Objective To study whether CK20 expression could be served as a noninvasive test for detecting and monitoring bladder cancer. Methods Reverse transcriptase polymerase chain reaction (RT PCR) was used to determine the expression of CK20 in cells collected from the urine of 10 healthy volunteers,41 patients with bladder cancer and in 20 hematuria patients with bladder cancer excluded. Results CK20 amplification band (370bp) was obtained with mRNA extracted from TCC cells of bladder cancer. Of 41 patients with bladder cancer, 37 specimen were positive.No false positive cases were found in the 10 healthy controls and only in 3 of the 20 hematuric cases.Of the 3 false positive, 2 had pelvic cancer and 1 chronic inflammation. CK20 was positive in 23 of the 25 G 1 patients,in 8 of the 9 G 2 patients,and in 6 of the 7 G 3 patients. Conclusions The preliminary results showed that CK20 might be a potential biomarker for the noninvasive detection of bladder cancer by means of assaying urothelial cells from the voided urine specimen with RT PCR.

Objective To investigate the efficacy of clinical case-based PBL in clinical practice in department of urology.Methods Medical students admitted by our clinical medical school in 2006 and 2007 were involved.Fifty-six students of 2007 grade were chosen as study group while 49students of 2006 grade as control group.Students in study group were taught by clinical case-based PBL method while those in control group by traditional method.All results were analyzed by SPSS 11.0.Results The scores in study group were higher than those in control group with statistical differences (82.84 ± 12.35 vs.72.95 ± 11.13 ; t =4.29,P ＜ 0.01).Students in study group showed more interests in practice lessons.Teachers were more satisfied with the overall performance of students in study group.Conclusions Clinical case-based PBL can increase students' overall performance such as better coordination,better clinical skills and better open-minded clinical case solution.

Objective　To study the malignant or benign characters of lung mini nodules for diagnosis and treatment.Methods　A retrospective analysis was performed on 80 post-operative cases with pathologically confirmed malignant or benign lung mini-nodules.Results　Lung mini-nodule resection cases accounted for 17.7%(80) out of a 451-cases group.Malignant cases accounted for 73.7%(59/80)，benign cases 26.3%(21/80).Most of the malignant cases were squamous cell carcinoma and adenocarcinoma,while most of the benign cases were tuberculosis and inflammatory pseudo-neoplasms.As for pTNM staging in malignant cases,there were 28 in pT1N0M0，19 in pT1N1M0,1 in pT1N1M1,10in pT1N2M0 and 1 in pT1N2M1;the average survival time was 29.4 months.The accurate rate of pre-operative X-ray and CT scan was 45% and 76.2% respectively.Conclusion　For patients with lung mini-nodules ＜2 cm CT value at 37HU,and the nature unknown ,resection is suggested.

Objective To evaluate the effect of ImmunoCyt on the early diagnosis of bladder cancer by comparing the result of cystoscopy with that of cytology. Methods Eighty-six consecutive patients with bladder cancer (mean age,63 years) were included in this group.Among them 38 had undergone transurethral resection of superficial transitional cell carcinoma and had been followed up and 48 had hematuria.These patients were evaluated with standard cytology and ImmunoCyt test.Then all the patients underwent cystoscopy and suspected lesions were biopsied. Results Transitional cell carcinoma of bladder was confirmed pathologically in 28 cases.The sensitivity of ImmunoCyt (82%) was superior to that of cytology (39%, P

Objective To investigate the value of MR perfusion-weighted imaging(PWI)in the evaluation of therapeutic effect of brain metastases with gamma knife.Methods Treatment by gamma knife before and after that 3 months or 6 months PWI studies were penformed respectively in 22 patients with brain metastases .Maps of relative regional blood volume(rCBV)and mean transit time(MTT)were obtained.The ratios of rCBV and MTT of lesions were analyzed.Results rCBV of tumors in 22 cases was increased.The ratios of maximum rCBV of the lesions and opposite side were 6.16?3.12 and 1.18?0.17 respectively.The ratios of MTT of the tumors was 1.44?0.53.After gamma knife treatment,9 of 22 cases appeared decreased rCBV,but the ratios of MTT were no changing,of them,3 cases presented cerebral necrosis.13 of 22 cases,the ratios of rCBV were increased in varied degree after treatment by gamma knife,and 6 cases presented brain radionecrosis.Conclusion PWI is a significant method in evaluating the therapeutic effect of brain metastases with gamma knife

Objective To explore the role of mitogen-activated protein kinase(MAPK)in lipopolysaccharide(LPS)-induced iNOS expression and NO production in rat Schwann cells by the use of inhibitors PD98059 selective for extracellular signal-regulated kinase 1/2(EPK1/2), SB202190 for P38 MAPK and SP600125 for the c-Jun NH_2-terminal kinase (JNK). Methods Schwann cells were pretreated with PD98059 (30, 50, 70?mol/L), SB202190 (10, 20, 40?mol/L) and SP600125 (10, 30, 50?mol/L) at the indicated concentrations for 1 hour before the stimulation with LPS (10mg/L) for 4 hour. The estimation of iNOS mRNA, IL-6 mRNA and TNF-? mRNA was performed by RT-PCR; the changes of iNOS protein expression were investigated by Western blotting. The NO level was observed with measurement of nitrite in the cell culture medium. Results LPS could significantly activate MAPK signal pathway and lead to the expression of iNOS and NO production. The iNOS expression and NO production induced by LPS stimulation were significantly inhibited by the three highly specific inhibitors of MAPK. In addition, the inhibitors decreased LPS-induced the expression of IL-6 mRNA and TNF-? mRNA. Conclusion Activation of MAPK pathway is involved in iNOS expression and NO production in rat Schwann cells, and the inhibition of the signal transduction pathway can be effective to reduce the production of iNOS and NO, which may be a useful strategy against inflammatory and immune reaction after peripheral nerve injury.

OBJECTIVE: To explore the mechanism, clinical characterization, diagnosis and therapeutic approach of vocal process granuloma(VPG) induced by gastroesophageal reflux. METHOD: We performed a retrospective review of 4 cases. RESULT: In 4 male cases, 3 cases had no obvious symptoms of stomach and esophagus and 1 case had symptoms of bloating and acid reflux. Additionally, 4 cases in which lesions were all located to the left side were diagnosed by trial therapy with proton pump inhibitors (PPIs) with good responding. 2 of 4 cases were relapsed after operations. Meanwhile 4 patients were treated by Rabeprazole for acid suppression therapy and 3 cases were cured and 1 invalid case was cured by Pantoprazole. All patients were followed up for 4-48 months with no recurrence. CONCLUSION Gastroesophageal reflux is an important pathogenic factor to the VPG. The majority of patients with VPG do not have gastroesophageal reflux symptoms. Besides, most lesions located in the left are associated with sleeping position. The diagnosis is mainly based on the laryngoscope examination and trial of acid suppression therapy. Moreover, recurrence risk is high-with simple operation in VPG therefore the main treatment is a antireflux and it is also valid by replacing byother PPI treatment. The treatment must be long enough. Meanwhile, the comprehensive treatment should be noticed.
2-Pyridinylmethylsulfinylbenzimidazoles ; therapeutic use ; Arytenoid Cartilage ; pathology ; Gastroesophageal Reflux ; complications ; drug therapy ; Granuloma ; etiology ; Humans ; Male ; Pantoprazole ; Proton Pump Inhibitors ; therapeutic use ; Retrospective Studies ; Treatment Outcome

BACKGROUND: Amniotic fluid cells have been widely used in antenatal diagnosis for gene mutation-related diseases. However,there are few reports concerning isolation, culture, surface character identification, differentiation and application perspective of fetal mesenchymal stem cells (MSCs) derived from amniotic fluid.OBJECTIVE: To investigate the differentiation of fetal mesenchymal stem cells (MSCs) derived from second-trimester amniotic fluid into osteoblasts in vitro.DESIGN, TIME AND SETTING: The cytological/n v/tro study was conducted at the Experimental Center of Xinhua Hospital from August 2005 to May 2006.MATERIALS: Ten amniotic fluid samples were obtained from pregnant women (18-22 weeks after conception) or aborted women,The informed consents were obtained from pregnant women.METHODS: Fetal MSCs were separated mechanically from amniocyte culture system and expanded in medium in vitro. At passage 3, fetal MSCs were induced in 100 nmol/L dexamethasone, 10 mmol/L β-glycerophosphoric acid and 50 mg/L vitamin C for 14 days.MAIN OUTCOME MEASURES: Collagen Ⅰ and alkaline phosphatase expression was detected by immunohistochemistry.Collagen Ⅰ protein expression was determined by Western Blot analysis. Calcium tuberoses were measured by Von Kossa staining. The cytoskeletal protein was detected by laser confocal microscopy.RESULTS: The isolated fetal MSCs were uniformly positive for CD44 and HLA-ABC, negative for CD34, CD45 and HLA-DR. After being induced with osteogenic medium for 14 days, 91% cells were positive for alkaline phosphatase, and 87% cells for collagen Ⅰ.Cells expressed collagen Ⅰ protein. Number of calcium tuberoses was increased and became big over time. Cytoplasm microfilament presented green fluorescence and the microfilament surrounding cells formed dense bundle.CONCLUSION: Fetal MSCs derived from amniotic fluid could be induced into osteeblasta and displayed a typical osteoblastic morphology and biological characteristic.

Objective To investigate the treatment of Pipkin fractures and curative effect. Methods From January 2003 to November 2009, we treated 19 cases of posterior dislocation of the hip with fracture of the femoral head,with type Ⅰ 8 cases, type Ⅱ6 cases, type Ⅲ 1 case, type Ⅳ4 cases. Seventeen patients were treated according to the illness with internal fixation treatment. Results Among type Ⅰ 8 cases, 2 cases were good with conservative treatment, 3 were excellent and 3 were good with surgical treatment;Among type Ⅱ6 cases, 3 were excellent, 2 were good, 1 was fair; 1 patient of type Ⅲ was fair; In 4 cases of type Ⅳ, 1 case was excellent, 2 cases were good, 1 case was fair. Conclusions Surgical treatment as soon as quickly is preferred for posterior dislocation of the hip with fracture of the femoral head( Pipkin fractures) , but the surgical time and methods should be chosen according to patients' detailed illness. It is important reserving the hip bone for preventing traumatic arthritis, and surgical skills to protect blood supply should not be ignored.

Objective To investigate the effects of spinal nerve ligation (SNL) on the changes of intestinal pathology and the levels of serum immunoglobulin in rats with ulcerative colitis.Methods Thirty-six healthy male rats, weighing 200-220 g, were randomly divided into three groups using the random number table method: spinal nerve ligation model group (group SNL), sham-operationgroup (group Sham) and non-operatedcontrol group (group Con), 12 in each group.After the establishment of SNL models, the three groups were given trinitro-benzene-sulfonic acid (TNBS) to induce ulcerative colitis.The serum level of immunoglobulin (IgG, IgM) were measured on the day before SNL, before TNBS modeling and 7, 14 d after TNBS modeling, respectively.Besides, the intestinal pathology were observed on 7 d after TNBS modeling.Results The basic values of IgM and IgG before operation were not statistically different among three groups.The level of IgG in group SNL was lower than that in group Sham after SNL operation with no significant difference, but the level of IgM was significantly lower than that of group Sham (P<0.05).On 7 d after TNBS modeling, both levels of IgG and IgM in group SNL were significantly lower than those in group Sham and group Con (P<0.01).On 14 d after TNBS modeling, the level of IgG in group SNL was significantly lower than that in group Sham and group Con (P<0.05).Furthermore, the colon lesions were more extensive and the inflammation was more serious in group SNL than those in group Sham and group Con on 7 d after TNBS modeling.Conclusion Neuropathic pain suppress immune activities, reduces the serum level of IgM and IgG and aggravates intestinal inflammation caused by TNBS.