Objective To study effect of application of clinical nursing pathway in patients undergoing transurethral resection of prostate. Methods Clinical nursing pathway was established accorded with patients undergoing transurethral resection of prostate.Patients admitted before the application of clinical nursing pathway were set as the control group,while those admitted after the application of clinical nursing pathway were set as the experimental greup.The hospitalization time,medical cost, mastering degree of disease-related knowledge and satisfaction degree were compared between the two groups. Resets The hoapitalization time was shorter, the medical cost was lower, the mastering degree of disease-related knowledge and satisfaction degree were improved in the experimental group compared with those of the control group, P < 0.05. Conclusions Application of clinical nursing pathway in patients undergoing transurethral resection of prostate can improve nursing quality and reduce the economic burden of patients.

AIM and METHODS: To explore the role of telomerase reverse transcriptase (TERT) in monocrotaline-induced pulmonary hypertension (PH), TERT was investigated by using immunohistochemistry and image analysis on the chronic PH induced by MCT in Sprague-Dawley rats. RESULTS: TERT was positive in pulmonary vascular smooth muscle cells, bronchial smooth muscle cells and chondrocytes in normal group. TERT in MCT group was more positive in pulmonary vascular smooth muscle cells and bronchial smooth muscle cells compared with normal group. CONCLUSION: Over expression of TERT in pulmonary vascular smooth muscle cells and bronchial smooth muscle cells is related to MCT-induced PH.

Objective To investigate the clinicopathological features of primary gastric malignant lymphoma.Methods 32 cases of primary gastric non Hodgkin's malignant lymphoma(NHL)were studied by clinicopathology,immunohistochemistry and ultrastructure.Results 3 cases of NHL arose from fundus of stomach,7 cases from body of stomach,8 cases from gastric angle,and 14 cases from gastric antrum.The paraffin sections of all cases were stained.There were 31 cases(96\^9%)exhibiting B cell phenotype,only 1 case(3\^1%)exhibiting T cell phenotype.11 cases of NHL and 6 cases of undifferentiated carcinoma(UC)in stomach were observed comparatively under electron microscope(EM).The ultrastructural characteristics of NHL were much different from those of UC.Conclusion Most primary gastric malignant lymphoma are B cell lymphomas.Immunohistochemistry and ultrastuctural observation are much helpful in the diagnosis and differential diagnosis between NHL and UC.

Objective To evaluate the clinical value of transrectal ultrasound(TRUS)guided biopsies of the prostate cancer(PCA)with serum prostate specific antigen(PSA)level less than 4 μg/L.Methods Fifty-nine patients suspected PCA were underwent TRUS guided-biopsy.The ultrasonographic features of lesions and prostate gland were observed.The PSA,PSA density(PSAD),F/T(free/total PSA ratio),prostatic volume(PV)were compared between PCA group and non-PCA group,and further analyzed the sensitivity and specificity of PSAD and F/T at different thresholds for PCA diagnosis.Results In 59 patients,16 were proved to be cancer by pathological examination,the positive detection rate was 27%.In these 16 patients,12 had lesions on ultrasound,which locatqed in outer gland.The rich vascularity was observed in PCA more than in benign and precancerous lesion.There were statistical significant differences in PSA,PSAD,F/T,PV between PCA and non-PCA groups.When selecting threshold of PSAD and F/T were 0.09 and 0.20,respectively,there were the highest diagnostic specificity and sensitivity.The diagnostic specificity and sensitivity of PSAD were higher than those of F/T.Conclusions TRUS guided biopsies of the prostate is one of the most efficient methods for detection of PCA with PSA level less than 4μg/L.Combining TRUS features with PSA parameters can further increase positive detection rate of PCA.

This report presented a male patient aged 69 years,who was admitted into our hospital for fever,hemoptysis and chest pain.Chest X-Ray showed shadows on the right lung and pleural thickening.The effect of broad spectrum antibiotic therapy was poor.With the disease progressed,pleural effusion appeared on the right side.Blood culture showed methicillin-resistant staphylococcus aureus.Pleural effusion tests indicated pyothorax,but the effects of closed chest drainage and sensitive antibiotic therapy were poor.After disentangling with open thoracic exploration,the right middle lobe was resected and the right lung lobe pathology showed Wegener granulomatosis.His blood antineutrophil cytoplasmic autoantibodies was negative.The paranasal sinus CT scan and renal function showed no abnormalities.The definitive diagnosis was pulmonary limited Wegener granulomatosis.

Objective To observe the effect of Yujin on cerebral function of acute hypoxia mice.MethodsThe acute hypoxia mice model was reproduced by cutting heads and establishing normal-pressure and closed hypoxic experimental settings. In yujin groups, the mice were treated with Yujin at the doses of 10 g/kg, 20 g/kg, 40 g/kg respectively through the intragastric tubes everyday. 6 days later, the mice survival time, the open-mouth times after cutting heads and the breathing time were observed. The activity of superoxide dismutase (SOD) and content of maleic dialdehyde (MDA) in cerebral tissues were measured. The morphological changes of the cerebral tissues under the microscope were examined.ResultsYujin could significantly prolong the survival time ( P<0.001) and the breathing time and increase the open-mouth times ( P<0.05～0.001), increase the activity of SOD ( P<0.001) and decrease the content of MDA ( P<0.01～0.001) in cerebral tissues. Compared with control group, the Yujin group mice had no obvious pathological alteration except some cerebral vascular dilatation.ConclusionYujin has an obvious protective effect on cerebral tissues of acute hypoxia mice.

Objective To observe the clinical effects of ambroxol on acute stroke-associated pneumonia (SAP).Methods From July 2011 to December 2012,a total of 82 patients with strokeassociated pneumonia (SAP) admitted to our hospital were selected and randomly divided into ambroxol group (n=43,treated with ambroxol in combination with antibiotic therapy) and control group (n =39,treated with antibiotic therapy).The defervescence time,hospitalization time,antibiotic use time,C-reactive protein level,blood oxygen partial pressure,bacterial clearance rate and the total effective rate were compared between the two groups.Results The defervescence time,hospitalization time,antibiotic use time were shorter in ambroxol group than in control group [(3.1 ± 0.8)d vs.(3.8±1.1)d,(11.7±3.7)d vs.(13.6±4.9)d,(5.4±1.7)dvs.(6.6±2.1)d,t=18.60,22.80,23.50,P=0.014,0.008,0.011,repectively].Bacterial clearance rate and the total effective rate were higher in ambroxol group than in control group [90.7％ vs.74.4％,93.0％ vs.74.4％,x2 =3.86,5.34,P=0.05,0.02].There were no significant differences in changes of C-reactive protein level and blood oxygen partial pressure between two groups before and after treatment (all P＞0.05).Conclusions Ambroxol is an effective treatment for acute stroke associated pneumonia,which can shorten antibiotic use time and duration of symptoms and remove bacteria effectively.

Objective To explore the protection and mechanism of hydrogen sulfide (H2S) preconditioning against injury induced by cisplatin in human marrow mesenchymal stem cells (HMMSCs).Methods HMMSCs were treated by cisplatin at 0,5,10,20,40,60,80 mg/L concentrations for 24 h respectively and were exposed to cisplatin at 20 mg/L concentrations for 0,6,12,24,36,48 h respectively.HMMSCs were pretreated with NaHS at 0,0.4,0.6,0.8,1.0 mmol/L respectively for 30 min before exposed to cisplatin at 20 mg/L concentrations for 24 h.HMMSCs were treated by U0126 or combined with human epidermal growth factor (HEGF) together for 30 min before they were preconditioned with NaHS for 30 min.The cell survival rate,cell apoptosis rate,the expression of p-ERK1/2 and t-ERK1/2 were recorded.Results The cell survival rate decreased to 71.72％±2.72％,59.41％±5.44％,50.37％±4.55％,38.97％±2.92％,30.11％±4.64％ and 21.71％±5.35％ respectively after cells were treated with cisplatin at 5,10,20,40,60,80 mg/L concentrations respectively,and the differences were statistically significant compared with 0 mg/L group.The cell viability fell to 70.30％±6.20％,61.63％±2.70％,51.29％±3.13％,38.72％±3.66％ and 27.57％±2.32％ after HMMSCs were treated with cisplatin at 20 mg/L for 6,12,24,36,48 h respectively,and the differences were statistically significant compared with 0 h group.The cell viability increased to 65.99％±2.67％,72.93％±5.44％,75.10％±4.71％ and 76.56％± 5.25％ when HMMSCs got pretreatment of NaHS,and the differences had statistical significance compared with cisplatin group.The cell apoptotic rate decreased from 35.29％±2.77％ to 18.62％±0.97％ when HMMSCs were pretreated with NaHS at 0.6 mmo/L.Treatment of HMMSCs with cisplatin at 20 mg/L for 24 h reduced p-ERK1/2 expression.The pretreatment of NaHS could inhibit the inhibitory action to the expression of p-ERK1/2 induced by cisplatin.Pretreatment with U0126 or HEGF inhibited or promoted the protection and the upregulated expression ofp-ERK1/2 caused by NaHS pretreatment.Conclusion The preconditioning of H2S can protect cell damage caused by cisplatin via activating the ERK1/2 pathway of HMMSCs.

BACKGROUND: Tissue engineering development brings a hope for articular cartilage defect repair. Current studies have demonstrated that bone marrow mesenchymal stem cells (MSCs) are the best cell source to repair full-thickness cartilage defects.OBJECTIVE: To induce MSCs to differentiate into chondrocytes with Ad-hTGF-pi in pellet culture system in vitro and identify the differentiated cells.DESIGN, TIME AND SETTING: Repetitive cellular measurements were performed at the Central Laboratory of Xinqiao Hospital,Third Military Medical University of Chinese PLA from June 2007 to January 2008.MATERIALS: Japanese rabbits, 2 months old, were provided by the Laboratory Animal Center of Third Military Medical University of Chinese PLA.METHODS: The rabbit MSCs were isolated, cultured and expanded in vitro. After transacted with Ad-hTGF-β1, the cells were cultured in pellet culture system. Chondrogenic differentiation was evaluated by histological, immunohistochemical and RT-PCR techniques.MAIN OUTCOME MEASURES: Cell morphological changes were observed by histological staining; proteoglycan and type Ⅱ collagen expression was detected by immunohistochemical and RT-PCR techniques.RESULTS: The induced cells exhibited a chondrocyte-like morphology by histological staining. Immunohistochemical and RT-PCR results showed that proteoglycan and type Ⅱ collagen were expressed in the induced cells.CONCLUSION: Bone marrow MSCs cultured in pellet culture system can differentiate into chondrocytes under the induction of Ad-hTGF-β1.