Fast-track protocol of endovascular aneurysm repair for ruptured abdominal aortic aneurysm / 中国医师进修杂志

Objective:To analyze the effective and safety of endovascular aneurysm repair (EVAR) for ruptured abdominal aortic aneurysm (RAAA) at one tertiary center, and to improve the outcomes of RAAA under fast-track protocol.Methods:Nineteen cases of RAAA in the 940th Hospital of Joint Logistic Support Force of PLA from January 2014 to December 2020 were reviewed retrospectively. EVAR-fist strategy was employed from the emergency room to the operating room by using fast-track protocol. Preoperative management, anatomic characteristics, choice of anesthesia, operative procedures and postoperative complications were collected and analyzed. Abdominal compartment syndrome (ACS) and hospital mortality were paid special attention.Results:Nineteen cases were undergone EVAR procedures. The age was (73.4 ± 7.4) years old, and the AAA size was (67.8 ± 13.6) mm. Two cases underwent cardiopulmonary resuscitation at emergency department. General anesthesia was used in 13 patients and local anaesthesia in 6 patients. Successful stent graft deployment was achieved in all cases. The duration from emergency room to operating room was (84.8 ± 22.4) min. The hospital stay time was (9.7 ± 5.7) d. The hospital mortality was 5/19. The 5 deaths were reviewed: 3 died for multiple organ failure, 1 for irreversible shock, and 1 for ongoing bleeding.Conclusions:Excellent results were confirmed by using EVAR-first strategy for RAAA. The management of hemodynamically unstable state, standardized endovascular procedure, fast-track program and multidiscipline team collaboration were the very important determining factors for the implementation of EVAR. Focused efforts to reduce RAAA mortality are warranted.

Study on preparation and formation mechanism of danazol-sodium caseinate composite nanoparticles / 中国药房

OBJECTIVE To prepar e and characterize danazol （DAZ）-sodium caseinate （SC）composite nanoparticles ，and to study the mechanism of preparing nanoparticles in “bottom-up”technology. METHODS SC was used as a stabilizer for regulating nanoparticles，so that DAZ-SC composite nanoparticles were prepared by anti-solvent precipitation method. The particle size ， Zeta-potential，micro-morphology，stability，encapsulation efficiency ，drug loading and in vitro dissolution rate were characterized. Fluorescence spectra ，IR spectra ，FBRM and other methods were used to analyze the interaction mechanism between DAZ and SC. RESULTS The particle size of DAZ-SC composite nanoparticles was （223.7±12.5）nm，and the polydispersity index was 0.274± 0.012. Zeta-potential was －（17.81±1.63）mV（n＝3）. The stability of nano-suspension was good ，the solid properties of DAZ were greatly improved ，and the dissolution rate was significantly increased. SC was statically quenched under the action of DAZ and the secondary structures of SC were changed. The crystallization process of DAZ was controlled under the action of SC ，and the interaction between DAZ and SC was mainly hydrogen bond and van der Waals force. CONCLUSIONS In this study ，DAZ-SC composite nanoparticles are successfully prepared. In the “bottom-up”technology，the interaction between SC and DAZ caused by hydrogen bond and van der Waals force inhibits the growth and agglomeration of drug crystals .

Endoreplication and its role in tumor development and progression / 中国肿瘤临床

Most diploid cells proliferate by proceeding through the canonical G1 (DNA pre-synthesis), S (DNA synthesis), G2 (DNA post-synthesis), and M(mitosis) phases of the cell cycle. However, there is another type of cell cycle that occurs frequently in both plants and animals, known as endoreplication. Endoreplication consists of alternating periods of G and S phases without cytokinesis, which results in polyploidy. It is indispensable for normal development, organ formation, and wound healing in humans. In recent years, con-siderable attention has been paid to delineating the connections of endoreplication with tumorigenesis and tumor progression. Here, we review the role of endoreplication in normal human development and discuss its possible role in tumor development and the un-derlying molecular mechanisms.

Clinical analysis of clear cell sarcoma of the kidney in children / 中国肿瘤临床

Objective:To summarize the clinical features of clear cell sarcoma of the kidney (CCSK) in children and to evaluate the effica-cy and safety of the WT-2009 chemotherapy protocol. Methods:Clinical data of children with CCSK recorded between January 2009 and December 2014 were retrospectively analyzed. Follow-ups were conducted to monitor the postoperative conditions of the pa-tients. Results:Nine cases of CCSK were recruited, and another three cases were excluded for the analysis because of incomplete clini-cal data. All patients achieved complete remission when the treatment was finished. The estimated 3-year overall survival rate was 100％, and the estimated 3-year event-free survival rate was 83.3％. No report is available on the significant side effects associated with this treatment. Conclusion:CCSK is rare in children and is easily misdiagnosed. The chemotherapy based on the WT-2009 proto-col can produce a favorable prognosis and a high tolerance for patients with CCSK. However, the treatment for high-risk patient needs to be further explored, and follow-ups must be intensified.

Imaging features and treatments of ischemic cerebrovascular disease with unruptured intracranial aneurysms / 临床神经病学杂志

Objective To investigate the imaging features and the treatments of ischemic cerebrovascular disease with unruptured intracranial aneurysms.Methods The clinical data of 23 patients of ischemic cerebrovascular disease with unruptured intracranial aneurysms ( unruptured group) and 147 patients of hemorrhagic cerebrovascular with ruptured intracranial aneurysms ( ruptured group) were retrospectively analyzed.Results There were no statistical significances between the two groups baselines such as age, gender, hypertension, diabetes, hyperlipidemia, heart disease, smoking, drinking alcohol (all P>0.05).There were 16 patients (69.6%) with single intracranial aneurysm and 7 patients (30.4%) with multi-intracranial aneurysms in the unruptured group, and the number of intracranial aneurysms were 34.There were 125 patients (85%) with single intracranial aneurysm and 22 patients ( 15%) with multi-intracranial aneurysms in the ruptured group, and the number of intracranial aneurysms were 170.There was no statistical significance of single aneurysm and multi-aneurysms percentage between the two groups (P>0.05).The maximum aneurysm diameter and the percentage of large aneurysms, dissecting aneurysms of the unruptured group were significantly greater than the ruptured group; and the percentage of small-middle aneurysms and saccular aneurysms were significantly smaller than the ruptured group ( all P<0.05 ) .In the unruptured group, 5 cases were treated with intervention treatment and 1 case was treated with aneurysm clip surgery, all of which recovered well after surgery;6 cases were treated with Plavix antiplatelet therapy, 5 cases were treated with Aspirin antiplatelet therapy, cerebrovascular disease events were not found of which followed-up for 6 months;6 cases were not taken antiplatelet therapy, and 1 case of which followed-up and occurred cerebral infarction.In the ruptured group, 46 cases were treated with intervention treatment, 2 cases of which were died;101 cases were treated with aneurysm clip surgery, 6 cases of which were died.Conclusions Small-middle aneurysms are more commonly occurred in patients of ischemic cerebrovascular disease with unruptured intracranial aneurysm, however, the maximum aneurysm diameter of which is significantly bigger than patiehts of hemorrhagic cerebrovascular with ruptured intracranial aneurysms.Most of unruptured aneurysms which had duty relationship with cerebral ischemic events are dissecting aneurysms and saccular aneurysms.Intervention treatment of unruptured intracranial aneurysms is relatively safe and effective.

Renal and extra-renal rhabdoid tumor:analysis of 4 cases and lit-erature review / 中国肿瘤临床

Objective:To analyze the clinico-pathological characteristics, pathological diagnosis, and treatment of rhabdoid tu-mor. Methods:The medical records of four rhabdoid tumor patients that were admitted to the Tianjin Medical University Cancer Insti-tute and Hospital since 2000 were analyzed based on existing literature. Results:In one of the four cases, the tumor originated from the kidney, whereas in the other three, the tumor occurred from extra-renal soft tissues. Histologic analysis revealed that the tumor cells were loosely arranged with diffuse growth, vesicular nuclei, dyed cytoplasm, visible eosinophilic inclusions, and more nuclear fission. The results of immunohistochemical staining showed that the vimentin and epithelial membrane antigen were positive, whereas CK, CD99, CD34, and S-100 were positive at different degrees. MyoD1, Desmin, and INI-1 were negative. Conclusion:Rhabdoid tumor is rare and highly aggressive. It occurs mainly in the kidney and can also be found in other systems. The unique pathological form and im-munohistochemical staining observed on the tumor can be used as reference for diagnosis.

Research progress on the relationship between FAK and cancer / 中国肿瘤临床

Focal adhesion kinase (FAK), a type of protein tyrosine kinase in the cytoplasm, is highly expressed in many types of malignant tumors. FAK is named as such because of its close relationship with the cell adhesion function. Recent studies show that FAK is expressed in many tumor cells and has a definite relationship with cancer progress, metastasis, and prognosis. Accordingly, FAK has become one of the new tumor therapeutic targets that will bring new methods for tumor therapy.

Analysis and comparison of the prognosis of combined and pure small cell lung cancer / 中国肿瘤临床

Objective:This study aimed to analyze and compare the prognosis and the prognostic factors of combined small cell lung cancer (CSCLC) and pure small cell lung cancer (PSCLC) retrospectively. Methods:The clinicopathological characteristics of the 343 small cell lung cancer patients who were diagnosed in Tianjin Medical University Cancer Institute and Hospital between January 2006 and December 2012 were collected and reviewed. Survival analysis was performed and prognostic factors were assessed. Results:The median OS (overall survival) and PFS (progression free survival) of CSCLC were 31 and 21 months, respectively, and the median OS and PFS of PSCLC were 15 and 9 months, respectively. The Kaplan-Meier survival curves revealed that the prognosis of CSCLC was significantly better compared with that of PSCLC. COX analysis showed that disease stage, pathology, and therapy were indepen-dent prognostic factors of small cell lung cancer. Univariate analysis indicated that the small cell lung cancer group benefited from the surgery, particularly the CSCLC. NLR , therapy, and disease stage influenced the prognosis of PSCLC, and disease stage and therapy in-fluenced the prognosis of CSCLC. Multivariate analysis revealed that disease stage and therapy were independent risk factors of CSCLC in regard to OS. Conclusion:The prognosis of CSCLC was better compared with that of PSCLC. Limited-stage small cell lung cancer should undergo surgery, particularly the CSCLC.

Two-tier system on the origin of epithelial ovarian carcinomas and associated molecular biological basis / 中国肿瘤临床

Ovarian epithelial carcinomas are the most common lethal gynecological malignancies. Ovarian carcinomas are divid-ed into Types I and II based on different morphologies, genetic alterations, and biomarker expression. Low-grade micropapillary serous carcinoma are Type I tumors. Type I tumors are slow growing, generally confined to the ovary at diagnosis, and with better prognosis. These tumors develop from well established precursor lesions that are termedborderlinetumors. Type 1 tumors are genetically stable and are characterized by mutations in a number of different genes including KRAS, BRAF, PTEN, and beta-catenin. Type II tumors are rapidly growing and highly aggressive neoplasms, for which well defined precursor lesions have not been described. They may arise in the fimbrial epithelium of the oviduct with advanced stage, more aggressive behavior, and worse prognosis. High-grade serous carcino-ma belongs to Type II tumors. This group of tumors has a high level of genetic instability and is characterized by TP53 mutation. Hence, ovarian cancer comprises a heterogeneous group of tumors with distinctly different histological characteristics, molecular genet-ic features, and clinical course.

DeBakey Ⅲ dissecting aneurysm treated by way of aortic isolation / 中国综合临床

Objective To study the technical skill and therapeutic effect of aortic isolation for treating DeBakey Ⅲ dissecting aneurysm.Methods Among 20 cases of DeBakey Ⅲ dissecting aneurysm,7 cases were with DeBakey Ⅲ a and 13 cases were with DeBakey Ⅲb.Imaging examinatin showed that among the 20 cases there were 5 cases with more than two tearings at difreret site.Covered stent was used to close left subclavian artery in 7 cases and distaI aortic isolation of left subclavian artery was conducted in other 13 cases.Restuls All cases were followed up for 3-40 months,finding that 19 cases survived but one case died because of pseudocoele bronchial fistula hemoptysis 18 months later.Conclusions Endovasular covered stent grafts is the simple,safe and effective way to treat dissecting aneurysm.

The effect of macrophage and granulocyte macrophage colony-stimulating factor on the survival of rat abdominal wall flap / 中华普通外科杂志

Objective To study the effect of macrophage, its stimulating factor, granulocyte macrophage colony-stimulating factor (GM-CSF), the combination of GM-CSF and macrophage on the survival of rat deep epigastric perforator flap (DEP). Methods The stable animal model of DEP flap in Sprague-Dawley rat mimicing human deep inferior epigastric perforator flap in breast reconstruction was established. The rats were treated with subcutaneous injection of recombined rat GM-CSF or rat peritoneal macrophages, respectively, or combination of GM-CSF/ Macrophages. Normal saline was used as parallel negative control. The rats were sacrificed and flap specimens were harvested on day 7 after operation, the flaps survival area were measured by the method of rubbings and the survival proportion of flaps were calculated, Von Will brand factor were detected by immunohistochemistry and microvessel density (MVD), and were calculated with microscopic study, and collagen were stained and quantified by Masson staining. Results Survival proportion of flaps in group GM-CSF (53.08% ± 8. 76% ) was not different with that in macrophages group (47. 95% ± 4. 92% ), and both of these two groups were significantly higher than parallel negative control group (43.28% ± 5.27% ) but significantly lower than combination GM-CSF/ macrophages group ( 61.68% ± 6. 60% ). For MVD, flap in GM-CSF group ( 24. 82 ± 4. 18 ) was not significantly different with macrophages group (24.30 ± 3.02 ), and both of these two groups were significantly higher than group parallel negative control (21.37 ± 2.65 ) but significantly lower than combination GM-CSF/macrophages group ( 29. 82 ± 4. 74). Collagen deposition in the flaps in GM-CSF group (17. 25% ± 2. 85% ) were significantly higher than parallel negative control group (14.41% ± 2. 89% ), macrophages group ( 12. 69% ± 3.55% ) were lower than parallel negative control group but there was no significant difference. That in combination GM-CSF/macrophages group (20.31% ± 3.01% )was significantly higher than GM-CSF group ( P < 0. 05 ). Conclusion Treatment with rat GM-CSF or macrophage can significantly promote the survival of the flaps. Combined application of GM-CSF and macrophage could synergetically promote the survival of the flaps, the vasculogenesis and the collagen deposition.

One-stage microsurgical treatment of dumbbell tumors / 中国微创外科杂志

Objective To summarize our experience in microsurgical treatment of dumbbell tumors. Methods The clinical features,surgical approaches,operative techniques and surgical results of 21 cases of dumbbell tumors were analyzed retrospectively.Four surgical approaches were adopted according to the size and location of tumors,including,posterior midline approach(in 7 cases),modified far lateral approach(in 5 cases),posterior midline supplied by anterior cervical approach(in 2 cases)and paramidline approach(in 7 cases). Results In this series,10 cases of tumors were situated in the cervical,6 in thoracic,4 in lumbar and 1 in sacral segment of the spine.Total removal were achieved in 95% (20/21),and subtotal removal in 5%(1/21).Postoperative pathological diagnosis revealed 15 neurinomas,5 spinal meningiomas and 1 metastatic adenocarcinoma.14 cases of meningiomas and 1 metastatic adenocarcinoma were followed up for 1 to 48 months.11 of the 14 patients recovered completely,with 3 of them living daily life independently,4 maintainly radical hypoesthesia,and one having decubital ulcer unhealed.No postoperative malformation and dysfunction of the disposed spine occurred in these patients.Magnetic resonance imaging scans in 11 of the 14 follow-up cases revealed no tumor recurrence,of which inhanced MRI scans were performed in 8 cases. Conclusions dumbbell tumors should be treated by one-stage operation.Microsurgical technique could improve the rate of total removal,and decrease postoperative complications.

Experimental study on relationship between ?_3-adrenoceptors and detrusor instability secondary to bladder outflow obstruction / 中华泌尿外科杂志

Objective To investigate the effect of ? 3-adrenoceptors(? 3-AR) on rat detrusor instability(DI) secondary to bladder outflow obstruction(BOO). Methods Animal models of DI were made in 15 female Wister rats.The filling cystometry was conducted after 6 weeks,and the rats were divided into DI group and detrusor stabitily (DS) group based on the detrusor function. The effects of ? 3-AR agonist BRL37344A on the frequency of contraction and relaxation response to isolated detrusor were examined by means of the in vitro detrusor strip study.And the expression of ? 3-AR subtypes mRNA was investigated in rat detrusor muscle by RT-PCR. Results The occurrence rate of DI was 67%(10/15).BRL37344A could inhibit the contraction frequence and amplitude of the isolated detrusor which was concentration-dependent.The intensity did differ significantly between normal controls or DS group and DI group.The relative contents of ? 3-adrenoceptor mRNA in DI group,controls and DS group were 10.27?3.54,19.84?2.62 and 18.38?1.95.There was a significant decrease in the concentration of ? 3-adrenoceptors in DI group compared with controls and DS group( P

THE CHANGE IN DENSITY AND FUNCTION OF ? AND ?_3 ADRENOCEPTORS IN INSTABLE RAT BLADDER / 解放军医学杂志

To investigate the role of ?and ? 3 adrenoceptors(? 3 AR) in rat detrusor instability secondary to bladder outflow obstruction(BOO). Animal models of detrusor instability were replicated in female rats, the relaxation response produced by ISO and ? 3 AR agonists BRL37344A were examined by means of in vitro detrusor strip study. ? and ? 3 adrenoceptors were detected in bladder specimens with radioligand binding assay. The concentrations of ISO and BRL37344A to produce relaxation were different in normal, stable and instable groups. There was a significant decrease in the density of ? adrenoceptors in the instable group compared with the controls and the stable group (66 23?6 39, 85 85?7 53, and 81 36?6 72 fmol/mg protein, respectively) ( P

EXPRESSION AND FUNCTION OF THE ?-ADRENOCEPTORS IN RAT DETRUSOR MUSCLE / 解放军医学杂志

To investigate the expression of ? adrenoceptors(? AR) and its possible function in rat detrusor. The relaxation response produced by ? AR subtypes(? 1 , ? 2 , ? 3 AR) agonists or antagonists were examined by means of the in vitro detrusor strip study, and the expression of ? AR subtypes mRNA was investigated in rat detrusor muscle by RT PCR. The selective ? 1 agonist T 0509, ? 2 agonist salbutamol, ? 3 agonist BRL37344A depressed the contractions of the detrusor muscle induced by KCl. The relaxant response to isoproterenol was antagonized by the ? 1 ,? 2 AR antagonists(100?mol/L) and the ? 3 AR antagonists SR59230(1?mol/L).RT PCR, showing that all three subtypes of ? AR subtypes mRNA were expressed in rat detrusor smooth muscles, in which ? 3 AR mRNA occupied 70%. All the ? 1 ,? 2 ,? 3 adrenoceptors participate in mediating relaxation of rat detrusor, among them ? 3 AR is the main one.

Study on the molecular mechanism of beta3- adrenoceptor subtypes mediating rat detrusor relaxation / 解放军医学杂志

Objective To investigate the molecular mechanisms of beta3 adrenoceptor subtypes mediating rat detrusor relaxation. Methods Cyclic adenosine monophosphate(cAMP) was detected by radioimmunoassay, the effects of the cyclic AMP inhibitor SQ 22,536 and the cyclic AMP dependent protein kinase inhibitor H 89 on the relaxation elicited by ISO and BRL37344A in the rat ditrusor were investigated based on pharmacological evaluations. Results After the stimulating of ? AR by ISO, the levels of intracellular cAMP was increased, and the relaxation mediated via ISO could be partly inhibited by SQ 22,536 or H 89 The concentrations of intracellular cAMP had no changes in the presence of SQ 22,536 or H 89, and the relaxant responses to BRL37344A was not affected by SQ 22,536 or H 89. Conclusion The effects of ISO via? AR on relaxant responses to detrusor was mediated mainly by the cyclic AMP independent pathway and in part by the cyclic AMP dependent pathway, but cAMP PKA pathway were not involved in the beta3 adrenoceptor signaling pathway