Objective To assess the safety of emergent invasive treatment in severe postpartum hemorrhage. Methods Invasive treatment was performed in 18 patients with severe postpartum hemorrhage. The operation time, therapeutic effect, collateral circulation of uterus feeding arteries, pathological changes in uterine muscle after embolization and radiation dose received by the ovary during operation were investigated for safety assessment. Results (1) All eighteen patients who had been failed to conservative treatment were successfully cured with invasive treatment. The duration of hemostasis was 3 to 10 minutes, mean time (6?4) minutes. The operation time was 30 to 50 minutes, mean time (39?5) minutes. (2) Although both sides of internal iliac arteries or uterine arteries were embolized, a small amount of blood supply for uterus remains from ovary arteries, from branches external iliac arteries and from other arteries. (3) Uterine biopsies were performed in 3 patients 5 to 10 days after the invasive treatments for pathological examinations. Pathological findings showed that the necroses of uterine muscles were disconnected and the whole areas were blow 1/4. (4) The mean radiation dose received by the ovary in 5 cases was (17?7) cGy, which was within the safe limit. Conclusions The use of the emergency invasive treatment is safe in severe postpartum hemorrhage.

Induction of immune tolerance is characterized by high efficiency,low toxicity and economic advantages,and immune tolerance has very important significance in organ transplantation.In the establishment of immune tolerance,dendritic cells (DCs) play the key roles such as clonal deletion or clonal anerge,expressing t-cell inhibiting factors,activating helper T cells electively and inducing regulatory T cells,especially CD4 + CD25 + regulatory T cells,etc.Similarly,CD4 + CD25 + regulatory T cells whose primary target point is dendritic cell also have various functions such as affecting dendritic cells'maturing,restraining dendritic cells'antigen presentation to T cells,inhibiting the activation of T cells in non-specific ways and inducing immune tolerance.Current research shows,dendritic cells and CD4 + CD25 + regulatory T cells regard each other as target point and work synergetically.Here we mainly discuss the function and interaction of dendritic cells and CD4 + CD25 + regulatory T cells in the immune tolerance.

Stanniocalcin (STC) was ifrst found as a calcium- and phosphate-regulating hormone produced in bony ifsh by the corpuscles of Stannius. In mammals, the homolog STC-1 displays a relative high amino acid sequence identity (nearly 50%) with ifsh STC, and STC-2 has a lower identity (nearly 35%) with STC-1 and ifsh STC. Both STC-1 and STC-2 are expressed in a variety of tissues. The functions of STC have not been understood. But some ifndings have been reported on their cellular localization, gene structure, and expression in different physiological and pathological conditions, which will be clues in elucidating the functions of STC in mammals. Moreover, STC-1 and STC-2 are expressed in many tumor cell lines, suggesting other biological functions of STC in mammals other than mineral metabolism.

Objective:To evaluate the efficacy and safety of docetaxel+ prednisone in the treatment of castrated resistant prostate cancer in patients over 75 years old.Methods:In this study, 118 metastatic castration resistant prostate cancer (mCRPC) patients over 60 years old treated in Beijing Hospital from February 2013 to December 2019 were retrospectively analyzed. The median age of the patients was 72 (65, 77)years, ECOG scores ≤2. All 118 cases had bone metastasis, 5 cases had visceral metastasis. A total of 40 patients chose docetaxel as the first-line treatment of mCRPC, and the remaining 78 patients chose docetaxel as second-line or third-line treatment. The study included 53 patients >75 years old and 65 patients aged 60-75 years. The age of patients in the two groups were 67 (63, 71) years old and 78 (76, 83) years old, the difference was statistically significant ( P<0.05). Among them, there were 24 cases with Gleason score ≤7 and 41 cases with Gleason score >7 in 60-75 years old group, and 30 cases with Gleason score ≤7 and 23 cases with Gleason score >7 in the group of >75 years old, with significant difference between the two groups ( P = 0.034). Sixty-one patients received endocrine therapy and 4 received orchiectomy in the 60-75 years old group; 43 patients received endocrine therapy and 10 received orchiectomy in the group of >75 years old, the difference was statistically significant ( P=0.035). There were 37 cases with ECOG 0 score, 25 cases with 1 scores and 3 cases with 2 scores in the group of 60-75 years old; there were 5 cases with ECOG 0 score, 38 cases with 1 score and 10 cases with 2 score in the group of >75 years old, with significant difference between the two groups ( P<0.05). There was no significant difference in PSA level[ 90 (35.5, 258) ng/ml vs. 115 (60, 296) ng/ml], G8 scale score [(14.3±2.1 vs. 13.6±1.1)], Mini-Cog score[3(2, 3) vs. 3(1, 3)], and visceral metastasis [2 cases (3.1%) vs. 3 cases (5.7%)]( P>0.05). The efficacy and safety of docetaxel in the two groups were further observed. Results:The median follow-up time was 21.5 (6, 62) months. There was no significant difference in chemotherapy cycle [(6.1±1.3) vs. (6.8±1.7)] and chemotherapy dose [(70.3±4.3) mg/m 2 vs. (66.3±5.2) mg/m 2] between the 60-75 years old group and the >75 year old group ( P> 0.05). The PSA response rate [72.3%(47/65)vs.66.0%(35/53)], pain relief rate [45.0% (9/20) vs. 54.5% (6/11)], and median progression-free survival[6.1 (1.4, 11.2) months vs. 5.9 (2.0, 12.0) months] had no statistical significance ( P>0.05). There were no deaths in the two groups during chemotherapy. The median overall survival(OS) of patients aged 60-75 years and those >75 years old who received docetaxel as first-line treatment were 26.5 (16.1, 31.3) months and 24.8 (17.5, 28.4) months, respectively ( P=0.223). The median OS of the two groups were 17.3 (13.2, 20.5) months and 15.4 (12.3, 20.0) months with docetaxel treatment as second or third line treatment ( P=0.331). There were 3 cases (4.6%) and 5 cases (9.4%) of grade 3 adverse reactions in 60-75 years group and >75 years old group, respectively. Grade 3 leukopenia occurred in 1 case time (1.5%) and 2 cases (3.8%) respectively. Grade 3 neutropenia fever occurred in 1 case time in both groups. There was no significant difference in the incidence of above complications between the two groups ( P > 0.05). Conclusions:The efficacy and safety of docetaxel + prednisone chemotherapy for mCRPC patients >75 years old were similar to those of 60-75 years old. Age should not be the absolute contraindication of docetaxel for prostate cancer chemotherapy.

The case of long-term complicated infectious mass on the inner thigh root after transobturator urethral sling is rare. This paper reported a case, who underwent a surgery of the "trans-obturator mid-urethral slings" for stress urinary incontinence 9 years ago. A mass on the root of the right thigh was found 3 months ago, accompanied with low fever. About 1cm tape was exposed on the front wall of the right side of the vagina. The patient underwent resection of the mass on the root of the right thigh and partial removal of the tape under spinal anesthesia. After one year’ follow-up, there was no significant change in urinary control ability compared with that before the operation.

Objective To evaluate the efficacy and safety of doxazosin gastrointestinal therapeutic system (DOX GITS) in the treatment of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH).Methods A total of 4063 BPH patients aged ≥60 years from 16 regions and 86 hospitals were enrolled in this study.Patients were divided into 4 groups according to the previous medication:group 1 (treated with α1 receptor blocker but non-doxazosin),group 2 (treated with drugs without α1 receptor blocker),group 3 (without treatment),group 4 (treated with α1 receptor blocker but non-doxazosin and other drugs for BPH).Patients received DOX GITS with a flexible-dosage for 4 weeks.International prostate symptom score (IPSS),quality of life (QOL),maximum urine flow rate (Qmax) and adverse effects were assessed.Results After 4 weeks of the treatment,lower urinary tract symptoms were significantly improved in the 4 group.IPSS in the 4 groups were decreased to (12.3±4.6) scores,(12.2±4.6) scores,(10.9±4.5) scores and (9.9±4.4) scores successively.QOL in the 4 groups were improved to (2.8±0.9) scores,(2.8 ±1.0) scores,(2.5±0.9) scores and (2.4±0.9) scores successively.Qma x in the 4 groups were increased to (16.4±4.5) ml/s,(15.0±4.7) ml/s,(15.3±4.8) ml/s and (16.7±5.7) ml/s qsuccessively.There were significant differences in IPSS,QOL and Qmax of the 4 groups between before and after the treatment (P＜0.001).Adverse events were reported in 64％ of patients.The most common adverse events were dizziness of 43 cases (1.06％),postural hypotension of 10 cases (0.25％) and hypotension of 8 cases (0.20％).Conclusions DOX GITS can significantly improveLUTS and quality of life in BPH patients with a good tolerance and compliance.

OBJECTIVETo study the relationship of the positive rate of transrectal ultrasound (TRUS) guided prostatic biopsies in detecting prostate cancer with the findings of digital rectal examination (DRE), prostate imaging and measurement of the f/t PSA ratio.

METHODSWe retrospectively analyzed the clinical findings of 365 patients with PSA of 4-10 microg/L who had received DRE, prostate imaging and measurement of the f/t PSA ratio. We performed TRUS guided prostatic biopsies and then analyzed the relationship between the biopsy results and previous findings.

RESULTSOf the 365 patients, 87 (23.84%) were found with prostate cancer by pathological biopsy, and 40 cases of prostate cancer (31.25% ) detected in 128 patients with positive findings in DRE, 26 cases of prostate cancer (37.68%) confirmed in 69 patients with positive findings in TRUS, and 59 cases of prostate cancer (55.14%) revealed in 107 patients with positive findings in MRI. The f/t PSA ratio was significantly lower in the malignant than in the benign cases (P < 0.01), and the area of f/t PSA ROC (0.725) was significantly higher than that of PSA ROC (0.542).

CONCLUSIONDRE, prostate imaging and measurement of the f/t PSA ratio can improve the positive rate of prostate cancer detection, and therefore reduce unnecessary prostatic biopsies.

Adult ; Aged ; Aged, 80 and over ; Biopsy ; Digital Rectal Examination ; Humans ; Male ; Middle Aged ; Prostate ; pathology ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; diagnosis ; pathology ; Retrospective Studies

Objective To observe the reception of using pig bone marrow stromal cells (BMSCs) that were transfected with human tissue factor pathway inhibitor (TFPI) to resolve the dysregulation of coagulation after liver xenotransplantation.Methods Pig BMSCs were immortalized by transfection with lentivirus containing SV40T and then transfection with human TFPI.At last the cells were tested for their ability to inhibit clotting in a model by co-incubation of human plasma,human monocytes and pig aortic endothelial cells.Results After transfection with SV40T,pig BMSCs were immortalized and similar to primary cells.The immortalized pig BMSCs showed a stable TFPI expression after transfection with human TFPI by lentivirus.Moreover,they showed the potential of regulating coagulation dysregulation in vitro.Conclusion Pig BMSCs transfected with human TFPI could solve the regulation dysregulation caused by TF activation effectively,and have the potential of resolving coagulation dysregulation in liver xenotransplantation.

Objective To evaluate the long term clinical effect of porcelain laminate veneer esthetic restoration for fluorosis teeth. Methods One hundred and thirty-two fluorosis teeth of 11 patients were restored with porcelain laminate veneer for esthetic purpose and the clinical effects were evaluated with modified Rygescriteria at 1.0 week, 0.5-year, 1.0-year, 1.5-year, and 2.0-year recalled time. Results After 2.0 years application, none of the veneers debonded, "A" degree rate of marginal adaptation was more than 85%, "A" degree rate of cavosurface marginal discoloration was more than 90%, "A" degree rate of secondary caries was more than 99%, "A" degree rate of post-operative sensitivity was more than 75%, and "A" degree rate of color match was more than 70%, "B" degree rate of color match was 100%. Conclusions The research indicates that the porcelain laminate veneer is a good esthetic restoration method for fluorosis teeth and the long term clinical effect is stable.

Objective To investigate the feasibility and clinical effect of the tubeless minipercutaneous nephrolithotomy (PCNL) in treatment of upper ureteral calculi.Methods From March 2014 to March 2015,all the patients with upper ureteral calculi except for those with severe infection,pyonephrosis or renal cortex less than 5 mm were randomized into two groups,the standard PCNL group (24 F nephrostomy tube) and the mini-PCNL group (18 F nephrostomy tube).After PCNL,all the patients received ultrasound examination to check residual stones,perforation and urine leakage.DJ tube was placed and the channel of PCNL was packed with hemostatic sponge without nephrostomy tube.There were 26 patients in standard group and 28 in mini-group.The operation time,postoperative hemoglobin change,postoperative visual analogue pain score (VAS),the time when urine turned clean,postoperative urinary extravasation,hydrothorax,fever and the stone-free rate were compared between two groups.Particularly,these data were compared in those aged＞65 years.Results The operation time in the standard PCNL and the mini-PCNL group was (58.3 ±21.8) and (86.4±23.3) minutes respectively,and had a significant difference (t=10.836,P＜0.05).The decrease in hemoglobin level was (8.3±5.8) g/L and (7.7±0.5.4) g/L,the VAS scores was (3.8±0.8) and (3.6±1.1),the time when urine turned clean was (11.9±4.7) h and (9.6±5.6) h,the postoperative hospital stay was (5.1±0.8) d and (4.8±1.2) d,and the stone free rate was 92.3％ and 89.2％ in standard PCNL and mini-PCNL group respectively(P＞ 0.05).No significant difference were found between two groups (all P＞0.05).There was one patient who got fever more than 38.5℃ in the standard group and 2 cases in the mini-group.Each group had 1 slight hydrothorax,and no blood infusion and perinephric urinary extravasation were found.The application of packing hemostatic sponge in the nephrostomy channel was feasible and suitable for both the standard and tubeless mini-PCNL groups.Conclusions The application of packing hemostatic sponge in the nephrostomy channel is feasible and suitable in both the standard and tubeless miniPCNL.It is safe for the treatment of renal and ureteral calculi,and it can decrease the hemorrhage and urine leakage,which works for the elderly patients too.