Objective To evaluate the clinical and pathological characteristics and treatment of small cell carcinoma of the prostate. Methods Two patients with small cell carcinoma of the prostate were reported. Case 1 was 50 year-old. He was admitted with a history of dysuria and perineal pain for 3 months. Digital rectal examination (DRE) showed that the enlarged prostate was 5. 0 cm?6. 0 cm and palpated hard and rough. Low-echo mass was shown on ultrasonography, and heterogeneous density of the prostate on CT. His serum PSA level was 0. 31 ng/ml,and fPSA level was 0.09 ng/ml. Prostate cancer was suspected by biopsy,and radical prostatectomy was performed. Case 2 was 82 year-old. The complaints consisted of dysuria and intermittent gross hematuria for 4 months. The enlarged prostate was 4. 0 cm?5. 0 cm and palpated hard and rough with multiple nodes by DRE. Low-echo mass was shown on ultrasonography, and heterogeneous density of the prostate and involvement of seminal vesicle and bladder neck on CT. His serum PSA level was 2.61 ng/ml,and fPSA level was 0.05 ng/ml. Prostate carcinoma was indicated by biopsy, and orchiectomy plus TURP was performed. Results The diagnosis of small cell carcinoma of the 2 cases were confirmed by postoperative pathology. Microscopically, the tumor cells were arranged in solid-sheet and nest structures, showing the histologic type of diffuse infiltrative carcinoma. Coagulated necrosis could be found easily. Small round or oval cells resembling lymphocytes or oat cells were the main constituents of the tumor. The nuclei were extremely hyperchromatic and scanty. The seminal vesicle and bladder neck had tumor infiltration. The immunohistochemical staining results were negative for LCA,L-26 and 34?E12,but positive for PSA,AE1/ AE3 and AR ,and suspected positive for CgA and S-100. Case 1 died of extensive lung metastasis 1 month after operation. Case 2 had retroperitoneal metastasis of the tumor 3 months after operation, and has been followed till now. Conclusions Small cell cancer of the prostate is rare but can be diagnosed properly based on clinical and pathological features. Radical prostatectomy combined with hormone and chemotherapy is reliable treatment for early stage cancer; but for late stage cancer, there is no effective treatment and the prognosis is poor.

Objective To provide an anatomic evidence for the double-bundle posterior cruciate ligament (PCL) reconstruction, the sizes and locations of the attachments of the PCL to the tibia and the femur were measured. Methods We studied 30 cadaveric knees. PCLs were divided into anterolateral and posteromedial bundles to the insertion footprint, and those locations were measured and described. Results The distances from the center of the femoral insertions of the anterolateral and posteromedial bundles to the anterior margin of the medial femoral condyle were (8.52±1.81)mm and (11.63±1.81)mm. The vertical distances from the center of the femoral insertions of the double-bundle to the intercondylar roof were (4.67±0.55)mm and (10.32±1.23) mm. The vertical distances from the tibial insertion of the center of the double-bundle to the plane of the tibial articular surface were (8.43±1.21)mm and (14.52±2.31)mm. The distances from the medial margin of the articular cartilage of the tibial plateau to the center of the tibial insertions of double-bundle were (47.44±6.23)mm and (45.95±6.32)mm. The areas of the insertions of the anterolateral and posteromedial bundles on the femur were (107.12±15.25)mm~2 and (65.35±10.27)mm~2. The areas of the insertions of the double-bundle on the tibia were (50.07±11.33)mm~2and (51.08±10.22)mm~2. Conclusion The anatomic characteristic of the attachment of the anterolateral and posteromedial bundles was revealed, providing anatomical bases for surgery.

Objective To explore the therapeutic effect on the prevention of eccyesis by optimizing fallopian tube to be pregnant.Methods Three hundred and seventy-nine patients with infertility were divided into two groups:control group with 187 patients received the combined optimized treatment,and study group with 192 patients received the combined optimized treatment and optimizing fallopian tube to be pregnant.All patients received the hysterosalpingography uterosalpingography(HSU)whik the patients of the study group received the ultraphonic monitor for the.dominant follicle besides for 6 ovulatory cycle.Results There were intrauterine gestation 59 patients(31.55%,59/187),eccyesis 20 patients(10.70%,20/187)and infertility 108 patients(57.75%,108/187)in control group while there were intrauterine gestation 83 patients(43.23%,83/192),eccyesis 10 patients(5.21%,10/192)and infertility 99 patients (51.56%,99/192)in study group.The intrauterine gestation rate in study group was higher than that in control group(P<0.05),and the eccyesis rate was lower than that in control group(P<0.05).But there was no significant difference in the infertility rate between two groups(P＞0.05).The eccyesis rate in fallopian tube unsmooth was higher than that in salpingemphraxis and fallopian tube canalization respectively[12.59%(18/143),2.63%(2/76),2.70%(2/74),P<0.05].Conclusion Selecting the optimizing fallopian tube by HSU and monitoring the dominant follicle by ultraphonic to guide pregnancy can let the dominant follicle grow and conceive in the optimizing fallopian tIlbe,and this treatment can raise the intrauterine gestation rate and decrease the cause of eccyesis.

Objective To investigate whether a novel long-acting tumor necrotic factor (TNF) antagonist (soluble TNF receptor:IgG Fc [sTNFR:IgG-Fc]) can protect hepatocyte damage against liver failure caused by drugs in immunity-induced cirrhotic rats.Methods Wistar rats were repeatedly sensitized by human serum albumin (HSA) emulsified in complete freud adjuvant.The blood was collected at day 10 after the final sensitization.If anti-albumin antibody was positive,the rats were intravenously injected with HSA twice a week.After six weeks,liver cirrhosis was induced by immunity.All the model rats were divided into three groups with 15 each.Liver failure was induced with D-galactosamine/ lipopolysaccharide (LPS) intraperitoneal injection in the rats with liver cirrhosis in model group.The rats in pretreatment group were intraperitoneally injected with long-acting soluble TNF receptor p55 18 h before D-galactosamine/LPS injection.The control group were injected with 0.9％ sodium chloride.General condition,survival rate,liver function and pathological changes were all examined.Serum levels of interleukin (IL)-6,IL-22 and intrahepatic level of IL-6 were detected by enzyme linked immunosorbent assay (ELISA).The activity of Caspase 3 in hepatocyte lysis solution was measured by spectrophotography.Real-time polymerase chain reaction (PCR) was used to detect mRNA expressions of proliferating cell nuclear antigen (PCNA),bcl-2,bax and IL-22 receptor.Data were analyzed by variance analysis among groups.Results Rats in model group were dispirited with poor response after 12 hours and only 3 survived,compared with soluble TNF receptor p55 pre-treated group rats,in which all survived (P=0.029 8) with flexible response.Serum alanine aminotransferase levels in these two groups were (6 533± 360) and (105 ± 7) U/L,respectively.Hepatic regenerative nodule developed massive or submassive necrosis with septal fibrosis in model group,whereas soluble TNF receptor p55 alleviated the inflammatory and necrosis reaction of hepatic tissue.Serum IL-6 levels in model group and pretreatment group were (842.0±12.9) and (91.9±1.6) pg/mL,respectively (F=380.30,P＜0.01).Intrahepatic levels of IL-6 in these two groups were (26.2±1.2) and (11.1±0.8) pg/mL,respectively (F=176.90,P＜0.01),and serum IL-22 levels were (167.0±27.8) and (988.0±109.6) pg/mL,respectively (F=37.91,P＜0.01).Hepatic Caspase-3 activity was reduced by almost 60％ by soluble TNF receptor p55 pretreatment (F=303.70,P＜0.01) and bax expression reduced by 22％ (F=108.80,P＜0.01),while bcl-2 and PCNA expressions were up-regulated by 3.6-folds and 23.0-folds,respectively (F=115.60,P＜0.01; F=594.20,P＜0.01).Conclusions Long acting soluble TNF receptor p55 could improve survival rate,liver function and reduce inflammatory reaction of rats with liver failure induced by drugs on the basis of liver cirrhosis caused by immunity,which indicates that this drug may process a potential therapeutic value.

According to the common standard of ethic review for clinical research , it is equal to each kind of research program whether western medicine or Traditional Chinese Medicine .It should be reviewed the ethic and scientific issues in the same time .However, on account of the two majority characteristics of Traditional Chinese Medicine , it would be concerned more evidence , such as the safety data before clinic , the syndrome differentiation and treatment of target disease , drug combination , dosage and course of treatment , the methods of outcome meas-urement, admixture of the drug, the selection of control drug including placebo and so on .

Objective To explore the isometry of grafts in PCL(posterior cruciate ligament)double-bundle re-construction under femoral tunnel shifting condition.Method Knee specimens from ten fresh frozen cadavers were used.PCL were divided into anterolateral bundles(ALB)and posteromedial bundles(PMB)to the inser-tion footorint.The anterior,postedor,proximal,distal and central points of the two bundles'femoral attachment site were respectivelyanchored to the middle of the PCL's tibial attachment site by the trial wires.Changes in length of the intra-articular part of the wires were recorded while the knee was flexed from 0°to 120°.Result The length changes in every point were compared.All of the maximal length changes of ALB's proximal,pos-todor points and PMB's proximal points were not greater than 2mm.No significant difference between the length changes of ALB's proximal point and posterior(P=0.864>0.05)was found.Conclusions The femo-ral tunnel for the PCL double-bundle reconstruction should be located as follows:ALB should be at the middle point of upper edge of femoral attachment site(proximal point),while PIVIB at the middle point of femoral attachment site(proximal point).

OBJECTIVE Through researching the ABR threshold, the cochlear morphology and miR-96 expression in the cochlear of BALB/c mice at different month's age, to find out if the miR-96 can regulate the age related hearing loss of BALB/c mice.METHODS ABR testing, AO/PI staining and scanning electron microscope were used to observe the ABR threshold and cochlear morphology of the BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months. Real-time PCR was used to detect the expression of miR-96 in the cochlea of BALB/c mice at the ages of 3 months, 6 months, 12 months and 18 months.RESULTS The ABR thresholds of BALB/c mice were (18.5±8.3), (45.8±7.8), and (85.6±15.6) dB SPL separately at the age of 3, 6 and 12 months. At the age of 18 months, no response was observed in the ABR testing with 120 dB SPL acoustic stimulation. In the AO/PI staining, we found that the outer hair cells was apparently lost since the age of 6 months and the loss of hair cells aggravated as the month's age increased. At the age of 12 months, no outer hair cells was left, inner hair cells was lost apparently too. With the scanning electron microscope, we found the changes of deficiency, lodging, fusion, shortening and inversion in the hair cell cilia. And these changes were aggravated as the month's ages increased. At the age of 3 months, the relative expression of miR-96 (2-△CT) was 0.0225±0.0073. The relative expression of miR-96 (2-△CT) in the cochlea were 0.0162±0.0048, 0.0116±0.0048, and 0.0050±0.0014 at the age of 6 months, 12 months and 18 months separately, comparing with the relative expression of miR-96 at the age of 3 months, the differences were significant(P<0.05).CONCLUSION The hearing loss, hair cells loss, and cilia damage aggravated as the month's age increased, but the miR-96 expression in the cochlea decreased. Which suggest that miR-96 might play an important role in the age related hearing loss.

ObjectiveTo investigate the histological features as well as the factors influencing liver disease progression in Chinese patients with chronic hepatitis C (CHC). MethodsA total of 102 CHC patients who underwent percutaneous liver biopsy between August 2007 and May 2010 were recruited. Age, gender, body mass index (BMI) and transmission route of recruited patients were recorded. Serum levels of alanine transaminase (ALT) and aspartate transaminase (AST), HCV genotypes, HCV viral load and liver histological changes were detected. Statistical analysis was done by t test and Logistic regression. ResultsThe serum levels of ALT and AST in CHC patients with histological activity index (HAI) ≥4 were much higher, while platelet (PLT) counts were lower than those with HAI ＜4(t=2.209, 2. 298 and 2. 565, respectively; all P＜0.05). Likewise, in patients with F≥3, the serum levels of ALT and AST as well as the mean age and the duration of infection were significantly elevated compared with F ＜ 3 group ( t = 3.497, 2. 758, 2. 340 and 2. 570,respectively; all P＜0. 05), while PLT counts were much lower (t = 2. 761, P=0. 007). The unvariate predictors for HAI≥4 were female, ALT＞1 × upper limits of normal (ULN), AST level,F≥3, HCV RNA≥6 lgIU/mL and PLT counts. By mutivariate analysis, the Ishak stage score was the only independent predictor for HAI≥4 (OR 3.098, 95％CI 1.884-5. 092; P＜0.01). Finally,the univariate predictors for F≥3 were age, BMI≥24 kg/m2 , ALT＞1 × ULN, AST level, HAI≥4,PLT counts and duration of infection≥ 15 years. Multivariate analysis revealed that age (OR 1. 074,95％CI 1.006-1. 146; P=0.033), ALT level (OR 1. 035, 95％CI 1.015－1.055; P＜0.01), ASTlevel (OR 0. 969, 95％CI 0. 948－0. 990; P=0. 005), the duration of infection ≥15 years (OR 37. 215, 95％CI 5. 816－238. 127; P＜0.01) and HAI≥4 (OR 1. 939, 95％CI 1. 426－2. 636; P＜0.01) were independent predictors for F≥ 3. ConclusionAge, ALT level, AST level, duration of infection≥15 years, HAI≥4 are independent predictors for liver fibrosis.

Objective To study the epidemiologic characteristics of trauma in the prehospital first-aid in megapolis. Methods The epidemiologic data of 10 654 traumatic patients,including treated by prehospital treatment and emergency treatment from January 2000 to January 2005,were analyzed.Results The proportion of male was 70.96%,adult patients(21～50 years old)79.23%,suburb 62.86%,downtown 37.14%.The patients whose ISS scores surpassed 16 accounted for 37.98%,which caused by traffic accident was 37.74%,by public order 24.39%,by industrial trauma 21.71%.The trauma in the limbs accounted for 67.51%,cephalic and cervical wounds accounted for 58.64%,multiple wounds 41.77%,thoracic and abdominal wounds 39.41%.Three hundred and sixty one were killed on the spot,which caused by traffic accident were 46.81%,by public order 28.81%,by industrial trauma 14.40%.Forty-two percent point six six patients died of multiple trauma,54.07% died of cephalic and cervical trauma,15.79% died of thoracic and abdominal wounds.Conclusion Suburban area gradually became the frequently-occurred areas of trauma in megapolis. The wounded were mainly young adults and had a tendency of juvenility.The majority of damaging and lethal factors were traffic accident,public order and industrial trauma.Some pertinet measures and professional first-aid models may improve the traumatic first-aid level.

OBJECTIVETo investigate the changes in circulating plasmacytoid dendritic cells (pDCs) in patients with chronic hepatitis B (CHB) during the course of treatment with pegylated-interferon alfa-2s (peg-IFNa-2a) and to determine the correlations with therapeutic response.

METHODSForty-one patients with CHB who were receiving peg-IFNa-2a antiviral treatment for 48 weeks were enrolled in the study.Expression of the Toll-like receptor 9 (TLR9) on and frequency and functionality of the pDCs were analyzed at treatment weeks 0, 2, 12, 24, 36 and 48.

RESULTSAll patients exhibited an initially rapid decrease in the numbers of circulating pDCs and showed CpG-induced endogenous IFNa production within the first 2 weeks of treatment.Subsequently, all responders displayed a continuous increase in pDC numbers as well as functionality, both of which peaked around week 12 of treatment; in addition, these treatment responses were accompanied by significantly increased levels of type 1 T helper cytokines (P less than 0.05), which did not occur in the non-responders.

CONCLUSIONpDCs are involved in the initial therapeutic immune response stimulated by peg-IFNa-2a treatment.Recovery of blood pDC number and functionality may represent a predictor of favorable response to peg-IFNa-2a antiviral treatment in patients with CHB.