Objective To discuss the curative effects of replacement of artificial femoral secured with cement in old aged patients with femoral neck fractures. Methods 131 cases (101 fresh and 30 obsolete; 23 type Ⅱ, 62 type Ⅲ, 46 type IV by Garden typing) were replaced with artificial femoral head secured with cement by a Gibson approach, and were injected with medicine to avoid venous thrombus. Results All cases were followed up for 0.5～8 years. The excellent and good rate was 96.4%. Conclusions The replacement of artificial femoral head secured with cement is suitable for old aged patients, because it is convenient and the patients can recover fast after the operation.

Objective To compare the urodynamic parameters in female patients with incontinence with or without pelvic organ prolapse. Methods The urodynamic data from 140 patients diagnosed urinary incontinence and another 42 patients coexisted with pelvic organ prolapse were reviewed and analyzed. The urodynamics parameters were compared in perfusion, urination, bladder compliance, maximum urinary flow rate (Qmax), detrusor muscle pressure of maximum urinary flow rate (Pdet,Qmax), minimum urinary flow rate(Pdet, Qmax), urethral resistance factor (RUA), obstruction of bladder index (OBI) and normalized detrusor contractility. The influence of pelvic organ prolapses with incontinence on bladder filling and voiding function was evaluated also.Results There were no significant differences between 140 patients of urinary incontinence and 42 patients coexisted with pelvic organ prolapse in perfusion (P=0.142), bladder compliance (P=0.273), Qmax(P=0.192),Pdet (P=-0. 629), Qmin (P=0.365) and normalized detrusor contractility (P=0.380). There were significant differences in age(P=2.2×10-5), urination(P=0.034), Pdet.Qmax(P=0.045), RUA(P=0.018), OBI (P=0.017). Conclusions There is not clinically significant change in urine storage function of bladder in patients with pelvic organ prolapse, but the parameters of voiding function of bladder may existe difference. The increased bladder outlet resistance and postvoid residual urine are noticed in patients with pelvic organ prolapse.

Objective To study the effect of down-rdgulation of EF-1 alpha gene in prostate cancer cell line DU-145 on cancer cell migration and invasion by using RNA interference technique. Methods The prostate cancer cell line DU-145 was divided into three groups: the control group (untransfected with siRNA), randomly control group (randomly transfected with siRNA) and experimental group (transfected with EF-1 alpha siRNA). Localization of EF-1 alpha and its relationship with F-actin in cytoplasm were analyzed by immunofluorescence technique. Cancer cell migration and invasion capability of DU145 cells were studied by transwell technique in these three groups. Results EF-1 alpha expression in DU145 cell line was down-regulated by using RNA interference technique. EF-1 alpha was localized in cytoplasm and co-located with F-actin. The down-regualtion of EF-1 alpha did not change the F-actin distribution in cytoplasm. The cell migration and invasion study showed that after seeding 20×104 DU145 cells into the upper chamber of transwall for 12 hours, the cells collected in the lower chambers were (10.6±1.0)×104 in control group, (11.2±0.8)×104 in randomly control group and (3.9±0.6)×104 in experimental group. Compared with controls, the cancer cell migration and invasion capability was significantly inhibited to only 37.1% (t= 13.9, P<0.05) after the specific down-regulation of EF-1 alpha expression in DU145 cells. Conclusions The down-regulation of EF-1 alpha expression has negative impacts on prostate cancer cell migration and invasion. EF-1 alpha plays important roles in prostate cancer local invasion.

Objective To study the elongation factor 1α(EF-1α) gene functions in prostate cancer cell line DU145 in the aspects of cell proliferation and clone formation by using the RNA interference technique. Methods DU145 cell lines were divided into control group, transfection control group transfected with scramble siRNA and experimental group transfected with EF-1α siRNA. After transfecting EF-1α siRNA into DU145 cell line, the down-regulation of EF-la expression in DU145 cell line was confirmed by Western blotting and immunofluorescence staining. Then, the cell proliferation and clone formation assays were carried on in these 3 groups of DU145 cells. Results Compared with controls, the specific down-regulation of EF-1α expression was achieved in experimental group only. Compared with control group, after the down-regualtion of EF-1α in DU145 cell line, the cell proliferation rate decreased from day 4 to day 7 after transfection by 45. 9%, 53. 5% , 35. 3% and 38. 1% , respectively(P<0. 05). The clone formation number in experimental group decreased by 67.0% (P<0. 01). Conclusions The down-regulation of EF-1α has a negative impact on prostate cancer cell proliferation and clone formation. EF-1α might be an appropiate targeting gene in prostate cancer targeting therapy.

Objective To compare the efficiency between mini-percutaneous nephrolithotomy (MPCNL) and extracorporeal shock wave lithotripsy (ESWL) for monotherapy of renal calculi in infants less than 3 years.Methods Forty-six infants were treated with either SWL (22 infants) or MPCNL monotherapy (24 infants).The mean age was (22.6 ± 8.7) months vs (23.5 ± 6.6) months and the stone size was (21.4 ± 3.5) mm vs (21.7 ± 1.7) mm,and there were no significant difference.Results For MPCNL,mean operating time was (76.2 ± 23.4) min and mean hospital stay was (14.13 ± 5.8) d.The stone-free rates were 84.0％ (21/25) after first session and 96.0％ (24/25) after second-look procedure.Postoperative fever happened in 4 (16.0％) cases.Hemoglobin drop was (8.5 ± 4.4) g/L and no one needed blood transfusion.For ESWL,the stone-free rate were 31.8％ (7/22) after first session and 86.3％ (19/22) after second session for 11 infants (50.0％).Mean hospital stay was (6.6 ± 2.3) d and 10 cases (45.5％)had complications.Hemoglobin drop was (10.6 ± 12.7) g/L.MPCNL was lower than ESWL in complications rate and re-treatment rate,and the stone-free rate was higher,but the hospital stay and operation time was longer (P ＜ 0.05).GFR revealed improve or stable after operation in both groups.Conclusions For a higher success rate,lower complication rate and re-treatment rate,MPCNL was an effective option for the management of relatively larger stones in children (even in infants).

Objective To evaluate the clinical significance of tension-free vaginal tape(TVT) procedure in the treatment with elder female stress incontinence(SUI). Methods Six patients with proven SUI were undergone the TVT with SPRAC. Results Six patients were operated under low spinal anesthesia. Mean operation time was 31.6 minutes and the mean blood loss was 36.2 ml. Five patients were able to micturate spontaneously within 24 hours after operation. One patient with fatty and vaginal colpoptosis was in-dwelling catheter for one week. Patients were followed-up for 10-28 months. Five patients were completely cured and one patient was failed after operation three months. Two patients were de novo urgency. One patient complained of persistent suprapubic discomfort. Conclusions The tension-free vaginal tape operation is a safe and effective surgical procedure for the treatment of urinary stress incontinence with fatty vaginal colpoptosis in elderly females.

Objective To investigate the effect of ambroxol pretreatment on the inflammatory response and lipid peroxidation during one-lung ventilation (OLV) .Methods Forty-five ASA I or II patients aged 37-64 yr weighing 53-65 kg undergoing thoracotomy under general anesthesia were randomly divided into 3 groups ( n = 15 each): group A two-lung ventilation (TLV); group B OLV and group C ambroxol 1 mg/kg + OLV. Anesthesia was induced with midazolam, fentanyl, propofol and atracurium and maintained with propofol infusion and intermittent iv boluses of fentanyl and atracurium. The patients were mechanically ventilated (VT8-10 ml/kg, RR 12 bpm during TLV, VT 6-7 ml/kg, RR 16 bpm during OLV, I: E 1:2, FiO2 100% ). In group C ambroxol 1 mg/kg in normal saline ( NS) 100 ml was infused at 25 min before OLV (infusion rate 4 ml/min) , while in group A and B equal volume of NS was infused instead of ambroxol. Blood samples were obtained from radial artery before induction of anesthesia and OLV (T0.1 ) and at 0.5, 1, 2 h of OLV (T2-4 ) and 1, 2 h of TLV (T5,6 ) and at 24 h after operation (T7) in group B and C for determination of serum SOD activity and TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts. The same indexes were detected in group A at the corresponding time points.Results Serum SOD activity was significantly lower and serum TNF-α, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly higher in group B than in group A. Serum SOD activity was significantly higher and serum TNF-a, IL-6 and IL-8 concentrations and WBC and neutrophil granulocyte counts were significantly lower in group C than in group B. Conclusion Pretreatment with ambroxol 1 mg/kg can inhibit inflammatory response and lipid peroxidation during OLV.

Objective To study the clinical efficacy of tolterodine tartrate combined with transcutaneous electrical nerve stimulation(TENS)in the treatment of elderly female patients with overactive bladder(OAB).Methods 30 patients with OAB were randomly divided into single treatment with tolterodine tartrate and combination treatment of tolterodine tartrate and TENS for 10d.The efficacy was evaluated by overactive bladder symptom score(OABSS),patient perception of bladder condition(PPBC),quality of life(QOL),visual analogy scale(VAS)and 5 grade pain scores.Results The post-treatment symptoms of urgent urination and urinary incontinence,OABSS,PPBC,QOL,VAS and 5 grade pain scores in single treatment group[(1.67±1.45)times /d,(1.53±1.25)times /week,(6.67±2.55)scores,(2.07±0.96)scores,(2.07±1.03)scores,(3.67±0.90)scores and(4.07±0.80)scores]were improved as compared with pre-treatment[(6.40±1.45)times /d,(3.93±1.03)times/week,(13.00±1.00)scores,(4.20±0.68)scores,(3.80±0.68)scores,(7.13± 1.19)scores and(9.40± 1.55)](t=8.94,5.74,8.94,7.03,5.44,9.01 and 11.85,all P＜0.01).The above indexes in combination treatment group after treatment[(1.27±0.80)times/d,(1.20±0.77)times/week,(5.33±1.72)scores,(1.67±0.62)scores,(1.47±0.52)scores,(2.93±0.80)scores and(3.40±0.99)scores]were also improved as compared with pretreatment[(6.20±1.26)times/d,(4.00±1.25)times/week,(12.73±1.03)scores,(4.07±0.80)scores,(4.00±0.65)scores,(7.47±0.74)scores and(9.67±1.35)scores](t=12.77,7.36,14.29,9.21,11.77,16.09 and 14.55,all P＜0.01).The VAS and 5 grade pain scores were higher in combination treatment group than in single treatment group(t=4.879 and 2.746,P＜0.01).Conclusions Tolterodine tartrate combined with TENS is safe and effective for the treatment of elderly female patients with OAB,and may alleviate pain and improve quality of life.

Objective To explore the clinical effect of three doses of mifepristone on patients with dysfunc-tional uterine bleeding.Methods 150 patients with dysfunctional uterine bleeding were chosen,and they were randomly divided into 3 groups,including low dose group (50 patients),middle dose group (50 patients)and high dose group (50 patients).All patients adopted routine treatment.On the basis of this,the low dose group received 6.25mg/d mifepristone,the middle dose group received 12.5mg/d mifepristone,the high dose group received 18.25mg/d mifepristone,continued 6 months.The influence of follicle stimulating hormone (FSH),luteinizing hor-mone (LH),estradiol (E),progesterone (P),volume of uterine and endometrail thickness of patients were observed. Results After treatment,the FSH,LH,E and P levels in the three groups were significantly decreased compared with before treatment (FSH:t=4.406,5.329,3.610,LH:t=4.563,6.134,4.455,P=0.000,0.000,0.000;P=0.000, 0.000,0.000;E:t=7.173,6.815,7.018,P=0.000,0.000,0.000;E:t=2.367,6.315,4.351,P=0.020,0.000, 0.000),and the difference were statistically significant (all P<0.05).Before and after treatment,FSH,LH,P levels among the three groups had no obvious differences (P>0.05 ).Compared with the low dose group,E levels in the middle dose group and high dose group significantly decreased(t=3.850,2.085,P=0.000,0.004).Before and after treatment,the uterine volume among the three groups had no significant difference (P>0.05 ).After treatment,the functional uterine bleeding symptoms were significantly relieved in the three groups,the effective rate was 100%.The recurrence rate of the low dose group was 32%,which was significantly higher than 8%and 10%of the middle dose group and high dose group.The amenorrhea rate of the middle dose group and high dose group(6% and 2%)was significantly lower than that of the low dose group (46%).Conclusion The treatment of 12.5mg/d mifepristone is effectively adapted to patients with dysfunctional uterine bleeding.

Objective To study the distribution and clinicopathological characteristics between VEGF-C and pefitumoral lymph vessels density(PLVD) in breast cancer tissue, and to investigate the development and the mechanism of breast cancer-related lymphoedema (BCRL). Methods VEGF-C and VEGFR-3 were detected by using immunohistochemical technique for the detection of VEGF-C and its receptor VEGFR-3 in forty-seven breast cancer specimens. We measured the patients' circumferences of bilateral upper limbs to determine whether there was lymphoedema and made classification in the follow-ups. Results VEGF-C was positive in 33 out of 47 cases. PLVD significantly increased in VEGF-C positive groups (30.39±10. 46) than in negative groups (23.16±11.67) (P<0.05). VEGF-C semi-quantitative score was in a positive correlation with PLVD (r=0.334). The positive expression rate (42.55%) and semi-quantitative score (3.68±1.59) of VEGF-C increased in the lymph node positive group than in the negative group, PLVD increased in the lymph node positive group compared with that in negative group (32.12±10.29 vs. 24.82±11.06), P<0.05. The risk of lymphoedema increased in the VEGF-C negative group (5/14) compared with that in the positive group (3/33) (P<0.05). Conclusion VEGF-C has a high rate of positive expression in breast cancer, and is positively correlated with PLVD. High expression of VEGF-C can reduce the risk of BCRL in breast cancer.