Objective To evaluate urodynamic diagnosis of intrinsic sphincter deficiency (ISD) in female stress urinary incontinence. Methods Leak-point pressures (LPP) and maximum urethra close pressures (MUCP) were detected in 30 patients with female stress urinary incontinence,among whom there were 11 cases with type Ⅲ,19 type Ⅱ/Ⅲ. Results Of type Ⅲ incontinence the LPP was less than 50 cmH 2O in 10 out of 11 and in 17 out of 19 type Ⅱ/Ⅲ incontinence the LPP 50～100 cmH 2O ( P

Objective:To explore the diagnosis and treatment of small intestine leiomyosarcoma. Methods:Ten patients with small intestine leiomyosarcoma in Changhai Hospital from 1993 to 2001 were retrospectively analyzed. Results:Radical resection was performed in 6 cases with the shortest survival time being over 1 year and the longest being 8.5 years (still in good health). One case received extirpation operation with the survival time being over 4 years.Partial resection was performed in 3 cases,and the 3 patients died 1,2,3 years after operation respectively.Conclusion:The small intestine leiomyosarcoma is rare and its diagnosis is difficult due to the lack of clinical feature. Final diagnosis should be based on pathology.The disease is not very sensitive to radiotherapy and chemotherapy,which makes surgical treatment the choice.

[Objective]To investigate the characteristics of the distally based sural neurofasciocutaneous flap for repairing soft tissue defects in heel.[Method]From June 2002 to July 2008,58 cases of soft tissae defects in heal were repaired with distally based sural neurofasciocutaneous flaps.Among them,10 cases combined with a dead cavity,13 cases were innervated with the anastomosis of the sural nerve to the cutaneous nerve of recipient site.The size of the flaps ranged from 8 cm?4 cm to 20 cm?15 cm.The perforating barnches of peroneal artery in fascia pedicle were exposed first,and then the flaps were harvested.[Result]Forty-six flaps survived uneventfully.Necrosis took place in the distal part in 12 flaps,and the wounds healed after changing dressing daily,two-stage suture or skingrafting.Through 1 to 34 months of follow-up,all the survival flaps provided good contours.Infection was controlled and no recurrence,ulcer or pressure sore was found.Walk function was good.[Conclusion]Distally based sural neurofasciocutaneous flaps for reparing soft tissue defects have many advantages.It can offer abundant blood supply,large survival size,simple operation,high achievement rate,and re-establishment of protective sensation.The flaps can repair almost all defects in heel.

BACKGROUND:Apoptosis,which result in various reasons,plays an important role in intervertebral disc degeneration. One of important reasons for apoptosis is oxidative stress. OBJECTIVE:To investigate effects and mechanism of hydrogen-peroxide(H2O2) on nucleus pulposus cell injury induced by oxidative stress at intracellular signal transduction level in rats. DESIGN,TIME AND SETTING:A single sample observation was performed at the institute of Traumatology and Orthopaedics of Shandong Province from March to October in 2008. MATERIALS:The specific p38 mitogen-activated protein kinase(p38 MAPK) inhibitor SB203580,the specific JNK inhibitor SP600125 were purchased from Beyotime Institute of Biotechnology;Two 24-hour-old SD rats of SPF degree were purchased from Qingdao Institute for Drug Control. METHODS:The primary cultured nucleus pulposus cells were divided into four groups:the H2O2 group,stimulated by H2O2 with concentrations of 0,50,100,200,400,and 800 ?mol/L;Control group;SB203580+H2O2 group:cells were preincubated with SB203580,and then were treated by stimulated by H2O2;SP600125+H2O2 group,cells were preincubated with SP600125,followed by stimulated by H2O2. MAIN OUTCOME MEASURES:The expression and cellular localization of P-p38MAPK and P-JNK was detected by immunohistochemistry,and the expression of total and phosphorylated SAPK/JNK,p38MAPK were measured by Western blotting. RESULTS:H2O2 could activate the activity of P38 and JNK. The expression of P38MAPK was significantly inhibited with the pretreatment of SB203580;however,the SP600125 could inhibit the expression of JNK. Immunofluorescence analysis demonstrated that P-p38MAPK and P-JNK were expressed and distributed mainly in cytoplasmic and nuclear exception of the control group. CONCLUSIONS:Apoptosis of rat nucleus pulposus cells are induced by oxidative stress via p38MAPK and JNK signal pathway.

Objective To assess the relationship between polymorphism of XRCC1 Arg194Trp Arg399Gln and ESCC TNM stage and regional lymph node metastasis. Methods PCR and PCR-RFLP were used to detect polymorphism of XRCC1 Arg194Trp and Arg399Gin. The results were analyzed and compared to TNM staging and regional lymph node metastasis. Results The XRCC1 194Arg/Trp and 399Arg/Arg wildtype in ESCC with metastasis is 32.3%, which is higher than 194Arg/Arg (20.0%, P=0.01). There was no remarkable difference between IIb-IV stage ESCC with lymph node metastasis and 0-IIa stage without metastasis. Conclusion The ESCC patients with 194 variability and 399 wildtype had high metastasis rate, XRCC1 Arg194Trp and Arg399Gln had relationship with ESCC TNM stage and lymph node metastasis. Both of them affected to prognosis of ESCC.

Background and purpose:Osteosarcoma is the most common primary malignant bone tumor in the children and young adults. Until now, there is no prognostic indicator with high speciifcity and high sensitivity. This study investigated the relationship between miR-92a level in palsma and clinical pathological characteristics, as well as the prognosis in osteosarcoma.Methods:The plasma from 30 healthy volunteers who underwent physical examination and from 45 cases of osteosarcoma before and after operation were collected. The miR-92a level was detected by real-time lfuorescent quantitative polymerase chain reaction (RTFQ-PCR) method. According to the relative expression≥5 of miR-92a, the osteosarcoma patients were divided into 2 groups: miR-92a high expression group and low expression group.Results:The miR-92a level in palsma from osteosarcoma is signiifcantly higer than that from healthy volunteers. Before surgery, the miR-92a level was markedly higher than after surgery. There was no correlation between the miR-92a level and the gender, age, tumor location, tumor size and histological type. However, signiifcant correlation was found with Enneking grade, tumor cell necrosis rate and lung metastasis. Compared with the low-expression group, high miR-92a expression was associated with a signiifcantly shorter overall survival using Kaplan-Meier analysis (P=0.035). Conclusion:The results suggest a signiifcant relationship between miR-92a and survival ratio. miR-92a expression level may be a useful prognostic indicator in osteosarcoma.

Objective To explore the epidemiology, clinical and pathological characteristics,treatment and prognosis of Richter's syndrome (RS). Methods The clinical and laboratory feature,treatment, prognosis of two cases were reported, and the related literature was reviewed. Results The major symptom of two cases suffered with enlarged lymph nodes, and pathological examination indicated a diffuse large B cell lymphoma. A large number of mature small lymphocytes were found in peripheral blood and bone marrow, and the immune phenotype was consistent with chronic lymphocytic leukemia. CHOP regiment was used on two cases. One obtained complete remission, and the other cases partial remission. Conclusion RS may occur at early stage after CLL diagnosis. In some cases, the diagnosis of RS and CLL are concomitant.Prognosis of some patients of RS is unfavourable. It was important to take biopsy at early stage.

Objective Investigate the reasonable surgical approach combined with frozen sections pathological features of papillary thyroid microcarcinoma.Methods Clinical data of 96 cases papillary thyroid microcarcinoma nearly 5 years of follow-up in our clinic referral was retrospectively analyzed.Metastasis and recurrence rate were compared between group of ipsilateral lobe plus isthmus resection (unilateral group) and group of ipsilateral lobe plus isthmus resection and contralateral lobe subtotal (bilateral group).Metastasis and recurrence rate were compared between group of central lymph node dissection (dissection group) and non-dissection group (non-dissection group),and the injury rate of the recurrent laryngeal nerve was also compared between the two groups.Results The diagnosis of cancer by intraoperative frozen pathology were 53 cases (55％).Whether in high or low risk populations,the metastasis and recurrence between unilateral and bilateral groups showed no significant difference (P ＞ 0.05).Whether in high or low risk populations,the metastasis and recurrence between dissection group and non-dissection groups showed no significant difference (P ＞0.05).The temporary injury rate of recurrent laryngeal nerve in dissection group were higher than thatin non-dissection group both in high-risk populations (P =0.040,P ＜ 0.05) and low risk populations(P =0.037,P ＜ 0.05).Conclusions Intraoperative frozen pathological diagnosis of papillary thyroid microcarcinoma is difficult.The reasonable surgical approach for the first time is ipsilateral lobe plus isthmus resection.Preventive cervical dissections operation should not be carried out if the exploratory of lymph node showed no metastasis.

Objective To explore the clinical application value of fast blood glucose meter in the emergency test of blood glu‐cose .Methods 186 critical patients in or hospital from August 2013 to August 2014 were selected for conducting the clinical re‐search .The average blood sugar was detected in all the research subjects by using the fast blood glucose meter and the fully auto‐matic biochemical analyzer .Results The consistency rate of detection results by the two kinds of detection method reached 22 .04% ,the difference of data was relatively small .In addition ,the detection time for the fast blood glucose meter was significantly shorter than that of the fully automatic biochemical analyzer ,the difference showed the statistical significance (P< 0 .05) .Conclu‐sion The detection results of the fast blood glucose meter have no too large difference with those of fully automatic biochemical an‐alyzer and have the same guidance significance to the diagnosis and treatment .The fast blood glucose meter has the advantages of quickness and convenience ,short time‐consuming and can be used in emergency .

Objective To observe whether bone marrow mesenchymal stem cells (MSCs) can promote the repair of IgA nephropathy and to explore its possible mechanism. Methods Sprague-Dawley rats were randomly divided into three groups which were MSCs injection group, normal saline(NS) infusion group and healthy control group. IgA nephropathy model was established by the improving method with BSA +SEB +CCl4 in former two groups. MSCs of SD rats were continuously cultured in vitro and identified with specific surface antigens by flow cytometry and osteogenic and adipogenic differentiation. MSCs were labeled with bromodeoxyuridine (BrdU) in vitro before transplanted. At 1st and 4th week after MSCs injection, the changes of body weight, urine protein, renal function, histopathology and IgA immunofluorescence were observed. MCP-1, TGF-β1 in urine were detected by ELISA. The expression of MCP-1, TGF-β1 in kidney were examined by RT-PCR. The cytokines and BrdU labeled MSCs were detected by immunohistochemistry to observe the disposition in kidney. Results At the end of the first week of MSCs transplantation, MSCs group urine protein (36.86±4.78) mg/24 h, serum creatinine (53.50±6.28) μmol/L, and the NS group urine protein (66.98±5.86) mg/24 h, serum creatinine (82.50±8.36) μmol/L, the differences between two groups were significant (P<0.05). At the same time, the content of MCP-1, TGF-β1 in urine and expression in renal tissue of MSCs group were obviously less than those of NS group (P <0.05). At the end of the 4th week, the body weight, histopatholngy, IgA immunofluorescence of MSCs group were remarkably improved as compared with those of NS group. The content of MCP-1, TGF-β1 in urine and expression in renal tissue, and renal pathological change in MSCs group had no significant differences as compared with those of healthy control group. As the time passed, the disposition of BrdU-labeled MSCs in kidney was taper. Conclusions MSCs injection contributes to renal repair in rat IgA nephropathy. The mechanism may partly depend on adjusting the excretion of cytokines in renal microenvironment and/or other functions rather than completely depend on their differentiation to renal cells.