis and 1 developed lung metastasis. Conclusion LRN has the advantages of minimal invasiveness and rapid postoperative recovery comparable to those of ORN, and it might be an alternative treatment option for the clinical T_2 stage renal cell carcinomas.

Establishment and magnetic resonance imaging monitoring of the orthotopic transplantation nude mouse model with human pancreatic cancer cell line PANC1 / 中华胰腺病杂志

Objective To establish a stable orthotopic transplantation nude mouse model of the human pancreatic cancer and to explore the role of monitoring tumor growth with noninvesive MRI.Methods The tumors cells suspension made by the subcutaneous injection of human pancreatic cancer cell lines PANC1 were used as the source of tissue for orthotopic implantation of tissue.and transplanted into the pancreas of 20 BALB/C-nu nude mice.After implantation,the successful rate,tumor formation time,tumor growth speed,tumor shape and the change of signal of the tumor were monitored and recorded noninvasively by MRI.At the end of the 7th week,all the specimens were examined by pathological methods.Results Thirty-five percent (7/20)mice with implantation of primary human PANC1 adenocarcinoma cells were detected to have orthotopic implanted tumors by MRI after 15 days,and all the 20 nude mice developed pancreatic tumor within 27 days after operations,and the successful rate was 100%.Compared with adjacent normal tissue,the T1 WI imaging of 90%(18/20)of all the tumors showed uniformly hypo-intense signal,10%(2/20)showed iso-intense signal,the T2W 75%(15/20)showed uniformly hyper-intense signal.The tumor size 2,3,4,5,6,7 weeks after implantation was(912.6±2.4)mm3,(94.3±11.2)mm3,(175.9±82.5)mm3,(395.8±126.6)mm3,(1290.2±167.2)mm3,(1583.4±87.4)mm3,respectively.Pathologic examination confirmed poody differentiated pancreatic adenocatcinoma and it remained the primary tumor's biolosic features.Conclusions The orthotopic transplantation nude mouse model was in accordance with the feature of human pancreatic cancer and was easy for noninvasive monitoring,which provided an effective and stable in vivo experimental system.

Clinical study of laporoscopic nephron sparing surgery for T1 renal cell carcinoma / 中华泌尿外科杂志

Objective To evaluate the clinical efficacy and safety of laparoscopic nephron sparing surgery in the treatment of T1 renal cell carcinoma. Methods Thirty-two patients (24 males and 8 females) were diagnosed with T1 N0 M0 renal cell carcinoma by ultrasound, CT or MRI and un derwent laparoscopic nephron sparing surgery. The mean age was (49±2)years old (from 31 to 72 years old). The mean tumor diameter was (2.8±0.8)cm. There were 21 tumors in left kidney, 11 in right kidney. Of them, 10 tumors were in upper pole, 13 in lower pole, 5 in kidney center, 4 close to renal hilum, 18 in dorsal side and 14 in ventral side of the kidney. Tumor masses were resected with the surgical margin of 0. 5 cm. Twenty-five cases were done through retroperitoneal approach and 7 cases was done through transperitoneal approach. The pathological results showed that there were clear cell renal carcinoma in 28 cases, granule cell renal carcinoma in 3 cases and oncocytoma in 1 case. Renal function was examined by ECT before and after the surgery. Results Thirty-one cases under went laparoscopic nephron sparing surgery successfully and only one case converted to open surgery due to excessive intra-operative bleeding. The mean renal pedicle blocking time was (24±4)min (from 19 to 52 min). There were 3 cases having blocking time longer than 30 min (38 min, 45 min and 52 min) and accepted secondary blockage during the procedure. The mean operative time was (105 ± 15) rain. The mean estimated blood loss was (120±22)ml. Only 6 cases accepted 400 ml blood transfusion. D-J stents were placed in 5 eases with the tumor in kidney center before operation. In 3 cases with intra-operative exposure of renal calyx, D-J stems were placed after operation. Urine leakage in 2 eases were noted at 2 and 3 days and recovered at 15 and 21 days after operation. The mean hospital stay was (9±2)days. There was no recurrence in a mean follow-up time of (23±5)months. There were 3 cases with local hematoma (1 case of 4 cm × 3 cm, 2 cases of 2 cm×3 cm) in the surgical site confirmed by ultrasound or CT scan 1 month after surgery and they disappeared 3 months after the operation. Serum creatinine and urea nitrogen were all in normal range after operation. Compared with renal blood flow of the operated kidney before operation, there were 9 cases decreased by 10 %- 15 and 3 cases decreased by 20% at 15 days, 7 cases decreased by 10%-15% at 1 month and 3 cases decreased by 10%- 15% at (23 ± 5) months after operation. Conclusion Laparoscopic nephron sparing surgery is one of feasible and safe options for the treatment of T1 renal cell carcinoma.

The Diagnostic Value of the C_2 “Hypertrophic sign” in the Axis Fracture on the Conventional Radiography / 实用放射学杂志

Objective To evaluate the diagnostic value of the C 2 “hypertrophic sign” in the axis fracture.Methods 37 cases with C 2 fracture confirmed by radiography,CT and operation partly retrospectively analysed,there were 29 men and 8 woman.After trauma all cases were examined by X-ray and 11 cases by CT scan.27 cases underwent operation.Results The incidence rate of the C 2 “hypertrophic sign” was 53.13%.This sign characterized by the distance increased between the anterior and posterior of the axis on the lateral conventional radiography compared with that of C 3 vertebrae.The maximal increasing distance was 11 mm and minimal one was 2.3 mm with average 4.3 mm.Fracture line and swollen soft tissue in front of the vertebra were showed in some cases.Conclusion The C 2 “hypertrophic sign” is main radiographic sign of C2 fracture.

Comparison between Ordinary MRCP and Half-Fourier Acquisition Single-shot Turbo Spin-echo(HASTE) MRCP Single-slice Acquisition Technique / 实用放射学杂志

Objective To compare HASTE-MRCP single-slice acquisition technique with ordinary MR cholangiopancreatography (OMRCP) and to assess the clinical application value of HASTE-MRCP single-slice acquisition technique.Methods 48 cases with biliary obstructive diseases and 30 cases without obstructive jaundice were studied with a 3. 0T super conductive unit(Magnetom Trio;Siemens,Germany) that used a body coil. Two acquisition techniques of MRCP were used for all patients . The accuracy of the two kinds of technique were compared. Results OMRCP , single-slice HASTE-MRCP had the same sensitivity and specificity in showing the site and feature of the diseases , the proximal dilated biliarys and distant normal cholangiopancreatic ducts .The diameter of dilated bile ducts at the same level was compared and no significant difference in them. Single-slice HASTE-MRCP had a high spatial resolution ,and shot aquisition time ,but more vessel artifact. OMRCP had high density resoultion ,but more motion artifacts.Conclusion The single-slice acquisition of HASTE-MRCP is an excellent technique in the diagnosis of biliary tract diseases.