Intravesical instillation after transurethral resection of bladder tumor (TURBT) has been considered as the most important and effective method for the prevention and treatment of non-muscle invasive bladder cancer (NMIBC).Nowadays, the main choices of intravesical instillation are chemical drugs and Bacillus Calmette-Guerin (BCG).For all pa-tients with NMIBC, intravesical instillation should be admistered as soon as possible after TURBT.For patients of G_(1-2)T, an immediate single postoperative instillation of chemotherapy as standard therapy for low-risk disease is enough.For interme-diate-risk patients, it is recommended to use an immediate single postoperative instillation of chemotherapy plus an induc-tion course or maintenance treatment, but the scheme of intravesical instillation should be based on the specific circum-stances of the patients.For high-risk patients, maintenance therapy with BCG should be the first chioce.The combination of intravesical BCG and chemotherapy has certain advantages in treating NMIBC, but its efficacy needs further verifica-tion.Although there is a long history of intravesical instillation after TURBT, the choice of drugs, the time of instillation, and the corresponding dosages are still inconclusive.This article summarizes the strategies of the treatment for NMIBC after TURBT.

Objective To investigate the clinical values of dexmedetomidine in general anesthetic for laparo-scopic cholecystectomy.Methods One hundred patients admitted to our center with cholelithes were prospectively studied.According to the principle of completely random digital table,all patients were randomly signed to dexmedeto-midine group or control group.The primary outcomes were hemodynamic changes and postoperative complications. Results There was no significant differences at t0,t1,t2,t3,t4 and t5 in mean arterial pressure (P >0.05).There was no significant difference in heart rate at t0 (P =0.503),however,compared with the control group,patients in the dexmedetomidine group got a significant reduction in t1,t2,t3,t4 and t5 in heart rate(all P <0.05).Compared with the control group,the operation time of the dexmedetomidine group was significantly shorten[(1 18.52 ±15.42)min vs.(127.24 ±19.14)min,t = -5.673,P =0.021 ],the rate of movement of the center of the operation was significantly decreased (36% vs.64%,χ2 =7.840,P <0.001),the incidence rate decreased significantly (0% vs. 10%,χ2 =5.263,P =0.022).There was no difference between the two groups in intra -operative bleeding volume, hypertension,hypotension,tachycardia,postoperative drainage volume,postoperative bleeding,infection and vomiting (all P >0.05 ).Conclusion Dexmedetomidine contributed to maintaining the hemodynamic stable in general anesthetic for laparoscopic cholecystectomy,and reducing the rate of shivering.

The centrosome plays a crucial role in the maintaining of cell conformation,mitosis and chromosome seg-regation.It responds to the DNA damage and keeps the genome stability via cross-talking with the intranuclear DNA damage repair system.The apoptosis of tumor cells can be induced through inhibition of the duplication of centro-some.So the inhibitors of centrosomal proteins will be a potential anti-tumor therapy.

[Objective] To evaluate the curative effect of anterior cruciate ligament(ACL)reconstruction for remaining anteromedial or posterolateral bundle and ruptured fiber.[Method]Among 89 cases of ACL rupture,there were 32 cases of sports injury,24 cases training injury,23 cases traffic accidents and 10 cases sprained in daily life.ACL ruptured at the notch of the femur in 24 cases,and at the intercondyle of the tibial in 28 cases.Thirty-two cases were reconstructed with quadri-bundle Hamstring tendon knot press-fit technique and 20 cases were reconstructed with quadriceps tendon press-fit technique with autogenetic patellar bone.ACL anteromedial bundle(AMB)ruptured in 14 cases and posterolateral bundle(PLB)ruptured in 23 cases.The intact bundle and the remnants of ACL were preserved.AMB and PLB were reconstructed with double-bundle Hamstring tendon knot press-fit technique in 37 cases.Absorbable interference screws were used at the tibial tunnel and sutured tendon was knotted across the tibial bone bridge.[Result]The average duration of follow-up were 25 months(14-37 months).Lysholm knee function score increased by 27.7 scores,from average 67.5 scores of pre-operation to average 95.2 scores at the end of the follow-up.Rulermetr examination tibial translation was 4 mm?2 mm in 72 cases and 6 mm?3 mm in 17 cases.Lachman test was negative in 79 case,weakly positive in 8 cases and positive in 2 cases.The function of the knees were improved and the stabilization was strengthened after operation.According to knee therapeutic effect evaluation criterion,76 cases were excellent and 13 cases were good.[Conclusion]To keep the remaining of anteromedial or posterolateral bundle and ruptured fiber for ACL reconstruction is beneficial for the graft revascularization or healing,and is helpful for the position sense or rehabilitation.

As a method of financial management and control,the implementation of cost accounting has a significant influence on management of sicentific research projects.The model patterns of cost accounting in the United Kingdom,the United States and European Union,respectively can be served as practical frameworks to guide Chinese scientific research project funds in terms of accounting forms,methods and contents.Based on the understanding of current domestic development and problrms of cost accounting experiences learned from internation practices are signifcant for improving cost accounting system in scientific research projects of China.

Background Neovascular glaucoma (NVG) is a serious eye disease with a variety of causes.It results from the secretion of growth factors by hypoxic retinal tissue,such as vascular endothelial growth factor (VEGF),but anti-VEGF treatment alone dose not completely inhibit neovascularization.Our previous study found that platelet-derived growth factor-c (PDGF-C) is also an important factor in pathological angiogenesis.However,the role of PDGF-C in the development of NVG remains unknown.Objective This study was to quantitatively detect the levels of VEGF and PDGF-C in the aqueous humor of patients with NVG and provide a basis for the anti-angiogenesis therapy.Methods A prospective cohort study was carried out.Sixty-two eyes of 62 patients with advanced NVG and 11 control subjects with age related cataract were included in Xijing Hospital of the Fourth Military Medical University from January 2014 to August 2015.Ten of 62 NVG eyes received retinal photocoagulation and/or cryotherapy,and 16 eyes resulted from central retinal vein occlusion,20 eyes from diabetic retinopathy,5 eyes from postopeartion of retinal detachment,4 eyes from Eales disease and 7 eyes from unknown cause.Iris neovascularization of grade Ⅱ was found in 13 eyes,grade Ⅲ in 29 eyes and grade Ⅳ in 10 eyes.Aqueous humor specimen was collected for 0.1-0.2 ml during the surgery,and the contents of VEGF and PDGF-C in the aqueous humor were detected by ELISA assay.Written informed consent was obtained from each subject prior to any medical procedure.Results The VEGF and PDGF-C concentrations in the aqueous humor were (1 138.17±69.31) ng/L and (29.80±1.64) ng/L in the NVG group,respectively,which were significantly higher than (679.54±49.81) ng/L and (18.60±1.85)ng/L in the control subjects (t=20.95,20.49,both at P＜0.01).The VEGF and PDGF-C concentrations in aqueous humor were (1 095.99±52.71) ng/L and (28.55±0.94) ng/L in the retinal photocoagulation group,showing significantly decreases in comparison with (1 146.28±69.57) ng/L and (30.04± 1.64) ng/L in the untreatment group (t =-2.160,P =0.034;t =-2.760,P =0.008).The VEGF content in aqueous humor was positively correlated with PDGF-C content in the patients with NVG (r=0.346,P=0.006).However,the aqueous levels of VEGF and PDGF-C were not significantly different among various primary disease groups and different iris neovascularitation gradings (all at P＞0.05).Conclusions Both VEGF and PDGF-C contents in the aqueous humour are considerably elevated in NVG patients.Retinal photocoagulation and/or cryotherapy can inhibit the release of VEGF and PDGF-C in the aqueous humor.PDGF-C may be a target for the treatment of NVG.

Objective To study the operative methods and surgical technique of arthroscopical meniscal suture in treatment of meniscal tears under local anesthesia. Methods From February 1999 to November 2003, we cure 32 patients (22 males and 10 females) with this method. The patients' average age is 29. Results All of the patients accept the operation through arthroscopy under local anesthesia. The procedure last 50 minutes on an average. 92% of the patients gain good results, no severe complications. Conclusion This method has the advantages of less pain, time saving(save time), quick recovery and less complications.

Objective To investigate a new method for reconstruction of posterior cruciate ligament(PCL)using hamstrings tendons knot and bone lock-bolt under arthroscopy.Methods Ten cases of PCL lesion were treated arthroscopically. Hamstrings were harvested with a stripper following standard procedure. The hamstring tendons tied a knot at the inter-media part of the tendons and insert a bone lock-bolt on the knot. The tunnel of femur and tibia were prepared. Tunnel diameter of the tibia and the infra 1/3 of femur was 5-7mm and the superior 2/3 of the femur side was 11-12mm,Pulling in the tendon from the lateral side of femur tunnel to the tibia.A hole of 4 5mm was drilled 1cm distal of tibia tunnel exit. Create a bone bridge using curved clamps,passing a tendon under the bone bridge and tying the tendon over the bone bridge in extension.Results All the patients were follow-up.Function and stability of knee during walking and activities improved apparently. All patients were evaluated with the knee functional scales.Patients were clinically rated as excellent in 6,good in 3,and fair in 1. There were no poor results.Conclusion The result of using semitendinosus and gracilis tendons tied a knot and implant a bone lock-bolt to reconstruct PCL is satisfactory. The advantages of the technique included well biological match, exemption from costly materials, promotion of healing of tendons and bone tunnel, decrease in medical cost.

Objective To study the effect of arthroscopic plasty of discoid meniscus with local anaesthesia and radiofrequency. Methods From Aug. 2000 to Aug.2002, arthroscopic plasty of discoid lateral meniscus with local anaesthesia and radiofrequency was performed on twenty-six joints in twenty-three patients including 12 male and 11 female, their average age was 25 years(13～14 yrs). The procedure of discoid meniscus reshaping in 23 cases was to produce the similar appearance to the normal lateral meniscus. Unstable leaf of the horizontally torn meniscus was removed, while the stable one was preserved. In 6 cases,the tear of edge rim was not only reshaped but also insider-out sutured. Results 21 cases were followed-up for average 11 months (from 5 months to 2 5 years).There was no pain snap and lock, the joint function is normal in 21 cases and 23 knees. Based on Ikeuch knee functional scales,16 cases were rated as excellent, 3 good and 2 fair. Conclusion Arthroscopic radiofrequency meniscus plasty is of importance in avoiding total meniscectomy. The procedures were safety and less traumatic.

Objective To study the effects of podophyllotoxin solid lipid nanoparticles (POD-SLN) on the proliferation of human epidermal cells in vitro. Methods POD-SLN was prepared by using microemulsion technique, the morphology of POD-SLN was examined by transmission electron microscope (TEM), and its particle size and Zeta potential were studied by Zetasizer analyzer. High-performance liquid chromatography (HPLC) was employed to determine the entrapment efficiency of podophyllotoxin (POD) in the nanoparticles, and its stability was observed. Human epidermal cells were treated with different concentrations (0.1-1 000 ?g/L) of POD-SLN, and the proliferation of human epidermal cells was studied at different time points after exposure (6h, 12h, 24h, 48h). The cytotoxic effects of POD-SLN, POD liposome, free POD, blank solid lipid nanoparticles (SLN) and control groups on human epidermal cells were assessed using a colorimetric MTT cell viability assay. Results POD-SLN displayed spherical or elliptical in shape, and it was stable. The average particle size of POD-SLN was 87.2?10.3nm, Zeta potential was 25.3?0.8mv and the entrapment efficiency of POD in the nanoparticles was 83.2%?2.5%. POD-SLN inhibited the proliferation of human epidermal cells in a concentration- and time-dependent manner. At the same concentration, the effect of PDP-SLN on anti-proliferation was stronger than that of POD liposome and POD. The inhibition of human epidermal cells after 48h exposure to PDP-SLN, POD liposome, and POD reached 91.05%, 77.02% and 68.46% respectively, at the highest concentration of 1000?g/L, and the IC50 were 2.11?g/L, 16.65?g/L and 101.42?g/L, respectively. Blank SLN had no effect on the proliferation of human epidermal cells. Conclusion This formulation and technology are stable and practical. POD-SLN can significantly inhibit the proliferation of human epidermal cells in vitro and the inhibitory effect was better than that of POD liposome and POD.