Objective To evaluate the efficacy and tolerability of midodrine (Gutron) in female patients with stress incontinence. Methods A randomized,double-blind,parallel,placebo-controlled,multicentric study was carried out.136 female patients with stress incontinence.68 cases in study group received Gutron (2.5 mg,thrice daily) for a course of 4 weeks.68 cases in control group received placebo in the same manner. Results 129 cases completed the treatment.The mean quantity of incontinent urine decreased by 9.9 g in those receiving Gutron ( n =66) and by 3.1 g in placebo ( n =63),respectively ( P 0.05). Conclusions Midodrine hydrochloride at the dose of 2.5 mg thrice daily has greater efficacy on female patients with stress incontinence than placebo, and the tolerability of midodrine was equivalent to that of placebo.

BACKGROUND: Focal ischemic model made by middle cerebral artery occlusion (MCAO) is much similar to the process of onset in human cere bral infarction, whereas in the process of modeling some problems such as selection of nylon strand with improper diameter and inserted depth would result in modeling failure. OBJECTIVE: To improve MCAO model of focal cerebral infarction. DESIGN: Single-factor design, animal experiment. SETTING: Department of Pediatrics, Affiliated Maternal and Children's Hospital of Guangzhou Medical College. MATERIALS: The experiment was conducted in the Experimental Center of Guangdong Province from January. 2002 to March 2004. A total of 24 healthy Wistar rats were randomly divided into sham-operation group and model group with 10 rats in each group.METHODS: In rats of the model group, the common carotid artery (CCA) and external carotid artery (ECA) were isolated and ligated. A strand was inserted via the incision on CCA near the furcation between CCA and ECA as deep as possible with the depth of (2.0±0.2) mm. The diameter of nylon strand was 0.2 mm, the top of nylon strand was treated by melting paraffin. The interrupted time of blood circulation was 3 hours. Rats in the sham-operation group were treated by slightly drawing back the nylon strand to the CCA immediately after inserting.MAIN OUTCOME MEASURES: ①Neurobehavioral rating: It was conducted at 3 and 12 hours after ischemia with the score ranged 0-4 points.The higher the score was, the severer the neural functional deficit was, 1-3 points signified successful modeling. ②Area of cerebral infarction: Rats wereexecuted at 12 hours after ischemia. Then, brains were quickly removed and stained with tetrazolium chloride (TTC). The percentage of cerebral infarction area was calculated. ③Observation on pathological changes under light microscope.RESULTS: All of 20 rats entered the final analysis.①Eight out of 10 rats in the model group represented contra lateral tumble or draw outward circles, positive Homer's syndrome can be seen in the ligated side (3 points);One rat was disable to completely extend the claws in the contra lateral side of ligation (1 point), one rat had no neural symptoms.②Some pathological changes can be seen in the model group such as swelled cerebral tissues in the ligated side, which were bigger than the contra lateral side and were in pale; The cortex, basal ganglia and thalamus in the ligated side after TTC staining were in pale, whereas the cerebral tissues in the sham-operation group were in red with clear border.③There was no infarct in the sham-operation group, and the percentage of cerebral infarction area in the model group was (22.40±4.52)%, the infarct area of rats in groups were fundamentally same.CONCLUSION: It is necessary to adapt the strand with appropriate diameter, inserted depth and interrupting time for successful modeling.

Objective To study effects of tethered spinal cord on functions of bladder and urethra. Methods Thirty six patients with tethered spinal cord were evaluated by video urodynamic studies. Filling phase function of bladder was evaluated by compliance of bladder and the presence of vesicoureteral reflux; voiding phase function of bladder was evaluated by maximal detrusor pressure; the synergy between detrusor and external urethral sphincter and continence of urethra were evaluated by voiding study with synchronous X ray image and pressure flow plot. Results 50% patients was diagnosed as detrusor areflexia with low compliance bladder, which was the main type of neurogenic bladder for patients with tethered spinal cord. And 22% was diagnosed as detrusor hyperreflexia. The incidence (83%)of damage of kidney function in patients with detrsusor areflexia and low compliance was significantly higher than patients with detrusor hyperreflexia ( P

Objective To study and evaluate islet cell adenoma of preliminary diagnosis.Method Retrospective analysis Wag done on 22 patients clinical data of preliminarily diagnosed islet cell adenoma.They were divided into two groups according to final diagnosis,group of islet cell adenoma(n=16)and group of reacfional hypoglycemia n=6).Results There were significant differences between the two groups in term of fames,cold sweat,cataphora,Whipple triad,hungry test,the ratio offasting blood insulin and fasting blood glucose exceeding 0.3 (I/G＞0.3) (P＜0.05).No statistical differences were found on blood glucose level in hypoglycemia onset,psychiatric symptom.Conclusion The clinic data is helpful for preliminary diagnosis,and Whipple triad,hungry test,I/G＞0.3 above all.

ObjectiveTo study the effects and mechanisms of hypoxia-ischemia (HI) on long-term learning and memory abilities and astrocytes in hippocampal formation and the efficacy of nimotop in treating hypoxic-ischemic brain damage. MethodsThe rats were subjected to right common carotid artery ligation followed by exposure to 8% oxygen at 37℃ for 2 h and then 13 rat pups received an introperitoneal injection of nimotop per day immediately following cerebral hypoxia-ischemia for 5 days. When the rats were 80-day-old, they were given test of Y-maze to determine their learning and memory abilities, and then their brain tissues were studied by immunohistochemistry for glial fibrillary acidic protein (GFAP) that marked astrocytes. ResultsThe learning and memory abilities of the HI group were lower than those of the normal control and nimotop treated group (P<0.01), nimotop significantly increased Y-maze learning abilities (P<0.05) of rats received HI, but did not affect their memory abilities. The numerical density of GFAP-positive cells in CA1 radiatum stratum of hippocampal formation were markedly higher in the HI group than those in the other two groups (P<0.01), but the others strata showed no difference. ConclusionHypoxic-ischemic brain damage cause rats to disorders of learning and memory that may be correlated with increase astrocyte in hippocampal formation which became easy to be damaged of declining regulation abilities of neurons microenvironment. Nimotop may be effective to counteract hypoxic-ischemic brain damages.

Objective To evaluate the relationship between von Hippel-Lindau (VHL) gene mutations and the prognosis of Chinese sporadic clear cell renal cell carcinoma (CCRCC). Methods VHL gene mutations were detected by polymerase chain reaction (PCR), direct DNA sequencing in 74 paired specimens of sporadic CCRCC and normal kidney. The mutation findings, pathologic fea-tures and prognostic characteristics were analyzed. Results Fifty-one patients (68.9%) were in clinical stage T1, 9 patients (12.2%) were in T2 and 14 patients (18.9%) were in T3. In the aspect of pathological grade, 15 patients (20.3%) were in G1, 50 patients (67.6%) were in G2 and 9 pa-tients (12.2%) were in G3. VHL gene mutations were detected in 40 of 74 cases (54.1%). There were no significant differences of VHL gene mutations in different pathological grade and clinical stage of CCRCC, P=0.915, P=0.237, respectively. All patients were followed up for 34 to 107 months (mean 71 months). Seven patients died of CCRCC. Another 11 patients developed CCRCC related me-tastasis. Five-year tumor-free survival was 78%. The incidence of death or metastasis of CCRCC in VHL gene mutation group (15.0%, 6/40) was significant lower than non-mutation group (35.3%,12/34), P=0.043. Logistic regression results showed that lower tumor pathological grade and stage, better patients' prognosis would be (P=0.016, P=0.024, respectively). However, VHL gene muta-tion was related with better prognosis (P=0.033). This association was stronger among patients with high grade tumors (G3, P=0.048). Conclusions There are frequent VHL gene mutations in spo-radic Chinese CCRCC. Tumors' pathological grade and clinical stage are the important parameters for prognosis. However, VHL mutations are strongly associated with better cancer specific survival for CCRCC patients. These associations are relatively stronger in patients with high grade tumors.

Objective To develop a set of high-frequency ultrasound grayscale blood flow imaging system based on field programmable gate array (FPGA) to execute simultaneous imaging of superficial blood flow and tissues.Methods This system was mainly composed of an ultrasonic transducer,an ultrasonic transmission and receiving modules,imaging software in host computer and peripheral equipment.A PVDF transducer with the frequency between 20 and 50 MHz was used for the ultrasonic transducer.In transmission and receiving modules,the radio frequency echo signals were digitized by high-speed A/D.Then the digital signals were transmitted,added,filtered,demodulated,log amplified,double sampled,and lastly transferred to the host computer by USB interface for real-time display.Results A vascular 1 mm far form the surface of the hand skin was examined by this system.Four blood flow images were obtained in corresponding with four transmission frequencies.Conclusion Real-time superficial organ blood flow imaging is realized by this system.The solution has the architecture concise and clear,and lays an experimental foundationfor high-frequency ultrasound gray-scale blood flow imaging.

In order to enhance the specificity of TNF-α monoclonal antibody to inflamed site, a bispecific antibody BsDb that targets TNF-α and the extra-domain B (ED-B) of fibronectin (FN) was constructed by covalently linking the anti-TNF-α single chain Fv antibody (TNF-scFv) and the anti-ED-B scFv L19 via a flexible peptide linker deriving from human serum albumin (HSA). ED-B is an antigen specifically expressed at the inflamed site. BsDb is expressed in E. coli, identified by immunoblot, and purified with affinity chromatography. This was followed by further examination of its bioactivities and pharmacokinetics. We demonstrated that BsDb retained the immunoreactivity of its original antibodies as it could simultaneously bind to TNF-α and ED-B and neutralize the biological action of TNF-α. In the collagen-induced arthritis mice model, BsDb selectively accumulate in the inflamed joint with a maximal uptake of (12.2 ± 1.50)% ID/g in a single inflamed paw and retain in the inflamed paw for at least 72 h. In contrast, BsDb showed a short serum half-life of (0.50 ± 0.05) h and a rapid clearance from normal tissues. The findings reported herein indicate that BsDb has good specificity to the inflamed site and low toxicity to normal tissues. BsDb is therefore likely to have greater clinical applications in the treatment of rheumatoid arthritis and other autoimmune diseases. This laid a stable basis for its preclinical study.

Objective: To observe the clinical effect of tuina plus medications on infantile diarrhea induced by rotavirus infection. Methods: After 55 cases of confirmed sick infants were divided into two groups by the order of their visits, 30 cases in the medication group were treated by intravenous infusion of Ribavirin and oral administration of Smecta; 25 cases in the tuina plus medication group were treated by the manual techniques of tonifying Pijing(脾经) and clarifying Dachangjing (大肠经), rubbing the abdomen and kneading the navel clockwise, pushing Shangqijiegu (上七节骨), kneading Guiwei (龟尾), and pinching the skin of the spine, in combination with same medications used as in the medication group. Results: The total effective rate was 96% in the tuina plus medication group, P < 0.01, in comparison with the medication group. Conclusion: tuina has a good therapeutic effect in the treatment of infantile diarrhea induced by rotavirus infection and is importantly significant for shortening the course, enhancing the therapeutic effect and lowering down the medical cost.

Objective To investigate the in vitro effects of acitretin on the apoptosis and expressions of insulin-like growth factor binding protein 7 (IGFBP7) and vascular endothelial growth factor (VEGF) in HaCaT cells.Methods Cultured HaCaT cells were treated with various concentrations (10-5,10-64,10-7,10-8 mol/L) of acitretin for various durations,with those cultured in acitretin-free medium serving as the control group.Then,CCK-8 assay was performed to evaluate the proliferation of cells after 24-,48-and 72-hour treatment,flow cytometry to detect the apoptosis of HaCaT cells,and Western blot and reverse transcription-PCR to quantify the protein and mRNA expressions of IGFBP7 and VEGF in HaCaT cells,respectively,after 48-hour treatment.Statistical analysis was carried out by one-way analysis of variance and Pearson correlation analysis.Results The proliferation of HaCaT cells was inhibited by the treatment with acitretin,and the inhibitory effect increased with the elevation of concentration and prolongation of treatment duration of acitretin.A significant decrease was observed in the proliferative activity of HaCaT cells treated with acitretin of 10-8 mol/L for 48 hours,and when the concentration of acitretin was 10-5 mol/L,the proliferation of HaCaT cells was inhibited by 39.94％ ± 2.27％ and 49.77％ ± 1.87％ at 48 and 72 hours respectively,compared with the control cells.The HaCaT cells treated with acitretin of 10-5 mol/L for 48 hours showed a significant elevation in apoptosis rate (7.617％ ± 0.767％ vs.1.803％ ± 0.313％,P ＜ 0.05),IGFBP7 protein and mRNA expressions (0.939 ± 0.040 vs.0.436 ± 0.013,0.872 ± 0.079 vs.0.190 ± 0.056,both P ＜ 0.05),but a significant reduction in VEGF protein and mRNA expressions (0.213 ± 0.032 vs.0.798 ± 0.036,0.274 ± 0.041 vs.0.933 ± 0.054,both P ＜ 0.05) in comparison to the control cells.Conclusions Acitretin can induce the apoptosis of HaCaT cells,and up-regulate IGFBP7 but down-regulate VEGF expressions in HaCaT cells at protein and mRNA levels.