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 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 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

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.

This study was aimed to observe the influence ofQing-Chang Hua-Shi Recipe (QHR) on IL-6trans-signaling in experimental colitis mice, in order to initially explore the possible mechanisms of QHR for ulcerative colitis (UC). TNBS/ethanol was used in the establishment of colitis mice model. After intervention of medication, ELISA was used in the detection of soluble Interleukin-6 receptor (sIL-6R). Real-time PCR was used to detect the mRNA expression level of IL-6 and glycoprotein 130 (gp130). Western blot was used in the observation of protein expression of IL-6 and gp130 in the colonic mucosa. The results showed that the level of sIL-6R, the mRNA and protein expression of IL-6 and gp130 in the model group were significantly higher than that in the control group. QHR was able to reduce the sIL-6R level (P < 0.01), decreased the mRNA and protein expression of IL-6 and gp130 (P < 0.01) in the colon tissues among experimental colitis mice. It was concluded that QHR had good anti-inflammatory effects on experimental colitis mice. It might be associated with influencing IL-6trans-signaling.

Objective To evaluate the effect of technical improvement of radical retropubic prostatectomy (RRP) for patients with localized prostatic cancer. Methods RRP was performed in 32 cases (mean age,68 years) of prostatic cancer at clinical T 1 and T 2 stages.Technical improvements included extensive lymph node clearance,protection of the neurovascular bundle,suture and ligation of the dorsal vein complex,preservation of the distal prostatic urethra,and intussusception of the bladder neck. Results The mean operative time was 3.5 h.The mean blood loss was 450 ml;blood transfusion was conducted in 17 cases.Postoperative pathologic findings revealed tumor confined disease in 30 cases,positive surgical margin in 1, and lymph node metastasis in 1.All the patients survived and were followed up for a mean of 22 months (range 8 to 48 months),with PSA

Objective To evaluate the clinical value of cystectomy with prostate capsule sparing in orthotopic bladder replacement for bladder cancer. Methods A total of 56 male patients (mean age,62 years) with bladder cancer were included.Of them 40 cases were of primary tumors and 16 were of recurrent ones.Pathology by cystoscopy and biopsy showed transitional cell carcinoma in 53 cases and squamous cell carcinoma in 3.According to the analysis of B ultrasound,CT,MRI and cystoscopy, they were clinically diagnosed as recurrent multiple superficial tumors (n=27) and invasive tumors (n=29).Radical cystectomy with prostate capsule sparing was performed on them.Detubularized ascending colon (20 cases) or ileal segment (36 cases) was used to form a neobladder,which was anastomosed with distal portion of prostate capsule. Results Mean operative time of ascending colonic neobladder and ileal neobladder was 5 h 50 min and 6 h 20 min,with blood loss of 580 ml and 540 ml,respectively.Pathology showed pT 1N 0 in 28 cases,pT 2N 0 in 25 and pT 3N + in 3.During the follow up of 4 to 102 months (mean,42 months) 3 patients of pT 3N + died of bladder cancer and 5 died of other diseases.The cancer specific 5 year survival was 94% in cases of T 1N 0,83% in T 2N 0.At 1 year follow up,17 out of 18 patients (94%) with ascending colonic neobladder and 30 out of 30 patients (100%) with ileal neobladder were fully continent during the day,and 46 (96%) voided 1 to 2 times at night and could stay dry.Of 31 patients with preoperative adequate sexual function, 23 (74%) maintained potency postoperatively. Conclusions Radical cystectomy with distal prostate capsule sparing and reconstruction with an orthotopic neobladder is a relatively safe and reliable surgical procedure.It can improve the continence and potency without compromising the principle of tumor control.

Objective To investigate treatment effect of the type of foot drop in patients with lumbar disc herniation.Methods Clinical data of 34 patients with foot drop in lumbar disc herniation who were treated in Spinal Surgery Department of Shunyi District Hospital of Beijing from January 2006 to December 2013 were retrospective analyzed,all patients were treated by operation.After 24 months of follow-up,the effect was observed,the prognosis and related factors were analyzed.Results Two years after operation,the recovery of the patients was excellent in 4 cases and good in 19 cases,common and poor in 11 cases,and the excellent and good rate was up to 67.6%(23/34).Analysis results showed that after 3 to 24 months after surgery,the anterior tibial muscle strength grades(grade 0-5) corresponding score were 28 points preoperatively,59 points at 3 months after surgery,69 points at 6 months after surgery,92 points 1 year after surgery,reached 95 points 2 years after surgery.Muscle strength score of patients with an increasing trend,especially after 3 months to 12 months after the operation.Conclusion The drop occurred should be operated as soon as possible,recommendations for open surgery,complete decompression,avoid injury.Three months to 1 years after operation is the key period of recovery.

Objective To investigate the short segment(less than 2 segments)of lumbar posterior open surgery in the application of iodophor rinse operation field for the prevention of wound infection effect.Methods One hundred and sixty-four cases patients who underwent all lumbar posterior short segment(less than 2 segments)decompression and fusion in Shunyi District Hospital of Beijing from January 2012 to December 2015 were selected as study objects,and were randomly divided into two groups according to random number table method,including 87 cases of single application of physiological saline(saline group)and 77 cases with diluted iodophor rinse liquid during the operation(diluted iodophor group).The incidence of infection in patients with different irrigation patterns during 3 months after the operation was followed up,and the results were analyzed by Fisher exact probability method.Results The infection rate of saline group was 8.05％(7/87),1.30％(1/77)of iodophor group,there was significant difference between two groups(P=0.04).Conclusion The application of iodophor rinse operation field for the prevention of wound infection has obvious effect on lumbar posterior open surgery.