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 relationship between the infarction area and the changes of serum fibrotic indexes in acute myocardial infarction (AMI) patients.Medthods Serum procollagen type Ⅲ (PCⅢ),collagen IV(IV?C) and laminin (LN) were measured in 42 AMI patients with successful recanalization,22 AMI patients with unsuccessful recanalization and 37 healthy controls.Michelle's method was used to calculate infarction area and correlative analysis was made between indexes and infarction area.Results Serum PCⅢ,IV.C and LN were significantly increased in AMI patients with unsuccessful recanalization as compared with the other two groups,which were positively correlated with the infarction area.However,there was no statistical significance between the indexes in the other two groups and infarction area.Conclusion Serum PCⅢ,IV.C and LN can be serum fibrotic indexes in AMI patients,which can reflect the infarction area indirectly.

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 compare the difference of the information about smoking affecting pharmacodynamics and pharma-cokinetics in prescription drug instructions between US and China. METHODS:The US and Chinese guidance for drug R&D and drug instructions editing,prescription drug instructions were collected;the information about smoking affecting pharmacodynamics and pharmacokinetics were retrieved from FDA drug instruction official website DailyMed and Yaozhi Network in China up to Jun. 19th,2014. The difference in related regulations and drug instruction were compared between US and China. RESULTS & CON-CLUSIONS:The guidance issued by US and China require that great importance should be attached to the effects of smoking on pharmacodynamics and pharmacokinetics,and it must be noted in drug instructions. Of 62 857 drugs recorded,smoking affected pharmacodynamics and pharmcokinetics of 34 drugs in US drug instructions,among which 9 drugs needed dose modifications;for above drugs,Chinese drug instructions pointed out great importance should be attached to the effect of smoking on pharmacodynam-ics and pharmacokinetics of 6 drugs,and only one drug(erlotinid hydrochloride)needed to be modified. The label rate of smoking affecting pharmacodynamics and pharmacokinetics was relatively low in Chinese drug instructions compared to US. It is suggested that the regulatory agent should standardize and improve related description in drug instruction,correct unsuitable content,revise the items which may result in severe consequence,and set up official website which can provide all drug instructions as soon as possible. Drug manufacturers should standardize clinical study of drugs before marketing,focus on the scientificity,completeness and normalization of drug instructions.

Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.

BACKGROUND:Titanium mesh is a new type of bone graft supports used for the treatment of spine, especial y the cervical spine disorders at home and abroad in recent years. But, at present, how to improve the cervical lordosis curvature during anterior surgery is the difficulty for the treatment of cervical spondylotic myelopathy.
OBJECTIVE:To observe the effect of straight titanium mesh and individual designed titanium mesh used in the bone graft fusion and internal fixation on the recovery of cervical curvature and Japanese Orthopaedic Association score during anterior cervical subtotal vertebrectomy in the patients with cervical spondylotic myelopathy.
METHODS:Forty-three patients with cervical spondylotic myelopathy treated with surgical indications of subtotal vertebrectomy and decompression internal fixation were included, and the patients were divided into two groups according to different internal fixation methods. There were 15 cases in the individual designed titanium mesh group and 28 cases in the straight titanium mesh group. The preoperative anteroposterior X-ray films of the cervical spine of al the patients were as the blank control group. The clinical data of the patients in two groups were retrospectively analyzed, and the postoperative Japanese Orthopaedic Association score, cervical curvature, intervertebral angles and intervertebral height were compared.
RESULTS AND CONCLUSION:The cervical lordosis angle and the intervertebral angle of surgery segment in the individual designed titanium mesh group were improved when compared with those in the straight titanium mesh group and the blank control group (P<0.01), and the straight titanium mesh group was better than the blank control group (P<0.05). The intervertebral height of surgery segment in the individual designed titanium mesh group and the straight titanium mesh group was increased for 3.69 mm and 3.22 mm respectively when compared with that in the blank control group, and there was significant difference between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). There was no significant difference in Japanese Orthopaedic Association score between individual designed titanium mesh group and the straight titanium mesh group (P>0.05). During subtotal vertebrectomy for the treatment of cervical spondylotic myelopathy, cutting titanium mesh into trapezoidal shape to simulate the normal disc shape of former high to low can effectively restore the physiological curvature of cervical spine and the intervertebral height of surgery segment.

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.

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.