Objective: To investigate the efficacy of percutaneous vertebroplasty (PVP) combined with intensity modulated radiation therapy (IMRT) for spinal vertebra metastases. Methods: Data of 106 patients with spinal metastases were retrospectively analyzed, including 38 patients underwent PVP combined with IMRT(PVP+IMRT group), 38 received PVP (PVP group) and 30 received IMRT (IMRT group). The pain visual analogue scale (VAS), tumors of spine instability score (SINS) and Karnofsky performance status score (KPS) were used to evaluate pain, spinal stability improvement and functional status. The adverse reaction and local progression were also observed. Kaplan-Meier was used to analyze the survival analysis, while Cox proportional hazard model was used to evaluate the correlations of survival and clinical factors. Results: There was no significant difference of local tumor progression among 3 groups 6 months after treatment (χ2=5.890, P=0.061). VAS were significant different among 3 groups 1 month, 3 months, 6 months and 12 months after treatment (all P<0.05), which in PVP+IMRT group was significantly lower than in IMRT group (both P<0.016 7). Significant intragroup differences after and before treatment were observed in all 3 groups (all P<0.016 7). Intragroup differences of KPS scores were noticed in PVP+IMRT and PVP groups before and after treatment (P=0.007, 0.033), also before and 3 months after treatment (both P<0.016 7). There were statistically significant differences of SINS among 3 groups 1 and 3 months after treatment, also between PVP+IMRT and PVP group (P<0.016 7). There was no significant difference of overall survival rate among 3 groups (P>0.05). Brain or visceral metastasis, KPS and the medical treatment were independent factors affecting prognosis. Conclusion: PVP combined with IMRT for spinal metastases is good at relieving pain, maintaining the stability of vertebral body and improving the functional status.

Objective To evaluate the efficacy and safety of CT-guided 125I radioactive seed implantation combined with gemcitabine and Gio (gemcitabine and S-1, GS scheme) chemotherapy in treating advanced pancreatic carcinoma. Methods Sixty-eight patients with inoperable advanced pancreatic carcinoma were randomly divided into two groups. Patients in group A(n=38) were treated with CT-guided 125I radioactive seed implantation combined with GS chemotherapy scheme, while patients in group B (n=30) received GS chemotherapy scheme only. The short-term effect, the median progression-free survival time, the median survival time and adverse reactions of the two groups were determined , and the results were compared between the two groups. Results The objective response rate (ORR), disease control rate (DCR) and clinical benefit rate (CBR) of the group A were 57.9%, 73.7%and 84.2%respectively, while those of group B were 26.7%, 46.7% and 60.0% respectively. The differences between the two groups were statistically significant (P<0.05). In group A the median progression-free survival time and the median survival time were 8.00 months and 11.84 months respectively, which were strikingly higher than those in group B (5.63 months and 10.40 months respectively), the differences between the two groups were statistically significantly (P<0.05). No significant differences in gastrointestinal reactions, blood toxicity, liver toxicity and other adverse reactions existed between the two groups (P>0.05). Conclusion For advanced pancreatic carcinoma, CT-guided 125I radioactive seed implantation combined with GS program is a safe and effective treatment.

Objective To investigate the value of CT-guided 125I particles implantation combined with gemcitabine plus S-1 (GS) regimen in the treatment of locally advanced pancreatic cancer.Methods 42 patients with unresectable local advanced pancreatic cancer were given with CT-guided 125I seed implantation.3-4 cycles of GS regimen was given based on the tolerance of patient s body within 3-7 d after implantation of particles.Review of blood,CA199,chest X-ray,CT scan + enhanced or MRI were performed at 2nd,4th,6th,12th month after surgery.Results 2nd,4th,6th month after surgery,tumor lesions were significantly reduced,ORRs were 59.5 ％ (25/42),66.7 ％ (28/42) and 73.8 ％ (31/42),respectively,DCRs were 83.3 ％ (35/42),78.6 ％ (33/42) and 76.2 ％ (32/42),respectively.No serious adverse reactions were observed,patient could tolerate these reactions.The 6th,12th,24th month survival rates were 100 ％ (42/42),47.6 ％ (20/42) and 11.9 ％ (5/42),respectively,mPFS was 8.27 months and mOS was 12.00 months.Conclusion CT-guided 125I particles implantation combined with GS regimen is convenient,safe,high efficacy in the treatment of locally advanced pancreatic cancer.

ObjectiveTo evaluate the feasibility of constructing tissue engineering cardiac patch with photooxidationfixed acellular bovine pericardium.MethodsFresh bovine pericardia were treated by dye-mediated photooxidation after decellularization.Some of them were seeded with bone marrow stromal cells(MSCs) isolated from male SD rats to construct cardiac patches.Myocardial infarction(MI) model was made in female SD rats by left anterior descending coronary ligation(LAD).One week later, the confirmed MI rats were divided into three groups randomly, group MI (n = 15)without any treatment; group P (n = 18) with photooxidated pericardia implantation ; group P + C (n = 18) with seeded pericardia implantation.A sham group (n = 10) was also performed with opening and closing chest twice only.The heart were explanted at 2 or 4 weeks after implantation, and examined histologically and immunohistochemically.The heart function was evaluated by echocardiography at 4 weeks before excising the rats.ResultsThere were no cells or cell debris remained in bovine pericardium tissue.The fiber structure became condensed after photooxidation.The seeded cells formed a continuous layer on the surface of the tissue.The pericardial degradation level and newly formed microvessel density were larger in group P + C than in group P after 2 [ (13.7 ±5.2)个/mm2 vs (7.1 ±3.1)个/mm2, P＜0.05]and4 [(22.6 ±4.9)个/mrn2 vs (14.1 ±5.3)个/mm2, P＜0.05]weeks.Four weeks after transplantation, cardiac echocardiography showed left ventricular ejection fraction(LVEF) was lower in group MI (44.8 ± 4.4) ％ and group P (48.4 ± 5.0) ％ compared with group P + C (49.3 ± 4.8) ％, left ventricular fractional shorterning(LVFS) was lower in group MI (18.0 ± 2.2) ％ and group P (19.8 ± 2.5) ％ compared with group P + C (20.4 ±2.5) ％, the difference between P + C and MI was significant.ConclusionTransplantation of the tissue engineered bovine pericardial patches with dye-mediated photooxidation can improve heart function in MI rats.This kind of patches demonstrates a promising prospect in the future.

Objective To study the present situation of benign prostatic hyperplasia (BPH) of male patients in geriatrics department. Methods Two thousand one hundred and twenty-five patients aged 60 years and above with BPH in geriatrics department of Chengdu, Lanzhou, Hangzhou, Wuhan, Changsha, Guangzhou, Shenyang, Shanghai, Nanjing, Jinan and Beijing were investigated using stratified cluster random sampling method. Results The constituent ratio of patients with benign prostatic hyperplasia in geriatrics department was 47.0%, and the proportions of the elderly of 60～,70～ ,80～ years old among the patients with benign prostatic hyperplasia were 18.1%,49.4 and 32.5%, respectively (x2 = 83.68, P<0.001). There was a significant difference in the occupation distribution of BPH constituent ratio: 66.4% for staffs of state organs, 18.0% for professional technical personnel and 14.7% for works and peasants (x2=410.27,P<0.001). The international prostate symptom scores (IPSS) were different among different cities (x2=101.00, P<0. 001 ). Logistic regression analysis showed that the IPSS was correlated with age and profession (age: OR= 1.029;worker and peasant as control group, working staff of state organs OR=O.707, professional technical personnel OR=0.339 ). Conclusions The benign prostatic hyperplasia is a common disease in male elderly patients in China, but the consultation rate is low. The IPSS of benign prostatic hyperplasia is correlated with age and profession. Prevention and treatment of benign prostatic hyperplasia in the elderly should be strengthened.

Objective To realize and analyze the current status of medical treatment for benign prostatic hyperplasia in special clinic for elderly in China.Methods The informations were gathered from 34 clinics for elderly located in 11 Chinese cities from February 2008 to September 2008.First, all male patients who visited the clinic were inquired about their history of benign prostatic hyperplasia , and then 1000 benign prostatic hyperplasia patients who were receiving medical treatment were selected to finish a detailed questionnaire and to get several examinations for benign prostatic hyperplasia.Results Among the 1000 patients, 774 completely finished the questionnaire, patients with middle or severe international prostate symptom score (IPSS) and with high volume of prostate occupied a large proportion.Medical treatments included the combined therapy of α-blockers plus 5α reductase inhibitors (45.48 %), α-blockers (36.30%), 5α reductase inhibitors (13.05 %) and other medicines (including phytotherapeutic agents and traditional medicines, 5.17%).Conclusions Nowadays in China, as to the prescription for benign prostatic hyperplasia in the clinic for elderly presents, doctors only concentrate on the improvement of symptoms, whereas ignore the progression of the disease.There is still a considerable gap between real medical treatment and international guidelines.Therefore, improvements of medical treatment are still needed in the future clinical practice.

ObjectiveTo evaluate in vivo antithrombosis property of optimized FW-Ⅱ axial blood pump and provides evidence for future clinical use.MethodsA left ventricle-pump-descending aorta bypass model was established in five healthy sheep (60-70 kg) and the circulation of these sheep was assisted by FW-Ⅱ axial blood pump for 2 weeks.In preoperative and postoperative day 1,2,3,7,10 and 14,blood was drawn from the jugular vein to examine platelet activation and leukocyte-platelet aggregation respectively quantified with Annexin V,CD41/61 and CD14-PE by flow cytometry assays.Immediately after termination of the experiment,FW-Ⅱ axial blood pumps were explanted and each part was inspected for thrombus formation.Macroscopic and histological examinations were checked on heart,brain,kidney and spleen,respectively for thrombosis.ResultsCompared with preoperative baseline,the number of platelet activation and leukocyte-platelet aggregation reached a peak at postoperative day 2,it retained a high level within 7 days,then gradually decreased,but was still higher than preoperative level at dayl4.According to rotating speed,the number of platelet activation and platelet-leukocyte aggregation were lowest at the speed of 8000 r/min Minus thrombus were found in the front and rear hub of the pump rotor,and there was no thrombus at other components (flow straighter,impeller and pump housing).There were no ischemia and infarction evidences in macroscopic and histological examination of the heart,brain,kidney and spleen.ConclusionFW-II axial blood pump can be used to assist left ventricular circulation for 2 weeks with a satisfactory antithrombosis property.The level of platelet activation and leukocyte-platelet aggregation can be reduced to a lowest level at an optimized pump rotating speed.

Objective To evaluate the diagnostic and therapeutic status of lower urinary tract symptoms(LUTS)/benign prostatic hyperplasia (BPH) (LUTS/BPH) in outpatient department for elderly patients, and to understand the patients' attitude and knowledge on the disease. Methods The investigation was conducted in 34 outpatient departments for elderly patients located in 11 cities from February to September 2008. The male patients who came to the clinic during the survey time were investigated whether they had LUTS /BPH history or not. Then some eligible patients were chosen to accept a more detailed questionnaire and BPH-related examinations. Results There were 31371 male patients who came to the clinic. 47.0% of them (14748 cases) had the history of LUTS / BPH, and 72.4 % (10678 cases) had medical or surgical treatments presently or previously, whereas 27.6% were untreated. The three most commonly performed examinations in clinical practice were urinalysis, prostate specific antigen (PSA) and transabdominal ultrasonography. In 3542 patients receiving medical investigation, 32.6% (1155 cases) were given 5a reductase inhibitor, and 35.0% (1239 cases) received a combination therapy of 5a reductase inhibitor plus a receptor blocker. 84.5 (1796 cases) and 79.0% (1678 cases) of all the patients were satisfied with the examinations and treatments respectively. Conclusions LUTS and BPH are common in outpatient department for elderly patients. There are discrepancies of examinations and medical treatments between real medical practice and international suggestion, and the patients' understanding of the disease should be improved

Objective To study the relationship between heparanase( Hpa) , urokinase type plasminogen activator( uPA) expression and lymph node metastasis in thyroid carcinoma.Methods Immunohistochemieal SP method was used to analyze the expression of Hpa and uPA in 113 cases of thyroid carcinoma and 134 cases of be-nign thyroid nodules.The expression of Hpa and uPA in thyroid carcinoma and its clinical significance were ana-lyzed.Results The positive expression rate of Hpa and uPA in thyroid carcinoma and benign nodular thyroid tis-sue were 82.30%,16.42%and 89.38%, 11.19%.The positive expression rate of Hpa and uPA in carcinoma tissues with lymph metastasis and without metastasis were 93.94%,100% and 65.96%,74.47%.Expression of Hpa and uPA in thyroid carcinoma group was significantly higher than that of benign thyroid nodules group( P<0.001) .The rate of positive expression in lymph metastatic tissues were significantly higher than those in tissue without metastasis( P<0.001) .Hpa and uPA expression in thyroid carcinoma tissues was positively correlated( r=0.437, P=0.021).Conclusion The expression of Hpa and uPA is closely related with the occurrence and metastasis of thyroid carcinoma.

Objective To investigate the expression of heparanase (Hpa) in serum and tissue of patients with papillary thyroid carcinoma (PTC) and its clinical significance.Methods Immunohistochemical method (SP) and enzyme linked immunosorbent assay (ELISA) were used to detect the expression of Hpa protein in serum and tissues of 38 cases of PTC,37 cases of patients with benign thyroid nodules,and 30 normal controls.Results Expression of Hpa in PTC was higher than that of benign thyroid nodules (P＜0.01).Expression of Hpa in lymph node metastasis group was higher than that in group without lymph node metastasis (P＜0.05).Compared with the normal control group,the content of serum Hpa in patients with benign thyroid nodules had no significant difference (P＞0.05).Hpa content in serum of patients with PTC was higher than that of benign thyroid nodules group and the normal control group (P＜0.01).There was no statistically significant difference of the level of serum Hpa between groups with and without lymph node metastasis.Conclusions Detecting tissue and preoperative serum Hpa concentration is valuable for diagnosis of PTC.Hpa detection in tissues can be used to determine whether there was lymph node metastasis in PTC patients,while Hpa detection in preoperative serum can not judge whether there is lymph node metastasis.