Nephrectomy and removal of inferior vena cava tumor thrombus under profound hypothermia and arrested circulation / 中华泌尿外科杂志

Objective To study the feasibility and safety of performing nephrectomy together with the removal of complicated inferior vena cava tumor thrombus under profound hypothermia and arrested circulation. Methods After made the median thoraco-abdominal incision, the exploration of the abdominal organs was done. The right kidney, inferior vena cava and renal pedicle were well exposed then. After the whole body heparinization, cannulas were put into ascending aorta, superior vena cava, aortic root and right superior pulmonary vein. The body temperature was reduced to 20℃ with cardiopulmonary bypass unit and the extracorporeal circulation was stopped then. Cut open the inferior vena cava at vena renalis dextra ingress and the F16 urinary catheter was inserted into atrum dextra through inferior vena cava and inflated. The tumor thrombus was pulled out and the right kidney was removed. The inferior vena cava incision was sutured to close and the extracorporeal circulation was resumed and patient was re-warmed.Results The operation time was 330 min and the extracorporeal circulation time was 90 min, while the profound hypothermia with circulatory arrest time was 20 min. The estimated blood loss during operation was 400 ml and 6 unit red cells and 600 ml blood plasm were transfused. The patient was awaked 2.5 h after the operation, food intake resumed 4 days after operation and the patient was discharged on day 10 post-operatively. After 6 months'follow-up, there were no local recurrence and metastasis occurred. Conclusion The technique of profound hypothermia and circulation arrest could improve the safety and efficacy in the treatment of renal cell carcinoma with suprahepatic (level Ⅲ) caval tumor thrombus.

Effects of mechanical stretching force on osteoblast-like function of human periodontal ligament cells in vitro / 中华口腔医学杂志

<p><b>OBJECTIVE</b>To investigate the osteoblast-like functional characteristics exhibited by human periodontal ligament cells (hPDLCs) under mechanical force.</p><p><b>METHODS</b>Human PDLCs cultured in vitro were stretched by mechanical force. Radioimmunoassay (RIA) was used to measure the expression of secreting alkaline phosphotase (ALP) and osteocalcin (OCN). The non-secreting ALP, OCN and osteopontin (OPN) in cells were determined by immunohistochemistry.</p><p><b>RESULTS</b>It exhibited increasing of ALP secreted into conditional media, and in the 24 hour period there were two peaks which appeared at the 2nd and 4th hour and the 24th hour (P < 0.01). While in the late of the 24 hours, expression of OCN in conditional media increased (P < 0.05).</p><p><b>CONCLUSION</b>Mechanical force induces hPDLCs to differentiate into functional osteoblast-like cells and plays a role in bone remodeling.</p>

Relationship of expression of extracellular matrix metalloproteinase inducer and hepatocyte growth factor with lymphoid metastasis and prognosis in non-small-cell lung carcinoma / 中国病理生理杂志

AIM:To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN)and hepatocyte growth factor(HGF)in non-small-cell lung carcinoma(NSCLC)and their relationship with lymphoid metastasis and prognosis.METHODS:Expression of EMMPRIN and HGF in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of expression of EMMPRIN and HGF with tumor size,smoking,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis was analyzed.RESULTS:The expressive rates of EMMPRIN and HGF were 68% and 44%,respectively.The expressions of EMMPRIN and HGF were associated positively with lymphoid metastasis(r=0.371 and 0.339,P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC.CONCLUSION:The expression of EMMPRIN and HGF is associated with lymphoid metastasis and prognosis in NSCLC.Overexpression of EMMPRIN and HGF implies infavourable prognosis in NSCLC.

Evaluation of the following treatment after cervical conization with positive margins for patients with cervical neoplasm / 中国癌症杂志

Background and purpose:Cervical conization, including high frequency loop electrosurgical excision procedure(LEEP) has been widely used in the treatment of cervical diseases, but how to deal with the patients with pathological positive margin is a problem for clinicians.The purpose of this study was to discuss the option of adjuvant treatment after cervical conization with positive margins for patients with cervical neoplasm.Methods:The data of 528 patients who had cervical conization from 1998 to 2008 was reviewed, among which 54 patients with pathological positive margin was retreated and analyzed.Results:Fifty-four patients were divided into observation group and treatment group, 17 cases were in observation group and 37 cases in treatmeat proup.The recurrence / duration / progress rate was 17.6%(3/17), in treatment group it was 2.7%(1/37) in observation.CINⅠ-Ⅱ positive margins in both group had no recurrence;among 14 patients with CINⅢ, 1 lesion persisted, and 1 progressed to cervical squamous cell carcinoma, none in treatment group was recurrent;For those 10 patients with micro-invasive margin-positive cases, 1 progressed to squamous cell carcinoma, the remaining 9 cases were followed up for 26 months without recurrence after operation.One case in invasive cancer group had recurrence.Conclusion:The patients with CINⅢ margin-positive patients after conization should receive individualized treatment.The patient with microinvasive carcinoma should be retreated with either re-conization or hysterectomy;if with margin-positive CINⅢ after conization, or re-conization or directly treated according to guideline addressing for ⅠB, if margin showed microinvasive carcinoma.The patients with margin-positive invasive carcinoma after conization should be treated according to guideline.