Objective To evaluate the modified POSSUM surgical scoring system in urologic surgery patients over 70. Methods 180 patients over 70 were retrospectively analyzed with the mo dified POSSUM surgical scoring system.A comparison between the observed and the predicted morbidity was made. Results In the complication group and noncomplication group,the mean age of the patients were 74.9?4.1 and 74.7?3.6,the mean length of stay were (42.1?4.2)d and (28.7? 14.2 )d,respectively.In the complication group,both the physiological scores and the operative severity scores of POSSUM scoring system were significantly higher than the no complication group ( 22.0 ? 4.1 vs 20.1?3.9 in pysiological score and 11.7?4.3 vs 10.3?3.5 in operative severity score, P

Objective To investigate the value of multiple sequential MRI in the differential diagnosis of vater ampulla carcinoma (VPC).Methods MRI data of 53 patients with VPC confirmed by surgery and pathology were analyzed retrospectively,which included 17ampullary carcinomas,15 pancreatic head carcinomas,10 duodenal papillary carcinomas and 11 distal common bile duct carcinomas.All patients underwent routine MRI plain scan,MRCP and multi-phase dynamic enhancement scan for the upper abdomen.The morphological characteristics and model of multi-phase dynamic enhancement of the tumor,and the morphological changes of pancreaticobiliary duct were focused,and relevant data were also measured.Results The differences of tumor size,central location,and signal homogeneity among the four different histological types showed statistical significance(P＜0.05),and their patterns of multi-phase dynamic enhancement also had differences.Double-segment sign was most found in VPC (26/53),four-segment sign was easy showed in pancreatic head carcinoma (8/15)and three-segment sign in distal common bile duct carcinoma (8/11).Beak sign was common seen in ampullary carcinoma(10/17),rat-tail sign was easy discovered in pancreatic head carcinoma (7/15) and truncated sign in distal common bile duct carcinoma(10/11).Diameter of major pancreatic duct in pancreatic head carcinoma was maximum and minimum in distal common bile duct carcinoma,and their difference had statistical significance(P＜0.05).Distance between obstructive end of bile common duct and major papilla of duodenum,and between obstructive end of major pancreatic duct and major papilla of duodenum as well as the pancreaticobiliary conjunction angle in pancreatic head carcinoma and distal common bile duct carcinoma were greater than that in ampullary carcinoma and duodenal papillary carcinoma.Conclusion MRI can prominently demonstrate various imaging characteristics of VPC with different histological origins.It is very valuable in the differential diagnosis of VPC with different histological types by comprehensive analysis of these findings.

Objective To identify whether cisplatin can induce autophagy of bladder cancer T24 cells and the possible mechanism, and to observe the relationship between outophagy and apoptosis.Methods MTT assay was applied to investigate the effects of various concentration of cisplatin( 0 , 10 , 20 and 40 μg/mL) on T24 survival.TEM was performed to detect the autophagosome formation .Western blot assay was used to analyze the expression changes of LC3-Ⅱ, P62 and extracellular signal-regulated kinase ( ERK1/2 ) and p-ERK at the protein level.The effects of autophagy on the survival and apoptosis of bladder cancer cells were investiga-ted.Results DDP observably inhibited proliferation of bladder cancer cells in a dose-dependent manner ( P<0.05), the 50% inhibiting concentration(IC50) was (30.3 ±2.4)μg/mL;DDP induced autophagy of bladder cancer cells, observably increased autophagosome induced by DDP; up-regulated expression levels of LC3-Ⅱproteins ( P<0.05 ) , down-regulated expression of P62 proteins ( P<0.05 );DDP increased the protein level of p-ERK (P<0.05); The inhibitor of ERK pathway U0126 inhibited DDP-induced autophagy, as evidenced by decrease in the expression of LC3-Ⅱproteins ( P<0.05 ) .After inhibition of autophagy by WTM in DDP-treated cells, cell viability was obviously decreased and apoptosis was increased (P<0.05);DDP combined with WTM observably enhanced cleavage of poly ADP-ribose polymerase 1 ( PARP-1 ) and cleaved-caspase-3 which is apop-tosis related proteins ( P<0.05 ) .Conclusions Autophagy can protect T24 cells against ciplatin-induced apop-tosis, the possible mechanism of autophagy is the ERK signaling pathway is activated .

ObjectiveTo investigate the effects of insulin on the proliferation and invasion of human pancreatic cancer cells PANC1,and on its HIF-1α,VEGF expression.MethodsPANC1 was pretreated with insulin of different concentrations (0.1,1,10,100 nmol/L).The proliferation of PANC1 was tested by MTTmethod,and transwell assay was used to test the invasion ability of PANC1.HIF-1α,VEGF and PCNA protein expression was assessed by Western blots,and HIF-1α,VEGF mRNA was detected by real-time PCR.Results Insulin could increase the proliferation of PANC1 in a dose-dependent manner (p ＜0.05 ),and increase the expression of HIF-1α,VEGF protein.After 100 nmol/L insulin treatment for4 d,the PCNA protein expression in the insulin group was significantly higher than that in the control group (1.196 ±0.014 vs 1.157 ±0.013,P ＜ 0.05).The cancer cells passed through the chamber in insulin group were much more than that in the control group ( 141.0 ± 2.1 vs 89.0 ± 1.4,P ＜0.05 ).The expression of HIF-1α protein was significantly increased (1.139 ±0.020 vs 0.598 ±0.013,P ＜0.05),while there was no significant change of HIF-1αmRNA expression.Both the expression of VEGF protein and mRNA were significantly increased (1.011 ± 0.023 vs 0.627 ± 0.013 0.970 ± 0.016 vs 0.350 ± 0.01 3,P ＜ 0.05 ).Conclusions High insulin microenvironment could enhance the proliferation and invasion of PANC1 cells by up-regulating the expression of HIF-1α and VEGF.

AIM:To investigate the clinical significance of microRNA-26a-5p (miR-26a-5p)-regulated mye-loid cell leukemia-1 (MCL-1) expression in the development of maternal preeclampsia.METHODS:Plasma and placen-tal tissues were collected from 21 cases of normal pregnancy, 13 cases of maternal gestational hypertension, 15 cases of mild preeclampsia and 26 cases of severe preeclampsia.The levels of plasma and placental miR-26a-5p and placental MCL-1 mRNA were detected by real-time PCR.Western blotting analysis was used to determine the protein expression of placen-tal MCL-1.The clinical significance of the above parameters was also analyzed.RESULTS:miR-26a-5p expression gradu-ally increased(P<0.01) in the 4 groups of maternal plasma and placentas with the disease development, and the mRNA expression of MCL-1 was significantly reduced in the placentas (P<0.01), both showing a significant negative correlation (P<0.01).Meanwhile, the expression of miR-26a-5p and MCL-1 protein in the placental tissues was negatively correla-ted (P<0.01).The miR-26a-5p up-regulation in maternal plasma and placental tissues was negatively correlated with ges-tational age, maternal plasma albumin levels and fetal weight, while it was positively correlated with maternal blood pres-sure and urinary protein level (P<0.01), which was in contrary to the down-regulation of placental MCL-1.CONCLU-SION:Up-regulation of miR-26a-5p is involved in the occurrence and development of preeclampsia by down-regulation of MCL-1.

Hyperthermia is an efficient type of cancer treatment in which body tissue is exposed to high temperatures to damage and kill cancer cells. Previous studies have focused on the treatment of tumor, however,it can not substitute for traditional methols. In recent years,new research in shows hyperthermia plays an important role in bone metastasis pain control because of the advantages of width rang,rapid onset and noninvasive, and it is therefore well used in. It is also becoming one of classical methods for bone metastasis from cancer. This article reviews recent research and progress of mechanisms of hyperthermia in relief of bone metastasis pain.
Bone Neoplasms ; physiopathology ; secondary ; therapy ; Humans ; Hyperthermia, Induced ; Pain, Intractable ; therapy

Objective To compare the effect of video‐assisted thoracoscopic(VAT) surgery and conventional thoracotomy in emergency treatment of multiple rib fracture complicating pulmonary laceration to provide the reference for clinical treatment .Meth‐ods Forty‐seven cases of multiple rib fracture complicating pulmonary laceration in our hospital from April 2013 to April 2014 were selected and divided into the VAT group(n=32) and thoracotomy group(n=15) according to the willingness of patients .The two groups performed the thoracoscopic and traditional thoracotomy titanium nickel alloy rib plate treatment respectively .The sur‐gery situation ,complications and changes of perioperative blood gas levels were compared between the two groups .Results The op‐eration time ,intraoperative bleeding volume ,ICU hospitalization time ,total hospitalization time and postoperative analgesic in the VAT group were lower than those in the thoracotomy group ,the differences were statistically significant (P<0 .05);the VAS score on postoperative 1 d had statistical difference(P<0 .01) .Compared with before operation ,arterial PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the two groups were increased ,while PaCO2 was decreased ,and the differences were statistically significant (P<0 .05);PaO2 ,SaO2 and PaO2/FiO2 at postoperative 12 h in the VAT group were higher than those in the thoracotomy group , while PaCO2 was lower than that in the thoracotomy group ,and the differences were statistically significant (P<0 .05) .The occur‐rence rate of complications had no statistical difference between the VAT group and thoracotomy group (3 .1% vs .6 .7% ,P>0 .05) .The excellent rate in the VAT group was 90 .6% ,which was higher than 66 .7% in the thoracotomy group ,and the differ‐ence was statistically significant (P<0 .05) .Conclusion Thoracoscopic internal fixation for the treatment of multiple rib fractures complicating laceration has the advantages of minimal trauma ,convenient operation and high safety ,could effectively alleviate the patient′s sufferring ,improve the living quality ,and be a better way of treatment .

With the deepening of the reform of public hospitals at the county level,as well as the development of medical technology personnel training and medical technology development in county hospitals,county hospitals should be able to make use of the latest technology to undertake the common diseases and frequently occurring diseases of county residents.So at present,the teaching hospitals affiliated to medical universities should carry out the short-term training of the latest special techniques in the training of the regular doctors.Department of Urology of the first Affiliated Hospital of Chongqing Medical University,in the 3 month training cycle,with improving the self-learning ability of the refresher doctors as the core,carried out the hand by hand teaching of small classes and introducing model teaching,which achieved good results.

AIM:To investigate whether oxidative stress is able to induce autophagy in mesenchymal stem cells (MSCs), and to explore the effects of autophagy on MSC proliferation and apoptosis under oxidative stress circumstance as well as the underlying mechanism for promoting the therapeutic effects of transplanted MSCs on treating diabetes mellitus e -rectile dysfunction ( DMED) .METHODS: Hydrogen peroxide ( H2 O2 ) was applied to simulate the oxidative stress cir-cumstance.The effects of H2 O2 at concentration of 0, 50, 100, 200, 400μmol/L on the viability of MSCs were tested by the method of Trypan blue exclusion and MTT assay respectively .The methods of MTT assay , Western blot and transmis-sion electron microscope ( TEM) were used to explore the effects of H 2 O2 on MSC apoptosis and autophagy .RESULTS:The proliferation of MSCs was obviously inhibited by H 2 O2 in a dose-dependent manner ( P<0.01) and the 50%inhibiting concentration (IC50) was (384.58 ±16.89) μmol/L.H2O2 induced apoptosis and autophay of MSCs .The proliferation rate of MSCs was suppressed by H 2 O2 significantly ( P<0.05 ) , with a further decline by blockade of autophagy ( P<0.05) whereas increased by blockade of apoptosis (P<0.05).H2O2 induced MSCs apoptosis obviously (P<0.05), with an augment of apoptosis ( P<0.05) by blockade of autophagy .Furthermore, the H2 O2 increased expression of cleaved caspase-3 and cleavage of poly ADP-ribose polymerase 1 (PARP1), Which were decreased by apoptosis blockade whereas were enhanced by blockade of autopahgy .CONCLUSION:Oxidative stress plays a dual role in MSC survival , which in-duces MSC apoptosis and autophagy .Moreover , blockade of autophagy intensifies MSC apoptosis .Therefore , it is a promis-ing method to ameliorate the effects of stem-cell based therapy on DMED by enhancing protective autophagy to increase the survival rate of transplanted MSCs against oxidative stress circumstance caused by diabetes mellitus .

Objective To explore the feasibility of detecting the cytokeratin 20 (CK-20) mRNA in exfoliated urothelial cells for the diagnosis of bladder carcinoma. Methods Reverse transcriptase-polymerase chain reaction (RT-PCR) was used to detect the expression of CK-20 mRNA in cells collected from the urine of 45 cases of bladder cancer, 15 cases of cystitis accompanied by hematuria, 10 healthy volunteers, and 7 different cell lines, including bladder cancer cell line T24, kidney cancer 786-0 and GRC-1, breast cancer MCF-7 and MDA-MB-435, and ovary cancer SKOV 3 and 3AO. Results CK-20 mRNA expression was detected in 36 of 41 cases of bladder transitional cell carcinoma (87.80%), in 18 of the 21 GⅠ patients (85.71%), in 11 of the 13 GⅡ patients (84.62%), in 7 of the 7 GⅢ patients (100%), in 20 of the 22 T a-1 patients (90.91%), and in 16 of the 19T 2-4 patients (84.21%). Sensitivity of the method was found to be 87.80%, whereas specificity was 73.33%. In 15 patients with hematuria, there were 4 cases of false positive: 1 case of BPH, 1 case of atypical hyperplasia, 1 case of chronic inflammation, and 1 case undergoing TURP previously. CK-20 amplification band was also obtained in all of 19 cases of bladder transitional cell tumor tissues and bladder cancer cell line T24, but not in 4 patients with non-transitional cell carcinoma and 6 other tumor cell lines. No false positive cases were found in the healthy control group. Conclusion These results suggest that CK-20 might be a useful tumor marker for early noninvasive diagnosis and follow-up of bladder cancer by detecting CK-20 mRNA expression of uroepithelial cells from the voided urine specimen by RT-PCR.